MAHONE v. Medical Center

Filing 10

ORDER granting 2 MOTION for Leave to Proceed in forma pauperis, denying 7 MOTION for Recusal, denying as moot 6 MOTION to serve compliant and summons, ORDER Directing Service as to Defendant MMC. Ordered by US MAGISTRATE JUDGE STEPHEN HYLES on 12/22/17. (AGH)

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF GEORGIA
COLUMBUS DIVISION
THOMAS JAMES MAHONE,
Plaintiff,
VS.
THE MEDICAL CENTER, INC.,
et al.,
Defendants.
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NO. 4:17-CV-113-MSH

ORDER
Presently pending before the Court is a Complaint filed by pro se Plaintiff Thomas
James Mahone raising claims pursuant to 42 U.S.C. § 1983 and the federal Emergency
Medical Treatment and Active Labor Act (“EMTALA”), 42 U.S.C. § 1395dd. Plaintiff
has also moved for leave to proceed in forma pauperis, to serve the Complaint and
summons, and to recuse the undersigned. For the following reasons, the undersigned
GRANTS Plaintiff’s motion to proceed in forma pauperis (ECF No. 2) and DENIES
Plaintiff’s motion to recuse (ECF No. 7). The undersigned further finds that Plaintiff’s
EMTALA claims against The Medical Center Inc., d/b/a Midtown Medical Center
(“MMC”) must proceed for further factual development but that Plaintiff’s § 1983 claims
must be DISMISSED and his state law claims against Defendants Kaiser, Foster,
Nichols, Clark, Hattaway, Sparks, Harris, and Demaro must be DISMISSED without
prejudice. Plaintiff’s motion to serve the Complaint and summons (ECF No. 6) is
DENIED as moot.

I.

Motion to Proceed in forma pauperis

Section 1915 allows the district courts to authorize the commencement of a civil
action without prepayment of the normally-required fees upon a showing that the plaintiff
is indigent and financially unable to pay the filing fee. A prisoner seeking to proceed in
forma pauperis (“IFP”) under this section must provide the district court with both (1) an
affidavit in support of his claim of indigence and (2) a certified copy of his prison “trust
fund account statement (or institutional equivalent) for the 6-month period immediately
preceding the filing of the complaint.” § 1915(b).
In this case, Plaintiff’s pauper’s affidavit and trust account statement show that he
is currently unable to prepay the Court’s filing fee. Plaintiff’s motion to proceed in forma
pauperis (ECF No. 2) is thus GRANTED and Plaintiff will be assessed an initial partial
filing fee of $0.00. Plaintiff, however, is still obligated to pay the full balance of the
filing fee, in installments, as set forth in § 1915(b) and explained below. It is accordingly
requested that the CLERK forward a copy of this ORDER to the business manager of
the facility in which Plaintiff is incarcerated so that withdrawals from his account may
commence as payment towards the filing fee. The district court’s filing fee is not
refundable, regardless of the outcome of the case, and must therefore be paid in full even
if the Plaintiff’s Complaint (or any part thereof) is dismissed prior to service.
A. Directions to Plaintiff’s Custodian
It is hereby ORDERED that the warden of the institution wherein Plaintiff is
incarcerated, or the sheriff of any county wherein he is held in custody, and any successor
custodians, each month cause to be remitted to the Clerk of this Court twenty percent
2

(20%) of the preceding month’s income credited to Plaintiff’s account at said institution
until the $350.00 filing fee has been paid in full. In accordance with provisions of the
Prison Litigation Reform Act (“PLRA”), Plaintiff’s custodian is hereby authorized to
forward payments from the prisoner’s account to the Clerk of Court each month until the
filing fee is paid in full, provided the amount in the account exceeds $10.00. It is further
ORDERED that collection of monthly payments from Plaintiff’s trust fund account shall
continue until the entire $350.00 has been collected, notwithstanding the dismissal of
Plaintiff’s lawsuit or the granting of judgment against him prior to the collection of the
full filing fee.
B. Plaintiff’s Obligations Upon Release
Pursuant to provisions of the PLRA, in the event Plaintiff is hereafter released
from the custody of the State of Georgia or any county thereof, he shall remain obligated
to pay any balance due on the filing fee in this proceeding until said amount has been
paid in full; Plaintiff shall continue to remit monthly payments as required by the PLRA.
Collection from Plaintiff of any balance due on the filing fee by any means permitted by
law is hereby authorized in the event Plaintiff is released from custody and fails to remit
payments. Plaintiff’s Complaint is subject to dismissal if he has the ability to make
monthly payments and fails to do so.
II.

Motion to Recuse

Plaintiff has filed a motion for recusal in which he alleges that the undersigned
should be recused from this case because the undersigned “was highly partial toward the

3

defendants in dismissing” his previous very similar lawsuit and because of the perceived
delays in issuing rulings in Plaintiff’s cases. Mot. Recuse 1-2, ECF No. 7.
28 U.S.C. § 455 provides the standard for when a judge, justice, or magistrate
judge must disqualify himself from a particular proceeding.1

