U. v. CITY OF PHILADELPHIA DEPT. OF HUMAN SERVICES

CourtDistrict Court, E.D. Pennsylvania
DecidedMay 3, 2023
Docket2:22-cv-04950
StatusUnknown

This text of U. v. CITY OF PHILADELPHIA DEPT. OF HUMAN SERVICES (U. v. CITY OF PHILADELPHIA DEPT. OF HUMAN SERVICES) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
U. v. CITY OF PHILADELPHIA DEPT. OF HUMAN SERVICES, (E.D. Pa. 2023).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA

C.U. and A.R., : : CIVIL ACTION v. : No. 22-4950 : CITY OF PHILADELPHIA DEPARTMENT : OF HUMAN SERVICES, et al. :

McHUGH, J. May 3, 2023 MEMORANDUM This is a civil rights case in which the core issue is whether the 14th Amendment provides due process protection for parents seeking to visit their hospitalized child, where public officials had limited their access based upon a suspicion of abuse. Because I am persuaded that the deprivation here was long enough and substantial enough to create a protectable interest, with one limited exception, I will deny the municipal Defendants’ Motion to Dismiss. I. Factual Background This case arises out of the following allegations. On December 10, 2020, Plaintiffs C.U. and A.R. brought their 5-week-old infant daughter (“C.T.R.”) to Children’s Hospital of Philadelphia (“CHOP”) when she became unresponsive. Compl. ¶¶ 22-23. Brain imaging taken upon her arrival showed a “progressive destructive process, possibly infectious or metabolic in origin . . . not typical of a direct traumatic brain injury.” Id. at ¶ 24. Further imaging revealed that C.T.R. was healing from acute rib fractures and a possible clavicle fracture. Id. at ¶ 28. Although the child was later diagnosed with Osteogenesis Imperfecta,1 a genetic disorder that causes bones

1 “Osteogenesis [I]mperfecta (OI) is an inherited (genetic) bone disorder that is present at birth. It is also known as brittle bone disease. A child born with OI may have soft bones that break (fracture) easily, bones that are not formed normally, and other problems. Signs and symptoms may range from mild to severe.” to break easily, those observing C.T.R. at the time believed that her “unexplained fractures” were suspicious and raised questions of abuse. Id. at ¶ 30. The next day, Defendant Amy Crescenzo, a supervisor for the Philadelphia Department of Human Services (“DHS”), spoke with a CHOP social worker to discuss whether CHOP could restrict her parents, the Plaintiffs here, from visiting C.T.R. Id. at ¶¶ 35-36, 38. The Complaint

includes an excerpt from C.T.R.’s medical records, which documents this conversation: On-call SW received call from DHS supervisor Amy Crescenzo asking if CHOP could restrict parents from visiting patient. SW asked if they had a court order/emergency custody for that? Worker explained that they did not and were not seeking custody at this time due to possible future passing of patient. SW consulted with LOC (Megan Bowers) and decision was made to not restrict at this time without court order. SW attempted to call Ms. Crescenzo back to inform her of this decision but she did not answer. Left VM asking for a return phone call.

Id. at ¶ 38 (cleaned up). Although hospital staff also suspected that C.T.R.’s injuries were caused by abuse, CHOP nonetheless elected to conduct a genetic panel on C.U., C.T.R.’s mother, as her personal medical history raised the possibility that she may have a bone disorder like Osteogenesis Imperfecta. Id. at ¶ 44. CHOP informed Plaintiffs that the results were negative for any such genetic mutation. Id. at ¶ 45. Plaintiffs allege, however, that CHOP’s testing revealed that both C.U. and C.T.R. were positive for a lesser-known genetic mutation associated with Osteogenesis Imperfecta, which CHOP staff overlooked at the time. Id. at ¶¶ 46, 75-77. Two months later, in February 2021, while still hospitalized, C.T.R. suffered a new fracture to her right femur, leading the hospital to institute “fragile bone precautions” for the remainder of C.T.R.’s care. Id. at ¶¶ 53-57. Plaintiffs allege that they could not have caused this fracture because it occurred while they were visiting their older child outside of the hospital. Id. at ¶ 48. They further allege that medical checks, including “placing a blood pressure cuff on C.T.R.’s right

