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UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO
RICO
MARITZA PUBILL-RIVERA,
Plaintiff
v.
JOSE O. CURET, et al,
Defendants
Civil No. 97-2815 (JAG)
218 F. Supp. 2d 89
May 28, 2002, Decided
GARCIA-GREGORY, D. J.
Plaintiff Maritza Pubill Seize ("plaintiff") brought suit
pursuant to 42 U.S.C. § 1983 (for violation of her son's Eighth Amendment
rights) n1. The named defendants are: Jose C. Curet, ("Dr. Curet"),
in his personal and official capacity as Director of the Correctional Health
Division ("Correctional Health"); Dr. Jose A. Madera, ("Dr.
Madera"), in his personal and official capacity as Medical Director of the
University Hospital Ramon Ruiz Arnau in Bayamon ("Regional Hospital"); and doctors Amaury Hernandez, Ramon L.
Rivera [*91] Schneider, Jellytza Maldonado Rondon, Neisa Torres Reyes, and
Nilma Rosado Villanueva. On January 26, 2001, co-defendants Dr. Curet and Dr.
Madera moved for dismissal of the complaint pursuant to Fed.R.Civ.P. Rule
12(b)(6) alleging that plaintiff failed to state a claim upon which relief
could be granted (Docket No. 57, 70, 94) n2. For the reasons discussed below,
defendants' motion is GRANTED.
FACTUAL BACKGROUND n3
Amaury Seise Pubill
("Amaury") was born to Maritza Pubill on August 8, 1974. In 1992, he
was incarcerated in section 308 of the Bayamon Regional Jail, then in the
Juvenile Detention Center in Miramar, then in section 292 of Bayamon Regional
Jail, and finally, in 1072 Annex of the Bayamon Regional Jail. On July 31,
1996, Amaury sought medical services at Correctional Health where he complained
that he was suffering from malaise, loss of appetite, fatigue, and fever.
Amaury was diagnosed as having Hepatitis C with symptoms that corresponded to
the initial manifestations of AIDS. On that date, tests were ordered, Amaury
was refereed to the health educator, and was instructed to return to the clinic
in one month. No follow-up or special treatment was provided to Amaury. On
October 31, 1996, Amaury tested positive to the HIV virus. Once again, no
follow up or special treatment was provided to him.
On November 30, 1996, Amaury
sought medical services again at Correctional Health. Amaury complained that he
was suffering from pain in the ribs, diarrhea, vomiting and loss of appetite.
The attending physician described Amaury as being "acutely" sick and
as having AIDS. Amaury was given medications and admitted at Correctional
Health at 7:30 p.m. until December 1 at 10:35 p.m., when he was transferred to
the Bayamon Regional Hospital. Amaury arrived at the Hospital on December 2,
1996, at 12:20 a.m.. Amaury told the attending physician that he had been
suffering from shortness of breath for three weeks. Medications were
administered and labs and x-rays were taken. The emergency room physician also
requested a consultation with Internal Medicine Services at 12:20 a.m. and
received an answer to his consultation at 2:00 p.m., fourteen (14) hours after
Amaury had arrived at the emergency room in a critical condition. On December
2, 1996, at 3:30 p.m., treatment with antibiotics was commenced. Amaury died on
December 3, 1996, at 9:40 a.m.
DISCUSSION
A. Motion to Dismiss Standard.
Pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure, a complaint
may not be dismissed unless it appears beyond doubt that plaintiffs can prove
no set of facts in support of her claim which would entitle her to relief.
See Brown v. Hot, Sexy, and Safer
Prods., Inc., 68 F.3d 525, 530 (1st Cir. 1995). The Court accepts all
well-pleaded factual allegations as true, and draws all reasonable inferences
in plaintiff's favor. See Correa-Martinez v. [*92] Arrillaga-Belendez, 903 F.2d
49, 51 (1st Cir. 1990). The Court need not credit, however, "bald
assertions, unsupportable conclusions, periphrastic circumlocutions, and the
like" when evaluating the Complaint's allegations. Aulson v. Elanchard, 83 F.3d 1, 3 (1st Cir.
