Neutral Citation Number: [2017] EWFC 64 IN THE FAMILY COURT SITTING AT THE ROYAL COURTS OF JUSTICE 29 September 2017 Before : THE HONOURABLE MR JUSTICE PETER JACKSON -------------------- Between : THE LONDON BOROUGH OF BARNET Applicant -and- (1) T (Mother) (2) G (Father) (3) H (Child) -and- (1) ALERE TOXICOLOGY (2) E4 LAW LIMITED (t/a LEXTOX) (3) DNA LEGAL Respondents Interveners -------------------- William Tyler QC and Emily James (instructed by instructed by Sarah Johnson, Legal Services) for the Local Authority Hannah Markham QC and Kate Tompkins (instructed by Dawn Wilson of Creighton & Partners) for the Mother Paul Hepher (instructed by Jalpa Vadgama of Guile Nicholas Solicitors) for the Father Timothy Parker and Edward Lamb (instructed by Sabina Mahmood of Gary Jacobs & Co) for the Children’s Guardian Tina Cook QC and Damian Woodward-Carlton (instructed by Nick Cunningham of Gowling WLG (UK) LLP) for Alere Toxicology Ronan O’Donovan (instructed by David MarVn of Carbon Law Partners) for Lextox John Tughan QC (instructed by Philip Banks-Welsh of Royds Withy King, Solicitors) for DNA Legal Hearing dates: 18-22, 25 & 29 September 2017 Judgment date: 29 September 2017 -------------------- JUDGMENT – Re H: Hair Strand Tes\ng
1. This judgment considers the science of hair-strand tesVng for cocaine (atparagraphs 25-56) and theway inwhich expert reports on the test results arepresented(57-59).
2. Theproceedingsareaboutaneight-month-oldbabygirl,whoIshallcallHolly.ShewasremovedfromhermotheratbirthbutreturnedtohercareattheageofsixweeksundersupervisionandsinceJulyhaslivedwithhermotherathome.ItisnowagreedthatalthoughthethresholdforintervenVoniscrossedonthebasisof thepast history and future risk,Hollywill remain in hermother’s carewithsupportprovidedbythelocalauthority,byotheragenciesandbyherfatherandmaternalgrandmother. Theonlylegalissueiswhetherthearrangementshouldbeunderpinnedbyacareorderorasupervisionorder.
3. Thereasonwhythishearinghasinvolvedfivedaysofevidenceisbecausethereisalsoanunderlyingfactualissue. Hasthemotherbeenusingdrugs,albeitatalowlevel,duringthepasttwoyears? Sheadamantlydeniesdoingsoand,withone significantexcepVon, theotherevidence supportsher. TheexcepVon is abody of scienVfic informaVon from hair strand tests taken over the two-yearperiod,whichare interpretedby the tesVngorganisaVonsas showing low-levelcocaine use for at least some of the Vme. That has been challenged by themotherandIhaveheardfromfiveexpertwitnesses:onefromeachofthethreetesVngorganisaVons,oneonbehalfofthemother,andonejointlyinstructed.
4. AlthoughtheissuesarenowrelaVvelynarrow,itwasnotalwaysso. Hollywasremoved at birth because of a posiVve hair strand test which, set against thebackgroundhistory,ledthelocalauthoritytoarguethatshewouldnotbesafeinhermother’scare. Evenafershewasreturnedhome,thelocalauthority’sfinalcasewas that she shouldbe removedagainandplaced for adopVon: thisplanonly changed twodays before thehearingbegan. It is thereforenecessary toconsiderhowthissequenceofeventscameabout.
Background
5. Themother,nowinherearly30s,hasalonghistoryofdrugabuse. ShespentVmeinlocalauthoritycareasateenager,lefschoolwithoutqualificaVonsandbythe age of 21 was using heroin and crack cocaine. In 2007, she underwentdetoxificaVonanda26-weektherapeuVcrehabilitaVonprogramme,butin2009sherelapsedandby2011,shewasagainreceivingtreatmentforuseofcannabis,crackcocaineandcocaine.Predictably,thisdrugusecontributedtoherlifebeingchaoVcandherparenVngunreliable.
6. Hollyisthemother’sfourthchildfromthreedifferentfathers.Theoldest,agirl,nowagedseven,wasmadethesubjectofaspecialguardianshiporderinfavourofhermaternalgrandmotherin2012.Thischildknowshermotherandseesherregularly. The second child, a boy now aged five, was born from an abusiverelaVonshipbetweenthemotherandamanwithdrugandalcoholproblems.Inhisfirstweeks,thechildbecamethesubjectofcareproceedingsthatendedwiththemakingofasupervisionorderinJuly2012.InJune2014,theseparentshadasecond son. He and his brother, now aged three, were removed from themother’scare in July2015underapoliceprotecVonorderafershewas foundwith them in the street, incapable afer taking cannabis, alcohol and cocaine.HomecondiVonswere squalid. Newcareproceedingswere takenand inMay2016, the courthearda substanVal amountof evidence, including fromHolly’sChildren’sGuardian,whothenactedfortheboysandadvocatedtheirreturntotheirmother.ThemagistratesacceptedthatthemotherhadkeptoffdrugssinceJanuary2016,buttheydidnotacceptthatshewashonestaboutheruseinthelaterpartof2015andfoundthattheriskofrelapsewastoohigh.Theboysweremadethesubjectofcareandplacementorders,andinOctober2016theywereplaced together for adopVon. AdopVon proceedings, recently issued, willconVnueinthelocalcourt.
7. BetweentheremovaloftheboysandthehearinginMay2016,themotherhadundergone hair strand tesVng carried out by Alere Toxicology in August 2015(covering the previous three months when she had admijedly been takingdrugs),inFebruary2016(coveringthepreviousthreemonths),andinMay2016(coveringtheprevioustwomonths).ThefirsttwotestsproducedseveralposiVveresultsforcocaineandBEatloworverylowlevels.
9. Meanwhile,inaroundApril2016,themotherhadbecomepregnantwithHollyafer a one-off encounter with the father. He has parVcipated in theseproceedings, and sees Holly two or three Vmes a week with the mother’ssupport.Theyremainfriends,andhisinvolvementisseenbyallasagoodthing.
