Mark R. Hornak, United States District Judge.
In late December, 2013, Derek A. Thomas was arrested and brought to Fayette
The next day, Sunday, December 22, 2013, Correctional Officer Tammy Popiesh came on duty around 3:30 p.m. Officer Popiesh and Mr. Thomas recognized each other from a prior incarceration of his, so Mr. Thomas helped Officer Popiesh distribute and re-collect the trays for dinner. About two hours later, Officer Popiesh took her break and was relieved by another Officer. When Officer Popiesh returned from her break, she found a tragic scene: Mr. Thomas was hanging from a bedsheet in his cell. Mr. Thomas had committed suicide.
Plaintiff, Mr. Thomas's Estate, as administered by Mr. Thomas's mother, Tonya Leigh Thomas, now sues Nurse DeLorenzo, Officer Popiesh, Fayette County (the municipality governing the Prison), PrimeCare Medical, Inc., (the private healthcare corporation which contracted to provide medical care to inmates of Fayette County Prison), and Warden Brian Miller (the Warden of Fayette County Prison). Plaintiff alleges violations of the Fourteenth Amendment of the United States Constitution, via 42 U.S.C. § 1983, and violations of Pennsylvania Wrongful Death and Survival Act statutes. See ECF No. 33. Specifically, Plaintiff alleges that Defendants violated Mr. Thomas's constitutional rights by failing to provide medical treatment for Mr. Thomas's alleged medical conditions, and by failing to take sufficient precautions to prevent Mr. Thomas's suicide. Further, Thomas asserts various claims of municipal liability, failure to train, and failure to supervise against Fayette County, Warden Miller, and PrimeCare Medical.
Before getting to those merits issues, the Court must consider Plaintiff's Motion to Exclude Expert Witnesses. ECF No. 67. Defendants introduced into the record the reports of three experts who, unsurprisingly, offered opinions supporting various Defendants' positions in this case.
First, Plaintiff alleges that the reports were improperly or insufficiently verified. Plaintiff may have been right initially, but, in the interests of justice, Defendants were provided an opportunity to correct any shortcomings in this regard. They have done so. See ECF No. 87; ECF No. 88; ECF No. 89.
Second, Plaintiff asserts that the statements of the experts should not be considered because they are contrary to Plaintiff's own assertions and, at the summary judgment stage, Plaintiff's assertions must be favored. But the statements made by Plaintiff in contradiction of the expert reports are not based upon facts in the evidentiary record. Instead, these conclusory factual assertions are found only in Plaintiff's pleadings and briefs. This is not enough to get past a summary judgment motion. Though factual disputes must be viewed in a light most favorable to the non-moving party, a non-moving party is not automatically entitled to a presumption of correctness on a given factual issue "without offering any concrete evidence from which a reasonable juror could return a verdict in his favor and by merely asserting
Finally, Plaintiff challenges the admissibility of the expert testimony under Fed. R. Evid. 702 and Daubert v. Merrell Dow Pharm., Inc., 509 U.S. 579, 113 S.Ct. 2786, 125 L.Ed.2d 469 (1993). As part of a court's essential "gatekeeping" function to ensure that expert testimony is not only relevant but also reliable, it must make sure that the proffered expert meets three requirements: "(1) the proffered witness must be an expert, i.e., must be qualified; (2) the expert must testify about matters requiring scientific, technical or specialized knowledge; and (3) the expert's testimony must assist the trier of fact." Pineda v. Ford Motor Co., 520 F.3d 237, 244 (3d Cir.2008) ("We have interpreted the second requirement to mean that an expert's testimony is admissible so long as the process or technique the expert used in formulating the opinion is reliable." (internal quotations omitted)). See also Fed. R. Evid. 702.
Rightly, "Plaintiff does not challenge here the credentials of any Prime expert." ECF No. 68, at 20. The experts are surely "qualified." See Pineda, 520 F.3d at 244. Furthermore, the expert testimony here would assist the trier of fact by providing the fact-finder with information pertinent to observable drug-withdrawal symptoms, suicide correlates, treatment procedures, and the standards of care to be employed by medical professionals in a prison setting. The expert testimony is just as surely "relevant."
Thus, Plaintiff primarily contests the second prong of the gatekeeping test: "Plaintiff urges [that] each of Prime's experts are not `reliable.'" See ECF No. 68, at 20. An inquiry into the reliability of an expert should be "flexible," Daubert, 509 U.S. at 594, 113 S.Ct. 2786, but the focus should remain "on principles and methodology, not on the conclusions generated by the principles and methodology." In re TMI Litig., 193 F.3d 613, 665 (3d Cir.1999) amended, 199 F.3d 158 (3d Cir.2000). See also Kumho Tire Co. v. Carmichael, 526 U.S. 137, 150, 119 S.Ct. 1167, 143 L.Ed.2d 238 (1999) ("[The objective] is to make certain that an expert, whether basing testimony upon professional studies or personal experience, employs in the courtroom the same level of intellectual rigor that characterizes the practice of an expert in the relevant field.").
