Carambot Ph.D. v. New York City Health And Hospitals Corporation et al

Filing 44

OPINION AND ORDER re: 26 MOTION to Dismiss the Complaint. filed by Virginia Fineran Ph.D., The City Of New York, Louis Molina, Wilma Soto, Patricia Yang Ph.D., New York City Health And Hospitals Corporation, Jessica Laboy. For the foregoing reasons, Defendants' motion to dismiss is GRANTED in part and DENIED in part. Plaintiff is granted leave to amend, provided that any amended complaint must be filed within 21 days after the date of this Opinion and Order. I f Plaintiff chooses not to file an amended complaint, she shall file a letter so stating, in which case Defendants shall file an answer within 14 days after the filing of such letter. The Clerk of Court is directed to close the motion at Docket Number 26. SO ORDERED. (Signed by Judge J. Paul Oetken on 3/10/2025) (vfr)

UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF NEW YORK
PATTY CARAMBOT,
Plaintiff,
24-CV-841 (JPO)
-vOPINION AND ORDER
NEW YORK CITY HEALTH AND
HOSPITALS CORP., et al.,
Defendants.

J. PAUL OETKEN, District Judge:
Plaintiff Patty Carambot brings this action against Defendants New York City Health and
Hospitals Corporation (“HHC”), the City of New York (“City”), Patricia Yang, Virginia Fineran,
Jessica Laboy, Wilma Soto, and Louis Molina, asserting claims under 42 U.S.C. § 1983 and New
York Civil Service Law § 75-b. Before the Court is Defendants’ motion to dismiss the
complaint for failure to state a claim. For the reasons that follow, the motion is granted in part
and denied in part.
I.

Background
A.

Factual Background

The following facts are taken from Carambot’s complaint and are assumed true for
purposes of resolving this motion to dismiss. Fink v. Time Warner Cable, 714 F.3d 739, 740-41
(2d Cir. 2013).
Patty Carambot worked as a forensic clinical psychologist at HHC’s Correctional Health
Services (“CHS”) department from 2016 to 2023. (ECF No. 9 (“Compl.”) ¶¶ 6, 9.) She
provided mental health care and treatment to detainees at Rikers Island Correctional Facility
(“Rikers”), which is operated by the City’s Department of Correction (“DOC”). (Id. ¶¶ 1, 6.) In
2019, Carambot was promoted to CHS’s Senior Associate Director/Senior Clinical Supervisor,

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where she “supervis[ed] mental health staff for multiple [therapeutic housing units (“THUs”)]
and general population in [Rikers’s George R. Vierno Center (“GRVC”)].” (Id. ¶ 53.) Shortly
thereafter, she also became “the Co-Director of Clinical Training for new staff, doctoral, social
work and creative art therapy . . . students on Rikers Island.” (Id. ¶ 54.) At all relevant times,
Carambot’s duties allegedly included “evaluating and performing scheduled examinations of
patients and prescribing and providing mental health care and treatment to detainees” (id. ¶ 55),
but not “formulating, implementing or providing feedback on CHS-wide policy” (id. ¶ 57).
Carambot received “stellar” performance evaluations and “frequently worked over 40 hours a
week, without overtime, to attend to her patients’ needs.” (Id. ¶ 59.)
Throughout her time at CHS, Carambot voiced many concerns about the treatment of
mentally ill detainees at Rikers, including the “lack of adequate staff and dangerous changes in
protocol and housing, overcrowding in Rikers [THUs], clinically inappropriate and unethical
placement of patients, lack of an adequate number of mental health staff to properly monitor and
manage patients, dangerous changes in protocol and housing of inmate-patients and the free and
continuing flow of illegal drugs into THUs.” (Id. ¶ 8.)
Specifically, in May 2022, Carambot complained to her supervisor Virginia Fineran, who
served as the Director of Mental Health Services at Rikers, about “the deliberately indifferent
medical treatment of mentally ill detainees, unethical moving of mentally ill detainees to units
not clinically appropriate for them and poor working conditions for patients and staff in these
units.” (Id. ¶ 82.) On September 16, 2022, Carambot complained to Fineran again that “staff
were being stretched thin” and that “her prior complaints . . . were not being addressed. (Id.
¶ 83.) Also in September 2022, Carambot criticized the opening of a mental observation (“MO”)

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unit in a GRVC building with enhanced security housing (“ESH”), because “it limited the
movement of patients to the clinic and allowed for greater access to illicit drugs.” (Id. ¶ 66.)
On October 22, 2022, E.T., a mentally ill detainee and a patient of Carambot, committed
suicide in GRVC. (Id. ¶ 71.) On December 14, 2022, speaking to a reporter “who asked
questions about the death of E.T.,” Carambot discussed “the difficult-to-manage high census of
detainees on the MO, the lack of adequate mental health and DOC staff to monitor and manage
patients and the difficulties of having an MO in a building with ESH.” (Id. ¶ 74.) Some of
Carambot’s comments were included in the news report on E.T.’s death. (Id. ¶ 75.) At that time,
“Carambot was directed by HHC and CHS staff to not discuss issues with the overcrowding and
lack of adequate mental health staff and deliberately indifferent medical treatment of detainees at
Rikers with non-employees of the City and HHC.” (Id. ¶ 76.)
In July 2023, DOC closed the largest jail on Rikers and folded all its THUs into GRVC.
(Id. ¶ 85.) Carambot raised her concerns about this decision to HHC management, including
CHS’s Senior Vice President Patricia Yang, Carambot’s supervisor Fineran, and DOC Assistant
Commissioners Thomas Griffin and James Saunders. (Id. ¶ 89.) On July 6, 2023, Carambot
emailed Yang and CHS’s Chief Medical Officer Bipin Subedi to complain about “unethical,
improper and unsafe practices, such as high mental health patient census in the face of staff
shortage, placement of high-risk patients into her units, greatly decreased clinically informed
decision-making and lack of staffing.” (Id. ¶ 90.) On or around July 26, 2023, Carambot
complained to Griffin about “staff and patients getting hurt due to unsafe practices and mental
health patient moves,” but Griffin responded dismissively that “jails will always be violent.” (Id.
¶¶ 92-93.) Carambot alleges, upon information and belief, that her “complaints and concerns to
Griffin were made known and reported to [DOC Commissioner Louis Molina].” (Id. ¶ 94.) On

