A.L. v. Eichman

376 F.Supp.3d 547

A.L. and S.W., Plaintiffs,

v.Adelaide L. EICHMAN, M.D., Defendant.

Civil Action No. 17-357

United States District Court, W.D. Pennsylvania.

Signed March 26, 2019

Mark D. Freeman, Media, PA, for Plaintiffs.

George P. Kachulis, Marcelle M. Theis, Sally A. Frick, Dickie, McCamey & Chilcote, P.C., Pittsburgh, PA, for Defendant.

MEMORANDUM OPINION

Nora Barry Fischer, United States District Judge

I. Introduction

Pending before the Court are the parties' cross-motions for summary judgment on the issue of whether Defendant Adelaide L. Eichman, M.D., is a state actor under 42 U.S.C. § 1983. (Docket Nos. 57 and 59). For the reasons that follow, the Court finds that Dr. Eichman is not a state actor; therefore, Defendant's summary judgment motion will be granted and Plaintiffs' motion will be denied.

II. Background

This matter arises from allegations of child abuse made against Plaintiffs A.L. and S.W. Plaintiffs filed this action on March 22, 2017, against Dr. Eichman and three other Defendants, Allegheny County, Andrew Fleming and Anjelica Salih, under 42 U.S.C. § 1983 alleging procedural, substantive, and Fourth/Fourteenth Amendment due process claims against Defendants. (Docket No. 1). Defendants filed motions to dismiss for failure to state a claim, which the Court denied on July 14, 2017. (Docket Nos. 23, 26, 35, 36). On March 28, 2018, pursuant to a stipulation of dismissal by the parties, the Court ordered that all claims against Defendants Fleming, Salih and Allegheny County were dismissed with prejudice. (Docket Nos. 53, 54).

Following discussion at a post-fact discovery status conference, the parties agreed to proceed to summary judgment on the issue of whether Dr. Eichman is a state actor. Accordingly, the parties filed their cross motions for summary judgment and supporting briefs on June 15, 2018, followed by responses in opposition, replies and sur-replies to same. (Docket Nos. 57-61, 63-66, 68, 70-73). On September 7, 2018, the Court held oral argument on the parties' cross-motions for summary judgment. (Docket No. 74). Each party subsequently submitted supplemental records and argument in support of their respective position, and the transcript of the oral argument was filed on October 1, 2018. (Docket Nos. 76, 77, 80). Accordingly, the matter is now ripe for disposition.

III. Relevant Facts ¹

The Allegheny County Department of Human Services, Office of Children Youth and Families ("CYF") entered into a contract with Children's Hospital of Pittsburgh of the UPMC Health System ("CHP") for the period July 1, 2015 to June 30, 2016, pursuant to which CHP agreed to provide health services for children including comprehensive physical exams, intake or discharge exams, x-rays, treatment for injury and psychosocial assessments. (Docket No. 60-4 at 1, 49). The contract stated that CHP "shall also participate in investigations of child abuse and neglect [and] shall provide written reports and/or court testimony in Allegheny County Juvenile Court and Allegheny County Criminal Court." (Id. at 49).

According to the Annual Statement of the Child Advocacy Center ("CAC") at CHP, its mission is "to protect children and promote healthy families through excellence in assessment of child maltreatment, medical and social care for vulnerable children, collaboration with child-protection agencies [and] education and research." (Docket No. 60-3 at 2). The purposes of the CAC are "(a) to ensure that injured, vulnerable patients receive competent assessment for concerns of maltreatment and (b) to ensure that there are ongoing medical and social services for children who have been abused or are at risk of abuse." (Id. at 3). To these ends, CAC physicians are responsible for medical service, teaching, research and administrative leadership. (Id. ). The goals and objectives of the medical/clinical service include the following:

• To provide consultative services for children receiving care at Children's Hospital, including forensic medical and social evaluations of children who may be victims of child abuse or neglect. This service involves collaboration with other physicians on the medical staff, including specialists from trauma, neurosurgery, orthopaedics, radiology, ophthalmology, emergency medicine, behavioral health, and pediatrics.

• To work with professionals from community-based child-protection agencies and to support the judicial system in the protection of children. This includes providing objective medical information through consultative reports and legal testimony for (a) the judicial system, both in family court and criminal court settings; (b) professionals working in the Office of CYF; (c) law-enforcement agencies; and (d) the district attorney's offices.

• To provide pediatric medical care to vulnerable children in the child-protection system....

(Id. ) (emphasis added).

