Grason v. Hardy et al

Filing 53

MEMORANDUM Opinion and Order signed by the Honorable Edmond E. Chang. For the reasons stated in the Opinion, the defense's partial motion to dismiss 35 the Eighth Amendment claim is granted. The claim is dismissed with prejudice. Emailed notice(slb, )

UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION
ABIGAIL GRASON,
Plaintiff,
v.
DANIEL HARDY, et al.,
Defendants.

)
)
)
)
)
)
)
)
)

No. 15 C 09290
Judge Edmond E. Chang

MEMORANDUM OPINION AND ORDER
Plaintiff Abigail Grason was involuntarily committed to the Elgin Mental
Health Center after a jury found her not guilty by reason of insanity at the
conclusion of a criminal trial. R. 21, Am. Compl. ¶ 26.1 Grason has since filed a civilrights suit, 42 U.S.C. § 1983, against thirteen Elgin employees,2 alleging that they
violated her Eighth3 and Fourteenth Amendment rights.4 Am. Compl. ¶¶ 81-85.
The Defendants now move to dismiss the Eighth Amendment claim for failure to
state a claim. Fed. R. Civ. P. 12(b)(6); R. 35, Defs.’ Mot. Dismiss. For the reasons

1Citations

to the record are indicated by “R.,” followed by the docket entry and, when
necessary, a page or paragraph number.
2The named defendants are Daniel Hardy, Jeff Pharis, Ulsa Kartan, Debbie
Giardina, Richard Malis, Carol Rosanova, Jacqueline Jordan, Carol Trelka-Rojas, Wayne
Beyer, Daniel Malone, Maureen Oliver, Jeff Pilario, and Jo Pflenger-Schultz. Am. Compl.
¶¶ 6-18. Grason originally sued all of these employees in their individual and official
capacities, see id., but she has since voluntarily dismissed her official capacity claims, R. 39,
Pl.’s Resp. Br. at 1 n.1.
3When the Court refers to the Eighth Amendment in this Opinion, that really means
the Eighth Amendment as incorporated through the Fourteenth Amendment against state
and local governments. See Robinson v. California, 370 U.S. 660, 667 (1962).
4Grason’s Amended Complaint also contained two state-law claims, Am. Compl. ¶¶
86-92, but she has since voluntarily dismissed both of them, Pl.’s Resp. Br. at 1 n.1. The
Court has federal-question subject matter jurisdiction over the remaining claims.

stated below, the partial motion to dismiss is granted and Grason’s Eighth
Amendment claim is dismissed with prejudice.
I. Background
For the purpose of deciding this motion to dismiss, Grason’s factual
allegations are accepted as true. Erickson v. Pardus, 551 U.S. 89, 94 (2007). Grason
was initially admitted to the Elgin Mental Health Center in October 2006. Am.
Compl. ¶ 22. At that time, she was diagnosed with hypothyroidism and prescribed
medication for treatment. Id. ¶ 23-24. A few months later she was transferred to
Cook County Jail. Id. ¶ 25.
In March 2008, Grason was involuntarily committed to Elgin after a criminal
jury found her not guilty by reason of insanity. Am. Compl. ¶ 26. Four years later,
she was placed under the care of the Hartman unit treatment team.5 Id. ¶ 27. The
treatment team met weekdays to discuss and make decisions (as a unified body)
about Grason’s medical care. Id. ¶¶ 28-29.
A. Tegretol Dosage
Between March and June 2012, Defendant Jacqueline Jordan (Grason’s
psychiatrist at the time) began increasing Grason’s dosage of the medication
Tegretol. Am. Compl. ¶¶ 30, 32-33. Jordan allegedly threatened Grason with
indefinite confinement in order to get her to agree to the increase. Id. ¶ 35.

5Members

of the treatment team, over time, included psychiatrists Jacqueline
Jordan, Ulsa Kartan, Carol Rosanova, and Richard Malis; recovery specialist Wayne Beyer;
social workers Daniel Malone, Debbie Giardina, and Maureen Oliver; nurse manager Jeff
Pilario; and activity therapist Jo Pflenger-Schultz. See Am. Compl. ¶¶ 6-8, 10-17.

2

In June 2012, Grason began experiencing episodes of double vision. Am.
Compl. ¶ 36. These episodes lasted for hours and occurred as often as two times per
day, five days per week. Id. ¶ 39. The treatment team did not tell Grason that these
episodes could be a consequence of the increased dosage of Tegretol; instead, Grason
was referred to a neuro-ophthalmologist. Id. ¶ 38.
Grason was not actually seen by a neuro-ophthalmologist, however, until
December 2014—nearly two years after she first started experiencing double
vision.6 Am. Compl. ¶ 54. The neuro-ophthalmologist did not find any neurological
abnormalities that would cause Grason to experience double vision, and so
recommended that Grason’s dosage of Tegretol be lowered. Id. ¶¶ 54, 56. Only then
did the treatment team act. Id. ¶ 57.
Shortly after her dosage was lowered, Grason stopped experiencing double
vision. Am. Compl. ¶ 58. Grason’s hypothyroidism, however, had worsened by this
time. Id. ¶ 59. The treatment team had not told Grason that Tegretol is not
recommended for patients with thyroid disorders. Id.
B. Lithium Prescription
In January 2014, Defendant Ulsa Kartan (who had replaced Jordan as
Grason’s psychiatrist, Am. Compl. ¶ 43) proposed that Grason take lithium as a
mood stabilizer. Id. ¶ 62. Grason did not want to take lithium, but Kartan told
Grason that refusing to take lithium would negatively impact her ability to be
released from Elgin in the future. Id. Defendant Daniel Hardy (Elgin’s Medical
6In

