McGugan v. Aldana-Bernier

Citation752 F.3d 224
Decision Date16 May 2014
Docket NumberDocket No. 12–4165–cv.
PartiesKraton McGUGAN, Plaintiff–Appellant, v. Linda L. ALDANA–BERNIER, M.D., personally, Shushan Hovanesian, M.D., personally, Rabbi Mahmudur, M.D., personally, Femi Abioye, R.N., personally, Jamaica Hospital Medical Center, Defendant–Appellees, New York City, Gamaliel Bonilla, personally, Kenneth Bogle, personally, Port Authority Police Department Officer Angerhauser, Shield Number 2653, personally, and The Port Authority of New York and New Jersey, Defendants.
CourtUnited States Courts of Appeals. United States Court of Appeals (2nd Circuit)

OPINION TEXT STARTS HERE

William M. Brooks, Mental Disability Law Clinic, Touro College, Jacob D. Fuchsberg Law Center, Central Islip, NY, for PlaintiffAppellant Kraton McGugan.

Brian E. Lee, Ivone, Devine & Jensen, LLP, Lake Success, NY, for DefendantAppellee Shushan Hovanesian, M.D.

Bruce M. Brady, Callan, Koster, Brady & Brennan LLP, New York, N.Y. (Stephen J. Barrett, on the brief), for DefendantAppellee Linda L. Aldana–Bernier, M.D.

Arjay G. Yao, Martin Clearwater & Bell LLP, New York, N.Y. (Kenneth R. Larywon and Gregory J. Radomisli, on the brief), for DefendantAppellees Jamaica Hospital Medical Center, Rabbi Mahmudur, M.D., and Femi Abioye.

Before: LEVAL, HALL, and LOHIER, Circuit Judges.

LEVAL, Circuit Judge:

Plaintiff Kraton McGugan appeals from the judgment of the United States District Court for the Eastern District of New York (Melançon, J.) dismissing her complaint. McGugan brought suit against Defendants Jamaica Hospital Medical Center and four of its employees—Linda L. Aldana–Bernier, M.D., Shushan Hovanesian, M.D., Rabbi Mahmudur, M.D., and Femi Abioye, R.N.—(collectively, Defendants) for their alleged role in forcibly medicating and hospitalizing McGugan.1 The Defendants moved to dismiss McGugan's complaint. The district court granted the motions, concluding that McGugan failed to state a claim against the Defendants (1) under 42 U.S.C. § 1983, because she failed to allege state action, and (2) under § 504 of the Rehabilitation Act, 29 U.S.C. § 794, because she failed to allege discrimination on the basis of disability against an otherwise qualified individual. The district court declined to exercise supplemental jurisdiction over McGugan's state law claims against the Defendants. On appeal, McGugan contests only the district court's conclusion that she failed to state a claim against Defendants under § 1983 and § 504.

We agree with the district court that McGugan failed to allege state action for the purposes of her § 1983 claims and that she failed to allege actionable discrimination for the purposes of her § 504 claim. We therefore affirm the judgment of dismissal.

BACKGROUND
I. McGugan's Involuntary Hospitalization

The facts, as alleged in McGugan's complaint, are as follows.

In the early morning of July 24, 2008, McGugan boarded a red-eye flight from San Francisco to New York City (John F. Kennedy International Airport) to visit her boyfriend, Chris Tulipanov. On the plane, McGugan began coughing uncontrollably. She asked to be moved to a less crowded area of the plane to avoid bothering neighboring passengers, but a flight attendant told her to return to her seat. Still coughing, McGugan renewed her request “using stronger language.” Second Am. Compl. ¶ 29. The flight attendant then moved another 15 passenger, leaving McGugan in a row of seats to herself.

McGugan fell asleep and did not wake up until after the plane had landed and all the other passengers had deplaned. When she woke up, three police officers were standing over her. They took her to a police station at the airport for questioning and handcuffed her to the wall. After McGugan answered the officers' questions, an unidentified man informed her that she would be taken to the Jamaica Hospital Medical Center (“JHMC”). JHMC is a private hospital that receives federal funding and is licensed by the New York State Office of Mental Health (OMH) to provide psychiatric services.

McGugan's boyfriend then accompanied her in an ambulance to the JHMC. During their ride to the JHMC, one of two government officials (defendants who are not parties to this appeal) injected McGugan with medication without her consent, after erroneously determining that she was a danger to others. The medication sedated her. When she woke up, she was restrained to a hospital bed.

