Produced by Ruth Chenetz, Kathleen O'Connell and Doug Longhini
Decatur, Alabama, Lacey Spears' hometown, was the place she first showed an interest in children -- working as a babysitter, and later, at day care.
"I love children," Spears told "48 Hours" correspondent Troy Roberts in her first interview. "They're our future. They should be cared for and loved. "
Shawna Lynch met Lacey about eight years ago at the daycare center where Spears took care of her son.
"When I first met Lacey she was very shy -- but was real good with kids," Lynch said. "She volunteered to take-- my kids ... if I needed to go to work and didn't want to take 'em to the daycare ... She loved my kids, and my kids adored her."
But after a few years, Lynch thought Spears was getting overly involved in her family's life, so Shawna stopped spending as much time with her.
"She was real clingy," she said. "It seemed like she never wanted to be by herself. She always had to have a kid there -- somebody's kids.
Christy Burnham's friendship with Spears also involved Lacey's willingness to babysit.
"She met my son Cameron and she became like a good friend," Burnham said.
The two became close while at junior college, where Lacey took a few nursing classes, before dropping out. Burnham, a single mom at the time, was relieved to have help with her son.
"I trusted her, cause I'm not gonna leave my kid with somebody that you don't trust," she said.
But that trust turned to trepidation, when, Burnham says, she heard some unusual stories, which made her question Lacey's honesty.
"Some lady from her church comes up and was like, 'Oh, that's Cameron. You got Lacey's baby.' And I look at her and I'm like 'What? This is my child. This isn't Lacey's baby,'" Burnham said. "I was like, 'Wow!'"
"I never said that I had more than one child. Garnett was my only child," said Spears.
Spears became pregnant with Garnett in 2008, when she was 20. His father, Chris Hill, was a neighbor whom Lacey briefly dated.
"Garnett's father was a friend of mine. We lived in the very same apartment complex," she explained.
Spears says Hill did not want to be part of Garnett's life, so she set out raising her son on her own -- something made especially difficult because Garnett had health issues, which she often posted about.
"He was in and out of the hospital for the first nine weeks of his life and ... afterwards," she said.
"And what was he suffering from. What were his issues?" Roberts asked.
"Garnett had severe ear infections," Spears replied. "And the biggest problem we had was we couldn't get him to eat. ...and he would projectile vomit, so he was losing weight.
Doctors diagnosed Garnett with failure to thrive, but could not figure out why he couldn't hold food down. So, at 9 weeks old, he had stomach surgery to prevent him from throwing up.
"They sent him home and he didn't eat," Spears explained. "...he wouldn't take a bottle, nothing, and about a week later, he was admitted to the hospital for severe dehydration."
Garnett's condition worsened and he was airlifted from Decatur General Hospital to Birmingham Children's Hospital. His sodium level was found to be dangerously high: 166. The normal range is 140 for infants. High levels of sodium can be deadly, potentially causing seizures and swelling in the brain.
"I wanted to know what was wrong," said Spears.
Doctors were able to bring his level down, but never understood how it had gotten so high. And once again, Spears brought Garnett home from a hospital.
"He spent more time in the hospital than he spent at home," Spears told Roberts. "I wanted my son to be healthy."
So she took Garnett to more doctors, telling them she still couldn't get him to eat. At 9 months old, Garnett had surgery again--this time to insert a feeding tube, commonly referred to as a G-tube, where nutrients go directly into an opening in the abdomen, either through a hanging bag or a bottle or through a syringe.
"What did doctors say to you about his prognosis?" Roberts asked Spears.
"You know ... they were hopeful that within time, he wouldn't have so much problems eating," she replied.
However, Spears says Garnett continued to be plagued by feeding issues. In 2010, they moved from Alabama to Florida to be near Lacey's grandmother. While there, Spears babysat, cleaned houses, and received some public assistance. She would occasionally come back to Alabama to visit.
"The day that they came to visit, Garnett was just a bouncing little 2-year-old kid, running around. I never thought he was sick or anything. And then we had lunch and he ate just like a normal 2-year-old would do. Pizza and drinks," said Lynch.
