Hospitals are reporting new mothers for neglect from poppyseed false positives
reason.com
reason.com
Using a cutoff that is 200 times more strict than standard drug testing practices without giving the patient any warning that they’ll be tested (and guidance to avoid poppy seed foods) is asking for false positives.
Given that the other cases resulted in six-figure settlements, it’s surprising that this practice continues.
a six figure settlement is a rounding error for these institutions. Given their inefficiency it could easily cost many times that just to change their practices and train doctors to not do the wrong thing.
Funding incentives for child welfare agencies also encourage them to cast a wide net (and miseducated mandatory reporters).
They refused to discharge the mother for days and kept the baby in the NICU for an extra week. Average cost per day for the NICU is ~$3k/day. Six-figure settlements aren't enough if they get away with it frequently.
It's the same way that courts grant protection orders or red flag orders - they're supposed to use the basis of something being more likely than not. Yet they consistently "err on the side of caution" and simply grant the order even though it's not actually likely to occur in most cases. Thus we see some lawyers advising their clients to file orders without basis during divorce to gain leverage. I'd love to see the numbers, but I would guess the process is abused or misruled on more often than it's used correctly.
You'd think the reaction to this problem would be to seriously downsize CPS, and raise the threshold for involvement. The opposite is happening.
> No one explained the details of the test results to Kaitlin at the time, but Kaitlin later learned that the second test conducted on her urine sample reported a finding of 18 nanograms of codeine per milliliter of the sample (18 ng/mL). The laboratory testing Kaitlin’s sample employed a cutoff of 10 ng/mL to determine whether a sample was positive for codeine, a testing cutoff level that is dramatically lower than recommended in Federal guidelines.
https://www.aclu-nj.org/sites/default/files/field_documents/...
Most opiates on the other hand, would be rarely prescribed by doctors
From the article: “Codeine regulation varies widely across countries and states. In some states, including North Carolina, Florida, Oklahoma, and Iowa,1,2 pharmacists can dispense a small quantity of cough syrup containing codeine OTC. Based on individual state law, this information may not be logged into the prescription drug monitoring program, which may contribute to providers being unaware of their patients’ use of codeine.”
This is an exceedingly rare practice in the US however.
[0]https://www.pharmacytimes.com/view/behind-the-counter-codein...
Occam's razor must apply here. They know what they're doing, and doing it intentionally.
It might be more bold right now, but the net effect of expanding words to mean stuff it didn't mean before is that words get even more watered down. If "evil" includes people acting negligently, what do you call people who were actually intentionally out to cause harm? Super-evil?
Honestly that sounds pretty low.
The US Fourth Amendment right against unreasonable search and seizure means that we, as a society, are OK not detecting all crime. But this doesn't feel like a commonly held value these days. "If we can save just one life..." is considered a valid argument for excessive safety protocols. Not far from "If we can detect just one crime..."
(Not necessarily disagreeing with your point; indeed, maybe that was the thinking.)
https://en.wikipedia.org/wiki/Reactive_attachment_disorder
That this can happen, of course, to any sane person would be a very strong argument not to interfere, and place the threshold for taking children forcibly away almost at the point they would die without aid, because the vast majority of problems neglect causes are much less bad than the problems CPS causes.
Neglect causes "parentification" [1], where sometimes very young children take responsibility for themselves and sometimes also for others. The one psychological problem children can develop that can actually improve outcomes for them. Essentially if children "succeed" at parentification, it results in good outcomes. So you'd think we would alter society to make it easier for children to take care of themselves (e.g. guarantee medical access for children by themselves WITHOUT referring them to CPS, in abstract a clear, workable, understandable set of rules. Do X, Y and Z (e.g. school) and you get to do what you want, which must of course include telling social services to get the fuck out)
The problem CPS has is that in general, very, very bad parents deliver better results with children than CPS interference. This is partly due to the state of CPS institutions and just how incredibly bad they are, but is also the result of how the human mind works. A constant relationship with even an abusive parent/caregiver is a lot better than many short caregiver relationships, even if those are pretty good ones.
Typically this would require a court order.
False. A doctor has zero ability to order tests without patient consent (or consent of a guardian) in the US.
> Patients don’t want to disclose illegal drug use,
This is why medical care should NEVER be directly connected to law enforcement or make conclusions. For a care provider to thing that a patient waking up, handcuffed will make that patient EVER come back for care again is insanity. Medicine should not be about punishment, ever.
Ability isn't the right word, because they absolutely do it. It's unethical and perhaps illegal in some places, but they are able.
I've personally been administered a test non-consensually: I showed up at a hospital with severe pancreatitis, the doctors seemed convinced it was due to alcoholism but I (and my partner who they questioned privately) both reported that I don't drink at all. After several days they suddenly started aggressively treating me, performing tests, etc. I wondered what changed and got hold of my chart-- without my knowledge or consent they took a hair test to assay long term alcohol use and suddenly wanted to treat me when it came back negative.
