False Positive

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0:36Or are you stuck in one you've outgrown? Or never wanted in the first place? Sure, you can probably list the reasons for staying, but are they actually just excuses for not leaving? Let a career coach from strawberry.me help you get unstuck. Discover the benefits of having a dedicated career coach in your corner. Go to strawberry.me slash unstuck to claim a special offer. My contractions were coming on a lot stronger, and I still had to make dinner for my family. So I got the easiest thing out of the fridge, which was frozen pizza and a salad kit from Costco. This is Susan Horton. She lives in Santa Rosa, California.

1:25And in August of 2022, she was just about to give birth to her fifth child. I don't think I got much sleep that night. And by morning, I remember I was in a lot of pain.

1:42Hallie was very big. She was 9 pounds, 11 ounces. And I had forgot how hard it is to birth a 9-pound baby. So the pushing out took a little longer. It was the next morning that I believe she was a social worker. She came in and said, so I just want you to know that your urine tested positive for drugs.

2:13Susan asked if they were sure it was her urine that had tested positive. They said yes. And she asked what drug the test said she'd taken. They told her codeine. Cough syrup? You mean like cough syrup? And she said, yes, but it's prescribed cough syrup. So they asked me, were you prescribed cough syrup? And I said, no, absolutely not. I hardly take Advil. Today we're sharing an episode from the radio show and podcast Reveal. It's one of the best investigative shows out there. And last year, they shared this story in collaboration with The Marshall Project. Here's reporter Shoshana Walter. She's lying down in her hospital bed, racking her brain over what she might have eaten or taken that could have caused this result.

3:04And she remembers, ding, ding, ding, the pizza and the salad. A poppy seed salad. It was delicious. You know, it had its separate little packages of dressing and it had a separate little package of just poppy seeds. And they were so crunchy. You know, when you crunch something and you can like hear it in your ears and stuff. So I vividly remember chomping down on those poppy seeds. After the provider leaves the room, she just does a quick Google search and she realizes that that had to be it. I have no clue what else it could be. So I tell them eventually, I'm like, 24 hours ago for dinner, I had a salad and pizza.

3:49And that salad had a lot of poppy seeds on it. I know from reading her medical records that providers noted her shifting story. At first, she said, you must have gotten me mixed up with someone else. And then they noted that she changed her story to assert that it was this poppy seed salad. Multiple providers file into Susan's room and tell Susan that because she tested positive for opiates, they need to keep the baby in the hospital for five days to monitor for withdrawal symptoms. You can leave, but your baby cannot. And I was not leaving baby. There was no way. And they're like telling me what's going to happen.

4:35That they contacted Child Protective Services and that a CPS investigator would be coming to ask her questions. There was a point where I was just like, this is absurd. I want to go home. I have not taken anything. She basically argues there's no reason for the baby to stay in the hospital because the baby is not going to experience withdrawal symptoms. That falls on deaf ears because the process has already been set in motion and the investigator is coming in a matter of hours to interview Susan. I felt very, like, emotional and I was alone.

5:21I just gave birth the day before. I'm not sleeping. And I just felt, like, really ganged up upon. They had a singular piece of evidence that I had taken something, and it was wrong. Susan calls her husband Colin and is basically like, I need you here. Because I'm losing it. So Colin comes to the hospital. His parents, who are elderly, go and stay at the house with the kids. And then the CPS investigator comes. Because this was her fifth child and it was during COVID, she skipped a lot of prenatal appointments. I felt like I went to all the important ones. You know, she lacked child care and both her husband and her 16-year-old are immunocompromised.

6:14My second born, Liam, was born with a congenital heart defect and had five open heart surgeries. So Susan basically avoided the doctor during COVID. And they wanted to go over some points like, why did you miss all the prenatal appointments? Your son has a heart condition, right? Would you miss appointments for him? I really went off on her when she asked me that. I was like, my son has a life-threatening congenital heart defect. Of course I would take him to every appointment or do whatever surgery needed to save his life. Not going to a prenatal appointment is not the same. Like, what is happening?

