Kerns v. Sw. Colo. Mental Health Ctr.

JUSTIN KERNS, individual, as Personal Representative of the Estate of Amanda Christensen,and as parent and next friend of C.K., T.K., and B.K,;ESTATE OF AMANDA CHRISTENSEN;C.K., a child of Amanda Christensen and Justin Kerns,by and through his/her father Justin Kerns;T.K., a child of Amanda Christensen and Justin Kerns,by and through his/her father Justin Kerns; andB.K., a child of Amanda Christensen and Justin Kerns,by and through his/her father Justin Kerns; Plaintiffs, v. SOUTHWEST COLORADO MENTAL HEALTH CENTER, INC.,d/b/a Axis Health System; BRIAN ENSIGN; ANN TREBELHORN;MORGAN WILLIAMS; DEBORAH QUAYLE; and ALFREDO CHAVARRIA; Defendants.

Civil Action No. 18-cv-2962-WJM-SKC

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO

December 18, 2019

Judge William J. Martínez

OMNIBUS ORDER ON MOTIONS TO DISMISS

This lawsuit alleges that Amanda Christensen ("Christensen") received constitutionally deficient medical care while on an involuntary hold in the Detox Unit at Crossroads at Grandview in Pagosa Springs, Colorado ("Crossroads"), a healthcare facility run by Defendant Southwest Colorado Mental Health Center, Inc., d/b/a Axis Health System ("Axis"), which resulted in Christensen taking her own life. (ECF No. 27.) Justin Kerns ("Kerns"), personally, as personal representative of the Estate of Amanda Christensen ("the Christensen Estate"), and as parent and next of friend of Kerns and Christensen's three minor children; the Christensen Estate; and minor children C.K., T.K., and B.K. (together, "Plaintiffs") sue five individuals and one entity allegedly responsible in some way for Christensen's death. Plaintiffs allege violations of Christensen's federal substantive due process rights and federal due process rights under 42 U.S.C. § 1983, as well as state law claims for wrongful death, negligence, and survival action, and a violation of the federal Rehabilitation Act § 504.

Currently before the Court are five motions to dismiss challenging the Amended Complaint (ECF No. 27).¹ One motion is brought by Defendants Ann Trebelhorn and Alfredo Chavarria, Axis staff members in the Detox Unit at Crossroads at the time of Christensen's death ("Staff Motion"). (ECF No. 33.) Another motion is brought by Defendant Debra Quayle ("Quayle Motion"). (ECF No. 45.) A third motion is brought by Defendant Morgan Williams ("Williams Motion") and a fourth by Defendant Brian Ensign ("Ensign Motion"). (ECF Nos. 32 & 36.) The final motion is brought by Axis ("Axis Motion"). (ECF No. 35.)² Axis, Williams, and Ensign also brought a sixth motion to dismiss, which was struck by the Court because the undersigned's Revised Practice Standard III.D.2 requires that all requests for relief by a particular defendant must be brought in a single Rule 12 motion. (ECF No. 92.)

I. BACKGROUND

The Court assumes the truth of the following facts pled in the First Amended Complaint for the purpose of resolving the pending motions.

This case arises from the tragic and untimely death of Christensen while she was involuntarily detained at Crossroads in November 2016. Crossroads is one of Axis's seven facilities. (ECF No. 27 ¶ 10.) At the time of the events that form the basis for this lawsuit, Ensign, Trebelhorn, Williams, Quayle, and Chavarria ("Individual Defendants") were employees of Axis. (Id. ¶¶ 11-15.) Ensign was the Acute Treatment Unit clinical team lead. (Id. ¶ 11.)

Christensen suffered from borderline personality disorder and bipolar II disorder, and struggled with substance abuse. (Id. ¶¶ 25-26.) On March 22, 2016, Christensen was arrested and charged with criminal mischief, and subsequently pled guilty to that charge and received one year of probation under a deferred sentence. (Id. ¶¶ 27-28.) The terms of her probation prohibited her from using alcohol, and required her to submit to drug and alcohol testing. (Id. ¶ 28.)

Christensen sought professional help from Dr. Paul Mattox, a psychiatrist in Durango, Colorado, and when Dr. Mattox was unavailable, Christensen often called the Axis Health System crisis hotline. (Id. ¶¶ 31-32.) In June 2016, Christensen began seeing Josh Bramble ("Bramble"), a licensed professional counselor. (Id. ¶ 33.) He helped her through several acute crises in the summer of 2016, and in the fall of 2016, encouraged Christensen to enter a full-time treatment program. (Id. ¶¶ 33-34.) Around October 1, 2016, Christensen attempted suicide by intentionally overdosing on medication. (Id. ¶ 35.)

