Deeths v. Lucile Salter Packard Children's Hospital at Stanford, et al

Filing 74

ORDER on Motions to Dismiss Second Amended Complaint signed by District Judge Lawrence J. O'Neill on 11/26/2013. (Flores, E)

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UNITED STATES DISTRICT COURT
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FOR THE EASTERN DISTRICT OF CALIFORNIA

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CHRISTINE DEETHS,

1:12-CV-02096-LJO-JLT

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Plaintiff,

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ORDER ON MOTIONS TO DISMISS
SECOND AMENDED COMPLAINT
(Docs. 58, 60, 61)

v.

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LUCILE SLATER PACKARD CHILDREN’S
12 HOSPITAL AT STANFORD, et al,
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Defendants.

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PRELIMINARY STATEMENT TO PARTIES AND COUNSEL
Judges in the Eastern District of California carry the heaviest caseload in the nation, and this

17 Court is unable to devote inordinate time and resources to individual cases and matters. This Court
18 cannot address all arguments, evidence and matters raised by parties and addresses only the arguments,
19 evidence and matters necessary to reach the decision in this order given the shortage of district judges
20 and staff. The parties and counsel are encouraged to contact the offices of United States Senators
21 Feinstein and Boxer to address this Court’s inability to accommodate the parties and this action. The
22 parties are required to consider consent to a Magistrate Judge to conduct all further proceedings in that
23 the Magistrate Judges’ availability is far more realistic and accommodating to parties than that of U.S.
24 District Judge Lawrence J. O'Neill who must prioritize criminal and older civil cases.
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INTRODUCTION
Plaintiff Christine Deeths (“Plaintiff”) alleges civil rights, invasion of privacy, and defamation

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claims against various Defendants1 for their alleged involvement in the removal of her adopted

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children from her home and the initiation of dependency proceedings. Pending before the Court are

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motions to dismiss by Defendant John Stirling, Jr. (“Dr. Stirling”), Defendant the County of Santa

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Clara’s (“County”), Defendant Cedars-Sinai Medical Center (“Cedars-Sinai”), Defendant Christopher

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Harris (“Dr. Harris”), and Defendant Lucile Packard Children’s Hospital at Stanford (“Stanford”),

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(collectively, “Defendants”). These Defendants move the Court to dismiss the claims alleged against

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them in Plaintiff’s Second Amended Complaint.

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GRANTS without leave to amend Dr. Stirling and the County’s motion to dismiss and GRANTS with

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leave to amend Dr. Harris and Cedars-Sinai’s motion to dismiss and Stanford’s motion to dismiss.

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For the reasons discussed below, this Court

BACKGROUND

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A.

Facts2
In May 2006, Plaintiff, a medical doctor, adopted R.D. shortly after her birth, when R.D. was

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13 10 hours old. At birth, R.D. tested positive for methamphetamine and marijuana intoxication.
1.

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R.D.’s Medical History

From birth, R.D. required specialized medical care.

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Throughout her life, she exhibited

16 symptoms such as vomiting, poor weight gain, violent coughing, chronic congestion, respiratory
17 problems, and hives. In December 2007, a pediatric gastroenterology specialist determined that R.D.
18 exhibited symptoms of cystic fibrosis and began a course of treatment common for children with the
19 disease. Despite the treatment, R.D. continued to have medical problems and was hospitalized at
20 several facilities for various ailments. By late November 2010, R.D. was diagnosed with failure to
21 thrive, cystic fibrosis, and constipation. She also received a presumptive diagnosis of celiac disease
22 which required her to avoid gluten products. In addition, R.D. received treatment for lymphocytic
23 colitis although she was not formally diagnosed with the disease until approximately December 29,
24 2010.
2.

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Events Giving Rise to the Lawsuit

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Plaintiff brought this action against the County of Santa Clara; Lucile Salter Packard Children’s Hospital at Stanford; John

27 Stirling, Jr.; Christopher Harris; Cedars-Sinai Medical Center; Anthony Thomas; Bakersfield Memorial Hospital; Legacy
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Behavioral Services, Inc.; Tara Cruz; Eddie Cruz; and Does 1 through 50.
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The background facts are derived from the complaint.

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a.

Transfer to and Treatment at Stanford

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In January 2011, R.D. was treated at Bakersfield Memorial Hospital for approximately two

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weeks. Shortly after R.D. was admitted at Bakersfield, medical professionals at Bakersfield contacted

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Dr. Harris at Cedars-Sinai, where R.D. had been treated previously. Plaintiff alleges that Dr. Harris

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falsely suggested that R.D. never had been diagnosed with cystic fibrosis and that Plaintiff possibly

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was subjecting R.D. to unnecessary medical treatment. Plaintiff further alleges that Dr. Thomas and/or

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other Bakersfield Memorial staff contacted Dr. Stirling at Stanford and falsely told him that Plaintiff

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was suffering from Munchausen’s Syndrome by Proxy (“MSBP”), a disorder where a parent

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purportedly induces real or apparent symptoms of a disease in a child. Plaintiff was not informed that

10 the main purpose of the transfer to Stanford was for Dr. Stirling, an expert in MSBP and a County
11 employee, to investigate Plaintiff.
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After R.D. was admitted at Stanford, Plaintiff was informed that a child abuse investigation had

13 commenced. Shortly thereafter, Dr. Stirling introduced himself to Plaintiff as a child abuse specialist
14 and informed her that Bakersfield Memorial had filed a child abuse report against her and that Kern
15 County Child Protective Services had become involved.
b.

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SCAN Team Meeting

On January 20, 2011, a Suspected Child Abuse and Neglect (“SCAN”) Team meeting was held

18 and included R.D.’s primary care doctor and various Stanford medical staff. Plaintiff alleges that Dr.
19 Stirling called the meeting in order to build a coalition of medical professionals willing to go along
20 with his plan to falsely accuse her of suffering from MSBP. Plaintiff further alleges that Dr. Stirling
21 told the medical professionals present that Plaintiff was improperly guiding the course of R.D.’s
22 medical treatment and that there was nothing wrong with R.D.
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At the conclusion of the meeting, Plaintiff agreed to follow the medical advice of R.D.’s

24 doctors.

