Opinion
B328504
11-14-2024
In re MATTHEW B., A person Coming Under the Juvenile Court Law. v. R.V., Defendant and Appellant. LOS ANGELES COUNTY DEPARTMENT OF CHILDREN AND FAMILY SERVICES, Plaintiff and Respondent,
Jesse McGowan, under appointment by the Court of Appeal, for Defendant and Appellant. Dawyn R. Harrison, County Counsel, Kim Nemoy, Assistant County Counsel, Melania Vartanian, Deputy County Counsel, for Plaintiff and Respondent.
NOT TO BE PUBLISHED
APPEAL from an order of the Superior Court of Los Angeles County, No. 22CCJP02054 Jean M. Nelson, Judge. Affirmed.
Jesse McGowan, under appointment by the Court of Appeal, for Defendant and Appellant.
Dawyn R. Harrison, County Counsel, Kim Nemoy, Assistant County Counsel, Melania Vartanian, Deputy County Counsel, for Plaintiff and Respondent.
CURREY, P. J.
INTRODUCTION
R.V. (mother) appeals from the juvenile court's orders taking jurisdiction over her child, Matthew (born December 2010), removing him from her, and placing him with the Los Angeles County Department of Children and Family Services (Department) pursuant to Welfare and Institutions Code section 300. As discussed in greater detail below, the juvenile court concluded mother had abused Matthew, and would likely continue to abuse him, by falsely reporting or exaggerating symptoms Matthew supposedly suffered to his medical providers and obtaining unneeded medical care for him. An expert testified mother's behavior was consistent with a condition sometimes called "factitious disorder imposed on another" or "Munchausen by Proxy."
All undesignated statutory references are to the Welfare and Institutions Code.
Mother argues (1) the juvenile court erred in granting the Department's request for a continuance, (2) the juvenile court erred in admitting expert testimony, and (3) insufficient evidence supports the juvenile court's jurisdictional findings and dispositional orders. We affirm.
The parties are familiar with the facts and procedural history of the case, so we do not fully restate those details here. (People v. Garcia (2002) 97 Cal.App.4th 847, 851 [unpublished opinion merely reviewing correctness of trial court's decision "does not merit extensive factual or legal statement" (fn. omitted)].) Instead, in the Discussion, post, we discuss the facts as needed to provide context for and resolve the issues presented on appeal.
DISCUSSION
I. Mother's Appeal is Not Moot
During the pendency of mother's appeal, the juvenile court terminated its jurisdiction, awarded father sole legal and physical custody, and ordered supervised visitation for mother. The order terminating jurisdiction is the subject of a separate appeal (B339233) still being briefed. We accordingly asked for supplemental briefing from the parties on whether this appeal was now moot.
"[T]he critical factor in considering whether a dependency appeal is moot is whether the appellate court can provide any effective relief if it finds reversible error." (In re N.S. (2016) 245 Cal.App.4th 53, 60.) Generally, once a juvenile court terminates jurisdiction, an appeal from an earlier order is moot. (In re Rashad D. (2021) 63 Cal.App.5th 156, 163.) Nonetheless, "a case is not moot where a jurisdictional finding affects parental custody rights [citation], curtails a parent's contact with his or her child [citation], or 'has resulted in [dispositional] orders which continue to adversely affect' a parent." (In re D.P. (2023) 14 Cal.5th 266, 277-278.) Here, the jurisdictional findings resulted in an exit order that granted father sole physical custody and limited mother's contact with the child.
Moreover, because mother has appealed from the juvenile court's order terminating its jurisdiction, we can grant her effective relief if she prevails in this appeal. (See In re Gael C. (2023) 96 Cal.App.5th 220, 225 ["'in most cases . . . for this court to be able to provide effective relief, the parent must appeal not only from the jurisdiction finding and disposition order but also from the orders terminating jurisdiction and modifying the parent's prior custody status'"]; In re Rashad D., supra, 63 Cal.App.5th at p. 164 ["to the extent an appellant argues, as here, that the challenged jurisdiction finding resulted in an adverse juvenile custody order . . ., an appeal from the orders terminating jurisdiction and awarding custody is necessary" (fn. omitted)].)
