Patterson v. City of Danville

Citation875 S.E.2d 65
Decision Date07 July 2022
Docket NumberRecord No. 210509
Parties Kareem PATTERSON, Personal Representative of the Estate of Langston Patterson, Deceased v. CITY OF DANVILLE, et al.
CourtSupreme Court of Virginia

Carrol M. Ching (John P. Fishwick, Jr. ; Daniel J. Martin ; Fishwick & Associates, Roanoke, on briefs), for appellant.

Julie S. Palmer (Stanley P. Wellman ; Harman Claytor Corrigan & Wellman, Glen Allen, on brief), for appellee Laurence Shu-Chung Wang, M.D.

PRESENT: Goodwyn, C.J., Powell, Kelsey, McCullough, and Chafin, JJ., and Koontz, S.J.


Langston Patterson died a few months after suffering from cardiac arrest

while an inmate in the Danville Adult Detention Center ("DADC"). The personal representative of Patterson's estate sued the DADC physician, Dr. Laurence Shu-Chung Wang, claiming that Dr. Wang committed medical malpractice by failing to provide appropriate care to Patterson. The circuit court granted Dr. Wang's plea in bar to the estate's negligence claim, holding that he was protected by derivative sovereign immunity. The court also granted Dr. Wang's demurrer to the estate's gross negligence claim because it was insufficiently pleaded. Finding no legal error in either of these decisions, we affirm.


In cases decided after an ore tenus hearing, we give the court's findings the same "weight" as a jury verdict. See Pike v. Hagaman , 292 Va. 209, 214, 787 S.E.2d 89 (2016) (citation omitted). For the purposes of reviewing sovereign immunity, therefore, we will recite the evidence in the light most favorable to Dr. Wang, the prevailing party before the circuit court sitting as the factfinder.


The timeline of relevant events begins when Patterson entered the DADC and ends with his death approximately nine months later.

On November 4, 2016, Patterson was incarcerated in the DADC, a minimum-security detention center owned and operated by the City of Danville. A few days after Patterson's admission, the correctional health assistant completed an "Intake Inmate Medical Sheet," J.A. at 5, and noted Patterson's various medical and psychiatric conditions, including Patterson's medical history of diabetes

, hypertension, depression, and schizoaffective disorder.

On November 10, after Patterson exhibited symptoms of confusion, Dr. Wang and the correctional health assistant met with Patterson. Patterson's blood pressure was elevated, and Dr. Wang prescribed Clondine and Amlodipine

"in an attempt to treat" Patterson's "high blood pressure." Id. at 6. Dr. Wang also directed that a comprehensive metabolic panel and complete blood count be obtained for Patterson.

On November 11, the DADC transported Patterson to the Danville Regional Medical Center. The hospital treated him for electrolyte imbalances

, metabolic toxic encephalopathy, dehydration, hyponatremia, hypokalemia, acute kidney injury, ketosis, and diabetes. Patterson's hyponatremia resolved after he was placed on a saline intravenous drip, and he returned to the DADC the next day with various prescriptions for the other diagnoses.

On November 16, Dr. Wang again examined Patterson and noted that Patterson's symptoms included gastric reflux syndrome, blurred vision, and shoulder pain. Dr. Wang prescribed Atenolol

, Zantac, and Ibuprofen to help Patterson with these symptoms.

On December 5, the DADC's correctional health assistant noticed that Patterson was experiencing an altered mental status. Dr. Wang examined Patterson the next day, diagnosed him with experiencing psychosis

, and put Patterson on a regime of Haldol, an anti-psychotic medication.

On December 23, Patterson complained that his feet were swelling. Dr. Wang considered this symptom to be a possible side effect of Haldol

and prescribed Cogentin to address the swelling. Over a month later, Patterson experienced tooth pain and underwent a tooth extraction. Dr. Wang examined him after the extraction.

On February 15, 2017, Patterson appeared to be anxious and mentally disturbed. He reported hearing voices, finding sleep elusive, and vomiting at night. Dr. Wang treated these conditions as a depressive syndrome

and prescribed Nortriptyline, an antidepressant medication.

On February 20, Patterson suffered cardiac arrest

in his cell. Medical personnel resuscitated Patterson, but he never regained consciousness. He died five months later on July 31, 2017, at the Danville Regional Medical Center.


Through its personal representative, Patterson's estate filed suit against Dr. Wang and others for ordinary and gross negligence. Only the claims against Dr. Wang remain in contest on appeal. The circuit court conducted an evidentiary hearing to determine whether Dr. Wang was protected by the City's sovereign immunity.

