Wideman v. Shallowford Community Hosp., Inc., 86-8512

Citation826 F.2d 1030
Decision Date08 September 1987
Docket NumberNo. 86-8512,86-8512
PartiesToni E. WIDEMAN and Myron Wideman, Individually and as Parents of Decedent Ebony Laslun Wideman, and Toni E. Wideman, in her capacity as Administratrix of the Estate of Ebony Laslun Wideman, Plaintiffs-Appellants, v. SHALLOWFORD COMMUNITY HOSPITAL, INC., A Georgia Corporation, et al., Defendants-Appellees.
CourtUnited States Courts of Appeals. United States Court of Appeals (11th Circuit)

Wade K. Copeland, Atlanta, Ga., for plaintiffs-appellants.

Albert Sidney Johnson, DeKalb Co. Atty., Decatur, Ga., for defendants-appellees.

Appeal from the United States District Court for the Northern District of Georgia.

Before HILL, KRAVITCH and EDMONDSON, Circuit Judges.

HILL, Circuit Judge:

This case presents the novel question of whether a county government's alleged practice of using its emergency medical vehicles only to transport patients to certain county hospitals which guarantee the payment of the county's medical bills violates a right protected by the federal constitution. We hold that such a practice, even if proved, would not violate any established constitutional right; therefore, the plaintiffs have failed to state a claim under 42 U.S.C. Sec. 1983.

I. BACKGROUND

The facts underlying this case are undeniably tragic. On April 12, 1984, Toni Wideman, who at the time was four months pregnant, began experiencing abdominal pain. She called her obstetrician, Dr. John Ramsey, who instructed her to come immediately to Piedmont Hospital. Ms. Wideman called the 911 emergency telephone number in DeKalb County and requested an ambulance to take her to Piedmont. Three employees of the DeKalb County Emergency Medical Service (EMS) responded to this call. Ms. Wideman claims that she again informed the EMS employees to take her to Piedmont where her doctor was waiting, but they refused and, instead, took her against her wishes to Shallowford Community Hospital. After a substantial delay, during which the attending physician at Shallowford spoke by phone with Dr. Ramsey, Ms. Wideman was transferred to Piedmont. At that point, however, Dr. Ramsey was unable to stop her labor, and Ms. Wideman gave birth to a premature baby, named Ebony Laslun Wideman, who survived for only four hours.

Toni Wideman and her husband subsequently filed this action under 42 U.S.C. Secs. 1983, 1985 and 1988 seeking damages for the wrongful death of their child. Specifically, they alleged that a conspiracy existed between Shallowford Hospital and DeKalb County, whereby the County had a policy and practice of using its emergency medical vehicles to transport patients only to hospitals such as Shallowford which guaranteed the payment of the County's emergency medical bills. Piedmont Hospital supposedly had no such agreement with DeKalb County. The plaintiffs claimed that this conspiracy deprived them of their federal constitutional right to essential medical treatment and care. In addition, the plaintiffs alleged various pendent state law claims based on false imprisonment, negligence, and intentional infliction of emotional distress. The Widemans named as defendants DeKalb County, Shallowford Hospital, and the three DeKalb County EMS employees in their official capacities.

The plaintiffs sought discovery against the County and the EMS employees. The plaintiff served interrogatories and noticed the depositions of the three EMS employees, as well as a designated individual for the County. The County and its employees, however, refused to participate in discovery due to the unresolved nature of a potential immunity defense. Shortly thereafter, the governmental defendants moved for summary judgment. They supported this motion with the affidavits of the three EMS employees, but still refused to make these individuals available to the plaintiffs. Defendant Shallowford Hospital also moved for partial summary judgment on the plaintiffs' federal claims. The plaintiffs then moved for leave to amend their complaint, supported by the affidavit of Kenneth Lamoureux, a former employee of the DeKalb County EMS. 1 The plaintiffs also filed a motion to compel discovery and a motion for a continuance pursuant to Fed.R.Civ.P. 56(f).

The district court denied all of the plaintiffs' motions. Further, finding the plaintiffs' opposing affidavits to be "wholly inadequate" to establish the alleged policy and conspiracy, the court granted summary judgment in favor of all defendants on the plaintiffs' federal claims. 2 This appeal followed.

