Mason v. Dauphin County Prison et al

Filing 42

MEMORANDUM ORDER re: 38 MOTION TO DISMISS FOR FAILURE TO STATE A CLAIM Plaintiff's 2nd Amended Complaint. IT IS HEREBY ORDERED THAT the defendants motion to dismiss the amended complaint (Doc. 38.) is GRANTED in part and DENIED in part. The motion is DENIED with respect to the plaintiffs claims against Dr. Hoffman and PrimeCare Medical. The motion is GRANTED with respect to the remaining defendants.Signed by Magistrate Judge Martin C. Carlson on November 5, 2015. (kjn)

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
SUSAN K. MASON,
as Administrator of the Estate
of Monique N. Mason,
Plaintiff
v.
DAUPHIN COUNTY PRISON,
et al.,
Defendants

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Civil No. 1:14-CV-1680
(Magistrate Judge Carlson)

MEMORANDUM ORDER
I.

INTRODUCTION
This is a lawsuit filed by Susan K. Mason, the Administrator of the Estate of

Monique N. Mason, a former inmate at the Dauphin County Prison who died while
in custody. The Administrator has sued the Prison, the Dauphin County Board of
Commissioners, PrimeCare Medical and one of its doctors, and Dominick DeRose,
the Warden, alleging that the defendants wrongfully caused Mason’s death, and
violated her rights under the Eighth and Fourteenth Amendments to the United States
Constitution. After the defendants moved to dismiss the initial complaint, the
plaintiff filed an amended complaint on December 22, 2014. On January 5, 2015, the
defendants filed a second motion to dismiss.

In that motion, the defendants argued that the plaintiff failed adequately to
plead a cause of action under 42 U.S.C. § 1983, the statutory vehicle used to
prosecute federal civil rights actions. Specifically, the defendants maintained that the
plaintiff did not allege sufficient facts to make out a viable claim for deliberate
indifference to Ms. Mason’s serious medical needs, in violation of the Eighth
Amendment. The defendants also argued that the plaintiff had improperly attempted
to impose liability against the Prison on the basis of supervisory liability, or
respondeat superior – something that is unavailable in § 1983 actions. The
defendants relatedly argued that the plaintiff did not allege facts that would be
sufficient to establish a Monell1 claim for municipal or institutional liability.
Upon consideration, we agreed, and entered an order dismissing the amended
complaint. However, out of an abundance of caution, and in light of the gravity of
the circumstances alleged, we provided the plaintiff with another opportunity to
amend the complaint to allege facts that could support a claim under Section 1983,
in light of the guidance we endeavored to provide in the Court’s opinion. The
plaintiff filed a second amended complaint that narrows her claims in some respects,
and provides some additional nuance and detail. The defendants have renewed their
motion to dismiss, on essentially the same grounds as those made before. Upon
1

Monell v. Dep’t of Soc. Servs. of City of New York, 436 U.S. 658 (1978).
2

consideration, although we find it to be a somewhat close issue, we conclude that the
plaintiff has sufficiently pleaded a cause of action for Eighth Amendment violations
and state-law torts against Dr. Hoffman and PrimeCare Medical to proceed beyond
the pleadings, and will deny these medical defendants’ motion to dismiss. In contrast,
we find that the plaintiff’s state-law tort claims against the municipal defendants must
be dismissed because these parties are entitled to immunity from suit under
Pennsylvania law.
II.

BACKGROUND
The factual background is taken from the well pleaded factual allegations set

forth in the amended complaint, which are accepted as true for purposes of
considering the motion to dismiss. See Eid v. Thompson, 740 F.3d 118, 122 (3d Cir.
2014) (when evaluating a motion to dismiss under Rule 12(b)(6), a court must “accept
all factual allegations as true, construe the complaint in the light most favorable to the
plaintiff, and determine whether, under any reasonable reading of the complaint, the
plaintiff may be entitled to relief.”).
Between November 21, 2011, and March 5, 2013, Monique Mason was housed
as an inmate at the Dauphin County Prison. Prior to her admission as an inmate, in