Though Plaintiff may not agree with the conclusions generated by these experts, each of the three experts considered the record facts of the case in light of their extensive education, training, and experience, in order to render their professional judgments. Nurse Fillman — a health care operations administrator and experienced Correctional Nurse who writes about, teaches, and implements Standardized Procedures for Registered Nurses — analyzed the documented actions of the Prison medical personnel to determine whether, given Fillman's training and experience, these actions were reasonable and comported with applicable standards of care. Dr. Guzzardi, M.D. — an expert in toxicology (the study of the adverse effect of chemicals on living organisms) and a long-time emergency medical physician — offered his expert opinion on the proper detoxification protocol for cocaine and whether the medical treatment provided to Mr. Thomas was reasonable. Finally, Dr. Althouse, Ph.D. — a former psychologist for various correctional institutions, Chair of the Practice Standards Committee for the American Association of Correctional and Forensic Psychology, a consultant for suicide prevention policies for jails and prisons, and an author of two versions of the STANDARDS FOR PSYCHOLOGY SERVICES IN JAILS, PRISONS, CORRECTIONAL FACILITIES, AND AGENCIES — opined on whether the intake procedures were appropriately conducted by Prison staff and whether Mr. Thomas indicated suicidality. Each expert analyzed the documents in the record in light of their respective area of expertise and rendered an opinion, based on this expertise, pertinent to a contested issue in the case. The expert opinions are reliable, and therefore should not be stricken from the record. See Ford Motor Co., 520 F.3d 237, 243 (3d Cir.2008) ("Rule 702, which governs the admissibility of expert testimony, has a liberal policy of admissibility.").
Notably, however, the use of expert reports at the summary judgment stage lies at the intersection of two doctrines that appear to be in tension. First is the rule, outlined above, that when a moving party produces record evidence to carry its burden under Rule 56, the nonmoving party cannot simply dispute that evidence in theory; it must present some actual record evidence to contravene the moving party's supported assertion. See Matsushita, 475 U.S. at 586, 106 S.Ct. 1348. Second is the oft-repeated understanding that "the trier of fact is not bound to accept expert opinion, even if it is uncontradicted." Minnesota Mining & Mfg. Co. v. Berwick Indus., Inc., 532 F.2d 330, 333 (3d Cir.1976). See also Drysdale v. Woerth, 153 F.Supp.2d 678, 689 (E.D.Pa.2001) aff'd, 53 Fed.Appx. 226 (3d Cir.2002) ("The fact finder is free
But does this mean that expert reports are meaningless at the summary judgment stage simply because a jury is free to disbelieve or reject the expert's conclusions? Imagine, for example, the following case: Peter-Plaintiff sues Cola-Company alleging that Cola-Company's soda has caused Peter-Plaintiff's lung cancer. In support of a motion for summary judgment, Cola-Company produces the reports of ten indisputably and highly qualified physicians/scientists who each independently opine (to a reasonable degree of medical or scientific certainty) that Cola-Company's product cannot have caused the lung cancer; Peter-Plaintiff produces no record evidence besides evidence of his consumption of cola and the lung cancer itself. Can (or even must) a court deny Cola-Company's motion for summary judgment because a later trier of fact could disbelieve the uncontradicted expert opinions? Such a rule would appear contrary to the purposes of summary judgment.
Over seventy years ago, in Sartor v. Arkansas Natural Gas Corporation, 321 U.S. 620, 64 S.Ct. 724, 88 L.Ed. 967 (1944) the Supreme Court waded into this morass, appearing to support the conclusion that a court may not rely solely on expert testimony for purposes of resolving a summary judgment motion. In Sartor the core issue was the market price of natural gas at the time that gas was delivered pursuant to a contract. In support of a motion for summary judgment, the defendant submitted the affidavits of several expert witnesses supporting the defendant's claim as to the price of the gas. The Supreme Court held that summary judgment was inappropriate and observed that "it is for the jury to decide whether any, and if any what, weight is to be given to [opinion] testimony... the jury, even if such testimony be uncontradicted, may exercise their independent judgment." Because of this, Sartor has often been cited for the proposition that a jury may accept or reject opinion evidence as it sees fit, even if the testimony is uncontradicted and unrefuted. See, e.g., Minnesota Mining, 532 F.2d at 333; University Marketing & Consulting v. Hartford Life & Accident Ins., 413 F.Supp. 1250, 1264 (E.D.Pa.1976).
However the ruling in Sartor is seemingly more nuanced than a blanket rejection of any effect of expert or opinion testimony at the summary judgment stage. The Sartor court noted that if the "admissible opinion evidence" could be "given conclusive effect" the Court would have to "sustain the [summary judgment] motion."
Much more recently, the Third Circuit touched on the issue in United States v. Donovan, 661 F.3d 174, 188 (3d Cir.2011). In Donovan, the United States submitted two expert reports concluding that the defendant's property affected the integrity of navigable waters, and thus fell under the jurisdiction of the Clean Water Act. The Donovan court held that "these reports satisfy the Government's initial burden on summary judgment," and thus the court examined whether the defendant "came forward with specific facts showing that there is a genuine issue for trial." Id. at 185-86. The defendant offered no evidence to counter this showing but instead contended that, under Sartor, summary judgment was inappropriate because "a reasonable jury would be free to disbelieve the opinions and conclusions of the Government's experts." Donovan held that Sartor "is not controlling here because the factual evidence offered by the Government" (which was contained in the two expert reports) "is enough to meet its burden of production for a Rule 56 motion." Id. (citing Pelphrey v. United States, 674 F.2d 243, 247 (4th Cir.1982) and noting that Pelphrey "distinguish[ed] Sartor as dealing with `opinion evidence' when the moving party had submitted factual affidavits") (emphasis in original).
