Opinion ID: 4520785
Heading Depth: 2
Heading Rank: 1

Heading: A.M.S.’s Birth and the Initial Drug Test

Text: In February 2017, St. Elizabeth Medical Center, Inc. (“St. Elizabeth”) admitted Plaintiff Holly Schulkers (“Holly”) for a scheduled labor induction. Prior to giving birth, St. Elizabeth tested a sample of Holly’s urine, which returned a “presumptive positive” result for opiates. Holly did not consent to the urine testing, and she was never told that the testing would be performed. Approximately sixteen hours after the urine testing, Holly gave birth to her newborn child, A.M.S., without complications. Holly breastfed A.M.S. within the first hour of giving birth. The hospital pediatrician examined A.M.S. and advised Plaintiff David Schulkers (“David”) that the hospital intended to discharge Holly and A.M.S. later that afternoon. Shortly after the pediatrician left Holly’s hospital room, Anne Marie Davis, a care coordinator and social worker with St. Elizabeth, visited Holly in her hospital room. Davis informed Holly that her urine had tested positive for opiates, and asked Holly if she was taking No. 19-5208 Schulkers, et al. v. Kammer, et al. Page 3 any medications. Holly responded that she had recently taken some of her daughter’s prescription cough medicine and that she had eaten a bag of chips that contained poppyseeds prior to giving birth. Holly was unable to confirm if the cough medicine contained codeine, which Davis stated could cause a positive result for opiates. Holly inquired whether her consumption of poppyseed chips prior to giving birth could have caused the false positive. Davis responded that it could not. Davis informed Holly that A.M.S.’s umbilical cord was also tested, but the results were still pending. Davis further informed Holly that depending on the results of the umbilical-cord testing, the hospital might contact the Kentucky Cabinet for Health and Family Services (“CHFS”).1 St. Elizabeth did not perform a confirmatory test, known as a “Drug of Abuse with Reflex to Confirmation” test, on Holly’s first urine sample even though that sample was still available. Before receiving the results for the umbilical cord testing, Davis charted that Holly had a positive drug screen and indicated that Holly had a “substance use disorder” even though St. Elizabeth’s records indicated that Holly’s prenatal lab tests had all been negative for substance abuse and that she had no history of drug use. At some point after speaking with Holly but before receiving the results for the umbilical cord testing, Davis reported to the CHFS via a web-based reporting system that Holly had a positive drug screen. The transmission stated: Holly [Schulkers] delivered baby on 2/9. [Urinary Drug Screen] was positive for opiates 200. At first Holly did not know why she would have had a positive drug screen. No prescriptions. Later she stated she was taking her other daughter’s prescribed cough medicine. Asked if there was codiene [sic] in the cough medicine as this would account for positive screen. Holly did not know. Holly has 4 other biological children in her custody. Baby’s [umbilical] cord was sent for tox screen. R. 67-3, CHFS Intake Summary, Pg. ID 1542. 1 A Kentucky reporting statute requires that “[a]ny person who knows or has reasonable cause to believe that a child is dependent, neglected, or abused shall immediately cause an oral written report to be made” to local law enforcement, state police, or the CHFS. Ky. Rev. Stat. § 620.030(1)–(2). No. 19-5208 Schulkers, et al. v. Kammer, et al. Page 4 The report was received by Bethany Grimes, a centralized intake social worker with the CHFS, who is responsible for determining whether a report meets the CHFS’s criteria for opening a case. Grimes understood from the report that Holly was the primary caregiver to five children, including newborn A.M.S. Pursuant to the CHFS’s Standards of Practice (“SOPs”), Grimes decided to open a case to investigate abuse or neglect of Holly’s children because she thought that the children might be at a “risk of harm.” R. 67-3, Grimes Dep., Pg. ID 1556. According to the relevant SOP, a child is at a risk of harm if “the caretaker engages in a pattern of conduct that renders him or her incapable of caring for the immediate and ongoing needs of the child due to incapacity due to alcohol or other drugs.”2 Id.; see also R. 67-7, SOP 2.3, Pg. ID 1624, 1632. The case was assigned to Defendant Allison Campbell, the superviser of Defendants Elizabeth Kammer (“Kammer”) and Kara (“Kara”).3 Later that afternoon, Holly and David were informed that A.M.S. could no longer be discharged because hospital policy required staff to observe A.M.S. for seventy-two hours for symptoms of withdrawal. St. Elizabeth permitted Holly to continue breastfeeding A.M.S. during the seventy-two hour observation period.