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April 28, 2011, Mason was diagnosed with a colloid cyst2 in the third ventricle of her
brain, small lateral ventricles, calcification of her pineal gland, as well as possible
Chiari formation. (Second Am. Compl. ¶ 21.) According to the complaint, the prison
and medical defendants were aware of this diagnosis. In addition, according to the
complaint, officials at the Prison were aware that on October 12, 2011, Dr. Stephen
Powers had performed an MRI and had diagnosed Mason with small lateral
ventricles, swollen brain symptoms, and severe headaches, including intermittent
episodes of pre-syncope. (Id.)
The plaintiff alleges that between November 21, 2011, and March 2, 2013,
prison officials and medical staff either were aware, or should have been aware, of
the plaintiff’s diagnosis, and indeed the plaintiff notes that on that date of her intake
at the prison defendant PrimeCare Medical noted in records that Mason had a cyst in
her brain, and anemia.
A month after her arrival at the prison, PrimeCare Medical noted that Mason’s
headaches were recurring more frequently, she was light-headed when she got out of
bed, and again observed that she had a history of a colloid cyst. (Second Am. Compl.
¶ 24.) Seven months later, Mason presented with a “severe headache,” and noted at
According to the plaintiff, a colloid cyst is a non-cancerous growth that
can increase in size. This size increase can cause headaches, dizziness and
ultimately death depending upon the growth. (Am. Compl. ¶ 21.)
2

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the time that she had been diagnosed with a cyst in her brain in 2011. (Am. Compl.
¶ 25.) Early in 2013, the plaintiff avers that Mason had experienced an incident
called syncope, which is a symptom of brain swelling. (Id. ¶ 26.)
The following month, on February 25, 2013, PrimeCare noted that the plaintiff
was again suffering from headaches attributable to migraines, and Mason was
prescribed Topomax. The plaintiff alleges that despite knowledge of Mason’s
condition, PrimeCare Medical had no protocols, rules or procedures in place to
assess, refer, or treat neurological problems such as those Mason experienced. (Id.
¶ 27.)
On February 27, 2013, Mason suffered a syncopal incident, which rendered her
nonresponsive; although she was later aroused at the time she received medical care.
The plaintiff alleges that PrimeCare Medical knew that Mason had been
nonresponsive for a period. (Id. ¶ 30.) The plaintiff alleges that up to this time,
Mason had reported severe and worsening headaches to the Dauphin County Prison
medical staff and PrimeCare Medical on numerous occasions, and the response was
to prescribe anti-migraine medication and Motrin without referring Mason to a
neurologist, despite prison officials and medical providers working for the prison
being aware of Mason’s brain abnormalities, and despite knowing that Mason’s
colloidal cyst needed to be followed periodically by neurologists and neurosurgeons,
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but failed to do so because they lacked any protocols, rules or procedures for such
referrals.
Days later, on March 2, 2013, Mason was found on the floor by her bunk,
nonresponsive.

Prison records indicate that CPR was administered and that

emergency services were summoned. Medical staff attempted to resuscitate Mason,
but were unsuccessful and she was transferred by ambulance to Harrisburg Hospital.
(Id. ¶¶ 34-36.) On March 5, 2012, Mason was declared brain dead, one day shy of
her 32nd birthday. (Id. ¶ 36.)
An autopsy was performed, which showed pressure, severe brain swelling and
brain herniation as a result of hydrocephalus caused by Mason’s underlying colloidal
cyst and possible Chiari formation. The autopsy listed the cause of death as
complications of hypoxic encephalopathy and cerebral edema. (Am. Compl. ¶ 3738.)
III.

Summary of Claims and the Defendants’ Motion in Response
In Counts I and II of her second amended complaint, the plaintiff alleges that

PrimeCare Medical and Dr. Carl A. Hoffman, Jr., were deliberately indifferent to Ms.
Mason’s known, serious medical conditions, and through this deliberate indifference
proximately caused her death by failing to respond to and treat those conditions;
ignored the condition of Mason’s cyst and possible Chiari malformation and the
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potential for it to cause hydrocephalus; failed to follow-up and consult with outside
medical providers; failed to make proper medical judgments through qualified
medical personnel; and failed to have in place proper protocols, rules or procedures
for referring inmates with brain abnormalities, frequent headaches, and episodes of
syncope to a specialist.
The remainder of the second amended complaint consists of two claims, listed
as “claims” rather than “counts.” In “Claim I”, the plaintiff purports to bring a
“survival action” against PrimeCare, Dr. Hoffman, Warden DeRose, the County of
Dauphin, and the Dauphin County Board of Commissioners for the alleged wrongful
death of Ms. Mason – a claim that is grounded in Pennsylvania state law. In “Claim
II”, the plaintiff purports to bring a claim for wrongful death under Pennsylvania law
against all of the defendants.3
The defendants maintain that the plaintiff has failed to plead facts sufficient to
state a claim for deliberate indifference under the Eighth Amendment, and
additionally argue that the plaintiff continues to fundamentally misapprehend the
reach of 42 U.S.C. § 1983, which does not afford liability based upon notions of
Thus, in addition to alleging the constitutional tort claims set forth in
Counts I and II, the plaintiff has brought a “survival action” on behalf of Mason’s
estate, pursuant to Pennsylvania state law, 42 Pa. Cons. Stat. Ann. § 8302.
Similarly, the plaintiff brings a claim for wrongful death under Pennsylvania state
law, 42 Pa. Cons. Stat. Ann. § 8301(b). (Am. Compl. ¶¶ 62-75.)
3