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August 21, 2023, Carambot sent an email to Fineran with similar complaints, writing that
“[p]utting more high-risk patients into these units at this point is just asking for something
horrible to happen.” (Id. ¶¶ 95-96.)
On August 22, 2023, D.U., a high-risk patient of Carambot, “was found dead in his cell,
allegedly after asking DOC officers for assistance hours prior.” (Id. ¶ 97.) That day, Jonathan
Levine, the DOC Assistant Commissioner for the Investigation/Prison Rape Elimination
Administration Division, interviewed Carambot as a part of investigating D.U.’s death. (Id.
¶ 98.) Carambot shared with Levine her concerns about “overcrowding, deliberately indifferent
medical treatment of mentally ill detainees, lack of staffing and drugs coming on the units” and
specifically referred to her August 21 email warning to Fineran. (Id. ¶ 99.) Levine assured
Carambot that he was close with Commissioner Molina and would report this information to
Molina “to see if he could get something done.” (Id. ¶ 100.) That evening, upon Levine’s
follow-up, Carambot forwarded him her August 21 email to Fineran “regarding her concerns
about improper mental patient care at Rikers.” (Id. ¶ 101.)
Also on August 22, 2023, distraught by D.U.’s death, Carambot emailed to “request[]
discretionary administrative paid leave.” (Id. ¶ 102.) On the next day, CHS’s Chief
Administrative Officer Jessica Laboy met with Carambot, with Senior Director of Employee and
Labor Relations/Legal Stephanie Palmadesso in attendance. (Id. ¶¶ 33, 109-10.) At the August
23, 2023 meeting, Laboy told Carambot that “[Yang] wants to give you time to regroup and get
your thoughts together to discuss the issues with your behavior.” (Id. ¶ 110.) Upon Carambot’s
inquiry, Laboy explained that “your behavior” referred to Carambot’s “email.” (Id.) Laboy
placed Carambot on administrative leave and stated that “it makes sense it feels punitive because
it is.” (Id. ¶ 111.)

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On September 11, 2023, upon Carambot’s return from administrative leave, Palmadesso,
with Fineran present, presented Carambot with a three-month Performance Improvement Plan
(“PIP”), allegedly based on her attendance and communications issues. (Id. ¶¶ 113-15.) Despite
Carambot’s refusal to sign the PIP, “HHC specifically directed Carambot to no longer express
her concerns about the deliberately indifferent medical treatment of mentally ill detainees at
Rikers to DOC or any others outside of HHC and CHS.” (Id. ¶ 119.) One month later, on
October 13, 2023, Palmadesso met with Carambot to terminate her employment. (Id. ¶ 120.)
Carambot alleges that the City, HHC, Yang, Fineran, Laboy, Molina, and CHS’s Senior Director
of Human Resources Wilma Soto were all involved in the decision to terminate her. (Id. ¶ 121.)
According to Carambot, although the purported reason for her termination was that her team was
dissatisfied and “no one wanted to work with her,” “many of Carambot’s colleagues, including
the Rikers warden, several supervisors, team members and students were vocally upset about her
being fired and have complained in writing about Carambot’s unlawful termination.” (Id.
¶¶ 122-23.)
B.

Procedural History

Plaintiff filed the operative complaint in this action on February 6, 2024. (Compl.)
Defendants moved to dismiss the complaint on May 7, 2024 (ECF No. 26) and filed a supporting
memorandum of law (ECF No. 28 (“Mem.”)). Plaintiff opposed the motion on June 4, 2024.
(ECF No. 32 (“Opp.”)). Defendants replied in further support of their motion on June 25, 2024.
(ECF No. 43 (“Reply”)).
II.

Legal Standard
To survive a motion to dismiss under Federal Rule of Civil Procedure 12(b)(6), a plaintiff

must plead “enough facts to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v.
Twombly, 550 U.S. 544, 570 (2007). A complaint need not contain “detailed factual
5

allegations,” but it must offer something “more than an unadorned, the-defendant-unlawfullyharmed-me accusation.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (internal quotation marks
and citation omitted). A plaintiff must plead “factual content that allows the court to draw the
reasonable inference that the defendant is liable for the misconduct alleged.” Id. In resolving a
motion to dismiss, the Court must accept as true all well-pleaded factual allegations in the
complaint, “drawing all reasonable inferences in favor of the plaintiff.” Koch v. Christie’s Int’l
PLC, 699 F.3d 141, 145 (2d Cir. 2012).
III.

Discussion
Carambot asserts two causes of action: a 42 U.S.C. § 1983 claim for violation of her First

Amendment rights 1 and a New York Civil Service Law § 75-b claim for retaliation. (Compl.
0F

¶¶ 11-12.) Defendants raise three arguments in support of their motion to dismiss: (1) that
Carambot’s speech was not protected by the First Amendment; (2) that she has failed to establish
either municipal or individual liability under Section 1983; and (3) that she has failed to plead a
cognizable Section 75-b claim. (See Mem. at 12-25.) These arguments are considered in turn.
A.

