DES MOINES, Iowa (AP) — Four members of a rural Iowa family have pleaded not guilty in the abduction and abuse of an 18-year-old relative who had allegedly showed up at a hospital so badly beaten that his brain was bleeding and so malnourished that he weighed just 70 pounds (32 kilograms), according to court documents.

Gary Graham Jr., 44; Danielle Graham, 42; Aaron Williams, 20; and a 16-year-old girl, all from Zearing, Iowa, were charged with first-degree kidnapping and willful injury last month. Each have submitted a written plea, the last of which — for Gary Graham Jr. — was filed Monday.

The teen girl is charged as an adult, but The Associated Press is not naming her because of her age. Her attorney filed a request that her case be transferred to juvenile court, court records show. She is being held at a juvenile detention center; the other three are in a county jail.

A hospital in Ames alerted the sheriff’s office on Jan. 27 of an 18-year-old patient who was severely malnourished with multiple injuries that included bleeding on the brain, rib fractures and bruising and wounds throughout his body. An affidavit filed in the case said the teen arrived at the hospital in a “semi-conscious to unconscious state.”

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Medical workers determined that the injuries were in various stages of healing, indicating that they didn’t all happen at the same time, the document stated.

The charges allege that the family members knowingly confined the victim and “while doing so had the intent to inflict serious injury” to the victim, who “suffered serious injury or ... was intentionally subjected to torture” as a result.

A judge issued an order to grant emergency protective services for the alleged victim and to prevent the four family members from having contact.