FILED U.S. COURT OF AP P E ALS E LE V EN T HC IRC U IT NOVEMB ER 30, 2006 THOMAS K. KAH

N CLERK [ DO NO T P UB L I S H] I N THE UN I TE D STATE S C OU RT OF APPE ALS F O R T H E E L E V E N T H C IR C U IT

________________________ N o. 06- 12426 N on -A rgum entC al endar

________________________ D. C . Do c k e tNo . 0 4 - 0 1 4 3 6 - C V- OR L - 3 1 DA B B E N J A M I N L E V I J O H N S O N , P la in tif f
- A p p e lla n t, v ersu s H E A L T H C E N T R A L H O S P I T A L , D e f e n d a n t- A p p e lle e .

________________________ A pp ea l fr om the U ni t ed S t at es D i stri ctC ou rt f orthe M i ddl e D i s tr i c tof F l or i da

_________________________ ( N ove m b e r 30, 2006) B efo re D U B IN A , C A RN E S an d M A R C U S , C i rcu i tJu d g es. P E R C U R I A M: B enj am i n L evi John son, proceedi ng pro se, appeal s the di stri ctcourt ’ s e ntry o f s u m m a r y ju d g m e n t in f a v o ro f th e d e f e n d a n t, H e a th C e n tr a l H o s p ita l ( “H e a lth C e ntr a l ” ) , i n thi s a c t i on a l l e gi ng v i o l at i o ns of the E m e r ge nc y M e di c a l T r e a tm e ntJ ohnson also alleg ed a violation of F lorida’s B aker Act, F la. Stat. § 394.467, which 1 allows a person to be plac ed involuntarily in a treatment fac ility

if clea r and c onvincingevidenc e indicates that the person is mentally ill, and inter alia, there is a substantial likelihood that, based on rec ent beha

vior, the per son will inflict serious bodily harm on himself or on a

nother person. We discern no error

in the entry

of summary

judgment on this claim, as J ohnson failed to pre sent any evidenc e showingthat he should havebeen placed in “ involuntary inpatient placement.” I d. at § 394.467(1). 2 a nd A c t i ve L aborA c t( “ E M T A L A ” ) , 42 U . S . C . § 1395dd, a nd di s c r i m i na t i on b a s e d o n r a c e , i n v i o l a t i o n o f th e Ci v i l Ri g h t s A c to f 1 8 7 1 , a s a m e nde d, 4 2 U . S. C. § 19 8 3 . O n appe a l , J ohns on a r gue s tha ta s pa r tof hi s e m e r ge nc y m e di c a l tr e a tm e nt atH ea l th C entra l , he w as no taf forded the sa m e l evel of ca re an d tre atm entas other p a tie n ts in s im ila r c i r c u m s ta n c e s . M o r e s p e c if ic a lly , h e a s s e r ts th a t b a s e d o n h is
r a c e , H eal th C e ntr a l f

a i l e d t o pe r f

or m c e r t a i n E M T A L A - r e qui r e d pr oc e dur e s pr i or t o r e l e a s i n g h i m f

r o m i t s f a c i l i ty . A f

t e rc a r e f u l r e v i e w , w e a f

f i r m. 1 W e r e vi e w a di s tr i c tc our t ’ s rul i ngs on a m ot i on f or sum m a ry j udgm e ntde novo, us i ng the s a m e l e ga l s t a nda r d a s the di s tr i c tc our t . N ol e n v. B oc a R a t on C om m un i ty H osp. , Inc. , 37 3 F . 3d 11 5 1 , 1 15 3-54 (11th C i r. 20 04 ). “ S um m ary ju d g m e n t is o n ly ap p r o p r ia te if t h e p l e a d in g s , d e p o s itio n s , a n s w e r s to i nt e rr oga t or i e s , a nd a dm i s s i ons on f i l e , t oge the rw i th the a f f i da vi t s , i f an y, s how th a t th e r e is n o g e n u in e is s u e a s to a n y m a te r ia l f a c t a n d th a t th e m o v in g p a r ty is e n t i t l e d t o a j u d g me n ta s a m a t t e r of l a w . ” I d . ( i n t e rn a l q u o t a t i o n s o mi tt e d ) ; Fe d . R. Ci v . P. 5 6 ( c ) . “ Su mma ry j u d g me n ts h o u l d b e g r a n t e d w h e n , a f t e r a n a de q u a t e t i me3

