L.A. v. D.Y.F.S (071921) (Mercer County and Statewide)

SYLLABUS
(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the
convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please note that, in the
interest of brevity, portions of any opinion may not have been summarized.)
L.A. v. D.Y.F.S. (A-55/56-12) (071921)
Argued January 6, 2014 -- Decided April 23, 2014
LaVECCHIA, J., writing for a unanimous Court.
The issue in this appeal is whether defendants breached the duty, imposed by N.J.S.A. 9:6-8.10, to report
suspected child abuse whenever a person forms a reasonable belief that a child has been subjected to child abuse.
On January 13, 2001, at about 8:00 p.m., two-year-old S.A. was brought to the emergency room of the
Jersey Shore University Medical Center (JSMC) by two men who identified themselves as her relatives. They
informed the triage nurse that they had been called to S.A.’s home by S.A.’s stepmother because S.A. was vomiting
and unable to walk. The nurse noted that S.A. was lethargic and weak, and that she had an unusual odor on her
breath. S.A. was examined by Dr. Daniel Yu, M.D., a board-certified Emergency Medicine specialist who was then
an attending physician in JSMC’s Emergency Department. Dr. Yu noted that S.A.’s mouth smelled of “cologne”
and “chemical alcohol.” Dr. Yu conducted a full examination of S.A. and performed a thorough set of diagnostic
tests. Dr. Yu treated S.A. with an intravenous saline drip to prevent dehydration. The blood test results revealed
that S.A. had a blood alcohol concentration of 0.035 percent.
S.A.’s father, K.L., arrived at the hospital around 8:30 p.m. He presented JSMC staff with a bottle of
cologne and stayed with S.A. while she was at JSMC. Dr. Yu noted that the cologne had a similar odor to S.A.’s
breath and diagnosed S.A. with accidental cologne ingestion. Dr. Yu did not record information about the cologne
and did not inquire as to how S.A. had come to consume it. Neither Dr. Yu nor any of the JSMC staff noted any
signs that S.A. had been abused or neglected, and the Division of Youth and Family Services (DYFS) 1 was not
contacted. Subsequent to S.A.’s treatment at JSMC, S.A. received medical treatment at another physician’s office
for a chemical burn on her foot. No reports were made to DYFS in connection with that incident. Reports,
however, were filed in connection with two other incidents, one in March and the other in April, 2001. Those
incidents resulted in findings of abuse and neglect by DYFS case workers. The April 2001 incident, which included
multiple burns and numerous bruises, led to the removal of S.A. from K.L.’s care and the placement of S.A. with
L.A., who adopted her in April 2006.
In April 2007, L.A. filed the instant complaint individually and on behalf of S.A. against several parties,
including Dr. Yu and JSMC. The complaint alleged that Dr. Yu had committed medical malpractice and had
breached the standard of care set forth in N.J.S.A. 9:6-8.10 by failing to notify DYFS after treating S.A. for
accidental cologne ingestion. With the exception of Dr. Yu and JSMC, all defendants settled out of court. Dr. Yu
and JSMC filed motions for summary judgment. On August 13, 2010, the trial court granted summary judgment in
favor of defendants, holding that no reasonable jury could find that Dr. Yu had reasonable cause to believe that child
abuse had been committed against S.A. L.A.’s motion for reconsideration was denied.
The Appellate Division reversed and remanded the matter for trial. The appellate panel concluded that
summary judgment was inappropriate because “a reasonable jury could find that a probable inference from the
information available to Dr. Yu at the time of treatment was that [S.A.’s] condition was the result of ‘reckless’ or
‘grossly or wantonly negligent’ conduct or inaction on the part of her parent or guardian.” L.A. ex rel. S.A. v. N.J.
Div. of Youth & Family Servs., 429 N.J. Super. 48, 60 (App. Div. 2012). The Supreme Court granted the petitions
for certification filed by Dr. Yu and JSMC. 213 N.J. 535 (2013).
1
DYFS is now known as the Division of Child Protection and Permanency. For ease of
reference, the Court refers to the agency as DYFS throughout this opinion.
1
HELD: Based on the record before the Court, the circumstances surrounding S.A.’s presentation at the hospital
were insufficient to give rise to a finding that defendants behaved unreasonably in failing to report an incident of
suspected child abuse, as required under N.J.S.A. 9:6-8.10.