10. Duringherpregnancy, themothermadepracVcalpreparaVons for thebaby’sarrival. Shewas fully cooperaVvewith the health services andwith the localauthority.InformaVonfromtheantenatalservices,fromthedrugsupportprojectWDP,and fromNarcoVcsAnonymouswas stronglyposiVve.ThemotherplacesparVcularvalueonheradvancedprogressinthe12-steprecoveryprogramme.
11. On 5 December, a urine drug screening test was negaVve. However, on 7December,themotherunderwentahairstrandtestapproximatelycoveringtheperiodApril–November. On16December,thistestwasreportedasshowingthe
12. On23December, an independent socialworker (whoknew themother fromthe proceedings about the boys) recommended that she had made sufficientchange to meet the needs of the expected baby, provided that the hair testresults could be explained. However, following further communicaVons fromLextox, she amended this view, staVng that the changes that had beenmadeweresuperficialandthatthemother’slackofhonestywouldmakeitdifficulttomonitorthebaby’sneedsandleaveitatriskofsignificantharm.
14. On1February,a furtherhairstrandtestwas taken,coveringtheperiodsinceMarch 2016. This was analysed by DNA Legal, who reported that it broadlyshowedthepresenceofcocaineandBEatamediumtolowlevelthroughouttheperiod. Although theoreVcally reporVng on the same period as Lextox, theconcentraVonsfoundbyDNALegalweresignificantlyhigherthantheearliertest.
15. On 22 February, Dr Hugh Rushton, a trichologist (expert in hair science)instructedonbehalfofthemother,reported.HewascriVcaloftheprocessesandopinionsofthetesVngorganisaVonsandadvisedthatthefindingsmaybeduetoenvironmentalcontaminaVon.HesaidthattherewasnounequivocalevidencetodefiniVvelysupport theviewthat themotherhadknowinglyusedcocaineoverthetesVngperiod.
16. On3March,themajercamebeforeHHJudgeMayer,whoorderedthatHollyshouldbereturnedtohermother’scare.Shemadeaninterimsupervisionorderand directed that the issue about the validity of the drug tesVng should betransferredtoHighCourtlevel.
20. On17July,afinalsetofhairstrandtestsweretakenonthesamedaybyeachofthethreetesVngorganisaVons. Thesecoveredthefirstsixmonthsof2017,andallowdirectcomparisonbetweenthethreeprocesses. Theresultsshowedthepresence of very small amounts of cocaine and low levels of BE. Again, themotherdeniedtakingdrugsofanykindduring2017.
21. Insummary,thereisnodoubtthatthemotherwasinadismalstatetwoyearsago,tothepointwhereshewasquiteincapableoflookingaferanychild. It isnowaccepted that shehas turnedher lifearound to thepoint that she isnowcapableoflookingaferonechildwithsupport. ShesaysthatshehasachievedthisbyavoidingdamagingrelaVonshipsandbycompleteabsVnencefromdrugsandalcohol. The localauthorityarguesthat thehairstrandtesVngshowsthatcomplete absVnencehasnotbeenachieved,which raises the level of risk thatHollywillgetcaughtup infuturedruguseofthekindseen inthepast. Italsoarguesthatthehairstrandtestsshowthatthemotherhasnotbeentellingthetruthandconsequentlythatshecannotbefullytrusted.
She has beenHolly’s socialworker since July. The state of the home is good.Holly has been making progress with significant support being given to themother. ThatsupportwillbeconVnuedunVllocalauthorityissurethatprogresswill be sustained: in thepast, supportwas givenwith theboys, but itwasnotsustained. The local authority cannot ignore the history of how the mother
struggledwithherolderchildren.Acareorderisthemostappropriateoutcome.Ifthemotherhadtakendrugsin2016,thatwouldbeverysignificantandwouldprovide further evidence of the need for the local authority to share parentalresponsibility, and to give Holly the resources and priority that would result,parVcularly ifthemothermovedtolivenearertoherownmother. MsTBsaidthatthechangeofcareplanwasamajeroffinebalance,andacceptedthattheyhadnotbeenaprofessionalsmeeVngorliaisonwiththedrugscounsellorMsLBbefore theoriginal careplanwas formed inAugust. Shepresented adetailedsupport plan that, she said,would have effectwhether the courtmade a careorderorasupervisionorder.
Themother
She said that she hoped to move to live nearer her own mother when theproceedingswereover. Shewashappyinmostwayswiththeproposedsupportplan, but said that there were Vmes in the recent past when she had feltburdenedwithassistance. Shewasanxiousabout theconsequencesofa careorder,giventhe localauthority’spastplanning. Whileshedescribedherselfas“figh%ngfortheboys”,sherealisVcallyacceptedthatit’s“allabout[Holly]”. ShedescribedherdrughabituptoJuly2015asinvolvingdailyuseofcannabiswithmuchlessfrequentuseofcocaine. ShehadnotknowinglytakencocainesincebecomingpregnantwithHolly.InMay2016,shehadtwicesleptwithamanthatshemet throughNA,butdidnot conVnuewith thiswhen she realised thatheshowed signsof usinghimself. She confirmedherwrijenevidenceabout thepossibilityofcontaminaVonthroughherhomefurnishingsandthroughthelevelofcontactshehadwithknownusersasasupportworkeratNA.Shesaidthatshefeltproudofherselfandthepeoplearoundherfortheprogressthatshemadeincomingoffdrugs.ItisfrustraVngthatheraccountisnotacceptedonthebasisofthehairstrandtests.Shecan’texplainthemanddoesn’tunderstandwhyshehastraces in her hair; she is not happy with it and does not think the tests arereliable. Sheacceptedthatinthepastshehadgonedownhillwhenfacedwithdifficult life events, but in the last two years she had withstood a familybereavement, the orders in relaVon to the boys, the removal ofHolly and thelocalauthority’soriginaladopVonplan,andkeptstrongthroughallofthat.Whenshefelttempted,shecontactedherNAsponsor. Sheagreedthatitwasariskydecision to have taken upwith someonewith a drug habit, but said that shewantedtofeelloved,notjustpartofaprogramme. Shealsoacceptedthatsheshouldhavebeenmorefrankwiththelocalauthorityaboutanoccasiononwhicha friendhadbeenmeant to stay thenight, but did not. She said itwould bestupidtogobacktodrugsasshewouldrisklosingHolly;but,shesaid,sheknewshewould not lose her for “one blip” and that shewould admit that if it hadhappened.Shesaidthatshehadn’ttakendrugsanddidn’tknowhowtheyweregeqngintoherhair.