for di sc ov ery, a p arty f ai l s t o m ake ashow i ng suff i ci entt o est abl i sh the exi st ence of an es sen ti al el em entof thatparty’ s c as e. ” I d. T he evi dence, and al l i nfer ence s dr a w n f r om the f

a c t s , m us tbe vi e w e d i n the l i ghtm os tf a vorab l e t o t h e nonmo v i n g p a r ty . M a t s u s h i t a El e c . I n d u s . Co . , Lt d . v . Ze n i th Ra d i o Co rp . , 4 7 5 U . S. 5 7 4 , 5 8 7 ( 1 9 8 6 ) . I n o r d e r to d e f e a t s u m m a ry ju d g m e n t, th e n o n - m o v in g p a r ty

“ m us tdo m or e tha n s i m pl y s how tha tth ere i s s om e m e t aphy s i c a l doubta s t o the
m a t e r i a l fact s. ” Id . a t586. R a the r , the non- m ovi ng pa r ty m us tm a ke a s uf f i c i e nt s how i ng on e a c h e s s e nt i a l e l e m e n t o f t h e case f orw hi c h he ha s the bur de n of proo f. C el ot ex C orp. v. C atre tt , 47 7 U . S . 31 7, 32 3 (19 86 ). T he r e l e va nt f

a c t s a r e s tr a i ght f

orw a r d. O n S e pt e m be r 29, 2004, Johns on fi le d h i s c om pl ai ntal l egi ng thaton N ov em ber 5, 20 00 , H ea l th C entra l em er gency phy s i c i a ns di a gnos e d hi m w i th an ove r dos e of the ps y c hi a tr i c m e di c a t i on b e n z o d ia z e p in e a n d a d m itte d h im to th e I C U u n d e r“s u ic id e p r e c a u tio n s .” A c c o r d in g to J o h n s o n , H e a lth C e n tr a l s ta f f u n d e r s to o d th e s e r io u s n e s s o f h is
m e d ic a l c o n d itio n , b u t f a ile d to p e r f

o r m th e “c u s to m a ry c h a r c o a l p r o c e d u r e to r e mo v e th e p i l l s ” a n d s t ab i l i z e h i m. H e a l s o a s s e r t e d th a tw h e n h e b e c a me c o m b a tiv e , th e I C U s ta f f b e c a m e a n g ry w i th h is p s y c h o tic c o n d u c t a n d tr e a te d h im di s pa r a t e l y f

r om othe rpa t i e nt s i n s i m i l a rc i r c um s t a nc e s . T he f ol l o w i n g d ay, on N o v em b er 6 , 2 0 0 0 , Jo h n s o n w a s rel eased fro m th e H eal th C en tral faci l i ty. H e says th a t h e w a s s till in a p s y c h ia tr ic a lly d is tu rb e d s ta te a n d th a t H e a lth C e n tr a l s h o u ldAbout four hour s after his relea se from the hospital, J ohnson was ar rested f or assa ulting 2 a law enforc ement off

icer . He pled guilty

to the charg e and w as sentenc ed to a 22- month term of imp ri so nment. 4 h a v e st ab i l i zed h i s co n d i t i o n p ri o r t o rel ease, o r tran sferred h i m t o a m en t al h ea lth f a c ility f o rf u r th e rtr e a tm e n t. I n th e c o m p l a in t, J o h n s o n a lle g e d th e f o llo w in g in

ju r ie s r e s u ltin g f

r o m h is a l l e g e d p r e ma tu r e r e l e a s e : ( 1 ) h e s u f f e r e d f r o m 6 0 % h e a r i n g a n d t o n e r e c o g n i t i on l os s ; ( 2) he a c qui r e d a “ s c hi z a f f e c t i ve ” di s or dera s s oc i a t e d w i thi n non- c onvul s i ve s e i z ur e s a nd a ne ur ops y c hi a tr i c br a i n di s or de r ; a nd ( 3) he w a s arr e s t e d f or i rr at i on al cond uct , re sul t i ng i n tw o yea rs i m pri sonm ent . John son r eq uest ed 2 da m a ge s i n the a m ountof f ou r m i l l i on dol l a r s f