The statute generally

provides that a magistrate judge “shall disqualify himself in any proceeding in which his
impartiality might reasonably be questioned.” 28 U.S.C. § 455(a). The statute also
enumerates certain other circumstances requiring a judge to disqualify himself. Id. at §
455(b)(1)-(5). Plaintiff does not specify which statutory circumstances apply to this case.
It appears, however, that Plaintiff’s primary complaint is that the undersigned is biased
towards Defendants in this action. Plaintiff may thus be relying on either subsection (a)
or subsection (b)(1).
The standard under subsection (a) is objective and requires the Court to ask
“whether an objective, disinterested lay observer fully informed of the facts underlying
the grounds on which recusal was sought would entertain significant doubt about the
judge’s impartiality.” United States v. Patti, 337 F.3d 1317, 1321 (11th Cir. 2003)
(internal quotation marks omitted). In the Eleventh Circuit, “it is well settled that the
allegation of bias must show that the bias is personal as distinguished from judicial in

1

28 U.S.C. § 144 also governs recusal, but it requires the moving party to file an affidavit
stating that the judge has a personal bias or prejudice against the plaintiff or defendant,
and the affidavit must provide facts and reasons for the belief that bias or prejudice exists.
Plaintiff has not filed such an affidavit, and this requirement is strictly enforced. See,
e.g., United States v. Perkins, 787 F.3d 1329, 1343 (11th Cir. 2015) (finding that the
court did not abuse its discretion by denying litigant’s pro se motion for recusal under 28
U.S.C. § 144 because the affidavit did not meet the statute’s procedural requirements).
As such, the undersigned will assume that Plaintiff intended to proceed under § 455.
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nature.” Bolin v. Story, 225 F.3d 1234, 1239 (11th Cir. 2000) (internal quotation marks
and citation omitted) (per curiam). As a result, “a judge’s rulings in the same or a related
case are not a sufficient basis for recusal,” except in rare circumstances where the
previous proceedings demonstrate pervasive bias and prejudice. Id.; see also Liteky v.
United States, 510 U.S. 540, 555 (1994) (“[J]udicial rulings alone almost never constitute
[a] valid basis for a bias or partiality recusal motion.”); McWhorter v. City of
Birmingham, 906 F.2d 674, 678 (11th Cir. 1990) (“[The bias] must derive from
something other than that which the judge learned by participating in the case.”). In this
case, Plaintiff has not alleged that any extrajudicial, personal bias pervaded the
undersigned’s rulings in Plaintiff’s previous case, nor has Plaintiff alleged that the
undersigned would not fairly and impartially consider all Plaintiff’s future contentions
and decide the issues accordingly.
28 U.S.C. § 455(b)(1) requires disqualification where the judge “has a personal
bias or prejudice concerning a party, or personal knowledge of disputed evidentiary facts
concerning the proceeding[.]” “Recusal under this subsection is mandatory, because ‘the
potential for conflicts of interest are readily apparent.’” Patti, 337 F.3d at 1321 (quoting
Murray v. Scott, 253 F.3d 1308, 1312 (11th Cir. 2001)). Again, Plaintiff has failed to
allege any personal bias on the part of the undersigned, and Plaintiff also fails to identify
any specific “disputed evidentiary facts” of which the undersigned has knowledge. Any
knowledge gained through the course of a judicial proceeding is not a “disputed
evidentiary fact” that requires recusal. United States v. Bailey, 175 F.3d 966, 969 (11th
Cir. 1999). Instead, knowledge of disputed evidentiary facts must be gained through an
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extrajudicial source to warrant recusal.

No such knowledge exists here.

Because

Plaintiff has failed to allege facts requiring the undersigned to recuse himself, his motion
for recusal must be DENIED.
In his motion for recusal, Plaintiff also asserts that he is unilaterally withdrawing
his consent to permit the undersigned “to decide any matter in the instant case dispositive
or non-dispositive.” Mot. Recusal 2, ECF No. 7. 28 U.S.C. § 636(c)(1) provides that:
Upon the consent of the parties, a full-time United States magistrate judge .
. . may conduct any or all proceedings in a jury or nonjury civil matter and
order the entry of judgment in the case, when specially designated to
exercise such jurisdiction by the district court or courts he serves.
Both parties in this case signed a consent form pursuant to this statute electing to permit a
United States magistrate judge “to conduct any or all proceedings in this case.” Notice 12, June 23, 2017, ECF No. 5.
Contrary to Plaintiff’s assertion, “there is no absolute right to withdraw a validly
given consent to trial before a magistrate.” Carter v. Sea Land Servs., Inc., 816 F.2d
1018, 1021 (5th Cir. 1987) (holding that once a party knowingly and voluntarily waives
his constitutional right to have an Article III judge conduct trial and enter judgment, he
“has no constitutional right to recant at will”). The district court may, however, “for
good cause shown on its own motion, or under extraordinary circumstances shown by
any party, vacate a reference of a civil matter to a magistrate judge under this
subsection.” 28 U.S.C. § 636(c)(4); see also Fed. R. Civ. P. 73(b)(3) (“On its own for
good cause—or when a party shows extraordinary circumstances—the district judge may
vacate a referral to a magistrate judge under this rule.”). If Plaintiff wishes to avail
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himself of this procedure, he must file a separate motion to vacate the reference of this
case to the undersigned and fully explain the “extraordinary circumstances” that justify
such relief. Plaintiff is advised, however, that “[d]issatisfaction with a magistrate judge’s
decision does not constitute ‘extraordinary circumstances.’”

Sanches v. Carrollton-

Farmers Branch Indep. Sch. Dist., 647 F.3d 156, 172 (5th Cir. 2011).
III.