1. To support her medical malpractice claim, plaintiff must establish: “(1) the applicable standard of care; (2) a
deviation from that standard of care; and (3) that the deviation proximately caused the injury.” Gardner v. Pawliw,
150 N.J. 359, 375 (1997). In this case, the applicable standard of care is provided by N.J.S.A. 9:6-8.10, which
requires that “[a]ny person having reasonable cause to believe that a child has been subjected to child abuse . . . shall
report the same immediately to [DYFS].” When statutory language “clearly reveals the meaning of the statute, the
court’s sole function is to enforce the statute in accordance with those terms.” McCann v. Clerk of Jersey City, 167
N.J. 311, 320 (2001). However, “[i]f the plain language of a statute is ambiguous or open to more than one
plausible meaning,” the court may look to sources of extrinsic evidence such as legislative history for assistance in
determining legislative intent.” State v. Marquez, 202 N.J. 485, 500 (2010). (pp. 13-15)
2. On its face, N.J.S.A. 9:6-8.10 clearly indicates that the reporting requirement is applicable to all persons. The
statute also states plainly that the reporting requirement is only triggered by a “reasonable cause to believe” that
child abuse has been committed. As a standard, “reasonable cause to believe,” as well as its derivatives “reasonable
belief,” “cause to believe,” and “reason to believe,” have been employed in a variety of contexts. The common
judicial application given to a “reasonable cause” standard in multiple settings must have been familiar to the
Legislature when it used “reasonable cause to believe” as its standard for imposing a duty to report suspected child
abuse. Based on a plain language reading of the statute, the Court perceives that the Legislature intended that
“reasonable cause to believe” that a child has been subjected to child abuse requires a reasonable belief based on the
facts and circumstances known to the person on the scene. (pp. 15- 20)
3. When the Legislature first enacted a statute providing for mandatory reporting of child abuse, that statute applied
only to physicians and hospitals. In amending Title 9 in 1971, the Legislature studied and created a new
requirement for reporting to child welfare authorities. The originally proposed bill mandated reporting by certain
individuals, including household members and medical personnel, while providing that anyone else “may report
suspicion or knowledge of child abuse.” Governor Cahill conditionally vetoed the proposed bill, amending it to
make the reporting requirement mandatory as to all persons and to change the standard from “suspicion or
knowledge” to “reasonable cause to believe.” The “reasonable cause to believe” standard, intended to be understood
on its face and applicable to all persons, including physicians, imposes a requirement that is subject to the test for
objective reasonableness. The statutory duty to report child abuse requires a reasonable belief based on the facts and
circumstances known to the person on the scene. The judgment and actions of the person on the scene must survive
the test of objective reasonableness. (pp. 20-26)
4. Based on the record before the Court, the circumstances surrounding S.A.’s presentation at the hospital were
insufficient to give rise to a finding that Dr. Yu behaved unreasonably in failing to report an incident of suspected
child abuse. There was no evidence of intentional behavior by S.A.’s parents or legal guardians in connection with
what Dr. Yu reasonably perceived to be an accidental ingestion of cologne. Moreover, the Court cannot ignore the
fact that the liquid two-year-old S.A. ingested was a common item found in many homes, and not an inherently
dangerous item that no reasonable adult would allow in any accessible proximity to a child of such tender age. The
idea that a toddler might find a way to get her hands on a common cosmetic or toiletry item is not equivalent to
grossly negligent or reckless behavior on the part of a parent. Later tragic events in the life of this child cannot
cloud the analysis when considering the objective reasonableness of Dr. Yu’s first and only interaction with two-
year-old S.A. Viewing the facts objectively and as presented to Dr. Yu, the Court concludes that he did not breach
the reporting obligation in N.J.S.A. 9:6-8.10 in respect of S.A.’s emergency room visit and treatment for apparent
accidental cologne ingestion. (pp. 26-30)
The judgment of the Appellate Division is REVERSED and the matter is REMANDED to the trial court
for reinstatement of its judgment dismissing this action against defendants.
CHIEF JUSTICE RABNER; JUSTICES ALBIN, PATTERSON, and FERNANDEZ-VINA; and
JUDGES RODRÍGUEZ and CUFF (both temporarily assigned) join in JUSTICE LaVECCHIA’s opinion.
2
SUPREME COURT OF NEW JERSEY
A-55/56 September Term 2012
071921
L.A., as Parent and Legal
Guardian of S.A., a minor,
and L.A., individually,
Plaintiff-Respondent,
v.
NEW JERSEY DIVISION OF YOUTH
AND FAMILY SERVICES; NEW
JERSEY DEPARTMENT OF HUMAN
SERVICES, now known as
DEPARTMENT OF CHILDREN AND
FAMILIES; KEVIN M. RYAN,
FORMER COMMISSIONER; EILEEN
CRUMMY, DIRECTOR OF DIVISION
OF YOUTH AND FAMILY SERVICES;
CHARLES VENTI, FORMER
DIRECTOR OF DIVISION OF YOUTH
AND FAMILY SERVICES; SHALONDA
MARTIN; RICHARD KLEIN, Ed.D.;
CATHERINE HINES, CADS;
GWENDOLYN ARMSTRONG; AUBREY
LUTZ; ANDREA STOKES; MONICA
DUDAK; and PAULETTE TARICA,
Defendants,
and
JERSEY SHORE UNIVERSITY
MEDICAL CENTER,
Defendant-Respondent
and Cross-Appellant,
and
DANIEL YU, M.D.,
Defendant-Appellant
1
and Cross-Respondent.
Argued January 6, 2014 – Decided April 23, 2014
On certification to the Superior Court,
Appellate Division, whose opinion is
reported at 429 N.J. Super. 48 (2012).
Hugh P. Francis argued the cause for
appellant and cross-respondent (Francis &
Berry and Buckley Theroux Kline & Petraske,
attorneys; Sean P. Buckley, of counsel;
Michael P. Opacki, on the briefs).
Richard A. Amdur argued the cause for
respondent and cross-appellant (Amdur, Maggs
& Shor, attorneys).
David A. Mazie argued the cause for
respondent (Mazie Slater Katz & Freeman,
attorneys; Mr. Mazie, David M. Freeman, and
David M. Estes, on the brief).
Mary M. McManus-Smith argued the cause for
amicus curiae Legal Services of New Jersey
(Melville D. Miller, Jr., President,
attorney; Ms. McManus-Smith, Mr. Miller, and
Jeyanthi C. Rajaraman, on the brief).
JUSTICE LaVECCHIA delivered the opinion of the Court.
The question presented in this medical malpractice matter
concerns the statutory standard to determine when reporting of
suspected child abuse is required. A toddler was brought to a
hospital’s emergency room for treatment of what was assessed as
accidental cologne ingestion. The child was treated and
released from the hospital’s emergency department to the care of
her father the same evening. The emergency room physician did
2
not report the matter as an incident of suspected child abuse.
However, subsequent events in the life of this child resulted in
findings that she was subjected to separate incidents of child
abuse, and she was removed from the care and custody of her
father and stepmother.
Based on the initial emergency room episode, the child’s
adoptive parent and legal guardian filed this malpractice action
against the hospital and the emergency room physician who
attended to the child. The complaint alleges that the doctor
breached the duty imposed by N.J.S.A. 9:6-8.10 to report
suspected child abuse. The hospital is named in its respondeat
superior capacity.
In this medical malpractice action, all parties agree that
the standard of care to which the emergency room physician
should be held is expressed in N.J.S.A. 9:6-8.10. N.J.S.A.
9:6-8.10 provides the longstanding standard for the reporting of
suspected child abuse: “Any person having reasonable cause to
believe that a child has been subjected to child abuse or acts
of child abuse shall report the same immediately” to the State.
If reasonable cause exists to believe that child abuse has
occurred, a statutory duty to report arises. See N.J.S.A.
