Benn v. Universal Health System, Inc.

• Decision Date: 17 June 2004
• Docket Number: No. 01-3450.,01-3450.
• Citation: 371 F.3d 165
• Parties: Donald BENN, Appellant v. UNIVERSAL HEALTH SYSTEM, INC.; Horsham Clinic; Ramesh Eluri, Dr.; Eileen Wilcox; Montgomery County MH-MR Emergency Service, d/b/a Montgomery County Emergency Service, Inc.; Venu Mukerjee, Dr., Individually, severally, jointly and/or in the alternative; Stephen Zerby, M.D.; Mohammad Quasim, Dr., c/o Montgomery County Emergency Service, Inc. 50 Beech Drive Norristown, PA 19401 Individually, Severally, Jointly and/or in the Alternative.
• Court: U.S. Court of Appeals — Third Circuit

371 F.3d 165

Donald BENN, Appellant v. UNIVERSAL HEALTH SYSTEM, INC.; Horsham Clinic; Ramesh Eluri, Dr.; Eileen Wilcox; Montgomery County MH-MR Emergency Service, d/b/a Montgomery County Emergency Service, Inc.; Venu Mukerjee, Dr., Individually, severally, jointly and/or in the alternative; Stephen Zerby, M.D.; Mohammad Quasim, Dr., c/o Montgomery County Emergency Service, Inc. 50 Beech Drive Norristown, PA 19401 Individually, Severally, Jointly and/or in the Alternative.

No. 01-3450.

United States Court of Appeals, Third Circuit.

Submitted Under Third Circuit LAR 34.1(a) December 4, 2003.

Decided June 17, 2004.

COPYRIGHT MATERIAL OMITTED

Ross Begelman, Begelman & Orlow, Cherry Hill, NJ, for Appellant.

Kevin J. O'Brien, Marks, O'Neill, O'Brien, & Courtney, Philadelphia, PA, Kenneth D. Powell, Jr., Rawle & Henderson, Media, PA, Charles W. Craven, Marion H. Griffin, Marshall, Dennehey, Warner, Coleman & Goggin, Philadelphia, PA, for Appellees.

Before: SLOVITER, ALITO, Circuit Judges, and OBERDORFER,^* District Court Judge.

OPINION OF THE COURT

ALITO, Circuit Judge:

This case concerns Donald Benn's short-term involuntary commitment to a psychiatric facility for an emergency examination. After his release, Benn brought federal and state claims against those involved in his commitment. The District Court granted summary judgment in favor of all defendants. We affirm.

I.

Prior to the events at issue here, Donald Benn was under the care of therapist Dr. Jack Hartke and psychiatrist Dr. Lynn Bornfriend, both of whom had treated him for depression and post-traumatic stress disorder. The treatment included anti-depressant medication.

On August 15, 1998, Benn telephoned the Horsham Clinic ("Horsham") three times. Horsham, a mental healthcare facility in Montgomery County, Pennsylvania, is wholly owned by Universal Health System, Inc. ("UHS"). Each time Benn called Horsham, he spoke to Eileen Wilcox, an experienced crisis-line counselor. Benn told Wilcox that he was looking for treatment for post-traumatic stress disorder and was interested in Horsham. Benn admits that during one conversation he told Wilcox that he was driving over the Tacony-Palmyra Bridge. Wilcox claims that Benn told her he had stopped his car and had considered jumping off the bridge. Benn denies this. Wilcox told Benn that Horsham did not make regular outpatient appointments but that they would assess his need for care if he came in.

Benn arrived at Horsham late that evening and was quickly interviewed by psychiatrist Dr. Ramesh Eluri. The interview lasted 40 minutes, and Dr. Eluri claims that, during the interview, Benn admitted to being depressed and suicidal. Benn asserts that he never told Dr. Eluri that he was suicidal and that Dr. Eluri misunderstood him because of Dr. Eluri's poor English. After the interview, Dr. Eluri told Wilcox that he was concerned for Benn's safety and that a petition for involuntary commitment might be necessary because Benn refused to seek treatment. Benn, however, did agree to sign a "Contract for Safety," which stated:

I, Donald Benn on August 15, 1998 agreed to keep myself safe and that if I feel any increase of suicidal thoughts or feeling I will contact Horsham Clinic [or] the police." Below the contract, Benn wrote: "While there is no doubt what-so-ever that my mental/emotional health has been GREATLY compromised I feel as certain as certain can be that a few more days won't hurt (too much)."

Wilcox asked Benn to remain at the clinic while Dr. Eluri looked over the contract, but Benn refused and left.

Upon seeing the contract, Dr. Eluri's concern about Benn's safety grew, and he filed an application under a provision of Pennsylvania's Mental Health Procedures Act (MHPA), 50 Pa. Stat. Ann. § 7302(a), requesting that Benn be examined to determine his need for treatment. See App. 240-42. The application stated:

[Benn] said he had seriously thought about jumping from Coney Bridge [sic], while he was driving. In fact, he stopped the car. He admits feeling suicidal now and feels unsafe and unstable. He also believes that his mental health is compromised and needs hospitalization. He also says he had suicidal thoughts consistently for the past few weeks. He is vague about his attempts ... In my assessment, Pt. is very suicidal, feels unsafe and dangerous to himself. He needs inpatient treatment.

