In Re: J.A., Appeal of: D.A., 107 A.3d 799

Background

J.A., born 2007, a dependent child with Turner syndrome, was hospitalized after a severe car-accident brain injury; treating physicians recommended an internal shunt and gallbladder drainage that Mother initially refused. CYF was legal custodian and KidsVoice was appointed guardian ad litem (GAL).
At a March 27, 2014 emergency hearing the juvenile court appointed KidsVoice (through its guardianship unit attorney) as J.A.’s “medical guardian” empowered to consent to ordinary and extraordinary medical care; Mother appealed.
KidsVoice’s medical guardian consented to life‑saving and other procedures while the child remained hospitalized. Mother challenged both the authority to appoint a "medical guardian" and the court’s later refusal (at a June 18 hearing) to permit evidence seeking return of medical decision‑making to Mother on grounds Rule 1701 barred reconsideration during appeal.
On November 7, 2014 the juvenile court returned medical decision‑making to Mother (terminating KidsVoice’s appointment); the Superior Court found the issue technically moot but reviewed the appeals because the issues were capable of repetition and likely to evade review.
Superior Court held (1) the juvenile court erred in barring evidence at the permanency hearing based on Rule 1701 because dependency courts retain authority to act in a child’s best interest while appeals are pending, and (2) the Juvenile Act and Juvenile Rules do not authorize appointment of a third‑party nonprofit (KidsVoice) as a child’s medical decision‑maker; legal custody (or the juvenile court itself via §6339(b)) is the proper source of medical decision authority.

Issues

Issue	Plaintiff's Argument (Mother)	Defendant's Argument (CYF / KidsVoice)	Held
1. Whether juvenile court had authority to appoint a third‑party nonprofit as a "medical guardian" with medical decision‑making power	Appointment unlawful: Juvenile Act and Rules identify who may hold legal custody and make medical decisions; KidsVoice cannot receive legal custody and thus cannot be a medical decision‑maker	Appointment necessary to ensure timely medical care when parent refuses; Rule 1145 and §6301(b)(1.1) permit measures to protect child	Held: Vacated. Appointment of KidsVoice as medical guardian unsupported by Juvenile Act / Rules; court should have used §6339(b) or authorize legal custodian (e.g., CYF) to consent
2. Whether Rule 1145 or other juvenile rules authorized delegating medical decision‑making to a GAL/nonprofit	Rule 1145 and comments do not permit delegation; Supreme Court detailed appointment criteria for educational decision makers (Rule 1147) but not medical ones	GAL/CYF argued child safety/potential impracticality of seeking court approval for every urgent decision supports appointing medical guardian	Held: Rejected. Rules/Act delineate who may be legal custodian and make medical decisions; the law does not contemplate a surrogate medical guardian outside those categories
3. Whether juvenile court erred by preventing Mother from presenting evidence at permanency hearing to regain medical decision‑making because appeal pending (Pa.R.A.P. 1701)	Trial court wrongly invoked Rule 1701 to bar evidence; dependency courts retain authority to act in child’s best interest and may receive evidence even while appeal pending	CYF relied on Rule 1701 to preserve status quo during appeal	Held: Reversed on this point. Court erred to preclude Mother from eliciting evidence; juvenile court may enter orders in child’s best interest during appeals
4. Whether Mother was deprived of due process (no hearing or opportunity to respond before appointment)	Mother denied procedural due process because no hearing and no time to present witnesses/opposition before appointment	GAL: emergency justified prompt appointment; Mother had opportunity at the March 20 hearing and did not request witnesses/continuance	Held: Due process argument waived for failure to timely object at the appointment hearing; not reached on merits

Key Cases Cited

In re Griffin, 690 A.2d 1192 (Pa. Super. 1997) (juvenile court retains continuing plenary jurisdiction under §6351 to protect dependent children while appeals are pending)
In re Tameka M., 580 A.2d 750 (Pa. 1990) (dependency courts’ continuing authority post‑appeal)
In re H.S.W.C.-B, 836 A.2d 908 (Pa. 2003) (best‑interest of child standard justifies juvenile court action during appeal)
In re Lowry, 484 A.2d 383 (Pa. 1984) (statutory construction; juvenile court authority vs. administrative code conflicts)
In re J.J., 69 A.3d 724 (Pa. Super. 2013) (appointment of temporary medical/educational decision makers affirmed where appointees qualified as temporary legal custodians)
In re D.A., 801 A.2d 614 (Pa. Super. 2002) (mootness doctrine in dependency appeals)
In re M.B., 101 A.3d 124 (Pa. Super. 2014) (capable of repetition/evading review exception to mootness)