The Preventionist – Episode 3: “Better Safe Than Sorry”

Podcast: The Preventionist
Production: Serial Productions & The New York Times
Host/Reporter: Diane Neary
Date: October 30, 2025
Episode Focus: The story of Amanda Saranofsky and the broader ramifications of the “better safe than sorry” approach in child abuse pediatrics and the child welfare system.

Overview of the Episode

This episode explores the controversial and heartbreaking consequences of the child welfare system’s “better safe than sorry” ethos, focusing on the case of Amanda Saranofsky in Pennsylvania. Through Amanda’s story, reporter Diane Neary questions the rising power of “child abuse pediatricians” and their near-unassailable authority in family separations, criminal accusations, and the long-term trauma families endure. The episode carefully exposes how professional judgment, system errors, and protocols intended to protect children can inflict deep harm – and asks whether institutions are, in fact, preventing more tragedy or creating more victims.

Key Discussion Points & Insights

1. Escalation of Lawsuits and the System’s Defense (00:33–03:00)

• Background: 27 families are suing Lehigh Valley Health Network, Dr. Deborah Essernio Jensen, and her Child Protection Team for malpractice and malicious prosecution.
• Institutional Response: The hospital and county officials stand by Dr. Jensen, framing the families as trying to deflect from actual abuse.
• County Perspective: Phil Armstrong, Lehigh County Executive, articulates the core logic: “We want to always make sure if there is going to be an error, it’s going to be to help the children stay safe. That was our number one concern.” (03:18)
• Neary’s Framing: The system’s “better safe than sorry” choice and its risks are introduced, especially in ambiguous cases where evidence is not clear-cut.

2. Amanda Saranofsky’s Story: System Entrapment & Catastrophe (03:37–19:49)

• Amanda’s Background: A single mother of five in rural Pennsylvania, previously scrutinized by child welfare but always regaining custody after thorough investigation.
• The Incident: In December 2019, Amanda’s newborn is injured in a freak early morning accident involving a toddler sibling (07:28). Amanda seeks immediate medical attention.
• Medical & Legal Spiral:
  • Dr. Doshi (colleague of Dr. Jensen) and later Dr. Jensen herself declare the injuries “abusive head trauma—near fatality.”
  • Amanda and all five children are separated; she faces criminal charges (five felonies, two misdemeanors) and months in pretrial limbo (18:23).
• Amanda’s Experience:
  • Agonizing separation and traumatic, sometimes dangerous foster placements for her children.
  • Amanda copes with guilt, hypervigilance, and institutional suspicion.
• Notable Quote:
  • “All her fears were spilling out. I feel so sick to my stomach, she wrote. Am I that bad of a person? I failed my children.” (08:03)

3. Expert Disagreement and Systemic Overreach (19:49–25:37)

• Second Opinions (Critical Segment, 19:49): Neary consults three independent child abuse pediatricians who review Amanda’s case and find no evidence supporting the certainty of abuse concluded by Dr. Doshi and Dr. Jensen. None would have recommended familial separation.
• Insight: The “child abuse pediatrician” model is revealed as powerful but highly fallible; families rarely win when pitted against their testimonies.
• Amanda’s Dilemma: Despite a no-contest plea (for a non-child-related charge, 19:52), the criminal case’s end doesn’t repair her family.

4. Family Reunion and Lingering Trauma (25:37–36:48)

• Return Home: Amanda gradually regains custody of four of her children, with her youngest son remaining in foster care under a permanent guardianship arrangement.
• Ongoing Anxiety: Amanda installs cameras in her house—not at CPS’s request, but for her own self-protection (24:03).
  • “Because I’m afraid they’re just… it’s gonna all come back. Like, when I have my kids, if an accident happens, they’re gonna take them again. So it’s not easy at all. I’m scared.” (25:10)
• Child Perspectives: Emotional wounds run deep for Amanda’s children, especially her youngest daughter, who exhibits behavioral problems and carries blame for the family’s ordeal.
• Ambiguous Loss: The concept that children experience grief for parents who are “not dead but out there somewhere,” introducing persistent trauma (26:31).

