A pediatric nurse in Pennsylvania has been accused of abusing a medically fragile infant, with disturbing surveillance footage revealing the incident.

Disturbing surveillance

A Ring camera captured a moment no parent should ever have to see. A pediatric nurse hired to care for a 1-year-old is now accused of abusing the child inside the child’s home.

Cindy Desser, 58, is accused of slamming the Newtown Township baby in her crib. In the video from May of last year, Desser adjusts the baby’s medical equipment, walks away, but when the alarm sounds, she chokeslams the baby a second time.

An attorney for the baby’s parents told NBC 10 they went to the police and have now filed a lawsuit against Desser and the company that employed her, Team Select Home Care.

“They were utterly horrified seeing what they saw on the camera,” the attorney said. “As soon as they saw Desser treating their child like that and abusing her, they rushed into her room and confronted her. And then immediately they called Team Select. They said she cannot come back.”

Baby born with spina bifida and needed 24-7 care

The baby was born with spina bifida and other medical complications. At the time of the incident, she was ventilator-dependent and needed 24-7 care.

“So, while she was unable to defend herself or speak out on her own behalf and talk to her parents or cry for help, her vital signs, through her vital signs, she was screaming out for help and Team Select, who monitors those, was ignoring that,” the attorney said.

Desser charged in separate case

On March 27, Desser was charged in a separate Bucks County case, accused of abusing a three-year-old child while working for another home care company, Dynamic Home Care.

Desser is facing several charges, including aggravated assault.

Officials believe there may be more victims.

“We firmly believe that given now that we’ve seen Desser assault two minor children who are medically compromised, that these are not isolated occurrences. These are rather part of her pattern,” the attorney said.

The companies that Desser works for have yet to comment on the claims, as have her attorneys.

McCormick made fighting the fentanyl epidemic a significant part of his 2024 campaign and has even advocated employing the military to attack drug cartels in Mexico. He co-sponsored the Halt Fentanyl Act, which permanently classifies fentanyl as a Schedule 1 drug, and was signed into law last year. Later, he introduced the Nitazene Control Act to similarly classify newer narcotics and, in March, introduced the Joint Task Force to Counter Illicit Synthetic Narcotics Act of 2025, to “improve federal coordination” to “go after trafficking organizations [and] address China’s central role in producing fentanyl precursors and laundering drug money.”

U.S. Attorney David Metcalf reinforced the importance of targeting higher levels of the drug supply chain.

“When you measure it by lives lost, the most significant criminal problem we face is still drugs,” he said. “We try to dismantle the problem at the highest level … with cartels and transnational organized crime.”

He noted that Pennsylvania removed more than 56 million doses of fentanyl in 2025 alone, calling it evidence of aggressive enforcement efforts while cautioning that progress must be sustained.

“Now’s the time where you triple down,” Sunday said.

Allentown Mayor Matt Tuerk, who was not present during the discussion, later told WHYY News that said the city is “happy when our federal partners come to Allentown in a collaborative spirit,” but warned that enforcement alone is not enough as federal dollars for social programs remain at risk.

“I hope that the administration is focused on not just the big headline gravity stuff, but on doing things that strengthen cities,” he said. “They can do that by making smart investments and working closely and collaboratively with cities.”

Tuerk said that includes funding social services that prevent addiction and help offset potential losses in access to fentanyl treatment for Medicaid recipients who may lose coverage under new work requirements and eligibility changes. Medicaid currently pays for about 90% of all treatment.

“As a mayor and as a city leader, my concern is that the good work that law enforcement does to deal with fentanyl or other violent crime gets undercut by decisions that the administration has made that weakens a social safety net and it just creates more problems at the local level,” Tuerk said.

McCormick acknowledged ongoing concerns about funding and long-term strategy, particularly around addiction treatment and mental health services.

“None of us feel like we have conquered all the dimensions of this problem,” he said, adding that Medicaid funding has actually been increased, though reforms may “slow the pace of growth in spending.”

“That pace of growth will slow to about 3%, which is still higher inflation, so it’s still growing,” he said. “How those additional funds will be allocated, I think, is something that remains to be seen.”

