Opinion ID: 204120
Heading Depth: 3
Heading Rank: 2

Heading: Dr. Deniz

Text: We have already determined that Dr. Deniz qualifies as a state actor under the first prong of the qualified immunity analysis. Maldonado v. Fontanes, 568 F.3d 263, 269 (1st Cir.2009). We have also concluded, under the second prong of the test, that plaintiff's allegations establish the violation of a clearly established constitutional right. We now must determine whether, under the particular facts of this case, a reasonable physician would have understood that her behavior violated that right. Id. We conclude that Dr. Deniz's qualified immunity defense also fails at this stage. In assessing whether Dr. Deniz may raise a defense of qualified immunity, we are guided by our analysis in Rodriques v. Furtado, 950 F.2d 805, 815 (1st Cir.1991). In Rodriques, we recognized that [i]t is a necessary though substantial imposition upon the physician to require him or her to learn the constitutional requirements of invasive body searches. Id. at 815. We concluded in that case that a doctor was entitled to a defense of qualified immunity after performing a body cavity search of the appellant, a woman suspected of distributing narcotics. Id. at 807, 815. Police had obtained a warrant for the search, which directed that it be conducted by a physician at a local hospital. Id. at 808. After consulting with the hospital's acting president, the defendant, a doctor at the hospital, performed a visual and manual inspection of the appellant's vaginal cavity. Id. The appellant brought suit under 42 U.S.C. § 1983 alleging, in part, that the search conducted by the doctor was unreasonable both on its face and in its method of execution. Id. We found that the doctor was entitled to qualified immunity because he had conducted the search pursuant to an objectively reasonable and facially valid warrant. Id. at 815. We explained, [t]here is no duty imposed upon the physician to make inquiry of the officer regarding his basis for probable cause where [a] warrant is objectively facially valid. Id. We noted, however, that the mere existence of a warrant would not immunize a doctor from liability where a reasonable physician under the particular circumstances would realize that the warrant was facially deficient. Id. at 815 n. 12. Two major factors differentiate this case from Rodriques. First, the search described in the complaint was not performed pursuant to judicial authorization in the form of a warrant or judicial order. We explained in Rodriques that a physician's reliance on a judicial authorization not only benefits society by effectuating acceptable means to execute body cavity searches pursuant to a warrant issued on probable cause, it also benefits the party being searched by providing a safe means of conducting the search in a medically approved manner. Id. at 815. Such authorization by a judicial body is, in many instances, required before prisoners can receive even salutary medical treatment when that treatment is sought by the State rather than the inmate. See, e.g., Sell v. United States, 539 U.S. 166, 180, 123 S.Ct. 2174, 156 L.Ed.2d 197 (2003) ([A] court must find that important governmental interests are at stake before a criminal defendant can be involuntarily treated with antipsychotic drugs.) (emphasis added). [17] We see no benefit, however, to encouraging doctors to participate in the type of invasive and potentially dangerous surgery described in the complaint, performed only for a law enforcement purpose, and without a judicial authorization affirming the necessity of such action. Rather, as we indicated in Rodriques, physicians asked to perform invasive body searches should not comply uncritically with the requests of prison officials and thereby become complicit in depriving prisoners of their constitutional rights. Second, this case differs from Rodriques in that the surgery alleged in the complaint far exceeds the scope of the visual and manual examination conducted by the physician in that case. As we discussed above, a surgical invasion is far more intrusive than the already severe encroachment on a prisoner's bodily privacy occasioned by a manual body cavity search. See Winston, 470 U.S. at 757-59, 105 S.Ct. 1611. That difference in scope also requires that the search at issue in this case be treated differently from the search in Rodriques. In summary, a reasonable doctor should have understood that the surgery at issue here, performed at the insistence of the correctional authorities and not for plaintiff's benefit, violated plaintiff's Fourth Amendment right to be free of unreasonable searches and seizures. The invasive surgery described in the complaintconducted without the force of judicial authorization and for the sole purpose of extracting contraband that had resisted discovery in multiple rectal searches and two forced bowel movementsfell beyond any objective test of reasonableness. On the facts alleged, we do not need to identify the precise level of familiarity with the Fourth Amendment fairly chargeable to a physician acting as a state agent. No detailed knowledge of the law was required to understand that a physician should not perform invasive, non-medically required surgery on a prisoner in circumstances such as those described in the complaint. The conduct described in the complaint violated plaintiff's clearly established rights. A reasonable doctor would have understood as much.