First Amendment

“To state a claim under Section 1983, a plaintiff must allege that defendants “acted under
color of state law and that [they] deprived [her] of a right secured by the Constitution or laws of
the United States.” Palmieri v. Lynch, 392 F.3d 73 (2d Cir. 2004). “Section 1983 itself creates
no substantive rights; it provides only a procedure for redress for the deprivation of rights
established elsewhere.” Thomas v. Roach, 165 F.3d 137 (2d Cir. 1999) (citing City of Oklahoma

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Plaintiff also claims to bring this action “pursuant to . . . 42 U.S.C. § 1988, providing
for the protection of all persons in their civil rights.” (Compl. ¶ 11.) Because Section 1988
provides for the discretionary award of attorney’s fees to a prevailing party, the Court does not
consider it at this stage.
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City v. Tuttle, 471 U.S. 808, 816 (1985)). Thus, the Court first analyzes whether Carambot states
a deprivation of her First Amendment rights, before turning to other components of her Section
1983 claims.
“To state a First Amendment retaliation claim, a plaintiff must establish that: (1) [her]
speech or conduct was protected by the First Amendment; (2) the defendant took an adverse
action against [her]; and (3) there was a causal connection between this adverse action and the
protected speech.” Cox v. Warwick Valley Cent. Sch. Dist., 654 F.3d 267, 272 (2d Cir. 2011).
Defendants argue that Carambot has failed to plausibly allege the first and third elements. (See
Mem. at 19-27.)
1.

Protected Speech

Because HHC is a “municipal corporation” (Compl. ¶ 17), the parties do not dispute that
Carambot is a public employee. (See Mem. at 19; Opp. at 14.) “It is by now well established
both that a citizen, upon entering government service, by necessity must accept certain
limitations on his or her freedom, and that upon accepting public employment, such employees
do not check all of their First Amendment rights at the door.” Jackler v. Byrne, 658 F.3d 225,
234 (2d Cir. 2011) (quotation marks omitted). Balancing these interests, a public employee’s
speech is only protected if she “spoke as a citizen on a matter of public concern.” Garcetti v.
Ceballos, 547 U.S. 410, 418 (2006).
i.

Citizen/Employee Distinction

“[W]hen public employees make statements pursuant to their official duties, the
employees are not speaking as citizens for First Amendment purposes.” Id. at 421. Accordingly,
“speech is not protected if it is part-and-parcel of the employee’s concerns about his ability to
properly execute his duties.” Matthews v. City of New York, 779 F.3d 167, 173 (2d Cir. 2015)
(cleaned up). As the Second Circuit has explained:
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The inquiry into whether a public employee is speaking pursuant to her official
duties is not susceptible to a brightline rule. Courts must examine the nature of
the plaintiff’s job responsibilities, the nature of the speech, and the relationship
between the two. Other contextual factors, such as whether the complaint was
also conveyed to the public, may properly influence a court’s decision.
Ross v. Breslin, 693 F.3d 300, 306 (2d Cir. 2012). The parties characterize Carambot’s speech
very differently in this regard. Defendants contend that Carambot’s speech “consisted of general
concerns about: (1) understaffing; (2) being stressed and overworked; (3) her staff’s working
conditions; (4) her patient[s’] physical locations within the facility; and (5) the access and quality
of mental health care offered to her patients,” all of which were made within her capacity as a
public employee, not as a citizen. (Mem. at 20.) By contrast, Plaintiff contends that her speech
concerned HHC “policies on closing sections of Rikers jails, opening an MO unit in GRVC,
dealing with a steady flow of illicit drugs to inmates [and] handling overcrowding” (Opp. at 19),
all of which fall outside of Carambot’s job duties, which were focused on “prescribing and
providing mental health care and treatment to detainees” (Compl. ¶¶ 55-57).
Courts also consider the existence of “a civilian analogue” in determining whether a
public employee spoke as a citizen, although this factor is not dispositive. See Montero v. City of
Yonkers, 890 F.3d 386, 397-98 (2d Cir. 2018). “Speech has a ‘relevant civilian analogue’ if it is
made through ‘channels available to citizens generally.’” Matthews, 779 F.3d at 175 (quoting
Jackler, 658 F.3d at 238). Again, the parties dispute this factor. Defendants argue that
Carambot’s complaints were made internally to her supervisors at HHC and DOC—a channel
not available to the public. (Mem. at 22-23.) Plaintiff counters that she went outside of her
chain of command, raising her concerns to a reporter, a DOC investigator, and other “high-level
HHC and DOC employees whose contact information is available online.” (Opp. at 22.)
The myriad factual disputes here reflect the fact-intensive and context-dependent nature
of measuring a public employee’s speech against the scope of her official duties. As Plaintiff
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correctly points out, the Second Circuit has “cautioned against granting a motion to dismiss
when the scope of a plaintiff’s official duties [is] at issue.” Brant v. New York City Health &
Hosps. Corp., No. 17-CV-3801, 2018 U.S. Dist. LEXIS 5428, at *9 (S.D.N.Y. Jan. 10, 2018)
(citing Matthews v. City of New York, 488 F. App’x 532, 533 (2d Cir. 2012) (summary order)).
“Other courts in this Circuit have heeded this warning and declined to dismiss cases of this kind
before discovery.” Id. at *2-3, 9 (denying a motion to dismiss where a HHC corrections
counselor at Rikers was fired after complaining to his supervisor and the New York State
Department of Labor about improper blood-sample collection practices) (collecting cases).
Indeed, most cases of dismissal on which Defendants rely for their official-duty argument were
decided at summary judgment, not on motions to dismiss. (See Mem. at 19-23; Reply at 6-9. 2)
1F

Here, Carambot has alleged sufficient facts to survive a 12(b)(6) motion to dismiss.
Carambot alleges that as Senior Associate Director/Senior Clinical Supervisor at CHS, her duties
“included evaluating and performing scheduled examinations of patients and prescribing and
providing mental health care and treatment to detainees.” (Compl. ¶ 55.) None of her duties

