Colon v. RamirezColon v. Ramirez
OPINION AND ORDER
The Court has before it the Motion for Summary Judgment filed by defendants San Juan Municipal Hospital and Drs. Efrain Ramirez Torres and José Alvarado (docket No. 38), plaintiffs Opposition (docket No. 40), defendants’ Reply to Plaintiffs Opposition (docket No. 46) and plaintiffs Surreply (docket No. 47). For the reasons set forth below, defendants’ Motion for Summary Judgment is hereby GRANTED.
I. INTRODUCTION
Plaintiff is a minor who is alleged to be a citizen of Florida. Defendants are the Municipality of San Juan, a hospital owned and administered by the Municipality, and two doctors employed by the hospital. Plaintiffs Complaint alleges that on March 3, 1975, acting with “reckless disregard” and “delib
Plaintiff alleges that this Court has jurisdiction pursuant to
II. UNCONTESTED FACTS
The parties do not controvert the following facts. See Initial Scheduling Conference Order (docket No. 34), defendants’ Motion for Summary Judgment, Statement of Uncontested Facts (docket No. 38), plaintiffs Opposition, Statement of Contested Facts (docket No. 40).
1.Mrs. Leila Frances Colón was 27 years old at the time she gave birth to Eric Rodriguez Frances.
2. Mrs. Frances Colón went to the San Juan Municipal Hospital, which is owned and operated by the Municipality of San Juan, on March 3,1975, in order to give birth to minor plaintiff.
3. On March 3, 1975, Dr. Efraín Ramirez was an employee of the San Juan Municipal Hospital and of the Municipality of San Juan and occupied the position of Resident Doctor.
4. On March 3, 1975, Dr. José Alvarado was an employee of the San Juan Municipal Hospital and of the Municipality of San Juan and occupied the position of Attending Physician.
5. On March 3, 1975, Dr. Alvarado was working in the emergency room of the San Juan Municipal Hospital.
6. Dr. Alvarado admitted Mrs. Leila Frances Colón to the San Juan Municipal Hospital on March 3, 1975, at 8:30 a.m. Dr. Alvarado delivered the plaintiff later that same day. 1
7. Dr. Alvarado did not perform a caesarean section on Mrs. Frances Colón; the baby was delivered vaginally.
8. Plaintiff was born on March 3, 1975, and the parents are Mrs. Leila Frances Co-lón and Mr. Juan Enrique Rodriguez.
9. The medical records reflect that the plaintiff was born in “poor” condition.
10. Eleven days after birth, plaintiffs medical records reflect that he had suffered severe perinatal asphyxia.
11. Neither plaintiff nor his parents sent any written notification of a claim to the Municipality of San Juan within ninety days following March 3,1975.
III. SUMMARY JUDGMENT STANDARD
Summary judgment is appropriate where, after drawing all reasonable- inferences in favor of the party against whom summary judgment is sought, there is not the slightest doubt as to whether a genuine issue of material fact exists.
Kennedy v. Josephthal & Co., Inc.,
The party filing a motion for summary judgment bears the initial burden of proof to show “that there is an absence of evidence to support the non-moving party’s case.”
Celotex Corp. v. Catrett,
IY. CAUSE OF ACTION UNDER SECTION 1983
Defendants allege that there is no cognizable cause of action under
Plaintiff counters that defendants violated his fundamental right under the Fourteenth Amendment to bodily integrity and that such right was clearly established in 1975. Alternately, plaintiff cites
Rochin v. California, 342 U.S.
165,
Plaintiff has failed to state a cause of action under
We have, reviewed the case law cited by the parties and can identify no general liberty interest in bodily integrity or adequate medical treatment. The cases plaintiff cites in support of his proposition that defendants violated his constitutional right to bodily integrity involve persons subjected to dangerous and unwanted procedures 'while in State custody or while their personal liberty had been restrained by the State.
See Clark v. Taylor,
A line of Supreme Court cases holds that the Constitution imposes upon the State affirmative duties of care and protection, including adequate medical care, with respect to particular individuals.
See Estelle v. Gamble,
The Supreme Court elucidated this line of precedent in
DeShaney v. Winnebago County Dep’t of Social Serv.,
In the substantive due process analysis, it is the State’s affirmative act of restraining the individual’s freedom to act on his own behalf — through incarceration, institutionalization, or other .similar restraints of personal liberty — which is the “deprivation of liberty” triggering the protections of the Due Process Clause, not its failure to act to protect his liberty interests against harms inflicted by other means.
