Shelton v. Arkansas Department of Human Services

677 F.3d 837, 2012 WL 1673085, 2012 U.S. App. LEXIS 9753
CourtCourt of Appeals for the Eighth Circuit
DecidedMay 15, 2012
DocketNo. 11-1822
StatusPublished
Cited by1 cases

This text of 677 F.3d 837 (Shelton v. Arkansas Department of Human Services) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Shelton v. Arkansas Department of Human Services, 677 F.3d 837, 2012 WL 1673085, 2012 U.S. App. LEXIS 9753 (8th Cir. 2012).

Opinion

MELLOY, Circuit Judge.

Amber Shelton, as the administratrix of Brenda Shelton’s estate, appeals the dis[839]*839trict court’s1 dismissal of her civil action against several public officials and health professionals. The complaint alleges shortcomings in the way medical professionals at a state mental health facility responded after Brenda hanged herself while a patient at the facility. The complaint alleges state law tort claims, a federal constitutional substantive due process claim, and federal statutory claims pursuant to the Americans with Disabilities Act, 42 U.S.C. § 12101 et seq., and the Rehabilitation Act, 29 U.S.C. § 794. The district court dismissed all federal claims with prejudice and dismissed the state law claims without prejudice, electing not to exercise jurisdiction over the state law claims. We affirm.

I. Background

Brenda Shelton voluntarily admitted herself under Dr. Linda Parker’s care to the Arkansas State Hospital on October 20, 2008, and was immediately placed on suicide watch. At Dr. Parker’s instruction, Brenda was later taken off of suicide watch. In late October, three days after being taken off of suicide watch, Brenda hanged herself in her room.

When discovered by nurses, Brenda was still alive. According to the complaint, nurses refused to administer mouth-to-mouth resuscitation because no protective shields were available. Also according to the complaint, nurses were authorized by facility policy to withhold such care in the absence of protective shielding. Further, the unit within which Brenda was housed had recently changed location within the overall facility, and ambulatory breathing bags that allegedly would have aided in her rescue were in a locked storage room. At the time, the storage room could not be accessed because a nurse had accidentally locked the key for the storage room inside that room. Appellant alleges that one nurse was specifically instructed not to administer mouth-to-mouth assistance. When a physician, Dr. Schay, arrived he also did not administer this form of aid.

Days later, Brenda died. Appellant brought the present action against the Arkansas State Hospital, the Arkansas Department of Human Services, several nurses, several physicians, and supervisory state actors. The complaint alleges facility policies, supervisors’ failure to train nurses, and the defendants’ failures to act following their discovery of Brenda all contributed to Brenda’s death. The complaint also alleges these shortcomings caused Brenda increased suffering prior to death and increased her medical expenses. The complaint alleges a substantive due process violation, state law tort claims, and federal statutory claims asserting that defendants improperly “placed” Brenda in violation of the ADA and the Rehabilitation Act.2

All defendants moved for dismissal pursuant to Federal Rule of Civil Procedure 12(b)(6). Regarding the federal statutory claims, the district court interpreted the complaint as alleging improper medical treatment or medical treatment decisions and held that the ADA and Rehabilitation Act claims could not be based upon allegedly improper medical treatment decisions. Regarding the due process claim, the district court held that Brenda was owed no constitutional-level duty of care from any [840]*840defendants because she was a voluntary-patient at the Arkansas State Hospital. In the alternative, the district court held the defendants were entitled to qualified immunity based upon the absence of a violation of any clearly established rights. The district court dismissed the state-law claims without prejudice.

On appeal, Appellant has made clear that the only claims she intended to direct towards the treating physicians, Dr. Parker and Dr. Schay were state-law tort claims. Accordingly we affirm the dismissal of all federal claims against these two physicians without further comment. Appellant challenges dismissal of the claims against the other defendants, as discussed below.

II. Discussion

A. Section 1983 Substantive Due Process Claim

State actors in mental health facilities owe a constitutional-level duty of care to involuntarily held patients. See DeShaney v. Winnebago Cnty. Dep’t of Soc. Servs., 489 U.S. 189, 194, 109 S.Ct. 998, 103 L.Ed.2d 249 (1989) (“[T]he substantive component of the Fourteenth Amendment’s Due Process Clause requires the State to provide involuntarily committed mental patients with such services as are necessary to ensure their ‘reasonable safety’ from themselves and others.” (citations omitted)). Appellant concedes that state actors owe no such duty to voluntary patients. In DeShaney, the Court emphasized the need for affirmative state action restricting a person’s liberty in order to justify imposing upon the state a constitutional-level duty of care. Id. at 200, 109 S.Ct. 998 (“[W]hen the State by the affirmative exercise of its power so restrains an individual’s liberty that it renders him unable to care for himself, and at the same time fails to provide for his basic human needs—e.g., food, clothing, shelter, medical care, and reasonable safety—it transgresses the substantive limits on state action set by the Eighth Amendment and the Due Process Clause.”).

A patient’s status at the time of admission is not necessarily dispositive, however, because a patient’s status may change over time. If circumstances change post-admission, it is possible that changed circumstances in combination with duties imposed upon state actors by state law may, together, effectively change a patient’s status from voluntary to involuntary. See Kennedy v. Schafer, 71 F.3d 292, 295-96 (8th Cir.1995) (remanding to determine whether a voluntarily admitted patient had become an involuntary patient through changed circumstances in combination with a governing state statute defining state actors’ duties regarding patient confinements and involuntarily commitments).

Appellant argues the rule of Kennedy, as applied to the circumstances surrounding Brenda’s death, requires that we find a constitutional-level duty of care arose when defendants discovered Brenda had hanged herself in her room. According to Appellant, at that time, any reasonable state official would have concluded that Brenda posed a grave risk to herself. Appellant argues state law imposed upon some or all of the present defendants a duty to confine Brenda upon recognition of this risk. Appellant cites Arkansas statutes for the proposition that a facility administrator must detain a voluntarily admitted patient if that patient “makes a request to leave” and if “the administrator or his designee determines that the person meets the criteria for involuntary admission.” Ark.Code Ann. § 20^47-204(2); see also Ark.Code Ann. § 20-47-210(c).

[841]*841In making this argument, Appellant appears to concede that, when Dr. Parker took Brenda off of suicide watch three days prior to her hanging, Dr.

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Related

Shelton v. ARKANSAS DEPT. OF HUMAN SERVICES
677 F.3d 837 (Eighth Circuit, 2012)

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Bluebook (online)
677 F.3d 837, 2012 WL 1673085, 2012 U.S. App. LEXIS 9753, Counsel Stack Legal Research, https://law.counselstack.com/opinion/shelton-v-arkansas-department-of-human-services-ca8-2012.