Gonzalez v. Ryan Health Nena

Background

Sierra Gonzalez filed the action without a lawyer and sought $100,000 in damages. She alleged that, on October 9, 2023, she underwent a gynecological examination at Ryan Health NENA and that her internal organs had been removed without authorization. She described the alleged conduct as involving medical negligence, lack of informed consent, trafficking, and unlawful sexual acts. She named Ryan Health NENA; Letitia James, identified as the Attorney General of New York; and Jonathan Fried, identified as Ryan Health NENA’s General Counsel and Health Insurance Portability and Accountability Act privacy officer.

The court understood the complaint to assert Federal Tort Claims Act claims against Ryan Health NENA, constitutional claims under 42 U.S.C. § 1983 against James, and state-law claims against James and Fried. Gonzalez attached a letter from the Department of Health and Human Services acknowledging receipt of an administrative tort claim on January 22, 2024. The letter did not describe the contents of that claim and requested additional supporting evidence. Gonzalez did not allege whether the agency later issued a final decision.

Guardian ad litem request

The court denied Gonzalez’s request for appointment of a guardian ad litem, a representative appointed to protect an unrepresented person who is legally unable to conduct litigation. The court stated that the materials showed treatment for mental-health issues, including attention-deficit/hyperactivity disorder and post-traumatic stress disorder, but did not show that a court or public agency had found Gonzalez legally incompetent or that a mental-health professional had documented a condition rendering her legally incompetent. The denial was without prejudice to Gonzalez providing sufficient information in an amended complaint.

Federal Tort Claims Act claims

The court treated Ryan Health NENA as covered by the federal health-care-center statute and therefore treated the alleged medical tort claims as claims under the Federal Tort Claims Act. Under that framework, the United States, rather than the health-care center, is the proper defendant. The court therefore construed Gonzalez’s claims as being brought against the United States.

Before filing a Federal Tort Claims Act damages action, a claimant must present an adequate claim to the appropriate federal agency and receive a final written determination, or proceed under the statute’s alternative timing provision when no determination is made within six months. The court found that Gonzalez’s complaint did not show that her administrative claim gave the agency enough information to investigate the allegations in this lawsuit. The attached acknowledgment letter alone did not establish that she had satisfied the administrative presentment requirement.

The court dismissed the Federal Tort Claims Act claims against Ryan Health NENA and the United States under sovereign immunity and, consequently, for lack of subject-matter jurisdiction. It granted Gonzalez 30 days to replead Federal Tort Claims Act claims against the United States. Any amended complaint must name the United States, describe the substance of the administrative claim, explain how it relates to the events alleged in the complaint, and state whether the agency issued a final decision and, if so, when it was mailed. The court encouraged her to attach a copy of the administrative claim if possible.

Section 1983 claims against James

A claim under 42 U.S.C. § 1983 requires facts showing both a violation of a federal right and action under state law. It also requires facts showing the defendant’s direct and personal involvement; a person cannot be held liable merely because she supervises someone who allegedly violated the plaintiff’s rights.

The court said James would appear to qualify as a state actor because she is the Attorney General of New York, but Gonzalez alleged nothing showing that James was directly or personally involved in the conduct described in the complaint. The court therefore dismissed the § 1983 claims against James for failure to state a claim.

Other claims and disposition

The court dismissed the action while granting limited leave to amend the Federal Tort Claims Act claims. It stated that, if Gonzalez did not file an amended complaint within 30 days, the resulting judgment would include denial of the guardian request, dismissal of the claims against Ryan Health NENA and the United States, dismissal of the § 1983 claims against James, and declining to consider the state-law claims against James and Fried under supplemental jurisdiction. The court also denied in forma pauperis status for an appeal after certifying that an appeal would not be taken in good faith, and directed the Clerk to keep the matter open until judgment was entered.