Case Information
UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA NOAH SPATH, et al., Case No. 22-cv-07599-JSC Plaintiffs, ORDER RE: MOTION TO DISMISS v. Re: Dkt. No. 19 COUNTY OF SANTA CLARA, et al., Defendants.
Santa Clara Valley Medical Center related to involuntary treatment Noah received during a mental health crisis. (Dkt. No. 1.) [1]
Before the Court is Defendants’ motion to dismiss. (Dkt. No. 19.) see After carefully considering the briefing, the Court concludes oral argument is unnecessary, N.D. Cal. Civ. L.R. 7-1(b), VACATES the April 19, 2023 hearing, and GRANTS the motion with leave to amend. Noah Spath and his father, Tim Spath, bring claims against the County of Santa Clara and
COMPLAINT ALLEGATIONS
Noah, whose family lives in Santa Clara County, developed mental health issues around the age of 16. (Dkt. No. 1 ¶ 5.) He was initially diagnosed with depression and anxiety disorder and later with schizophrenia. ( Id. ¶ 67.) With effective treatment from his psychiatrist and psychologist, Noah managed his condition, with periodic episodes requiring intervention. ( ¶¶ 6–7.)
On May 12, 2021, at the age of 19, Noah suffered an episode that led him to walk around his neighborhood in his underwear. Tim went looking for Noah around 10:30 p.m. and found Noah’s sweatpants on the sidewalk. ( Id. ¶¶ 69–70.) Tim and Noah’s mother, Tracey Spath, called the Gilroy Police Department and a dispatcher told them Gilroy police had taken Noah to St. Louise Regional Hospital on a Welfare & Institutions Code § 5150 hold. ( Id. ¶ 71.) St. Louise is “not an approved location for [Section] 5150 evaluation and treatment.” ( Id. ¶ 72.) Instead, Gilroy police used St. Louise “as a temporary location pending transfer to the county mental health facility at Santa Clara Valley Medical Center” (“SCVMC”), which is “one of several facilities designated by the Santa Clara County Behavioral Health Department for involuntary assessment, evaluation, and for [Section] 5150 holds.” ( Id. ¶¶ 72–73.) St. Louise staff initially diagnosed Noah as tachycardic and COVID-19 positive. ( Id. ¶¶ 30, 75.) He was held in the emergency department overnight while waiting for a bed in emergency psychiatric services at SCVMC. ( Id. ¶ 74.) On the morning of May 13, Noah walked out of the hospital of his own accord. ( Id. ¶¶ 31,
76.) Gilroy police found Noah hiding under a car. ( Id. ¶ 76.) St. Louise informed the police that Noah was on a Section 5150 hold and COVID-19 positive, and the officers brought Noah back to St. Louise. ( Id. ) Noah told St. Louise staff he had left because he did not think he needed to go to an emergency psychiatric facility. ( Id. ¶ 33.) A St. Louise emergency department physician gave Noah the “final psychiatric diagnoses” of psychosis and suicidal ideation. ( Id. ¶¶ 32, 77.) St. Louise staff spoke with SCVMC’s emergency psychiatric services and informed them about Noah’s medical status. ( Id. ¶¶ 77, 79.) Gilroy police stayed at Noah’s bedside until paramedics transferred Noah, in restraints, to SCVMC’s emergency psychiatric services. ( Id. ¶¶ 34–35, 78, 80.) He arrived around 1:00 p.m. on May 13. ( Id. ¶ 80.)
Noah waited for four hours in emergency psychiatric services, without receiving psychiatric treatment, until around 5:00 p.m., when he was transferred to the SCVMC emergency department “for medical clearance for his known fever and positive COVID test.” ( ¶ 81.)
This transfer took Noah away from the secure and safe mental health facility and put him with the general population, without any mental health professional accompanying him, and in an unsafe and unsecure environment.
