United States District Court, S.D. New York
November 18, 2014
BEVERLY DIANE ANTWI, Plaintiff,
MONTEFIORE MEDICAL CENTER, Defendant.
OPINION AND ORDER
EDGARDO RAMOS, District Judge.
This action is one of two, related to substantially similar parties and events, brought in this Court by pro se litigant Beverly Diane Antwi ("Plaintiff"). In an ongoing, earlier-filed action, Plaintiff alleges that Health & Human Services Systems (Centers) F.E.G.S. ("FEGS"), a non-profit health center where she resides and receives care, denied her benefits from government programs, misappropriated federal funds intended for her use, and made reports that resulted in her unlawful hospitalization at Montefiore Medical Center in violation of her human rights and civil liberties. See Antwi v. Health & Human Servs. Sys. (Centers) F.E.G.S., No. 13 Civ. 835 (ER), 2014 WL 4548619, at *1 (S.D.N.Y. Sep. 15, 2014) (denying Plaintiff's motion for summary judgment).
In the instant case, Plaintiff alleges that psychiatrists employed by Montefiore Medical Center ("Defendant" or "Montefiore") involuntarily hospitalized her, placed her in a mandatory outpatient treatment program due to a "mix-up of records, " and forcibly medicated her. See Compl., Doc. 2 at 3-5. Liberally construed, the Complaint asserts claims against Montefiore for defamation, gross negligence, intentional infliction of emotional distress, and civil rights violations pursuant to 42 U.S.C. § 1983. Id. Defendant now moves to dismiss the Complaint pursuant to Rules 12(b)(1) and 12(b)(6) of the Federal Rules of Civil Procedure. See Def.'s Mot., Doc. 17. For the reasons discussed below, Defendant's motion to dismiss for lack of subject matter jurisdiction is DENIED. However, Defendant's motion to dismiss for failure to state a claim is hereby GRANTED.
A. Factual Background
The following facts, accepted as true for purposes of the instant motion, are based on the allegations in the Complaint, Plaintiff's Opposition to Defendant's motion to dismiss, exhibits attached to her Complaint and Opposition,  and affidavits submitted by the parties. See Koch v. Christie's Int'l PLC, 699 F.3d 141 (2d Cir. 2012) (evaluating a Rule 12(b)(6) motion); J.S. ex rel. N.S. v. Attica Cent. Sch., 386 F.3d 107, 110 (2d Cir. 2004) (citing Shipping Fin. Servs. Corp. v. Drakos, 140 F.3d 129, 131 (2d Cir. 1998)) (evaluating a Rule 12(b)(1) motion).
Plaintiff is a 40-year-old woman with a history of psychiatric disorders and hospitalizations. Doc. 2-1 at 1. Defendant is a private, not-for-profit hospital corporation organized and established under the laws of the State of New York. Pl.'s Opp'n, Doc. 21 at 30. On multiple occasions, Plaintiff has been hospitalized and treated in the psychiatric unit at Defendant's Montefiore North Medical Center ("Montefiore North"), which provides inpatient and outpatient services. Id.
On July 11, 2012, Plaintiff was involuntarily admitted to the psychiatric unit at Montefiore North pursuant to § 9.39 of the New York Mental Health Law (MHL), which permits short-term confinement on an emergency basis. Doc. 21 at 12, 25. She was "continued on involuntary status" at Montefiore on July 17, 2012, pursuant to MHL § 9.27. Id. at 25. Prior to her July 11 admission, Plaintiff had been hospitalized at Montefiore North on several other occasions: January 1 to January 6, 2011; January 25 to February 21, 2012; and March 16 to March 22, 2012. Doc. 21 at 36. According to Dr. Willy Alexis, whose affirmation Plaintiff includes among her exhibits, "Upon discharge from each of the above hospitalizations, [Plaintiff] was to receive outpatient services from the Montefiore North Clinic, but did not comply, stopped taking her medications, and decompensated as a result of non-compliance with treatment." Id. 
Plaintiff was hospitalized for several months following her July 11 admission. During that time, Dr. Alexis, "after consultation with [Plaintiff] and other members of her treatment team, " devised a treatment plan providing for care coordination among an Assertive Community Treatment (ACT) Team, supportive housing at FEGS, and a course of many medications. Id. at 37. Dr. Alexis stated that Plaintiff was "in need of Assisted Outpatient Treatment ["AOT"] in order to prevent a relapse or deterioration which would likely result in serious harm to [her] or others..., " and that Plaintiff, to his belief, could not "be safely maintained in any less restrictive placement...." Id.