MsLB
She is a pracVVoner of 14 years’ experience who has been the mother’s keyworkeratWDPforthepasteightmonths.Shespokeofherownexperienceandthatofhermanager,whohadknownthemotherforlonger. Sheconsideredthe
mother tobe is a verygood stage inher recoveryand,but theseproceedings,ready fordischarge from the service. Her levelof engagementwasabsolutelyexcellent and she now fully recognise the effect of parental substancemisuse.Sheofenvisitedthemotherathometoadministerurinetestsandhadseenanexcellentmother/child relaVonshipandnothinguntoward. Shehadbeenveryshockedbytheresultofthehairstrandtests,giventhatherownveryfrequentscreenings, many of which were at short noVce, had all been negaVve. Themotherwasabletodiscussherissueswithher,andwhatmostmakesherfeellowis not being believed. Ms LB expressed some concern about the turnover ofsocial workers that the mother had experienced since the later stages of herpregnancy, and also about the unusual lack of consultaVon on the part of thelocalauthority.
TheChildren’sGuardian
MrSimmonds isaveryexperiencedGuardian,whohasalsoknownthemotherthrough the proceedings about the boys. In these proceedings, he takes asimilarlyposiVveview.Sincehefirstmetherin2015,shehasbecomeachangedperson. Shehasshownhimthatshecansustainchange,notgetinvolvedinanabusiverelaVonship,reflectonherfailingswithherolderchildrenandappeartoremain clear of drugs. She has done this despite a number of difficult recentevents inher lifeandhasbuiltagoodsupportnetworkaroundher. Onafinebalance, he favours the making of a supervision order. A care order withplacementathomeisunusualforachildofthisage,andtheremightbeissuesaboutitrunningonunnecessarily.Heisalsoconcernedaboutthemessagethatacare order sends to the mother, who he described as being in many ways aremarkablewoman. If there is a supervision order, the local authority shouldmethodicallyplanreviewsinordertodecidewhetheritneedstoberenewed.Hefurtherconsidersthatahighturnoverofsocialworkersmayleadtoinconsistentplanning,eventhoughthemotherherselfcanbeworkedwithandisabletobereflecVve. Finally, the Guardian accepted that the court had yet to make adecision about themother’smore recent drug use or absVnence, but believesthatthedecisionaboutthelegalordershouldtakeaccountofalltheaspectsofthesituaVon,andnotbedecidedbythatmajeralone.
Hairstrandtes\ng
25. Anyassessmentof a family situaVon,whether carriedoutby the courtorbyotherprofessionals,involvesthegatheringandanalysisofarangeofinformaVon.Most of the informaVon is factual, and in some cases itwill be interpreted byexperts, who will express an opinion. That will be the case when scienVficinvesVgaVonssuchashairstrandtestsarecarriedout. ThesetestscanprovideimportantinformaVon,butinorderforthattobeofrealuse,theexpertmust(a)describe the process, (b) record the results, and (c) explain their possiblesignificance,allinawaythatcanbeclearlyunderstoodbythoselikelytorelyontheinformaVon.Iftheseimportantrequirementsarenotmet,thereisariskthattheresultswillacquireapseudo-certainty,parVcularlybecause(unlikemostotherformsofinformaVoninthisfield)theyappearasnumbers.
“Thereportspreparedforthecourtbythe…expertsshouldbearinmindthatthey are addressing lay people. The report should strive to interpret theiranalysisinclearlanguage.Whileitwillusuallybenecessarytorecitethetestsundertakenand the likely ra%osderived from them, care shouldbegiven toexplainthoseresultswithinthecontextoftheiriden%fiedconclusions.”
InLondonBoroughofRichmondvB[2010]EWHC2903(Fam),acaseabouthairstrand tesVng for alcohol,Moylan J said this at paragraph 10, referring to thepracVcedirecVonthatbecamePD12B:
“10. I have referred to the Prac%ce Direc%on because some of the expertevidencewhichhasbeenproducedinthiscaseappearstohavebeentreatedasthoughitwasnotexpertevidence.Itmaywellbethatresultsobtainedfromchemical analysis are such as to cons%tute, essen%ally, factual rather thanopinionevidencebecause theyarenotopen toevalua%ve interpreta%onandopinion. Although I would add that it is common for such analysis to havemargins of reliability. However, the Prac%ce Direc%on applies to all expertevidence and it will be rare that the results themselves are not used andinterpretedforthepurposesofexpertopinionevidence.”
Andfurther,atparagraph22:
“Whenused,hairtestsshouldbeusedonlyaspartoftheeviden%alpicture.Ofcourse,attheveryhighlevelswhichcanbefound(mul%plesoftheagreedcutofflevels)suchresultsmightformasignificantpartoftheeviden%alpicture.Subjecttothishowever,bothProfessorPragstandMrO'Sullivanagreedthat"You cannot put everything on the hair test"; in other words that the testsshouldnotbeusedtoreacheviden%alconclusionsbythemselvesinisola%onofotherevidence. IsensedconsiderableuneaseonthepartofProfessorPragstattheprospectoftheresultsofthetestsbeingused,otherthanmerelyasonepartoftheevidence,tojus%fysignificantchildcaredecisions;”
Bristol CityCouncil v TheMotherandothers [2012] EWHC2548 (Fam),Baker JwasconcernedwithtesVngforcocaineandopiates.Inthatcase,anunidenVfiedhumanerrorintheprocessledtoafalseposiVvereport.Atparagraph25,BakerJendorsedthesefourproposiVons:
“(1) The science involved in hair strand tes%ng for drug use is now well-establishedandnotcontroversial.
(2) Aposi%veiden%fica%onofadrugataquan%tyabovethecut-offlevelisreliable as evidence that the donor has been exposed to the drug inques%on.
(3) Sequen%al tes%ng of sec%ons is a good guide to the paaern of use
revealed.