9:6-8.14 (making violation of duty punishable as disorderly
person offense).
3
We discern in N.J.S.A. 9:6-8.10 a legislative intent to
impose a universal obligation to report child abuse whenever a
person forms a reasonable belief that a child has been subjected
to child abuse. The statute’s language and history plainly
establish that the enactment was a carefully thought out
imposition of a general duty, and that great care was taken when
choosing “reasonable belief” as its trigger. We hold that, in
light of the statute’s language and history, the “reasonable
belief” threshold requires an objective assessment of whether
given all of the facts and circumstances known at the time a
person similarly situated would have held a reasonable belief
that child abuse had occurred. That interpretation is neither
novel nor new and is consistent with other judicial applications
of a “reasonable cause” standard.
Application of an objective reasonableness review in this
matter compels the conclusion that the trial court correctly
determined that, as a matter of law, defendants did not breach
the statutory duty imposed by N.J.S.A. 9:6-8.10. The trial
court’s grant of summary judgment to those defendants was
correct. We therefore reverse the contrary Appellate Division
judgment.
I.
A.
The summary judgment record reveals the following. On
4
January 13, 2001, at about 8:00 p.m., two-year-old S.A. was
brought to the emergency room of the Jersey Shore University
Medical Center (JSMC) by two men who identified themselves as
her relatives. They informed the triage nurse that they had
been called to S.A.’s home by S.A.’s stepmother because S.A. was
vomiting and unable to walk. The nurse noted that S.A. was
lethargic and weak, and that she had an unusual odor on her
breath.
S.A. was examined by Dr. Daniel Yu, M.D., a board-certified
Emergency Medicine specialist who was then an attending
physician in JSMC’s Emergency Department. Dr. Yu noted that
S.A.’s mouth smelled of “cologne” and “chemical alcohol.” Dr.
Yu conducted a full examination of S.A., including checking her
breathing, pulse, blood sugar, mucous membranes, neck, heart,
lungs, abdomen, extremities, and skin. He also performed a
thorough set of diagnostic tests, including a urinalysis, a
blood test, and chest x-rays, as well as checking for metabolic
disorders and internal bleeding. Dr. Yu treated S.A. with an
intravenous saline drip to prevent dehydration. The blood test
results revealed that S.A. had a blood alcohol concentration of
0.035 percent.
S.A.’s father, K.L., arrived at the hospital around 8:30
p.m. He presented JSMC staff with a bottle of cologne and
stayed with S.A. while she was at JSMC. Dr. Yu noted that the
5
cologne had a similar odor to S.A.’s breath. Taking into
account the low body weight of this child when assessing the
impact of ingesting cologne containing chemical alcohol, Dr. Yu
diagnosed S.A. with accidental cologne ingestion. Dr. Yu did
not record information about the cologne such as the size of the
bottle, how much cologne remained in the bottle, the brand of
cologne, or the ingredients of the cologne, although he
testified that he understood cologne to have a high ethanol
content. Dr. Yu also did not inquire as to how S.A. had come to
consume the cologne. While she was at JSMC, S.A. also was
assessed by a pediatric resident and several nurses. Neither
Dr. Yu nor any of the JSMC staff noted any signs that S.A. had
been abused or neglected, and the Division of Youth and Family
Services (DYFS)2 was not contacted.
S.A. became more alert and was able to stand by 9:30 p.m.
She was discharged to K.L. at 11:20 p.m., at which time she was
walking steadily and was able to tolerate fluids.
Subsequent to S.A.’s treatment at JSMC, S.A. received
medical treatment at another physician’s office for a chemical
burn on her foot. She was seen by that doctor on February 23,
February 27, and March 1, 2001, and he made no reports to DYFS
2
Pursuant to L. 2012, c. 16, effective June 29, 2012, the
Division of Youth and Family Services is now known as the
Division of Child Protection and Permanency. For ease of
reference, we refer to the agency as DYFS throughout this
opinion.
6
in connection with the incident. On March 15, 2001, DYFS
received a report of suspected child abuse concerning S.A. The
caller informed DYFS that S.A. had burn marks over her body and
a belt mark on her chest, and that she was being beaten by her
stepmother. A DYFS case worker examined S.A. and determined
that S.A.’s injuries were the result of abuse and neglect.
Nevertheless, DYFS did not remove S.A. from the care of K.L. and
his wife. On April 5, 2001, DYFS received a report that S.A.
had been found hanging from a hook on a door with her hands
bound. DYFS’s investigation revealed numerous injuries
inflicted on S.A.: multiple burns including ones located on her
private parts, numerous bruises on her body, and a welt on her
chest. She was removed from K.L.’s care, taken into DYFS’s
custody, and ultimately placed with L.A., who adopted her in
April 2006.
B.
In April 2007, L.A. filed the instant complaint
individually and on behalf of S.A. against several parties,
including Dr. Yu and JSMC.3 The complaint alleged that Dr. Yu
had committed medical malpractice and had breached the standard
of care set forth in N.J.S.A. 9:6-8.10 by failing to notify DYFS
after treating S.A. for accidental cologne ingestion. With the
3
L.A.’s complaints against Dr. Yu and JSMC, which are the only
ones at issue here, were brought on behalf of S.A.
7
exception of Dr. Yu and JSMC, all defendants settled out of
court.
Following the exchange of discovery, Dr. Yu and JSMC filed
motions for summary judgment. On August 13, 2010, the trial
court granted summary judgment in favor of defendants, holding
that no reasonable jury could find that Dr. Yu had reasonable
cause to believe that child abuse had been committed against
S.A. The trial court concluded that the ingestion of any type
of substance by a two-year-old child, in and of itself, does not
create reasonable cause to believe that child abuse has been
committed. L.A.’s motion for reconsideration was denied.
On appeal from the grant of summary judgment to defendants,
the Appellate Division reversed and remanded the matter for
trial. L.A. ex rel. S.A. v. N.J. Div. of Youth & Family Servs.,
429 N.J. Super. 48 (App. Div. 2012). The Appellate Division
rejected L.A.’s argument that N.J.S.A. 9:6-8.10 requires
reporting of all incidents that might cause suspicion of child
abuse. Id. at 56. Rather, the panel described N.J.S.A.
