Rebecca S. Doby Herbert K. Doby, in No. 98-1124 v. James Decrescenzo Bucks County Department of Mental Health and Mental Retardation Phillip M. Fenster, County Administrator, Bucks County Department of Mental Health and Mental Retardation, in His Official Capacity Amy Bryant, Individually and in Her Official Capacity as Delegate for the County Administrator of the Bucks County Department of Mental Health/mental Retardation Lenape Valley Foundation Debbie Neidhardt, Individually and in Her Official Capacity as Delegate for the County Administrator of the Bucks County Department of Mental Health and Mental Retardation Township of Warrington Warrington Township Police Department John Bonargo, Chief of Police, Warrington Township Police Department, in His Official Capacity John Doe, Police Officer 1, Officer Who, With Police Officer 2, Asked Mrs. Doby to Step Outside Apartment at Approximately 7:00 P.M. And Took Mrs. Doby in Handcuffs and Shackles to the Hospital, Individually and in His Official Capacity as Poli

Citation: 171 F.3d 858Docket: 98-1124

Court: Court of Appeals for the Third Circuit; March 21, 1999; Federal Appellate Court

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The case involves appellants Rebecca S. Doby and Herbert K. Doby in two appeals (Nos. 98-1124, 98-1224) against multiple parties, including James DeCrescenzo, the Bucks County Department of Mental Health and Mental Retardation, and various officials and police officers from Warrington Township. The appellants challenge the actions of law enforcement officers who, on December 30, 1993, requested Mrs. Doby to leave her apartment and subsequently transported her to a hospital in handcuffs and shackles. The officers involved include John Doe Officer 1 and Officer 2, who escorted Mrs. Doby, and Officer 3, who remained at the apartment after her departure. Additional parties in the case include representatives from Lenape Valley Foundation, Doylestown Hospital, and various police department personnel, all named in their official and individual capacities. The legal proceedings focus on the appropriateness of these actions by the involved parties.

Timothy I. McCann and Linda A. Carpenter represented the appellants, while Joseph Goldberg and others represented the appellees in a case before the United States Court of Appeals for the Third Circuit, argued on February 16, 1999, and decided on March 22, 1999. James DeCrescenzo filed a petition for the involuntary examination of his employee, Rebecca Doby, suspecting she was suicidal. The Bucks County Department of Mental Health approved the petition, leading to Doby's involuntary commitment after a psychiatric evaluation. Doby and her husband filed a lawsuit under 42 U.S.C. § 1983, claiming violations of her due process rights and protection against unreasonable searches and seizures. The district court dismissed parts of their case and granted judgment for the defendants on other claims. The Dobys' appeal centered on the assertion that Bucks County's policy for involuntary examinations was unconstitutional. The court ultimately upheld the district court's rulings, affirming the constitutionality of the county's enforcement of the Mental Health Procedures Act and denying the Dobys' appeal for reversal of the judgments. Jurisdiction was established under 28 U.S.C. §§ 1331, 1343 for federal claims and § 1367 for related state law claims, with appellate jurisdiction under § 1291 regarding final orders.

Doby, an employee of DeCrescenzo's court reporting agency for two years, presented a personal letter on December 22, 1993, alleging an intimate relationship with DeCrescenzo, which he denies. The letter, spanning 11 pages, detailed past abuse Doby suffered and her desires for sexual conduct with DeCrescenzo, concluding with a statement about leaving her life behind. Alarmed, DeCrescenzo sought counsel from his wife, marriage counselor Dr. Linda Edelstein, and his attorney, who advised him that Doby was in psychiatric distress and potentially suicidal. Following this advice, DeCrescenzo arranged for a mobile crisis team to meet Doby on December 30, 1993, without her consent.

On that day, Doby left the office before the team arrived and, during a distressed phone call to a co-worker, expressed her emotional state but refused to discuss her whereabouts. After receiving updates from Doby's co-worker and husband, DeCrescenzo contacted the police and the mental health office for guidance. At their suggestion, a search of Doby's work area was conducted, revealing a suicide note and plans for organ donation and custody arrangements for her children. DeCrescenzo later sought to have Doby involuntarily examined under the Pennsylvania Mental Health Procedures Act (MHPA) based on the evidence of her mental state. The MHPA allows for a warrant to be issued for emergency examination if a person is deemed severely mentally disabled and poses a danger to themselves or others. During his drive to the hospital to file this petition, DeCrescenzo received confirmation from Herbert Doby that Doby was fine.