Donovan appears to draw a distinction between "factual evidence" — even that factual evidence contained in an expert opinion — and expert "opinion evidence" for purposes of what may be considered as conclusive at the summary judgment stage. But even this distinction doesn't seem applicable to every case, and is a somewhat elusive one in any event, as can be seen from the Donovan Opinion itself. Consider the hypothetical above concerning Peter-Plaintiff: must summary judgment be denied if it was the uncontradicted "medical opinion" of the ten qualified experts that Cola-Company's soda simply cannot cause lung cancer? Is that "fact" or "opinion" as to a lack of a causal link? Indeed, numerous district courts have recognized that a summary judgment motion can be properly granted based upon what would appear to be the opinion of an expert. See Stiso v. State Farm Fire & Cas. Co., 2015 WL 7296081, at *9 (D.N.J. Nov. 18, 2015) (collecting cases). See also Diaz v. Johnson Matthey, Inc., 893 F.Supp. 358, 361 (D.N.J.1995) (finding that where plaintiff had no expert "on the issue of whether [plaintiff's] exposure to platinum salts caused his chronic, post-employment asthma" to counter defense experts,
This Court concludes that, in accord with Donovan, opinion testimony may be considered at the summary judgment stage in the following manner. Experts may be used to satisfy (or help satisfy) the "initial burden [] on the party seeking summary judgment to point to the evidence which it believes demonstrate[s] the absence of a genuine issue of material fact." Donovan, 661 F.3d at 185 (noting that the expert "reports satisfy the Government's initial burden on summary judgment.") (quotations omitted). See also Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). "If the moving party carries this initial burden," then the nonmoving party may negate the expert reports by "com[ing] forward with specific facts" (rather than "some metaphysical doubt as to the material facts") that counter the moving party's arguments and show "that there is a genuine issue for trial." Donovan, 661 F.3d at 185 (citing Matsushita, 475 U.S. at 586-87, 106 S.Ct. 1348) (emphasis in original). See also Deitrick v. Costa, 2015 WL 1605700, at *4 (M.D.Pa. Apr. 9, 2015) ("More simply put a party moving for summary judgment who does not bear the burden of persuasion at trial is not required to negate the nonmovant's claim, but only point out a lack of evidence sufficient to support the nonmovant's claim."). As such, an unopposed, favorable expert report will not automatically win a summary judgment motion for a moving party. However, consistent with Donovan, the expert report may allow a moving party to fulfill its initial burden of showing that the nonmoving party has failed to support its claim or failed to introduce a genuine issue of material fact necessitating a trial; such a showing requires the nonmoving party to come forward with specific record evidence to show why a trial is necessary. Presumably this could take the form of an opposing expert opinion, but it could also be fulfilled by
Having now concluded that Defendants' expert reports should not be stricken from the summary judgment record (and after analyzing what this means at the summary judgment stage), the Court can proceed to consider Defendant's Motion for Summary Judgment.
Defendants first contend that "there is no genuine dispute as to any material fact" and that Defendants are "entitled to judgment as a matter of law" on Plaintiff's claims that Defendants were deliberately indifferent to Mr. Thomas's medical needs. See Fed. R. Civ. P. 56(a). One of Plaintiff's two constitutional claims is that Defendants violated Mr. Thomas's Fourteenth Amendment
A medical need is "serious," in satisfaction of the first prong of the deliberate indifference test, if it is "one that has been diagnosed by a physician as requiring treatment or one that is so obvious that a lay person would easily recognize the necessity for a doctor's attention." Atkinson v. Taylor, 316 F.3d 257, 272-73 (3d Cir. 2003). A medical need is also serious where the denial of treatment would result in the "unnecessary and wanton infliction of pain," Estelle, 429 U.S. at 103, 97 S.Ct. 285, or a "life-long handicap or permanent loss," Monmouth Cty. Corr. Inst. Inmates v. Lanzaro, 834 F.2d 326, 347 (3d Cir. 1987).
Mr. Thomas's depression was diagnosed by a physician in 2012 and he was prescribed Zoloft for treatment. See ECF 78-2, at 2-3. Generally, this is a serious medical need. See Smith v. Carver, 2008 WL 436911, at *4 (E.D.Pa. Feb. 15, 2008). Mr. Thomas's alleged drug withdrawal is a different and closer question. Prison inmate Bittner indicated that Mr. Thomas repeatedly asked the nurses and CO's for medication for his "dope sickness" (withdrawal), and, in Bittner's opinion, Thomas had the "telltale signs" of drug withdrawal. See ECF No. 78-18, at 7-10 (Inmate Bittner: "It is just that kind of attitude and telltale signs about it, you can tell who was a user and who wasn't using."). Likewise, inmate Davanzo heard Mr. Thomas's continuous requests for medication and concluded that Mr. Thomas must therefore require treatment. See ECF No. 78-19, at 8 (Inmate Davanzo: "He wanted them, which in my opinion says, I need them.").