9:6-8.10 as requiring the reporting of injuries resulting from
conduct that is “reckless, or grossly or wantonly negligent, but
not conduct that is merely negligent.” Id. at 58.
In addressing N.J.S.A. 9:6-8.10’s “reasonable cause to
believe” standard, the panel looked to N.J.S.A. 9:6-8.16 for
guidance. Id. at 59. N.J.S.A. 9:6-8.16 provides that a
8
physician may take a minor into protective custody where “the
child has suffered serious physical injury or injuries, and the
most probable inference from the medical and factual information
supplied” is that the injuries occurred by other than accidental
means and were inflicted or permitted to be inflicted by the
person into whose custody the child would otherwise be returned.
Based on the language in those two statutes, the panel
determined that reporting is required pursuant to N.J.S.A.
9:6-8.10 when a
physician has “reasonable cause to believe”
that there has been abuse if a “probable
inference” from the medical and factual
information available to the physician is
that the child’s condition is the result of
child abuse, including “reckless” or
“grossly or wantonly negligent” conduct or
inaction by a parent or caregiver.
[L.A., supra, 429 N.J. Super. at 59.]
Applying that standard in this matter, the panel concluded that
summary judgment was inappropriate because “a reasonable jury
could find that a probable inference from the information
available to Dr. Yu at the time of treatment was that [S.A.’s]
condition was the result of ‘reckless’ or ‘grossly or wantonly
negligent’ conduct or inaction on the part of her parent or
guardian.” Id. at 60.
We granted the petitions for certification filed by Dr. Yu
and JSMC. 213 N.J. 535 (2013). We also granted amicus curiae
9
status to Legal Services of New Jersey (LSNJ).
II.
A.
Before this Court, Dr. Yu asserts that the Appellate
Division’s decision misconstrues N.J.S.A. 9:6-8.10 and
improperly increases the reporting requirements imposed on
physicians.4 Citing the explicit imposition of different
standards for DYFS personnel to report suspected abuse in
N.J.S.A. 9:6-8.36a and for doctors to take children into
protective custody in N.J.S.A. 9:6-8.16, Dr. Yu argues that the
Legislature intended N.J.S.A. 9:6-8.10’s “reasonable cause to
believe” standard to apply equally to all persons. Dr. Yu
maintains that “reasonable cause” has been used in numerous
statutes and long defined as “reasonable grounds for thought
supported by circumstances sufficiently strong to warrant the
ordinarily prudent person to believe.” He argues that the Court
should apply that definition to N.J.S.A. 9:6-8.10. Further,
from a policy perspective Dr. Yu argues that the Appellate
Division created an unworkably open-ended reporting requirement
that in practice will have the undesirable result of obligating
physicians to report any child injuries where an inference of
abuse or neglect could be made, even when the parents offer an
explanation and the physician thinks abuse or neglect is
4
JSMC primarily relies on Dr. Yu’s arguments.
10
unlikely.
B.
L.A. asserts that the Appellate Division did not establish
a new standard, but instead clarified when a doctor has a
“reasonable cause to believe” that a child has been subjected to
abuse or neglect. In other words, the “probable inference”
language in N.J.S.A. 9:6-8.16 merely informs the “reasonable
cause to believe” analysis. L.A. argues that, based on the
statutory framework as a whole, the Appellate Division was
correct to conclude that the obligation to report under N.J.S.A.
9:6-8.10 falls between the high “most probable inference”
standard for taking a child into protective custody under
N.J.S.A. 9:6-8.16 and the well-established threshold requirement
that something more than parental negligence is required to
establish child abuse under Title 9.
Citing this Court’s decision in G.S. v. Department of Human
Services, 157 N.J. 161 (1999), which held that accidental
ingestion of a foreign substance may be indicative of child
abuse, L.A. argues that the Appellate Division did not create a
new rule by holding that Dr. Yu may have had a duty to report
under the circumstances. L.A. also disputes the argument by Dr.
Yu and LSNJ that the Appellate Division’s interpretation of
N.J.S.A. 9:6-8.10 will result in over-reporting. She notes that
the Appellate Division required “more than speculation or
11
suspicion” to trigger the requirement, and that the holding was
explicitly limited to civil litigation involving professional
malpractice. She also asserts that our courts have consistently
found that the Legislature intended Title 9 to be construed
broadly in order accomplish its purpose of protecting children
from abuse, and that this intention supports the Appellate
Division’s interpretation of the reporting requirement.
C.
LSNJ, as amicus curiae, argues that the “reasonable cause
to believe” standard used by the Legislature in N.J.S.A.
9:6-8.10 is clear, unambiguous, and has been extensively
interpreted by our courts in a variety of contexts. LSNJ
asserts that N.J.S.A. 9:6-8.10 was carefully designed, with this
standard used to achieve a delicate balance between (1) the
danger of under-reporting potential child abuse at the expense
of child safety and wellbeing and (2) the danger of over-
reporting at the expense of unnecessary trauma and disruption to
families and children. LSNJ urges our Court to take into
account the potential for harm from over-reporting, including
intrusion on fundamental liberties and family autonomy, and the
distress and uncertainty experienced by children during
investigations and removals. In the case of doctors
specifically, LSNJ notes that increased reporting may lead
families to forego important medical services or be less candid
12
with their doctors for fear of reporting to DYFS. LSNJ also
emphasizes the particular impact that over-reporting would have
on low-income and minority children and families, who are
significantly overrepresented in the child welfare system and
are disproportionately likely to use emergency rooms, where many
DYFS reports originate, as their primary source of healthcare.
III.
A.