He was in minor distress and had no symptoms or risk factors to require treatment other than isolation to protect others. His Covid symptoms were consistent with the same symptoms he exhibited at [St. Louise]. ( Id. ¶¶ 82–83.) Two people who were not mental health professionals escorted Noah. ( Id. ¶¶ 42, 82, 85.) Neither wore a mask or interacted with Noah other than to tell him where to go. ( Id. ¶¶ 40, 42, 85.) Noah did not wear a mask in the emergency department. ( Id. ¶¶ 40, 85.)
Noah “did not want or need” COVID treatment and objected to treatment. ( Id. ¶¶ 37, 84, 90.) Noah “was placed in a room,” “required to lie in a bed,” and given an IV against his will and without his consent or his parents’ consent. ( Id. ¶¶ 37, 83, 86, 90, 92.) “He begged to go home but he was ignored.” ( Id. ¶ 83.)
By this time, Noah had been detained for over 24 hours without
receiving any psychiatric treatment. He had been without his support system which included his home, his family, and his psychiatrist,
without receiving any compensating treatment or assistance. His medications were at home and not available to him. Whatever his condition was at the time that [Gilroy police] first detained him, was worsening due to a lack of care, support, medication, and medical assistance.
( Id. ¶ 88; see id. ¶ 39.) Throughout the Section 5150 hold, Noah “never received any mental health assessment, evaluation, or treatment at SCVMC despite being initially admitted to [emergency psychiatric services].” ( Id. ¶ 89.) While Noah’s escort “was busy texting on his cell phone,” Noah removed the IV, left the room, and wandered away. ( Id. ¶ 43.) Across the street from the hospital, Noah borrowed a phone from a college security guard, called his parents, and asked them to pick him up. ( Id. ¶ 45.) Tim and Tracey “were immediately aware of their son’s danger and the imminence of his injury.” ( Id. ¶ 152.) Tim drove in a rush to get Noah. ( Id. ¶ 46.) Tracey called SCVMC “to find out what was going on and why her son was not getting treatment.” ( Id. ¶ 47.) “She had been on the phone over these many hours trying to coordinate treatment and support services,” but “never received any assistance for her son.” ( Id. ¶¶ 47, 150.)
While Noah was waiting for Tim, SCVMC staff panicked and located Noah. ( Id. ¶ 48.) “Their panic and aggression created terror in Noah’s fragile state” and he “fled to the fourth floor of a nearby parking structure.” ( Id. ¶¶ 48–49.) As staff ran after him, Noah jumped off the ledge of the parking structure into a tree. ( ¶ 49.) Noah “begged to see his parents” but was “not allowed to speak to [them] by phone.” ( Id. ¶¶ 49, 52.) The SCVMC staff at the scene did not call in a psychiatrist, mental health professional, negotiator, or interventionalist. ( Id. ¶¶ 50–51.) “Desperate, psychotic, and untreated, Noah jumped from the tree.” ( Id. ¶ 53.) “He landed flat on his face and lost consciousness.” ( Id. ¶ 54.) Tim arrived “just after his son dropped from the tree to the ground” and was aware Noah had been injured. ( Id. ¶¶ 149, 151.) As a result of the fall, Noah “suffers from permanent brain damage, . . . is partially crippled, and has a myriad of disabilities which require a lifetime of care.” ( ¶ 55.)
Noah, through Tracey as guardian ad litem, (Dkt. No. 13), brings claims of (1) unreasonable seizure in violation of the Fourth Amendment to the U.S. Constitution and Article I, Section 13 of the California Constitution; (2) denial of due process in violation of the Fifth and Fourteenth Amendments to the U.S. Constitution and Article I, Section 7 of the California Constitution; (3) violation of California’s Bane Act; (4) negligence; and (5) medical negligence in violation of California’s Medical Injury Compensation Reform Act (“MICRA”). Tim brings a claim of (6) negligence. DISCUSSION I. NOAH’S CONSTITUTIONAL CLAIMS A. Federal Constitutional Rights (Counts One and Two) To state a claim under Section 1983 against a municipality, a plaintiff must allege: “(1)
[he] had a constitutional right of which he was deprived; (2) the municipality had a policy; (3) the
policy amounts to deliberate indifference to his constitutional right; and (4) the policy is the
moving force behind the constitutional violation.”
