Adam Kanuszewski v. Mich. Dep't of Health & Human Servs.
927 F.3d 396
6th Cir.2019Background
- Michigan's Newborn Screening Program (NSP) routinely takes dried blood spot samples from nearly all newborns to screen for diseases; samples are retained and transferred to Michigan Neonatal Biobank (a state-funded nonprofit) for storage and potential research use.
- Plaintiffs are three sets of parents (and their minor children) who sued MDHHS, individual state officials, the Neonatal Biobank, and its director alleging violations of the Fourth and Fourteenth Amendments based on nonconsensual collection, retention, transfer, and storage of newborn blood samples.
- Plaintiffs seek damages and prospective injunctive/declaratory relief, including destruction/return of samples obtained without informed parental consent.
- District court dismissed the complaint with prejudice; plaintiffs appealed. The Sixth Circuit reviewed standing, immunity (Eleventh Amendment/state sovereign immunity and qualified immunity), and the merits of asserted Fourth and substantive due process rights.
- The Sixth Circuit affirmed dismissal in part and reversed in part: damages claims largely barred by sovereign or qualified immunity; but plaintiffs have standing and stated plausible claims for prospective relief (injunctive/declaratory) against individual state officials in their official capacities under Ex parte Young for ongoing retention/storage use of samples implicating parents’ and children’s rights; remanded for further proceedings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Standing to sue for past blood draws (children & parents) | Past nonconsensual blood draws injured bodily integrity/privacy; entitles plaintiffs to damages and (plaintiffs argued) prospective relief | Defendants argued lack of standing for prospective relief because harm was completed and speculative | Children and parents have standing for damages only (no standing for injunctive/declaratory relief tied to the completed draws) |
| Standing for ongoing storage/transfer/use of samples | Ongoing retention and risk of future analysis/use creates imminent or substantial risk of harm supporting injunctive/declaratory relief | Defendants contended harms are speculative (risk of misuse/discrimination) and alternative remedies exist | Plaintiffs (children and parents) have standing for damages and for prospective injunctive/declaratory relief as to retention/storage/use (some speculative risks rejected, but privacy/analysis risk accepted) |
| Immunity to damages claims | Plaintiffs sought damages from state entities and officials | Defendants invoked Eleventh Amendment/state sovereign immunity and qualified immunity for individual officers | Damages claims against state agencies and officials in official capacity barred by sovereign immunity; damages against individual officers barred by qualified immunity; Ex parte Young permits prospective relief against officials in official capacity |
| Merits: substantive due process and Fourth Amendment challenges to retention/storage of samples | Retention/transfer/storage without informed parental consent violates parents’ fundamental right to direct medical care and children's privacy; storage/use may be an ongoing seizure under Fourth Amendment | Defendants argued state interests in newborn screening, public health, and that law is unsettled; collection/retention may be for medical purposes | Court held parents have a fundamental right to direct children's medical care; plaintiffs stated plausible claims that retention/storage (after screening) without informed parental consent may violate parents' substantive due process rights and children's Fourth Amendment rights; these claims as to prospective relief survive dismissal and are remanded for fact development |
Key Cases Cited
- Shearson v. Holder, 725 F.3d 588 (6th Cir. 2013) (standing review de novo and standing framework)
- Clapper v. Amnesty Int'l USA, 568 U.S. 398 (2013) (future-harm standing requires a substantial risk; speculation insufficient)
- Lyons v. City of Los Angeles, 461 U.S. 95 (1983) (past injury alone does not support injunctive relief absent real and immediate threat)
- Ex parte Young, 209 U.S. 123 (1908) (prospective injunctive relief against state officials in official capacity not barred by sovereign immunity)
- Will v. Michigan Dep't of State Police, 491 U.S. 58 (1989) (states and state agencies are not "persons" under § 1983 for damages; official-capacity injunctive suits differ)
- Pearson v. Callahan, 555 U.S. 223 (2009) (qualified immunity framework; courts may decide constitutional violation or clearly-established-right prong first)
- Cruzan v. Dir., Mo. Dep't of Health, 497 U.S. 261 (1990) (competent adults possess liberty interest to refuse medical treatment; court guidance on minors and competence)
- Schmerber v. California, 384 U.S. 757 (1966) (drawing blood can constitute a Fourth Amendment search; context matters for reasonableness)