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P r e c e de n t i al or N on-P r e c e de n t i al : P r e c e de n t i al
D ocke t N o . 01-3450

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Thi s de c i sion i s br ou gh t t o you for f r e e a nd ope n a c c e s s b y the O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit at V i l l a no va U nive r sit y S choo l of L a

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. It h as be e n a c c e pt e d for inclusion in 2004 D e c i sion s b y a n author i z e d a dmini s tr at or of V i l l a no va U nive r sit y S choo l of L a

w Di g it al Re posit or y

. F or mor e infor m at ion, p le as e c on t a ct Be n j a min

. C a rl s on@l a

w . v i l l a no va . e du

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w . v i l l a no va . e du/thir dc ir c uit_2004/548PRECE DENTI AL

UNIT ED STA TES C OURT OF

APPEALS FO R T HE TH IRD CIR CU IT

____________ No. 01-3450

____________ DONALD BENN , Appellant

v.
UNI VE RS AL HE AL TH SY ST EM, INC. ; HORSHAM CLI NIC; RAMESH ELUR I, DR.; EILEEN WILCOX; MONTGOMERY COUNTY MH-MR EMERGENCY SERVI CE, d/b/ a MONTGOMERY COUNTY EM ERGENCY SERVICE, IN C.; V EN U M UK ER JEE , DR ., Indiv idually, sev erally, jointly and /or in

the al ternat

ive; ST EP HE N Z ER BY , M .D.; M OH AM M AD QU AS IM , DR ., C/O

MONTGOMERY COUNTY EM ERGENCY SERVICE, INC . 5 0 BEE CH DRI VE NORR ISTOWN, PA 194 01 INDIVI DUALLY, SEVER ALLY, JOI NTLY AND/OR I N THE ALTER NATI VE

___________________ ON APPEAL FROM THE UNITED STATES DI STRI CT COURT FOR THE EASTE RN DI STRI CT OF

PEN NS YL VA NIA Dis tric t C our t J udg e: Hon or ab le Mar y A. M cLa ugh lin (D.C. No. 99-cv- 6526)

____________________ Sub mi tted Und erThi rdCi rc ui t L AR

34.1(a) December 4, 2003

Be for e: S LO VI TE R, A LIT O, Circu it Judges , a nd OBERDORF ER, * Distri ct

Court Judge (Opinion Fi led: J une 17, 2004)

ROSS B EGELMAN Begelman & Orlow 411 Rou te 70 East Suite 245 Cherry Hill, New Jersey 08034 Counsel for

Appellant

KEVIN J. O’BRIEN Marks, O’Neill , O’Brien, & Courtney 1880 JF K B oulevard Suite 1200 Philadelphia, PA. 19103

KENNETH D. P OWELL, J R. Rawle & H enderson 334 West Front St

reet 2 nd Floor Media, PA. 19063

CHARLES W. CRAVEN MA RIO N H . GRIF FIN

* T he Hon orable Lo uis F. Ob erdorfer, United States Distri ct Judge f or the Di st rict of Columbia, s itt ing b y designation.2

M arsha ll, Dennehey, Warner, Coleman & Go ggin 1845 Walnut Stre et 16 th Floor Philadelphia, PA 19103 Counsels f

or Appelle es

____________________ OPINI ON OF THE COURT

____________________ Ali to, Circuit

Judge :
This case concerns Don al d Ben n’s short- t erm involunt ary commitment t o a ps ychiatric facil ity

for an emergency examinati on. After his relea se, Benn broughtfedera l and state claims against those involved i n his commitment. The Distri ctCourt granted summary j udgment in fav orof a lldef

end ant s. We af

fi rm.
I.

Prior to the event s at i ssue here , Donal d Ben n was under the care of therapist Dr. Jack Hartke and psychiatris t Dr. Lynn Bornfri en d, both of whom had treated him for depre ssion an d p osttraum atic stress dis o rd er. The t reatment include d anti- depressant medication.

On August 15, 1 998, Benn tele phoned th e Hor sha m Cl ini c (“Hor s ham”) thre e tim es. H orsh am , a m entalhealthcare faci lit y i n Montgom er y C ou nt y, Pennsyl vania, is wholl y owned by UniversalHealth Sy stem , I nc. (“UH S”). Each ti me Benn called Hors ham, he spoke to Eileen Wil cox, an experienced crisisline coun selo r. Benn t old Wilcox t hat he
was look ing fo r treatm ent fo r posttraum atic stress d is order and w a s in teres ted in Horsham. Benn admit s that during one conversat

ion he t old Wilcox that he was dr ivi ng ov er th e T ac on yPalmyra Bridge. Wil cox cl ai ms that Benn told her he had stopped his car and had
co ns ideredjumping off the bridge. Benn denies this. W ilco x told Benn that Horsham did not make r eg ula r outpatient appo intme nts but that

theywould as se ss his need for

care i f he came in.