Dr. Stirling assured Plaintiff that, as long as she followed all of the doctor’s

25 recommendations, Child Protective Services would not take R.D.
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Plaintiff alleges that Dr. Stirling asked a medical social worker at Stanford to contact Kern

27 County CPS regarding R.D. and that Dr. Stirling himself called Kern CPS shortly after the meeting.
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c.

SCAN Report

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The following day, Dr. Stirling prepared a report on behalf of the SCAN team that contained

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numerous misrepresentations. In that report, Dr. Stirling allegedly “concocted numerous lies and

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misrepresentations and fabrications,” including that:

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The Stanford team conclusively determined that R.D. did not have cystic fibrosis;

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R.D. should discontinue pancreatic enzymes;

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3.

The Stanford team determined that R.D. does not have celiac disease;

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R.D. does not have or meet the criteria for lymphocytic colitis;

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R.D. did not have encorpesis or constipation; and

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There was no objective evidence of serious pulmonary symptoms at any time.

11 Plaintiff alleges that Dr. Stirling actively suppressed the true findings of the Stanford team in order to
12 manufacture a MSBP case against her. She further alleges that, in order to conceal these misdeeds, Dr.
13 Stirling instructed Stanford to refrain from releasing to Plaintiff a copy of R.D.’s medical records from
14 Stanford despite her numerous requests and her statutorily guaranteed right of access.
d.

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Discharge from Stanford

On January 23, 2011, R.D. was discharged from Stanford. Two weeks after discharge, R.D.

17 became sick again and eventually was admitted to San Joaquin Hospital. After her condition stabilized
18 sufficiently for her to be released, Dr. Harris from Cedars-Sinai and the doctors at San Joaquin hospital
19 disagreed as to whether R.D. should be treated with oxygen at home. Plaintiff alleges that, on or
20 around February 17, 2011, a telephone call took place between Dr. Stirling, Dr. Harris, and doctors
21 from San Joaquin Hospital and from Stanford regarding R.D.
e.

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Contact with Social Worker Email Follow-up

On February 18, 2011, Dr. Stirling contacted a Kern County social worker regarding Plaintiff’s

24 case. Plaintiff alleges that Dr. Stirling knowingly made several misrepresentations to the social worker
25 in order to obtain Child Protective Services involvement with the case. Dr. Stirling represented to the
26 social worker that he believed Plaintiff suffered from MSBP and that R.D. should be removed from her
27 care. Specifically, he represented to the social worker that:
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R.D. merely has asthma;
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He wanted to take R.D. off pulmozyme and enzymes;

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Plaintiff could not be trusted because she lied to them in the past;

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While at Stanford, Plaintiff turned up R.D.’s oxygen levels;

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Plaintiff may have body image issues;

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Plaintiff believes that to keep R.D. sick is to keep her healthy; and

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R.D. has never been intubated.

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Plaintiff alleges that Dr. Stirling and the social worker agreed that R.D. would be removed from

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Plaintiff’s care.

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After this contact, Dr. Stirling sent an email to Dr. Harris and the social worker regarding

10 Plaintiff and R.D.
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f.

Team Decision Meeting

On February 24, 2011, a Team Decision Meeting was held by phone between social workers,

13 public health nurses, and several doctors including Dr. Stirling and Dr. Harris. The group agreed that a
14 concerted effort must be made to compile a list of allegedly false “unequivocal” reasons for seizing
15 Plaintiff’s children. Plaintiff alleges that during the meeting, each of the three doctors knowingly or
16 with reckless disregard for the truth stated various lies about R.D.’s condition and Plaintiff.
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Plaintiff further alleges that when the social worker asked the doctors, including Dr. Stirling

18 and Dr. Harris, whether they felt that R.D. was at risk and needed to be removed, all three emphatically
19 agreed that R.D. should be removed from Plaintiff’s care. In addition, Plaintiff alleges that the meeting
20 participants, including Dr. Stirling, reached an agreement that Plaintiff’s children should be removed,
21 without a warrant or other court order, and that the reasons advanced in court documents should be
22 uniform and unequivocal.
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g.

Juvenile Dependency Proceedings

Allegedly as a result of Dr. Stirling’s misrepresentations and bad faith refusal to provide

25 Plaintiff with R.D.’s medical records, Plaintiff’s children were seized by Kern County Child Protective
26 Services and a juvenile dependency case was opened. On February 25, 2011, a social worker and two
27 Bakersfield Police Department detectives seized R.D. and T.D. from Plaintiff’s home without a
28 warrant or court order. On March 2, 2011, a social worker filed juvenile dependency petitions on
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behalf of T.D. and R.D. which alleged that both children came within the protection of California

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Welfare and Institutions Code § 300. After eighty days of separation, Kern County offered Plaintiff a

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deal. If Plaintiff agreed to plead no contest plea to an amended petition under § 300(b), which alleged

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that Plaintiff’s children were at risk due to Plaintiff having an anxiety disorder and that Plaintiff

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misrepresented R.D.’s symptoms such that R.D. endured unnecessary medical treatment, her visitation

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time with R.D. would be increased from two hours a week to “liberal” and all other allegations would

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be dropped. Plaintiff accepted the deal.

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Plaintiff alleges that Kern County social workers and Bakersfield police have a regularly

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established custom and practice of seizing children from their homes without a warrant and fabricating

10 evidence to support juvenile dependency petitions. Plaintiff further alleges that Dr. Stirling knew of
11 this practice.
Overall, Plaintiff alleges that Dr. Stirling schemed to separate R.D. from Plaintiff to experiment

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13 on R.D. in order to prove his MSBP case against Plaintiff even though Dr. Stirling knew Plaintiff did
14 not suffer from MSBP.
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B.