7:05they want me to sign a safety plan. A safety plan is essentially a voluntary agreement between a family and child protective services that may include additional drug testing. It may include inspections and searches of the home, allowing CPS to interview other people in your life. It can be a very intrusive and invasive agreement. I literally just said, I haven't done anything. Like, there was no reason for any of this to be taken place. And I didn't want to sign something almost like admitting guilt because I was not guilty. But they did not realize what the consequences would be if they did not sign it.

7:50Basically, as soon as I made the choice to not sign, she stomped out. I didn't know this at the time, but she was getting a judge to sign a paper to take away my baby. Around the same time that I started talking to Susan, I was reaching out to other families, and Grace and Michael Smith had had this experience at a hospital in Pennsylvania. Their case is a little bit different from Susan's because instead of poppy seeds, it actually involves Grace's prescribed medication. They had just moved to the Poconos to be closer to Grace's parents when essentially Grace went into labor with their fourth child.

8:37I called Michael and I was like, okay, my water broke, we gotta go. And then me and Michael went in to have a baby. Everything seemed to be fine. He grabbed my finger and I told him that I was going to love him for the rest of his life. And everybody in the room just got really quiet and they're like, aww. When did you get the sense that something might be going awry? It was the following day when they started talking to us about trying to get him into the NICU. Doctors seemed to think that their son was developing respiratory issues, so they took him to the neonatal intensive care unit. But shortly after that, the OBGYN started asking Grace and Michael some questions.

9:21You know, why they moved? What do they do for a living? Grace told the doctor that she's a lawyer and Michael is a stay-at-home homeschooling dad who also went to law school. And then finally the doctor told them, Well, you tested positive for methamphetamine. I was like, I'm not sure how that's possible. I mean, I don't take anything that would come up as methamphetamine. Grace was diagnosed with attention deficit disorder when she was 12 years old. So she was on a medication called Vyvanse for her ADHD. And I'm like, well, I take an amphetamine. She's like, well, your urine tests show that you were positive for methamphetamine.

10:04And so we've had to alert the Children's Services who will conduct a, what was the word they used? They're going to conduct a... An investigation of your family. Yeah. Just like Susan and like many parents I've talked to, Grace and Michael just felt furious that their home and privacy would be invaded over something that they didn't do. I'm like, I don't think so. And Mike's going, nope, I've got rights. They're not coming to my house. The conversation basically went south from there. I went, I don't trust this hospital anymore. I want to leave. And Michael went, yep, I agree. And I said, we're withdrawing all consent for treatment for me and for the baby.

10:49And we're leaving immediately. And it got really scary, like, just so fast. As soon as she left, I was like, I'm going to adjust right now. Go get the baby. And he went to the NICU. He gave the baby a kiss. Gave him a kiss on the forehead. And I told him I would be right back. And I wasn't. and I hate that. He goes downstairs to the car to get the car seat. Pulled the car around to the front, got Grace, went up two floors to the NICU and found it locked. They weren't allowed back in the NICU to get their son and then shortly after that the police arrived. Running out of the elevator, like into Michael's face, like, okay, so what's the problem here?

11:35To which my response was, that's exactly what I'm trying to figure out. This is all going on in the NICU waiting room where there are other families. So we've got a little bit of an audience collected here. And in front of all of these people, the officer goes, they're saying that you have tested positive for meth and that you need to leave. You are trespassing. And if you don't leave, you're going to be arrested. In the hospital records, the doctor had described Michael as agitated and confrontational. Michael says he was stern. But at this point, he and Grace understood the stakes of being combative.

12:13I looked at Michael and I said, Michael, you can't say anything. You just, please don't say anything. The police escort the parents down the elevator, out through the hospital doors. And then finally, they drive home without their baby. It was a really dark moment. Like, I don't think I've ever felt that low. I know what to do. I don't even know where to start.

12:43We'll be right back. Thank you.