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vicarious liability. Additionally, the defendants contend that the plaintiff has in any
event failed to plead facts sufficient to support a claim for municipal liability under
Monell.
IV.

STANDARD OF REVIEW
Federal Rule of Civil Procedure 12(b)(6) provides for the dismissal of a

complaint, in whole or in part, if the plaintiff fails to state a claim upon which relief
can be granted. The moving party bears the burden of showing that no claim has been
stated, Hedges v. United States, 404 F.3d 744, 750 (3d Cir.2005), and dismissal is
appropriate only if, accepting all of the facts alleged in the complaint as true, the
plaintiff has failed to plead “enough facts to state a claim to relief that is plausible on
its face,” Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570 (2007) (abrogating “no
set of facts” language found in Conley v. Gibson, 355 U.S. 41, 45–46 (1957) ). The
facts alleged must be sufficient to “raise a right to relief above the speculative level.”
Twombly, 550 U.S. 544, 555. This requirement “calls for enough fact[s] to raise a
reasonable expectation that discovery will reveal evidence” of necessary elements of
the plaintiff's cause of action. Id. at 556. Furthermore, in order to satisfy federal
pleading requirements, the plaintiff must “provide the grounds of his entitlement to
relief,” which “requires more than labels and conclusions, and a formulaic recitation
of the elements of a cause of action will not do.” Phillips v. County of Allegheny,
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515 F.3d 224, 231 (3d Cir.2008) (brackets and quotations marks omitted) (quoting
Twombly, 550 U.S. 544, 555).
In considering a motion to dismiss, the court generally relies on the complaint,
attached exhibits, and matters of public record. Sands v. McCormick, 502 F.3d 263,
268 (3d Cir.2007). The court may also consider “undisputedly authentic document[s]
that a defendant attaches as an exhibit to a motion to dismiss if the plaintiff's claims
are based on the [attached] documents.” Pension Benefit Guar. Corp. v. White
Consol. Indus., 998 F.2d 1192, 1196 (3d Cir.1993). Moreover, “documents whose
contents are alleged in the complaint and whose authenticity no party questions, but
which are not physically attached to the pleading, may be considered.” Pryor v. Nat'l
Collegiate Athletic Ass'n, 288 F.3d 548, 560 (3d Cir.2002); see also U.S. Express
Lines, Ltd. v. Higgins, 281 F.3d 383, 388 (3d Cir. 2002) (holding that “[a]lthough a
district court may not consider matters extraneous to the pleadings, a document
integral to or explicitly relied upon in the complaint may be considered without
converting the motion to dismiss into one for summary judgment.”). However, the
court may not rely on other parts of the record in determining a motion to dismiss.
Jordan v. Fox, Rothschild, O'Brien & Frankel, 20 F.3d 1250, 1261 (3d Cir.1994).

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V.

DISCUSSION
A.

42 U.S.C. § 1983

The text of 42 U.S.C. § 1983 provides as follows:
Every person who, under color of any statute, ordinance,
regulation, custom, or usage, of any State or Territory or
the District of Columbia, subjects, or causes to be
subjected, any person of the United States or other person
within the jurisdiction thereof to the deprivation of any
rights, privileges, or immunities secured by the
Constitution and laws, shall be liable to the party injured in
an action at law, suit in equity, or other proper proceeding
for redress . . . .

42 U.S.C. § 1983. Section 1983 is not itself a source of substantive rights, but is
rather a vehicle that plaintiffs may use in order to seek redress against state actors for
alleged violations of rights under the Constitution or other federal law, including
under the Eighth Amendment to the United States Constitution. City of Oklahoma
City v. Tuttle, 471 U.S. 808, 816 (1985); Kneipp v. Tedder, 95 F.3d 1199, 1204 (3d
Cir. 1996).
B.