Procedural History
Plaintiff brought this action against all Defendants in this Court on December 28, 2012. On

17 April 23, 2013, Plaintiff filed a first amended complaint alleging four claims for relief: (1) violations of
18 42 U.S.C. § 1983; (2) a Monell claim; (3) invasion of privacy; and (4) slander. On July 31, 2013, this
19 Court granted with leave to amend Dr. Stirling and the County’s motion to dismiss the claims against
20 them in Plaintiff’s first amended complaint. Plaintiff filed a second amended complaint, the operative
21 complaint, on August 20, 2013. On September 6, 2013, Stanford filed the instant motion to dismiss the
22 claims against it in Plaintiff’s second amended complaint. On September 9, 2013, Dr. Harris and
23 Cedars-Sinai and Dr. Stirling and the County filed the instant motions to dismiss the claims against
24 them in Plaintiff’s complaint. Plaintiff then filed oppositions to each motion on October 11, 2013, and
25 Defendants filed replies on October 24, 2013.
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Relevant to the instant motions are Plaintiff’s § 1983 claims against Dr. Stirling, Dr. Harris,

27 Stanford, and Cedars-Sinai and Monell claims against the County, Cedars-Sinai, and Stanford. In
28 Plaintiff’s § 1983 claim, she alleges that Dr. Stirling Dr. Harris, Stanford, and Cedars-Sinai violated
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her Fourteenth Amendment right to familial association, privacy, warrantless seizure of child, and

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unlawful detention.

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Amendment right to be free from falsification of evidence in juvenile court proceedings. In Plaintiff’s

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Monell claim, she alleges that the County, Cedars-Sinai, and Stanford collaborated with Kern County

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to improperly curtail her constitutional rights by following policies and practices which were the

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moving force behind the violations of her constitutional rights.

She also alleges that Dr. Stirling and Dr. Harris violated her Fourteenth

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DISCUSSION

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Fed. R. Civ. P. 12(b)(6) Failure to State a Claim

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A.

Legal Standard
A motion to dismiss pursuant to Fed. R. Civ. P. 12(b)(6) is a challenge to the sufficiency of

11 the allegations set forth in the complaint. A dismissal under Rule 12(b)(6) is proper where there is
12 either a “lack of a cognizable legal theory” or “the absence of sufficient facts alleged under a
13 cognizable legal theory.” Balisteri v. Pacifica Police Dept., 901 F.2d 696, 699 (9th Cir. 1990). In
14 considering a motion to dismiss for failure to state a claim, the court generally accepts as true the
15 allegations in the complaint, construes the pleading in the light most favorable to the party opposing
16 the motion, and resolves all doubts in the pleader's favor. Lazy Y. Ranch LTD. v. Behrens, 546 F.3d
17 580, 588 (9th Cir. 2008).
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To survive a Fed. R. Civ. P. 12(b)(6) motion to dismiss, the plaintiff must allege “enough

19 facts to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544,
20 570 (2007). “A claim has facial plausibility when the plaintiff pleads factual content that allows the
21 court to draw the reasonable inference that the defendant is liable for the misconduct alleged.”
22 Ashcroft v. Iqbal, 129 S.Ct. 1937, 1949 (2009). “The plausibility standard is not akin to a ‘probability
23 requirement,’ but it asks for more than a sheer possibility that a defendant has acted unlawfully.” Id.
24 (citing Twombly, 550 U.S. at 556). “Where a complaint pleads facts that are merely consistent with a
25 defendant's liability, it stops short of the line between possibility and plausibility for entitlement to
26 relief” Id. (citing Twombly, 550 U.S. at 557).
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“While a complaint attacked by a Rule 12(b)(6) motion to dismiss does not need detailed

28 factual allegations, a plaintiff's obligation to provide the ‘grounds' of his ‘entitlement to relief’ requires
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more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will

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not do.” Twombly, 550 U.S. at 555 (internal citations omitted). Thus, “bare assertions ... amount[ing]

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to nothing more than a formulaic recitation of the elements ... are not entitled to be assumed true.”

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Iqbal, 129 S.Ct. at 1951. A court is “free to ignore legal conclusions, unsupported conclusions,

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unwarranted inferences and sweeping legal conclusions cast in the form of factual allegations.” Farm

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Credit Services v. American State Bank, 339 F.3d 764, 767 (8th Cir. 2003) (citation omitted).

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Moreover, a court “will dismiss any claim that, even when construed in the light most

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favorable to plaintiff, fails to plead sufficiently all required elements of a cause of action.” Student

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Loan Marketing Ass'n v. Hanes, 181 F.R.D. 629, 634 (S.D.Cal. 1998). In practice, “a complaint ...

10 must contain either direct or inferential allegations respecting all the material elements necessary to
11 sustain recovery under some viable legal theory.” Twombly, 550 U.S. at 562 (quoting Car Carriers,
12 Inc. v. Ford Motor Co., 745 F.2d 1101, 1106 (7th Cir. 1984)).
To the extent that the pleadings can be cured by the allegation of additional facts, the

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14 plaintiff should be afforded leave to amend. Cook, Perkiss and Liehe, Inc. v. Northern California
15 Collection Serv. Inc., 911 F.2d 242, 247 (9th Cir. 1990) (citations omitted).
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B.

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Analysis
1.

§ 1983 Claims against Dr. Stirling, Dr. Harris, Stanford, and Cedars-Sinai

Plaintiff alleges that Dr. Stirling, Dr. Harris, Stanford, and Cedars-Sinai violated § 1983 by

19 acting under the color of state law to effectuate the warrantless seizure of Plaintiff’s children by Kern
20 County CPS. Plaintiff further alleges that Dr. Stirling and Dr. Harris violated § 1983 by acting under
21 the color of state law to present false and fabricated evidence to the juvenile court.
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“Section 1983 ‘is not itself a source of substantive rights,’ but merely provides ‘a method for

23 vindicating federal rights elsewhere conferred.’” Albright v. Oliver, 510 U.S. 266, 271 (1994) (quoting
24 Baker v. McCollan, 443 U.S. 137, 144, n. 3 (1979)). “Section 1983 imposes two essential proof
25 requirements upon a claimant: (1) that a person acting under color of state law committed the conduct
26 at issue, and (2) that the conduct deprived the claimant of some right, privilege, or immunity protected
27 by the Constitution or laws of the United States.” Leer v. Murphy, 844 F.2d 628, 632–633 (9th Cir.
28 1988).