2

See, e.g., Weintraub v. Bd. of Educ. of City Sch. Dist. of New York, 593 F.3d 196, 200
(2d Cir. 2010) (reviewing a grant of summary judgment); Ross, 693 F.3d at 302 (same); Severin
v. New York City Dep’t of Educ., No. 23-732-CV, 2024 WL 1904574, at *1 (2d Cir. May 1,
2024) (same); Kaye v. New York City Health & Hosps. Corp., No. 18-CV-12137, 2023 WL
2745556, at *2 (S.D.N.Y. Mar. 31, 2023) (granting summary judgment); Gotfryd v. City of
Newburgh, No. 21-CV-4009, 2024 WL 1555693, at *1 (S.D.N.Y. Apr. 10, 2024) (same). The
only exceptions, where a First Amendment retaliation claim is dismissed on a Rule 12(b)(6)
motion, involve much more clear-cut facts on the face of the complaint. See Reynolds v. City of
New York, No. 23-76-CV, 2024 WL 1043495, at *3 (2d Cir. Mar. 11, 2024) (summary order)
(“Reynolds’s Amended Complaint is devoid of any assertions articulating the nature of his job
responsibilities and how his complaints fell outside of those duties.”); Dubois v. Beaury, No. 212096-CV, 2022 WL 1701497, at *3 (2d Cir. May 27, 2022) (summary order) (“[Plaintiff’s
speech] referenc[ed] that [it was] made pursuant to Police Department policy and that he was
required to conduct the investigation as part of his job responsibilities.”); Waronker v.
Hempstead Union Free Sch. Dist., 788 F. App’x 788, 792 (2d Cir. 2019) (summary order) (“The
complaint makes clear that rooting out corruption and mismanagement was part-andparcel . . . of Waronker’s daily responsibilities as superintendent.” (cleaned up)).
9

allegedly involved “formulating, implementing or providing feedback on CHS-wide policy, such
as policies on mental health care and treatment to detainees, clinically appropriate and ethical
placement of patients, adequate number of mental health staff required to properly monitor and
manage patients and housing of inmate-patients.” (Id. ¶ 57.) And Carambot’s speech allegedly
concerned a variety of subjects beyond the scope of her day job, including the opening of a MO
in GRVC, the housing arrangement of inmate-patients, and the flow of illegal drugs into THUs.
(E.g., id. ¶¶ 66, 95.) While these issues might have come to Carambot’s attention through her
employment and might have “impacted her ability to properly execute her duties” (Reply at 6-7),
the Supreme Court has made clear that “[t]he First Amendment protects some expressions
related to the speaker’s job.” Garcetti, 547 U.S. at 421. A public employee’s speech is not
unprotected simply because it “concerned the subject matter of [her] employment,” id., and “the
mere fact that a citizen’s speech concerns information acquired by virtue of his public
employment does not transform that speech into employee—rather than citizen—speech,” Lane
v. Franks, 573 U.S. 228, 240 (2014).
The Second Circuit reversed a grant of summary judgment based on analogous facts in
Matthews. 779 F.3d at 167. Matthews, a police officer, allegedly experienced retaliation for
complaining to his commanding officers about the arrest quota policy at his precinct. Id. at 17374. The Second Circuit held that Matthews spoke as a citizen because “his job as a police officer
consisted of radio runs, patrols, complaint reports, and other tasks involving enforcement of the
law; it did not include reporting misconduct of supervisors [or] commenting on precinct-wide
policy” that he “had no role in setting.” Id. at 174. Similarly, Carambot alleges that her duties as
a clinical psychologist at CHS included examining patients and providing mental health
treatment, but did not include “uncover[ing] deficiencies” or “formulating, implementing or

10

providing feedback on CHS-wide policy” such as staffing and inmate-patient placement. 3
2F

(Compl. ¶¶ 55-57.) As to the “civilian analogue” consideration, the Matthews court concluded
that “Matthews pursued the same avenue to complain about a precinct-wide policy as would a
concerned civilian,” because he “did not follow internal grievance procedures, but rather went
directly to the Precinct commanders, with whom he did not have regular interactions and who
had an open door to community comments and complaints.” 779 F.3d at 176. Carambot has
alleged even more here: Not only did she take her complaints to top officers at CHS to whom
she does not regularly report, such as Yang and Subedi (Compl. ¶ 90), but she also expressed her
concerns to three DOC Assistant Commissioners, including one in charge of investigations (id.
¶¶ 89, 92, 98), and to a reporter who published her comments in the news (id. ¶¶ 74-75). As in
Matthews, the fact that Carambot “had better access to [these individuals] than would ordinary
citizens” is immaterial as long as “the same or a similar channel exists for the ordinary citizen.”
779 F.3d at 176.
Accordingly, Carambot has adequately alleged that she was speaking as a citizen for
purposes of her First Amendment claim. See id. at 174 (“We hold that when a public employee