(4) The quan%ty of drug in any given sec%on is not proof of the quan%tyactuallyusedinthatperiodbutisagoodguidetotherela%velevelofuse(low,medium,high)over%me.”
“The jurisdic%on of the family courts is to determine specific disputes aboutspecific families. It is not to conduct general inquiries into general issues.Occasionally,aspecificcasemaydemonstratetheneedforgeneralguidance,butthecourtmustbecircumspectaboutgivingit,confiningitselftoinstanceswhereitissa%sfiedthatthecircumstancesgenuinelywarranttheneedforsuchguidanceand,importantly,thatisfullybriefedandequippedtoprovideit.”
“Itispar%cularlyimportanttoemphasisethateachofthethreeexpertsinthiscase confirmed that hair strand tes%ng should never be regarded asdetermina%veorconclusive.Theyagree,asdoI,thatexpertevidencemustbeplaced within the context of the broader picture, which includes e.g. socialworkevidence;medicalreports;theevalua%onofthedonor'sreliabilityinheraccountetc.Theseareallul%matelymaaersfortheJudgetoevaluate.”
(1) Normal hair growth comprises a cycle of three stages: acVve growing(anagen),transiVon(catagen)andresVng(telogen). Inthetelogenstagecanremainonthescalpfor3-4(oreven5or6)monthsbeforebeingshed.Approximately 15% of hair is not acVvely growing; this percentage candecreaseduringpregnancy.
(2) HumanheadhairgrowsatarelaVvelyconstantrate,rangingasbetweenindividualsfrom0.6cm(or,inextremecases,aslowas0.5cm)to1.4cm(or,inextremecases,upto2.2cm)permonth.Ifthedonorhasagrowthrate significantly quicker or slower than this, there is scope both forinaccuracyintheapproximatedatesajributedtoeach1cmsampleandfor confusion ifoverlaying supposedly corresponding samplesharvested
significantperiodsapart.
(3) Thehairfollicleislocatedapproximately3-5mmbeneaththesurfaceoftheskin;henceittakesapproximately5-7daysthegrowinghairtoappearabove the scalp and can take approximately 2-3 weeks to have grownsufficientlytobeincludedinacuthairsample.
(4) Aferadrugentersthehumanbody,itismetabolisedintoitsderivaVvemetabolites. The parent drug and the metabolites are present in thebloodstream,insebaceoussecreVonsandinsweat.Thesearethoughttobe three mechanisms whereby drugs and their metabolites areincorporatedintohumanscalp.
(6) Haircanbecomeexternallycontaminated(e.g.throughpassivesmokingor drug handling). Means of seeking to differenVate between drugingesVonandexternalcontaminaVoninclude:
(i) washing hair samples before tesVng to remove surfacecontaminaVon
(ii) analysingthewashes
(iii) tesVng for the presence of the relevant metabolites andestablishingtheraVobetweentheparentdrugandthemetabolite
(iv) seqngthresholdlevels.
(7) DecontaminaVon canproduce variable results as it dependsupon thedecontaminaVonsolventused.
(9) Cocaine (COC) is metabolized into benzoylecgonine (BE or BZE),norcocaine (NCOC) and, if consumed, together with alcohol (ethanol),cocaethylene(CE).Thepresenceofanydroecgoninemethylester(AEME)inhairisindicaVveoftheuseofcracksmokecocaine.
(10) Cocaine is quickly metabolised in the body: therefore, in thebloodstreamtheconcentraVonofcocaineisusuallylowerthanthatofBE.However, cocaine is incorporated intohair toagreaterdegree thanBE:therefore,theconcentraVonofcocaineinthehairtypicallyexceedsthatof BE. Norcocaine is aminormetabolite and its concentraVon in bothbloodandhairisusuallymuchlowerthaneithercocaineorBE.
(11) Some metabolites can be produced outside the human body. InparVcular, cocaine will hydrolyse to BE on exposure to moisture tovariable degree, although high levels of BE as a proporVon of cocainewouldnotbeexpected. ItisveryunlikelythatNCOCwillbefoundintheenvironment.Thefactthatcocainemetabolitescanbeproducedoutsidethebodyraisesthepossibilitythattheirpresenceisduetoexposure:thisisnotthecasewithcannabis,whosemetabolite isproducedonly insidethebody.
(12) HavingwashedthehairbeforetesVng,analysisofthewashsamplecanallow for comparison with the hair tesVng results. There have beenvarious studies aimed at creaVng formulae to assist in differenVaVngbetweenacVveuseandexternalcontaminaVon.InparVcular:
(ii) Schaffer proposed “correcVng” the hair level for cocaineconcentraVonbysubtracVngfiveVmes the leveldetected in thewash.
The underlying fundamentals are that if external contaminaVon hasoccurred(andthereforeariskofmigraVonintothehairgivingresultsthatwouldappeartobeposiVve)thisislikelytobeapparentfromtheamountofcocaineidenVfiedinthewashrelaVvetothatextractedfromthehair.
29. The ability towork in this field requires the drug tesVng organisaVons to beaccredited and validated to the required standard. Each of the organisaVonsconcerned in these proceedings has the necessary accreditaVon and regularlysubmits itsproceduresforexternalvalidaVon. Eachofthemhasprovidedveryfull informaVon and I am saVsfied that they havedone everything they can tohelpthecourt.
30. Before coming to areas of disagreement between the scienVfic witnesses, IsummarisetheresultsoftheveryextensivetesVnginthiscaseverybroadly,thefull details being set out in a schedule. The esVmated period assumes hairgrowthat1cmpermonth.FiguresinboldindicatefindingsatorabovetheSoHTcut-offs.
Testdate Tester Est.period COCrange BErange NCOC
8.15 Alere 4.15–7.15(3cm)
1.18-0.44 0.97-0.46 -
2.16 Alere 11.15-2.16(3cm)
0.54-0.26 0.12-0.14 -
5.16 Alere 1.16–4.16(3cm)
0.19-0.11 - -
12.16 Lextox 3.16–11.16(8cm)
0.87-0.26 0.21-0.06 -
2.17 DNA 2.16–1.17(12cm)
1.5-0.42 0.52-0.24 <0.02
7.17 DNA 1.17–7.17(6cm)
0.52-0.11 0.13-0.07 <0.005
7.17 Alere 1.17–7.17(6cm)
0.44-0.11 0.17-0.08 -
7.17 Lextox 1.17–7.17(6cm)
0.26-0.07 0.09-0.05 -
31. Thischartisacrudecompressionof47hairsecVontestsforthepurposeofthisjudgment. It does not contain the full sequenVal informaVon on which thetestersbasetheirinterpretaVons.
