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A baby overdosed on fentanyl. Was it an accident or a crime?

Methuen police addressed the media Monday about a fentanyl case in which a 10-month-old girl had somehow ingested the drug and was revived twice on New Year’s Eve.
Methuen police addressed the media Monday about a fentanyl case in which a 10-month-old girl had somehow ingested the drug and was revived twice on New Year’s Eve.(Keith Bedford/Globe staff)

METHUEN — Was it a crime or a terrible accident? Did someone recklessly expose the 10-month-old to a potentially lethal dose of fentanyl, or did the child ingest residue unintentionally left on a toy or other object?

And when police were trying desperately to revive the child, was the mother shuttling between her bedroom and the bathroom because she was flushing evidence, or just pacing in a panic?

These are a few of the knotty questions police are trying to unravel as they work to determine who, if anyone, is to blame for poisoning the 10-month-old with fentanyl, a powerful synthetic painkiller responsible for hundreds of deaths in Massachusetts in recent years. The girl had to be revived twice at Lawrence General Hospital on Saturday after suffering cardiac arrests.

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The investigation aims to resolve the central question of whether the case represents child endangerment that should be treated as a crime or another instance of opioid-era parental neglect best handled by child welfare officials.

Attention has focused on the mother, because she has acknowledged a history of drug use and drug paraphernalia was found in her car, but police said they are looking at anyone who might have come into contact with the child, because even a trace amount of fentanyl left anywhere in the child’s reach could have led to her poisoning.

“Right now, I can’t tell you mom is responsible,” Police Chief Joseph Solomon said in an interview Wednesday, adding that the mother, father and grandparents have been “100 percent cooperative.”

“It’s not even he said-she said,” Solomon said. “It’s nobody knows.”

Solomon said police are waiting for lab tests from the State Police to determine whether items taken from the mother’s home contain fentanyl or other drugs.

If there had been needles or drugs strewn about when police arrived, he said, the case would have been a clear example of child endangerment, something akin to leaving a loaded gun near a child.

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But fentanyl is potent in such small amounts that it can enter a child’s system if anyone who handled the drug touched an object that the child then touched or put in her mouth. That makes pinpointing blame and determining intent more difficult, he said.

“The most concerning thing to me is that the baby had fentanyl in her system and we want to know how. We just have to figure out how,” Solomon said. “A tiny, tiny speck of fentanyl can kill a child.”

The mother has told police the ordeal began as she was in her bedroom putting the baby down for a nap on Saturday at about 12:30 p.m. That’s when police received a 911 call reporting that a baby was not breathing.

When officers arrived, they determined that nothing was blocking the girl’s airway, and that she had a pulse. But her breathing was irregular and she was purple, Solomon said.

Firefighters and paramedics arrived, taking over the care of the baby and rushing her to Lawrence General Hospital, where, according to a police report, she “coded two times,” medical slang for suffering cardiac arrests.

“The baby died twice at the hospital,” Solomon said, adding that he credits all involved with helping to save the child’s life, including the grandfather who he said was attempting to resuscitate her when police first arrived.

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Hospital tests later revealed the baby had ingested a potentially fatal dose of fentanyl.

The child’s brush with death remains under investigation by Methuen police, the Essex District Attorney office, and the Department of Children and Families.

Opioids and other drugs have already emerged as the most common factor found in child abuse and neglect cases in Massachusetts, outpacing mental illness and domestic violence.

The mother has acknowledged that she used drugs in the past, but told police she had not relapsed, an assertion reiterated by a family spokesman who said the mother has been in drug treatment for about a year.

“The mother is still clean and is troubled as to how this happened and has no answers,” said Michael Quinn, an attorney and neighbor. The baby, he said, has been released from the hospital into the temporary custody of the mother’s older sister and is doing “very well.”

Solomon said the fact that the mother was upstairs shuttling between her bedroom and bathroom “raises a red flag,” because “it helps lead you closer to probable cause that something was in the house that shouldn’t be in the house.”

But he cautioned that investigators are still not sure if the mother was disposing of evidence or just in a state of extreme distress. He said officers may seek to interview her again.

“It could be next week we bring charges, or it could be next week saying there are no charges,” Solomon said. “Even if there were no charges, our goal is to make sure she stays clean. This isn’t just to charge someone and throw them in jail.”

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Levenson can be reached at michael.levenson@globe.com.