McIlwain v. Prince William Hosp.

774 F. Supp. 986

Tyrone A. McILWAIN & Valeria Y. McIlwain, Plaintiffs, v. PRINCE WILLIAM HOSPITAL, et al., Defendants.

Civ. A. No. 91-39-A.

United States District Court, E.D. Virginia, Alexandria Division.

September 24, 1991.

Robert Huston Hovis, III, Annandale, Va., for Tyrone A. and Valeria Y. McIlwain.

Robert Harkness Herring, Jr., Office of the Atty. Gen., Richmond, Va., for Com. of Va., Dept. of Corrections.

John Allen Blazer, Crews & Hancock, Fairfax, Va., for Prince William Hosp.

John Baldwin Catlett, Jr., Sands, Anderson, Marks & Miller, Richmond, Va., for Davis Mathias, M.D.

MEMORANDUM OPINION

ELLIS, District Judge.

Introduction

Before the Court are motions for summary judgment raising the question whether (1) a private physician under contract with a prison and (2) a private hospital without such a contract may be held liable under § 1983 for failing to inform a prisoner-patient of his HIV infection. Because the undisputed facts of this case show that the hospital was not a state actor, and because no policy or custom of the hospital contributed to the failure to tell the prisoner of his HIV test results, the § 1983 action must be dismissed as to the hospital. The same result does not obtain with respect to the private physician, who by virtue of his contract with the prison is a "state actor" for § 1983 purposes. Moreover, summary judgment against the physician is not appropriate because the parties hotly dispute whether the physician knowingly and deliberately failed to inform the prisoner of the test results. Accordingly, plaintiff's action against the physician survives for trial on these disputed facts.

Facts

On September 11, 1988, plaintiff Tyrone McIlwain ("McIlwain"), a prisoner at Virginia's Haymarket Correctional Facility, lapsed into unconsciousness from an overdose of heroin and was rushed to the emergency room of defendant Prince William Hospital ("Prince William Hospital" or "the Hospital"). During his two-day stay at the Hospital, McIlwain's blood was tested without his knowledge or consent for the presence of HIV antibodies, a symptom of exposure to the virus that causes acquired immuno-deficiency syndrome ("AIDS"). On September 13th, McIlwain was sent back to prison. It appears, however, that McIlwain was then incarcerated at Virginia's Powhatan Correctional Facility and was never returned to the Haymarket facility. The treating physician on call in the Hospital's emergency room when McIlwain arrived there on September 11 received the HIV test results on September 14th and 16th. The tests were positive. McIlwain's medical chart indicates that the treating physician then forwarded the positive HIV test results to "the camp physician" and also telephoned "the camp physician" concerning the results. The "camp physician" is the physician under contract to treat prisoners. The current record suggests that defendant David Mathis was the "camp physician" at the Haymarket Correctional Facility at the time, although the record does not establish whether Mathis was the person actually contacted by the treating physician. What is undisputed is that neither Mathis nor any other prison official informed McIlwain of the positive HIV test results, nor did McIlwain receive any treatment. Subsequently, McIlwain was released from prison. He alleges that he then infected his wife with the AIDS virus.

McIlwain and his wife filed a § 1983 action against The Commonwealth of Virginia's Department of Corrections, Prince William Hospital, the emergency room treating physician, and Mathis. Count I of the complaint alleges a violation of plaintiff's civil rights stemming from the defendants' failure to inform or treat McIlwain for a medical condition known to defendants that posed imminent danger to McIlwain's life and to that of his wife. Count II alleges a pendent state law claim for medical malpractice. The Commonwealth of Virginia and the treating room physician previously were dismissed from the case.¹ Before the Court are the motions for summary judgment of the Hospital and Mathis.

Analysis

To prevail under 42 U.S.C. § 1983, a plaintiff must satisfy two elements:

"First, the plaintiff must prove that the defendant has deprived him of a right secured by the constitution and laws of the United States. Second, the plaintiff must show that the defendant deprived him of this constitutional right under color of any statute, ordinance, regulation, custom or usage, of any State or Territory (42 U.S.C. § 1983). This second element requires that the plaintiff show that the defendant acted under color of state law."