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a.

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§ 1983 Prong 1: Whether Defendants were acting under color of state
law

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Plaintiff alleges that Dr. Stirling was acting under the color of state law because 1) he is an

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employee of Santa Clara County rather than of Stanford and, therefore, he was acting within the scope

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of his employment with the County at all times relevant to this action; and 2) he conspired with Kern

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County social workers to violate Plaintiff’s constitutionally protected rights. Plaintiff further alleges

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that the remaining § 1983 Defendants were acting under the color of state law because they conspired

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with state actors to violate Plaintiff’s constitutionally protected rights. 3

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i.

Whether Dr. Stirling was a State Actor

“The traditional definition of acting under color of state law requires that the defendant in a §

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11 1983 action have exercised power ‘possessed by virtue of state law and made possible only because the
12 wrongdoer is clothed with the authority of state law.’” West v. Atkins, 487 U.S. 42, 49 (1988) (quoting
13 United States v. Classic, 313 U.S. 299, 326 (1941). The Supreme Court has “insisted that the conduct
14 allegedly causing the deprivation of a federal right be fairly attributable to the State” and adopted a
15 “two-part approach to this question of ‘fair attribution.’” Lugar v. Edmondson Oil Co., Inc., 457 U.S.
16 922, 937 (1982). “First, the deprivation must be caused by the exercise of some right or privilege
17 created by the State or by a rule of conduct imposed by the state or by a person for whom the State is
18 responsible.” Id. “Second, the party charged with the deprivation must be a person who may fairly be
19 said to be a state actor.” Id.
Dr. Stirling is employed by Santa Clara County at the Santa Clara Valley Medical Center.

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21 (“SCVMC”) (Doc. 62, Exh. A). Stanford, a private entity, has a child abuse screening program called
22 the SCAN Team. (Doc. 62, Exh. B). SCVMC and Stanford have a contractual partnership under
23 which a SCVMC child abuse expert serves as a consultant on Stanford’s SCAN Team. Id. Stanford’s
24 SCAN Team is comprised of a medical doctor, a child abuse certified social worker, a child abuse
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Plaintiff’s allegation that Defendants were acting under the color of state law is a conclusory statement that the Court is

26 not obligated to accept as true. SFPP, L.P. v. Union Pac. R. Co., 274 F. App'x 549, 550 (9th Cir. 2008) (citing Clegg v.

Cult Awareness Network, 18 F.3d 752, 754-55 (9th Cir. 1994)) (“Although SFPP alleged that the railroad is a state actor,

27 that allegation is a legal conclusion that we need not, and do not, accept.”). See also, Price v. Hawaii, 939 F.2d 702, 708
(9th Cir. 1991) (“[A] defendant is entitled to more than the bald legal conclusion that there was action under color of state

28 law.”).

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certified nurse practitioner, a hospitalist, and a SCVMC consultant. Id. Here, Dr. Stirling served as

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the SCVMC consultant on Stanford’s SCAN Team that handled R.D.’s case.

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indicate that it is in this capacity that Dr. Stirling met and interacted with Plaintiff, rather than at

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SCVMC.

The alleged facts

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The Supreme Court has held that a private physician who contracts with the state to provide

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medical services to inmates is liable under § 1983 for conduct undertaken in performing his duties that

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allegedly violated an inmate’s constitutionally protected rights. West, 487 U.S. at 54. The Court found

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that “[s]uch conduct is fairly attributable to the State.” Id.

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However, neither the Supreme Court nor the Ninth Circuit has spoken clearly on the opposite

10 situation: whether a state employee physician under contract with a private hospital to provide medical
11 consultation services as part of a team to the private hospital’s patients can be held liable under § 1983
12 for conduct undertaken in performing his duties at the hospital.
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“Employment by the state is relevant, but not conclusive, to the question of color of law.”

14 Anthony v. Cnty. of Sacramento, Sheriff's Dep't, 845 F. Supp. 1396, 1400 (E.D. Cal. 1994) (citing Polk
15 County v. Dodson, 454 U.S. 312, 321 (1981). “For that reason, the Ninth Circuit looks to the nature of
16 the conduct involved, as well as the surrounding circumstances, and not simply to the defendant's
17 official capacity.” Id. (citing Traver v. Meshriy, 627 F.2d 934, 938 (9th Cir. 1980) for its analysis of
18 circumstances surrounding an off-duty police officer's conduct for “indicia of state action”). “Whether
19 a state employee acts under color of law turns on the relationship of the wrongful act to the
20 performance of the defendant's state duties.” Id. (citing Dang Vang v. Vang Xiong X Toyed, 944 F.2d
21 476, 479 (9th Cir. 1991)).
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Here, part of Dr. Stirling’s duties as a state physician at SCVMC is to serve as a consultant

23 on Stanford’s SCAN Team. The SCAN Team “consults on suspected child abuse cases initiated by a
24 social worker, and meets regularly to review all Child Protective Services referrals and consultations.”
25 (Doc. 62, Exh. 2). Specifically, the SCAN Team is charged with providing “inpatient consultation
26 services on suspected physical and sexual abuse” and “outpatient consultation services on emergent
27 cases.” Id. The SCAN Team program “may be activated by contacting any hospital social worker at
28 any time.” Id.

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Plaintiff alleges that Dr. Stirling abused his state-given power and authority by causing and

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directing Kern County CPS to remove R.D. from Plaintiff’s care without a warrant, court order, or

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exigent circumstances. Plaintiff further alleges that Dr. Stirling abused his power and authority by

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preventing Stanford from releasing to Plaintiff R.D.’s medical records and falsifying and suppressing

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evidence that was used at the juvenile dependency hearing.