This medical malpractice case is before this Court from the
Appellate Division’s reversal of the trial court’s grant of
summary judgment for Dr. Yu and JSMC. In reviewing a grant of
summary judgment, we review the decision de novo, applying the
same standard as the trial court. Coyne v. N.J. Dep’t of
Transp., 182 N.J. 481, 491 (2005). Summary judgment should be
granted where “there is no genuine issue as to any material fact
challenged and . . . the moving party is entitled to a judgment
or order as a matter of law.” R. 4:46-2(c). An issue of
material fact exists where “the competent evidential materials
presented, when viewed in the light most favorable to the non-
moving party, are sufficient to permit a rational fact finder to
resolve the alleged disputed issue in favor of the non-moving
party.” Brill v. Guardian Life Ins. Co., 142 N.J. 520, 540
(1995).
To support her medical malpractice claim, plaintiff must
13
establish: “(1) the applicable standard of care; (2) a
deviation from that standard of care; and (3) that the deviation
proximately caused the injury.” Gardner v. Pawliw, 150 N.J.
359, 375 (1997) (citations omitted). As noted, the parties to
this case agree that the applicable standard of care is provided
by N.J.S.A. 9:6-8.10, which requires that “[a]ny person having
reasonable cause to believe that a child has been subjected to
child abuse . . . shall report the same immediately to [DYFS].”
They disagree as to how this standard, and specifically the
phrase “reasonable cause to believe,” should be interpreted and
applied to physicians.
B.
The goal in statutory interpretation is “to discern and
effectuate the intent of the Legislature.” Murray v. Plainfield
Rescue Squad, 210 N.J. 581, 592 (2012). To accomplish that
goal, a court first looks to the plain language of the statute,
“which is typically the best indicator of intent.” In re Plan
for the Abolition of the Council on Affordable Hous., 214 N.J.
444, 467 (2013). When statutory language “clearly reveals the
meaning of the statute, the court’s sole function is to enforce
the statute in accordance with those terms.” McCann v. Clerk of
Jersey City, 167 N.J. 311, 320 (2001) (internal quotation marks
omitted). “A court may neither rewrite a plainly-written
enactment of the Legislature nor presume that the Legislature
14
intended something other than that expressed by way of the plain
language.” O’Connell v. State, 171 N.J. 484, 488 (2002).
However, “[i]f the plain language of a statute is ambiguous
or open to more than one plausible meaning,” the court may look
to sources of extrinsic evidence such as legislative history for
assistance in determining legislative intent. State v. Marquez,
202 N.J. 485, 500 (2010); Marino v. Marino, 200 N.J. 315, 329
(2009). Our desired result is to effectuate sensibly the
statutory words and underlying legislative intent of the
enactment whose application is in issue.
IV.
A.
In relevant part, N.J.S.A. 9:6-8.10 provides:
Any person having reasonable cause to
believe that a child has been subjected to
child abuse or acts of child abuse shall
report the same immediately to the Division
of Child Protection and Permanency by
telephone or otherwise.
On its face, the language of this provision clearly indicates
that the reporting requirement is applicable to all persons. In
referring to “any” person, the provision carves out no one. The
statute also states plainly that the reporting requirement is
only triggered by a “reasonable cause to believe” that child
abuse has been committed.
In past cases, we have employed N.J.S.A. 9:6-8.10’s
15
“reasonable cause to believe” standard without uncertainty or
interpretive explanation. See, e.g., N.J. Dep’t of Children &
Families v. A.L., 213 N.J. 1, 29 (2013) (quoting N.J.S.A.
9:6-8.10’s requirement that “‘[a]ny person having reasonable
cause to believe’ that a child has been abused” must report the
information to DYFS and stating “[t]here is no doubt that the
presence of cocaine metabolites in the meconium of a newborn
child should trigger a report to the Division”); Frugis v.
Bracigliano, 177 N.J. 250, 271 (2003) (stating that school
personnel who observed principal’s sexually suggestive behavior
with children “had an independent obligation to report directly
to DYFS” and their “failure to do so, standing alone, was
evidence of negligence”); see also F.A. by P.A. v. W.J.F., 280
N.J. Super. 570, 578 (App. Div. 1995) (interpreting N.J.S.A.
9:6-8.13’s grant of immunity for reporting suspected child abuse
pursuant N.J.S.A. 9:6-8.10 as requiring use of an objective test
for reasonableness: “The test will be whether a reasonable
person would have reasonable cause to believe that a child has
been abused.”).
That said, as a standard, “reasonable cause to believe,” as
well as its derivatives “reasonable belief,” “cause to believe,”
and “reason to believe,” have been employed in a variety of
16
contexts.5 See, e.g., Stengart v. Loving Care Agency, Inc., 201
N.J. 300, 325-26 (2010) (finding law firm’s review of privileged
emails violated RPC 4.4(b), which provides that “lawyer who
receives a document and has reasonable cause to believe that
[it] was inadvertently sent” shall not read it); Application of
Ries, 20 N.J. 140, 145, 159 (1955) (assessing petition for
investigation of township’s conduct of municipal affairs and
interpreting statutory standard of “cause to believe” municipal
or county monies “are being, or have been, unlawfully or
corruptly expended” as requiring “reasonable cause to believe”);
see also Carmona v. Resorts Int’l Hotel, Inc., 189 N.J. 354,
372-73 (2007) (discussing requirement in New Jersey Law Against
Discrimination action that plaintiff have “reasonable belief”
5
Our research reveals that the Legislature has used the phrase
“reasonable cause to believe” in more than sixty statutes
predating and postdating the enactment at issue before us. See,
e.g., N.J.S.A. 45:1-35 (providing immunity for reporting by
person with reasonable cause to believe medical professional’s
actions involve disciplinable misconduct); N.J.S.A. 52:27D-419
(requiring reporting to law enforcement based on reasonable
cause to believe criminal act has been committed against
vulnerable adult); N.J.S.A. 52:27D-409 (requiring reporting to
adult protective services based on reasonable cause to believe
vulnerable adult is subject of abuse); N.J.S.A. 39:3-72
(allowing stop of vehicle based on reasonable cause to believe
vehicle’s tires violate statutory safety requirements); N.J.S.A.
17:16C-15 (allowing Commissioner of Banking to make
investigations based on reasonable cause to believe person has
violated Retail Installment Sales Act); N.J.S.A. 33:1-66
(requiring law enforcement officer to investigate based on
reasonable cause to believe person is engaged in unlawful
alcoholic beverage activity and to seize property based on
reasonable ground to believe property is unlawful).
