Ann Pettway

How could a baby go missing from one of the most public of public hospitals in the United States? Almost 24 years after Carlina White was abducted from Harlem Hospital in New York City as a 19-day-old newborn, that question still haunts people who have had connections to public medical centers serving a mostly poor and nonwhite populace throughout the United States.

Carlina's re-emergence as an adult after being raised by her abductor reveals a system still in disarray, with medical facilities, social services agencies, school monitors and law enforcement failing to adequately execute checks and balances that exist on paper. In the case of Carlina, who was renamed Nejdra "Netty" Nance" by her abductor, the victim actually had to discover and solve her own abduction in order to reunite with her biological family.

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That reunion, which took place in New York last month, has hit a snag, according to her birth mother, Joy White, who this morning told the Today show that Carlina/Netty has cut off ties with her because of conflicted loyalties and the issue of whether her biological parents collected money to which she feels she is entitled.

In court on Monday, lawyers agreed to postpone until Feb. 22 the deadline for a grand jury to decide whether to indict Ann Pettway, the woman who has told federal authorities that she took Carlina from Harlem Hospital in 1987. Pettway surrendered to authorities after Carlina's reunion with her parents. According to the federal complaint, Pettway said that she just wanted a baby and feared that, after several miscarriages, she could not have one of her own.

Carlina White's disappearance in 1987 spurred investigations by law enforcement and various state and federal oversight agencies. Pretty soon, a story emerged: A woman in a nurse's uniform had been seen lurking around the hospital, particularly the maternity ward, for weeks. She is believed to be the woman who comforted Joy White, then 16, and her boyfriend, Carl Tyson, then 22, when they brought the baby to the pediatric unit suffering from a fever. After they spent some time waiting to see a physician, that woman suggested that the young parents go home to rest. When they returned hours later, the baby — and the mysterious woman — had disappeared.

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To describe the scene in the hospital in those days, a former senior administrator, who did not want to be identified, tells of informing her boss that if she collapsed while working there, she did not want to be taken to the hospital's emergency room.

Even before the newborn's disappearance, the future of the hospital was in doubt because of so many deficiencies uncovered during routine inspections by local and state oversight agencies. The place was chaotic nearly 24-7 because everyone — from elected officials to community groups to loan sharks — was in and out of the hospital as if it were a community center, the administrator says.

The homeless knew that if they came to the emergency room, they could obtain food. Occasionally, celebrities like Bill Cosby came in, drawing impromptu audiences from the street as word spread of their presence, even if they were there for medical care rather than a performance. Amid all this, the former administrator says, "Who's going to pay attention to a woman in a white uniform?"

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"From 1980 to 1990, there were 12 to 18 [abductions] a year," says John Rabun, executive vice president of the Arlington, Va.-based National Center for Missing & Exploited Children. "There are not that many anymore — usually one or two a year."

He and others attribute that change to a number of factors, starting with enhanced security. "Security at all hospitals has improved dramatically over the years as hospitals and the medical community have learned more about how to keep patients safe," says Evelyn Hernandez, a spokeswoman for the New York City Health and Hospitals Corp., which sees 1.3 million patients each year. "All the hospitals in our system, including Harlem Hospital, have adopted many security practices to keep patients safe, especially babies and children, that include high-level security systems as well as checks and balances."

Says Rabun of what's happening nationwide: "They have hardened the target at maternity [wards], but unfortunately that has driven the crime into homes and other places." In medical facilities, newborns are fitted with identification tags, many of them electronic, and shortly after preliminary examinations, the babies are returned to the mothers rather than left in nurseries, as in the old days.

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There has also been better staff training throughout the industry, according to Rabun, who says that he has conducted more than 1,000 audits of birthing centers over the last 20 years. In discussions with some hospital administrators, he has pointed out that there used to be more security for a pack of AA batteries in a hospital gift shop than there was for newborns in the maternity ward. These days in New York hospitals, according to Hernandez, periodic drills are conducted "to test the systems and staff responses."

Not insignificantly, in the competitive 24-hour news cycle, media have paid more attention to these abductions in recent years than would have been typical in 1987 after a black baby was stolen from a hospital that was itself on financial life support amid a crime wave.

Recalling those days, Elaine Rivera, a journalism professor at Lehman College in New York City and a former police reporter for New York Newsday and the New York Daily News, says, "It was insane. There was no control." This was a time when there were at least a half dozen homicides a day, and with all that Wild West violence, emergency rooms were overflowing. "You had a very stressed hospital system, and there are going to be a lot of distractions."

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Keith Wright, a New York state legislator who represents part of Harlem and whose daughter was born in Harlem Hospital a month after Carlina's disappearance, says, "The crack epidemic was at an all-time high. Crack was ravaging — ravaging — the community."

That was then. The system is not foolproof at medical facilities, and severe budget cuts at all levels of government could affect what strides have been made. Still, says Rivera, reflecting on the Carlina White case, "The likelihood of that happening today is far less," in part because "we live in a more security-prone society since 9/11."

Says Wright, "I would bet you dollars to doughnuts it would not happen at Harlem Hospital today. Those folks they have, the security folks, they take their jobs very, very seriously. Even when I'm in a suit and tie — and they know me! — they want to see my pass and my identification."

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E.R. Shipp, a Pulitzer Prize-winning journalist, is a frequent contributor to The Root. In the 1990s she reported on Harlem Hospital's problems.