Allen v. New York State Department of Corrections and Community Supervision

Background

This putative class action was brought by inmates in the custody of the New York State Department of Corrections and Community Supervision (DOCCS) who required pain-management or neurological medication for chronic health conditions. The plaintiffs challenged DOCCS’s Medications With Abuse Potential Policy, adopted on June 2, 2017. The policy required medical providers to submit a request to a regional medical director or the chief medical officer before a pharmacy could fill certain medications. If the request was denied, medical personnel could not provide the requested medication.

The plaintiffs alleged that the policy was unconstitutional as applied to patients for whom the restricted medications were the most effective, or the only effective, treatments. They claimed that the policy shifted treatment decisions away from treating providers and specialists and caused medications to be discontinued or denied regardless of individual medical needs. Their claims arose under 42 U.S.C. § 1983 and alleged deliberate indifference to serious medical needs in violation of the Eighth Amendment.

The court considered two motions to dismiss the Second Amended and Supplemental Class Action Complaint. The medical providers moved under Rule 12(b)(6), which tests whether a complaint states a legally sufficient claim. The state-represented defendants moved under Rules 12(b)(1), 12(b)(3), and 12(b)(6), challenging jurisdiction, venue, and the sufficiency of the claims. The court expressly did not decide the pending Rule 12(b)(1) motions because the plaintiffs had not yet filed the opposition papers associated with their request for injunctive relief.

Claims Against the Medical Providers

To state an Eighth Amendment deliberate-indifference claim involving medical care, the plaintiffs had to plausibly allege both that they were deprived of adequate care in a sufficiently serious way and that the defendants acted while aware of a substantial risk of serious harm. The medical providers argued that the plaintiffs had received medical attention, medication, referrals, and alternative treatments, and therefore had not stated such a claim.

The court rejected that argument at the pleading stage. It found that the plaintiffs plausibly alleged that providers departed from reasonable medical practice by disregarding specialists’ recommendations for restricted medications without explanation and by choosing less effective treatments because of the policy rather than medical judgment. The court relied in part on allegations concerning Aaron Dockery, whose Neurontin was tapered off and replaced with Depakote, while a neurologist’s recommendation for Lyrica was not pursued, and Mark Daniels, whose specialists repeatedly recommended certain medications that were not provided.

The court also found that the plaintiffs adequately alleged serious suffering after the medications were discontinued and that providers knew about the plaintiffs’ chronic pain and neurological problems. It therefore denied the medical providers’ motion to dismiss for failure to state a claim.

Claims Against the Administrators

The administrators argued that the complaint did not show a common policy or pattern and instead described individual medical decisions. The court held that the plaintiffs adequately alleged that the MWAP Policy existed and that administrators implemented it in a way that denied individualized assessments and departed from medical standards. The court stated that whether particular medication decisions reflected sound medical judgment, negligence, or deliberate indifference was a factual issue that could not be resolved on a motion to dismiss.

The court also rejected the administrators’ argument that disagreements about medication ordinarily cannot support a constitutional claim. It distinguished ordinary disagreements over treatment from the plaintiffs’ allegations that administrators denied medication requests because of the policy rather than because of medical judgment. The court found the allegations sufficient to support both the objective and subjective parts of a deliberate-indifference claim and denied the administrators’ motion to dismiss for failure to state a claim.

The court separately held that the plaintiffs adequately alleged personal involvement by Salotti, Hammer, Dinello, and Mueller. It cited allegations that these defendants discontinued medication or denied particular medication requests. The court also held that the complaint adequately alleged personal involvement by Morley and Koenigsmann. Although merely receiving or forwarding complaints would not ordinarily be enough, the court found that Morley’s alleged investigations and Koenigsmann’s detailed response to an email about John Gradia’s treatment supported an inference that they knew about and disregarded a serious risk to inmates’ health. The motion to dismiss these defendants for lack of personal involvement was denied.

Qualified Immunity

Qualified immunity is a defense that can protect government officials from damages when their conduct did not violate a clearly established constitutional right. The providers argued that they reasonably believed they had no effective way to provide restricted medications after a regional medical director denied a request. The administrators made related arguments concerning the policy and their involvement.

The court held that granting qualified immunity on a motion to dismiss would be premature. The complaint alleged that providers had methods for seeking or providing restricted medications and that administrators made decisions based on the policy rather than sound medical judgment. Taking those allegations as true, the court denied both groups’ motions to dismiss on qualified-immunity grounds.

Venue

The administrators also sought dismissal for improper venue as to Plaintiffs Ortiz and Knight. The court held that both plaintiffs had made the required initial showing that venue was proper. The allegations concerning Ortiz showed that he had previously received effective treatment with Neurontin and Baclofen before a medication was discontinued after his transfer. The allegations concerning Knight showed that Lyrica had effectively treated his pain and that alternative medications were unsuccessful. The motion to dismiss Ortiz and Knight for improper venue was denied.

The court did not consider the venue argument concerning Vattiato because his claims had already been voluntarily dismissed, and the administrators withdrew their venue argument concerning Rahman. The court also noted that other claims and defendants had previously been voluntarily dismissed or otherwise removed from the case.

Disposition

The court denied the medical providers’ motion to dismiss and denied the administrators’ motion to dismiss. The court closed the two motions. This was a ruling on motions to dismiss, not a final determination that the plaintiffs would ultimately prevail on their constitutional claims.