5. The Slow Path Toward Healing—and Systemic Critique (36:48–45:55)

• Long-Term Struggles: Amanda’s situation is precarious—job loss, lack of a car, ongoing mental health challenges, reluctance to rush reunification.
• Custody Battle: Amanda weighs the risks and emotional potential cost of fighting for her youngest son, who no longer fully recognizes her as “Mom.”
  • “I don’t even think he knows I’m his mom, Mom… I don’t want to give myself that false hope.” (43:53)
• Empathy for the Foster Family: Amanda shares the pain of potentially putting his foster parents through what she endured: “I know how I felt when I had my children ripped away from me. I worry about how it’s going to make the foster mom and dad feel. It’s so hard because I don’t want them to feel like I felt.” (41:43)

6. Systemic Reckoning and the Call for Change (49:15–End)

• Recent Reforms:
  • District attorneys review Dr. Jensen’s cases.
  • Dr. Jensen steps away from her post and retires, but later consults for the FBI.
  • Some counties shift to prevention, halving local foster system numbers.
• Legislation: Some states (Texas, Washington, Georgia) have enshrined the right to a second medical opinion in child abuse investigations.
• Key Insight: The removal calculus must be precise, erring on removal only for “serious, imminent harm”—explicitly rejecting “better safe than sorry” as default.
  • “Reporting this story, I’ve seen it again and again. Different doctors looking at the exact same information and coming to different conclusions about what that information means.” (49:15)
• Statistics: 40% of US children (53% for Black children) will face a child abuse investigation.
• Closing Note: Amanda’s case—now heading to a custody trial—exemplifies the system’s human stakes and the need for humility, transparency, and reform.

Notable Quotes & Memorable Moments

• Phil Armstrong:
  • “We want to always make sure if there is going to be an error, it’s going to be to help the children stay safe. That was our number one concern.” (03:18)
• Amanda on her fear and anxiety:
  • “Because I’m afraid they’re just... it’s gonna all come back. Like, when I have my kids, if an accident happens, they’re gonna take them again.” (25:10)
• Expert pediatrician finding:
  • “None of them agreed with Dr. Doshi and Dr. Jensen’s assessment that the baby’s injury could only have been caused by an adult.” (20:08)
• Amanda on ambiguous loss:
  • “Every day I grieve him not being here. … I want him to be brought home slowly because that’s in his best interest. I don’t want to rip him away from all he’s known. It’s just to me, it’s wrong.” (49:29)
• Neary’s closing observation:
  • “Even one pause, one ‘wait a second,’ might be the difference between a family staying together or being broken apart.” (49:15)

Timestamps for Important Segments

• [00:33] Lawsuits begin, institutional defense of Dr. Jensen
• [03:18] Phil Armstrong articulates “better safe than sorry”
• [07:28] Amanda discovers her baby is injured and calls 911
• [12:09] Dr. Doshi’s (and later Dr. Jensen’s) accusation of abuse
• [18:23] Amanda is charged with multiple felonies
• [19:49] Second-opinion pediatricians disagree with Dr. Jensen’s findings
• [24:03] Amanda describes her own hypervigilance and self-protection strategies
• [25:37] Effects of foster care on Amanda’s children, concept of ambiguous loss
• [36:19] Case closed on Amanda’s daughter; focus shifts to custody of son
• [41:43] Amanda’s empathy for the foster family
• [43:53] Amanda discusses the loss of the mother-child bond with her son
• [49:15] Neary outlines need for system humility and “second opinions”
• [50:19] Amanda files for custody with measured demands; custody trial scheduled

Structure and Flow

• Starts with legal and bureaucratic background, setting stakes for the institutional culture of child protection.
• Dives deep into Amanda’s personal and familial story, using narrative detail and Amanda’s direct perspective.
• Weaves in expert medical disagreement to challenge the infallibility of child abuse pediatricians.
• Illustrates systemic problems via the personal—emotional trauma, instability, and administrative hurdles families endure.
• Closes with cautious optimism about reforms and a repeated call for pause, humility, and the prioritization of true, evidence-based prevention over reflexive intervention.

Summary Takeaway

This episode is a wrenching portrait of the cost of “erring on the side of caution” within the American child welfare system. Amanda Saranofsky’s story exposes how professional overconfidence, structural conservatism, and a lack of accountability among child abuse pediatricians can rip families apart—sometimes unnecessarily, always traumatically. The episode challenges listeners—and policymakers—to consider whether the system is truly acting in children’s best interests, making a compelling case for second opinions, system oversight, and reforms focused not just on preventing hypothetical harm, but on preserving families and minimizing trauma for those already vulnerable.