DCPP VS. J.C. AND A.R., IN THE MATTER OF G.M.R. (FN-02-0251-17, BERGEN COUNTY AND STATEWIDE) (RECORD IMPOUNDED) ( 2019 )


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  •                                       RECORD IMPOUNDED
    NOT FOR PUBLICATION WITHOUT THE
    APPROVAL OF THE APPELLATE DIVISION
    This opinion shall not "constitute precedent or be binding upon any court." Although it is posted on the
    internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
    SUPERIOR COURT OF NEW JERSEY
    APPELLATE DIVISION
    DOCKET NO. A-4902-17T1
    NEW JERSEY DIVISION
    OF CHILD PROTECTION
    AND PERMANENCY,
    Plaintiff-Respondent,
    v.
    J.C.,
    Defendant-Appellant,
    and
    A.R.,
    Defendant.
    _____________________________
    IN THE MATTER OF G.M.R.,
    a Minor.
    _____________________________
    Argued November 13, 2019 – Decided December 12, 2019
    Before Judges Fisher, Accurso and Gilson.
    On appeal from the Superior Court of New Jersey,
    Chancery Division, Family Part, Bergen County
    Docket No. FN-02-0251-17.
    David Anthony Gies, Designated Counsel, argued the
    cause for appellant (Joseph E. Krakora, Public
    Defender, attorney; David Anthony Gies, on the briefs).
    Jason Wade Rockwell, Assistant Attorney General,
    argued the cause for respondent (Gurbir S. Grewal,
    Attorney General, attorney; Kenneth M. Cabot, Deputy
    Attorney General, on the brief).
    Cory Hadley Cassar, Designated Counsel, argued the
    cause for minor (Joseph E. Krakora, Public Defender,
    Law Guardian, attorney; Cory Hadley Cassar, on the
    brief).
    PER CURIAM
    A mother appeals from an order finding that she abused or neglected her
    infant daughter by using unprescribed drugs while she was pregnant with the
    child. At birth, the child suffered from withdrawal symptoms and had to be
    treated in a hospital for several weeks. We affirm.
    I.
    J.C. (Joyce), the mother, and A.R., the father, are the parents of G.M.R.
    (Gen), who was born in March 2017. 1 At birth, a toxicology analysis showed
    1
    We use initials and fictitious names to protect privacy interests and the
    confidentiality of the record. R. 1:38-3(d)(12).
    A-4902-17T1
    2
    that Gen had methadone, benzodiazepines, tetrahydrocannabinol (THC), and
    cocaine in her blood.     The child was diagnosed with neonatal abstinence
    syndrome (NAS) and treated for withdrawal symptoms for several weeks in a
    neonatal intensive care unit at the hospital where she was born.
    On April 21, 2017, after Gen was discharged from the hospital, the
    Division of Child Protection and Permanency (the Division) conducted an
    emergency removal and placed her in the care of a family member. Thereafter,
    the Division was granted custody of Gen, and Joyce was charged with child
    abuse or neglect. A.R., the father, was not charged and no findings of abuse or
    neglect were made against him.
    A fact-finding hearing was conducted on July 24, 2017. The Division
    entered a number of exhibits into evidence and called two witnesses: Laurie
    Laverty, a Division caseworker, and Stephen Percy, M.D., a pediatrician who
    treated Gen after her birth. Joyce did not testify.
    Documents submitted into evidence established that Joyce overdosed on
    heroin in November 2016, while pregnant with Gen.          At that time, Joyce
    admitted that she was using heroin daily and crack cocaine twice a week.
    Accordingly, she was referred to a treatment program.
    A-4902-17T1
    3
    Laverty testified that she met with Joyce at the hospital on the day of Gen's
    birth.     Joyce admitted she had tested positive for use of methadone,
    benzodiazepines, cocaine, and marijuana. She claimed that she was prescribed
    methadone through the Monsignor Wall treatment program.
    The court twice entered orders before the fact-finding hearing directing
    Joyce to sign and give a medical release to the Division. Moreover, Laverty
    testified that Joyce told her she had signed a release with Monsignor Wall
    granting the Division access to information pertaining to her treatment program.
    Joyce, however, never signed such a release. Accordingly, Laverty testified that
    the Division could not confirm that Joyce had been in a methadone treatment
    program and that the methadone was being administered with medical oversight.
    Dr. Percy was qualified as an expert in pediatrics, including pediatric
    critical care. He testified that Gen was diagnosed with NAS and described her
    symptoms as including tremors, exaggerated moro reflex, and increased
    respiratory rate.
    Dr. Percy also stated that Gen was treated for methadone withdrawal in
    both the intensive care unit and the general pediatric area for several weeks. He
    explained that an infant withdrawing from benzodiazepines would exhibit
    similar symptoms to an infant withdrawing from an opioid, such as methadone .
