Association for Retarded Citizens of Connecticut, Inc. v. Thorne

30 F.3d 367, 1994 WL 387226
Court of Appeals for the Second Circuit·Decided July 25, 1994·No. No. 1663, Docket 93-9049·Published·Cited by 6 cases

Opinion

WALKER, Circuit Judge:

The Commissioner of the Connecticut Department of Public Health & Addiction Services, formerly known as the Department of Health Services (hereinafter “DHS”), appeals from a judgment of the United States District Court for the District of Connecticut (Alfred V. Covello, Judge), granting plaintiffs’ motion to join DHS as a defendant in this action and issuing a preliminary injunction requiring DHS to abide by the terms of a previously-entered final order, in a proceeding to which DHS was not a party, which restricted when “Do Not Resuscitate” orders may be placed in the medical files of mentally retarded patients. While this case raises the significant issue of when “Do Not Resuscitate” orders should be prescribed for mentally retarded individuals, this appeal primarily concerns the propriety of adding a party to an action pursuant to the All Writs Act, 28 U.S.C. § 1651, after a final order has already been entered on the basis of a consent decree and settlement agreements. We hold that it was improper for the district court to add DHS as a party to this case and accordingly reverse its order granting plaintiffs’ joinder motion and issuing a preliminary injunction against DHS.

BACKGROUND

This lawsuit was filed in December 1978 by twelve individual plaintiffs and the Connecticut Association for Retarded Citizens in order to challenge the quality of care, living conditions, and residential placement of some 1200 mentally retarded individuals who either resided at the Mansfield Training School (“MTS”) or who had been transferred from MTS to long-term care facilities. The named defendants included the Commissioners of the Department of Mental Retardation (“DMR”), the Department of Social Services, now known as the Department of Income Maintenance (“DIM”), and DHS.

In 1980, the district court certified a plaintiff class consisting of “all persons who reside at MTS or who may be transferred there in the future; retarded persons residing at home who are in jeopardy of being sent to MTS; and persons who have been transferred to skilled nursing facilities, intermediate care facilities, homes for the aged, and similar facilities yet remain Mansfield’s responsibility.” In 1982, the district court granted DHS’s motion to be dismissed from the suit on the ground that it was not “essential to the Court’s resolving the disputed issues in this litigation.” Plaintiffs have never challenged this order.

On April 9, 1984, the magistrate judge to whom the case had been referred by the district court approved a consent decree entered into by the remaining parties which provided for an interdisciplinary planning process through which the needs of each class member would be identified and addressed. The magistrate’s order provided that he would oversee the implementation of the consent decree and would retain jurisdiction over any necessary future proceedings. In the years that followed, the parties continued to develop policies addressing the needs [369] of class members; some of their settlement agreements were explicitly approved by the magistrate judge.

On November 14, 1990, the magistrate judge, with the agreement of the parties, issued a “Final Order” establishing a framework for the ultimate resolution of the case. The Final Order reiterates portions of the consent decree, but also includes new provisions relating to the numerous settlements entered into between 1984 and 1990. One of the new provisions, paragraph XI. J, pertains to the use of “Do Not Resuscitate” (“DNR”) orders for class members. It provides in relevant part that:

The DMR defendants shall continue to enforce and seek full implementation of the DMR Medical Advisory 87-2 (regarding withholding of cardiopulmonary resuscitation for terminally ill DMR clients) with respect to all classmembers.

The referenced Medical Advisory (the “Advisory”) is a set of guidelines adopted by DMR in 1987. It provides that the use of DNR orders for a “client of [DMR] who lives in a facility operated or licensed by [DMR]” is appropriate only where the client’s attending physician has determined that the client is terminally ill, has requested a second opinion regarding the client’s terminal illness from a Connecticut licensed physician in the appropriate specialty, and has presented the Ghent’s full medical condition to the client and his or her surrogate for their final approval regarding the use of DNR orders. The Advisory defines a terminally ill patient as one who has an incurable or irreversible medical condition and is considered by the physician to be within “days or weeks” of death. If a Ghent’s attending physician cannot state that the chent may be expected to die within “days or weeks,” the Advisory provides that the Commissioner of DMR, after consulting with the Connecticut Attorney General’s Office and DMR’s director of community services, will decide whether a particular DNR order is acceptable or further investigation is warranted.

On July 9, 1992, about two years after the Final Order had been entered, plaintiffs filed a motion to join DHS as a defendant and for a preliminary injunction requiring DHS along with DMR and DIM to implement the Advisory in all licensed health care facilities in the state. Plaintiffs asserted that many class members were transferred to health care facilities hcensed by DHS, such as hospitals and nursing homes, which did not abide by the Advisory, and further, that DMR was unable to implement the Advisory in these facilities without DHS’s cooperation. On February 12, 1993, the magistrate judge granted plaintiffs’ motion regarding DMR and DIM and recommended granting plaintiffs’ motions regarding DHS. The magistrate judge concluded that DHS should be joined as a party pursuant to the All Writs Act because it was “in a position to render the Final Order meaningless,” and that, by not implementing the Advisory in its licensed facilities, DHS had violated the Final Order and the class members’ constitutional due process rights. The district court adopted and affirmed the magistrate judge’s recommended ruling without significant change. DHS subsequently filed this appeal.

DISCUSSION

The primary issue on this appeal concerns the validity of the district court’s decision to join DHS to this litigation pursuant to the All Writs Act nearly two years after the Final Order was entered. We review this decision for an abuse of discretion. See In re “Agent Orange” Prod. Liab. Litig., 996 F.2d 1425, 1431 (2d Cir.1993), cert. denied, — U.S. -, -, 114 S.Ct. 1125, 1126, 127 L.Ed.2d 434 (1994).

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Association for Retarded Citizens of Connecticut, Inc. v. Thorne, 30 F.3d 367, 1994 WL 387226 (2d Cir. 1994).

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