On October 11, 2012, Defendant submitted an application to the New York State Supreme Court, Bronx County, seeking an AOT program pursuant to MHL § 9.60. Doc. 21 at 26. Also known as "Kendra's Law, " § 9.60 authorizes courts to order that patients "selfadminister psychotropic drugs or accept the administration of such drugs by authorized personnel" and participate in outpatient programs including "case management or case coordination services, medication, substance abuse counseling and testing, and therapy." Coleman v. State Supreme Ct., 697 F.Supp.2d 493, 498-99 (S.D.N.Y. 2010) (quoting MHL § 9.60). Defendant supported its application for an AOT program with Dr. Alexis' affirmation and testimony, describing Plaintiff's history of noncompliance with treatment and episodes in which Plaintiff had become "psychotic, paranoid, agitated, delusional, threatening, loud, belligerent, and hypereligious." Doc. 21 at 36; Doc. 23-1 at 1. A hearing was held before the Honorable Sharon Ann Aarons in the Mental Hygiene Part of the Supreme Court of the State of New York, Bronx County, on October 17, 2012, at which Plaintiff was represented by counsel. Doc. 21 at 41-42. Judge Aarons found, by clear and convincing evidence, that Plaintiff met the MHL criteria for AOT, and that AOT was the "least restrictive treatment that [was] appropriate and feasible." Id. She issued a court order for the treatment plan devised by Dr. Alexis. Id.
Although Judge Aarons' order states that she approved Defendant's treatment plan pursuant to MHL § 9.60 based on the evaluations and diagnoses of Dr. Alexis and the staff at Montefiore North, Doc. 21 at 41-44, Plaintiff alleges that her hospitalization and AOT both resulted from Defendant's faulty record-keeping. See, e.g., Doc. 21 at 3 ("Kendra's law criteria wouldn't have been satisfied if my real records were used at the time of trial.") (emphasis in original); Doc. 2 at 3 (claiming that her hospitalization resulted from a "mix-up of records" and "faulty paperwork" claiming that she was "somebody dangerous" or "criminally minded"); id. at 22 (claiming that Montefiore "mixed up" her records "by Hospitalizing 2 other women under [her] name and chart number As [her]"); Doc. 21 at 2-3 (claiming that on January 6, 2011, "Montefiore admitted 3 people under [her] name and information, all at the same time on the same day"). She explains that Defendant's "years of ruined records" amount to "defamation, gross negligence, and psychological abuse." Id. She further states that her hospitalization and court-ordered treatment plan, which includes biweekly injections of what she describes as "horse pill amounts" of anti-psychotic medications,  constitute civil rights violations and wrongful punishments. Id.; Doc. 2 at 3. Additionally, Plaintiff asserts that she should not have been subjected to treatment supervised by an ACT Team because she was hospitalized for four months prior to her hearing. Id. at 3.
B. Procedural History
Plaintiff commenced this action on February 6, 2014. Doc. 2. Originally assigned to the Honorable Richard J. Sullivan, the case was transferred to the undersigned on May 21, 2014 based on its relatedness to Plaintiff's earlier-filed suit, Antwi v. FEGS Health and Human Services System. Doc. 11; see also Doc. 21 at 3 ("I sued FEGS my residence for the application of admission and seek to sue Montiefore [sic] for the actual admission (which because it is a form of incarceration) is a civil rights violation.") (emphasis and parentheses in original).
Although the Complaint does not identify specific causes of action, Doc. 2, the Court construes her allegations as asserting substantive and procedural due process claims under 42 U.S.C. § 1983 and state law claims for gross negligence, defamation, and intentional infliction of emotional distress. See, e.g., Doc. 21 at 2-3 (discussing defamation, gross negligence, "psychological abuse, " "civil rights violations, " and her "inability to refuse treatment"). She seeks more than $50 million in damages: $250, 000 for each intra-muscular anti-psychotic injection, $15 million for her involuntary hospitalization from July to October 2012, and $5 million for each hospitalization from 2010 to 2012. Doc. 2 at 5. Plaintiff asserts federal question jurisdiction under 28 U.S.C. § 1331 and asks the Court to exercise jurisdiction over the pendent state law claims pursuant to 28 U.S.C. § 1367.
Defendant now moves to dismiss the Complaint pursuant to Rules 12(b)(1) and 12(b)(6) of the Federal Rules of Civil Procedure, arguing that this Court lacks subject matter jurisdiction and that the Complaint fails to state a claim upon which relief can be granted. Doc. 17.