Clear and present danger is indicated when an individual has made recent suicide threats and engaged in actions supporting those threats, as defined under Pa. Stat. Ann. tit. 50. 7301(b)(2)(ii). A physician must examine a person brought in under a section 7302 warrant within two hours of arrival at the facility (Pa. Stat. Ann. tit. 50. 7302(b)). If the physician finds the individual severely mentally disabled and in need of immediate treatment, they may be involuntarily committed for up to 120 hours, with potential for extension.

Upon arrival at the hospital, DeCrescenzo met crisis worker Amy Bryant and reported finding a suicide note on Rebecca Doby's desk. He provided detailed information indicating Doby's need for emergency psychiatric care, including her preparations regarding financial and personal matters, reminders about organ donations, and letters addressed to friends and family expressing her feelings. Doby had also exhibited a concerning decline in work performance and had access to firearms, raising fears for her safety.

Following DeCrescenzo's application, Bryant consulted with Debbie Neidhardt from the Bucks County Department of Mental Health to confirm that involuntary treatment was the least restrictive option. After a 14-minute discussion, Neidhardt approved the issuance of a section 7302 warrant, which Bryant signed on Neidhardt's behalf. DeCrescenzo then delivered the warrant to the police.

Three officers executed the warrant at the Dobys' apartment around 7:00 p.m. The officers' account of explaining the custody reasons to Doby and the subsequent events is disputed. After Doby resisted the officers' attempts to take her into custody, they forcibly restrained her and transported her to Doylestown Hospital.

Dr. John Richards examined Doby at the hospital, where they discussed a letter and Doby's long-standing depression. Doby revealed she had stopped taking her prescribed Prozac and acknowledged needing help but declined voluntary treatment. Dr. Richards subsequently committed her involuntarily for up to 120 hours. The following day, a different physician assessed Doby and deemed her mentally disabled, deciding against her release. On January 3, 1994, Doby voluntarily signed commitment papers, anticipating her release the next day, which occurred.

In June 1994, the Dobys filed a lawsuit claiming that the involuntary commitment violated their federal and state rights, naming multiple defendants, including DeCrescenzo, the Lenape Valley Foundation, and various police and hospital personnel. They alleged violations under section 1983, false arrest and imprisonment, assault and battery, conspiracy, gross negligence, intentional infliction of emotional distress, loss of consortium, invasion of privacy, defamation, and wrongful use of civil proceedings.

On June 27, 1995, the district court dismissed the section 1983 claim against Dr. Richards and conspiracy claims against all defendants. Following discovery, the court ruled on September 9, 1996, dismissing claims against the foundation defendants, county defendants, Doylestown Hospital, and Dr. Richards, while allowing some claims against DeCrescenzo and the police defendants to proceed, including defamation, invasion of privacy, false arrest, gross negligence, and intentional infliction of emotional distress.

The remaining claims were tried before a jury starting January 21, 1998. At the close of the Dobys' case, the court granted judgment as a matter of law to the police defendants, leaving the jury to deliberate only on claims against DeCrescenzo. The jury found him liable for simple negligence but ruled in his favor on all other counts, with no damages awarded.

DeCrescenzo successfully moved for a judgment as a matter of law, leading the court to rule that the evidence did not support a simple negligence verdict. Subsequently, the Dobys filed post-trial motions for reconsideration, amendment of the verdict, and a new trial, all of which were denied by the district court on March 10, 1998. The Dobys are appealing this denial. 

The appeal primarily challenges the district court's grant of summary judgment to LVF and the county regarding the Dobys' official capacity claims. The key issue is whether the district court erred by concluding that LVF and the county were not liable for a constitutional deprivation due to a lack of established custom or policy. The court's review of the summary judgment is plenary, favoring the Dobys as the non-moving party.

The district court stated that the Dobys could only recover under section 1983 if they demonstrated a policy or custom leading to a deprivation of constitutional rights, as established in Monell v. Department of Social Services. The Dobys contend that the county's practice of allowing non-mental health professionals to petition for involuntary examinations and requiring probable cause for warrants constitutes an unconstitutional policy.

