False Positive

Summary

Criminal Podcast Episode Summary: "False Positive"

Criminal, hosted by Phoebe Judge and produced by Vox Media Podcast Network, delves into the complexities of crime and justice through human stories that highlight systemic flaws and personal struggles. In the episode titled "False Positive", released on May 9, 2025, the podcast explores the alarming issue of false-positive drug tests for new mothers, leading to unwarranted interventions by Child Protective Services (CPS). This detailed summary captures the key discussions, personal narratives, expert insights, and the broader implications of flawed drug testing protocols in hospitals.

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Introduction to False Positives in Drug Testing

The episode begins by presenting the unsettling reality that false-positive drug tests can have devastating effects on families. These tests, commonly administered to new mothers, are intended to identify illicit drug use but often lack the precision to distinguish between legal substances and illegal drugs. This flaw leads to wrongful accusations and the potential separation of children from their parents.

Susan Horton's Ordeal

Susan Horton, a resident of Santa Rosa, California, becomes the central figure in this narrative. In August 2022, while preparing to welcome her fifth child, Susan undergoes a routine urine test postpartum, which falsely indicates the presence of codeine—a finding that sets off a chain reaction of unjust interventions.

• Birth and Initial Test:
  • "There was a point where I was just like, this is absurd. I want to go home. I have not taken anything." (Susan Horton, 04:18)

Despite her protestations of innocence, the hospital staff proceeds with CPS involvement based solely on the preliminary test result.

• Identification of the False Positive:
  • Susan recalls realizing the mistake after consuming a poppy seed-laden 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..." (Susan Horton, 03:02)

Poppy seeds are known to contain trace amounts of codeine, which can trigger false positives in urine drug screens.

• Impact on Her Family:
  • "I felt very emotional and I was alone... they had a singular piece of evidence that I had taken something and it was wrong." (Susan Horton, 05:02)

Grace and Michael Smith's Similar Struggle

Parallel to Susan's story is that of Grace and Michael Smith from Pennsylvania. Grace, a lawyer diagnosed with Attention Deficit Disorder (ADD) and prescribed Vyvanse, an amphetamine-based medication, tests positive for methamphetamine—another flaw in the drug testing process.

• Initial Hospital Interaction:
  • "Well, your urine tests show that you were positive for methamphetamine." (Grace Smith, 09:40)

Grace presents her medical records to clarify that her prescription medication is the cause of the positive result. However, the hospital staff dismisses this explanation, leading to immediate CPS intervention.

• Confrontation and Separation:
  • "They couldn't have lived with themselves if they hadn't tried. Just to make sure that this wouldn't happen again. You gotta try." (Grace Smith, 33:58)

Despite providing evidence of her legitimate medication use, Grace and Michael face the bureaucratic and emotional turmoil of having their newborn child temporarily removed.

Expert Insights: The Science Behind False Positives

The episode features an interview with Dr. Gwen Miller, a medical director specializing in drug test analysis. Dr. Miller elucidates the technical shortcomings of standard urine drug tests:

• Common Causes of False Positives:

  • "Some common cold medications will trigger positive results... Labetalol metabolites are triggering the test into thinking that fentanyl or methamphetamine are present." (Dr. Gwen Miller, 14:21)
  • "Vyvanse, the medication for attention deficit disorders, also looks like methamphetamine." (Dr. Gwen Miller, 14:21)

• Limitations of Preliminary Tests:

  • Dr. Miller emphasizes that preliminary tests, often used for their cost-effectiveness and non-invasiveness, lack the specificity to accurately identify illicit substances, leading to high false-positive rates—"Close to 50% for many drug classes." (Dr. Gwen Miller, 14:21)

• Need for Confirmatory Testing:

  • She advocates for a second, more definitive test conducted by toxicologists to verify initial results, a step that is not routinely mandated or standardized across hospitals.

Systemic Flaws and Policy Shortcomings

The podcast highlights significant policy and procedural deficiencies within the healthcare and child welfare systems:

• Lack of Standardized Confirmatory Testing:

  • "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." (Dr. Gwen Miller, 14:21)

• Overreliance on Preliminary Results:

  • Hospitals, driven by legal liabilities and the opioid epidemic's urgency, often bypass confirmatory tests, acting on initial screenings despite their inaccuracies.