I get that they needed to exclude an obvious potential cause and couldn't trust the patient to give an honest answer... but the non-consensual test really destroyed my trust. Of course, if they'd asked I would have readily agreed and it isn't as if their skepticism wasn't already apparent.
Able does not always refer to physical ability. It can refer to legal ability.
I disagree with this resigned acceptance to medical paternalism. The basic situation is that you are the patient, and all care should be per your direction. The doctors' responsibility is to treat you based on what you've told them. If you're actually lying, the responsibility for misdiagnosis rests entirely on you.
Doctors hedging against a patient lying should only ever be considered within this larger backdrop. For example independent of the nonconsensual sample and testing, it was severely unethical for them to have delayed your care by several days while indulging their own curiosity.
Hospitals generally require a very broad consent at admission.
Huh? So if they pickup my comatose body in an alley, the doctor (or medic!) can’t take test my blood sugar?
A secret drug test on a conscious person who is not showing symptoms of intoxication is pretty far outside of the limits of implied consent.
Irrelevant to know for say, a job (if you can do the work; who cares?) but could be quite relevant if you’re hospitalized, or your new child needs to be treated for withdrawal from it.
Medical consent is more complicated than just this, and what you’re talking about crosses into doctor patient confidentiality as well.
Suffice it to say that testing patients without informed consent and sharing that data with law enforcement is not something that most ethical review boards would condone.
From a practical and moral point of view this kind of incident is what keeps people from telling their doctor all of the relevant information for best care. If you have a drug problem and think a medical provider will work to have your child taken away if you are honest about it, will you ever seek treatment or be honest?
If you don’t have a drug problem, but still think that what you say to your doctor or kids doctor will get used against you, will you hesitate to get care in the future?
Do you think these mothers will ever interact with another pediatrician with full trust again?
> Do you think these mothers will ever interact with another pediatrician with full trust again?
These are already issues. Only what you share with your lawyer is truly privileged. Everything else might get fanned out in a court.
Indeed, if you talk about your seizure with your doctor, your driver's license might get suspended. If you share that your medical condition isn't stable anymore, you may lose your travel health insurance (or pay for it but still get rejected when you make a claim).
That they have the authority doesn't mean they should have the authority. There is nothing more sacrosanct that bodily autonomy. It doesn't matter if the doctor "knows better" or the medical testing you don't opt in for could potentially lead to worse medical outcomes for you. If you are an adult, it should be your right to decide what testing and procedures are performed on you - full stop.
testing for drugs, and then reporting them is a gross fucking violation of patient privacy rights.
Even if a procedure is "medically necessary", that does not give doctors the permission to do that procedure without your informed consent. When a procedure is not "medically necessary", it's even worse. There are people who refuse "medically necessary" procedures every day in this country on numerous different grounds, including religious grounds, and this is deeply legally protected and well upheld in case law.
There is no valid justification for the behavior of these hospitals.
The lack of informed consent as to what will happen with a collected sample is the thing. It's also incredibly stupid, as without informed consent a person can't think to tell the collector that they've recently eaten a poppyseed bagel, and thus their results will be tainted.
How could the hospital possibly not know about the false positives?
They don't "need to be sued out of existence" any more than their thousands of patients need to have their healthcare provider yanked out from under them.
The law should be changed to give them some discretion.
This makes them look pretty negligent.
The law declares a specific threshold concentration level, and they are using a level 1/200th of that. They absolutely should suffer severe recompense and punative damages for doing that.
Laws should not allow discretion. That is how you get abuse and discrimination through selective enforcement. If a law would be intolerable and inhumane with 100% enforcement, then that is how you know it shouldn't exist in the first place, and is in fact still intolerable and inhumane even with discretion and selective enforcement.
In this case, the law doesn't in fact exist, and no selective enforcement is needed. The law already does not say that eating poppy seeds is illegal, because that doesn't approach the level to trigger the law.
So long as the War on Drugs exists, you're going to have dumb as shit people interpreting dumb as shit rules in dumb as shit ways.
You have to choose between having a War On Drugs, or accept that there will always be nasty, unintended consequences to it.
https://www.foodsafetynews.com/2022/11/poppy-seeds-not-meant...
The thébaine is found in the pod the same way as morphine is, not the seed itself. But if the seeds aren’t washed enough and the variety isn’t a low alkaloid one…
Not sure how much the manufacturers test. Obviously one wasn’t testing for thébaine.
https://kochen.kerpe.at/wp-content/uploads/2020/02/Mohnstrud...
It depends on what strain, and whether they've been cooked into a bagel or are uncooked: https://www.frontiersin.org/articles/10.3389/fchem.2020.0073...
> In this work, it was found that in harvested poppy seeds, and thermally processed poppy seeds (with and without a food matrix), if used in normal levels would not exceed the recommended acute reference dose. It was also shown that the levels of all alkaloids reduce when thermally processed, in comparison with harvested, untreated seeds.
But basically a lot. Which is why poppies are processed for heroin. Not eaten straight.
many people have died while doing this, because the seeds carry an unknown and highly variable amount of poppy latex. One may use some amount and feel nothing, but later use the same amount with a different batch of seeds and rapidly OD (usually fatal for opioid naive people).
