NOT PRECEDENTIAL
UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
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No. 18-2872
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A.P.; V.P.,
Appellants
v.
GLADIBEL MEDINA, Medical Doctor
____________
On Appeal from the United States District Court
for the District of New Jersey
(D.C. No. 2-17-cv-13794)
District Judge: Honorable Susan D. Wigenton
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Submitted Under Third Circuit L.A.R. 34.1(a)
June 13, 2019
Before: HARDIMAN, KRAUSE, and PORTER, Circuit Judges.
(Filed: June 18, 2019)
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OPINION*
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*
This disposition is not an opinion of the full Court and pursuant to I.O.P. 5.7 does
not constitute binding precedent.
HARDIMAN, Circuit Judge.
A.P. and V.P. appeal the District Court’s order dismissing their complaint for
failing to state a claim against Gladibel Medina, M.D. The crux of their complaint is that
Dr. Medina, acting on behalf of the Hudson County Division of Child Protection and
Permanency (DCPP), deprived them of their right to substantive due process. The parents
claim Dr. Medina caused them to lose custody of their two-month-old son because of her
improper investigation and report of the child’s injuries. Because we agree with the
District Court that the complaint failed to meet the high standard to plead a constitutional
tort, we will affirm.
I1
According to the complaint, A.V.P. fell and hit his head on a television stand on
December 23, 2015 and was taken to Christ Hospital. After A.V.P. was transferred to St.
Peter’s Hospital, on December 25, 2015, police officers from the Hudson County Special
Victims Unit interviewed A.P. and V.P. Five days later, DCPP took custody of A.V.P.
without a court order based on the concern that the infant’s injuries had been inflicted.
That custody arrangement was continued by order of the Superior Court of Hudson
1
The District Court had jurisdiction under 28 U.S.C. §§ 1331 and 1343. We have
jurisdiction under 28 U.S.C. § 1291. We review a District Court’s order granting a
motion to dismiss for failure to state a claim de novo. E.g., Evancho v. Fisher, 423 F.3d
347, 350 (3d Cir. 2005).
2
County, New Jersey on January 4, 2016, pending a hearing on the petition for custody
filed by DCPP.
Dr. Medina’s involvement in the matter began on January 6, 2016, when she
examined A.V.P. at the Dorothy B. Hersch Regional Child Protection Center following a
referral by DCPP. She completed Child Protection Center reports dated January 20,
March 21, April 19, and August 1, 2016.
A.V.P.’s parents alleged that Medina violated their right to substantive due process
by relying on “junk science,” by omitting from her reports a test result that supported a
non-abusive explanation for A.V.P.’s injuries, and by misrepresenting his injuries in her
reports. App. 30, ¶¶ 88–90. These circumstances, they argue, supported a reasonable
inference that Medina was deliberately indifferent to their parental rights and to well-
established medicine and science. We agree with the District Court that the complaint
contained insufficient facts to find that Medina’s conduct “shocks the conscience.”
Nicini v. Morra, 212 F.3d 798, 811 (3d Cir. 2000) (en banc) (quoting Miller v. City of
Phila., 174 F.3d 368, 375 (3d Cir. 1999)); see Mammaro v. N.J. Div. of Child Prot. &
Permanency, 814 F.3d 164, 169 (3d Cir. 2016). After DCPP and the Superior Court
decided to separate A.V.P. from his parents pending medical investigation, Medina had a
reasonable basis to continue her investigation until genetic testing revealed another
(extremely rare) explanation for A.V.P.’s injuries. And when Medina stated those results
in her final report, DCPP immediately sought dismissal of its custody petition.
3
Integral to the parents’ complaint, and quoted throughout it, are Medina’s detailed
reports and updates about her investigation. As such, the District Court could consider the
reports in their entirety—without converting the motion to dismiss into one for summary
judgment or necessarily accepting the complaint’s characterizations of their contents. See
In re Burlington Coat Factory Sec. Litig., 114 F.3d 1410, 1426 (3d Cir. 1997).
Those reports show that Medina recognized from the outset that A.V.P.’s injuries
might not have resulted from abuse and that further investigation was needed, because
abusive head trauma had not been ruled out. See App. 47 (“[M]edical work-up is not
complete and metabolic testing through genetics is still pending to rule out an organic
disorder potentially associated with the injuries found on this infant. Abusive Head
Trauma must be considered as this investigation continues and should be explored with
all of [A.V.P.’s] caregivers given the safety risks involved.”). The parents respond that
the reports’ discussion of the evidence about A.V.P.’s bilateral multilayered retinal
hemorrhages and chronic subdural hemorrhages shows that Medina’s ongoing medical
investigation was a “cover up” and “stall tactic.” Appellants’ Br. 11.
Regarding both types of hemorrhages, A.V.P.’s parents argue that Medina’s
references to “rapid” or “repetitive acceleration/deceleration incidents” reveal that she
based her decisions to continue the investigation on shaken baby syndrome—a
discredited basis, they allege, for explaining his hemorrhages. App. 47, 50; see also
Cavazos v. Smith, 565 U.S. 1, 13–14 (2011) (Ginsburg, J., dissenting) (collecting
4
research). This forms the crux of their “junk science” argument, but it ignores two key
qualifications in Medina’s reports. First, Medina did not diagnose “inflicted” or “Abusive
Head Trauma” based on “repetitive acceleration/deceleration incidents” alone. App. 47,
50. She merely noted that injuries like A.V.P.’s can result from such incidents. In
addition, she cited “acceleration/deceleration incidents with or without impact.” App. 47
(emphasis added). Incidents with impact—as could result from inflicted abuse without
shaking—could have caused the hemorrhages Medina observed. So the parents claim
only half of one example was in error. Even assuming it was, Medina’s mention of
acceleration/deceleration incidents without impact as a potential cause, when read in
context, does not plausibly demonstrate deliberate indifference or shock the conscience.
See Miller, 174 F.3d at 375–76 (explaining that the degree of wrongfulness depends on
the circumstances, but allegations of negligence or simple error do not state a valid
substantive due process claim). What’s more, she had another reasonable basis to
continue investigating, which she made clear in the same sentence: incidents with impact.
At the same time, she did not rule out “an organic disorder potentially associated with the
injuries.” App. 47.
Regarding the chronic subdural hemorrhages, A.V.P.’s parents argue that
Medina’s omission of an MRI scan showing extra-axial cerebral spinal fluid collection
(not just blood) and her misrepresentation of that fluid collection as only a chronic
subdural hemorrhage (just blood) reveal her deliberate indifference. But Medina’s first
5
report does mention the MRI scan. App. 46–47. And that mention, albeit brief, does not
rule out the presence of spinal fluid; instead, it accurately states that blood was present:
“defined by CT and MRI head studies as demonstrating acute, subacute and chronic
subdural intracranial bleeding components (old and new blood).” Id. Thus, reading the
reports in full, Medina did not omit or misrepresent the MRI findings, let alone do so in a
way that could support a claim of deliberate indifference or conscience-shocking
behavior.2
* * *
For the reasons stated, we will affirm the District Court’s order.
2
For the same reasons, the complaint proves insufficient under the professional
judgment standard we have noted could apply to professionals in the child custody
context. Nicini, 212 F.3d at 811 n.9 (requiring “such a substantial departure from
accepted professional judgment, practice, or standards as to demonstrate that the person
responsible actually did not base the decision on such a judgment” (quoting Youngberg v.
Romeo, 457 U.S. 307, 323 (1982)).
6