Natale v. Camden County Correctional Facility, 01-3449.

• Decision Date: 07 February 2003
• Docket Number: No. 01-3449.,01-3449.
• Citation: 318 F.3d 575
• Parties: Daniel NATALE; Kathleen Natale, Appellants v. CAMDEN COUNTY CORRECTIONAL FACILITY; County of Camden; Camden County Sheriff's Department; Prison Health Services, Inc. John Doe, MD 1-5; Richard Roe, 1-5
• Court: U.S. Court of Appeals — Third Circuit

318 F.3d 575

Daniel NATALE; Kathleen Natale, Appellants v. CAMDEN COUNTY CORRECTIONAL FACILITY; County of Camden; Camden County Sheriff's Department; Prison Health Services, Inc. John Doe, MD 1-5; Richard Roe, 1-5

No. 01-3449.

United States Court of Appeals, Third Circuit.

Argued June 27, 2002.

Filed February 7, 2003.

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Saul J. Steinberg (Argued), Sufrin, Zucker, Steinberg, Waller & Wixted, Camden, NJ, for Appellant.

Kevin W. Lynch (Argued), White & Williams LLP, Westmont, NJ, for Appellee.

Before AMBRO and STAPLETON, Circuit Judges, O'NEILL,^* District Judge.

OPINION OF THE COURT

AMBRO, Circuit Judge.

We decide two issues: whether New Jersey law required Daniel and Kathleen Natale (collectively, the "Natales"; in the singular, the reference is to Daniel Natale) to file an affidavit of merit in order to state a medical malpractice claim, and whether the Natales provided sufficient evidence of a governmental policy or custom for their claim under 42 U.S.C. § 1983 to survive the motion of Prison Health Services ("PHS") for summary judgment. The District Court dismissed the Natales' malpractice claim on the grounds that New Jersey law required the filing of an affidavit of merit that they did not submit. The District Court granted summary judgment to PHS on the Natales' § 1983 claim because it concluded that they had not presented any evidence of a policy or custom at PHS that deprived Daniel Natale of his constitutional right to adequate medical care.

We reverse and remand both rulings. Because the Natales' malpractice claim falls within the "common knowledge" exception to the affidavit requirement, they did not need to submit the affidavit of a medical expert. In addition, the Natales produced sufficient evidence of a policy or custom at PHS that deprived Daniel Natale of his right to adequate medical care to survive a motion for summary judgment.

I. Background

On the evening of November 23, 1997, Gloucester Township police arrested Daniel Natale, an insulin-dependent diabetic. Before transporting him to the Camden County Correctional Facility ("CCCF"), the police took him to the emergency department of John F. Kennedy Memorial Hospital for a medical clearance prior to incarceration. The physician treating Natale at the hospital gave him a dose of insulin, and wrote a note stating that Natale "must have insulin" while incarcerated. The note did not, however, indicate how often the insulin should be administered.

At 3:30 a.m. on November 24, 1997, Natale arrived at CCCF, where, as part of his initial processing, employees of PHS, a private company that provides health services to CCCF inmates, performed a medical screening. Natale informed PHS employees that he was an insulin-dependent diabetic, and a PHS employee noted this fact on Natale's chart. There is no indication in the record that the PHS employee screening Natale ever asked him how often he needed insulin. Natale was then admitted to the general prison population.

At 12:30 a.m. on November 25, 1997, twenty-one hours after being admitted to CCCF, Natale received his first dose of insulin at that facility. He was released later the same day. Two days later, Natale suffered a stroke. Attributing this stroke to the failure of PHS to administer insulin during the first twenty-one hours of his incarceration. Natale and his wife, Kathleen Natale, filed suit in New Jersey state court on March 9, 1999, alleging medical malpractice and violations of 42 U.S.C. §§ 1981 and 1983. Defendant Camden County removed the action to the United States District Court for the District of New Jersey. Discovery proceeded over the course of the next year.

On July 26, 2000, the District Court ordered sua sponte that the Natales show cause why their medical malpractice claim should not be dismissed for failure to state a claim, citing the Natales' failure to comply with N.J. Stat. Ann. § 2A:53A-27 (the "affidavit of merit statute"), which requires the plaintiff in a malpractice case to file an expert affidavit attesting to the merit of the plaintiff's claim.¹ The District Court also entered summary judgment in favor of CCCF, the County of Camden, and the Camden County Sheriff's Department (the "County Defendants") on the Natales' § 1983 claim, and dismissed the Natales' § 1981 claim as to all defendants.²

On July 24, 2001, the District Court issued an order dismissing the Natales' medical malpractice claim for failure to state a claim as a result of their failure to file an affidavit of merit. On July 30, 2001, the District Court granted PHS's motion for summary judgment on the Natales' § 1983 claim. The District Court's orders dismissing the Natales' malpractice claim and granting summary judgment in favor of PHS on their § 1983 claim were final orders, and the Natales' appeal of both was timely. We have jurisdiction under 28 U.S.C. § 1291.

