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New Jersey Division of Youth and Family Services v. V.M.

August 6, 2010

NEW JERSEY DIVISION OF YOUTH AND FAMILY SERVICES, PLAINTIFF-RESPONDENT,
v.
V.M. AND B.G., DEFENDANTS-APPELLANTS.
IN THE MATTER OF THE GUARDIANSHIP OF J.M.G., A MINOR.



On appeal from the Superior Court of New Jersey, Chancery Division, Family Part, Essex County, Docket Nos. FG-07-190-07 and FN-07-572-06.

Per curiam.

RECORD IMPOUNDED

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION

Submitted May 4, 2010

Before Judges Carchman, Lihotz and Ashrafi.

On this appeal from a judgment terminating the parental rights of defendants V.M. and B.G. and granting guardianship of their infant child J.M.G. to plaintiff Division of Youth and Family Services (DYFS), we conclude that DYFS did not establish the statutory criteria, N.J.S.A. 30:4C-15.1a, by clear and convincing evidence. Accordingly, we reverse and remand for further proceedings.

Much of the background of this matter can be found in our majority and concurring opinions in N.J. Div. of Youth & Family Servs. v. V.M., 408 N.J. Super. 222 (App. Div.), certif. denied, 200 N.J. 505 (2009), cert. denied, ___ U.S. ___, ___ S.Ct. ___, ___ L.Ed. 2d ___ (2010) (V.M.). On that appeal, we concluded that "the independent evidence presented, irrespective of the evidence concerning the mother, V.M.'s, resistance to the c-section, amply supported the judge's ultimate finding as to V.M." Id. at 224. However, we reversed the judgment as to B.G., the father, determining that there was no factual support for a finding of abuse and neglect on his part. Id. at 225.

At the conclusion of the ensuing guardianship proceeding, the Family Part judge found that DYFS had met its burden of proof as to the first and third prongs of the best interests of the child test set forth at N.J.S.A. 30:4C-15.1a, but that prongs two and four remained "open." He then ordered the guardianship case temporarily returned to protective services status, and appointed an independent psychiatrist to evaluate defendants. Upon receipt of the expert's report, the judge reinstated the guardianship proceeding. At the conclusion of the guardianship hearing, he found that DYFS had established all four prongs of the best interests of the child test and terminated defendants' parental rights.

I.

Needless to say, as the trial judge concluded, a "profound disagreement" existed among the experts regarding defendants' ability to parent J.M.G. Our analysis requires an expansive discussion of the relevant facts.*fn1 In assessing the facts, we observe that generally, DYFS presented substantive and relevant factual information interspersed with seemingly trivial issues that has little impact on the dominant issue of the best interests of the child. We present both to provide a comprehensive overview of what was before the trial judge in assessing the best interests of the child.

V.M. and B.G. have been married since 1995. B.G. was self-employed as a limousine driver.*fn2 V.M. has a bachelor's degree in communications and a paralegal certificate but has been unemployed since 1997, in large part due to a workplace injury, which resulted in a workers compensation action.

V.M. was treated by Ronni Lee Seltzer, M.D., a psychiatrist, from 1993 to 2005 for "psychiatric symptoms secondary to [the] work related injury." Seltzer initially diagnosed V.M. as suffering from post-traumatic stress disorder ("PTSD"), major depression and panic disorder, and treated her with a combination of pharmacotherapy and psychotherapy. Over the course of V.M.'s treatment, Seltzer prescribed antidepressant (Zoloft), antipsychotic (Abilify and Seroquel), antianxiety (Klonopin), and sleep medications (Ambien). Toward the later part of her treatment, Seltzer's notes increasingly reported V.M.'s paranoia.

V.M. stopped seeing Seltzer in January 2006. Seltzer's notes concluded that the doctor was [s]urprised by [V.M.'s] canceling all future [appointments]. Learned that [V.M.'s workers' compensation] litigation settled, which may have precipitated this decision. Attempted to contact [V.M.] to discuss the benefit of ongoing [treatment], but [she] did not return any calls. Since [V.M.] demonstrates neither suicidal nor homicidal ideation, she is within her right to terminate [treatment], though clearly not recommended by this MD.

Meanwhile, V.M. became pregnant with the couple's first child in July or August 2005. She sought treatment from Ted Cohen, M.D., an obstetrician, for prenatal care, and read books on pregnancy and parenting. V.M. also stopped taking the psychotropic medication prescribed by Seltzer for fear of adverse effects on her unborn child.

