June-Lori Mears v. Elizabeth Connolly, 24 F.4th 880

June Mears visited her son Brenden at Greystone, a New Jersey state psychiatric hospital; Brenden suffered severe bipolar disorder, was psychotic, refused medication, and had recently violently attacked another patient.
Greystone staff encouraged family visits as part of treatment; June asked whether it was safe and Dr. Joseph Young assured her it was.
Visits were supposed to be supervised; no one was assigned for this particular visit.
Head nurse Shira Oglesby initially accompanied June into the visiting room but left during the visit; Brenden watched her leave and then violently assaulted June, causing severe physical and psychological injuries.
June and her husband sued under 42 U.S.C. § 1983 and state law; the District Court dismissed all claims, citing sovereign immunity and concluding no state-created-danger.
On appeal, the Third Circuit considered only the § 1983 claims against Dr. Young and Nurse Oglesby and reversed as to Oglesby while affirming dismissal as to Dr. Young; the case was remanded for further proceedings against Oglesby.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Dr. Young’s assurances and encouragement to visit constituted an "affirmative act" that created danger	Young told June the visit was safe and encouraged visits, thereby inducing a visit and creating risk	Mere assurances or failures to warn/act are not affirmative acts and did not strip June of her freedom to choose	Held: Affirmances alone are not affirmative acts; claims against Dr. Young dismissed
Whether Nurse Oglesby’s leaving the visitation room during the visit was an affirmative act that increased June’s vulnerability and whether harm was foreseeable	Oglesby initially supervised then withdrew supervision, leaving June confined in the room and exposed to a violent patient with a known recent attack	Oglesby’s conduct was mere inaction and did not restrict June’s liberty or create foreseeable risk to June specifically	Held: Allegations plausibly plead an affirmative act and foreseeable, fairly direct harm; dismissal as to Oglesby reversed and remanded
Whether the state has a duty to protect absent a state-created-danger	June argues the state assumed a duty by supervising then withdrawing supervision, invoking the state-created-danger doctrine	Defendants rely on general rule (DeShaney) that government has no affirmative duty to protect from private violence	Held: DeShaney remains controlling; a duty arises only if the state affirmatively created or increased the danger (state-created-danger standard applies)

DeShaney v. Winnebago Cnty. Dep’t of Soc. Servs., 489 U.S. 189 (1989) (no general constitutional duty to protect individuals from private violence)
Bright v. Westmoreland Cnty., 443 F.3d 276 (3d Cir. 2006) (elements of a state-created-danger claim)
Phillips v. County of Allegheny, 515 F.3d 224 (3d Cir. 2008) (foreseeability and identifiable-victim considerations)
Ye v. United States, 484 F.3d 634 (3d Cir. 2007) (affirmative-act requirement tied to restraint or deprivation of liberty)
Walter v. Pike County, 544 F.3d 182 (3d Cir. 2008) (failure to warn or mere omissions are not affirmative acts)
Kneipp v. Tedder, 95 F.3d 1199 (3d Cir. 1996) (affirmative conduct that increases vulnerability can create liability)
L.R. v. School Dist. of Philadelphia, 836 F.3d 235 (3d Cir. 2016) (inherent risks of leaving a visitor with a violent psychiatric patient)
Chavarriaga v. N.J. Dep’t of Corr., 806 F.3d 210 (3d Cir. 2015) (§ 1983 claims require personal wrongdoing)