Hospital Emergency Hotline for Ex Parte Treatment Orders Over Parents’ Religious Objection

Hospital Emergency Hotline for Ex Parte Treatment Orders Over Parents’ Religious Objection

Hospital employees used emergency hotline with Superior Court to obtain medical treatment orders after minor patient and parents refused blood transfusions on religious grounds. With two exceptions, Arizona subject matter jurisdiction attaches upon filed petition or complaint. In this special action, the Court of Appeals held that because Banner hospital failed to initiate legal action by petition or complaint, Maricopa County Superior Court orders authorizing medical treatment for the minor child were void for lack of subject matter jurisdiction. Hospital employees’ ex parte oral requests for medical treatment orders via emergency hotline (telephone) did not fall within any exception and did not establish jurisdiction.

Glenn H. and Sonia H. v. Hon. N.B. Hoskins and Banner Cardon Children’s Medical Center

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No Arizona statute or rule authorized the Superior Court to maintain an emergency hotline with any hospital so medical treatment orders could be provided for non-consenting minors.

Emergency Hotline Connected Hospital with Superior Court Judges

At issue was the Superior Court’s legal authority to enter orders following the treating hospital’s verbal request via emergency hotline. Because a petition or complaint initiates court proceedings upon which subject matter jurisdiction attaches, oral ex parte requests cannot result in valid medical treatment orders absent exception to the contrary.

Here an emergency hotline (direct telephone line) connected the hospital to Superior Court judges after business hours. The emergency hotline was used by hospital employees to verbally request court authorization allowing them to perform medical procedures on a non-consenting teenager. On religious grounds, the patient and his parents had clearly withheld consent to one specific treatment.

Blood Transfusion Refused on Religious Grounds

In August 2017, 14-year-old Cody H. was diagnosed with bone cancer and was being treated at Banner Cardon Children’s Medical Center (“Banner Children’s) in Mesa, Arizona. As Jehovah’s Witnesses, the family refused medical care that violated their beliefs. They consented to cancer treatment, but refused blood transfusions on religious grounds. As agreed by all, Cody’s medical team at Banner Children’s  hospital “developed a treatment plan using alternative therapies designed to avoid the need for blood transfusions.”

Emergency Hotline for Medical Treatment Orders

As “standard practice in the county,” the emergency hotline connected Banner Children’s hospital with Superior Court judges for Maricopa County after hours on a rotating basis. Using the hotline, hospital employees requested medical treatment orders allowing them to give the teenage cancer patient blood transfusions. Parents were not notified of the oral requests for relief.

On October 12th, 13th, 16th, and December 4, hospital employees phoned in requests for ex parte orders authorizing blood transfusions, overriding the religious beliefs of child and parents. Three of five requests for medical treatment orders were granted. Under color of law without parental consent, the medical team administered blood transfusions to the child on December 1st and 5th.

Subject Matter Jurisdiction Required for Relief

When the Superior Court has subject matter jurisdiction, the judge may order medical treatment for a minor child even against parents’ wishes. Arizona’s Title 8 regarding Child Safety provides in part:

“A. When a child under the jurisdiction of the juvenile court appears to be in need of medical or surgical care, the juvenile court may order the parent, guardian or custodian to provide treatment for the child in a hospital or otherwise. …”

[ARS § 8-245(A).]

The court emphasized how ARS § 8-245(A) “does not confer jurisdiction but instead permits the [superior] court to order medical treatment only when the child is already under [its] jurisdiction.” However, this order was extra-jurisdictional.

Exception to Rule Against Oral Ex Parte Relief

As a general rule, Arizona “[s]ubject matter jurisdiction attaches … when a complaint or petition is filed” and not before. Consistent with the general rule, those “complaints or petitions that fail to comply with [Arizona] rules of civil procedure or other statutory requirements do not confer jurisdiction on the court.” Given Banner Children’s hospital never filed with the court, subject matter jurisdiction could not attach absent an exception.

There are but two exceptions to the general rule against oral ex parte requests for relief – “telephonic search warrants and emergency orders of protection,” neither of which occurred. No Arizona statute or rule authorized the Superior Court to “maintain an emergency hotline” with any hospital so medical treatment orders could be provided for non-consenting minors. Nor is there a law “guaranteeing the participation or protection of the persons likely to be affected by such an order.”

Ex Parte Proceeding Meant Parents Not Notified

These parents were never notified of “proceedings,” learning about the first ex parte proceeding only after a judge denied the hospital’s request for authorization to treat. Parents hired an attorney after “overhearing conversations in the Hospital’s corridors” about a second emergency hotline request for medical treatment orders. Thereafter, “[a]t each stage, Petitioners argued first that the court lacked jurisdiction to consider the requests, and second that the Hospital had failed to prove Cody’s medical condition constituted an emergency warranting a blood transfusion.”

Banner Children’s hospital never initiated court proceedings by formally petitioning for relief. Instead, one-sided oral requests via emergency hotline were made by unidentified hospital employees (“it is unclear whether the callers here were doctors, administrators, or staff…”). The appeals court held the Superior Court lacked subject matter jurisdiction to consider the hospital’s ex parte oral requests for relief to medically treat the teenaged patient.

The parents petitioned the Court of Appeals for special action and, while pending, the Superior Court appointed a child’s attorney and guardian ad litem. Banner Children’s hospital appeared and answered. Watchtower Bible and Tract Society of New York, Inc., filed an amicus brief.

In January 2018 the patient was transferred for alternative care to a facility in Portland, Oregon. Despite mootness, as the child was no longer a patient of Banner Children’s hospital, the appeals court decided the issue as one of “great public importance or … capable of repetition yet evading review.” Citing Bank of NY Mellon v. DeMeo, 227 Ariz. 192 (Ariz. Ct. App. 2011).

Complaint or Petition Must Precede Judge’s Order

The appeals court held the hospital cannot proceed to treat against parents’ wishes without first filing a written complaint or petition. Only then can the Superior Court assert legal authority to enter relief. When seeking authorization to treat a child without parental consent, properly initiated legal action must precede assertion of subject matter jurisdiction. Said jurisdiction is prerequisite to entering medical treatment orders allowing blood transfusions to a non-consenting minor child.

The Superior Court’s orders authorizing medical treatment of the minor child were void. No specific statutory authority existed. And “[h]owever well-intended the emergency hotline may be,” the trial court lacked subject matter jurisdiction to “entertain ex parte oral requests” from hospital employees. Citing Redewill v. Superior Court, 43 Ariz. 68 (1983).

Glenn H. v. Hon. Hoskins and Banner, 1 CA-SA 17-0303 (Ariz. App. 2018)

For precise language, please read the court’s original opinion. Legal citations have been omitted.

A guardian ad litem and child’s attorney may be appointed by the family law judge in many circumstances. Talk to an experienced child custody lawyer about authorizing medical treatment or limiting the other parent’s legal decision-making.