Ruiz-Rosa v. Rullán

• Decision Date: 24 April 2007
• Docket Number: No. 06-1761.,06-1761.
• Parties: Angelina RUIZ-ROSA, Plaintiff, Appellant, v. Johnny RULLÁN, Secretary of the Department of Health of the Commonwealth of Puerto Rico, et al., Defendants, Appellees.
• Court: U.S. Court of Appeals — First Circuit

485 F.3d 150

Angelina RUIZ-ROSA, Plaintiff, Appellant, v. Johnny RULLÁN, Secretary of the Department of Health of the Commonwealth of Puerto Rico, et al., Defendants, Appellees.

No. 06-1761.

United States Court of Appeals, First Circuit.

Heard March 9, 2007.

Decided April 24, 2007.

José R. Olmo-Rodríguez, for appellant.

Susana I. Peñagarícano-Brown, Assistant Solicitor General, Department of Justice, with whom Salvador J. Antonetti-Stutts, Solicitor General, and Maite D. Oronoz-Rodríguez, Deputy Solicitor General, were on brief, for appellees.

Before TORRUELLA and LIPEZ, Circuit Judges, and DiCLERICO, JR.,^* District Judge.

DiCLERICO, District Judge.

Angelina Ruiz-Rosa brought suit against officials of the Puerto Rico prison system and prison medical personnel after her eighteen-year-old son, Jose Luis Machuca-Ruiz, died of septicemia while being detained at the Bayamón 1072 Correctional Complex ("BCC"). In her amended complaint, Ruiz alleged violations of the Fifth, Eighth, and Fourteenth Amendments, actionable under 42 U.S.C. § 1983, and medical malpractice under Puerto Rico law. The district court dismissed her suit as a sanction for failing to comply with its order to allege her claims as directed, and alternatively, granted summary judgment in the defendants' favor on the federal claim, and declined supplemental jurisdiction as to the malpractice claim, which was dismissed without prejudice.

Background¹

Jose Luis Machuca-Ruiz was incarcerated at BCC beginning on September 19, 2001. On November 21, 2001, he reported to sick call, requesting medical care for a skin infection on his upper right thigh. He was evaluated and given topical medication. The infection worsened, and Machuca was seen in the prison's emergency room on December 5 when the attending doctor found a mass in his upper right thigh area, ordered a complete blood count ("CBC"), and prescribed Tylenol. Another doctor examined Machuca in the emergency room later in the day and noted swollen lymph nodes (adenopathy), with high fever and pain. Machuca was discharged from the emergency room early in the morning of December 6 before the results of the CBC were available.

The prison received the results of Machuca's CBC test later in the day on December 6. The results showed that he had an elevated white blood count, including elevated readings for neutrophils. He was given an antibiotic, which his mother contends was not effective to fight the type of infection that he had. On December 8, Machuca returned to the prison emergency room because of pain. The infection site showed signs of worsening, as his leg was tender, swollen, and red. The next day, Machuca was diagnosed with cellulitis in his right thigh. On December 10, another doctor in the prison emergency room diagnosed Machuca with a right thigh abscess and referred him to the prison infirmary.

Dr. Pichardo, the prison's part-time surgeon, was consulted about Machuca's case. Dr. Pichardo drained the abscess, ordered a culture of the abscess discharge, and ordered a second antibiotic. After the surgery, Dr. Pichardo, who worked at the prison only two days each week, did not do a follow up evaluation. On December 12, Machuca began to experience headaches and the wound site was secreting pus. During the night of December 12, Machuca began to experience respiratory problems. Early in the morning of December 13, Machuca was transferred to Bayamón Regional Hospital, where he died the next day.

Angelina Ruiz-Rosa brought suit on her own behalf and on behalf of her deceased son on April 12, 2004. She alleged federal civil rights claims based on violations of the Fifth, Eighth, and Fourteenth Amendments and claims under Puerto Rico law of negligence and medical malpractice. Ruiz brought her claims against the Puerto Rico Administrator of Corrections, Victor Rivera González; the Secretary of the Department of Health, Johnny Rullán; the Chief Health Care Coordinator for Puerto Rico, Aida Guzmán-Font; the Medical Director at BCC, Hector Mena; medical doctors at BCC, including Rafael Pichardo; unnamed nurses at BCC; the unnamed Superintendent of BCC; and unidentified insurance companies.