On this record, we conclude mother's challenge to the jurisdictional and dispositional findings are not moot. We thus consider the merits of her argument.
II. The juvenile court did not prejudicially err in granting the Department's request for a continuance to retain an expert on Munchausen by Proxy Syndrome
Mother contends the juvenile court prejudicially erred in granting the Department's request for a continuance to retain an expert because it failed to state good cause for granting the continuance, erred by continuing disposition beyond the sixmonth time limit outlined in section 352, subdivision (b), and erred by continuing the hearing to allow the Department to introduce expert testimony.
Section 352, subdivision (b) provides in relevant part: "The court shall not grant continuances that would cause the [disposition] hearing . . . to be completed more than six months after [the detention] hearing ...."
a. Governing Principles and Standard of Review
"The juvenile court has the power to 'control all proceedings during the hearings with a view to the expeditious and effective ascertainment of the jurisdictional facts and the ascertainment of all information relative to the present condition and future welfare of the person upon whose behalf the petition is brought.'" (In re Emily D. (2015) 234 Cal.App.4th 438, 447-448.) "Although continuances are discouraged in dependency cases [citation], the juvenile court may continue a dependency hearing upon a showing of good cause, provided the continuance is not contrary to the interest of the child. (See § 352, subd. (a) ['. . . In considering the minor's interests, the court shall give substantial weight to a minor's need for prompt resolution of his or her custody status, the need to provide children with stable environments, and the damage to a minor of prolonged temporary placements.']; [Citation].)" (In re Emily D., supra, 234 Cal.App.4th at p. 448.)
"We review an order denying or granting a continuance for abuse of discretion." (In re Emily D., supra, 234 Cal.App.4th at p. 448.) "To show abuse of discretion, the appellant must demonstrate the juvenile court exercised its discretion in an arbitrary, capricious or patently absurd manner that resulted in a miscarriage of justice." (In re Joey G. (2012) 206 Cal.App.4th 343, 346.)
In In re Angelique C. (2003) 113 Cal.App.4th 509, 523, disapproved on another ground in Conservatorship of O.B. (2020) 9 Cal.5th 989, 1010, the appellate court explained that a failure to abide by the time requirements of section 352, subdivision (b), is not jurisdictional: "'[F]ail[ure] to complete a disposition hearing within six months . . . undermines the expedited policy underlying the bypass provisions.' However, . . . the remedy for a violation of the time limits of section 352, subdivision (b) [is not] to reverse the dispositional order .... Section 352 does not supply a penalty for noncompliance."
b. Analysis
Here, the juvenile court held its detention hearing on May 27, 2022. All counsel stipulated to continue the adjudication hearing in August 2022 because the Department had not submitted its jurisdiction report. The juvenile court granted minor's counsel request for a continuance in September 2022 because the Department had not interviewed Matthew. Based on the Department's request, the court continued the adjudication hearing in November 2022. Mother requested a continuance in December 2022 and another in January 2023. The court issued its disposition order on April 10, 2023, almost a year after it removed Matthew from mother.
Mother's claim that the juvenile court failed to state good cause for the November 2022 continuance is unfounded. The court explained it granted the continuance to obtain additional information on the single allegation in the petition, namely whether mother was obsessively obtaining excessive medical examinations.
Although the delays in this case were regrettable, and perhaps to some extent avoidable, the record fully supports the juvenile court's decision to grant the Department's requested continuance. It was in Matthew's best interest for the juvenile court to obtain his complete medical history. Consequently, mother has not shown the court abused its discretion by ordering the November 2022 continuance.
