J.A.L. v. Howard

CourtDistrict Court, E.D. Kentucky
DecidedOctober 4, 2022
Docket5:22-cv-00130
StatusUnknown

This text of J.A.L. v. Howard (J.A.L. v. Howard) is published on Counsel Stack Legal Research, covering District Court, E.D. Kentucky primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
J.A.L. v. Howard, (E.D. Ky. 2022).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF KENTUCKY CENTRAL DIVISION (at Lexington)

J.A.L. and L.L., individually and as parents ) of J.B.L. and C.L., minors, et al., ) ) Plaintiffs, ) Civil Action No. 5: 22-130-DCR ) V. ) ) DR. CHRISTINA HOWARD, et al., ) MEMORANDUM OPINION ) AND ORDER Defendants. ) *** *** *** *** This action, originally instituted in Fayette Family Court relates to dependency, neglect, and abuse proceedings concerning the minors J.B.L. and C.L. Having won that case, L.L. and J.A.L., the children’s mother and father, and B.P., the children’s maternal grandmother, filed this action against the parties they consider responsible for their ordeal: Dr. Christina Howard and Kamika Joyner. I. Background J.B.L. was born on April 3, 2020, with a head circumference in the 88th percentile for newborns. [Record No. 6, ⁋⁋ 22-23] His head continued to grow quickly and, by August 2020, J.B.L.’s head circumference was in the 99.8th percentile. [Id. at ⁋ 23] On August 10 and August 11, 2020, the child began to exhibit concerning symptoms, including vomiting, fever, “not acting like himself,” and a twitching right leg. [Id. at ⁋ 29] His mother, L.L., contacted the family’s pediatrician, Dr. Shawn Taylor, who directed her to take J.B.L. to the University of Kentucky Emergency Department. L.L. complied with this direction. [Id. at ⁋⁋ 30] An August 12, 2020, MRI revealed that the child had experienced a subdural hematoma, and an ophthalmological consult on the same day showed bilateral bleeding. [Id. at ⁋ 31] The University of Kentucky Medical Center referred J.B.L.’s injury to its Division of

Pediatric Forensic Medicine for a non-accidental trauma work-up pursuant to its policy for infants under the age of twelve months who experience head trauma. [Id. at ⁋ 32] The Division of Pediatric Forensic Medicine receives grant funding from the Kentucky Department of Health, Kosair Charities, and the Victims of Crime Act, of which “approximately $150,000.00 [is] paid annually to Dr. Howard.” [Id. at ⁋⁋ 18-19] The plaintiffs allege that Howard has “a financial and personal self-interest . . . in applying a standard that results in the reporting of an increased number of substantiated child abuse cases” so that she

can secure additional grant funding for the Division. [Id. at ⁋⁋ 20-21] Howard and Stephanie Smith performed the work-up for J.B.L. with the help of a licensed clinical social worker. [Id. at ⁋ 33] The social worker interviewed L.L. and J.A.L., J.B.L.’s father, on August 12. Both parents “denied a history of threats, violence, prior arrests, legal issues, and harm to or mistreatment of children.” [Id. at ⁋ 36] And the social worker found that the parents were “appropriate and cooperative throughout the interview.”1 [Id.]

Howard herself did not meet with the parents and did not personally examine J.B.L. or his sister, C.L. [Id. at ⁋⁋ 37-38] The work-up documented the following evidence that the plaintiffs characterize as “overwhelmingly inconsistent with abuse”: (a) “nine (9) color photographs of J.B.L., none of