Deliberate Indifference Under the Eighth Amendment

The Eighth Amendment provides that “[e]xcessive bail shall not be required,
nor excessive fines imposed, nor cruel and unusual punishments inflicted.” With
respect to prisoner confinement, the Eighth Amendment obligates the government “to

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provide medical care for those whom it is punishing by incarceration.” Estelle v.
Gamble, 429 U.S. 97, 103 (1976); see also Farmer v. Brennan, 511 U.S. 825, 832-33
(1994); Reynolds v. Wagner, 128 F.3d 166, 172-73 (3d Cir. 1997). “An inmate must
rely on prison authorities to treat his medical needs; if the authorities fail to do so,
those needs will not be met. In the worst cases, such a failure may actually produce
physical torture or a lingering death.” Estelle, 429 U.S. at 103 (quoting In re
Kemmler, 136 U.S. 436, 447 (1890)).
In Estelle, the United States Supreme Court held that prison officials violate
the Eighth Amendment’s proscription of cruel and unusual punishment when they
exhibit “deliberate indifference to serious medical needs of prisoners.” 429 U.S. at
104. The standard that Estelle established “requires [both that there be] deliberate
indifference on the part of the prison officials and [that] the prisoner’s medical needs
. . . be serious.” Monmouth County Correctional Inst. Inmates v. Lanzaro, 834 F.2d
326, 346 (3d Cir. 1987) (quoting West v. Keve, 571 F.2d 158, 161 (3d Cir. 1978)).
Under this two-prong test, an inmate must first objectively establish a deprivation of
medical care, or the result of such deprivation, the result of which was sufficiently
serious to implicate a constitutional violation. Montgomery v. Pinchak, 294 F.3d
492, 499 (3d Cir. 2002) (citing Wilson v. Seiter, 501 U.S. 294, 298 (1991)). An
inmate’s medical need is serious under this standard when it “has been diagnosed by
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a physician as requiring treatment or . . . is so obvious that a lay person would easily
recognize the necessity for a doctor’s attention.”

Monmouth County Corr.

Institutional Inmates v. Lanzaro, 834 F.2d 326, 347 (3d Cir. 1987) (citations and
internal quotations omitted). Secondly, the inmate-plaintiff must show that prison
officials subjectively knew of the deprivation and “disregard[ed] an excessive risk to
[the] inmate[’s] health or safety.” Natale v. Camden County Corr. Facility, 318 F.3d
575, 582 (3d Cir. 2003).
Thus, in the medical context, a constitutional violation under the Eighth
Amendment occurs only when state officials are deliberately indifferent to an
inmate’s serious medical needs. Estelle, 429 U.S. at 105. To establish a violation of
his constitutional right to adequate medical care in accordance with this standard, the
plaintiff is thus required to point to evidence that demonstrates (1) Mason had a
serious medical need, and (2) acts or omissions by prison officials that indicate
deliberate indifference to that need. Rouse v. Plantier, 182 F.3d 192, 197 (3d Cir.
1999); see also Woloszyn v. County of Lawrence, 396 F.3d 314, 321 (3d Cir. 2005)
(for a claim of deliberate indifference against a prison official to survive, “the official
must both be aware of facts from which the inference could be drawn that a
substantial risk of serious harm exists, and he must also draw the inference.”). The
Third Circuit has found deliberate indifference where a prison official: “(1) knows
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of a prisoner’s need for medical treatment but intentionally refuses to provide it; (2)
delays necessary medical treatment based on a non-medical reason; or (3) prevents
a prisoner from receiving needed or recommended medical treatment.” Rouse, 182
F.3d at 197. The Third Circuit has also held that “[n]eedless suffering resulting from
the denial of simple medical care, which does not serve any penological purpose, . .
. violates the Eighth Amendment.” Atkinson v. Taylor, 316 F.3d 257, 266 (3d Cir.
2003).
At the same time, it is also clear that the mere misdiagnosis of a condition or
medical need, or negligent treatment provided for a condition, is not actionable as an
Eighth Amendment claim because medical malpractice is not a constitutional
violation. See Spruill v. Gillis, 372 F.3d 218, 235 (3d Cir. 2004); Singletary v. Pa.
Dep’t of Corr., 266 F.3d 186, 192 n.2 (3d Cir. 2002) (claims of medical malpractice,
absent evidence of a culpable state of mind, do not constitute deliberate indifference
under the Eighth Amendment). Instead, deliberate indifferent represents a much
higher standard, one that requires “obduracy and wantonness, which has been likened
to conduct that includes recklessness or a conscious disregard of a serious risk.”
Rouse, 182 F.3d at 197 (quoting Whitley v. Albers, 475 U.S. 312, 319 (1986)).
Furthermore, in a prison medical context, deliberate indifference is generally
not found when some significant level of medical care has been offered to the inmate.
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Clark v. Doe, 2000 U.S. Dist. LEXIS 14999, 2000 WL 1522855, at *2 (E.D.Pa. Oct.
13, 2000)(“courts have consistently rejected Eighth Amendment claims where an
inmate has received some level of medical care”). “Indeed, prison authorities are
accorded considerable latitude in the diagnosis and treatment of prisoners.” Durmer,
991 F.2d at 67 (citations omitted). Thus, “the exercise by a doctor of his professional
judgment is never deliberate indifference.

