Opinion ID: 769838
Heading Depth: 3
Heading Rank: 3

Heading: Appeals of Moritsugu and Barraco

Text: 30 It is undisputed that Moritsugu and Barraco are doctors and members of the Public Health Service. They argue that as such they enjoy absolute immunity from Cuoco's suit, and that they therefore are entitled to summary judgment regardless of whether questions of fact exist as to the merits. [T]he denial of a substantial claim of absolute immunity is an order appealable before final judgment, for the essence of absolute immunity is its possessor's entitlement not to have to answer for his conduct in a civil damages action. Mitchell, 472 U.S. at 525. 31 1. Statutory Immunity. Moritsugu and Barraco claim that they are absolutely immune under the terms of the Public Health Service Act, 42 U.S.C. § 233(a)(1998). Section 233(a) makes the Federal Tort Claims Act the exclusive remedy for specified actions against members of the Public Health Service: 32 The remedy against the United States provided by sections 1346(b) and 2672 of Title 28 [the Federal Tort Claims Act], or by alternative benefits provided by the United States where the availability of such benefits precludes a remedy under section 1346(b) of Title 28, for damage for personal injury, including death, resulting from the performance of medical, surgical, dental, or related functions..., by any commissioned officer or employee of the Public Health Service while acting within the scope of his office or employment, shall be exclusive of any other civil action or proceeding.... 33 42 U.S.C. § 233(a) (emphasis added). The question is therefore whether the injury for which Cuoco seeks compensation was one resulting from the performance of medical... or related functions by Barraco and Moritsugu while acting within the scope of their offices or employment. Id. 34 In construing the terms of a statute, we look first to its language to ascertain its plain meaning. Cheung v. United States, 213 F.3d 82, 89 (2d Cir. 2000). We conclude that under its plain meaning, § 233(a) covers the conduct of both Barraco and Moritsugu. 35 Cuoco alleges that Barraco and Moritsugu were inexperienced doctors (i.e., they lacked expertise about transsexualism), that they misdiagnosed Cuoco (i.e., they did not think she was a true transsexual), and that that explains why they prescribed the wrong course of treatment (i.e., they stopped estrogen treatments when they should have renewed Cuoco's prescription). The complained of behavior of these defendants thus occurred within the scope of their offices or employment and during the course of their performance of medical... or related functions, 42 U.S.C. § 233(a). Cuoco's exclusive remedy for injuries caused by that behavior is therefore against the United States under the Federal Tort Claims Act. 36 Cuoco asserts that § 233(a) provides immunity only from medical malpractice claims. But there is nothing in the language of § 233(a) to support that conclusion. When Congress has sought to limit immunity to medical malpractice claims it has done so explicitly. See 38 U.S.C. § 7316(a)(1) (providing exclusive remedy for damages for personal injury... allegedly arising from malpractice or negligence of a medical care employee of the Veterans Health Administration). 37 The district court relied on Mendez v. Belton, 739 F.2d 15 (1st Cir. 1984), in holding that Plaintiff's claims against defendants Moritsugu and Barraco... may not properly be dismissed on the basis of Section 233(a) immunity because Plaintiff has not brought medical malpractice claims, but rather a claim alleging violation of her constitutional rights. But Mendez is inapposite. It does not stand for the proposition that § 233(a) applies only to medical malpractice suits. The Mendez court commented that § 233(a) protects Public Health Service officers or employees from suits that sound in medical malpractice, Mendez, 739 F.2d at 19, but it did so while considering an allegation of intentional discrimination on the basis of race and sex by a supervisor against an employee during a professional peer review process. That conduct, by contrast with that of Barraco and Moritsugu here, had nothing to do with the performance of medical... or related functions. It was for that reason, not because the action was other than a medical malpractice claim, that § 233(a) was held to be inapplicable. 38 Of course Congress could not, by the simple expedient of enacting a statute, deprive Cuoco of her constitutional due- process rights, but that is not what § 233(a) does. It protects commissioned officers or employees of the Public Health Service from being subject to suit while performing medical and similar functions by requiring that such lawsuits be brought against the United States instead. The United States thus in effect insures designated public health officials by standing in their place financially when they are sued for the performance of their medical duties. Cf. 42 U.S.C. § 233(f) (listing alternative forms of insurance government can procure for public health officials when remedies against United States are likely to be precluded). The statute may well enable the Public Health Service to attract better qualified persons to perform medical, surgical and dental functions in order better to serve, among others, federal prisoners. [W]hen defendants show that Congress has provided an alternative remedy which it explicitly declared to be a substitute for recovery directly under the Constitution and viewed as equally effective the plaintiff is barred from bringing a Bivens action. Carlson v. Green, 446 U.S. 14, 18-19 (1980) (emphasis in original). We think that § 233(a) is just such an alternative remedy. See id. at 20 (citing § 233(a), in the Bivens action context, as an example of a statutory provision that explicitly designates an action under the Federal Tort Claims Act as the exclusive remedy). 