orpa s ta nd f

utur e phy s i c a l pa i n, m en t al an g u i s h , b o d il y i n j u ri es, i n co n v en i en ce, m ed i cal ex p en ses, l o ss o f earn i n g s, a n d d im in is h e d e a rn in g c ap a c ity . H ea l th C en tr al m ov ed for s um m ary j ud gm ent , al l egi ng thatJohn son h ad be e n tr a ns por t e d t o H e a l th C e ntr a l ’ s e m e r ge nc y r oom w i th a n a l l e ge d drug o v e r d o s e a n d c o c a i n e i n t o x i c a t i o n o n No v e mb e r 5 , 2 0 0 0 a n d wa s a d m i tt e d t o I C U, af t erw hi ch he became fai rl y c om bat i ve and u l t i m at el y l ef tagai nstm edi ca l advi ce . H eal th C en tral p o i n t ed o u tth ati n th e co u rs e o f d is c o v ery, i th ad serv ed a req u est f ora dm i s s i ons on J ohns on, t o w hi c h he ne ve rr e s ponde d. C i t i ng R u l e 3 6 of the F e de r a l Ru l e s o f

Ci v i l Pr o c e d u r e , H e a l th Ce n tr a l n o t e d th a tr e q u e s t s f o ra d mi s s i o ns a r e a ut om a t i c a l l y de e m e d a dm i tt e d i f nota ns w e r e d w i thi n 30 da y s a nd tha tthe5

m att er s there i n con cl usi vel y e st abl i shed u n less the courton m ot i on perm i tt ed
w i thdr a w a l ora m e ndm e ntof the a dm i s s i ons . N ot abl y , by notr e s pondi ng t o the re qu es tfor a dm i ss i on s, John son adm i tt ed that : he w as eval uat ed by an em er gency m e di c a l phy s i c i a n; he w a s pl a c e d unde rthe c a r e o f D r. P r a de e p K . V a nga l a , w ho a d m itte d h im to I C U a n d o r d e r e d a p s y c h ia tr ic c o n s u l t a tio n ; a n d h e le f t th e H e a lth C entra l fa ci l i ty a gai nstm edi ca l advi ce . H e a l th C e ntr a l a r gue d f ur the rtha tJ ohns on a l s o a dm i tt e d, by notr e sp o ndi ng, thathe re ce i ved the fol l ow i ng m ed ical ca re , sc re eni ng , and t es t i ng : (1) a n e m e r ge nc y phy s i c i a n e va l ua t i on; ( 2) a n a dm i s s i on unde rD r . V a nga l a a nd t o the IC U ; (3) 1: 1 m on i t ori ng by a nu rs e: (4) cont i nu ou s ca rdi ac , re spirato ry ra t e, o x y g e n s a tu r a tio n , a n d b lo o d p r e s s u r e m o n ito r in g ; ( 5 ) in tr a v e n o u s ( “I V ” ) f lu id the r apy ; ( 6) ur i na l y s i s ; ( 7) c ul tur e a nd t oxi c ol ogy s c r e e ni ng; ( 8) c hest x -ray; ( 9) b lo o d w o r k ; a n d ( 1 0 ) a s s e s s m e n t f o ru lc e rr is k . I n s u p p o r t o f s u m m a ry ju d g m e n t, H ea l th C ent erprov i ded the af fi davi tof D r. C h ar les L . L oP i cc ol o, i t s e xp ert f or e ns i c ps y c hi a tr i s tw ho r e vi e w e d J ohns on’ s m e di c a l r e c or ds , t o co rr obor a t e the fact s ad m i tt ed b y Jo h n so n ’ s fai l u re t o resp o n d t o th e re q u e s t fo r ad m i ssi o n s. H e a l th C e ntr a l a l s o a rg ue d tha tthe E M T A L A ’ s s t abi l i z a t i on r e qui r e m e ntdi d not appl y be c a us e J ohns on w a s not“ tr a ns f e rr e d” a s de f

i ne d unde rE M T A L A , but
r a th e rwa s a d mi tt e d t o th e I CU. Ac c o r d i n g t o He a l t h Ce n tr a l , i t s EM TALA6

obl i ga t i ons c e a s e d onc e J ohns on w a s a dm i tt e d a nd r e c e i ved tr e a tm e nt , a nd a ny a c tio n ab le c la im s w o u ld b e r e m e d ie d e x c lu s iv e ly u n d e rs ta te to r t la w . I n f ur the r s uppor t of i t s m ot i on, H e a l th C e ntr a l s ubm i tt e d: ( 1) i t s r eq u estf or a dm i s s i ons f