Pennsylvania Attorney General Dave Sunday emphasized that opioid settlement funds are being directed toward treatment and recovery programs, calling them “crucial” to reducing demand alongside supply-side crackdowns.

“We’re here talking about everything we’re doing today to address the supply, but at the same time, we have to just as vigorously go after the demand,” he said.

U.S. Rep. Ryan Mackenzie, R-Allentown, noted that the Lehigh Valley has been heavily impacted due to its location along major trafficking routes, with “hundreds of families” affected over the years.

Sunday added a personal perspective, describing the crisis not just as a law enforcement issue, but as a fear shared by parents across the state.

“When I was a kid, if you made a mistake, you might not feel well for a day,” Sunday said. “In today’s world, one mistake can equal death. That’s not hyperbole, that is very, very real.”

Pennsylvania’s first two years of funding indigent defense resulted in progress toward better services for criminal defendants who cannot otherwise afford their own counsel, according to reports released earlier this year.

County defender offices across the state hired new attorneys, added crucial support staff, and implemented case management systems, some for the first time.

A new body, the Indigent Defense Advisory Committee, created the commonwealth’s first standards for this kind of representation. And a massive data collection effort has provided policymakers with the first statewide picture of public defense.

“The money is a good start,” said Sara Jacobson, who spoke with Spotlight PA in her capacity as executive director of the Public Defender Association of Pennsylvania, or PDAP. Jacobson also served as chair of the advisory committee for its first two years.

But an annual $7.5 million investment split across 67 counties couldn’t fix the dire state of many public defender offices across Pennsylvania.

An analysis of indigent defense by the committee and the Pennsylvania Commission on Crime and Delinquency shows the state is about 400 attorneys short of what it needs to provide adequate representation for adult criminal cases. It also found that starting public defender salaries lagged that of the average attorney in the state.

In addition, defense offices are hemorrhaging staff, with counties reporting that nearly 40% of attorneys hired within the past five years have already left. Of these, most departed within two years of being hired.

Because of turnover, there are fewer full-time public defense attorneys today than in 2024, when county offices received their first round of funding from the state government.

Jacobson said the money is important and the gains made in spending on public defense would be lost without it.

“But at flat-funding, we don’t gain more,” she said. “At flat-funding, we stay where we are.”

A first step

For decades, Pennsylvania was one of only two states in the country that did not fund public defense, leaving counties to shoulder the burden of constitutionally guaranteed representation. But beyond the funding, public defense was plagued by a culture of isolation.

“Because it’s county-based there’s never been a comprehensive movement to change it, or connect it,” said Samuel Encarnacion, a veteran public defender with the Lancaster County office who left it in March 2025 after more than 30 years.

“We were all little fiefdoms,” he said.

But in recent years, three things changed, Encarnacion said.

In 2020, PDAP hired its first employee, Jacobson, and became more active in organizing training across county public defender offices and advocating for change at the state level.

Then in 2023, the state legislature and Gov. Josh Shapiro approved $7.5 million, giving most public defenders’ offices their first-ever infusion from the state. The funds recurred in 2024 and 2025, and are proposed at the same level in the 2026 budget.

And in 2024, the ACLU of Pennsylvania sued the state, arguing Pennsylvania’s county-by-county system of funding public defense has resulted in a patchwork that violates the U.S. Constitution. The case is ongoing.

It all amounts to a psychological dam breaking, Encarnacion said.

“We used to say we were the only one, or one of the only ones not funding,” Encarnacion said. “Well, now we can’t say that.”

In two rounds of funding since 2023, counties were awarded just under $13 million in grants from the state, which are noncompetitive and allocated through a formula.

Each county will receive between $184,000 and $295,000. The money is intended to supplement, not replace, support from county governments, which are still required by state law to be the primary funder of public defense.

Every county has put money toward personnel, with 76% of the grant money funds being budgeted for staff and contracted positions. Across the state, offices created 37 new attorney and support staff positions.

The legislature also created the Indigent Defense Advisory Committee to allocate the money and establish statewide standards for public defense.

Those standards were finalized in September, and submitted to the Supreme Court of Pennsylvania for approval. They mandate that attorneys providing no-cost criminal defense have sufficient knowledge of the law, continue their education, and have a reasonable understanding of relevant technology and forensic science.

