Iowa will pay $10 million to the siblings of an adopted 16-year-old girl who weighed just 56 pounds (25 kilograms) when she died of starvation in 2017, according to a state board that approved the settlement Monday.

Sabrina Ray was severely malnourished when authorities found her body at her home in Perry, about 40 miles (64 kilometers) northwest of Des Moines. She lived with three other adoptive siblings as well as foster siblings. Her adoptive parents, Misty Jo Bousman Ray and Marc Ray, were convicted of kidnapping and child endangerment in her death and received lengthy prison sentences.

Two of Sabrina Ray’s siblings, former foster care children who were also adopted by the Rays, sued the state, claiming authorities failed to protect them from severe physical abuse, torture and neglect. The siblings — identified only by initials in their lawsuit — had pushed for $50 million each but settled for $5 million apiece after mediation.

“In short, the amount of abuse committed by the Rays is indefensible, and the foster-care system’s failures to protect the children were significant,” Iowa Deputy Attorney General Stan Thompson wrote in an Oct. 31 letter encouraging the State Appeals Board to approve the settlements. “The prolonged exposure to such an environment caused significant physical and emotional damage to these children.”

The board is responsible for approving claims against state entities and state workers.

A state watchdog found in 2020 that Sabrina Ray’s life could have been saved if state social workers and contractors had been more thorough when they investigated the girl’s living conditions.

The report by the Iowa state ombudsman found that the state Department of Human Services received 11 child abuse reports against the adoptive parents between 2010 and 2015. Some of the allegations included comments that Ray looked extremely thin and unhealthy.

Other reports accused the Rays of forcing their foster children to drink soapy water, stand over cold vents and eat their own vomit. They also alleged that the Rays beat and belittled the children.

Authorities found locks, alarms and coverings on the doors and windows in the bedroom where Sabrina Ray died, according to the report. Police said she slept on a thin mattress on the floor and apparently used a toilet in the room intended for toddlers.

According to the report, a department inspector failed to check the room just months before Ray’s death because she misunderstood a policy requiring a complete examination of the house. Other Department of Human Services workers noted in their assessments that Ray appeared thin but said they didn’t have the training necessary to recognize malnutrition.

Part of the settlement approved Monday requires the department to create a task force to ensure that recommendations from the ombudsman’s report are implemented and to make additional suggestions to help improve Iowa’s foster care system.