Acevedo v. City of New York

Background

Felipe Acevedo alleged that an unknown assailant shot him in the foot on August 6, 2023. He was treated at Harlem Hospital, where he says he was handcuffed to his hospital bed and surveilled by New York City police officers. Harlem Hospital staff took X-rays that did not show a fracture. He was discharged within a few hours into police custody with a cane, an orthopedic shoe, and instructions to take over-the-counter pain medication and attend a follow-up appointment.

Acevedo alleged that he remained in severe pain and had difficulty walking. After a follow-up visit at Harlem Hospital, he went to Mount Sinai Hospital on August 15, 2023. Providers there observed him overnight, found several fractures, prescribed stronger pain medication, provided crutches and a splint, and later provided a walking boot and prescribed physical therapy.

Acevedo proceeded without a lawyer and brought claims under 42 U.S.C. § 1983, a federal law allowing claims against people acting under state authority who violate federal constitutional rights. He alleged that the Harlem Hospital medical providers were deliberately indifferent to his serious medical needs and that New York City Health + Hospitals, referred to as H+H, was liable for its employees’ conduct.

Motion and legal standards

H+H, Dr. Katherine Bruce, and Dr. Sebastian Rueda Valdivieso moved to dismiss under Federal Rule of Civil Procedure 12(b)(6), which asks whether a complaint states a legally sufficient claim. The moving defendants argued that Acevedo was not protected by the constitutional rules governing people in custody, that his allegations showed at most disagreement with medical treatment or medical negligence, and that Dr. Bruce and Dr. Valdivieso were protected by qualified immunity. They also argued that Acevedo had not alleged the policy or custom needed to hold H+H liable under the municipal-liability doctrine recognized in Monell v. Department of Social Services.

Because Acevedo was proceeding without a lawyer, the court read his filings liberally and considered factual allegations in his opposition brief. The court also considered Harlem Hospital and Mount Sinai medical records because Acevedo relied on them and the defendants did not dispute their authenticity, accuracy, or relevance.

Federal claims against the individual medical providers

The court held that the medical providers were acting under state authority because they were employees of H+H, which the court described as a public benefit corporation. The court analyzed Acevedo’s claims under the Due Process Clause of the Fourteenth Amendment because he did not allege that he had been convicted and sentenced.

The court found that Acevedo plausibly alleged that he was in involuntary state custody during his first Harlem Hospital visit. He alleged that he was handcuffed to his hospital bed, watched by police officers, discharged into police custody, taken to a police station, and not released until after questioning. The court held that the Fourteenth Amendment therefore applied to the medical care provided during that visit.

The court reached a different conclusion about Acevedo’s second Harlem Hospital visit. Because he did not allege facts showing that he was in custody or was compelled to attend that visit, the court dismissed the federal claims against Dr. Valdivieso and Dr. Cameron Wilkinson based on the absence of an alleged involuntary-custody relationship.

The court also dismissed the federal claims against Dr. Sukhman Kaur and Dr. Rajesh Dhillon because Acevedo alleged only that they took and assessed X-rays. The court found that he did not adequately allege their personal involvement in the decision to discharge him or facts showing deliberate indifference. At most, the court said, a failure to diagnose the broken foot could amount to medical malpractice or negligence, which is not enough by itself for a deliberate-indifference claim under § 1983.

The court allowed Acevedo’s federal claim against Dr. Bruce to proceed. It found that the gunshot wound and broken foot were objectively serious conditions and that Acevedo plausibly alleged that he was in extreme pain, struggled to walk, was discharged without more extensive treatment, and later suffered serious consequences. The court also found that the allegations about Dr. Bruce’s knowledge of the gunshot wound, her medical training, Acevedo’s visible difficulty walking, and the more extensive care later provided at Mount Sinai supported a plausible claim that she knew or should have known that the treatment posed a serious risk.

The court further found plausible Acevedo’s allegation that Dr. Bruce chose an easier and less effective course of treatment for an improper reason: that the police presence caused medical providers to view him as a criminal undeserving of full attention. The court therefore declined to dismiss Dr. Bruce’s claim based on qualified immunity at this stage.

The court did not dismiss Acevedo’s federal claim against Dr. Revello because she had not responded to the third amended complaint. The court stated that Dr. Revello was in default and that similar reasoning to the claim against Dr. Bruce supported allowing the claim against Dr. Revello to continue.

Federal claim against H+H

The court dismissed Acevedo’s § 1983 claim against H+H under the municipal-liability rules. A municipality cannot be held liable merely because it employs someone who allegedly violated a person’s rights. Instead, the plaintiff must allege an official policy or custom that caused the constitutional violation.

Acevedo alleged that H+H delegated policymaking authority to the medical providers, but the court found that he did not plead facts showing that any provider had final authority over significant policy matters. He also did not adequately allege a formal policy, widespread custom, or failure to train or supervise that caused the alleged violation. The court dismissed the federal claim against H+H with prejudice and denied leave to amend that claim because Acevedo had already received earlier opportunities to correct the same deficiencies.

State-law claims

Although Acevedo did not expressly assert state-law claims, the court construed his filings as potentially raising negligence claims against the medical providers and a claim against H+H based on its employees’ alleged negligence. New York law requires a plaintiff suing a municipality or its officers, agents, or employees for tort claims to serve a notice of claim and plead that the requirement was satisfied.

Because Acevedo did not allege that he served a notice of claim, the court dismissed the state-law claims. The court did not reach the moving defendants’ separate argument that it lacked jurisdiction over those claims because the federal claims had been dismissed.

Disposition

The court granted in part and denied in part the moving defendants’ motion to dismiss. It denied the motion as to Acevedo’s § 1983 claim against Dr. Bruce. It granted the motion as to the state-law claims and the § 1983 claims against H+H and Dr. Valdivieso, but those dismissals were without prejudice except for the § 1983 claim against H+H. Under the court’s screening authority for cases filed without paying fees, it dismissed the § 1983 and state-law claims against Dr. Kaur, Dr. Dhillon, and Dr. Wilkinson, and dismissed the state-law claim against Dr. Revello, all without prejudice.

The court granted Acevedo permission to file an amended complaint addressing the identified deficiencies in the state-law claims against all defendants and in the § 1983 claims against Dr. Kaur, Dr. Dhillon, Dr. Valdivieso, and Dr. Wilkinson. The amended complaint was due within 30 days of entry of the order. The court also certified that any appeal would not be taken in good faith and denied fee-waiver status for an appeal.