Opinion ID: 2291751
Heading Depth: 4
Heading Rank: 2

Heading: Emergency Medical Care

Text: We turn next to plaintiffs' section 1983 claims presented to the jury in Phase II. [17] The plaintiffs sought damages under section 1983 on behalf of Therese Miller's estate for her loss of life without due process and for the individual plaintiffs' loss of their liberty interest in consortium and association with the decedent. Both claims flow from the care and treatment ultimately provided by the defendants for Mrs. Miller during her heart attack at the hospital. Because the State had no constitutional duty to provide emergency medical care to Mrs. Miller, we affirm the Superior Court's direction of a verdict in favor of the defendants on the plaintiffs' section 1983 claims. As with all section 1983 claims, we are guided primarily by federal interpretations of that statute. The threshold inquiries are 1) whether the defendants acted under color of state law and 2) whether the plaintiffs were deprived of a right secured by the Constitution or laws of the United States. See Parratt v. Taylor, 451 U.S. 527, 535, 101 S.Ct. 1908, 1912, 68 L.Ed.2d 420, 428 (1981), overruled in part on other grounds by Daniels v. Williams, 474 U.S. 327, 106 S.Ct. 662, 88 L.Ed.2d 662 (1986). No one argues on appeal that the supervisory defendants were not acting under color or of state law. We assume here, without deciding, that Szelenyi, acting under a one-year contract with the State, was also acting under color of state law. See West v. Atkins, ___ U.S. ___, ___, 108 S.Ct. 2250, 2258-60, 101 L.Ed.2d 40 (1988), rev'g 815 F.2d 993 (4th Cir.1987). As to whether Mrs. Miller had a right to basic medical care, we start our analysis cognizant of the fact that the Supreme Court has not yet found in the due process clause of the fourteenth amendment any general, substantive right to the provision of basic medical services by the State. See, e.g., Youngberg v. Romeo, 457 U.S. 307, 317, 102 S.Ct. 2452, 2459, 73 L.Ed.2d 28, 38 (1982) (a State is under no constitutional duty to provide substantive services for those within its border); Maher v. Roe, 432 U.S. 464, 469, 97 S.Ct. 2376, 2380, 53 L.Ed.2d 484, 492 (1977) (The Constitution imposes no obligation on the States to pay... any of the medical expenses of indigents.); see also Wideman v. Shallowford Community Hosp. Inc., 826 F.2d 1030, 1034 (11th Cir.1987) (no general right to the provision of medical care and services by the state). While the free citizen on the street has no federal constitutional right to basic medical or other protective services by the State, those people in the State's custody often do have such a right. If the State takes a person into custody or otherwise assumes responsibility for that person's welfare, a so-called special relationship may be created between the State and the individual whereby the fourteenth amendment imposes a duty on the State to assume some measure of responsibility for the person's safety and well-being. Estate of Gilmore v. Buckley, 787 F.2d 714, 721 (1st Cir.), cert. denied, 479 U.S. 882, 107 S.Ct. 270, 93 L.Ed.2d 247 (1986). In Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 291, 50 L.Ed.2d 251, 260 (1976), the Supreme Court held that deliberate indifference by prison officials to a prisoner's serious medical needs states a cause of action under section 1983. While a prisoner's right arises from the eighth amendment's prohibition against cruel and unusual punishment, the Supreme Court has also implicitly held that the due process clause itself provides a right to basic medical care for individuals who are involuntarily committed in civil institutions. Youngberg v. Romeo, 457 U.S. at 324, 102 S.Ct. at 2462, 73 L.Ed.2d at 42 ([T]he State concedes a duty to provide adequate food, shelter, clothing, and medical care. These are the essentials of the care that the State must provide.). Thus, when an individual is either incarcerated or involuntarily committed in a civil institution, the State must provide certain basic services which the individual can no longer provide for himself. The required services should comport fully with the purpose of [the individual's] commitment. Youngberg v. Romeo, 457 U.S. at 324, 102 S.Ct. at 2462, 73 L.Ed. 2d at 43; see also City of Revere v. Massachusetts General Hosp., 463 U.S. 239, 244, 103 S.Ct. 2979, 2983, 77 L.Ed.2d 605, 611 (1983) (Due process clause requires responsible government or governmental agency to provide medical care to persons... who have been injured while being apprehended by the police.). As a State