"Garnett would eat and then he would just stop eating. He would say, 'My stomach hurts. I don't wanna eat,'" Spears said. "He would go for an extended period of time where he just simply wouldn't take anything by mouth and so we used his G-tube as he got older for supplemental feeds only when he needed to be nourished."
"Tell me how challenging that was - taking care of a child with so many medical issues?" said Roberts.
"That's all I knew," she Spears replied. "It was just something that I was given and I embraced it."
"Garnett was becoming of age where he was gonna go to school," Lacey Spears told Roberts. "...and I decided that I was going to take him from Florida to New York so that he could have the best education that I felt was possible for him."
Spears learned, from a friend, about an alternative community located an hour outside of New York City, called the Fellowship. Its mission is to care for its elderly residents. Workers live on the premises, contributing to all aspects of the community, receiving free room and board and schooling for children. Lacey thought it would be the ideal atmosphere to raise Garnett, then 3 years old.
"I took care of elderly people," said Spears.
"Did you like it?" Roberts asked.
"I embraced it. I loved it," she said.
"What about your son?"
"He loved it. He loved the freedom that he could run around the community and there was always a watchful eye on him," Spears replied.
Valerie Plauche, a Fellowship member, met Lacey and Garnett when they moved there in 2012, and immediately saw something special in Garnett.
"He just knew how to reach every person and sort of make them smile," said Plauche.
"And he reached you?" Roberts asked.
"Yes, Garnett and I were very good friends, actually," she replied.
"He just went around opening everyone's hearts," Plauche continued. "There was so much love there."
While Spears told people at the Fellowship about Garnett's medical problems, the boy Plauche knew seemed active and healthy.
"As far as I could tell, he was hungry often and ... I would have nuts or fruit on the counter and he would eat," she said.
"Did she seem like a good mother to you?" Roberts asked.
"I thought she seemed like a good mother," Plauche replied. "They had a very loving relationship. And she ... cared about him and talked about him all the time."
Spears says Garnett still could not consistently eat food by mouth, as he continued to suffer from stomach aches. So she sought help from local doctors.
Dr. Ivan Darenkov, a pediatric gastroenterologist, saw Garnett for five visits over a period of several months in 2013, treating him for stomach ailments and to check on his G-tube.
"What were your impressions of Garnett -- did he seem like a healthy boy?" Roberts asked Dr. Darenkov.
"Absolutely. Absolutely healthy boy," he replied. "The most unusual, in Garnett Spears' case, was his feeding tube was left in place ... for such a long time. He was 4 when he came to my office."
"Did you have a discussion with Lacey during your first visit with her about removing the G-tube from Garnett?" Roberts asked.
"Yes," Dr. Darenkov replied. "I always say to all my patients that we really need to be absolutely sure that child cannot eat and needs some of all of the calories be provided by the G-tube."
To rule out serious diseases, Dr. Darenkov suggested a number of complicated tests, which Spears readily agreed to -- and which all came back negative. But when he recommended simple nutritional evaluations to see if the feeding tube was necessary, Spears' reaction, he says, was different.
"She would not say yes, she would not say no," he explained. "But she wouldn't do it."
"We had begun to talk about the removal of the G-tube, but neither one of us -- me as his mother or him as the physician -- were comfortable with removing the G-tube. It was a goal for the future," Spears explained.
"I was telling her that I don't like this tube being there if we don't need it," Dr. Darenkov said. "That was my mantra every time we would meet."
Dr. Darenkov grew frustrated. He says he also asked Spears for Garnett's previous medical records, which he never received. Dr. Darenkov stopped seeing Garnett because he moved to a practice in another state, but unsettling suspicions stayed with him.
"There were red flags along this case -- all through the visits that I had with this child. I thought about them. I tried to work my way through them," he said. "Munchausen by proxy was on my mind ... from day one."
Suspicious, but not certain. And so, Dr. Darenkov did not share his concerns with authorities.
"Physicians feel they need to know for sure and they don't. If they have reasonable suspicion ... get consultation. ...But if you suspect, report," said Dr. Mary Sanders, a clinical psychologist and associate professor at Stanford University.
Dr. Sanders has spent years evaluating Munchausen by proxy cases, where illnesses might be faked or created in a child. She and other Munchausen experts believe the syndrome is child abuse and, as such, needs to be reported.
