IN THE UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS

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CASSANDRA SAMPSON

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Plaintiff,

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v.

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BETH ISRAEL DEACONESS MEDICAL CENTER )

and HEATHER A. RICHTER,

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Defendants.

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CIVIL ACTION NO.

COMPLAINT
I. Introduction 1. This case is brought against Beth Israel Deaconess Medical Center (“the
Hospital”) and Heather Richter (“Richter”), a nurse at the Hospital, arising out of the physical assault and forced stripping of the plaintiff, Cassandra Sampson, a woman with a history of severe sexual abuse. This forced stripping was done by five male Hospital security guards on the order of defendant Richter, pursuant to the Hospital’s mandatory disrobing policy, which permits forcible stripping of patients who refuse a request to disrobe.
2. Ms. Sampson was physically bruised, emotionally devastated, and became suicidal as a result of being forcibly stripped. Although Ms. Sampson went to the Hospital’s Emergency Department voluntarily for treatment of cluster migraines, she was involuntarily detained and forcibly stripped, despite her pleas that she be allowed to retain her pants due to a history of sexual abuse, her willingness to remove the rest of her clothes, and her agreement to undergo a pat-down search. In addition, Richter refused to honor Ms. Sampson’s repeated requests for a hospital advocate to inform her of her legal rights and to help resolve the situation.
3. This action is brought against defendant Hospital for 1) injunctive and declaratory relief under Title III of the Americans with Disabilities Act; 2) injunctive and declaratory relief and compensatory damages under Section 504 of the Rehabilitation Act of 1973; 3) injunctive and declaratory relief and compensatory damages under M.G.L. §272, Sec. 98 and MGL Chapter 12, Section 11H and 11I (Massachusetts Civil Rights Act); and 4) compensatory damages under
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state tort actions for negligence, assault, battery, and intentional or reckless infliction of emotional distress.
4. This action is brought against defendant Richter for interference with the plaintiff’s civil rights under the Massachusetts Civil Rights Act, as well as negligence, assault, battery, and intentional or reckless infliction of emotional distress. Plaintiff seeks compensatory damages.
II. Parties 5. Ms. Cassandra Sampson. is a citizen of the State of Massachusetts. She lives at
13-25 Warren Ave., Somerville, Massachusetts. Ms. Sampson. has a long history of psychiatric and physical disabilities.
6. Beth Israel Deaconess Medical Center is located at 330 Brookline Ave., Boston, Massachusetts.
7. Defendant Heather A. Richter worked at Beth Israel Deaconess Medical Center on March 25, 2005, as a nurse in the Emergency Department, and, on information and belief, currently resides at 30 Curtis Lane in Edgartown, Duke’s County, Massachusetts.
III. Jurisdiction 8. This court has jurisdiction pursuant to 42 U.S.C. §12188(a), 29 U.S.C. §794a, and
28 U.S.C. §1331. It has supplemental jurisdiction over the state claims under 28 U.S.C. §1367.
IV. Facts 9. Ms. Sampson is a 50 year old African-American woman with psychiatric
disabilities stemming from years of extreme emotional and sexual abuse as a child, worsened by the death of her son shortly after he was born. Ms. Sampson. has a history of self-injury stemming from these experiences.
10. Ms. Sampson is an individual with a disability under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act because her psychiatric impairments substantially limit major life activities, including caring for herself, working, and interacting with others. Ms. Sampson was also regarded by defendants Richter and Beth Israel Deaconess
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Medical Center as being substantially limited in her ability to care for herself, and has a history of psychiatric disabilities.
11. Ms. Sampson also has a number of life-threatening physical disabilities, such as respiratory problems and Type II diabetes, as well as other painful physical conditions, including cluster migraines.
12. Ms. Sampson has used the clinical and emergency services of defendant Hospital to treat these conditions for over two decades. Because Beth Israel Deaconess Medical Center is where many of Ms. Sampson’s medical doctors practice, she often seeks both medical and emergency care at defendant Hospital. The Hospital is well aware of Ms. Sampson’s history of severe childhood sexual abuse and her history of disability. The Hospital regarded Ms. Sampson as an individual who was substantially limited in her ability to care for herself.
13. In two decades and hundreds of visits to many Emergency Departments, including defendant Hospital’s Emergency Department, Ms. Sampson has never injured or threatened to injure herself while in an Emergency Department setting. In two decades and hundreds of visits to many Emergency Departments, Ms. Sampson has never been forcibly stripped of her clothing in any other Emergency Department, despite her history of serious self-injury and her reluctance to remove her pants.
14. On or around March 22, 2005, Ms. Sampson began experiencing extremely severe migraines. She took her prescribed medication, Toradol, and the headaches did not improve. She called the office of her migraine doctor, Dr. Bajwa, on March 24, 2005, and the office told her to reduce the dosage of Toradol she had been taking, which she did.
The Events of March 25, 2005 15. On March 25, 2005, Ms. Sampson again called Dr. Bajwa’s office because her migraines were interfering with her ability to sleep and function. He was not available, and his office advised her to see her primary care physician, Dr. Gila Kriegel, at Beth Israel Deaconess Medical Center. Upon arriving at the hospital, Ms. Sampson learned that Dr. Kriegel was also unavailable. She spoke briefly to Dr. Kreigel by telephone, and the doctor advised her to go to the Hospital’s Emergency Department for treatment of her migraines.
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16. There is no evidence in the Ms. Sampson’s emergency department records that Dr. Kriegel contacted the Emergency Department prior to Ms. Sampson’s admission or that Emergency Department staff relied upon information from Dr. Kriegel in deciding to strip and search Ms. Sampson.
17. Ms. Sampson proceeded to defendant Hospital’s Emergency Department, expecting to receive treatment for her migraines.
18. As part of the routine triage procedures, the triage nurse asked Ms. Sampson to identify the medications that she was taking. Ms. Sampson told him that she took psychiatric medications and Toradol for her migraines. After learning that she took psychiatric medications, the triage nurse asked Ms. Sampson if she was feeling safe. Ms. Sampson told him that she had been struggling with safety issues. At the time of her admission to the Hospital, Ms. Sampson was not suicidal nor did she have any desires to injure herself.
19. The triage nurse did not ask Ms. Sampson any further questions, but told her that on the basis of this response she needed a psychiatric evaluation, and that her migraines would also be treated. He then transferred Ms. Sampson to the psychiatric portion of the Emergency Department for assessment.
20. Upon Ms. Sampson’s arrival in the psychiatric portion of the Emergency Department, defendant Richter assigned Ms. Sampson to a room and, pursuant to hospital policy, assigned a “sitter,” (an aide who sat outside the door of the room) to provide continuous one-onone monitoring of Ms. Sampson.
21. Based on stereotypes and misperceptions about the level of risk that people with mental illness pose to themselves, and also to prevent any patient, including voluntary patients such as Ms. Sampson, from leaving the Emergency Department, the Hospital requires patients on the psychiatric portion of the Emergency Department to disrobe or be forcibly stripped if they refuse. The Hospital does not require an individualized assessment of the patient’s risk by a psychiatric professional prior being stripped. Nor does it consider any request for accommodation, or the use of less intrusive means such as pat-downs or wands. Patients on the medical portion of the Emergency Department are not routinely asked to disrobe for reasons unrelated to the assessment being performed, or to prevent them from leaving the Emergency Department, and are not forcibly stripped.
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22. Consistent with this policy, after Ms. Sampson was assigned a sitter, Ms. Richter informed her that she was required to completely disrobe prior to her psychiatric evaluation. Defendant Richter made no attempt to evaluate Ms. Sampson’s current safety risk before asking her to disrobe by asking her any questions about her current thoughts with regard to self-injury or whether she was carrying anything she might use to hurt herself or others.
23. Ms. Sampson explained to defendant Richter that she had a history of sexual abuse, and explained that she was willing to take off most of her clothes, but requested to retain her pants.
24. Ms. Sampson willingly and promptly surrendered all of her belongings and took off her blouse, bra, shoes and socks, and put a hospital johnny (a thin smock which extends to her knees and ties in the back) over her pants.
25. Defendant Richter continued to insist that hospital policy required Ms. Sampson to remove her pants. Ms. Sampson refused and explained that her refusal was due to her history of traumatic sexual abuse. Ms. Sampson asked Defendant Richter to allow her to see a patient advocate to clarify this issue.
26. A female physician came to assess Ms. Sampson’s physical condition. Ms. Sampson again requested to keep her pants on due to her history of sexual abuse. The physician considered Ms. Sampson’s objections and asked whether Ms. Sampson would consent to a clothed pat-down, to which Ms. Sampson readily agreed. With Ms. Sampson’s consent, in the presence of a security guard, the physician conducted the pat-down herself, which included reaching under the legs of Ms. Sampson’s pants to search for contraband.
27. After conducting the pat-down, the doctor reported that there was no evidence of any unsafe object or threat to safety. She evaluated Ms. Sampson’s medical condition and told Ms. Sampson she was ordering medication for her migraines.
28. Ms. Sampson believed that the pat-down had resolved the matter. She was sitting calmly in the room waiting for a psychiatric evaluation. She remained under one-on-one observation with a sitter outside her door.
29. However, after the physician left, defendant Richter once again demanded that Ms. Sampson remove her pants, even though Ms. Sampson was calm. Defendant Richter made
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this demand without documenting the need for an intrusive personal search, or obtaining a clinical determination that one was necessary from a psychiatric professional.
30. At some point during these events, the designated clinician arrived to perform Ms. Sampson’s psychiatric assessment. Defendant Richter told her that the evaluation could not proceed until Ms. Sampson took off her pants.
31. The clinician left, and defendant Richter threatened Ms. Sampson that if she did not immediately accede to removal of her pants, they would be forcibly removed by security guards.
32. Ms. Sampson became extremely afraid, and tried to leave the Emergency Department.
33. A group of male security guards massed together to forcibly return Ms. Sampson to her room. One security guard asked Ms. Sampson to immediately return to her room to avoid being forcibly returned. Ms. Sampson felt she had no choice but to accede. When she returned to the room, she once again asked Defendant Richter to allow her to speak with a patient advocate.
34. Defendant Richter brought in another nurse, and they jointly insisted that Ms. Sampson remove her pants. Defendant Richter again threatened Ms. Sampson that if she did not remove her pants, Richter would have them forcibly removed by security guards.
35. During this entire time, defendant Richter did not call for a mental health consultation. Ms. Richter did not call Beverly Zaluk, Ms. Sampson’s therapist for a consultation, even though Zaluk’s phone number was readily available.
36. At no time during this entire episode did Ms. Sampson state, imply, or otherwise indicate that she had any current thoughts or intention to hurt herself or anyone else. At no time during this entire period did Ms. Sampson act in a manner which would have led a reasonable health care professional to believe that there was any immediate risk of harm to Ms. Sampson or to others.
37. Although mental health professionals were available at the Hospital, no one evaluated Ms. Sampson’s current safety risk by asking her any questions about her current thoughts regarding self-injury or whether she was carrying anything that she might use to hurt herself before ordering that she be forcibly stripped.
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38. Instead, Defendant Richter called in five male security guards and instructed them to hold Ms. Sampson down and forcibly strip off her pants.
39. The security guards held down Ms. Sampson’s arms and legs, pulled Ms. Sampson’s johnny up above her waist and unbuckled her pants while she struggled and screamed, bruising her in the process
40. The security guards then unzipped Ms. Sampson’s pants, continuing to hold her arms and legs down despite her twisting and crying out in pain. Finally, the security guards forcibly pulled off Ms. Sampson’s pants.
41. As she was being assaulted and stripped, Ms. Sampson struggled and screamed and was physically injured in the process. She cried out that she was being raped and sobbed.
42. Defendant Richter told Ms. Sampson she had only herself to blame for the use of force.
43. Neither Defendant Richter nor any clinical staff at the Hospital comforted Ms. Sampson or tried to help her as she lay curled up and sobbing after being stripped. The sitter whispered a few words of consolation.
44. Several hours later, a mental health clinician assessed Ms. Sampson for the first time. Ms. Sampson, who was profoundly traumatized by being forcibly stripped, explained what had happened.
45. Ms. Sampson was found to not be a threat to herself or others and to not meet the commitment standard. She was transferred to the medical portion of the Emergency Department and discharged the following morning.
Injuries to Ms. Sampson 46. As a result of the March 25, 2005 assault and stripping by security guards, Ms S experienced nightmares and flashbacks and greatly increased urges to harm and kill herself. Although she had not experienced a lengthy hospitalization in years, shortly after the security guards’ assault on her, she was hospitalized at several facilities for lengthy periods of time. These hospitalizations were a direct result of the events at Beth Israel Deaconess Medical Center Emergency Department on March 25, 2005.
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47. Ms. Sampson has not returned to the Hospital’s Emergency Department. She is afraid that current Hospital policies and practices will lead to her being forcibly stripped. Indeed, after the events of March 25, 2005, she required extensive therapeutic intervention to enable her to enter any hospital Emergency Department. Because the doctors for her serious medical conditions are affiliated with the Hospital, its policy practice requiring mandatory stripping of psychiatric patients who refuse to remove their clothing forces her to choose between risking her physical health or preserving her emotional health.
The Hospital’s Policy and Practice Related to Forced Stripping of Psychiatric Patients
48. Shortly after Ms. Sampson’s discharge, she took photographs of her extensive and discolored bruises and wrote a letter to the Hospital complaining about her abusive treatment by defendant Richter and the security guards, the assault by male security guards, and the denial of her repeated requests for a patient advocate. She attached photographs of the bruises.
49. In response, she received a phone call from the patient advocate stating that Emergency Department and Hospital staff had met about her complaint and determined that no mistakes had been made in her treatment. When Ms. Sampson reiterated how traumatized she was after being forcibly stripped, the patient advocate advised her to “just let it go.”
50. In early May 2005, Ms. Sampson received a written response from Beth Israel Deaconess Medical Center. The letter (attached as Exhibit A) confirmed the hospital policy requiring mandatory disrobing and forcible stripping:
In the future, if you come to the emergency room for a purely medical–not a psychiatric–reason, you would not be taken to the area reserved for psychiatric patients, and you would not be asked to remove your clothing. However, if your reason for coming involved a psychiatric issue, you would be asked to remove your clothing. This is now a strict emergency room policy which is designed to protect both patients and staff. As there have been several incidents in which patients concealed harmful items or substances, we cannot make any exceptions. (emphasis in letter).
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51. At the end of the letter, the Hospital reiterated that, although they were aware of Ms. Sampson’s disability and “how difficult” the clothing removal requirement was for her, she would still be asked to remove her clothes if she came to the Emergency Department for psychiatric reasons. The Hospital took this unequivocal position, refusing to make any accommodations to Ms. Sampson’s disability, despite the fact that in all her trips to the Hospital’s Emergency Department over two decades, Ms. Sampson had never hidden anything unsafe on her person, had never injured herself in the Emergency Department, and had never before been forcibly stripped of her clothing.
52. A year later, Defendant Hospital produced a written clothing removal policy that, on its face, creates a number of categories including “patient on suicide/self harm precautions,” and requires all patients who fall into those categories be searched, including forcible searches and stripping if patients refuse. However, even that policy fails to provide for any exception, waiver or accommodation, and fails to require a contemporaneous, individualized assessment by a psychiatric professional of the immediate need for a personal search or forcible stripping.
53. As a practical matter, due to stereotypes and misperceptions about the level of risk posed by people with mental illness, and to keep all patients in the psychiatric portion of the Emergency Department from leaving, the Hospital’s practice results in all patients in the psychiatric portion of the Emergency Department falling into one of the categories listed in the written policy, all of which involve mandatory searches, including forcible searches if the patient refuses.
54. Because of her history of self-injury and because the Hospital regards Ms. Sampson as a person who is substantially limited in her ability to care for herself, when Ms. Sampson is on the psychiatric portion of the Emergency Department, the Hospital will always place her into the category “patient on suicide/self harm precautions” and she will, as the Hospital’s letter stated, always be required to remove her clothing if she finds herself in the psychiatric portion of the Emergency Department, regardless of whether she is at actual risk of suicide or self-harm. If she refuses, she will be forcibly stripped, regardless of her request for accommodation and the availability of less intrusive means to ensure safety.
55. The Hospital’s policy and practice of requiring patients to disrobe and forcibly stripping patients who refuse to remove their clothing applies to all psychiatric patients,
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regardless of the lack of any assessment of immediate level of risk by a mental health professional, imminence of risk, availability of less intrusive means to ensure safety, history of sexual abuse or trauma, or any other individual contraindications to requiring or forcing a patient to remove her clothes.
56. Fifty to seventy percent of women with chronic mental illness have histories of childhood sexual or physical abuse, or both. This history has been recognized by the psychiatric community to cause life-long trauma and disability in some women, for whom it is a priority to never again be involuntarily touched, forced, or held down. The practice in some Emergency Departments of requiring psychiatric patients to disrobe can cause patients severe anxiety because it triggers memories of prior rapes and sexual abuse. Forced stripping by security guards when a patient refuses to remove her clothing is even more traumatic and can greatly exacerbate existing psychiatric disabilities. Forcible stripping by male security guards of a female patient with a history of sexual abuse is the most traumatizing and damaging of all.
57. It is well recognized in the psychiatric profession that in the absence of an emergency, an individualized assessment should be made by a mental health professional before forcibly stripping a patient of her clothing. It is also well recognized in the psychiatric profession that for some patients, requests or requirements that they remove their clothing can cause such emotional turmoil that it causes extreme agitation and panic, and exacerbates existing psychiatric conditions including anxiety, depression, and post-traumatic stress disorder.
58. The Hospital’s policy and practice do not require contemporaneous assessment of clinical necessity and a written order by a licensed mental health professional prior to the physical restraint and forcible stripping of an individual with a psychiatric disability in nonemergency situations.
59. The Hospital’s policy and practice do not permit reasonable accommodation, exception, or waiver of the most intrusive and forcible searches including reasonable accommodation of a disabled patient’s disability-related reluctance to remove her clothing.
60. The Hospital’s policy and practice preclude the use of less-intrusive means such as wands or pat-down searches. This policy and practice is at odds with the practices in other hospital Emergency Departments, where pat-downs are considered sufficient to ensure safety for the patient and others.
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61. The Hospital’s policies and practices, described above, violate current standards of medical practice, as well as applicable legal and regulatory requirements.
V. Legal Claims CLAIMS AGAINST BETH ISRAEL DEACONESS MEDICAL CENTER A. Title III of the Americans with Disabilities Act 62. Plaintiff realleges and incorporates by reference paragraphs 1-61. 63. The Americans with Disabilities Act was passed in 1990 to “provide a clear and
comprehensive national mandate for the elimination of discrimination against people with disabilities,” 42 U.S.C. §12101(b)(1). Congress explicitly defined discrimination to include “over-protective rules and policies,” “failure to make modifications to existing ... practices,” and “segregation, and relegation to lesser services,” 42 U.S.C. §12101(a)(5).
64. When Congress passed the ADA, it intended to “invoke the sweep of Congressional authority...in order to address the major areas of discrimination faced day to day by people with disabilities,” 42 U.S.C. §12101(b)(4), including in the area of “health services,” 42 U.S.C. 12101(a)(3).
65. Beth Israel Deaconess Medical Center is a “place of public accommodation” as that term is defined in Title III of the Americans with Disabilities Act, 42 U.S.C. 12181(7)(F), 28 C.F.R. 36.104. The ADA prohibits discrimination by a public accommodation against any individual on the basis of disability. 28 C.F.R. 36.201(a).
66. Ms. Sampson is an individual with a disability under the Americans with Disabilities Act because (a) her psychiatric impairments substantially limit major life activities, including caring for herself, working, and interacting with others; (b) Ms. Sampson was also regarded by defendants Richter and Hospital as being substantially limited in the ability to care for herself; and (c) Ms. Sampson has a history of psychiatric disabilities.
67. Because Ms. Sampson has received treatment at defendant Hospital for her chronic respiratory, migraine, and other medical difficulties for over two decades, it is virtually certain that she will continue to need the services of the Hospital’s Emergency Department in the future. Because of her psychiatric difficulties, she is forced to risk being forcibly stripped when she seeks needed services at the Hospital.
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Failure to Provide Reasonable Accommodations 68. Title III of the ADA prohibits public accommodations from discriminating against individuals with disabilities in the full and equal enjoyment of the goods, services, facilities, privileges, advantages or accommodations of any place of public accommodations, 42 U.S.C. 12182(a). The definition of discrimination includes “failure to make reasonable modifications in policies, practices, or procedures, when such modifications are necessary to afford such goods, services, facilities, privileges, advantages or accommodations to individuals with disabilities, unless the entity can demonstrate that making such modifications would fundamentally alter the nature of such goods, services, facilities, privileges, advantages, or accommodations.” 42 U.S.C. 12182(b)(2)(A)(ii). 69. The Hospital discriminated against Plaintiff on the basis of her disability in violation of 42 U.S.C. 12182(b)(2)(A)(ii) by failing to grant her the reasonable accommodation of waiving its requirement of removal of all clothing, despite Plaintiff’s willingness to remove most of her clothing, her consent to a pat-down, and the presence of a one-on-one observer. 70. Numerous other methods exist for meeting the Hospital’s legitimate safety concerns besides forcible removal of clothing, including using a wand, or pat-down or other methods of determining whether a patient is carrying objects to harm him or herself. In the absence of an individualized determination by a qualified mental health professional that a patient is so currently dangerous to him or herself that complete clothing removal was required, and forcible removal justified, defendant Hospital fails to meet the ADA’s requirement to make reasonable accommodations or modifications of policies. 71. The Hospital discriminated against Plaintiff on the basis of her disability in violation of 42 U.S.C. 12182(a) by requiring her to disrobe and by forcibly stripping her when she refused without an individualized determination of immediate necessity by a mental health professional, and without provision for reconsideration, reasonable accommodation or waiver because she was seen on the psychiatric side of the emergency room. Patients on the medical portion of the emergency room are not required to disrobe. They are asked to disrobe only upon a medical determination of a clear medical necessity and are not forcibly stripped if they refuse to disrobe.
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Unequal Access to Services 72. Title III of the ADA requires public accommodations to provide equal access to their services to people with disabilities, 42 U.S.C. § 12182(a), 28 C.F.R. 36.201(a). Defendant Hospital’s policy and practice of requiring mandatory disrobing of patients in the psychiatric portion of the Emergency Department, including the removal of clothing by force, without an individualized determination of immediate necessity by a mental health professional, and without provision for reconsideration, reasonable accommodation or waiver, limits Ms. Sampson’s access to defendant Hospital’s services, as it forces Ms. Sampson to risk being forcibly stripped when she seeks needed services at the Hospital.
Discriminatory Eligibility Criteria 73. Title III of the ADA prohibits public accommodations from applying eligibility criteria that single out individuals with disabilities and prevent them from fully and equally enjoying the services and advantages of the facility, unless those criteria are necessary for the provision of services offered by the facility, 42 U.S.C. 12182(b)(2)(A)(i), 28 C.F.R. 36.301(a). 74. In order to be eligible to receive psychiatric services at Beth Israel Deaconess Medical Center, patients in the psychiatric portion of the Emergency Department are subject to a search. The Hospital’s policy and practice of requiring mandatory disrobing, including the removal of clothing by force, without an individualized determination of necessity by a mental health professional and without provision for reconsideration, reasonable accommodation or waiver screens out the Plaintiff from fully and equally enjoying the Hospital’s services and advantages on the basis of her disability. 75. The policy and practice violate the ADA by placing an additional and unnecessary burden on patients in the psychiatric portion of the emergency room in order to receive the services of the Hospital. 76. While a public accommodation may impose “legitimate safety requirements” that are necessary for the safe operation of the facility, these requirements must be “based on actual risk and not on mere speculation, stereotypes, or generalizations about people with disabilities,” 28 C.F.R. 36.301(b). The Hospital’s practice violates the ADA because it requires mandatory
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disrobing and forcible stripping without an individualized assessment by a mental health professional that the risk of harm to the individual’s mental health from forcibly stripping her is outweighed by the risk of harm in permitting her to keep some or all of her clothing.
Discriminatory Methods of Administration 77. The Americans with Disabilities Act prohibits public accommodations from adopting methods of administration that have the effect of discriminating on the basis of disability. 42 U.S.C. § 12182(b)(1)(D), 42 U.S.C. § 12182(b)(2)(A)(i), 28 C.F.R. 36. 204. 78. Beth Israel Deaconess Medical Center’s policy and practice of requiring mandatory disrobing, including the removal of clothing by force, without an individualized clinical determination of necessity by a mental health professional, and without provision for reconsideration, reasonable accommodation or waiver, constitutes a method of administration that has the effect of discriminating on the basis of disability in violation of the ADA.42 U.S.C. § 12182(b)(1)(D), 42 U.S.C. § 12182(b)(2)(A)(i), 28 C.F.R. 36.204.
B. Section 504 of the Rehabilitation Act 79. Plaintiff realleges and incorporates by reference paragraphs 1-78. 80. Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794(a) provides that “no otherwise qualified individual with a disability... shall, solely by reason of his or her disability, be ...denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.” 81. Defendant Hospital receives federal funds for the purposes of the Rehabilitation Act through the Medicaid and Medicare programs. In order to receive Medicare and Medicaid reimbursements, defendant Beth Israel Deaconess Medical Center is required to assure the federal government in writing that it complies with the requirements of Section 504 of the Rehabilitation Act, and, upon information and belief, it has made these assurances. 82. Ms. Sampson is an individual with a disability under 504 of the Rehabilitation Act because her psychiatric impairments substantially limit major life activities, including caring for herself, working, and interacting with others. Ms. Sampson was also regarded by defendants Richter and Beth Israel Deaconess Medical Center as being substantially limited in the ability to
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care for herself. Ms. Sampson also qualifies as an individual with a disability under Section 504 because of her history of psychiatric disabilities.
83. As a person in physical pain seeking medical attention, and a regular patient at Beth Israel Deaconess Medical Center, she was otherwise qualified to receive its services. Because Ms. Sampson has received treatment at Beth Israel Deaconess Medical Center for her respiratory, migraine, and psychiatric conditions for over two decades, it is virtually certain that she will continue to visit the Emergency Department at Beth Israel Deaconess Medical Center in the future; because of her psychiatric difficulties, she would be likely to use the services of the psychiatric portion of the Emergency Department in the future, but for the policy and practices of the defendant Hospital with regard to mandatory disrobing and forcibly stripping patients.
Less Effective Services 84. Regulations applicable to hospitals under Section 504 of the Rehabilitation Act prohibit affording a qualified handicapped person less effective or unequal services than those received by others, 45 C.F.R. 84.4(b)(1)(ii) and (iii). In addition, the regulations forbid limiting a qualified handicapped person in the enjoyment of any advantage or opportunity enjoyed by others receiving the services of the facility, 45 C.F.R. 84.4(b)(1)(vii). 85. By adopting a policy and practice requiring mandatory disrobing, including the removal of clothing by force, of any individual in the psychiatric emergency room, without an individualized determination of clinical necessity and with no provision for reasonable accommodations or modifications, the Hospital interferes with the trust needed to establish an effective doctor patient relationship, inflicts harm on patients with mental illness, and provides less effective treatment services. 86. When she was stripped of her clothing forcibly while being held down by male security guards, Ms. Sampson received less effective treatment services from the Hospital than medical patients who could receive treatment services without being subject to the Hospital policy of mandatory disrobement.
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Failure to Provide Reasonable Accommodations 87. Beth Israel Deaconess Medical Center’s policy and practice of requiring mandatory disrobing, including the removal of clothing by force, without a determination of clinical necessity and without provision for reconsideration, reasonable accommodation or waiver, denies the reasonable accommodations required by Section 504 of the Rehabilitation Act to Ms. Sampson. Numerous other methods exist for meeting the Hospital’s legitimate safety concerns besides forcible removal of clothing, including using a wand, pat –down, or other methods of determining if she is carrying objects to harm herself. 88. The Hospital’s conduct in rejecting Ms. Sampson’s request for the reasonable accommodation of considering the pat-down, despite the removal of most of her clothing, and the presence of the one-on-one as sufficient to ensure her safety on March 25, 2005 violated the requirements of Section 504 of the Rehabilitation Act to make reasonable accommodations or modifications of policies to afford individuals with disabilities access to their services. 89. The Hospital discriminated against Plaintiff on the basis of her disability in violation of 29 U.S.C. § 794(a) by requiring her to disrobe and forcibly stripping her when she refused without an individualized determination of immediate necessity by a mental health professional, and without provision for reconsideration, reasonable accommodation or waiver because she was seen on the psychiatric portion of the emergency room. Patients without psychiatric disabilities are not routinely required to disrobe, and are not forcibly stripped if they refuse.
Limiting the Participation of Qualified Handicapped Persons 90. Section 504 of the Rehabilitation Act prohibits health care entities receiving federal funds from “providing benefits or services in a manner that limits or has the effect of limiting the participation of qualified handicapped persons,” 45 C.F.R. 84.52(a)(4). Beth Israel Deaconess Medical Center’s policy and practice requiring mandatory disrobing and forcible removal of clothing without determination of clinical necessity or provision for reconsideration, reasonable accommodation or waiver, limits or has the effect of limiting the participation of Ms. Sampson in its services as it forces Ms. Sampson to risk being forcibly stripped when she seeks needed services at the Hospital.
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Discriminatory Methods of Administration 91. The regulations to Section 504 of the Rehabilitation Act specifically prohibit the use of criteria or methods of administration that have the effect of subjecting qualified handicapped persons to discrimination on the basis of handicap or have the purpose or effect of defeating or substantially impairing accomplishment of the objectives of the program with respect to handicapped persons, 45 C.F.R. 84.4(b)(4). 92. The “objectives of the program” of Beth Israel Deaconess Medical Center for purposes of 45 C.F.R. 84.4(b)(4) are to provide treatment to those in need of care, including individuals in psychiatric crisis. These objectives are “defeated or substantially impaired” when, Ms. Sampson is dissuaded from seeking care and treatment at the Hospital and has to chose between obtaining services or taking the risk that she will be forcibly stripped because of the Hospital’s policy and practice requiring mandatory disrobing and forcible removal of clothing without determination of clinical necessity or provision for reconsideration, reasonable accommodation or waiver in violation of 45 C.F.R. 84.4(b)(4). 93. Defendant Hospital’s policy and practice of requiring mandatory disrobing, including the removal of clothing by force, without an individualized clinical determination of necessity, and without provision for reconsideration, reasonable accommodation or waiver, violates the prohibition in Section 504 on methods of administration that have the effect of subjecting Ms. Sampson to discrimination on the basis of handicap. 45 C.F.R. 84.4(b)(4).
C. Chapter 272, Section 98 of Massachusetts General Laws 94. Plaintiff realleges and incorporates by reference paragraphs 1-93. 95. M.G.L. Ch. 272, Section 98, prohibits a place of public accommodation from making any distinction, discrimination or restriction on account of mental disability, and requires that all persons shall have the right to full and equal accommodations and facilities of any place of public accommodation. The Hospital is a place of public accommodation pursuant to M.G.L. Ch. 272, Section 92A(10). Ms. Sampson is a person with a mental disability under the statute. The Hospital discriminated against and imposed restrictions on Ms. Sampson on the basis of her mental disability in violation of her right to full and equal accommodations under this statute.
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Ms. Sampson filed a timely complaint with the Massachusetts Commission Against Discrimination on Dec. 23, 2005, and has removed the action to this court, in fulfillment of statutory requirements necessary to bring an action under this statute.
96. Defendant Hospital violated M.G.L. Ch. 272, Section 98, by refusing her request for a reasonable accommodation to keep her pants, especially in light of the presence of a fulltime sitter, her removal of most of her clothing, and her voluntary submission to a pat-down search. The Hospital also violated her rights by failing to make accommodations to her known psychiatric disability and history of severe sexual trauma when five male security guards held her down while she was stripped on the order of a Hospital nurse.
97. Plaintiff seeks declaratory and injunctive relief enjoining defendant Beth Israel Deaconess Medical Center from policies and practices that discriminate on the basis of psychiatric disability, including but not limited to: 1) requiring Ms. Sampson to disrobe completely without considering requests for reasonable accommodation to these requirements as a matter of both policy and practice; and 2) requiring Ms. Sampson to disrobe, and forcibly stripping her, without an individualized assessment and finding of clinical necessity by a mental health professional, taking into consideration her history of sexual and physical abuse.
98. Plaintiff also seeks compensatory damages from defendant Hospital.
CLAIMS AGAINST BETH ISRAEL DEACONESS MEDICAL CENTER AND HEATHER RICHTER D. Chapter 12, Section 11H and I of Massachusetts General Laws 99. Plaintiff realleges and incorporates by reference paragraphs 1-98. 100. Beth Israel Deaconess Medical Center, by its policies and through its agent Ms. Heather Richter, interfered with Ms. Sampson’s exercise and enjoyment of her statutory rights under both federal law and the law of the Commonwealth through threats, intimidation and coercion. As discussed above, Ms. Richter directly interfered with Ms. Sampson’s exercise and enjoyment of her rights under both federal and state law. 101. When Nurse Richter repeatedly threatened Ms. Sampson with forcible stripping by male security guards, she used threats, intimidation and coercion to interfere with Ms. Sampson’s rights, including her right to privacy when receiving medical treatment under MGL
18

