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Grace and Michael Smiths youngest son turned 1 last month, but there were few happy memories from the days after his birth, the couple said.

What should have been a time for the parents to bond with their newborn boy, Julian, became a waking nightmare that still intrudes on the happiness of their family.

Hours after Julian was born in April 2021, staff at St. Lukes Hospital-Anderson Campus took him to the neonatal intensive care unit and accused Grace Smith of abusing methamphetamine while pregnant, launching a monthlong investigation by child welfare authorities that ultimately found no abuse, the couple claims in a federal civil rights lawsuit.

St. Lukes Hospital-Anderson Campus in Bethlehem Township. (April Gamiz / Morning Call file photo)

I wanted to enjoy my sons first birthday, Grace Smith said. Its hard to separate the joy in celebrating him from the pain of having him taken away from us.

The Smiths allege St. Lukes doctors made decisions based on a single drug test that led to their son spending the second night of his life alone in the hospital while they returned in tears to their Monroe County home.

That test was unable to differentiate between the prescription amphetamine Vyvanse that Grace Smith took for attention-deficit/hyperactivity disorder and methamphetamine, which a doctor surmised she got off the street, the lawsuit says.

Methamphetamine, like amphetamine, is a controlled substance that is legally prescribed in some cases but not as commonly as amphetamines such as Vyvanse or Adderall. The two types of drugs have molecular and pharmacological differences but are similar in that they are both stimulants and have the potential to be abused. Vyvanse and Adderall are most commonly prescribed to treat ADHD in both children and adults. When amphetamine is taken by a person with ADHD as prescribed, the risk of abuse or addiction is extremely low, according to Dr. Russell Barkley, an internationally recognized authority on ADHD.

After the Smiths told hospital staff that they intended to leave with their child, they were locked out of the NICU and police arrived, instigating an argument with Michael Smith and blocking his vehicle in the patient pickup area outside. The officers then told the couple that they needed to leave the hospital immediately or they would be arrested for defiant trespassing, the suit says.

The reason given for the ejection of plaintiffs Mr. & Mrs. Smith from defendant St. Lukes Hospital premises was that Mrs. Smith was a methamphetamine addict and that St. Lukes Hospital no longer would tolerate their presence on defendant St. Lukes Hospital property, the suit says.

Although Grace Smith and Julian were reunited in the hospital the following day, the Smiths say the ordeal had a lasting impact on their son and family.

We had pretty much one tradition where our entire family would get together and the siblings would get to meet the newborn baby and that was taken away from us, Michael Smith said. The couple has three other children: Aurora, 8, Anakin, 6, and Ellika, 2.

Michael and Grace Smith spend time with their children Aurora, 8, Anakin, 6, Ellika, 2, and Julian, 1, in their home in Coolbaugh Township, Monroe County. (April Gamiz/The Morning Call)

Julian developed a condition called pyloric stenosis, in which the opening between the stomach and the small intestine becomes constricted, which the Smiths allege was caused by unnecessary antibiotics administered against their wishes. The baby required surgery to correct the condition.

The causes of pyloric stenosis are unknown, but genetic and environmental factors might play a role. Pyloric stenosis usually isnt present at birth and probably develops afterward. The Mayo Clinic lists early antibiotic use as a risk factor.

Now, the Smiths, both lawyers, say they hope their lawsuit will ensure that others like them arent traumatized in the same way. Michael Smith said he drafted the 973-page complaint over the last year and the Smiths are representing themselves. The suit demands tens of millions of dollars in damages and policy changes.

Nobody was listening to us. I just want someone to take us seriously and for them to stop doing this to people, Michael Smith said.

A spokesperson for St. Lukes University Hospital Network did not address the Smiths allegations and said the hospital system maintains full compliance with all federal and state rules and regulations regarding reporting requirements.

The suit also names as defendants nearly two dozen doctors and health care professionals, Monroe and Northampton counties and several of their child welfare employees, and the Bethlehem Township police. Monroe and Northampton counties declined to comment. Bethlehem Township police Chief Greg Gottschall said he is not aware of the suit and could not comment.

