Civil rights – Bridgewater State Hospital – Restraint – Seclusion

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Where plaintiffs who claim that they were secluded and restrained unnecessarily and for prolonged periods while involuntarily civilly committed at Bridgewater State Hospital, two defendants — the former Department of Correction Commissioner and the former Bridgewater Superintendent — are not entitled to dismissal of the plaintiff’s 42 U.S.C. 1983 count, as the plaintiffs have alleged facts plausibly suggesting that the two defendants violated the plaintiffs’ clearly established due process rights.

Background

“The plaintiffs, severely mentally ill individuals, allege that they were secluded and restrained unnecessarily and for prolonged periods at Bridgewater State Hospital (‘Bridgewater’) where they were involuntarily civilly committed. Claiming that the seclusion and restraint violated their state and federal rights, they commenced this lawsuit against the Commonwealth, the Department of Correction (‘DOC’), former DOC Commissioner Luis S. Spencer (‘Spencer’), and former Bridgewater Superintendent Robert Murphy (‘Murphy’) (collectively, ‘defendants’)’ seeking damages for violations of 42 U.S.C. section1983 (Count I), G.L.c. 123, section21 (Count II), and the Americans with Disabilities Act (‘ADA’) and the Rehabilitation Act (Count IV); and seeking declaratory judgments for violations of G.L.c. 123, section 21, and the Massachusetts Declaration of Rights (Count III), and for violations of the ADA and the Rehabilitation Act (Count V).”

Section 1983 claim

“In Count I, the plaintiffs seek damages for violations of their federal constitutional rights under 42 U.S.C. section1983. …

“The plaintiffs have alleged facts plausibly suggesting that the seclusion and restraint that the plaintiffs experienced constituted a substantial departure from accepted professional judgment, practice, or standards. For example, Bridgewater staff secluded and/or restrained the plaintiffs when they were not presenting threatening behavior; their seclusion and/or restraint orders were renewed even when they were calm, compliant, or sleeping; and they were secluded and/or restrained in the absence of emergency situations. Moreover, the high rates of seclusion and restraint that the plaintiffs each experienced at Bridgewater as compared not only to DMH facilities but also to the national average support the inference that the seclusion and restraint decisions were a substantial departure from accepted professional judgment, practice, or standards.

“The plaintiffs have therefore alleged facts plausibly suggesting that ‘the subordinate’s behavior resulted in a constitutional violation.’ …

“The plaintiffs allege that, as superintendent and commissioner, Murphy and Spencer had the ‘responsibility and liability’ to ensure that Bridgewater employees complied with constitutional requirements, and the requirements of the Restraint Law and Bridgewater’s restraint regulations. …

“It is a fair inference that facility superintendent Murphy, working every day at a facility housing many mentally ill persons being subjected to the extraordinarily high rates of restraint and seclusion alleged in the amended complaint, must have been aware of these rates. In addition, in 2009, Murphy received a formal reprimand for misconduct with respect to the death of a restrained Bridgewater patient. Knowledge of this misconduct could also have led Murphy to infer that a substantial risk of serious harm existed, i.e., the unconstitutional restraint of patients at Bridgewater. … Against the backdrop of this inference, then, the allegations that Murphy knew of the unconstitutional seclusion and restraint plausibly suggest that Murphy’s conduct amounted to deliberate indifference. …

“Spencer received quarterly reports that documented seclusion and restraint practices at Bridgewater. These reports revealed that the occurrence of these practices was 100 times the national seclusion and restraint averages. Knowledge of these facts could have led Spencer to draw the inference that Bridgewater unconstitutionally secluded and restrained its patients and that, therefore. a substantial risk of serious harm existed. … Accordingly, these facts plausibly suggest that Spencer’s conduct also amounted to deliberate indifference. …

“The plaintiffs have therefore met their burden of alleging facts that plausibly suggest that Murphy and Spencer are liable as supervisors under 42 U.S.C. section1983 for the alleged violations of the plaintiffs’ constitutional rights while patients at Bridgewater. …

“But Murphy and Spencer argue that nonetheless, the court must dismiss Count I because they are entitled to qualified immunity. …

“As the plaintiffs have alleged facts plausibly suggesting that Murphy’s and Spencer’s conduct violated the plaintiffs’ clearly established due process rights, Murphy and Spencer are not entitled to qualified immunity on Count I.”