• Inconsistent State Policies:

  • The episode reveals that while federal law mandates reporting substance exposure, most states extend this requirement without necessitating follow-up confirmations, exacerbating the issue of false positives.

• Impact on Child Welfare Decisions:

  • "Federal law requires states to identify babies that are... exposed to substances and refer them to child welfare authorities." (Narration, 14:21)

Emotional and Personal Toll

Both Susan Horton and Grace and Michael Smith endure profound emotional distress due to these systemic failures:

• Susan Horton's Fear and Determination:

  • "This is just how P tests work... But really, that type of testing is not mandated." (Narration, 14:21)
  • After enduring CPS intervention, Susan faces the daunting task of proving her innocence in court, battling both legal hurdles and personal doubts.

• Grace and Michael Smith's Resolution:

  • The Smiths invest significant resources into legal battles, including a hair follicle test to establish the illegitimacy of the methamphetamine result. Their persistence leads to the eventual dismissal of the case, but not without enduring financial and emotional strain.
  • "We could not have lived with ourselves if we hadn't tried. Just to make sure that this wouldn't happen again." (Grace Smith, 33:58)

Potential Solutions and Calls for Reform

The episode underscores the urgent need for reform in drug testing protocols and CPS procedures:

• Implementation of Mandatory Confirmatory Testing:

  • Aligning with practices established during employee drug screenings, pregnant women should be granted the right to a second, precise test to confirm any preliminary positive results.

• Standardization Across Healthcare Facilities:

  • Developing unified guidelines that mandate confirmatory tests can help prevent wrongful CPS interventions based on inaccurate drug screening results.

• Education and Training for Medical and CPS Personnel:

  • Enhancing awareness about the common causes of false positives among healthcare providers and CPS workers can reduce bias and improve decision-making processes.

Conclusion: The Human Cost of Systemic Failures

"False Positive" poignantly illustrates how flawed drug testing systems and rigid bureaucratic policies can inflict unnecessary pain and trauma on innocent families. Through the harrowing experiences of Susan Horton and Grace and Michael Smith, the episode calls for compassionate reform and greater accuracy in medical testing to safeguard the well-being of both parents and children.

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Notable Quotes:

• "I was just sitting there having to swallow my pride and going like, this person is about to make a decision based on, like, my kids." — Grace Smith (25:17)

• "I have no clue what else it could be." — Susan Horton (03:02)

• "Close to 50% for many drug classes." — Dr. Gwen Miller (14:21)

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Attributions:

• Reporter: Shoshana Walter
• Producer: Marianne McCune
• Edited by: Jenny Casas
• Additional Contributors: Manuel Torres, Nina Martin, Kate Howard, Jim Briggs, Fernando Arruda, Claire Mullen, Nikki Frick, Kim Frida, Leda Walker

For further information and to listen to the full episode, visit Criminal's Official Website or the Vox Media Podcast Network.

Transcript

[Phoebe Judge]

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[Shoshana Walter]

Tender, juicy and its own sauce.

[Susan Horton]

Would you look at that? Well, you can't see it, but trust.

[Shoshana Walter]

Me, it looks delicious. New McCrispy strips now at McDonald's. 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.

[Phoebe Judge]

This is Susan Horton. She lives in Santa Rosa, California. And In August of 2022, she was just about to give birth to her fifth child.

[Shoshana Walter]

I don't think I got much sleep that night, and by morning I remember I was in a lot of pain. Hallie was very big. She was 9 pounds 11 ounces. And I had forgot how hard it is to birth a nine 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.

[Phoebe Judge]

Susan 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.

[Shoshana Walter]

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.

[Phoebe Judge]

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.

[Susan Horton]

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.

[Shoshana Walter]

And she remembers, ding, ding, ding.

[Susan Horton]

The pizza and the salad, a poppy seed salad.

[Shoshana Walter]

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.