"A surgically implanted feeding tube is an avenue of chaos. Anything can go in that tube," Dr. Sanders explained.
"You've seen that in other cases?" Roberts asked.
"We have seen that in several cases, yes," Dr. Sanders replied.
Doctor Sanders never met Lacey Spears, but has reviewed information about her. She believes the condition explains much of Spears' behavior.
"The red flags in this case and for me in any case of medical child abuse is when the story does not fit what you see. So when a mother presents symptoms, that when you see the child don't make sense -- lab levels that don't make sense ... A mother that says my child will not feed ... we see evidence that the child will feed," she explained.
"What are the motives behind this?" Roberts asked.
"The motives are varied ... but we can assume that the motives are to gain attention to have drama in one's life, excitement," Dr. Sanders replied.
Another potential red flag for Dr. Sanders: all those posts on social media.
"Certainly the internet opens up a wide audience, you know, not only friends and families, but strangers," she explained. "The social media is there to ... send support."
"I did it to inform my family and my friends. I didn't do anything for sympathy. But I just did it to share my life, Garnett's life," Spears told Roberts.
"Do you suffer from Munchausen by proxy?" Roberts asked Spears.
"I do not have Munchausen by proxy. I was evaluated by a psychiatrist and he determined that I do not have Munchausen by Proxy," she replied.
That evaluation was done after Garnett's death. And, says Spears, it did not find that she suffered from any mental illness. Spears did not share the report with "48 Hours."
"The psychological evaluation is not where we identify the illness," Dr. Sanders explained. "What we're looking for in inconsistencies in what's being reported and what is seen clinically."
"Elevated sodium was a factor in this case," Roberts noted. "Is that common?"
"It's not uncommon ... as a form of Munchausen by proxy child abuse," said Dr. Sanders.
A TURN FOR THE WORSE
Life at the Fellowship was going well for Spears and for Garnett, who, after living there a year-and-a-half, was thriving.
"He was a little social butterfly and he loved it," Spears said.
Spears said Garnett still required occasional supplemental feedings through his G-tube, which she administered at home, but was otherwise active and seemingly healthy. That changed in January of 2014, shortly after Garnett turned 5, when she says, he came down with a fever, stomachache and headache.
"I took him to the pediatrician who said, 'You know, I can't figure out anything that's going on with him, but we're gonna watch ... him..." said Spears.
Garnett's temperature went down and he seemed better, but then several days later his condition worsened.
"And I just remember he's screaming in pain and holding his head," said Spears.
Garnett was admitted to New York's Nyack Hospital with seizure-like symptoms. A video EEG was set up using a special cap on his head, wired to a machine that monitors brain activity. Meanwhile, with Spears' consent, a camera recorded Garnett in the room. Lacey remained by her son's side, caring for him, taking him to the bathroom, and everything seemed normal.
"His condition improved greatly," she told Roberts. "Friday night, Saturday he was fine."
But almost two days after being admitted, he took a turn for the worse - with stomach issues and pain.
"He starts screaming that his head hurts and he's trying to throw up," Spears said. "They call code blue because he's not breathing."
Tests showed Garnett's sodium level, which was a normal 138 when he was admitted, was now a dangerous 182 -- which could lead to death. Nyack Hospital decided Garnett's best chance for recovery was to transfer him to a more specialized children's hospital at Westchester Medical Center, where over the phone, a doctor there was filled in on Garnett's condition:
Nurse | Nyack Hospital: Sodium is 182.
Doctor | Westchester Medical Center: 182?
Nurse | Nyack Hospital: 182.
Doctor |Westchester MedicalCenter: No, then you need to repeat it. OK? That's impossible.
Two-and-a-half hours later, Garnett was airlifted to Westchester's Maria Fareri Children's Hospital. Doctors quickly worked to treat him, and through IVs, they were able, within a day, to bring his sodium level down.
"The doctor came in to evaluate Garnett. ...And said that He was improving," Spears explained. "That's what every mother wants to hear.
But the recovery lasted less than 24 hours. The damage to Garnett's body had already been done - the high sodium levels caused his brain to swell. And two days after being admitted to Children's Hospital, Garnett is brain dead, on life support.