When McGugan arrived at the JHMC emergency room, and while she was still sedated, the late Dr. Bacares (not a party to this action) wrote an order for the forcible administration of medication on an immediate basis for McGugan. Defendant Dr. Mahmudur also wrote an order to forcibly administer those medications on an “as needed[ ] basis for severe agitation.” Id. ¶ 51. Pursuant to those medication orders, Defendant Abioye injected McGugan multiple times with a combination of Haldol, Benadryl, and Ativan.

Beginning on July 25, 2008, the staff of the JHMC attempted to gather informationabout McGugan. During the information gathering process, clinical staff learned that McGugan was dating someone named “Chris.” For reasons that are not explained in McGugan's complaint, they mistakenly believed McGugan was referring to Kris Dickman,” who was her ex-boyfriend. JHMC staff called Dickman. He told them that he was not dating McGugan and that McGugan had thrown a metal object at him, requiring him to seek medical attention. From this conversation, clinical staff believed that McGugan “was suffering from delusions of a romantic nature.” Id. ¶ 67.

Defendant Dr. Aldana–Bernier performed a psychiatric evaluation on McGugan while McGugan was still sedated. Based on the evaluation, on Dickman's statements, and on McGugan's apparent uncooperative refusal to answer questions, Dr. Aldana–Bernier certified McGugan as having a mental illness likely to result in substantial harm to herself or others, thus rendering McGugan subject to involuntary admission to the JHMC under New York Mental Hygiene Law § 9.39. McGugan alleges that Dr. Aldana–Bernier's assessment of McGugan's dangerousness was not “minimally competent” because she failed to ask McGugan relevant questions, failed to recognize that McGugan's “uncooperative” behavior was merely the result of her heavy sedation, and failed to perform an appropriate risk assessment. Id. ¶¶ 66–79. McGugan also alleges that Dr. Aldana–Bernier performed a deficient assessment because she stereotyped McGugan as dangerous based on her perception that McGugan was mentally ill.

On July 26, 2008, Defendant Dr. Hovanesian certified McGugan for further confinement under § 9.39, concluding that McGugan was a danger to herself or others on the basis of Dickman's statements. McGugan alleges that Dr. Hovanesian's certification was also flawed in that she did not try to corroborate Dickman's statements with McGugan. McGugan remained confined in JHMC until July 30, 2008.

McGugan alleges that had any of the defendants performed their duties properly, they would have realized that she was never a danger to herself or others and that she should never have been certified for forcible sedation or involuntary hospitalization.

II. New York State's Regulatory Scheme for Civil Commitment

OMH has developed a regulatory framework for the evaluation, detainment, and treatment of individuals deemed to be mentally ill and dangerous. Except in rare circumstances, OMH has delegated the authority to civilly commit individuals to local hospitals—both public and private. Specifically, OMH has divided the state into “catchment areas,” each of which is covered by a designated hospital. Anyone deemed to potentially require psychiatric inpatient care is taken to the hospital covering the catchment area where he or she is located. The hospital then determines whether the individual requires inpatient care—in the case of candidates for civil commitment, by evaluating whether they pose a danger to themselves or others. If the individual merely requires inpatient care for the short term, the hospital will provide that care (voluntarily or, if necessary and appropriate, involuntarily). If he or she requires long-term inpatient psychiatric care, then he or she will be transferred to a hospital operated by OMH. The civil commitment system is thus coordinated among local governments, private entities, and OMH.

JHMC is a private hospital responsible for the catchment area covering John F. Kennedy International Airport.

DISCUSSION2

This appeal presents two questions: (1) whether private health care professionals or a private hospital engage in state action when they forcibly medicate and hospitalize someone deemed to have a mental illness likely to result in serious harm; and (2) whether their failure to adequately assess that risk of harm according to proper medical standards constitutes discrimination under the Rehabilitation Act if the assessment is based on drawing stereotyped inferences from medical conditions that are appropriately considered as part of a proper assessment. Because we conclude that both questions must be answered in the negative, we affirm the judgment of the district court.

I. State Action

To state a claim under § 1983, a plaintiff must allege that defendants violated plaintiff's federal rights while acting under color of state law. See42 U.S.C. § 1983; Washington v. County of Rockland, 373 F.3d 310, 315 (2d Cir.2004). A private entity acts under color of state law for purposes of § 1983 when (1) the State compelled the conduct [the ‘compulsion test’], (2) there is a sufficiently close nexus between the State and the private conduct [the ‘close nexus test’ or ‘joint action test’], or (3) the private conduct consisted of activity that has traditionally been the exclusive prerogative of the State [the ‘public function test’].” Hogan v. A.O. Fox Memorial Hosp., 346 Fed.Appx. 627, 629 (2d Cir.2009) (citing Sybalski v. Indep. Grp. Home Living Program, Inc., 546 F.3d 255, 257 (2d Cir.2008)). “The fundamental...

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