Id.
at 200,
DeShaney was applied by the First Circuit in Monahan v. Dorchester Counsel-
Neither the plaintiff nor his mother were in the San Juan Municipal Hospital against their will through some affirmative act of the state. Rather, Mrs. Frances Colón voluntarily sought out the Hospital’s services and requested to be admitted there for medical treatment. That once admitted she became dependent upon the state’s doctors because of her medical circumstances is insufficient to trigger the protections of the Due Process Clause since the state doctors did not cause her helplessness by restraining her liberty.
DeShaney,
Neither can plaintiff prevail by showing state conduct that “shocks the conscience.” This case involves a woman who voluntarily sought the services of a public hospital and who may or may not have received substandard medical care. If plaintiffs allegations are true, defendants may have been negligent or even grossly negligent in failing to heed Mrs. Frances Colon’s admonition that her baby was to be delivered by caesarean section and/or in failing to conduct tests that would have indicated whether she was capa-ble of giving birth vaginally. ■ However unfortunate the outcome of defendants’ alleged acts, we are not speaking here of conduct so egregious that it offends even “hardened sensibilities.”
See Rochin,
The United States Supreme Court has long insisted that not every tort committed by a state actor is a constitutional violation.
DeShaney,
Since the focus of the Due Process Clause is prevention of the arbitrary and oppressive use of state power, it historically has been applied to “deliberate decisions of government officials to deprive a person of life, liberty, or property.”
Daniels,
Since plaintiff has failed to identify a protected liberty interest and has failed to show that defendants acted with the requisite degree of culpability, his
V. NEGLIGENCE ACTION PURSUANT TO PUERTO RICO LAW
Plaintiff also claims a cause of action under Puerto Rico law for defendants’ actions. Defendant doctors claim immunity pursuant to
No health service professional may be included as a defendant in a civil suit for damages due to malpractice caused in the performance of his profession while said health service professional acts in compliance with his duties and functions as an employee of the Commonwealth of Puerto Rico, its dependencies, instrumentalities and municipalities.
Plaintiff maintains that under Flores Román v. Ramos González, 90 J.T.S. 132, 127 P.R.Dee.-(1990), the defendant doctors are not immune if they acted with such recklessness and indifference as would demonstrate a failure to exercise professional judgment. Plaintiff claims further that even if the doctors are immune, he should be entitled to recover from their insurers. Plaintiff also argues that failure to notify the Municipality of his claim within ninety days of knowledge of his damages is not fatal since defendants have not been prejudiced thereby.
Under
Flores Román,
a person must meet three requirements to acquire immunity under
As to the liability of the doctors’ insurers, plaintiff contends that Opinion No. 1987-16, issued by the Commonwealth’s Secretary of Justice, is a legislative overruling of the Puerto Rico Supreme Court’s decision in Lind Rodríguez v. Commonwealth, 112 P.R.Dec. 67 (1982). Plaintiff urges the Court to apply this “legislative overruling” to the instant case. The Supreme Court of Puerto Rico held in Lind that the immunity afforded state doctors is not a personal defense but rather the “inexistence of a cause of action” and that where no cause of action lies against the insured, the insurer is not liable. Id. at 69.
There remains plaintiffs claim against the Municipality of San Juan. Defendants allege such claim is barred by plaintiffs failure to notify the Municipality within ninety days of learning of his damages. Plaintiff cites to numerous cases in which the Supreme Court of Puerto Rico held that failure to comply with the notice requirement did not bar prosecution of a claim. Plaintiff argues that his claim should be allowed to proceed since defendants have not shown that they were prejudiced by the lack of notice.