Gomez v. Toledo, 446 U.S. 635, 640, 100 S.Ct. 1920, 1923, 64 L.Ed.2d 572 (1980). Defendants move for summary judgment on the grounds that the undisputed facts show that neither the Hospital nor Mathis acted under color of state law or participated in joint activity with the state or its agents. Defendants therefore contend that the Court lacks subject matter jurisdiction. Rule 12(b)(1), Fed.R.Civ.P. Alternatively, they assert that the complaint fails to state a claim upon which relief may be granted. Rule 12(b)(6), Fed.R.Civ.P.² Because the parties have submitted affidavits and rely on additional materials outside the complaint, the Court treats their submissions as motions for summary judgment, Rule 56, Fed.R.Civ.P., and analyzes them accordingly. Upon reviewing the record, the Court concludes that no facts support a claim of state action by the Hospital and the Hospital is therefore entitled to judgment as a matter of law. It is otherwise, however, with defendant Mathis.

A. The Hospital

To determine whether the action of a private, regulated entity such as Prince William Hospital constitutes "state action," a court "must inquire `whether there is a sufficiently close nexus between the State and the challenged action of the regulated entity that the action of the latter may fairly be treated as that of the State itself.'" Modaber v. Culpeper Memorial Hospital, Inc., 674 F.2d 1023, 1025 (4th Cir.1982) (quoting Jackson v. Metropolitan Edison Co., 419 U.S. 345, 351, 95 S.Ct. 449, 453, 42 L.Ed.2d 477 (1974)). In Modaber, a case involving the revocation of a private physician's clinical staff privileges, the Fourth Circuit held that a state becomes responsible for the acts of a private party such as a hospital if the party "acts (1) in an exclusively state capacity, (2) for the state's direct benefit, or (3) at the state's specific behest." 674 F.2d at 1025. The Fourth Circuit held that the provision of health care did not involve the exercise of powers traditionally reserved to the state and that the state had not directed or encouraged the revocation procedures employed by the hospital. Therefore, the court found no state action.

In a case more closely analogous to the facts of the case at bar, the Supreme Court found that a private physician under contract to provide orthopedic services to inmates at a prison hospital was a state actor. West v. Atkins, 487 U.S. 42, 108 S.Ct. 2250, 101 L.Ed.2d 40 (1988). In West, the Supreme Court found that the state had a duty to provide adequate medical care to persons it had incarcerated and that this duty had been delegated to the doctor. The Court stated that "the dispositive issue concerns the relationship among the State, the physician, and the prisoner." Id. 108 S.Ct. at 2259. It held that:

Contracting out prison medical care does not relieve the State of its constitutional duty to provide adequate medical treatment to those in its custody, and it does not deprive the State's prisoners of the means to vindicate their Eighth Amendment rights. The State bore an affirmative obligation to provide adequate medical care to West: the State delegated that function to respondent doctor Atkins; and respondent voluntarily assumed that obligation by contract.

Id. See also Lopez v. Dept. of Health Services, 930 F.2d 28 (1991) (Table) (holding that allegations in a complaint that a private hospital had a contract with Arizona to provide services for indigents was sufficient to support a § 1983 action against the hospital for alleged refusal to serve an indigent).

The present action differs from West v. Atkins in that no contractual relationship existed between the Hospital and the Haymarket Correctional Facility. The prison did not routinely treat inmates at the Hospital. Rather, McIlwain was rushed to the Hospital because he needed emergency care. A hospital's mere acceptance of a prison inmate for emergency care does not transform the hospital into a state actor. By seeking emergency treatment for McIlwain, the prison did not delegate its duty to provide him with medical care; the Hospital, in admitting McIlwain to its emergency room, did not accept any such duty. The Hospital was not "fully vested with state authority ... to provide essential medical care to those the State had incarcerated." West v. Atkins, 108 S.Ct. at 2260. In short, the Hospital was not a state actor.

Moreover, even assuming that the mere acceptance of a prisoner in its emergency room was sufficient to render Prince William Hospital a "state actor" for purposes of § 1983, the Hospital cannot be held liable for "the actions of its employees unless plaintiffs can show a policy which the employees were carrying out in their alleged denial of treatment." Mitchell v. Chontos, 756 F.Supp. 243, 249 n. 9 (D.S.C.1990) (citing Monell v. Dept. of Social Services, 436 U.S. 658, 98 S.Ct. 2018, 56 L.Ed.2d 611 (1978)). In Monell, the Supreme Court held that vicarious liability may not be imposed on a municipality under § 1983. Id. at 691-92, 98 S.Ct. at 2036. The Supreme Court did not address directly whether a private corporate employer may be held liable under § 1983 on a respondeat superior theory. But numerous lower courts, including the Fourth Circuit, have understandably relied on Monell in holding that a corporate employer may not be made vicariously liable under § 1983. See ...