i l e d A ugus t25, 2005; a nd ( 2) D r . L o P i c c ol o’ s c urr i c ul um vi t a e a nd a f f i da vi ti n w hi c h he s t a t e d tha thi s e xa m i na t i on of the m e di c a l r e c or ds r e ve a l e d no e vi de nc e of

ne gl i ge nc e a s t o J ohns on’ s tr a ns f e rt o I C U ori n the s t abi l i zat i o n a nd thatH ea l th C entra l ’ s a ct i on s w er e w el l w i thin th e stan dard of m edi ca l ca re . D r. L oP i cc ol o al so no t ed thatthe re cords s ho w ed thatJo h n so n w as se en by an e m e r ge nc y phy s i c i a n; w a s a dm i tt e d t o the h o sp i t al ; w a s s e ntt o the I C U upon orders of D r. V an gal a f or ob se rvat i on on a 1: 1 b as i s; re ce i ved con t i nu ed
m oni t or i ng f

orc a r di a c i s s ue s , r e s pi r a t i on, bl ood pr e s s ur e , a nd oxy ge n s a tur a t i on; a nd r e c e i ve d I V f

l ui d the r apy , e m erg enc y r oom a na l y s i s , c ul tur e , a nd t oxi c ol ogy sc re eni ng , ches tx-ra y, bl oo d w ork-up , and u l ce r r i sk as se ss m ent. F i nal l y, D r. L oP i c c ol o not e d tha ta ps y c hi a tr i c co n su l t at i on w a s or de r e d butJ ohns on l e f tthe ho spi t al “ of hi s ow n fre e w i l l ” a nd si gn ed a w ritt en ac kn ow l edgm entthathe w as le a v in g th e h o s p ita l a g a in s t th e a d v ic e o f h is p h y s ic ia n . I n r e s p o n s e t o He a l th C e n tr a l ’ s mo t i o n , J o h n s o n s u b m i tt e d th a th i s o wn a f f i da vi te s t abl i s he d tha tm a t e r i a l i s s ue s of f a c tr e m a i ne d a s t o w he the rhe l e f tthe ho spi t al by hi s o w n choi ce or w as forc ed ou tand as t o w hether he w as st abi l i ze d
w h e n h e w a s f

o r c e d to le a v e . I n h is a f f id a v it, J o h n s o n a tte s te d th a t h e r e q u e s t e d to7

u se th e p h o n e atH eal th C en tr a l a n d th e n u rse rep eat ed l y t o l d h i m h e co u l d n o tu se the phone . A f

t e rhe c ont i nue d a s ki ng, h o w ev e r , he w a s gi ve n a f or m t o s i gn a nd si g n ed i taft er b ei n g to l d h e h ad t o si g n th e fo rm b efo re u si n g th e p h o n e. T h e n u rse t hen re move d h i s I V s a nd t oo k h i m t o at e l e ph on e . H e “ c a l l e d mybo s s , a nd af t er abou tf i ve ( 5) m i nut e s m y bos s c a m e t o pi c k m e up. ” H e s a i d he ne ve rr e a d the f o r m h e s i g n e d . J o h n s o n d id n o t w a n t to le a v e H e a lth C e n tr a l b u t w a s f o r c e d to l e a ve by the nur s e a nd, ap p roxi m a t e l y f ourhour s a f

t e rhe l e f t , he w a s s t i l l “ outof c o n tr o l” a n d “h a llu c in a tin g ,” w h ic h r e s u lte d in h is a rr e s t b y th e p o lic e . T h e d is tr ic t c o u r t g r a n te d H e a lt h C e n tr a l’s m o tio n f o rs u m m a ry ju d g m e n t. T he di stri ctcourtfoun d thatthe sol e quest i on w as w hethe r H eal th C entra l c om pl i e d w i th the E M T A L A by pr ovi di ng appr opr i at e m edi c a l s c r e e ni ng a nd st abi l i za t i on . B as ed o n D r. L oP i cc ol o’ s a ff i davi t , the courtfoun d thatJohn son h ad
r e c e i ve d both appr opr i a t e m e di c a l s c r e e ni ng a nd s t abi l i z a t i on tr e a tm e nt . T he di s tr i c tc our tf