See e.g. Brown v. Borough of

Chambersburg, 903 F.2d 274, 278 (3d Cir.1990) (‘[A]s long as a physician exercises
professional judgment his behavior will not violate a prisoner's constitutional
rights.’)”. Gindraw v. Dendler, 967 F. Supp. 833, 836 (E.D. Pa. 1997). It follows
that a plaintiff’s disagreement over the type of medical treatment given to him will
not support a claim for deliberate indifference. See Lanzaro, 834 F.2d at 346.
C.

Individual Defendants Must Be Shown to Have Had Personally
Involved in the Alleged Constitutional Deprivation

In addition to the foregoing substantive legal principles governing claims for
Eighth Amendment violations premised on alleged deliberate indifference to a serious
medical need, we note that in all claims brought for relief under § 1983, a plaintiff
must show that each defendant had personal involvement in the alleged constitutional
deprivation. In order to prevail on a civil rights claim, a plaintiff must establish that:
(1) the alleged wrongful conduct was committed by a person acting under color of

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state law, and (2) the conduct deprived him of a right, privilege, or immunity secured
by the Constitution or laws of the United States. Nicini v. Morra, 212 F.3d 798, 806
(3d Cir. 2000). It is thus axiomatic that in order to be liable under § 1983, a
defendant must have had actual personal involvement in the alleged wrongdoing.
Rode v. Dellarciprete, 845 F.2d 1195, 1207-08 (3d Cir. 1988). Such personal
involvement may be shown through allegations of personal direction or actual
knowledge and acquiescence.

Id.

To prove personal involvement through

acquiescence requires that a plaintiff demonstrate that the defendant had
contemporaneous knowledge of the alleged wrongdoing, and actual supervisory
authority over the alleged violator. Robinson v. Pittsburgh, 120 F.3d 1286, 1293-94
(3d Cir. 1997). Thus, section 1983 liability cannot be predicated upon the application
of respondeat superior. Rode, 845 F.2d at 1207-08.
D.

Monell Liability Likewise May Not Be Predicated on Principles of
Respondeat Superior

Municipalities and private corporations that contract with the state to provide
services cannot be subjected to liability under § 1983 on the basis of respondeat
superior. See Natale v. Camden County Corr. Facility, 318 F.3d 575, 583-84 (3d Cir.
2003); see also Monell v. Dep’t of Soc. Servs., 436 U.S. 658, 691-94 (1978) (holding
that a municipality cannot be liable under § 1983 on a theory of respondeat superior).

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Instead, in order to hold a private corporation liable under § 1983, a plaintiff must
prove that he suffered a constitutional deprivation as a result of an official corporate
policy or custom. Natale, 318 F.3d at 583-84; see also Bd. of the County Comm’rs
v. Brown, 520 U.S. 397, 404 (1997); Griggs v. Dauphin County Prison, No. 1:060823; 2008 WL 2518090, at *4 (M.D. Pa. June 19, 2008); Miller v. City of Phila., No.
96-3578, 1996 U.S. Dist. LEXIS 17514, 1996 WL 683827, at *4 (E.D. Pa. Nov. 26,
1996) (in order to establish liability for a private corporation, a plaintiff must show
that the corporation, “with ‘deliberate indifference to the consequences, established
and maintained a policy, practice or custom which directly caused [plaintiff’s]
constitutional harm.’”) (quoting Stoneking v. Bradford Area Sch. Dist., 882 F.2d 720,
725 (3d Cir. 1989)). As the Third Circuit has explained, a
policy or custom can be established in two ways. Policy is
made when a “decisionmaker possessing final authority to
establish municipal policy with respect to the action”
issues an official proclamation, policy, or edict. A course
of conduct is considered to be a “custom” when, though
not authorized by law, “such practices of state officials
[are] so permanent and well-settled” as to virtually
constitute law.
Beck v. City of Pittsburgh, 89 F.3d 966, 971 (3d Cir. 1996) (quoting Andrews v. City
of Philadelphia, 895 F.2d 1469, 1480 (3d Cir. 1990)). Custom may also be

