371 F.3d 165 | 3rd Cir. | 2004
Opinions of the United
2004 Decisions States Court of Appeals for the Third Circuit 6-17-2004 Benn v. Unvrsl Health Sys Precedential or Non-Precedential: Precedential Docket No. 01-3450 Follow this and additional works at: http://digitalcommons.law.villanova.edu/thirdcircuit_2004 Recommended Citation "Benn v. Unvrsl Health Sys" (2004). 2004 Decisions. Paper 548. http://digitalcommons.law.villanova.edu/thirdcircuit_2004/548 This decision is brought to you for free and open access by the Opinions of the United States Court of Appeals for the Third Circuit at Villanova University School of Law Digital Repository. It has been accepted for inclusion in 2004 Decisions by an authorized administrator of Villanova University School of Law Digital Repository. For more information, please contact Benjamin.Carlson@law.villanova.edu.
PRECEDENTIAL District Court Judge: Honorable Mary A. McLaughlin UNITED STATES COURT OF (D.C. No. 99-cv-6526) APPEALS ____________________
FOR THE THIRD CIRCUIT
____________ Submitted Under Third Circuit LAR 34.1(a) No. 01-3450 December 4, 2003 ____________ Before: SLOVITER, ALITO, Circuit Judges, and OBERDORFER, [*] District DONALD BENN, Court Judge Appellant (Opinion Filed: June 17, 2004) v.
ROSS BEGELMAN
UNIVERSAL HEALTH SYSTEM, Begelman & Orlow INC.; HORSHAM CLINIC; 411 Route 70 East RAMESH ELURI, DR.; EILEEN Suite 245 WILCOX; MONTGOMERY Cherry Hill, New Jersey 08034 COUNTY MH-MR EMERGENCY Counsel for Appellant SERVICE, d/b/a MONTGOMERY
COUNTY EM ERGENCY SERVICE,
KEVIN J. O’BRIEN INC.; VENU M UKERJEE, DR., Marks, O’Neill, O’Brien, & Courtney Individually, severally, jointly and/or in 1880 JFK Boulevard the alternative; Suite 1200 STEPHEN ZERBY, M.D.; Philadelphia, PA. 19103 MOHAM MAD QUASIM, DR., C/O MONTGOMERY KENNETH D. POWELL, JR. COUNTY EM ERGENCY SERVICE, Rawle & Henderson INC. 50 BEECH DRIVE 334 West Front Street 2 nd Floor
NORRISTOWN, PA
19401 INDIVIDUALLY, SEVERALLY, Media, PA. 19063 JOINTLY AND/OR IN THE ALTERNATIVE CHARLES W. CRAVEN ___________________ MARION H. GRIFFIN
ON APPEAL FROM THE UNITED
STATES DISTRICT COURT
[*] The Honorable Louis F. Oberdorfer,
FOR THE EASTERN DISTRICT OF
United States District Judge for the
PENNSYLVANIA
District of Columbia, sitting by designation.
Marshall, Dennehey, Warner, Coleman & Each time Benn called Horsham, he spoke Goggin to Eileen Wilcox, an experienced crisis- 1845 Walnut Street line counselor. Benn told Wilcox that he 16 th Floor was looking for treatment for post- Philadelphia, PA 19103 traumatic stress disorder and was
interested in Horsham. Benn admits that Counsels for Appellees during one conversation he told Wilcox that he was driving over the Tacony- ____________________ Palmyra Bridge. Wilcox claims that Benn told her he had stopped his car and had OPINION OF THE COURT considered jumping off the bridge. Benn ____________________ denies this. W ilcox told Benn that Horsham did not make regular outpatient Alito, Circuit Judge: appointments but that they would assess his need for care if he came in. This case concerns Donald Benn’s short-term involuntary commitment to a Benn arrived at Horsham late that psychiatric facility for an emergency evening and was quickly interviewed by examination. After his release, Benn psychiatrist Dr. Ramesh Eluri. The brought federal and state claims against interview lasted 40 minutes, and Dr. Eluri those involved in his commitment. The claims that, during the interview, Benn District Court granted summary judgment admitted to being depressed and suicidal. in favor of all defendants. We affirm. Benn asserts that he never told Dr. Eluri
that he was suicidal and that Dr. Eluri I. misunderstood him because of Dr. Eluri’s poor English. After the interview, Dr. Prior to the events at issue here, Eluri told Wilcox that he was concerned Donald Benn was under the care of for Benn’s safety and that a petition for therapist Dr. Jack Hartke and psychiatrist involuntary com mitm ent m ight be Dr. Lynn Bornfriend, both of whom had necessary because Benn refused to seek treated him for depression and post- treatment. Benn, however, did agree to traumatic stress disorder. The treatment sign a “Contract for Safety,” which stated: included anti-depressant medication.