Benn arri ved at Horsham late that evening and w as quickly interv iew ed by p s ychiat rist Dr. Ramesh Eluri . The interview lasted 40 minutes, and Dr. Eluri cl ai ms th at , d ur in g the in te rv ie w, Be nn admitt ed to being de pr esse d and suicida l. Benn asserts that he nev er tol d Dr. E luri that he w as suicidal and that Dr. Eluri misunderstood him bec ause of D r. Eluri’s poor Eng lis h. After the interv iew, D r. Eluri told Wil cox that he was concerned for Benn’s s afetyand that a peti tion for invo lu ntary com mitm ent m ight b e necessary b ecause Benn refus ed to seek treatm ent. Be nn, h ow eve r, did agree to sign a “Contract

for Saf ety,” which stated:
I, Donald Benn on Aug ust 15, 1 998 agreed t o keep myselfsafe and that if

I feel any in cr ease of sui cidal thou ghts or fe e ling I w ill contact Horsh am C linic [or] the police .” Below the3

contra ct, B enn w rote : “W hil e there i s no doubt wha t-so-e ver that m y mental/emotionalhealth has b e e n GREATL Y compromised I fe e l as certain as certa in can be that
a fe w m ore days wo n’t hurt (too much). ”

Wilcox asked Benn to re main atthe clinic wh ile Dr. E luri look ed ov er the c ontrac t, but B enn r efus ed an d left. Upon seeing the co ntract, Dr. Eluri’s concern about

Benn ’s sa fe ty

gr ew, and he file d an a pplica ti on un der a pro visi on of P enns ylvania’s M ental He alt h Procedures Act (MHPA ), 50 Pa. Stat. Ann. § 730 2(a), req uesting that B e nn be examined to dete rmin e hi s need for tr eatm ent. See Ap p. 24 0-4 2. Th e applic ationstated:
[Benn] said h e had seriou sly thoughtaboutjumping from Coney Bridge [sic], while he
was driv i ng. In fac t, he stopped the ca r. He a dm its feeli ng su ic idal now and feels un s afe and unst able. He also bel ieves t

ha t his
m e ntal healt h i s compromised and needs hospit aliz ation. He also
sa ys h e had suici da l thou ghts cons istently for the pa st few we eks. H e is vague abou t h i s atte mp ts... In my asse ssme nt, Pt. is very suicida l, f eels uns afe and dange rou s to h ims elf. He need s inpa tient treatm ent. App. 242.

The petiti o n was reviewed bythe
coun ty administ

rat o r, who authorized the policeto takeBen n int o custody . The p olicewent to Benn’s home, and he wa s trans portedby ambulance to M ontgom ery Co unty Emerge ncy Ser vice Inc

. (“M CE S”), a private, not -for- profi t psychiatric hosp it al in No rr is to wn , Pennsyl vania, that, by cont ract, handles all involuntary and emergencypsyc h i atric
con fine me nts in the c oun ty. Upon a rri val at

MC ES, Benn was placed in an is olate d w aitin g r oom . H e was then seen by

Dr. Stephen Zer

by , a n MCES psyc hiatrist , who conducted an hour-l ong interview and decided, based on the interview and Dr. Eluri’s pe tition, t hat Benn should be admitt ed for an emergency examinati on for the peri od permitted by the MHP A, 50 P a. Stat. Ann. § 7 302(d), i.e., not m o re than 120 hour s. App. 244. The next day , August 16 , B enn was interview ed by Dr. Mohamma d Qua si m, an other MCES psychia tri st, who continued the treatm ent started byDr. Zerby . The following day, August 17, Benn was seen by Dr. Venu Muker

je e, ye t a notherMCES psychiatris t, who f ound him to have “limi ted insi ght and obvious [] diffi culti es with impulse control , where he might have
ve rbali zed suici da l int ent while a t Horsham

. . . . His i nsight is l imit ed and his judg men t is defini tely impaire d.” App.4

21. On Aug ust 18, Dr. Mukerjee not ed that “[ Ben n] is no w c ontrac ting fo r safe ty and has n ever b een s uicida l since h is admissi on here.” He was then rele ased. App. 22. During his time at MCES, Benn
was in conta ctwith his common-law wife, his treat ing ther apis t, a la wyer, and a friend. Benn claims t hat his detentio n room had no toil et and that hewas forced to urinate on the walls.

In December 1999, Benn fil ed t his acti on in the Un ited States District Co urt for the Eastern D istri ct o f Pe nnsylva nia againstWil cox , Dr . Elur i, Hors ham, UHS, MCES, Dr . M uke rjee, Dr. Zerby, and D r. Qu as im. Benn asserted clai ms unde r 4 2 U.S .C. § 1983 for allege d vio lations o f his proceduraland substantive due process rights, as w ell a s nu mer ous to rt cl ai ms under Pen ns y lv an ia la w, to wit , neglige nc e/ malpract ice, intent iona l infli ctionof emotionaldist ress, assaul t and b a tte ry, neglig ence , and f als e impris onm ent. In a ddi tion , Ben n sought punitive damages against all defendants.