Restraint Law claims

“In Count II, the plaintiffs allege that Murphy, as Bridgewater’s superintendent, violated the Restraint Law by subjecting the plaintiffs to unjustified restraint and by failing to comply with his responsibilities under the statute. …

“I … conclude that the Legislature intended that G.L.c. 123, section21, would create a private right of action. …

“In Count III, the plaintiffs seek a declaration against the defendants that, through the isolation, restraint, and overall confinement to which they subjected the plaintiffs, and through the failure to provide their employees with minimally adequate training, they violated G.L.c. 123, section21, and they violated the plaintiffs’ liberty protections under Articles 10 and 12 of the Declaration of Rights. …

“Sovereign immunity … bars the plaintiffs from bringing a claim against the Commonwealth and the DOC, a state agency, for violations of the Restraint Law (but not against Spencer and Murphy in their individual capacities). The defendants’ motion to dismiss this portion of Count III as against the Commonwealth and the DOC is therefore allowed. …

“The plaintiffs allege that they have a liberty interest under Article 10 of the Massachusetts Declaration of Rights that entitles them to safe confinement conditions, adequate medical care, freedom from unreasonable restraints, and treatment by staff adequately trained to protect those interests; and under Article 12 of the Massachusetts Declaration of Rights that entitles them the right to be free from imprisonment and from deprivation of privileges and immunities afforded to them by state law. …

“… Given the stringency of ‘[t]he rules of construction governing statutory waivers of sovereign immunity[,]’ … I decline to conclude that the Commonwealth has consented to suit under Article 10 or Article 12. The defendants’ motion to dismiss Count III as to the Commonwealth and the DOC on this basis is therefore allowed as well.”

ADA/Rehabilitation Act claims

“The plaintiffs contrast the services and treatment they received at Bridgewater with the services and treatment that other Bridgewater patients received and that are provided at DMH facilities and allege that the disparities were illegal and discriminatory. In Count IV, they allege the defendants violated the ADA and the Rehabilitation Act, by providing these unequal services; in Count V, they seek a declaration that the defendants violated those federal statutes. …

“Here, the plaintiffs allege that the defendants subjected them to seclusion and restraint for punitive and disciplinary purposes rather than under emergency circumstances; the renewals of their seclusion and restraints would occur even when the plaintiffs were calm, compliant, or sleeping; and as a matter of general practice, the defendants would seclude and/or restrain the plaintiffs without first trying to de-escalate situations or trying to treat the plaintiffs to avoid having to seclude and restrain them. These facts plausibly suggest that the defendants secluded and restrained the plaintiffs because of their disabilities, rather than based on ‘an individualized inquiry into [each plaintiff’s] condition.’ …

“As the plaintiffs have framed their allegations against the defendants ‘“within [a] larger theory of disability discrimination[,]”‘ the plaintiffs’ challenge is not to the adequacy of mental health services at Bridgewater. … These facts plausibly suggest that the defendants provided the plaintiffs with discriminatory services at Bridgewater in violation of the ADA and the Rehabilitation Act, and, consequently, the defendants’ motion to dismiss Counts IV and V fails on this basis. …

“The defendants also seek to dismiss these counts because the plaintiffs have failed to compare their situation to that of non-disabled individuals. They rely on Atkins v. Orange, 251 F. Supp. 2d 1225 (S.D.N.Y. 2003), arguing that the court in that case dismissed the plaintiffs’ ADA and Rehabilitation Act claims on similar grounds. …

“The facts in Atkins are distinguishable from those in this case. There, the isolation at issue occurred at a facility that housed both mentally disabled and non-mentally disabled individuals, and the facility’s procedure made both groups eligible for isolation for the same reasons. Conversely, in this case, the plaintiffs seek to compare facilities that house only mentally disabled individuals. Atkins therefore does not serve as persuasive support for the defendants’ position. …

“… In their ADA and Rehabilitation Act claims against the defendants, the plaintiffs allege that the staff at DMH facilities receive ongoing training in methods to avoid using seclusion and restraint whereas the Bridgewater correctional officers who often make the seclusion and restraint decisions do not, and that DMH facilities provide personalized treatment plans, exercise programs and other activities, and regular therapy sessions with licensed mental health professionals; by denying the plaintiffs these services and treatment programs, the defendants have failed to make reasonable accommodations for the plaintiffs in violation of the ADA and Rehabilitation Act. …

“The plaintiffs have therefore stated a claim ‘based upon defendants’ failure to provide them reasonable accommodations,’ i.e., access to mental health treatment and services from which they could benefit. … The defendants’ motion to dismiss Counts IV and V on this basis accordingly fails as well.”

Minich, et al. v. Spencer, et al. (Lawyers Weekly No. 12-047-16) (40 pages) (Wilson, J.) (Suffolk Superior Court) (Civil No. 2015-00278) (May 12, 2016).

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