I, Donald Benn on August On August 15, 1998, Benn 15, 1998 agreed to keep t e l ep h o n e d t he H o rs h am C li n ic myself safe and that if I feel (“Horsham”) three times. Horsham, a any increase of suicidal mental healthcare facility in Montgomery thoughts or feeling I will County, Pennsylvania, is wholly owned by contact Horsham Clinic [or] Universal Health System, Inc. (“UHS”). the police.” Below the
contra ct, B enn w rote: suicidal, feels unsafe and “While there is no doubt dangerous to himself. He wha t-so -e ve r that m y needs inpatient treatment. mental/emotional health has b e e n G R E A T L Y App. 242. compromised I feel as certain as certain can be that The petition was reviewed by the a few more days won’t hurt county administrator, who authorized the (too much).” police to take Benn into custody. The
police went to Benn’s home, and he was Wilcox asked Benn to remain at the clinic transported by ambulance to Montgomery while Dr. Eluri looked over the contract, Co unty E m e r g e nc y Se rvic e I n c. but Benn refused and left. (“MCES”), a private, not-for-profit
psychiatric hospital in Norristown, Upon seeing the contract, Dr. Pennsylvania, that, by contract, handles all Eluri’s concern about Benn’s safety grew, involuntary and emergency psychiatric and he filed an application under a confinements in the county. provision of Pennsylvania’s M ental Health Procedures Act (MHPA), 50 Pa. Stat. Ann. Upon arrival at MCES, Benn was § 7302(a), requesting that Benn be placed in an isolated waiting room. He examined to determine his need for was then seen by Dr. Stephen Zerby, an treatment. See App. 240-42. The MCES psychiatrist, who conducted an application stated: hour-long interview and decided, based on
the interview and Dr. Eluri’s petition, that [Benn] said he had seriously Benn should be admitted for an emergency thought about jumping from examination for the period permitted by Coney Bridge [sic], while he the MHPA, 50 Pa. Stat. Ann. § 7302(d), was driving. In fact, he i.e., not more than 120 hours. App. 244. stopped the car. He admits The next day, August 16, Benn was feeling suicidal now and interviewed by Dr. Mohammad Quasim, feels unsafe and unstable. another MCES psychiatrist, who continued He also believes that his the treatment started by Dr. Zerby. The m e n t a l h e a l t h i s following day, August 17, Benn was seen compromised and needs by Dr. Venu Mukerjee, yet another MCES hospitalization. He also psychiatrist, who found him to have says he had suicidal “limited insight and obvious[] difficulties thoughts consistently for the with impulse control, where he might have past few weeks. He is verbalized suicidal intent while at vague about his attempts... Horsham . . . . His insight is limited and In my assessment, Pt. is very his judgment is definitely impaired.” App.
21. On August 18, Dr. Mukerjee noted procedural due process. The Court also that “[Benn] is now contracting for safety granted summary judgment on the state and has never been suicidal since his tort claims for all parties except Wilcox, admission here.” He was then released. because it found that these parties were App. 22. immune from such claims under Section
114 of the MHPA, 50 Pa. Stat. Ann. During his time at MCES, Benn §7114. As for Wilcox, the Court found was in contact with his common-law wife, that there was no evidence against her to his treating therapist, a lawyer, and a support the state tort claims. Benn friend. Benn claims that his detention appealed. room had no toilet and that he was forced to urinate on the walls. II.