33. Where thewashings have been analysed, they did not detect cocaine, BE orNCOC, except that DNA Legal reported cocaine at 0.06 in the 12 cm strand,withoutidenVfyingwhatsecVonsthisrelatedto.
34. When it came to interpreVng these results, the witnesses from the tesVngorganisaVons(MsJohn,MrPoultonandDrBreidi)gavetheopinionthat,takeninisolaVon, theywere likely to result from the acVveuseof cocaine, rather thanfromexternal contaminaVon. TheexcepVon to thiswas thatDrBreidididnotreachthisconclusioninrelaVontothe2017resultsbecauseoftheirlowerlevels–only one of the 18 secVons reported cocaine at above the cut-off, and thatsecVonwasonly justabove it (0.52). Incontrast,DrRushtonwasnotsaVsfiedthat theresultsestablishacVvedruguseatall,whileDrMcKinnon’sconclusionwasthattheymayormaynot.
35. The evidence of the expert witnesses in this case ranged over a number of
“There has beenmuch scien%fic debate about the interpreta%on of hair tests.Developmentsinanaly%calmethodologyhaveproceededfasterthantheabilitytoaccuratelyinterpretthefindings. Althoughitisnowpossibletodetectextremelylow levelsofdrugs inhair, thishasraisedproblemsbecausethe lowerthedruglevel, the more difficult it becomes to dis%nguish whether it has arisen frominges%onorexposure.Thishasbeenapar%cularissuewithcocaine.”
37. In relaVon to the variability of results, the tables provided byMr Poulton at[C164z-164ac] illustrate that the range of results obtained by the differentlaboratories variesquite considerably. Notably, theDNALegal results for2016were in some cases two or three Vmes higher than those found by the otherorganisaVons. ThisisthenreflectedinthefactthatDNALegalreportedfindingsin the low to medium range, while the others reported only low findings.However, direct comparison between the test results is to some extentconfounded by the fact that hair was taken at different Vmes, and that theassumed1cmgrowthratemaynotbecorrect.Itisalsoimportanttorememberthat the results may be affected by differences in laboratory equipment anddifferencesinthewaythehairiswashedbeforeanalysis.
38. ThetesVngcarriedout in July2017,allows for themostdirectcomparisonasthehairwasallharvestedatthesameVme.Evenso,asanexampleofvariability,two laboratoriesshowedacocaineresult relaVngtothemonthofAprilat0.11and0.17(wellbelowthecut-off),whilethethirdshowed itas0.52(justabovethecut-off).
39. DrRushtonsaidthatthesedispariVesaresignificantandthattheycanincreasewith low-level findings. In response, the witnesses for the testers claim agenerallygooddegreeofconsistency. Forexample,theJulytestresultscoveringthreemonthsfoundcocainetobepresentbelowthecut-offinallbutonecase,andBE at or above the cut-off in all cases. DrMcKinnon considered that thedifferences could be due to analyVcal variaVon, Vming andmethodology. HesharedDrRushton’sconcernstosomeextent,butregardedthemasafactoflife.
40. Inmyview,thevariabilityoffindingsfromhairstrandtesVngdoesnotcallintoquesVontheunderlyingscience,butunderlinestheneedtotreatnumericaldatawith proper cauVon. The extracVon of chemicals from a solidmatrix such ashumanhair is inevitably accompaniedbymargins of variability. Nodoubt ourunderstandingwill increasewithdevelopmentsinsciencebut,asmajersstand,theevidence in thiscasesaVsfiesmethat thesetesVngorganisaVonsapproachtheirtaskconscienVously. Also,aspreviousdecisionsremindus,atestresult isonlypartoftheevidence.Averyhighresultmayamounttocompellingevidence,butinthelowerrangenumericalinformaVonmustbesetalongsideevidenceofotherkinds. Oncethisisappreciated,thesignificanceofvariabilitybetweenonelowfigureandanotherfallsintoperspecVve. IthereforeaccepttheapproachofthetesVngexpertsandofDrMcKinnon inpreferencetothatofDrRushtononthis issue. His approach requires an exacVtude that can never be achieved inpracVceinthepresentday.
41. Imust say something about the reporVng of test results as beingwithin thehigh/medium/lowrange.InfairnesstothetesVngorganisaVons,thispracVcehasdevelopedattherequestofclientswishingtounderstandtheresultsmoreeasily.Thedanger isthatthereport istooeasilytakentobeconclusiveproofofhigh/medium/lowuse,wheninfacttheactuallevelofusemaybelowerorhigherthanthedescripVon.Youcannotreadbackfromtheresulttothesuspecteduse.Twopeople can consume the sameamountof cocaineandgivequitedifferent testresults. Two people can give the same test result and have consumed quitedifferentamountsofcocaine. This is theconsequenceofphysiology:therearevariables in relaVon to hair colour, race, hair condiVon (bleaching andstraightening damages hair), pregnancy and body size. Then there are thevariables inherent in the tesVngprocess. DrMcKinnonexplained that there isthereforeonlyabroadcorrelaVonbetweenthetestresultsandtheconclusionsthatcanbedrawnaboutlikelyuseandthatitshouldberecognisedthatinsomecases (of which this is in his opinion, one) there will be scope for reasonabledisagreementbetweenexperts.
42. Furthermore, the evidence in this case shows that even as between leadingtesVngorganisaVons,thedescripVonsareappliedtodifferentnumericalvalues.DNA adopts the figures set out in the relevant studies, while the two otherorganisaVons divide their own historic posiVve laboratory results into thirds(Alere)orusetheinterquarVlerangeformedium(Lextox).
