Harold Levy: Publisher; The Charles Smith Blog.
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PASSAGE OF THE DAY; 'The Donlins' ordeal is not unique. Hospitals routinely conduct nonconsensual drug tests on perinatal patients and their newborns. As a result, medical providers are often the leading reporters nationwide of new parents who become involved with child protective services and law enforcement agencies. Broadlawns (Medical Center) declined to comment on the Donlins' case, citing federal and state privacy laws. But hospitals say such policies are necessary for child welfare and to ensure the long-term wellness of parents who may be struggling with substance use. Yet while providers say they approach testing with compassion, existing policies create immense stress for parents, who often face the threat of separation from their children or even criminal charges.'
STORY: "Hospital policy prompted a surprise drug test that nearly cost an Iowa couple their 2 sons," by Michaela Ramm, published by The Des Moines Register, on January 4, 2024.
GIST: The birth of Emily and Michael Donlin's second child did not go as planned.
The labor progressed quickly, and Emily gave birth March 30 on the back porch of their Des Moines home. Michael caught the baby, a healthy baby boy they named Paul.
Emily and Michael were overjoyed, eager to introduce Paul to his older brother, Walter, now 2, after an ambulance transported Emily to be checked over at Broadlawns Medical Center in Des Moines.
But their joy was soon shattered when they discovered Broadlawns had conducted a drug screening on a portion of the umbilical cord, without Emily Donlin's knowledge or her consent. It came back positive for cocaine.
The Donlins were reported to Iowa Child Protective Services for child abuse, thrusting them into an eight-month fight for custody of their sons.
Emily, 31, maintains there was a mistake, saying neither she nor her husband, also 31, have ever used any illicit substances — let alone cocaine. But their protests didn't matter, they say: The system immediately assumed they were bad parents.
“It changes your whole worldview because you believe you can trust these parties. We trusted that they were going to do what’s right, and that they would see what’s actually going on and that we’re not doing drugs," Emily Donlin said. "But we quickly realized that we actually can’t trust them.”
The Donlins' ordeal is not unique. Hospitals routinely conduct nonconsensual drug tests on perinatal patients and their newborns.
As a result, medical providers are often the leading reporters nationwide of new parents who become involved with child protective services and law enforcement agencies.
Broadlawns declined to comment on the Donlins' case, citing federal and state privacy laws. But hospitals say such policies are necessary for child welfare and to ensure the long-term wellness of parents who may be struggling with substance use.
Yet while providers say they approach testing with compassion, existing policies create immense stress for parents, who often face the threat of separation from their children or even criminal charges.
Many Iowa hospitals test patients if risk factors are identified
Though Iowa hospitals each have their own policies for perinatal drug screening, Des Moines hospitals say they follow guidelines developed by the Iowa Neonatal Quality Collaborative that recommend providers follow a risk-based assessment to decide whether to conduct testing. That includes determining whether the patient or the patient's partner has a past history of using substances, among other risk factors.
These state guidelines say all pregnant patients should be assessed for the risk of alcohol use and illicit drug use during every prenatal care visit and at delivery. Drug testing should be used to confirm suspected use.
Broadlawns officials confirmed it does have a policy for drug testing maternal and newborn patients "in the event certain risk factors are identified."
"We want to ensure that families have resources and support, where needed, including referrals for evaluation and services," Emily Toribio, assistant director of communications at Broadlawns, said in a statement.
However, officials declined to elaborate on what may have triggered that test in the Donlins' case. Emily Donlin said she was never told why she was the subject of a drug screen, but she suspects the nature of Paul's birth may have been a reason.
UnityPoint Health and MercyOne also follow these recommendations from state officials, they say.
State guidelines say consent is required if the screening is done on the mother, but no consent is needed for newborn drug testing, according to Dr. Amy Ferguson, medical director for the newborn nursery at Blank Children’s Hospital in Des Moines.
However, Ferguson said many providers inform patients of newborn drug-screening policies early in their prenatal care. Pregnancy is one of the best opportunities to intervene with expecting mothers who are using substances, because the health of the fetus motivates them to seek treatment.
“The earlier that we can identify it, it gives a great layer of support to the mother, and it also gives a great layer of support to this baby when they're born," Ferguson said.
Testing ensures providers have an accurate medical history and can closely follow young patients who have been exposed to substances, said Jennifer Sleiter, pediatric nurse practitioner at the Drug Endangered Children program at Blank’s STAR Center.
“We know if we monitor these kids and identify any problems early on, we can refer these kids to services so they can stay on track, get back on track and to try to avoid problems when they do get older,” she said. “We’re just trying to set them up for success later in life.”
Under state law, health care workers are required to report suspected cases of child abuse, including instances of drug or alcohol use by a pregnant patient.
Though substance use in pregnancy is classified as child abuse under Iowa law, it is not considered a crime.
"The state respects the bond between parent and child," according to guidelines from the Iowa Neonatal Quality Collaborative. "However, the state does assert the right to intervene for the general welfare of the child when there is a clear and present danger to the child’s health, welfare and safety."