On April 16, 2006, V.M., who was then forty-two years old, and B.G., then forty-one years old, went to St. Barnabas Hospital after V.M. experienced contractions. We described the relevant facts adduced at the abuse and neglect trial regarding V.M.'s labor and delivery:

[V.M.] consented to the administration of intravenous fluids, antibiotics, oxygen, fetal heart rate monitoring, an episiotomy[] and an epidural anesthetic. She refused to consent to any other invasive treatment, however, including a c-section or fetal scalp stimulation. Hospital personnel explained the potentially dire consequences of not allowing a c-section in the event of fetal distress, but V.M. remained adamant in her refusal.

In the hospital records, V.M. is described as "combative," "uncooperative," "erratic," "noncompliant," "irrational" and "inappropriate." She ordered the attending obstetrician, Dr. Shetal Mansuria, to leave the room and told her if she did not do what V.M. said, she would be off the case. V.M. then threatened to report the doctor to the police. In fact, at one point V.M. did call the Livingston Police to report that she was being abused and denied treatment. She told a nurse that "no one is going to touch my baby." She continuously refused to wear the face mask that provided her with oxygen and also refused to remain still in order to allow for fetal heart monitoring. She thrashed about to the extent that it was unsafe for the anesthesiologist to administer an epidural. She would not allow Dr. Mansuria to touch the baby or perform an ultrasound examination. . . . V.M. "was very boisterous and yelling and screaming at the top of her lungs."

B.G. was present while all of these events occurred. Dr. Mansuria explained the complications, such as brain damage, mental retardation and fetal death, that could occur if the fetus went into distress and a c-section was not performed. She also explained that an examination revealed a "nonreassuring fetal status." B.G. said that he understood the risks, but V.M. would not consent to the procedure.

The hospital responded appropriately to confront V.M.'s mental state and her refusal to consent to the c-section. After considering V.M.'s "extreme behavior" and signs of developing fetal distress, the hospital staff requested an emergency psychiatric evaluation to determine V.M.'s competency. Dr. Devendra Kurani responded to the delivery room and spoke to V.M. for approximately one hour. While Dr. Kurani was there, the anesthesiologist was able to administer an epidural. V.M. informed Dr. Kurani that she had a psychiatric history and had been on medication prior to getting pregnant. B.G. confirmed that V.M. had been treated by a psychiatrist for post-traumatic stress disorder and had been prescribed Zoloft, Prozac and Seroquel. When Dr. Mansuria stressed the need for V.M. to consent to a c-section, V.M. stated that she understood the risks, but she did not want the procedure. Dr. Kurani then made a critical finding. Although he acknowledged that V.M. was very anxious, Dr. Kurani concluded that V.M. was not psychotic and had the capacity for informed consent with regard to the c-section. At no time did anyone seek judicial intervention or the appointment of a special medical guardian.

After Dr. Kurani left, the staff requested a second psychiatric opinion from Dr. Jacob Jacoby. Before Dr. Jacoby's evaluation was completed, V.M. gave birth vaginally to J.M.G. without incident. In his report, Dr. Jacoby recounted V.M.'s professed history of childhood abuse, workplace violence and societal discrimination. He noted that V.M. was treated by a psychiatrist, Dr. Ronnie Lee Seltzer, for many years until V.M. stopped seeing her allegedly at the behest of her lawyers. Although he concluded that V.M. appeared to be cognitively intact, he admitted that "there is a gnawing concern overall that the patient may not be as intact as I may have described."

Later that day, Dr. Jacoby dictated an addendum report recounting a conversation with Dr. Seltzer. Dr. Seltzer related that she initially treated V.M. for post-traumatic stress disorder but later began to appreciate that V.M. suffered from either a schizoaffective disorder or a bipolar disorder. Dr. Seltzer questioned the reliability of B.G. and was concerned about V.M.'s "ability to care for her child in a responsible manner." Dr. Jacoby also related a conversation with B.G. in which B.G. indicated that he feels the way the patient [V.M.] is acting now is not her normal manner and that she is not as "tranquil." She seems to be more rambunctious and over expansive (i.e., in a possible hypomanic state)[.] He also was hesitant but seemed to intimate that the patient has in fact had episodes of psychotic ideation, which he did not want to elaborate upon, prior to this present birth.

Dr. Jacoby concluded that V.M.'s and B.G.'s ability to parent the child "needs to be more fully evaluated by state social services."

