Chen v. D'Amico

SUSAN CHEN, et al., Plaintiffs, v. NATALIE D'AMICO, et al., Defendants.

CASE NO. C16-1877JLR

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON AT SEATTLE

May 24, 2019

ORDER ON MOTIONS FOR SUMMARY JUDGMENT

I. INTRODUCTION

Before the court are: (1) Defendants City of Redmond ("the City") and Natalie D'Amico's (collectively, "City Defendants") motion for summary judgment against Plaintiff Susan (Shiying) Chen (1st MSJ (Dkt. # 106)); City Defendants' motion for summary judgment against Plaintiffs Naixing (Nash) Lian, J.L., and L.L. (Ms. Chen, Mr. Lian, J.L., and L.L. are collectively referred to as "Plaintiffs") (2d MSJ (Dkt. # 108)); and Plaintiffs' motion for summary judgment against City Defendants (3d MSJ (Dkt. # 141)). The parties filed responses and replies to the motions. (See 1st Resp. (Dkt. # 155); 2d Resp. (Dkt. # 151); 3d Resp. (Dkt. # 142); 1st Reply (Dkt. # 166); 2d Reply (Dkt. # 165); 3d Reply (Dkt. # 143); see also Joinder (Dkt. # 144).) The court has considered the motions, the parties' submissions concerning the motions, the relevant portions of the record, and the applicable law. Being fully advised,¹ the court GRANTS City Defendants' summary judgment motion against Ms. Chen; GRANTS in part, DENIES in part, and DENIES as moot in part City Defendants' summary judgment motion against Mr. Lian, J.L., and L.L.; and GRANTS in part and DENIES in part Plaintiffs' motion for summary judgment against City Defendants.

II. BACKGROUND

A. J.L.'s Medical History

Ms. Chen and Mr. Lian are the parents of J.L. and L.L. (FAC (Dkt. # 96) ¶¶ 3-7; Lian Decl. (Dkt. # 122) ¶ 2; Chen Decl. (Dkt. # 131) ¶ 1.) J.L. was born in 2008, andL.L. was born in 2010. (FAC ¶¶ 6-7.) In 2012, J.L. was diagnosed with gastrointestinal ("GI") problems and Autism Spectrum Disorder. (Chen Decl. ¶¶ 3-7; see also Lo Decl. (Dkt. # 132) ¶ 2, Exs. B-L at RED00721.²) GI issues are common in children with autism. (See Green Decl. (Dkt. # 129) ¶ 6.) From August 2012 to October 2013, Plaintiffs took J.L. to several medical providers, including a naturopath, to address his GI issues. (See 1st Resp. at 5 (citing medical records).)

One of J.L.'s medical providers is Dr. John Green, an autism specialist in Portland, Oregon. (See Green Decl. ¶¶ 2-11.) J.L. first saw Dr. Green in October 2012. (Id.) At this appointment, Dr. Green recommended a low carbohydrate diet for J.L. (See id. ¶ 19 ("[M]y Case Summary also discusses various low carbohydrate diets that I recommended."); RED00575 ("No sugar, no potato, no rice, no yams or sweet potatoes.").) Because Dr. Green was in Portland and Plaintiffs are in Washington (see Lian Decl. ¶ 1), Plaintiffs allege that Dr. Green referred J.L. to Dr. Hatha Gbedawo (see Chen Decl. ¶ 10; Gbedawo Decl. (Dkt. # 158) ¶ 6; but see RED00565 (Dr. Green's case summary, explaining that he "subsequently learned that [J.L.'s] care had been transferred in April 2013 to Hatha Gbedawo ND.")). Dr. Gbedawo is a "board certified naturopathic physician," who saw J.L. nine times between April 2013 and October 2013. (Gbedawo Decl. ¶¶ 2, 7.)

// On October 7, 2013, Ms. Chen took J.L. to see Dr. Kate Halamay at Pediatric Associates. (RED00351-53.) Dr. Halamay had seen J.L. previously. (E.g., RED00339.) According to the notes from the October 7 appointment, J.L. had been experiencing abdominal pain for around six weeks. (RED00351.) Dr. Halamay recommended that Ms. Chen take J.L. to the GI department at Seattle Children's Hospital ("SCH"), but Ms. Chen declined, stating that "she has seen them for the past 14 months and they 'have not done anything for [J.L.]'" (RED00352.) Dr. Halamay's notes show that J.L. only visited the SCH GI department once in the prior year. (Id.) Ms. Chen then asked Dr. Halamay to order a number of labs, but Dr. Halamay refused because she was "unfamiliar with several of them and would not know how to interpret them." (RED00353.)

On October 19, 2013, Ms. Chen and Mr. Lian took J.L. to Dr. Julie Ellner at Mercer Island Pediatrics, in part hoping that Dr. Ellner would order the labs they were seeking. (See RED00107; Chen Decl. ¶ 27-28.) Dr. Ellner's notes state that Ms. Chen was worried that J.L. has a "severe problem with kidney or liver," that he was losing weight, and was eating poorly. (RED00107.) Ms. Chen told Dr. Ellner that J.L. had laboratory tests at a hospital in New York, as well as an ultrasound, which showed that there was something wrong with J.L.'s liver. (Id.) However, Ms. Chen did not bring the lab results to Dr. Ellner; nor was she able to remember the doctor or the hospital where the tests were performed. (Id.) Dr. Ellner referred J.L. to the emergency room. (Id.)

