John KAUCHER; Dawn Kaucher, h/w, Appellants,
v.
COUNTY OF BUCKS; Michael Fitzpatrick, Charles Martin, Sandra Miller, Individually and as Bucks County Commissioners; Gordian Ehrlacher, Individually and as Director, Bucks County Dept. of Health; Harris Gubernick, Individually and as Director, Bucks Co. Dept. Of Corrections; Willis Morton, Individually and as Warden, Bucks County Correctional Facility; Lewis Polk, M.D., Individually and as Medical Director, Health Dept.; Joan Crowe, Individually and as Nurse, Health Dept.
No. 05-1598.
United States Court of Appeals, Third Circuit.
Argued February 14, 2006.
Filed August 2, 2006.
COPYRIGHT MATERIAL OMITTED David Rudovsky, Esquire (Argued), Kairys, Rudovsky, Epstein & Messing, Philadelphia, PA, Martha Sperling, Esquire, Silver & Sperling, Doylestown, PA, Attorneys for Appellants.
Frank A. Chernak, Esquire (Argued), Ballard Spahr Andrews & Ingersoll, Philadelphia, PA, Attorney for Appellees.
Before SCIRICA, Chief Judge, BARRY and FISHER, Circuit Judges.
OPINION OF THE COURT
SCIRICA, Chief Judge.
John Kaucher, a corrections officer at the Bucks County Correctional Facility, and his wife, Dawn Kaucher, filed suit under 42 U.S.C. § 1983 against the County of Bucks and several County employees responsible for the operation of the Correctional Facility, alleging a violation of their substantive due process rights. The Kauchers contend they contracted Methicilin Resistant Staphylococcus aureus infections as a result of defendants' conscience-shocking behavior in creating unsanitary and dangerous conditions at the jail. The District Court concluded the Kauchers failed to establish a substantive due process violation and granted defendants' motion for summary judgment. For the reasons set forth, we will affirm.
I.
Because this appeal comes to us from an order granting summary judgment in favor of defendants, we present and consider the facts in the light most favorable to plaintiffs. See Nicini v. Morra,
The Pennsylvania Department of Corrections conducts annual inspections of the jail to ensure compliance with statutory standards. After the June 2002 inspection, the Department of Corrections reported the jail was in compliance with the state's standards relating to personal hygiene, sanitation, safety, clothing, and personnel. It issued recommendations for improvement with respect to findings of mold, peeling paint, rusted vents, and leaking roofs, but noted jail officials were making a "good faith effort" to address these issues. In 2003, an expert in prison conditions inspected the jail and reported, among other things, problems with overcrowding, unsanitary conditions, food spoilage, and inadequate methods for handling contaminated clothing.
There had always been cases of inmates with skin infections at the jail, but in July 2002, the County Health Department noted an increase. The Health Department determined the infections were caused by Methicilin Resistant Staphylococcus aureus (MRSA), a drug-resistant strain of staph bacteria. MRSA is only susceptible to a limited number of antibiotics, but most MRSA skin infections can be treated without antibiotics by draining the sores.
MRSA can be spread through direct contact with infected individuals or through contact with materials that have been exposed to the bacteria. Conditions frequently associated with corrections facilities—including overcrowding, shared facilities, and close contact between inmates — can increase the risk of spreading. Unsanitary conditions can exacerbate the problem. The Kauchers contend the increase in skin infections among inmates during the summer of 2002 was the result of defendants' role in creating unsanitary and dangerous conditions at the jail.
Jail medical officials responded to the spread of infection by isolating infected inmates in single-occupancy cells. When single-occupancy cells were not available, infected inmates were isolated in a restricted housing unit, generally reserved for inmates with disciplinary problems. The Kauchers contend these efforts were counterproductive because fear of isolation led many inmates to hide their infections.
One of the County's doctors recommended to two nurses at the jail that inmates be treated with a particular antibiotic proven effective in treating MRSA infections—vancomycin. The doctor was informed that the drug was too costly and that his recommendation should not appear in the jail's medical records. He later testified he believed a "cover-up" was in effect.
Kaucher contends the first infectious disease training he received was in late 2003. But he does not dispute receiving a copy of the jail's standard operating procedures when he was first employed in 1999. These procedures include policies for supervising hospitalized inmates and handling inmates with communicable diseases. They warn that "[e]very inmate should be considered potentially infectious for communicable diseases," (Suppl.App.174), and advise corrections officers to wash their hands frequently and to wear gloves when coming into direct contact with inmates and their possessions.
