Brown v. Erie Cnty.

Decision Date18 May 2021
Docket NumberCase No. 1:20-CV-0251 (Erie)
PartiesDAWN BROWN, as Administrator of the Estate of MATHEW ORSINI, deceased, Plaintiff v. ERIE COUNTY, WEXFORD HEALTH SOURCES, INC., MEDICAL ASSOCIATES OF ERIE, INC., DIAGNOSTIC X-RAY SERVICE, INC., GARY L. PETERSON D.O., and DAVID PAUL, M.D., Defendants.
CourtU.S. District Court — Western District of Pennsylvania

SUSAN PARADISE BAXTER UNITED STATES DISTRICT JUDGE

RICHARD A. LANZILLO UNITED STATES MAGISTRATE JUDGE

REPORT AND RECOMMENDATION ON DEFENDANT ERIE COUNTY'S MOTION TO DISMISS

ECF NO. 36
I. Recommendation

It is respectfully recommended that Defendant Erie County's motion to dismiss Count I of Plaintiff's Amended Complaint pursuant to Fed. R. Civ. P. 12(b)(6) be granted. Because Plaintiff may be able to cure certain deficiencies in Count I, it is further recommended that dismissal of Count I be without prejudice and that Plaintiff be granted leave to file a second amended complaint. Finally, if Plaintiff declines to file a second amended complaint, it is further recommended that the Court decline to exercise supplemental jurisdiction over Plaintiff's state law claims.

II. Introduction

Nineteen-year-old Mathew Orsini (Orsini or decedent) died on March 18, 2019, three weeks after he entered the population of the Erie County Jail. ECF No. 22. Plaintiff Dawn Brown (Plaintiff), as administrator of his estate, alleges that Orsini's death was the result of Erie County's unconstitutional policies and practices as well as the professional negligence of the named medical defendants. Id. Plaintiff's sole claim against Erie County and sole basis for federal court jurisdiction is Count I of the Amended Complaint, which alleges that Erie County's policies and practices were deliberately indifferent to Orsini's rights under the Eighth and Fourteenth Amendments to the United States Constitution and the cause of his death. Plaintiff brings this claim pursuant to 42 U.S.C. §1983 and Monell v. Dep't of Social Serv. of City of N.Y., 436 U.S. 658, 98 S. Ct. 2018, 56 L.Ed.2d 611 (1978).

Erie County moves to dismiss Count I on the grounds that Plaintiff's factual allegations do not support an inference that it maintained a policy or practice of deliberate indifference to inmates' medical needs or that any policy or practice of the County was the "moving force" behind the violation of Orsini's constitutional rights. ECF No. 37. The motion has been fully briefed and the Court heard argument on the motion in open court on May 14, 2021. ECF Nos. 36-37; 41-42; 45-46. Accordingly, the motion is ripe for decision.

III. Legal Standard on Motion to Dismiss

A motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6) tests the legal sufficiency of the complaint. Kost v. Kozakiewicz, 1 F.3d 176, 183 (3d Cir. 1993). In deciding a motion to dismiss, a court is not opining on whether a plaintiff is likely to prevail on the merits; instead, the plaintiff must only present factual allegations sufficient "to raise a right to relief above the speculative level." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555, 127 S. Ct. 1955, 167 L.Ed.2d 929 (2007) (citing 5 C. Wright & A. Miller, Federal Practice and Procedure § 1216, pp. 235-236 (3d ed. 2004)). See also Ashcroft v. Iqbal, 556 U.S. 662, 129 S. Ct. 1937, 173 L.Ed.2d 868 (2009). A complaint should only be dismissed under Rule 12(b)(6) if it fails to allege "enough facts to state a claim to relief that is plausible on its face." Twombly, 550 U.S. at 570, 127 S. Ct. 1955 (rejecting the traditional Rule 12(b)(6) standard established in Conley v. Gibson, 355 U.S. 41, 78 S. Ct. 99, 2 L.Ed.2d 80 (1957)). In making this determination, the court must accept as true all well-pleaded factual allegations in the complaint and views them in a light most favorable to the plaintiff. U.S. Express Lines, Ltd. v. Higgins, 281 F.3d 383, 388 (3d Cir. 2002).

While a complaint does not need detailed factual allegations to survive a motion to dismiss, a complaint must provide more than labels and conclusions. Twombly, 550 U.S. at 555, 127 S. Ct. 1955. A "formulaic recitation of the elements of a cause of action will not do." Id. (citing Papasan v. Allain, 478 U.S. 265, 286, 106 S. Ct. 2932, 92 L.Ed.2d 209 (1986)). Moreover, a court need not accept inferences drawn by a plaintiff if they are unsupported by the facts in the complaint. See Cal. Pub. Emps.' Ret. Sys. v. Chubb Corp., 394 F.3d 126, 143 (3d Cir. 2004) (citing Morse v. Lower Merion Sch. Dist., 132 F.3d 902, 906 (3d Cir. 1997)). Nor must the Court accept legal conclusions disguised as factual allegations. Twombly, 550 U.S. at 555, 127 S. Ct. 1955. See also McTernan v. City of York, Pa., 577 F.3d 521, 531 (3d Cir. 2009).