"I don't know what's happening," Spears said. "This is my 5-year-old son on life support."
"I got the first call ... That there was a sick child in the Maria Farreri's Children Hospital and they wanted to start an investigation," said retired Westchester County Det. Dan Carfi.
Doctors could not figure out how Garnett's sodium level had gotten so high -- unless, someone had given him salt. And the person doctors suspected was Lacey Spears.
"The thought of this being a death by a loving mother was difficult to swallow. But we didn't have a whole lot of time to dwell on that," said Det. Carfi.
An investigation, involving Detective Carfi and Ramapo detectives Kirk Budnick and Greg Dunn, was immediately under way.
Carfi focused on what happened at the hospital. Budnick and Dunn immediately obtained a search warrant for Spears' home.
"And it just seemed strange that when we walked in, there were four or five medicines in a kitchenette table behind a can of salt," said Det. Budnick.
"What first caught my eye," said Det. Dunn, "was in the middle of the living room section was an IV-type pole with a substance hanging from it which was kind of unusual."
"And ... I looked at him and I said, 'You know, she told me she was breastfeeding and that looks like breast milk in the bags.' So we decided not to take it," Det. Budnick added.
They also noticed a similar looking bag in the garbage, and decided to leave that as well. But they did take more than 150 other items -- ranging from food; salt containers; holistic medicines; vitamins; syringes, and tubes. The following day, the detectives interviewed a cooperative Spears at the hospital.
"Were you surprised when the police showed up?" Roberts asked Spears.
"Absolutely. I'm surprised that my son is brain dead. I'm surprised that all these events have transpired because one minute's he's fine and the next minute he's not," she replied.
"Lacey seemed very interested in what was going on in the investigation," said Det. Budnick.
"If your child is sick and dying or perhaps brain dead, you'd want to be by that child's side. Lacey was the opposite. She wanted to spend more time with us, bringing us people to interview," Det. Carfi said. "...it was a little bit odd."
"You're trying to deal with your son, and then what has happened and transpired and then you're thrown into a mix of police officer and investigators? I was denied time with my son, the last hours, days of his life, because I was doing everything the police asked of me so that they and myself could figure out what happened to my son," Spears explained.
"I heard ... that Garnett was brain dead. And it was just so completely devastating," said Valerie Plauche.
Plauche, the neighbor at the Fellowship, wanted to help Spears through this unimaginable time and had been in contact with her the day after Garnett was pronounced brain dead.
"She asked me to go to her apartment and take the feeding bag off the stand and dispose of it," said Plauche.
"Did you ask why?" Roberts asked.
"No I didn't ask why," Plauche replied. "I was in a very emotional state and just any request she would have asked me to do, anything, I would have done it because I was in such sympathy over the situation that she was losing her child."
Plauche headed to Spears' apartment. A neighbor told her the police had been there. She now had second thoughts about disposing of the bag, so she brought it home.
"First I put it in a garbage bag. And then I put it in the closet," she said.
Plauche told the leaders of the Fellowship what had transpired.
"They came and got it from me a little bit later," she said.
And they, in turn, called the police. The detectives recovered that bag and returned to Spears' apartment, taking the feeding bag in the garbage they had left nearly two days earlier. Both bags were sent out for testing.
"I didn't ask Valerie to go to my apartment and remove anything. I asked her to go and see in which state my apartment was in and what the police had been there doing," said Spears.
"Two feeding bags were recovered --" Roberts pointed out.
"Yes," she said.
"And what did investigators find?"
"Why were high levels of sodium found in the feeding bags in your home?" Roberts pressed.
"You would have to ask the person that put it in there, because I didn't put sodium in the bag. And the proof is that when I took him to the hospital that night had there been high levels of sodium in that feeding bag ... that I had fed my son out of immediately before he went to the hospital, he would have had high levels of sodium and he didn't," Spears replied.
Roberts asked, "So it magically appears?"
"It was exchanged between a multitude of hands before the police got it 48 hours after the bag had been taken from my home," said Spears.
"So someone is setting you up?" Roberts asked.
"I didn't say that someone was setting me up. I'm saying that I didn't place it in the bag," she replied.
