Family members and home health care nurses have been arrested in connection with the death of a 7-year-old Florida boy who weighed just seven pounds at the time of his death last December.

Police and medics were called to a home in Fort Lauderdale on December 25 for a medical emergency involving the boy, identified as Deonte Atwell, WTVJ reported. They rushed the boy to Broward Health Medical Center, where he was pronounced dead.

Prosecutors said it court that it appeared Atwell had been dead “for quite some time.”

Atwell’s mother, 37-year-old Michelle Doe, has been charged with first degree murder, aggravated manslaughter of a child, aggravated child abuse, neglect of a child, and failure to report child abuse.

The child’s 21-year-old brother, Tyreck Irvin, was arrested on similar charges, and the boy’s grandfather, 70-yea-old James Graham, was charged with aggravated manslaughter of a child, neglect of a child, and failure to report child abuse.

The owner of the home health provider, 47-year-old Mirlande Moltimer Ameda, faces charges of third degree murder, aggravated manslaughter of a child, Medicaid fraud, and neglect of a child. The nurse assigned to the case, 33-year-old Cassandre Lassegue, is charged with first degree murder, aggravated manslaughter of a child, third degree murder, aggravated child abuse, and Medicaid fraud.

According to the Broward County State’s Attorney’s Office, Atwell had thoracic spina bifida and hydrocepahlus, requiring breathing and feeding tubes and round-the-clock skilled nursing care — care that he wasn’t getting. Investigators found 264 unopened bottles of the boy’s feeding formula in the home.

“It’s sad that Deonte had to die in this manner,” Fort Lauderdale Police Det. Jacqueline Sanchez told reporters on Wednesday. “It’s sad to say that Deonte had suffered all the way through his death by the people who were supposed to be caring for him the most.”

Sanchez said the nurse had stopped going to the house, but investigators have not yet determined how long it had been since she visited. She continued to file paperwork as if she was visiting.