Opinion
FROEHLICH, J.
Troy D. was declared a dependent child of the juvenile court under former section 300(a)1 of the Welfare and Institutions Code2 on [895]*895the basis of a petition which alleged that he was bom under the influence of morphine, methamphetamine and amphetamine, and that his parents were unable to protect him. He was placed in his paternal grandmother’s custody. Troy’s mother, Kelly D. (Mother) appeals.
Factual and Procedural Background
Troy was born prematurely on February 10, 1988. Tests taken on Troy and Mother at the time of Troy’s birth were positive for amphetamines and opiates.3 On February 16, 1988, a petition was filed alleging that Troy came within the provisions of section 300(a) in that his “mother used narcotics and dangerous drugs, to wit, codeine and methamphetamine, to excess to the detriment of said minor, and the father was unable to protect said minor.”
At a detention hearing on February 17, the court detained Troy from residing in his parents’ home. At a readiness hearing on March 16, the court changed Troy’s placement to his parents’ home and conditioned this placement on his parents continuing to be tested for drugs and attending parenting classes.
On March 25 an amended petition was filed alleging that Troy came within the provisions of section 300(a) in that he “was diagnosed as being born under the influence of a narcotic and/or dangerous drugs, to wit, morphine, methamphetamine and amphetamine, and the parents were unable to protect said minor, and the minor is in need of the protection of the Juvenile Court.”
At an April 19 hearing Mother’s demurrer to the amended petition was overruled. At a hearing on April 21 the court changed Troy’s placement, ordering him detained with his grandmother.
On May 18 the court found the amended petition true, and on June 14 took custody from the parents under section 361(b) and Civil Code section 4600, placing Troy with his grandmother, who was residing at his parents’ home. The court ordered that “any unsupervised time between the parents and minor may occur only with the agreement of the social worker.” It further ordered that the parents submit to psychological evaluation and [896]*896participate in parenting classes and drug rehabilitation, including drug testing.
Contentions
Mother appeals, contending her demurrer to the petition alleging that Troy was born under the influence of dangerous drugs should have been sustained. She also asserts that the court should have sustained her objections to the introduction into evidence of her and her son’s medical records because such introduction was a violation of the Confidentiality of Medical Information Act and of the physician-patient privilege. She further asserts the medical records are hearsay. In addition, she maintains that insufficient evidence was introduced to justify sustaining the allegations of the amended petition. We shall affirm.
Discussion
A
Mother first contends her demurrer to the amended petition should have been sustained. She argues that even if there were sufficient admissible evidence to sustain the allegation that Troy was born under the influence of dangerous drugs, such fact would be an insufficient legal showing for the juvenile court to exercise jurisdiction.
Although we have found no statute specifically authorizing a demurrer in the context of a dependency proceeding, due process requires that the parents be given constitutionally adequate notice of allegations which may result in the court asserting jurisdiction. As one court has observed, since there must be a means of testing the adequacy of notice in the petition’s allegations, “the juvenile court has inherent power to entertain a prehearing challenge to the petition’s sufficiency by a motion akin to a demurrer. The parties should have an opportunity to test the sufficiency in the trial court, rather than reserving that question for the Court of Appeal.” (In re Fred J. (1979) 89 Cal.App.3d 168, 176 [152 Cal.Rptr. 327].)4
An order overruling a demurrer is not an appealable order, (see 9 Witkin, Cal. Procedure (3d ed. 1985) Appeal, § 82, pp. 104-105; Harmon v. De Turk (1917) 176 Cal. 758, 761 [169 P. 680]), but may be reviewed on an [897]*897appeal from the judgment itself. (Adams v. Christopher (1931) 112 Cal.App. 37, 39 [296 P. 85].) In reviewing the court’s ruling on Mother’s prehearing challenge to the petition’s sufficiency, we hold her challenge to the amended petition was correctly overruled.5
The fact that Troy was diagnosed as being born under the influence of a dangerous drug is legally sufficient for the juvenile court to exercise jurisdiction. Section 355.1(a) provides: “Where the court finds, based upon competent professional evidence, that an injury, injuries, or detrimental condition sustained by a minor of such a nature as would ordinarily not be sustained except as the result of the unreasonable or neglectful acts or omissions of either parent, the guardian, or other person who has the care or custody of the minor, that evidence shall be prima facie evidence that the minor is a person described by subdivision (a), (b), or (d) of Section 300.”
Troy was born with a detrimental condition caused by Mother’s unreasonable acts of ingesting dangerous drugs while pregnant with him. This fact created a legal presumption that he is a person described by section 300(a). Mother has not presented sufficient evidence to rebut this presumption.