Chapter 111, Section 70E(j), as well as her federal and state rights to receive medical treatment free from discrimination on the basis of disability. To condition her right to receive medical treatment on removal of her clothing, by force if necessary, violated Ms. Sampson’s rights, and when she attempted to assert these rights, she was threatened, intimidated, and coerced.
102. Plaintiff seeks declaratory and injunctive relief enjoining defendant Beth Israel Deaconess Medical Center from policies and practices that discriminate on the basis of psychiatric disability, including but not limited to: 1) requiring Ms. Sampson to disrobe completely without considering requests for reasonable accommodation to these requirements as a matter of both policy and practice; and 2) requiring Ms. Sampson to disrobe, and forcibly stripping her, without an individualized assessment and finding of clinical necessity by a mental health professional, taking into consideration her history of sexual and physical abuse.
103. . Ms. Sampson also seeks compensatory damages from both defendants.
E. Negligence 104. Plaintiff realleges and incorporates paragraphs 1-103. 105. On or about March 25, 2005, defendants Beth Israel Deaconess Medical Center and Heather Richter, undertook for compensation to provide care, treatment, and advice to Cassandra S. At all times relevant herein, Heather Richter was acting an agent, servant, and/or employee of Beth Israel Deaconess Medical Center, acting within the scope of that employment. 106. Beth Israel Deaconess Medical Center and Heather Richter owed Ms. Sampson a duty of care as a patient at the Hospital on the day of March 25, 2005. 107. In attending to Ms. Sampson, the defendant, Heather Richter, was negligent in failing to provide acceptable medical care and in failing to exercise that degree of skill, care, and diligence that is exercised by the average qualified practitioner engaged in practice at a professional level such as that in which the defendant was then engaged. 108. Defendants further breached their duty to the plaintiff when, among other things, they forced her to comply with Beth Israel Deaconess Medical Center’s policy requiring her to take her pants off, when they knew or should have known on the basis of her past history that requiring Ms. Sampson to take off her clothing would cause her substantial emotional and potential physical harm, and which in fact did cause her substantial emotional and physical harm.
19

109. Defendants further breached their duty to the plaintiff when, among other things, they allowed security guards to assault and forcibly strip Ms. Sampson of her pants, leaving her bruised and crying in pain, and causing her substantial emotional and physical harm.
110. Defendant Heather Richter owed Ms. Sampson a duty of care as her nurse. By, among other things, insisting that Ms. Sampson remove her clothing even when told of Ms. Sampson’s sexual abuse history; failing to consult Ms. Sampson’s therapist when such consultation was readily available; refusing Ms. Sampson’s request for a patient advocate, and ordering the forcible stripping of Ms. Sampson by male security guards, Nurse Richter violated her duty of care to Ms. Sampson, causing Ms. Sampson substantial emotional and physical harm.
111. As a direct and proximate consequence of the defendants’ conduct, Ms. Sampson suffered, and continues to suffer severe physical and emotional injuries, including, but not limited to, bruising, increased migraines, and a greatly deteriorated psychiatric condition. As a direct result of the defendants’ conduct, Ms. Sampson attempted suicide. Ms. Sampson has suffered terrifying nightmares and increased flashbacks of her childhood sexual abuse and was hospitalized for months at several different facilities. She was unable to return to Emergency Departments for any kind of treatment for months after her forcible stripping by male guards, and required substantial treatment to enable her to do so.
F. Intentional or Reckless Infliction of Emotional Distress 112. Plaintiff realleges and incorporates by reference paragraphs 1-111. 113. Nurse Richter and Beth Israel Deaconess Medical Center knew or should have known that its conduct, including, but not limited to, ordering four or more male security guards to forcibly strip a female patient with a psychiatric disability stemming from severe sexual abuse as a child was likely to cause emotional distress. Both Beth Israel Deaconess Medical Center and Nurse Richter were on notice that Ms. Sampson had a history of severe sexual abuse when Nurse Richter ordered security guards to forcibly strip Ms. Sampson. 114. The defendants’ conduct, including, but not limited to, gang-stripping of a woman known to have a history of severe sexual abuse by a group of male security guards was extreme and outrageous, and beyond all possible bounds of decency in a hospital setting where patients
20

can expect to receive care and treatment. The defendants’ conduct is utterly intolerable in a civilized community.
115. As a direct and proximate cause of the defendants’ conduct the plaintiff suffered, and continues to suffer, severe emotional distress. Further, as a direct and proximate cause of the defendants’ conduct, the plaintiff attempted suicide, and required inpatient hospitalization for months.
G. Assault and Battery 116. Plaintiff realleges and incorporates by reference paragraphs 1-115. 117. The defendants placed Ms. Sampson in reasonable fear of imminent physical harm when, among other things, Nurse Richter and another hospital nurse repeatedly threatened that the security guards would strip her forcibly. 118. Despite being on notice that Ms. Sampson was a patient with a severe history of sexual abuse, and despite Ms. Sampson’s attempts in good faith to meet the Hospital and Ms. Richter’s requirements by taking off her blouse, socks and shoes, and by submitting to a patdown, the defendants caused and allowed security guards to forcibly restrain and strip the plaintiff. 119. As a result of defendants’ conduct the plaintiff suffered, and continues to suffer, severe emotional and physical injuries.
VI. Relief Because plaintiff will suffer irreparable harm in the absence of permanent injunctive
relief, and respectfully requests this Court to: 1. Assume jurisdiction over this action. 2. Enter a declaratory judgment finding that defendant Hospital violates the ADA, Section 504 of the Rehabilitation Act, and M.G.L. Chapter 272, Section 98, because it discriminates against persons with psychiatric disabilities by: 1) requiring them, but not medical patients, to disrobe for reasons unrelated to the assessment to be performed; 2) by enforcing the disrobing requirement by force on psychiatric patients, but not on medical patients who refuse to disrobe; 3) by
21

not ensuring that there is an individualized assessment by a psychiatric professional prior to forcibly stripping a psychiatric patient; 4) by failing to make any provision for reasonable accommodation on the basis of an individual’s psychiatric disability; and 5) by not permitting waiver of the requirement for complete clothing removal on the basis of disability. 3. Issue injunctive relief ordering the Hospital to 1) treat Ms. Sampson the same whether she seeks medical or psychiatric care; 2) require an individualized assessment of Ms. Sampson by a psychiatric professional with written findings before she is required to disrobe or be forcibly stripped, except in immediate emergencies; 3) allow for reasonable accommodations for Ms. Sampson’s psychiatric disability; and 4) permit a waiver of the disrobing and forced stripping policy for Ms. Sampson. 4. Award plaintiff her costs and reasonable attorney’s fees, as permitted under 42 U.S.C. §2205, 29 U.S.C. §794a(b), M.G.L. Chapter 272, Section 98 (by reference to M.G.L. Chapter 151B, Section 5) and M.G.L. Chapter 12, Section 11I. 5. Award plaintiff compensatory damages of over one million dollars under 29 U.S.C. 794, M.G.L. Chapter 272, Section 98 (by reference to M.G.L. Chapter 151B, Section 5), M.G.L. Chapter 12, Section 11H and I, and state tort claims. 6. Award plaintiff such other and further relief as the Court may deem just and appropriate.
Plaintiff demands a jury trial on all claims for which she is entitled to a jury, including her claim for damages under Section 504 of the Rehabilitation Act, M.G.L. Ch. 272, Sec. 98, M.G.L. Ch. 12, Section 11H and I, and under the state claims of negligence, intentional or reckless infliction of emotional distress, and assault and battery for compensatory and punitive damages.
22

Respectfully Submitted,
Susan Stefan BBO #600897 Steven Schwartz BBO #448440 Center for Public Representation 246 Walnut Street Newton, MA 02460 617-965-0776 Clyde Bergstresser, BBO#039200 Scott Heidorn, BBO #661787 Campbell, Campbell, Edwards & Conroy One Constitution Plaza Boston, MA 02129 Ira Burnim, DC Bar #406154 Karen Bower, DC Bar #450888 Bazelon Center for Mental Health Law Suite 1212 1101 15th St. N.W., Washington, D.C. 20005
23

 
 Beth Israel Deaconess Medical Center Manual of Clinical Practice
Title: Patient Search Policy
Policy: PR-08
Policy Statement/Purpose: Our goal at BIDMC is to preserve the health, safety and welfare of the patients and staff and to provide a safe environment for all patients. In pursuing this goal, it may, at certain times, be necessary to search some patients who, based upon individual assessment, are determined to be at risk for causing harm to self or to others. This policy is intended to guide clinicians in the requirements for searches of patients’ belongings and/or room, as well as searches of the person. This policy is also intended to guide clinicians in situations where a patient does not consent to a requested search or is uncooperative in the process. Patients may refuse to remove their clothing unless they are at imminent risk of injuring themselves or others and all other reasonable alternatives have been exhausted.

