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Wednesday, April 30, 2014

L.A. v. D.Y.F.S.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.


L.A. v. D.Y.F.S. (A-55/56-12)  
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. 
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. 
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).

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).  
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. ( 
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. 
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.