The Second Circuit reversed trial court holdings that, as a matter of law, the procedural due process and Fourth Amendment rights of a child and her parents were not violated when, without notifying the parents or obtaining court permission, the Child Welfare Association removed the child from kindergarten in order to take her to the hospital for medical and gynecological examination the week after a teacher reported suspected sexual abuse by the father. However, the Second Circuit affirmed the lower court's decision that, as a matter of law, the removal of Sarah from school did not constitute a substantive due process violation.

The Second Circuit held that it is a denial of procedural due process for state officials to remove a child on an 'emergency basis' where there is time to obtain judicial authorization, ex parte or otherwise, without subjecting the child to imminent danger. The court held that medical examinations performed for investigative reasons, rather than for treatment, violate the due process rights of parents and children.

There may be instances where child protection agencies are subject to special needs beyond the normal need for law enforcement that make the probable cause requirement for search and seizure impracticable, but this is no such case. A jury could reasonably conclude (1) that there was not probable cause for the agency to conclude that Sarah would be subject to danger of abuse if not removed before court authorization could have been obtained, and (2) that there were not exigent circumstances such that the agency could have reasonably surmised that life or limb was in immediate jeopardy. Because there was no imminent danger present once Sarah was taken into the agency's custody, the agency was required under the Fourth Amendment to obtain a court order before subjecting Sarah to medical examinations.

The city was liable for maintaining unconstitutional policies regarding the emergency removal of children. The individual defendants were entitled to qualified immunity because the law was not clearly settled in 1990.