The district court dismissed the claims, asserting that a single constitutional violation (Doby's involuntary examination) could not establish a custom or policy. However, this interpretation misapplied Monell. Unlike the precedent cited, where no express policy existed, the county and LVF clearly maintained a policy concerning involuntary examination petitions. Specifically, LVF's written procedures permit petitions from non-physicians and do not mandate an investigation, with the defendants not disputing this operational process.

A plaintiff challenging the constitutionality of a policy or custom does not need to allege a sequence of constitutional deprivations to satisfy Monell; the claim that the policy resulted in a deprivation is sufficient. The district court incorrectly dismissed the Dobys' official capacity claims for not alleging a custom or policy. A key issue is whether the defendants' petition processing method constitutes a county policy rather than merely enforcing state law, as counties cannot be held liable under Monell for enforcing state law without adopting their own policy. The court referenced cases indicating that municipalities can be liable if they adopt specific policies related to state laws. The Dobys argue that LVF and the county enforced the statute unconstitutionally by allowing warrants to be issued based on uncorroborated information from non-professionals. They assert that the enforcement procedures should be viewed as a county policy because the statute does not dictate how warrants must be processed, granting the county some discretion. However, the court ultimately concludes that it does not need to determine if the policy is county or state as the enforcement policy by LVF and the county is constitutional. The Dobys do not argue against the state's right to permit involuntary examinations but contend that LVF and the county's practices are flawed: they allow petitions from anyone rather than just mental health professionals and fail to conduct personal interviews or investigations before issuing warrants. The district court's ruling, which upheld the constitutionality of these practices based on a First Circuit decision, was supported by this analysis.

The court addresses the Dobys' argument regarding the interpretation of "physician or other responsible party" under section 7302(a)(1) of the Mental Health Procedures Act (MHPA). They assert that this phrase should be restricted to mental health professionals. However, the application form for requesting a warrant indicates that petitioners can include individuals other than physicians, such as police officers and county administrators. The state agency overseeing the MHPA's implementation interprets the statute in this broader context, and courts typically defer to such interpretations unless they are clearly erroneous. The Dobys' constitutional argument claims that allowing non-mental health professionals to petition for a warrant violates the Fourteenth Amendment's Due Process Clause, potentially leading to arbitrary deprivations of liberty without independent investigation of the petitioner's motives. 

Despite acknowledging Pennsylvania's legitimate interest in involuntary examinations, the Dobys contend that this process, as currently structured, is unconstitutional. The court finds that the procedures established under section 7302 are intended for emergency situations and that due process is adaptable based on the individual and state interests involved. It is deemed reasonable for the state to forgo notice and hearing requirements in emergencies, particularly given that the deprivation (detention for examination) is short-term. The court references precedents indicating that minimal procedural safeguards may suffice when the risk of significant loss is low and the underlying decision-making processes are sufficiently reliable.

The Dobys acknowledge the State's urgent need for action in emergencies but assert that notice and a hearing are necessary when the petitioner is not a physician, citing concerns about the reliability of non-physicians' information. However, they fail to prove that non-physicians are inherently unreliable. The Dobys misunderstand the petitioner's role, as the assessment of dangerousness is conducted by a trained mental health professional rather than the petitioner. The law allows for information from a physician or another responsible party, and the county has procedures to ensure warrant applications are handled promptly while safeguarding against misuse. There is no evidence that the county issues warrants based on clearly impaired petitioners.

The application process includes a warning against providing false information, which can lead to criminal prosecution. The Dobys do not provide a compelling case that allowing non-physicians to apply for warrants undermines due process. Their second argument, based on the Fourth Amendment, is also unpersuasive. They contend that warrants for involuntary examinations should meet criminal law standards, yet the Fourth Amendment's reasonableness standard applies to civil proceedings. The Supreme Court has recognized that states can act without a warrant or probable cause when special needs justify such actions, and the temporary involuntary commitment of individuals deemed dangerous qualifies as such a special need.