Although the juvenile court failed to comply with section 352, subdivision (b) by holding the dispositional hearing more than six months after Matthew's removal, mother fails to establish prejudicial error. Mother contends it is probable she would have "secured a more favorable result" if the juvenile court denied the November 2022 request for a continuance because, at that time, the Department did not have enough evidence to support the jurisdictional finding. While the additional evidence obtained during the continuance ultimately supported the petition, the evidence could have, as the juvenile court acknowledged, shown mother's actions were justified and the allegation against her was unfounded. Because mother "cannot demonstrate prejudice resulting from the unauthorized delay, we decline [her] invitation to" reverse the jurisdictional and dispositional orders based on the juvenile court's decision to continue the disposition hearing. (In re Angelique C., supra, 113 Cal.App.4th at p. 523.)
III. The juvenile court did not prejudicially err in allowing the Department to admit expert testimony
Mother next contends the juvenile court erred by allowing the Department to offer Professor Beatrice Yorker as an expert witness.
We will not disturb the juvenile court's evidentiary rulings absent a showing of manifest abuse of discretion. (In re Roberto C. (2012) 209 Cal.App.4th 1241, 1249.)
Contrary to mother's claims, the record shows Professor Yorker did not provide a medical diagnosis nor testify (except in passing) about forms of child abuse. Nor did Professor Yorker "second-guess" Matthew's doctors. Instead, she distilled the extensive medical records to make them understandable to laypeople and the court. Professor Yorker also testified mother's actions of exaggerating and falsely reporting medical conditions placed Matthew at risk of serious physical harm, damage, and danger. These topics were relevant and within Professor Yorker's field of expertise. Consequently, the juvenile court did not abuse its discretion in admitting Professor Yorker's testimony.
IV. Substantial evidence supports the juvenile court's jurisdictional findings
Mother next challenges the juvenile court's findings sustaining the petition. She argues the juvenile court's findings are unsupported by substantial evidence. We disagree.
a. Governing Principles and Standard of Review
"'In reviewing a challenge to the sufficiency of the evidence supporting the jurisdictional findings and disposition, we determine if substantial evidence, contradicted or uncontradicted, supports them. "In making this determination, we draw all reasonable inferences from the evidence to support the findings and orders of the dependency court; we review the record in the light most favorable to the court's determinations; and we note that issues of fact and credibility are the province of the trial court."'" (In re I.J. (2013) 56 Cal.4th 766, 773.) "'"We do not reweigh the evidence or exercise independent judgment, but merely determine if there are sufficient facts to support the findings of the trial court. [Citations.] '"[T]he [appellate] court must review the whole record in the light most favorable to the judgment below to determine whether it discloses substantial evidence . . . such that a reasonable trier of fact could find [that the order is appropriate]."'"'" (Ibid.; see also In re Dakota H. (2005) 132 Cal.App.4th 212, 228 ["The [order] will be upheld if it is supported by substantial evidence, even though substantial evidence to the contrary also exists and the trial court might have reached a different result had it believed other evidence"].)
As relevant here, a dependency court may determine a child is subject to the court's jurisdiction under section 300, subdivision (b) if it finds by a preponderance of the evidence that "The child has suffered, or there is a substantial risk that the child will suffer, serious physical harm or illness, as a result of . . . [¶] . . . [t]he failure or inability of the [ ] parent [ ] to adequately supervise or protect the child[,] [¶]. . .[¶] [or by] [t]he willful or negligent failure of the parent [ ] to provide the child with adequate . . . medical treatment[,] [¶] [or by] [t]he inability of the parent [ ] to provide regular care for the child due to the parent's . . . mental illness . . ." Where the child has not suffered actual harm, the evidence must establish "'that at the time of the jurisdictional hearing the child is at substantial risk of serious physical harm.'" (In re A.G. (2013) 220 Cal.App.4th 675, 683.)