This is especially a problem due to the potentially long delay of come-up, which is why many folks die after redosing (believing that the first dose did nothing or wasn't sufficient).
Lastly, baked goods containing poppy seeds do not pose any danger, as high heat destroys basically all the alkaloids.
[0]https://www.google.com/search?q=poppy+seed+strudel&hl=hr&sxs...
I had to do a USA federally mandated drug test for a license once and one of the questions they ask before administering is if you have had poppy seeds recently.
You can still get the filling by the can in most grocery stores. Nothing like a warm poppy seed kolache...
No attitude like this exists with alcohol, yet that drug seems to cause the odd problem.
It's a symptom of social pressure. Like when the ratcage gets too crowded and they start eating each other.
This is where we are. We are not here by accident. Each time a 'feel good' proposal was made, 'for the children' argument countered any reasoned argument against it. I am a parent and I already had a taste of this intrusion into my life by our kid's doctor ( she asked me whether I have guns in my house -- and my wife answered before I could even say 'It is not your business' ).
It is going to get worse until it sufficiently pisses off the population. We are not there yet.
ISTR New Scientist doing a fun article many decades ago about all the psychoactive items in a traditional British afternoon tea. Quite a lot of laudanum in some varieties of lettuce
usually the manufacturer of the screening test mentions this in the documentation, that nobody feels like reading. certainly not the administrators implementing/enforcing the policies.
How many kids never get to exist at all because the government and other institutions have made it ever more obnoxious, even personally dangerous, to have one?
But the examples I had in mind were parents getting prosecuted for letting their children outside unsupervised (several stories on HN in the last year or two), or examples in this thread like overzealous mandatory reporting in the original article or someones pediatric doctor becoming a problem after asking if they have guns in their home.
Anecdotally I know people for whom concerns about invasive bureaucracies caused them to choose to delay or not have children, as well as people who relocated to places which they thought had better practices before doing so. Anecdotes don't count for much but I think it's not controversial that have many policies that are ineffective. Any policy that doesn't actually protect children but imposes a risk or cost on parents is probably a net reduction on the production of new adults, but maybe only a very small one.
There’s considerable debate over whether even China’s “One Child” policy had any direct effect or it just happened to coincide with a natural decline in birth rates that would’ve happened in China regardless.
If it’s not even clear that an incredibly blunt government policy had that much of a direct effect, I’m not sure what research could possibly turn up for other nations.
Surely you jest: https://www.chinadaily.com.cn/china/images/attachement/jpg/s...
How does natural decline in birth rates explain the massive shift towards male children not experienced in other developing nations?
I’ll never forget the look of horror on the nurses face when she found out what he was requiring.
https://healthnews.com/womens-health/menopause/can-you-get-p...
> Generally speaking, postmenopausal pregnancy is unlikely, although not entirely impossible. HRT will not trigger the ovaries to produce new eggs. If a woman has remaining eggs after menopause, HRT might trigger the release of an egg. There are few reports of postmenopausal women conceiving naturally, but this is very rare.
He was open and made a recommended investigation contingent or knowledge of the risks.
And she could decide the invasiveness of peeing on a stick is not worth the benefit of being able to have an x-ray.
On the other hand no offer was made. A test was illegally applied (even if you can force someone to have a test they must know about it), incorrectly interpreted with unjustly severe outcome.
Also, you can be a celibate lesbian nun and in some countries you can't get prescribed valproate without having a coil or implant. Seems much more problematic.
Of course someone being reported for neglect is going to lie. What proof do they have that it was poppy seeds? Do they have hair tests etc showing zero opiate use?
You’re not concerned about nonconsensual drug testing and reporting to state agencies.
You just think maybe the women are liars?
>The day after Kate learned that she was suspected of using opioids—five days after she gave birth—the hospital "refused to discharge" her, the complaint says. That afternoon, DCPP caseworkers separately interrogated Kate and her husband, Jesse. Kate agreed to a second urine test, which came up negative. She was finally released that evening, but her baby did not come home until October 1, "ten days after her birth and five days after DCPP cleared Kate to bring her baby home."
> Although the DCPP "cleared Kate and Jesse to take baby A.L. home," the hospital kept the baby for another five days, and the agency's investigation continued. It included a "Certified Alcohol and Drug Counseling evaluation" and yet another urine test, which was "negative for all substances." In November, Kate received a letter saying the DCPP had concluded that "the allegation of neglect was 'unfounded.'"
That was unlawful detention, by the way. By fraud, under false color of authority, and/or by force. They have no authority to hold anybody against their will (with very specific exceptions having to do with mental state and not applicable here).
> She was finally released that evening, but her baby did not come home until October 1, "ten days after her birth and five days after DCPP cleared Kate to bring her baby home."
That was kidnapping, by the way.
We're talking about actual felonies here. Not that you can get prosecutors interested in that kind of crime, but it's still true.
You are not winning with this.
So if you get flagged then you have plausible deniability.