The parti e s fil ed cross- motions for
summ ary judgment. In July 200 1, the Distri ctCourt granted summary j udgment in favo r of all d efen dants . The Co urt held that Dr. Elu ri , Wi lc ox, Hors ham, an d UHS
were not state actors and th us co uld not be sued under §1983. In addi tion, assuming for the sake of

argum ent that MC ES, D r. M ukerjee , Dr. Zer

by , and D r. Qua si m we r e state actors , the C ourt h eld tha t they did not violate Benn ’s right to subst antiveor procedu ra l d ue process. The Court also grantedsumm ary jud gm ent on the state tort cla ims for al l parties exce pt Wilcox, because it found t

hat the s e par ties were immune from such claims underSec tion 11 4 of th e M HP A, 5 0 P a. St at. Ann

. §7114. As for Wilcox, t he C o urt found that there was no evidence against he r to sup port th e s ta te to rt cl ai ms. Be n n appealed.

II.

We turn fi rst to Benn’s § 1983 cl ai m. Sectio n 19 83 p rovid es i n relevant part: Every person who, under color of an y statute , o r dinance, regu la tion , c ustom, or usage, of an y State or Terri t ory or the Dist ric t of C olum bia , subjects, or causes to be subjected, any citi zen of the United States o r othe r person with in th e ju ri sdiction thereof

to the depri va tion of any rights, privileges, o r immuniti es securedby the Constit

ution
an d laws , shall be liable t o the partyinjured in an acti on atlaw, sui t in equi ty , or otherp ro per procee ding for redress.

To es tabl ish a cl aim under §1983, Benn must show that the defen dants 1) w ere5

state actors 1 who 2) v iol ated h is rights under the Consti tuti on o r fe de ra l l aw. Flagg Bros., Inc. v. Brooks , 436 U.S. 149, 155 (19 78).

A.

Benn co nt en ds th at

Ho rsh am, UHS, Dr. Eluri, and Wilcox 2 (t he “Horsham defendants ”) we re sta te actors because theywer e a ctin g pu rs ua ntto th e MHPA. Under the MHPA , a phy sici an or other “resp onsib le party ” may file an appli cati on that may lead to the is su a nce of a warrant authori zing a person w ho i s “sev erely
men tally disabl ed and in need of imm ediate treatm ent” 3 to be taken to a designated facilit y f or an emergency examinati on. 50 P a. St at. A nn. § 7302(a )(1). 4 In addition, aphysi cian or

1 “In cases under § 19 83, ‘under color’ of law has consistently

been tre ated as t

he
sam e thing as the ‘s tateacti on’ requi red unde r the Fo urteen th A men dm ent. ” Rendell- Baker v. K ohn , 457 U.S. 830, 838 (198 2); see also Dluho s v. Strasberg , 321 F .3d 365, 37 4 (3d C ir. 2003).

2 For the pu rpose of s umm ary judg men t, MCES, Dr. Mukerjee, Dr. Quasim, andDr. Zerby co n cede d that th ey wer e “state acto rs,” and th erefo re w e do n ot d ec ide that que sti on.

3 A person is “s ever e ly menta lly di sab led” “when, as a re sult of mental illness, hi s c ap ac ity to exerci se sel fcontro l, judgment and di scretion in the conductof h is affa irs and social re la tio ns or to ca re fo r h is own personalneeds is so lesse ned tha t he poses a cl ear and pre sent dangerof h arm to o ther s or to him self .” 50 Pa. S tat. Ann § 7 301(a).

4 50 P.S. § 7302( a) provides as follows:
(a) Applicat ion fo r Ex am inati on.- -Eme rgenc y e xam inati o n m ay b e undertake n at a treatm e nt facility upon th e certi fication of a physi c ian statin g t he need for such examinat i on; or upon a warrantissued by the co unty administ ratora u thorizin g such exam ination ; o r withouta warrant upon applic ationby a physi cian or otherauthori zed person who ha s p ersonal lyobserved conductshowing the need for such exami nation.
(1) Wa rrant for E m ergency Exa min ation. --Upon writte n applic ationby a physi cian or
o ther re sponsible p art y sett ing forth fact s cons tit uting r easonabl e grounds to beli eve a person is se ve re ly m entally disa bled and in need of im med iate treatm ent, the c oun ty administ rator may issu e a warrant requiri ng a person aut ho rizedby hi m, or any peace offic er, to take such6

otherperson who has observed a person engaging in conduct tha t provi des
reaso nable grounds to be lievethat t he person is “se verely