"The court need not wait until a child is seriously abused or injured to assume jurisdiction and take steps necessary to protect the child." (In re N.M. (2011) 197 Cal.App.4th 159, 165.) "'The purpose of dependency proceedings is to prevent risk, not ignore it.'" (Jonathan L. v. Superior Court (2008) 165 Cal.App.4th 1074, 1104.) "A parent's '"[p]ast conduct may be probative of current conditions" if there is reason to believe that the conduct will continue.'" (In re Kadence P. (2015) 241 Cal.App.4th 1376, 13831384, overruled on another ground in In re N.R. (2023) 15 Cal.5th 520, 560.) However, "[e]vidence of past conduct, without more, is insufficient to support a jurisdictional finding under section 300. There must be some reason beyond mere speculation to believe the alleged conduct will recur." (In re James R. (2009) 176 Cal.App.4th 129, 135-136, abrogated on other grounds by In re R.T. (2017) 3 Cal.5th 622, 628.) "The appellant has the burden of showing there is no evidence of a sufficiently substantial nature to support the findings or orders." (In re E.E. (2020) 49 Cal.App.5th 195, 206.)
b. Analysis
As described below, the juvenile court examined lengthy reports describing Matthew's medical records and history. It also heard testimony from Professor Yorker, a doctor, Matthew's foster mother, and mother. We discuss some of the relevant medical history below.
Mother claimed Matthew could not attend in-person schooling because he experienced migraines, seizures, severe panic attacks, and "horrible" behavior. School staff reported Matthew was well-mannered and engaging and had never had a panic attack while in school. During a virtual Individualized Education Plan meeting, mother abruptly logged off because she said Matthew was traumatized by the meeting. Matthew did not directly participate in the meeting. But he was seen smiling in the background and did not appear traumatized or upset.
During an in-home interview with the Department, mother reported fire alarms caused Matthew to experience panic attacks. When the Department social worker told Matthew not to worry about the fire alarm making a loud sound, he shrugged and said, "I don't care"
During Matthew's removal from mother, mother stated he was having a panic attack and that he was "going to lose it." The Department observed Matthew to be calm. While Matthew gathered belongings, mother stated, "[P]lease be patient[;] he is having a panic attack." A police officer observed Matthew was fine and reported this to mother. She responded: "No, he is sitting on the floor and his heart is beating fast." Matthew appeared calm and curious throughout his transport to the foster home and at no point had a panic attack.
Mother reported Matthew had pulled out ten of his teeth due to anxiety. But Matthew was not missing any teeth.
Based on mother's complaints that Matthew had constipation, food allergies, dysphasia (an eating and swallowing disorder), other eating problems, and food intake issues, Matthew had five or six contacts with the hospital. None of these contacts led to any remarkable findings. Matthew underwent a colon biopsy based on mother's concerns, which required him to be sedated and included a colonoscopy. The results of the procedure were unremarkable. Matthew was ultimately diagnosed with constipation.
Because mother reported Matthew was suffering from seizures, severe headaches, and migraines, Matthew underwent three neurology consults between 2014 and 2016 and an MRI in 2015. None of the consults nor the MRI identified a condition. Mother again reported Matthew was suffering from seizures in 2017 and Matthew underwent additional testing. The results came back normal. Hospital staff never observed any indication of Matthew's seizures, nor did he seize while at the hospital. Matthew's foster mother reported he had not had any seizures while he was in her care.
Mother reported Matthew could not hear people when they spoke to him and was hypersensitive to certain noises. Based on these complaints, Matthew was placed under sedation and underwent an audiology test. The results were negative. Matthew's foster mother reported he did not have any hearing issues while in her care.
Mother reported Matthew suffered from a condition that prevented him from recognizing faces. This condition was never confirmed and Matthew's foster mother reported he had no difficulty recognizing people's faces. A person at Matthew's school reported he went "'in and out,' as he does not recognize familiar faces" but also reported Matthew appeared "drugged up" during virtual learning.