In December 1999, Benn filed this We turn first to Benn’s § 1983 action in the United States District Court claim. Section 1983 provides in relevant for the Eastern District of Pennsylvania part: against Wilcox, Dr. Eluri, Horsham, UHS, MCES, Dr. Mukerjee, Dr. Zerby, and Dr. Every person who, under Quasim. Benn asserted claims under 42 color of an y statute, U.S.C. § 1983 for alleged violations of his o r d i n a n c e , r e g u l a t i o n, custom, or usage, of any procedural and substantive due process rights, as well as numerous tort claims State or Territory or the under Pennsylvania law , to wit, District of C olum bia , negligence/malp rac tice, inten tional subjects, or causes to be infliction of emotional distress, assault and subjected, any citizen of the b a t t e r y , n e g l i g e n c e , a n d f a l s e United States or other imprisonment. In addition, Benn sought p e r s o n w i t h i n t h e punitive damages against all defendants. jurisdiction thereof to the
deprivation of any rights, The parties filed cross-motions for privileges, or immunities summary judgment. In July 2001, the secured by the Constitution and laws, shall be liable to District Court granted summary judgment in favor of all defendants. The Court held the party injured in an action that Dr. Eluri, Wilcox, Horsham, and UHS at law, suit in equity, or other proper proceeding for were not state actors and thus could not be sued under §1983. In addition, assuming redress. for the sake of argument that MCES, Dr. Mukerjee, Dr. Zerby, and Dr. Quasim were To establish a claim under §1983, Benn state actors, the Court held that they did must show that the defendants 1) were not violate Benn’s right to substantive or state actors [1] who 2) violated his rights designated facility for an emergency under the Constitution or federal law. examination. 50 Pa. Stat. Ann. § 7302(a)(1). [4] In addition, a physician or Flagg Bros., Inc. v. Brooks, 436 U.S. 149, 155 (1978).
50 Pa. Stat. Ann § 7301(a).
A.
[4] 50 P.S. § 7302(a) provides as follows: Benn contends that Horsham, UHS, Dr. Eluri, and Wilcox [2] (the “Horsham ( a ) A p p l i c a ti o n f o r defendants”) were state actors because Examination.--Emergency they were acting pursuant to the MHPA. e x a m i n a t io n m a y b e Under the MHPA, a physician or other undertaken at a treatment “responsible party” may file an application f a c i l i t y u p o n t h e that may lead to the issuance of a warrant certification of a physician authorizing a person who is “severely stating the need for such mentally disabled and in need of examination; or upon a immediate treatment” [3] to be taken to a warrant issued by the county administrator authorizing s u c h exam ination ; o r [1] “In cases under § 1983, ‘under color’ without a warrant upon of law has consistently been treated as the application by a physician or same thing as the ‘state action’ required other authorized person who under the Fourteenth Amendment.” has personally observed Rendell-Baker v. Kohn, 457 U.S. 830, conduct showing the need 838 (1982); see also Dluhos v. Strasberg, for such examination. 321 F.3d 365, 374 (3d Cir. 2003). (1) Warrant for Emergency [2] For the purpose of summary judgment, Examination.--Upon written MCES, Dr. Mukerjee, Dr. Quasim, and Dr. application by a physician or Zerby conceded that they were “state other responsible party actors,” and therefore we do not decide s e t t i n g f o r t h f a c t s that question. constituting reasonable [3] A person is “severely mentally grounds to believe a person disabled” “when, as a result of mental is severely mentally disabled illness, his capacity to exercise self- and in need of immediate control, judgment and discretion in the treatment, the county conduct of his affairs and social relations administrator may issue a or to care for his own personal needs is so warrant requiring a person lessened that he poses a clear and present authorized by him, or any danger of harm to others or to himself.” peace officer, to take such other person who has observed a person it is determined that the person is “severely engaging in conduct that provides mentally disabled and in need of reasonable grounds to believe that the immediate treatment,” the treatment must person is “severely mentally disabled and begin immediately. 50 Pa. Stat. Ann. § in need of treatment” may take the person 7302(b). If it is determined at any time to an approved facility for such an that the person is not in need of treatment, examination. 50 Pa. Stat. Ann. § 7302(b). the person must be discharged, and in any At the facility, the individual who brought event the person must be released within the person thought to need treatment must 120 hours unless a certification for make “a written statement setting forth the extended involuntary emergency treatment grounds for believing the person to be in is filed under 50 Pa. Stat. Ann. § 7303. In need of examination.” 50 Pa. Stat. Ann. § this case, the District Court held that, 7302(a)(2). A person taken to a facility because the Horsham defendants were must be examined within two hours, and if merely involved in the application for
Benn’s commitment, they were not state actors.