mentall y di sabled and in need of treatment” maytake the person to an approved fa c ili tyfor such an examinati on. 50 Pa. Stat . Ann. § 7302 (b). At th e f ac ilit y, the indivi dual who brought the person thought to need treatment must make “a w ritten statem ent settin g fo rth the g rounds for beli eving theperson t o be i n need of e xam inati on.” 50 P a. St at. A nn. § 7302(a )(2 ). A p erson taken to a fa cility must be ex amin ed w ithin two hours, and if it is determined that the perso n is “se verely
men tally d i sabled and i n need of imm ediate treatment,” t he treatment must beg in imm edia tely. 50 Pa. S tat. A nn. § 7302(b ). If it i s det er mi nedatanyti me that the pers on is not

in need of

treatm ent, the person must bedischar ged, and in any eventthe pers on m u st be re leased with in 120 hours unle ss a certifi cati on for exten ded involuntary eme rgency tre atmen t is file d under 50 P a. St at. A nn. § 7303. In this case, th e D istrict Co urt held that, because the Ho rsham d efenda nts were
mere ly invol ved in the application for Benn ’s com mitm ent, they w ere no t state acto rs.
In Brentwood Acad. v. Tennes see Secon dary Sc h. Athletic A ss’n , 531 U. S. 288, 296 (2001), the Supreme Court noted that the criter ia for determi ning whether st ate action is prese nt “lac k rigid simpli ci ty,” but th e Cou rt identified factors that bear on thequ esti on . The C ourt wrote:

We hav e, fo r ex am ple, hel d that a cha llenge d activ ity may be state action wh en it
r esults from the S tate ' s exe rcise of "coe rciv e p ow er," [ Blum v. Yarets ky , 457 U.S. 991, 1004 (1 982)], when the State provides "signi fi can t enco urag eme nt, eithe r overt or

cov ert," ibid ., or when a privat e actor operate s as a " willfu l parti cipant

in joint a ctivity with the State or its age nts," pe rs on to the f acility spec ified in the w arrant. (2) Emergency Examination W ithout a Warrant. --Upon perso na l observation of the conduct of a p e rso n cons titu ting reaso nabl e grounds to belie ve tha t he is
se v erely mentall y di sabled and in nee d ofimm ediate treatm ent, a nd (sic ) physi cian o r peace of ficer, or any one authori zed by t he
coun ty administ

rator may take such person to an a pproved facil ity

for an emergency exa m inati on
. Upon arri val, he shallmake
a written state m ent set ting forth the gr ou nds fo r belie ving the pers on to be in need of such examination.

.7

[ Lugar v. Ed mo ndso n O il Co. , 457 U.S

. 922 , 941 (1982)] (Int ernal quot ation marks omitt ed). We have treated a nom inally priva te
en t ity as a st ate actor when it is cont

roll ed by an "agency of

t he State , " Pennsyl van ia v. Board of Dir ectors of CityTrusts of Philad elphia , 353 U.S. 230. 231 (1957) (

per cur iam ), when it has been delegated a pub lic functi on by the State, cf., e.g., [ West v. Atki ns , 487 U.S. 42 , 56 (1 9 88)]; Edm onson v. Leesv ill e Co ncrete Co. , 500 U.S. 614, 627-62 8 ( 199 1), w hen it is " e ntw i n e d wit h governmentalpolici es," or when g over n m ent i s "ent wine d in [its ] management or c o ntro l," Evans v. Newton , 382 U. S. 296 , 299 , 301 (19 66)

. 531 U.S . at 29 5.

In the pre sent c as e, none of these factors points tow ard the pre senc e of s tate acti on. Firs t, the M HP A, o n w hich Benn predicates his st ate action a rgum ent, did not coerce the H orsha m d efen dants to file the applic atio n that led to B enn’s
com mitm ent. Nor did the MHPA provide “signi ficant

encour agem ent, either overt or cov ert.” Blum , 457 U.S. at 1004

. Although the M HP A p ermit s a phys ician or other “respo ns ible party ” to fi le an ap plication for an emergency examinati on , we see nothi ng in the MPHA that com pels
or even signi ficantlyencourages t he fil ing of an a ppl icatio n. See Ro ckw ell v. Cape Cod Hosp ., 26 F. 3d 254, 258 ( 1 stCir. 1994) (no com pulsi on where state law
mere ly permits physi cians to pe tition for involuntary commitment but does not
man date that t

he y do so); Harvey v. Harvey , 949 F.2d 1127, 1131 ( 11 th Cir. 1992) (no compulsi on or encourage ment whe re state sta tu tes no t enac ted to encourage com mitm ent); Spenc er v . Le e , 864 F.2d 1376,13 79 (7 th Cir.1989 ) (same); Janics ko v. Pell man , 774 F.Supp. 331, 338-39 (M.D.Pa.1991) (“this court cannot hold that the stand ards se t b y the MHPA rise to the l evel of coercion”) , af f'd , 970 F.2d 89 9 (3d C ir. 1992) (table).
Second, the H orsha m d efen dants did not o perate as “w illful par ticipan t[s] in joint activity with the State or it s agents” under Lugar , 457 U .S. at 9 4 1. In Lugar , creditors moved for a prej udgment writ of at ta chm ent, an d t he w rit w as iss ue d b y a court clerk and execut e d by a she riff

