By Shawn Cohen and Peter D. Kramer

Garnett died Jan. 23 at Maria Fareri Children%27s Hospital in Valhalla

Investigators suspect Munchausen by proxy%2C that she sickened her son to garner sympathy

Spears documented the boy%27s illness on social media%2C posting photos from his deathbed

His killing, police said, was the final act of a deranged mother who, fueled by attention on social media, medically tortured her child for years.

Lacey Spears pleaded not guilty Tuesday to murder and manslaughter charges in the poisoning death of her five-year-old son, Garnett. She was ordered held without bail at Westchester County jail and is due back in court July 2.

The only words the 26-year-old Alabama native uttered in state Supreme Court in White Plains were "Yes, sir," when Justice Barry Warhit asked if she was Lacey Spears.

Assistant District Attorney Doreen Lloyd presented the government's case, focusing on Spears' time at Nyack Hospital between Jan. 17 and 19 when, Lloyd said, the mother took Garnett into the hospital room's private bathroom and administered the sodium into a tube in the boy's stomach.

"This mother was intentionally feeding her son salt in toxic levels," Lloyd said.

Lloyd said prosecutors know from computer records that Spears had searched the Internet to research what the effects of salt would be on her son.

Earlier in the day, Spears' head was bowed as she walked into the back door of Westchester County Police headquarters in Hawthorne, escorted by detectives. Her father, Terry, had his arm around her as she solemnly surrendered. After being processed -- and having her mug shot taken -- Spears left the headquarters silently, not answering reporters' questions before getting into the back of a black, unmarked police car and speeding off.

Acting on a sealed grand jury indictment, law enforcement on Tuesday obtained a warrant to arrest the former Chestnut Ridge resident on a charge of second-degree murder and first-degree manslaughter in the Jan. 23 death of her son, Garnett, at Maria Fareri Children's Hospital in Valhalla, sources said. The murder charge does not accuse her of intentionally killing her son but of acting with depraved indifference toward his life. Spears, 26, who had been staying with her parents in Kentucky, had returned to Westchester and was accompanied by her attorney, David Sachs.

The grand jury's vote concluded a two-week presentation from prosecutors, who based their case on months of investigation in New York, Florida and Alabama -- where Spears and her son lived -- and Tennessee, where they visited Vanderbilt University Hospital.

Capt. Christopher Calabrese, commander of the Westchester County Police Detective Division, said the investigation involved hundreds of interviews and the analysis of tens of thousands of pages of medical records by Westchester and Ramapo detectives and the Westchester County District Attorney's office.

"This is a very sad day for everyone, but it is a day for justice," Calabrese said. "Justice for the betrayal of the intimate trust between a mother and child, justice for a mother's continual abuse and death of her innocent child for her own selfish psychological needs and financial gain; justice for Garnett."

Authorities suspect the single mother, who was a constant presence on social media sharing stories of Garnett's medical crises, may have poisoned the little boy at least twice; once before he experienced seizures that sent him to Nyack Hospital Jan. 17 and again on Jan. 19 at Nyack when his sodium level spiked and he had to be flown to Valhalla.

As Garnett lay dying in the hospital, a Chestnut Ridge neighbor said Spears called and told her to dispose of a bag Spears used to feed the boy through a tube. Police later recovered the bag which had extremely high levels of sodium.

The homicide case may be one of the first involving Munchausen by proxy – a psychiatric disorder in which a parent sickens a child to garner sympathy – in the era of social media.

Spears was living with Garnett in the secluded Fellowship Community when the alleged crime occurred. She faces a maximum of 25 years to life in prison on the murder charge and up to 25 years for manslaughter.

The reaction in Spears' hometown of Decatur, Ala., was swift.

Former nurse Ginger Dabbs-Anderson, who first met Spears and Garnett when the boy was six months old, was grateful for the action, but remorseful that it came too late to save Garnett, who friends called "G."

"I'm happy they got her and I do believe that she's had this problem for years and that he's been suffering at her hands. I really wish we could have prevented this because there were signs.

"Maybe the hospitals should have caught it, maybe her parents should have caught it, maybe those people closest to her should have caught it. She put all over Facebook how wonderful she was. She had us all snowed, she had us all believing she was wonderful. But obviously not."

The former nurse was not surprised to learn that officials suspect Spears may suffer a psychological disorder.

"I don't care if it is a case of Munchausen by Proxy. I think she should get whatever it is anyone else who murders someone gets."

Shawna Lynch, who knew Spears before Garnett was born and initially defended her, said: "I cried. It broke my heart but thank God they're finally going to get justice for G. I just hope she gets what she deserves. I know G's not coming back, but at least we'll have justice for him."

At the Fellowship Community in Chestnut Ridge, people were saddened at the mention of Spears and her son.

"There has to be some way where this isn't true," said one woman who wished not to be named.

Another Fellowship member said she couldn't reconcile the Spears she knew with the one in court on Tuesday.

"I don't see her as a murderer," the woman said. "I think (it was) sickness and I think a lot of things happen to us in our lives that are tragic and make us seek this kind of grief or sympathy that she was looking for. We all do it in different ways. I think it was really wrong of course, and I think it was terrible and all I can do is pray for her."

The charges relate to Garnett's death, but authorities suspect Spears subjected him to past medical abuse, fueled by attention on Facebook, Twitter and blog posts. She presented herself as a doting mother caring for a son who'd been in and out of hospitals his entire life. In a Facebook post in November 2009, she wrote that Garnett was back in the hospital again, his 23rd hospital visit in his first year.

The investigation began in January, while Garnett was still alive, when doctors at Maria Fareri alerted police that the boy's sodium level had spiked to suspiciously high levels.