No one at Broadlawns told the Donlins of a drug screening, according to the couple. Michael Donlin said they felt betrayed that testing was conducted without their knowledge.
“The sad part is that these doctors don’t realize that even if the kids aren’t taken away, even if the parents are innocent, how it can mess up an entire family,” Michael Donlin said. “… They have no understanding of what it does when somebody comes to your door unannounced with the threat of taking away your kids.”
Parents get unexpected visit, are threatened with losing custody of their sons
Two weeks after Paul's birth, without warning, a case worker from Iowa's Child Protective Services arrived at their door to inform them that Emily had been deemed founded for child abuse because of the positive test.
The couple, who moved to Monroe County shortly after Paul was born, are adamant there was a mistake with the testing. Emily Donlin said she takes a "holistic approach" to her children, declining certain medical interventions during her pregnancies and declining to vaccinate her sons.
She doesn't even take ibuprofen to stave off headaches, she said.
"I have never taken cocaine in my entire life," she said. "This is not an exaggeration. I have literally never taken cocaine."
But Broadlawns declined her request to retest the sample, she said.
Emily Donlin is a stay-at-home mom. Michael Donlin has worked for a Des Moines-based remodeling and construction firm since 2017, and previously helped create a Des Moines urban housing rehabilitation business in 2015.
Emily had seven additional drug tests in the weeks that followed, including a random urine test ordered by the state and a hair test designed to detect use of illicit substances over a 12-month period. All came back negative, according to documents the Donlins provided to the Register.
A drug analysis using umbilical cord tissue is “99.9% accurate” in detecting metabolites the human body creates when consuming substances such as illicit drugs, according to Anthony Burriola, vice president of Mid-Iowa Occupational Testing, a West Des Moines-based lab that specializes in drug and alcohol testing. His company conducted a hair-follicle drug screening for Emily Donlin that came back negative.
Burriola said the highly accurate nature of an umbilical test doesn’t necessarily account for human error. Though exceedingly rare, it is possible samples from two patients could have been switched by mistake.
“That’s the more likely scenario where you would run into a false positive, rather than a scientific reason with the test,” Burriola said.
Burriola said urine tests are accurate only if the individual has consumed that drug four to five days before the sample was taken. Hair strand tests can detect frequent drug usage over several months, but they wouldn't be able to detect if an individual used a drug once or twice.
Emily and Michael Donlin questioned why they were under such intense scrutiny from state officials. A case worker's inspection of their home on April 18 and May 1 found no other evidence of drug use, as confirmed by documents provided by the Donlin family to the Register.
Iowa Department of Health and Human Services, which oversees the state's Child Protective Services division, wouldn't comment on the family's allegations, citing privacy laws.
"Ensuring children are safe is the top priority of the Iowa Department of Health and Human Services (HHS), and we take that responsibility very seriously," according to a statement. "Whenever abuse is suspected, mandatory reporters are required by law to report it to the state and HHS is required to investigate."
Emily and Michael Donlin soon became frustrated with the state's case workers and resisted recommendations that the family undergo intervention services and additional substance-abuse evaluations.
Child Protective Services then escalated the investigation into a Child In Need of Assistance (CINA) case, which occurs when the state asks for the court's intervention to enforce services for the family or to make decisions about custody.
Emily and Michael Donlins' attorney did not return calls from the Des Moines Register.
In November, ahead of a scheduled hearing before a Monroe County judge, the Donlins received a letter informing them that the state planned to recommend their two sons be removed from their custody and placed into foster homes.
“It really does change your whole perspective when a government body can accuse you of something that you haven’t done, and they can remove your children," Emily said.
In some states, hospital drug screenings lead to criminal arrests
Reports from medical professionals are one of the leading causes that entwine families with a state's child protective services division or with law enforcement, accounting for one in three cases nationwide, according to the advocacy group Pregnancy Justice.
The vast majority of referrals result from substance use during pregnancy, according to cases the group studied from 2006 to 2022, per a reportpublished in September.
Research efforts from Pregnancy Justice, which strongly opposes hospital-based drug screenings, focus on arrests or criminal prosecutions of people for reasons related to their pregnancy. The report identified one arrest in Iowa during the time period it studied.
Major medical associations strongly oppose criminalizing substance use in pregnancy, noting that doing so often deters patients from seeking care and leads to worse outcomes for mothers and their children. Local health care officials echoed that stance, saying substance use should be treated as a health condition — not as a crime.
“We wouldn’t criminalize a parent’s ability to care for their child if they have cancer. We’re not going to do that for a substance use disorder either," said Chaney Yeast, director of family services and government relations for Blank Children’s Hospital.
It’s hard to calculate the exact number of families reported to child protective services because of hospital-based drug screening, since those records are not publicly available, according to Lourdes Rivera, president of Pregnancy Justice.
However, the group has found 43% of arrests came from a child abuse investigation.
"Any positive test could open the door to this scrutiny by child protective services, whether or not it's an appropriate or legitimate test or a false positive or a real positive," she said. "People are getting entangled in the system and having their families destroyed and potentially going to jail, so it’s really problematic.”
