Opinion
04 CV 8690 (KMW) (HBP).
December 20, 2007
OPINION AND ORDER
This is a pro se civil rights action brought pursuant to 42 U.S.C. § 1983 in which Plaintiff Miguel Lara, a/k/a Alberto Francisco Arias, ("Plaintiff") complained of medical care he received while in the custody of the New York City Department of Correction at Rikers Island.
I. Procedural Posture
On December 1, 2004, Plaintiff filed an Amended Complaint which named 27 individuals as defendants. Docket Entry 4. On August 31, 2006, four of the 27 named defendants moved (1) for dismissal of this action pursuant to Fed.R.Civ.P. 41(b) for Plaintiff's failure to comply with a November 4, 2004 court order; (2) for dismissal of this action pursuant to Fed.R.Civ.P. 12(b)(6) for failure to state a cause of action under 42 U.S.C. § 1983; (3) for summary judgment pursuant to Fed.R.Civ.P. 56; and (4) to drop certain defendants pursuant to Fed.R.Civ.P. 21. Docket Entry 46.
The four defendants are Michael Bloomberg, Mayor of New York City; Martin Horn, New York City Corrections Commissioner; Van Dunn, M.D., Senior Vice President of Medical Professional Affairs for the New York City Health Hospitals Corporation ("HHC"); and Frank J. Cirillo, Senior Vice President of Operations for HHC (collectively, "Moving Defendants").
On August 21, 2007, Magistrate Judge Henry B. Pitman issued a Report and Recommendation ("Report"), familiarity with which is assumed, recommending that the Moving Defendants' August 31, 2006 motion be (1) denied insofar as it seeks dismissal for Plaintiff's failure to comply with a November 4, 2004 court order and (2) granted regarding dismissal for failure to state a cause of action under 42 U.S.C. § 1983. Docket Entry 55. Because the Report recommends dismissal of all 27 named defendants based on the Moving Defendants' second argument, it does not reach the Moving Defendants' third argument for summary judgment or their fourth argument for dismissing certain defendants.
Plaintiff filed timely written objections to the Report. The Moving Defendants timely responded to Plaintiff's objections, but filed no objections of their own.
II. Discussion
A. Standard of Review for a Magistrate Judge's Report and Recommendation
Where no timely written objections have been filed, the Court reviews a magistrate judge's report and recommendation for clear error. See 28 U.S.C. § 636(b)(1); Fed.R.Civ.P. 72(b). Similarly, where a party "makes only conclusory or general objections, or simply reiterates the original arguments," the Court will review for clear error. Dixon v. Ragland, 2007 U.S. Dist. LEXIS 85159, *2-3 (S.D.N.Y. Nov. 16, 2007) (citations omitted); see also Pilgrim v. Luther, 2007 U.S. Dist. LEXIS 7410, *7 (S.D.N.Y. Jan. 24, 2007) (citations omitted). However, where a party has filed timely written objections beyond those just described, the Court reviews a magistrate judge's report and recommendation de novo. See 28 U.S.C. § 636(b)(1); Fed.R.Civ.P. 72(b).
As Plaintiff proceeds pro se, his objections "are generally accorded leniency," Dixon, 2007 U.S. Dist. LEXIS at *3 (citation omitted). Furthermore, the Court shall construe Plaintiff's objections to "raise the strongest arguments that they suggest."Pabon v. Wright, 459 F.3d 241, 248 (2d Cir. 2006) (citation omitted).
The Court therefore reviews for clear error the portions of the Report to which no objections were filed. The Court liberally construes Plaintiff's objections, but where Plaintiff presented only general and conclusory objections, the Court reviews for clear error.
B. Dismissal for Failure to Comply with a Court Order
Magistrate Judge Pitman recommended denying the Moving Defendants' August 31, 2006 motion to dismiss pursuant to Fed.R.Civ.P. 41(b) on the ground that Plaintiff failed to comply with a November 4, 2004 court order. Report 11-12, 23. Neither Plaintiff nor Moving Defendants objected to this recommendation. Reviewing the Report's recommendation with respect to this issue, the Court finds the Report to be well-reasoned and free of any "clear error on the face of the record." Fed.R.Civ.P. 72(b) advisory committee's note; see also Nelson v. Smith, 618 F. Supp. 1186, 1189 (S.D.N.Y. 1985). The Court therefore adopts the Report's recommendation to deny the Moving Defendants' motion to dismiss for Plaintiff's failure to comply with a court order.
C. Dismissal for Failure to State a Cause of Action
Magistrate Judge Pitman recommended granting the Moving Defendants' August 31, 2006 motion to dismiss as to all 27 defendants for failure to state a cause of action under 42 U.S.C. § 1983. Report 22, 23.
