DUNCAN, Circuit Judge.
Dr. Joseph Jemsek filed suit seeking declaratory and injunctive relief against the State of North Carolina, the North Carolina Medical Board ("NCMB" or "Board"), and former and current Board members, alleging that a conflict of interest infected Board disciplinary proceedings that sanctioned Jemsek, thereby violating his Fourteenth Amendment right to procedural due process. The district court dismissed Jemsek's complaint because he lacked standing to sue the former Board members and Defendants were otherwise immune from suit under the Eleventh Amendment. Jemsek appealed the district court's dismissal. Finding no error, we affirm.
Jemsek is a licensed physician who previously practiced medicine in North Carolina.
Jemsek submitted claims to Blue Cross Blue Shield of North Carolina ("BCBSNC") on behalf of insured patients for care that included long-term antibiotic treatment. Although BCBSNC initially accepted Jemsek's claims, in 2003, it began to examine more closely those claims that included long-term antibiotic use. In 2005, BCBSNC stopped accepting such claims altogether. In 2005, BCBSNC insureds treated by Dr. Jemsek also filed several complaints with the NCMB concerning his use of long-term antibiotic treatments.
The Board investigated Jemsek, formally charged him with professional misconduct, conducted disciplinary hearings, and ultimately sanctioned him. In an order dated August 21, 2006 ("2006 order"), the Board suspended Jemsek's medical license for one year but stayed the suspension provided that (1) Jemsek develop an informed consent form approved by the Board, (2) if Jemsek's diagnosis of patients was not supported by Center for Disease Control criteria, then those patients must receive a consultation or second opinion before Jemsek could treat them, (3) Jemsek's treatment of Lyme disease with long-term antibiotics be included in a formal research protocol with institutional review board supervision, and (4) any complications of treatment be addressed immediately.
In 2008, the Board launched another investigation into Jemsek's treatment of patients with chronic Lyme disease through the use of hyperbaric chambers. During this investigation, NCMB investigators informed Jemsek that, if he allowed his North Carolina medical license to become inactive, the Board would end the investigation. Jemsek agreed, and the investigation ended with the Board issuing a public letter of concern dated June 23, 2008 ("2008 letter"). Dr. Janelle A. Rhyne, then-president of the Board, signed the 2008 letter.
In 2012, Jemsek began a campaign of unsuccessful litigation before the Board and in state court seeking a declaration that the 2006 order was null, void, and illegal.
During June of 2014, while his petition for discretionary review was pending, Jemsek learned that Rhyne may have had a conflict of interest when she participated in the disciplinary process that led up to the 2006 order and the 2008 letter. Rhyne was, at the same time, a paid consultant to BCBSNC. Jemsek did not bring this fact to the attention of the Supreme Court of North Carolina through a procedural mechanism available to him.
With his petition for discretionary review still pending in state court, on September 9, 2014, Jemsek filed the instant suit in federal district court against the State of North Carolina, the Board, and former and current Board members in their official and individual capacities (collectively, "Defendants"). The complaint alleged that bias infected the state medical license disciplinary proceedings in violation of his due process right to an impartial tribunal. Jemsek sought declaratory relief under 28 U.S.C. § 2201 that the 2006 order and 2008 letter were unconstitutional and an injunction under 42 U.S.C. § 1983 rescinding them. In October and November of 2014, Defendants moved to dismiss Jemsek's federal complaint.
On December 18, 2014, the Supreme Court of North Carolina denied Jemsek's petition for discretionary review, thus ending the state court litigation.
Subsequently, on March 20, 2015, the district court granted the Defendants' motions to dismiss in the instant suit. The district court found that Jemsek lacked standing to sue the former Board members because they could not redress his injuries; they had no authority to comply with an injunction to rescind a Board order and a declaratory judgment would have no legal effect as to these individuals. The district court also found that the Eleventh Amendment otherwise barred Jemsek's claims because Jemsek alleged past violations of his due process rights and did not seek prospective relief. Jemsek timely appealed on April 16, 2015.
Jemsek's arguments have narrowed on appeal. Jemsek now concedes that the Eleventh Amendment bars his claims against the State of North Carolina and the NCMB, and he has abandoned those claims. Appellant's Br. at 9; ECF Nos. 22, 25.
It appears that Jemsek has also abandoned his claims against current and former Board members in their individual capacities. He clarifies in his opening brief that he is only suing former Board members in their official capacities. Appellant's Br. at 44-45. As for current Board members, Jemsek only states that he seeks injunctive relief against them in their official capacities.
The issues of standing and Eleventh Amendment immunity, including the
As we explain below, we conclude that the district court correctly dismissed Jemsek's claims for injunctive and declaratory relief against the former Board members for lack of standing.
For Article III standing, "[t]he party invoking federal jurisdiction bears the burden of establishing" (1) injury in fact, (2) causation, and (3) redressability.
Here, whatever authority the former Board members had at the time of the 2006 order and the 2008 letter, they have none now. Jemsek acknowledges that injunctive relief cannot be enforced against the former Board members. Appellant's Br. at 38, 45-46. Having identified no other relief besides a declaratory judgment that the former Board members can provide, Jemsek thus effectively concedes that he lacks standing to sue them.
The district court also correctly concluded that Jemsek's claims do not fit within the
The Eleventh Amendment bars suits in federal court by citizens against unconsenting states and state agencies.
The doctrine of
Jemsek argues that because the 2006 order and 2008 letter remain on the record, there is an ongoing violation such that a declaratory judgment voiding those documents, and an injunction rescinding them, would qualify as prospective relief. This contention fails under our established precedent.
In
Jemsek asserts that the continued existence and "publication" of the 2006 order and 2008 letter amount to an ongoing constitutional violation.
Regardless of whether the allegations are true, the Board is not continuing to violate Jemsek's rights. Jemsek admitted at oral argument he has not sought reinstatement of his North Carolina medical license as the Board's rules allow. 21 N.C. Admin. Code 32B.1350. Jemsek has not plausibly alleged that the Board is "continuing to prevent [him], either by action or non-action, from" seeking to resume his medical practice in the state.
The Supreme Court has acknowledged that "the difference between the type of relief barred by the Eleventh Amendment and that permitted under
Finally, we note that this is not a case in which allegations of constitutional violations might escape judicial review entirely. Jemsek claims he discovered Rhyne's alleged conflict of interest in June of 2014. At that time, his petition for discretionary review with the Supreme Court of North Carolina was still pending. Jemsek could have raised his current claims in the state court litigation pursuant to Rule 60(b)(6) of the North Carolina Rules of Civil Procedure. N.C. Gen. Stat. § 1A-1, Rule 60(b). North Carolina allows a state trial court to rule on a Rule 60(b) motion while an appeal is pending and, if it is denied, allows consideration of that claim on appeal as well.
Jemsek had an opportunity to raise his claims of unconstitutional bias in state court. He may apply for reinstatement with the Board. And if unsuccessful, he may seek redress of any unfavorable action in state court. "Under [our] system of dual sovereignty, we have consistently held that state courts . . . are . . . presumptively competent . . . to adjudicate claims" of federal right.
For the foregoing reasons, the judgment of the district court is