Carl v. Muskegon Cnty.

• Decision Date: 15 August 2014
• Docket Number: No. 13–2296.,13–2296.
• Citation: 763 F.3d 592
• Parties: Timothy A. CARL, Plaintiff–Appellant, v. MUSKEGON COUNTY, et al., Defendants, Katherine Jawor, Defendant–Appellee.
• Court: U.S. Court of Appeals — Sixth Circuit

763 F.3d 592

Timothy A. CARL, Plaintiff–Appellant,

v.MUSKEGON COUNTY, et al., Defendants,Katherine Jawor, Defendant–Appellee.

No. 13–2296.

United States Court of Appeals,Sixth Circuit.

Aug. 15, 2014.

ON BRIEF:Bradford W. Springer, Scholten Fant, P.C., Grand Haven, Michigan, for Appellant. Douglas P. Vanden Berge, Rhoades McKee, P.C., Grand Rapids, Michigan, for Appellee.

Before: COLE, Chief Judge; ROGERS and ALARCÓN, Circuit Judges. ^*

OPINION

COLE, Chief Judge.

Medical professionals at the Muskegon County Jail evaluated Timothy Carl, a pretrial detainee with a history of mental illness, after he exhibited several odd behaviors. Concerned that Carl might endanger himself or others, Dr. Katherine Jawor examined Carl but determined that he did not meet the criteria for involuntary hospitalization. In making this determination, Dr. Jawor acted under color of state law because she performed a public function by evaluating an individual in the state's custody. The district court erred in reaching a different conclusion. We therefore reverse the district court's grant of summary judgment to Dr. Jawor and remand for further proceedings.

I. BACKGROUND

Timothy Carl was arrested under bizarre circumstances. While working as an in-home healthcare provider for an elderly couple, Carl experienced a psychotic break, urinating on one client's head and attempting to dispense liquid soap on another's. Muskegon County prosecutors charged Carl with vulnerable-adult abuse, and he was held as a pretrial detainee at the county jail.

The strange nature of Carl's arrest, coupled with his behavior during the inmate-booking process, prompted an evaluation as to whether he presented a danger to himself or others and whether he should be involuntarily hospitalized. Mental health services at the jail were contracted out to an agency established by Muskegon County. That agency, Community Mental Health Services (“CMH”), agreed to “provide mental health [and psychiatric] services to the inmates of the Muskegon County Jail” in its operating agreement.

On March 3, 2008, two CMH employees, Jule McLaughlin and Steve Weinert, examined Carl at the jail. McLaughlin, a physician's assistant, indicated that Carl was “floridly psychotic,” that he had considered killing himself, and that he required treatment in a psychiatric facility. McLaughlin had previously prescribed Carl an anti-psychotic medication but noted that his current medications were “not very effective.”

Weinert's assessment of Carl echoed McLaughlin's conclusions. Weinert, a limited-licensed psychologist at CMH, documented that Carl was “paranoid” because he described a “glowing light in his cell that [was] tugging at his brain.” In Weinert's judgment, Carl “require[d] intensive psychiatric treatment” and hospitalization. Unable to certify Carl for involuntary hospitalization himself, Weinert enlisted Dr. Katherine Jawor's assistance to determine whether hospitalization was appropriate.

Dr. Jawor is the focal point of this case. She served as an independent contractor for CMH and examined Carl on March 5. Before interviewing Carl, Dr. Jawor knew that McLaughlin had prescribed an anti-psychotic and that Weinert had documented Carl's paranoid behaviors. But during Dr. Jawor's evaluation, Carl denied feeling depressed, denied suicidal and homicidal ideations, and denied experiencing paranoid delusions and auditory hallucinations. This marked a dramatic change from the delusional state Weinert and McLaughlin reported merely two days before. Dr. Jawor asked Carl about this transformation, and Carl stated that he was just “messing with” Weinert and McLaughlin when they interviewed him. By the end of Dr. Jawor's evaluation, Carl agreed to take his medications, which he had previously refused. In Dr. Jawor's opinion, based on Carl's “pleasant and cooperative” demeanor, he did not meet the criteria for involuntaryhospitalization. This was the first and only time Dr. Jawor examined Carl.

Carl argues that, due in part to Dr. Jawor's negative certification, he did not receive the mental health services he needed and that his “uncontrolled psychotic state” worsened, causing serious harm to his mental and physical health while detained at the jail. He filed a complaint under 42 U.S.C. § 1983 in federal district court against Dr. Jawor, Muskegon County, and others, alleging that the defendants disregarded an obvious and excessive risk to his health in violation of his Eighth and Fourteenth Amendment rights. All defendants except Dr. Jawor were dismissed after signing a settlement agreement.