17
that employer engaged in unlawful discrimination); State v.
Lund, 119 N.J. 35, 39-40 (1990) (stating that, in order to
conduct frisk, police must have “reasonable belief” or “reason
to believe” that person is armed and dangerous).
The “reasonable cause to believe” standard is thus a
familiar touchstone. Moreover, as our cases demonstrate, its
application results in substantially similar analyses that
objectively test the reasonableness of a person in particular
circumstances. See, e.g., Graham v. Connor, 490 U.S. 386, 396-
97, 109 S. Ct. 1865, 1872, 104 L. Ed. 2d 443, 455-56 (1989)
(discussing how, when assessing officer’s use of force, Fourth
Amendment’s reasonableness requirement must be judged from
perspective of on-the-scene officer, and actions must be
objectively reasonable in light of facts and circumstances
confronting officer); see also DelaCruz v. Borough of Hillsdale,
183 N.J. 149, 165-66 (2005) (discussing same); F.A., supra, 280
N.J. Super. at 578 (applying objective reasonableness test in
granting immunity for child abuse reporting).
The common judicial application given to a “reasonable
cause” standard in multiple settings must have been familiar to
the Legislature when it used “reasonable cause to believe” as
its standard for imposing a duty to report suspected child
abuse. See, e.g., Bhd. of R.R. Trainmen v. Palmer, 47 N.J. 482,
486-87 (1966) (requiring minimal judicially mandated
18
administrative hearing processes because “Legislature is
presumed to know the construction placed by the courts on a
statutory requirement for [a] hearing”); Eckert v. N.J. Hwy.
Dep’t, 1 N.J. 474, 479 (1949) (“In construing legislation we
must assume the Legislature was thoroughly conversant with its
own legislation and the judicial construction placed thereon.”).
The Legislature’s selection of a “reasonable cause” standard in
N.J.S.A. 9:6-8.10 signals a preference for a reasonableness
obligation, which courts have enforced using an objective
standard of review applied to the perceptions and actions of the
person on the scene. N.J.S.A. 9:6-8.10’s inclusion of language
imposing a “reasonable cause” standard compels a strong belief
that the Legislature intended to follow the common application
given to that standard in other settings.
Thus, based on a plain language reading of the statute, we
perceive that the Legislature intended that “reasonable cause to
believe” that a child has been subjected to child abuse requires
a reasonable belief based on the facts and circumstances known
to the person on the scene. The reasonableness of forming that
belief, or, as here, the reasonableness of not forming that
belief, must be tested based on the circumstances of the case
and requires an individualized assessment of what the person on
the scene observed or discerned. In that review, the actions of
the person on the scene must be objectively reasonable given the
19
facts and circumstances known to that person.
Although that is commonly how “reasonable cause to believe”
has been applied in other settings, we address the argument that
a variation to N.J.S.A. 9:6-8.10’s standard should apply to
doctors. To further our review of that possible interpretation,
we turn to the legislative history on the provision in issue.
B.
In 1964, when the Legislature first enacted a statute
providing for mandatory reporting of child abuse, that statute
applied only to physicians and hospitals. See L. 1964, c. 30.
Specifically, that statute provided in relevant part:
Any physician having reasonable cause to
suspect that any child under the age of 18
brought to him or coming before him for
examination, care or treatment . . . has had
serious physical injury or injuries
inflicted upon him by other than accidental
means by a parent, parents, guardian, or
person having custody and control of the
child, shall immediately report or shall
cause to be reported to the county
prosecutor of the county in which the child
resides such injury or injuries in
accordance with the provisions of this act.
[Id. at § 3, codified at N.J.S.A. 9:6-8.1,
repealed by L. 1974, c. 119, § 54.]
A physician making such a report to a prosecutor was given
immunity from liability, civil or criminal, that might be
incurred as a result of making the report, id. at § 6, and
“knowingly and wilfully” failing to report was made a
20
misdemeanor, id. at § 7. That provision was repealed by the
Legislature in 1974. See L. 1974, c. 119, § 54.
In amending Title 9 in 1971, the Legislature studied and
created a new requirement for reporting to child welfare
authorities. See L. 1971, c. 437, § 3. The originally proposed
bill provided that “[a]ny person may report suspicion or
knowledge of child abuse,” while a number of specifically listed
individuals (including household members, prosecutors, social
workers, school officials, and medical personnel) “shall report
suspicion or knowledge of child abuse.” S. 747, 194th Leg.
(Apr. 6, 1970). Although the proposed bill passed both houses
of the Legislature, Governor Cahill exercised his conditional
veto power in respect of the reporting requirement, amending it
to provide that “[a]ny person having reasonable cause to believe
that a child has been subjected to child abuse or acts of child
abuse shall report the same promptly to the Bureau of Children’s
Services by telephone or otherwise.” See Governor’s Conditional
Veto to Senate Bill No. 747, at 2 (Nov. 15, 1971). In
justifying the change included in the conditional veto, Governor
Cahill explained that
Section 3 deals with the reporting of
“suspicion or knowledge of child abuse”; as
to some persons the reporting of “suspicion
of child abuse” is made mandatory. The
meaning and connotation of the word
“suspicion” is legally too ill-defined to be
helpful or appropriate in this context.
21
What is desired is that a report should be
made whenever there is reasonable cause to
believe an offense has been committed.
Imposing an absolute requirement that
“suspicion” be reported provides an
invitation to abuse, harassment and
litigation, none of which will assist in the
alleviation of this serious problem.
[Id. at 1.]
Governor Cahill’s conditional veto language was adopted by both
Houses of the Legislature. See L. 1971, c. 437, § 3.
Subsequent amendments to the provision have merely updated the
name of the agency to which reports shall be made. See L. 1987,
c. 341, § 4; L. 2012, c. 16, § 21.
A governor’s conditional veto of a bill is a significant
source of insight into the legislative intent underlying a
provision affected by the conditional veto. See Fisch v.