Witnesses told The Journal News they saw a doctor at Maria Fareri confront Spears the night of Jan. 19, shortly after she and her son arrived there on an emergency helicopter flight from Nyack. The doctor told her it was "metabolically impossible" for her son's body to produce such extreme levels, and that "something isn't right."

At Maria Fareri, Spears continued to sleep in Garnett's room and had unmonitored access to him in the room's attached bathroom, sources said. There was a similar setup at Nyack Hospital.

The boy was alert and talking on the night of Jan. 20 when friends visited him and Spears in his hospital room. One friend recalled the 5-year-old pleading with her: "Don't leave me."

It wasn't until the following morning, Jan. 21 — after Garnett's condition worsened and he "coded" — that the medical staff notified the state's child-abuse hotline, prompting police and the district attorney's office to get involved. The boy was taken off life support and declared dead Jan. 23.

In April, the Westchester Medical Examiner ruled Garnett's death a homicide, and detectives have focused on Lacey Spears from the start. Even before the boy's death, they seized food, her cellphone and computer from her home at the Fellowship Community and confiscated the feeding bag Spears was so concerned about that she contacted her neighbor from the hospital.

A second Fellowship neighbor reported seeing Spears feed Garnett through his tube Jan. 17, shortly before a seizure sent him to Nyack Hospital. That version of events contradicted Spears' claim to others that she hadn't fed him through the tube for at least a week.

Both neighbors testified before the grand jury.

Westchester County police, Ramapo police and the district attorney's office have also secured medical records and video surveillance from Nyack and Maria Fareri, and statements from medical staff and friends who accompanied Spears at both hospitals.

Investigators have dug into Spears' 14 months at the Fellowship and the time she spent in Alabama and Florida, poring over medical reports and interviewing friends, hospitals and social-service agencies that have fielded calls in the past about Spears' parenting.

Police have also spoken to members of a parenting group in Spears' former community of Clearwater, Fla., where she'd share tearful stories about raising a sickly son whose father she claimed died in a crash. One member contacted that state's Department of Children and Families in 2011, one of several times Spears was reported to child-welfare authorities.

None of the reports, however, resulted in action to remove Garnett from her care.

Spears, who repeatedly sought treatment for Garnett's severe ear infections and purported digestive problems, told friends her son needed to be tube-fed because he'd go days without eating and was a "failure to thrive" case, a diagnosis for children defined by inadequate weight gain.

But those same friends saw him eat solid foods routinely. To them, Garnett – sporting a gap-toothed smile and long blond hair – appeared happy and healthy.

During the final hospital stay at Maria Fareri, Spears took to Facebook frequently, pleading for prayers as she posted pictures of her son on life support, noting that the pain in his head was making him scream out loud in pain.

Then, on Jan. 23, Spears posted a final Facebook declaration: "Garnett the great journeyed onward today at 10:20 a.m."

Initially flooded with condolences, support for Spears diminished as friends learned about the investigation and stories from her past: that her frequent emergency-room visits raised eyebrows among medical staff; that she misrepresented herself as the mother of a child she babysat; and that she'd lied about Garnett's father. He was not a police officer who died in a crash; he is a garage-door installer still living in Alabama.

Staff writers Jonathan Bandler, Greg Shillinglaw and Frank Becerra Jr. contributed to this report.

Twitter: @SPCCohen

About the series

Read our five-part series, "Losing Garnett the Great," a Journal News report that follows the life of Lacey Spears from Alabama to Florida to Rockland's Fellowship Community where her well-documented devotion to Garnett ends in his unexplained death. We explore how a woman whose existence centered on her only child became the focus of a police probe into whether her son was poisoned.

Part 1: Boy's death reveals mom's lies

A little blond boy beams in dozens of photos on Lacey Spears' MySpace page with captions like "My World My Everything" and "He Completes Me." There's just one problem with this maternal picture: It isn't true. That boy is not her son.

Part 2: Two fathers; one real, one imagined

When Chris Hill heard from a friend that Garnett was dying, he reached out to Lacey Spears in the only way he knew how: He sent her a Facebook friend request. It's a strange way for a father to seek news about his son.

Part 3: Red flags, in and out of the hospital

Some people in Lacey Spears' life described her as a caring and nurturing mother but others saw darker signs. Were the surgeries, IVs and feeding tube really necessary? Lacey Spears has denied doing anything to harm her son. (Audio: Ex-nurse recalls Lacey as "the biggest liar I ever met.")

Part 4: Sun and sandcastles

It was a brief idyll for a happy child. Lacey Spears and son Garnett move to Florida, but the happier times didn't last. Just before Superstorm Sandy, mother and son moved north to Chestnut Ridge and the Sunbridge Institute, known as the Fellowship.

Part 5: 'Garnett the Great journeyed onward'

Lacey Spears and her son Garnett settle in to life at the Fellowship, where Lacey spoke frequently about her sickly son's medical history. Garnett seemed like a normal, healthy boy to many in the Chestnut Ridge enclave. In late January, Garnett was transported from Nyack Hospital to Westchester Medical Center. He died Jan. 23. Westchester County Police subsequently launched an investigation.

Read more

Garnett's last days: 'Something is not right here'

Friends share shocking new details about the time Lacey Spears spent with her dying son at Nyack Hospital and Westchester Medical Center.

Spears case has red flags seen in Munchausen by Proxy

Garnett Spears had feeding tube most of his life

Losing Garnett: Listen to reporter Peter D. Kramer read the series

Chat live with lohud

Journal News/lohud reporters Shawn Cohen and Peter D. Kramer will be taking your questions and sharing insights into the Lacey Spears arrest at 7 p.m. ET Wednesday, June 18, on lohud. Find the chat and set up an email reminder at http://lohud.us/spears-arrest-chat.

Read the indictment

http://data.lohud.com/documents/lacey-spears-indictment.html