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To be liable under § 1983, Dr. Stirling must have “exercised power ‘possessed by virtue of

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state law and made possible only because [he] is clothed with the authority of state law.’” West, 487

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U.S. at 49 (quoting Classic, 313 U.S. at 326). The SCAN Team acts as a consultant to social workers

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on suspected and emergent child abuse cases initiated by social workers. (Doc. 62, Exh. 2). In fact,

10 Dr. Stirling’s role on the Scan Team is contracted consultant rather than full member. Id. Therefore,
11 the extent of Dr. Stirling’s power and authority here is as a consultant to a group who then acts as a
12 consultant to social workers. Dr. Stirling’s representation of his professional opinion as to R.D.
13 certainly may influence the overall opinion and report of the SCAN Team which in turn may influence
14 a social worker’s handling of his or her child abuse case regarding R.D. However, under the facts
15 alleged, Dr. Stirling’s state-given authority does not appear to cover controlling the social worker’s
16 decision to remove a suspected child abuse victim from her mother or the manner in which such
17 removal is carried out. Rather, the decision to remove R.D. from Plaintiff’s care and the manner in
18 which R.D. was removed – the conduct that allegedly violated Plaintiff’s constitutional rights – appear
19 to be firmly within the authority of Kern County social workers and CPS. Plaintiff has not alleged
20 sufficient facts to show that this authority was in fact granted to Dr. Stirling by the state.
21

The alleged facts also fail to show that the state gave Dr. Stirling authority over R.D.’s

22 medical records or that Dr. Stirling exercised control over R.D.’s medical records. Further, Plaintiff
23 alleges no facts to show that Dr. Stirling held state-given authority as a consultant on the SCAN Team
24 to prevent Stanford from releasing a patient’s medical records. Rather, the authority to make decisions
25 on whether and when to release Stanford patients’ medical records appears to belong to Stanford.
26 Plaintiff also has alleged no facts to show that this authority was in fact granted to Dr. Stirling by the
27 state.
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Dr. Stirling cannot be said to abuse state-given power that he does not possess and that the
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state never granted to him. West, 487 U.S. at 49 (citing Classic, 313 U.S. at 326). For these reasons,

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Dr. Stirling was not a state actor for the purposes of § 1983 liability.

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ii.

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Whether any of the § 1983 Defendants Conspired with Kern
County

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“[P]rivate parties are not generally acting under color of state law, and ... conclusionary

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allegations, unsupported by facts, will be rejected as insufficient to state a claim under the Civil Rights

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Act.” Price v. Hawaii, 939 F.2d 702, 707–708 (9th Cir. 1991) (internal alterations and quotation

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marks omitted). Therefore, courts “start with the presumption that private conduct does not constitute

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governmental action.” Sutton v. Providence St. Joseph Medical Ctr., 192 F.3d 826, 835 (9th Cir.

10 1999).
11

“A private party may be considered to have acted under color of state law when it engages in

12 a conspiracy or acts in concert with state agents to deprive one’s constitutional rights.” Fonda v. Gray,
13 707 F.2d 435, 437 (9th Cir. 1983) (internal citations omitted). “To prove a conspiracy between private
14 parties and the government under § 1983, an agreement or ‘meeting of the minds’ to violate
15 constitutional rights must be shown.” Id. at 438 (internal citations omitted). “To be liable, each
16 participant in the conspiracy need not know the exact details of the plan, but each participant must at
17 least share the common objective of the conspiracy.” United Steelworkers of Am. v. Phelps Dodge
18 Corp., 865 F.2d 1539, 1541 (9th Cir. 1989) (citing Fonda, 707 F.2d at 438). “[A] bare allegation of ...
19 joint action will not overcome a motion to dismiss.” Dietrich v. John Ascuaga's Nugget, 548 F.3d 892,
20 900 (9th Cir. 2008) (internal citation omitted). The mere furnishing of information to state actors does
21 not constitute joint action under color of state law which renders a private citizen liable under § 1983.
22 Benavidez v. Gunnell, 722 F.2d 615, 618 (10th Cir. 1983); Butler v. Goldblatt Bros., Inc., 589 F.2d
23 323, 327 (7th Cir. 1978). See also, Radcliffe v. Rainbow Const. Co., 254 F.3d 772, 783 (9th Cir. 2001)
24 (“A relationship of cause and effect between the complaint and the prosecution is not sufficient, or
25 every citizen who complained to a prosecutor would find himself in a conspiracy.”). Rather, joint
26 action “requires a substantial degree of cooperative action.” Collins v. Womancare, 878 F.2d 1145,
27 1154 (9th Cir. 1989).
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Plaintiff alleges that Dr. Stirling, Dr. Harris, Stanford, and Cedars-Sinai violated § 1983 by
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conspiring with state actors to effectuate the warrantless seizure of Plaintiff’s children by Kern County

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CPS.4 Plaintiff further alleges that Dr. Stirling and Dr. Harris violated § 1983 by conspiring with state

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actors to present false and fabricated evidence to the juvenile court. However, Plaintiff does not allege

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that any Defendant played a direct part in the seizure or detention of Plaintiff’s children or participated

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in the juvenile dependency proceeding.

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“In order for a private individual to be liable for a § 1983 violation when a state actor

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commits the challenged conduct, the plaintiff must establish that the private individual was the

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proximate cause of the violations.” Franklin v. Fox, 312 F.3d 423, 445-46 (9th Cir. 2002) (citing King

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v. Massarweh, 782 F.2d 825, 829 (9th Cir. 1986)). “Absent some showing that a private party had

10 some control over state officials’ decision to commit the challenged act, the private party did not
11 proximately cause the injuries stemming from the act.” Id. at 446 (quoting Massarweh, 782 F.2d at
12 829) (internal quotation omitted).
Therefore, the relevant inquiry is whether Plaintiff alleged sufficient facts to show that each

13

14 Defendant engaged in joint action with Kern County and held and exercised some control over Kern
15 County’s decisions to seize Plaintiff’s children and present false evidence to the juvenile court in
16 violation of Plaintiff’s constitutional rights.
a.