Requiring a county delegate to obtain a warrant from a magistrate before acting on reasonable grounds of an individual's immediate danger would cause delays that could be life-threatening, especially in emergencies as defined by section 7302. This section is applicable only in urgent situations where seeking a warrant is impractical. The Supreme Court's reasoning in Griffin supports the idea that magistrate authorization is less necessary when a trained county delegate in mental health makes emergency decisions about involuntary examinations. The Dobys' concerns regarding the reliability of decisions made over the phone, without face-to-face interviews, overlook the urgent nature of section 7302 warrants and the fact that magistrates also issue warrants based on second-hand information.

Although the "special need" exception applies under the Mental Health Procedures Act (MHPA), the reasonableness of the county's procedures must still be assessed. Under Fourth Amendment principles, shorter detentions require less compelling evidence of necessity. The MHPA mandates that a physician examine individuals detained under section 7302 within two hours, limiting the deprivation of liberty to a few hours unless further examination determines the need for involuntary treatment. The warrant process includes safeguards, such as authorization by a neutral county delegate and the requirement that a responsible party convinces the delegate of the individual's dangerousness.

Given the emergency context, it is reasonable for the county delegate to issue warrants based on telephone consultations with crisis workers. Statutory requirements ensure that the information is reliable, including warnings about the criminal liability for false statements. Consequently, the Dobys' Fourth Amendment challenge is rejected. The document then shifts focus to whether the District Court erred in granting a judgment as a matter of law to DeCrescenzo regarding negligence.

The jury found in favor of DeCrescenzo on all claims except for simple negligence. The district court, however, granted judgment as a matter of law on the negligence claim due to a lack of supporting evidence and determined that the Dobys failed to establish proximate cause linking the alleged negligence to Doby's injury. Furthermore, the court ruled that DeCrescenzo was immune from simple negligence claims under section 7114 of the Mental Health Procedures Act (MHPA), which protects authorized individuals involved in decisions for examination or treatment from civil or criminal liability in the absence of willful misconduct or gross negligence. DeCrescenzo's role in initiating involuntary examination proceedings qualified him as an "authorized person." Although a prior case, McNamara v. Schleifer Ambulance Serv., suggested that only mental health professionals might qualify for such immunity, the court distinguished this case by affirming that the application for a section 7302 warrant does allow for participation in the decision-making process, which includes peace officers. Thus, DeCrescenzo, having acted similarly to a peace officer, was granted immunity unless he had engaged in willful misconduct or gross negligence. Consequently, the district court's judgment on the simple negligence claim was upheld. Additionally, the court's review of the police defendants' claims of excessive force was also performed under a plenary standard, requiring evidence to be viewed in the light most favorable to the nonmoving party.

The district court granted judgment as a matter of law to the police defendants on the excessive force claims brought by the Dobys, concluding that no rational jury could find in their favor. The court noted that the plaintiff's own testimony indicated she was not mistreated and acknowledged her aggressive behavior, including kicking and screaming, which justified the officers' response to subdue her and transport her to the hospital. In assessing excessive force claims under the Fourth Amendment, the court emphasized the necessity of evaluating the police's actions as "objectively reasonable" based on the circumstances they faced, without considering their intent. Key factors included the plaintiff's resistance and the officers' awareness of potential danger, as they were informed of firearms in the residence and that the plaintiff posed a risk. 

Upon arrival, the officers requested Doby to step outside, but she refused and attempted to resist, resulting in the officers grabbing her, handcuffing her, and subsequently shackling her due to her continued resistance. Once at the hospital, her restraints were removed when she agreed to cooperate. The court concluded that the force used by the police was reasonable given Doby's actions and affirmed the district court’s decision regarding the excessive force claims.

Additionally, the district court denied the Dobys' request for a declaratory judgment declaring the Mental Health Procedures Act (MHPA) unconstitutional. The court ruled that the claim was abandoned as the Dobys failed to renew it before trial, and thus, the Attorney General was not given the required notice. The court found that the statute was constitutional regardless of whether non-physicians could petition for warrants, rendering any possible error in denying the motion harmless. Finally, there was a question regarding the exclusion of expert testimony from Susan Bierker, which the court noted but did not elaborate on in this excerpt.