Kaucher describes two incidents of transporting infected inmates to a hospital for treatment, one during the summer of 2001 and the other during the fall of 2002. These incidents involved handcuffing and shackling the infected inmates and assisting them in using the hospital's telephones and bathrooms. Kaucher contends that in both cases, he was not advised of the inmates' infections or of the risk posed to his own health.
On August 21, 2002, Harris Gubernick, the Bucks County Director of Corrections, issued a memorandum to "quell any concerns about MRSA," and to reassure inmates and jail employees that "the medical staff is aware of the situation and is working diligently to treat those who have been diagnosed." (App. Vol. II 160.) The memorandum stated, "there are NO known cases in the facility," but advised that "proper hygiene is always recommended" to prevent the spread of infection. (Id.) It also reproduced a fact sheet about MRSA from the Department of Health and Human Services' Centers for Disease Control and Prevention, describing colonization, infection, and methods of prevention.
On August 27, 2002, as part of an inmate class action suit contesting conditions of confinement at the jail, a Magistrate Judge ordered that all inmates and staff be screened for MRSA. The order only required testing for MRSA infection, but the jail tested for colonization as well. Colonization occurs when the bacteria are present in the body without causing illness or infection. According to the Centers for Disease Control and Prevention, staph bacteria, including MRSA, are "commonly carried on the skin or in the nose of healthy people," and at any given time, approximately 25% to 30% of people in the United States have staph bacteria colonized in their noses. (App. Vol. I 40.) Of the approximately 1,126 individuals who were tested for colonization, 32 inmates and two corrections officers tested positive. Though colonization does not require treatment, all of the inmates and corrections officers who tested positive were immediately informed and treated to eradicate the colonized bacteria. At that time, Kaucher had no symptoms of an active MRSA infection. But he was given medicated ointment and advised to consult his personal physician.
In 2003, several inmates filed an action for damages against County and jail officials relating to MRSA infections they contracted at the jail. In January 2004, a jury returned a verdict for the plaintiffs. In sustaining the verdict, the District Judge determined the jury had a sufficient basis for concluding the defendants "through deliberate indifference allowed conditions in the facility that were likely to cause disease, injury, or suffering." Keller v. County of Bucks, No. 03-4017,
In April 2003, Kaucher developed MRSA lesions on his chin and chest. He was treated surgically and received a 30-day course of antibiotics. Dawn Kaucher developed an infection earlier, in February 2002. She was hospitalized and received surgical treatment in March 2002 and again in September 2002. She was not employed at the jail, but an expert stated she most likely contracted MRSA from her husband.
On February 27, 2003, the Kauchers filed suit in the District Court for the Eastern District of Pennsylvania, alleging substantive due process violations under 42 U.S.C. § 1983, state law fraudulent misrepresentation, Pennsylvania constitutional violations, and violations of the Family and Medical Leave Act of 1993. Defendants filed a motion for summary judgment, which was granted on all claims on February 7, 2005. The Kauchers appeal, on the sole basis of their § 1983 claim.
II.
The District Court exercised jurisdiction under 28 U.S.C. § 1331 and § 1343(a)(3). We have jurisdiction under 28 U.S.C. § 1291. We exercise plenary review over a district court's order of summary judgment. Shields v. Zuccarini,
Summary judgment is proper "if there is no genuine issue as to any material fact and the moving party is entitled to judgment as a matter of law." Fed.R.Civ.P. 56(c). An issue is genuine only if there is a sufficient evidentiary basis on which a reasonable jury could find for the non-moving party, and a factual dispute is material only if it might affect the outcome of the suit under governing law. Anderson v. Liberty Lobby, Inc.,
III.
Section 19831 provides remedies for deprivations of rights established in the Constitution or federal laws. It does not, by its own terms, create substantive rights. Baker v. McCollan,
The District Court characterized the Kauchers' claim as alleging defendants failed in their duty to provide a safe working environment for the jail's corrections officers. Citing Collins v. City of Harker Heights, Tex.,
On appeal, the Kauchers acknowledge the failure to provide minimum levels of workplace safety does not support an actionable substantive due process claim. But they contend their claim is not based on a right to safe working conditions at the jail. Rather, it is based on defendants' "conscience-shocking" conduct in creating dangerous conditions that led to the spread of infection, in failing to offer sufficient medical treatment to infected inmates and corrections officers, and in misrepresenting the risks of infection. They contend defendants should be held liable for this conduct under the state created danger doctrine.
