USCA1 Opinion
UNITED STATES COURT OF APPEALS
FOR THE FIRST CIRCUIT
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No. 96-1293
LEILA FRANCES-COLON, ET AL.,
Plaintiffs - Appellants,
v.
DR. EFRAIN RAMIREZ, ET AL.,
Defendants - Appellees.
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APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
[Hon. Jaime Pieras, Jr., Senior U.S. District Judge]
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Before
Torruella, Chief Judge,
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Coffin, Senior Circuit Judge,
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and DiClerico,* District Judge.
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Kevin G. Little, with whom Law Offices David Efr n was on
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brief for appellants.
Jos Angel Rey for appellees.
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February 24, 1997
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* Of the District of New Hampshire, sitting by designation.
TORRUELLA, Chief Judge. Plaintiffs-appellants Leila
TORRUELLA, Chief Judge.
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Frances-Col n and Juan Enrique Rodr guez brought a malpractice
action on behalf of their minor son Eric Rodr guez-Frances
("Eric") against two doctors, a municipal hospital and the
municipality of San Juan, on both federal and state law grounds.
They alleged that the doctors' mishandling of Eric's delivery1
amounted to a violation of Eric's substantive due process rights,
actionable under 42 U.S.C. 1983, and that the defendants were
liable for negligence under Puerto Rico tort law. The district
court granted defendants' summary judgment motion as to all
counts, for the following reasons: (1) the plaintiffs failed to
identify a protected substantive due process liberty interest
giving rise to their federal civil rights claim; (2) the
defendants' actions were not state conduct that shocks the
conscience for the purposes of sustaining their federal civil
rights claim; (3) the defendant doctors are immune from liability
under Puerto Rico law; (4) the tort claim against the
municipality was time-barred under Puerto Rico law. See Col n v.
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Ram rez, 913 F. Supp. 112 (D.P.R. 1996). Plaintiffs appeal from
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the grant of summary judgment.
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1 The essential mistake alleged was the doctor's failure to
perform a caesarian section. Plaintiffs allege that the
defendant doctors acted with reckless disregard and deliberate
indifference by delivering Eric vaginally, using forceps, even
though his mother told the doctors that she could not deliver
vaginally. Eric was born in poor physical condition, suffered
severe perinatal asphyxia, and has suffered permanent
disabilities.
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Having reviewed the record and the parties' briefs on
appeal, we are satisfied with the reasoning of the decision below
and affirm the judgment for substantially the reasons elucidated
in the district court opinion. Cf. Lawton v. State Mut. Life
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Assurance Co., 101 F.3d 218, 220 (1st Cir. 1996) ("We have long
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proclaimed that when a lower court produces a comprehensive,
well-reasoned decision, an appellate court should refrain from
writing at length to no other end than to hear its own words
resonate.") We need only note the following.
I. The Federal Civil Rights Claim
I. The Federal Civil Rights Claim
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The district court correctly held that plaintiffs-
appellants failed to establish a violation of constitutional
rights actionable under section 1983. Appellants claim on appeal
that, in making this determination, the district court improperly
resolved an issue of fact in favor of defendants by holding that
the doctors failed to act with the requisite degree of
culpability to sustain a section 1983 claim. See Col n, 913 F.
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Supp. at 119. Appellants urge us to consider certain affidavits
they produced in support of the view that the defendant doctors
were reckless, and not merely negligent. First, it is not clear
that the district court's statement that plaintiffs "failed to
show that defendants acted with the requisite degree of
culpability" means that the district court explicitly found that
defendants were not reckless. More importantly, there is no need
to arrive at a factual conclusion regarding whether the doctors
were negligent or something more than negligent, because, either
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way, the plaintiffs fail to state a cause of action under section
1983. As the district court opinion explains, plaintiffs must
fail on their civil rights claim because they do not demonstrate
either of the following: that there was an interest protected by
the due process clause at stake, or that there was governmental
conduct that "shocks the conscience." See id. at 116-18
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(applying Pittsley v. Warish, 927 F.2d 3, 6 (1st Cir. 1991)).
