What happened to Ariel?

A rare rainy sky covered Las Vegas the day Cheryl Botzet stood to face charges of first degree murder.

Rob Stafford, Dateline correspondent: First degree murder to most people is somebody plans to kill someone.  They go out, they take a gun and they do it.

Dave Stanton, Las Vegas prosecutor: If you understand diabetes and what’s required of a parent of a juvenile diabetic, there is no distinction factually between what you just said.  That Cheryl walked up, put a loaded gun to the back of her daughter’s head, and pulled the trigger.  Cause that’s exactly what happened other than it wasn’t a gun.

Right away, in his opening statement, prosecutor Dave Stanton described Botzet not as a caring parent but a neglectful mother who killed her own child.

Stanton (in court): Type 1 juvenile diabetics have a fatal disease.  In this day and age, they should never be next to a cliff. This defendant took her daughter’s hand and walked her to the edge of that cliff and shoved her off.

Vicki Monroe: It’s a shame and a travesty that an 11-year-old little girl should be dead because she wasn’t cared for.

To prove murder prosecutors Stanton and co-counsel Vicki Monroe had to convince the jury that Cheryl Botzet knew how to care for her daughter’s diabetes, but didn’t, and that neglect caused her death. 

FREE VIDEO Interview in jail Web exclusive: Footage of Cheryl Botzet in jail, after she was accused of murdering her diabetic child by neglecting to properly care for her. Dateline NBC

It was the first case of its kind in Nevada: a mother charged with murder in the death of her diabetic child. If convicted of the most serious murder charge against her, Cheryl Botzet faced the possibility of spending the rest of her life behind bars.

The prosecution says Cheryl began a pattern of neglecting Ariel shortly after she separated from her husband and moved to Colorado. It was then, according to prosecutors, that Ariel’s health— and Cheryl’s attention to it— began to deteriorate.

Nurse Molly Jane Bangert examined Ariel in Colorado 18 months before Ariel’s death. She told the jury she was concerned about the results of a test called a “hemoglobin a1c”— a forensic snapshot of Ariel’s blood sugar for the past three months.

Molly Jane Bangert, Ariel’s nurse in Colorado: We talked about the importance of blood glucose control. We discussed what her—what Ariel’s current A1C was. Because it was obvious that the blood sugars had been too high for too long.

A healthy test result for a diabetic is roughly 7 percent. Ariel’s was 15 — more than twice what it should have been, a result prosecutors say would alarm any parent of a diabetic child, but not Cheryl Botzet. Instead, it was the nurse who was alarmed.

A diabetic herself, the nurse testified Cheryl had lost Ariel’s glucometer: the crucial device needed daily to measure her daughter’s blood sugar. and worse, she’d even run out of insulin—the daily medication Ariel desperately needed to stay alive.

Bangert testified she was so concerned about the little girl she gave Ariel some of her own insulin.

Bangert (in court):  I gave them two blood glucose meters; one for home and one for school, and I gave her a bottle of insulin from my personal supply because I was concerned about the blood sugars being so high.

Even though Cheryl had been taught at least twice over the years about how to care for her daughter, the nurse testified she too tried to teach Cheryl how to better maintain Ariel’s health, but she says Cheryl seemed more defensive than concerned.

Attorney (in court): What do you recall about the defendant’s response to your request for education about diabetes.

Bangert: She said that she didn’t need anybody to tell her how to help take care of her daughter’s diabetes.

Perhaps the most convincing part of the prosecutions case focused on the week Ariel died. By then, Cheryl and Ariel had moved back to Las Vegas.   

It was Superbowl Sunday 2004.  Ariel rode her bike across town from her mother’s apartment to a party at her father’s house.

Stanton (in court): Can you describe how Ariel looked, both her physical appearance to you, and how her behavior was at your Super Bowl party?

Randy Botzet, father: She was a little bit pale.  Not real pale.  But, just a little discolored.  I thought maybe it had been from riding her bike or something.