1 This social worker goes unnamed in the plaintiffs’ Amended Complaint, and the pleading does not particularly suggest that it was Joyner. which showed any signs consistent with abuse”; (b) a Pediatric Trauma Survey performed on August 12, 2020, showing “no acute or healing or healed fracture of complete skeletal survey”; (c) an August 12, 2020, MRI showing “[m]ildly to moderately enlarged lateral and third

ventricles and enlarged subarachnoid spaces in the temporal and frontal regions despite the presences of bilateral subdural collections,” which “could be seen in the presence of underlying communicating hydrocephalus, and there could also be a component of benign enlarged subarachnoid spaces of infancy (BESS)”; and (d) bleeding labs (Factor 8, Factor 9, Von Willebrand antigen and Von Willebrand Ristocetin CoFactor) “within normal limits.” [Id. at ⁋ 39] BESS “is a relatively rare neurological disorder, which can produce bleeding in the

brain (or . . . subdural hematoma) spontaneously or during ordinary care of [an] infant” and “can also produce residual retinal bleeding” with the associated subdural hematomas. [Id. at ⁋ 25] BESS is a hereditary condition, and the plaintiffs indicate that the child’s father and sister both had “larger-than-typical heads during infancy.” [Id. at ⁋ 27-28] Following the work-up, the parents sought a second opinion from the Cincinnati Children’s Hospital, which conducted an MRI. [Id. at ⁋ 40] “A review of the MRI report . . .

also noted that the MRI findings could be ‘correlated with head circumference,’ an indicator of BESS and a benign explanation inconsistent with physical abuse by the parents.” [Id.] Howard determined that she “could not rule out abuse” for J.B.L.’s injury, notwithstanding the potential for a BESS diagnosis. [Id. at ⁋ 41] The plaintiffs state that: [b]etween August 12, 2020 and June 15, 2021, Defendant Howard was presented with no less than 5 other medical expert opinions, all of which refuted her claim, and all of which she ignored. These experts included a board-certified child abuse pediatrician (CAP), an ophthalmologist, a board-certified pediatrician and child neurologist, J.B.L. and C.L.’s pediatrician, as well as a licensed clinical psychologist who compiled extensive reports on both J.A.L. (father) and L.L. (mother).

[Id. at ⁋ 42] Joyner is a social service worker and employee of the Department for Community Based Services (“DCBS”), a division of the Kentucky Cabinet for Health and Family Services. [Id. at ⁋ 17; Record No. 10-1] She and the children’s parents signed an August 14, 2020, safety plan, which has been produced by Joyner. [Record No. 10-1] The safety plan provided that the paternal grandparents would care for the children, subject to visits supervised by DCBS personnel. [See id.] The safety plan states “[t]he undersigned understand that this document is not a court order. It is a voluntary agreement between the signed parties.” [Id.] It further indicates that the agreement “may be revoked at any time.” [Id.] The plaintiffs allege that Joyner coerced them into signing the safety plan, threatening them “with the prospect that J.B.L. and C.L. might become wards of the state in a foster care home in the event that the Parents and Maternal Grandmother did not agree to the placement . . . .” [Record No. 6, ⁋ 53] Joyner initiated the removal proceedings (Case Numbers 20-J-674-001 and 20-J-675- 001) on August 19, 2020, seeking court intervention to remove both J.B.L. and C.L. from the custody of J.A.L., L.L., and B.P., the maternal grandmother who had some contact with J.B.L., during the period in question. [Id. at ⁋⁋ 36, 40, Record No. 10-2, pp. 1-2] Joyner’s petitions initiating these actions alleged that the University of Kentucky had informed her that J.B.L.’s injuries were “the result of abusive head trauma,” C.L. was “at risk” due to the “uncertain circumstances and severity” of her brother’s injury, and both J.B.L. and C.L. were neglected children. [Record Nos. 6, ⁋ 44, and 4-2, pp. 4, 8] The petitions sought to place the children in the temporary custody of their paternal grandparents while the removal proceedings were

ongoing, with the parents having only supervised contact. [Record No. 4-2, pp. 4, 8] Howard participated in the removal proceedings, issuing a forensic medicine consult report on January 13, 2021, that “included no discussion of the basis for [her] decision to disregard BESS as a possible explanation for the subdural hematoma J.B.L. had suffered.” [Record No. 6, ⁋ 69] The doctor was deposed on March 3, 2021, testifying that this was “likely a case of abusive head trauma” because “[t]here was no history of trauma provided to our team . . . no sign of metabolic disease, no sign of a bleeding disorder or anything like that.” [Id. at

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