44. Regarding industryguidelines, themainguidelinesare thosepublishedby theSoHTbasedonresearch:Cooper,Kronstrand&KintzForensicSciInt2012.TheseguidelinesappeartostatethataposiVvetestrequiresatleastaconcentraVonoftheparentdrugatgreaterthanthecut-offlevelandtheidenVficaVonofoneofthemetabolites. Dr Rushton drew ajenVon to other guidelines issued by anAmericanbody,theSubstanceAbuseandMentalHealthServicesAdministraVon(SAMHSA) and by the EuropeanWorkplaceDrug TesVng Society (EWDTS). Hesuggested that there were “agreed interna%onal guidelines” that required thediscoveryof cocaineand twometabolites, ineachcaseabove thecut-off level,beforeatestcanbeconsideredposiVve.Hewentfurther,sayingthatforhisparthewouldalsoneedtohaveanegaVvewashresultbeforethetestcouldbetakento indicate use rather than exposure. This posiVonwas not supportedby theotherexpertwitnesses.
45. IdonotrecogniseDrRushton’sdescripVonof“agreedinterna%onalguidelines”:thecurrentindustrystandardinthiscountryisfoundintheguidelinesissuedbytheSoHT. ItmaybethattheseguidelineswillbechangedinVme,possiblyevenin the direcVon of themore rigorous requirements of the other organisaVons.ButinthemeanVme,itisnotappropriatetorequirecompliancewithahighersetofstandards.
46. TherewassimilardisagreementbetweenDrRushtonandtheotherwitnessesinrelaVon to the significance of findings below the cut-off level. He was notprepared to entertain a posiVve finding that takes account of any data fallingbelow the cut-off level. The other witnesses considered that all informaVonshould be taken into account, but giving due regard towhether or not resultspassedthecut-offlevelornot.
47. Havingconsideredtheevidenceinthiscase,IarriveatthesameconclusionasHaydenJinReR,where(atparagraph50)hepreferred“arealengagementwiththe actual findings” to “a strong insistence on a ‘clear line’ principle ofinterpreta%on”.IaccepttheevidenceofthewitnessesforthetesVngcompaniesthatwhenoneanalysesthousandsoftests,pajernscanemergethathelpwhendrawingconclusions.ItwouldbearVficialtorequirevaliddatatobestruckfromtherecordbecauseitfallsbelowacut-offlevelwhenitmaybesignificantinthecontext of other findings. Thatwould elevate useful guidelines into iron rulesand,asDrMcKinnonsays,increasethenumberoffalsenegaVvereports. Whatcan,however,besaidisthatconsiderablecauVonmustbeusedwhentakingintoaccountresultsthatfallbelowthecut-offlevel
48. Astothesignificanceofcomparingwashsamplesandtestsamples,therewerea rangeof views. The tesVng companies asserted that thisprovideda furthersafeguard against a false posiVve. In broad terms, they adopted the TsanacliswashprotocolandwereamenabletoapplyingtheSchafferraVo. DrMcKinnon,however,notedthevariabilityinapproachbetweenthelaboratories;forexample,twoofthelaboratoriesfollowtheTsanaclismethod,whilethethird(DNA)usesadifferent washing agent. Dr Rushton was criVcal of the status of the scienceunderlyingtheTsanaclis/Schafferapproach,sayingthatithadnotbeenadoptedbyinternaVonalbodiesorreplicatedandthathecouldnotendorsetheapproach
49. Onceagain,IfeltthatDrRushtonwasrequiringmorefromtheprocessthanitcanbeexpectedtoprovide. Thedesiretoknowmore isnatural,but itcannotlead to paralysis unVl we know everything. In this instance, the tesVngorganisaVonsarevoluntarilyapplyinganaddiVonalsafeguardoverandabovetheSoHTrequirementsandcannotbecriVcisedfordoingso.
50. There was also discussion of whether wash samples should rouVnely beanalysed.Ofthethreetesters,onlyDNALegalundertakesthis.Theothersretainthewashes for a year to allow for later analysis if required. Therewas somesupportfromDrMcKinnonandDrRushtonforrouVneanalysistobeadopted;asagainstthat,MrPoultonsuggestedthatthewashescanbeanalysedwhereverthetesterfeelsthatmoreinformaVonisneeded.
51. ThisinmyviewisaquesVonfordeterminaVonbyexpertsworkinginthefield,notbythecourt.Ican,however,seethattheanalysisandwashsamplesmaybeparVcularlyhelpfulincaseswherethehairstrandresultsfallintotheloworverylow range, or where the outcome is for some other reason likely to becontenVous. Ialsoconsiderthat,wereitpossible, itwouldbemorehelpfulforwashresultstobereportedinrelaVontoindividualsecVonsofhairratherthantothewholestrand.
52. The mother’s hair is, as it happens, very long. During the hearing, I askedwhether therewasanypossibilityof cross-contaminaVonofnewerhairbyold,drug-affectedhair,perhapsifthehairwaspiledupwetaferwashing. Noneofthewitnesses suggested that this couldproduce thesortof tesVng results thatwerefound.
53. In relaVonto thedisputed issues, Ihaverejectedanumberof theargumentspresentedbyDrRushton. HislongexperVseintrichologydoesnotsignificantlyextendintotoxicology,andhisinsistenceonhispointofviewoverlookedmanyofthe realiVes that allow science to grapplewith everyday problems. WhileMsJohn,MrPoultonandDrBreidihaveenormousexperienceofgivingopinionsonhair strand tests in their professional life, and DrMcKinnon at least some, DrRushtonhasneverdoneso,andhasonlybeenaskedforhisopinioninafewcasesas an expert witness. He was markedly unwilling to entertain one obviousexplanaVon for the test results,namely that themothermayhavebeen takingcocaine. In parVcular, under examinaVon by Ms Cook QC for Alere, he wasprepared toaccept that the test results fromsamplesobtained inAugust2015suggesteduse,butunwillingtosaythesameforcomparableresultsobtainedinDecember2016; thedifferencebeing that themotherhadadmijeduse in thefirstcase,butnotinthesecond. Hewasalsopreparedtoexpresstheviewthatthe2017resultsposiVvelyexcludedtheuseofcocaine.NordidheacknowledgethatthetesVngorganisaVonsareoperaVngwithinrecognisedindustrystandards,whicharesetinordertominimisesofaraspossiblebothfalseposiVvesandfalsenegaVves.