. Id

. at924 . The debto r whose property was atta ched brought an ac tion as serting two § 1983 claim s aga inst t he c reditors. Count
one cl ai me d that the prejudgmen t atta chment proc ess pe rmitted by state law
was “procedura lly

defect iv e under the Fou rteenth Amendment.” Id . at 9 41. Count two alle ged that the cre ditor s had invo ked the attachment pr ocess i n a way that wa s “‘m alicio us, w anto n, wil lful, opressi ve [sic] ” and un lawf ul un der sta te la w. Id

. at940 (brac kets in Sup reme C ourt opinion). The S uprem e Cou rt held that the8

first coun t stated a § 19 83 cla im because “the proceduralscheme” was “the pr oduct of state acti on.” Id

. By contrast, the Co urt concluded that t

he second count

did not sati sfy the st a te action requirement because “priva te misu se of a state sta tute does not describe conduct that c an be attributedto th e St ate.” Id . The C ourt stated: “[t]ha t [the creditor] i nvoked the statute with out the grou nds to do so could in no way be attri bu ted to a st ate rul e or decisi on.” Id . at 94 0.

In this case, Benn’s const itu tional cl ai ms against the H ors h am d efen dants paralle l the claim found to be defect ive in Lugar

. As Benn’s Memoran dum of Law in Sup port o f his M oti on for Sum mary Judgment makes clear, Benn ’s theory was tha t these def

endants vi olat ed hi s cons titu tionalrig ht s b ec au se th ey alle gedl y did not co mp ly wit h th e M HP A. See App. 428-429. The porti on of B e nn’s Memo ra ndum addressing his consti tuti ona l clai ms begins bystating:

De fend ants had [a] dutyand obligat ion to foll ow the rules and st and ards of the Pen nsylvan ia Mental He alth Procedures Ac t. Suc h act governed the circumst ances and procedures surroundi ng the extre me acti on o f invo luntarily committi ng an individ ual.

Id . at 428. The Mem orandum then adds:

De fend ants clearlyfai l ed to actacco rding to the A ct, and the h i gh dutyplaced upon th em. Such intent

iona l , reckle s s, and gross di sreg ar d of th e rules and standards theywere bound by , the Defend ants inten tionall y committeda ho rr ible a ct upon Plaintiff.

Id . at 42 9.

The crux of Benn ’s complaint about th e conduct of the Horsham defenda nt s appears to be tha t they conducted a “serio usly defecti ve evaluative p ro ces s,” App ellant’s Br. at 1 0, and that he d id not
mee t the st andard for emer gen c y commitmentunder t he M HP A. See App. 429 ( Memorandum in S upp ort o f Summary Judg men t); id . at 263 (expe rt report). Benn’s const it utiona l claim againstHorsham d efendants is th us precis ely the type o f claim that Lugar fo und to be ina dequate t o establ ish s tat e actio n. Third, this is cle ar ly n ot a ca se in wh ic h nom inally private persons w ere cont ro lled by an ag ency of th e Commonw ealth. B enn makes no such alleg ation s.
F ourth, the co ndu ct in qu estio n her e

– ap ply ing for Benn’s emerge nc y comm it ment – is not

a “publi c functi on” that the MHPA delega t ed to p rivate pe rson s. In co nside ring the “pub lic functi on” issue, w e mu st a sk whether the chall enged acti on relates to a func tion t hat9

has bee n “ tradi tional lythe excl usive prerogative of the State .” J ackson v. Metropolit an Edison Co. , 419 U.S. 345 (1974)

. He re, we have no bas is for concludi ng that petitioning for inv oluntary confinementis or e ver was the exc lusi ve prerogative of the state, eithe r in Pen nsylvan ia or in the co untry in gene ral. See Ro ckw ell v. Cape Cod Hosp. , 26 F.3d at259 (“T he history of involun tary treat ment o f the m enta lly ill i n M a ssach usetts demonstrat es tha t involuntary treatment has b y no means been t h e exclusi ve prerogat ive of the State.”); Spen cer v. Lee , 864 F.2d 1376, 138 0-81 (7th Cir. 1989 )(h o lding th at civil commitmentin Illinois wa s not a tradi tionaland exclusi ve pub lic function); Bodor v. Horsham Clini c, Inc. , 199 5 WL 424906 at *8 (E .D.P a. July 19 , 1995) (Pennsylvania).
Fifth, this case does not involve “entwinemen t ” within t he meaning of Brentwood

