Adam Kanuszewski v. Mich. Dep't of Health & Human Servs.

Court of Appeals for the Sixth Circuit
927 F.3d 396 (2019)

ELI5:

Rule of Law:

Parents possess a fundamental substantive due process right to direct their children's medical care. The government's indefinite retention and storage of a newborn's blood sample after initial disease screening, without parental consent, may violate this right and the child's Fourth Amendment protection against unreasonable seizure, and is therefore subject to strict scrutiny.

Facts:

The state of Michigan, through its Department of Health and Human Services (MDHHS), operates a Newborn Screening Program (NSP).
As part of the NSP, MDHHS and its agents collect blood samples from nearly every newborn in Michigan to test for over fifty diseases.
Plaintiffs Adam and Ashley Kanuszewski, Shannon Laporte, and Lynnette Wiegand are parents whose newborn children had blood samples collected under this program.
The parents allege these blood samples were collected without their informed consent.
After the initial disease screening is complete, the state retains the blood samples indefinitely.
The retained samples are transferred to the Michigan Neonatal Biobank, a nonprofit corporation, for storage and future use by the state.
The parents allege the state uses the stored samples for research and sells or provides some samples to third-party businesses without their consent.

Procedural Posture:

Plaintiffs Adam and Ashley Kanuszewski, et al., filed a complaint against the Michigan Department of Health and Human Services and other state actors in the United States District Court.
The complaint alleged violations of the Fourth and Fourteenth Amendments and sought injunctive relief, declaratory relief, and money damages.
Defendants filed motions to dismiss the complaint under Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim.
The district court granted the Defendants' motions and dismissed the complaint with prejudice.
Plaintiffs, as appellants, filed a timely appeal of the district court's dismissal to the United States Court of Appeals for the Sixth Circuit.

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Issue:

Does the state's indefinite retention and storage of a newborn's blood sample after completion of mandatory disease screening, without parental consent, violate the parents' fundamental substantive due process right to direct their child's medical care and the child's Fourth Amendment right against unreasonable seizure?

Opinions:

Majority - Clay, Circuit Judge

Yes. The state's indefinite retention and storage of a newborn's blood sample after the completion of mandatory disease screening plausibly violates the parents' fundamental substantive due process right to direct their child's medical care and the child's Fourth Amendment right against unreasonable seizure. The court reasoned that parents possess a fundamental right under the Fourteenth Amendment to make decisions concerning their children's medical care. While the state's role as 'parens patriae' may create a compelling interest that justifies the initial blood collection and screening for life-threatening diseases, that interest significantly diminishes once the screening is complete. The subsequent indefinite retention and storage of the blood samples for different purposes, such as research or sale to third parties, burdens this fundamental right and must therefore survive strict scrutiny. Similarly, regarding the Fourth Amendment, a seizure that is initially lawful can become unconstitutional if its duration is unreasonable. The government's justification for the seizure—disease screening—ends once that purpose is effectuated. Therefore, the ongoing, indefinite seizure of the samples for purposes unrelated to the child's immediate health may be unreasonable. The court allowed these claims for prospective relief to proceed, while affirming the dismissal of all claims for money damages based on sovereign and qualified immunity.

Concurring - Rogers, Circuit Judge

Yes. The judge concurred in full with the majority's judgment but wrote separately to offer a different framing for the standing analysis regarding damages claims. Judge Rogers argued that a suit for money damages almost always constitutes an Article III case or controversy because the plaintiff inherently stands to gain a direct, personal benefit if successful. He suggested that the majority's detailed injury-in-fact analysis for the damages claims was more complex than necessary. Nevertheless, he agreed with the ultimate outcome that all damages claims must be dismissed due to sovereign or qualified immunity.

Analysis:

This case establishes significant constitutional limits on state-run newborn screening programs and the subsequent use of biological data. By affirming that parents' right to direct their children's medical care is a fundamental right subject to strict scrutiny, the court requires states to provide a compelling interest for retaining blood samples beyond the initial health screening. This decision distinguishes the state's powerful interest in protecting a child's immediate health from its much weaker interest in using biological materials for long-term research or commercial gain. Furthermore, by applying the Fourth Amendment's 'duration of seizure' principle to biological samples, the ruling creates a precedent that could impact a wide range of government programs involving the collection and long-term storage of biometric or genetic data without ongoing, informed consent.

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