3

Defendants argue to the contrary that “as both a Director and a Supervisor [Carambot]
was necessarily responsible for monitoring the performance of her subordinates and trainees,
implementing [HHC] policies and procedures within the mental health units she oversaw, and
providing feedback to her own managers about the practical realities of those policies.” (Mem.
at 21.) However, the “proper inquiry” into the scope of an employee’s duties “is a practical
one,” since “[f]ormal job descriptions often bear little resemblance to the duties an employee
actually is expected to perform.” Garcetti, 547 U.S. at 424-25. Defendants’ factual speculations
based on Carambot’s job title alone are divorced from the complaint and are exactly the kind of
issue that should be resolved after discovery. See Buchanan v. City of New York, 556 F. Supp.
3d 346, 359 (S.D.N.Y. 2021) (“[N]owhere do plaintiffs concede that their day-to-day work
involved high-level policy formation and implementation . . . . Instead, defendants’ deduction
appears to be drawn from plaintiffs’ job titles alone. This inference may be borne out in
discovery, but dismissing the complaint based on formal titles alone would fly in the face of the
functional approach required by precedent.”)
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whose duties do not involve formulating, implementing, or providing feedback on a
policy . . . engages in speech concerning that policy, and does so in a manner in which ordinary
citizens would be expected to engage, he or she speaks as a citizen, not as a public employee.”);
see also Dillon v. Suffolk Cnty. Dep’t of Health Servs., 917 F. Supp. 2d 196, 204, 210 (E.D.N.Y.
2013) (holding that a medical doctor at the Riverhead Correctional Facility spoke as a citizen
when she complained to county officials about “the deliberate indifference of medical treatment
and the abuse of prisoners,” because those complaints “referred to systemic mistreatment and
corruption extending outside of her own personal duties and affecting inmates with whom she
had no personal or job connection”).
ii.

Matter of Public Concern

“To constitute speech on a matter of public concern, an employee’s expression must ‘be
fairly considered as relating to any matter of political, social, or other concern to the
community.’” Jackler, 658 F.3d at 236 (quoting Connick v. Myers, 461 U.S. 138, 146 (1983)).
On the one hand, speech that “primarily concerns an issue that is personal in nature and generally
related to the speaker’s own situation, such as his or her assignments, promotion, or salary, does
not address matters of public concern.” Id. (cleaned up). On the other hand, “a topic is a matter
of public concern for First Amendment purposes if it is ‘of general interest,’ or ‘of legitimate
news interest,’ or ‘of value and concern to the public at the time’ of the speech.” Id. (quoting
City of San Diego v. Roe, 543 U.S. 77, 83-84 (2004)).
As Carambot describes it, her speech falls within the latter category. Contrary to
Defendants’ assertion, Carambot has done more than “make[] the conclusory allegation that her
various workplace complaints were ‘matters of public concern and a public health risk.’” (Mem.
at 23-24 (quoting Compl. ¶¶ 140-141)). The complaint cites a New York Times article (Compl.
n.1), which reported that “mentally ill detainees [at Rikers] have been subject to harsh
12

conditions, inhumane treatment and inadequate supervision,” and that “[a]t least 18 mentally ill
detainees have died by suicide, drug overdoses and other causes in the past three years alone.”
Jan Ransom & Amy Julia Harris, How Rikers Island Became New York’s Largest Mental
Institution, N.Y. Times (Dec. 29, 2023), https://www.nytimes.com/2023/12/29/nyregion/nycrikers-homeless-mental-illness.html. The complaint also alleges that in 2022, the death of E.T.
received news coverage that included Carambot’s comments to a reporter (Compl. ¶ 75); in
2023, the death of D.U. led to an investigation by the DOC Assistant Commissioner for the
Investigation/Prison Rape Elimination Administrative Division (id. ¶¶ 97-98). The concerns
about Rikers’s treatment of mentally ill detainees, which garnered significant media and public
attention, mirror Carambot’s complaints about the “lack of adequate staff and dangerous changes
in protocol and housing, overcrowding in Rikers [THUs], clinically inappropriate and unethical
placement of patients, lack of an adequate number of mental health staff to properly monitor and
manage patients, dangerous changes in protocol and housing of inmate-patients and the free and
continuing flow of illegal drugs into THUs.” 4 (Id. ¶ 8.)
3F

These factual allegations readily clear the threshold of “matter[s] of political, social, or
other concern to the community.” Jackler, 658 F.3d at 236. The Court agrees with Plaintiff that
“[t]he ongoing crises at Rikers,” “[t]he lives of inmates,” “[a] flourishing drug trade within
Rikers,” and “[u]nderstaffing that results in human suffering and deaths” (Mem. at 25)—all
subjects of Carambot’s speech—are matters of public concern. Cf. Hale v. Mann, 219 F.3d 61
(2d Cir. 2000) (“We conclude that as a matter of law, the report addressed a matter of public

4

Carambot also alleges that during her time at HHC, due to various ethical and public
safety concerns, “most of the forty psychologists employed by HHC at Rikers . . . had quit,
leaving only seven psychologists remaining.” (Id. ¶ 80.) This cuts against Defendants’
suggestion that Carambot was merely raising a “personal grievance.” (Mem. at 24 (quoting
Montero, 890 F.3d at 394).)
13

concern: the proper administration of State facilities for the incarceration of juveniles.”).
Because Carambot has adequately pleaded that she spoke as a citizen on matters of public
concern, her speech qualifies for First Amendment protection.
2.

Causation

Defendants further contest the causal connection between Carambot’s speech and any
adverse employment action such as her administrative leave, PIP, or termination. “To
demonstrate a causal connection a plaintiff must show that the protected speech was a substantial
motivating factor in the adverse employment action.” Smith v. Cnty. of Suffolk, 776 F.3d 114,
119 (2d Cir. 2015) (quotation marks omitted). “A causal relationship can be demonstrated either
indirectly by means of circumstantial evidence, including that the protected speech was followed
by adverse treatment, or by direct evidence of animus.” Wrobel v. Cnty. of Erie, 692 F.3d 22, 32
(2d Cir. 2012). Here, Carambot has alleged sufficient facts to support a causal inference of
retaliation.
First, “a plaintiff can establish a causal connection that suggests retaliation by showing
that protected activity was close in time to the adverse action.” Espinal v. Goord, 558 F.3d 119,
129 (2d Cir. 2009) (holding that a six-month interval is sufficient to support a casual inference).
Carambot has alleged a clear timeline around her adverse employment action: On August 21,
2023, Carambot sent an email to Fineran, complaining about conditions at Rikers and cautioning
that “[p]utting more high-risk patients into these units at this point is just asking for something
horrible to happen.” (Compl. ¶¶ 95-96.) On August 22, 2023, D.U. died in his cell, and
Carambot was interviewed by DOC Assistant Commissioner Levine, who came to investigate
the death. (Id. ¶¶ 97-98.) Carambot shared with Levine her concerns about “overcrowding,
deliberately indifferent medical treatment of mentally ill detainees, lack of staffing and drugs
coming on the units.” (Id. ¶ 99.) That evening, Carambot sent Levine an email explaining her
14

