Attorneys for a Butler County couple accused of manipulating the medical community so their children received unnecessary and life-threatening treatments rested their defense yesterday.

At 15 full court days, the case was as complicated and heated as it was long, featuring complex testimony from more than a half-dozen medical experts and outbursts of name-calling and insults among attorneys. At one point, a defense lawyer was arrested and fined for yelling at the judge.

The case against Mannie and Ron Taimuty-Loomis boiled down to testimony that two of the couple's three children -- Ezra, 7, and Symia, 2 -- were transformed by foster care from fatigued children reliant on feeding tubes and intravenous painkillers into energetic youngsters who eat on their own and are medication-free.

Juvenile Court master Joe Brydon said he would rule by Monday whether the children should remain in foster care or be returned to their parents.

Children and Youth Services Solicitor Dan Houlihan's case included more than a dozen witnesses over 11 days of testimony. His theory: The mother suffers from Munchausen syndrome by proxy, a psychiatric disorder in which a parent, usually the mother, induces or feigns medical problems for her children to get attention.

The parents insist they have never abused their children and, in fact, have been abused themselves by a medical community unable to agree on a diagnosis or treatment for their children, who they say have had feeding and fatigue problems virtually since birth.

The couple believe son Ezra has mitochondrial disease and that his youngest sibling, Symia, also may have the disease, which causes energy-manufacturing mitochondria to malfunction, in turn shutting down body systems. Feeding problems and lethargy are common symptoms.

Five-year-old Adia, who was taken from her home along with her siblings last fall, appears to be healthy. A fourth child, Jonah, died in January 2001 just shy of his third birthday. The death certificate reads that his cause of death was "most likely" mitochondrial disease, which often runs in families.

The defense case featured three days of testimony and keyed on two medical experts, a nationally known psychologist who specializes in medical deception and an internationally renowned neurologist with expertise in genetic disorders including mitochondrial disease.

Dr. Loren Pankratz, a medical psychologist with Oregon Health Sciences University in Portland, testified Monday that he flew to Pittsburgh at his own expense and gave up his usual $15,000 witness fee because he feels certain the parents have been falsely accused.

He said the CYS position that separation from their parents caused the children's health to improve is faulty because other things, like a change in medical treatment, can cause such changes. The children were removed from feeding tubes and drugs when they went into foster care.

Dr. Salvatore DiMauro, director of the clinical research center at Columbia University Medical Center in New York City, testified Tuesday that "it is quite clear" from laboratory tests that Ezra has mitochondrial disease.

He undercut testimony from pediatric neurologist Bruce Cohen of the Cleveland Clinic who testified for CYS that the child does not have mitochondrial disease. DiMauro pointed out that Cleveland's initial lab test matched his findings and that only a second test at Cleveland concluded differently. He contended Cleveland's first test was accurate, as was his.

DiMauro also testified that it would not be unusual for someone with mitochondrial disease to experience relief from symptoms for varying durations.

In closing arguments yesterday, Ron Taimuty-Loomis' defense attorney, Jennifer Gilliland-Vanasdale, told the court that "clear and convincing evidence [of abuse] has not been presented."

Mannie Taimuty-Loomis' attorney, Mildred Sweeney, argued that "these parents and their children have suffered enough at the hands of medical professionals and Children and Youth Services. Reunite this family."

Houlihan noted the children's medical improvement that began as soon as they were taken from their parents. "Can they be returned to their parents? I don't know. Can the mom be trusted? I don't know. Can the dad be trusted? I don't know. And those 'I don't knows' scare me to death."