    A-4902-17T1
    4
    Dr. Percy stated that he could not offer an opinion as to whether Gen's
    withdrawal symptoms were caused by just methadone or benzodiazepines
    because there is "a fair amount of overlap" between the symptoms caused by
    each substance.
    The family court announced its ruling on the record on October 18, 2017.
    On that same day it entered an order finding that Joyce had abused or neglected
    Gen. The court found the testimony of both Laverty and Dr. Percy credible.
    Based on that testimony, as well as the documents that had been entered into
    evidence, the court found that Gen's physical condition had been impaired
    because of Joyce's use of unprescribed drugs, including benzodiazepines,
    cocaine, marijuana, and methadone. In that regard, the court found that Gen had
    "[u]nquestionably . . . suffered actual harm."
    In April 2018, the family court accepted the Division's permanency plan
    to terminate Joyce's parental rights so that Gen can be adopted. The Division,
    thereafter, filed a guardianship complaint, and the court terminated this Title 9
    matter.
    II.
    Joyce now appeals from the October 18, 2017 order finding that she
    abused or neglected Gen.      She makes a series of related and overlapping
    A-4902-17T1
    5
    arguments, contending (1) the Division did not prove that her prenatal use of
    drugs caused harm to Gen; (2) the court improperly shifted to her the burden to
    show that she participated in a methadone treatment program; and (3) the
    Division, through the testimony of Dr. Percy, failed to prove that any drugs other
    than methadone caused Gen to have withdrawal symptoms. We reject all of
    those arguments because the evidence at the fact-finding hearing refutes each of
    Joyce's contentions.
    The scope of our review of an appeal from an order finding abuse or
    neglect is limited. N.J. Div. of Child Prot. & Permanency v. Y.A., 
    437 N.J. Super. 541
    , 546 (App. Div. 2014) (citing and quoting N.J. Div. of Youth &
    Family Servs. v. I.Y.A., 
    400 N.J. Super. 77
    , 89 (App. Div. 2008)). We will
    uphold the trial judge's factual findings and credibility determinations if they
    are supported by "adequate, substantial, and credible evidence." N.J. Div. of
    Youth & Family Servs. v. G.L., 
    191 N.J. 596
    , 605 (2007) (first citing In re
    Guardianship of J.T., 
    269 N.J. Super. 172
    , 188 (App. Div. 1993); then citing
    Cesare v. Cesare, 
    154 N.J. 394
    , 411-13 (1998)). Accordingly, we will only
    overturn the judge's findings if they "went so wide of the mark that th e judge
    was clearly mistaken." 
    Ibid.
     (citing J.T., 
    269 N.J. Super. at 188-89
    ). We do not,
    however, give "special deference" to the trial court's interpretation of the law.
    A-4902-17T1
    6
    D.W. v. R.W., 
    212 N.J. 232
    , 245 (2012) (citing N.J. Div. of Youth & Family
    Servs. v. I.S., 
    202 N.J. 145
    , 183 (2010)). Consequently, we apply a de novo
    standard of review to legal issues. 
    Id. at 245-46
    .
    The adjudication of abuse or neglect is governed by Title 9, which is
    designed to protect children. N.J.S.A. 9:6-1 to -8.114. Under Title 9, a child is
    abused or neglected if:
    [a] parent or guardian . . . creates or allows to be created
    a substantial or ongoing risk of physical injury to such
    child by other than accidental means which would be
    likely to cause death or serious or protracted
    disfigurement, or protracted loss or impairment of the
    function of any bodily organ . . . or a child whose
    physical, mental, or emotional condition has been
    impaired or is in imminent danger of becoming
    impaired as the result of the failure of his parent or
    guardian . . . to exercise a minimum degree of care . . .
    in providing the child with proper supervision or
    guardianship, by unreasonably inflicting or allowing to
    be inflicted harm, or substantial risk thereof . . . .
    [N.J.S.A. 9:6-8.21(c)(2), (c)(4)(b).]
    The protection of the abuse and neglect statute "is limited to the condition
    of a child after birth." N.J. Dept. of Children v. A.L., 
    213 N.J. 1
    , 22 (2013)
    (citing N.J. Div. of Youth and Family Servs. v. L.V., 
    382 N.J. Super. 582
    , 590
    (Ch. Div. 2005)).
    Therefore, the primary question under Title 9 is
    whether [the child], as a newborn, "ha[s] been
    A-4902-17T1
    7
    impaired" or was in "imminent danger of becoming
    impaired" as a result of his [or her] mother's failure to
    exercise a minimum degree of care by unreasonably
    inflicting harm or allowing a "substantial risk" of harm
    to be inflicted.
    [Ibid. (quoting N.J.S.A. 9:6-8.21(c)(4)(b)).]