However, Davanzo also noted that these kinds of requests were a common occurrence at the Prison: "[t]here would always be multiple inmates [saying] I want to see the nurse. I want to see the nurse." See ECF No. 78-19, at 13. Indeed, the record
It is, therefore, unclear whether Mr. Thomas was actually suffering from a "sufficiently serious" medical condition — that is, a condition "diagnosed by a physician as requiring treatment," a condition "so obvious that a lay person would easily recognize the necessity for a doctor's attention," or a condition leading to the "unnecessary and wanton infliction of pain" without treatment. Atkinson, 316 F.3d at 272-73; Lanzaro, 834 F.2d at 347. Nonetheless, the Court need not definitively determine whether or not Mr. Thomas's alleged drug withdrawal was "sufficiently serious" to warrant Fourteenth Amendment consideration because, no matter the answer to that question, the record does not support an inference that any Defendant was deliberately indifferent to an alleged serious medical need.
To be "deliberately indifferent" to a plaintiff's serious medical need, the plaintiff "must make a subjective showing that defendant acted with a sufficiently culpable state of mind." Pinchak, 294 F.3d at 499. The level of culpability required for a deliberate indifference claim lies "somewhere between the poles of negligence at one end and purpose or knowledge at the
The record demonstrates that Plaintiff cannot show that any Defendant was deliberately indifferent to Mr. Thomas's depression needs, because there is no allegation that Mr. Thomas requested depression medication or that any Prison official knew or was on notice that Mr. Thomas required, but was not receiving, any form of depression medication. During Mr. Thomas's medical intake process, he denied being on any psychotropic medication, ECF No. 78-16, at 37, and there is no record evidence that Mr. Thomas requested or should have been receiving any form of depression-related medication.
With respect to the denial of medication for alleged cocaine withdrawal (assumed, for these purposes, to be a sufficiently serious medical condition), Plaintiff argues that Nurse DeLorenzo should have recognized that Mr. Thomas was suffering from drug withdrawal because of his consistent requests for medication and the statements of fellow inmates. Plaintiff further argues that DeLorenzo subjectively disregarded this known medical condition because Mr. Thomas was allegedly previously involved in an altercation with other members of the medical staff. Nurse DeLorenzo testified that she knew nothing about an altercation between Mr. Thomas and medical staff and that Mr. Thomas had not been rude to her, but that the other nurses had told her that Mr. Thomas had been rude and belligerent around the other medical staff. See ECF 78-16, at 28-29, 38-39.
Regardless of whether there was or was not such an "altercation," however, the record would not support a conclusion that Nurse DeLorenzo acted with deliberate indifference toward a serious medical need of Mr. Thomas. Nurse DeLorenzo was asked to see Mr. Thomas because he told the guards that he was going through withdrawal. When DeLorenzo met with
However, after DeLorenzo informed Mr. Thomas that both the heroin and oxycodone screens were negative, Mr. Thomas said that he had been using cocaine as well. ECF No. 78-16, at 39. As DeLorenzo informed Mr. Thomas, the Prison did not provide detoxification medication for cocaine because there is no medical protocol for such, and Plaintiff has not pointed to the existence of any. Id. See also ECF 78-16 at 19-20 (DeLorenzo: "We don't test for cocaine. We used to, but we don't anymore, because there is not a detox protocol for cocaine."). This is a medical judgment on behalf of the Prison; it may be an incorrect or negligent medical judgment, but that alone does not give rise to deliberate indifference.
Of note, the Court is not favoring one side's evidence (cocaine withdrawal was not to be treated with medication) over the other's (medication was not provided because of Mr. Thomas's prior belligerence toward uninvolved Prison staff members). Instead, it is a case of two things being true at the same time. It may well be true (and, indeed, for purposes of summary judgment the court assumes that it is true) that there was a heated emotional exchange between Mr. Thomas and some other Prison medical officials. However, since it is uncontested in the record, the Court also accepts as true that Prison officials had a uniform policy of not following a medical protocol to treat cocaine withdrawal, given the uncontradicted record that there is no such generally recognized or recommended protocol. The Court is not resolving a factual dispute in favor of one party, but rather accepting both sets of facts to be true and applying settled law in light of these uncontested facts.
For the same reasons, a deliberate indifference claim cannot be asserted against Officer Tammy Popiesh, either. Plaintiff asserts that "Popiesh was deliberately indifferent, along with the other guards on duty, based upon a jail climate of `do-nothingness' regarding Thomas." ECF No. 76, at 55. However, in the Third Circuit, non-medical prison personnel are entitled to rely on the advice and opinions of medical personnel with respect to a prisoner's treatment and care. See Spruill v. Gillis, 372 F.3d 218, 236 (3d Cir.2004). Non-medical personnel may be held liable only if they have a reason to believe that the medical personnel are mistreating or not treating a prisoner. Id. Here, there is nothing in the record to suggest that Popiesh (or any other non-medical personnel, for that matter) had reason to believe that the Prison medical personnel were mistreating Mr. Thomas by declining to provide him with cocaine withdrawal medication in accordance with Prison medical policy.