[Susan Horton]

After the provider leaves the room, she just does a quick Google search and she realizes like that that had to be it.

[Shoshana Walter]

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 and that salad had a lot of poppy seeds on it.

[Susan Horton]

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.

[Shoshana Walter]

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.

[Susan Horton]

To happen, that they contacted Child Protective Services and that a CPS investigator would be coming to ask her questions.

[Shoshana Walter]

There was a point where I was just like, this is absurd. I want to go home. I have not taken anything.

[Susan Horton]

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.

[Shoshana Walter]

I felt very like emotional and I was alone, like I 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 Horton]

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.

[Shoshana Walter]

I felt like I went to all.

[Susan Horton]

The important ones, you know, she lacked childcare and both her husband and her 16 year old old are immunocompromised.

[Shoshana Walter]

My second born, Liam, was born with a congenital heart defect and had five open heart surgeries.

[Susan Horton]

So Susan basically avoided the doctor during.

[Shoshana Walter]

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. They want me to sign a safety plan.

[Susan Horton]

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.

[Shoshana Walter]

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.

[Susan Horton]

But they did not realize what the consequences would be if they did not sign it.

[Shoshana Walter]

Basically, 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.

[Susan Horton]

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, but because instead of poppy seeds, it actually involves Grace's prescribed medication. They had just moved the Poconos to be closer to Grace's parents when essentially Grace went into labor with her fourth child.

[Grace Smith]

I called Michael and I was like, okay, my water broke. We gotta go. And then me and Michael went in to have a baby.

[Susan Horton]

Everything seemed to be fine.

[Michael Smith]

He grabbed my finger, and I told him that I was gonna love him for the rest of his life.

[Grace Smith]

And everybody in the room just got really quiet and they're, aww.

[Susan Horton]

When did you get the sense that something might be going awry?

[Michael Smith]

It was the following day when they started talking to us about trying to get him into the nicu.

[Susan Horton]

Doctors seemed to think that their son was developing respiratory issues, so they took him to the neonatal intensive care unit. Shortly after that, the OB GYN started asking Grace and Michael some questions. You 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.

[Grace Smith]

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.

[Susan Horton]

Grace was diagnosed with attention deficit disorder when she was 12 years. So she was on a medication called Vyvanse for her adhd.

[Grace Smith]

And I'm like, well, I take an amphetamine. She's like, well, your urine tests show that you were positive for methamphetamine. And so we've had to alert the Children's Services, who will conduct a. What was the word they used? They're gonna conduct a.

[Michael Smith]

An investigation of your family.

[Grace Smith]

Yeah.

[Susan Horton]

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.

[Grace Smith]

I'm like, I don't think so. And Michael's going, nope, I've got rights. They're not coming to my house.

[Susan Horton]

The conversation basically went south from there.

[Grace Smith]

I went, I don't trust this hospital anymore. I want to leave. And Michael went, yep, I agree. And I said, where was drawing all consent for treatment for me and for the baby, and we're leaving immediately. And it got really scary, like, just so fast. As soon as she left, I was like, I'm getting dressed right now. Go get the baby. And he went to the nicu. He gave the baby a kiss.

[Michael Smith]

Gave him a kiss on the forehead. And I told him I would be right back, and I wasn't. And I hate that.

[Susan Horton]

He goes downstairs to the car to get the car seat, pulled the car.

[Michael Smith]

Around to the front, got Grace, went up two floors to the NICU and found it locked.

[Susan Horton]

They weren't allowed back in the NICU to get their son. And then shortly after that, the police.

[Grace Smith]

Arrived, running out of the elevator, like, into Michael's face, like, okay, so what's the problem here?

[Michael Smith]

To which my response was, that's exactly what I'm trying to figure out.

[Susan Horton]

This is all going on in the NICU waiting room where there are other families.

[Michael Smith]

So we've got a little bit of an audience collected here.

[Grace Smith]

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.

[Susan Horton]

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.

[Grace Smith]

I looked at Michael and I said, michael, you can't say anything. You just please don't say anything.