Preliminary Screening
A. Standard of Review

In accordance with the Prison Litigation Reform Act (“PLRA”), the district courts
are obligated to conduct a preliminary screening of every complaint filed by a prisoner
who seeks redress from a government entity, official, or employee. See 28 U.S.C. §
1915A(a). Screening is also required under 28 U.S.C. § 1915(e) when the plaintiff is
proceeding IFP. Both statutes apply in this case, and the standard of review is the same.
When conducting preliminary screening, the Court must accept all factual allegations in
the complaint as true. Boxer X v. Harris, 437 F.3d 1107, 1110 (11th Cir. 2006); Hughes
v. Lott, 350 F.3d 1157, 1159-60 (11th Cir. 2003). Pro se pleadings, like the one in this
case, are “held to a less stringent standard than pleadings drafted by attorneys and will,
therefore, be liberally construed.” Id. (internal quotation marks omitted). Still, the Court
must dismiss a prisoner complaint if it “(1) is frivolous, malicious, or fails to state a claim
upon which relief may be granted; or (2) seeks monetary relief from a defendant who is
immune from such relief.” 28 U.S.C. §1915A(b).
A claim is frivolous if it “lacks an arguable basis either in law or in fact.” Miller
v. Donald, 541 F.3d 1091, 1100 (11th Cir. 2008) (internal quotation marks omitted). The
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Court may dismiss claims that are based on “indisputably meritless legal” theories and
“claims whose factual contentions are clearly baseless.” Id. (internal quotation marks
omitted). A complaint fails to state a claim if it does not include “sufficient factual
matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Ashcroft
v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544,
570 (2007)). The factual allegations in a complaint “must be enough to raise a right to
relief above the speculative level” and cannot “merely create[] a suspicion [of] a legally
cognizable right of action.” Twombly, 550 U.S. at 555 (first alteration in original). In
other words, the complaint must allege enough facts “to raise a reasonable expectation
that discovery will reveal evidence” supporting a claim. Id. at 556. “Threadbare recitals
of the elements of a cause of action, supported by mere conclusory statements, do not
suffice.” Iqbal, 556 U.S. at 678.
To state a claim for relief under § 1983, a plaintiff must allege that (1) an act or
omission deprived him of a right, privilege, or immunity secured by the Constitution or a
statute of the United States; and (2) the act or omission was committed by a person acting
under color of state law. Hale v. Tallapoosa Cnty., 50 F.3d 1579, 1582 (11th Cir. 1995).
If a litigant cannot satisfy these requirements or fails to provide factual allegations in
support of his claim or claims, the complaint is subject to dismissal. See Chappell v.
Rich, 340 F.3d 1279, 1282-84 (11th Cir. 2003).
B. Factual Allegations
According to Plaintiff’s Complaint in this case, on November 12, 2013, at
approximately 12:44 a.m., Plaintiff “presented himself” to the emergency room at MMC.
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Compl. 7, ECF No. 1. Plaintiff “requested an appropriate medical screening examination
and treatment for his suicidal ideations, depression, post traumatic stress disorder (PTSD)
and hallucinations.” Id. At approximately 1:06 a.m., Plaintiff was triaged by Defendant
Harris, a registered nurse. Defendants Harris registered Plaintiff “as a category two (2)
patient, and dressed him out in hospital gowns and obtained an initial urine sample.” Id.
at 10. At approximately 1:25 a.m., Defendant Harris “did not accept Plaintiff’s initial
urine sample and so at that point Plaintiff request[ed] to be discharged.” Id. Instead of
discharging Plaintiff, Defendant Harris and Defendant Demaro (an emergency room
physician) “ordered MMC security guards to detain Plaintiff against his will and
subjected him to false imprisonment and battery.” Id. at 11.
Plaintiff was placed on “suicidal observation precautions” at approximately 1:45
a.m., and nurses Defendants Clarks, Hattaway, and Sparks observed him at this time. Id.
at 13. At some point, Plaintiff also contends that Defendant Demaro “ordered Plaintiff to
be ‘chemically restrained’ with the psychotropic drugs Haldol and Activan [sic]” in
violation of MMC policy. Id. at 12.2 At approximately 3:45 a.m., Plaintiff alleges he
“was pressured and threatened” by Defendants Harris and Foster, an MMC security
guard, “to provide a second urine sample by means of a catheter.” Id. at 14. Plaintiff
attempted to decline the procedure, stating that it would be “too painful,” and “renewed