II. Relevant Legal Standards
A. Rule 12(b)(1)
Federal Rule of Civil Procedure 12(b)(1) requires that an action be dismissed for lack of subject matter jurisdiction when the district court lacks the statutory or constitutional power to adjudicate the case. Fed.R.Civ.P. 12(b)(1). The party asserting subject matter jurisdiction carries the burden of establishing, by a preponderance of the evidence, that jurisdiction exists. Morrison v. Nat'l Australia Bank Ltd., 547 F.3d 167, 170 (2d Cir. 2008) (quoting Makarova v. United States, 201 F.3d 110, 113 (2d Cir. 2000)). On a Rule 12(b)(1) motion challenging the district court's subject matter jurisdiction, evidence outside of the pleadings, such as affidavits, may be considered by the court to resolve the disputed jurisdictional fact issues. Zappia Middle E. Constr. Co. v. Emirate of Abu Dhabi, 215 F.3d 247, 253 (2d Cir. 2000); see also Morrison, 547 F.3d at 170 (citing Makarova, 201 F.3d at 113). When evaluating a motion to dismiss for lack of subject matter jurisdiction, the court accepts all material factual allegations in the complaint as true but does not necessarily draw inferences from the complaint favorable to the plaintiff. J.S. ex rel. N.S. v. Attica Cent. Sch., 386 F.3d 107, 110 (2d Cir. 2004) (citing Shipping Fin. Servs. Corp. v. Drakos, 140 F.3d 129, 131 (2d Cir.1998)).
Where, as here, a party also seeks dismissal on Rule 12(b)(6) grounds, the court must consider the Rule 12(b)(1) motion first, Baldessarre v. Monroe-Woodbury Cent. Sch. Dist., 820 F.Supp.2d 490, 499 (S.D.N.Y. 2011), aff'd sub nom. Baldessarre ex rel. Baldessarre v. Monroe-Woodbury Cent. Sch. Dist., 496 F.Appx. 131 (2d Cir. 2012), because "disposition of a Rule 12(b)(6) motion is a decision on the merits, and therefore, an exercise of jurisdiction." Chambers v. Wright, No. 05 Civ. 9915 (WHP), 2007 WL 4462181, at *2 (S.D.N.Y. Dec. 19, 2007) (quoting Magee v. Nassau Cnty. Med. Ctr., 27 F.Supp.2d 154, 158 (E.D.N.Y.1998)).
B. Rule 12(b)(6)
When ruling on a motion to dismiss pursuant to Rule 12(b)(6), district courts are required to accept as true all factual allegations in the complaint and to draw all reasonable inferences in the plaintiff's favor. Walker v. Schult, 717 F.3d 119, 124 (2d Cir. 2013). However, this requirement does not apply to legal conclusions, bare assertions or conclusory allegations. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007)). In order to satisfy the pleading standard set forth in Rule 8 of the Federal Rules of Civil Procedure, a complaint must contain sufficient factual matter to state a claim to relief that is plausible on its face. Id. (citing Twombly, 550 U.S. at 570). Pleadings that tender "naked assertions devoid of further factual enhancement, " Id. (quoting Twombly, 550 U.S. at 557) (internal quotation marks omitted), or "an unadorned, the-defendant-unlawfully-harmed-me accusation" will not suffice. Id. (quoting Twombly, 550 U.S. at 555).
In addition to requiring sufficient factual matter to state a plausible claim to relief, Rule 8 requires a "short and plain statement" of a plaintiff's claim in order to "give the adverse party fair notice of the claim asserted so as to enable him to answer and prepare for trial." Salahuddin v. Cuomo, 861 F.2d 40, 41-42 (2d Cir. 1988). It is within the court's discretion to dismiss a complaint "so confused, ambiguous, vague, or otherwise unintelligible that its true substance, if any, is well disguised." Shomo v. New York, 374 Fed.App'x 180, 182 (2d Cir. 2010) (quoting Salahuddin, 861 F.2d at 42).