person to the facility In Brentwood Acad. v. Tennessee specified in the warrant. Secondary Sch. Athletic Ass’n, 531 U.S. 288, 296 (2001), the Supreme Court noted
(2) Emergency Examination that the criteria for determining whether Without a Warrant.--Upon state action is present “lack rigid personal observation of the simplicity,” but the Court identified factors condu ct of a person that bear on the question. The Court cons tituting reasonable wrote: grounds to believe that he is severely mentally disabled
We have, for example, held and in need of immediate that a challenged activity t r e a t m e n t , a n d ( s i c ) may be state action when it physician or peace officer, results from the State's or anyone authorized by the e xer c i s e o f "coe rciv e county administrator may power," [Blum v. Yaretsky, take such person to an
457 U.S. 991, 1004 (1982)],
approved facility for an when the State provides emergency examination. "significant encouragement, Upon arrival, he shall make either overt or covert," ibid., a written statement setting or when a private actor forth the grounds for operates as a "willful believing the person to be in participant in joint activity need of such examination. with the State or its agents," . [Lugar v. Edmondson Oil application for an emergency examination, Co., 457 U.S. 922, 941 we see nothing in the MPHA that compels (1982)] (Internal quotation or even significantly encourages the filing marks omitted). We have of an application. See Rockwell v. Cape Cod Hosp., 26 F.3d 254, 258 (1 st Cir. treated a nominally private entity as a state actor when 1994) (no compulsion where state law it is controlled by an merely permits physicians to petition for "agency of the State," involuntary commitment but does not Pennsylvania v. Board of mandate that they do so); Harvey v.
Harvey, 949 F.2d 1127, 1131 (11 th Cir. Directors of City Trusts of Philadelphia, 353 U.S. 230. 1992) (no compulsion or encouragement 231 (1957) (per curiam), where state statutes not enacted to when it has been delegated a encourage commitment); Spencer v. Lee, 864 F.2d 1376,1379 (7 th Cir.1989) (same); public function by the State, cf., e.g., [West v. Atkins, Janicsko v. Pellman, 774 F.Supp. 331, 487 U.S. 42, 56 (1988)]; 338-39 (M.D.Pa.1991) (“this court cannot Edmonson v. Leesville hold that the standards set by the MHPA Concrete Co., 500 U.S. 614, rise to the level of coercion”), aff'd, 970 627-628 (1991), when it is F.2d 899 (3d Cir. 1992) (table). " e n t w i n e d w i t h governmental policies," or Second, the Horsham defendants w h e n g o v e r n m e n t i s did not operate as “willful participant[s] in " e n t w i n e d i n [ i t s ] joint activity with the State or its agents” management or control," under Lugar, 457 U.S. at 941. In Lugar, Evans v. Newton, 382 U.S. creditors moved for a prejudgment writ of 296, 299, 301 (1966). attachment, and the writ was issued by a
court clerk and executed by a sheriff. Id. 531 U.S. at 295. at 924. The debtor whose property was attached brought an action asserting two § In the present case, none of these 1983 claims against the creditors. Count factors points toward the presence of state one claimed that the prejudgment action. First, the M HPA, on which Benn attachment process permitted by state law predicates his state action argument, did was “procedurally defective under the not coerce the Horsham defendants to file Fourteenth Amendment.” Id. at 941. the application that led to Benn’s Count two alleged that the creditors had commitment. Nor did the MHPA provide invoked the attachment process in a way “significant encouragement, either overt or that was “‘malicious, wanton, willful, covert.” Blum, 457 U.S. at 1004. opressive [sic] ” and unlawful under state Although the MHPA permits a physician law. Id. at 940 (brackets in Supreme Court or other “responsible party” to file an opinion). The Supreme Court held that the first count stated a § 1983 claim because act according to the Act, and “the procedural scheme” was “the product the high duty placed upon of state action.” Id. By contrast, the Court them. Such intentional, concluded that the second count did not reckless, and gross disregard satisfy the state action requirement of the rules and standards because “private misuse of a state statute they were bound by, the does not describe conduct that can be Defendants intentionally attributed to the State.” Id. The Court committed a horrible act stated: “[t]hat [the creditor] invoked the upon Plaintiff. statute without the grounds to do so could in no way be attributed to a state rule or Id. at 429. decision.” Id. at 940.