. There, the Court he ld that an intersch olastic athle tic a ssociation was entwined with the s tatewhere the gre at majori t y of the ass ociation’s member scho ols were public, repres entatives of the scho ols acti ng in their offici al capaci ties selected members of the as sociation’ s governing bodies, state offici als al so sat on those bodies i n an ex offici o capacity, the associ at ion wa s large ly financ ed by ga te receip ts fr om member-school tourn ame nts , and assoc iation e mp loyees pa rticipated in the st ate re tirement sy stem. 531 U.S. at 298-300

. In this case, Benn does not alle ge that t

he Commonw ealth was “entwined” in a ny com parab le sens e w ith the Horsham defendan ts. Thus, none of the factor s identifie d in Bren tw ood supp orts a find ing o f state a ction in this
cas e.
Nor does thi s case satis fy t he “symb iotic relat

ionshi p” test

that de rives from Bur t on v. Wilmington Parking Au thority , 365 U.S

. 715 (1961). After Brentwood , our Court, sitting enba nc, held that t

he “sy mbioti c relations hip” t est continue s to provi de a n additio nal, albe it “na rrow ,” basis f

o r finding that priv ate acti on may fairly be attrib uted to the st ate. Crissman v. Dover Do wn s En tertainm ent, Inc. , 289 F.3d 231 , 24 2 (3d C ir. 2002). This theory, however, has no appl ication here. A “sy mbioti c relations hip” demands “a close ass oci ation o f mu tual be nefit” between the s tateand the pri vate entity or person. Crissman , 289 F.3d at 240

. In Bur ton , such a rel ations hip exis ted between a c it

y th at own ed a parking structure and a restau rant to w hich it leasedspace. I n this case, t here is no indication th atth e Hor sham de fend ants
ma de any pr ofit f

rom the petiti on t o com mit Benn, and the re cert ainly is no evidence that

the government

recei ved any tangib le b enefit from Horsham, save a poss ible increa se in t

he g e neral wel fare. “Th at a priv ate entity performs a functi on which serves the publi c does notmak e its acts state acti on.” Rendell- Baker v. Kohn , 457 U.S. 83 0. Thus, ne ither the factors ci ted in Brentwood nor the s ymbioti c relation ship th e ory shows the pres ence of state acti on in thi s case.
The decisi on s of other courts of10

appe als and th ose o f distr i ct cou rts in this circuit also suppor

t the c oncl usio n that persons who petition for the invo luntary commitmentof

others are not state actors. See Ro ckw ell v. Cape Cod Hosp. , 26 F.3d at257 -58; H ar ve y v. Harvey , 949 F.2d 1127, 1131 (11th Cir.19 92); Spencer , 864 F.2d at 138 0-81 ; Doby v. Decres cenzo , 1996 WL 510095 (E.D.Pa. Sep t. 9, 1996), aff’d , 118 F.3d 1575 (3r d Cir. 1997) (table); Bod or v. Horsham Cli nic, Inc. , supra (thoro ugh ly analyzing th e “state actor” question); Savacool v. Delaw are Co unty De partm ent of M ental H ealth , 19 93 WL 21209, *6 (E.D.Pa. Jan.25, 1993); Janics ko v . Pellm an , 774 F.Supp. 331, 339 (M .D.P a.19 91) , af f'd , 970 F. 2d 899 (3d Cir. 1992)

. Our analysi s l ead s t o the s ame result. We thus h old th a t the Hors ham def end ants we re n ot sta te ac tors.

B.

Ben n c laims that M CE S, Dr. Mukerjee, Dr . Ze rby, an d D r. Q uasim , all of whom conceded thatth ey wer e state
a ctor s for purpose s of the moti on for
summ ary jud gm ent, vio lated b oth h is proceduraland substantive due process right s. We disagree.

1.

Benn argu e s that M CE S an d its doctors violated proceduraldue process by f aili ng to co mpl y wit

h the MHPA and b y fail ing to grant hi m a hearing before he
w as involuntaril y confined. This argumen t has n o m erit.

F irst, even if these defe ndan ts violated the MH PA, this wo uld not establisha §1 983 claim

. “The plain language of secti on 1983 , inter preted and under sc ored by the S upre me C ourt in M ain e v . Thibout ot , 448 U .S. 1 (1980), solely supports ca u ses of action based upo n violatio ns, un der the color o f state la w, of fe de ra l s ta tu to ry la w o r consti tuti ona l right s. Section 1983 does not provide a cause of acti on for viol ations of state stat