"Losing Garnett is the greatest loss I will ever suffer in my life," Lacey Spears told Roberts.
Two days after Garnett's brain swelled from the effects of high sodium, he was taken off life support and officially declared dead.
"I miss just being able to pick him up and hug him and kiss him and tell him I love him," Spears said. "I miss everything about him, everything."
Police were drilling down on their investigation. Lab results on those feeding bags from Spears' apartment revealed massive amounts of sodium. Each bag had the equivalent of at least 69 small salt packs.
"The amounts of sodium that were in those bags were lethal," said Westchester County Det. Dan Carfi.
"You didn't poison your son with salt?" Roberts asked Spears.
"No, I did not. I never poisoned him with salt," she replied adamantly.
"Then why is his sodium level so high?" Roberts asked.
"You would have to ask the hospital that," said Spears.
Ten weeks after Garnett's death, the coroner ruled it a homicide. And there seemed to be only one suspect: Lacey Spears. As law enforcement looked into Spears' past, they contacted Johnny Coker, an investigator with the D.A.'s office in Decatur, Alabama, Lacey's hometown.
"I realized I had actually known Lacey when she was a child ... and remember seeing her at church on a regular basis," said Coker.
Coker came across a disturbing discrepancy in Lacey's background: she had lied about the identity of Garnett's father.
"Who was his biological father?" Roberts asked Spears.
"Garnett's biological father was Chris Hill," she replied.
But that's not what Lacey was telling people.
"Lacey liked to tell the story that Garnett's father was a local deputy in the Morgan County Sheriff's Department. His name was Blake and that Blake was a hero that he had died in a car crash," said Coker.
On social media there was post after post, recalling traveling to Blake's memorial service, as well as holidays missed.
But Blake Robinson is alive and well, currently a sergeant with the Morgan County, Ala., Sheriff's Office.
"About a decade ago, Lacey and I ... met approximately three times," Robinson said. "Not in my wildest dreams would I ever have thought ... that my name would've been drawn out of this big hat ... as this make-believe father."
"Didn't you tell people that the biological father was Blake?" Roberts asked Spears.
"I did," she replied. "I decided with my family that if anybody asked ... we would say his name was Blake and that he was a police officer and he died in a car accident. And I did it so that when people asked ... it would shut the conversation down. ...I didn't want Garnett to have the stigmatism that his father was a deadbeat."
But Chris Hill, Garnett's biological father, says that's completely false. Hill, declined an on camera interview, but says he would have welcomed being part of Garnett's life, but Spears shut him out. He also said he's active in another son's life.
In addition to looking into Spears' personal life, investigators in New York and Alabama were working to piece together Garnett's medical history. They obtained subpoenas for his health records and started interviewing doctors.
"In a period of two years, Miss Spears sought medical attention for her son in about ... 20 different doctor's offices. Some of them were referrals from one doctor to another," said Coker.
"Sometimes when maybe a doctor's getting a little too close to figuring out what's going on, we might see a move to another doctor," said Dr. Sanders.
And in the investigation, Coker found doctors who were suspicious about Spears.
"Five weeks into his life, one of the doctors ... documented in the medical records that it was possible ... Munchausen by proxy," he said.
But that suspicion did not get acted upon; nor did other irregularities found during the investigation. Like a medical report that noted Spears said she wanted to harm the child or one that Garnett suffered bleeding from the eyes and ears with no known medical explanation. And that report at 10 weeks old of unexplained high sodium levels.
"Looking back in hindsight the doctors said, 'I wish I had noticed this before,' or' I wish I had put all this together,'" said Coker.
"48 Hours" wanted to speak to additional medical providers who treated Garnett, but our requests were denied, as privacy rules were cited.
"There were so many missed opportunities," Dr. Sanders said. "It appears that somehow, something fell through the cracks."
Calls were made to child service agencies. "48 Hours" obtained redacted reports regarding Spears and concerns about feeding issues, Garnett's weight, and about her changing stories regarding his medical problems. Those cases were all investigated and closed, saying neglect was unsubstantiated.
"It appears that these cases were not investigated at the level that they needed to be," said Dr. Sanders.