Expounding on the Twombly/Iqbal line of cases, the Third Circuit has articulated the following three-step approach:

First, the court must "tak[e] note of the elements a plaintiff must plead to state a claim." Second, the court should identify allegations that, "because they are no more than conclusions, are not entitled to the assumption of truth." Finally, "where there are well-pleaded factual allegations, a court should assume their veracity and then determine whether they plausibly give rise to an entitlement for relief."

Burtch v. Milberg Factors, Inc., 662 F.3d 212, 221 (3d Cir. 2011) (quoting Santiago v. Warminster Twp., 629 F.3d 121, 130 (3d Cir. 2010)). This determination is "a context-specific task that requires the reviewing court to draw on its judicial experience and common sense." Iqbal, 556 U.S. at 679, 129 S. Ct. 1937.

IV. Amended Complaint

Plaintiff's Amended Complaint alleges the following facts, which the Court accepts as true for purposes of Erie County's motion to dismiss:

On February 25, 2019, Orsini began a period of detention at the Erie County Jail.1 ECF No.22 ¶ 21. At intake, he informed Nurse Teri Masi that he had undergone an aortic valve replacement in 2009, had a history of cardiovascular disease and hypertension, and was taking medication (Atenolol and Losartan) to treat his heart condition. Id., ¶¶ 19, 22-23. Nurse Masi recorded his surgical history on his "Medical Nurse Order Form" and ordered that his blood pressure be checked every Monday, Wednesday, and Friday for two weeks. Id., ¶ 23. It is unclear from the Amended Complaint whether this was done. Id.

Two weeks later, Orsini complained to Heidi Karash, Director of Nursing at the Erie County Prison, that he had not yet been provided with his prescription medications. Id., ¶¶ 24, 30. Director Karash responded that his local pharmacy reported that he last refilled his prescriptions in December. Id., ¶ 25. Although Orsini objected to Director Karash's assertion that he had not taken his medication in "a while," Director Karash replied that his vital signs would continue to be monitored and a doctor would review his records and vitals at his next appointment. Id., ¶ 25. It is unclear from the pleadings whether this appointment occurred prior to Orsini's death.

On March 18, 2019, Orsini notified security that he was experiencing shortness of breath, tooth pain, and back pain. Id., ¶¶ 27-28. Nurse Denise Long prescribed ibuprofen and gave him techniques to slow his breathing. Id., ¶ 27. Three hours later, Orsini complained of heartburn. Id., ¶ 29. Defendant Dr. Gary Peterson was contacted by phone, and he ordered "Alum/mag/s." Id. Ten minutes later, Orsini began hyperventilating and withering in pain. Id., ¶ 30. An X-ray of his chest, lumbar spine, and thoracic spine was taken by Defendant Diagnostic X-Ray Service, Inc. Id. ¶ 31. Defendant Dr. David Paul, a radiologist, diagnosed Orsini with left lower lung pneumonia with effusion. Id., ¶ 34. He ordered a Z-Pac, Augmentin, and a follow-up X-ray on March 26, 2019. Id., ¶ 38. Although an EKG was attempted, Orsini was not cooperative because he was unable to remain still. Id., ¶ 37.

At some point, Orsini started vomiting in the B-pod. Id., ¶ 39. He also turned very pale andbecame unsteady on his feet. Id. Although a staff nurse and another medical employee witnessed this, they offered no medical assistance. Id., ¶¶ 39-40. Instead, Corrections Officer Howell taunted Orsini, stating he "just needs his Mommy." Id., ¶ 40. Other officers nearby told Orsini he was fine and all he needed was a shower. Id. ¶ 41. However, Orsini continued to vomit and complain about chest pain while clutching his chest until he ultimately became unresponsive. Id., ¶¶ 42-43. An ambulance was called at 10:01 p.m. Id., ¶ 42-43.

As soon as the paramedics arrived, they began CPR. Id., ¶ 43. An AED was not able to detect a shockable rhythm. Id. Orsini was transported to UPMC Hamot via ambulance. Id., ¶ 44. In route, paramedics continued chest compressions and administered multiple doses of epinephrine. Id. At the hospital, Orsini was given 3 liters of normal saline and started on a norepinephrine drip. Id., ¶ 46. Shortly thereafter, Orsini went into cardiac arrest. Id. He was declared dead at 11:01p.m. Id.

An autopsy was performed on March 28, 2019 at UPMC Children's Hospital of Pittsburgh. Id., ¶ 47. The autopsy report concluded that the cause of death was a rupture of an aortic aneurysm. Id. Included in the final autopsy diagnosis was "dissecting aortic aneurysm (Type 1) with rupture of aortic root." Id. The final autopsy also revealed that Orsini had a "marfanoid body habitus consisting of pectus excavatum, retrognathia, arachnodactyly, camptodactyly[,] and long lower limbs." Id. ¶ 48. He was further diagnosed with Loeys-Dietz Syndrome, a connective tissue disorder. Id.

Prior to Orsini's detention, Erie County had contracted with Defendant Wexford Health Sources, Inc. (Wexford Health) to provide medical and healthcare services to inmates at the Erie County Jail. Id., ¶¶ 4-5. The agreement between Erie County and Wexford Health included a requirement that Wexford Health provide an onsite medical director for 14 hours a week—4 hours on every Monday, Thursday, and Friday and 2 hours on every Tuesday....

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