2

The documents attached to Plaintiff’s Complaint state that at 1:06 a.m., a medical
professional (likely Defendant Harris) “attempted” to medicate Plaintiff with Haldol and
Ativan, but Plaintiff stated he was allergic to both medications and a doctor was notified.
Attach. 1 to Compl. at 10, ECF No. 1-1. It is therefore unclear whether Plaintiff was
actually “chemically restrained.” Documents attached to pleadings are considered part of
the pleading under Federal Rule of Civil Procedure 10(c).
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his request to be discharged.” Id. Despite this request, at approximately 4:15 a.m.,
Defendants Demaro and Harris ordered hospital security guards Defendants Nichols,
Foster, and Kaiser, four other security guards, and Defendants Sparks, Clark, and
Hattaway “to restrain Plaintiff in order to obtain a second urine sample from him.” Id.
Plaintiff alleges that Defendant Harris “maliciously and forcefully inserted a catheter into
Plaintiff’s penis and extracted a urine sample while he was being restrained” and that he
“urinated blood” and “was sore for three days after the catheter.” Id. Plaintiff also
contends that Defendant Nichols “choked Plaintiff and used pressure points” and that
Defendant Foster “twisted Plaintiff’s left arm causing extreme pain” while they were
attempting to restrain Plaintiff during the catheterization. Id.
While Plaintiff was being restrained, he admittedly threatened to “kick [Defendant
Nichols’] ass for choking [Plaintiff] and for using pressure points to get him to submit to
the catheter.” Id. at 15. As a result of these threats, “Defendant Nichols had Plaintiff
arrested on criminal charges, terroristic threats and disorderly conduct” at approximately
4:23 a.m., eight minutes after the forced catheterization procedure. Id. At 4:29 a.m.,
Defendant Demaro “medically cleared Plaintiff to be transferred to Muscogee County
Jail, without admitting him as an inpatient” and “without providing [Plaintiff] with a
psychiatric evaluation or treatment.” Id.
Plaintiff contends that his “emergency medical condition deteriorated when he was
transferred to the county jail”: he “became emotionally traumatized and experienced
prolonged suicidal ideations for six (6) months, suffered serious cognitive impairment
and incontinence, has been under mental health care for the past three years, and he has
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developed a distrust for medical practicioners [sic] touching or examining him[.]” Id.
Plaintiff also contends that he has suffered “lapse in memory” and his “chronic rage
flares up” as a result of Defendants’ conduct. Id.
Plaintiff brings claims under 42 U.S.C. § 1983 against each of the Defendants,
alleging they have violated various constitutional rights. See Counts 2, 3, 4, 7, Compl.
16-18, 20, ECF No. 1. Plaintiff also contends Defendants Demaro, Harris, and MMC
should be liable under EMTALA. See Count 1, Compl. 16, ECF No. 1. Plaintiff also
appears to bring state law claims for battery, fraud, false imprisonment, and intentional
infliction of emotional distress. See Claims 5, 6, 8, Compl. 19-21, ECF No. 1. Plaintiff
seeks a declaratory judgment, compensatory and punitive damages, and other fees,
penalties, and fines as a result of these alleged violations. Compl. 21-22, ECF No. 1.
C. Procedural History
Plaintiff’s claims are familiar to the Court—he raised them in an action based on
precisely the same November 12, 2013 course of events giving rise to his claims in the
above-captioned action. See Mahone v. Midtown Medical Center, No. 4:15-cv-00180CDL-MSH (Nov. 9, 2015) (“Mahone I”). In Mahone I, Plaintiff also raised § 1983 and
EMTALA claims against many of the same Defendants in this case, including
Defendants MMC, Nichols, Foster, and Kaiser. Plaintiff also attempted to raise these
federal claims against numerous John and Jane Doe security guards and nurses, including
Defendants Demaro and Harris. See Order 10, ECF No. 59 in Mahone I (denying motion
to amend to add parties).

In addition, Plaintiff alleged state law claims against

Defendants Nichols, Foster, Kaiser, MMC, and numerous Doe Defendants for battery,
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false imprisonment, and intentional infliction of emotional distress. See Suppl. Compl.
13-16, ECF No. 16 in Mahone I.
Following an initial screening of Plaintiff’s claims in Mahone I, Plaintiff’s
individual capacity § 1983 claims against Defendants Nichols, Foster, and Kaiser, and his
state law claims against MMC, were permitted to proceed for further factual
development. See Recommendation 16, May 20, 2016, ECF No. 18 in Mahone I. The
Court dismissed Plaintiff’s remaining claims without prejudice over Plaintiff’s
objections. Order Adopting Recommendation, June 22, 2016, ECF No. 25 in Mahone I.
On October 7, 2016, the remaining Defendants filed a motion for summary
judgment. Over the next several months, the parties engaged in partial discovery and
Plaintiff’s time for responding to Defendants’ motion was stayed while several discovery
motions were resolved. In the interim, Plaintiff filed two motions seeking leave to amend
and one amended complaint. On May 22, 2017, Plaintiff also filed the Complaint in the
above-captioned action.
On June 8, 2017, Plaintiff was ordered to file a response to Defendants’ motion for
summary judgment. Plaintiff responded with his own motion for summary judgment in
which he also requested that the Court consolidate this case with Mahone I. See Attach. 1
to Pl.’s Mot. Summ. J., ECF No. 53-1 in Mahone I. On August 24, 2017, the undersigned
recommended that Plaintiff’s claims against Defendants Nichols, Foster, and Kaiser—the
only remaining individual Defendants in Mahone I after preliminary screening—be
dismissed on grounds that they were not state actors and Plaintiff therefore could not
maintain his § 1983 claims against them. The undersigned further recommended that the
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Court decline to exercise supplemental jurisdiction over Plaintiff’s state law claims and
denied Plaintiff’s motions to amend and his motion to consolidate. See Recommendation
9-12, ECF No. 59 in Mahone I.
D. Plaintiff’s Claims
Because the Court denied Plaintiff’s motion to consolidate the above-captioned
action into Mahone I, the Complaint in this case is now ripe for screening under 28
U.S.C. § 1915A and 1915(e). Having conducted such screening, the undersigned finds
that although Plaintiff’s § 1983 claims are barred by federal preclusion principles,
Plaintiff’s EMTALA claims against MMC cannot be summarily dismissed.
1.

Section 1983 Claims

Plaintiff alleges that all Defendants violated his constitutional rights and that they
should be held liable for these violations under 42 U.S.C. § 1983. These claims are
barred by federal preclusion principles.