"They say this goes back years, how you've tried to hurt your son for years," Roberts noted to Spears.
"So you take your child to the doctor and the hospital, seeking help to figure out what was going on with them ... or you neglect them, so you're damned if you do and you're damned if you don't. So what do they expect you to do? I took care of him. I made sure he had adequate medical history. I did never once harm my son," she said.
But the police and the Westchester, N.Y., district attorney thought she did harm Garnett. Five months after Garnett died, Lacey Spears was charged, and held without bail, for murder in the second degree and first-degree manslaughter.
"We were able to take what she was telling us ... look at the medical records and you know what? ...Everything is explained and matches," said David Sachs.
Sachs and Stephen Riebling are Lacey Spears' attorneys.
"It was clear through her actions and her demeanor ... obviously, she didn't do this and ... from the first second... said, 'I didn't do this,'" said Sachs.
Instead, Spears and her legal team insist Garnett's death is a medical mistake, with Nyack Hospital at fault.
"They changed his diet that caused or exacerbated his stomach problem," Riebling said. "They didn't give him the necessary medication during the day to combat dehydration. Then they exacerbated the dehydration by giving him a rapid infusion ... of ... IV solution."
IVs contain sodium solutions, which the defense believes could have contributed to Garnett's condition and death. That argument was refuted by the prosecution when Lacey Spear's trial began in February of 2015, with her family, traveling from out of state, there to support her.
"The evidence will show and convince you that this defendant took her son into that bathroom and poisoned him with salt in his G-tube. You will see what she does," Westchester County Assistant District Attorney Doreen Lloyd told the court in her opening statement.
The prosecution set out to prove this by playing that video recorded at the hospital. They contend when Lacey took Garnett to the bathroom, she poisoned him with salt on two occasions through his feeding tube - a claim Lacey and her lawyers dismiss.
"There is not one single frame of this video that shows Lacey Spears doing anything to her child, Riebling told Roberts. "In fact, when you watch it, it has just the opposite effect. It's exonerating."
LOVING MOM OR KILLER?
In February of 2015, the prosecution and defense put on their case in Lacey Spears' trial for the murder of her 5-year-old son, Garnett. That video from the hospital, intended to record possible seizures, is crucial.
"The video shows him ... being the healthy kid he could be, if his mother would leave him alone," Westchester County Assistant District Attorney Patricia Murphy told the court.
Spears' lawyers showed "48 Hours" sections of the video, recorded without audio, which they believe portrays a caring mother. Spears, they say, takes Garnett, at his request, to the bathroom, which is out of camera range, 17 times during his stay, and takes part of the feeding tube in only twice, just to clean it.
"All she has to do is load up a syringe and jam it in the tube. It won't take any time at all," Murphy addressed the court.
"Every time she takes her son into that bathroom the door remains open," said Stephen Riebling.
"Every time?" Roberts asked.
"Every time," Riebling replied. "If you're going to do something as the prosecution alleged, that's as devious and is as sophisticated of having to connect a tube to his abdomen, to have to then pour a fluid down this tube to poison him ... You're gonna do it with the door open? So anybody can walk in and interrupt you? It just doesn't make common sense."
But, the prosecution says the video shows that Garnett becomes ill after two of those bathroom visits. First, in the morning, he appears uncomfortable and requires the attention of the nurse. And then, later that same day, about 30 minutes after another bathroom trip, he starts gagging and thrashing.
"No eyewitness ... No forensic evidence ... And no answer to the question why," Riebling told jurors.
The defense, however, questions where the salt or syringe would come from. And if Spears used the cup in her hand, they say she wouldn't be able to pour from it into the extremely small opening in the feeding tube.
What is clear, to both sides, is that Garnett was in distress. He soon stops breathing, and is intubated. And blood work shows his sodium level has soared - without any medical explanation.
"In five hours, it went from 144 to 182. And they all agree. Every doctor who testified agreed that that cannot -- cannot -- happen naturally," Murphy said in court.
Adding to suspicion, Spears had been searching on the internet about high sodium levels.
"More searches, dangers of high sodium -- signs of high sodium," Murphy said in court.
"Garnett was presenting with the exact same symptoms that he presented with when he was 9 to 10 weeks old and we found out he had high sodium," said Spears.