Next, Defendants argue that Plaintiff's suicide-risk claim also fails as a matter of law. The heart of Plaintiff's claim in this regard is that Defendants violated Mr. Thomas's constitutional rights by failing to provide adequate suicide prevention measures, and in particular, failing to place him on suicide watch. And indeed, such claims are well established in Third Circuit law. Liability for prisoner suicides developed out of the deliberate indifference standard when cases recognized that a "particular vulnerability to suicide" could represent a "serious medical need." See Colburn v. Upper Darby Twp., 838 F.2d 663, 669 (3d Cir.1988) (Colburn I). From this, prison suicide cases developed a discrete body of case-law defining the contours of the right and the action: "a plaintiff
Under the first prong, the plaintiff must show that there was a "strong likelihood, rather than a mere possibility, that self-inflicted harm will occur."
Contrary to Plaintiff's assertions, Dr. Althouse opined that Mr. Thomas was not a significant suicide risk:
ECF 73-2, at 7. Though Plaintiff (unsuccessfully) hoped to exclude Dr. Althouse's report, Plaintiff did not test the opinions in this report through deposition examination or a contrasting expert report. Further, even if this is considered to be pure opinion and thus, under a broad reading of Donovan, unusable in support of summary judgment motions, Plaintiff has nonetheless failed to provide an evidentiary basis from which a jury could conclude that Mr. Thomas possessed a "particular vulnerability" to suicide while he was held at Fayette County Prison as defined by Circuit precedent.
Notably, other cases in our Circuit have held that even evidence of actual suicide correlates (that is, characteristics that correlate with higher rates of suicide) does not establish a particular vulnerability for suicide. In Wargo v. Schuylkill Cty., 2008 WL 4922471 (M.D.Pa. Nov. 14, 2008), aff'd, 348 Fed.Appx. 756 (3d Cir.2009), the plaintiff presented an expert report indicating that people exhibiting the plaintiff's characteristics — "youth, the severity of the crime he had committed and his awareness of it, his addiction to Oxycontin and his likely withdrawal from the drug" — are more likely to commit suicide than other inmates. Id. at *6. However, this evidence was not enough to get past summary judgment because the "vulnerability to suicide" examination "requires that the evidence establish that the particular individual, not members of a demographic class to which the individual belongs, exhibits a particular vulnerability to suicide." Id. ("Plaintiff has produced no evidence that [the plaintiff] himself represented the suicide risk that would create liability for the prison, and the court cannot ascribe to him a particular vulnerability based on broad social and demographic characteristics."). Likewise, in Joines v. Twp. of Ridley, 229 Fed.Appx. 161, 163 (3d Cir.2007), the plaintiff offered expert testimony that he was "young, intoxicated, and acting irrationally in his cell," and that "these factors point toward a heightened risk of suicide." Id. at 163. However, even this evidence did not show that there was a "strong likelihood of self-inflicted harm" or that plaintiff, himself, "was inclined toward self-inflicted harm." Id. ("Therefore, Plaintiff has not established
Furthermore, Plaintiff has failed to show that any individual Prison official "knew or should have known" about Mr. Thomas's (alleged) particular vulnerability to suicide, or that the officers "acted with reckless indifference" to this knowledge. See Colburn II, 946 F.2d at 1023. Liability may not be imposed unless "there is something more culpable on the part of the officials than a negligent failure to recognize the high risk of suicide." Id. at 1025. Instead, the "strong likelihood of suicide must be so obvious that a lay person would easily recognize the necessity for preventative action." Id. ("[T]he risk of self-inflicted injury must be not only great, but also sufficiently apparent that a lay custodian's failure to appreciate it evidences an absence of any concern for the welfare of his or her charges."). Just as Plaintiff has produced no evidence to suggest that there was a strong likelihood that Mr. Thomas would commit suicide, there is no evidence that a lay observer who heard Mr. Thomas's screening responses and observed his restlessness would believe that suicide-preventative action was necessary. Indeed, a professional observer who had this information — Nurse DeLorenzo — concluded that no suicide precautions were necessary; there is no record basis to conclude that a lay observer would have reached a different conclusion. See Baez v. Lancaster Cty., 487 Fed.Appx. 30, 31 (3d Cir.2012) ("[T]he likelihood that [plaintiff] would harm himself was not obvious to the psychologist, let alone a layperson."). Perhaps Nurse DeLorenzo was incorrect or negligent in reaching this conclusion (as outlined above, the Court does not conclude that she was), but negligence, even if proven, would not be enough.
Plaintiff also asserts a number of municipal liability and "failure to" allegations against PrimeCare, Fayette County, and Warden Miller.
However, the Third Circuit has clarified that, in some limited cases, a municipality can be held independently liable for violating a plaintiff's constitutional rights, even if there is no individual liability. See Fagan v. City of Vineland, 22 F.3d 1283, 1292 (3d Cir.1994); Simmons v. City of Philadelphia, 947 F.2d 1042 (3d Cir.1991). "If it can be shown that the plaintiff suffered that injury, which amounts to deprivation of life or liberty, because [an individual official] was following a city policy reflecting the city policymakers' deliberate indifference to constitutional rights, then the City is directly liable under section 1983 for causing a violation of the plaintiff's Fourteenth Amendment rights." Fagan, 22 F.3d at 1292.