CSX Transp., Inc. v. Brotherhood of

Maintenance of Way Employees, 327 F.3d 1309, 1316 (11th Cir. 2003) (federal
preclusion principles apply in cases where a federal question was previously decided by a
federal court). “The preclusive effect of a judgment is defined by claim preclusion and
issue preclusion, which are collectively referred to as ‘res judicata.’” Taylor v. Sturgell,
553 U.S. 880, 892 (2008). “Under the doctrine of claim preclusion, a final judgment
forecloses successive litigation of the very same claim, whether or not relitigation of the
claim raises the same issues as the earlier suit.” Id. The doctrine of issue preclusion, or
collateral estoppel, “bars successive litigation of an issue of fact or law actually litigated
and resolved in a valid court determination essential to the prior judgment, even if the
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issue recurs in the context of a different claim.” Id. Each of these doctrines applies in
this case.
a.

Claim Preclusion

First, claim preclusion principles plainly bar Plaintiff’s § 1983 claims against
Defendants Nichols, Kaiser, and Foster in this case.

Claim preclusion bars the

subsequent filing of claims that were raised (or could have been raised) in an earlier
proceeding. See, e.g., Sealy v. Branch Banking & Trust Co., 693 F. App’x 830, 833 (11th
Cir. 2017) (per curiam). The doctrine bars the subsequent claims when the following
four elements are present: “(1) a final judgment on the merits was entered; (2) the prior
decision was rendered by a court of competent jurisdiction; (3) the parties, or those in
privity with them, are identical in both suits; and (4) the same cause of action is involved
in both cases.” Id.
As to Plaintiff’s § 1983 claims against Defendants Nichols, Kaiser, and Foster, the
judgment in Mahone I was a final judgment on the merits entered by a court of competent
jurisdiction, and the parties are identical in both suits. See, e.g., Sealy, 693 F App’x at
834 (“In light of [plaintiff’s] federal-law claims, the court had federal question
jurisdiction.”); Humphrey v. U.S. Dep’t Homeland Sec., 681 F App’x 797, 798 (11th Cir.
2017) (per curiam) (district court’s grant of summary judgment in favor of defendant on
all of plaintiff’s claims “resulted in a final judgment on the merits” for res judicata
purposes). Because the cases both arose out of the “same nucleus of operative fact,” the
same cause of action is also involved in both cases. See Maldonado v. U.S. Att’y Gen.,
664 F.3d 1369, 1375 (11th Cir. 2011) (“[T]wo cases are generally considered to involve
14

the same cause of action if the latter case arises out of the same nucleus of operative fact,
or is based upon the same factual predicate, as the former one.” (internal quotation marks
omitted)). Although the legal theories raised in the current case appear to be virtually
identical to the legal theories in Mahone I, even if they were not, “claim preclusion bars
not only those claims that were actually litigated in the prior suit, but any and all legal
theories and claims that could have been brought out of the same nucleus of operative
fact.” Sealey, 693 F. App’x at 833-34 (citing Maldonado, 664 F.3d at 1376). Plaintiff’s
§ 1983 claims against Defendants Nichols, Foster, and Kaiser are therefore barred by
claim preclusion, and they must be DISMISSED.
b.

Issue Preclusion

The doctrine of issue preclusion, or collateral estoppel, bars Plaintiff’s remaining §
1983 claims in this case. This doctrine “forecloses relitigation of an issue of fact or law
that has been litigated and decided in a prior suit.” CSX Transp., Inc., 327 F.3d at 1317
(internal quotation marks omitted). In the Eleventh Circuit, the prerequisites to the
application of collateral estoppel are:
(1) the issue at stake must be identical to the one involved in the prior
litigation; (2) the issue must have been actually litigated in the prior suit;
(3) the determination of the issue in the prior litigation must have been a
critical and necessary part of the judgment in that action; and (4) the party
against whom the earlier decision is asserted must have had a full and fair
opportunity to litigate the issue in the earlier proceeding.
Id.

The doctrine “has the dual purpose of protecting litigants from the burden of

relitigating an identical issue with the same party or his privy and of promoting judicial