For the reasons set forth, we agree with the District Court that the Kauchers fail to state a cognizable substantive due process claim. Under the facts alleged, the Kauchers cannot establish defendants' conduct was conscience shocking, nor can they state a valid claim under the state created danger doctrine. At base, they claim defendants failed to provide a safe working environment at the jail, free from risk of infection. Collins forecloses this claim as a basis for substantive due process liability.
A.
We begin our analysis with a review of Collins, where the Supreme Court established the principle—previously applied by lower courts—that the Constitution does not guarantee public employees a safe working environment. See Collins,
The Court began by stressing the importance of "judicial self-restraint" in the area of substantive due process, "because guideposts for responsible decisionmaking in this uncharted area are scarce and open-ended." Id. at 125,
The Court dismissed the first theory by concluding "[n]either the text nor the history of the Due Process Clause supports petitioner's claim that the governmental employer's duty to provide its employees with a safe working environment is a substantive component of the Due Process Clause." Id. Citing DeShaney v. Winnebago County Dept. of Soc. Servs.,
With respect to the second theory, the Court concluded the City's alleged deliberate indifference to the decedent's safety did not rise to the level of conscience-shocking, arbitrary government action. Id. at 128,
The Court's refusal to characterize the city's actions as arbitrary rested on other grounds as well—on "the presumption that the administration of government programs is based on a rational decisionmaking process that takes account of competing social, political, and economic forces." Id. The Court reasoned that policy choices concerning resource allocation are best made by locally elected representatives and not by federal judges interpreting the Due Process Clause. See id. at 128-29,
The Kauchers note that notwithstanding Collins's well-established principle that the Due Process Clause does not guarantee public employees a workplace free of risks of harm, an employee can allege a constitutional violation for an employer's behavior that "shocks the conscience." See id. at 125,
B.
In Lewis, the Supreme Court explained that "the core of the concept" of due process is "protection against arbitrary action," County of Sacramento v. Lewis,
But "the measure of what is conscience shocking is no calibrated yard stick," Lewis,
Because the "exact degree of wrongfulness necessary to reach the `conscience-shocking' level depends upon the circumstances of a particular case," Miller v. City of Philadelphia,
Here, both parties characterize defendants' decisions at the jail as evolving over a period of more than two years. They agree the appropriate standard is deliberate indifference. We note defendants were under some pressure to respond quickly to the spread of infection, and we question whether deliberately indifferent conduct is truly conscience shocking in this context.3 But because we hold defendants' conduct was not even deliberately indifferent, we need not reach the question of whether a higher standard of culpability would be necessary to shock the conscience here.
In a suit challenging prison conditions under the Eighth Amendment, the Supreme Court has equated the concept of deliberate indifference with the criminal law concept of recklessness.4 See Farmer v. Brennan,
a prison official cannot be found liable . . . unless the official knows of and disregards an excessive risk to inmate health and safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference.
Id. at 837,
In Nicini, we recognized that Farmer's subjective deliberate indifference standard did not necessarily apply in other contexts, but we "note[d] that after Farmer the courts of appeals have shown a tendency to apply a purely subjective deliberate indifference standard outside the Eighth Amendment context." Nicini,
Here, under either a subjective or an objective standard, defendants' conduct does not exhibit deliberate indifference to a serious risk of prison officials contracting MRSA infections. There is no evidence that at the time defendants made their decisions as to conditions at the jail, they were aware, or should have been aware, that their remedial and preventative measures were inadequate to protect corrections officers from infections. We note the Department of Corrections found the jail substantially in compliance with state standards in 2002, giving defendants reason to believe the measures were adequate. Because only two of 170 corrections officers tested positive for colonization in 2002, we think defendants could reasonably believe the corrections officers did not face a great risk of infection. And we think no reasonable jury could conclude defendants knew, or should have known, the corrections officers faced a substantial risk.
