Thomas v. Westmoreland Cnty., Civil Action No. 20-1903

CHARLES E. THOMAS, MARSHA HALL, and MARK THOMAS,Individually and as Co-Administrators of the ESTATE OFELIZABETH M. THOMAS, Deceased, Plaintiffs, v. WESTMORELAND COUNTY; and WESTMORELAND COUNTYd/b/a WESTMORELAND MANOR, Defendants.

Civil Action No. 20-1903

UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA

April 27, 2021

MEMORANDUM OPINION

Presently before the Court is the Rule 12(b)(6) Motion to Dismiss and brief in support thereof filed by Defendants Westmoreland County and Westmoreland County d/b/a Westmoreland Manor (Docket Nos. 6, 7), the response in opposition thereto filed by Plaintiffs Charles E. Thomas, Marsha Hall, and Mark Thomas, who have brought suit individually and as co-administrators of the estate of Elizabeth M. Thomas, deceased (Docket No. 8), and Defendants' reply (Docket No. 9). For the reasons set forth herein, Defendants' Motion to Dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6) is granted without prejudice to amendment with sufficient facts to state a claim.

I. Background

As alleged in the Complaint, Plaintiffs are the adult children of the late Elizabeth M. Thomas (hereinafter, "Ms. Thomas") and are also the administrators of her estate. (Docket No. 1, ¶¶ 4, 5). Plaintiffs contend that Westmoreland County is a governmental agency that owned and operated Westmoreland Manor, a skilled nursing facility, at the time of the events alleged in this action (hereinafter, "Defendants"). (Id. ¶¶ 6-9).

According to the Complaint, on December 4, 2018, Ms. Thomas was admitted to Westmoreland Manor following a hospitalization at Excela Hospital. (Docket No. 1, ¶ 18). Although Ms. Thomas was transferred back to Excela Hospital the following day, she was readmitted to Westmoreland Manor two days later, on December 7, 2018. (Id. ¶¶ 20, 21). As alleged, after a series of events involving urinary retention as well as some other health issues, Ms. Thomas was again transferred back to Excela Hospital on January 21, 2019. (Id. ¶ 40). Plaintiffs contend that Ms. Thomas was admitted to the hospital with diagnoses of pancreatitis, UTI, dehydration and elevated magnesium and BUN. (Id. ¶ 44).

Plaintiffs aver that on January 27, 2019, Ms. Thomas was readmitted to Westmoreland Manor and, upon her discharge from Excela Hospital, it was noted that she had been treated at the hospital for pancreatitis, acute kidney injury, elevated blood urea nitrogen, vomiting, dehydration, UTI and hypotension. (Docket No. 1, ¶¶ 48, 49). On January 30, 2019, a nutrition evaluation completed at Westmoreland Manor showed that Ms. Thomas had experienced a ten-pound weight loss the previous month. (Id. ¶ 52). On February 1, 2019, Ms. Thomas' laboratory results were processed and indicated dehydration and infection. (Id. ¶¶ 53, 54). Plaintiffs claim that a Westmoreland Manor nurse practitioner reviewed the laboratory results and ordered follow-up in one week with fluid encouragement. (Id. ¶ 55).

According to Plaintiffs, the next day, February 2, 2019, a Westmoreland Manor staff nurse documented Ms. Thomas' poor fluid intake and, that evening, after nursing staff were unable to start an IV on Ms. Thomas, she was transferred back to Excela Hospital. (Docket No. 1, ¶¶ 57, 61). Upon admission to the hospital, Ms. Thomas was diagnosed with severe sepsis, UTI, acutekidney failure, pneumonia, hypernatremia and altered mental status, while laboratory studies indicated dehydration. (Id. ¶¶ 63, 64). According to the Complaint, over the next several days, Ms. Thomas's condition deteriorated, and on February 8, 2019, Ms. Thomas died. (Id. ¶¶ 65, 66). Ms. Thomas' death certificate indicated that she died of respiratory failure and pneumonia. (Id. ¶ 67).

On December 8, 2020, Plaintiffs filed their Complaint, alleging two claims against Defendants: (I) Deprivation of Civil Rights Enforceable via 42 U.S.C. § 1983; and (II) Wrongful Death. Plaintiffs seek damages in excess of $75,000.00, plus interest, costs of suit, and attorney fees. Defendants have filed a motion to dismiss both counts of the Complaint pursuant to Rule 12(b)(6) for failure to state claims upon which relief can be granted.