Guideline(s) for Implementation:
GUIDELINES FOR SEARCHES:
 Searches will not be conducted without specific justification for the search. The justification for all searches must be clearly documented in the patient’s record.
 The scope and method of all searches must be related to the objective of the search and must not be more intrusive than necessary to accomplish the goal of protecting the patient and others by removing items that may be potentially harmful.
 Any patient subject to a search must be informed of the reason for the search. Every effort must be made to accomplish all searches in a consensual, non-forcible manner with the cooperation and participation of the patient. Every effort should be made to complete the search in a voluntary manner before considering proceeding with an involuntary search. When appropriate under the circumstances, a patient representative, social worker, or administrative clinical supervisor may be contacted to speak with the patient about the need for the search.
 If a patient does not consent to a request to perform a search, the patient may not be restrained for purposes of accomplishing the search unless there is compelling evidence that the patient is at imminent risk of harming himself, herself or others and all other reasonable alternatives have been exhausted. This includes the restraint of a patient for purposes of removing clothing to conduct a search in a hospital gown. If there is any question as to the level or immediacy of the risk posed by the patient and his or her condition, other sources and providers should be consulted. Refusal to comply with a

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request does not, in and of itself, justify restraining a patient for purposes of proceeding with an involuntary search.
 If holding or restraint is necessary to accomplish the search of a patient determined to be at imminent risk of harm to self or others, staff must implement the guidelines contained in the hospital restraint policy, CP-28: Use of Restraints and/or Seclusion.
 Prior to a search whenever possible under the circumstances, clinicians should gather an assessment of possible trauma and sexual abuse history. In cases of where a patient has a history of past sexual abuse, a condition such as post-traumatic stress disorder, or a physical or mental disability, reasonable accommodations to this policy should be considered to the extent the patient’s history, condition or disability is relevant to or may be impacted by the manner in which the search will be conducted or the patient’s reluctance to consent to a search. In such situations, the clinician should weigh the risks and benefits of proceeding under the policy. Resources to consult in such a situation include social workers, nurse specialists and psychiatrists.
 All searches must be fully documented in the patient’s medical record so this can be communicated to subsequent providers of care.
WHEN SEARCHES ARE REQUIRED:
A voluntary search must be initiated in the following situations:
1. When a registered nurse or physician or both have assessed a patient to be a danger to self, has ordered the patient to be observed, and has placed the patient on suicide precautions.
2. When a registered nurse or physician has assessed a patient to be a danger to others and has ordered the patient to be observed.
3. When a patient is going to be admitted for in-patient psychiatric care (a setting where there may be other patients who are a danger to self or others, making the presence of potentially dangerous objects or medications dangerous even if the patient does not present a danger to self).
GUIDELINES FOR IMPLEMENTATION
There are two types of searches that may be appropriate in a given situation:
1. Search of a Patient’s Room/Living Space and/or Belongings:
Such a search may be authorized by an RN or a physician where the clinical staff have a reasonable and justified belief that a patient has a potentially hazardous item(s) in his or her room or living space. The search shall include a thorough inventory of the patient’s belongings (including suitcases, purses and bags). If indicated, the patient’s room/living space should also be searched. Whenever possible, the search should be

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conducted in the presence of the patient. Two staff members must participate in this type of search and one must be the same gender as the patient. Security staff is available to assist. In the case of a search of belongings, the goal of achieving a safe environment may also be achieved by removing the belongings and sending them home with a person designated by the patient or storing them in a secured area away from the patient (valuables envelope or locked storage). If belongings are removed from a patient without being searched, they must be searched before returning them to the patient if the patient is still under treatment at the medical center and the grounds for the search still exist. If the patient is reluctant to comply with this request, he or she should be informed of the right to refuse.
2. Search of the Person
Such a search may be authorized where the clinical staff have a reasonable and justified belief that a patient has a potentially hazardous item(s) on or in his or her person. There are three types of searches under this search category. The type of search is justified by the situation and the clinical judgment of the clinician.
a) External Search
An external search of the person may be authorized by a physician or RN. The clinician will request that the patient empty the contents of his or her pockets and turn the pockets inside out A staff member who is the same gender as the patient will pat down the patient (keeping hands outside of the patient’s clothing) to ensure no hazardous objects or substances are concealed. If the patient is reluctant to comply with this request, he or she should be informed of the right to refuse.
b) Search in Hospital Gown
A search of a patient in a hospital gown may be authorized by a physician or an RN. The patient will be asked to change into a hospital gown or other hospital clothing provided by the clinician in the presence of a clinician who is the same gender as the patient. If the patient is reluctant to comply with this request, he or she should be informed of the right to refuse. (NOTE: There may also be medical conditions requiring a patient to change into hospital clothing to facilitate an examination and appropriate medical treatment.) Clothing should be searched and returned to the patient as soon as reasonable under the situation.
c) Body Cavity Search
A body cavity search may only be authorized by the attending physician who has reviewed the clinical rationale and believes that this level of search is warranted. This is the most intrusive level of search and may only be authorized if there is a significant clinical situation justifying it. This type of search may only be conducted by a physician in the presence of at least one

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other clinician. Either the physician or the other clinician must be the same gender as the patient. If the patient is reluctant to comply with this request, he or she should be informed of the right to refuse.
PROCEDURE FOR HANDLING OF ITEMS FOUND DURING SEARCH
1. Any medication, sharps, or potentially harmful objects or substances that have not been destroyed pursuant to the hospital’s policies must be labeled and placed in locked storage until the patient is discharged or the items are removed by a person designated by the patient.
2. If the patient has or if there is any suspicion that a patient has weapons/firearms, contact security immediately. Do not attempt to remove weapons/firearms from a patient. (See Security Policy #PR3: Handling of Fire Arms and Dangerous Weapons).
3. Any suspected illicit drugs must be disposed of pursuant to the “Disposition of Drug or Substance Suspected of Being Illegal” policy, Manual of Clinical Practice PA-05.
4. If a patient is being transferred to a locked psychiatric facility, the patient’s belongings should be given to unit or ambulance staff, not to the patient, during transport.
DOCUMENTATION
The Search shall be documented in the patient record and documentation shall include:
1. The clinical rationale for instituting the search;
2. The staff involved in the decision making and the actual search;
3. A description of any objections found, and disposition (example: White powder in a plastic bag, green pill, disposed of according to hospital policy.); and
4. Where/with whom any objects/substances have been secured.
Author/Owner/Chair Name: Patricia Folcarelli RN, PhD
Vice President Sponsor: Kenneth Sands MD
Approved by: Code Purple/Restraint Committee
MEC/ Date:
Original Date Approved:
Revised:
Next Review Date: 9/10

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2/6/2009

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 Beth Israel Deaconess Medical Center BIDMC Manual Revision Draft September ‘08
Title: Use of Restraints and/or Seclusion
(for patients on the inpatient psychiatry unit refer to the Deaconess 4 policies)
Policy #: CP – 28
Purpose: This policy serves to describe those situations where a restraining device or seclusion may be used to manage patient safety. This policy outlines the required orders, assessments, and documentation.
This policy applies to restraint or seclusion regardless of where these patients are in the organization, with the exception of patients on Deaconess 4, the inpatient psychiatry unit.

Policy Statement: Restraint or seclusion may only be imposed to assure the imminent safety of the patient, staff or others and must be discontinued at the earliest possible time. Patients may not be restrained as a means of coercion, discipline, convenience or retaliation. Patients may also not be restrained for purposes of conducting a search unless they meet the standards set forth in this policy.
Restraint or seclusion are used only if, in the clinical judgment of a nurse and/or licensed independent practitioner, the patient is at imminent risk of causing harm to self or others and other less restrictive measures are ineffective or inappropriate. If it is determined that less restrictive interventions are ineffective in protecting the patient or others from harm, the hospital may then consider the use of restraint.
The decision to use restraint or seclusion is driven by a comprehensive individual assessment that concludes that for this patient at this time, the use of less intrusive measures poses a greater risk than the use of using a restraint or seclusion. The comprehensive assessment of patients should include a physical assessment to identify medical problems that may be causing the behavior changes in the patient. For example, temperature elevations, hypoxemia, hypoglycemia, electrolyte imbalances, drug interactions and drug side effects can cause confusion, agitation, and combative behavior. Addressing these medical issues can often eliminate or minimize the need for the use of restraints or seclusion. Documentation must reflect that these assessments have been conducted prior to application of restraint or seclusion.
When used, restraint or seclusion must be the least restrictive intervention that protects the patient’s safety if alternatives have failed. Restraint/seclusion must end as soon as possible.

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In all instances of restraint and seclusion use, measures will be taken to protect the rights, dignity, and well being of the patient.
Definitions:
Restraint: • Any manual or physical or mechanical device, material or equipment that immobilizes or reduces the ability of a patient to move his arms, legs, body or head freely. • A drug or medication when it is used as a restrictive means to manage a patient’s behavior or to restrict the patient’s movement and is not a standard treatment or dosage for the patient’s condition.
Seclusion: • The involuntary confinement of a patient alone in a room or area from which the patient is physically prevented from leaving. Seclusion may only be used for the management of violent or self-destructive behavior.
Licensed Independent Practitioner: • Any individual permitted by law and by the organization to provide care and services without direction or supervision, within the scope of the individual’s license and consistent with individually granted clinical privileges (NP’s or MD’s).
Exceptions:
Does not include devices such as orthopedically-prescribed devices, surgical dressing or bandages, protective helmets or other methods that involve the physical holding of a patient for the purpose of conducting routine physical examination or tests or to protect the patient from falling out of bed (i.e. cribs, emergency room stretchers, side rails on specialty beds) or to participate in activities without the risk of physical harm (i.e. gait belts).
Implementation:
USE OF RESTRAINT:
Restraint and seclusion are significant interventions which have the potential to produce psychological and physiological consequences for the patient. All efforts should be directed toward using restraint or seclusion only when absolutely necessary to prevent injury to the patient or others or to prevent the destruction of property. Restraint and seclusion shall be used only as an unusual and temporary measure when the independent licensed practitioner and nursing assessment deem it necessary and other available techniques or interventions have failed.

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Issues to be considered in determining that restraint or seclusion are clinically appropriate and adequately justified are: • Identifying and eliminating/correcting when possible, the cause of the patient’s
behavior, including physiologic, cognitive and/or environmental factors. • Initiating alternative measures to manage the patient’s behavior without restraints or
seclusion.

The type of restraints or seclusion should be determined after: • Assessment of the patient and the situation have been completed, • Precipitating factors have been identified and eliminated, whenever possible, • Consultations with other healthcare professionals have occurred, when appropriate, • Information from the patient’s initial assessment is taken into consideration.

It is acceptable and standard practice to raise 4 siderails when a patient is on a stretcher, recovering from anesthesia, suffering from involuntary movement or on certain types of therapeutic beds to prevent the patient from falling out of bed. If 4 siderails are raised for other reasons (i.e. to prevent the patient from getting out of bed), this is an episode of restraint.

LICENSED INDEPENDENT PRACTITIONER’S ROLE

1. Determine that restraints and/or seclusion are appropriate and necessary and less restrictive treatment is not feasible.

2. At the time of the in-person evaluation: ● Works with the patient and staff to identify ways to help the patient regain control ● Revises the patient’s plan for care, treatment and services as needed ● If necessary, provides a new written order

3. Must document restraint/seclusion episode(s) as required and defined in the Assessment and Documentation Guidelines table embedded within this policy.

NURSE’S ROLE

1. Assess the behavior requiring intervention/determine the less-restrictive interventions, and patient response to these interventions.

2. In an emergency situation to protect the patient and/or others from imminent injury, restraint may be initiated by a registered nurse if, in the judgment of that nurse, other less restrictive measures are either not effective or not feasible.

3. Page LIP to request a face-to-face evaluation and a written order within 1 hour of initiation of restraint.

4. Patients/family should be informed regarding the use and reason for restraint and

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seclusion within a reasonable period of time, and behavioral expectations for release of restraint or seclusion.

5. Restraint devices are applied in accordance with manufacturer’s directions by staff that have been trained to do so.

6. Restraint or seclusion may be discontinued by the RN, (except in the cases where the restraints were at the recommendation of a consulting psychiatrist, in which case the consultant’s concurrence must be documented).

7. Documentation on the Restraint or Seclusion Flow Sheet must include an assessment using the guidelines defined in the Assessment and Documentation Guidelines table embedded within this policy.

8. A constant observer should be employed for patients in restraint or seclusion for reasons of violent or self destructive behavior. The required 15-minute assessment by the observer or RN must be documented using the Observer Section of the Restraints or Seclusion Flow Sheet.

9. Document a patient’s response to trial/early release and less restrictive alternatives. Consider requesting support from security personnel when releasing a potentially violent patient. In suicidal patients, consult with a psychiatrist or licensed independent practitioner prior to attempting early release.

10. If a patient was released from restraint or seclusion and suddenly exhibits the behavior that can only be handled by the reapplication of restraint or seclusion, a new order is required. Staff cannot discontinue and restart under the same order. Reapplication of restraint requires a new order. However- a temporary release for the purpose of caring for a patient’s needs – for example toileting, feeding, range of motion is not considered a discontinuation of the intervention.)

Assessment and Documentation Guidelines:

Assessment and Documentation Guidelines for Restraint/Seclusion Interventions

Non-violent Behavior: Restraint

Violent and/or Self-destructive Behavior: Restraint

Violent and/or Self-destructive Behavior: Seclusion

Restraint Ordering Timeframe

MD must complete order within 1 hour of initiation

Restraint Order/Reorder Time
Limitation

• 4 hours for adults • 2 hours for patients age 17 and under • PRN orders are not permitted.

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MD Face-to-Face Evaluation

Must occur within 1 hour of restraint/seclusion initiation

Assessment and Documentation Guidelines for Restraint/Seclusion Interventions (cont).

Non-violent Behavior: Restraint

Violent and/or Self-destructive Behavior: Restraint

Violent and/or Self-destructive Behavior: Seclusion

4-hour renewal of orders may take place by a verbal order EXCEPT in the case of patients restrained for violent or self-destructive behavior.

MD Face-to-Face Reevaluation

If a patient has been in restraint/seclusion for 24 hours (a total of 6 consecutive orders, the MD must return for a face to face evaluation of the patient prior to a written renewal of the order. The evaluation must be documented in the progress notes.

Must occur every 4 hours with each new restraint/seclusion order issued.
For patients age 17 and under, this is not to exceed 2 hours.

Components of Required MD
Documentation

• Restraint Order in POE or ED Restraints/Seclusion Flow sheet must be completed with every application/ reapplication of restraint/seclusion OR renewal of order for continuation of restraint/seclusion. Each order must be time-limited and written for a specific behavior which puts the patient at risk. Examples of such behaviors include: pulling at lines/tubes, risk of assault or self-harm, extreme aggression and impulsivity.
• Documentation of Initial Face-to-Face Evaluation must be made in the progress notes, including time. Restraint/ seclusion intervention must be incorporated into plan of care.

Components of Required 15-minute
RN or Observer Documentation

None required

None required

Components of Required 1-hour RN Documentation on
Flow sheet

• Circulation (a finger check beneath restraint only)
• Body Alignment • Patient’s Behavior

• Patient’s Behavior

• Basic needs (food,

• Basic needs (food,

fluids, elimination)

fluids, elimination)

• Skin condition

• Consideration of

• Exercise of restrained

less restrictive

extremities (when

interventions

awake)

• Signs of injury

• Consideration of less

associated with

restrictive

seclusion

interventions

intervention

• Signs of Injury

• Vital Signs

associated with

• Patient’s response

application of restraint

to restraint

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• Vital Signs

• Behavior indicating

• Patient’s response to

reason for

restraint

continuation of

• Behavior indicating

seclusion

reason for

continuation of

restraint/ seclusion

Assessment and Documentation Guidelines for Restraint/Seclusion Interventions (cont).

Non-violent Behavior: Restraint

Violent and/or Self-destructive Behavior: Restraint

Violent and/or Self-destructive Behavior: Seclusion

Components of Required 2-hour RN Documentation on
Flow sheet

• Basic needs (food, fluids, elimination)
• Skin condition • Patient’s response to
restraint • Exercise of restrained
extremities (when awake) • Consideration of less restrictive interventions • Signs of Injury associated with application of restraint • Vital Signs • Less restrictive interventions attempted/ considered • Behavior indicating reason for continuation of restraint

Maintain hourly documentation of above

Maintain hourly documentation of above

Training Requirements: Staff must be trained and able to demonstrate competency in the application of restraints and seclusion, the assessment, monitoring and care for patients in restraint and/or seclusion at orientation and through an annual competency review.
CMS Mandates Reporting of:: Each death that occurs while a patient is in restraint or seclusion Each death that occurs within 24 hours of restraint or seclusion episode Each death known within 1 week after removal of restraint/seclusion when it is reasonable to assume death was due to restraint/seclusion * A notation must be made in patient medical record if their death is reported to CMS

Vice President Sponsor: Dianne Anderson, Sr VP, Patient Care Services

Responsible Person: Patricia Folcarelli RN, PhD Director of Professional Practice Development

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Approved By:

⌧ Medical Executive Committee: 5/16/07 Original Date Approved: 6/15/05

Mary Anne Badaracco, MD Chair

Revisions: 6/05 (CP-04 divided into 2 policies) 3/07 (in response to New CMS guidelines) 8/08 (in reponse to new CMS guidelines) Has been approved by the
Code Purple/Restraint Committee and is awaiting MEC approval

Next Review Date: 5/10

Eliminated: (Date)

CP-28

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 Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 1 of 15
United States District Court District of Massachusetts (Boston) CIVIL DOCKET FOR CASE #: 1:06−cv−10973−DPW

CLOSED

Sampson v. Beth Israel Deaconess Medical Center et al Assigned to: Judge Douglas P. Woodlock Cause: 42:1218(2) Americans with Disabilities Act
Plaintiff

Date Filed: 06/08/2006 Date Terminated: 03/10/2009 Jury Demand: Both Nature of Suit: 446 Civil Rights: Americans with Disabilities − Other Jurisdiction: Federal Question

Cassandra Sampson

represented by Ira A. Burnim Judge Bazelon Center for Mental Health Law 1101 15th St NW Suite 1212 Washington, DC 20005 202−467−5730 Fax: 202−223−0409 Email: irabster@gmail.com LEAD ATTORNEY ATTORNEY TO BE NOTICED

Karen A. Bower Bazelon Center for Mental Health Law 1101 15th Street N.W. Suite 1212 Washinton, DC 20005 202−467−5730 Fax: 202−223−0409 Email: Karenb@bazelon.org LEAD ATTORNEY ATTORNEY TO BE NOTICED

Steven J. Schwartz Center for Public Representation 22 Green Street Northampton, MA 01060 413−586−6024 Fax: 413−586−5711 Email: sschwartz@cpr−ma.org LEAD ATTORNEY ATTORNEY TO BE NOTICED

Susan Stefan Center for Public Representation 246 Walnut Street Newton, MA 02460 617−965−0776 Fax: 617−928−0971 Email: sstefan@cpr−ma.org LEAD ATTORNEY ATTORNEY TO BE NOTICED

Megan E. Kures Melick, Porter & Shea, LLP 28 State Street Boston, MA 02109 617−523−6200 Fax: 617−523−8130 Email: mkures@hmdrlaw.com ATTORNEY TO BE NOTICED

Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 2 of 15

Scott M. Heidorn Bergstresser & Pollock LLC 4th Floor 52 Temple Place Boston, MA 02111 617−682−9211 Email: scott@bergstresser.com ATTORNEY TO BE NOTICED

V. Defendant Beth Israel Deaconess Medical Center
Defendant Heather A Richter TERMINATED: 06/24/2008

represented by Robert Reid Hamel , Jr. Hamel, Marcin, Dunn and Reardon, PC 24 Federal Street Boston, MA 02110 617−482−0007 Fax: 617−523−8130 Email: rhamel@hmdrslaw.com LEAD ATTORNEY ATTORNEY TO BE NOTICED
Angela L. Linson Litchfield Cavo, LLP 6 Kimball Lane Suite 100 Lynnfield, MA 01940 781−309−1500 Fax: 781−246−0167 Email: linson@litchfieldcavo.com TERMINATED: 07/12/2007 ATTORNEY TO BE NOTICED
John F. Rooney Melick & Porter, LLP 28 State Street Boston, MA 02109−1775 617−523−6200 Fax: 617−523−8130 Email: jrooney@melicklaw.com TERMINATED: 09/21/2006 ATTORNEY TO BE NOTICED
Megan E. Kures (See above for address) ATTORNEY TO BE NOTICED
Robert P. Powers Melick & Porter, LLP 7th Floor One Liberty Square Boston, MA 02109 617−523−6200 Email: rpowers@melicklaw.com ATTORNEY TO BE NOTICED
represented by Curtis L.S. Carpenter Morrison Mahoney LLP 250 Summer Street Boston, MA 02210 617−439−7589

Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 3 of 15

Fax: 617−342−4841 Email: ccarpenter@morrisonmahoney.com ATTORNEY TO BE NOTICED

Robert P. Powers (See above for address) ATTORNEY TO BE NOTICED

William J. Flanagan Morrison, Mahoney, & Miller LLP 250 Summer Street Boston, MA 02210−1181 617−439−7500 Fax: 617−342−4887 Email: jflanagan@morrisonmahoney.com ATTORNEY TO BE NOTICED

Defendant Kelly Corrigan, MD

represented by Megan E. Kures (See above for address) ATTORNEY TO BE NOTICED

Date Filed 06/05/2006 06/05/2006 06/05/2006 06/08/2006
06/23/2006 08/14/2006 08/15/2006 08/17/2006 08/18/2006

# Docket Text
1 COMPLAINT against Beth Israel Deaconess Medical Center, Heather A Richter Filing fee: $ 350, receipt number 72826, filed by Cassandra Sampson. (Attachments: # 1 Exhibit # 2 Civil Cover Sheet)(Nici, Richard) (Entered: 06/08/2006)
If the trial Judge issues an Order of Reference of any matter in this case to a Magistrate Judge, the matter will be transmitted to Magistrate Judge Bowler. (Nici, Richard) (Entered: 06/08/2006)
Summons Issued as to Beth Israel Deaconess Medical Center, Heather A Richter. (Nici, Richard) (Entered: 06/08/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered. ELECTRONIC ORDER REQUIRING ELECTRONIC FILING. It is hereby ORDERED that, unless leave is granted, upon good cause shown, to file paper documents in lieu of electronic filing via this Court's CM/ECF system, ALL future submissions in this case must be electronically filed. Such filings shall be made in accordance with, and subject to, the terms and conditions of electronic filing as set forth by this Court. All parties and counsel who choose to appear in this action must make arrangements to register for participation in electronic case filing, if they have not already done so. It is FURTHER ORDERED that Notices, Orders and Memoranda of the Court will only be filed and served electronically. Once a party or counsel has registered for electronic filing, it is his/her responsibility to monitor his/her e−mail to ensure receipt of electronic notices. Any changes in e−mail addresses must be reported to the Court immediately(Nici, Richard). (Entered: 06/08/2006)
2 WAIVER OF SERVICE Returned Executed Beth Israel Deaconess Medical Center waiver sent on 6/8/2006, answer due 8/7/2006. (Schwartz, Steven) (Entered: 06/23/2006)
3 ANSWER to Complaint with Jury Demand by Beth Israel Deaconess Medical Center.(Rooney, John) (Entered: 08/14/2006)
Summons Reissued as to Heather A Richter. (Nici, Richard) (Entered: 08/15/2006)
4 NOTICE of Appearance by Angela L. Lackard on behalf of Beth Israel Deaconess Medical Center (Lackard, Angela) (Entered: 08/17/2006)
5 NOTICE of Scheduling Conference: Scheduling Conference set for 9/28/2006 03:00 PM in Courtroom 1 before Judge Douglas P. Woodlock. (Rynne, Michelle) (Entered: 08/18/2006)

Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 4 of 15

08/23/2006 09/01/2006 09/13/2006 09/20/2006 09/20/2006 09/22/2006 09/22/2006 09/25/2006 09/28/2006 10/05/2006 10/05/2006 10/06/2006 10/06/2006 10/12/2006
10/16/2006
10/16/2006 10/20/2006 10/25/2006 10/25/2006

6 NOTICE of Appearance by Scott M. Heidorn on behalf of Cassandra Sampson (Heidorn, Scott) (Entered: 08/23/2006)
7 Assented to MOTION to Continue September 28, 2006 Scheduling Conference to October 6, 2006 at 3:00 p.m. by Beth Israel Deaconess Medical Center.(Lackard, Angela) (Entered: 09/01/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 7 Motion to Continue. Scheduling Conference reset for 10/12/2006 03:00 PM in Courtroom 1 before Judge Douglas P. Woodlock. (Rynne, Michelle) (Entered: 09/13/2006)
8 NOTICE of Withdrawal of Appearance by John F. Rooney (Rooney, John) (Entered: 09/20/2006)
9 NOTICE of Appearance by Robert Reid Hamel, Jr on behalf of Beth Israel Deaconess Medical Center (Hamel, Robert) (Entered: 09/20/2006)
10 MOTION for Extension of Time to December 3, 2006 to Serve Process by Cassandra Sampson.(Heidorn, Scott) (Entered: 09/22/2006)
11 MEMORANDUM in Support re 10 MOTION for Extension of Time to December 3, 2006 to Serve Process filed by Cassandra Sampson. (Attachments: # 1 Affidavit Declaration of Diligence)(Heidorn, Scott) (Entered: 09/22/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 10 Motion for Extension of Time to 12/3/06 to serve process. (Rynne, Michelle) (Entered: 09/25/2006)
12 Assented to MOTION for Referral to Medical Tribunal in Suffolk Superior Court by Beth Israel Deaconess Medical Center.(Lackard, Angela) (Entered: 09/28/2006)
13 JOINT STATEMENT of counsel. (Attachments: # 1 Certification by Plaintiff)(Stefan, Susan) (Entered: 10/05/2006)
14 CERTIFICATE OF CONSULTATION Pursuant to Local Rule 16.1(D)(3). (Lackard, Angela) (Entered: 10/05/2006)
15 NOTICE of Appearance by William J. Flanagan on behalf of Heather A Richter (Flanagan, William) (Entered: 10/06/2006)
16 NOTICE of Appearance by Curtis L.S. Carpenter on behalf of Heather A Richter (Carpenter, Curtis) (Entered: 10/06/2006)
ElectronicClerk's Notes for proceedings held before Judge Douglas P. Woodlock : Scheduling Conference held on 10/12/2006, 12 Assented to MOTION for Referral to Medical Tribunal in Suffolk Superior Court − Allowed. Discovery will go forward parallel to the Medical Malpractice Tribunal. Parties shall submit proposed protective order by 10/27/06. Plaintiff may file motion to compel regarding peer review by 10/31/06. Defendant may respond by 11/14/06. Schedule set: Fact discovery completed by 6/29/07. Plaintiff's expert reports disclosed by 7/17/07. Defendant's expert reports disclosed by 8/14/07. Expert depositions completed by 9/28/07. Motions for summary judgment due by 11/10/07. (Court Reporter D.Joyce.) (Rynne, Michelle) (Entered: 10/12/2006)
17 Judge Douglas P. Woodlock : ORDER entered. SCHEDULING ORDER: Further Scheduling/Status Conference set for 12/20/2007 02:30 PM in Courtroom 1 before Judge Douglas P. Woodlock. Discovery to be completed by 6/29/2007. Motions due by 11/10/2007. Status report due 12/13/07.(Rynne, Michelle) (Entered: 10/16/2006)
18 Judge Douglas P. Woodlock : ORDER entered. ORDER REFERRING CASE to Medical Tribunal.(Rynne, Michelle) (Entered: 10/16/2006)
19 First MOTION for Referral to Medical Tribunal by Heather A Richter.(Flanagan, William) (Entered: 10/20/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 19 Motion for Referral to Medical Tribunal. (Rynne, Michelle) (Entered: 10/25/2006)
20 Judge Douglas P. Woodlock : ORDER entered. ORDER REFERRING CASE to Medical Tribunal re: Heather A. Richter.(Rynne, Michelle) (Entered: 10/25/2006)

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10/26/2006 10/27/2006 10/31/2006 10/31/2006
10/31/2006 11/08/2006 11/13/2006 11/17/2006
11/17/2006
11/20/2006 11/21/2006 11/21/2006 11/22/2006 11/22/2006 11/27/2006
11/27/2006

21 NOTICE of Appearance by Megan E. Kures on behalf of Beth Israel Deaconess Medical Center (Kures, Megan) (Entered: 10/26/2006)
22 MOTION for Protective Order by Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit)(Kures, Megan) (Entered: 10/27/2006)
23 MOTION to Compel DISCLOSURE OF DEFENDANT BETH ISRAEL DEACONESS MEDICAL CENTER?S PEER REVIEW DOCUMENTS by Cassandra Sampson.(Heidorn, Scott) (Entered: 10/31/2006)
24 MEMORANDUM in Support re 23 MOTION to Compel DISCLOSURE OF DEFENDANT BETH ISRAEL DEACONESS MEDICAL CENTER?S PEER REVIEW DOCUMENTS filed by Cassandra Sampson. (Attachments: # 1 Exhibit Attachment A (Letter from Robert Hamel to Susan Stefan, October 12, 2006))(Heidorn, Scott) (Entered: 10/31/2006)
25 Judge Douglas P. Woodlock : ORDER entered. PROTECTIVE ORDER(Nici, Richard) (Entered: 11/01/2006)
26 Defendant's ANSWER to Complaint and Jury Demand by Heather A Richter.(Flanagan, William) (Entered: 11/08/2006)
27 MOTION for Extension of Time to File Opposition to Plaintiff's motion for Order Compelling Production of Peer Review Documents by Beth Israel Deaconess Medical Center.(Kures, Megan) (Entered: 11/13/2006)
28 Opposition re 23 MOTION to Compel DISCLOSURE OF DEFENDANT BETH ISRAEL DEACONESS MEDICAL CENTER?S PEER REVIEW DOCUMENTS Opposition to Plaintiff's Motion to Compel Production of Peer Review Documents filed by Beth Israel Deaconess Medical Center, Heather A Richter. (Attachments: # 1 # 2 # 3 # 4 # 5 # 6 # 7 # 8 # 9 # 10)(Powers, Robert) (Entered: 11/17/2006)
29 DUPLICATE ENTRY OF #28 Opposition re 23 MOTION to Compel DISCLOSURE OF DEFENDANT BETH ISRAEL DEACONESS MEDICAL CENTER?S PEER REVIEW DOCUMENTS Opposition to Plaintiff's Motion to Compel Production of Peer Review Documents filed by Beth Israel Deaconess Medical Center, Heather A Richter. (Attachments: # 1 # 2 # 3 # 4 # 5 # 6 # 7 # 8 # 9 # 10)(Powers, Robert) Modified on 11/21/2006 (Nici, Richard). (Entered: 11/17/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 27 Motion for Extension of Time to file opposition, nunc pro tunc. (Rynne, Michelle) (Entered: 11/20/2006)
30 MOTION for Leave to File Reply to Defendant's Opposition to Plaintiff's Motion to Disclose by Cassandra Sampson. (Attachments: # 1 Reply to Defendant's Opposition to Plaintiff's Motion to Disclose)(Stefan, Susan) (Entered: 11/21/2006)
31 MOTION for Leave to Appear Pro Hac Vice for admission of Karen Bower by Cassandra Sampson. (Attachments: # 1 Affidavit)(Stefan, Susan) (Entered: 11/21/2006)
32 NOTICE of Appearance by Robert P. Powers on behalf of Beth Israel Deaconess Medical Center, Heather A Richter (Powers, Robert) (Entered: 11/22/2006)
33 NOTICE of Appearance by Robert P. Powers on behalf of Beth Israel Deaconess Medical Center (Powers, Robert) (Entered: 11/22/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 30 Motion for Leave to File; Counsel using the Electronic Case Filing System should now file the document for which leave to file has been granted in accordance with the CM/ECF Administrative Procedures. Counsel must include − Leave to file granted on (date of order)− in the caption of the document. (Rynne, Michelle) (Entered: 11/27/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered. REFERRING MOTION 23 MOTION to Compel DISCLOSURE OF DEFENDANT BETH ISRAEL DEACONESS MEDICAL CENTER'S PEER REVIEW DOCUMENTS filed by Cassandra Sampson, to Magistrate Judge Marianne B. Bowler(Rynne, Michelle) (Entered: 11/27/2006)

Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 6 of 15

11/27/2006 11/28/2006 11/28/2006 11/29/2006 11/29/2006 11/29/2006
11/30/2006 12/13/2006 12/21/2006
01/03/2007 01/16/2007 01/16/2007 01/22/2007 02/09/2007 02/09/2007 02/09/2007
02/09/2007 02/12/2007

34 REPLY to Response to Motion re 23 MOTION to Compel DISCLOSURE OF DEFENDANT BETH ISRAEL DEACONESS MEDICAL CENTER?S PEER REVIEW DOCUMENTS filed by Cassandra Sampson. (Stefan, Susan) (Entered: 11/27/2006)
ELECTRONIC NOTICE of Hearing on Motion. Hearing on 23 MOTION to Compel set for 12/7/2006 at 2:30 PM in Courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 11/28/2006)
35 Opposition re 31 MOTION for Leave to Appear Pro Hac Vice for admission of Karen Bower filed by Heather A Richter. (Carpenter, Curtis) (Entered: 11/28/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 31 Motion for Leave to Appear Pro Hac Vice Added Karen A. Bower for Cassandra Sampson (Nici, Richard)Receipt# 76645 $50 (Entered: 11/29/2006)
36 Assented to MOTION to Continue Motion to Disclose Beth Israel's Peer Review Records to 12/11/06 or 12/21/06 by Cassandra Sampson.(Stefan, Susan) (Entered: 11/29/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered. re 31 MOTION for Leave to Appear Pro Hac Vice for admission of Karen Bower filed by Cassandra Sampson. Motion is ALLOWED, over the remarkable objection of defendant Richter seeking to instruct plaintiff and the court how and by whom plaintiff should be respresented among qualified attorneys. (Rynne, Michelle) (Entered: 11/30/2006)
Judge Marianne B. Bowler: Electronic ORDER entered granting 36 Motion to Continue. The hearing is continued until December 21, 2006 at 10:00 a.m. (Bowler, Marianne) (Entered: 11/30/2006)
37 MOTION for Leave to Appear Pro Hac Vice for admission of Ira A. Burnim by Cassandra Sampson. (Attachments: # 1)(Stefan, Susan) (Entered: 12/13/2006)
ElectronicClerk's Notes for proceedings held before Judge Marianne B. Bowler: Motion Hearing held on 12/21/2006 as to 23 MOTION to Compel. Attorney Stefan for the Pltf. and Attorneys Powers and Carpenter for the Defts. The motion is taken under advisement. (Duffy, Marc) (Entered: 12/21/2006)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 37 Motion for Leave to Appear Pro Hac Vice Added Ira A Burnim for Cassandra Sampson (Nici, Richard)Receipt #77143 $50 (Entered: 01/03/2007)
38 MOTION for Leave to File Supplemental Motion by Cassandra Sampson. (Attachments: # 1 Exhibit Interrogatory Responses)(Stefan, Susan) (Entered: 01/16/2007)
39 MEMORANDUM in Support re 38 MOTION for Leave to File Supplemental Motion filed by Cassandra Sampson. (Stefan, Susan) (Entered: 01/16/2007)
40 Opposition re 38 MOTION for Leave to File Supplemental Motion filed by Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A)(Kures, Megan) (Entered: 01/22/2007)
41 MOTION to Amend Complaint by Cassandra Sampson.(Stefan, Susan) (Entered: 02/09/2007)
42 MEMORANDUM in Support re 41 MOTION to Amend Complaint filed by Cassandra Sampson. (Attachments: # 1 Exhibit)(Stefan, Susan) (Entered: 02/09/2007)
43 AMENDED COMPLAINT against all defendants Beth Israel Deaconess Medical Center, Heather A. Richter, Dr. Kelly Corrigan, filed by Cassandra Sampson. (Attachments: # 1 Amended Complaint second half)(Stefan, Susan) (Entered: 02/09/2007)
44 CERTIFICATE of Compliance pursuant to Local Rule 15.1(b) by Cassandra Sampson. (Stefan, Susan) (Entered: 02/09/2007)
45 Opposition re 41 MOTION to Amend Complaint filed by Heather A Richter. (Carpenter, Curtis) (Entered: 02/12/2007)

Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 7 of 15

02/16/2007 02/20/2007
02/20/2007 02/22/2007 02/22/2007 02/22/2007 02/22/2007 02/22/2007 03/02/2007 03/04/2007
03/05/2007 03/06/2007 03/06/2007

46 MOTION for Leave to File Reply to Heather Richter's Opposition to her Motion for Leave to File Amended Complaint by Cassandra Sampson. (Attachments: # 1 Exhibit A)(Heidorn, Scott) (Entered: 02/16/2007)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 46 Motion for Leave to File Reply to Heather Richter's Opposition to her Motion for Leave to File Amended Complaint; Counsel using the Electronic Case Filing System should now file the document for which leave to file has been granted in accordance with the CM/ECF Administrative Procedures. Counsel must include − Leave to file granted on (date of order)− in the caption of the document. (Rynne, Michelle) (Entered: 02/20/2007)
Judge Douglas P. Woodlock : Electronic ORDER entered. REFERRING CASE to Magistrate Judge Marianne B. Bowler Referred for: Full pretrial and Report and Recommendation on dispositive motions.(Rynne, Michelle) (Entered: 02/20/2007)
47 Opposition re 41 MOTION to Amend Complaint filed by Beth Israel Deaconess Medical Center. (Kures, Megan) (Entered: 02/22/2007)
ELECTRONIC NOTICE of Hearing on Motion. Hearing on 41 MOTION to Amend Complaint set for 3/15/2007 at 2:30 PM in courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 02/22/2007)
48 REPLY to Response to Motion re 41 MOTION to Amend Complaint filed by Cassandra Sampson. (Heidorn, Scott) (Entered: 02/22/2007)
49 MOTION to Compel Responses to Interrogatories by Cassandra Sampson. (Attachments: # 1 Exhibit Attachment 1# 2 Exhibit Attachment 2)(Stefan, Susan) (Entered: 02/22/2007)
50 MEMORANDUM in Support re 49 MOTION to Compel Responses to Interrogatories filed by Cassandra Sampson. (Attachments: # 1 Part two of memo)(Stefan, Susan) (Entered: 02/22/2007)
51 MOTION for Leave to File A Reply to Beth Israel Deaconess Medical Center's and Kelly Corrigan's Opposition to her Motion for Leave to Amend Complaint by Cassandra Sampson. (Attachments: # 1 Exhibit A)(Heidorn, Scott) (Entered: 03/02/2007)
Judge Marianne B. Bowler: Electronic ORDER entered granting 38 Motion for Leave to File and denying 23 Motion to Compel, without prejudice to be renewed at a later date. Federal law applies in determining whether to recognize a medical peer review privilege in a federal question case. See F.R.E. 501; Krolikowski v. Univ. of Mass., 150 F.Supp.2d 246, 248 (D.Mass. 2001). Massachusetts state law undeniably recognizes a medical peer review privilege. Mass. Gen. L. ch. 111, section 204. Whether to recognize the privilege therefore turns upon an evaluation of the four factors set forth in In re Hampers, 651 F.2d. 19, 23−24 (1st Cir. 1981). See In re Admin Subpoena Blue Cross Blue Shield of Massachusetts, Inc., 400 F.Supp.2d 386, 391 (D.Mass 2005). Although "the Massachusetts medical peer review privilege satisfies the first three elements" under Hamper, Id., it is premature to evaluate the fourth factor inasmuch as the parties have not completed depositions (Docket Entry # 40, p. 2) that might provide information similar to that sought by plaintiff. Cf. In re Admin Subpoena Blue Cross Blue Shield of Massachusetts, Inc., 400 F.Supp.2d at 392 (noting that "nothing in the record indicates that the government could easily get the information elsewhere"). (Bowler, Marianne) (Entered: 03/04/2007)
52 REPLY to Response to Motion re 41 MOTION to Amend Complaint filed by Cassandra Sampson. (Heidorn, Scott) (Entered: 03/05/2007)
53 MOTION for Protective Order For the Deposition of Cassandra Sampson by Cassandra Sampson.(Heidorn, Scott) (Entered: 03/06/2007)
54 MEMORANDUM in Support re 53 MOTION for Protective Order For the Deposition of Cassandra Sampson filed by Cassandra Sampson. (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E# 6 Exhibit F)(Heidorn, Scott) (Entered: 03/06/2007)

Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 8 of 15

03/06/2007 03/08/2007 03/08/2007
03/09/2007 03/13/2007 03/15/2007 03/22/2007
03/22/2007 03/22/2007 03/22/2007 03/22/2007 03/22/2007 03/29/2007 03/29/2007 04/02/2007