15

economy by preventing needless litigation.” Id. (internal quotation marks and citation
omitted).
An application of the doctrine of collateral estoppel negates an essential element
of Plaintiff’s § 1983 claims against the remaining Defendants in this case. In order to
state a viable § 1983 claim, Plaintiff must allege that the deprivation of his rights was
caused by a person who was acting under color of state law. Hale, 50 F.3d at 1582. In
this case, Plaintiff states that each Defendant “was working under color of state law at a
public hospital whose premises is owned by the Medical Center Hospital Authority a
state agency.” Compl. 6, ECF No. 1. Plaintiff thus proceeds on the theory that MMC is a
state actor by virtue of its relationship with the Medical Center Hospital Authority
(“MCHA”), and the individual Defendants are state actors by virtue of their employment
with MMC. See id.
The relationship between MCHA and MMC was central to the resolution of
Plaintiff’s claims in Mahone I. In the summary judgment briefing in Mahone I, Plaintiff
argued that MMC was a state actor because MMC was intertwined with the MCHA. See
Pl.’s Reply to Defs.’ Mot. Summ. J. 2, ECF No. 57 in Mahone I (stating that “MMC has
so far insinuated itself into a position of interdependence with Hospital Authority for the
past 28 years or more that the action of MMC cannot be considered private”); see also
Recommendation 7, ECF No. 59 in Mahone I. The Court consequently analyzed the
relationship between MMC and MCHA and determined there was an insufficient nexus
between the two entities to constitute state action. Id. at 9. Because MMC was not a
state actor, the Court found that Defendants Kaiser, Nichols, and Foster could not be
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considered to be state actors “solely by virtue of their employment with MMC.” Id. The
Court therefore concluded that Plaintiff had failed to establish that Defendants Kaiser,
Nichols, and Foster acted “under color” of state law, as required for § 1983 liability and
granted those Defendants’ motion for summary judgment on that basis. See id.
Based on the Court’s reasoning in Mahone I, Plaintiff is collaterally estopped from
asserting in this case that MMC is a state actor based solely on its relationship with
MCHA. This identical issue was resolved against Plaintiff in Mahone I, and it was fully
and fairly litigated and critical to the judgment entered therein. CSX Transp., 327 F.3d at
1317; see also Brotherton v. Cleveland, 173 F.3d 552, 567 (6th Cir. 1999) (affirming
dismissal of § 1983 claims against hospital where prior federal case arising from same
facts held that hospital did not act under color of law); Porter v. Cancelmi, 318 F. App’x
48, 50 n.3 (3d Cir. 2008) (collateral estoppel applied to prevent plaintiff from
“relitigating the issue of whether [defendant] acted under color of state law because
[plaintiff] actually litigated and lost that same issue in his first suit, which was finally
decided against him on that basis”); Miller v. Indiana Hosp., 562 F. Supp. 1259, 1279
(W.D. Pa. 1983) (applying collateral estoppel as to the issue of whether hospital’s
activities constituted state action).
Plaintiff’s inability to relitigate whether MMC is a state actor because of its
relationship with MCHA is also fatal to his claims against the remaining individual
Defendants in this case. Again, the only basis Plaintiff has provided in this case for his
contention that any Defendants are “state actors” is his allegation that they worked for
MMC, and MMC was owned by MCHA. Compl. 6, ECF No. 1. Because Plaintiff is
17

estopped from alleging that MMC is a state actor because of its relationship with MCHA,
Plaintiff also cannot claim that MMC employees are state actors just because they work
for MMC. See Recommendation 10, ECF No. 59 in Mahone I (finding that Plaintiff’s
motion to amend to add Defendants Demaro, Harris, and various administrative nurses
would be futile because “Plaintiff cannot maintain actions pursuant to § 1983 against
MMC or its employees”).
Absent the relationship between MMC and MCHA, Plaintiff has alleged no other
facts to support his assertion that any Defendants acted under color of state law in this
case. He has therefore failed to state a § 1983 claim upon which relief may be granted as
to Defendants MMC, Clark, Hattaway, Sparks, Harris, and Demaro, and his § 1983
claims against these Defendants must be DISMISSED.
2.