The district court held that Dr. Jawor was not a state actor because Carl had not demonstrated that performing an involuntary commitment determination is a public function. In granting summary judgment to Dr. Jawor, the court did not address whether she deprived Carl of a right secured by the Federal Constitution or federal law.

Carl timely filed this appeal.

II. ANALYSIS

We review the grant of summary judgment de novo and draw all inferences in favor of the non-moving party. Keith v. Cnty. of Oakland, 703 F.3d 918, 923 (6th Cir.2013). Summary judgment is required where “there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a).

A plaintiff suing under § 1983 must establish that he was denied a constitutional right, and that the deprivation was caused by a defendant acting under color of state law. Jones v. Duncan, 840 F.2d 359, 361–62 (6th Cir.1988). The Eighth Amendment protects prisoners from cruel and unusual punishment, and pretrial detainees are similarly protected under the Due Process Clause of the Fourteenth Amendment. Phillips v. Roane Cnty., Tenn., 534 F.3d 531, 539 (6th Cir.2008).

The only issue before the court is whether Dr. Jawor, a private psychiatrist, acted under color of state law. Private individuals may be considered state actors if they exercise power “possessed by virtue of state law” and if they are “clothed with the authority of state law.” United States v. Classic, 313 U.S. 299, 326, 61 S.Ct. 1031, 85 L.Ed. 1368 (1941). The question turns on whether the private individual's actions can be fairly attributed to the state. Lugar v. Edmondson Oil Co., Inc., 457 U.S. 922, 937, 102 S.Ct. 2744, 73 L.Ed.2d 482 (1982). Our court has identified three tests to resolve the state-actor inquiry: the public-function test, the state-compulsion test, and the nexus test. Ellison v. Garbarino, 48 F.3d 192, 195 (6th Cir.1995). The parties agree that this case implicates the public-function test, which “requires that the private [individual] exercise powers which are traditionally exclusively reserved to the state.” Wolotsky v. Huhn, 960 F.2d 1331, 1335 (6th Cir.1992). The Sixth Circuit has interpreted this test narrowly; rarely have we attributed private conduct to the state. Chapman v. Higbee Co., 319 F.3d 825, 833–34 (6th Cir.2003). Nevertheless, Carl argues that Dr. Jawor is a state actor under the public-function test and that West v. Atkins, 487 U.S. 42, 108 S.Ct. 2250, 101 L.Ed.2d 40 (1988), supports his position. We agree.

We start from the basic premise that states must provide medical care to those in custody. Estelle v. Gamble, 429 U.S. 97, 103, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976) (“[E]lementary principles establish the government's obligation to provide medical care for those whom it is punishingby incarceration.”). West v. Atkins outlines the contours of this principle in the context of using private contractors to provide prison healthcare. In West, North Carolina contracted with a private physician to provide orthopedic services to inmates at a state prison. 487 U.S. at 43–44, 108 S.Ct. 2250. After an inmate tore his Achilles tendon, the doctor refused to operate and opted for a non-surgical treatment plan. Id. at 44, 108 S.Ct. 2250. The inmate then sued under § 1983, claiming that the doctor's decision to forgo surgery constituted deliberate indifference to his medical needs. Id. at 45, 108 S.Ct. 2250.

The Supreme Court held that the doctor was a state actor because “[t]he State bore an affirmative obligation to provide adequate medical care to [the plaintiff]; the State delegated that function to [the doctor]; and the [doctor] voluntarily assumed that obligation by contract.” Id. at 56, 108 S.Ct. 2250. Although the physician in West had a contractual obligation to treat inmates, the Court made two points clear: first, an employment relationship with the state is not dispositive of the state-actor inquiry. Id. Second, the amount of time a physician expends exercising his duties does not resolve the state-actor question either. Id. Rather, “[i]t is the physician's function ... that determines whether he is acting under color of state law.” Id. Courts discern this function by focusing on “the relationship among the State, the physician and the prisoner.” Id.

A state may not escape § 1983 liability by contracting out or delegating its obligation to provide medical care to inmates. Id. at 56 n. 14, 108 S.Ct. 2250; cf. Estelle, 429 U.S. at 103, 97 S.Ct. 285 (“An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met.”). Indeed, our court has held that “private physicians serving inmate populations satisfy the state-action requirement of [§ 1983].” Johnson v. Karnes, 398 F.3d 868, 876 (6th Cir.2005); Street v. Corr. Corp. of Am., 102 F.3d 810, 814 (6th Cir.1996); Hicks v. Frey, 992 F.2d 1450, 1458 (6th Cir.1993) (“It is clear that a private entity which contracts with the state to perform a traditional state function such as providing medical services to prison inmanes may be sued under § 1983 as one acting ‘under color of state law.’ ”); see also Conner v. Donnelly, 42 F.3d 220, 225–26 (4th Cir.1994) (holding that a private doctor who treated an inmate was a state actor although he had no contract with the prison). Applying these...