Gordon v. County of Orange
,
Section 5150 allows certain medical professionals and law enforcement officers to place a
person in an approved mental health facility for up to 72 hours for evaluation and treatment if
there is probable cause to believe the person “is a danger to others, or to himself or herself, or
gravely disabled” “as a result of a mental health disorder.” Cal. Welf. & Inst. Code § 5150(a);
see
Bias v. Moynihan
,
Because the gravamen of the complaint relates to conduct during the Section 5150 hold
(not its initiation) by medical professionals (not law enforcement), the Fourteenth Amendment due
process clause is the proper framework for the federal constitutional claims.
See Maag
, 960 F.2d
at 775;
Austen v. County of Los Angeles
, No. 15-07372 DDP (FFMX),
governs Fourteenth Amendment due process claims.
Ammons v. Wash. Dep’t of Soc. & Health
Servs.
,
While “[m]any of the cases applying
Youngberg
address the [Fourteenth Amendment]
right of involuntarily committed individuals to ‘safe conditions,’”
Townsend
,
The complaint plausibly alleges violations of that standard. The complaint alleges police
took Noah into custody due to his mental health crisis. Noah was diagnosed at St. Louise with
psychosis and suicidal ideation and St. Louise communicated those diagnoses to SCVMC. Noah
did not receive psychiatric treatment for more than 24 hours, was deprived of his usual
medications at home, and was not able to speak with his parents or other support. Although Noah
had walked out of St. Louise earlier the same day, he was again able to leave SCVMC without
being stopped. After Noah left SCVMC and jumped into a tree, staff pursued him in a way that
escalated his crisis rather than calling in another kind of professional. These allegations plausibly
support an inference that the care Noah received while involuntarily detained fell substantially
below the generally accepted standards or constituted a substantial departure from accepted
professional judgment.
See Ammons
,
The complaint also alleges Noah objected to and refused medical treatment that was
unrelated to his psychiatric condition, plausibly supporting an inference that he was competent to
refuse such treatment. After Noah was transferred from emergency psychiatric services, he was
not isolated or masked, his escorts were not masked, and he was placed in the emergency
department around members of the public. He was treated with an IV to which he objected and
did not consent. As alleged, forced medical treatment unrelated to the psychiatric basis for Noah’s
Section 5150 hold plausibly supports an inference the treatment fell substantially below the
generally accepted standards or constituted a substantial departure from accepted professional
judgment.
See Ammons
,
officials responsible for establishing final policy with respect to the subject matter in question.” (cleaned up). A plaintiff can satisfy Monell ’s policy requirement in one of three ways. First, a local government may be held liable when it acts pursuant to an expressly adopted official policy. Second, a public entity may be held liable for a longstanding practice
or custom. Such circumstances may arise when, for instance, the
public entity fails to implement procedural safeguards to prevent
constitutional violations or, sometimes, when it fails to train its
employees adequately.
Third, a local government may be held liable under Section 1983
when the individual who committed the constitutional tort was an
official with final policy-making authority or such an official ratified
a subordinate’s unconstitutional decision or action and the basis for
it.
Gordon
,
The complaint does not explain which form of municipal policy the Spaths are
challenging. Nor does it identify a specific policy. It offers only conclusory allegations,
see
Ashcroft v. Iqbal
,
Accordingly, the complaint does not state a Section 1983 claim against the municipality Defendants.
B. State Constitutional Rights (Counts One and Two)
The protections of Article I, Section 7 of the California Constitution “substantially
overlap” with Fourteenth Amendment due process.
Today’s Fresh Start, Inc. v. L.A. Cnty. Off. of
Educ.
,
Similarly, the protections of Article I, Section 13 “parallel[]” those of the Fourth
Amendment.
Sanchez v. County of San Diego
,
* * *
The Spaths’ complaint adequately alleges only the first of four elements required to state a
Fourteenth Amendment Section 1983 claim against Defendants.