Mother argues that it is improper to sustain jurisdiction on the basis of the petition because it involves conduct with respect to a fetus, not with respect to a child. We disagree with this argument.
Although, as Mother points out, a dependency petition cannot be sustained with respect to a fetus (In re Steven S. (1981) 126 Cal.App. 3d 23 [178 [898]*898Cal.Rptr. 525]), Troy is not a fetus but a living child bom with dangerous drugs in his body because his mother used the drugs while pregnant with him. The petition was concerned with the protection of a living child, not with a fetus as in the case of Steven S.
The severe problem of babies born under the influence of dangerous drugs due to their mothers’ use of such drugs during pregnancy has reached great proportions. It has been estimated that 11 percent of children born in United States hospitals are born having been exposed to dangerous drugs and are consequently at risk. (See Cal. Sen. Office of Research, Drug-Exposed Infants—Summary of Related Legislation (Oct. 19, 1989) p. I.)6 To enable juvenile courts to protect drug-exposed infants and to compel parents to undergo drug rehabilitation therapy and to afford child protection services to the family, courts must be able to assert jurisdiction over infants born at risk because of prenatal exposure to dangerous drugs.
A fetus is accorded variable legal treatment due to social policies underlying different areas of the law. For example, an unborn fetus is not consid[899]*899ered to be a child within California’s felony child abuse statute, Penal Code section 273a. (Reyes v. Superior Court (1977) 75 Cal.App.3d 214, 219 [141 Cal.Rptr.
Free access — add to your briefcase to read the full text and ask questions with AI
Opinion
FROEHLICH, J.
Troy D. was declared a dependent child of the juvenile court under former section 300(a)1 of the Welfare and Institutions Code2 on [895]*895the basis of a petition which alleged that he was bom under the influence of morphine, methamphetamine and amphetamine, and that his parents were unable to protect him. He was placed in his paternal grandmother’s custody. Troy’s mother, Kelly D. (Mother) appeals.
Factual and Procedural Background
Troy was born prematurely on February 10, 1988. Tests taken on Troy and Mother at the time of Troy’s birth were positive for amphetamines and opiates.3 On February 16, 1988, a petition was filed alleging that Troy came within the provisions of section 300(a) in that his “mother used narcotics and dangerous drugs, to wit, codeine and methamphetamine, to excess to the detriment of said minor, and the father was unable to protect said minor.”
At a detention hearing on February 17, the court detained Troy from residing in his parents’ home. At a readiness hearing on March 16, the court changed Troy’s placement to his parents’ home and conditioned this placement on his parents continuing to be tested for drugs and attending parenting classes.
On March 25 an amended petition was filed alleging that Troy came within the provisions of section 300(a) in that he “was diagnosed as being born under the influence of a narcotic and/or dangerous drugs, to wit, morphine, methamphetamine and amphetamine, and the parents were unable to protect said minor, and the minor is in need of the protection of the Juvenile Court.”
At an April 19 hearing Mother’s demurrer to the amended petition was overruled. At a hearing on April 21 the court changed Troy’s placement, ordering him detained with his grandmother.
On May 18 the court found the amended petition true, and on June 14 took custody from the parents under section 361(b) and Civil Code section 4600, placing Troy with his grandmother, who was residing at his parents’ home. The court ordered that “any unsupervised time between the parents and minor may occur only with the agreement of the social worker.” It further ordered that the parents submit to psychological evaluation and [896]*896participate in parenting classes and drug rehabilitation, including drug testing.
Contentions
Mother appeals, contending her demurrer to the petition alleging that Troy was born under the influence of dangerous drugs should have been sustained. She also asserts that the court should have sustained her objections to the introduction into evidence of her and her son’s medical records because such introduction was a violation of the Confidentiality of Medical Information Act and of the physician-patient privilege. She further asserts the medical records are hearsay. In addition, she maintains that insufficient evidence was introduced to justify sustaining the allegations of the amended petition. We shall affirm.
Discussion
A
Mother first contends her demurrer to the amended petition should have been sustained. She argues that even if there were sufficient admissible evidence to sustain the allegation that Troy was born under the influence of dangerous drugs, such fact would be an insufficient legal showing for the juvenile court to exercise jurisdiction.