54. I accept that Dr Rushton has asked some good quesVons, and has done sofearlessly,butforthemostpartIamnotabletoaccepttheanswersthathegives.All in all, I do not consider that his criVcisms of hair tesVng science, or of theacVviVes of the companies concerned in this case, were made out to anysignificantextent.
56. IfoundtheevidenceofMsJohn,MrPoultonandDrBreiditobeevidence-basedandcarefullyconsidered. TheyhaveacombinaVonofexperVseandexperiencethatenabledthemtodealsaVsfactorilywiththeissuesunderconsideraVon. MrPoultonmadeapoint that theyeachmade in theirdifferentways:“Knowingatypical result comes with experience. Experience is the key. Knowing whenfurther work is necessary, looking at the paaerns – this is probably the mostvaluablepartofwhatwecancontribute”.
Reportwri\ngandreading
57. TheparVeshavemadesuggesVonsastohowthepresentaVonofreportsmightbe developed so as to bemost useful to those working in the field of familyjusVce. Iwill recordsomeof thesesuggesVonsandsomeofmyown. Beforedoingso, InotethateachofthetesVngorganisaVonsalreadyproducesreportsthatcontainmuchofthenecessaryinformaVoninoneshapeoranother.ItisalsoimportanttostresstheresponsibilityformakingproperuseofscienVficevidencefalls both on thewriter and the reader. Thewritermustmake sure as far aspossiblethatthetruesignificanceofthedataisexplainedinawaythatreducesthe risk of it becoming lost in translaVon. The reader must take care tounderstand what is being read, and not jump to a conclusion about drug oralcoholusewithoutunderstandingthesignificanceofthedataanditsplaceintheoverallevidence.
59. TherearecurrentlynineaccreditedhairstrandtesVngorganisaVonsworkinginthefamily lawarea. It isnotforthecourthearingonecasetodictatethewayreportsarewrijenbythosewhohaveintervenedinthiscaseorbyotherswhohavenottakenpart,butIincludethefollowingsevensuggesVonsincasetheyarehelpful.
(1) Useofhigh/medium/lowdescriptor:
Thisisinmyviewuseful,provideditisaccompaniedby:
• A numerical descripVon of the boundaries between high/medium/low, with an explanaVon of the manner in which theboundariesaresetshouldbestated.
• AclearstatementthatthedescripVonisofthelevelofsubstancefound and not of the level of use, though there may a broadcorrelaVon.
• A reminder that the finding from the testmust always be setalongside other sources of informaVon, parVcularly where theresultsareinthelowrange.
(2) ReporVngofdatabelowthecut-offrange:
There is currently inconsistency as between organisaVons on reporVngsubstancesdetectedbetweenthe lower limitofdetecVon (LLoD)andthelowerlimitofquanVficaVon(LLoQ),andthosebetweentheLLoQandthecut-offpoint.
Iwouldsuggestthatreportsrecordallfindings,sothat:
• afindingbelow theLLoQ isdescribedas“detected,but so lowthatitisnotquan%fiable”
Effortstounderstandthesignificanceoftestsarehamperedbythelackofacommonvocabularytodescriberesultsintheverylowranges,DescripVonssuchas“posi%ve”, “nega%ve”, “indicates that”and“notdetected” canbeused and understood vaguely or incorrectly. The creaVon of a commonvocabularyacrosstheindustrycouldonlybeachievedbyabodysuchastheSoHT. In the absence of uniformity, reporters should define their termspreciselysothattheycanbeaccuratelyunderstood.
(4) Expressionsofprobability:
TheFamilyCourtworksonthecivilstandardofproof,namelythebalanceofprobabiliVes. Itwould thereforehelp if opinionsabout tesVng results
(6) The FAQ sheet accompanying the report (which might bejer bedescribedas“Essen%alInforma%on”),mightbetailoredtogiveinformaVonrelevanttotheparVcularreport,andtherebymakeiteasiertoassimilate.
(7) When it isknownthat tesVnghasbeencarriedoutbymorethanoneorganisaVon,thereportshouldexplainthatthefindingsmaybevariableasbetweenorganisaVons.
Conclusionsonthefindingssoughtbythelocalauthority
60. Insummary,theserelateto
A. Themother’sneglecyulparenVngofthethreeolderchildren(admijed)
B. Her long-standing history of drug and alcoholmisuse up to July 2015(admijed)
C. HerconVnueduseofcocaine,albeitatalowand/orinfrequentlevel
i. between July 2015 andDecember 2016, including at Vmeswhen shewaspregnant,and
ii. between January and July 2017, when she was under close scruVnybecauseoftheseproceedings,whenshehadthecareofHolly,whenshewas providing urine tests, and when she knew that she would be thesubjectoffurtherhairstrandtests.
D. Her repeated lying to professionals and the court about her use ofcocaine.
62. My conclusion, taking account of all the evidence, both scienVfic andnonscienVfic,isthatthelocalauthorityhasmadeoutitscaseinrelaVontoA,B,C(i)andD.TheevidenceasawholedrivesmetotheconclusionthatthemotherregrejablyusedcocaineatarelaVvelylowandinfrequentlevelduringthelajerpartof2015andduring2016andthatshehasnottoldthetruthaboutthat. AstoC(ii),thereismuchweakerscienVficevidenceofconVnuinglimitedcocaineuseaferHolly’sbirth. GivenmyfindinginrelaVontoearlieruse,Icannotdiscountthepossibilitythatthemotherisnottellingthetruthaboutthateither,buttakingtheevidenceasawhole,IamnotsaVsfiedthelocalauthorityhasproveditscaseinrespectofthatperiod.