concerns and forwarded him her August 21 email to Fineran—information that Levine promised
to relay to Commissioner Molina “to see if he could get something done.” (Id. ¶¶ 100-01.) On
August 23, 2023, Carambot was called into a meeting and placed on administrative leave
because of her “email.” (Id. ¶ 109.) As soon as Carambot returned from the leave, she was
presented with a PIP. (Id. ¶ 113.) One month later, she was terminated. (Id. ¶ 120.) The close
temporal proximity between Carambot’s latest complaint and the first adverse employment
action—only one or two days—raises a strong inference of retaliation. 5
4F

Defendants argue that when Laboy referred to Carambot’s “email” in placing her on
administrative leave, he was referring to Carambot’s email asking for leave, not her email raising
complaints. (Mem. at 26.) However, this is a factual dispute that demands further evidence. It
is true that Carambot requested “discretionary administrative paid leave” by email on August 22,
2023. (Compl. ¶ 102.) But Carambot also alleges that at the August 23, 2023 meeting, when she
suggested that “placing her on administrative leave felt very punitive,” Laboy “responded that ‘it
makes sense it feels punitive because it is’ and that they were putting Carambot on-leave for
‘punitive’ reasons.” (Id. ¶ 111.) These remarks support an inference that HHC placed Carambot
on administrative leave in a hostile, rather than accommodating, manner.
Moreover, HHC issued multiple explicit warnings to Carambot regarding the expression
of her concerns. “After the death of E.T., Carambot was directed by HHC and CHS staff to not
discuss issues with the overcrowding and lack of adequate mental health staff and deliberately
indifferent medical treatment of detainees at Rikers with non-employees of the [City] and HHC.”

5

The fact that Carambot first started complaining in May 2022 (Mem. at 26) is not
material. Notably, most of her previous complaints were made internally to HHC managers,
whereas her August 22, 2023 complaint was the first one addressed to a DOC Assistant
Commissioner tasked with investigating an inmate’s death at Carambot’s facility, who then
promised to share those concerns with the DOC Commissioner.
15

(Id. ¶ 76.) And when Carambot was presented with and refused to sign the PIP, “HHC
specifically directed Carambot to no longer express her concerns about the deliberately
indifferent medical treatment of mentally ill detainees at Rikers to DOC or any others outside of
HHC and CHS.” (Id. ¶ 119.) These direct attempts to curtail Carambot’s speech further support
an inference of retaliatory animus on the basis of such speech.
Finally, the allegations suggest that the reasons offered for the adverse employment
actions against Carambot may have been pretextual. The PIP discussed Carambot’s “excessive
attendance issues, lack of communication and documentation in relation to the absences, and
unprofessional day-to-day communications and behaviors with coworkers.” (Id. ¶ 114.)
However, the complaint alleges that “Carambot’s performance evaluations were stellar, receiving
‘exceeds expectations’ consistently on annual performance evaluations, and she frequently
worked over 40 hours a week, without overtime, to attend to her patients’ needs.” (Id. ¶ 59.)
“[S]he had never received any write-ups, formal verbal warnings or any other indication that her
work was lacking.” (Id. ¶ 58.) HHC further claims that it terminated Carambot because
“Carambot’s team members were dissatisfied with [her], and ‘no one wanted to work with her.’”
(Id. ¶ 122.) However, “many of Carambot’s colleagues, including the Rikers warden, several
supervisors, team members and students were vocally upset about her being fired and have
complained in writing about Carambot’s . . . termination.” (Id. ¶ 123.) These alleged
discrepancies prevent the Court from determining as a matter of law that HHC’s actions were not
taken in retaliation for Carambot’s protected speech.
The Court concludes that Carambot has adequately alleged “a causal connection between
[the] adverse action and the protected speech.” Cox, 654 F.3d at 272. Accordingly, Carambot
has stated a violation of her First Amendment rights. The Court next turns to whether she can

16

establish liability under 42 U.S.C. § 1983 against the municipal and individual Defendants for
their deprivation of her First Amendment rights.
B.

Section 1983 Liability

Carambot asserts Section 1983 claims against HHC, the City, as well as Yang, Fineran,
Laboy, Soto, and Molina in both their official and personal capacities. The Court analyzes the
liability of each Defendant in turn.
1.

Municipal Liability

“[W]hen the defendant sued . . . under . . . § 1983 is a municipality—or an individual
sued in his official capacity—the plaintiff is required to show that the challenged acts were
performed pursuant to a municipal policy or custom.” 6 Patterson v. Cnty. of Oneida, 375 F.3d
5F

206, 226 (2d Cir. 2004) (citing Monell v. Dep’t of Soc. Servs., 436 U.S. 658, 692-94 (1978)). To
survive a motion to dismiss on such a claim, “plaintiffs must do more than ‘merely assert’ the
existence of a municipal policy or custom leading to a rights violation”; instead, they must
“actually allege facts ‘tending to support, at least circumstantially,’ the inference that the
complained-of actions were pursuant to a municipal policy or custom.” Kimble v. Kingston City
Sch. Dist., 792 F. App’x 80, 82 (2d Cir. 2019) (summary order) (quoting Montero, 890 F.3d at
403-04) (brackets omitted). Carambot has not identified a municipal policy or custom in her
complaint. She alleges only that “[t]he decision to terminate [her] was made by the City, HHC,
Yang, Fineran, Laboy, Soto, Molina and others at HHC and DOC” “in retaliation for [her]
complaints” (Compl. ¶¶ 121, 127 (capitalization altered)). Those statements fall short of

