Rockwell v. Cape Cod Hosp.

Citation26 F.3d 254
Decision Date04 January 1994
Docket NumberNo. 93-1581,93-1581
PartiesSusan ROCKWELL, Plaintiff, Appellant, v. CAPE COD HOSPITAL, et al., Defendants, Appellees. . Heard
CourtUnited States Courts of Appeals. United States Court of Appeals (1st Circuit)

Cailie Currin and Timothy A. Clune on brief, for Disability Advocates, Inc., amicus curiae.

John M. Dellea, with whom Jeanmarie Papelian, Ficksman & Conley, were on the briefs, for appellee Joan Marie Corr, M.D.

Leslie Lockard and Gaffin & Krattenmaker, P.C., were on the brief for appellee Cape Cod Hosp.

Colleen M. McKenna, with whom Mary Morrissey Sullivan, Richard L. Nahigian and Sullivan, Sullivan & Pinta, were on brief, for appellees Benjamin Ianzito, M.D. and Cape Cod Hosp.

Joel I. Klein, Paul M. Smith and Klein, Farr, Smith & Taranto on brief, for The American Psychiatric Ass'n, amicus curiae.

Before TORRUELLA, Circuit Judge, ALDRICH, Senior Circuit Judge, and STAHL, Circuit Judge.

TORRUELLA, Circuit Judge.

Susan Rockwell ("Rockwell") brought this 42 U.S.C. Sec. 1983 action pro se in the district court against Cape Cod Hospital ("the Hospital"), a private institution, and two private physicians, who pursuant to Mass.Gen.L. ch. 123, Sec. 12, involuntarily restrained her, admitted her to the Hospital and gave her medication. The doctors moved to dismiss the complaint. The court allowed the motion and entered final judgment in this case, dismissing all claims against all defendants.

STANDARD OF REVIEW

We review the grant of a motion to dismiss de novo, taking the allegations in the complaint as true and making all reasonable inferences in favor of plaintiff. Rumford Pharmacy, Inc. v. East Providence, 970 F.2d 996, 997 (1st Cir.1992). We must liberally construe Rockwell's pro se complaint and affirm its dismissal only if she cannot prove any set of facts entitling her to relief. Conley v. Gibson, 355 U.S. 41, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957); Estelle v. Gamble, 429 U.S. 97, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976).

BACKGROUND

On January 26, 1992, Rockwell entered the Emergency Room of the Hospital in Hyannis, Massachusetts to inquire about the precise location and time of an Alcoholics Anonymous ("AA") meeting which she knew was in a building on the grounds of the Hospital. Apparently concerned about her appearance, Hospital personnel suggested that she speak with a social worker. Rockwell agreed to do so, in lieu of her regular AA meeting.

After a brief conversation, the social worker contacted a Hospital physician, Dr. Joan Corr ("Dr. Corr"). Over Rockwell's objection, Dr. Corr ordered that her body and clothes be searched. According to Rockwell, she asked to telephone both her father, who is a physician, and her private psychiatrist, Dr. Christine Barney, but her requests were denied. Rockwell maintains that she then Dr. Corr ordered that Rockwell be physically restrained. After Rockwell refused to consent to medication, Dr. Corr ordered the forcible administration of anti-psychotic drugs. Dr. Corr signed the order admitting Rockwell to the Cape Cod Hospital on the evening of January 26, 1992 without Rockwell's consent.

urged Dr. Corr to call her treating therapist, but that request was also ignored. Without her consent, Dr. Corr telephoned the local mental health center and obtained access to her psychiatric records maintained by that facility.

According to Rockwell, she was awakened after midnight, while heavily drugged, and told to sign a "voluntary application" for admission to the Hospital. Rockwell repeatedly asked to see another doctor and to be released to the care of her treating psychiatrist. On January 27, 1992, Rockwell was allowed to sign a request for discharge. Dr. Benjamin Ianzato, another Hospital physician, examined Rockwell that same day and found no indications of dangerousness, suicidal thinking, or need for involuntary detention. On January 28, he agreed to discharge her to the care of a friend with the concurrence of her personal physician.

On January 19, 1993, Rockwell filed a civil rights action in the district court, seeking damages against Dr. Corr, Dr. Ianzato, the Hospital, and the Commonwealth of Massachusetts 1 for the violation of her federal constitutional rights to free speech, liberty, privacy, and procedural due process. Rockwell alleged that she was illegally and unnecessarily committed by doctors Corr and Ianzato and thereby deprived of her physical freedom and privacy. She also claimed that she was improperly confined by the Hospital. The complaint further alleged that both physicians and the Hospital physically restrained and forcibly drugged her, without cause and without legal authority. Finally, the complaint stated that Rockwell, while heavily sedated and partially asleep, was coerced into signing a voluntary admission form by Dr. Corr and the Hospital.

