Opinion
A152794
06-06-2018
In re M.M., a Person Coming Under the Juvenile Court Law. ALAMEDA COUNTY SOCIAL SERVICES AGENCY, Plaintiff and Respondent, v. O.M., Defendant and Appellant.
NOT TO BE PUBLISHED IN OFFICIAL REPORTS
California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115. (Alameda County Super. Ct. No. JD002859401) MEMORANDUM OPINION
We resolve this case by memorandum opinion pursuant to the California Standards of Judicial Administration, section 8.1. (See also People v. Garcia (2002) 97 Cal.App.4th 847, 853-855.)
O.M. (father) appeals from an order declaring his daughter M.M. a dependent of the juvenile court pursuant to Welfare and Institutions Code section 300, subdivision (b), and placing her in his home under a plan of family maintenance. He contends the evidence was insufficient to support the jurisdictional order, which was predicated on his failure to seek appropriate medical treatment for M.M. We affirm.
Further statutory references are to the Welfare and Institutions Code.
I. BACKGROUND
In accordance with the substantial evidence standard of review (see post), we state the facts in the light most favorable to the judgment. (In re Ryan N. (2001) 92 Cal.App.4th 1359, 1371.)
M.M. was born to father and T.M. (mother) in 2013 and lives with father along with her two older siblings, who were born in 2009 and 2011. Mother relinquished custody of all three children to father, but visits them often. Father has a long history of contacts with child welfare services in connection with his older children (M.M.'s half-siblings) and stepchildren from previous relationships.
On July 24, 2017, when M.M. was almost four years old, father took her to the emergency room because she had been walking on her toes for over a year. Father, who did not believe in Western medicine, had not previously taken her to a pediatrician except for two occasions when M.M. was accidentally dropped by mother as a newborn and when she was in another accident. M.M. was very small and the physicians at the hospital were concerned she might be suffering from malnutrition or failing to thrive syndrome. She also appeared to have "demineralized bones," a condition that occurs when the body does not get enough calcium and consequently uses calcium from the bones. Malnutrition was ruled out, but hormonal tests suggested a thyroid condition. Casting was necessary to fix a malformation in her feet. Dr. Golden, who treated M.M. at the hospital, was concerned that father had never taken M.M. to see a doctor and believed her health issues could have been addressed sooner if she had been seeing a pediatrician on a regular basis.
M.M. was referred to a gastroenterologist, Dr. Gleghorn, who concluded that M.M.'s tests showed a metabolic abnormality and recommended additional lab work and follow-up with a geneticist. Dr. Gleghorn reported that father did "not want to comply with anything" and thought it was difficult to get him to believe that she had anything important to say. She found father's parenting practices to be "scary" because he would not allow her to communicate with M.M.'s older siblings when they accompanied him to appointments and he made them sit in chairs they carried around with them. She was concerned that father did not feed the children when they were hungry because they ate ravenously when fed in her presence. Dr. Gleghorn thought M.M. might have a syndrome causing her small stature and believed she should be monitored to make sure she is growing.
M.M. was referred to Dr. Shanahan, a neurologist, to evaluate whether her toe-walking was the result of neurological issues. M.M.'s MRI scan was clear, but Dr. Shanahan had concerns about M.M.'s cognitive development and recommended a consultation with a geneticist.
M.M. was also referred to Dr. Amad, an endocrinologist, due to concerns about her growth and a possible hormone disorder. He reported that M.M. had a chromosomal abnormality that might be causing skeletal issues, though the nature of the abnormality was unclear. Dr. Amad thought it was very difficult for father to acknowledge any diagnosis of M.M., and while he had no concerns about father's ability to get M.M. to appointments, he did have concerns about father following recommended treatment. Father was apt to take M.M.'s medical issues "into his own hands," and had substituted a prescription for Vitamin D with an over-the-counter supplement because he believed the vitamin was making M.M. sick. Father was also complacent and dismissive of medical concerns regarding M.M. The minor appeared to have a developmental delay that should be assessed and she required additional lab work to check her hormones.
Father took M.M. to her orthopedic appointments each week to adjust her cast, and those treatments had been successful. The orthopedics nurse who saw M.M. reported that she had transitioned from the cast to leg braces and she (the nurse) had no concerns about M.M. The nurse described father as "odd and unwilling to listen to instructions given by women," and noted that at one appointment he had refused to sign paperwork allowing the hospital to administer treatment, crossing out portions of the form and writing, "I do not agree." His refusal to consent was not an issue at the time but could be in the future.
Respondent the Alameda County Social Services Agency (Agency) filed a second amended dependency petition alleging that M.M. was a person described by section 300, subdivision (b), because "The father, [O.M.] and mother [T.M.] are unwilling to address critical areas of medical care for the minor, [M.M.], to wit: [¶] 1. The father and mother did not take the minor to annual medical appointments resulting in the minor having the following medical issues: abnormal thyroid, demineralized bones, and a chromosomal abnormality."