55 MOTION for Extension of Time to March 22, 2007 to File Response/Reply by Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A)(Kures, Megan) (Entered: 03/06/2007)
56 Opposition re 53 MOTION for Protective Order For the Deposition of Cassandra Sampson filed by Heather A Richter. (Attachments: # 1 Exhibit # 2 Exhibit)(Flanagan, William) (Entered: 03/08/2007)
57 Opposition re 49 MOTION to Compel Responses to Interrogatories filed by Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E# 6 Exhibit F# 7 Exhibit G# 8 Exhibit H# 9 Exhibit I# 10 Exhibit J)(Kures, Megan) Additional attachment(s) added on 3/9/2007 (Nici, Richard). (Entered: 03/08/2007)
Notice of correction to docket made by Court staff. Correction: entry #57 corrected because: the opposition was missing page #2 (Nici, Richard). (Entered: 03/09/2007)
58 STIPULATION by Heather A Richter. (Flanagan, William) (Entered: 03/13/2007)
Electronic Clerk's Notes for proceedings held before Judge Marianne B. Bowler: Motion Hearing held on 3/15/2007 as to 41 MOTION to Amend Complaint and 53 MOTION for Protective Order. Motion 41 taken under advisement, ruling as to 53 as stated on the record in open court. (Duffy, Marc) (Entered: 03/15/2007)
Judge Marianne B. Bowler: Electronic ORDER entered granting in part and denying in part 41 Motion to Amend; granting 51 Motion for Leave to File; and granting 55 Motion for Extension of Time to File Response/Reply re 41 MOTION to Amend, nunc pro tunc. Docket Entry # 41 is denied as to the chapter 93A claim for the reasons stated in section III, Part A, of the hospital's and Dr. Corrigan's opposition (Docket Entry # 47) as well as in the opposition of Nurse Richter (Docket Entry # 45). Having reviewed the relevant case law, the allegations in this case do not set forth the necessary and required entrepreneurial and business aspects as discussed by the SJC in Darviris v. Petros, 812 N.E. 2d 1188, 1193−96 (Mass. 2006). The motion is allowed as to adding Dr. Corrigan. Without more, Dr. Corrigan's status as the attending physician on the date of the incident does not reveal her specific role in the incident. The plaintiff shall file an amended complaint on or before April 2, 2007. (Bowler, Marianne) (Entered: 03/22/2007)
ELECTRONIC NOTICE of Hearing on Motion. Hearing on 49 MOTION to Compel set for 3/29/2007 at 2:30 PM in Courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 03/22/2007)
59 MOTION to Compel Production of Documents by Cassandra Sampson.(Heidorn, Scott) (Entered: 03/22/2007)
60 MEMORANDUM in Support re 59 MOTION to Compel Production of Documents filed by Cassandra Sampson. (Attachments: # 1 Exhibit 1# 2 Exhibit 2# 3 Exhibit 3)(Heidorn, Scott) (Entered: 03/22/2007)
61 First AMENDED COMPLAINT against all defendants, filed by Cassandra Sampson.(Heidorn, Scott) (Entered: 03/22/2007)
Judge Marianne B. Bowler: Electronic ORDER entered granting in part and denying in part 53 Motion for Protective Order, to the extent that the deposition of the plaintiff is not to be noticed for a date prior to March 26, 2007. (Bowler, Marianne) (Entered: 03/22/2007)
Electronic Clerk's Notes for proceedings held before Judge Marianne B. Bowler: Motion Hearing held on 3/29/2007 as to 49 MOTION to Compel. Rulings made as stated on the record in open court. (Duffy, Marc) (Entered: 03/29/2007)
Judge Marianne B. Bowler: Electronic ORDER entered granting in part and denying in part 49 Motion to Compel, in accordance with rulings made on the record in open court on this date. (Bowler, Marianne) (Entered: 03/29/2007)
62 MOTION to Correct 61 Amended Complaint by Cassandra Sampson. (Attachments: # 1 Exhibit A)(Heidorn, Scott) (Entered: 04/02/2007)

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04/05/2007 04/05/2007 04/05/2007 04/05/2007 04/06/2007 04/10/2007
04/18/2007 05/01/2007 05/02/2007 05/03/2007 05/08/2007
06/05/2007
06/12/2007 06/13/2007 06/13/2007

63 MOTION for Extension of Time to File Response/Reply Memorandum in Support of Objections to Magistrate's Ruling on Plaintiff's Motion to Compel Responses to Interrogatories by Cassandra Sampson.(Stefan, Susan) (Entered: 04/05/2007)
64 Objection by Cassandra Sampson to Magistrate's Ruling. (Stefan, Susan) (Entered: 04/05/2007)
65 Opposition re 59 MOTION to Compel Production of Documents filed by Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A)(Kures, Megan) (Entered: 04/05/2007)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 63 Motion for Extension of Time to File Memorandum in Support of Objections to Magistrate's Ruling on Plaintiff's Motion to Compel Responses to Interrogatories. Memorandum due 4/18/07. (Rynne, Michelle) (Entered: 04/05/2007)
ELECTRONIC NOTICE of Hearing on Motion: Hearing on 59 MOTION to Compel set for 5/1/2007 at 2:30 PM in Courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 04/06/2007)
66 TRANSCRIPT of Motion Hearing held on March 29, 2007 before Judge Bowler. Digital Recording: Transcribed by Maryann Young. The original transcripts are maintained in the case file in the Clerk's Office. Copies may be obtained by contacting Maryann Young at 508/384−2003 or the Clerk's Office. (Scalfani, Deborah) (Entered: 04/10/2007)
67 Objection by Cassandra Sampson Memorandum in Support of Objections to Magistrate's Ruling Denying Motion to Compel Responses to Interrogatories. (Attachments: # 1 Exhibit Excerpts from Edlow deposition)(Stefan, Susan) (Entered: 04/18/2007)
Electronic Clerk's Notes for proceedings held before Judge Marianne B. Bowler: Motion Hearing held on 5/1/2007 as to 59 MOTION to Compel. Rulings made as stated on the record in open court. (Duffy, Marc) (Entered: 05/01/2007)
68 MOTION for Extension of Time to Complete Discovery by Beth Israel Deaconess Medical Center.(Kures, Megan) (Entered: 05/02/2007)
69 Objection to 64 Objection by Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit a)(Kures, Megan) (Entered: 05/03/2007)
70 MOTION for Leave to File Reply to Defendant's Opposition to Plaintiff's Objections to Magistrate's Order by Cassandra Sampson. (Attachments: # 1 Attachment A Plaintiff's Reply to Defendant's Opposition to Objections to Magistrate's Order# 2 Exhibit 1# 3 Exhibit 2# 4 Exhibit 3# 5 Exhibit 4# 6 Exhibit 5# 7 Exhibit 6)(Stefan, Susan) (Entered: 05/08/2007)
ELECTRONIC NOTICE issued requesting courtesy copy for 69 Objection, 64 Objection, 65 Opposition to Motion, 70 MOTION for Leave to File Reply to Defendant's Opposition to Plaintiff's Objections to Magistrate's Order, 62 MOTION to Correct 61 Amended Complaint, 68 MOTION for Extension of Time to Complete Discovery. Counsel who filed this document are requested to submit a courtesy copy of this document (or documents) to the Clerk's Office by. These documents must be clearly marked as a Courtesy Copy and reflect the document number assigned by CM/ECF. (Nici, Richard) (Entered: 06/05/2007)
71 STIPULATION by Cassandra Sampson, Beth Israel Deaconess Medical Center, Heather A Richter. (Heidorn, Scott) (Entered: 06/12/2007)
Judge Marianne B. Bowler: Electronic ORDER entered granting 62 Motion to Correct and granting 68 Motion for Extension of Time to Complete Discovery. (Bowler, Marianne) (Entered: 06/13/2007)
72 Judge Marianne B. Bowler : ORDER entered. MEMORANDUM AND ORDER RE: PLAINTIFF'S MOTION TO COMPEL RESPONSES TO DOCUMENT REQUESTS,(DOCKET ENTRY #59)is ALLOWED inasmuch as the hospital's assertion of the medical peer review privilege is no longer well taken.(Feeney, Eileen) (Entered: 06/13/2007)

Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 10 of 15

06/13/2007 06/13/2007 06/18/2007 06/28/2007 07/02/2007 07/02/2007 07/03/2007 07/03/2007 07/06/2007 07/06/2007 07/11/2007 07/12/2007 07/20/2007
07/30/2007 07/30/2007 07/30/2007
08/06/2007 08/07/2007 08/13/2007

ELECTRONIC NOTICE of Hearing: Status Conference set for 8/16/2007 T 2:30 PM in Courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 06/13/2007)
73 Second AMENDED COMPLAINT against Kelly Corrigan, MD, Beth Israel Deaconess Medical Center, Heather A Richter, filed by Cassandra Sampson.(Heidorn, Scott) (Entered: 06/13/2007)
74 ANSWER to Amended Complaint by Heather A Richter.(Carpenter, Curtis) (Entered: 06/18/2007)
75 Joint MOTION Revised Scheduling Order To Reflect Court's Order Extending Discovery by Kelly Corrigan, MD, Cassandra Sampson, Beth Israel Deaconess Medical Center, Heather A Richter.(Stefan, Susan) (Entered: 06/28/2007)
Set/Reset Hearings: Further Status and Scheduling Conference set for 12/20/2007 02:30 PM in Courtroom 1 before Judge Douglas P. Woodlock. (Lovett, Jarrett) (Entered: 07/02/2007)
76 MOTION for Protective Order Concerning Peer Review Materials by Kelly Corrigan, MD, Cassandra Sampson, Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A)(Kures, Megan) (Entered: 07/02/2007)
77 ANSWER to Amended Complaint by Kelly Corrigan, MD, Beth Israel Deaconess Medical Center.(Kures, Megan) (Entered: 07/03/2007)
Judge Douglas P. Woodlock : Electronic ORDER entered granting 75 Motion (Nici, Richard) (Entered: 07/03/2007)
78 MOTION for Leave to File Supplemental Memorandum by Cassandra Sampson. (Attachments: # 1 Supplement Memorandum in Support of Objections# 2 Exhibit Exhibit 1 to Supplemental Memorandum)(Stefan, Susan) (Entered: 07/06/2007)
79 SUMMONS Returned Executed Kelly Corrigan, MD served on 7/2/2007, answer due 7/23/2007. (Nici, Richard) (Entered: 07/09/2007)
Judge Marianne B. Bowler: Electronic ORDER entered granting 76 Motion for Protective Order. (Bowler, Marianne) (Entered: 07/11/2007)
80 NOTICE of Withdrawal of Appearance by Angela L. Lackard (Lackard, Angela) (Entered: 07/12/2007)
81 MOTION for Order to to obtain records from Caritas Carney Hospital and Solomon Carter Fuller Mental Health Center by Kelly Corrigan, MD, Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A# 2 Exhibit B)(Kures, Megan) (Entered: 07/20/2007)
82 MOTION for Protective Order by Kelly Corrigan, MD, Beth Israel Deaconess Medical Center.(Kures, Megan) Additional attachment(s) added on 7/30/2007 (Nici, Richard). (Entered: 07/30/2007)
83 MEMORANDUM in Support re 82 MOTION for Protective Order filed by Kelly Corrigan, MD, Beth Israel Deaconess Medical Center. (Attachments: # 1 # 2 # 3 # 4 # 5 # 6 # 7 # 8)(Kures, Megan) (Entered: 07/30/2007)
Notice of correction to docket made by Court staff. Correction: docket entry #82 corrected because: the memorandum was scanned with the motion. The memorandum was deleted so that only the motion remained. The memorandum is #83. (Nici, Richard) (Entered: 07/30/2007)
84 Opposition re 82 MOTION for Protective Order filed by Cassandra Sampson. (Attachments: # 1 Exhibit Transcript from Joshua Wallace's Deposition)(Heidorn, Scott) (Entered: 08/06/2007)
ELECTRONIC NOTICE of Hearing on Motion. Hearing on 82 MOTION for Protective Order set for 8/16/2007 at 2:30 PM in Courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 08/07/2007)
ELECTRONIC NOTICE OF RESCHEDULING: The Status Conference and Hearing on MOTION for Protective Order 82 previously scheduled for 8/16/2007 at 2:30 PM

Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 11 of 15

08/16/2007
08/16/2007
08/17/2007 08/20/2007 09/12/2007 09/14/2007 09/14/2007 09/24/2007 09/24/2007 10/01/2007 10/12/2007 10/12/2007 10/17/2007
10/17/2007
10/26/2007 11/30/2007

in Courtroom 25 before Magistrate Judge Marianne B. Bowler is hereby rescheduled to 11:00 AM. Please note that this is a change in time ONLY. (Duffy, Marc) (Entered: 08/13/2007)
Electronic Clerk's Notes for proceedings held before Judge Marianne B. Bowler: Status Conference held on 8/16/2007. Close of discovery extended to 9/28/2007, at the request of Deft.'s counsel. Further Status Conference set for 10/2/2007 at 2:30 PM. Hearing as to MOTION for Protective Order 82 held, ruling made as stated on the record in open court. (Duffy, Marc) (Entered: 08/16/2007)
Judge Marianne B. Bowler: Electronic ORDER entered granting 81 Motion for Order, there being no opposition, and granting in part and denying in part 82 Motion for Protective Order, to the extent that the plaintiff may propose two written deposition questions to Joshua Wallace covering the subject matter set forth on the record in open court on this date. (Bowler, Marianne) (Entered: 08/16/2007)
85 Proposed Document(s) submitted by Beth Israel Deaconess Medical Center. Document received: Proposed Orders. (Kures, Megan) (Entered: 08/17/2007)
86 Judge Marianne B. Bowler: ORDER of production entered. (Duffy, Marc) Additional attachment(s) added on 8/20/2007 (Duffy, Marc). (Entered: 08/20/2007)
87 FINDINGS of the Medical Tribunal (Nici, Richard) (Entered: 09/12/2007)
88 MOTION to Compel Inspection of the Scene by Cassandra Sampson.(Stefan, Susan) (Entered: 09/14/2007)
89 MEMORANDUM in Support re 88 MOTION to Compel Inspection of the Scene filed by Cassandra Sampson. (Attachments: # 1 Exhibit 1# 2 Exhibit 2# 3 Exhibit 3)(Stefan, Susan) (Entered: 09/14/2007)
ELECTRONIC NOTICE OF RESCHEDULING. The status conference previously set for 10/2/2007 is hereby rescheduled to 10/17/2007 at 2:00 PM. (Duffy, Marc) (Entered: 09/24/2007)
90 Opposition re 88 MOTION to Compel Inspection of the Scene filed by Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E)(Kures, Megan) (Entered: 09/24/2007)
91 MOTION for Leave to File Reply to Opposition to Motion to Compel Expert Tour by Cassandra Sampson. (Attachments: # 1 Exhibit 1# 2 Exhibit 2)(Stefan, Susan) (Entered: 10/01/2007)
Judge Marianne B. Bowler: Electronic ORDER entered granting 91 Motion for Leave to File. (Bowler, Marianne) (Entered: 10/12/2007)
92 REPLY to Response to Motion re 88 MOTION to Compel Inspection of the Scene filed by Cassandra Sampson. (Attachments: # 1 Exhibit)(Stefan, Susan) (Entered: 10/12/2007)
Electronic Clerk's Notes for proceedings held before Judge Marianne B. Bowler: Motion Hearing held on 10/17/2007 as to 88 MOTION to Compel. Ruling made as stated on the record in open court. Discovery schedule updated: Pltf.'s expert disclosures due by 1/15/2008, Deft.'s expert disclosures due by 2/15/2008. Further Status Conference set for 12/11/2007 at 2:30 PM. (Duffy, Marc) (Entered: 10/17/2007)
Judge Marianne B. Bowler: Electronic ORDER entered denying 88 Motion to Compel without prejudice after hearing. The motion may be renewed after plaintiff's counsel reviews of the blueprints, photographs and computer simulations and provides this court with a further showing of need supported by an affidavit of plaintiff's expert. (Bowler, Marianne) (Entered: 10/17/2007)
93 MOTION for Order to To obtain records from Massachusetts General Hospital by Kelly Corrigan, MD, Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A)(Kures, Megan) (Entered: 10/26/2007)
94 MOTION to Compel Production of Documents and Response to Interrogatories by Cassandra Sampson.(Stefan, Susan) (Entered: 11/30/2007)

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11/30/2007
11/30/2007 12/11/2007 12/12/2007
12/12/2007 12/13/2007 12/14/2007 01/25/2008 01/28/2008 02/01/2008 02/01/2008
02/04/2008 02/04/2008 02/11/2008 03/13/2008 03/13/2008

95 MEMORANDUM in Support re 59 MOTION to Compel Production of Documents, 88 MOTION to Compel Inspection of the Scene, 94 MOTION to Compel Production of Documents and Response to Interrogatories, 49 MOTION to Compel Responses to Interrogatories filed by Cassandra Sampson. (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C)(Stefan, Susan) (Entered: 11/30/2007)
96 NOTICE by Cassandra Sampson re 95 Memorandum in Support of Motion, Of Filing with Clerk's Office (Stefan, Susan) (Entered: 11/30/2007)
Electronic Clerk's Notes for proceedings held before Judge Marianne B. Bowler: Status Conference held on 12/11/2007. The court allows MOTION 93 , there being no opposition. The Pltf. agrees to withdraw MOTION 94 , without prejudice. Further Status Conference set for 3/13/2008 at 2:30 PM. (Duffy, Marc) (Entered: 12/11/2007)
ELECTRONIC NOTICE Cancelling Hearing. Hearing cancelled: Further Scheduling/Status Conference set for 12/20/2007 02:30 PM in Courtroom 1 before Judge Douglas P. Woodlock is hereby cancelled in light of the Further Status Conference set for 3/13/2008 before Magistrate Judge Marianne B. Bowler (Lovett, Jarrett) (Entered: 12/12/2007)
Judge Marianne B. Bowler: Electronic ORDER entered finding as moot 70 Motion for Leave to File; finding as moot 78 Motion for Leave to File; granting 93 Motion for Order, there being no opposition and withdrawing 94 Motion to Compel, without prejudice to be renewed at a later date. (Bowler, Marianne) (Entered: 12/12/2007)
97 Joint MOTION for Extension of Time to 02/28/08 to Complete Discovery − Expert Disclosures − by Cassandra Sampson.(Heidorn, Scott) (Entered: 12/13/2007)
Judge Marianne B. Bowler: Electronic ORDER entered granting 97 Motion for Extension of Time to Complete Discovery. (Bowler, Marianne) (Entered: 12/14/2007)
98 MOTION for Extension of Time to March 28, 2008 to Serve Expert Reports, MOTION for Settlement Conference ( Responses due by 2/8/2008) by Cassandra Sampson.(Heidorn, Scott) (Entered: 01/25/2008)
ELECTRONIC NOTICE of Hearing on Motion. Hearing on 98 MOTION for Extension of Time/MOTION for Settlement Conference set for 2/1/2008 at 2:30 PM in Courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 01/28/2008)
Magistrate Judge Marianne B. Bowler: Electronic ORDER entered granting 98 Motion for Extension of Time 98 and granting Motion for Expedited Status Conference. (Bowler, Marianne) Modified text on 2/4/2008 (Seelye, Terri). (Entered: 02/01/2008)
Electronic Clerk's Notes for proceedings held before Magistrate Judge Marianne B. Bowler: Motion Hearing held on 2/1/2008 re 98 MOTION for Extension of Time and for Settlement Conference. The court allows MOTION 98 , there being no opposition. The court sets expert discovery schedule. Pltf. experts by 3/28/2008, Deft. experts by 4/28/2008. Close of all expert discovery 6/6/2008. Further Status Conference set for 6/11/2008 at 2:30 PM. (Duffy, Marc) (Entered: 02/01/2008)
99 MOTION to Compel Inspection by Cassandra Sampson.(Stefan, Susan) (Entered: 02/04/2008)
100 MEMORANDUM in Support re 99 MOTION to Compel Inspection, 94 MOTION to Compel Production of Documents and Response to Interrogatories filed by Cassandra Sampson. (Attachments: # 1 Exhibit Joel Dvoskin)(Stefan, Susan) (Entered: 02/04/2008)
101 Opposition re 99 MOTION to Compel Inspection filed by Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A)(Kures, Megan) (Entered: 02/11/2008)
102 STIPULATION Regarding Expert Discovery by Kelly Corrigan, MD, Cassandra Sampson, Beth Israel Deaconess Medical Center, Heather A Richter. (Heidorn, Scott) (Entered: 03/13/2008)
Electronic Clerk's Notes for proceedings held before Magistrate Judge Marianne B. Bowler: Motion Hearing held on 3/13/2008 re 99 MOTION to Compel. The court ALLOWS motion 99 to the extent stated on the record in open court. Status