    "If an expectant mother's drug use causes actual harm to the physical, mental,
    or emotional condition of a newborn child, a finding of abuse or neglect is
    appropriate." Id. at 8.
    Nevertheless, "not every instance of drug use by a parent during
    pregnancy, standing alone, will substantiate a finding of abuse and neglect in
    light of the specific language of the statute." Id. at 23; see also id. at 23 n.3
    (noting that New Jersey has not joined those states whose laws treat prenatal
    drug use as per se child abuse); N.J. Div. of Youth & Family Servs. v. N.D., 
    435 N.J. Super. 488
    , 494 (App. Div. 2014) (same). Actual harm under the statute
    can be established by offering proof that a child suffered drug "withdrawal
    symptoms at birth" or by "showing evidence of respiratory distress,
    cardiovascular or central nervous system complications, low gestational age at
    birth, low birth weight, poor feeding patterns, weight loss through an extended
    hospital stay, lethargy, convulsions, or tremors." A.L., 213 N.J. at 22-23 (citing
    In re Guardianship of K.H.O., 
    161 N.J. 337
    , 349-50 (1999)). When, as here,
    A-4902-17T1
    8
    there is actual harm, proof of such harm "may come from any number of
    competent sources including medical and hospital records, health care providers,
    [or] caregivers, [as well as] qualified experts." Id. at 23.
    Our Supreme Court has clarified that, under certain circumstances, proof
    of prenatal drug use coupled with the fact that a newborn suffered withdrawal
    symptoms may not be sufficient to establish abuse and neglect. See N.J. Div. of
    Child Prot. & Permanency v. Y.N., 
    220 N.J. 165
    , 168 (2014).                  Those
    circumstances require proof that the mother was (1) participating in a bona fide
    treatment program, (2) prescribed methadone by a licensed healthcare
    professional, (3) after full disclosure. 
    Ibid.
     In that regard, the Court held,
    [A]bsent exceptional circumstances, a finding of abuse
    or neglect cannot be sustained based solely on a
    newborn's enduring methadone withdrawal following a
    mother's timely participation in a bona fide treatment
    program prescribed by a licensed healthcare
    professional to whom she has made full disclosure. In
    this case, a finding of abuse or neglect under N.J.S.A.
    9:6-8.21(c)(4)(b) required proof that [the mother]
    unreasonably inflicted harm on her newborn and did so,
    at least, by acting with gross negligence or
    recklessness.
    [Id. at 168-69.]
    Joyce's drug use during pregnancy actually harmed Gen. The child tested
    positive for methadone, benzodiazepines, cocaine, and THC, and was not born
    A-4902-17T1
    9
    healthy. Instead, Gen suffered from withdrawal symptoms that included tremors
    and respiratory problems. She was hospitalized for several weeks and treated in
    an intensive care unit.
    Joyce contends that, pursuant to Y.N., the finding of abuse and neglect
    must be reversed. Joyce's reliance on Y.N. is misplaced for two reasons.
    First, in Y.N., the sole drug identified as causing the newborn's
    withdrawal symptoms was methadone. Id. at 170. The Court accepted the
    mother's testimony that she was taking methadone as part of a treatment program
    she entered prior to giving birth. Id. at 169-70. Here, in contrast, there is no
    credible evidence in the record that Joyce was prescribed methadone in
    conjunction with a bona fide treatment program or that her use of methadone
    during her pregnancy was authorized by a qualified physician after full
    disclosure.
    Second, Gen had additional substances in her system that caused her harm
    or threatened to cause her harm. In addition to methadone, at birth Gen also had
    benzodiazepines, cocaine, and THC in her blood. Dr. Percy testified that the
    withdrawal symptoms for methadone and benzodiazepines "overlapped" and
    therefore Gen's symptoms could have been caused by the benzodiazepines.
    A-4902-17T1
    10
    Moreover, the evidence that Joyce used benzodiazepines, cocaine, and
    marijuana while pregnant exposed Gen to a substantial risk of harm.
    In short, Joyce's first and third arguments are rebutted by the substantial
    credible evidence presented at the fact-finding hearing. The family judge found
    that evidence credible and reliable and based her findings on that evidence. We
    discern no grounds for disagreeing with the trial court's findings.
    We also reject Joyce's argument that the family court improperly shifted
    a burden to her. There was no burden shifting. Instead, the Division presented
    strong evidence that Joyce used unprescribed drugs without prescriptions while
    pregnant with Gen, and those drugs caused actual harm to Gen. In response,
    Joyce attempted to argue that her use of at least one of the drugs – methadone –
    was prescribed by a bona fide treatment program. Joyce, however, did not
    present any evidence that she was in such a treatment program.           Just as
    importantly, Joyce prevented the Division from contacting her treatment
    program to determine whether she had been properly prescribed methadone by
    a licensed healthcare professional after full disclosure.
    Affirmed.
    A-4902-17T1
    11