But Fagan's reach is limited. Fagan carved out a distinction from a prior Supreme Court case that seemed to say that a municipality cannot face liability if no individual faces liability, City of Los Angeles v. Heller, 475 U.S. 796, 106 S.Ct. 1571, 89 L.Ed.2d 806 (1986), and Fagan itself has been cabined on the merits. As described by the Third Circuit in a later case:
Grazier ex rel. White v. City of Philadelphia, 328 F.3d 120, 124 (3d Cir.2003) (internal citations omitted). See also, Mark v. Borough of Hatboro, 51 F.3d 1137, 1153 (3d Cir.1995) ("[T]he Fagan panel opinion appeared to hold that a plaintiff can establish a constitutional violation predicate to a claim of municipal liability simply by demonstrating that the policymakers, acting with deliberate indifference, enacted an inadequate policy that caused an injury. It appears that, by focusing almost exclusively on the `deliberate indifference' prong of the Collins [v. City of Harker Heights, 503 U.S. 115, 112 S.Ct. 1061, 117 L.Ed.2d 261 (1992)] test, the panel opinion did not apply the first prong — establishing an underlying constitutional violation."). Indeed, some courts have actively cabined Fagan to its facts and held that, generally, plaintiffs may not pursue a municipal liability claim without any concomitant individual liability. See, e.g., DeNinno v. Municipality of Penn Hills, 269 Fed.Appx. 153, 158 (3d Cir.2008) ("Even more fundamentally, there can be no municipal liability here because we have determined that none of the individual defendants violated the Constitution.") (citing Grazier, 328 F.3d at 124 n. 5); Cole ex rel. Cole v. Big Beaver Falls Area Sch. Dist., 2009 WL 3807185, at *8 (W.D.Pa. Nov. 12, 2009) (holding that "Plaintiff's reliance on Fagan is misplaced" because Fagan merely carved out an exception to "the general rule of law that a municipality cannot be held accountable pursuant to § 1983 when no individual officer violated the Constitution" — "[s]ubsequent to Fagan, the United States Court of Appeals for the Third Circuit has clearly stated that it `carefully confined Fagan to its facts: a substantive due process claim resulting from a police pursuit.'") (citing Grazier, 328 F.3d at 124 n. 5); Leddy v. Twp. of Lower Merion, 114 F.Supp.2d 372, 377 (E.D.Pa.2000) (holding that "if the actions of [the officer] did not reach the level of a constitutional tort, the Township through its police department cannot be liable because of an inadequate policy or ineffective training program" and noting Mark's criticism of Fagan). See also Willard v. Pennsylvania Soc. for the Prevention of Cruelty to Animals, 2012 WL 1392657, at *6 (E.D.Pa. Apr. 23, 2012) aff'd, 525 Fed.Appx. 217 (3d Cir.2013) ("[A] municipality cannot be liable for the failure to supervise or train an officer when there is no underlying constitutional violation by the officer."); Thomas v. City of Philadelphia, 804 A.2d 97, 111 (Pa.Comm.Ct.2002) (noting that Fagan "has not stood the test of time even in the Third Circuit.").
As such, this Court believes that the key to untangling Fagan is to analyze whether, in this case, any alleged municipal policy or custom could be found to have "caused" the alleged constitutional deprivation. As should be clear by now, simply pointing out the existence of an allegedly unlawful policy or custom is not enough to maintain such a § 1983 claim.
Notably, this "causation" requirement also applies to the claims against PrimeCare and the failure to train/supervise claims. As a state contractor, for PrimeCare to be liable under Monell, Plaintiff "must provide evidence that there was a relevant [PrimeCare] policy or custom, and that the policy caused the constitutional violation they allege." See Natale v. Camden Cty. Corr. Facility, 318 F.3d 575, 583-84 (3d Cir.2003) (emphasis added). Likewise, a "failure to train" claim requires a showing that the "inadequate training policies were the `moving force' behind their injuries. This is at base a causation requirement." Grazier, 328 F.3d at 125. Ditto for a failure to supervise. See Brown v. Muhlenberg Twp., 269 F.3d 205, 216 (3d Cir.2001) (requiring, for supervisory liability, that "the underlying's violation resulted from the supervisor's failure to employ that supervisory practice or procedure.")
In making their motion, Defendants have adequately demonstrated that there is not a factual basis from which a jury could conclude that any of the allegations underlying the municipal liability or "failure to" claims actually caused Mr. Thomas's alleged constitutional harm — allowing him to commit suicide. See Celotex, 477 U.S. at 322-24, 106 S.Ct. 2548 ("the burden on the moving party may be discharged by `showing' — that is, pointing out to the district court — that there is an absence of evidence to support the nonmoving party's case"). In doing so, Defendants fulfilled their initial summary judgment burden; Plaintiff has not responded with specific record facts to plausibly show that a jury could rationally conclude that the alleged policy failures caused Mr. Thomas's injuries. For example, Plaintiff alleges that the Prison guards and intake officials were inadequately trained to recognize the symptoms of mental illness. See ECF No. 76, at 32. Even assuming that this were true, Plaintiff has not identified the basis from which a jury could plausibly infer that this lack of training caused the harm — or, put differently, that proper training would have alleviated or prevented the harm here, and what that training was. The medical staff — and specifically Nurse DeLorenzo who conducted Plaintiff's medical screening — were trained to recognize the symptoms of mental illness and concluded that Mr. Thomas did not need to be on any form of suicide watch. There is no evidence presented from which a jury could infer that more or different medical training of intake officials or Prison guards would have trumped the decisions of the Prison's medical professionals and resulted in Mr. Thomas being placed on suicide watch, notwithstanding the contrary conclusions of the medical professionals.