Although we have found no statute specifically authorizing a demurrer in the context of a dependency proceeding, due process requires that the parents be given constitutionally adequate notice of allegations which may result in the court asserting jurisdiction. As one court has observed, since there must be a means of testing the adequacy of notice in the petition’s allegations, “the juvenile court has inherent power to entertain a prehearing challenge to the petition’s sufficiency by a motion akin to a demurrer. The parties should have an opportunity to test the sufficiency in the trial court, rather than reserving that question for the Court of Appeal.” (In re Fred J. (1979) 89 Cal.App.3d 168, 176 [152 Cal.Rptr. 327].)4
An order overruling a demurrer is not an appealable order, (see 9 Witkin, Cal. Procedure (3d ed. 1985) Appeal, § 82, pp. 104-105; Harmon v. De Turk (1917) 176 Cal. 758, 761 [169 P. 680]), but may be reviewed on an [897]*897appeal from the judgment itself. (Adams v. Christopher (1931) 112 Cal.App. 37, 39 [296 P. 85].) In reviewing the court’s ruling on Mother’s prehearing challenge to the petition’s sufficiency, we hold her challenge to the amended petition was correctly overruled.5
The fact that Troy was diagnosed as being born under the influence of a dangerous drug is legally sufficient for the juvenile court to exercise jurisdiction. Section 355.1(a) provides: “Where the court finds, based upon competent professional evidence, that an injury, injuries, or detrimental condition sustained by a minor of such a nature as would ordinarily not be sustained except as the result of the unreasonable or neglectful acts or omissions of either parent, the guardian, or other person who has the care or custody of the minor, that evidence shall be prima facie evidence that the minor is a person described by subdivision (a), (b), or (d) of Section 300.”
Troy was born with a detrimental condition caused by Mother’s unreasonable acts of ingesting dangerous drugs while pregnant with him. This fact created a legal presumption that he is a person described by section 300(a). Mother has not presented sufficient evidence to rebut this presumption.
Mother argues that it is improper to sustain jurisdiction on the basis of the petition because it involves conduct with respect to a fetus, not with respect to a child. We disagree with this argument.
Although, as Mother points out, a dependency petition cannot be sustained with respect to a fetus (In re Steven S. (1981) 126 Cal.App. 3d 23 [178 [898]*898Cal.Rptr. 525]), Troy is not a fetus but a living child bom with dangerous drugs in his body because his mother used the drugs while pregnant with him. The petition was concerned with the protection of a living child, not with a fetus as in the case of Steven S.
The severe problem of babies born under the influence of dangerous drugs due to their mothers’ use of such drugs during pregnancy has reached great proportions. It has been estimated that 11 percent of children born in United States hospitals are born having been exposed to dangerous drugs and are consequently at risk. (See Cal. Sen. Office of Research, Drug-Exposed Infants—Summary of Related Legislation (Oct. 19, 1989) p. I.)6 To enable juvenile courts to protect drug-exposed infants and to compel parents to undergo drug rehabilitation therapy and to afford child protection services to the family, courts must be able to assert jurisdiction over infants born at risk because of prenatal exposure to dangerous drugs.
A fetus is accorded variable legal treatment due to social policies underlying different areas of the law. For example, an unborn fetus is not consid[899]*899ered to be a child within California’s felony child abuse statute, Penal Code section 273a. (Reyes v. Superior Court (1977) 75 Cal.App.3d 214, 219 [141 Cal.Rptr. 912].) As stated above, according to California law, a dependency petition cannot be sustained with respect to a fetus. (In re Steven S., supra, 126 Cal.App.3d 23.) A stillborn fetus is not considered a person within the wrongful death statute in California (Justus v. Atchison (1977) 19 Cal.3d 564, 579 [141 Cal.Rptr. 912]), although the majority of states follow the contrary rule. (Nelson, Buggy & Weil, Forced Medical Treatment of Pregnant Women: ‘Compelling Each to Live as Seems Good to the Rest’ (1986) 37 Hastings LJ. 703, 737.) Although the fetus does not enjoy the same legal status as a child in every context, a living child must be afforded the protection of the juvenile court even though he is at risk because of his mother’s actions before his birth.
Since no California court has specifically answered the question of whether dependency jurisdiction may be assumed solely on the basis of an allegation that an infant is bom under the influence of dangerous drugs,7 we looked to other states for guidance. In so doing, we found only one case which dealt squarely with the issue. In Matter of Baby X (Mich.App. 1980) 293 N.W.2d 736, a Michigan appellate court held that a court may assert jurisdiction over a baby born with drug withdrawal symptoms caused by his mother’s prenatal drug addiction. (Id. at p. 739.) The Baby X court rejected the mother’s assertion that prenatal conduct cannot constitute neglect or abuse, reasoning that “[s]ince prior treatment of one child can support neglect allegations regarding another child, . . . prenatal treatment can be considered probative of a child’s neglect as well.” (Ibid.) The court went on to state, however, that it made no determination whether prenatal drug use by the mother would alone be enough permanently to deprive a parent of custody. (Ibid.)