employee at the Benda Hospital of the Pineland Center, Mrs. Miller was neither a state prisoner nor was she in the state's custody as an involuntarily committed patient. Thus, she was deprived of no constitutional right to basic medical care as delineated thus far by the Supreme Court. Nevertheless, some federal circuits have alluded to the expansion of the special relationship to circumstances in which the individual is not in the State's physical custody. See, e.g., Ellsworth v. City of Racine, 774 F.2d 182, 186 (7th Cir.1985) (noting that there may be situations when a municipal employee and the municipality have, by virtue of the employment relationship, a special relationship for purposes of § 1983, but finding no such relationship on the facts of that case), cert. denied, 475 U.S. 1047, 106 S.Ct. 1265, 89 L.Ed.2d 574 (1986). To expand the State's duty to provide basic services to instances where the individual is outside the State's physical custody, the State must either strip the individual of his ability to procure the basic service or affirmatively place the individual in a position of danger that [he] would not otherwise have been in. Estate of Buckley v. Gilmore, 787 F.2d at 722; see also Wideman v. Shallowford Community Hosp, Inc., 826 F.2d at 1035-36 (state must exercise coercion, dominion or restraint over the individual); Walker v. Rowe, 791 F.2d 507, 511 (7th Cir.1986) (the rationale lies in constraints the state imposes on private action), cert. denied, 479 U.S. 994, 107 S.Ct. 597, 93 L.Ed.2d 597 (1986). Mrs. Miller's employment relationship with the State did not itself prevent her from securing her own basic medical services. Her employment with the State was of her own choosing. The employment relationship was neither coercive nor restraining; it in no way prevented her from choosing her own private physician. Indeed, no court has yet imposed a duty on the State to provide a basic service merely because of an individual's voluntary employment with the State. See Walker v. Rowe, 791 F.2d at 510-11 (due process clause does not assure safe working conditions for public employees); Ellsworth v. City of Racine, 774 F.2d at 186 (no duty to protect policeman's wife from hostile police investigation suspect). Although Szelenyi arguably took custody over Mrs. Miller during her emergency, and did affirmatively prevent defibrillation of her, the State did nothing to cause Mrs. Miller's original heart attack. The State did not affirmatively place Mrs. Miller in a situation of danger. Her heart attack was a completely fortuitous event. Far from creating the danger to Mrs. Miller, the State attempted to help her. See Wideman v. Shallowford Community Hosp., Inc., 826 F.2d at 1036 n. 9 (no special relationship creating right to emergency medical service between pregnant plaintiff and government ambulance service that took plaintiff to wrong hospital, since the condition allegedly causing her injury occurred before she submitted to [ambulance] `custody') (emphasis in original); Bradberry v. Pinellas County, 789 F.2d 1513, 1518 (11th Cir.1986) (defendant county, which hired and trained lifeguard, had no constitutional duty to rescue decedent who swam too far off shore because county did not create decedent's peril); see also DeShaney v. Winnebago County Dep't of Social Servs., 812 F.2d 298, 303 (7th Cir. 1987) (The botched rescue must be distinguished from the case where the State places the victim in a situation of high risk....), cert. granted, ___ U.S. ___, 108 S.Ct. 1218, 99 L.Ed.2d 419 (1988). Courts have also recognized that the duty under state law to perform an attempted rescue in a non-negligent way does not inhere in the due process clause. The Constitution, as opposed to local tort law, does not prohibit grossly negligent rescue attempts nor even the grossly negligent training of state officers. Bradberry v. Pinellas County, 789 F.2d at 1517; see also Wideman v. Shallowford Community Hosp., Inc., 826 F.2d at 1037; Jackson v. Byrne, 738 F.2d 1443, 1447 (7th Cir.1984). Thus, in the instant case, the plaintiffs' proof failed as a matter of law to show that the State had a duty to provide Mrs. Miller with emergency medical care. Neither Mrs. Miller's employment relationship with the State nor the grossly negligent treatment provided her by Szelenyi at the scene of her collapse created a duty under the fourteenth amendment to provide competent emergency medical care. Accordingly, the trial court properly granted the defendants' motion for a directed verdict. [18] The entry is: Judgment affirmed. All concurring.