Dr. Eichman is listed in the CAC's Annual Statement as an Assistant Professor of Pediatrics, but she testified that she is not employed by the CAC. (Docket No. 60-3 at 3; Docket No. 60-6 at 57:16-17). Dr. Eichman is employed by University of Pittsburgh Physicians ("UPP"), which is a physician group affiliated with UPMC, and the University of Pittsburgh as a pediatrician and an assistant professor of pediatrics. (Docket No. 60-6 at 12:1-17, 57:16-17). Dr. Eichman is separately compensated by UPP and the University, and she does not receive any compensation from the CAC. (Id. at 17:11-13, 20:25-21:5).

As an educator, Dr. Eichman's responsibilities include teaching medical residents, as well as teaching and training for community physicians, caseworkers and judges. (Docket No. 60-6 at 21:6-17). Dr. Eichman does not receive any compensation when she teaches and trains caseworkers or judges, but sometimes a donation is made to the hospital. (Id. at 21:25-22:4).

As a clinician, Dr. Eichman's job responsibilities include working as an attending pediatrician with the CAC, which began on July 1, 2013. (Docket No. 60-6 at 11:1-2, 15:12-16, 16:18, 57:16-58:1). In that role, Dr. Eichman is a consultant who evaluates a child and offers recommendations to physicians on the various primary services at CHP, such as general pediatrics, neurology or trauma. (Id. at 44:5-10). As a medical consultant, Dr. Eichman evaluates whether or not a child has been abused or neglected, which includes performing a comprehensive physical examination of the child. (Id. at 79:9-80:8). Dr. Eichman testified that she does not investigate child abuse, as would a caseworker or a police officer. (Id. at 78:14-16). Nonetheless, as a pediatrician, Dr. Eichman is a mandated reporter,² meaning that she is mandated to make a report to Child Protective Services ("CPS") if she has a reasonable suspicion of abuse or neglect. (Id. at 59:16-20).

Plaintiffs are the parents of two children, S.L.W. and D.W. (Docket No. 1 at ¶¶ 4-5). During S.L.W.'s one-month well child visit on July 14, 2015, the nurse practitioner at his pediatrician's office noticed four bruises on S.L.W., one each on his forehead, left inner elbow, right lower leg and back/waist area. (Docket No. 64-1 at 3). According to the pediatrician office notes, S.L.W.'s mother, Plaintiff A.L., stated that she may have remembered accidentally hitting his head when she placed him into his swing, but she did not see the other bruises until they were pointed out that day. (Id. ). The office notes state, "d/w mother concern for possible medical condition as well as concern for someone inflicting intentional injury to nonmobile infant." (Id. ). A.L. indicated that she understood and agreed to take S.L.W. to the emergency room at CHP for evaluation. (Id. ). The office notes state that A.L. was aware that S.L.W. would have lab work and a skeletal survey as part of the evaluation. (Id. ).

CHP Emergency Department records indicate that S.L.W. presented for evaluation because his primary pediatrician's office was concerned about the unexplained bruises. (Docket No. 76-1 at 21). Based on the history provided by S.L.W's mother, there was concern for non-accidental trauma perpetrated by his father, Plaintiff S.W. (Id. ). The Emergency Department notes document that S.W. had been on feeding duty with S.L.W. on Saturday night (three days prior to presenting to CHP), and A.L. first noticed a bruise on S.L.W.'s back and leg on Sunday morning. (Id. at 24). A.L. asked S.W. about the bruises, and he responded that he "may have been frustrated" and "perhaps he had been a little rough with the baby." (Id. ). The Emergency Department notes further indicate that there was no family history of bleeding disorders, but A.L. bruises easily, and it was noted that S.L.W.'s leg was bruised after his blood pressure was taken. (Id. at 25).

The Emergency Department consulted with a doctor on the trauma service, as well as Dr. Eichman to perform an evaluation of S.L.W. because of concerns for abuse. (Docket Nos. 60-6 at 175:17-25; 76-1 at 23). Dr. Eichman performed a physical examination of S.L.W. and obtained history from A.L, who told Dr. Eichman that S.W. had night duty on Saturday night, and she noticed a bruise on S.L.W.'s forehead and back on Sunday morning. (Docket No. 64-3 at 2, 3, 6). S.W. did not have an explanation for the forehead bruise, other than he "was probably too rough with the baby." (Id. at 3). As to the back bruise, S.W. said that was probably due to him "massaging S.L.W.'s belly due to gas." (Id. ). A.L. also noted that she bumped S.L.W.'s head while putting him into his swing a few days earlier, but the impact seemed insignificant. (Id. ). Dr. Eichman's notes indicate that A.L. said she bruises easily and has heavy periods, but she has not had a formal work-up. (Id. at 4).

Dr. Eichman reported that S.L.W.'s CT scan and skeletal survey were preliminarily normal, but his bloodwork was pending. (Docket No. 64-3 at 8). The report stated that "[b]ruising in a non-mobile infant is HIGHLY CONCERNING for physical child abuse," thus more medical information,...