utes. ” Bro wn v . Grabowski , 922 F.2 d 1 097, 1113 (3d Cir . 1990) ; see also Flagg Bro s., Inc. v. Brooks , 436 U. S. 149, 155 (1978).
Second, in an emergency situation,
a sh or t- te rm c ommi tm en t wi th out a hearing does no t violate procedu ra l d ue process. In a si milar c ase deal ing with t he MHPA, we observed that “[i]t may be
reason able . . . for a state to om it a provi sion for noti ce and a heari ng in a
s tatu te created to deal with emergencies, particu larly where the deprivati on atissue, in this case det ention f or a maxi mum o f
sever al hours to pe rmit an e xaminati on, continue s for o nly a short per iod of tim e.” Doby v. DeCrescenzo , 1 71 F.3d 858, 870 (3d. Cir. 19 99); see also Project Release v. Prevost , 722 F.2d 960, 974 ( 2d Cir. 1983 ); Co vell v. Sm ith , 1996 WL 750033 (E.D.Pa. De c. 30 1 996 ); Luna v. Zandt , 554 F.S upp . 68, 7 6 (S .D.T ex. 1 982 ).

Benn ’s cas e clearlypresented an emergency situation . Both his calls to the Horsham clini c and his note at the bottom11

of his Contr act for

Safetysuggeste d to the doctors that Benn was hi ghly unstabl e. Furthermore, he wa s co mm itted for a “short period of t

ime” and was rel eased upon Dr. M uker

jee’s ev aluati on that he
was no lon ger suic idal. While committed, Benn wa s con stantl y evaluated by t he MCES physicia ns. Under thes e circumstances, we hold that the defe ndan ts did no t v iolate Benn’s ri ghts bynot granti ng him a heari ng before he was committed.
Third, w e see n o evid entiary ba sis in the record forBenn’ s cl ai m that MCES maintai ns a polic y that

denied hi m his due proces s r igh ts . On t

he co ntr ary , MCES gu ideli nes track t

he MH PA, which does not den y due pro ces s. See Monell v. Departmentof Social Services , 4 36 U.S. 658, 694 (1978). In sum , we h old that Benn ’s proc edur al due proc ess righ ts were not viol ated.

2.

Benn appe ars to a rgue that his substant ive due process rights w er e violated i n thr ee way s. Fi rs t, he c la ims t hat Dr s. Zerb y and M uker je e incom peten tly fa i led to recognize t hat he
was not suic idal. Sec ond, he ass erts that he was kept in a room with out a to ilet. Third, he c la ims that hewas forcibl y gi ven antip sycho tic m edic ation

. “[I]n a due process c hal lenge to executi ve acti on, the thres hold question is whetherthe behavi or of the governmental officer is so egregious, so outrageous, that it may fai rlybe said to shock the
co n tempora ry conscienc e.” County of Sacr ame nto v. Le wis , 523 U.S . 8 3 3, 847, fn. 8 (1 998 ). Whether an inci dent“shocks the cons cienc e” is a matter of l aw for the
cour ts to deci de, see Ro chin v. Ca lifornia , 342 U.S. 165, 172 ( 1952), and we have prev iously held tha t invol untar y commitmentunder the MHPA does not in itself violate substantive due process. See Do by v. DeCrescenzo , 171 F.3d at 871 n. 4 (“[T]he MHPA authori zes sei zures t hat
are ‘reas onable’ unde r th e Fourt h Amendment [and so] the MHPA meets the rationa lity test

imposed by subs tanti ve due process analy sis. ”)

In this cas e, non e of th e spe cific conductthat Benn al leges s hocks the conscienc e. First , Benn’ s c om plaints aboutDrs. Zerby or M ukerjee are in suff icient. Benn claims t hat Drs. Zerby and Mukerjee exhibit ed “ tota l in comp etenc[e] . . . . [by failing] to underst and that pl ainti ff was show in g no suici dal ideatio n w hic h merite d his involuntary con fine me nt.” B r. o f Ap pellan ts at 13. But whether or not Drs. Ze rby and Mukerjee properlyanaly zed Benn ’s conditi on , t heir conduc t did not violate substant

ive due pro ces s. In view of the event s that

led to Ben n’s commitment and the steps take n afte r his arri val at MCES, the doct ors’ conduc t was not
con scie nce -sho ckin g. Second, Ben n’s alleg atio n t hat he
was temporari lyke pt in a roo m w ithout a toil etis insuf ficie nt without fur ther aggravating evidence to meet the hig h12

standard needed to st ate a subs tanti ve due process violatio n. A s the D istrict Cou rt poin ted out, Benn fai led to produce a n y evidence that the defen dants w ere aw are that he needed to use a bat hroom or that “MCES had a custom or pol icyof refusi ng to allo w p atien ts to u se th e ba thro om .” App. 31.
Third, the admini stration of antipsych otic drugs is not shocki ng to the
cons cience und er the c ir cumstance s present here. We have hel d that author it ies may ad minis ter antip sychotic drugs over a patient’ s objection “where the decisi on is a pr oduct of the authoriti es’ professi onal judg ment.” Wh ite v. Napoleon , 897 F .2d 103, 11 2 (3d C ir. 1990). See also Ren nie v. K lein , 720 F.2d 266, 269 (3d Cir. 1983). I n th is cas e, how ever, as the Dis tri ct Court noted, Benn has not alle ged that heobject ed to the administ rati on of the me dica tion

. App. 32. Under these circum stances, Dr. Z erby’s conduct di d not shock t he conscie nce.
III.