C. Pro Se Plaintiff
The Court holds submissions by pro se litigants to "less stringent standards than formal pleadings drafted by lawyers, " Ferran v. Town of Nassau, 11 F.3d 21, 22 (2d Cir. 1993) (quoting Hughes v. Rowe, 449 U.S. 5, 9 (1980)), and liberally construes their pleadings "to raise the strongest arguments that they suggest." McPherson v. Coombe, 174 F.3d 276, 280 (2d Cir. 1999) (citations omitted). The obligation to be lenient while reading a pro se plaintiff's pleadings "applies with particular force when the plaintiff's civil rights are at issue." Jackson v. N.Y.S. Dep't of Labor, 709 F.Supp.2d 218, 224 (S.D.N.Y. 2010) (citing McEachin v. McGuinnis, 357 F.3d 197, 200 (2d Cir. 2004)). Nonetheless, pro se status "does not exempt a party from compliance with relevant rules of procedural and substantive law." Triestman v. Fed. Bureau of Prisons, 470 F.3d 471, 477 (2d Cir. 2006) (quoting Traguth v. Zuck, 710 F.2d 90, 95 (2d Cir. 1983)); see also Zapolski v. Federal Republic of Germany, 425 Fed.App'x 5, 6 (2d Cir. 2011) ( pro se plaintiffs must plead sufficient facts to establish a plausible claim to relief and establish subject matter jurisdiction).
A. Section 1983
To state a claim under § 1983, a plaintiff must allege that: (1) a right secured to them by the Constitution or federal law was violated; and (2) the alleged violation was committed by a person acting under color of state law. Am. Mfrs. Mut. Ins. Co. v. Sullivan, 526 U.S. 40, 49-50 (1999). Section 1983 does not create any rights, but merely provides "a procedure for redress for the deprivation of rights [already] established." Sykes v. James, 13 F.3d 515, 519 (2d Cir. 1993) (citation omitted). It is well-established that involuntary confinement and forced medication constitute significant deprivations of liberty requiring due process protection. See Addington v. Texas, 441 U.S. 418, 425 (1979) (citing numerous cases in which the United States Supreme Court affirmed this principle with regard to involuntary commitment); see also Washington v. Harper, 494 U.S. 210, 229 (1990) ("The forcible injection of medication into a nonconsenting person's body represents a substantial interference with that person's liberty."). The pivotal issue in this case is whether Defendants were state actors when they hospitalized and medicated Plaintiff against her will. See Doe v. Harrison, 254 F.Supp.2d 338, 342 (S.D.N.Y. 2003).
"[P]rivate conduct, no matter how discriminatory or wrongful, " is not controlled by § 1983, Am. Mfrs., 526 U.S. at 50, except in the limited situations where a "private entity's challenged actions are fairly attributable' to the state." Fabrikant v. French, 691 F.3d 193, 207 (2d Cir. 2012) (quoting Rendell-Baker v. Kohn, 457 U.S. 830, 838 (1982)). "The conduct of private actors can be attributed to the State" for § 1983 purposes if: "(1) the State compelled the conduct, (2) there is a sufficiently close nexus between the State and the private conduct, or (3) the private conduct consisted of activity that has traditionally been the exclusive prerogative of the State." Hogan v. A.O. Fox Memorial Hosp., 346 Fed.App'x. 627, 629 (2d Cir. 2009).
Plaintiff offers no facts or arguments to establish that Defendant, a private hospital, meets the state action requirement of § 1983. Regardless, had she provided any such arguments, they would have proven unavailing, for it is well-settled in the Second Circuit that a private hospital confining a patient under the New York MHL is not acting under color of state law. See McGugan v. Aldana-Bernier, 752 F.3d 224, 229 (2d Cir. 2014) (reaffirming the principle that "forcible medication and hospitalization... by private health care providers" cannot be attributed to the state); Hogan, 346 Fed.App'x at 629 (affirming district court's grant of summary judgment to private hospital and physician that involuntarily committed patient, finding that conduct could not be attributed to the state); Doe v. Rosenberg, 166 F.3d 507 (2d Cir. 1999) (holding that private health care professionals and a private hospital had not functioned as state actors when they involuntarily committed a patient to their psychiatric ward).