1996). When opposing a Rule 12(b)(6) motion, "a plaintiff cannot expect a
trial court to do his homework for him." McCoy v. Massachusetts Institute
of Tech., 950 F.2d 13, 22 (1st Cir. 1991). Plaintiff is responsible for putting
her best foot forward in an effort to present a legal theory that will support
her claim. Id., at 23 (citing Correa
Martinez, 903 F.2d 49 at 52). Plaintiff must set forth "factual
allegations, either direct or inferential, regarding each material element
necessary to sustain recovery under some actionable theory." Goolev v.
Mobil Oil Corp., 851 F.2d 513, 514 (1st Cir. 1988).
B. Failure to State a claim under 42 U.S.C. § 1983 (Eight Amendment) against
co-defendants Dr. Curet and Dr. Madera in their official capacity.
With respect to plaintiff's 42
U.S.C. § 1983 claim against co-defendants Dr. Curet and Dr. Madera in their official
capacity, it is well established that the Eleventh Amendment bars a section
1983 action against a State, State Agency, or any State Official in his
official capacity for monetary damages that would have to be paid from the
state treasury. See Wang v. New
Hampshire Board of Registration in Medicine, 55 F.3d 698, 700 (1st Cir.1995);
Vega Castro v. Puerto Rico, 43 F. Supp.2d 186, 189 (D.P.R.1999). The
Commonwealth of Puerto Rico enjoys the full benefits of the Eleventh Amendment.
See Ursulich v. Puerto Rico Nat.
Guard, 384 F. Supp. 736, 737 (D.P.R. 1974).
In the present case, although
plaintiff seeks equitable and prospective relief from Dr. Curet and Dr. Madera,
the facts in the Fourth Amended Complaint show that plaintiff is not entitled to
any equitable relief. When plaintiff filed the Original Complaint, Amaury was
no longer incarcerated in any Puerto Rico prison. He had died. Consequently,
plaintiff's claims for prospective and equitable relief do not present a case
or controversy under Article III of The United States Constitution.
See Preiser v. Newkirk, 422 U.S.
395, 401, 45 L. Ed. 2d 272, 95 S. Ct. 2330-04 (1975); North Carolina v. Rice,
404 U.S. 244, 246, 30 L. Ed. 2d 413, 92 S. Ct. 402 (1971). (Federal Courts do
not have the power to
decide questions that cannot affect the rights of litigants in the case before
them.) Here, there is no possible expectation that any of the alleged wrongs
will be repeated inasmuch as Amaury is dead and thus no longer incarcerated.
Accordingly, plaintiff's 42 U.S.C. § 1983 claim against co-defendants Dr. Curet
and Dr. Madera in their official capacity must be dismissed as moot.
C. Failure to State a claim under 42 U.S.C. § 1983 (Eight Amendment) against
co-defendants Dr. Curet and Dr. Madera in their personal capacity.
1. Plaintiff's allegations n4
The Eighth Amendment to the
Constitution prohibits states from inflicting "cruel and unusual
punishment" on the prisoners it confines. See Wilson v. Seiter, 501 U.S. 294, 297, 115
L. Ed. 2d 271, 111 S. Ct. 2321, (1991). "It is now settled that the
treatment a prisoner receives in prison and the conditions under which he is
confined are subject to scrutiny under the Eighth Amendment." Farmer v.
Brennan, 511 U.S. 825, 831, 128 L. Ed. 2d 811, 114 S. Ct. 1970, (1994). In the [*93] present case,
plaintiff avers that Dr. Curet, as the Director of Correctional Health, was
"deliberately indifferent" under the Eighth Amendment toward the
events that led to Amaury's death inasmuch as he was the official responsible
for the adequate training, conduct and supervision of all of Correctional
Health's employees. Plaintiff alleges that the policies, protocols and
procedures that were established or that should have been established by Dr.