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13:52Check them out to see how much you can save versus the other big guys at T-Mobile.com slash switch. The most common way for new mothers to be tested for drugs is through urine tests, because they're non-invasive and inexpensive. But the tests aren't always very precise. They identify anything that looks like it could be an illicit drug, but they don't really tell you exactly what the drugs are. Reporter Shoshana Walter talked with Dr. Gwen Miller, a medical director at a lab that analyzes drug tests, including those given to women who have just given birth. Can you list off a few substances that could cause false positives on screens?

14:34Some common cold medications will trigger positive results. the Sudafed that they're taking or the Vix nasal inhaler. Labetalol, the blood pressure medication, looks similar to meth and amphetamine. Labetalol metabolites are triggering the test into thinking that fentanyl or methamphetamine are present. Byvance, the medication for attention deficit disorders, also looks like meth. There's a baby soap that is very commonly used in hospital nurseries, and that can show up as positive for marijuana when an infant's urine is tested. Codeine and morphine could come from poppy seeds. I was really shocked when Gwen told me how high the false positive rates can be on these tests.

15:19Close to 50 % for many drug classes. These are the types of drug tests that hospitals routinely rely on to determine whether or not a patient used substances during their pregnancy. And the issue is not that they're malfunctioning. You know, this is how P-tests work. They cast this wide net. The problem is when hospitals act on these preliminary results. Actions should not be taken based on a single drug testing result, period. What Gwen said is that there should be a second step. And that's a more definitive test where a toxicologist looks at the molecules in that sample to determine whether or not they are the illicit substance that the screen identified.

16:08But really that type of testing is not mandated. It's not standardized. And so each hospital gets to decide what type of test they do. Many hospitals just don't do that second, more definitive test. For one, it's expensive, and also, they're just not legally required to do it. Federal law requires states to identify babies that are, quote, affected by substances and refer them to child welfare authorities. But when I reviewed every state law and policy, I learned that most states go even further than that. They're requiring hospitals to take action any time an infant is simply exposed or even potentially exposed to substances.

17:00And the fastest, easiest way to determine exposure is having the mom pee in a cup. No state requires hospitals to do any follow-up test once they have that initial result. And even when they do that follow-up test, it can take a while for the results to come back, which could mean releasing a baby to a potentially unsafe caregiver. And you have to remember, medical providers are mandatory reporters. They can be criminally charged for failing to report child abuse and neglect. So hospitals are basically erring on the side of caution, either because they're worried about the baby or they're worried about liability.

17:47When Grace Smith tested positive for meth at a hospital in Pennsylvania, she and her husband insisted the result was wrong. I've never done anything like that in my life. So it was just unthinkable that it was being thrown as an accusation, and by the hospital no less. This was a new hospital for Grace and Michael. They had just moved. So when she came in to give birth, she actually gave them a copy of her medical records from her previous provider. So they would know what medications she was on. Because they were like, you know, we're going to do a drug screen. Like they told us at the outset.

18:20And I was like, okay, here's my medical marijuana card. And here's my prescription for Vyvanse. Her OB had told her it was fine to continue her ADHD meds during pregnancy. So when this new doctor came in saying Grace had tested positive for meth, Michael started urging her to look at Grace's old records. You have her medical records. You know she's on Vyvanse. Vyvanse is amphetamine. It's prescribed amphetamine. And when Grace was drug tested by her previous OB, who used a more precise test, she tested positive for amphetamine, her prescription medication, and negative for methamphetamine. I asked her, did you call her OB, whose name is right at the top there?

19:03It's been her OB for years. And what was her response to you asking if she'd looked at her records? She didn't care. She didn't care. In the doctor's notes, she says that Michael asked why they weren't consulting the records or contacting medical providers. And in her own notes, she tells the parents it's not the hospital's job to investigate. Their responsibility is to report the case to Monroe County Children and Youth Services. They shouldn't have a test that doesn't differentiate between a legal substance and any legal substance, period. They shouldn't use that, ever. I reached out to St. Luke's University Health Network, and a spokesperson declined to answer questions about Grayson Michael's case.