EMTALA Claims

As in Mahone I, Plaintiff in this case also contends that MMC and several of the
individual Defendants are liable under the EMTALA. Plaintiff’s EMTALA claims were
dismissed without prejudice prior to service pursuant to 28 U.S.C. § 1915A in Mahone I,
and thus res judicata principles do not apply to these claims.
EMTALA imposes two primary duties on covered hospitals. First, the statute
requires covered hospitals to “screen for an emergency medical condition any individual
who is admitted to its emergency room seeking treatment.” Johnson v. Health Cent.
Hosp., 208 F. App’x 797, 801 (11th Cir. 2006) (per curiam). Second, “[i]f such a
condition exists, the hospital must then provide stabilizing treatment before discharging
or transferring the patient.” Id. “An EMTALA violation thus arises when a hospital
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either (1) fails to adequately screen a patient, or (2) discharges or transfers the patient
without first stabilizing his emergency medical condition.” Id. A covered hospital may,
however, satisfy “its obligations under the statute if the patient refuses to consent to
treatment.” Stevison by Collins v. Enid Health Sys., Inc., 920 F.2d 710, 713 (10th Cir.
1990) (per curiam) (citing 42 U.S.C. § 1395dd(b)(2)). EMTALA has a fairly limited
scope in that it “was not intended to establish guidelines for patient care, to replace
available state remedies, or to provide a federal remedy for medical negligence.” Harry
v. Marchant, 291 F.3d 767, 773 (11th Cir. 2002) (en banc).
Plaintiff appears to allege both a “screening” claim and a “stabilization” claim
under EMTALA. Compl. 9, ECF No. 1. As a preliminary matter, Plaintiff contends that
various individual Defendants violated EMTALA, but recovery under the statute is
“limited to actions against participating hospitals.” Deron v. Wilkins, 879 F. Supp. 603,
606 (S.D. Miss. 1995) (collecting cases). Thus, Plaintiff’s only potential EMTALA
claim would be against MMC itself, and thus any EMTALA claims against the individual
Defendants must be DISMISSED.
With respect to Plaintiff’s screening claim, EMTALA “requires a hospital to
develop a screening procedure designed to identify such critical conditions that exist in
symptomatic patients and to apply that screening procedure uniformly to all patients with
similar complaints.” Baber v. Hosp. Corp. of Am., 977 F.2d 872, 879 (4th Cir. 1992).
“The key requirement is that a hospital ‘apply its standard of screening uniformly to all
emergency room patients, regardless of whether they are insured or can pay.’” Power v.
Arlington Hosp. Ass’n, 42 F.3d 851, 856 (4th Cir. 1994) (quoting Brooks v. Maryland
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Gen. Hosp., Inc., 996 F.2d 708, 710-11 (4th Cir. 1993)). Plaintiff alleges that he “was
not provided with the same psychiatric evaluation or treatment provided to other
patients,” and he cites to specific hospital policies in support of this contention. Compl.
10, ECF No. 1; see also id. at 13 (stating that “MMC Policy Hosd.Ps.0110 Section 8”
provides that patients placed on suicide precautions “should be observed for 23 hours,”
but Plaintiff “was observed for only 3 hours at max). Construing his allegations liberally,
Plaintiff’s EMTALA screening claim is therefore not necessarily frivolous. See Holcomb
v. Monahan, 30 F.3d 116, 117 (11th Cir. 1994) (holding that EMTALA’s screening
provision “requires a hospital to provide indigent patients with a medical screening
similar to one which they would provide any other patient”); see also Cleland v. Bronson
Health Care Group, Inc., 917 F.2d 266, 272 (6th Cir. 1990) (“A hospital that provides a
substandard (by its standards) or nonexistent medical screening for any reason (including,
without limitation, race, sex, politics, occupation, education, personal prejudice,
drunkenness, spite, etc.) may be liable under [EMTALA].”); Summers v. Baptist Med.
Ctr. Arkadelphia, 91 F.3d 1132, 1137-38 (8th Cir. 1996) (en banc) (plaintiff not required
to “prove some sort of improper motive in order to recover under EMTALA”).
With respect to Plaintiff’s EMTALA stabilization claim, Plaintiff must present
evidence that he had an emergency medical condition about which the hospital was
aware; that he was not stabilized before transfer; and that “the hospital neither obtained
the patient’s consent to transfer nor completed a certificate indicating the transfer would
be beneficial to the patient and was appropriate. Holcomb, 30 F.3d at 117. Plaintiff
states that his “suicidal ideations, depression, PTSD, and hallucinations” constituted an
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“emergency condition” from which he suffered at the hospital. Compl. 16, ECF No. 1.
He further alleges that this condition “deteriorated when he was transferred to the county
jail,” and he provides specific examples of that deterioration. Id. at 15. It also appears
Plaintiff did not consent to be transferred to the jail, and it is unclear whether the hospital
completed a certificate regarding the transfer.3 For purposes of preliminary screening,
the undersigned also cannot conclude that Plaintiff’s EMTALA stabilization claims are
necessarily frivolous. See, e.g., Carlisle v. Frisbie Mem. Hosp., 152 N.H. 762, 769
(2005) (holding that jury questions existed on EMTALA claims where plaintiff alleged
hospital transferred her to jail without proper stabilization while she was intoxicated and
suicidal).
It should be noted, however, that Plaintiff did appear to refuse (or attempt to
refuse) at least some of the screening and stabilization measures offered to him at MMC,
and he may be “estopped from later seeking relief based on the defendant’s failure to
perform the very act the plaintiff had prevented.” Cavender v. Sutter Lakeside Hosp.,
Inc., No. C-04-3110 MMC, 2005 WL 2171714, at *4 (N.D. Cal. Sept. 6, 2005). But it is
presently unclear, however, whether MMC met all of its obligations under the statute.
See, e.g., Stevison, 920 F.2d at 713-14 (where a request for treatment is made, burden is
on defendant to show that request was later withdrawn); see also Henderson v. Med.
Center Enterprise, No. 1:05-cv-823-MEF, 2006 WL 2355467, at *5 (M.D. Ala. Aug. 14,

3

Under the EMTALA, a “transfer” is defined as “the movement (including the discharge)
of an individual outside a hospital’s facilities at the director of any person employed by
(or affiliated or associated, directly or indirectly, with) the hospital[.]” 42 U.S.C. §
1395dd(e)(4).
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2006) (finding that questions of fact existed regarding whether hospital “offer[ed] the
individual further examination and/or treatment,” “inform[ed] the individual of the risks
and benefits of such examination/treatment,” and took “‘all reasonable steps’ to secure
[the plaintiff’s] written informed consent to refuse examination/treatment” as required by
EMTALA when patient refuses to consent to treatment). Plaintiff’s EMTALA claims
must therefore proceed for further factual development.
E. State Law Claims
In addition to his § 1983 and EMTALA claims, Plaintiff asserts various state law
claims against Defendants.

Compl. 20-21, ECF No. 1. As a rule, a district court will

decline to exercise supplemental jurisdiction over state law claims when it has dismissed
all claims over which it has original jurisdiction. See 28 U.S.C. § 1367(c)(3).
In this case, the undersigned has dismissed of all the federal claims against the
individually-named Defendants in this case (i.e., all Defendants except MMC). The
undersigned therefore declines to exercise supplemental jurisdiction over any state law
claims Plaintiff may be attempting to bring against the individually-named Defendants
and any such claims shall be DISMISSED without prejudice. See Kimbell v. Clayton
Cnty., Civil Action No. 1:03-CV-2910-JEC, 2005 WL 7861525, at *17 (N.D. Ga. Sept.
27, 2005) (declining to exercise supplemental jurisdiction over state law claims against
only those defendants whose motions for summary judgment were granted), aff’d 170 F.
App’x 663 (11th Cir. 2006) (per curiam).
Although the undersigned has determined that Plaintiff’s EMTALA claims against
MMC should survive initial screening, it has not done so without reservations, and it is
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possible that such claims may fail if faced with a motion to dismiss or motion for
summary judgment. In the event that the federal claims over which this Court has
original jurisdiction are dismissed, the Court will likely decline to exercise supplemental
jurisdiction over Plaintiff's state law claims. 28 U.S.C. § 1367(c)(3). Therefore, as
federal jurisdiction over Plaintiff's state law claims against MMC remains an unsettled
issue, the Court finds it unnecessary and inappropriate to fully address the merits of such
claims at this early stage of the case.
IV.