Mother complained Matthew experienced bluish lips and worried he would pass out due to his racing heartbeat. As a result, Matthew underwent two separate EKGs and echocardiograms and wore a halter monitor for two weeks. The test results came back normal.
Because mother reported Mathew suffered psychological and behavioral issues, doctors prescribed Matthew Ritalin, Zoloft, Serta, Ritalin extended release, guanfacine, and melatonin. Doctors first prescribed medication when Matthew was four years old and continued to do so until the time of the detention hearing. Before the COVID pandemic, mother reported Matthew's behavior was worsening, that the medication was wearing off, and that he needed medication more times during the day. In contrast, Matthew's teachers reported there was no indication he was on medication or that it was wearing off throughout the day when he was going to school in person.
Matthew last saw his doctor in person in June 2021. Notably, Matthew's medication increased significantly during the COVID pandemic, when his medical visits were virtual or telephonic. The impetus for the increase in medications was mother's calls to medical professionals where she reported Matthew's medical issues were getting worse. Specifically, she alleged he was becoming harder to manage, was much more anxious, and was displaying obsessive-compulsive disorder. When a doctor recommended Matthew undergo lab work essential to monitor his prescriptions, mother was resistant. The doctor continued prescribing medication due to mother's accounts of Matthew's behavior. Doctors attempted to reduce Matthew's medication dosage in 2022 but mother reported Matthew was exhibiting serious behavioral issues.
In August 2022, after Matthew's removal, mother requested a medication refill on behalf of Matthew's caregiver. The doctor refused to refill the prescription and advised that Matthew's foster mother take him to a provider. In 2023, Matthew's psychiatrist reported his psychotropic medication doses were extremely high and indicated his Sertraline dosage (a medication used to treat his anxiety and depression) would be considered high for many adults. The psychiatrist was concerned mother used Matthew's medication as a behavioral control.
Although Matthew was diagnosed with autism at two and a half years old in 2013, the assessor strongly recommended his diagnosis be later reevaluated because of Matthew's young age. When Matthew was reassessed in 2015, doctors determined he was not autistic. Despite the new diagnosis, mother continued to report Matthew was severely autistic to his school, doctors, therapist, and the Department.
Because mother represented Matthew was immunocompromised, Matthew underwent repeated blood tests. All of his tests came back normal. Mother reported this alleged condition to a doctor who reviewed Matthew's medical records and determined no evidence supported her claim.
When the Department interviewed Matthew and asked whether mother had reported to a doctor that something was wrong with him, but the doctor said there was nothing wrong, Mathew responded: "Many times. Many, many, many times. My mom says something like, 'Help me,' and the doctor says, 'I don't see anything wrong.'"
The record does show some of mother's reporting was accurate. For example, the record shows Matthew occasionally experienced panic attacks. He reported he had a panic attack after locking himself in a suitcase. Matthew's foster mother reported he experienced three or four panic attacks when he could not control his hiccups or sneezes. Additionally, mother's report that Matthew had a spinal cyst is supported by medical records. However, as detailed above, the record reflects mother repeatedly reported unfounded medical issues that subjected Matthew to significant medical testing, scans, biopsies, appointments, and medication. In her opening brief, mother admits her reporting was exaggerated. Consequently, substantial evidence supported the juvenile court's finding that mother obsessively obtained excessive medical examinations and treatments for Matthew.
Mother argues Matthew's medical and mental health treatment was not based solely on her reporting but instead on "first-hand observations and testing by qualified professionals." In support, mother cites testimony and reporting from Dr. Edward Bloch, Dr. John Harlow, and Dr. Stephanie Marcy. Dr. Bloch reported mother was "overly concerned" but did not exhibit Munchausen by Proxy. Dr. Harlow initially reported Matthew underwent various tests and assessments based solely on mother's requests, but later reported he was summarizing what he saw in Matthew's medical records and emphasized he had "never met the minor or the mother." Dr. Marcy initially reported mother "may be projecting her trauma on [Matthew] by selfdiagnosing him with various issues that were proven false after [Matthew] [wa]s thoroughly checked by medical professionals." She also never witnessed Matthew having the panic attacks or behavioral issues mother reported. During trial, Dr. Marcy reported she never had any concerns about Matthew's safety and that, as a mandatory reporter, she would have reported such concerns if she had them.