Later that day, instead of going to the emergency room, Ms. Chen took J.L. to Pediatric Associates. (See RED00356-58; D'Amico Decl. (Dkt. # 107) ¶ 3h, Ex. H ("CPS Docs") at RED00050-51.) Similar to Dr. Ellner, Dr. Roberta Winch at PediatricAssociates told Ms. Chen to take J.L. to emergency care. (RED00358 ("IT IS VERY IMPORTANT [J.L.] BE SEEN FOR FURTHER EVAL IN THE ED [emergency department] AT SCH. I RECCOMEND [sic] THEY GO NOW. PARENTS AGREED TO BE SEEN AT SCH ED AND SAID THEY WILL GO THERE NOW.").) Ms. Chen says that she did not understand Dr. Winch's instruction. (See Chen Decl. ¶ 27.) Instead, Ms. Chen took J.L. to SCH's urgent care to have lab work done. (Id.; RED00853-55.)

Ms. Chen returned to SCH urgent care on October 20, 2013, to pick up J.L.'s lab work. (Chen Decl. ¶ 28.) Once there, doctors told Ms. Chen that J.L.'s lab work was abnormal, showing elevated levels of creatinine and blood urea nitrogen ("BUN"). (Id.) Ms. Chen then took J.L. to SCH emergency care. (Id.; CPS Docs at RED00050-51.) That day, Dr. Russell Migita in SCH's emergency department examined J.L. and performed additional tests, which showed J.L. improved since his October 19, 2013, lab results, but were still "not normal." (RED00370-75.) Dr. Migita also expressed that J.L. "would benefit from having a coordinated workup that includes endocrinology, gastroenterology, and nephrology." (RED00374.) However, Dr. Migita discharged J.L. from the hospital on October 20, 2013, because he did not have "hypertensive emergency at this time and d[id] not meet the eminent risk criteria for medical hold." (See RED00374-75.) Dr. Migita released J.L. on the understanding that Ms. Chen and Mr. Lian would follow-up with J.L.'s primary care provider. (RED00374-75 (noting "Plan" to see Dr. Halamay "[w]ithin 1 to 3 days").)

On October 23, 2013, Ms. Chen brought J.L. to see Dr. Gbedawo. (Chen Decl. ¶ 31; Gbedawo Decl. ¶ 8.) Dr. Gbedawo understood that J.L. had been to emergency andurgent care a few days earlier and that he had been discharged "as non-emergent." (Gbedawo Decl. ¶ 8.) At the appointment, Dr. Gbedawo "did not recommend that [Ms. Chen] take J.L. to the emergency department." (Id.) Rather, he recommended that Ms. Chen take J.L. "to a nephrologist and a nutritionist for additional consultations, and ordered additional labs and imaging." (Id.)

Later that day, Ms. Chen took J.L. to Dr. Halamay, as she had been instructed by Dr. Migita. (Chen Decl. ¶ 32.) According to Dr. Halamay's notes, Dr. Hal Quinn at Mercer Island Pediatrics, who had seen J.L. previously, called Dr. Halamay before the appointment. (RED00397; RED00105-06.) Dr. Quinn:

[E]xpressed great concern about this pt as well as family, feels that he his [sic] very sick, concern about failure to thrive, has lost several pounds since April, concerned that family has been going from dr to dr but that pt is not actually receiving appropriate medical attention.

(Id.) At the October 23 appointment, Dr. Halamay noted that J.L. appeared "[v]ery tired" and continued to "have distended abdomen," though Ms. Chen said his condition was improving. (RED00397.) Dr. Halamay also noted that Ms. Chen was confused about doctors' instructions from October 19 and 20 to take J.L. to certain specialists. (Id.) Dr. Halamay recommended that Ms. Chen admit J.L. to the hospital "at once" so that he could be seen by renal, endocrine, and GI specialists. (Id.) Ms. Chen "refused to take [J.L.] for admission, even after [Dr. Halamay] stated that [she] felt admission was medically necessary given his abdominal distension, weight loss, and worsening lab values compared to those drawn a few weeks ago." (Id.)

// Ms. Chen recalls that she "felt as though Dr. Halamay and SCH were dismissive and had not provided proper care for [J.L.]" (Chen Decl. ¶ 32.) Further, Ms. Chen told Dr. Halamay at the October 23 appointment that she "would not go back to see [Dr. Halamay] anymore" and that she "would make a complaint against her." (Id.) Dr. Halamay told Ms. Chen that, if Ms. Chen did not admit J.L. to the hospital, then she was going to call the Child Protective Services ("CPS") division of the Washington State Department of Social and Health Services ("DSHS"). (Id.; RED00397.) Ms. Chen restated that she would not take J.L. to SCH and left Dr. Halamay's office. (Id.) Dr. Halamay then called CPS. (RED00397; CPS Docs at RED00051.)

Late at night on October 23, 2013, a CPS social worker arrived at Plaintiffs' home and took J.L. to SCH's emergency department. (See 3d MSJ at 7; but see Chen Decl. ¶ 33 (stating that "[a]t [CPS]'s recommendation, we took J.L. to SCH.").) J.L. was seen on October 24, 2013, by Dr. Virginia Sanders and Dr. Shannon Staples. (See RED00791.) According to Dr. Sanders's summary, J.L.'s showed a "failure to thrive . . . [and] gross malnutrition and muscle wasting. Concern for medical cause of wasting vs. neglect." (RED00792.) J.L. was then admitted to SCH's "general medicine service" to treat his malnutrition and receive a Suspected Child Abuse Network ("SCAN") consultation. (Id.)

While at SCH on October 24, 2013, providers gave J.L. Pedialyte even though Ms. Chen told them that "whenever [J.L.] eats sugar his belly gets big." (RED00927, RED00930.) Ms. Chen also told the SCH providers that J.L. "cannot eat many foods, including...