[Susan Horton]

The police escort the parents down the elevator, out through the hospital doors, and then finally they drive home without their baby.

[Grace Smith]

It was a really dark moment. Like, I don't think I've ever felt that low. I didn't know what to do. I didn't even know where to start.

[Phoebe Judge]

We'll be right back.

[Susan Horton]

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[Shoshana Walter]

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[Susan Horton]

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[Grace Smith]

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[Phoebe Judge]

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.

[Susan Horton]

Can you list off a few substances that could cause false positives on screens? Some common cold medications will trigger positive results. The Sudafed that they're taking or the Vicks 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. Vyvanse, the medication for attention deficit disorders, also looks like method. 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. Close 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. 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. But really, that type of testing is not mandated. It's not standardized. And so each hospital gets to decide what type of tests 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 anytime an infant is simply exposed or even potentially exposed to substances. And the fast, 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 with 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. When Grace Smith tested positive for meth at a hospital in Pennsylvania, she and her husband insisted the result was wrong.

[Grace Smith]

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.

[Susan Horton]

This was a new hospital for Grace and Michael. They 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.

[Grace Smith]

Because they were like, you know, we're gonna do a drug screen like they told us at the outset. And I was like, okay, here's my medical marijuana card and here's my prescription.

[Susan Horton]

For 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.

[Michael Smith]

You have her medical records. You know she's on Vyvanse.

[Susan Horton]

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.

[Michael Smith]

I asked, did you call her ob, whose name is right at the top there? It's been her OB for years.

[Susan Horton]

And what was her response to you asking if she'd looked at her records?

[Michael Smith]

She didn't care. She didn't care.

[Susan Horton]

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.

[Grace Smith]

They shouldn't have a test that doesn't differentiate between a legal substance and an illegal substance, Period. They shouldn't use that, ever.

[Susan Horton]

I reached out to St. Luke's University Health Network, and a spokesperson declined to answer questions about Grayson Michael's case. What 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.

[Shoshana Walter]

Can poppy seeds give a dirty drug test? And the answer was yes.

[Susan Horton]

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 Thebain. But there's no indication in the medical records that they did that test or even were aware that it existed.

[Shoshana Walter]

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 Horton]

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 multifaceted assessment before reporting. Someone, an 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. People 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. In 2022 alone, more than 35,000 of these cases were reported in, and authorities removed more than 6,000 infants from their families. When 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.

[Michael Smith]

He's super friendly.

[Susan Horton]

Two dogs, Daddy. Okay, you have to tell me how to play it. Four kids.

[Michael Smith]

This is the kid himself.

[Susan Horton]

This is Julian.

[Grace Smith]

Yeah, this is Julian.

[Shoshana Walter]

Hi, Julian.

[Susan Horton]

Grace grew up in a big family, and both of her parents and her sister have an attention deficit disorder.

[Grace Smith]

My sister was the youngest person in the state to be medicated for it.

[Susan Horton]

Oh, my gosh. How old was she?

[Grace Smith]

Three, I think. Wow. Yeah. And the CDC wanted to do a family study on our family because we all had it.

[Susan Horton]

Grace's mom was actually pretty funny about so many of them having adhd.

[Grace Smith]

We're not a very good breeding pair. It was Christmas last year.

[Susan Horton]

This 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 just moved here.

[Grace Smith]

When I went into labor, the house was completely. It was still boxed up. We all had our mattresses, but everything. Everything was in boxes.

[Susan Horton]

And they both just felt broken.

[Grace Smith]

The next day when we woke up, I would call the hospital every couple hours and see if he was doing okay. And they'd tell me, he's doing okay. He's taking formula okay. And I just remember how hard that hit me.

[Susan Horton]

Later that day, the hospital tells Grace that she is allowed to come back to the hospital and visit.

[Grace Smith]

You're allowed to come back in, and.

[Susan Horton]

Michael is not allowed to come.

[Grace Smith]

But your husband can't come.

[Susan Horton]

He's still barred from entering the hospital.

[Grace Smith]

I was like, okay, I'm coming. I'll Be right there. If he was there for two weeks, I was gonna sleep on a chair for freaking two weeks. And that's what I slept on for the next two nights.