Bellshot, 135 N.J. 374, 386 (1994). A governor’s conditional
veto message often states with particularity why the changed
language is essential for a passed bill to secure the governor’s
signature and be enacted into law. Thus, we have recognized
that a governor’s conditional veto provides legitimate
information to be “considered in determining legislative intent,
and may be ‘strong evidence’ of that intent when the veto
directly affects that part of the legislation to be construed.”
DiProspero v. Penn, 183 N.J. 477, 503 (2005). Here, Governor
Cahill exercised his conditional veto to make the reporting
22
requirement mandatory as to all persons and to change the
standard from “suspicion or knowledge” to “reasonable cause to
believe.” His statement indicates that these changes were
connected. Because the “suspicion” standard was “legally too
ill-defined” and was “an invitation to abuse, harassment and
litigation,” the standard was changed to “reasonable cause to
believe.” Moreover, because reporting was desired “whenever
there is reasonable cause to believe an offense has been
committed,” reporting was made mandatory for all persons.
C.
That legislative history, read in connection with the
entirely straightforward language of N.J.S.A. 9:6-8.10, supports
the conclusion that “reasonable cause to believe” was intended
as a standard that would be understandable on its face, and that
would be applicable to all persons who come into contact with
children who may be victims of child abuse. The “any persons”
language in N.J.S.A. 9:6-8.10 and the Legislature’s failure to
enact a reporting requirement specific to physicians after
N.J.S.A. 9:6-8.1 was repealed indicate that the standard set
forth in N.J.S.A. 9:6-8.10 is presently intended to apply to
physicians.
Although we find N.J.S.A. 9:6-8.10 to be clear on its face,
and find our interpretation of its application to be supported
by its legislative history, we briefly address the proposition,
23
put forward by L.A. and the Appellate Division, that N.J.S.A.
9:6-8.16 should inform our understanding of when a physician has
“reasonable cause to believe” that child abuse has been
committed.
N.J.S.A. 9:6-8.16, which was enacted in 1973 and is the
only provision of Title 9 specifically addressed to physicians,
provides:
Any physician examining or treating any
child, or the director or his designate of
any hospital or similar institution to which
any child has been brought for care or
treatment, is empowered to take the said
child into protective custody when the child
has suffered serious physical injury or
injuries, and the most probable inference
from the medical and factual information
supplied, is that the said injury or
injuries were inflicted upon the child by
another person by other than accidental
means, and the person suspected of
inflicting, or permitting to be inflicted,
the said injury upon the child, is a person
into whose custody the child would normally
be returned.
Under this provision, a physician is authorized to take the
more extreme step of placing a child in protective custody
instead of simply filing a report with DYFS. However, to
warrant such action, the child must have suffered from a
“serious physical injury” and “the most probable inference from
the medical and factual information” must be that the injuries
were inflicted or permitted to be inflicted by the person to
whose care the physician would return the child. Ibid.
24
(emphasis added). Moreover, whereas under N.J.S.A. 9:6-8.10 a
person with reasonable cause to believe a child has been subject
to abuse “shall report” the incident to child welfare
authorities, under N.J.S.A. 9:6-8.16 the physician is
“empowered,” but not required, to take the child into protective
custody. The two provisions by their very language reveal that
they pertain in different circumstances. More importantly,
nothing in the language of either provision suggests that they
should be read together. The Appellate Division erred in
coupling the two provisions and setting forth a wholly new
standard, untethered to the literal language of N.J.S.A.
9:6-8.10.
N.J.S.A. 9:6-8.10 is the only statute that addresses the
general requirement for reporting to DYFS and it uses the
familiar and well-understood standard of “reasonable cause to
believe.” We hold that the phrase “reasonable cause to
believe,” as used in N.J.S.A. 9:6-8.10, imposes a requirement
that is subject to the test for objective reasonableness. The
statutory duty to report child abuse requires a reasonable
belief based on the facts and circumstances known to the person
on the scene. In other words, was it reasonable for the person
who must decide whether to report to believe that abuse has
occurred, taking into account the background of that person and
the facts and circumstances known to him or her at the time? In
25
each instance, the reasonableness of forming, or not forming, a
belief that an incident of child abuse has occurred must be
tested based on the circumstances of the case. In that review,
the judgment and actions of the person on the scene must survive
the test of objective reasonableness.
V.
Having defined the standard under which any person,
including a doctor like Dr. Yu, is required to report suspected
child abuse, we turn to whether Dr. Yu’s failure to make such a
report in this case was in breach of the standard.
N.J.S.A. 9:6-8.9 defines actions that constitute child
abuse for the purpose of the reporting requirement at issue in
this case. In relevant part, this provision defines “abused
child” as
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, or such other person having his
custody and control, to exercise a minimum
degree of care . . . (2) in providing the
child with proper supervision or
guardianship, by unreasonably inflicting or
allowing to be inflicted harm, or
substantial risk thereof, . . . or by any
other act of a similarly serious nature
requiring the aid of the court[.]
[N.J.S.A. 9:6-8.9(d).6]
6
Subsections (a) and (b) of this provision describe injury
inflicted, or risk of injury created, by “other than accidental
26
In G.S., supra, we considered identical language in
N.J.S.A. 9:6-8.21(c)(4)(b), and concluded that “the phrase
‘minimum degree of care’ refers to conduct that is grossly or
wantonly negligent, but not necessarily intentional.” 157 N.J.
at 178. We held that “a guardian fails to exercise a minimum
degree of care when he or she is aware of the dangers inherent
in a situation and fails adequately to supervise the child or
recklessly creates a risk of serious injury to that child.” Id.
at 181. In Department of Children and Families v. T.B., we
clarified that the statute applies to “grossly negligent or
reckless” conduct by the parent or guardian but does not cover
conduct that is “merely negligent.” 207 N.J. 294, 307 (2011).
Although G.S. and T.B. involved abuse and neglect findings
by DYFS rather than the duty to report child abuse, the
interpretation of N.J.S.A. 9:6-8.21(c)(4)(b) that we espoused in
those cases is applicable to the identical language of N.J.S.A.
