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(CNN) —  

A Florida judge ruled Monday that the parents of a 4-year-old boy with leukemia lost their bid Monday to regain custody after their struggle with the state over giving him chemotherapy.

Noah McAdams was removed from his parents’ custody in April when they skipped a chemotherapy session and left the state in pursuit of alternative treatments.

Bland and McAdams’ fight for natural cancer treatment for Noah garnered national attention after a multistate police search ensued after they skipped the chemotherapy appointment and took Noah for a consultation in Cincinnati with an alternative medicine practitioner.

In court Monday, Palermo ordered Noah to remain a dependent of the state, ruling that he will stay in the care of his maternal grandmother, according to Brooke Elvington, an attorney for Bland and McAdams.

Noah’s parents will still be allowed to visit and attend medical appointments under supervision, the attorney said.

Bland and McAdams were “obviously devastated” by the judge’s decision, she said.

“Noah is going through an absolutely traumatic medical experience, and he is doing so without his parents,” Elvington told CNN.

In video from court shot by CNN affiliate WFTS, Judge Palermo referenced previous testimony in which Bland acknowledged she removed an intravenous catheter from her son’s arm without medical permission.

Elvington said the judge referenced a domestic violence incident involving McAdams from 2016, in which court records show McAdams threw a plastic bucket at Bland and hit Noah in the face, causing a minor cut. The charges were later dropped after a pre-trial diversion program, court records show.

Judge Palermo also cited familial testimony calling McAdams’ mental health into question, the lawyer said. Elvington called the domestic violence incident isolated and the familial testimony unfounded.

A lengthy custody battle

Noah, who was diagnosed with acute lymphoblastic leukemia in April, has been in state custody since police removed him from his parents’ custody in Kentucky.

A dependency court judge then ordered Noah to complete the prescribed chemotherapy treatment against his parents’ wishes.

About 98% of children with acute lymphoblastic leukemia “go into remission within weeks of starting treatment,” according to St. Jude Children’s Research Hospital.

Noah’s parents had asked the court to allow them to forgo chemotherapy in favor of alternative treatments, including medicinal cannabis, vitamins and a dietary plan. They had previously informed doctors that they wanted to seek a second opinion and pursue alternatives, Bland told CNN.

Now, in conjunction with the court-ordered chemotherapy protocol, Noah has been receiving THC and CBD oil for about a month, according to the family’s attorney. The family was unhappy with the treatment Noah received at Johns Hopkins All Children’s Hospital in Tampa, and they are still pursuing oncology options at other hospitals, Elvington told CNN.

Now in conjunction with the court-ordered chemotherapy protocol, Noah has been receiving THC and CBD oil for about a month, according to the family’s attorney. The family was unhappy with the treatment Noah received at Johns Hopkins All Children’s Hospital in Tampa, and they are still pursuing oncology options at other hospitals, Elvington told CNN.

The hospital earlier declined to comment on the case, citing laws protecting patient privacy. The Florida Attorney General’s Office did not respond to a request for comment.

The Florida Attorney General’s Office did not respond for comment.

The judge ruled that Bland and McAdams undergo psychological evaluations as a part of the process to potentially regain custody, Elvington said. They have 30 days to appeal the judge’s decision. A disposition hearing to discuss the Child Protective Services case plan for family reunification is scheduled for October 1, the lawyer said.