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It is surprising, in light of clear Supreme Court and
First Circuit precedent, that appellants would consider it worth
their while to try their luck, or, rather, waste time and energy,
with what is essentially a malpractice claim clothed in section
1983, civil rights, language. This is plainly not a situation
in which the state "takes a person into custody and holds him
there against his will," thereby implicating a possible
constitutional due process interest in adequate medical care.
DeShaney v. Winnebago County Dept. of Social Servs., 489 U.S.
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189, 199-200 (1989). To avoid future waste of judicial
resources, we wish to underscore the decisive legal principle in
this case. A substantive due process interest in "bodily
integrity" or "adequate medical care" cannot support a personal
injury claim under section 1983 against the provider of a
governmental service unless: (a) the government has taken the
claimant into custody or otherwise coerced the claimant into a
situation where he cannot attend to his own well-being, see,
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e.g., Monahan v. Dorchester Counseling Ctr., Inc., 961 F.2d 987,
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990-93 (1st Cir. 1992) (no due process claim where claimant
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voluntarily entered mental institution) (applying DeShaney); or
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(b) the government employee, in the rare and exceptional case,
affirmatively acts to increase the threat of harm to the claimant
or affirmatively prevents the individual from receiving
assistance, see Dwares v. City of New York, 985 F.2d 94, 96 (2d
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Cir. 1993) (due process implicated where complaint under section
1983 alleged that police assured skin-heads that they could
attack protestors with impunity, thereby affirmatively increasing
threat of harm to protestors) (distinguishing DeShaney); Ross v.
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United States, 910 F.2d 1422, 1429-34 (7th Cir. 1990) (due
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process interest in life implicated where county officials
prevented city officials from rescuing drowning boy, thereby
affirmatively restricting source of aid) (distinguishing
DeShaney).
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A proximate causal link between a government agent's
actions and a personal injury does not, in itself, bring a case
out of the realm of tort law and into the domain of
constitutional due process. Daniels v. Williams, 474 U.S. 327,
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332 (1986). Appellant's counsel would have done well to consider
more carefully the cases it cites for support in its brief --
such as the following passage from Estate of Gilmore v. Buckley,
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787 F.2d 714, 722 (1st Cir. 1986) (holding failure of state
employees to protect victim from murderous attack by inmate on
furlough not actionable under section 1983):2
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2 See Brief for Appellants at 17.
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Enormous economic consequences could follow
from the reading of the fourteenth amendment
that plaintiff here urges. Firemen who have
been alerted to a victim's peril but fail to
take effective action; municipal ambulances
which, when called, arrive late; and myriad
other errors by state officials in providing
protective services, could all be found to
violate the Constitution. It would seem
appropriate that the citizenry, acting
through state legislatures and state courts,
should determine how far it wishes to go in
reimbursing claims of this type. We can see
no justification for rewriting the due
process clause of the federal Constitution so
as to construct a basis for relief that can
be more flexibly provided elsewhere, if that
is deemed advisable.
II. Defendants' Immunity under Puerto Rico Law
II. Defendants' Immunity under Puerto Rico Law
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It is undisputed that the defendant doctors were acting
as government employees when they were attending to Eric's birth.
The district court correctly held that the doctors are protected
under the immunity for government health care professionals
provided by P.R. Laws Ann. tit. 26, 4105 (1989). On appeal,
appellants repeat their argument that the doctors' alleged
recklessness brings them outside of this immunity provision. We
note that the Puerto Rico Supreme Court's decision in V squez
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Negr n v. E.L.A., 113 D.P.R. 148, 151 (1982), interprets the
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immunity provision broadly, adding further strength to the
district court's holding that the sole inquiry required under
Puerto Rico law in determining whether immunity applies is
whether the health care professional was acting as an employee of
the government at the time of the events giving rise to the suit.
This much said, we allow the district court opinion to
speak for itself.
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Affirmed.
Affirmed
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