Similarly, Plaintiff alleges that the Prison officials failed to follow the written PrimeCare policy which prescribed that an inmate who had been placed on suicide watch could only be removed from the watch with the authorization of the Psychiatrist/Psychologist.
Perhaps an even more daunting hurdle to Plaintiff's claims is the lack of record evidence showing that the policies or customs were enacted or undertaken with deliberate indifference to the likelihood of a constitutional violation. If the allegedly unconstitutional policy or custom does not facially violate federal law — as none of the alleged policies do — liability will only be imposed if "the municipal action was taken with `deliberate indifference' as to its known or obvious consequences. A showing of simple or even heightened negligence will not suffice." Berg v. Cty. of Allegheny, 219 F.3d 261, 276 (3d Cir.2000). See also Mark, 51 F.3d at 1149 ("[A] municipal entity may be liable when its policymakers made a deliberate choice from among various alternatives to follow a particular course of action, where the policy reflected deliberate indifference to the constitutional rights of the municipality's inhabitants, and where the policy was the moving force behind a constitutional violation."). "To satisfy this standard, a plaintiff must adduce evidence that the municipality (1) had notice that similar rights violations had occurred on such a widespread basis that they were likely to occur again and (2) failed to act to address that risk despite the known or obvious consequences of inaction. Notice is generally established by a pattern of prior constitutional violations." Peters v. Cmty. Educ. Centers, Inc., 2014 WL 981557, at *4 (E.D.Pa. Mar. 13, 2014) (citing Berg, 219 F.3d at 276; Beck v. City of Pittsburgh, 89 F.3d 966, 975 (3d Cir. 1996)).
Plaintiff has not put forth record facts showing that either (1) Fayette County, PrimeCare, or Warden Miller knew that the policies or practices at the Prison would lead to constitutional harm and then implemented (or failed to implement as the case may be) the policies with deliberate indifference to that knowledge, or (2) that these policies or practices were so obviously deficient and "so likely to result in the violation of constitutional rights, that the policymakers of the [Prison] can reasonably be said to have been deliberately indifferent." See Brown, 269 F.3d at 215. There is no indication that any of these Defendants had notice of previous constitutional deprivations as a result of the policies and practices in play, nor is there any factual record to support the conclusion that the policies would so obviously result in constitutional harm. The latter proposition is put forth in Plaintiff's briefs, but, as Defendants have identified, there is no factual record to support this proposition.
That leaves what is to the Court the most troubling of Plaintiff's municipal liability claims against the County, PrimeCare, and Warden Miller. According to the Prison's and PrimeCare's initial processing protocols, Officer Barnes was required to retrieve and utilize an entering inmate's Prison file from any prior incarcerations. See ECF 78-10, at 3. Plaintiff alleges (and the record supports) that this procedure was never followed here. As noted above, this alleged failure is insufficient in itself to establish liability because it did not cause Mr. Thomas's alleged constitutional deprivation — there was a later medical screening in which Nurse DeLorenzo exercised her independent medical judgment and concluded that Mr. Thomas should not have been placed on any kind of suicide watch. However, Plaintiff also alleges that this subsequent medical screening was insufficient because there was a policy or custom
Perhaps more importantly (and wholly independent of Dr. Althouse's views if they are to be disregarded under Donovan), an examination of the Prison's "Intake Suicide Screening" scoresheet for Mr. Thomas, ECF No. 59-1, at 4, shows that even if Nurse DeLorenzo had been aware of Mr. Thomas's prior suicide attempt in April of 2008, it would have added one "point" to the suicide score, resulting in a score of 4 rather than 3, still far short of the score of 8 which would have triggered suicide watch treatment. See ECF No. 59-1, at 4. Further, that scoresheet shows that Mr. Thomas's history of mental illness was actually noted and scored. Finally, there is nothing in the record calling into question the Intake Screening forms' treatment in this way of a five year old suicide attempt, such that its existence, in and of itself, would necessarily create an issue of fact as to causation or otherwise calls into question the validity or integrity of that screening and scoring process.
In the same vein, there is a "deliberate indifference" problem with this claim as
Therefore, Plaintiff's inability to establish a genuine issue of fact as to either causation or deliberate indifference in these regards requires dismissal of his municipal liability, failure to train, and failure to supervise claims against Fayette County, PrimeCare, and Warden Miller.