The juvenile court explained it relied on the records from the above-referenced doctors and noted: "This is really a case that is driven more by medical records, and [ ] the assessments [ ] these professionals provided in letters and reports." Moreover, the juvenile court explained it did not put much weight on Dr. Bloch's assessment or Dr. Marcy's change in position. Additionally, it explained Dr. Harlow's original list of concerns in the Detention Report still carried significant weight.
Finally, mother's contention that the juvenile court's decision was primarily based on concerns for Matthew's educational and behavioral development misrepresents the record. Although the juvenile court did note mother's actions could possibly impact Matthew's life as an adult, the juvenile court cited evidence outlining mother's actions that placed Matthew at risk of harm. Specifically, the juvenile court noted how mother's exaggerated and false reporting impacted Matthew's level of medication and the number of medical assessments he underwent.
As noted above, it is not our role to "'"reweigh the evidence or exercise independent judgment, but merely determine if there are sufficient facts to support the findings of the trial court."'" (In re I.J., supra, 56 Cal.4th at p. 773.)
V. Substantial evidence supports the juvenile court's removal order
We next consider mother's challenge to the juvenile court's removal order.
"At the dispositional hearing, a dependent child may not be taken from the physical custody of the parent under section 361 unless the court finds there is clear and convincing evidence there is or would be a substantial danger to the child's physical health, safety, protection, or physical or emotional well-being if returned home, and that there are no reasonable means to protect the child's physical health without removing the child." (In re D.B. (2018) 26 Cal.App.5th 320, 328; see also § 361, subd. (c)(1).) The court must determine "whether reasonable efforts were made to prevent or to eliminate the need for removal of the minor from their home" and "shall state the facts on which the decision to remove the minor is based." (§ 361, subd. (e).)
In determining whether to remove a child from parental custody, "the juvenile court may consider the parent's past conduct and current circumstances, and the parent's response to the conditions that gave rise to juvenile court intervention." (In re D.B., supra, 26 Cal.App.5th at p. 332.) The court "must also consider whether there are any reasonable protective measures and services that can be implemented to prevent the child's removal from the parent's physical custody." (Ibid.) "The parent need not be dangerous and the minor need not have been harmed before removal is appropriate. The focus of the statute is on averting harm to the child." (In re T.W. (2013) 214 Cal.App.4th 1154, 1163; accord, In re D.B., supra, 26 Cal.App.5th at p. 328.)
We review the disposition order for substantial evidence, bearing in mind that because section 361 requires clear and convincing evidence, the record must contain substantial evidence "from which a reasonable trier of fact could find the existence of that fact to be highly probable." (In re V.L. (2020) 54 Cal.App.5th 147, 149.) We view the record in the light most favorable to the judgment and accord deference to the juvenile court's credibility determinations, reasonable inferences, and resolution of evidentiary conflicts. (See id. at p. 155.)
The facts supporting jurisdiction also support the removal order. As explained above, mother's repeated reporting of invented or exaggerated medical issues subjected Matthew to excessive medical examinations and treatments. Although mother argues the juvenile court could have ordered Matthew to attend a "more traditional school," this remedy would not prevent mother from falsely reporting medical issues and subjecting Matthew to excessive medical examinations and treatments. Because the court's finding of substantial danger to Matthew if left in mother's custody is supported by substantial evidence, we affirm the removal order.
DISPOSITION
The jurisdictional findings and dispositional orders are affirmed.
We concur: COLLINS, J., ZUKIN, J.