Two days before Christmas 2015, first responders rushed 3-year-old Sophia Rand to Maine Medical Center in Portland, where doctors performed emergency surgery to save her life.
Acting on reports that the toddler had a seizure and fell unconscious at her home in Norway, doctors discovered swelling on the right side of her brain and pooling blood. To ease the pressure, surgeons removed a piece of Sophia’s skull. They also installed a thin plastic tube, called a shunt, to help drain excess fluid, as well as a metal plate, both of which are still there, seven years later.
Doctors suspected the toddler’s injuries were consistent with a traumatic brain injury, according to hospital records. They also suspected they weren’t accidental, but inflicted, the records show. In addition to the damage in her brain, Sophia had other injuries, including bruises on her face, legs, buttocks and hips, two partially healed fractured ribs, and hemorrhages in her eyes.
The state’s child abuse physician examined her and wrote that nothing about her pattern of injuries suggested anything other than “severe, life threatening child abuse.”
But as time passed, doctors were no longer so sure.
Dr. Thomas Reynolds, a pediatric neurologist at Maine Medical Center, later came to believe that some of Sophia’s condition might have been caused by a rare genetic disease called Aicardi-Goutieres syndrome, which mainly affects the brain and immune system, and can be difficult to diagnose. Sophia tested negative for the genetic mutations associated with the disease, but the doctor observed a pattern of calcification in her brain that could be a sign of it, according to her medical records.
That uncertainty over the cause of her symptoms would upend a criminal case against the man accused of assaulting her, even though her other injuries still needed an explanation. The lack of resolution has been agonizing for the family who eventually adopted Sophia, especially after medical specialists later cast doubt on the Aicardi-Goutieres diagnosis and once again attributed her profound cognitive and physical disabilities to abuse.
The family wants justice, but it’s unlikely to come from a court. In cases like Sophia’s, the signs of wrongdoing are sometimes easier to prove than the culprit. At a time when the state is grappling with how to address a troubling number of children who have died under the care of their guardians, her family considers Sophia lucky to be alive. But her disabilities are a daily reminder of her painful past.
“I can’t just let it go,” said Brandie Rand of Wales, who, with her husband, Adam, adopted Sophia last summer and oversees the around-the-clock care that Sophia requires as a result of her disabilities. “I know she’s in a good home now. I have to do more than that. God put me in a place where I need to be a voice for all children, and it starts with Sophia.”
On a sunny, windy day earlier this month, Brandie sat with Sophia, now 10, in their living room to practice her language skills with a set of flash cards depicting letters and images.
When Brandie showed her a picture of a tractor, Sophia smiled ear to ear and shouted, “That’s dad’s!” A little while later, Brandie had to help her remember the word for fish.
Sophia has constant seizure activity in her brain, but on Feb. 10 she had a major episode that caused a setback in her ability to recall words and pictures. Of the 100 flashcards, she used to be able to recall about 75 words. She is nowhere close to that these days, Brandie said.
When they moved on to naming the color of different plastic blocks, Sophia thought they were all yellow.
Soon it was time for lunch: a blend of chicken, rice, banana, water and a nutritional supplement that Jenn Verrill, who provides in-home nursing care to Sophia four days a week, gives to her through a feeding tube in her stomach.
Sophia needs help with everything from eating to walking to using the bathroom. Twice, Brandie has had to remove Sophia from schools for kids with special needs because Sophia’s care surpassed what they could provide. The plan is to homeschool her from now on.
At left: Jenn Verrill feeds Sophia Rand, 10, a lunch of chicken, rice and a banana via a tube in her stomach this month. Verrill, a nurse, provides 33 hours a week of in-home care to Rand; at right: Registered nurse Jenn Verrill dissolves a dose of medication in water before administering it to Sophia Rand via a tube in her stomach. Verrill helps take care of Rand four days a week. Credit: Troy R. Bennett / BDN
“Daily I see what Sophia deals with,” Brandie said. “And I know a lot of people are quick to say she’s in a good home now, with a loving family, but I can’t see how everyone can allow for this to happen.”