Plaintiff's remaining claims allege state law claims under the Pennsylvania Wrongful Death Act, 42 Pa. Con. Stat. Ann. § 8301, and Survival Act, 42 Pa. Con. Stat. Ann. § 8302. See ECF No. 33, at 37-39. A District Court may decline to exercise supplemental jurisdiction over state law claims if "the district court has dismissed all claims over which it has original jurisdiction." 28 U.S.C.A. § 1367. However, the Third Circuit has recognized, "where the claim over which the district court has original jurisdiction is dismissed before trial, the district court must decline to decide the pendent state claims unless considerations of judicial economy, convenience, and fairness to the parties provide an affirmative justification for doing so." Hedges v. Musco, 204 F.3d 109, 123 (3d Cir.2000) (quoting Borough of West Mifflin v. Lancaster, 45 F.3d 780, 788 (3d Cir.1995)) (emphasis in original). Here, all of Plaintiff's federal claims — that is, all of the claims over which the district court had original jurisdiction — will have been dismissed. Considerations of judicial economy, convenience, and fairness do not provide an affirmative justification for maintaining Plaintiff's state law claims. Shaffer v. Bd. of Sch. Dir. of Albert Gallatin Area S.D., 730 F.2d 910, 912-13 (3d Cir.1984) (noting that "time already invested in litigating the state cause of action is an insufficient reason to sustain the exercise of pendent jurisdiction" and that "decisions of state law should be avoided both as a matter of comity and to promote justice between the parties, by procuring for them a surer-footed reading of applicable law"). As such, the Court will dismiss these state law claims without prejudice for want of jurisdiction. See Burnsworth v. PC Lab., 364 Fed.Appx. 772, 776 (3d Cir. 2010) (affirming a district court's decision to decline supplemental jurisdiction over state law claims when the federal claims had been dismissed); Alexander v. New Jersey State Parole Bd., 160 Fed.Appx. 249, 251 (3d Cir.2005) (same).
Mr. Thomas's medical situation and tragic suicide while detained at the Fayette County Prison do not provide a basis for constitutional liability against Nurse DeLorenzo, Officer Popiesh, Fayette County, PrimeCare Medical, Inc., or Warden Brian Miller. There is no genuine issue of material fact warranting a trial on Plaintiff's federal claims; these claims fail as a matter of law based on the record before the Court. Further, the Court should not invoke its supplemental jurisdiction to adjudicate Plaintiff's state law claims, and therefore declines to do so.
An appropriate Order shall issue.
The second report was offered by Terry S. Fillman. Mr. Fillman is a Registered Nurse and Certified Correctional Health Professional who has worked as a Correctional Nurse and Health Services Administrator for the San Bernardino County Sherriff's Department for 23 years. Mr. Fillman is also a Health Administrator Corrections Inspector for the Institute of Medical Quality, and is a member and educator for numerous national correctional health care associations. Mr. Fillman opined that the medical and custody staff at the Prison provided appropriate and comprehensive health screening for Mr. Thomas within applicable correctional standards. According to Mr. Fillman, the documented actions of the staff at the Prison were consistent with what a reasonable person would have done given the same circumstances. See ECF No. 73-4.
The third report was offered by Lawrence J. Guzzardi, M.D. Dr. Guzzardi received an M.D. from Jefferson Medical College, a Masters in Toxicology from the University of Kentucky Medical Center, and a Masters of Business Administration from University of Pennsylvania's Wharton School. In practice, Dr. Guzzardi worked in Emergency Medical Departments at a number of hospitals for 26 years and held academic positions at the University of Kentucky Medical Center, the Hershey Medical Center of the Pennsylvania State University, and the University of Pennsylvania School of Medicine. Dr. Guzzardi is also a member of numerous medical societies and has published and lectured about various correctional medical and toxicological subjects. Dr. Guzzardi opined that the cocaine withdrawal does not require specific medical intervention and that there is no generally recognized detoxification protocol for cocaine. Further, Dr. Guzzardi opined that the medical treatment rendered to Mr. Thomas at the Prison was within acceptable standards. See ECF No. 73-6.
Plaintiff's citation to Johnson v. Medlock, 2011 WL 311359, at *4 (W.D.Pa. Jan. 28, 2011) is not determinative either — indeed the case is hardly applicable. Plaintiff suggests that the case holds "in part, that nurses and guards were indifferent by not providing drug withdrawal medical assistance," ECF No. 76, at 29, but this is not the holding of that case. Yes, the plaintiff in that case did, once, tell guards that he thought he was going through drug withdrawal, but the plaintiff actually died of peritonitis — an infection of the abdominal wall caused, in Medlock, by a perforation and necrosis of the small intestine. This is surely a serious medical condition. Denial of summary judgment in Johnson was premised, in part, on the opinion of plaintiff's medical expert that death by peritonitis is terribly slow and painful. As such, there was a contested issue of material fact as to whether the prison officials heard the plaintiff's agony and recognized that the plaintiff was suffering from a painful medical condition.
ECF No. 73-6, at 9. Applying the Donovan standard, Dr. Guzzardi is advancing a "fact" — that there is no generally recognized specific detoxification protocol for cocaine. Indeed, even according to one of Mr. Thomas's fellow inmates, "you don't withdraw from cocaine and you are not going to be sick from two bags of dope." See ECF No. 78-19. Thus, there is an unrebutted plausible medical basis for the judgment to not provide treatment for cocaine withdrawal and the Court cannot say that the Prison's decision was so facially incongruous that it could call into question whether or not the judgment was really medical in nature.