the interim, members of the treatment team had refused to take Grason off of
Tegretol or to lower the dosage, Am. Compl. ¶ 48, despite blood tests revealing that
Grason’s blood levels for Tegretol were in the high toxic range, id. ¶ 47.

3

Director) ultimately directed Kartan to prescribe the lithium. Id. ¶ 63. Hardy had
never examined Grason, nor was he familiar with Grason’s medical history. Id.
Grason requested a second opinion regarding the prescription but that
request was rejected. Am. Compl. ¶ 66. Because Grason felt coerced and threatened,
she decided to take the lithium. Id. ¶ 67. At no point in time did a member of the
treatment team inform Grason of the possible side effects of lithium, or of the
dangers of lithium to patients with hypothyroidism. Id. ¶¶ 63-64.
After she started taking lithium, Grason experienced abnormal thyroid
readings, general neck pain, soreness in her throat, and difficulty swallowing. Am.
Compl. ¶ 68. As a result, she was sent to an endocrinologist who ordered an
ultrasound. Id. The ultrasound revealed a goiter and multiple nodules on Grason’s
thyroid. Id. ¶ 69. The endocrinologist initially diagnosed Grason with Hashimoto’s
disease, but a biopsy of her thyroid later revealed that Grason had thyroid cancer.
Id. ¶¶ 70-72. She received a thyroidectomy in November 2015. Id. ¶ 73.
C. Procedural History
Grason has filed suit against thirteen members of Elgin’s staff (in their
individual capacities), alleging that they were deliberately indifferent to Grason’s
medical needs and denied her adequate medical care in violation of the Eighth and
Fourteenth Amendments. Am. Compl. ¶ 83. The Defendants now move to dismiss
the Eighth Amendment aspect of Grason’s § 1983 claim. Defs.’ Mot. Dismiss.

4

II. Standard of Review
Under Federal Rule of Civil Procedure 8(a)(2), a complaint generally need only
include “a short and plain statement of the claim showing that the pleader is
entitled to relief.” Fed. R. Civ. P. 8(a)(2). This short and plain statement must “give
the defendant fair notice of what the … claim is and the grounds upon which it
rests.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007) (alteration in original)
(internal quotation marks and citation omitted). The Seventh Circuit has explained
that this rule “reflects a liberal notice pleading regime, which is intended to ‘focus
litigation on the merits of a claim’ rather than on technicalities that might keep
plaintiffs out of court.” Brooks v. Ross, 578 F.3d 574, 580 (7th Cir. 2009) (quoting
Swierkiewicz v. Sorema N.A., 534 U.S. 506, 514 (2002)).
“A motion under Rule 12(b)(6) challenges the sufficiency of the complaint to
state a claim upon which relief may be granted.” Hallinan v. Fraternal Order of
Police of Chi. Lodge No. 7, 570 F.3d 811, 820 (7th Cir. 2009). “[A] complaint must
contain 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 Twombly,
550 U.S. at 570). These allegations “must be enough to raise a right to relief above
the speculative level.” Twombly, 550 U.S. at 555. The allegations that are entitled to
the assumption of truth are those that are factual, rather than mere legal
conclusions. Iqbal, 556 U.S. at 678-79.

5

III. Analysis
Section 1983 provides a private cause of action against a person, who, acting
under color of state law, deprives an individual of any “rights, privileges, or
immunities secured by the Constitution and laws” of the United States. Lividas v.
Bradshaw, 512 U.S. 107, 132 (1994) (quoting 42 U.S.C. § 1983). But § 1983 is not
itself the substantive basis for a constitutional or federal right. Rather, it is a
procedural vehicle for bringing suit to “vindicat[e] federal rights elsewhere
conferred.” Graham v. Connor, 490 U.S. 386, 393-94 (1989) (internal quotation
marks omitted). Thus, the first step in a § 1983 action is identifying the specific
constitutional right allegedly infringed. Id. at 394.
Here, Grason alleges that the way in which the named Elgin employees
addressed

her

medical

needs

violated

both

the

Eighth

and

Fourteenth

Amendments. See Am. Compl. ¶ 83. The Defendants contend, however, that the
Eighth Amendment claim fails as a matter of law because the Eighth Amendment
does not apply to those involuntarily committed following a verdict of not guilty by
reason of insanity.7 R. 36, Defs.’ Br. at 5-6; R. 45, Defs.’ Reply Br. at 1-2. The Court
agrees.
The constitutional source of a confined person’s right to receive medical care
depends on her relationship to the State at the time of the encounter. See Webber v.
Pharis, 2015 WL 475956, at *3 (N.D. Ill. Feb. 3, 2015). For example, the Fourteenth
Amendment protects persons involuntarily committed as a result of civil
7The