The new standards also establish that effective representation includes a client-centered approach.

These new baselines are currently pending before the high court, which has referred them to the criminal and juvenile rules committees, said Ted Skaarup, assistant public defender for Northampton County. Skaarup is also the chair of the advisory committee.

But despite the forward progress, there’s still a long way to go, Encarnacion said.

“The volume of cases and the number of cases per lawyer is a cancer for effective representation,” Encarnacion said. “That’s really the illness. I think we’ve known that for years.”

In other states, and in larger counties such as Philadelphia and Allegheny, bigger, well-funded offices enable more delegation between attorneys, Encarnacion said, more time for mentorship, and more room for senior attorneys to take managerial roles.

After the COVID-19 pandemic, his office was hollowed out as traumatized and burnt-out attorneys left for better paying jobs in the private sector. The state grant funding helped make small gains, he said, and has begun a conversation he hopes will lead to bigger change.

“The question is whether we want to make it into an impossible job,” Encarnacion said. “I stayed long enough because I refused to believe it was an impossible job.”

“More to do”

The new money can have a noticeable impact for public defender offices across the state, but it can’t fix all the problems with indigent defense.

In Lebanon County, Chief Defender Megan Tidwell was able to hire a part-time attorney to handle cases involving mental health issues, as well as a part-time social services advocate to connect clients with resources that attorneys otherwise would not have time to seek out.

Indigent clients often need mental health care, substance abuse treatment, or both, Tidwell said, but sometimes lack the ability to find that help on their own.

The social services advocate is “already handling so much that she could be full-time,” Tidwell said. But the grant can’t cover that workload.

Similarly, while the grant funding is helping counties bring on more attorneys, it can’t make up for decades of underfunding.

The committee found the number of full-time public defense attorneys actually decreased from 828.5 to 820.5 over the course of the grant program, driven by aggressive turnover in the offices.

“Initial data analysis from the IDAC and others suggests that indigent defense workforce challenges have reached a crisis point, with significant turnover and recruitment challenges leading to overall staffing shortages compared to levels that would meet national standards,” the report found.

The new money also allowed some counties to implement case management systems for the first time. Public defender offices cannot accurately measure their caseloads without them, according to Jacobson.

“Without being able to track overall how many cases they’re handling it’s really hard to then — actually it’s impossible — to match their work against, say, national caseload standards,” Jacobson said.

When public defense caseloads get overwhelming, there’s less time to devote to each individual case. Attorneys can only triage cases and negotiate the best guilty plea they can, Jacobson said, which is not an effective level of defense.

An analysis of case outcomes by PDAP found this already happens. Using the indigent defense committee report and a 2021 report by the Legislative Budget and Finance Committee, PDAP found that between 2022 and 2024, 11 counties took three or fewer cases to trial and 16 counties filed two or fewer appeals.

“Indigent defense shouldn’t be like haggling over the price of a car,” Jacobson said. “There’s much more to do.”

Preliminary caseload figures are likely an undercount, Jacobson said, because the data the indigent defense committee gathered from the court system has gaps that could obscure the true amount of work public defense attorneys are handling.

In up to 20% of cases, court documents showed that the defendant had either no or “unknown” representation. It’s unclear whether these defendants truly did not have representation, or whether the court clerks just didn’t enter their attorney information into Pennsylvania’s case management system.

If people are moving through the system without the representation they’re entitled to, “It means that no one is reviewing their discovery, no one is looking to see if there are motions to suppress because police violated their constitutional rights, no one’s really making sentencing arguments for them,” Jacobson said.

Looking forward, the Indigent Defense Advisory Committee is focused on three areas for continued progress, Skaarup said.

The committee is creating a centralized, digital resource library for indigent defenders around the state, where standards and practices vary by county. It’s also continuing to engage with the Supreme Court of Pennsylvania and rules committees to produce robust standards for public defense.

But closing gaps in the data might be the most important task ahead, because an accurate picture of caseloads is “the baseline for a lot of the other work we want to do,” Skaarup said.

“We have a lot of qualitative impressions of the quality of indigent services throughout the commonwealth, but we also are working to try and get some numbers behind those,” he said.