II. NATURE OF A SECTION 1983 ACTION

The Widemans' federal claims are brought pursuant to the federal civil rights statutes, primarily 42 U.S.C. Sec. 1983. It is well established that section 1983 itself creates no substantive rights; it merely provides a remedy for deprivations of federal rights established elsewhere. City of Oklahoma City v. Tuttle, 471 U.S. 808, 105 S.Ct. 2427, 2432, 85 L.Ed.2d 791 (1985) (plurality); Wilson v. Garcia, 471 U.S. 261, 105 S.Ct. 1938, 1948, 85 L.Ed.2d 254 (1985); Baker v. McCollan, 443 U.S. 137, 144 n. 3, 99 S.Ct. 2689, 2694 n. 3, 61 L.Ed. 433 (1979). To sustain a cause of action based on section 1983, the Widemans must establish two elements: (1) that they suffered a deprivation of "rights, privileges or immunities secured by the Constitution and laws" of the United States, and (2) that the act or omission causing the deprivation was committed by a person acting under color of law. Dollar v. Haralson County, 704 F.2d 1540, 1542-43 (11th Cir.), cert. denied, 464 U.S. 963, 104 S.Ct. 399, 78 L.Ed.2d 341 (1983). Thus, section 1983 imposes liability only "for violations of rights protected by the Constitution, not for violations of duties of care arising out of tort law." Baker v. McCollan, 443 U.S. at 146, 99 S.Ct. at 2695. It does not provide a remedy for "any and all injuries inflicted by persons acting under color of state law." Washington v. District of Columbia, 802 F.2d 1478, 1480 (D.C.Cir.1986). Absent the existence of an underlying constitutional right, no section 1983 claim will lie.

When a local governmental entity is the subject of a section 1983 suit, the plaintiff bears an additional burden. To establish the liability of a city or county under section 1983, the plaintiff must show that the constitutional deprivation resulted from a custom, policy, or practice of the municipality. Monell v. Dept. of Social Servs., 436 U.S. 658, 694, 98 S.Ct. 2018, 2037, 56 L.Ed.2d 611 (1978); Bradberry v. Pinellas County, 789 F.2d 1513, 1515 (11th Cir.1986). Moreover, proof of a single, isolated incident of unconstitutional activity generally is not sufficient to impose municipal liability under Monell. City of Oklahoma City, 471 U.S. at 823-24, 105 S.Ct. at 2436; Anderson v. City of Atlanta, 778 F.2d 678, 685 (11th Cir.1985).

The arguments and briefs both in this court and in the district court have focused primarily on the dispute as to whether the plaintiffs have made a sufficient showing that the alleged custom or practice in fact exists. The plaintiffs' arguments on appeal regarding discovery, the amendment of their complaint, and the sufficiency of their affidavits all relate to the issue of the existence of the allegedly unlawful policy. Similarly, the defendants' arguments relate to whether the plaintiffs' evidence is sufficient to establish such a policy, and, if so, whether the individual defendants can avail themselves of a qualified immunity defense. It seems that both parties, as well as the district court, have assumed that the alleged policy violates a cognizable constitutional right, which the plaintiffs characterize as their right to the provision of essential medical treatment and services by the County. 3 However, because section 1983 provides a remedy only for violations of rights secured by the Constitution or federal laws, the proper resolution of this case requires us first to determine whether the Constitution grants a right to medical care and treatment in these circumstances.

III. EXISTENCE OF A CONSTITUTIONAL RIGHT TO ESSENTIAL MEDICAL CARE
A.

Beginning from the broadest prospective, we can discern no general right, based upon either the Constitution or federal statutes, to the provision of medical treatment and services by a state or municipality. If such a right exists at all, it must derive from the fourteenth amendment's due process clause, which forbids a state to deprive anyone of life, liberty or property without due process of law. The due process clause, however, has traditionally been interpreted as protecting certain "negative liberties," i.e., an individual's right to be free from arbitrary or discriminatory action taken by a state or municipality. This circuit has recognized the "well established notion that the Constitution limits the actions the states can take rather than mandating specific obligations." Bradberry v. Pinellas County, 789 F.2d 1513, 1517 (11th Cir.1986). The Constitution is "a charter of negative rather than positive liberties." Jackson v. City of Joliet, 715 F.2d 1200, 1203 (7th Cir.1983), cert. denied, 465 U.S. 1049, 104 S.Ct. 1325, 79 L.Ed.2d 720 (1984). "[I]t tells the state to let people alone; it does not require the federal government or the state to provide services...." Bowers v. DeVito, 686 F.2d 616, 618 (7th Cir.1982). 4

Two Supreme Court decisions dealing with access to abortions also support our conclusion that there is no general right to medical care or treatment provided by the state. In Maher v. Roe, 432 U.S. 464, 97 S.Ct. 2376, 53 L.Ed.2d 484 (1977), two indigent women brought suit challenging a Connecticut regulation prohibiting the funding of abortions that were not medically necessary. The plaintiffs argued under the fourteenth amendment that the state regulation impinged on their constitutional right to an abortion, as recognized in Roe v. Wade, 410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147 (1973). The Court upheld the state regulation, concluding that Roe did not declare an...

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