Curet were inadequate and/or were not followed by the individual doctors he
supervised inasmuch as Amaury was not given adequate treatment when he was first
diagnosed as having Hepatitis C and possibly AIDS on July 31, 1996. On that
date, tests were ordered, Amaury was referred to the health educator, and he
was instructed to return to the clinic in one month. Nonetheless, no follow up
or special treatment was provided to Amaury. On October 31, 1996, Amaury was
diagnosed with full blown AIDS. Once again, no follow up or special treatment
was provided to him in spite of the drugs available by then to treat AIDS.
After suffering for weeks from
symptoms related to his AIDS condition, Amaury was transferred to the emergency
room of the Bayamon Regional Hospital on December 2, 1996. Plaintiffs aver that
Dr. Madera, as the hospital administrator of the Bayamon Regional Hospital, was
"deliberately indifferent" under the Eighth Amendment toward the
events that led to Amaury's death inasmuch as he was the official responsible
for the adequate training, conduct and supervision of the Hospital's employees.
Plaintiff alleges that the policies, protocols and procedures that were
established or that should have been established by Dr. Madera were inadequate
and/or not followed by the individual doctors he supervised inasmuch as Amaury
had to wait fifteen hours to receive the results of the lab tests performed
before his arrival and to be given treatment with antibiotics.
Plaintiff concludes that these
repeated negligent acts indicate systemic deficiencies in the method of
providing medical care and a consistent pattern of reckless or negligent
conduct that amounts to "deliberate indifference". Plaintiff further
concludes that Dr. Curet and Dr. Madera's failure to train amounts to the
"deliberate indifference" standard applicable in Eighth Amendment
cases inasmuch as these physicians had constructive knowledge that their
subordinates engaged in a conduct that posed a substantial risk of serious harm
to Amaury's health. Dr. Curet and Dr. Madera's constructive knowledge is
allegedly derived from this Court's previous recognition of the serious medical problems that inmates face
in Puerto Rico's correctional facilities and public hospitals. See Morales Feliciano v. Romero Barcelo, 497
F. Supp. 14, 18 (1980).
2.
Supervisory Liability under the Eighth Amendment.
Plaintiff's conclusion is based
on the same analysis that led the Supreme Court to conclude that under 42
U.S.C. § 1983 a supervisor can be held liable for failure to train his
employees when the supervisor's failure amounts to a "deliberate
indifference" of the constitutional rights of others. See Canton
vs. Harris, 489 U.S. 378, 389, 103 L. Ed. 2d 412, 109 S. Ct. 1197 (1989). Under
Canton, when the need for training is so obvious, and the inadequacy so likely
to result in the violation of constitutional rights, a supervisor could be
found to be "deliberately indifferent." 489 U.S. 378 at 390. This
objective inquiry of "deliberate indifference" allows liability to be
premised on obviousness or constructive knowledge.
Plaintiff's analysis is,
however, inappropriate to determine the liability of [*94] a prison official
under the Eighth Amendment. See
Farmer, 511 U.S. at 841 (1994). Under Farmer, "deliberate
indifference" exists when "the official knows of and disregards an
excessive risk to inmate health or safety; the official must both be aware of
facts from which the inference could be drawn that a substantial risk of
serious harm exists, and he must also draw the inference." Id. at 837. A
prison official's failure to alleviate a significant risk that he should have
perceived but did not is insufficient to establish an Eighth Amendment
violation. Id. at 838. Accordingly, Farmer's
subjective inquiry of "deliberate indifference" requires plaintiff to
allege that Dr. Curet and Dr. Madera had actual knowledge that their subordinates engaged in a
conduct that posed a substantial risk of serious harm to Amaury's health and
that they disregarded that risk by failing to take reasonable measures to abate
it. Id. at 842.
Plaintiff's Fourth Amended
Complaint does not satisfy the "deliberate indifference" standard of
Farmer, because it fails to specifically aver that Dr. Curet and Dr. Madera
knew and acted with "deliberate indifference" to the possibility that
Amaury and other AIDS patients were not given adequate treatment and medication
to prolong their lives. Thus, plaintiff's pleadings, even if liberally
construed under Haines v. Kerner, 404 U.S. 519, 520, 30 L. Ed. 2d 652, 92 S.