Case: 1:06-cv-10973-DPW As of: 07/30/2017 09:25 PM EDT 13 of 15

03/13/2008 03/28/2008 05/13/2008
06/05/2008
06/05/2008 06/09/2008 06/10/2008 06/18/2008 06/20/2008 06/23/2008 06/24/2008 06/26/2008 06/27/2008 06/27/2008 08/18/2008
09/24/2008 10/07/2008 10/14/2008

Conference set for 5/13/2008 at 2:30 PM. (Duffy, Marc) (Entered: 03/13/2008)
Magistrate Judge Marianne B. Bowler: Electronic ORDER entered granting 99 Motion to Compel, after hearing. The motion is allowed to the limited extent set forth on the record in open court. (Bowler, Marianne) (Entered: 03/13/2008)
103 STIPULATION Regarding Disclosure of Experts by Kelly Corrigan, MD, Cassandra Sampson, Beth Israel Deaconess Medical Center, Heather A Richter. (Heidorn, Scott) (Entered: 03/28/2008)
Electronic Clerk's Notes for proceedings held before Magistrate Judge Marianne B. Bowler: Status Conference held on 5/13/2008. Parties to depose experts by 7/18/2008. Further Status Conference set for 8/18/2008 at 2:30 PM in Courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 05/13/2008)
104 Emergency MOTION for Discovery Reopening by Cassandra Sampson. (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D, # 5 Exhibit E, # 6 Exhibit F, # 7 Exhibit G, # 8 Exhibit H, # 9 Exhibit I, # 10 Exhibit J, # 11 Exhibit K, # 12 Exhibit L, # 13 Exhibit M, # 14 Exhibit N)(Stefan, Susan) (Entered: 06/05/2008)
105 Emergency MEMORANDUM in Support re 104 Emergency MOTION for Discovery Reopening filed by Cassandra Sampson. (Stefan, Susan) (Entered: 06/05/2008)
106 MOTION for Extension of Time to June 18, 2008 to File Response/Reply to Plaintiff's Emergency Motion by Beth Israel Deaconess Medical Center.(Kures, Megan) (Entered: 06/09/2008)
Magistrate Judge Marianne B. Bowler: Electronic ORDER entered granting 106 Motion for Extension of Time to File Response/Reply. (Bowler, Marianne) (Entered: 06/10/2008)
107 Opposition re 104 Emergency MOTION for Discovery Reopening filed by Beth Israel Deaconess Medical Center. (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D)(Kures, Megan) (Entered: 06/18/2008)
108 REPLY to Response to 104 Emergency MOTION for Discovery Reopening filed by Cassandra Sampson. (Attachments: # 1 Exhibit A − ED Guideline)(Stefan, Susan) (Entered: 06/20/2008)
ELECTRONIC NOTICE of Hearing on Motion: Hearing on 104 Emergency MOTION for Discovery Reopening set for 6/27/2008 at 2:30 PM in Courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 06/23/2008)
109 STIPULATION of Dismissal by Heather A Richter. (Flanagan, William) (Entered: 06/24/2008)
110 STIPULATION by Beth Israel Deaconess Medical Center. (Kures, Megan) (Entered: 06/26/2008)
111 Withdrawal of motion: 104 Emergency MOTION for Discovery Reopening filed by Cassandra Sampson.. (Stefan, Susan) (Entered: 06/27/2008)
ELECTRONIC NOTICE Canceling Hearing. The hearing on MOTION 104 previously scheduled for 6/27/2008 is CANCELED. (Duffy, Marc) (Entered: 06/27/2008)
Electronic Clerk's Notes for proceedings held before Magistrate Judge Marianne B. Bowler: Status Conference held on 8/18/2008. Dispositive Motion deadline set: Summary Judgment Motions due by 10/20/2008, responses due by 11/3/2008. (Duffy, Marc) (Entered: 08/18/2008)
112 Joint MOTION for Extension of Time to 11/3/08 to file dispositive motions by Cassandra Sampson.(Stefan, Susan) (Entered: 09/24/2008)
Magistrate Judge Marianne B. Bowler: Electronic ORDER entered granting 112 Motion for Extension of Time. (Bowler, Marianne) (Entered: 10/07/2008)
113 MOTION for Leave to File Excess Pages by Cassandra Sampson.(Heidorn, Scott) (Entered: 10/14/2008)

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10/15/2008 11/03/2008
11/03/2008 11/03/2008 11/03/2008 11/03/2008
11/06/2008 11/17/2008 11/19/2008 11/20/2008 11/26/2008
12/04/2008 12/04/2008 12/05/2008 12/08/2008 12/11/2008

Magistrate Judge Marianne B. Bowler: Electronic ORDER entered granting 113 Motion for Leave to File Excess Pages. (Bowler, Marianne) (Entered: 10/15/2008)
114 MOTION for Partial Summary Judgment by Cassandra Sampson. (Attachments: # 1 Statement of Facts Not in Dispute, # 2 Exhibit 1, # 3 Exhibit 2−5, # 4 Exhibit 6−11, # 5 Exhibit 12−13, # 6 Exhibit 14, # 7 Exhibit 15−18, # 8 Exhibit 19, # 9 Exhibit 20−21, # 10 Exhibit 22−24, # 11 Exhibit 25−28, # 12 Exhibit 29−32, # 13 Exhibit 33−41, # 14 Exhibit 42−47, # 15 Exhibit 48−52, # 16 Exhibit 53−59)(Stefan, Susan) (Entered: 11/03/2008)
115 MEMORANDUM in Support re 114 MOTION for Partial Summary Judgment filed by Cassandra Sampson. (Stefan, Susan) (Entered: 11/03/2008)
116 MOTION for Summary Judgment (Partial) by Beth Israel Deaconess Medical Center.(Powers, Robert) (Entered: 11/03/2008)
117 MEMORANDUM in Support re 116 MOTION for Summary Judgment (Partial) filed by Beth Israel Deaconess Medical Center. (Powers, Robert) (Entered: 11/03/2008)
118 STATEMENT of facts re 116 MOTION for Summary Judgment (Partial). (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D, # 5 Exhibit E, # 6 Exhibit F, # 7 Exhibit G, # 8 Exhibit H, # 9 Exhibit I, # 10 Exhibit J, # 11 Exhibit K, # 12 Exhibit L, # 13 Exhibit M, # 14 Exhibit N, # 15 Exhibit O, # 16 Exhibit P, # 17 Exhibit Q, # 18 Exhibit R, # 19 Exhibit S, # 20 Exhibit T, # 21 Exhibit U, # 22 Exhibit V, # 23 Exhibit W, # 24 Exhibit X, # 25 Exhibit Y, # 26 Exhibit Z, # 27 Exhibit AA, # 28 Exhibit BB, # 29 Exhibit CC, # 30 Exhibit DD, # 31 Exhibit EE, # 32 Exhibit FF, # 33 Exhibit GG, # 34 Exhibit HH, # 35 Exhibit II, # 36 Exhibit JJ)(Powers, Robert) (Entered: 11/03/2008)
119 MOTION for Extension of Time to 11/28/08 to File Response/Reply as to 114 MOTION for Partial Summary Judgment by Beth Israel Deaconess Medical Center.(Kures, Megan) (Entered: 11/06/2008)
120 Opposition re 116 MOTION for Summary Judgment (Partial) filed by Cassandra Sampson. (Attachments: # 1 Exhibit, # 2 Exhibit, # 3 Exhibit, # 4 Exhibit, # 5 Exhibit)(Stefan, Susan) (Entered: 11/17/2008)
Magistrate Judge Marianne B. Bowler: Electronic ORDER entered granting 119 Motion for Extension of Time to File Response/Reply. (Bowler, Marianne) (Entered: 11/19/2008)
ELECTRONIC NOTICE of Hearing on Motion: Hearing on MOTIONS for Partial Summary Judgment 114 and 116 set for 12/12/2008 at 2:30 PM in Courtroom 25 before Magistrate Judge Marianne B. Bowler. (Duffy, Marc) (Entered: 11/20/2008)
121 Response by Beth Israel Deaconess Medical Center to 114 MOTION for Partial Summary Judgment. (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D, # 5 Exhibit E, # 6 Exhibit F, # 7 Exhibit G, # 8 Exhibit H, # 9 Exhibit I, # 10 Exhibit J, # 11 Exhibit K, # 12 Exhibit L, # 13 Exhibit M, # 14 Exhibit N)(Kures, Megan) (Entered: 11/26/2008)
ELECTRONIC NOTICE OF RESCHEDULING: The hearing on MOTIONS for summary judgment 114 and 116 previously scheduled for 12/12/2008 is hereby rescheduled to 12/15/2008 at 2:00 PM. (Duffy, Marc) (Entered: 12/04/2008)
122 Assented to MOTION for Leave to File Reply to Defendant's Opposition to Plaintiff's Motion for Partial Summary Judgment by Cassandra Sampson.(Stefan, Susan) (Entered: 12/04/2008)
Magistrate Judge Marianne B. Bowler: Electronic ORDER entered granting 122 Motion for Leave to File Reply to Defendant's Opposition to Plaintiff's Motion for Partial Summary Judgment. (Bowler, Marianne) (Entered: 12/05/2008)
123 REPLY to Response to 116 MOTION for Summary Judgment (Partial) filed by Cassandra Sampson. (Stefan, Susan) (Entered: 12/08/2008)
124 Assented to MOTION to Continue Hearing on Motions for Summary Judgment to January 14, 15 or 16, 2009 by Beth Israel Deaconess Medical Center.(Kures, Megan) (Entered: 12/11/2008)

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12/12/2008
01/13/2009
01/14/2009 03/10/2009 03/10/2009 03/24/2009

Magistrate Judge Marianne B. Bowler: Electronic ORDER entered granting 124 Motion to Continue. The hearing is continued until January 14, 2009 at 2:00 p.m. (Bowler, Marianne) (Entered: 12/12/2008)
125 Joint MOTION to Vacate 1/14/09 Hearing on Parties' Partial Motions for Summary Judgment by Beth Israel Deaconess Medical Center.(Kures, Megan) (Entered: 01/13/2009)
Magistrate Judge Marianne B. Bowler: ORDER entered granting 125 Motion to Vacate. (Bowler, Marianne) (Entered: 01/14/2009)
127 Judge Douglas P. Woodlock: ORDER entering settlement agreement of parties and granting 126 Motion to Dismiss. (Seelye, Terri) (Entered: 03/10/2009)
Civil Case Terminated. (Seelye, Terri) (Entered: 03/10/2009)
Case no longer referred to Magistrate Judge Marianne B. Bowler. (Irwin, Nancy) (Entered: 03/24/2009)

 
 Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 1 of 35

IN THE UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS

)

)

CASSANDRA SAMPSON

)

Plaintiff,

)

)

v.

)

)

BETH ISRAEL DEACONESS MEDICAL CENTER, )

HEATHER A. RICHTER,

)

and Dr. KELLY CORRIGAN

)

Defendants.

)

CIVIL ACTION NO. 06-10973 DPW

SECOND AMENDED COMPLAINT

I. Introduction

1. This case is brought against Beth Israel Deaconess Medical Center ("the
Hospital"), Dr. Kelly Corrigan ("Corrigan"), a physician at the Hospital, and Heather Richter

("Richter"), who worked as a nurse at the Hospital, arising out of the physical restraint, assault, and forced stripping of the plaintiff, Cass,andra Sampson, a woman with a history of severe
sexual abuse. This restraint and forced stripping was done by five male Hospital security guards
on the orders of defendants Corrigan and Richter, pursuant to the Hospital's mandatory disrobing policy, which permits restraint and forcible stripping of patients who refuse a request to disrobe.

, 2. Ms. Sampson was physically bruised, emotionally devastated, and became

suicidal as a result of

being restrained and forcibly stripped. Although Ms. Sampson wentto the

Hospital's Emergency Department voluntarily for treatment of cluster migraines, she was

involuntarily detained, then physically restrained and forcibly stripped, despite her pleas that she

be allowed to retain her pants due to a history of sexual abuse, her wilingness to remove the rest

1

Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 2 of 35

of her clothes, and her agreement to undergo a pat-down search. Defendant Richter ordered and

Defendant Corrigan authorized the forcible restraint and stripping of Ms. Sampson in violation of

federal and state regulations and without mental health consultation about the need to forcibly

strip Ms Sampson. In addition, neither defendant considered the use of available less intrsive

methods of meeting any alleged safety concerns. Finally, Richter refused to honor Ms.

Sampson's repeated requests for a hospital advocate to inform her of

her legal rights and to help

resolve the situation without the use of force.

3. This action is brought against defendant Hospital for: 1) injunctive and

declaratory relief

under Title II of

the Americans with Disabilities Act; 2) injunctive and

declaratory relief and compensatory damages under Section 504 of the Rehabiltation Act of

1973; 3) injunctive and declaratory relief

and compensatory damages under M.G.L. §272, Sec.

98, and MGL Chapter 12, Section l1I and ILL (Massachusetts Civil Rights Act); and 4)

compensatory damages under state tort actions for negligence, assault, battery, and intentional or

reckless inflction of emotional distress.

4. This action is brought against defendant Corrigan for damages for interference
with the plaintiffs civil rights under the Massachusetts Civil Rights Act, as well as for malpractice, assault, battery, and intentional or reckless infliction of emotional distress.

5. This action is brought against defendant Richter for damages for interference with
the plaintiff s civil rights under the Massachusetts Civil Rights Act, and for negligence, assault, battery, and intentional or reckless inflction of emotional distress.

2

Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 3 of 35

II. Parties

6. Ms. Cassandra Sampson is a citizen ofthe State of Massachusetts. She lives at

13-25 Warren Ave., Somervile, Massachusetts. Ms. Sampson has a long history of

psychiatric

and physical disabilities.

7. Beth Israel Deaconess Medical Center is located at 330 Brookline Ave., Boston,
Massachusetts.

8. Defendant Kelly Corrigan is a physician who works at the Beth Israel Deaconess

Medical Center. She is a citizen of

the Commonwealth of

Massachusetts.

9. Defendant Heather A. Richter is a citizen of the State of California. She worked at

Beth Israel Deaconess Medical Center on March 25, 2005, as a nurse in the Emergency

Departent.

III. Jurisdiction

10. This court has jurisdiction pursuant to, 42 U.S.C. § 12188(a), 29 U.S.C. §794a, and

28 U.S.C. § 1331. It has diversity jurisdiction over the state claims against defendant Richter

under 28 U.S.C. §1332, and supplemental

jurisdiction over state claims against defendants Beth

Israel Deaconess Medical Center and COlTigan under 28 D.S.C. § 1367.

iv. Facts 11. Ms. Sampson is a 50 year old African-American woman with psychiatric
disabilities stemming from years of extreme emotional and sexual abuse as a child, worsened by the death of her son shortly after he was born. Ms. Sampson has a history of self-injury stemming from these experiences.

3

Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 4 of 35

12. Ms. Sampson is an individual with a disability under the Americans with

Disabilties Act and Section 504 of

the Rehabilitation Act because her psychiatric impairments

substantially limit major life activities, including caring for herself, working, and interacting with

others. Ms. Sampson also has a record of psychiatric disabilities that were substantially limiting

and was regarded by defendants Corrigan, Richter and Beth Israel Deaconess Medical Center as

being substantially limited in her abilty to care for herself.

13. Ms. Sampson also has a number oflife-theatening physical disabilities, including

severe respiratory problems and Type II diabetes, as well as other painful physical conditions, including cluster migraines.
14. Ms. Sampson has used the clinical and emergency services of defendant Hospital to treat these conditions for over two decades. Because Ms. Sampson's medical doctors practiced at Beth Israel Deaconess Medical Center, she has often sought both medical and

emergency care at defendant hospitaL. The Hospital is well aware of
severe childhood sexual abuse and her history of disability.

Ms. Sampson's history of

15. In two decades and

hundreds of visits to many Emergency Departments, including

defendant Hospital's Emergency Department, Ms. Sampson has

never injured or threatened to

injure herself while in an Emergency Department setting. In two decades and hundreds of visits

to many Emergency Departments, Ms. Sampson has never been physically restrained and

forcibly stripped of

her clothing in any other Emergency Deparment, despite her history of

serious self-injury and her reluctance to remove her pants.

16. On or around March 22, 2005, Ms. Sampson began experiencing extremely severe
migraines. She took her prescribed medication, Toradol, and the headaches did not improve. On

4

Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 5 of 35

March 24, 2005, she called the offce of Dr. Bajwa's assistant told her to reduce the dosage of
did.

her neurologist, Dr. Bajwa, who treated her migraines. Toradol she had been taking, which she

The Events of

March 25, 2005

17. On March 25,2005, Ms. Sampson again called Dr. Bajwa's office because her

migraines were interfering with her abilty to sleep and function. He was not available, and his

assistant advised her to see her primary care physician, Dr. Gila Kriegel, at Beth Israel

Deaconess Medical Center. Dpon alTiving at the hospital, Ms. Sampson learned that Dr. Kriegel

was also unavailable. She spoke briefly to Dr. Kreigel by telephone, and the doctor advised her

to go to the Hospital's Emergency Deparment for treatment of

her migraines.

18. There is no evidence in the Ms. Sampson's medical records that Dr. Kriegel

contacted the Emergency Department prior to Ms. Sampson's admission or that Emergency

Deparment staff

relied upon information from Dr. Kriegel in deciding to restrain and forcibly

strip and search Ms. Sampson.

19. Ms. Sampson proceeded to defendant Hospital's Emergency Deparment,
expecting to receive treatment for her migraines.

20. During her admission to the Hospital, Ms. Sampson was calm. She was not
suicidal nor did she have any desires to injure herself. During the routine triage procedures, Ms. Sampson told the triage nurse that she had been struggling with safety issues.

21. The triage nurse did not ask Ms. Sampson any fuher questions about her
psychiatric condition, but told her that she needed a psychiatric. evaluation, and that her migraines would also be treated. He then transfelTed Ms. Sampson to the psychiatric portion of

5

Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 6 of 35

the Emergency Department (called "the Yellow Zone" at Beth Israel Deaconess Medical Centcr)

for assessment.

22. Dpon Ms. Sampson's alTival in the Yellow Zone, defendant Richter assigned Ms.

Sampson to a room, where, pursuant to hospital policy, she was watched by one or more "sitters"

(aides who sit outside the door of
Sampson.

the room) to provide continuous one-on-one monitoring of

23. Based on stereotypes and misperceptions about the level of

Ms. risk that people with

mental ilness pose to themselves, and also to prevent any patient, including voluntar patients

such as Ms. Sampson, from leaving the Emergency Deparment, the Hospital requires patients on

the psychiatric portion of

the Emergency Department (the "Yellow Zone") to disrobe or be

restrained and forcibly stripped if

they refuse. The Hospital does not require an individualized

assessment of

the patient's risk by a mental health professional prior being restrained and

forcibly stripped. Nor does it consider any request for accommodation, or the use of less

intrsive means such as pat-downs or wands. Although the Hospital has wands for this purose,

they have never been used. Patients on the medical portion of

the Emergency Department are not

routinely asked to disrobe for reasons unrelated to their medical assessment or to prevent them

from leaving the Emergency Deparment, and they are not restrained or forcibly stripped.

24. Consistent with this policy, Ms. Richter informed Ms. Sampson that she was
required to completely disrobe prior to her psychiatric evaluation. Defendant Richter made no attempt to evaluate Ms. Sampson's current safety risk before asking her to disrobe by asking her any questions about a risk of self-injury or whether she was carrying anything she might use to

hurt herself or others.

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25. Ms. Sampson explained to defendant Richter that she had a history of sexual

abuse, and explained that she was wiling to take off most of her clothes, but requested that she

be permitted to keep her pants. Similar requests h to staff at the Emergency Depaiiment of

the

Hospital as well as to emergency deparents of other hospitals had always been honored, and

had never resulted in restraint and forcible stripping.

26. Ms. Sampson wilingly and promptly sUlTendered all of

her belongings and took

off her blouse, bra, shoes and socks, and put a hospital

johny (a thin smock which extends to

her knees and ties in the back) over her pants.

27. Defendant Richter continued to insist that Hospital policy required Ms. Sampson

to remove her pants. Ms. Sampson refused and explained that her refusal was due to her history

of traumatic sexual abuse. Ms. Sampson asked Defendant Richter to allow her to see a patient

advocate to clarify this issue.

28. Dr. Tarina Kang, a medical resident assigned to the Emergency Department"

arrived to assess Ms. Sampson's condition. Ms. Sampson again requested to keep her pants on

due to her history of sexual abuse. Dr. Kang considered Ms. Sampson's objections and asked

whether Ms. Sampson would consent to a clothed pat-down, to which Ms. Sampson readily

agreed. With Ms. Sampson's consent, in the presence of a security guard, Dr. Kang conducted

the pat-down herself, which included reaching under the legs of

Ms. Sampson's pants to search

for contraband.

29. After conducting the pat-down, Dr. Kang found no evidence of any unsafe object

or theat to safety.