17

Dr. Stirling

According to Plaintiff’s allegations, Dr. Stirling had contact with Kern County social

18

19 workers on the following occasions: 1) some form of contact at some point after January 20, 2011; 2)
20 some form of contact on February 18, 2011; 3) an email on February 18, 2011 following up on the
21 contact; 4) a Team Decision Meeting telephone call on February 24, 2011; and 5) some form of contact
22 at some point after Kern County removed R.D. from Plaintiff’s care.
Plaintiff alleges that, during these contacts, Dr. Stirling made false statements about R.D.’s

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24 medical condition, Plaintiff’s MSBP, and told social services to remove R.D. from and keep her out of
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Warrantless seizures of children from their parents are not per se unlawful. “Government officials are required to obtain
prior judicial authorization before intruding on a parent’s custody of her child unless they possess information at the time of
the seizure that establishes ‘reasonable cause to believe that the child is in imminent danger of serious bodily injury and that
the scope of the intrusion is reasonably necessary to avert that specific injury.’” Mabe v. San Bernardino Cnty., Dep't of
Pub. Soc. Servs., 237 F.3d 1101, 1107 (9th Cir. 2001) (quoting Wallis v. Spencer, 202 F.3d 1126, 1138 (9th Cir. 2000)).
Because Plaintiff’s claims against Defendants fail the first prong of § 1983 analysis, the Court does not reach the second
question of whether the warrantless seizure of Plaintiff’s children here violated her constitutional rights.

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Plaintiff’s care. The Team Decision Meeting call occurred shortly before Kern County social workers

2

seized R.D. from Plaintiff’s home. During the Team Decision Meeting, the social worker asked each

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of the doctors present whether they felt that R.D. was at risk and all three emphatically agreed that

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R.D. should be removed from Plaintiff’s care.

5

Even if Dr. Stirling made false statements to Kern County social workers regarding the need

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to remove R.D. from Plaintiff’s care, supplying information alone does not amount to conspiracy or

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joint action under color of state law. Benavidez, 722 F.2d at 618; Butler, 589 F.2d at 327. Also, the

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facts alleged do not show that Dr. Stirling had reached a meeting of minds with social workers to

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violate Plaintiff’s Fourteenth Amendment rights. Fonda, 707 F.2d at 438. Instead, despite Plaintiff’s

10 conclusory statements, Plaintiff’s allegation that social workers asked Dr. Stirling and other doctors
11 during the meeting whether R.D. was at risk suggests that no common consensus had yet been reached.
12 Further, the social workers asking Dr. Stirling and other doctors for their professional opinion on
13 whether Plaintiff’s children should be removed during the February 24, 2011 telephone call does not
14 show Dr. Stirling’s control over how the social workers made that decision. Franklin, 312 F.3d at 446.
15 On the contrary, the alleged facts show that the social workers requested and obtained information
16 from the doctors for their own use in their investigation of Plaintiff. See, Fonda, 707 F.2d at 438
17 (stating that the mere acquiescence of private actors to the investigation request of state actors is
18 insufficient to prove a conspiracy).
19

Plaintiff alleges no facts to show that Dr. Stirling exerted control over how the social

20 workers used the information they obtained to reach a decision to remove Plaintiff’s children or to
21 falsify evidence at the juvenile dependency proceeding. Compare, Phelps Dodge Corp., 865 F.2d at
22 1540 (“Evidence that [state actors] failed to exercise independent judgment will support an inference
23 of conspiracy with a private party.”). Therefore, Plaintiff does not adequately allege that Dr. Stirling
24 acted under color of state law in effecting the seizure and detention of Plaintiff’s children or the
25 falsifying of evidence at the juvenile dependency hearing in violation of Plaintiff’s constitutional
26 rights.
27

For these reasons, the Court DISMISSES without leave to amend Plaintiff’s claims against

28 Dr. Stirling.

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2

b.

Dr. Harris

3

Plaintiff alleges that Dr. Harris had contact with Kern County on two occasions – as a

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recipient of Dr. Stirling’s email that Dr. Stirling also sent to a Kern County social worker on February

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18, 2011, and as a participant in the Team Decision Meeting call on February 24, 2011.

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Plaintiff alleges no facts to show that Dr. Harris reached a meeting of the minds and engaged

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in joint action with Kern County, or that Dr. Harris held or exercised control over Kern County social

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workers’ decisions to unlawfully seize Plaintiff’s children or to falsify evidence at the juvenile

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dependency hearing. Fonda, 707 F.2d at 438, Franklin, 312 F.3d at 446. At most, Plaintiff alleges

10 that Dr. Harris supplied false information about R.D. and Plaintiff to the social workers. Based on this,
11 Plaintiff makes the conclusory allegation that Dr. Harris “conspired to, and did, cause the presentation
12 of false and fabricated evidence before the juvenile court, thereby maliciously interfering with
13 Plaintiff’s familial association rights.” (Doc. 66, p. 6). Again, supplying information alone does not
14 amount to conspiracy or joint action under color of state law. Benavidez, 722 F.2d at 618; Butler, 589
15 F.2d at 327. Further, as discussed above, the allegations regarding the Team Decision Meeting show
16 that no common consensus had yet been reached and that the social workers requested and obtained
17 information from the doctors for their own use in their investigation of Plaintiff.
18

Plaintiff alleges no facts to show that Dr. Harris exerted control over how the social workers

19 used the information they obtained to reach a decision to remove Plaintiff’s children or to falsify
20 evidence at the juvenile dependency proceeding. Therefore, Plaintiff’s allegations fall far short of
21 supporting a reasonable inference that Dr. Harris “cloaked [himself] with the authority of the state in
22 effecting” the seizure and detention of Plaintiff’s children or the falsification of evidence at juvenile
23 court. Howerton v. Gabica, 708 F.2d 380, 385 (9th Cir. 1983).
24

For these reasons, the Court DISMISSES with leave to amend Plaintiff’s claims against Dr.