Puerto Rico’s municipal notification requirement was first established by Article 96 of the Municipal Law, L. No. 142 of July 21, 1960 (codified as
The Court began its review with Mangual v. Tribunal Superior, 88 P.R.Dec. 491 (1963), in which the Court resolved that notification is a strict condition precedent for suing a municipality. The Court noted in Mangual that the purposes of the law were: to grant municipalities the opportunity to investigate claims; to discourage groundless claims; to permit settlement; to permit inspection of the physical location of accidents; to discover the names of witnesses and to interview them while them memories were still reliable; to notify authorities of claims so they could budget for them; and to mitigate damages by offering free medical services to plaintiffs. Id. at 494. In subsequent cases, the . Court held that the notice provision was inapplicable in variety of situations, see García v. Northern Assurance Co., 92 P.R.Dec. 245 (1965) (notice provision doesn’t apply to municipality’s insurance company); Rosario v. Municipio de Ponce, 92 P.R.Dec. 586 (1965) (no application to breach of contract claims); Ins. Co. of P.R. v. Ruiz, 96 P.R.Dec. 175 (1968) (no notice required for mandatory counterclaim filed against a municipality); Díaz v. Municipio de Cayey, 99 P.R.Dec. 196 (1970) (inapplicable to constitutional claim for just compensation for private property taken by eminent domain); Passalacqua v. Municipio de San Juan, 116 P.R.Dec. 618 (1985) (separate notice not required where lawsuit is filed and process is served within ninety days). However, the López Court stressed that its decisions in these eases were not based on the belief that the provision lacked force or because the requirement was unreasonable or so restrictive of plaintiffs’ rights that it should be disregarded. Rather the purposes of the law were simply not implicated in the situations presented in these eases. López, 93 J.T.S. 64 at 10657-58, 134 P.R.Dec. at -. For example, if a municipality sues to recover damages, the defendant should not be barred from bringing a mandatory counterclaim because he failed to comply with the notice requirement. The municipality is presumably well aware of the incident underlying its claim.
In contrast, the Supreme Court found that the facts in
López
reflected precisely the situation to which the notice requirement was directed. López fell on August 21, 1991, at the intersection of Ashford and Condado. Ms. López filed a complaint on November 21, 1991, against the Highway Authority and the Department of Transportation and Public Works. During discovery, the Highway Authority raised as a defense that the place where the accident occurred was under the jurisdiction of the Municipality of San Juan. Ms. López promptly proceeded to notify the municipality but was already outside the ninety-day notification period. The Supreme Court stated that this situation was precisely that which legislators had in mind when they developed the notification scheme. It dealt with: i) an extracontraetual claim for damages; ii) based on the municipality’s alleged fault or negligence; in) initiated by the claimant; iv) directly against the municipality; v) in which the municipality has no way of knowing the essential details of the damage claim absent notification by the plaintiff.
López,
93 J.T.S. 64 at 10658, 134 P.R.Dec. at -;
see also Santiago v. U.S.,
López
reveals the fallacy of plaintiffs contention that the Supreme Court of Puerto Rico has construed the municipal notification provision to apply only when the municipality can show that it is prejudiced by lack of notice. Rather, the Supreme Court has held that notice is not required in specific situations that do not implicate the purposes of the legislative scheme. The instant case
VI. CONCLUSION
Plaintiffs attempts to characterize the defendants’ conduct as something more sinister than medical malpractice are without avail.
IT IS SO ORDERED.
Notes
. While both parties agree that Dr. Alvarado delivered the plaintiff, his medical record at birth nevertheless states that Dr. Ramirez performed the delivery.
. Section 4108, enacted as Article 41.080 of the Puerto Rico Insurance Code, L. No. 74 of May 30, 1976, read:
No health care professional who works exclusively for the Commonwealth of Puerto Rico, its dependencies, instrumentalities and municipalities may be included as defendant party in a complaint for damages for malpractice caused in the discharge of his profession while he acts in compliance with his duties and functions as employee of the Commonwealth of Puerto Rico, its dependencies, instrumental-ities and municipalities.
The Insurance Code was amended by L. No. 4 of December 30, 1986. The immunily originally afforded under Section 4108 was retained in Article 41.050 of the amended Code, which states:
No health service professional may be included as a defendant in a civil suit for damages due to malpractice caused in the performance of his profession while said health service professional acts in compliance with his duties and
functions as an employee of the Commonwealth of Puerto Rico, its dependencies, instru-mentalities and municipalities.
.
Any person who has a claim of any kind against a municipality for personal or property damages due to the fault or negligence of the municipality shall so notify the Mayor, in writing, stating clearly and concisely the date, place, cause and general nature of the damages suffered. Said notification shall specify the amount of monetary compensation or the kind of relief appropriate for the damages suffered, the names and addresses of his/her witnesses, the claimant’s address and, in cases of personal damages, the place where medical treatment was first received.
If the injured party is a minor or a ward, the person exercising patria potestas or the custody of the minor, or the guardian, as the case may be, shall be obliged to notify the Mayor of theclaim within ninety (90) days of the date on which he/she learned of the damages claimed. The above shall not be an obstacle to the minor or ward's making said notification on their own initiative within the specified term, if the person exercising patria potestas, or custody or guardianship fails to do so.