After Sophia was hospitalized in 2015, she was taken into state custody due to concerns about her safety, and the Maine Department of Health and Human Services launched an investigation. It wasn’t the first time the department had been concerned about the toddler’s biological mother, according to a summary of Sophia’s family history that the state provided to the Rands.
Child Protective Services interacted multiple times with Sophia’s biological mother over the years, beginning just a day after Sophia was born in September 2012 because nurses worried that the new mother was yelling at her daughter for crying, according to a neuropsychological evaluation of Sophia completed in 2020 that detailed the child’s history. Officials had concerns about the new mother’s mental health, her “unrealistic expectations of Sophia” and her failures to keep up with Sophia’s medical appointments and services, according to the state’s summary.
Sophia’s biological mother did not respond to multiple interview requests. The Bangor Daily News is not naming her because she was not charged with a crime.
When Sophia was only 18 days old, she was hospitalized for a seizure. Sophia displayed developmental delays as she got older as well as aggressive behavior. She was also diagnosed with mild cerebral palsy that caused her to favor her left side, although that is no longer the case. The trauma to her brain in December 2015 seriously affected her mobility on the left side of her body, requiring her to use a wheelchair, ankle braces and a wrist brace on what was previously her dominant hand.
In 2016, the state attempted to reunite Sophia with her biological mother, but her mother did not regularly attend counseling sessions, visitations with her daughter or Sophia’s medical appointments. The state found that she failed to provide “a consistent or credible explanation for how Sophia received her injuries,” the summary states.
What’s more, she failed to protect Sophia from her boyfriend at the time, Nickolas Coffin, it said.
In February 2016, a grand jury in Oxford County indicted Coffin, who had been living with Sophia’s biological mother in Norway, with three counts of felony assault for causing the injuries that sent Sophia to the hospital the previous Christmas.
Police suspected him because he was the adult at home with the children while their mom was at work, said Alexandra Winter, the assistant district attorney who prosecuted the case. He was the one to call 911 on Dec. 23, 2015, to report that Sophia had stopped breathing, according to a paramedic report. He reportedly told first responders that Sophia had fallen off a table two days before but had seemed OK, so he and her biological mother decided to just keep an eye on her instead of taking her to the hospital.
Coffin denied ever causing Sophia harm.
In an interview, he said he wasn’t entirely sure what evidence police had against him. Sophia’s biological mom defended his innocence to police, he said, until it became clear to her that one of them was likely going to face blame for what happened. The Norway Police Department declined to provide reports from its investigation, citing a confidentiality statute because the case was dismissed.
“They saw the bruising, and the first thing they said was, ‘That’s abuse,’ and I totally understand that,” said Paige Coffin, Nickolas’ mother. “The first person [Sophia] asked for was Nick. She wanted Nick. She didn’t want her mother.”
Indeed, as the case moved toward trial, the case against Coffin fell apart when Sophia’s neurologist told prosecutors that he could no longer say with certainty that her injuries were caused solely by non-accidental head trauma, and not a rare genetic disease, Winter said. Lawrence Ricci, the state’s child abuse physician at the time, reviewed the conclusion and agreed, she said.
“As you probably know, the state is obligated to bring a case which they believe they are able to prove beyond a reasonable doubt,” Winter said.
Now, she wasn’t so sure she’d be able to do that. She didn’t think a jury would be convinced of Coffin’s guilt if one of her key witnesses, Reynolds, from Maine Medical Center, couldn’t testify with certainty about what caused Sophia’s injuries.
As for Sophia’s other injuries — the bruises, the partially healed broken ribs — prosecutors couldn’t say for certain who caused those either.
“There were no witnesses, no party saying, ‘I left her alone, and I came back, and she was injured,’” Winter said.