1. Rule 12(b)(6) Motion to Dismiss
A defendant may move to dismiss a claim under Fed.R.Civ.P. 12(b)(6) for failure to state a claim on which relief can be granted. In weighing a motion to dismiss, the Court must "accept as true the factual allegations in the complaint and draw all inferences in the plaintiff's favor." Allaire Corp. v. Okumus, 433 F.3d 248, 249-50 (2d Cir. 2006) (internal quotation marks and citation omitted). "[W]hen a complaint adequately states a claim, it may not be dismissed based on a district court's assessment that the plaintiff will fail to find evidentiary support for his allegations or prove his claim to the satisfaction of the factfinder." Bell Atlantic Corp. v. Twombly, 127 S.Ct. 1955, 1969 n. 8 (2007). "Factual allegations must be enough to raise a right to relief above the speculative level."Id. at 1965.
2. The Right to Adequate Medical Treatment
i. The Claim of Deliberate Indifference to a Serious Medical Condition
The Report construed Plaintiff's Amended Complaint as setting forth a claim for deliberate indifference to a serious medical condition. Report 14. During the period of confinement at issue, it appears that Plaintiff was a pretrial detainee. Report 14 n. 4, 15. Therefore, Plaintiff's rights concerning the conditions of his confinement derive from the Due Process Clause of the Fourteenth Amendment, rather than the Eighth Amendment. Id. at 15. The Report further concludes that Plaintiff's rights under the Fourteenth Amendment are equivalent to, if not more expansive than, the rights provided by the Eighth Amendment. Id. at 15.
The Court agrees that the medical records attached to the Amended Complaint indicate that Plaintiff was confined as a pretrial detainee. See, e.g., Observations, Mar. 11, 2004; Apr. 9, 2004.
The Court clarifies that, contrary to the Report's reference to an "alleged assault," Report 15, this case involves the medical care Plaintiff received during his confinement. Despite the Report's apparent factual error, the Court agrees that for a pretrial detainee, the right to adequate medical treatment derives from the Fourteenth Amendment. For a convicted prisoner, the right to adequate medical treatment derives from the Eighth Amendment. See Bryant v. Maffucci, 923 F.2d 979, 983 (2d Cir. 1991) (citations omitted).
The Second Circuit "has often applied the Eighth Amendment deliberate indifference [to a serious medical condition] test to pre-trial detainees bringing actions under the Due Process Clause of the Fourteenth Amendment." Cuoco v. Moritsugu, 222 F.3d 99, 106 (2d Cir. 2000) (citation omitted). This Court therefore utilizes the Eighth Amendment analysis to review Plaintiff's Fourteenth Amendment claim of deliberate indifference to a serious medical condition. Thus, if Plaintiff was a convicted prisoner during the relevant period of confinement, the same analysis would be used and the same conclusion would be reached.
Neither Plaintiff nor Moving Defendants objected to this analysis. The Court finds the analysis to be well-reasoned and free of any "clear error on the face of the record." Fed.R.Civ.P. 72(b) advisory committee's note; see also Nelson, 618 F. Supp. at 1189. The Court therefore adopts the Report's construction of Plaintiff's claim as a Fourteenth Amendment claim of deliberate indifference to a serious medical condition.
ii. Dismissal of the Claim of Deliberate Indifference to a Serious Medical Condition
The Report reached the conclusion that it "is inescapable that [P]laintiff has alleged, at most, a claim of medical malpractice." Report 22. Under the Report's analysis, Plaintiff failed to state a cause of action for deliberate indifference to a serious medical condition. Id. Magistrate Judge Pitman therefore recommended dismissal of this claim. Id.
Plaintiff's objections to this recommendation — even liberally construed — are presented in a general and conclusory manner, and do not assert any specific errors made in the Report. The Court therefore reviews for clear error the Report's recommendation to dismiss the claim of deliberate indifference to a serious medical condition.
Plaintiff's objections reveal only his disagreement with the conclusions reached by Magistrate Judge Pitman. Plaintiff asserted that "[t]he claim of deliberate indifference by medical personnel on Riker's [sic] Island should not be dismissed because I have alleged sufficient facts in all my moving papers in which a jury and or [sic] judge would grant the relief sought." Pl.'s Objections 1. Plaintiff further asserted "[t]his is not a case and the facts outlined in the moving papers do not present a case of mere medical malpractice, recklessness, or negligence. This case is deliberate indifference." Id. at 4. Plaintiff concluded "[t]he case law cited by Magistrate [Judge] Pitman is not applicable to the facts and circumstances of the case at bar. The Report and Recommendation should not be adopted and the complaint should not be dismissed because the damage is irreparable and there are no other available avenues to address these doctors' transgressions." Id. at 5. These conclusory statements do not assert any specific errors contained in the Report.