The crux of Benn’s complaint about In this case, Benn’s constitutional the conduct of the Horsham defendants claims against the Horsham defendants appears to be that they conducted a parallel the claim found to be defective in “seriously defective evaluative process,” Lugar. As Benn’s Memorandum of Law Appellant’s Br. at 10, and that he did not in Support of his M otion for Summary meet the standard for emergency Judgment makes clear, Benn’s theory was commitment under the MHPA. See App. that these defendants violated his 429 (Memorandum in Support of constitutional rights because they allegedly Summary Judgment); id. at 263 (expert did not comply with the MHPA. See App. report). Benn’s constitutional claim 428-429. The portion of Benn’s against Horsham defendants is thus Memorandum addressing his constitutional precisely the type of claim that Lugar claims begins by stating: found to be inadequate to establish state
action. Defendants had [a] duty and obligation to follow the Third, this is clearly not a case in rules and standards of the which nominally private persons were Pennsylvania Mental Health controlled by an ag ency of the Procedures Act. Such act Commonwealth. Benn makes no such governed the circumstances allegations. and procedures surrounding the extreme action of Fourth, the conduct in question here involuntarily committing an – applying for Benn’s emergency individual. commitment – is not a “public function”
that the MHPA delegated to private Id. at 428. The Memorandum then adds: persons. In considering the “public function” issue, we must ask whether the Defendants clearly failed to challenged action relates to a function that has been “traditionally the exclusive the Horsham defendants. Thus, none of prerogative of the State.” Jackson v. the factors identified in Brentwood Metropolitan Edison Co., 419 U.S. 345 supports a finding of state action in this (1974). Here, we have no basis for case. concluding that petitioning for involuntary confinement is or ever was the exclusive Nor does this case satisfy the prerogative of the state, either in “symbiotic relationship” test that derives Pennsylvania or in the country in general. from Burton v. Wilmington Parking See Rockwell v. Cape Cod Hosp., 26 F.3d Authority, 365 U.S. 715 (1961). After at 259 (“The history of involuntary Brentwood, our Court, sitting en banc, treatment of the m entally ill in held that the “symbiotic relationship” test M a ssach usetts d e m o n s t r a te s t h at continues to provide an additional, albeit involuntary treatment has by no means “narrow,” basis for finding that private been the exclusive prerogative of the action may fairly be attributed to the state. State.”); Spencer v. Lee, 864 F.2d 1376, Crissman v. Dover Downs Entertainment, 1380-81(7th Cir. 1989)(holding that civil Inc., 289 F.3d 231, 242 (3d Cir. 2002). commitment in Illinois was not a This theory, however, has no application traditional and exclusive public function); here. A “symbiotic relationship” demands Bodor v. Horsham Clinic, Inc., 1995 WL “a close association of mutual benefit” 424906 at *8 (E.D.Pa. July 19, 1995) between the state and the private entity or (Pennsylvania). person. Crissman, 289 F.3d at 240. In
Burton, such a relationship existed Fifth, this case does not involve between a city that owned a parking “entwinement” within the meaning of structure and a restaurant to which it Brentwood. There, the Court held that an leased space. In this case, there is no interscholastic athletic association was indication that the Horsham defendants entwined with the state where the great made any profit from the petition to majority of the association’s member commit Benn, and there certainly is no schools were public, representatives of the evidence that the government received any schools acting in their official capacities tangible benefit from Horsham, save a selected members of the association’s possible increase in the general welfare. governing bodies, state officials also sat on “That a private entity performs a function those bodies in an ex officio capacity, the which serves the public does not make its association was largely financed by gate acts state action.” Rendell-Baker v. Kohn, receipts from member-school tournaments, 457 U.S. 830. Thus, neither the factors and association employees participated in cited in Brentwood nor the symbiotic the state retirement system. 531 U.S. at relationship theory shows the presence of 298-300. In this case, Benn does not state action in this case. allege that the Commonwealth was “entwined” in any comparable sense with The decisions of other courts of appeals and those of district courts in this has no merit. circuit also support the conclusion that persons who petition for the involuntary First, even if these defendants commitment of others are not state actors. violated the MHPA, this would not See Rockwell v. Cape Cod Hosp., 26 F.3d establish a §1983 claim. “The plain at 257-58; Harvey v. Harvey, 949 F.2d language of section 1983, interpreted and 1127, 1131 (11th Cir.1992); Spencer, 864 underscored by the Supreme Court in F.2d at 1380-81; Doby v. Decrescenzo, Maine v. Thiboutot, 448 U.S. 1 (1980), 1996 WL 510095 (E.D.Pa. Sept. 9, 1996), solely supports causes of action based aff’d, 118 F.3d 1575 (3rd Cir. 1997) upon violations, under the color of state (table); Bodor v. Horsham Clinic, Inc., law, of federal statutory law or supra (thoroughly analyzing the “state constitutional rights. Section 1983 does actor” question); Savacool v. Delaware not provide a cause of action for violations County Department of Mental Health, of state statutes.” Brown v. Grabowski, 1993 WL 21209, *6 (E.D.Pa. Jan.25, 922 F.2d 1097, 1113 (3d Cir. 1990); see 1993); Janicsko v. Pellman, 774 F.Supp. also Flagg Bros., Inc. v. Brooks, 436 U.S. 331, 339 (M.D.Pa.1991), aff'd, 970 F.2d 149, 155 (1978). 899 (3d Cir.1992).
