Freudenberg v. County Of Orange

Background

Michelle Freudenberg sued as administratrix of the estate of her son, Eric Freudenberg. The defendants were the County of Orange, Wellpath NY LLC, Sheriff Carl E. DuBois, Salwa Khouri, Mandi Zaccagnino, and John Does 1–10. Eric Freudenberg was a pretrial detainee at the Orange County Correctional Facility beginning in December 2018. He had been diagnosed with Bipolar 1, which the complaint described as a mental-health disability.

The complaint alleged that, beginning in 2019, Eric repeatedly reported lumps, severe pain, coughing or spitting up blood, and other symptoms that he believed could indicate cancer. He asked to be checked for cancer and reported a family history of cancer. The complaint further alleged that medical staff generally responded with pain, anti-anxiety, and antidepressant medication, and that Khouri and others repeatedly treated his symptoms as hypothyroidism.

An outside endocrinologist later noted an enlarged thyroid, stated that the symptoms might result from cancer, and recommended a fine-needle biopsy. The complaint alleged that this recommendation was communicated to Orange County Correctional Facility staff, including Khouri and Zaccagnino, but that medical defendants did not schedule the biopsy despite more than 100 follow-up requests over the next 10 months. Eric was hospitalized in late May or early June 2021, diagnosed with probable lung cancer that had spread to multiple areas, and died on July 3, 2021, from complications of stage IV lung cancer.

Motion and Legal Standards

The defendants filed a motion under Federal Rule of Civil Procedure 12(b)(6), which asks whether the complaint states a legally sufficient claim. In deciding that motion, the court accepted the complaint’s factual allegations as true and drew reasonable inferences for Freudenberg.

The claims at issue were: (1) deliberate indifference to serious medical needs under the Fourteenth Amendment and 42 U.S.C. § 1983; (2) discrimination under Title II of the Americans with Disabilities Act and the Rehabilitation Act; (3) municipal liability against the County under the rule commonly called Monell; and (4) wrongful death under New York law.

Deliberate Indifference

The court held that the complaint plausibly alleged deliberate indifference. For a pretrial detainee, the claim required allegations that the deprivation of medical care was sufficiently serious and that the defendant intentionally imposed the condition or recklessly failed to take reasonable care despite knowing, or having reason to know, of an excessive health risk.

The court found significant the allegations that Eric repeatedly reported cancer symptoms, that an outside specialist specifically identified possible cancer and recommended a biopsy, and that the medical defendants allegedly failed to schedule the biopsy for more than 10 months despite repeated requests. The court concluded that these allegations plausibly showed that the Medical Defendants knew or should have known of a serious cancer risk and nevertheless failed to investigate or provide appropriate care. The court rejected the defendants’ argument that the allegations described only a mistaken medical judgment or negligence. It stated that whether the defendants actually exercised medical judgment, or failed to schedule the biopsy for another reason, would need to be resolved at summary judgment or trial rather than on the motion to dismiss.

Disability Discrimination

The court dismissed the Americans with Disabilities Act and Rehabilitation Act claims. It assumed, without deciding, that Wellpath was a public entity for purposes of the relevant statutes. But it found that the complaint did not include sufficient non-conclusory allegations that Eric was denied medical services or treated differently because of his disability.

The court stated that allegations of inadequate medical treatment, without allegations of disability-based discrimination, do not ordinarily state an ADA claim. The complaint alleged that defendants ignored Eric’s requests because they thought he did not understand what was happening to his body because of his disability, but the court found that allegation speculative and unsupported by allegations of discriminatory interactions, different treatment, or other indicators of discrimination. The court also rejected the attempt to characterize the same allegations as a failure-to-accommodate claim because the complaint did not connect the alleged denial of medical care to the disability.

Municipal Liability

The court dismissed the claim that the County was liable under Section 1983 for an unconstitutional policy or practice. Freudenberg alleged that the County had a widespread practice of providing constitutionally inadequate medical care as a cost-saving measure.

The court found the allegations insufficient to show a widespread practice, official policy, policymaker action, or failure to train or supervise. The complaint relied on lawsuits involving Wellpath or its predecessor, media reports, a complaint letter, and Eric’s own experience. The court held that lawsuits, settlements, complaints, and news reports—without specific findings of liability or allegations that County policymakers knew of and ignored unconstitutional conduct at the facility—did not plausibly establish a County policy or custom. It also held that Eric’s individual experience, including the many follow-up requests, remained a single alleged incident rather than proof of a widespread practice.

Wrongful Death

The court dismissed the New York wrongful-death claim because the complaint did not allege that a distributee suffered a pecuniary loss. New York wrongful-death damages are compensation for financial losses resulting from the death to the people for whose benefit the action is brought. The complaint alleged only that Eric was damaged in an amount exceeding the jurisdictional limit and did not allege Freudenberg’s own pecuniary loss or the existence of a distributee who suffered such a loss.

Disposition

The court granted in part and denied in part the defendants’ motion to dismiss. The deliberate-indifference claim survived. The ADA, Rehabilitation Act, municipal-liability, and wrongful-death claims were dismissed without prejudice because this was the first adjudication of those claims on the merits. The court gave Freudenberg 30 days to file an amended complaint if she had a good-faith basis to do so. It stated that failure to amend properly and on time would result in dismissal of the non-surviving claims with prejudice. The Clerk was directed to terminate the pending motion.