Nobody was listening to us. I just want someone to take us seriously and for them to stop doing this to people.

Under Pennsylvania law health care providers are required to give notice to the state Department of Human Services when they determine, based on standards of professional practice, that a child was born affected by substance abuse or withdrawal symptoms resulting from prenatal drug exposure or fetal alcohol spectrum disorder.

The law explicitly states that the notification to Human Services is not a child abuse report. The purpose of the notification is to allow assessment of the child and family to develop a plan of safe care.

Cathleen Palm of the Center for Childrens Justice said the law is intended to ensure that the baby and family are connected to the resources they need.

The concept behind the law is to make sure that we are attentive to an infant that is in withdrawal and provide the support and treatment it requires, Palm said. The challenges are that it is hard to have the law, which might be well-intentioned, implemented in the way it is intended.

She noted that approach is a relatively recent shift from a mindset that reporting mothers who used illegal substances while pregnant was intended to be punitive. The law was amended in 2018 to remove requirements that health care providers make reports directly to county welfare agencies and include substances other than illegal drugs.

Human factors such as bias or a parents demeanor might lead a health care provider to vary in their subjective assessment of a parent and childs situation, Palm said.

Its challenging in that you can have situations that can spin out of control in a way that the law never intended, Palm said.

Advocates for reforming child welfare laws say experiences like the Smiths are unfortunately common in Pennsylvania.

Emma Roth, an attorney at National Advocates for Protecting Women, said there are widespread misconceptions about what health care providers are required to do in terms of responding to infants who are exposed to drugs in utero. Roth said there are also extreme racial disparities in how doctors and authorities respond. People of color and lower income are more likely to be secretly tested, reported and charged.

This is much more common than any of us would hope given the serious civil rights implications, Roth said.

In addition to civil rights violations, reporting mothers who use drugs while pregnant to child welfare authorities and law enforcement has a harmful effect on the overall health of mothers and children, according to the American College of Obstetricians and Gynecologists.

We know that it really undermines the physician-patient relationship by making patients not trust their doctors, Roth said. When mothers dont trust their doctors theyre less likely to seek assistance from their doctors.

Many medical societies encourage doctors to talk with their patients about drug use during pregnancy and, if a patient is using drugs, to make referrals and suggest courses of treatment to ensure the best health and medical outcomes.

The ACOG has said the use of the legal system to address perinatal alcohol and substance abuse is inappropriate. It urges physicians and legislators to work to repeal laws that punish women with substance use disorders and implement programs outside of the legal system to support women with addiction.

Its challenging in that you can have situations that can spin out of control in a way that the law never intended.

The U.S. and Pennsylvania supreme courts have also issued decisions that protect women from being criminally prosecuted for using illegal drugs when pregnant.

The U.S. Supreme Court ruled in 2001 that a hospital violated a patients right to be free from unreasonable searches when it tested her without consent in cooperation with police.

The Medical University of South Carolina in Charleston, South Carolina, started testing obstetric patients for drugs in response to a rise in pregnant patients using cocaine. Those who tested positive were arrested.

The women sued and the court ruled in a 6-3 decision that hospital workers cannot test pregnant women for the use of illegal drugs without their informed consent or a valid warrant. The court found regardless of the risks to the fetus posed by the mothers drug use, testing without patient consent was not a reasonable search under the Fourth Amendment.

At the time, 75 organizations including the American Medical Association and the American Public Health Association filed amicus briefs in favor of the plaintiff.

The Pennsylvania Supreme Court ruled in 2018 that a mother cant be charged with child abuse against her newborn baby because she used drugs while pregnant.

The state courts ruling was the result of a protective custody case initiated by Clinton County Children and Youth Services against a mother. The county alleged the mother had abused her baby because her drug use caused the baby to be born suffering from withdrawal symptoms. The mother had tested positive for opiates, benzodiazepines and marijuana while pregnant.