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Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 8 of 35

30. Ms. Sampson believed that the pat-down had resolved the matter. She was sitting calmly in the room waiting for a psychiatric evaluation. She remained underone-on-one observation with a sitter outside her door.
31. However, after Dr. Kang left, defendant Richter once again demanded that Ms. Sampson remove her pants, even though Ms. Sampson was calm. Defendant Richter made this demand without asking Ms. Sampson whether she felt safe, without determining that Ms. Sampson presented any immediate risk to herself or others, without documenting the need for an intrusive personal search, and without obtaining a clinical determination that one was necessary

from a mental health professionaL.

32. At some point during these events, the designated clinician, Jean Christofferson,

arrived to perform Ms. Sampson's psychiatric assessment. Defendant Richter told her that the

evaluation could not proceed until Ms. Sampson took off

her pants.

33. Ms. Christofferson left, and defendant Richter threatened Ms. Sampson that if she

did not immediately accede to removal of

her pants, they would be forcibly removed by security

guards.

34. Ms. Sampson became extremely afraid, and tried to leave the Emergency

Deparment.

35. A group of male security guards massed together to forcibly return Ms. Sampson
to her room. One security guard asked Ms. Sampson to immediately return to her room to avoid being forcibly returned. Ms. Sampson felt she had no choice but to accede. When she returned to the room, she once again asked Defendant Richter to allow her to speak with a patient advocate.

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Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 9 of 35

36. Defendant Richter brought in another nurse, Deb Melia, and they jointly insisted that Ms. Sampson remove her pants. Defendant Richter again threatened Ms. Sampson that if she did not remove her pants, Richter would have them forcibly removed by security guards.
37. During this entire time, defendant Richter did not ask for a mental health consultation. Ms. Richter did not call Beverly Zalek, Ms. Sampson's psychotherapist for a consultation, even though Zalek's phone number was readily available. She made no effort to contact Dr. Kriegel, Ms. Sampson's primary care physician who had referred her to the Emergency Department. Nor did she contact the patient advocate.

38. At no time during this entire episode did Ms. Sampson state, imply, or otherwise

indicate that she had any current thoughts or intention to hur herself or anyone else. At no time

during this entire period did Ms. Sampson act in a maner which would have led a reasonable

health care professional to believe that there was any immediate risk of

harm to Ms. Sampson or

to others.

39. Although mental health professionals were available at the Hospital, no one

evaluated Ms. Sampson's current safety risk by asking her any questions about her current

thoughts regarding self-injury or whether she was carrying anything that she might use to hurt

herself before ordering that she be forcibly stripped.

40. Instead, Defendant Richter called five male security guards and instructed them to

physically restrain Ms. Sampson and forcibly strip off

her pants.

41. After the security guards began to restrain Ms. Sampson, Ms. Richter stepped into
the hallway and told Dr. Kelly Corrigan, Ms. Sampson's attending physician, that Ms. Sampson

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Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 10 of 35
needed to be restrained because she refused to remove her clothing. Ms. Richter asked Dr.
COlTigan to authorize the restraint.
42. Dr. Corrigan, who was outside the room, authorized the restraint without first examining Ms. Sampson, even though she was only several feet away from Ms. Sampson's room. Dr. COlTigan did not ask Nurse Richter whether Ms. Sampson was calm or agitated, - whether she presented any immediate risk to herself or others, whether she had any medical or psychiatric contraindications to restraint, whether there were any less restrictive alternatives to the restraint, whether Nurse Richter had attempted to obtain a mental health consultation, or whether Richter had attempted to call Beverly Zalek, Ms Sampson's therapist, or Dr. Kriegel, her primary care physician. Nor did Dr. COlTigan herself speak with Ms. Sampson to ask if she had any thoughts of self-injury, had any items which could be used to injure herself or others, or assess Ms. Sampson's condition. In fact, Dr. Corrigan did not ask Richter or Sampson anyting relating to the need to remove Ms. Sampson's pants by force but simply orally authorized the restraint.
43. Neither Nurse Richter nor Dr. COlTigan ever documented their conversation. Nor
did Dr. Corrigan ever sign a written order authorizing or documenting the restraint. In fact, Dr. Comgan was unaware of any Beth Israel Deaconess Medical Center protocol or policy regarding the use of restraint at the time.
44. On Nurse Richter's order, the security guards physically restrained Ms. Sampson's ars and legs, pulled Ms. Sampson's johny up above her waist and unbuckled her pants while she strggled and screamed, bruising her in the process.
10

Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 11 of 35

45. The security guards then unzipped Ms. Sampson's pants, continuing to hold her

arms and legs down despite her twisting and crying out in pain. Finally, the security guards

forcibly pulled off

Ms. Sampson's pants.

46. As she was being restrained, assaulted and stripped, Ms. Sampson struggled and
screamed and was physically injured in the process. She cried out that she was being raped and sobbed.

47. After the restraint and forcible stripping, Defendant Richter told Ms. Sampson she

had only herself

to blame for the use offorce.

48. Neither Defendant Richter nor any clinical staff at the Hospital comforted Ms.

Sampson or tried to help her as she lay curled up and sobbing after being stripped. The sitter

whispered a few words of consolation.

49. Several hours later, Ms. Jean Christofferson assessed Ms. Sampson. This was the

first time that anyone with mental health training had even met Ms. Sampson, let alone

conducted a clinical mental health evaluation. Ms. Sampson, who was profoundly traumatized by

being restrained and forcibly stripped, explained what had happened. Ms. Christofferson sought

to obtain a patient advocate for Ms. Sampson, but no patient advocate ever came to speak to Ms.

Sampson.

50. Ms. Sampson was found to not be a threat to herself or others and to not meet the

commitment standard by the independent evaluators that determine whether a patient qualifies

for inpatient admission (the BEST team). She was transferred to the medical portion of

the

Emergency Department and discharged the following morning.

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Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 12 of 35

Injuries to Ms. Sampson

51. As a result ofthe March 25, 2005 restraint, assault and stripping by security

guards, Ms Sampson experienced nightmares and flashbacks and greatly increased urges to har

and kil herself. Although she had not experienced a lengthy hospitalization in years, shortly

afer the security guards' assault on her, she was hospitalized at several facilities for lengthy

periods of

time. These hospitalizations were a direct result of

the events at Beth Israel

Deaconess Medical Center Emergency Department on March 25, 2005.

52. Ms. Sampson has not returned to the Hospital's Emergency Department. She is

afraid that current Hospital policies and practices wil

lead to her being forcibly stripped.

Indeed, after the events of

March 25, 2005, she required extensive therapeutic intervention to

enable her to enter any hospital Emergency Department. Because the doctors for her serious

medical conditions are affliated with the Hospital, its policy and practice requiring mandatory

stripping of psychiatric patients who refuse to remove their clothing forces her to choose

between risking her physical health or preserving her emotional health.

The Hospital's Policy and Practice Related to Forced Stripping of Psychiatric Patients

53. Shortly after Ms. Sampson's discharge, she took photographs of

her extensive and

discolored bruises and wrote a letter to the Hospital complaining about her abusive treatment by

defendant Richter and the security guards, the assault by male security guards, and the denial of

her repeated requests for a patient advocate. She attached photographs of the bruises.

54. In response, she received a phone call from the patient advocate stating that

Emergency Departent and Hospital staff

had met about her complaint and determined that no

mistakes had been made in her treatment. When Ms. Sampson reiterated how traumatized she

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Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 13 of 35

was afer being restrained and forcibly stripped, the patient advocate advised her to "just let it go."

55. In early May 2005, Ms. Sampson received a written response from Beth Israel

Deaconess Medical Center. The letter (attached as Exhibit A) confirmed the hospital policy

requiring mandatory disrobing and forcible stripping:

In the future, if you come to the emergency room for a purely medical-not a

psychiatric-reason, you would not be taken to the area reserved for psychiatric

patients, and you would not be asked to remove your clothing. However, if

your

reason for coming involved a psychiatric issue, you would be asked to remove

your clothing. This is now. a strict emergency room policy which is designed to

protect both patients and staff. As there have been several incidents in which

patients concealed harmful items or substances, we cannot make any exceptions.

(emphasis in letter).

56. At the end ofthe letter, the Hospital reiterated that, although they were aware of
Ms. Sampson's disability and "how diffcult" the clothing removal requirement was for her, she would stil be asked to remove her clothes if she came to the Emergency Department for
psychiatric reasons. The Hospital took this unequivocal position, refusing to make any accommodations to Ms. Sampson's disability, despite the fact that in all her trips to the
Hospital's Emergency Depaiment over two decades, Ms. Sampson had never hidden anything
!
unsafe on her person, had never injured herself in the Emergency Department, and had never

before been restrained and forcibly stripped of

her clothing. The Hospital has never retreated

from nor rescinded this letter to Ms. Sampson.

57. A year later, Defendant Hospital produced a written clothing removal policy that,

on its face, creates a number of categories including "patient on suicide/selfharm precautions,"

and requires all patients who fall into those categories to be searched, including forcible searches

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Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 14 of 35

and stripping if patients refuse. However, even that policy fails to provide for any exception,

waiver or accommodation for a patient's disabilty, and fails to require a contemporaneous,

individualized assessment by a mental health professional ofthe immediate need for a personal

search, restraint, or forcible stripping in the absence of a clear emergency.

58. Because forcible stripping involves physical restraint, it can only take place in

response to a clear emergency, when less restrictive methods are not effective. It must be

authorized in writing by a licensed independent professionaL. Dnder state law and accepted

professional standards, the fact that a patient is on suicidal or self-harm precautions does not, by

itself, constitute suffcient reason for forcible restraint.

59. As a practical matter, due to stereotypes and misperceptions about the level of

risk

posed by people with mental ilness, and to keep all patients in the psychiatric portion of the

Emergency Departent from leaving, the Hospital's practice results in most or all patients in the

psychiatric portion of the Emergency Departent fallng into one of the categories listed in the

written policy, all of which involve mandatory searches, including restraint and forcible stripping

if the patient refuses.

60. The Hospital's policy and practice of

requiring psychiatric patients to disrobe,

and restraining and forcibly stripping patients who refuse to remove their clothing, is applied on

the basis of a three to five-minute triage interview by a busy nurse who may have little or no

mental health training. The policy is applied without seeking any assessment of immediate level

of risk by a mental health professional, even though an offce staffed with psychiatric

professionals is immediately adjacent to the emergency deparent. It is applied without

consideration of imminence of risk, availability ofIess intrusive means to ensure safety, history

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Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 15 of 35

of sexual abuse or trauma, or any other individual medical or psychiatric contraindications to

physically restraining and forcing a patient to remove her clothes.

61. Because of

her history of self-injury, when Ms. Sampson is on the psychiatric

portion of the Emergency Deparment, the Hospital wil always place her into the category

"patient on suicide/self

harm precautions" and she wil, as the Hospital's letter stated, always be

required to remove her clothing, regardless of

whether she is at any actual risk of suicide or self-

harm. If she refuses, she wil be restrained and forcibly stripped, regardless of whether she is

calm, regardless of

whether she presents any risk of

self injury, regardless of

whether she

requests an accommodation because of

her disabilty, and regardless of

the availabilty ofless

intrusive means to ensure safety.

62. Fifty to seventy percent of women with chronic mental ilness have histories of
childhood sexual or physical abuse, or both. This history has been recognized by the psychiatric community to cause life-long trauma and disabilty in some women, for whom involuntar or forcible restraint by others brings flashbacks, renewed trauma, and destroys any tiust they may have built with their treaters. The practice in some Emergency Departments of requiring psychiatric patients to disrobe can cause patients severe anxiety because it triggers memories of
prior rapes and sexual abuse. Physical restraint and forced stripping by security guards when a
patient refuses to remove her clothing is even more traumatic and can greatly exacerbate existing

psychiatric disabilties. Forcible stripping by male security guards of a female patient with a
history of sexual abuse is the most traumatizing and damaging of all.

63. It is well recognized in the mental health profession that in the absence of an
emergency, an individualized assessment should be made by a mental health professional before

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Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 16 of 35

restraining and forcibly stripping a patient of

her clothing. It is also well recognized in the

psychiatric profession that for some patients, requests or requirements that they remove their

clothing can cause such emotional turmoil that it results in extreme agitation and panic, and

exacerbates existing psychiatric conditions including anxiety, depression, and post-raumatic

stress disorder.

64. The Hospital's policy and practice, both o.n March 25, 2005, and today, do not

require a contemporaneous mental health assessment, a deteimination of clinical necessity, and a

written order by a licensed independent professional prior to the physical restraint and forcible

stripping of an individual with a psychiatric disability in nonemergency situations.

65. The

Hospital's policy and practice, both on March 25, 2005 and today, do not

permit reasonable accommodation, exception, or waiver of

the most intrusive and forcible

searches including reasonable accommodation of a disabled patient's disability-related refusal to

remove her clothing.

66. The Hospital's policy and practice, both on March 25,2005 and today, preclude
the use ofless intrusive means to ensure safety such as wands or pat-down searches. This policy and practice is at odds with the practices in other hospital emergency depaiments, where patdowns are considered suffcient to ensure safety for the patient and others.

67. The Hospital's policies and practices, both on March 25, 2005 and today, permit
the forcible physical restraint of patients to remove their clothing without meeting criteria for restraint, without the written order of a licensed independent practitioner, and without the patient
being assessed within an hour by the licensed independent practitioner, as required by CUlTent
state, federal, and professional standards.

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68. The Hospital's policies and practices, described above, violate current standards of medical practice, as well as applicable legal and regulatory requirements and standards.

V. Leiial Claims
CLAIMS AGAINST BETH ISRAEL DEACONESS MEDICAL CENTER
A. Title III of the Americans with Disabilties Act

69. Plaintiffrealleges and incorporates by reference paragraphs 1-68.

70. The Americans with Disabilities Act was passed in 1990 to "provide a clear and

comprehensive national mandate for the elimination of discrimination against people with

disabilties," 42 D.S.C. §12101(b)(1). Congress explicitly defined discrimination to include

"over-protective rules and policies," "failure to make modifications to existing ... practices," and

"segregation, and relegation to lesser services," 42 D.S.C. §12101(a)(5).

71. When Congress passed the ADA, it intended to "invoke the sweep of

Congressional authority...in order to address the major areas of discrimination faced day

to day

by people with disabilities," 42 U.S.C. §121 01(b)(4), including in the area of
42 D.S.C. 12101(a)(3).

"health services,"

72. Beth Israel Deaconess Medical Center is a "place of public accommodation" as

that term is defined in Title II of

the Americans with Disabilties Act, 42 D.S.C. 121

81 (7)(F), 28

C.F.R. 36.104. The ADA prohibits discrimination by a public accommodation against any

individual on the basis of

disabilty. 28 C.F.R. 36.201(a).

73. Ms. Sampson is an individual with a disability under the Americans with

Disabilties Act because: (a) her psychiatric impairments substantially limit major life activities,

including caring for herself, working, and interacting with others; (b) Ms. Sampson was also

17

Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 18 of 35

regarded by defendants Richter and Hospital as being substantially limited in the abilty to care

for herself; and (c) Ms. Sampson has a history of psychiatric disabilties.

74. Because Ms. Sampson has received treatment at defendant Hospital for her

chronic respiratory, migraine, and other medical diffculties for over two decades, it is virtually

certain that she wil continue to need the services of the Hospital's Emergency Department in the

future. Because of

her psychiatric diffculties, she is forced to risk being restrained and forcibly

stripped when she seeks needed services at the HospitaL.

Failure to Provide Reasonable Accommodations

75. Title II of

the ADA prohibits public accommodations from discriminating against

individuals with disabilities in the full and equal enjoyment of

the goods, services, facilities,

privileges, advantages or accommodations of any place of public accommodations, 42 U .S.C.

12182(a). The definition of discrimination includes "failure to make reasonable modifications in

policies, practices, or procedures, when such modifications are necessary to afford such goods,

services, facilties, privileges, advantages or accommodations to individuals with disabilities,

unless the entity can demonstrate that making such modifications would fundamentally alter the

nature of such goods, services, facilities, privileges, advantages, or accommodations." 42 D.S.C.

12182(b )(2)(A)(ii).

76. The Hospital discriminated against Plaintiff on the basis of

her disabilty in

violation of 42 U .S.C. 12182(b )(2)(A)(ii) by failng to grant her the reasonable accommodation

of waiving its requirement of

removal of all clothing, despite Plaintiffs wilingness to remove

most of her clothing, her consent to a pat-down, and the presence of a one-on-one observer.

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77. Numerous other methods exist for meeting the Hospital's legitimate safety

concerns besides physical restraint and forcible removal of clothing, including using a wand, or

pat-down or other methods of deteimining whether a patient is calTying objects to harm him or

herself. In the absence of an individualized determination by a qualified mental health

professional that a patient is so presently dangerous to him or herself that complete clothing

removal is required, that restraint is necessary and legally authorized, and that forcible removal

of clothing is justified, defendant Hospital fails to meet the ADA's requirement to make

reasonable accommodations or modifications of

policies.

78. The Hospital discriminated against Plaintiff on the basis of

her disability in

violation of 42 D.S.C. 12182(a) by requiring her to disrobe, using physical restraint to hold her

down, and by forcibly stripping her when she refused to disrobe without an individualized

clinical determination of immediate necessity by a mental health professionaL. The Hospital

fuher discriminated against Plaintiff by not affording her any reconsideration, reasonable

accommodation or waiver, solely because she was seen on the psychiatric side of

the Emergency

Department. Patients on the medical portion of the Emergency Deparment are not required to

disrobe. They are asked to disrobe only upon a medical determination of a medical necessity and

are not restrained and forcibly stripped if

they refuse to disrobe.

Unequal Access to Services

79. Title

!I of the ADA requires public accommodations to provide equal access to

their services to people with disabilities, 42 D.S.C. § 12182(a), 28 C.F.R. 36.201(a). Defendant

Hospital's policy and practice of

requiring mandatory disrobing of

patients in the psychiatric

portion of

the Emergency Department, including the use of

physical restraint and removal of

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clothing by force, without an individualized clinical determination of immediate necessity by a mental health professional, and without provision for reconsideration, reasonable accommodation or waiver; limits Ms. Sampson's access to defendant Hospital's services. It also forces Ms. Sampson to risk being physically restrained and forcibly stripped when she seeks

needed services at the HospitaL.

Discriminatory Eligibilty Criteria

80. Title II of

the ADA prohibits public accommodations from applying eligibilty

criteria that single out individuals with disabilties and prevent them from fully and equally

enjoying the services and advantages of

the facility, unless those criteria are necessary for the

provision of

services offered by the facilty, 42 U.S.C. 121

82(b)(2)(A)(i), 28 C.F.R. 36.301(a).

81. In order to be eligible to receive psychiatric services at Beth Israel Deaconess

Medical Center, most if

not all patients in the psychiatric portion of

the Emergency Department

are subject to a search. The Hospital's policy and practice of

requiring mandatory disrobing,

including physical restraint and the removal of clothing by force, without an individualized

clinical determination of necessity by a mental health professional and without provision for

reconsideration, reasonable accommodation or waiver, screens out the Plaintiff

from fully and

equally enjoying the Hospital's services and advantages on the basis of

her disability.

82. The policy and practice violate the ADA by placing an additional and unnecessary
burden on patients with psychiatric disabilities, such as Ms. Sampson, that result in great pain and suffering from having to remove clothing in order to receive the services offered
Defendant's Emergency Deparment and HospitaL.

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83. While a public accommodation may impose "legitimate safety requirements" that are necessary for the safe operation of the facility, these requirements must be "based on actual

risk and not on mere speculation, stereotypes, or generalizations about people with disabilties,"

28 C.F.R. 36.301(b). The Hospital's practice violates the ADA because it requires mandatory

disrobing and forcible stripping without an individualized assessment by a mental health

professional that that disrobing is necessary and that the risk of

harm to the individual's mental

health from physically restraining and forcibly stripping her is outweighed by the risk of

harm in

permitting her to keep some or all of her clothing. Even if the Hospital policy allowing physical

restraint and forcible stripping only applies to people with suicidal ideation who refuse to

disrobe, this category is broader than necessary to fulfill

legitimate safety requirements. In fact,

the Hospital's policy increases rather than decreases the risk to safety for patients and staff.

Discriminatory Methods of Administration

84. The Americans with Disabilities Act prohibits public accommodations from

adopting methods of administration that have the effect of discriminating on the basis of

disability. 42 U.S.C. § 12182(b)(I)(D), 42 D.S.C. § 121

82(b)(2)(A)(i), 28 C.F.R. 36. 204.