See Gordon
,
II. STATE LAW CLAIMS
A. Tim’s Negligence Claim (Count Six)
Tim’s negligence claim is based on emotional distress he suffered when he “arrived just
after his son dropped from the tree to the ground” and was immediately “aware that his child had
been injured.” (Dkt. No. 1 ¶¶ 149, 151.) The complaint does not allege Tim was physically
injured.
Cf. Long v. PKS, Inc.
,
a plaintiff may recover damages for emotional distress caused by observing the negligently inflicted injury of a third person if, but only if, said plaintiff: (1) is closely related to the injury victim; (2) is present at the scene of the injury producing event at the time it occurs and is then aware that it is causing injury to the victim; and (3) as a result suffers serious emotional distress—a reaction beyond that which would be anticipated in a disinterested witness and which is not an abnormal response to the circumstances.
Thing v. La Chusa
,
The complaint does not satisfy the second requirement because it does not allege Tim was
present at the scene at the time Noah’s injury occurred. Nor does it allege Tim
contemporaneously perceived the injury-producing event in some other way. Accordingly, Tim
does not state a claim for negligence. Defendants’ motion is GRANTED as to count six of the
complaint, with leave to amend.
See Yagman
,
B. Noah’s Bane Act Claim (Count Three) The Tom Bane Civil Rights Act authorizes “[a]ny individual whose exercise or enjoyment of rights secured by the Constitution or laws of the United States, or of rights secured by the Constitution or laws of this state, has been interfered with, or attempted to be interfered with,” to sue for damages. Cal. Civ. Code § 52.1(c). Interference means “a person or persons” “interferes by threat, intimidation, or coercion, or attempts to interfere by threat, intimidation, or coercion.” Id. § 52.1(b). Although “[n]o California court has directly interpreted the Bane Act’s ‘person or persons’ language” with respect to municipalities, “several federal courts interpreting the statute have concluded municipalities do fall within its purview.” Sanchez v. City of Fresno , 914 F. Supp. 2d 1079, 1117 (E.D. Cal. 2012); see Aguilar v. City of South Gate , No. 2:12-CV-10669-ODW, 2013 WL 300914, at *6 (C.D. Cal. Jan. 25, 2013) (“[E]ven cursory research into Bane Act jurisprudence reveals myriad cases pled directly against cities.”). Following the reasoning of those cases, Defendants’ motion to dismiss on the basis that the Bane Act does not apply to municipalities is DENIED.
However, the Bane Act does not override any statutory immunity that otherwise expressly
bars a claim.
See Towery v. State
,
C. Immunities (as to Counts Three, Four, and Five)
“In California, all government tort liability is dependent on the existence of an authorizing
statute or enactment.”
Herd v. County of San Bernardino
,
It establishes the basic rules that public entities are immune from 17 18
16 (cleaned up; citing Cal. Gov. Code §§ 815, 815.2, 820). Defendants invoke five immunities [2] under the Act. Section 856.2 provides, in part: as otherwise provided by statute. for their torts except as otherwise provided by statute, that public entities are vicariously liable for the torts of their employees, and that public entities are immune where their employees are immune, except liability except as provided by statute, that public employees are liable 1. Section 856.2 – Injury by or to escaped person confined for mental illness 19 (a) Neither a public entity nor a public employee is liable for: 20 (1) An injury caused by an escaping or escaped person who has been confined for mental illness or addiction. 21 (2) An injury to, or the wrongful death of, an escaping or
22
escaped person who has been confined for mental illness or addiction.
Cal. Gov. Code § 856.2(a). “[A] person on a 72-hour psychiatric hold is ‘confined’ for purposes
23
of section 856.2.”
L.A. Cnty.-U.S.C. Med. Ctr. v. Superior Ct.
,
27
[2]
As Defendants do not invoke Section 820.2 (Discretionary acts), the Spaths’ arguments about
Defendants’ obligation to treat Noah are not on point.