25 Harris.
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c.

Stanford

Plaintiff alleges that Stanford conspired and engaged in joint conduct with Kern County

28 based on Stanford’s SCAN Team’s cooperation with child welfare services. Specifically, Plaintiff
15

1

alleges that Stanford’s withholding of R.D.’s medical records from Plaintiff until after Plaintiff agreed

2

to the plea deal demonstrates Stanford’s participation in the conspiracy.

3

The well-pleaded facts that Stanford withheld R.D’s medical records and that Stanford’s

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SCAN Team cooperates with CPS on child abuse cases fail to give rise to a reasonable inference that

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Stanford conspired with state actors to violate Plaintiff’s constitutional rights. As the Supreme Court

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stated in Twombly, “[a]lthough in form a few stray statements speak directly of agreement, on fair

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reading these are merely legal conclusions resting on the prior allegations.”

8

Likewise, here, the complaint’s allegations that, based on the above facts, Stanford “voluntarily

9

collaborated, acted in concert, and maliciously conspired” with Kern County CPS and social workers

550 U.S. at 564.

10 to violate Plaintiff’s rights are “merely legal conclusions resting on the prior allegations” that the Court
11 need not accept. Id. “The need at the pleading stage for allegations plausibly suggesting (not merely
12 consistent with) [conspiracy] reflects Rule 8(a)(2)’s threshold requirement that the ‘plain statement’
13 possess enough heft to ‘sho[w] that the pleader is entitled to relief.’” Id. at 545. Plaintiff’s allegations
14 “stop[] short of the line between possibility and plausibility.”
15

For these reasons, the Court DISMISSES with leave to amend Plaintiff’s claims against

16 Stanford.
d.

17
18

Cedars-Sinai

The complaint contains no allegations of any contact or relationship between Cedars-Sinai

19 and Kern County. Following Cedars-Sinai’s motion to dismiss the claims against it, Plaintiff makes no
20 arguments as to its first cause of action under § 1983 against Cedar-Sinai in her opposition.
21

These actions may indicate that Plaintiff agrees to voluntarily dismiss her first cause of

22 action against Cedars-Sinai. Regardless of whether Plaintiff chooses to dismiss it, this Court finds that
23 the complaint cannot sustain a reasonable inference that Cedars-Sinai engaged in joint action and
24 conspired with Kern County to violate Plaintiff’s rights in violation of § 1983.
25

Therefore, this Court DISMISSES with leave to amend Plaintiff’s first cause of action

26 against Cedars-Sinai.
27
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2.

Monell Claims against the County, Cedars-Sinai, and Stanford

In her second cause of action, Plaintiff alleges that the County, Cedars-Sinai, and Stanford
16

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collaborated with Kern County through policies and practices which were the moving force behind the

2

violations of Plaintiff’s constitutional rights. The Monell Defendants argue that Plaintiff fails to state a

3

claim under Monell v. Department of Social Services. 436 U.S. 658, 690-91 (1978).

4

i.

The County

5

Monell provides that a municipality can be liable under § 1983 only where the municipality

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itself causes the constitutional violation through a “policy or custom, whether made by its lawmakers

7

or those whose edicts or acts may fairly be said to represent official policy.” Id. at 694. Therefore,

8

municipal liability in a § 1983 case may be premised upon: (1) an official policy; (2) a “longstanding

9

practice or custom which constitutes the standard operating procedure of the local government entity;”

10 (3) the act of an “official whose acts fairly represent official policy such that the challenged action
11 constituted official policy;” or (4) where “an official with final policy-making authority delegated that
12 authority to, or ratified the decision of, a subordinate.” Price v. Sery, 513 F.3d 962, 966 (9th Cir.
13 2008).
Plaintiff alleges that the County violated § 1983 by establishing and/or following policies

14

15 and practices of improperly detaining, removing, and examining children, fabricating evidence, falsely
16 accusing parents of having undiagnosed mental disorders, and providing inadequate training and
17 supervision of employees working in child abuse and dependency type proceedings. (Doc. 57, ¶ 136).
Plaintiff again appears to allege three distinct Monell claims against the County: (1) policies

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19 of constitutional violations; (2) a pattern and practice of constitutional violations; and (3) a failure to
20 properly train employees. Plaintiff again fails to allege sufficient facts to sustain a claim of Monell
5
21 liability under any of these theories.

a.

22

Policies of Unconstitutional Action

Plaintiff again fails to allege any facts as to the actual policies of the County of Santa Clara

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24 with regard to the type of events alleged. Plaintiff repeats her bare assertions that the County had a
25 plethora of various unconstitutional policies, but still offers no facts that give rise to the inference that
26 such policies actually existed. “In order to establish an official policy or custom sufficient for Monell
27
5

Plaintiff makes virtually no changes in her Monell allegations between her former complaint and the operative complaint.

28 The Court’s previous analysis of Plaintiff’s Monell claim against the County likewise applies here.
17

1

liability, a plaintiff must show a constitutional right violation resulting from an employee acting

2

pursuant to an expressly adopted official policy.” Delia v. City of Rialto, 621 F.3d 1069, 1081 (9th

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Cir. 2010). Plaintiff’s pleading fails to provide any allegations as to the substance of the County’s

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expressly adopted policies.

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6

Plaintiff therefore fails to state a valid claim as to the express policies of the County which
could give rise to Monell liability.

7

b.