Furthermore, defendants had in place policies and procedures to ensure sanitary conditions in the jail, including requirements that cells be regularly cleaned with an all-purpose detergent and that showers be disinfected with a bleach and water solution. After conducting their 2002 inspection, the Department of Corrections noted jail officials' good faith efforts to improve conditions. When defendants recognized an increased number of MRSA infections, they took various remedial and preventative measures, including isolating and treating infected inmates and distributing information to staff and inmates. In retrospect, these actions may have been insufficient to prevent the Kauchers' infections. But we evaluate defendants' decisions at the time they were made. See DeShaney,
The Kauchers contend defendants acted with deliberate indifference in providing false and misleading information regarding the dangers of MRSA, and in covering up the extent of the problem. They further contend corrections officers were discouraged from taking preventative measures to protect themselves because of defendants' misrepresentations. This claim rests largely on Gubernick's memorandum, which states "there are NO known cases in the facility." (App. Vol. II 160.) Read in its entirety, the memorandum summarizes the situation at the jail as Gubernick understood it at the time it was issued, and warns inmates and staff to take appropriate precautions. The memorandum states, "[t]he medical staff is aware of the situation and is working diligently to treat those who have been diagnosed." (Id.) A reasonable jury could not conclude the memorandum was intended to mislead corrections officers as to the harm they faced. Nor could a reasonable jury conclude that by distributing it, Gubernick manifested deliberate indifference to a "substantial risk of serious harm" to corrections officers. Ziccardi,
The Kauchers contend Gubernick should have issued a second memorandum when he realized there were, in fact, confirmed cases of MRSA infections at the jail. They contend his failure to do so evidences a "cover-up" of the problem, intended to allow defendants to avoid facing the financial and other costs of properly addressing the outbreak. In the absence of other evidence, and in light of the warnings and suggested precautions in Gubernick's memorandum, we do not think Gubernick's failure to issue a second memorandum could lead a reasonable jury to conclude that a cover-up was in effect or that Gubernick had engaged in conscience-shocking behavior. The first memorandum advised all inmates and staff of the MRSA issue, and of means of protection and prevention. In failing to update it with reports of diagnosed cases, Gubernick neglected to keep inmates and staff fully apprised of the details of the situation. But he did not misrepresent or cover up the situation.
The Kauchers note Dr. Lewis Brandt testified that he suggested infected inmates be treated with a particular antibiotic—vancomycin. He further testified he was informed vancomycin was too expensive, and that he should not put his recommendation in writing. The Kauchers contend this provides further evidence that defendants engaged in a "cover-up" of the problem. But Brandt testified that he made his recommendation to two nurses, only one of whom is named as a defendant. After both nurses rejected his suggestion, he did not discuss vancomycin with any other County or jail official. And at the nurses' instruction, he did not put his suggestion in writing. There is no evidence that any other defendant was aware of Brandt's suggestion. In light of this, there is insufficient evidence that defendants' decision to pursue treatment options other than vancomycin reveals a coordinated "cover-up," designed to misrepresent the risk of infection faced by corrections officers.
Even assuming the jail might have been a safer place to work had defendants treated all infected inmates with vancomycin, defendants' failure to provide a workplace free from health risks cannot form the basis of a substantive due process claim. And even assuming defendants breached a duty to the inmates in failing to use vancomycin, there are well recognized differences between the duties owed to prisoners and the duties owed to employees and others whose liberty is not restricted. See DeShaney,
This case is distinguishable from the cases the Kauchers cite, in which deliberate misrepresentations formed the basis of substantive due process violations. See Kallstrom v. City of Columbus,
This case is also distinguishable from cases cited as examples of conscience-shocking conduct in the workplace. In Eddy v. Virgin Islands Water & Power Authority,
We do not rule out the possibility that the evidence on the record could support a jury finding that defendants acted negligently. But the Kauchers have not alleged conduct that rises to a level of deliberate indifference that could be characterized as conscience shocking.
C.
Nor have the Kauchers alleged a valid claim under the state created danger doctrine. Generally, the Due Process Clause does not impose an affirmative obligation on the state to protect its citizens. See DeShaney,
(1) the harm ultimately caused was foreseeable and fairly direct;
(2) a state actor acted with a degree of culpability that shocks the conscience;
(3) a relationship between the state and the plaintiff existed such that the plaintiff was a foreseeable victim of the defendant's acts, or a member of a discrete class of persons subjected to the potential harm brought about by the state's actions, as opposed to a member of the public in general; and
(4) a state actor affirmatively used his or her authority in a way that created a danger to the citizen or that rendered the citizen more vulnerable to danger than had the state not acted at all.