Despite being slightly premature, J.M.G. was in good medical condition upon her vaginal delivery. She was taken to the neonatal intensive care unit, placed on antibiotics and observed for signs of jaundice. No drugs or alcohol were detected in her blood or urine.

[V.M., supra, 408 N.J. Super. at 227-29 (footnote omitted).]

However, V.M. testified at the guardianship trial that she fully cooperated with the health care professionals, including signing the form giving the doctors permission to perform a c-section and disclosing her prior psychiatric treatment. V.M. said that when the nurses failed to place a timely request for an anesthesiologist to perform an epidural, she asked them to call another doctor and "somehow a psychiatrist was called[.]"

On April 18, 2006, a social worker at St. Barnabas contacted DYFS reporting concerns about releasing J.M.G. to defendants' care. DYFS caseworker Heather Frommer spoke to defendants later that day. As she indicated at the guardianship trial, V.M. and B.G. denied that V.M. had ever received psychiatric treatment, denied knowing Seltzer, and claimed that V.M. had requested a psychiatric consultation at the hospital because she was being mistreated by the staff who refused to place her request for an epidural. However, V.M. countered by noting that she gave Frommer, who was "very combative" and was "yelling" questions at her, Seltzer's phone number, and said that she had taken the medication prescribed by Kurani.

Frommer also spoke to Kurani, who told her that he had prescribed Zyprexa, a mood stabilizing medication, for V.M. on April 17 and 18, 2006, but she had refused to take it, and said that V.M. "distorts everything that is told to her." V.M. refused to participate in an outpatient psychiatric care program following her discharge. Frommer also spoke to the social worker, who confirmed that V.M. had been "noncompliant with recommendations from a psychiatrist for medication before her pregnancy," and had been "uncooperative" with the hospital psychiatrists.

After consulting with her superiors, Frommer informed defendants that J.M.G. would not be discharged to their care and that DYFS would file a motion for custody. She told defendants that there would be a court hearing on April 20, 2006, and wrote down the relevant information. V.M. became upset, started yelling, and called the police. Frommer asked defendants if they had available relatives for placement, but they did not provide any relative placement resources.

V.M., but not J.M.G., was discharged from the hospital later that day. That evening, Frommer and Ketleen Israel, another DYFS worker, went to defendants' apartment in Short Hills to complete a home assessment. Frommer observed that defendants had not purchased a crib for the infant, who was born several weeks premature, but had purchased other baby items and found no safety concerns.

During the assessment, V.M. was speaking to an individual on the telephone who she said was her attorney. V.M. asked Frommer to speak to the attorney, but Frommer said she was not permitted to do so. Frommer reminded defendants about the court hearing on April 20, 2006, and told them that if they did not provide relative resources J.M.G. would be placed in a foster home. In her referral response report, Frommer wrote:

[t]he allegation of neglect of [J.M.G.] by her mother cannot be substantiated; however, there are serious child welfare concerns surrounding [V.M.'s] past and current mental health. It was documented by the hospital that she was uncooperative with hospital psychiatric staff. Furthermore, it was learned that she discontinued psychiatric treatment with . . . Seltzer in December of 2005. [V.M.] has refused to sign a release for the Division to obtain relevant information regarding her mental health functioning and compliance with treatment.

Defendants did not appear at the hearing on April 20, 2006, although they were present at all other hearings, and denied having any knowledge of the date. Frommer claimed that she telephoned their house that morning, but no one answered the phone. The judge found that removal of J.M.G. was required based on V.M.'s psychiatric condition, her refusal to cooperate with DYFS in disclosing medical information, her refusal to take the medication prescribed by the hospital, and her failure to be forthcoming with information.

On April 21, 2006, DYFS received a call from a social worker at St. Barnabas reporting that defendants "were creating a scene" while visiting J.M.G. in the hospital. The social worker stated that V.M. was "threatening the hospital and stating that she knows Donald Trump[.]" V.M. claimed at the guardianship trial that she knew nothing about the court proceedings. She said she believed J.M.G. had not been discharged because the infant was jaundiced and because V.M. had had a fever during the delivery. Defendants visited J.M.G. every day in the hospital until she was released. J.M.G. was discharged on April 24, 2006, and placed in a foster home.

On April 25, 2006, Frommer, accompanied by members of the Milburn police, served defendants with a copy of the order awarding DYFS temporary legal custody of J.M.G. V.M. refused to sign the document authorizing release of her medical information to DYFS and accused DYFS of kidnapping J.M.G.