Pattern and Practice of Unconstitutional Action

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Plaintiff also again alleges that the County followed unconstitutional practices. To prevail

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on this theory, Plaintiff must show “the existence of a widespread practice that ... is so permanent and

10 well settled as to constitute a ‘custom or usage’ with the force of law.” Gillette v. Delmore, 979 F.2d
11 1342, 1348 (9th Cir. 1992) (quoting City of St. Louis v. Praprotnik, 485 U.S. 112, 127 (1988)). Yet,
12 apart from the conclusory statements discussed above, the second amended complaint again contains
13 no factual allegations from which a “longstanding practice or custom which constitutes the standard
14 operating procedure of the local government entity” can be inferred. Price, 513 F.3d at 966. Rather,
15 the complaint focuses on a single incident and makes unsupported conclusory extrapolations that the
16 alleged conduct in the single incident represents a widespread, permanent, well-settled unconstitutional
17 practice.
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19
20

Plaintiff again fails to assert a pattern and practice claim as to any of the alleged conduct.
c.

Failure to Train

Plaintiff further alleges the County failed to provide adequate training and/or supervision

21 which resulted in violations of her constitutional rights. While inadequacy of training may constitute a
22 “policy” giving rise to Monell liability, “adequately trained [employees] occasionally make mistakes;
23 the fact that they do says little about the training program or the legal basis for holding the
24 [municipality] liable.” City of Canton v. Harris, 489 U.S. 378, 379 (1989). Therefore, a claim of
25 inadequate training is only cognizable under § 1983 “where [the County]’s failure to train reflects
26 deliberate indifference to the constitutional rights of its inhabitants.” Id. at 392. In order to show that
27 a failure to train amounts to deliberate indifference, it is “ordinarily necessary” to demonstrate “a
28 pattern of similar constitutional violations by untrained employees.” Connick v. Thompson, 131 S. Ct.
18

1

1350, 1360 (2011).

2

As Plaintiff does not allege facts to show a pattern of violations, the Court analyzes this

3

claim under the “single-incident” theory of liability. Connick, 131 S. Ct. at 1361 (stating that a

4

particular showing of “obviousness … can substitute for the pattern of violations ordinarily necessary

5

to establish municipal liability.”). Essentially, a single-incident theory can only arise in circumstances

6

with “the complete absence of legal training that the Court imagined in Canton.” Id. at 1363.

7

Here, Plaintiff claims her rights were violated by a lone County employee in a single

8

incident, but fails to allege how this shows that employees of the County had a complete absence of

9

training on the issues alleged. Plaintiff again simply makes the conclusory allegation that the County

10 failed to train its employees. Plaintiff therefore fails to state a “failure to train” claim against the
11 County.
12

Because Plaintiff again fails to state a claim under Monell against the County, Plaintiff’s

13 second cause of action against the County is DISMISSED without leave to amend.
14
15

ii.

Private Entities: Cedars-Sinai and Stanford

The Ninth Circuit has held that Monell applies to suits against private entities under § 1983.

16 Tsao v. Desert Palace, Inc., 698 F.3d 1128, 1139 (9th Cir. 2012). To make out a claim against Cedars17 Sinai and Stanford under Monell, Plaintiff must show that 1) Cedars-Sinai and Stanford each acted
18 under color of state law, and 2) if a constitutional violation occurred, the violation was caused by an
19 official policy or custom of Cedars-Sinai and of Stanford. Id.
20

As discussed above, Plaintiff fails to allege facts to show that either Cedars-Sinai or Stanford

21 acted under color of state law. The complaint cannot sustain any reasonable inference that either
22 Defendant engaged in joint conduct or conspired with Kern County to violate Plaintiff’s rights.
23 Therefore, Plaintiff fails to meet the first prong of the two-pronged analysis the Ninth Circuit outlined
24 in Tsao. 698 F.3d at 1139
25

For these reasons, Plaintiff’s second cause of action under Monell against Cedars-Sinai and

26 Stanford is DISMISSED with leave to amend.
27
28

19

1
2
3

CONCLUSION AND ORDER
For the reasons discussed above, the Court:
1.

DISMISSES without leave to amend Plaintiff Christine Deeths’ first cause of

4

action for violations of 42 U.S.C. § 1983 against Defendant John Stirling, Jr., and

5

second cause of action for violations of 42 U.S.C. § 1983 against Defendant the

6

County of Santa Clara;

7

2.

8
9

DISMISSES John Stirling, Jr. and the County of Santa Clara as Defendants in this
action;

3.

ORDERS the Clerk of Court to enter judgment in favor of Defendants John

10

Stirling, Jr. and the County of Santa Clara and against Plaintiff Christine Deeths in

11

that there is no just reason to delay to enter such judgment given that Plaintiff

12

Christine Deeth's claims against Defendants John Stirling, Jr. and County of Santa

13

Clara and their alleged liability are clear and distinct from claims against and

14

liability of other defendants. See F.R.Civ.P. 54(b);

15

4.

DISMISSES with leave to amend Plaintiff Christine Deeths’ first cause of action

16

for violations of 42 U.S.C. § 1983 against Defendants Christopher Harris and

17

Cedars-Sinai Medical Center, and second cause of action for violations of 42

18

U.S.C. § 1983 against Defendant Cedars-Sinai Medical Center;

19

5.

DISMISSES with leave to amend Plaintiff Christine Deeths’ first cause of action

20

for violations of 42 U.S.C. § 1983 against Defendant Lucile Packard Children’s

21

Hospital at Stanford, and second cause of action for violations of 42 U.S.C. § 1983

22

against Defendant Lucile Packard Children’s Hospital at Stanford;

23

6.

GRANTS Plaintiff one opportunity to file and serve a third amended complaint in

24

an attempt to cure the deficiencies described herein as to the remaining Defendants;

25

and

26

7.

ADMONISHES Plaintiff to respect the limited resources and extraordinary

27

caseload of this Court by limiting any further amended complaint in this action to

28

no more than 30 pages of well-pleaded allegations.
20

1

Any such further amended complaint shall be filed and served within 20 days of electronic service of

2

this order. Defendants no later than 20 days after service of the second amended complaint shall file a

3

response thereto.

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5
6
7

IT IS SO ORDERED.
Dated:

/s/ Lawrence J. O’Neill

November 26, 2013

UNITED STATES DISTRICT JUDGE

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