"Lacey, five years later, you're thinking that he's exhibiting the same symptoms of high sodium and you want to do research -- days before the boy enters Nyack Hospital?" Roberts asked.
"I'm his mother. I have to figure out what's going on with him," Spears replied.
"She spends a considerable amount of time not searching for sodium, but searching for other possible reasons, whether it be a vitamin D deficiency, a brain tumor ... All sorts of stuff," Dave Sachs explained.
Another area of contention -- those feeding bags from Spears' apartment that tested for deadly levels of sodium -- bags the police did not recover in their initial search.
"This defendant had two feeding bags loaded with salt in her house. And there is no explanation for that," the prosecutor told jurors.
"The police lost the chain of custody," Riebling explained. "...they only reestablished it after somebody went in and admittedly took it out and had it for more than 24 hours ... that is tampering."
One thing not brought up: Munchausen by proxy.
"The responsible thing to do as attorneys is to have your client submit to mental examination and she did. She was not diagnosed Munchausen by proxy," said Sachs.
It is up to Spears' lawyers, not the prosecution, to raise a psychiatric defense and her attorneys contend this is not about Lacey, but about the hospital not giving Garnett proper medical care. Nyack Hospital denied "48 Hours"' requests to comment on the case.
After approximately three weeks, the trial neared its close.
"Lacey Spears is presumed innocent in the eyes of the law," Riebling told jurors in his closing.
Without the defense calling a single witness, counting on they did all they needed to do -- just raise reasonable doubt.
"You are required to also presume her innocence until they meet their burden," Riebling continued in court.
"I'd ask you to put the pieces together," Murphy said in her closing. "I'm gonna ask you to do justice for a 5-year-old boy who should not be dead."
One month after Lacey Spear's trial began, on the third day after the case went to the jury, a verdict is reached: Guilty of depraved indifference murder of a child.
Spears, her family, and her attorneys were stunned.
"Shocking," Spears told Roberts. "I did not murder my son. I did not hurt my son. And to be told that I was found guilty of murdering my own son, there are no words to describe that."
"Juries make mistakes every day," said Sachs.
"I strongly believe that there was ... insufficient evidence to -- convict her of murder -- depraved indifference murder in this case," said Riebling.
The defense believes the charge of depraved indifference murder was one the jury did not fully understand -- and one that should have never been applied to this case. That is a focus of their appeal.
"Depraved indifference means that you have a complete disregard for the victim in this case?" Roberts asked.
"A complete uncaring or disregard whether or not the victim lives or dies," Riebling replied. "And time after time in this case, it's Lacey Spears and only Lacey Spears who's calling for help for her son."
Her lawyers remain steadfast in their belief Spears could never harm Garnett -- or any child.
"If circumstances were different, would you feel comfortable having Lacey Spears take care of your children?" Roberts asked her attorneys.
"I'd have no reason not to, right?" said Sachs.
"And I would agree with that," said Riebling.
InApril of 2015, Lacey Spears was sentenced. And those words never heard during trial were now spoken by the judge.
"One does not have to be a psychologist to realize you suffer from a mental illness, known as Munchausen by proxy," Judge Robert Neary addressed Spears.
He then delivered his sentence: 20 years to life.
"Do you even realize the magnitude of your crime?" Judge Neary continued. "By not imposing the maximum sentence, I'm combining punishment with something that you really did not exhibit towards your son, namely, mercy."
"I sit here in prison innocent," Spears told Roberts. "I loved my son. ...he was cherished, he was taken care of. ...When I lost Garnett, I lost the part of who I was and I lost my future."
And for friends who knew Garnett, memories are tinged with regrets.
"I feel like if we would have saw the signs, we could have helped Lacey and helped Garnett," Shawna Lynch said. "It hurts my heart. Because ... that poor innocent child didn't deserve this."
And there is the hope that the little boy, who moved so many, is not forgotten.
"He connected with people and he made people feel loved," Valerie Plauche said. "He was this soaring spirit of goodness and that's how we should remember him ... and honor him."
Lacey Spears will be 46 when eligible for parole.
Her attorneys are considering filing a malpractice suit against Garnett's medical providers.