Second, in an emergency situation, Our analysis leads to the same a short-term commitment without a result. We thus hold that the Horsham hearing does not violate procedural due defendants were not state actors. process. In a similar case dealing with the
MHPA, we observed that “[i]t may be B. reasonable . . . for a state to omit a provision for notice and a hearing in a Benn claims that MCES, Dr. statute created to deal with emergencies, Mukerjee, Dr. Zerby, and Dr. Quasim, all particularly where the deprivation at issue, of whom conceded that they were state in this case detention for a maximum of actors for purposes of the motion for several hours to permit an examination, summary judgment, violated both his continues for only a short period of time.” procedural and substantive due process Doby v. DeCrescenzo, 171 F.3d 858, 870 rights. We disagree. (3d. Cir. 1999); see also Project Release v.
Prevost, 722 F.2d 960, 974 (2d Cir. 1983); 1. Covell v. Smith, 1996 WL 750033 (E.D.Pa. Dec. 30 1996); Luna v. Zandt, Benn argues that MCES and its 554 F.Supp. 68, 76 (S.D.Tex. 1982). doctors violated procedural due process by failing to comply with the MHPA and by Benn’s case clearly presented an failing to grant him a hearing before he emergency situation. Both his calls to the was involuntarily confined. This argument Horsham clinic and his note at the bottom of his Contract for Safety suggested to the it may fairly be said to shock the doctors that Benn was highly unstable. contemporary conscience.” County of Furthermore, he was committed for a Sacramento v. Lewis, 523 U.S. 833, 847, “short period of time” and was released fn. 8 (1998). Whether an incident “shocks upon Dr. M ukerjee’s evaluation that he the conscience” is a matter of law for the was no longer suicidal. While committed, courts to decide, see Rochin v. California, Benn was constantly evaluated by the 342 U.S. 165, 172 (1952), and we have MCES physicia ns. Under these pr eviously he ld that involuntary circumstances, we hold that the defendants commitment under the MHPA does not in did not violate Benn’s rights by not itself violate substantive due process. See granting him a hearing before he was Doby v. DeCrescenzo, 171 F.3d at 871 n. committed. 4 (“[T]he MHPA authorizes seizures that
are ‘reasonable’ under the Fourth Third, we see no evidentiary basis Amendment [and so] the MHPA meets the in the record for Benn’s claim that MCES rationality test imposed by substantive due maintains a policy that denied him his due process analysis.”) process rights. On the contrary, MCES guidelines track the MHPA, which does In this case, none of the specific not deny due process. See Monell v. conduct that Benn alleges shocks the Department of Social Services, 436 U.S. conscience. First, Benn’s complaints 658, 694 (1978). In sum, we hold that about Drs. Zerby or Mukerjee are Benn’s procedural due process rights were insufficient. Benn claims that Drs. Zerby not violated. a n d M u k e r j e e e x h i b i te d “ t o t a l
incompetenc[e] . . . . [by failing] to 2. understand that plaintiff was showing no suicidal ideation which merited his Benn appears to argue that his involuntary confinement.” B r. of substantive due process rights were Appellants at 13. But whether or not Drs. violated in three ways. First, he claims Zerby and Mukerjee properly analyzed th a t Dr s . Zerb y and M uker je e Benn’s condition, their conduct did not incompetently failed to recognize that he violate substantive due process. In view of was not suicidal. Second, he asserts that the events that led to Benn’s commitment he was kept in a room without a toilet. and the steps taken after his arrival at Third, he claims that he was forcibly given MCES, the doctors’ conduct was not antipsychotic medication. conscience-shocking.