See Caldwell v. Montoya
,
The Spaths argue Noah was no longer “confined” within the meaning of Section 856.2 because the Section 5150 hold became an unlawful detention as a result of Noah not receiving psychiatric treatment. This argument is inconsistent with the California Court of Appeal’s reasoning in Los Angeles County : Negligence in restraining a patient on a 72-hour hold does not serve to vitiate the escape immunity of section 856.2. . . . [T]he Pedregons argue . . . that Lucy ‘was not confined and therefore could not escape within the meaning of section 856.2’ because she ‘was left unattended and could have exited from a number of places in the hospital.’ . . . The Pedregons’ position confuses the issue of negligence with the immunity issue. The contention that negligent failure to adequately confine a mental patient would negate the escape immunity in section 856.2 [has been] rejected . . . . Before discussing any immunity, one assumes as a matter of course that there is a basis for liability to which the immunity is relevant .
Thus, Section 856.2 immunity shields Defendants, who are public entities, from liability
for Noah’s injuries when he was “escaping” or after he had “escaped” from SCVMC. Cal. Gov.
Code § 856.2(a)(1), (2). However, the complaint alleges Noah was harmed not only by injuring
himself after he escaped (that is, walked out of the hospital), but also by Defendants’ failure to
provide psychiatric treatment before he escaped.
Cf. Brookhouser v. State
,
2. Section 854.8 – Injury by or to a patient Section 854.8 provides, in part:
(a) Notwithstanding any other provision of this part, except as provided in this section and in Sections 814, 814.2, 855, and 855.2, a public entity is not liable for:
(1) An injury proximately caused by a patient of a mental institution. (2) An injury to an inpatient of a mental institution.
Cal. Gov. Code § 854.8(a).
Section 854.8 “provides immunity for diagnosing, treating, confining, and releasing the
mentally ill, but makes clear that public entitles and employees are liable for injuries caused by
negligent or wrongful acts or omissions in administering or failing to administer prescribed
treatment or confinement.”
Los Angeles County v. Superior Ct. of L.A. Cnty.
,
The Spaths invoke the Section 855 exception to Section 854.8 immunity, see Cal. Gov. Code § 854.8(a), which states:
A public entity that operates or maintains any medical facility that is
subject to regulation by the State Department of Health Services,
Social Services, Developmental Services, or Mental Health is liable
for injury proximately caused by the failure of the public entity to
provide adequate or sufficient equipment, personnel or facilities
required by any statute or any regulation of the State Department of
Health Services, Social Services, Developmental Services, or Mental
Health prescribing minimum standards for equipment, personnel or
facilities, unless the public entity establishes that it exercised
reasonable diligence to comply with the applicable statute or
regulation.
Id.
§ 855(a). Section 855 is “intended to impose liability only when [a] statute or regulation sets
forth a specific standard that gives the public medical facility clear notice as to the minimum
requirements with which it must comply.”
Lockhart v. County of Los Angeles
, 155 Cal. App. 4th
289, 308 (2007),
as modified
(Sept. 19, 2007),
as modified
(Oct. 4, 2007). The Spaths’ opposition
to the motion to dismiss argues Noah’s injuries were proximately caused by Defendants’ failure to
provide adequate equipment, personnel, or facilities. But their complaint does not allege that, nor
does it cite any “specific standard.” Accordingly, the complaint allegations do not support a
plausible inference that the Section 855 exception to Section 854.8 immunity applies.
See Brackin
v. Cal. Dep’t of State Hosps.
, No. C 15-03351 WHA,
On the face of the complaint, Noah’s Bane Act claim, negligence claim, and medical
negligence claim under MICRA are barred in part by Section 856.2 immunity and in whole by
Section 854.8 immunity. Accordingly, Defendants’ motion to dismiss is GRANTED as to counts
three, four, and five, with leave to amend.
See Caldwell
,
CONCLUSION
Defendants’ motion to dismiss is GRANTED. The Spaths may file an amended complaint on or before May 10, 2023. The April 19, 2023 initial case management conference is CONTINUED to July 6, 2023 at 1:30 p.m. by Zoom video.
This Order disposes of Docket No. 19.
IT IS SO ORDERED.
Dated: April 17, 2023
JACQUELINE SCOTT CORLEY United States District Judge
Notes
[1] Record citations are to material in the Electronic Case File (“ECF”); pinpoint citations are to the ECF-generated page numbers at the top of the documents.