63. IarriveatmyconclusioninrelaVontodrugusein2015and2016foressenVallythe reasons set out in the closing submissions ofMr Tyler QC andMs James.Althoughthereisconsiderableevidenceofthemother’sajemptstogethelpandto rid herself of drug use, the almost conVnuous array of test results showingcocaineandBEsignificantlyabovethethresholdcannotadequatelybeexplainedbyinadvertentexposure. InaddiVon,thewashsampleswereeithernegaVveorproducedaminimal cocaine reading farbelow theamount thatwould suggestthatthemuchhigherreadingsfrominsidethehairmatrixarosefromexposure.Iaccepttheevidenceonbehalfoftheintervenersthatthispajernismuchmoreconsistentwith use than exposure, although exposure (including perhaps fromknowing drug use) may also have been a contributor. I also note, though itcannotbeconclusive,thatthereadingsarenotinsomecasesdissimilartothosefound in theAugust 2015 tesVng that covered a periodwhen themotherwasadmijedlyusingcocaine. Finally,withregardto thescienVficevidenceonthisissue, I find that the conclusions of the interveners’ witnesses Vp the scalesagainsttheargumentsofDrRushtonandtheuncertaintyofDrMcKinnon.
64. In reaching this conclusion, I must give my assessment of the mother as awitness.Thereweremanyappealingaspectsofherevidence,andIdonotdoubthergood intenVonswhen it comes tokickingdrugs. However, theundoubtedpresenceofcocaineanditsmetabolitescanonlycomefromuseorexposure,andnoneof thepossibiliVes for innocent exposure in this case canbe acceptedasproducingthesereadings. MuchthoughIwouldwishtotakethemotheratherword,IregretthatIcannotdosoandIfindthatonthebalanceofprobabiliVesshefoundherselffallingintooccasionalbutrepeatedlowlevelcocaineuseduringthelaterpartof2015andthrough2016.
65. However, theevidence in relaVonto2017 leadsmetoadifferentconclusion.FollowingHolly’sbirth,therehasbeenveryregularurinetesVngandconVnuousface-to-facecontactbetweenthemotherandawiderangeofprofessionalsandothers concerned forHolly’swelfare. Scarcely a daywill have passedwithoutcontactofthiskindandnoonehasnoVcedtheslightestsuggesVonofdruguse.TheresultsoftheJulytesVngarewithonemarginalexcepVonbeloworfarbelowthe cut-off limit for cocaine. The interpretaVons of the toxicologists vary:Mr
Poulton thought the results in isolaVon represented likely use, Dr Breidiconsideredthemtobetheresidualresultsofearlierusein2016,whileMsJohnand Dr McKinnon could not choose between these possibiliVes. The localauthorityhasputtheargumentsveryfairlywhenseekingafindingonthisissueand,takingtheevidenceasawhole, IamnotsaVsfiedthat ithasmadeout itscaseinrelaVontorecentuseofcocaine.ItfollowsthatonbalanceIampreparedtoacceptthemother’sevidencethatshehasbeenfreeofdrugssinceHollywasborn.
66. IagreewiththeparVesthatthesefindingsdonotcallintoquesVonthedecisionthatHollyshouldremaininhermother’scare.Bythesametoken,Iamdoubyulthat theevidencethatwasavailable in Januarywas in truthsufficient to jusVfytheverysevereorderoftheremovalofababyatbirth.
Conclusionontheformoforder
67. I remindmyselfof theanalysis inReO [2001]EWCACiv16,whichspeaks forsupervisionorderstobemadewheretheyareproporVonatetothelevelofrisk.Theclosing submissionsofMrParkerandMrLamb for theGuardian containausefulsummaryofthepracVcalconsideraVonsregardingmonitoring,supportandduraVon.AstothewiderconsideraVons,itiscommongroundthatinHolly’scasewearenotdealingwithharminthepast,butwiththeriskoffutureharm,andthatthesituaVoniswellcontainedunderthecurrentinterimsupervisionorder.
68. The local authority emphasises the mother’s vulnerability and the troublinghistoryofabsVnenceandrelapse inrelaVontotheolderchildren. Itagreestoincludeaprovision in thecareplan that confirms thatwrijennoVcewouldbegiven of any intenVon to remove Holly unless she was at risk of immediatephysicalharm.
69. Inmy view, neither a care order nor a supervision order would be a wrongchoiceinthiscase. Eachhasadvantagesanddisadvantages. Holly’splacementwith her mother will not succeed if the mother at some point and for somereasonslipsbackintoheroldways. Everyoneinthiscourtroomsincerelyhopesthatshedoesn’t,andifshecanremainabsVnentthereiseverychancethatshewon’t. Against a background of this kind, the opportunity for a child to bebroughtupbyhermotherisapreciousthingandthebestorderinmyviewistheonethatgivesthisoutcomethebestchance. Wheretheglasscanfairlybeseenasbeinghalfemptyorhalffull,thecourtordershouldtellthemotherthatHolly’sfutureisherresponsibilityandthat,whilehelpisavailableonallsides,thisisonlygoingtoworkifshemakesitwork.
70. Iamalsoinfluencedbythepossibilityofsomeunintendeddisadvantagesfromthelocalauthoritysharingparentalresponsibility. Thecareplanninginthiscasehas been subopVmal, with a high turnover of social workers and poorconsultaVon. Ithinkthatthemother’sself-confidenceneedstobebuiltupandthat this is more likely to happen if she no longer has to share parentalresponsibilitywiththelocalauthority.Thelocalauthoritycommendablysaysthat
itssupportserviceswillbeessenVally thesame,whetherornotthere isacareorder. Themaking of a supervision order is Vme-limited, for one or for threeyears. InpracVce,eithergoodprogresswillconVnuetobemadeandstatutoryintervenVon will reduce and cease or the mother will relapse, there will befurtherproceedings,andHollywillalmost inevitablyberemovedfromhercareforgoodandall.
71. Onthefactsofthiscase, Idonotseeacareorderasconferringbenefitsthatoutweigh those arising under a supervision order. I will therefore make asupervisionorder infavourofthe localauthorityfor12months,trusVngthat itwillbereviewedin9monthstodecidewhetheranextensionwillbenecessary.
72. That concludes the proceedings in relaVon toHolly. I am aware that a finaldecisionremainstobemadeaboutthefutureoftheboys. Thatdecisionwillbetaken byHH JudgeMayer, based on the evidence before her. Nothing in thisjudgment is intended to influence her decision; in parVcular, the fact that themotherisretainingHollyunderthelesserformofstatutoryorderdoesnotinanywayimplyaviewonthepartofthiscourtthatsheispresentlycapableoflookingafermorethanonechild.