Though local health care providers emphasize the risk assessments for substance use among pregnant patients are crafted to ensure objectivity, Rivera said Pregnancy Justice research has found these policies are often biased toward people of color and those who are low-income.
As a result, those patients are more likely to face scrutiny from law enforcement or child protective service.
“This testing and criminalizing people through pregnancy has been a really effective tool of surveilling and punishing poor people and people of color through the family policing and the criminal justice system,” she said.
Still, local health care providers who support drug screening say it's necessary, oftentimes becoming a balancing act between supporting families who might be struggling while ensuring the safety of children.
“We want these kids to be able to be with their families and to keep those families together,” UnityPoint Health's Sleiter said. “But there are definitely times when the No. 1 priority is making sure that that child's in a safe and nurturing environment. Sometimes that does require a placement outside of the home."
What could be next for pregnancy drug screening in Iowa?
A bill was introduced during the 2023 Iowa legislative session that would have required Iowa hospitals to test all newborns for illicit substances, and when children test positive, to charge mothers with child endangerment. The bill, Senate File 88, was halted in a subcommittee.
Proposed legislation criminalizing substance use in pregnancy pops up every few years at the Statehouse, but so far, there's been no significant movement on these bills, Yeast said.
On Nov. 20, the Monroe County judge dismissed the CINA case against the Donlin family, and the couple are no longer facing the threat of losing custody of their sons, Walter and Paul, now age 9 months.
During the hearing, District Associate Judge Richelle Mahaffey stated a report from the children’s court-appointed guardian ad litem indicated there was no ongoing safety concerns for the children within the Donlin household and no other evidence of drug use by Emily Donlin. Because of this, the judge said the state hadn't met the grounds for removing parental custody.
Emily will remain on the state's child abuse registry, maintained by Iowa HHS, for the next five years because of the founded report from child protective services. She said they're exploring legal action to remove her name from the registry.
Emily said she was “tormented” by the long months while the case dragged out, and Michael said she was wracked with guilt over the impact the investigation had on their children. She still fears that a wrong move will result in another report to Child Protective Services.
“When you’re accused of something that you haven’t done, it opens up this whole world of possibilities of what could happen to you,” she said.
While Emily and Michael Donlin said they understand the intent behind hospital drug screenings, they believe the practice can cause real, irreversible harm to families. They question why they faced threats of losing custody of their children when they said there was no other evidence of abuse or neglect.
“I can forgive mistakes," Emily Donlin said. "I can forgive a lab if they give me a false positive drug test. I don’t know if I can forgive the nonconsensual drug tests.
"When you’re going to found me for child abuse when I’ve already tested negative on other drug tests, that’s wrong.”"
The entire story can be read at:
https://mail.google.com/mail/u/0/#inbox/FMfcgzGwJcbCLPmlQfGqnhVbJFHVbKdH
| PUBLISHER'S NOTE: I am monitoring this case/issue/resource. Keep your eye on the Charles Smith Blog for reports on developments. The Toronto Star, my previous employer for more than twenty incredible years, has put considerable effort into exposing the harm caused by Dr. Charles Smith and his protectors - and into pushing for reform of Ontario's forensic pediatric pathology system. The Star has a "topic" section which focuses on recent stories related to Dr. Charles Smith. It can be found at: http://www.thestar.com/topic/charlessmith. Information on "The Charles Smith Blog Award"- and its nomination process - can be found at: http://smithforensic.blogspot.com/2011/05/charles-smith-blog-award-nominations.html Please send any comments or information on other cases and issues of interest to the readers of this blog to: hlevy15@gmail.com. Harold Levy: Publisher: The Charles Smith Blog; |
SEE BREAKDOWN OF SOME OF THE ON-GOING INTERNATIONAL CASES (OUTSIDE OF THE CONTINENTAL USA) THAT I AM FOLLOWING ON THIS BLOG, AT THE LINK BELOW: HL
https://www.blogger.com/blog/post/edit/120008354894645705/47049136857587929
FINAL WORD: (Applicable to all of our wrongful conviction cases): "Whenever there is a wrongful conviction, it exposes errors in our criminal legal system, and we hope that this case — and lessons from it — can prevent future injustices.
Lawyer Radha Natarajan;
Executive Director: New England Innocence Project;
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FINAL, FINAL WORD: "Since its inception, the Innocence Project has pushed the criminal legal system to confront and correct the laws and policies that cause and contribute to wrongful convictions. They never shied away from the hard cases — the ones involving eyewitness identifications, confessions, and bite marks. Instead, in the course of presenting scientific evidence of innocence, they've exposed the unreliability of evidence that was, for centuries, deemed untouchable." So true!
Christina Swarns: Executive Director: The Innocence Project;
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YET ANOTHER FINAL WORD:
David Hammond, one of Broadwater's attorneys who sought his exoneration, told the Syracuse Post-Standard, "Sprinkle some junk science onto a faulty identification, and it's the perfect recipe for a wrongful conviction.