The defendants moved to dismiss. On April 16, 1993, the district court entered a final judgment in this case, dismissing all claims against all defendants. The district court held that Dr. Corr was immune from liability under a state statutory provision, Mass.Gen.L. ch. 123, Sec. 22. The district court also concluded that Rockwell's complaint failed to allege sufficient facts to demonstrate that defendants Corr, Ianzato, and Cape Cod Hospital acted under color of state law as required to state a civil rights cause of action.

On appeal, Rockwell argues that the district court erred (1) in concluding that the defendant-appellants did not act under color of state law, (2) by failing to construe her pro se complaint leniently, and (3) by not affording her an opportunity to amend her complaint before dismissing the action. Rockwell also challenges the district court's conclusion that Dr. Corr was immune from liability under state law.

DISCUSSION

"Title 42 U.S.C. Sec. 1983 provides a remedy for deprivations of rights secured by the Constitution and laws of the United States when that deprivation takes place 'under color of any statute, ordinance, regulation, custom, or usage, of any State or Territory....' " Lugar v. Edmondson Oil Co., 457 U.S. 922, 924, 102 S.Ct. 2744, 2747, 73 L.Ed.2d 482 (1982). In order to state a claim under Sec. 1983, a plaintiff must show both the existence of a federal constitutional or statutory right, and a deprivation of that right by a person acting under color of state law. Watterson v. Page, 987 F.2d 1, 7 (1st Cir.1993) (citing Willhauck v. Halpin, 953 F.2d 689, 703 (1st Cir.1991)).

There is no question that involuntary confinement for compulsory psychiatric treatment is a "massive curtailment of liberty." Humphrey v. Cady, 405 U.S. 504, 509, 92 S.Ct. 1048, 1052, 31 L.Ed.2d 394 (1972). Rockwell clearly has a liberty interest in being free from unwarranted confinement. The issue before us is whether the Hospital, Dr. Corr and Dr. Ianzato acted under color of state law when they acted pursuant to Mass.Gen.L. ch. 123, Sec. 12 to restrain and involuntarily admit Rockwell to the Hospital. In other words, we must decide whether private physicians and a private Hospital who "admit" a mentally disturbed person pursuant to the Massachusetts statute act under color of state law. 2 We find that they do not and hence, they are not subject to suit under 42 U.S.C. Sec. 1983.

Claims against the Hospital

Rockwell's claims against the Hospital are very similar to those brought by the plaintiff against a private hospital in Harvey v. Harvey, 949 F.2d 1127 (11th Cir.1992). In Harvey, the plaintiff was placed at a private hospital which had been designated by the state as an emergency receiving and evaluating facility for involuntarily committed mental health patients. She alleged that she was placed in a locked ward and given medication against her will. The court of appeals affirmed the district court's dismissal of her 42 U.S.C. Sec. 1983 suit against the hospital. Reasoning that the actions plaintiff questioned were actually the actions of the hospital's employees, not the actions of the hospital itself, the court held that the hospital could not be held liable because "[a] defendant cannot be held liable under section 1983 on a respondeat superior or vicarious liability basis." Harvey, 949 F.2d at 1129 (citing Monell v. Department of Social Servs., 436 U.S. 658, 98 S.Ct. 2018, 56 L.Ed.2d 611 (1978)). The court further found that even if the plaintiff could attribute liability to the hospital directly and not vicariously, her Sec. 1983 claim would still fail because the hospital was not a state actor. Harvey, 949 F.2d at 1130.

The court applied three tests to determine if there was state action: the state compulsion test, the nexus/joint action test, and the public function test. Id. Finding that the Georgia statutes governing the commitment process for the mentally ill neither compel nor encourage involuntary commitment, the court concluded that the hospital was not a state actor under the state compulsion test. The court further found that the Georgia statute in question did not create a sufficiently close nexus between the state and the hospital to satisfy the second test and therefore mandate the hospital's classification as a state actor. Finding that "the Georgia statute functions as a licensing provision enabling the hospital to receive mental patients" the court held that licensing and regulation are not enough to transform private hospitals into state actors for section 1983 purposes. Finally, under the third test, the court was "unwilling to categorize involuntary commitment in Georgia as a function so reserved to the state that action under the commitment statute transforms a private actor into a state actor" for purposes of section 1983 because the involuntary commitment of patients in Georgia was not traditionally the exclusive prerogative of the State, but rather was a power held co-extensive with the state. Id. at 1131.

Similarly, we apply the state compulsion test,...

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