The dog sitter

I was called to the emergency room last night to evaluate an 11 year old boy who was there due to "out of control" behavior. When I arrived, one of the hospital's clinicians was standing outside talking to a security guard. As she walked with me into the hospital, she explained that mom "flipped out" on her coworker and stormed out of the ER cursing and yelling. She wasn't sure exactly what happened but was concerned that the situation could become "volatile." The other clinician explained that mom was telling her how Johnny was initiated into a gang last Saturday by being severely beaten. The following day, mom allowed him to go to the store alone and he was beaten again. The clinician was asking mom if she thought it was appropriate for Johnny to be allowed to be unsupervised after he was just hurt the day before. I guess mom took offense to the questions, and showed her short fuse. So, when Johnny indicated that he was afraid to go home, we had some genuine concerns that his fears were legitimate. But, why might he be punished and why was in the ER?
Johnny and his 7 year old brother were home alone after school and got bored. They decided to play with the dog. They put nail polish on him, dressed him up, and ....stuck a tampon in his anus. When mom returned home, she apparently got mad and Johnny locked himself in the bathroom. He then threw a temper tantrum, breaking the towel rack and punched his hand through the window. That's when mom called 911 and he was transported to the hospital for an evaluation. Though his behaviors were very concerning, he was not suicidal or homicidal and unfortunately I can't hospitalize him for endangering animals. A report was made with social services however, and though the caseworker felt it was safe for Johnny to go home with mom, the other clinicians and myself have our doubts. Somehow I don't think that is the last time I hear about little Johnny.