See Johns Hopkins Medicine, Osteogenesis Imperfecta (2023), https://www.hopkinsmedicine.org/health/ conditions-and-diseases/osteogenesis-imperfecta. leg at least twice,” may have been the cause of the injury. Id. at ¶¶ 48-50. Dr. Mazzeo wrote in C.T.R.’s medical notes that when she informed Plaintiffs of the new fracture, they were “tearful” and “distressed,” and again objected that the hospital was overlooking some other explanation for C.T.R.’s fragile bone health. Id. at ¶ 54. Moreover, the following day, a skeletal survey revealed additional, unhealed fractures. Id. at ¶ 58. A progress note written by Defendant Laura Pompa –

a social worker on CHOP’s Suspected Child Abuse and Neglect (“SCAN”) team – explained: These fracture[s] have not been previously identified and are considered new. At this time, there are no known accidents or events that would have led to these fractures. Mother and Father expressed concern for CHOP staff causing patient’s injuries due to patient being admitted at CHOP when injuries occurred. At this time, a report to Child Protective Services is warranted to further reinvestigate the cause of [patient’s] injuries.

Id. That evening at 9:30pm, Defendant Pompa asked her colleague Defendant Shanik Hood- Haly, another CHOP social worker, to restrict Plaintiffs’ ability to visit and stay with their daughter. Id. at ¶ 59. Defendant Hood-Haly made the following note in C.T.R.’s medical records: “On-call SW received a call from SCAN SW requesting that parents (C.U. & A.R.) be restricted from the hospital at the request of DHS worker (Sharina Johnson)2 due to ongoing investigation. On-call SW implemented the restriction and distributed to unit clerk and security.” Id. at ¶ 62 (emphasis added). Plaintiffs learned of the ban from Defendants Johnson and Crescenzo of DHS. Id. at ¶ 63. For the next two months, C.U. and A.R. were prohibited from visiting or staying with their daughter. Id. at ¶ 65. Plaintiffs were only allowed visitation on one occasion – the day that C.T.R. underwent neurosurgery – during which they were constantly supervised by Ms. Crescenzo. Id. at ¶¶ 65-68. C.T.R.’s medical records verify: “Child Protection Team SW spoke to DHS

2 Sharina Johnson is a caseworker at DHS and also named as a defendant in this action. Supervisor . . . and Ms. Crescenzo confirmed that she will come to CHOP on Wednesday (2/24/21) at 6:30AM to supervise Mother and Father throughout the day due to [patient] going to the OR for a VP shunt.” Id. at ¶ 68 (cleaned up). While Plaintiffs were banned from the hospital, C.T.R. sustained new fractures to her arms and legs. Id. at ¶ 69. Even before these new fractures occurred, however, CHOP’s genetic

department determined that C.U. and C.T.R. should again be tested for genetic disorders related to fragile bones, and this time employed an outside laboratory to do so. Id. at ¶ 64. The results came back on April 1, 2020 and confirmed that “both C.T.R. and C.U. had one copy of a genetic FKBP10 mutation associated with Osteogenesis Imperfecta.” Id. at ¶ 73. Moreover, a genetics doctor confirmed that the initial testing CHOP performed in February showed that both C.U. and C.T.R. had this particular genetic mutation as well. Id. at ¶ 75. A few weeks later, Ms. Crescenzo called CHOP to discuss how to move forward. Id. at ¶ 84. C.T.R.’s medical records state: “SW received a call from CYS [supervisor], Amy Crescenzo. Current plan for discharge is to train parents in preparation for discharge home with them; DHS

will work on a safety plan including supervision. SW spoke with [patient’s] mother to inform her that Visitation Restriction will be lifted.” Id. (cleaned up). On May 7, 2021, C.T.R. was discharged from the hospital. Id. at ¶ 87. She continues to receive treatment at CHOP to manage her condition and the impacts of her neurological infection. Id. at ¶¶ 88-89. II. Procedural Background In their Complaint, Plaintiffs assert that Defendants violated their procedural and substantive due process rights.

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