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established by evidence that demonstrates knowledge or acquiescence. Beck, 89 F.3d
at 971 (citing Fletcher v. O’Donnell, 867 F.2d 791, 793 (3d Cir. 1989)).
The law is similar with respect to municipal liability. Following Monell, a
local government cannot be sued pursuant to § 1983 for injuries inflicted solely by
its employees. 436 U.S. at 694. Instead, local governments may be held liable under
this statute only for “their own illegal acts.” Connick v. Thompson, – U.S. –, 131 S.
Ct. 1350, 1359 (2011). The Third Circuit has recognized that local governments may
be liable in three circumstances:
First, the municipality will be liable if its employee acted pursuant to a
formal government policy or a standard operating procedure long
accepted within the government entity; second, liability will attach when
the individual has policy making authority rendering his or her behavior
an act of official government policy; third, the municipality will be
liable if an official with authority has ratified the unconstitutional
actions of a subordinate, rendering such behavior official for liability
purposes.
McGreevy v. Stroup, 413 F.3d 359, 367 (3d Cir. 2005).
E.

Plaintiff’s Claims Against Dr. Hoffman Are Sufficient to State a
Claim under Section19834

Initially, it appears that Dr. Hoffman may have been named because he holds
some kind of supervisory responsibility within PrimeCare Medical, or is responsible
It appears the plaintiff has dropped her Eighth Amendment claims against
Warden DeRose, and is instead now attempting to pursue them only as to Dr.
Hoffman and PrimeCare.
4

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for supervising other medical providers at the prison. The complaint contains few
allegations to show that Dr. Hoffman was personally involved in Mason’s care.
However, upon consideration, we find that the plaintiff has alleged marginally
sufficient facts in her second amended complaint to permit her to survive Dr.
Hoffman’s motion to dismiss at this stage.
Indeed, the plaintiff all but concedes the point in the amended complaint itself
because she has made few allegations regarding Dr. Hoffman other than to note that
he is a Medical Director at PrimeCare, and thus evidently a supervisor of some kind
with that entity. However, we note that plaintiff alleges that Dr. Hoffman and others
“were aware that decedent Monique N. Mason had been diagnosed on April 28, 2011,
with a colloid cyst in the third ventricle of her brain, small lateral ventricles,
calcification of the pineal gland as well as possible Chiari malformation.” (Second
Am. Compl., ¶ 19.) The plaintiff has alleged that in addition to having intake records
showing this serious diagnosis and condition (id. ¶¶ 22-23), the defendants were
becoming increasingly aware that the decedent’s headaches were more frequent and
severe during her incarceration (id. ¶ 24). Despite knowing of Ms. Mason’s diagnosis
of having a colloid cyst and other brain abnormalities, and despite her medical history
not indicating a problem with migraine headaches, the plaintiff alleges that the
medical defendants, including Dr. Hoffman, prescribed symptomatic care with
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Topomax rather than assessing or treating her actual neurological problems of which
they were already aware. (Id. ¶¶ 27-29.)
The plaintiff further alleges that the “defendants”, including Dr. Hoffman, were
aware that in February 2013, that Ms. Mason had suffered another syncopal event, but
“again refused and delayed treatment of Monique Mason’s increasingly serious and
potentially life-threatening condition in spite of their knowledge that her condition
was deteriorating.” (Id. ¶ 31.) The plaintiff also alleges that Ms. Mason’s condition
was obvious and potentially fatal, and yet the defendants refused to treat her. (Id. ¶
32.) Prior to Ms. Mason’s death on March 2, 2013, it is alleged that she on numerous
occasions reported to the PrimeCare Medical staff that her headaches were severe and
worsening. (Id. ¶ 40.) Despite these complaints, and what are described as
“accelerating symptoms,” it is alleged that the defendants, including Dr. Hoffman,
took no action to determine the cause of her condition or to provide “effective and
adequate medical treatment for decedent.” (Id. ¶ 43.) The plaintiff also alleges that
the medical defendants, including Dr. Hoffman, withheld the care that Ms. Mason
manifestly needed because they did not want to expend the funds necessary to pay for
treatment by an outside provider, since Ms. Mason was simply a parole violator, since
the defendants wanted to wait to see if she would be released so that they would not
need to incur further costs. (Id. ¶ 45.)
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Upon review of the allegations in the second amended complaint, we find that
there are relatively few allegations that point to specific, personal involvement on the
part of Dr. Hoffman. However, upon consideration, we conclude that the foregoing
highlighted factual averments in this case, which is predicated on a deliberate denial
of medical care by Dr. Hoffman and PrimeCare as the third-party medical services
provider for Dauphin County Prison and its inmates, are sufficient to allow the second
amended complaint to survive a motion to dismiss. Whether these claims ultimately
can be proven remains to be seen, and the parties will be directed to engage in
specific and targeted discovery that is intended to discover what Dr. Hoffman’s
personal, individual role was with respect to Ms. Mason and her treatment, or lack
thereof, prior to her death. But we will not dismiss these claims prior to the parties
having an opportunity to test these claims through discovery.
F.