85. Beth Israel Deaconess Medical Center's policy and practice of requiring

mandatory disrobing, including physical restraint and the removal of clothing by force, without

an individualized clinical determination of necessity by a mental health professional, and without

provision for reconsideration, reasonable accommodation or waiver, constitutes a method of

administration that has the effect of discriminating on the basis of disability in violation of

the

ADA.42 D.S.C. § 12182(b)(l)(D), 42 U.S.C. § 12182(b)(2)(A)(i), 28 C.F.R. 36.204. This

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Case 1:06-cv-10973-DPW Document 73 Filed 06/13/07 Page 22 of 35

method conditions the availabilty of its services on compliance with a rule that places an

unecessary burden on plaintiff by reason of her disability.

B. Section 504 of

the Rehabiltation Act

86. llaintiffrealleges and ineorporates by reference paragraphs 1-85.

87. Section 504 of

the Rehabilitation Act of 1973, 29 D.S.C. § 794(a) provides that

"no otherwise qualified individual with a disabilty... shall, solely by reason of

his or her

disabilty, be ...denied the benefits of, or be subjected to discrimination under any program or

activity receiving Federal financial assistance."

88. Defendant Hospital receives federal funds for the purposes of

the Rehabiltation

Act through the Medicaid and Medicare programs. In order to receive Medicare and Medicaid

reimbursements, defendant Beth Israel Deaconess Medical Center is required to assure the

federal

governent in writing that it complies with the requirements of

Section 504 of

the

Rehabilitation Act, and, upon information and belief, it has made these assurances.

89. Ms. Sampson is an individual with a disability under 504 of

the Rehabiltation Act

because her psychiatric impairments substantially limit major life activities, including caring for

herself, working, and interacting with others. Ms. Sampson was also regarded by

defendants

Richter and Beth Israel Deaconess Medical Center as being substantially limited in the abilty to

care for herself. Ms. Sampson also qualifies as an individual with a disability under Section 504

because of

her history of

psychiatric disabilities.

90. As a person in physical pain seeking medical attention, and a regular patient at

Beth Israel Deaconess Medical Center, she was otherwise qualified to receive its services.

Because Ms. Sampson has received treatment at Beth Israel Deaconess Medical Center for her

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respiratory, migraine, and psychiatric conditions for over two decades, it is vIiiually certain that

she wil continue to visit the Emergency Deparment at Beth Israel Deaconess Medical Center in

the future; because of

her psychiatric diffculties, she would be likely to use the services ofthe

psychiatric portion of the Emergency Department in the future, but for the policy and practices of

the defendant Hospital with regard to mandatory disrobing and physically restraining and

forcibly stripping patients.

Less Effective Services

91. Regulations applicable to hospitals under Section 504 of

the Rehabiltation Act

prohibit affording a qualified handicapped person less effective or unequal services than those

received by others, 45 C.F.R. 84.4(b)(1)(ii) and (iii). In addition, the regulations forbid limiting

a qualified handicapped person in the enjoyment of any advantage or opportnity enjoyed by

others receiving the services of the facility, 45 C.F .R. 84.4(b)(1 )(vii).

92. By adopting a policy and practice requiring mandatory disrobing, including

physical restraint and the removal of clothing by force, of any individual in the psychiatric

portion of the Emergency Departent, without an individualized determination of clinical

necessity and with no provision for reasonable accommodations or modifications, the Hospital

interferes with the doctor patient relationship, inflcts harm on patients with mental ilness, and

provides less effective treatment services.

93. When she was restrained and forcibly stripped while being held down by male

securty guards, Ms. Sampson received less effective treatment services from the Hospital than

medical patients who could receive treatment services without being subj ect to the Hospital

policy of restraint and mandatory disrobement.

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Failure to Provide Reasonable Accommodations

94. Beth Israel Deaconess Medical Center's polièy and practice of

requiring

mandatory disrobing, including physical restraint and the removal of clothing by force, without a

determination of clinical necessity and without provision for reconsideration, reasonable

accommodation or waiver, denies the reasonable accommodations required by Section 504 of

the

Rehabiltation Act to Ms. Sampson. Numerous other methods exist for meeting the Hospital's

legitimate safety concerns besides the use of physical restraint and forcible removal of clothing,

including using a wand, pat -down, or other methods of determining if she is calTying objects to

harm herself.

95. The Hospital's conduct in rejecting Ms. Sampson's request for the reasonable

accommodation through the use of a pat-down, the removal of most of her clothing, and the

presence of the one-on-one sitter as sufficient to ensure her safety on March 25, 2005, violated

the requirements of Section 504 ofthe Rehabilitation Act to make reasonable accommodations

or modifications of policies to afford individuals with disabilties access to their services.

96. The Hospital discriminated against Plaintiff on the basis of

her disability in

violation of29 D.S.C. § 794(a) by requiring her to disrobe and physically restraining and

forcibly stripping her when she refused, without an individualized determination of immediate

necessity by a mental health professional, and without provision for reconsideration, reasonable

accommodation or waiver because she was seen on the psychiatric portion of

the Emergency

Department. Patients without psychiatric disabilties are not routinely required to disrobe, and

are not physically restrained and forcibly stripped if

they refuse.

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Limiting the Participation of Qualified Handicapped Persons

97. Section 504 of

the Rehabilitation Act prohibits health care entities receiving

federal funds from "providing benefits or services in a maner that limits or has the effect of

limiting the paricipation of qualified handicapped persons," 45 C.F.R. 84.52(a)(4). Beth Israel

Deaconess Medical Center's policy and practice requiring mandatory disrobing and forcible

removal of clothing, without a determination of clinical necessity or provision for

reconsideration, reasonable accommodation or waiver, limits or has the effect of limiting the

paricipation of Ms. Sampson in its services, since it forces Ms. Sampson to risk being physically

restrained and forcibly stripped when she seeks needed services at the HospitaL.

Discriminatory Methods of Administration

98. The regulations to Section 504 of

the Rehabiltation Act specifically prohibit the

use of criteria or methods of administration that have the effect of subjecting qualified

handicapped persons to discrimination on the basis of handicap or have the purpose or effect of

defeating or substantially impairing accomplishment of

the objectives of

the program with

respect to handicapped persons, 45 C.F.R. 84.4(b)(4).

99. The "objectives of

the program" of

Beth Israel Deaconess Medical Center for

purposes of 45 C.F.R. 84.4(b)( 4) are to provide treatment to those in need of care, including

individuals in psychiatric crisis. These objectives are "defeated or substantially impaired" when

Ms. Sampson is dissuaded from seeking care and treatment at the Hospital and has to chose

between obtaining services or taking the risk that she wil be restrained and forcibly stripped if

she requires a psychiatric evaluation. As a result, the Hospital's policy and practice requiring

mandatory disrobing and forcible removal of clothing without a determination of clinical

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necessity or provision for reconsideration, reasonable accommodation or waiver violates 45
C.F.R. 84.4(b)(4). 100. Defendant Hospital's policy and practice ofrequiring mandatory disrobing,
through physical restraint and removal of clothing by force, without an individualized clinical determination of necessity, and without provision for reconsideration, reasonable accommodation or waiver, violates the prohibition in Section 504 on methods of administration

that have the effect of subjecting Ms. Sampson to discrimination on the basis of
C.F.R.84.4(b)(4).

handicap. 45

C. Chanter 272. Section 98 ofMassacliusetts General Laws

101. Plaintiffrealleges and incorporates by reference paragraphs 1-100.

102. M.G.L. Ch. 272, Section 98, prohibits a place

of public accommodation from

making any distinction, discrimination or restriction on account of mental disability, and requires

that all persons shall have the right to full and equal accommodations and facilities of any place

of public accommodation. The Hospital is a place of public accommodation pursuant to M.G.L.

Ch. 272, Section 92A(l0). Ms. Sampson is a person with a mental disability under the statute.

The Hospital discriminated against and imposed restrictions on Ms. Sampson on the basis of

her

mental disability in violation of

her right to full and equal accommodations under this statute.

Ms. Sampson fied a timely complaint with the Massachusetts Commission Against

Discrimination on Dec. 23, 2005, and has removed the action to this court, in fulfillment of

statutory requirements necessary to bring an action under this statute.

103. Defendant Hospital violated M.G.L. Ch. 272, Section 98, by refusing her request

for a reasonable accommodation to keep her pants on, especially in light of the presence of a full-

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time sitter, the removal of most of her clothing, and her voluntary submission to a pat-down search. The Hospital also violated her rights by failing to make accommodations to her known psychiatric disability and histOlY of severe sexual trauma when five male security guards physically restrained while she was forcibly stripped on the order of a Hospital doctor.
104. Plaintiff seeks declaratOlY and injunctive relief enjoining defendant Beth Israel Deaconess Medical Center from continuing its policies and practices that discriminate on the basis of psychiatric disability, including but not limited to: 1) requiring Ms. Sampson to disrobe completely without considering requests for reasonable accommodation to these requirements as a matter of both policy and practice; and 2) requiring Ms. Sampson to disrobe, and physically restraining and forcibly stripping her, without an individualized assessment and finding of clinical necessity by a mental health professional, taking into consideration her history of sexual

and physical abuse.
105. Plaintiff

also seeks compensatory damages from defendant HospitaL.

CLAIMS AGAINST BETH ISRAEL DEACONESS MEDICAL CENTER, DR. CORRGAN, AND HEATHER RICHTER

D. Chapter 12. Section llH and I of

Massachusetts General Laws

106. Plaintiffrealleges and incorporates by reference paragraphs 1-105.

107. Beth Israel Deaconess Medical Center, by its policies and through its agents Dr. Kelly Corrigan and Ms. Heather Richter, interfered with Ms. Sampson's exercise and enjoyment

of her statutory rights under both federal

law and the law of the Commonwealth through threats,

intimidation and coercion. As discussed above, Dr. Corrigan and Ms. Richter directly interfered

with Ms. Sampson's exercise and enjoyment of

her rights under both federal and state law.

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108. When Nurse Richter repeatedly threatened Ms. Sampson with physical restraint

and forcible stripping by male security guards, she used threats, intimidation and coercion to interfere with Ms. Sampson's rights, including her right to privacy when receiving medical

treatment under MGL Chapter 111, Section 70EG), as well as her federal and state rights to

receive medical treatment free from discrimination on the basis of disability and her right under.

state law to be free from physical assault and restraint in the absence of an emergency. To

condition her right to receive medical treatment on removal of

her clothing, by force if

necessary, violated Ms. Sampson's rights, and when she attempted to assert these rights, she was

threatened, intimidated, and coerced.

109. When Dr. Kelly Corrigan authorized the restraint of

Ms. Sampson without

examining

her or considering less restrictive alternatives, without a determination of an

imminent risk of

har to self or others, and without even observing Ms. Sampson, she interfered

with Ms. Sampson's rights to be free from unnecessai'y restraint under federal regulations and

state law, as well as her right to be free from restraint used as a means of coercion. 110. Plaintiff seeks declaratory and injunctive relief enjoining defendant Beth Israel
Deaconess Medical Center from continuing its policies and practices that discriminate on the

basis of psychiatric disability, including but not limited to: 1) requiring Ms. Sampson to disrobe

completely without considering requests for reasonable accommodation to these requirements as

a matter of both policy and practice; and 2) requiring Ms. Sampson to disrobe, and restraining

and forcibly stripping her, without an individualized assessment and finding of clinical necessity

by a mental health professional, taking into consideration her history of sexual and physical

abuse.

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ILL. Ms. Sampson also seeks compensatory damages from the Hospital, Dr. COITigan,

and Ms. Richter for these ilegal actions.

F. Neiiliiience
112. Plaintiff realleges and incorporates paragraphs 1-111. 113. On or about March 25,2005, defendants Beth Israel Deaconess Medical Center,

Dr. Kelly Corrigan, and Heather Richter, undertook for compensation to provide care, treatment,

and advice to Cassandra Sampson. At all times relevant herein, Dr. Kelly COlTigan and Heather

Richter were acting as agents, servants, and/or employees of Beth Israel Deaconess Medical

Center, acting within the scope of

that employment.

114. Beth Israel Deaconess Medical Center, Dr. COlTigan, and Heather Richter owed

Ms. Sampson a duty of care as a patient at the Hospital on the day of March 25, 2005.

115. In attending to Ms. Sampson, the defendant, Heather Richter, was negligent in
failing to provide acceptable medical care and in failing to exercise that degree of skil, care, and

diligence that is exercised by the average qualified practitioner engaged in practice at a

professional

level such as that in which Nurse Richter was then engaged.

116. In attending to Ms. Sampson, defendant Kelly Corrigan was negligent in failing to

provide acceptable medical care and in failing to exercise that degree of skil, cai'e and diligence

that is exercised by the average qualified practitioner engaged in practice at a professional

level

such as that in which Dr. Corrigan was then engaged.

117. Defendants further breached their duty to the plaintiff when, among other things,

they physically restrained and forcibly stripped her in compliance with Beth Israel Deaconess Medical Center's policy requiring her to remove her pants when they knew or should have

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known on the basis of her past history that restraining her and removing her pants by force would

cause her substantial emotional and potential physical harm, and which in fact did cause her

substantial emotional and physical harm.

118. Defendants further breached their duty to the plaintiff they instructed security guards to restrain and forcibly strip Ms. Sampson of

when, among other things,
her pants, leaving

her bruised and crying in pain, and causing her substantial emotional and physical harm.

119. Defendant Heather Richter owed Ms. Sampson a duty of care as her nurse. By,

among other things, insisting that Ms. Sampson remove her clothing even when told of

Ms.

Sampson's sexual abuse history; failing to consult Ms. Sampson's therapist when such

consultation was readily available; failing to inquire about the potential for use ofless restrictive

alternatives; refusing Ms. Sampson's request for a patient advocate, and ordering the physical

restraint and forcible stripping of Ms. Sampson by male security guards without ever

independently determining whether Ms. Sampson presented any kind of safety risk, Nurse

Richter violated her duty of care to Ms. Sampson, causing Ms. Sampson substantial emotional

and physical harm.

120. Dr. Kelly COlTigan owed Ms. Sampson a duty of care as her attending physician.

By, among other things, orally authorizing a physical restraint without first examining and

assessing Ms. Sampson, who was in a room a few feet away, without seeking consultation from

knowledgeable and available mental health professionals, without inquiring about the existence

of less restrictive alternatives, without making a determination that Ms. Sampson presented an

imminent risk of harm, and without taking the responsibility for determining the existence of an

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emergency sufficient to justify restraint, Dr. COlTigan violated her duty of care to Ms. Sampson,
causing Ms. Sampson substantial emotion and physical harm.

121. Defendant Beth Israel Deaconess Medical Center was also negligent in

developing, implementing and enforcing a policy requiring forcible removal of psychiatric

patients' clothing without any opportunity for waiver, exceptions, or individual mental health

examinations, when it knew or should have known that many psychiatric patients have traumatic

sexual abuse histories such that forcible clothing removal would foreseeably cause substantial

psychiatric and potential physical harm.

122. As a direct and proximate consequence of

the defendants' conduct, Ms. Sampson

suffered, and continues to suffer severe physical and emotional injuries, including, but not

limited to, bruising, increased migraines, and a greatly deteriorated psychiatric condition. As a

direct result of the defendants' conduct, Ms. Sampson attempted suicide. Ms. Sampson has

suffered terrifying nightmares and increased flashbacks of her childhood sexual abuse and was

hospitalized for months at several different facilities. She was unable to retur to Emergency

Deparments for any kind of treatment for months after her forcible stripping by male guards,

and required substantial treatment to enable her to do so.

G. Intentional or Reckless Inflction of Emotional Distress

123. Plaintiffrealleges and incorporates by reference paragraphs 1-122.

124. Nurse Richter, Dr. COlTigan, and Beth Israel Deaconess Medical Center knew or
should have known that their conduct, including, but not limited to, ordering five male security guards to physically restrain and forcibly strip a female patient with a psychiatric disability stemming from severe sexual abuse as a child was likely to cause emotional distress. Beth Israel

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Deaconess Medical Center, Dr. Corrigan, and Nurse Richter were on notice or should have been

on notice that Ms. Sampson had a history of severe sexual abuse when Nurse Richter ordered

security guards to forcibly strip Ms. Sampson and Dr. Corrigan authorized such restraint without

examining Ms. Sampson.

125. The defendants' conduct, including, but not limited to, stripping of a woman

known to have a history of severe sexual abuse by a group of male security guards was extreme

and outrageous, and beyond all possible bounds of decency in a hospital setting where patients

can expect to receive cai'e and treatment. The defendants' conduct is utterly intolerable in a

civilized community.

126. As a direct and proximate cause of

the defendants' conduct the plaintiff suffered,

and continues to suffer, severe emotional distress. Further, as a direct and proximate cause of the

defendants' conduct, the plaintiff attempted suicide, and required inpatient hospitalization for

months.

H. Assault and Batterv

127. Plaintiff real

leges and incorporates by reference paragraphs 1-126.

128. The defendants placed Ms. Sampson in reasonable fear of

imminent physical

har when, among other things, Nurse Richter and another hospital nurse repeatedly threatened

that the security guards would strip her forcibly.

129. Despite being on notice that Ms. Sampson was a patient with a severe history of

sexual abuse, and despite Ms. Sampson's attempts in good faith to meet the Hospital and Ms.

Richter's requirements by taking off

her blouse, socks and shoes, and by submitting to a pat-

down, the defendants caused and allowed security guards to forcibly restrain and strip the

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plaintiff. Nurse Richter and Dr. COlTigan are jointly responsible in that the assault was instigated by Richter and approved by COlTigan without investigation.
130. As a result of defendants' conduct the plaintiff suffered, and continues to suffer, severe emotional and physical injuries.

VI. Relief
Because plaintiff wil suffer irreparable har in the absence of permanent injunctive relief, and respectfully requests this Court to:
1. Assume jurisdiction over this action.

2. Enter a declaratory judgment finding that defendant Hospital violates Ms.

Sampson's rights under the ADA, Section 504 of

the Rehabilitation Act, and

M.G.L. Chapter 272, Section 98, by discriminating against her in the following

ways: 1) promulgating over-protective rules and policies applicable to patients

with psychiatric disabilties such as Ms. Sampson regarding required clothing

removal, leading to the unnecessar use of

force and restraint on Ms. Sampson

and other patients with psychiatric disabilities; 2) informing Ms. Sampson that

she would always be required to remove her clothing whenever she went to the

psychiatric portion of the Emergency Department in the future, regardless of her

mental condition or emotional state; 3) refusing to make reasonable

modifications to its practices and policies regarding clothing removal, when Ms.

Sampson requested those modifications on March 25, in its subsequent letter to

her, and up to the current day;; 4) failing to require an individualized assessment

by a mental health professional prior to restraining and forcibly stripping Ms.

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Sampson; 5) restraining and stripping Ms. Sampson in a situation that is not an

emergency.

3. Issue injunctive relief enjoining the Hospital

1) from applying its current

search/disrobing policy to Ms. Sampson; 2) to modify its search/disrobing policy

to permit consideration of requests for reasonable accommodations on the basis of

disability, including reasonable accommodations for people with psychiatric

disabilities such as wanding, two-on-one observation, or immediate assessment by

a mental health professional; 3) to conduct an individualized.

assessment of

Ms.

Sampson by a mental health professional and written findings prior to initiating

any requirement of clothing removal unless Ms. Sampson meets CUlTent

professional standards for immediate restraint; and 4) from restraining Ms.

Sampson in the future unless she meets the current professional standards for

restraint as set fort in CUlTent law and regulations.

4. Award plaintiff

her costs and reasonable attorney's fees, as permitted under 42

U.S.C. §2205, 29 D.S.C. §794a(b), M.G.L. Chapter 272, Section 98 (by reference

to M.G.L. Chapter 15lB, Section 5) and M.G.L. Chapter 12, Section 111.

5 . Award plaintiff compensatory damages of over one millon dollars under 29
D.S.C. 794, M.G.L. Chapter 272, Section 98 (by reference to M.G.L. Chapter 15lB, Section 5), M.G.L. Chapter 12, Section IlH and I, and state tort claims. 6. Award plaintiff such other and further relief as the COUli may deem just and appropriate.

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Plaintiff demands a jury trial on all claims for which she is entitled to a jury, including

her claim for damages under Section 504 of

the Rehabilitation Act, M.G.L. Ch. 272, Sec. 98,

M.G.L. Ch. 12, Section IIH and I, and under the state claims of

negligence, intentional

or

reckless inflction of emotional distress, and assault and battery for compensatory and punitive

damages.

Respectfully Submitted,

Date: April 2, 2007

Isl Scott M. Heidorn Clyde Bergstresser, BBO#039200 Scott Heidorn, BBO #661787 Campbell, Campbell, Edwards & Conroy One Constitution Plaza Boston, MA 02129

Susan Stefan BBO #600897 Steven Schwartz BBO #448440
Center fOr Public Representation
246 Walnut Street Newton, MA 02460 617-965-0776

Ira Burnim, DC Bar #406154

Karen Bower, DC Bar #450888

Bazelon Center for Mental

Health Law

Suite 1212

1101 15th St. N.W.,

Washington, D.C. 20005

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