Stanton: Is that the last time you saw your daughter, Ariel, alive?

Randy Botzet: Yes.

Stanton: Did you talk to your daughter the next day?

Randy Botzet: Yes. She wanted to go swimming.

Stanton: Was there anything about her demeanor on the telephone that concerned you about her swimming?

Randy Botzet: She had sniffles and I told her, “Tell your mom, you should make a doctor appointment or go to the doctor’s.”

Despite Ariel’s symptoms, the prosecution says Cheryl did nothing, and waited, taking her daughter to this clinic five days later. At 3 p.m. Friday, Feb. 6, Ariel’s condition was getting worse.

Doctor Emerita Abela testified that Cheryl told her Ariel had been sick for several days.

Dr. Emerita Abela (in court): She was saying that, “Oh, she had this three or four days ago but I thought it was flu.”

Abela also heard Cheryl say was Ariel had been vomiting on and off for approximately three to four days.

To prosecutors, it was a critical piece of testimony. They say Cheryl had been repeatedly taught that unlike a healthy child, anytime a diabetic child vomited, a doctor needed to be called immediately, not days later.

In fact, Ariel’s condition was so grave by the time she sought help, the clinic couldn’t handle it. They rushed her to a nearby hospital where Ariel was given that a1c blood test again. This time, the reading was 16.1, even higher than the number that had concerned the nurse from Colorado a year and a half earlier.

Prosecutors called Las Vegas homicide detective Mark McNett to prove the high test result was caused by Cheryl’s pattern of neglect.

Detective McNett (in court): The glucometer has a downloadable feature.  It stores data on it for a certain number of readings.

McNett testified when Ariel was sick, her glucometer— that crucial blood testing device—showed Ariel was tested just two times that entire week instead of the minimum of four times every single day.

Stafford: That glucometer doesn’t just talk about the tests that were done, it talks about the tests that weren’t done?

Vicky Monroe, Las Vegas prosecutor: Absolutely. Ultimately the results of that glucometer came out that this child was tested on January the 30^th, Friday, the day she was in school and February the 6^th, the day she was taken to the hospital.  There were no other readings on that glucometer.

Stafford: Not on Monday, Tuesday, Wednesday or Thursday?

Monroe: Not on any of those days.

On top of that, insurance records show Cheryl purchased just two bottles of insulin the year before Ariel died— most diabetics need two bottles each month.

After receiving this information from detectives, Clark County medical examiner Dr. Larry Simms crystallized the prosecutions case.

Stanton (in court): Do you have an opinion, Dr. Simms, after your entire examination of what the cause of death for Ariel Botzet was?

Dr. Larry Simms, medical examiner: The cause of death was diabetic ketoacidosis.

Stanton: And manner of death?

Dr. Simms: Homicide…  there wasn’t enough insulin being purchased in order to sustain the dosages. It was very reasonable to me to conclude that there was chronic medical neglect.

It was a definitive conclusion that seemed to seal the prosecution’s case— as Vicky Monroe hammered home the loss of a little girl’s life and pointed the finger at the woman she says caused it.

Monroe (closing argument in court): Do you have any idea or any doubt that the defendant did not know how to take care of this child properly?  You bet she did.  She knew.  She wasn’t a parent who wasn’t told these things.  And her failure to care for this child over the last three months of her life was her own doing, her choice. To let this child not get her insulin. Her choice to not test this child 4 to 6 times a day.

Perhaps if she’d been brought to the hospital earlier, Ariel Botzet would not be a photo on a monitor, and we’re talking about her death and who’s responsible for it.  We wouldn’t be here possibly.

I would submit to you there can be no doubt in anyone’s mind that that woman  (pointing to Cheryl Botzet) is guilty.

And, the proper verdict in this case is first degree murder.   Thank you.

To prosecutors, it was open and shut— but defense attorney Herb Sachs was about to pull off a Perry Mason moment he was convinced would change the jury’s mind.

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