II. Discussion

A. Dismissal of the Natales' Medical Malpractice Claim

We review de novo the dismissal of the Natales' New Jersey malpractice claim. Island Insteel Sys. Inc. v. Waters, 296 F.3d 200, 206 (3d Cir.2002). The Natales argue that because the issue of negligence in this case was one that could be resolved from the jury's common knowledge without expert testimony, there was no need for an affidavit of merit, citing to the Supreme Court of New Jersey's recent decision in Hubbard v. Reed, 168 N.J. 387, 774 A.2d 495, 499-500 (2001) (holding that no affidavit of merit need be filed in "common knowledge" malpractice cases).

A successful malpractice claim requires a plaintiff to show, inter alia, that a duty of care existed and that the defendant breached that duty.³ Rosenberg v. Cahill, 99 N.J. 318, 492 A.2d 371, 374 (1985). In the typical malpractice case, the duty of care, or "the standard of practice to which the defendant-practitioner failed to adhere[,] must be established by expert testimony." Id. (quoting Sanzari v. Rosenfeld, 34 N.J. 128, 167 A.2d 625, 628 (1961)). But where "the jurors' common knowledge as lay persons is sufficient to enable them, using ordinary understanding and experience, to determine a defendant's negligence without the benefit of the specialized knowledge of experts," Estate of Chin v. Saint Barnabas Med. Ctr., 160 N.J. 454, 734 A.2d 778, 785 (1999), "the jury itself is allowed `to supply the applicable standard of care and thus to obviate the necessity for expert testimony relative thereto.'" Rosenberg, 492 A.2d at 374 (quoting Sanzari, 167 A.2d at 632). The factual predicate for a common knowledge case is one where "`the carelessness of the defendant is readily apparent to anyone of average intelligence and ordinary experience.'" Estate of Chin, 734 A.2d at 785-86 (quoting Rosenberg, 492 A.2d at 375).

The New Jersey legislature enacted the affidavit of merit statute as part of a tort reform package "designed to strike a fair balance between preserving a person's right to sue and controlling nuisance suits." Palanque v. Lambert-Woolley, 168 N.J. 398, 774 A.2d 501, 505 (2001) (internal quotation marks omitted). The statute requires the plaintiff in a malpractice action to file "an affidavit of an appropriate licensed person [stating] that there exists a reasonable probability that the care, skill or knowledge exercised or exhibited in the treatment, practice or work that is the subject of the complaint, fell outside acceptable professional or occupational standards or treatment practices." N.J. Stat. Ann. § 2A:53A-27. The penalty for not following the statute is severe: absent a showing of extraordinary circumstances, the failure to file the affidavit within sixty days of the filing of the answer "shall be deemed a failure to state a cause of action." § 2A:53A-29. This requirement "curtail[s] frivolous litigation without preventing access to the courts for meritorious claims." Palanque, 774 A.2d at 505.

Where, however, common knowledge makes apparent a claim's merit, an expert's affidavit is unnecessary. Hubbard, 774 A.2d at 499-500. In these cases, "the threshold of merit should be readily apparent from a reading of the plaintiff's complaint ... [and] an expert is no more qualified to attest to the merits of a plaintiff's claim than a non-expert." Id. at 500. The District Court concluded that in this case "the crucial issue is whether defendant failed to timely administer medication to Mr. Natale, an insulin-dependent diabetic," and that "[t]he acceptable professional standard for treating an insulin-dependent diabetic is not within a lay person's common knowledge such that PHS's negligence can be determined without the benefit of the specialized knowledge of experts."

We disagree. A reasonable jury could conclude that PHS personnel were negligent absent expert testimony. PHS personnel failed to call Natale's treating physician to determine how often he needed insulin to be administered. They didn't even ask Natale. When "defendant's careless acts are quite obvious," Palanque, 774 A.2d at 506, no affidavit of merit is required. While laypersons are unlikely to know how often insulin-dependent diabetics need insulin, common sense — the judgment imparted by human experience — would tell a layperson that medical personnel charged with caring for an insulin-dependent diabetic should determine how often the diabetic needs insulin. No special expertise or expert testimony is needed to show, at the outset of a case, that the claim is not frivolous. The New Jersey Supreme Court's decision in Hubbard supports this view; thus no affidavit of merit need be filed. The District Court's decision to dismiss the Natales' malpractice claim for failure to file such an affidavit was therefore erroneous, and we reverse.

B. Dismissal of the Natales' 42 U.S.C. § 1983 Claim

The District Court granted summary judgment to PHS on the Natales' § 1983 claim on the ground that they failed to provide any evidence "that a decisionmaker for PHS established a policy or well-settled custom...