On April 28, 2006, defendants had their first visit with J.M.G. since her release from the hospital. Defendants were "very quiet and calm" throughout the visit and left "without incident." A visitation program ensued at the Children's Aid and Family Service's office. A report regarding their progress during that first month of visits indicates that defendants were always early for the visits, brought appropriate gifts for the infant, including formula, diapers, clothing and diaper bags, and had developed a cordial relationship with the foster mother, expressing their appreciation for the quality of J.M.G.'s care.

Meanwhile, on May 10, 2006, V.M. contacted DYFS reporting that DYFS had "kidnapped her baby" and that no one from DYFS had informed her about visitation or what would happen next regarding their case. V.M. wanted J.M.G. to be placed with a family member not in a foster home.

At the fact-finding hearing of the abuse and neglect issues, the judge entered an order reflecting his findings that both parents had abused or neglected J.M.G. in that they "refused to cooperate with the medical professionals of Saint Barnabas Hospital during child birth," although the judge made no findings in his oral decision that B.G. had abused or neglected the child. V.M., supra, 408 N.J. Super. at 251.

[T]he judge also rejected B.G. as a custodial parent (assuming V.M. left the marital premises), focusing on B.G.'s lack of cooperation with DYFS. The judge stated that J.M.G. would be returned to B.G. if certain conditions were met: B.G. receives a psychological evaluation within the next week; the evaluator concludes that the child would be in no danger with B.G.; V.M. is not in the home; and a mechanism is in place for monitoring V.M.'s visits. [Id. at 232.]

On June 1, 2006, Gregory Defilippo, a DYFS caseworker, contacted M.G.M., V.M.'s mother, who said that V.M. had had problems "dealing with other people, her whole life." M.G.M. believed that V.M.'s problems had been exacerbated by her treatment with Seltzer, and by her marriage to B.G. M.G.M. said that her daughter could not reside with her, and she hoped that J.M.G. would "be adopted by a loving family."

On June 12, 2006, DYFS referred defendants to Mark Singer, a psychologist, who did not testify at trial, for evaluation.*fn3

During his evaluation, B.G. denied that V.M. had refused "medication or medical treatment, including denying refusing consent for a C-section, while in the hospital." B.G. also denied that V.M. had "been diagnosed with psychosis." B.G. claimed that V.M. never took the medications prescribed by Seltzer, and that she had sought treatment with her as a part of a court case. B.G. alleged that Seltzer "got a lot under the table for prescribing medication that she has no diagnosis for." B.G. reported that they were suing Seltzer and St. Barnabas, and alleged that Cohen, V.M.'s treating physician, had "touched [V.M.] inappropriately during a OB-GYN examination."

During her evaluation with Singer, V.M. said she had taken some, but not all, of the medication prescribed by Seltzer, and claimed Seltzer's notes had been altered "because they were used for litigation purposes." She also reported that Seltzer had "issues," "never had children," and "had countless problems with patients." V.M. explained that the current controversy started when "there was harassment perpetrated on [her] by the medical staff," and further alleged that Cohen "has a little bit of bias [against] anyone over 35 becoming pregnant."

Singer administered a series of personality tests on V.M., the results of which he found indicated that she was secretive, defensive, felt victimized by others, excessively displayed emotions, had a dramatic need for attention, and "may manipulate others and events to satisfy [her] need for attention and approval."

Singer found that "many of the elements presented in the case record are in direct contrast with the perceptions reported by [B.G.] and [V.M.]." He concluded that:

If the Court should determine that the record is credible, it would not be recommended to place a child with any individual who has not been compliant with medication, has significant mental health issues that are not being treated, and has significantly distorted reality. Placing a child with any such individual is likely to expose that child to a risk of harm.

Nonetheless, Singer found that reunification with J.M.G. was the ultimate goal, and toward that end he recommended that defendants be evaluated by a qualified psychiatrist, participate in individual and joint psychotherapy, maintain appropriate housing, and continue supervised visitation. Compliance with the recommendations was anticipated to lead to reunification. However, the length of time required to achieve reunification was "dependent upon the abilities of both adults to reduce their level of defensiveness and to benefit from the above recommendations."