ound tha tJ ohns on of

f e r e d no r e butt al t o the f or e goi ng f

a c t s , e xc e pt t o s ugge s ttha the s houl d ha ve r e c e i ve d a “ ch a r c oa l t e s t , ” a nd tha thi s l a y opi ni on d i d n o t p r e s e n t a m a te r ia l f a c t s u f f ic ie n t to p r e v e n t th e e n try o f s u m m a ry ju d g m e n t. T h e d is tr i c tc o u r t w e n t o n to e x p la in th a t th e p u rp o s e o f th e E M T A L A w a s to pr e ve nt“ pa t i e ntdum pi ng” a nd nott o a c ta s a s ubs t i tut e f ors t a t e l a w c l a i m s of
m e di c a l ne gl i ge nc e . T he c ou rt fo u n d t h a tthe f a i l ur e t o pe r f

or m a pa r t i c ul a rnonE M T A L A -m andat ed m edi ca l procedure w as no ta genui ne i ss ue of m at er i al fa ct8

because the om i ss i on di d n o t r ise t o the l evel of a f ai l ure t o app ropri at el y s cr ee n and st abi l i ze the pa ti en t, w ith i n the m ea ni ng of the E M T A L A . F i nal l y, the court foun d thatJohn son’ s s t at em entthath e w as fo rc ed t o l eave H ea l th C entra l w as “p a te n tly r id ic u lo u s ” b e c a u s e th e e v id e n c e s h o w e d th a t h e h a d ab a n d o n e d h is tr e a tm e nta nd l e f

tH e a l th C e ntr a l a f

t e rs i gni ng a n a c know l e dgm e nttha thi s l e a vi ng w a s c ontr a ry t o the a dvi c e of H e a l th C e ntr a l phy s i c i a ns . T hi s appe a l f ol l ow e d. O n ap p e a l , J o h n s o n u r g e s th a t w he t he r H e a l th Ce n tr a l ’ s f a i l u r e t o p e r f

o r m a

“ c ha r c oa l pr oc e dur e ” a nd a “ ps y c h c ons ul t at i o n ” vi ol a t e d the E M T A L A orthe C i vi l Ri g h t s A c t i s a g e n u i n e i s s u e o f ma t e r i a l f a c t th a t p r e v e n t e d e n tr y of sum m ary j ud gm entagai nsthi m . W e di sa gree . U nd erthe E M T A L A , covered hospi t al s m ustsc re en fo r an em er gency m e di c a l c ondi t i on a ny i ndi vi dua l w ho i s a dm i tt e d t o i t s e m e r ge nc y r oom s e e ki ng treatm en t . S ee 4 2 U . S . C . § 1 3 9 5 d d (a). If su ch a co n d i t i o n ex i st s, th e h o s p it al m u st t h e n p r o v id e s tab iliz in g tr e a tm e n t b e f o r e d is c h a r g in g o rtr a n s f e rr in g th e p a tie n t. I d. a t§ 1395dd( b) . A n E M T A L A vi ol a t i on thus a r i s e s w he n a hos pi t a l e i the r( 1) f a i l s t o a deq u at el y s c r e e n a pa t i e nt , or( 2) di s c ha r ge s ortr a ns f e r s the pa t i e nt w ith o u t f

ir s t s tab iliz in g h is e m e r g e n c y m e d ic a l c o n d itio n . S e e H a r r y v . M a r c h a n t, 2 9 1 F .3 d 7 6 7 , 7 7 0 ( 1 1 th C ir . 2 0 0 2 ) ( e n b a n c ) . A d d r e s s in g th e “ap p r o p r ia te m e d ic a l s c r e e n in g ” r e q u i r e m e n t, w e h a v e h e ld tha t“ [ s ] e c t i on 1395dd( a ) i s notde s i gne d t o red re s s a ne gl i ge ntdi a gnos i s by the9

ho spi t al ; no fe dera l m al prac ti ce cl ai m s a re cr ea t ed. A s l on g as aho spi t al appl i es t h e sa m e s c r e e ni ng pr oc e dur e s t o i ndi ge ntpa t i e nt s w hi c h i tappl i e s t o pa y i ng pa t i e nt s , the hos pi t a l doe s notvi ol at e thi s s e c t i on of the A c t . ” H ol c om b v. Mo n a h a n , 3 0 F . 3 d 1 1 6 , 1 1 7 ( 1 1 t h C i r . 1 9 9 4 ) ; s e e a l s o 4 2 U. S . C . § 1 3 9 5 d d ( a ) . As for the se cond re qu irem en t, the “ st abi l i za t i on ” r equi re m ent , w e have expl ai ned that