Benn next cont ends that the Distri ct Cou rt erred in granti ng summary j udgment in fav or of the de fend ants on h is state tort clai ms. We disagre e.

A.

The MHPA gi ves b road imm unity to physicians and o thers wh o par ticipate in the involuntarycommitment process:

In the absenc e of will ful misco nduct or gr o s s neglige n ce , a count y administrator, a direc torof a fa cil ity, a physi cian, a peace of ficer or any othe r authori zed perso n wh o parti cipat es in a deci sion that a person be examined or treated under this act, or that
a person be di scha r ged, or p l aced unde r partia l hospit aliz ation, outpati ent
ca re or leaveof absence, or that the res trai nt u pon such per son be other wis e re du ced, or a count y administ rator or othe r authori zed pe rson w h o denies a n applic ation f or voluntary treat

ment or for invo luntary emergenc y examinati on and treat men t, shall not be civi lly or crimin ally liabl e for such decisi on or fo r any of its consequences.
50 Pa. Stat . Ann. § 7114(a) . As the Distri ctCo urt p rop erly fo und , W ilcox , a cris is-l ine counselor

who had no effect on the decision to commit Benn, is no t covered un der t he strict l anguage of the imm unity pro visio n. I t is clear, howe ver, thatthe remai ning defendant s quali fy for imm unity if the y di d not engage in “willf ul
m i sconductor gross neglige nce.” See Doby v. DeCrescenzo , 171 F.3d 858 , 875 (3d Cir. 199 9).

Under Pennsylvania law, “gross13

neglige nce” is “more egregiousl y devi ant conduct than ordina ry care less ness , i nadverte nce, laxit y or ind iffe ren ce.” Rather, gross negl igence requires conduct that is “flag rant, gross ly deviating from the ordinary standard of c ar e.” Alrbight v. Abington M emo rial Hos pital , 696 A.2d 1159, 1164 (P a. 1997). “Willful miscondu c t” occu rs wh en “th e dan ger to the plaintif f, t hough realized, is so reckle ssly disre garded t hat, even though there be no ac tual inten t, there is a t least a willingness to inflict i njur y, a conscious indiff erence to the pe rpetr ation of the
wr ong .” Krivij anski v. Union R. Co. , 515 A.2 d 93 3, 93 7 (P a. Su per . Ct. 1 986 ).
Here, n one o f the d efen dants committedeithe r gross neglige nce or willfulmi s conduct. The only evidence that Benn pu ts fo rward to show such behavior cons ists of the two expe rt repo rts of his treatin g psych iatrist, Dr. Bornfri end. In her se cond repo rt, Dr. B ornf rie n d alleges:

Ther e appears to b e evidence, h ow ever, th a t
so me of the mist

reatment Mr. Benn endured appeared secondar y to even m ore mali gnant causes [tha n simp le neglige nce], r aisi ng issues of deli berat e in differe nce, arrogan ce , condescensi on, and puniti ve hostility from these doctors. I find sho c king the l evel of disr egard for st anda r d practi ces involved i n ps yc hi atric treat ment , espe cially as theyrel at e to involuntary commi tme n t
a n d find tha t thes e Depositi ons show clear and convinci ng evidence t hat Mr. Ben n wa s inapp ropria tely i nvo luntaril y c om mitt ed and held i n the psy chiatric hos pital , su bject e d to abus iv e mistrea tmen t, and a victim of med ical m a lpract

ice and neglige nce.
We agree w ith the District Cou rt that the ass erti ons in this re port do not compor t wi th the f acts and that , considering the rec ord as a whole, no reaso nable jury could find that the do ctors acted with gross neglige nce or will ful misco ndu ct. The docto rs all parti cipat ed in mee tings, too k care ful n otes, and prescribed a carefulrouti ne and course of treat ment for Benn. He was rel eased as
s oo n as they fo und him to be sa fe. T heir behavior did not meet

the le gal defi niti on of either gro ss neglige nce or will ful misco ndu ct. Since none of the d oct ors committedany s uch co ndu ct , w e will also affirm th e di smi ss al of t he rel at ed c la ims againstM CE S. See Farago v. Sacred Heart Hospital , 562 A.2d 300, 303 (Pa. 1989).

B.

Fi na lly, we hol d that t he District Cou rt properl y di smissed t he state t o rt cl ai ms against

Eileen Wil cox. There i s no14

evidence whatsoever t hat would even begin to sup port an y of th ose cl ai ms against Wilcox.

IV.

For the rea sons expla ined above , we affirm the ord er of th e D istrict Co urt.