II. Standard of Review

In considering a Rule 12(b)(6) motion to dismiss, the factual allegations contained in the complaint must be accepted as true and must be construed in the light most favorable to the plaintiff, and the court must "'determine whether, under any reasonable reading of the complaint, the plaintiff may be entitled to relief.'" Phillips v. County of Allegheny, 515 F.3d 224, 231 (3d Cir. 2008) (quoting Pinker v. Roche Holdings Ltd., 292 F.3d 361, 374 n.7 (3d Cir. 2002)); see Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 563 n.8 (2007). While Federal Rule of Civil Procedure 8(a)(2) requires only "a short and plain statement of the claim showing that the pleader is entitled to relief," the complaint must "'give the defendant fair notice of what the . . . claim is and the grounds upon which it rests.'" Phillips, 515 F.3d at 231 (quoting Twombly, 550 U.S. at 555 (additional internal citation omitted)). Moreover, while "this standard does not require 'detailed factual allegations,'" Rule 8 "demands more than an unadorned, the-defendant-unlawfully-harmed-me accusation." Id. (quoting Twombly, 550 U.S. at 555); Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Twombly, 550 U.S. at 555).

It should be further noted, therefore, that in order to survive a motion to dismiss, "a complaint must contain sufficient factual matter, accepted as true, to 'state a claim to relief that is plausible on its face.'" Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 570). The Supreme Court has noted that a "claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Id. (citing Twombly, 550 U.S. at 556). The standard "'does not impose a probability requirement at the pleading stage,' but instead 'simply calls for enough facts to raise a reasonable expectation that discovery will reveal evidence of' the necessary element." Phillips, 515 F.3d at 234 (quoting Twombly, 550 U.S. at 556). Moreover, the requirement that a court accept as true all factual allegations does not extend to legal conclusions; thus, a court is "'not bound to accept as true a legal conclusion couched as a factual allegation.'" Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 555 (internal citation omitted)).

III. Legal Analysis

A. Count I: Deprivation of Civil Rights via 42 U.S.C. § 1983

In Count I of their Complaint, Plaintiffs allege a claim against Defendants for deprivation of Ms. Thomas' civil rights pursuant to 42 U.S.C. § 1983. (Docket No. 1, ¶¶ 68-80). Plaintiffs contend that Westmoreland Manor is bound by the Federal Nursing Home Reform Act ("FNHRA"), which was passed as part of the Omnibus Budget Reconciliation Act of 1987 ("OBRA"), Pub. L. No. 100-203, §§ 4201-4218, 101 Stat. 1330, 1330-160 to -221 (1987) (codified at 42 U.S.C. §§ 1395i-3, 1396r), and that it is also bound by the OBRA/FNHRA implementing regulations found at 42 C.F.R. § 483 et seq. (Id. ¶¶ 70, 71). Plaintiffs note that the specific detailedregulatory provisions as well as the statutes themselves create rights which are enforceable pursuant to 42 U.S.C. § 1983. (Id. ¶ 72).

Section 1983 functions as a "vehicle for imposing liability against anyone who, under color of state law, deprives a person of 'rights, privileges, or immunities secured by the Constitution and laws.'" Grammer v. John J. Kane Reg'l Ctrs.-Glen Hazel, 570 F.3d 520, 525 (3d Cir. 2009) (quoting 42 U.S.C. § 1983 (emphasis added)). Here, Plaintiffs allege that Westmoreland Manor acted under color of state law because it is owned and operated by Westmoreland County. The Third Circuit has held that provisions of the FNHRA "confer individual rights that are presumptively enforceable through § 1983." Id. at 532. It is clear that the facts alleged by Plaintiffs, viewed in the light most favorable to them, sufficiently allege a violation of Ms. Thomas' federally protected rights under the FNHRA. See Robinson v. Fair Acres Geriatric Ctr., 722 Fed. Appx. 194, 197 (3d Cir. 2018).

To hold Defendants liable for such violations under Section 1983, however, Plaintiffs must allege more than a violation of Ms. Thomas' rights by Defendants' employees; Plaintiffs must also sufficiently plead that those alleged violations are attributable to Defendants. "'[A] municipality cannot be held liable solely because it employs a tortfeasor—or, in other words, a municipality cannot be held liable under 1983 on a respondeat superior theory.'" Id. (quoting Monell v. Dep't of Soc. Servs., 436 U.S. 658, 691 (1978)). Thus, the alleged violation of rights must have been caused by actions that were taken pursuant to a municipal "policy" or "custom." See id. at 198 (citing Natale v. Camden County Correctional Facility, 318 F.3d 575, 583-84 (3d Cir. 2003)); see also Monell, 436 U.S. at 690-94 (explaining what has been referred to as the Monell framework or Monell liability). "A policy is made 'when a decisionmaker possess[ing] final authority to establish municipal policy with respect to the action issues a final proclamation, policy or edict.'"Natale, 318 F.3d at 584 (quoting Kneipp v. Tedder, 95 F.3d 1199, 1212 (3d Cir. 1996)). A "custom," on the other hand, involves "practices of state officials . . . so permanent and well settled as to constitute a 'custom or usage' with the force of law." Monell, 436 U.S. at 691.

Acts by a government employee may be deemed to be the result of a policy or custom of the entity for whom the employee works in three situations: (1) "where 'the appropriate officer or entity promulgates a generally applicable statement of policy and the subsequent act complained of is simply an implementation of that policy;'" (2) "where 'no rule has been announced as policy but federal law has been violated by an act of the...