In numerous § 1983 cases involving private hospitals and health care professionals, Southern District courts have found that none of the three tests for state action-"state compulsion, " "public function, " and "close nexus"-are satisfied. See, e.g., McGugan v. Aldana-Bernier, No. 11 Civ. 342 (TLM), 2012 WL 1514777, at *4 (E.D.N.Y. Apr. 30, 2012) aff'd 752 F.3d 224 (2d Cir. 2014); Amofa v. Bronx-Lebanon Hosp. Center, No. 05 Civ. 9230 (SHS), 2006 WL 3316278, at *4 (S.D.N.Y. Nov. 13, 2006); Turturro v. Continental Airlines, 334 F.Supp.2d 383, 395-97 (S.D.N.Y. 2004); Doe v. Harrison, 254 F.Supp.2d 338, 342-45 (S.D.N.Y. 2003); Doe v. Rosenberg, 996 F.Supp. 343, 353 (S.D.N.Y. 1998), aff'd 166 F.3d 507; Alcena v. Raine, 692 F.Supp. 261, 266-67 (S.D.N.Y. 1988). Nor are they satisfied in the case of Plaintiff. The MHL provisions supporting her hospitalization and treatment do not "compel" or encourage action by private hospitals and health care professionals; the statute merely permits such action under certain circumstances. See Doe, 996 F.Supp. at 349; McGugan, 2012 WL 1514777, at *4-5. Civil commitment pursuant to the MHL does not constitute the exercise of a power "traditionally the exclusive prerogative of the State." Id. Rather, involuntary confinement has been a traditionally "private remedy" in New York. Id. at *4; see also Doe, 996 F.Supp. at 355-56. There is no "sufficiently close nexus" between Defendant and the state, because Defendant chose to commit Plaintiff based on the evaluations and diagnoses of its own employees, without consultation or direction from state officials. See Doe, 254 F.Supp.2d at 343; Doe, 996 F.Supp. at 353; McGugan, 2012 WL 1514777, at *5-6. Because Plaintiff cannot establish state action, her § 1983 claims must be dismissed.
Defendant asks the Court to dismiss this action pursuant to Rules 12(b)(1) and (6) of the Federal Rules of Civil Procedure but declines to offer specific grounds for dismissal under each. To the extent that Defendant's motion to dismiss for lack of subject matter jurisdiction is based upon the deficiency in Plaintiff's § 1983 allegations, Rule 12(b)(1) is the improper vehicle for such an argument. See Sisak v. Nat'l R.R. Passenger Corp. (Amtrak), No. 91 Civ. 1030 (JFK), 1992 WL 42245, at *2 (S.D.N.Y. Feb. 24, 1992) (quoting AVC Nederland B.V. v. Atrium Inv. Partnership, 740 F.2d 148, 152-53 (2d Cir.1984)) ("[A] section 1983 claim should not be dismissed for want of jurisdiction except when it appears to be immaterial and made solely for the purpose of obtaining jurisdiction or where such a claim is wholly insubstantial and frivolous.'"). Even where the Court anticipates that dismissal under Rule 12(b)(6) would be proper, it should not dismiss an action for lack of jurisdiction. Spencer v. Casavilla, 903 F.2d 171 (1990). Dismissal pursuant to Rule 12(b)(6), however, is necessary. Plaintiff's inability to allege that Defendant acted under color of state law when it hospitalized and medicated her, or when it applied for a court-ordered assisted outpatient treatment plan, renders her unable to state a claim upon which relief can be granted pursuant to 42 U.S.C. § 1983.
B. Remaining Claims
In addition to her § 1983 claims, Plaintiff's Complaint may be liberally construed as alleging claims for gross negligence, defamation, and intentional infliction of emotional distress. Under 28 U.S.C. § 1367(c)(3), if the Court has dismissed all of the claims over which it has original jurisdiction, it may decline to exercise jurisdiction over any non-federal claims over which it could have exercised supplemental jurisdiction. Subject matter jurisdiction in the instant action is based on federal question jurisdiction. 28 U.S.C. § 1331. Having dismissed all of Plaintiff's federal claims under Rule 12(b)(6), it would be inappropriate to adjudicate her state law claims. See United Mine Workers v. Gibbs, 383 U.S. 715, 726 (1966) ("Certainly, if the federal claims are dismissed before trial... the state claims should be dismissed as well."); McGugan, 2012 WL 1514777, at *8 ("[W]hen all federal claims are eliminated in the early stages of litigation, the balance of factors generally favors declining to exercise pendent jurisdiction over remaining state law claims and dismissing them without prejudice."). Therefore, all non-federal claims in the Amended Complaint are hereby dismissed as well.
For the reasons stated above, Defendants' motion to dismiss Plaintiff's § 1983 claims is GRANTED. The Court declines to exercise supplemental jurisdiction over her remaining claims pursuant to 28 U.S.C. § 1367(c)(3) and therefore DISMISSES them without prejudice. The Clerk of the Court is respectfully directed to terminate the motion, Doc. 17, to mail a copy of this Opinion and Order to Plaintiff, and to close this case.