6

The same rule applies to HHC. See Simpkins v. Bellevue Hosp., 832 F. Supp. 69, 73
(S.D.N.Y. 1993) (“As a municipal corporation, NYCHHC’s liability under § 1983 is governed
by the principles set forth in Monell v. Department of Social Services and its progeny.”).
17

pleading a policy or custom of, for example, disciplining HHC employees for criticizing jail
conditions.
Plaintiff argues, however, that she has pleaded “a single act by an official with ‘final
policymaking authority’ in a particular area of city business,” which “can constitute a municipal
policy for purposes of Section 1983 liability.” (Opp. at 29 (quoting City of St. Louis v.
Praprotnik, 485 U.S. 112, 123 (1988)).) It is true that “[w]here an official has final authority
over significant matters involving the exercise of discretion, the choices he makes represent
government policy.” Rookard v. Health & Hosps. Corp., 710 F.2d 41, 45 (2d Cir. 1983). But
two limitations are pertinent here. First, “with respect to the conduct challenged, [the official]
must be responsible under state law for making policy in that area of the municipality’s
business.” Jeffes v. Barnes, 208 F.3d 49, 57 (2d Cir. 2000) (cleaned up). Second, “[i]t does not
suffice for these purposes that the official has been granted discretion in the performance of his
duties.” Id.; see also Praprotnik, 485 U.S. at 127 (“[T]he authority to make municipal policy is
necessarily the authority to make final policy. When an official’s discretionary decisions are
constrained by policies not of that official’s making, those policies, rather than the subordinate’s
departures from them, are the act of the municipality.” (citation omitted)). Thus, “[t]he critical
characteristic of final policymakers when employment is at issue is whether the municipal
official has authority to formulate the rules governing personnel decisions rather than authority
to make decisions pursuant to those rules.” Chin v. N.Y.C. Hous. Auth., 575 F. Supp. 2d 554,
562 (S.D.N.Y. 2008); see also Baity v. Kralik, 51 F. Supp. 3d 414, 437 (S.D.N.Y. 2014) (“[A]
number of courts in the Second Circuit have found that the authority to make individual
employment decisions was not sufficient to make an official a policymaker for the purposes of
Monell liability.” (collecting cases)).

18

Carambot argues that Yang (Senior Vice President of CHS), Fineran (Director of Mental
Health Services at Rikers), and Molina (DOC Commissioner) are final policymakers for
purposes of her First Amendment retaliation claim. (Opp. at 29.) But the complaint is devoid of
allegations that either Yang or Fineran has final policymaking authority to enact personnel rules
at HHS. 7 This deficiency renders the cases cited by Plaintiff distinguishable from this case. Cf.
6F

Rookard, 710 F.2d at 45 (holding that the “final” authority over personnel decisions by the
Executive Director of Harlem Hospital and HHC’s Vice President for Corporate Affairs is
evidenced by “[t]he reluctance of HHC’s President and General Counsel to intervene, or even to
inquire into [the plaintiff’s] claims”); Nagle v. Marron, 663 F.3d 100, 117 (2d Cir. 2011)
(holding that a school superintendent is the final decisionmaker on personnel appointments
“because no potential employee can obtain full school board approval without the
superintendent’s recommendation” (cleaned up)). On the other hand, while Carambot alleges
that Commissioner Molina “was responsible for overseeing Rikers” and “ensuring that . . . HHC
staff with Rikers . . . are not subjected to retaliatory practices” (Compl. ¶¶ 42, 45), Carambot has
failed to allege in more than a conclusory fashion Molina’s involvement in any employment
action against her (see id. ¶¶ 121, 127-29).

7

Carambot alleges that “Yang was responsible for formulating and implementing CHSwide policy, such as policies on mental health care and treatment to detainees, clinically
appropriate and ethical placement of patients, adequate number of mental health staff required to
properly monitor and manage patients and housing of inmate-patients. At all relevant times,
Yang was also responsible for ensuring that employees are not subjected to retaliatory practices.”
(Compl. ¶¶ 23-24 (capitalization altered); see also id. ¶¶ 29-30 (similar language for Fineran).)
Notably, the authority to formulate policies on inmate-patient treatment is different from the
authority to formulate policies on employment decisions, and the responsibility to ensure
compliance with any non-retaliatory rules is different from the final authority to enact such rules.
19

Therefore, Carambot has not adequately pleaded a Monell claim for municipal liability.
Her Section 1983 claims against HHC, the City, and the individual Defendants in their official
capacities must be dismissed.
2.

