Court: Hospital records can substantiate abuse

Bedford child services had appealed law judge’s ‘hearsay’ ruling in child abuse case

Commonwealth Court in a Bedford County case ruled this week that hospital records can be used to substantiate child abuse and that the treating physicians do not have to be called to present evidence of the abuse.

The unusual situation involved suspected a child abuse case.

Bedford County Children and Youth Services through Pennsylvania’s Childline on

June 1, 2017, received a report that a 17-month-old boy was being abused by the mother and the mother’s paramour.

The agency began an investigation on June 2 and removed the child from the mother’s home on June 7.

Records indicated that the child had been treated six times in a period of six months at UPMC facilities for various bruises of the head and neck, swelling in the midsection and a leg injury.

The mother had no explanation for the injuries.

After completing its investigation, the agency concluded child abuse was “indicated” and listed the mother on Childline as the perpetrator.

The mother appealed the decision and was granted a hearing before the Bureau of Hearings and Appeals within the Pennsylvania Depart­ment of Human Services.

An administrative law judge last year reviewed the evidence used by Children and Youth Services and ruled the mother’s name should be expunged because the evidence against her was “not substantial” enough to warrant the finding that she was a perpetrator.

Even though the judge concluded the evidence showed a “troubling narrative,” he commented the finding by the agency was a “classic case of hearsay.”

Hearsay — the lack of direct evidence of wrongdoing — is typically not permitted in court proceedings.

Bedford Children and Youth Services appealed the administrative law judge’s ruling to Commonwealth Court.

On Tuesday, a three-judge Commonwealth Court panel reversed the law judge’s ruling.

In an opinion written by Judge Anne E. Covey, the court ruled the use of authenticated medical records was a hearsay exception.

Medical records from UPMC Children’s Hospital of Pittsburgh outlined the child’s repeated trips to the hospital, the treatment he received and the symptoms that were addressed by the treatment.

The records were introduced during the mother’s hearing by Dr. Rachel P. Berger, who is the chief of UPMC’s Child Advocacy Center.

She stated she weekly reviews medical records underlying each Childline report to determine if proper testing was completed by the physicians, and if not, seeks clarification.

UPMC’s record showed the child was treated six times between Dec. 31, 2016, and June 4, 2017, at UPMC.

According to her review, Berger testified that at least four of the visits resulted from child abuse and a fifth was “concerning.”

A caseworker for Bedford County Children and Youth Services testified she too used the hospital records to confirm injuries to the child.

Because neither Berger nor the caseworker, Ashley Black, had personally examined the child’s injuries, the defense challenged the evidence against the mother as inadmissible hearsay.

The Commonwealth Court cited a prior Superior Court decision that found hospital records are “routinely used to make decisions upon which the health and life of the patient depend.”

The Covey opinion cited other cases in which “hospital records are admissible to show the fact of hospitalization, treatment prescribed and symptoms found.”

She wrote the medical records cited by Berger and Bedford County “were admissible as a hearsay exception under the (Penn­sylvania) Business Records Act.”

“Because BCCYS met its burden of establishing substantial record evidence that minor suffered child abuse by reason of (mother’s) acts or omissions and, thus, (mother’s) indicated report is accurate and the administrative law judge and the Bureau of Hearings and Appeals erred by concluding otherwise,” according to the opinion.

Judges P. Kevin Brobson and Christine Fizzano Cannon were on the panel with Covey.

The child, who initially was placed in a foster home, now lives with a relative.