Father testified that he had first noticed M.M. walking on her toes about two weeks before he took her to the hospital, and he denied telling a social worker at the hospital that she had been walking on her toes for up to a year. Rather, he had seen her walking on her toes in play for some time, but it wasn't until two weeks prior to the hospital visit that her toe-walking caused him concern. Father claimed that tests had shown there was nothing wrong with M.M.'s thyroid and denied that Dr. Amad had told him she suffered from a chromosomal abnormality or should be assessed for developmental dely. He understood from the doctors that M.M.'s chromosomal issue was not a problem unless he and the mother were planning to have more children together, which they were not. Father did not recall Dr. Gleghorn telling him to make a follow-up appointment or advising him that M.M. needed to see another specialist. Father was willing to continue taking M.M. to follow-up tests and examinations and to general check-ups with a pediatrician.
The court sustained the petition and placed M.M. in father's home under a plan of family maintenance.
II. DISCUSSION
The juvenile court may adjudge a minor a dependent child under section 300, subdivision (b), if there is a substantial risk she will suffer serious physical harm or illness from the willful or negligent failure of the parent to provide her with adequate medical treatment. (In re Eric B. (1987) 189 Cal.App.3d 996, 1002-1004 (Eric B.).) We review a finding under this provision for substantial evidence and will affirm the judgment when the finding is supported by reasonable, credible evidence of solid value. (In re Matthew S. (1996) 41 Cal.App.4th 1311, 1319.) As the appellant, father " 'has the burden of showing there [was] no evidence of a sufficiently substantial nature to support the findings or order.' " (In re D.C. (2015) 243 Cal.App.4th 41, 52.)
Substantial evidence supports the juvenile court's jurisdictional finding. Viewed in the light most favorable to the judgment, the evidence showed that father did not take M.M. to regular check-ups with a pediatrician because he did not trust Western medicine. He did take her to the emergency room after seeing her walking on her tiptoes for over a year, where it was discovered that M.M. suffered from a foot abnormality requiring casts that needed to be changed out weekly. If she had been taken to the pediatrician on a regular basis, her walking issues could have been treated in infancy. In addition to the issues with her feet, M.M. appeared to suffer from a hormonal (thyroid) issue, a chromosomal abnormality, and a possible developmental delay. Father appeared unconcerned about these conditions, and denied in his testimony that he had ever been told about them.
Father argues there was no nexus between his conduct and M.M.'s medical conditions. We are not persuaded this renders the evidence insufficient. It is true that father's failure to seek out pediatric care at an earlier date did not cause M.M.'s various medical issues, but the court could reasonably conclude that his delay in taking her to the doctor meant that a foot abnormality which could have been treated during her infancy was allowed to persist until she was almost four years old. Moreover, father's testimony at trial showed he had either failed to mentally absorb the doctors' recommendations, or that he was choosing to ignore the medical advice provided. In light of this, and in light of father's mistrust of Western medicine, the court could reasonably find that jurisdiction was necessary to ensure that M.M. received the treatment she needed in the future. "[N]o reason in either law or logic exists to demonstrate why the state, with the substantial interests it is entitled to assert on its own behalf as well as for a child, should be compelled to hold its protective power in abeyance until harm to a minor child is not only threatened but actual. The purpose of dependency proceedings is to prevent risk, not ignore it." (Eric B., supra, 189 Cal.App.3d at p. 1004.)
Father acknowledges that the record shows he did not correctly understand some of the diagnoses and recommendations made by the doctors, he but argues there was no evidence this lack of understanding placed M.M. at risk. Again we disagree. While a parent might not be expected to understand every nuance of a medical opinion offered about his child, father's testimony that he was not told about M.M.'s possible developmental disability or hormonal condition, and his claim that the endocrinologist told him her chromosomal abnormality was only germane if father and mother planned on having other children, suggested a fundamental misunderstanding of what was at stake. (See In re Petra B. (1989) 216 Cal.App.3d 1163, 1169-1170 [affirming jurisdictional order in case where parents attempted to treat minor's serious burns with herbal remedies; even though wounds had healed by the time of the hearing, "attitude of the parents and confusion about proper medical treatment posed a then-existing threat to Petra's well-being and justified the court's assumption of jurisdiction"].)
Father argues that this case is comparable to In re Joaquin C. (2017) 15 Cal.App.5th 537, 562-565 (Joaquin C.). We find that decision distinguishable. In Joaquin C., the court reversed a jurisdictional finding because the minor was healthy and well-cared for by his mother, the only issue being the mother's mental illness. Unlike the case before us, there was no evidence in Joaquin C. that the mother had ever failed to secure medical treatment for her child and no evidence of an antipathy toward Western medicine suggesting that court supervision was necessary to ensure that appropriate medical treatment was obtained in the future. (Id. at p. 563.)
III. DISPOSITION
The judgment is affirmed.
/s/_________
NEEDHAM, J. We concur. /s/_________
JONES, P.J. /s/_________
SIMONS, J.