Considered in the light most favorable to Dr. Wang, the prevailing party in the circuit court, the evidence showed that the City owned and operated the DADC as well as all medical equipment and supplies within it. The Virginia Board of Corrections promulgated medical standards for the DADC and similar facilities, regularly inspected the DADC for compliance, and conducted recertification reviews every three years. These requirements protected the inmates’ constitutional and statutory rights to medical care while incarcerated. See Estelle v. Gamble , 429 U.S. 97, 103, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976) ("These elementary principles establish the government's obligation to provide medical care for those whom it is punishing by incarceration."); Code § 53.1-126 (providing that, subject to certain exceptions, "medical treatment shall not be withheld for any communicable diseases, serious medical needs, or life threatening conditions").

Consistent with the DADC's legal duties, the DADC director drafted policies and procedures governing the medical care of inmates. The DADC director testified that he had the ultimate responsibility for ensuring that inmates are provided with appropriate medical care. The City employed Dr. Wang as the DADC physician, paid him on an hourly basis, and required him to come to the DADC at least once a week to treat inmates and to consult with the DADC director about the inmates’ medical needs. Dr. Wang also treated inmates at other City facilities.

No inmates were asked to pay or required to pay for Dr. Wang's medical care. The inmates did not choose Dr. Wang as their physician, nor did he choose them as his patients. Under the terms of his employment, Dr. Wang was obligated to treat any inmate who requested Dr. Wang's medical care. Dr. Wang was also required to use the examination rooms at the DADC as well as the medical equipment and supplies kept on site. When treating patients, Dr. Wang wore personal protective gear supplied by the DADC. The medical records created by Dr. Wang were kept at the DADC. All prescriptions were filled by the DADC staff at a local pharmacy pursuant to a contract between the City and the pharmacy.

In aggregate, these facts demonstrate that the DADC controlled when and where Dr. Wang worked, the number and identity of the patients that he saw, the medical equipment that he used on site, and the medical policies and procedures that governed his work at the DADC. He could not refuse to see any patient and could not receive compensation from any patient. His salary was paid by the City, calculated on an hourly basis. And unlike a private physician treating patients, Dr. Wang served as an agent of the City, charged with a constitutional and statutory duty to provide medical care to a specific class of patients.


On appeal, Patterson argues that Dr. Wang is not entitled to derivative sovereign immunity, and, even if Dr. Wang were entitled, his gross negligence precludes him from asserting it. The circuit court rejected both assertions, as do we.


While sovereign immunity has stood the test of time, the testing process seems to never end. It began at the very founding of our nation. Five years after the ratification of the United States Constitution, Chisholm v. Georgia , 2 U.S. (2 Dall.) 419, 1 L.Ed. 440 (1793), held that sovereign immunity was inimical to a constitutional republic in which the people, not the government, are sovereign. See generally Randy E. Barnett, The People of the State?: Chisholm v. Georgia and Popular Sovereignty , 93 Va. L. Rev. 1729, 1730-31 (2007). Shortly after losing in Chisholm , the State of Georgia reasserted its sovereignty by passing a bill that charged anyone attempting "to enforce the Chisholm decision" with a capital crime. Alden v. Maine , 527 U.S. 706, 721, 119 S.Ct. 2240, 144 L.Ed.2d 636 (1999). A day after the United States Supreme Court decided Chisholm , Congress introduced a bill amending the Constitution to overturn the decision. Id. That bill led to the adoption of the Eleventh Amendment. See id.

Since then, the sovereign-immunity doctrine in Virginia has persevered "alive and well," Commonwealth ex rel. Fair Hous. Bd. v. Windsor Plaza Condo. Ass'n , 289 Va. 34, 56, 768 S.E.2d 79 (2014) (citation omitted),1 though not without substantial debate over its permissible scope and the consistency of its applications.2 Addressing some of these concerns, "the General Assembly has employed an incremental approach by enacting a limited waiver of immunity in the Virginia Tort Claims Act." AlBritton v. Commonwealth , 299 Va. 392, 399, 853 S.E.2d 512 (2021) (citation omitted). Claims against localities and their employees, however, continue to be governed by the common-law principles.3 See Rector & Visitors of the Univ. of Va. v. Carter , 267 Va. 242, 244-45, 591 S.E.2d 76 (2004). One of the more difficult principles — the derivative sovereign immunity of a municipal employee — must be examined in the case now before us.


The first step in this analysis is to determine the scope of the governmental entity's immunity. Sovereign immunity protects municipalities from tort liability arising from governmental functions but not proprietary functions. See City of Chesapeake v. Cunningham , 268 Va. 624, 634, 604 S.E.2d 420 (20...

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  • Pfaller v. Amonette
    • United States
    • U.S. Court of Appeals — Fourth Circuit
    • December 15, 2022
    ...sovereign immunity applies to a state employee, a court must "focus on four, non-exclusive factors." Patterson v. City of Danville , ––– Va. ––––, 875 S.E.2d 65, 70 (2022). These factors are (1) "the function th[e] employee was performing"; (2) "the extent of the state's interest and involv......

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