The court held under Pennsylvanias Child Protective Services Law a fetus is not a child and therefore cannot be the victim of child abuse.

The Smiths, who were not charged with any crimes, are not alone in bringing a civil lawsuit for civil rights violations.

In 2010, the American Civil Liberties Union of Pennsylvania sued Jameson Hospital and Lawrence County Children and Youth Services on behalf of a couple from New Castle.

A hospital drug test found Elizabeth Morts urine positive for opiates and she was reported to the county. Mort and her fiance, Alex Rodriguez, took their newborn daughter home, but the next day social workers and police officers showed up and took the baby away for five days.

Sara Rose, the ACLUs deputy legal director and lead counsel on that case, said the test had an extremely low threshold for detecting opiates, seven times lower than what the federal government used when it tested its employees. Because of this low threshold, the test detected opiates in Morts body that came from poppy seeds on an everything bagel she ate.

This case was eventually settled out of court.

The ACLU and Rose are also involved in an ongoing case against University of Pittsburgh Medical Center involving multiple women who were reported by the hospital system to the Allegheny County Office of Children, Youth and Families.

According to a court document filed in 2017, Cherell Harrington was investigated for child abuse after UPMC reported she used marijuana while pregnant. Harringtons urine, which UPMC staff took without her consent or knowledge, tested positive for marijuana. A test of Harringtons newborn son showed a negative result and Harrington claimed she hadnt used marijuana during her pregnancy.

Harrington had her home inspected and was told she would have to participate in drug counseling and undergo drug testing.

Another plaintiff, Deserae Cook, also had her urine taken without her knowledge or consent, but she tested negative. However, UPMC reported Cook to CYF for using marijuana while pregnant after Cook told a hospital employee she had previously taken medical marijuana to treat her multiple sclerosis but stopped after she found out she was pregnant. This resulted in Cook having her home inspected by the county along with continued unwanted contact from the county.

Rose said UPMC had a duty to protect patient confidentiality under state law, and it breached that duty by sharing the mothers confidential medical information with Allegheny County. She added St. Lukes had the same responsibility to Smith.

I think this is a clear violation of patient confidentiality, Rose said.

When Grace Smith was allowed to return to St. Lukes the night after she was ordered to leave, she was kept under constant watch by security guards and was not afforded the support the hospital provides to new mothers, such as a wheelchair or meals. She also was not given privacy in the NICU to breastfeed or have skin-to-skin contact with Julian, the suit alleges.

Grace Smith holds Julian. (April Gamiz/The Morning Call)

Nurses told Grace Smith that she would not be permitted to leave with Julian because the family had to be cleared by the Monroe County Children Youth and Family office and because it was a weekend no one was available to handle the case. She also learned that a second report had been made to CYF about Michael Smith, alleging that he was aggressive and violent, the suit says.

When she questioned the hospitals handling of her case, a nurse told her, I dont care if you were the preachers daughter, were required to report it by law, the suit alleges.

The Smiths state in the lawsuit that Grace Smith never ingested methamphetamine and has a well-documented history of ADHD for which she had taken Vyvanse since she was 12. The suit also states that Julian had no signs of methamphetamine withdrawal and no court order was obtained to separate the Smiths from their child.

Although the Smiths say in the lawsuit they never obtained the results of the initial urine test that prompted the welfare report, a test of their sons umbilical cord was negative for methamphetamines. Nonetheless, Monroe County ended its investigation of the Smith family only after Grace Smith paid $300 for a hair follicle test that showed she was not a methamphetamine user.

No one involved has admitted that what they did was wrong, Grace Smith said. It makes it all that much more difficult to get past because theyre still acting this way.

Morning Call reporter Peter Hall can be reached at 610-820-6581 or peter.hall@mcall.com.

Morning Call reporter Leif Greiss can be reached at 610-679-4028 or lgreiss@mcall.com.

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St. Luke's doctors mistook a new mom's ADHD medication for illegal drugs. Then they separated her from her baby, lawsuit claims - The Morning Call