On August 19, 2006, defendants began attending parenting classes with Final Stop Family Services. Within a few days, Marninne Rejouis, the parenting skills facilitator, advised DYFS that they would not be able to provide services to the family until V.M. "receives treatment." Rejouis reported that although initially "the class was going well," when Rejouis began going over the rules of the class, V.M. became "extremely upset," and threatened to add Final Stop to the list of defendants she was suing, including the state, doctors, and the hospital. B.G. was unable to calm V.M. and apologized for her behavior, explaining that they were "under a lot of stress." By letter dated August 25, 2006, addressed to Kimberly Lewis, a DYFS caseworker, defendants responded that Rejouis told us that our clothing is too expensive and that if we continue to attend classes she will have to actually work and she doesn't want to do that. Ms. Rejouis said that her other clients just sign in and leave so she doesn't have to work, Ms. Rejouis also stated that we are not on public assistance and she doesn't understand the case. Please inform us of the new location and schedule for another parenting skills class.

One month later, the judge conducted a compliance hearing, during which, as we noted in our prior concurring opinion, it became clear that the plan suggested at the fact-finding hearing had gone awry.

Attempts to obtain psychological/psychiatric evaluations of V.M. and B.G. proved unsuccessful,[] as had efforts to provide V.M. with parenting classes.[]

The judge expressed his frustration, observing that he "wanted desperately to reunify this family," but the parents were "snatching defeat from the jaws of victory." He also expressed concern that no psychiatrists would undertake the evaluation if they thought they would be sued, to which V.M. responded, "[t]hat's your problem." When V.M. was asked if she would waive her right to sue psychiatrists, she replied, "[n]o way." As a result, the judge ordered that a psychiatrist be appointed who would have the same immunity as the court.

[V.M., supra, 408 N.J. Super. at 232-33 (footnotes omitted).] Defendants were referred to St. Barnabas's Family Life Education Center for parenting classes. Dr. Christine Baker reported that V.M., who appeared delusional and paranoid, would not be appropriate for their program until she received psychiatric treatment.

By letter dated October 20, 2006, defendants informed caseworker Lewis that they wanted to attend parenting classes at Overlook Hospital. With reference to the scheduled psychological evaluations, defendants wrote that "[t]o insure our safety it is necessary to have officers from the Bloomfield Police Dep[artment] accompany us to these appointments."

In October 2006, defendants were referred to Vivian Chern Shnaidman, M.D., a psychiatrist, for evaluations. Shnaidman found that V.M. suffered from chronic paranoid schizophrenia and that B.G. suffered from "folie a deux," a rare condition in which one person subscribes to the psychoses and paranoid delusions of another.

In a letter sent to a DYFS caseworker on November 17, 2006, V.M.'s brother, R.M., who did not testify at trial, wrote that defendants were "currently incapable of making the proper decisions necessary to provide a healthy environment for themselves or their new baby." He said that defendants believed that V.M.'s father's girlfriend's daughters were involved in a "conspiracy to call DYFS," and believed that Frommer was the daughter of one of V.M.'s father's girlfriends. V.M. threatened to burn her father's store down and threatened "to take revenge" against her father and his girlfriend. V.M. also claimed that an eighty-five year old man had raped her in his friend's restaurant and that "some stranger forced himself on her and all sorts of other ridiculous fabrications that are obviously brought on by Zoloft." R.M. believed that V.M.'s "psychiatric related issues" were caused by "a lack of sleep."

On December 7, 2006, Lori Schreuders, director of Clinical Services at Family Connections, reported that it would not be in defendants' best interest for them to continue to participate in their parenting group. She said defendants "would be better served by a program that would offer them a more individualized approach to address their parenting skills needs." Defendants ultimately attended parenting and nutrition classes at Overlook Hospital.

Defendants were referred by DYFS to Northwest Essex Community Healthcare Network for individual psychotherapy treatment with Yanada Essex, a licensed social worker. Defendants attended all of the weekly sessions with Essex, were cooperative, and completed the year-long treatment program. Essex recommended that V.M. pursue individual therapy.

Instead, defendants began treatment on a monthly basis with Marc Cantillon, M.D., a psychiatrist, and continued to see him through the time of the guardianship trial.

Shnaidman and Cantillon testified at the abuse and neglect hearing, providing diametrically opposite observations and recommendations. The judge found: "'I don't think I've ever seen a case of mental disorder where the diagnoses . . . [were] so diametrically opposed. We're in different worlds.'" V.M., supra, 408 N.J. Super. at 234. J.M.G.'s foster mother also testified, stating that defendants visited the child once every two weeks, always brought shopping bags full of supplies, and listened to and followed her suggestions. Id. at 233. The foster mother opined that they "would be wonderful parents." Ibid. Nonetheless, the judge approved DYFS's plan of terminating defendants' parental rights based on V.M.'s psychiatric history and on B.G.'s unwillingness to accept her condition.

