RAMIREZ v. NUGENT
1:12-cv-06781
| D.N.J. | Dec 30, 2014Background
- Plaintiff Jose A. Ramirez, a state prisoner, underwent two urological surgeries performed by Dr. Dennis Nugent while incarcerated; after surgery Ramirez was unable to ejaculate and later learned the injury was permanent and that an alternate diagnosis (overactive bladder) might have made the surgery unnecessary.
- Ramirez filed a pro se civil complaint under 42 U.S.C. § 1983 and later, after appointment of counsel, an Amended Complaint asserting: (a) state-law medical malpractice, (b) Eighth Amendment deliberate indifference to serious medical needs, (c) Fourteenth Amendment due-process claim for failure to obtain informed consent, and (d) a parallel New Jersey constitutional claim.
- Defendant moved to dismiss for failure to timely serve an Affidavit of Merit under N.J.S.A. 2A:53A-29 and for failure to state constitutional claims under § 1983; the parties disputed whether the 120-day period to serve the affidavit ran from the answer to the original or the amended complaint.
- The court found Snyder controlling and held the affidavit deadline runs from the answer to the final amended complaint; Ramirez’s affidavit (filed April 15, 2014) was timely and the malpractice claim survives the motion to dismiss.
- On constitutional claims, the court dismissed Ramirez’s Eighth Amendment deliberate indifference claim (concluding allegations amount to negligence or malpractice, not the requisite subjective deliberate indifference) but denied dismissal of the Fourteenth Amendment informed-consent claim (finding those allegations state a cognizable claim).
- The Eighth Amendment and related New Jersey constitutional claims were dismissed without prejudice, and Ramirez was given 90 days to move for leave to amend those claims.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Timeliness of Affidavit of Merit | Affidavit timely because filed within 120 days after answer to Amended Complaint | Affidavit should have been due 120 days after answer to original Complaint because allegations unchanged | Court held Snyder applies; deadline runs from answer to final amended complaint; affidavit timely — malpractice claim survives |
| Sufficiency of Eighth Amendment claim (deliberate indifference) | Failure to diagnose and unnecessary surgery causing sterilization shows deliberate indifference | Allegations at most medical negligence; no subjective deliberate indifference pleaded | Dismissed: allegations amount to negligence/malpractice, not deliberate indifference; claim dismissed without prejudice |
| Sufficiency of Fourteenth Amendment informed-consent claim | Dr. Nugent failed to inform Ramirez of risks and alternatives, eliminating ability to refuse surgery | Argues complaint insufficient to plead constitutional violation | Denied dismissal: allegations plausibly state a Fourteenth Amendment claim for lack of informed consent |
| New Jersey constitutional cruel and unusual punishment claim | Parallels Eighth Amendment deliberate indifference | Merits analyzed like Eighth Amendment claim | Dismissed for same reasons as federal Eighth Amendment claim; dismissal without prejudice |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (1976) (Eighth Amendment requires adequate medical care but medical malpractice alone is not a constitutional violation)
- White v. Napoleon, 897 F.2d 103 (3d Cir. 1990) (convicted prisoners retain a limited right to refuse treatment and a right to be informed to exercise that right)
- Snyder v. Pascack Valley Hosp., 303 F.3d 271 (3d Cir. 2002) (Affidavit-of-merit deadline begins from answer to final amended complaint)
- Farmer v. Brennan, 511 U.S. 825 (1994) (deliberate indifference requires a mental state akin to reckless disregard of a known risk)
- Nuveen Mun. Trust ex rel. Nuveen High Yield Mun. Bond Fund v. Withum–Smith Brown, P.C., 692 F.3d 283 (3d Cir. 2012) (failure to timely file affidavit of merit generally requires dismissal, but limited equitable exceptions exist)