On Aug. 30, 2017, Winter filed a motion to dismiss the charges against Coffin, writing that in light of Sophia’s Aicardi-Goutieres syndrome diagnosis, the state had insufficient evidence to move forward.
“It was just a horribly tragic case all around,” Winter said, calling it incredibly factually complicated and one of the most serious she has ever dealt with. “To emphasize, it was an extraordinarily difficult decision to dismiss a case of this nature post-indictment.”
It was around the time of the dismissal that Brandie and Adam Rand began fostering Sophia.
The decision is part of a broader calling for the couple. Their three biological sons all suffer from a lung disease, and during a trip to Boston Children’s Hospital with their youngest, they learned that medically fragile foster children struggle especially hard to find permanent homes.
“I feel like the Lord put it on my heart that that’s why I was there,” she said.
Since then, the couple has fostered dozens of children in addition to their four biological children, and they adopted two, including Sophia.
“She was instantly a sibling, and we were mom and dad,” Brandie said.
In 2018, Brandie took Sophia to see a specialist at Boston Children’s Hospital, Dr. Laura Lehman, to get a second opinion on the Aicardi-Goutieres syndrome diagnosis. The specialist did not agree.
Rather, she believed Sophia’s condition stemmed from previous non-accidental trauma, according to a May 2018 report. She encouraged Brandie to seek a third opinion from a genetic diseases expert at the Children’s Hospital of Philadelphia.
Sophia was examined there in November 2018, and she underwent another round of genetic testing that again came back negative. Brandie said the specialists in Philadelphia called her on the phone to tell her they did not believe Sophia had Aicardi-Goutieres syndrome.
The following year, Sophia had a consultation with her current neurologist in Maine, Dr. Jason Helis, where he agreed that the pattern of calcification in her brain seemed inconsistent with the rare disease.
Over time, Brandie grew more confused and upset about why no one had been held responsible for Sophia’s abuse. She watched doctor after doctor cast doubt upon a diagnosis that had scuttled the prosecution of the only person whom officials had formally accused of abuse. Though it didn’t name a perpetrator, the Rands also had foster care paperwork from the state saying that Sophia had been the victim of physical abuse, emotional abuse and neglect.
A few years ago, though she can’t remember exactly when, Brandie called Winter to ask about why the case against Coffin was dismissed. The women remember that conversation differently: Winter said she let Brandie know that she’d be happy to review any new information that could shed light on the case, whereas Brandie recalls feeling as though there was little left the prosecutor could do.
In January, Winter reiterated her offer in an interview to review any new information. But the statute of limitations for the offenses in this case have most likely run out, she said.
As much as Brandie wants to see someone held responsible for the alleged abuse that sent Sophia to the hospital in 2015, she also feels like some of the blame might fall on the greater child welfare system for not intervening in Sophia’s life sooner.
Whether or not she has Aicardi-Goutieres, “there are all these facts that she was abused. It brings all this ball of confusion and emotions,” Rand said. “Abuse and neglect is abuse and neglect, whether a child is born with a disability.”
In fact, children with disabilities are at a higher risk of abuse because of the behavioral challenges they may present, the high demands they can place on their guardians, and the fact that they can have a harder time telling people what’s happening.
Shortly after Sophia finished her blended lunch of chicken and banana earlier this month, her sunny disposition changed. She started screaming, and her face turned red. In a calm movement, Brandie applied braces around her daughter’s elbows, so she couldn’t bite or hit herself, stick her fingers down her throat or poke herself in the eyes. She and Verrill, the nurse, then helped her out of her gait-trainer, a device that helps her walk on her own.
Sophia was still screaming and crying when the two women closed the door to her room so she could take a nap. These meltdowns happen multiple times a day, often with little warning, Brandie said. When Sophia woke up an hour later, so her mother could carry her to the family van to pick up her brothers from school, she would be all smiles again.