His mother has been jailed, and his protector is the state. His home is a hospital, and his health is nearly as fragile as the day he landed in the ER at Memorial Hermann Children's Hospital.

Weighing just 17 pounds, 3-year-old Kayvon Lewis arrived in the emergency room last month extremely malnourished, dehydrated and at risk of heart failure and liver damage. He can neither walk nor talk. He is blind and suffers seizures, sometimes five a day.

His mother, authorities say, was starving him to death, a form of child abuse so rare that doctors almost never see it.

About 200 children each year die from abuse and neglect in Texas. Kayvon escaped death by a thread.

And as is often the case, a lengthy list of people knew about the boy's eroding condition, but failed to intervene.

“The care Kayvon was given was pathetic,” said Gary Polland, the attorney appointed to represent Kayvon at court after ER physicians had the boy taken into temporary custody by Texas Child Protective Services.

His mother, Marcia Holliday, 30, has been charged with injury to a child causing serious bodily injury by omission, a first-degree felony.

For more than a month now, doctors slowly have introduced the boy to what's been missing much of his short life: food.

On the night of Oct. 15, according to records, Holliday brought Kayvon to Memorial Hermann Children's Hospital, telling the staff that her son was not eating or drinking and had not wet his diaper all day. She seemed not to mention, records show, that he was half the size of a normal toddler, or had the head of a boy and the body of an infant — or that he could do none of the things children of his age are supposed to do.

Underlying problems

“He cannot walk, crawl, sit unsupported, pass objects between hands, reach, say ‘mama' or ‘dada,' wave ‘bye-bye,' does not orient to voice,” reads a medical report after his ER exam.

Texas Child Protective Services caseworker Sandra Moy stated the case in more startling clinical terms: “Kayvon T. Lewis' nutritional level was 9.2 when a normal level is 45 and a low level is 18.”

On the same day, pediatrician Dr. William Risser referred Kayvon's case to the Child Abuse Resource and Education Center team, an inpatient consultation service for suspected child abuse and neglect cases. University of Texas-Houston Medical School's Dr. Oscar G. Larrazolo performed Kayvon's exam, and the findings were verified by CARE team director Dr. Rebecca Giradet, an associate professor at the medical school and staff physician at Memorial Hermann.

Kayvon, the doctors' report noted, was first diagnosed at 9 months of age with “failure to thrive” — a catch-all phrase used to describe a child's condition, not the underlying reason why a child cannot gain weight or develop. Doctors found he had seizures, scoliosis and asthma, underlying health problems. But they told CPS those conditions could not be responsible for his starved state.

“The only reasonable explanation for his starvation is physical neglect,” their report stated.

But as is all too often in the case of abused children, there was no shortage of people who knew about the boy's eroding condition but for one reason or another failed to intervene.

Weight loss a ‘red flag'

CPS investigated its first complaint about the boy's care in January 2008. They found Kayvon's mother was “intoxicated on drugs” and the child appeared to be a “failure to thrive child.” Services were ordered, including sessions with a state dietitian and physical therapist. Nothing about the boy's small size or condition alerted workers that Kayvon was in enough danger that he should be removed from his home, according to court documents.

On March 27, 2008, while the investigation was still open, Holliday tested positive for marijuana. Still, the boy was left in the home after Holliday promised to enroll in a series of early childhood intervention classes. The case was closed on April 1, 2008.

The following month, he was taken to his pediatrician, Dr. Niala Siddiqi. Kayvon, who was just shy of his second birthday, weighed 18 pounds, 6 ounces. Sixteen months later, on Aug. 28, 2009, his weight had dropped by more than a pound.

Siddiqi did not return calls for comment to the Houston Chronicle.

Giradet, one of the team of doctors who examined Kayvon last month in the emergency room, would not comment specifically on Kayvon's case. However, she did say that any young child who maintained such a low weight over more than half his life was a “red flag” that starvation was occurring.

Children, particularly those in poorer circumstances, can be found to be malnourished. But starvation abuse of a child is so rare that Giradet has seen it only three times, counting Kayvon, in her decades-long career.

In interviews, Kayvon's relatives admitted to officials that they had told Holliday to take Kayvon to the hospital on other occasions. But when she didn't, they did not call his doctors or CPS

“Maternal grandmother and maternal aunt stated that they encouraged Kayvon's mother, Marcia Holliday to take Kayvon to the hospital for his condition but that she failed to act,” Moy wrote.

There was a second CPS investigation in November 2008. The agency was notified the boy may not have access to his anti-seizure medication. The case, too, was closed quickly after a check found that he did have his medication.

Denies starving her son

Holliday, who was released from the Harris County Jail this past week, denies she systematically starved her son.

“Everything they say (CPS) is a lie. He wasn't eating or drinking,” she said during a recent interview at the jail. “He has a lot of problems going on.”

Now, two months later, Kayvon's intake of liquid formula is monitored constantly. Too much food at this stage can overwhelm the underdeveloped organs of his tiny 17-pound body. A white mesh glove has been placed over his left hand to keep him from sucking it. Kayvon was starved for so long, he had sucked his thumb raw and a sore developed.

“Since their bodies have not been seeing normal quantities of fats and carbohydrates, their bodily functions kind of shut down,” explained Giradet. “It's very dangerous to suddenly feed a starved child normal food. They can go into liver failure, heart arrhythmia. Their pancreas does not make insulin anymore. All of those functions are not working.”

Explanation elusive

Why Kayvon was starved is hard to say.

“Typically these children come from very stressed families,” Giradet said. “It may be one child is singled out and the other ones are getting adequately fed.”

Neither Kayvon's 6-year-old brother nor his 5-year-old sister showed signs of starvation or other abuse.

Until recently, the children lived with their mother in the Forest Pointe apartments, one of a string of low-income complexes that snake along Northborough Drive in the Greenspoint area of Houston. Both siblings are in foster care.

While Kayvon is out of intensive care, he has yet to try solid food, not even Cheerios or crackers, according to CPS.

Giradet could not say how long it will take a child like Kayvon to recover.

terri.langford@chron.com