App. 242.

The petition was reviewed by the county administrator, who authorized the police to take Benn into custody. The police went to Benn's home, and he was transported by ambulance to Montgomery County Emergency Service Inc. ("MCES"), a private, not-for-profit psychiatric hospital in Norristown, Pennsylvania, that, by contract handles all involuntary and emergency psychiatric confinements in the county.

Upon arrival at MCES, Benn was placed in an isolated waiting room. He was then seen by Dr. Stephen Zerby, an MCES psychiatrist, who conducted an hour-long interview and decided, based on the interview and Dr. Eluri's petition, that Benn should be admitted for an emergency examination for the period permitted by the MHPA, 50 Pa. Stat. Ann. § 7302(d), i.e., not more than 120 hours. App. 244. The next day, August 16, Benn was interviewed by Dr. Mohammad Quasim, another MCES psychiatrist, who continued the treatment started by Dr. Zerby. The following day, August 17, Benn was seen by Dr. Venu Mukerjee, yet another MCES psychiatrist, who found him to have "limited insight and obvious[] difficulties with impulse control, where he might have verbalized suicidal intent while at Horsham.... His insight is limited and his judgment is definitely impaired." App. 21. On August 18, Dr. Mukerjee noted that "[Benn] is now contracting for safety and has never been suicidal since his admission here." He was then released. App. 22.

During his time at MCES, Benn was in contact with his common-law wife, his treating therapist, a lawyer, and a friend. Benn claims that his detention room had no toilet and that he was forced to urinate on the walls.

In December 1999, Benn filed this action in the United States District Court for the Eastern District of Pennsylvania against Wilcox, Dr. Eluri, Horsham, UHS, MCES, Dr. Mukerjee, Dr. Zerby, and Dr. Quasim. Benn asserted claims under 42 U.S.C. § 1983 for alleged violations of his procedural and substantive due process rights, as well as numerous tort claims under Pennsylvania law, to wit, negligence/malpractice, intentional infliction of emotional distress, assault and battery, negligence, and false imprisonment. In addition, Benn sought punitive damages against all defendants.

The parties filed cross-motions for summary judgment. In July 2001, the District Court granted summary judgment in favor of all defendants. The Court held that Dr. Eluri, Wilcox, Horsham, and UHS were not state actors and thus could not be sued under § 1983. In addition, assuming for the sake of argument that MCES, Dr. Mukerjee, Dr. Zerby, and Dr. Quasim were state actors, the Court held that they did not violate Benn's right to substantive or procedural due process. The Court also granted summary judgment on the state tort claims for all parties except Wilcox, because it found that these parties were immune from such claims under Section 114 of the MHPA, 50 Pa. Stat. Ann. § 7114. As for Wilcox, the Court found that there was no evidence against her to support the state tort claims. Benn appealed.

II.

We turn first to Benn's § 1983 claim. Section 1983 provides in relevant 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.

To establish a claim under § 1983, Benn must show that the defendants 1) were state actors¹ who 2) violated his rights under the Constitution or federal law. Flagg Bros., Inc. v. Brooks, 436 U.S. 149, 155, 98 S.Ct. 1729, 56 L.Ed.2d 185 (1978).

A.

Benn contends that Horsham, UHS, Dr. Eluri, and Wilcox² (the "Horsham defendants") were state actors because they were acting pursuant to the MHPA. Under the MHPA, a physician or other "responsible party" may file an application that may lead to the issuance of a warrant authorizing a person who is "severely mentally disabled and in need of immediate treatment"³ to be taken to a designated facility for an emergency examination. 50 Pa. Stat. Ann. § 7302(a)(1).⁴ In addition, a physician or other person who has observed a person engaging in conduct that provides reasonable grounds to believe that the person is "severely mentally disabled and in need of treatment" may take the person to an approved facility for such an examination. 50 Pa. Stat. Ann. § 7302(b). At the facility, the individual who brought the person thought to need treatment must make "a written statement setting forth the grounds for believing the person to be in need of examination." 50 Pa. Stat. Ann. § 7302(a)(2). A person taken to a facility must be examined within two hours, and if it is determined that the person is "severely mentally disabled and in need of immediate treatment," the treatment must begin immediately. 50 Pa. Stat. Ann. § 7302(b). If it is determined at any time that the person is not in need of treatment, the person must be discharged, and in any event the person must be released within 120 hours unless a certification for extended involuntary emergency treatment is filed under 50 Pa. Stat. Ann. § 7303. In this case, the District Court held that, because the Horsham defendants were merely involved in the application for Benn's commitment, they were not state actors.

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