Plaintiff’s Claims Against PrimeCare Medical Will Be Permitted to
Proceed

In her prior pleadings, the plaintiff overlooked the fact that claims for
municipal or corporate liability in the § 1983 context expressly may not be predicated
on respondeat superior or vicarious liability. Nevertheless, that was precisely the
basis for liability that the plaintiff asserted in her initial and first amended complaint
with respect to her claims for municipal and corporate liability against Dauphin

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County, its Commissioners, and PrimeCare Medical. This is legally improper, and
these claims were accordingly dismissed without prejudice. In our prior order, we
noted despite some conclusory allegations regarding corporate policies, it was clear
that the plaintiff was mistakenly presenting her claims on a legally untenable theory
of vicarious liability, and explicitly including allegations that said precisely that.
In the latest iteration of the complaint, the plaintiff has pared this claim back
and brings it against PrimeCare Medical alone. (Second Am. Compl., Count I.)
Although the plaintiff continues to include allegations about PrimeCare’s role as an
agent, servant or employee of Dauphin County Prison, she has now alleged with
some specificity that PrimeCare failed in a number of specific ways to provide
necessary medical care to Ms. Mason’s known and serious medical conditions (id. ¶¶
49(a)-(h)), and also alleges that PrimeCare had inadequate protocols, rules or
procedures for addressing brain anomalies like those suffered by Ms. Mason. Like
the allegations against Dr. Hoffman, these allegations are somewhat thin and border
on conclusory; however, we find that the plaintiff’s narrowing of her claims, and the
allegations regarding the policies of PrimeCare Medical, and its alleged lack of
sufficient protocols and procedures for dealing with Ms. Mason’s ultimately fatal
condition, are sufficient to allow this Monell claim to proceed past a motion to
dismiss so that the parties can undertake discovery focused on PrimeCare’s policies
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and procedures, so that a determination may be made about whether there is sufficient
factual support for the plaintiff’s claims of corporate liability under 42 U.S.C. § 1983.
G.

Plaintiff’s Municipal Liability Claims Against the Non-Medical
Defendants Must Be Dismissed

Finally, the defendants have moved to dismiss the plaintiff’s state-law claims
seeking recovery for wrongful death pursuant to Pennsylvania’s wrongful death and
survival act statutes. The municipal defendants, including Dauphin County and its
Commissioners, argue that they are entitled to immunity from these claims pursuant
to the Pennsylvania Political Subdivision Tort Claims Act (“PSTCA”), 42 Pa. Cons.
Stat. Ann. §§ 8501 et seq. For her part, the plaintiff disregards this argument in her
brief and has not disputed this defense.
The PSTCA provides immunity for the Commonwealth’s political
subdivisions, such as municipalities, except under limited circumstances that are
defined by statute.5 Pursuant to Section 8541 of the PSTCA, “[e]xcept as otherwise
provided in this subchapter, no local agency shall be liable for any damages on
The exceptions include: (i) the operation of motor vehicles; (ii) the care,
custody or control of personal property; (iii) the care, custody or control of real
property; (iv) a dangerous condition of trees, traffic controls and street lighting;
(v) a dangerous condition of stream, sewer, gas or electric systems; (vi) a
dangerous condition of streets; (vii) a dangerous condition of sidewalks; and (viii)
the care, custody and control of animals. 42 Pa. Cons. Stat. Ann. § 8542(b).
These exceptions must be strictly construed. Lindstrom v. City of Corry, 763 A.2d
394 (Pa. 2000).
5