The defendants filed a motion to dismiss in July of 2004 and also filed an answer to Ruiz's complaint. During the fall of 2004 and the winter of 2005, Ruiz moved to substitute some named parties for the John Doe defendants and to extend the deadlines for discovery and for identifying other defendants. With their motion to dismiss still pending, the defendants moved for summary judgment on March 15, 2005. On March 21, 2005, the district court denied the defendants' motion to dismiss but found that "the complaint jumbles the allegations pertaining to the constitutional tort with those partaking of a medical malpractice, and imputes all defendants with liability under either legal theory." The court ordered Ruiz to file an amended complaint, on or before April 18, to "separate the factual allegations corresponding to each legal theory of liability, and ... also define which defendants are liable under each of the theories, and for what actions." The court also warned Ruiz that failure to file an amended complaint as ordered would result in dismissal of her case. The court denied Ruiz's motions to substitute parties and to extend discovery deadlines.

Ruiz filed an amended complaint within the time allowed. The amended complaint named several new defendants in place of John Doe defendants. Ruiz also moved to dismiss all claims against Victor Rivera González. The court dismissed the claims against Rivera and against Hector Mena. The defendants supplemented their motion for summary judgment after the amended complaint was filed, and Ruiz filed a response. On February 15, 2006, the court dismissed the defendants who had been named as John Does but were then identified by name in Ruiz's amended complaint. On February 28, 2006, the court found that Ruiz's amended complaint did not comply with the order to separate her allegations as to each of her theories of liability and as to each defendant and dismissed all of Ruiz's claims as a sanction for noncompliance. At the same time, the court granted the defendants' motion for summary judgment on Ruiz's federal claim and declined supplemental jurisdiction as to her malpractice claim under Puerto Rico law, which was dismissed without prejudice.

Discussion

Ruiz appeals the district court's order that dismissed her claims as a sanction and alternatively granted summary judgment in the defendants' favor on her federal claims.² She contends that dismissing her claims as a sanction was inappropriate and that the district court erred in granting summary judgment in the defendants' favor on her federal claim. The remaining defendants, Johnny Rullán, Aida Guzmán-Font, and Rafael Pichardo, defend the district court's decision to dismiss Ruiz's claims as a sanction and argue that summary judgment was properly granted.³

A. Dismissal as Sanction

In response to a defendant's motion, a court may dismiss an action "[f]or failure of the plaintiff to prosecute or to comply with ... any order of court." Fed. R.Civ.P. 41(b). A dismissal entered to sanction a party for failure to comply with a court's order or for failure to prosecute the case is reviewed for abuse of discretion. Malot v. Dorado Beach Cottages Assocs., 478 F.3d 40, 44 (1st Cir.2007). In determining whether an abuse of discretion has occurred, "we must fairly balance the court's venerable authority over case management with the larger concerns of justice, including the strong presumption in favor of deciding cases on the merits." Id.

Dismissal with prejudice, along with contempt, are the most severe penalties that may be ordered against a recalcitrant party. Benitez-Garcia v. Gonzalez-Vega, 468 F.3d 1, 4 (1st Cir.2006). We therefore reserve dismissal with prejudice for egregious misconduct that is measured by considering all aspects of the case, including "`the severity of the violation, the legitimacy of the party's excuse, repetition of violations, the deliberateness vel non of the misconduct, mitigating excuses, prejudice to the other side and to the operations of the court, and the adequacy of lesser sanctions.'" Id. at 5 (quoting Robson v. Hallenbeck, 81 F.3d 1, 2-3 (1st Cir.1996)). In addition, procedural fairness mandates that the plaintiff be afforded an opportunity to explain her noncompliance or to advocate for a lesser sanction. Id. at 7.

In this case, the district court found Ruiz's original complaint wanting, but instead of dismissing her claims, the court granted her an opportunity to file a more clearly stated complaint. Ruiz filed an amended complaint within the time the court allowed. As directed, Ruiz separated her claims into separate causes of action, alleging deliberate indifference to serious medical needs under federal law as her first claim and medical malpractice under Puerto Rico law as her second claim. Ruiz alleged particular actions and conduct by each defendant, including the newly named defendants, in support of her federal claim. For her malpractice claim, however, Ruiz adopted by reference all of the allegations made in support of the federal claim and stated that those "acts and omissions, also amount to gross negligence and/or fault under Puerto Rico" law.

The district court found Ruiz's amended complaint deficient, concluding that she "utterly failed to comply with our Order of March 21, 2005." In particular, the court faulted Ruiz for "once again jumbl[ing] the allegations pertaining to the constitutional violation based on denial of medical care with those which would sustain a tort for medical malpractice, and unabashedly reassert[ing] that all defendants are liable under both legal theories." The court also found it unacceptable that Ruiz adopted by reference all of the facts alleged in support of her federal claim to support her malpractice claim.⁴ The court concluded that...