Ct. 594 (1972), fail to state a personal-capacity claim under § 1983 since they
do not allege that Dr. Curet and Dr. Madera knowingly disregarded a known harm
in the alleged deprivation of Amaury's medical care.
At most, plaintiff's pleadings
may give rise to a negligence claim under the local tort statute. "An act
or omission unaccompanied by knowledge of a significant risk of harm might well
be something society wishes to discourage, and if harm does result society
might well wish to assure compensation. The common law reflects such concerns
when it imposes tort liability on a purely objective basis." 511 U.S. 825
at 838. (citation omitted). In sum, plaintiff has failed to state a claim
against Dr. Curet and Dr. Madera for an Eighth Amendment violation for
"deliberate indifference" to a serious medical need.
Although the Court is persuaded
that plaintiff has failed to state a claim, the defect is one that might easily
be cured by an amendment. The Court would ordinarily grant dismissal without
prejudice to plaintiff's filing of an
amended complaint realleging her claim. Plaintiff has already Amended
the Complaint on three occasions, however, and she has not been able to
adequately plea an Eighth Amendment violation. Thus, the Court has given
plaintiff more than ample opportunity to correct her defective pleading.
When opposing a Rule 12(b)(6) motion, "a plaintiff cannot expect a trial
court to do [her] homework for [her]." See McCoy v. Massachusetts Institute of Tech., 950 F.2d 13, 22
(1st Cir.1991). Plaintiff is responsible for putting her best foot forward in
an effort to present a legal theory that will support her claim. Id. at 23 (citing Correa-Martinez v. Arrillaga-Belendez,
903 F.2d 49, 52 (1st Cir.1990)). The plaintiff must set forth "factual
allegations, either direct or inferential, regarding each material element
necessary to sustain recovery under some actionable theory." Gooley v.
Mobil Oil Corp., 851 F.2d 513, 514 (1st Cir.1988). Accordingly, the Court must
dismiss plaintiff's 42 U.S.C. § 1983 Eighth Amendment claim against
co-defendants Dr. Curet and Dr. Madera.
D. Supplemental State Claims.
Supplemental state claims against co-defendants Dr. Curet and Dr. Madera
are dismissed without prejudice pursuant to 28 U.S.C. § 1367(c)(3), [*95] since
no federal claims to ground jurisdiction remain against them.
CONCLUSION
In
light of the foregoing, the Court grants defendants' motion to dismiss (Docket
Nos. 57, 70, 90) and dismisses all federal claims against co-defendants Dr.
Curet and Dr. Madera with prejudice. The supplemental state claims against them
are dismissed without prejudice pursuant to 28 U.S.C. § 1367 (c)(3).
IT
IS SO ORDERED.
In
San Juan, Puerto Rico, this 28th day of May 2002.
JAY
A. GARCIA-GREGORY
United States District Judge
FOOTNOTE:
n1 Amaury Seise Pubill
("Amaury") was born to Maritza Pubill on August 8, 1974. Amaury was
an inmate in the Bayamon Regional jail when he died from AIDS complications.
n2 The Court referred the
pending motions to U.S. Magistrate Judge Justo Arenas for a report and
recommendation. The Court has carefully reviewed the magistrate judge's report
and recommendation and agrees that plaintiff's claims against Dr. Madera and
Dr. Curet are time barred inasmuch as nothing in the record reveals that
plaintiff served Dr. Madera and Dr. Curet within the six months period
established by Rule 4.3(b) of the Puerto Rico Rules of Civil Procedure. The
Court, however, believes that assuming, arguendo, that plaintiff's claims
against Dr. Madera and Dr. Curet are not time barred, plaintiff's claim against
Dr. Madera and Dr. Curet must still be dismissed for failure to state a claim
upon which relief could be granted.
n3 The facts are taken from
the Fourth Amended Complaint.
n4 The entire discussion is
taken from plaintiff's opposition to defendants motion to dismiss (Docket 99 at
19-39), and from the Fourth Amended Complaint.