Individual Liability

While “[o]fficial-capacity liability . . . require[s] proof of a municipal policy or custom,”
“personal liability . . . require[s] only that [the defendant] himself caused the deprivation of a
federal right while acting under color of state law.” McCray v. Cnty. of Suffolk, 598 F. App’x 48,
50 (2d Cir. 2015) (summary order) (citing Kentucky v. Graham, 473 U.S. 159, 166-67 (1985)).
In other words, “a defendant in a § 1983 action may not be held liable for damages for
constitutional violations merely because he held a high position of authority. Rather, the
personal involvement of defendants in alleged constitutional deprivations is a prerequisite to an
award of damages under § 1983.” Victory v. Pataki, 814 F.3d 47, 67 (2d Cir. 2016) (cleaned up).
Carambot has alleged the personal involvement of Yang, Fineran, and Laboy, but not
Soto and Molina, in the deprivation of her First Amendment rights. Laboy led the August 23,
2023 meeting placing Carambot on a punitive administrative leave. (Id. ¶¶ 109-11.) At that
meeting, Laboy told Carambot that CHS was placing her on leave because “[Yang] wants to give
you time to regroup and get your thoughts together to discuss the issues with your behavior.”
(Id. ¶ 110). And Fineran attended the meeting at which Carambot received a PIP upon returning
from administrative leave. (Id. ¶ 113.) These allegations support an inference that Yang, Laboy,
and Fineran were personally involved in HHC’s decision to punish Carambot by placing her on
leave, giving her a PIP, and terminating her employment. By contrast, the complaint makes no
mention of Molina’s or Soto’s role in the adverse employment actions against Carambot (see id.
¶¶ 102-34), other than in laundry lists such as “the decision to terminate Carambot was made by
the City, HHC, Yang, Fineran, Laboy, Soto, Molina and others at HHC and DOC” (id. ¶ 121
20

(capitalization altered)). Such conclusory allegations, unaccompanied by additional factual
detail, are insufficient to survive a motion to dismiss. 8
7F

Thus, Carambot has stated Section 1983 claims against Yang, Fineran, and Laboy in their
personal capacities, but has failed to do so against Soto and Molina.
C.

New York Civil Service Law

Carambot also asserts whistleblower and retaliation claims under New York Civil Service
Law § 75-b, which “prohibits a public employer in New York State from taking adverse
personnel action against a public employee in retaliation for the employee’s disclosure of illegal
activity.” Maher v. Town of Stony Point, No. 16-CV-607, 2018 WL 4759786, at *10 (S.D.N.Y.
Sept. 29, 2018) (citing N.Y. Civ. Serv. Law § 75-b). To state a claim under Section 75-b, a
plaintiff must allege
(1) an adverse personnel action; (2) disclosure of information to a governmental body (a)
regarding a violation of a law, rule, or regulation that endangers public health or safety,
or (b) which she reasonably believes to be true and which she reasonably believes
constitutes an improper governmental action; and (3) a causal connection between the
disclosure and the adverse personnel action.
Morales v. City of New York, 525 F. Supp. 3d 463, 482 (S.D.N.Y. 2021), aff’d, No. 21-925-CV,
2022 WL 2840035 (2d Cir. July 21, 2022). An “improper governmental action” is defined as
“any action by a public employer or employee . . . in violation of any federal, state or local law,
rule or regulation.” N.Y. Civ. Serv. Law § 75-b(2)(a).

8

Plaintiff states in her opposition brief that “Carambot’s termination letter was signed by
Soto in her capacity as Senior Director of Human Resources at CHS.” (Opp. at 29-30.) This
allegation is not found in the complaint, and the Court does not consider it. See In re Agape
Litig., 773 F. Supp. 2d 298, 316 (E.D.N.Y. 2011) (“It is well-settled that a plaintiff cannot amend
the complaint through briefs and affidavits, and such facts are thus irrelevant for purposes of
determining whether the Plaintiff’s complaint should be dismissed for failure to state a claim.”
(cleaned up)).
21

Defendants contend that Carambot has failed to meet the second element of a Section
75-b claim, because “all of the issues that Plaintiff complained to [HHC] about were not illegal
under any law.” (Mem. at 31.) That is plainly incorrect. Carambot repeatedly complained that
the treatment of inmate-patients at Rikers was “deliberately indifferent.” (E.g., Compl. ¶¶ 70,
82, 83, 89, 90, 99, 105.) “When the state is deliberately indifferent to the medical needs of a
person it has taken into custody, it violates the Eighth Amendment’s prohibition on cruel and
unusual punishment.” Charles v. Orange Cnty., 925 F.3d 73, 82 (2d Cir. 2019). Thus,
Carambot’s reporting of her concerns falls squarely within the protection of Section 75-b. 9
8F

Accordingly, Carambot has stated a Section 75-b claim.
D.

Leave to Replead

Plaintiff requests leave to replead any claims that the Court deemed factually deficient.
(Opp. at 32.) Leave to amend should be freely given “absent evidence of undue delay, bad faith
or dilatory motive on the part of the movant, undue prejudice to the opposing party, or futility.”
Monahan v. N.Y.C. Dep’t of Corr., 214 F.3d 275, 283 (2d Cir. 2000); see Fed. R. Civ. P.
15(a)(2). Plaintiff has not amended her complaint before, and the deficiencies in her complaint
could conceivably be remedied by additional factual allegations showing that individual
defendants possessed final policymaking authority or that Molina or Soto were personally
involved in the retaliation against Carambot. Thus, Plaintiff is granted leave to replead if she
wishes to do so. Alternatively, she may file a letter stating that she intends to proceed on the

9

Defendants also state passingly that “[i]n any event, Plaintiff also fails to establish the
required causal nexus between her alleged disclosures and her adverse actions to properly plead a
Section 75-b claim.” (Mem. at 32.) Carambot has adequately alleged the requisite causal
connection for the same reasons explained in Section III.A.3.
22

surviving claims, in which case the remaining Defendants shall file an answer within 14 days of
the filing of such letter.
IV.

Conclusion
For the foregoing reasons, Defendants’ motion to dismiss is GRANTED in part and

DENIED in part. Plaintiff is granted leave to amend, provided that any amended complaint must
be filed within 21 days after the date of this Opinion and Order. If Plaintiff chooses not to file an
amended complaint, she shall file a letter so stating, in which case Defendants shall file an
answer within 14 days after the filing of such letter.
The Clerk of Court is directed to close the motion at Docket Number 26.
SO ORDERED.
Dated: March 10, 2025
New York, New York
____________________________________
J. PAUL OETKEN
United States District Judge

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