Conclusion

Based on the foregoing, the undersigned GRANTS Plaintiff’s motion to proceed
in forma pauperis (ECF No. 2), DENIES Plaintiff’s motion to recuse (ECF No. 7), and
concludes that Plaintiff’s EMTALA claims against MMC must proceed for further
factual development. The undersigned further finds, however, that Plaintiff’s § 1983
claims against all Defendants must be DISMISSED, and his state law claims against
Defendants Kaiser, Foster, Nichols, Clark, Hattaway, Sparks, Harris, and Demaro must
be DISMISSED without prejudice. Because service of the Plaintiff’s Complaint on
Defendants is addressed in this Order, Plaintiff’s Motion for Service (ECF No. 6) is
DENIED as moot.
ORDER FOR SERVICE
Having found that Plaintiff’s allegations against MMC require further factual
development, it is accordingly ORDERED that service be made on Defendant MMC and
that it file an Answer, or such other response as may be appropriate under Rule 12, 28
U.S.C. § 1915, and the Prison Litigation Reform Act. Defendant is reminded of the duty
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to avoid unnecessary service expenses, and of the possible imposition of expenses for
failure to waive service pursuant to Rule 4(d).
DUTY TO ADVISE OF ADDRESS CHANGE
During the pendency of this action, all parties shall keep the Clerk of this Court
and all opposing attorneys and/or parties advised of their current address. Failure to
promptly advise the Clerk of a change of address may result in the dismissal of a party’s
pleadings.
DUTY TO PROSECUTE ACTION
Plaintiff is also advised that he must diligently prosecute his Complaint or face the
possibility that it will be dismissed under Rule 41(b) of the Federal Rules of Civil
Procedure for failure to prosecute. Defendant is similarly advised that it is expected to
diligently defend all allegations made against it and to file timely dispositive motions as
hereinafter directed. This matter will be set down for trial when the Court determines
that discovery has been completed and that all motions have been disposed of or the time
for filing dispositive motions has passed.
FILING AND SERVICE OF MOTIONS,
PLEADINGS, AND CORRESPONDENCE
It is the responsibility of each party to file original motions, pleadings, and
correspondence with the Clerk of Court. A party need not serve the opposing party by
mail if the opposing party is represented by counsel.

In such cases, any motions,

pleadings, or correspondence shall be served electronically at the time of filing with the
Court. If any party is not represented by counsel, however, it is the responsibility of each
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opposing party to serve copies of all motions, pleadings, and correspondence upon the
unrepresented party and to attach to said original motions, pleadings, and correspondence
filed with the Clerk of Court a certificate of service indicating who has been served and
where (i.e., at what address), when service was made, and how service was
accomplished.
DISCOVERY
Plaintiff shall not commence discovery until an answer or dispositive motion has
been filed on behalf of the Defendant from whom discovery is sought by the Plaintiff.
The Defendant shall not commence discovery until such time as an answer or dispositive
motion has been filed. Once an answer or dispositive motion has been filed, the parties
are authorized to seek discovery from one another as provided in the Federal Rules of
Civil Procedure. The deposition of the Plaintiff, a state/county prisoner, may be taken at
any time during the time period hereinafter set out provided prior arrangements are made
with his custodian. Plaintiff is hereby advised that failure to submit to a deposition
may result in the dismissal of his lawsuit under Rule 37 of the Federal Rules of Civil
Procedure.
IT IS HEREBY ORDERED that discovery (including depositions and the service
of written discovery requests) shall be completed within 90 days of the date of filing of
an answer or dispositive motion by the Defendant (whichever comes first) unless an
extension is otherwise granted by the court upon a showing of good cause therefor or a
protective order is sought by the defendant and granted by the court. This 90-day period
shall run separately as to Plaintiff and Defendant beginning on the date of filing of
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Defendants’ answer or dispositive motion (whichever comes first). The scheduling of a
trial may be advanced upon notification from the parties that no further discovery is
contemplated or that discovery has been completed prior to the deadline.
Discovery materials shall not be filed with the Clerk of Court. No party shall be
required to respond to any discovery not directed to him/her or served upon him/her by
the opposing counsel/party. The undersigned incorporates herein those parts of the Local
Rules imposing the following limitations on discovery: except with written permission
of the court first obtained, interrogatories may not exceed TWENTY-FIVE (25) to each
party, requests for production of documents and things under Rule 34 of the Federal
Rules of Civil Procedure may not exceed TEN (10) requests to each party, and requests
for admissions under Rule 36 of the Federal Rules of Civil Procedure may not exceed
FIFTEEN (15) requests to each party. No party shall be required to respond to any such
requests which exceed these limitations.
REQUESTS FOR DISMISSAL AND/OR JUDGMENT
The Court shall not consider requests for dismissal of or judgment in this action,
absent the filing of a motion therefor accompanied by a brief/memorandum of law citing
supporting authorities. Dispositive motions should be filed at the earliest time possible,
but in any event no later than one hundred - twenty (120) days from when the discovery
period begins unless otherwise directed by the Court.
SO ORDERED, this 22nd day of December, 2017.
/s/ Stephen Hyles
UNITED STATES MAGISTRATE JUDGE
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