“[I]n a due process challenge to Second, Benn’s allegation that he executive action, the threshold question is was temporarily kept in a room without a whether the behavior of the governmental toilet is insufficient without further officer is so egregious, so outrageous, that aggravating evidence to meet the high standard needed to state a substantive due m i s c o n d u c t o r g r o s s process violation. As the District Court n e g l i g en c e , a c o u n ty pointed out, Benn failed to produce any administrator, a director of a evidence that the defendants were aware facility, a physician, a peace that he needed to use a bathroom or that o f f ic e r or any o t h er “MCES had a custom or policy of refusing authorized person who to allow patients to use the bathroom.” participates in a decision App. 31. that a person be examined or
treated under this act, or that Third, the administration of a person be discharged, or antipsychotic drugs is not shocking to the p l a c e d u n d e r p a r t i a l conscience under the circumstances hospitalization, outpatient present here. We have held that care or leave of absence, or authorities may administer antipsychotic that the restraint upon such drugs over a patient’s objection “where the p e r s o n b e o t h e r w i s e decision is a product of the authorities’ reduced, or a county professional judgment.” White v. administrator or other Napoleon, 897 F.2d 103, 112 (3d Cir. authorized person who 1990). See also Rennie v. Klein, 720 F.2d denies an application for 266, 269 (3d Cir. 1983). In this case, voluntary treatment or for however, as the District Court noted, Benn involunta ry e me r ge ncy has not alleged that he objected to the examination and treatment, administration of the medication. App. 32. shall not be civilly or Under these circumstances, Dr. Zerby’s criminally liable for such conduct did not shock the conscience. decision or for any of its
consequences.
III.
50 Pa. Stat. Ann. § 7114(a). As the Benn next contends that the District District Court properly found, Wilcox, a Court erred in granting summary judgment crisis-line counselor who had no effect on in favor of the defendants on his state tort the decision to commit Benn, is not claims. We disagree. covered under the strict language of the
immunity provision. It is clear, however, A. that the remaining defendants qualify for immunity if they did not engage in “willful The MHPA gives broad immunity misconduct or gross negligence.” See to physicians and others who participate in Doby v. DeCrescenzo, 171 F.3d 858, 875 the involuntary commitment process: (3d Cir. 1999).
In the absence of willful Under Pennsylvania law, “gross negligence” is “more egregiously deviant ps yc h i a t r i c t r e a tm e n t , conduct than ordinary carelessness, especially as they relate to inadvertence, laxity or indifference.” involuntary commitment Rather, gross negligence requires conduct a n d f i n d t h at t h e se that is “flagrant, grossly deviating from the Depositions show clear and ordinary standard of care.” Alrbight v. convincing evidence that Abington Memorial Hospital, 696 A.2d M r . B e n n w a s 1159, 1164 (Pa. 1997). “Willful inappropriately involuntarily misconduct” occurs when “the danger to committed and held in the the plaintiff, though realized, is so p s y c h i a t r i c h o s p i t a l , recklessly disregarded that, even though s u b j e c te d t o a b u s i v e there be no actual intent, there is at least a mistreatment, and a victim willingness to inflict injury, a conscious of medical malpractice and indifference to the perpetration of the negligence. wrong.” Krivijanski v. Union R. Co., 515 A.2d 933, 937 (Pa. Super. Ct. 1986). We agree with the District Court
that the assertions in this report do not Here, none of the defendants comport with the facts and that, committed either gross negligence or considering the record as a whole, no willful misconduct. The only evidence reasonable jury could find that the doctors that Benn puts forward to show such acted with gross negligence or willful behavior consists of the two expert reports misconduct. The doctors all participated of his treating psychiatrist, Dr. Bornfriend. in meetings, took careful notes, and In her second report, Dr. Bornfriend prescribed a careful routine and course of alleges: treatment for Benn. He was released as
soon as they found him to be safe. Their There appears to be behavior did not meet the legal definition evidence, however, that of either gross negligence or willful some of the mistreatment misconduct. Since none of the doctors Mr. Benn endured appeared committed any such conduct, we will also secondary to even more affirm the dismissal of the related claims malignant causes [than against MCES. See Farago v. Sacred simple negligence], raising Heart Hospital, 562 A.2d 300, 303 (Pa. i s s u e s o f d e l i b e r a t e 1989). indifference, arrogance, condescension, and punitive B. hostility from these doctors. I find shocking the level of Finally, we hold that the District disregard for standard Court properly dismissed the state tort p r a c t ic e s i n v o l v e d in claims against Eileen Wilcox. There is no
evidence whatsoever that would even begin to support any of those claims against Wilcox.
IV.
For the reasons explained above, we affirm the order of the District Court.
