The sores were something you’d see on someone living in a derelict nursing home — or someone held in restraints. The malnourishment hinted at weeks, if not months, without adequate food. And then there was the trauma to the head.
The final days of 5-year-old Elijah Lewis’s short life remain shrouded in mystery, but medical experts say the recent autopsy findings alone suggest the shaggy-haired little boy from Merrimack, N.H., suffered a level of abuse that went far beyond what they typically see.
“It’s more than just . . . minor medical neglect,” said Alice W. Newton, medical director of the Child Protection Program at Massachusetts General Hospital. “It would fall into the category of torture, really.”
The autopsy results also raise new questions about text messages sent by the boy’s mother, Danielle Dauphinais, 35, who is being held without bail in New Hampshire along with her boyfriend, Joseph Stapf, 30. In the January texts sent to a friend and obtained by the Globe, Dauphinais said she argued with Stapf’s mother for giving Elijah too much food, saying “this child will eat till he pukes.” Stapf’s mother, according to Dauphinais’s text, said it was “child abuse” to withhold food from a child.
Reached Monday, Dauphinais’s attorney, Jaye Rancourt, declined to comment on the messages, saying that “without verification that this is actually a text message from my client, I can’t really respond. This could be a complete fabrication.”
The texts match a detailed description of the messages given by the person who originally received them.
Questions about the circumstances of Elijah’s death have only grown since his body was discovered in the woods of Abington, Mass., on Oct. 23, following a 10-day search that included law enforcement agencies from at least five states. Since then, authorities have released little in the way of details as they continue to investigate. Meanwhile, relatives and people who lived near the child’s home in Merrimack say they seldom saw the boy in the months leading up to his disappearance.
The Massachusetts medical examiner’s office last month ruled the boy’s death a homicide, determining the cause to be “violence and neglect, including facial and scalp injuries, acute fentanyl intoxication, malnourishment and pressure ulcers.” Pressure ulcers, more commonly referred to as bedsores, are typically found in bedridden people unable to change position.
But neither Dauphinais nor Stapf has been charged with murder. Instead, they are being held on charges of child endangerment and witness tampering related to their alleged attempts to mislead investigators trying to determine the boy’s whereabouts in October. Both have pleaded not guilty.
It remains unclear how involved New Hampshire’s Division for Children, Youth and Families was with the boy prior to his disappearance. The agency has declined to comment on the case, though authorities have said that DCYF initially reported the boy missing to law enforcement on Oct. 14, and Dauphinais told a friend last June that she’d been in contact with the agency.
Texts sent by Dauphinais to another friend and obtained by the Globe make it clear that she had serious concerns about her son, including the amount he ate, at least nine months before the boy was discovered missing.
In a text to a friend on Jan. 7, Dauphinais complained that Stapf’s mother, Joanne — with whom the couple shared a home — was feeding the boy against her wishes. Dauphinais said Joanne Stapf would also “baby him and love on him” even when Elijah acted up.
“I made Elijah a decent plate of food and she insisted on giving him seconds,” Dauphinais wrote in a January text. “I told her no because this child will eat till he pukes and then eat some more. I also told her that he’s having cake after so there is no need for seconds.”
“She said I was wrong and that was child abuse,” Dauphinais continued. “She said that she’s an Italian grandma and that she considers this child abuse in her family. Like wtf!”
According to two physicians who spoke with the Globe, both of whom specialize in cases of child abuse or neglect, the details outlined in the autopsy report paint a particularly grim picture. Though neither is involved with the case or privy to case files, both described the autopsy findings to be extreme, even within the realm of neglect cases.
“This is not like an everyday thing,” said Dr. Suzanne Haney, a Nebraska-based child abuse pediatrician who serves as the chair of the American Academy of Pediatrics’ Council on Child Abuse and Neglect. “This extreme of a case, fortunately, is very rare.”
Both doctors described the bedsores, in particular, as highly irregular in a developmentally normal child. The painful, circular lesions are almost never seen in young, physically mobile patients, leading them to believe that Elijah could have been restrained in some way prior to his death.
“Skin breakdown or bedsores is not something you’d ever see in a healthy 5-year-old,” said Newton. “That, to me, speaks to being tied down . . . or [being] so weak or malnourished that he was unable to move at the end of his life.”
Added Haney, “If you combine malnourishment and pressure ulcers, I’m thinking he was either restrained or his malnourishment was to the point where . . . he was unconscious or semiconscious for a period of time.”
Either condition would’ve been a red flag to doctors, said Newton — but it’s unclear whether Dauphinais ever took Elijah to see a physician in New Hampshire.
Born in Arizona in 2016, the boy spent much of his early life in the custody of his father following his parents’ contentious 2017 divorce. In divorce paperwork, Timothy Lewis accused Dauphinais of being “violent and impulsive” and having a “history of domestic violence and substance abuse.” A decree approved by the court blocked Dauphinais from spending time with her son.
Last May, however, for unclear reasons, Elijah arrived in New Hampshire to live with Dauphinais and her boyfriend, Stapf.
Though initially excited by her son’s arrival, Dauphinais, two friends said, soon became exasperated by what she described as the boy’s myriad behavioral issues. In texts to a friend last summer, Dauphinais likened her son to a serial killer, saying she felt no connection to the child and that she wanted him “gone.”
One friend, Michelle O’Brien, who has known Dauphinais since both were teenagers, told the Globe she’d provided the name of a pediatrician to Dauphinais, but did not know whether she ever followed up on it.
The office of New Hampshire Attorney General John M. Formella, which is handling the case, has declined to release records of previous police visits to the home that Dauphinais and Stapf shared, though neighbors said police were a common presence at the residence, which backs up to a quiet lake.
New Hampshire Representative Kimberly Rice, who chairs the House committee on children and family law, acknowledged that the state’s child welfare agency has suffered from staffing issues that have left it hamstrung.
“I don’t think they’re doing a bad job at DCYF,” said Rice. “We have positions that need to be filled that are funded, but the people aren’t there, and if the people aren’t there, I don’t know how you continue to hold an agency accountable when you can’t get the positions filled.”
As the criminal case moves forward, meanwhile, Moira O’Neill, director of the New Hampshire Office of the Child Advocate, said her office would be opening an investigation into the circumstances surrounding Elijah’s death.
Appointed by New Hampshire Governor Chris Sununu in 2018, O’Neill provides oversight of the state’s child protection services, as well as “holding systems accountable,” according to the state website.
But with a small office currently engaged in other cases, she cautioned that the process could take up to a year to complete.
“If what’s reported in the newspapers is correct,” O’Neill said, “it does sound as though this was a preventable death.”
Dugan Arnett can be reached at email@example.com.