Bright v. Westmoreland County,
The fourth element of the state created danger test asks whether a defendant exercised his or her authority to create a foreseeably dangerous situation. In Bright, we emphasized that "[i]t is misuse of state authority, rather than a failure to use it, that can violate the Due Process Clause."9
Accordingly, the fourth element is satisfied where the state's action was the "but for cause" of the danger faced by the plaintiff. In Kneipp v. Tedder, we concluded a jury could find this element satisfied where officers used their authority to separate an intoxicated woman from her husband and send her home unescorted.
Where the state's action is not the "but for cause" of the plaintiff's harm, the fourth element is not satisfied. In Morse v. Lower Merion School District,
The Kauchers have not alleged affirmative acts that were the "but for cause" of the risks they faced. They frame their claim in terms of actions affirmatively creating dangerous conditions and affirmatively misrepresenting dangers. But at base, both aspects of their claim allege failures to take actions sufficient to prevent the Kauchers' infections. In the first instance, they contend defendants failed to act affirmatively to improve conditions at the jail. In the second instance, they contend defendants failed to act affirmatively to educate and warn inmates and corrections officers about MRSA and to train them in infection prevention.11
Gubernick's issuance of the memorandum regarding MRSA is the one alleged act that might be characterized as affirmative. But the memorandum was not the "but for cause" of the Kauchers' infections. There had always been cases of staph infections at the jail, including MRSA infections, and there had always been a corresponding risk of infection to inmates and corrections officers. The increase in the number of infections in the summer of 2002 occurred prior to Gubernick's issuance of the memorandum. In fact, the memorandum was issued in response to the outbreak. Accordingly, the memorandum was not the "but for cause" of the outbreak or of the risk of infection faced by Kaucher. To the contrary, the memorandum instructed Kaucher as to appropriate measures to prevent an infection.
In contending defendants caused the outbreak, the Kauchers cite the jury verdict holding County and jail officials liable for the conditions that led to MRSA infections among inmates. But as noted, there are well recognized differences between the duties owed to prisoners and the duties owed to employees and other individuals whose liberty is not restricted. See DeShaney,
Though not based on the state created danger doctrine, Wallace v. Adkins,
Here, too, Kaucher chose to remain employed at the jail, in a position that obliged him to work amidst MRSA infections. From the outset of his employment and well before Gubernick's memorandum was issued, he was aware of the safety risks associated with working in a prison. He was on notice of the jail's standard operating procedures, which described proper methods of handling inmates with communicable diseases. Moreover, with the exception of those related to Gubernick's issuance of his memorandum, all of the Kauchers' allegations relate to defendants' failure to take certain affirmative acts to increase safety standards at the jail. Just as in Wallace, these allegations of omissions are insufficient to trigger substantive due process liability.
The one alleged affirmative act was Gubernick's memorandum regarding MRSA. Under the second part of Wallace's inquiry, we ask what dangers the Kauchers would have faced in the absence of the memorandum, and we conclude the dangers would have been the same. With or without the memorandum, jail employees risked MRSA infections. Had the memorandum actually represented there was no MRSA bacteria present at the jail, the Kauchers might have a claim that Gubernick effectively discouraged corrections officers from taking safety precautions and thereby created a risk for harm that would not otherwise have existed. But we have already concluded the memorandum did not constitute a misrepresentation of the MRSA problem.
Kaucher contends that when he transported infected inmates to the hospital, he faced specific opportunities for harm, created by defendants. He does not allege defendants forced him to perform this part of the job (i.e., that Kaucher objected and defendants insisted), that they forced him to perform it without taking proper preventative measures, or that they threatened to fire him if he declined. Even if defendants acted affirmatively in ordering Kaucher to perform these duties, the situation would be analogous to Wallace. Just as the Wallace plaintiff would have faced danger from the violent inmate whether or not he received a specific order to remain at his post, Kaucher would have faced the danger of contracting an MRSA infection whether or not he received an order to transport an infected inmate to the hospital. In both cases, "these are the risks of the guard's job." Wallace,
The Kauchers have not alleged an affirmative, culpable act on the part of defendants sufficient to implicate the state created danger doctrine. Nor have they alleged conscience-shocking conduct on the part of defendants that could transform a workplace safety claim into a substantive due process claim. At base, the Kauchers contend defendants failed to provide a working environment free from risk of infection—a claim precluded by Collins.
D.