9:6-8.9(d). See Oldfield v. N.J. Realty Co., 1 N.J. 63, 69
(1948) (“[T]he general rule is that where a word or phrase
means.” Like the Appellate Division, “we are aware of no facts
in the record to support a reasonable belief that [S.A.’s
ingestion of the cologne] was the result of deliberate conduct.”
L.A., supra, 429 N.J. Super. at 60 n.8. To the extent that L.A.
points to opinion statements in the report of her expert that
cologne tastes badly, that additives are often included to deter
ingestion, and that, in his experience, cologne is normally spit
out, such statements are at best a speculative basis on which to
rest a claim of intentional ingestion. We regard L.A.’s
expert’s speculative comments in his report as legally
insufficient to generate a trial requirement in this matter.
27
occurs more than once in a statute, it should have the same
meaning throughout, unless there is a clear indication to the
contrary . . . .”). Dr. Yu therefore was required to report
S.A.’s emergency room treatment to DYFS if, objectively viewing
the circumstances of the child’s admittance, an emergency
medicine specialist involved in handling this treatment should
have believed that S.A.’s parents or guardians had been reckless
or grossly negligent in supervising her or in allowing her to
access and/or consume the cologne.
Based on the record before us, we agree with the trial
court that, objectively viewed, the circumstances surrounding
S.A.’s presentation at the hospital were insufficient to give
rise to a finding that Dr. Yu behaved unreasonably in failing to
report an incident of suspected child abuse. As all the courts
reviewing this matter have noted, there was no evidence of
intentional behavior by S.A.’s parents or legal guardians in
connection with what Dr. Yu reasonably perceived to be an
accidental ingestion of cologne.
To the extent that in G.S. and T.B. we recognized that
grossly negligent or reckless conduct can sustain an abuse and
neglect finding and, therefore, can provide the underpinnings to
a potentially reportable event, we cannot ignore the fact that
the liquid two-year-old S.A. ingested was a common item found in
many homes. It was not an inherently dangerous item such as an
28
acid, a poison, a gun, or a non-household, sharp cutting
instrument that no reasonable adult would allow in any
accessible proximity to a child of such tender age. While
child-proofing of homes is not a new or revolutionary precaution
in modern life, the idea that a toddler might find a way to get
her hands on a common cosmetic or toiletry item is not
equivalent to grossly negligent or reckless behavior on the part
of a parent. Were that to be so, every accidental ingestion
case presenting at a hospital emergency room would risk becoming
a mandatory child abuse reporting incident. We do not believe
that the reporting obligation was meant to operate in such
fashion. Indeed, it would foster over-reporting, something the
Legislature and Governor Cahill cast a wary eye toward when
fashioning the standard for requiring reporting.7
We add only that later tragic events in the life of this
child cannot cloud the analysis when considering the objective
reasonableness of Dr. Yu’s first and only interaction with two-
year-old S.A. Given that S.A. had no prior history of hospital
involvement at JSMC, the circumstances support Dr. Yu’s
diagnosis and treatment of S.A.’s symptoms and do not render
7
We note in particular the potential negative consequences for
low-income individuals who must resort to emergency room
facilities for health care needs and who might resist seeking
medical help for fear of overly protective medical personnel
reporting suspected child abuse in order to avoid future
liability.
29
objectively unreasonable his failure to report suspected child
abuse. That later episodes of child abuse transpired in this
child’s life does not mean that Dr. Yu erred in not detecting
something prescient of those subsequent events based on his
emergency room interaction with S.A. involving her ingestion of
a common household item like cologne.
In sum, viewing the facts objectively and as presented to
Dr. Yu, we conclude that he did not breach the reporting
obligation in N.J.S.A. 9:6-8.10 in respect of S.A.’s emergency
room visit and treatment for apparent accidental cologne
ingestion.
VI.
The judgment of the Appellate Division is reversed and the
matter is remanded to the trial court for reinstatement of its
judgment dismissing this action against defendants Dr. Yu and
JSMC.
CHIEF JUSTICE RABNER; JUSTICES ALBIN, PATTERSON, and
FERNANDEZ-VINA; and JUDGES RODRÍGUEZ and CUFF (both temporarily
assigned) join in JUSTICE LaVECCHIA’s opinion.
30
SUPREME COURT OF NEW JERSEY
NO. A-55/56 SEPTEMBER TERM 2012
ON CERTIFICATION TO Appellate Division, Superior Court
L.A., as Parent and Legal
Guardian of S.A., a minor,
And L.A., individually,
Plaintiff-Respondent,
v.
NEW JERSEY DIVISION OF YOUTH
AND FAMILY SERVICES; NEW
JERSEY DEPARTMENT OF HUMAN
SERVICES, now known as
DEPARTMENT OF CHILDREN AND
FAMILIES; KEVIN M. RYAN,
FORMER COMMISSIONER; EILEEN
CRUMMY, DIRECTOR OF DIVISION
OF YOUTH AND FAMILY SERVICES;
CHARLES VENTI, FORMER
DIRECTOR OF DIVISION OF YOUTH
AND FAMILY SERVICES; SHALONDA
MARTIN; RICHARD KLEIN, Ed.D.;
CATHERINE HINES, CADS;
GWENDOLYN ARMSTRONG; AUBREY
LUTZ; ANDREA STOKES; MONICA
DUDAK; and PAULETTE TARICA,
Defendants,
and
JERSEY SHORE UNIVERSITY
MEDICAL CENTER,
Defendant-Respondent
and Cross-Appellant,
and
DANIEL YU, M.D.,
Defendant-Appellant
and Cross-Respondent.
1
DECIDED April 23, 2014
Chief Justice Rabner PRESIDING
OPINION BY Justice LaVecchia
CONCURRING/DISSENTING OPINIONS BY
DISSENTING OPINION BY
REVERSE AND
CHECKLIST
REMAND
CHIEF JUSTICE RABNER X
JUSTICE LaVECCHIA X
JUSTICE ALBIN X
JUSTICE PATTERSON X
JUSTICE FERNANDEZ-VINA X
JUDGE RODRÍGUEZ (t/a) X
JUDGE CUFF (t/a) X
TOTALS 7
2