[Susan Horton]

There's no privacy. A security guard is posted outside, and she's required to leave the curtain open.

[Grace Smith]

It made me feel paranoid and like I also couldn't act like I was paranoid.

[Susan Horton]

Grace 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.

[Grace Smith]

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.

[Susan Horton]

At the same exact time, a caseworker goes to Grayson Michael's house to do a home inspection and to interview Michael.

[Michael Smith]

He came to the door. He's a big guy.

[Susan Horton]

Michael's approach was kind of just to be very amiable.

[Michael Smith]

I was really nice to him.

[Susan Horton]

I reached out to Monroe County Children and Youth Services, and they declined to comment. But after those two interviews and the home inspection, the agency notifies the hospital that they can release the baby.

[Grace Smith]

Do you remember when I finally got to bring Julian home from the hospital? I just remember, like, you got back.

[Susan Horton]

And you were like, we have him now or something.

[Grace Smith]

That was, like, the only thing I.

[Susan Horton]

Remember from that day.

[Shoshana Walter]

And you just told him, Julian.

[Grace Smith]

And when we didn't have him, you.

[Susan Horton]

And dad were crying. Hello, Julian. During my visit, I gave Julian my headphones so he could hear people talking on the mic. Hello. Why do you do that?

[Michael Smith]

Hi, Julian. What's your name? What's your name?

[Susan Horton]

Julian.

[Michael Smith]

That's right.

[Susan Horton]

Julian.

[Grace Smith]

How old are you?

[Shoshana Walter]

We're old.

[Grace Smith]

My name is Julian2.

[Michael Smith]

He's in the weeks or two where he's starting to take sentences. Oh, it's delightful.

[Phoebe Judge]

We'll be right back.

[Susan Horton]

Did you know that parents rank financial literacy as the number one most difficult life skill to teach? Meet Greenlight, the debit card and money app for families. With greenlight, you can send money to kids quickly, set up chores automate allowance, and keep an eye on your kids spending. With real time notifications, kids learn to earn, save, and spend wisely. And parents can rest easy knowing their kids are learning about money. With guardrails in place, Try Greenlight risk free [e-mail] Spotify this episode is brought to you by Pluto TV. Are you looking for your next case? Pluto TV has all your favorite crime dramas streaming for free, which means suspicion is free. With countless cases to crack. Watch csi, Criminal Minds, ncis, Blue Bloods, Tracker, FBI and swat. All for free from all your favorite devices. Feel the free Pluto TV stream now. Pain never. Susan Horton's poppy seed salad saga officially ended about two weeks after her daughter was born. Yeah.

[Shoshana Walter]

Where's your toys?

[Susan Horton]

Hey. The baby didn't get to live at home those first couple of weeks.

[Phoebe Judge]

Thank you.

[Susan Horton]

Before Susan was allowed to even be alone with her, she had to convince child welfare authorities and a juvenile court judge that she wasn't a danger to her child. Susan remembers her attorney advising her not to bring up the poppy seeds in court.

[Shoshana Walter]

I had receipts that I had bought it from Costco about four or five days before. But he was like, do not mention the poppy seed salad because it sounds stupid. And I realized that. But that is what caused the dirty drug test. So why are we not talking about the poppy seed salad?

[Susan Horton]

Susan and her husband agreed to more testing and a home inspection. And once that was done, the judge just dismissed the case. But this experience has created an undercurrent of doubt for Susan.

[Shoshana Walter]

We can go outside if you want.

[Susan Horton]

Susan really believes in teaching her kids to feel comfortable in nature. And so she has them playing outside all the time, helping to plant the garden.

[Shoshana Walter]

It's a worm. Should we save the worm?

[Grace Smith]

Yes.

[Shoshana Walter]

Yes.

[Susan Horton]

This scene right here is like Susan Horton's mothering strategy.

[Grace Smith]

Yeah.

[Shoshana Walter]

Yeah. So she's got her toes in what was a water hole. Now that she's kicking, it's more of a mud hole.