The district court's rulings on the admissibility of expert testimony are reviewed for abuse of discretion. The trial judge has broad discretion to determine whether expert testimony aids the trier of fact. In this case, the court, presided by Judge Fullam, excluded testimony from Susan Bierker, a licensed clinical social worker, regarding Doby's posttraumatic stress disorder linked to her involuntary commitment, citing Bierker's lack of qualification and a "seriously inaccurate" understanding of the facts. The Dobys argue this exclusion was erroneous; however, since the jury did not calculate damages due to a verdict favoring DeCrescenzo on all claims except simple negligence, any error is deemed harmless.

Regarding Dr. Richards, the court, under Judge Rendell, found he qualified for immunity under section 7114 of the MHPA, allowing liability only for gross negligence or willful misconduct. The court determined the Dobys failed to provide sufficient evidence demonstrating egregious conduct deviating from the standard of care. The claim against Dr. Richards primarily concerned his decision to commit Doby involuntarily. The Dobys did not contest the court's conclusion that Dr. Richards' liability was limited to gross negligence/willful misconduct, as defined by Pennsylvania law.

To support their claims, the Dobys submitted expert reports from Dr. Paul S. Applebaum and Dr. Eileen A. Bazelon. Dr. Bazelon's report stated that Dr. Richards failed to adhere to the customary standard of care by not questioning the motivations of others involved and showed "complete disregard" for Doby's rights. However, it also acknowledged the alarming nature of Doby's writings. Ultimately, this report did not establish a genuine factual dispute regarding Dr. Richards' alleged gross negligence or willful misconduct.

Dr. Bazelon claims that Dr. Richards deviated from the standard of care, indicating potential ordinary negligence, but does not classify this deviation as gross or flagrant. In contrast, Dr. Applebaum identifies five significant deficiencies in Dr. Richards' evaluation and diagnosis of Doby's depression, including neglecting to assess common depression symptoms, inadequately evaluating suicidality, failing to consult Doby's psychiatrist and family, conducting a "grossly inadequate" mental status evaluation, and not considering less restrictive options before involuntary commitment. While Dr. Applebaum's report suggests gross negligence, it is undermined by his omission of crucial evidence, specifically Doby's 11-page letter and suicide note, which are pivotal to understanding her mental state. The conclusion drawn from the established facts indicates Dr. Richards acted with simple negligence rather than gross negligence, particularly given that Doby had a documented history of depression and suicidal thoughts. The court emphasizes the need for caution in assessing physician liability in involuntary commitments to avoid deterring necessary interventions. The district court's rulings, including the granting of summary judgment for the defendants and denial of the Dobys' motions for a new trial, are affirmed. Additionally, the context of Pennsylvania's Mental Health Procedures Act supports a preference for voluntary treatment and minimal restrictions. The Dobys' claims about constitutional rights violations are also noted, referencing interpretations by Pennsylvania courts.

Determining liability under section 1983 involves analyzing federal law, specifically referencing Baker v. McCollan. The district court dismissed state law claims against LVF and the county due to their immunity under the MHPA, a ruling that the Dobys did not appeal. The key issue for appeal is whether the county and LVF had a policy that violated Doby's federal constitutional rights to due process and protection from unreasonable seizures. The Dobys argue that the MHPA creates substantive rights, particularly that only licensed professionals should petition for section 7302 warrants, but this interpretation is disputed. 

The court found that the MHPA allows for "reasonable" seizures under the Fourth Amendment, satisfying substantive due process requirements. There was no evidence indicating that the actions of the LVF or county defendants were irrational or motivated by improper motives. The jury ruled in favor of DeCrescenzo regarding claims of defamation, invasion of privacy, false arrest, and other allegations, indicating he acted on a legitimate interest.

The Dobys have not clarified how their Fourth Amendment argument relates to municipal or county policy, as the MHPA allows for alternative warrant procedures without requiring a magistrate's approval. The Dobys also referenced Pennsylvania law regarding a "special need" exception for seizures, which they misinterpret, as the Pennsylvania Supreme Court's ruling in Kohl does not eliminate the exception but clarifies its applicability under federal law.

The court concurred with the district court that there was insufficient evidence to support a negligence claim against DeCrescenzo, who was not specifically accused of simple negligence in the pleadings. Lastly, the claim that section 4422 of Pennsylvania mental health statutes made the officers' actions illegal was deemed without merit, as the use of restraints was justified to prevent harm to Doby or the officers during transport.