Our conclusion that the Kauchers' claims are precluded by Collins is informed and supported by the Court's admonition that we refrain from importing traditional tort law into the Due Process Clause. This principle, emphasized in Collins, was established well before. See, e.g., DeShaney,
In Washington v. District of Columbia,
Just as in Washington, the Kauchers have alleged what is properly characterized as a tort law claim. They contend defendants breached a duty of care by failing to provide Kaucher a safe work environment. As the Court of Appeals for the D.C. Circuit noted, defendants may have a duty under state law to provide a working environment free from unreasonable risks of harm, but they have no duty to do so under the Constitution. See id. at 1481.
E.
We conclude the Kauchers' claims relate to a failure to remedy conditions at the jail. The Kauchers allege defendants failed to prevent MRSA from spreading through the jail, took insufficient action to protect the jail's corrections officers from contracting an infection, and failed to warn and educate corrections officers in infection prevention. Despite their attempts to characterize defendants' actions as affirmatively creating dangerous conditions, they allege a failure to act to prevent dangerous conditions. Under Collins, this claim must fail. Kaucher "voluntarily accepted[] an offer of employment," Collins,
IV.
For the foregoing reasons, we will affirm the District Court's grant of summary judgment dismissing the Kauchers' claim.
Notes:
Notes
42 U.S.C. § 1983 provides, in part:
Every person who, under color of any statute, ordinance, regulation, custom, or usage, of any State or Territory or the District of Columbia, subjects, or causes to be subjected, any citizen of the United States or other person within the jurisdiction thereof to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws, shall be liable to the party injured in an action at law, suit in equity, or other proper proceeding for redress.
If we determined the Kauchers had alleged a deprivation of a constitutional right, we would proceed to determine (1) whether the individual defendants were entitled to qualified immunity, and (2) whether the County of Bucks could be held liable. But the initial inquiry under the doctrine of qualified immunity and the doctrine of municipal liability asks whether the plaintiff asserted a violation of a cognizable constitutional rightSee Saucier v. Katz,
InLewis, the Court identified deliberate indifference as the appropriate standard for holding prison officials liable for their role in creating unsafe conditions of confinement. The Court noted this standard "rests upon the luxury enjoyed by prison officials of having time to make unhurried judgments, upon the chance for repeated reflection, largely uncomplicated by the pulls of competing obligations." County of Sacramento v. Lewis,
Here, defendants had much more time to deliberate than they would in responding to a prison riot. But their decisionmaking was neither "unhurried" nor "largely uncomplicated by the pulls of competing obligations." Id. at 853,
But in the context of municipal liability, the Court has defined deliberate indifference as "a stringent standard of fault, requiring proof that a municipal actor disregarded a known or obvious consequence of his action."Bd. of County Comm'rs v. Brown,
We have expressed approval of a subjective standard of deliberate indifference in other § 1983 substantive due process cases as wellSee, e.g., Schieber v. City of Philadelphia,
The Kauchers draw our attention to a jury verdict for inmates seeking to hold jail officials liable for their MRSA infections, and to the district judge's opinion in sustaining the verdict: "[t]here was ample evidence from which the jury could conclude that Defendants, including the County, knew of the MRSA infection spreading throughout the prison and failed to take necessary steps to minimize the number of inmates affected."Keller v. County of Bucks, No. 03-4017,
Furthermore, "[i]n order to prevail on a § 1983 claim against multiple defendants, a plaintiff must show that each individual defendant violated his constitutional rights."Estate of Smith v. Marasco (Smith II),
In addition, Dawn Kaucher has not alleged a relationship with defendants such that she was a foreseeable victim. The third element of the test asks whether a plaintiff was part of a "discrete class of persons subjected to [a] potential harm."Morse v. Lower Merion Sch. Dist.,
We noted that "[i]f there were any inconsistency in the holdings of our prior cases regarding the fourth element of a state-created danger claim, the controlling precedent would be ouren banc decision in D.R. by L.R. v. Middle Bucks Area Vo. Tech. School," where we affirmed DeShaney. Bright v. Westmoreland County,
Other courts of appeals agree that under the state created danger doctrine, a defendant's actions must be the "but for cause" that put the plaintiff in a position of danger that otherwise would not have existedSee, e.g., Penilla v. City of Huntington Park,
We have held failures to act cannot form the basis of a valid § 1983 claimSee, e.g., Bright,
