Frances-Colon v. Ramirez, Dr.

• Court: Court of Appeals for the First Circuit
• Decided: February 24, 1997
• Docket: 96-1293
• Status: Published

Opinion

USCA1 Opinion

UNITED STATES COURT OF APPEALS

                                FOR THE FIRST CIRCUIT

                                 ____________________



          No. 96-1293



                             LEILA FRANCES-COLON, ET AL.,



                               Plaintiffs - Appellants,



                                          v.



                             DR. EFRAIN RAMIREZ, ET AL.,



                               Defendants - Appellees.



                                 ____________________



                     APPEAL FROM THE UNITED STATES DISTRICT COURT



                           FOR THE DISTRICT OF PUERTO RICO



                 [Hon. Jaime Pieras, Jr., Senior U.S. District Judge]
                                          __________________________



                                 ____________________



                                        Before



                               Torruella, Chief Judge,
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                            Coffin, Senior Circuit Judge,
                                    ____________________



                           and DiClerico,* District Judge.
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                                _____________________



               Kevin  G. Little, with whom  Law Offices David  Efr n was on
               ________________             ________________________

          brief for appellants.

               Jos  Angel Rey for appellees.
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                                  February 24, 1997

                                 ____________________


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          *  Of the District of New Hampshire, sitting by designation.



TORRUELLA, Chief Judge.    Plaintiffs-appellants  Leila
                    TORRUELLA, Chief Judge.  
                               ___________



          Frances-Col n and  Juan Enrique  Rodr guez brought  a malpractice



          action  on  behalf  of  their minor  son  Eric  Rodr guez-Frances



          ("Eric")  against  two  doctors,  a municipal  hospital  and  the



          municipality  of San Juan, on both federal and state law grounds.



          They alleged  that the  doctors' mishandling of  Eric's delivery1



          amounted to a violation of Eric's substantive due process rights,



          actionable under 42 U.S.C.    1983, and that the  defendants were



          liable for negligence under  Puerto Rico tort law.   The district



          court  granted  defendants' summary  judgment  motion  as to  all



          counts, for the  following reasons: (1) the  plaintiffs failed to



          identify  a protected  substantive  due process  liberty interest



          giving  rise  to  their  federal  civil  rights  claim;  (2)  the



          defendants'  actions  were  not  state conduct  that  shocks  the



          conscience  for the  purposes of  sustaining their  federal civil



          rights claim; (3) the defendant doctors are immune from liability



          under   Puerto  Rico  law;    (4)  the  tort  claim  against  the



          municipality was time-barred under Puerto Rico law.  See Col n v.
                                                               ___ _____



          Ram rez,  913 F. Supp. 112 (D.P.R. 1996).  Plaintiffs appeal from
          _______



          the grant of summary judgment.


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          1   The  essential mistake  alleged was  the doctor's  failure to

          perform  a  caesarian  section.     Plaintiffs  allege  that  the

          defendant doctors acted  with reckless  disregard and  deliberate

          indifference by  delivering Eric  vaginally, using forceps,  even

          though his mother  told the  doctors that she  could not  deliver

          vaginally.   Eric was born  in poor physical  condition, suffered

          severe   perinatal   asphyxia,   and   has   suffered   permanent

          disabilities. 



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Having reviewed the record  and the parties' briefs on



          appeal, we are satisfied with the reasoning of the decision below



          and affirm the judgment  for substantially the reasons elucidated



          in the  district court opinion.   Cf. Lawton  v. State Mut.  Life
                                            ___ ______     ________________



          Assurance Co., 101  F.3d 218, 220 (1st Cir. 1996)  ("We have long
          _____________



          proclaimed  that when  a  lower court  produces a  comprehensive,



          well-reasoned decision,  an appellate  court should refrain  from



          writing at  length to no  other end  than to hear  its own  words



          resonate.")  We need only note the following.



                          I.  The Federal Civil Rights Claim
                          I.  The Federal Civil Rights Claim
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                    The  district  court  correctly  held  that plaintiffs-



          appellants  failed to  establish  a violation  of  constitutional



          rights actionable under section 1983.  Appellants claim on appeal



          that, in making this determination, the district court improperly



          resolved  an issue of fact in favor of defendants by holding that



          the  doctors  failed  to   act  with  the  requisite   degree  of



          culpability  to sustain a section 1983  claim.  See Col n, 913 F.
                                                          ___ _____



          Supp.  at 119.  Appellants urge us to consider certain affidavits



          they produced in support  of the view that the  defendant doctors



          were reckless, and not merely negligent.  First, it is  not clear



          that the  district court's  statement that plaintiffs  "failed to



          show  that   defendants  acted  with  the   requisite  degree  of



          culpability" means that the  district court explicitly found that



          defendants were not reckless.  More importantly, there is no need



          to arrive at a  factual conclusion regarding whether  the doctors



          were negligent or something  more than negligent, because, either


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way, the plaintiffs fail to state a cause of action under section



          1983.   As the district  court opinion explains,  plaintiffs must



          fail  on their civil rights claim because they do not demonstrate



          either of the following:  that there was an interest protected by



          the due process clause  at stake, or that there  was governmental



          conduct  that  "shocks  the conscience."    See  id.   at  116-18
                                                      ___  ___



          (applying Pittsley v. Warish, 927 F.2d 3, 6 (1st Cir. 1991)).
                    ________    ______



                    It is surprising,  in light of clear Supreme  Court and



          First Circuit precedent, that  appellants would consider it worth



          their while to try their luck, or, rather, waste time and energy,



          with what is  essentially a malpractice claim  clothed in section



          1983, civil rights,  language.   This is  plainly not a situation



          in which the  state "takes  a person into  custody and holds  him



          there  against   his  will,"   thereby  implicating  a   possible



          constitutional  due process  interest in  adequate medical  care.