39 Cuoco's response is to assert that the Federal Tort Claims Act is an inadequate alternative remedy because it does not provide for the declaratory or injunctive relief she seeks. Whatever the strength of that argument in the abstract, by the time the motions at issue in this appeal were made in the district court, Cuoco was no longer a pre-trial detainee and was no longer incarcerated in FCI Otisville. Her estrogen problem had also been resolved and she makes no claim that there is a danger that Moritsugu will again deny her necessary estrogen treatment. There is thus no basis for us to conclude that Cuoco had any claim against either Barraco or Moritsugu at the time the district court considered her complaint beyond a claim for compensation for her past treatment at FCI Otisville, which was entirely amenable to resolution under the Federal Tort Claims Act. 40 Finally, we emphasize that Barraco's and Moritsugu's positions as Public Health Service officials do not alone render them immune from suit. Critical to Barraco's immunity is the fact that his complained of behavior occurred entirely in his capacity as a doctor responsible for, and in the course of rendering medical treatment for, Cuoco. Similarly, Moritsugu's alleged misdeeds related only to his decision, as the principal medical official for the Bureau of Prisons, not to authorize a particular medical treatment for Cuoco. If Cuoco alleged and could prove that either of these defendants violated her constitutional rights in the course of something other than the performance of a medical or related function, or while acting outside the scope of his employment, § 233(a) would not, of course, provide that defendant with absolute immunity. 41 2. Inappropriate statements. Cuoco also alleges that she overheard Barraco asking a prison official, Did you bring the HE/SHE? Whether or not covered by § 233(a), this sort of rudeness and name-calling does not rise to the level of a constitutional violation. See Purcell v. Coughlin, 790 F.2d 263, 265 (2d Cir. 1986). A. Appeal of Quinlan 42 1. Principles of Qualified Immunity. A government official is entitled to qualified immunity from suit for actions taken as a government official if (1) the conduct attributed to the official is not prohibited by federal law, constitutional or otherwise; (2) the plaintiff's right not to be subjected to such conduct by the official was not clearly established at the time of the conduct; or (3) the official's action was objectively legally reasonable in light of the legal rules that were clearly established at the time it was taken. See Rohman, 215 F.3d at 216-17 (citing X-Men, 196 F.3d at 65-66). Ordinarily, '[t]hese... issues should be approached in sequence, for if the second is resolved favorably to the official, the third becomes moot; a favorable resolution of the first moots both the second and the third.' Id. at 216, n.4, (quoting X-Men, 196 F.3d at 66). 43 2. Quinlan's Qualified Immunity. The claim against Quinlan does not make it past the first criterion for qualified immunity. There is no conduct at all attributed to Quinlan in either the amended complaint or in Cuoco's affirmation except for his service as Director of the Bureau of Prisons. That conduct, if conduct it may be said to be, is obviously not prohibited by federal law. 44 The district court allowed the case against Quinlan to proceed because he was the federal prisons' policy maker. A supervisory official may be liable because he or she created a policy or custom under which unconstitutional practices occurred, or allowed such a policy or custom to continue, or if he or she was grossly negligent in managing subordinates who caused the unlawful condition or event. Williams v. Smith, 781 F.2d 319, 323-24 (2d Cir. 1986). But here there are no allegations and there is no evidence in the record to that effect. For liability to accrue, it is not enough for the defendant simply to be a policy maker at the time unconstitutional events occur. 45 Indeed, Cuoco makes no allegation that Bureau of Prisons policies or customs were unconstitutional -- to the contrary, she argues that Bureau policy mandated that she receive estrogen treatments. And there is no evidence or allegation that Quinlan knew about Cuoco's dispute with FCI Otisville officials or that he was personally involved in the decision to deny Cuoco estrogen. Finally, there is no allegation or evidence that Quinlan had supervisory authority over medical decisions made by doctors in federal prisons. 46 Quinlan is plainly immune from Cuoco's lawsuit.