“ [ t ] he r e i s no duty unde rE M T A L A t o pr ovi de s t abi l i zat i o n tr e a tm e ntt o a pa t i e nt w i t h a n e me r g e n c y me d i c a l c o n d i t i o n w h o i s n o t tr a n s f e rr e d ” a n d th a t i n s uc h a s itu a tio n , a p la in tif

f is n o t w i t h o u t r e c o u r s e b e c a u s e “r e m e d ie s p r o v id e d b y s ta te m a l pr a c t i c e a nd t or tl a w r e m a i n a va i l abl e t o r e dr e s s ne gl i ge nt p a t i e ntc a r e by hos pi t a l s . ” H a rry , 291 F . 3d a t775. H ere, t h e di s tr i c tc our tdi d note rrby gr a nt i ng H e a l th C e ntr a l ’ s m ot i on f or s u m m a ry ju d g m e n t b e c a u s e th e e v id e n c e , v i e w e d in th e lig h t m o s t f a v o r ab le to J ohns on, f

a i l s t o e s t ab l i sh t h a tH e a l th C e ntr a l vi ol a t e d hi s r i ght s unde rthe E M T A L A . A s t o the “ approp ri at e m ed ical sc re eni ng ” r equi re m ent , no evi dence s u g g e s te d th a t J o h n s o n w a s tr e a te d d if f e r e n tly f r o m o th e rp a tie n ts . T h e o n ly evi dence thatJohn son p rovi ded w as hi s o w n l ay op i ni on thatthe “ cust om ary c ha r c oa l pr oc e dur e t o r e m ove t h e p i l l s” s houl d ha ve be e n pe r f or m e d a l ong w i th a psyc ho l og i c a l e xa mi na t i on , w hi c h he w a s s c he du l e d t o un de r go bu t vo l un t a r i l y l ef t th e f a c i l i t y b e f

o r e r e c e iv in g . A s to th e “s tab iliz a tio n ” r e q u ir e m e n t, th e r e c o r d f a ils t o e s t abl i s h tha tJ ohns on w a s e i the r“ tr a ns f e rr e d” or“ di s c ha r ge d” w i thi n theUnder the EMTALA, “‘ [t ]ransfer ’ is define d as ‘the movement (includingthe 3 dis c ha rg e ) o f a n indiv idual outsi deof

a ho sp ital’ s f

a c ili tie s’ ”and

re ferenc eto a

patient who is “tra nsfer red . . . will apply

equally to a patient who is discharg ed.” H arr y , 291 F.3d at 768 n.1 (citing42 U.S.C. § 1395dd(e)(4) (1994)) . 10 m ea ni ng of the E M T A L A . O n thi s r ec ord, th e d istri ctcourtcorr ec t l y e nt er ed 3
s u mma ry j u d g me n to n J o h n s o n ’ s EM TA LA c l a i m. W e l i kew i se ar e unp er suaded by John son’ s a rgum entthatth e di stri ctcourt e rr e d i n i t s a na l y s i s of

hi s r a c e di s c r i m i na t i on c l a i m unde r 4 2 U . S . C . § 1983. F r om ou r r evi ew , i ti s i m pl i ci ttha t th e d i stri ctcourtfoun d the cl ai m t o b e f ri vo l ou s, af

t er ob se rv i ng thatJohn son’ s E M T A L A cl ai m s, w hi ch re l y on the sa m e f ac tual basi s a s th e § 1 9 8 3 c la im , w e r e “f r iv o lo u s .” I n a n y e v e n t, H e a lth C e n tr a l w a s e n title d to sum m ary j ud gm enton the cl ai m sin ce John son est abl i shed nei ther avi ol at i on of a const i tut i on al ri gh tno r thatw hen the al l eged vi ol at i on occurre d, H ea l th S ou th -- a p r i v a t e e n t i ty - - w a s a c t i n g u n d e rc o l o ro f s t a t e l a w . Cf

. W e s tv . A tk i ns , 487 U . S. 4 2 , 4 8 ( 1 9 8 8 ) ( e n u m e r a tin g e le m e n ts o f § 1 9 8 3 c la im ) . AF F I RME D.