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account of any injury to a person or property caused by any act of the local agency or
an employee thereof or any other person.” 42 Pa. Cons. Stat. Ann. § 8251. Dauphin
County is a local agency within the meaning of the PSTCA. Francis ex rel. Estate of
Francis v. Northumberland County, 636 F. Supp. 2d 368, 401 n.72 (M.D. Pa. 2009).
Likewise, a prison board and county board of commissioners also constitute local
agencies within the purview of the PSTCA, and are thus entitled to immunity from
liability for any alleged negligence on their part that allegedly resulted in Ms.
Mason’s death. Damron v. Smith, 616 F. Supp. 424, 426 (E.D. Pa. 1985); Holloway
v. Brechtse, 279 F. Supp. 2d 613 (E.D. Pa. 2003) (under PSTCA, municipal agencies’
immunity from liability for all state law tort claims extends to municipal offers acting
in their official capacities). The PSTCA also provides that “[a]n employee of a local
agency is liable for civil damages on account of any injury to a person or property
caused by acts of the employee which are within the scope of his office or duties only
to the same extent as his employing local agency and subject to the limitations
imposed by this subchapter.” 42 Pa. Cons. Stat. Ann. 8545. What this means, in
practice, is that “the liability of local agency employees cannot exceed the liability
of their employing agency.” Francis ex rel. Estate of Francis v. Northumberland
County, 636 F. Supp. 2d 368, 401 (M.D. Pa. 2009) (quoting Pettit v. Namie, 931 A.2d
790, 798 (Pa. Commw. Ct. 2007)).
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Wrongful death and survivor act claims “‘are not substantive causes of action;
rather, they provide a means of recovery for unlawful conduct that results in death.’”
Henderson v. City of Phila., No. 12-2602, 2012 WL 3024033, at *2-3 (E.D. Pa. July
23, 2012) (quoting Sullivan v. Warminster Twp., No. 07-4447, 2010 WL 2164520,
at *6 (E.D. Pa. May 27, 2010)). Wrongful death and survivor actions are claims that
sound in tort under Pennsylvania law, and are governed by the PSTCA. Id.; see also
Marks v. Phila. Indus. Corr. Ctr., 2014 WL 5298008, at *4 (E.D. Pa. Oct. 15, 2014);
Costobile-Fulginiti v. City of Phila., 719 F. Supp. 2d 521, 525 (E.D. Pa. 2010) (“Both
of these claims sound in tort and are governed by the [PSTCA].”); Bomstad ex rel.
Estate of Bomstad v. Honey Brook Twp., No. 03-3822, 2005 WL 2212359, at *22
n.53 (E.D. Pa. Sept. 9, 2005). Neither wrongful death nor survivorship actions fall
within the eight enumerated exceptions to the broad immunity provided, and thus the
municipal defendants are immune from these state-law tort claims, and the claims
against these defendants will be dismissed. See Francis, 636 F.Supp. 2d at 401-02.
The medical defendants do not argue that they are entitled to the immunity
conferred under the PSTCA, but instead reiterate their view that the plaintiff has not
articulated a viable federal cause of action against them, and, therefore, urge the
Court to decline to exercise supplemental jurisdiction under 28 U.S.C. § 1367. The
medical defendants make no other substantive argument in favor of dismissal. We
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have already found that the plaintiff has sufficiently stated Eighth Amendment claims
against Dr. Hoffman and PrimeCare Medical, and, therefore, decline to embrace the
defendants’ argument that the tort claims should be dismissed at this time for lack of
supplemental jurisdiction. Whether the plaintiff is able to develop sufficient evidence
to support her tort claims, and her constitutional claims, may be tested following
discovery through summary judgment motions practice, if warranted.
VI.

ORDER
Accordingly, for the reasons explained above, IT IS HEREBY ORDERED

THAT the defendants’ motion to dismiss the amended complaint (Doc. 38.) is
GRANTED in part and DENIED in part. The motion is DENIED with respect to the
plaintiff’s claims against Dr. Hoffman and PrimeCare Medical. The motion is
GRANTED with respect to the remaining defendants.
So ordered this 5th day of November 2015.

/s/ Martin C. Carlson
Martin C. Carlson
United States Magistrate Judge

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