Defendants do not dispute that Grason has properly stated a claim for violation
of her Fourteenth Amendment rights. See R. 36, Defs.’ Br. at 6. So there is no need (yet) to
discuss which specific right (or rights) are at issue under the Fourteenth Amendment.

6

commitment proceedings, see Youngberg v. Romeo, 457 U.S. 307, 314-316 (1982),
while the Eighth Amendment protects persons imprisoned following a formal
adjudication of guilt, see Estelle v. Gamble, 429 U.S. 97, 104 (1976); see also City of
Revere v. Mass. Gen. Hosp., 463 U.S. 239, 244 (1983) (“[T]he State does not acquire
the power to punish with which the Eighth Amendment is concerned until after it
has secured a formal adjudication of guilt in accordance with due process of law.”
(internal quotation marks omitted)). This distinction, according to the Supreme
Court, turns on the fact that the “conditions of [incarcerated persons’] confinement
are designed to punish”; because involuntary civil commitment is not designed to
punish, the “involuntarily committed are entitled to more considerate treatment
and conditions of confinement than criminals.” Youngberg, 457 U.S. at 321-22.
The Supreme Court and the Seventh Circuit have yet to directly address
whether it is the Eighth Amendment or the Fourteenth Amendment that protects
persons involuntarily committed following a verdict of not guilty by reason of
insanity. But the Supreme Court has suggested a similarity between those civilly
committed and those committed following a verdict of not guilty by reason of
insanity. See Jones v. United States, 463 U.S. 354, 368 (1983) (the purpose of
commitment following an insanity acquittal, “like that of civil commitment,” is to
“treat the individual’s mental illness” (emphasis added)). And it has repeatedly
stated that commitment following a verdict of not guilty by reason of insanity is not
punitive. Jones v. United States, 463 U.S. 354, 368 (1983); Foucha v. Louisiana, 504
U.S. 71, 80 (1992); cf. People v. Pastewski, 647 N.E.2d 278, 283 (Ill. 1995) (the

7

purpose of commitment following an insanity acquittal is to “treat the individual’s
mental illness, and at the same time protect him and society from his potential
dangerousness” (internal quotation marks omitted)). This makes sense under
Illinois’s statutory scheme. Under Illinois law, insanity is an affirmative defense
that a defendant must prove by clear and convincing evidence. 725 ILCS 5/6-2(e).
When that burden is met, the defendant is found “not guilty by reason of insanity”
and the trial court enters a judgment of acquittal. Id. § 5/104-25(c). This is distinct
from when a defendant is found “guilty but mentally ill.” A defendant who has been
found guilty but mentally ill “is not relieved of criminal responsibility,” id. § 5/6-2(c),
and the trial court “may impose any sentence upon the defendant which could be
imposed pursuant to law upon a defendant who had been convicted of the same
offense without a finding of mental illness,” id. § 5/5-2-6(a). Here, Grason was
acquitted, so she may not be punished. See Foucha, 504 U.S. at 80. Accordingly,
Grason may not state a claim for relief under § 1983 for infringement of her Eighth
Amendment rights.8

8The

dismissal of the Eighth Amendment claim is not likely to hurt Grason’s overall
chances of winning the case. After all, it is unclear what extra protections (if any) the
Eighth Amendment would offer that the Fourteenth Amendment does not. See Youngberg,
457 U.S. at 315-16 (“If it is cruel and unusual punishment to hold convicted criminals in
unsafe conditions, it must [violate the Fourteenth Amendment] to confine the involuntarily
committed—who may not be punished at all—in unsafe conditions.”). Indeed, the Supreme
Court has said that individuals subjected to involuntary civil commitment are “entitled to
more considerate treatment and conditions of confinement than criminals whose conditions
of confinement are designed to punish.” Id. at 322 (applying the professional judgment
standard rather than the deliberate indifference standard to civilly committed plaintiff’s
§ 1983 claim). So, if anything, the Fourteenth Amendment supplies Grason more protection
than the Eighth Amendment.

8

IV. Conclusion
The Defendants’ partial motion to dismiss, R. 35, is granted and Grason’s
Eighth Amendment claim is dismissed with prejudice. Only the Fourteenth
Amendment claim remains. The status hearing on July 27, 2017 remains as
scheduled.

ENTERED:

s/Edmond E. Chang
Honorable Edmond E. Chang
United States District Judge
DATE: June 30, 2017

9