Reviewing the Report's conclusion, the Court finds it to be well-reasoned and free of any "clear error on the face of the record." Fed.R.Civ.P. 72(b) advisory committee's note; see also Nelson, 618 F. Supp. at 1189. The Court therefore adopts the recommendation that the claim of deliberate indifference to a serious medical condition be dismissed as to all 27 defendants.
The Court notes that a de novo review of the Report's recommendation reaches the same conclusion. In reviewing the Report's recommendation, the Court has carefully considered the Report, the Amended Complaint, the medical files attached to the Amended Complaint, the parties' other submissions, and the applicable legal authorities. The Court finds that the Report's recommendation is supported by the law and the submissions in all respects. Specifically, Magistrate Judge Pitman properly concluded that Plaintiff's manifestation of erectile dysfunction and other side effects as an alleged result of prescribed medication cannot support a claim of deliberate indifference to a serious medical condition. Report 19, 22; see, e.g., Pabon v. Wright, 2004 U.S. Dist. LEXIS 5565, *17 (S.D.N.Y. Mar. 29, 2004).
3. The Right to Medical Information
i. The Claim of Failure to Receive Medical Information
After recommending dismissal of the claim of deliberate indifference to a serious medical condition, the Report further recommended dismissal of the Amended Complaint as to all 27 defendants for Plaintiff's failure to state a claim on which relief can be granted. Report 23. The Report, however, fails to consider an additional claim raised in the Amended Complaint. The Court now reviews de novo Plaintiff's claim of failure to receive medical information.
In his objections, Plaintiff argues that the "doctors' failure to inform [him] of . . . severe, painful and disorienting side-effects [sic], and erectile dysfunction/impotence" as a result of taking certain medications, deprived him of constitutionally required notice. Pl.'s Objections 2-3. To support this argument, Plaintiff attached the April 14, 2000 "Patient Bill of Rights" promulgated by the New York State Department of Correctional Services, which provided patients in New York State Correctional Facility Health Units the right to "information necessary to give informed consent prior to the start of any procedure or treatment." Pl.'s Objections Ex. A. Plaintiff framed this argument as a violation of due process under the Fourteenth Amendment. Pl.'s Objections 2-3.
Moving Defendants correctly note that Plaintiff was in the custody of the New York City Department of Correction during his confinement at Rikers Island. Therefore, the protections outlined in the "Patient Bill of Rights" promulgated by the New York State Department of Correctional Services do not apply to Plaintiff's claim. Response to Pl.'s Objections ¶ 7.
The Court interprets Plaintiff's objections to "raise the strongest arguments that they suggest." Pabon, 459 F.3d at 248 (citation omitted). In his Amended Complaint, Plaintiff alleged that he "[w]as prescribed medication by one of the defendants" and "[e]ach defendants is [sic] involved by cross prescribed [sic] medication and failing to notify Plaintiff of adverse side effects." 4. Therefore, this Court interprets Plaintiff's claim as a failure to receive medical information in violation of his right to due process under the Fourteenth Amendment. The Court reviews this claim de novo because it was not addressed in the Report.
To the extent that Plaintiff's claim of deliberate indifference to a serious medical condition proceeded under the Fourteenth Amendment, the right to medical information constitutes a separate Fourteenth Amendment claim. As the Second Circuit explained, the Fourteenth Amendment:
protects the individual's liberty interest in making decisions that affect his health and bodily integrity. The right to make these decisions, and the corollary right to the information necessary to make them intelligently, is recognized in order to vindicate this fundamental liberty interest in bodily integrity, not to protect against treatment that may amount to cruel and unusual punishment. So rather than concerning itself with prison officials' decisions, it governs individuals' decisions regarding the administration of treatment. These two very different motivations implicate different constitutional protections.Pabon, 459 F.3d at 253 (emphasis in original). The Second Circuit articulated a separate Fourteenth Amendment right to medical information. Id. at 249-50.
ii. Dismissal of the Claim of Failure to Receive Medical Information
Plaintiff fails, however, to allege a violation of his constitutional right to medical information. The Court therefore dismisses this claim.
To establish a violation of the right to medical information, Plaintiff must "show that (1) government officials failed to provide him with such information; (2) this failure caused him to undergo medical treatment that he would have refused had he been so informed; and (3) the officials' failure was undertaken with deliberate indifference to the prisoner's right to refuse medical treatment." Pabon, 459 F.3d at 246. Plaintiff alleged that he was not informed of the risks and side effects associated with the medications that he was prescribed. Assuming arguendo that these factual allegations "raise a right to relief above the speculative level" regarding the first two factors, the Court simply cannot conclude that Plaintiff's factual allegations "raise a right to relief above the speculative level" for the third factor. Twombly, 127 S.Ct. at 1965.