          DeShaney v. Winnebago  County Dept.  of Social  Servs., 489  U.S.
          ________    __________________________________________



          189,   199-200  (1989).    To  avoid  future  waste  of  judicial



          resources, we wish to underscore  the decisive legal principle in



          this  case.    A  substantive  due  process  interest  in "bodily



          integrity" or  "adequate medical  care" cannot support a personal



          injury  claim  under  section  1983  against  the  provider of  a



          governmental  service unless:  (a) the  government has  taken the



          claimant  into custody or  otherwise coerced the  claimant into a



          situation where  he cannot  attend to  his  own well-being,  see,
                                                                       ___



          e.g., Monahan v. Dorchester Counseling Ctr.,  Inc., 961 F.2d 987,
          ____  _______    _________________________________



          990-93 (1st  Cir.  1992) (no  due  process claim  where  claimant


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voluntarily entered mental  institution) (applying DeShaney);  or
                                                             ________



          (b) the  government employee, in  the rare and  exceptional case,



          affirmatively acts to increase the threat of harm to the claimant



          or   affirmatively   prevents  the   individual   from  receiving



          assistance, see Dwares v. City  of New York, 985 F.2d 94,  96 (2d
                      ___ ______    _________________



          Cir. 1993) (due process  implicated where complaint under section



          1983  alleged  that police  assured  skin-heads  that they  could



          attack protestors with impunity, thereby affirmatively increasing



          threat of harm to protestors) (distinguishing DeShaney);  Ross v.
                                                        ________    ____



          United  States, 910  F.2d  1422,  1429-34  (7th Cir.  1990)  (due
          ______________



          process  interest  in  life  implicated  where  county  officials



          prevented  city officials  from  rescuing drowning  boy,  thereby



          affirmatively   restricting   source   of  aid)   (distinguishing



          DeShaney).
          ________



                    A proximate  causal link  between a  government agent's



          actions and a  personal injury does not, in itself,  bring a case



          out  of   the  realm  of   tort  law  and  into   the  domain  of



          constitutional due process.   Daniels v. Williams,  474 U.S. 327,
                                        _______    ________



          332 (1986).  Appellant's counsel would have done well to consider



          more carefully the  cases it cites  for support in  its brief  --



          such  as the following passage from Estate of Gilmore v. Buckley,
                                              _________________    _______



          787  F.2d  714, 722  (1st Cir.  1986)  (holding failure  of state



          employees  to protect victim  from murderous attack  by inmate on



          furlough not actionable under section 1983):2


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          2  See Brief for Appellants at 17.
             ___



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Enormous  economic consequences  could follow

                    from the reading  of the fourteenth amendment

                    that plaintiff here urges.   Firemen who have

                    been alerted to a  victim's peril but fail to

                    take  effective action;  municipal ambulances

                    which,  when called, arrive  late; and myriad

                    other  errors by state officials in providing

                    protective  services, could  all be  found to

                    violate  the  Constitution.    It  would seem

                    appropriate   that   the  citizenry,   acting

                    through state legislatures and  state courts,

                    should determine  how far it wishes  to go in

                    reimbursing claims of this  type.  We can see

                    no  justification  for   rewriting  the   due

                    process clause of the federal Constitution so

                    as to  construct a basis for  relief that can

                    be more flexibly  provided elsewhere, if that

                    is deemed advisable.



                   II.  Defendants' Immunity under Puerto Rico Law
                   II.  Defendants' Immunity under Puerto Rico Law
                        __________________________________________



                    It is undisputed that the defendant doctors were acting



          as government employees when they were attending to Eric's birth.



          The district court correctly held  that the doctors are protected



          under  the  immunity  for  government  health care  professionals



          provided by  P.R. Laws Ann. tit.  26,   4105 (1989).   On appeal,



          appellants  repeat  their  argument  that  the  doctors'  alleged



          recklessness brings them  outside of this immunity provision.  We



          note  that the Puerto  Rico Supreme  Court's decision  in V squez
                                                                    _______



          Negr n v.  E.L.A., 113  D.P.R. 148,  151  (1982), interprets  the
          ______     ______



          immunity  provision  broadly,  adding  further  strength  to  the



          district  court's holding  that the  sole inquiry  required under



          Puerto  Rico  law  in  determining whether  immunity  applies  is



          whether the health care professional was acting as an employee of



          the government at the time of the events giving rise to the suit.



                    This much said, we allow the district court  opinion to



          speak for itself.



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Affirmed.
                    Affirmed
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