J.M.G. was placed in her current pre-adoption home on April 2, 2007, and on April 25, 2007, DYFS filed an order to show cause and verified complaint for guardianship seeking termination of defendants' parental rights to J.M.G.

Patrice Amatrudi, a DYFS caseworker assigned to this case, began supervising the weekly visits. Amatrudi observed some areas of concern during the visits, which appear rather trivial in context, including that B.G. placed the infant's diaper on backwards. She admitted that although B.G. was initially "hesitant" to change J.M.G.'s diaper, he ultimately did it correctly. B.G. explained he was "nervous" because that was the first time he had changed a diaper.

Amatrudi also observed that on one occasion when J.M.G. was sitting on V.M.'s lap drinking a bottle, they heard a "suction" sound, and J.M.G. threw the bottle onto the floor. Amatrudi saw that the nipple had inverted into the bottle, but V.M., who apparently thought J.M.G. had swallowed the nipple, "shrieked and jumped up and came running towards [Amatrudi] with the child." Although Amatrudi was pleased that V.M. had noticed that the nipple was "not evident," she was concerned that V.M. had come to her for help, instead of trying to extract the nipple on her own, or seek help from B.G. Amatrudi admitted that V.M. "was calm when she saw that the baby was okay and then . . . commented she had once saved [B.G.] from choking by using the Heimlich maneuver . . . ."

Further, Amatrudi observed that during the visits V.M. would often play music at a very loud volume. Although J.M.G. liked music, the loud volume seemed to agitate her, and V.M. did not realize that the volume should be turned down. On one occasion V.M. tried to zip J.M.G.'s jacket, but the zipper was broken, so V.M. said that J.M.G. did not like to have her coat zipped, even though the child had never expressed that preference. Amatrudi admitted, however, that defendants interacted with J.M.G. and always brought appropriate gifts. She also admitted that B.G. was a good support for V.M., and that the couple appeared close. However, she testified that J.M.G., who had no special needs, had interacted with and had bonded to her foster parents, who wanted to adopt her.

V.M. was hospitalized at Overlook Hospital for depression and anxiety from May 25 to June 7, 2007. A hospital form, under the caption "History of Present Illness," indicated that the patient had complained of worsening depression and had actually stopped taking her outpatient psychiatric medication for 7 weeks and had returned to her outpatient psychiatrist, Dr.

Miller, about 1 month ago. . . . The patient states that she has been under an enormous amount of stress within the last few months, ending a relationship with her boyfriend, moving in with her parents 2 months ago who are not supportive, and also needing to end a relationship with her husband whom she has been estranged for the last several years.

This history was obviously inaccurate in that V.M. was not estranged from B.G., nor did she live with her parents, who were divorced. The judge in the guardianship action relied on this report and found that the history "evidences" the "serious nature" of V.M.'s "mental health stability." However, although the form contains V.M.'s correct name, patient number and birth date, it may have been erroneously assigned to her, because it lists different treating physicians (Monahan and Miller, not Cantillon), different psychiatric medications (prescribed by Miller), and indicates that the patient admitted to gambling, an admission not contained in any other reports.

Following her discharge, Overlook referred V.M. to its outpatient program. According to hospital records, V.M. attended the program for twelve days, but was then terminated "[b]ecause of her continued disruptive behavior [] in groups; [and] despite medical team's efforts to redirect and set limits; and alienation from other group members due to her inappropriate behavior [and] insensitivity to others[.]" However, V.M. maintained that she had attended sixteen sessions, and had then been discharged because her insurance would not pay for further treatment.

Meanwhile, DYFS learned about V.M.'s admission to Overlook during a scheduled visitation on May 31, 2007. Amatrudi reported that B.G. telephoned V.M. in the hospital at least five times during the visit, thereby confirming her "suspicion that [B.G.] could never live apart from his wife and maintain [J.M.G.] for [J.M.G.'s] sake alone." At the time of her discharge V.M. was taking antidepressant (Wellbutrin and Paxil) and anti-psychotic (Seroquel) medication.

In July 2007, DYFS referred defendants to Alice Nadelman, a psychologist, for evaluation. Nadelman, who prepared four separate reports and testified at the guardianship trial, opined that V.M. and B.G. were "unable to provide safe and appropriate care" for J.M.G., and placement with them would place the child at a "high risk" for psychological harm as well as "possible inadvertent physical harm." Nadelman based her ...


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