The medical records attached to the Amended Complaint reveal that Plaintiff was prescribed a variety of medications during his confinement at Rikers Island. The Court clarifies that, contrary to the Report's description, 14, these medications were administered to treat not only depression, but also insomnia, anxiety, bipolar disorder, and other medical problems. See Observations, Psychiatry — Medication Reevaluation, Mar. 3, 2004; Mar. 18, 2004; Apr. 16, 2004; Apr. 29, 2004; May 5, 2004; May 14, 2004; and May 15, 2004. Furthermore, in response to the Moving Defendants' August 31, 2006 motion, on November 27, 2006, Plaintiff filed an unsworn statement providing greater detail of his allegations. Docket Entry 51. According to this statement, Plaintiff was prescribed the following medications in 2004: Celexa, Trazodone, Seroquel, Zoloft, Atarax, Benadryl, and Colace. Pl.'s Stmt. 2-3. Magistrate Judge Pitman observed that according to excerpts from the Physicians Desk Reference Family Guide to Prescription Drugs attached to the November 27, 2006 statement, impotence is a "[m]ore common" side effect of Celexa, a "[l]ess common or rare" side effect of Trazadone and Zoloft, and a "[r]are" side effect of Seroquel. Report 14 n. 5.
Plaintiff does not and cannot allege that any of the defendants were deliberately indifferent to his right to refuse medical treatment. "[I]n order to incur liability a prison official's failure to adequately inform a patient regarding that patient's proposed medical treatment must be done with, at minimum, deliberate indifference to the prisoner's right to refuse treatment." Pabon, 459 F.3d at 251. "Inadvertent failures to impart medical information," "simple lack of due care," and "simple negligence" do "not make out a violation of either the substantive or procedural aspects of the Due Process Clause of the Fourteenth Amendment." Id. at 250-51 (citations omitted) (emphasis in original).
It is clear that Plaintiff guided his treatment throughout his confinement at Rikers Island. According to the Amended Complaint, Plaintiff was first prescribed medication after he voluntarily sought treatment for "headaches and sleeplessness." 4. The numerous medical records attached to the Amended Complaint reveal that Plaintiff's medication was modified several times during the course of his confinement. The prison doctors were responsive to Plaintiff's concerns that the medication was not working and that the medication may be causing erectile dysfunction. See Observations, Psychiatry — Medication Reevaluation, Mar. 3, 2004; Mar. 18, 2004; Apr. 16, 2004; Apr. 29, 2004; May 5, 2004; May 14, 2004; and May 15, 2004. Plaintiff exercised his right to refuse treatment on May 15, 2004 when he rejected prescriptions for Wellbutrin and Buspar. Observations, Psychiatry — Medical Reevaluation, May 15, 2004. Plaintiff also rejected treatment with Viagra. Amended Compl. 5.
In White v. Napoleon, a decision heavily relied on by the Second Circuit in articulating the right to medical information, a prison doctor allegedly refused to answer a prisoner's questions about whether a proposed treatment contained penicillin, to which the prisoner was allergic. 897 F.2d 103, 113 (3d Cir. 1990). The prisoner further alleged that the doctor's purpose in refusing to answer the prisoner's questions was to require the prisoner to accept the treatment chosen by the doctor. Id. at 114. In Pabon, a prison doctor allegedly aware of "extremely severe and dangerous side effects of [the prescription drugs administered]" to a prisoner, "[n]evertheless . . . falsely informed [the prisoner] that there were no side effects." 459 F.3d at 254. From these allegations, the Second Circuit found that the prisoner's complaint "implie[d] that at least some Defendants acted with the intent to induce [the prisoner] to undergo treatment that he otherwise might have declined." Id.
In contrast, Plaintiff does not, and indeed Plaintiff cannot, allege that the doctors' purported failures to inform Plaintiff of the side effects of his medication were driven by the doctors' desire to require Plaintiff to accept the treatment offered. Plaintiff simply cannot satisfy the third element of the claim of failure to receive medical information. Accordingly, the Court dismisses Plaintiff's right to medical information claim.
III. Conclusion
Because the Court dismisses Plaintiff's right to medical information claim, Plaintiff has failed to state a cause of action under 42 U.S.C. § 1983. This deficiency is fatal to Plaintiff's claims against each of the 27 defendants. The Court therefore dismisses the Amended Complaint [Docket Entry 4] as to all 27 defendants for failure to state a claim upon which relief can be granted. Fed.R.Civ.P. 12(b)(6). The Court does not reach the other arguments presented by the Moving Defendants or the other defects of the Amended Complaint. See Report 22 n. 7. The Clerk of Court is directed to close this case; all pending motions are moot.
SO ORDERED.