We agree that prenatal use of dangerous drugs by a mother is probative of future child neglect. As the trial court said in overruling the demurrer, “the care of a minor to me includes anticipatory actions,” and “[the [900]*900petition] indicates that the mother conducted herself in a manner that was dangerous to the child prior to the child’s birth but with full knowledge the child would be bom.” Mother’s prenatal drug use indicated that Troy was at risk and in need of the court’s protection.
While jurisdiction must be asserted on the basis of conditions which exist at the time of the jurisdictional hearing, the court is not required to disregard the mother’s prior conduct. (In re Robert P. (1976) 61 Cal.App.3d 310, 316-317 [132 Cal.Rptr. 5].) “[P]ast events can aid in a determination of present unfitness.” (In re Melissa H. (1974) 38 Cal.App.3d 173, 175 [113 Cal.Rptr. 139].) Although we recognize that the cases just cited deal with prior conduct with a living child, rather than a fetus, we believe the same reasoning is applicable. Mother’s conduct prior to Troy’s birth was sufficient to establish the court’s jurisdiction.
The trial court correctly overruled Mother’s demurrer.
B
Mother next asserts that the trial court should have sustained her objections to placing her and Troy’s medical records into evidence. She argues disclosure of medical records is a violation of the Confidentiality of Medical Information Act (Civ. Code, § 56 et seq.) and a violation of the physician-patient privilege. She also claims the medical records are hearsay.
Preliminarily, we observe that we are concerned about applying a physician-patient privilege to Mother regarding Troy’s medical records. Under ordinary circumstances, it would be reasonable for a parent to be able to assert the privilege on behalf of his child. Evidence Code section 993, subdivisions (a) and (b) provide that the holder of the physician-patient privilege is “(a) [t]he patient when he has no guardian or conservator” or “(b) [a] guardian or conservator of the patient when the patient has a guardian or conservator.” But we question the appropriateness of Mother asserting a privilege to prevent the disclosure of Troy’s medical records during his dependency hearing when his and her interests are potentially conflicting. The physician-patient privilege is entirely statutory, and its purpose is to encourage the patient to be free in disclosing facts about his illness to enable the physician to treat the illness or maintain the patient’s general health. (See 2 Witkin, Cal. Evidence (3d ed. 1986) Witnesses, §§ 1188-1189, pp. 1131-1132.) “The rules of privilege are designed to protect personal relationships and other interests where public policy deems them more important than the need for evidence.” (Koshman v. Superior Court (1980) 111 Cal.App.3d 294, 297 [168 Cal.Rptr. 558].) We see no legitimate public policy being served by allowing [901]*901Mother to prevent disclosure of Troy’s medical records. Troy was represented by counsel at the jurisdictional hearing, and his attorney made no objection to admitting his medical records.8
Even assuming that Mother held a privilege to prevent the disclosure of Troy’s medical records, the trial court correctly overruled her objections.
Mother’s acts of ingesting dangerous drugs while pregnant resulted in injury to Troy, evidenced by the fact that he was born under the influence of dangerous drugs. Pursuant to Penal Code section 11166, if the hospital social worker concluded that Troy’s positive toxicology test results raised a reasonable suspicion of child abuse, the hospital was required to report that fact to a child protective agency.9 Civil Code section 56.10, subdivision (b)(7) states: “A provider of health care shall disclose medical information if the disclosure is . . . [fl] otherwise specifically required by law.” Penal Code section 11171, subdivision (b) states: “Neither the physician-patient privilege nor the psychotherapist-patient privilege applies to information reported pursuant to this article in any court proceeding or administrative hearing.” When a hospital social worker makes a risk assessment of a newborn’s situation and concludes there is a reasonable suspicion of child abuse, under Penal Code section 11166, the social worker must report to a child protective agency. Here, the social worker made the discretionary decision that child abuse existed.10 Accordingly, there was no violation of the act or the physician-patient privilege based on the reporting mandate in Penal Code section 11166, subdivision (a).