19:47What he said is that the hospital complies with all the rules and regulations around testing and reporting. In Grayson Michael's case, a confirmation test could have clarified that she was positive only for her prescription medication. But in other cases I've looked at, confirmation tests are not enough. For example, poppy seeds actually do contain codeine. So when Susan Horton ate that crunchy poppy seed salad, it's not a surprise that her test was positive. And behind the scenes, her doctors and the CPS caseworkers were even talking about the poppy seeds. Can poppy seeds give a dirty drug test?

20:32And the answer was yes. There is a way to determine whether poppy seeds might have caused a positive result. And that is to look in the urine sample for the presence of the compound thebane. but there's no indication in the medical records that they did that test or even were aware that it existed. I felt like everyone at the hospital immediately after having the positive drug test was against me. I didn't feel like any one of them felt like there was a possibility that it could be wrong. Susan's hospital and CPS both declined to say anything about her case specifically. A spokesperson for Kaiser Permanente said that they take their role as mandated reporters very seriously and that they always conduct a, quote, multifaceted assessment before reporting someone.

21:33An official with CPS told me, in general, a positive drug test on its own doesn't warrant an investigation. She said they need to see an impact to the child.

21:48People are always asking me how many women are affected by false positive drug tests. How many babies have been removed from their families? I wish I had an answer. There's no agency that tracks this information, and it's extraordinarily difficult to get medical and child welfare records, which are confidential. What I do know from talking to top experts in this field is that drug testing of pregnant patients is incredibly common, due in part to the opioid epidemic. And every year, tens of thousands of babies are reported to Child Protective Services without any guarantee that the underlying test results are accurate.

22:35In 2022 alone, more than 35 ,000 of these cases were reported, and authorities removed more than 6 ,000 infants from their families.

22:52When Grace and Michael told me their story, it was almost three years after Grace had given birth. I visited them at their house in the Poconos in the dead of winter. He's super friendly. Two dogs. Daddy! Okay, you have to tell me how to play it. Four kids. This is the kid himself. Yeah, this is Julian. Hi, Julian. Grace grew up in a big family, and both of her parents and her sister have an attention deficit disorder. My sister was the youngest person in the state to be medicated for it. Oh, my gosh. How old was she? Three, I think. Wow. Yeah. And the CDC wanted to do a family study on our family because we all had it.

23:30Grace's mom was actually pretty funny about so many of them having ADHD. We're not a very good breeding pair.

23:42This is the house Grace and Michael came home to after they were kicked out of the hospital without their new baby Julian. But at the time, it wasn't all decked out in thrift store furniture and sci-fi books. Instead, there was stuff piled everywhere because they'd just moved here. When I went into labor, the house was completely, it was still boxed up. We all had our mattresses, but everything was in boxes. And they both just felt broken. The next day when we woke up, I would call the hospital every couple of hours and see if he was doing okay, and they'd tell me, He's doing okay. He's taking formula okay.

24:28I just remember how hard that hit me.

24:34Later that day, the hospital tells Grace that she is allowed to come back to the hospital and visit. You're allowed to come back in. And Michael is not allowed to come. But your husband can't come. He's still barred from entering the hospital. I was like, okay, I'm coming. I'll be right there. If he was there for two weeks, I was going to sleep on a chair for freaking two weeks. And that's what I slept on for the next two nights. There's no privacy. A security guard is posted outside, and she's required to leave the curtain open. It made me feel paranoid, and like I also couldn't act like I was paranoid.

25:13Grace stays in the hospital for a couple days while the hospital is treating her son's respiratory problem. And while she's there, a worker from Child Protective Services arrives. The guy who came into the hospital, he couldn't have been older than 21, 22, tops. It was just, I'm just sitting there having to swallow my pride and going like, this person is about to make a decision based on like my kids. At the same exact time, a caseworker goes to Grace and Michael's house to do a home inspection and to interview Michael. He came to the door. He's a big guy. Michael's approach was kind of just to be very amiable.

25:51I was really nice to him.