Around November 13, 2016, Christensen violated the terms of her probation by drinking heavily, and taking opiates for which she did not have a prescription. (Id. ¶¶ 36, 57, 59-60.) Kerns wrestled a knife away from Christensen to prevent her from hurting herself. (Id. ¶ 57.) Bramble called the police because he perceived Christensen as a danger to herself and possibly others. (Id. ¶ 58.) Police escorted Christensen in handcuffs to the Pagosa Springs Medical Center for evaluation. (Id. ¶ 59.) Instead of arresting her, Archuleta County law enforcement officials agreed to place Christensen in Axis's custody where she could receive treatment. (Id. ¶¶ 37, 62.) Plaintiffs allege that "Axis performed similar and related services at the request and direction of Archuleta County . . . although her detention was maintained at the Crossroads facility rather than at either the Archuleta County Detention Center or the La Plata County Jail." (Id. ¶ 46.)

During Christensen's booking into Crossroads, the Intake Admnistrator noted that Christensen had a blood alcohol content level of 0.103 and was being admitted in part because she made suicidal statements. (Id. ¶ 68.) Christensen was placed in the Detox Unit. (Id. ¶ 70.)

On November 14, 2016, Christensen met with Jamie Denier for a crisis assessment. (Id. ¶ 72.) The ten-page crisis assessment form detailed Christensen's high suicide risk, mental health diagnosis and symptoms, and history of depression, suicide attempts, self-harm, and substance abuse. (Id. ¶¶ 72-74.) The form was saved into the Axis patient database. (Id. ¶ 72.) Christensen ranked as "moderate or high risk" in most categories of the suicide risk assessment, but denied attempting to take her own life in October 2016. (Id. ¶¶ 76, 80.) Christensen's medical records also stated that Christensen was "exhibiting a deteriorating course leading toward danger to self or others." (Id. ¶ 82.) The form also noted that Christensen had been diagnosed with bipolar disorder, an unspecified personality disorder, and alcohol dependence. (Id. ¶ 83.) Defendant Ensign, the Acute Treatment Unit clinical team lead, did not review or approve this initial screening form until November 16, 2016.

When Christensen was admitted to Crossroads, Kerns and Bramble contacted the District Attorney's Office for the 6th Judicial District and the Colorado Department of Human Services to arrange for the filing of a petition for Christensen's temporary involuntary commitment to an intensive, 30-day inpatient alcohol treatment program. (Id. ¶ 86.) On November 15, 2016, Bramble met with Christensen and told her that he was pursuing involuntary commitment. (Id. ¶ 87.) Christensen was distraught upon hearing the news. (Id. ¶ 90.) Defendant Williams performed a safety assessment and noted that Christensen was "very escalated" following her meeting with Bramble. (Id. ¶ 90.) She did not want to be committed and planned to contest it. (Id. ¶ 92.)

After meeting with Christensen at Crossroads, Bramble told Defendant Quayle that Christensen was "at an extremely high risk for completing suicide" and that her October 2016 suicide attempt "was a serious one." (Id. ¶ 87.)

On November 18, 2019, Deputy District Attorney Alexander Lowe filed a petition for involuntary commitment for alcohol abuse under Colo. Rev. Stat. § 27-81-112. (Id. ¶ 93.) That same day, Christensen was taken to Mercy Medical Center to refill her anti-anxiety medications. (Id. ¶ 94.) Defendant Chavarria spoke with Christensen when she returned to Crossroads. (Id. ¶ 95.) His notes from the meeting state "Patient returned from Mercy ER with Librium and a prescription for Ativan." (Id.) Chavarria did not record Christensen's emotional, physical, or psychological state at that time.

At approximately 3:45 p.m. on November 18, 2019, Christensen made a phone call supervised by Crossroads. (Id. ¶ 97.) To make a call, a patient must sit in front of a window with an Axis staff member on the other side. (Id.) Plaintiffs believe that Defendant Trebelhorn was responsible for monitoring Christensen's call. (Id.) During the call, Christensen moved out of the chair and slumped to the floor, and was, according to Plaintiffs, "visibly distraught." (Id. ¶ 98.)

At approximately 4:08 p.m., Christensen entered the women's bathroom alone, carrying a tote bag and towel. (Id. ¶ 102.) She was in the line of sight of facility staff responsible for monitoring Christensen, and in view of the video surveillance system. (Id.) At 4:38 p.m., two women tried to open the bathroom door, but could not because it was locked. (Id. ¶ 103.) At 5:15 p.m., another woman unsuccessfully tried to open the door and alerted staff that the door had been locked for over an hour. (Id. ¶ 104.) Trebelhorn escorted the woman away from the bathroom. Around 5:35 p.m., Trebelhorn tried to open the door and found it locked. (Id. ¶ 106.) Trebelhorn and a male staff member started looking for a key. (Id. ¶ 107.) A janitor opened the door at approximately 5:38 p.m. (Id.)

Inside the bathroom, they found Christensen hanging by a towel. (Id. ¶ 109.) Trebelhorn found scissors, and cut Christensen down at approximately 5:39 p.m. (Id. ¶ 110.) Someone commenced CPR. (Id. ¶ 111.) Emergency Medical Services ("EMS") arrived at 5:43 p.m. and found Christensen unresponsive and without a pulse. (Id.) EMS intubated Christensen, gave her a shot of epinephrine, and continued CPR. (Id. ¶ 112.) Despite these efforts, Christensen died. Her cause of death was asphyxia due to hanging. (Id. ¶ 113.)

...