[902]*902Mother’s reliance on Koshman v. Superior Court, supra, 111 Cal.App.3d 294 is misplaced. In Koshman the parents were involved in a dispute over the custody of their children, and, unlike the situation here, the mother’s physician-patient privilege was not subject to any statutory exception. (Id. at p.298.)11
Mother argues the reporting requirement under Penal Code section 11166, subdivision (a) does not apply because her act of ingesting drugs prior to Troy’s birth does not constitute child abuse. (See Reyes v. Superior Court, supra, 75 Cal.App.3d 214 (an unborn fetus is not a child within California’s felony child abuse statute, Pen. Code, § 273a].) Here, however, the case does not involve an unborn fetus, but a child born under the influence of a dangerous drug. Although Mother’s actions took place before Troy was born, her prenatal drug use caused injury to a living child. Thus, the requirements of Penal Code section 11166, subdivision (a) apply once a hospital social worker makes a discretionary decision of suspected child abuse. Since the case involves a newborn child, there is no issue of so-called “fetal child abuse.”12
Mother also maintains that her hearsay objections to the introduction of medical records should have been sustained. She claims proponents of the medical records evidence failed to lay an adequate foundation for admission of the medical records within the business records exception to the hearsay rule. This contention also is unmeritorious.
The trial court holds wide discretion to determine whether evidence is admissible, and such a determination will not be disturbed unless there is a clear showing that the court has abused its discretion. (County of Sonoma v. Grant W. (1986) 187 Cal.App.3d 1439, 1448 [232 Cal.Rptr. 471].) Determining whether a proper foundation has been laid for the admission of business records under Evidence Code section 1271 is within the trial court’s discretion and “will not be disturbed on appeal absent a showing of abuse.” (Id. at p. 1450.)
The medical records were admissible under the business records exception to the hearsay rule. (Evid. Code, § 1271.) When presenting the medical records for admission into evidence the department of social [903]*903services complied with the procedure required for a subpoena duces tecum (Evid. Code, §§ 1560-1566), which allows for the admission of business records if accompanied by an authenticating affidavit. The medical records were delivered under seal to the court as required by Evidence Code section 1560,13 and accompanied by an affidavit as required by Evidence Code section 1561.14 Because the department of social services complied with these requirements, the medical records were admissible “to the same extent as though the original[s] thereof were offered and the custodian had been present and testified to the matters stated in the affidavit.” (Evid. Code, § 1562.)15 The hospital records were properly admitted.16
C
Mother finally contends that insufficient evidence was introduced to justify sustaining the amended petition. She claims the medical records [904]*904and accompanying expert medical testimony were insufficient individually and together to establish the jurisdictional allegations. We disagree.
A reviewing court must uphold a juvenile court’s findings during a section 300 dependency hearing if they are supported by substantial evidence. (§ 355; In re Amos L., supra, 124 Cal.App.3d 1031, 1036.) Here, substantial evidence was presented to support the allegations that Troy was born under the influence of narcotics and/or dangerous drugs and that his parents were unable to protect him. On the day of Troy’s birth, a positive toxicology screen showed the presence of amphetamines and opiates in his urine. At the hearing, pediatrician Dr. Suzanne Dixon testified at great length about the harmful effects and potential long-term consequences of prenatal exposure to dangerous drugs. The parents earlier had lost custody of an older child after police found Mother under the influence of a narcotic and took custody of the child. The fact that Troy was born under the influence of drugs shows that the drug problem continued.
Dr. Dixon told about other factors besides the positive urine toxicology screen which indicated Troy was born under the influence of drugs. These included his prematurity and low birth weight, symptoms associated with methamphetamine withdrawal, a longer than normal hospital stay, poor feeding, lethargy, and weight loss. Mother’s arguments that there was no showing that Troy actually suffered any harm from drugs are without merit. Dr. Dixon testified extensively about the potential harmful consequences for children who have suffered prenatal drug exposure. Mother’s argument that Dr. Dixon’s testimony established that a positive toxicology screen does not prove a baby is born under the influence of a dangerous drug is totally unfounded. Dr. Dixon never indicated the tests did not show that Troy was bom under the influence of the drug.17
Mother’s claim that Dr. Dixon conceded it was impossible to determine whether any of Troy’s problems were attributable to prematurity instead of [905]*905to drug exposure is also meritless. Dr. Dixon stated that some of the symptoms associated with babies born under the influence of drugs are clearly distinct although some irritability and feeding problems are also seen in preterm infants. She reported that his feeding pattern was seen as extremely atypical by the doctors and nurses caring for him, and agreed under cross-examination that the feeding pattern was also possibly due to Troy’s prematurity. This statement does not indicate that Dr. Dixon thought Troy’s problems were possibly a result of his prematurity instead of his prenatal drug exposure.
The evidence was sufficient to justify sustaining the allegations of the amended petition.
Disposition
The judgment is affirmed.
Kremer, P. J., concurred.