[Susan Horton]

She was like splashing in the mud puddle on her bare feet and legs.

[Shoshana Walter]

Just kicking her little toes.

[Susan Horton]

Susan feels like that's such an important part of childhood. Oh, my gosh. There's a bug. And she said that even in this moment when she and I were talking and watching her daughter delighting in the muddy puddle, that she had this fear that passed through her.

[Shoshana Walter]

Like if anyone knew that she was in a little dirty, watery hole playing, that someone out there would see it as neglect or abuse in some way.

[Susan Horton]

It's just undermined her sense of self and confidence as a mother.

[Shoshana Walter]

Mama's gonna get you. Mama's gonna get you.

[Susan Horton]

It took Grace and Michael Smith three days to bring their son Julian back to their home in the Poconos. Yep.

[Michael Smith]

Diapers, poops.

[Susan Horton]

But they remained under investigation by Child Protective Services for another month. Like Susan, they spent several thousand dollars on an attorney, plus $300 more to pay for their own follow up drug test. It was Grace's mom who had the idea of doing a hair follicle test which can identify specific illicit drugs going back three months. We knew that we had to get the lie, the initial lie, put down.

[Grace Smith]

Before we could make any progress. And as soon as I turned that into them, that was. That was it.

[Susan Horton]

CPS then closed their case.

[Michael Smith]

Very cut and dry, very bureaucratic.

[Susan Horton]

Oh, my God, there's a dog peeking. You see just one eye peeking around that door. One of the things I found in my reporting that totally blew me away is that there's a known solution to all of this. There are already laws and regulations for drug testing, just not when it comes to pregnant people. When the Reagan administration started drug testing many workers in the 1980s, those workers were up in arms about false positives. So now there are all these protections. Many workers have the right to confirmation tests. They have the right to a review from a specially trained doctor who talks to them about what they've eaten or taken that could have caused a positive result. I actually found this report from the 90s where a federal advisory committee recommended pregnant women get all of those same rights. But that detail buried in that report was basically ignored. So today, even most child welfare workers have protections in the workplace, but the mothers they're tasked with investigating have none. Michael and Grace were so incredibly upset by their experience that they spent the entire next year filing their own lawsuit against everyone they thought might have been involved. The complaint was almost 1000 pages long, and it didn't get very far. The hospital argued it did not violate Grace's privacy and civil rights, and the judge eventually dismissed the case, saying in part that the Smiths did not sufficiently argue their claims. You could see that as a total failure, but that's not how Grace's parents see it.

[Grace Smith]

They had to do that lawsuit.

[Susan Horton]

They could not have lived with themselves if they hadn't tried. Just to make sure that this wouldn't happen again. You gotta try. They wanted justice.

[Grace Smith]

Justice is important to people. You know, when things go wrong, you.

[Susan Horton]

Say, well, somebody's gotta do something here. It's the only way we improve.

[Phoebe Judge]

Special thanks to the team at Reveal and the Marshall Project. You can listen to a longer version of this piece on the Reveal podcast at the link in our show notes. This piece was reported by Shoshana Walter and was Produced by Marianne McCune and edited by Jenny Casas. Additional editorial support from Manuel Torres, Nina Martin and Kate Howard. Score and sound design by Jim Briggs and Fernando Arruda. They had help from Claire Mullen. Fact checking by Nikki Frick and Kim Frida. Legal review by Leda Walker. Reveal's interim executive producers are Bret Myers and Taki Telenides. You can listen to many more great episodes of [e-mail] Criminal is created by Lauren Spohr and me. Nadia Wilson is our senior producer. Katie Bishop is our supervising producer. Our producers are Susanna Roberson, Jackie Sajiko, Lily Clark, Lena Sillison and Megan Kinane. Our show is mixed and engineered by Veronica Simonetti. Julian Alexander makes original illustrations for each episode of Criminal. You can see [e-mail] and you can sign up for a [e-mail] Criminal is part of the Vox Media Podcast network. Discover more great [e-mail] I'm Phoebe Judge this is Criminal.

[Susan Horton]

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