Healthcare professionals working in an emergency department see and treat a vast array of patients with unique conditions each and every shift. With few exceptions, emergency providers must treat and stabilize all patients who enter their facility with an emergency medical condition.[1] Under the Emergency Medical Treatment and Labor Act, a “emergency medical condition” is defined as  “a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual’s health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs.”[2] Chances are, for a variety of reasons, during any given shift a patient will present to the emergency department in the custody of law enforcement, and the provider will receive the relevant and necessary background information needed to treat the patient from law enforcement. But treating a patient in custody and taking some direction from law enforcement can possibly transform the provider’s care into a state action. In this instance, a healthcare professional’s treatment may be colorable under state law and the individual could share liability with law enforcement for violating a patient’s civil rights by conducting, directing, approving, supervising, or allowing an unlawful bodily search. Medical professionals in an emergency department must understand how they can treat their patients without fear of unknowingly undertaking a duty of the state and, thus, becoming a target of civil rights complaints.

A patient can maintain a claim for a violation of his or her civil rights against a private medical professional acting under the color of state law.[3] To determine whether a private party acts under the color of state law, the court must find a “close nexus between the State and the challenged action” so that the challenged action “may be fairly treated as that of the State itself.”[4] The ultimate question is whether the alleged violation of constitutional rights is “fairly attributable to the State.”[5] This does not mean that any time a patient in the custody of law enforcement is provided treatment that the treating provider is conducting a state action.[6]

For example, an individual may present to the emergency department in custody after being detained on a suspicion of operating a vehicle under the influence of alcohol or drugs. It would be standard procedure to collect a blood and/or urine sample to determine what drugs or alcohol the patient consumed because alcohol and drug consumption increases the patient’s risk of medical emergencies.[7] While law enforcement may have informed the emergency medical professional of the possibility that the patient consumed drugs or alcohol and they cannot admit him to jail in this condition, the emergency medical professional chooses the medically appropriate course of action. Law enforcement does not require the emergency medical professional to follow their orders.

Emergency medical professionals cannot and should not bear additional liabilities by virtue of performing their medical duties and treating a patient who happens to present to the emergency department in the custody of the law enforcement, a.k.a. the State.[8] Providers must be able to treat their patients without fear or violating someone’s constitutional rights. LGK attorneys recently won summary judgment dismissing civil rights claims brought by a detainee against a private emergency department physician[9], however defending these claims is a very fact specific process. If you are facing issues regarding your medical treatment of a prisoner, detainee, or other individual in the custody of law enforcement, contact LGK so we can help defend your reputation today.

[1] See 42 U.S.C. § 1395dd.

[2] 42 U.S.C. § 1395dd(e)(1).

[3] Rodriguez v. Plymouth Ambulance Serv., 577 F.3d 816, 822 (7th Cir. 2009).

[4] Jackson v. Metro. Edison Co., 419 U.S. 345, 351, 95 S. Ct. 449, 42 L. Ed. 2d 477 (1974).

[5] Rendell-Baker v. Kohn, 457 U.S. 830, 838, 102 S. Ct. 2764, 73 L. Ed. 2d 418 (1982) (citation omitted).

[6] “[P]rivate organizations and their employees that have only an incidental and transitory relationship with the state’s penal system usually cannot be said to have accepted, voluntarily, the responsibility of acting for the state and assuming the state’s responsibility for incarcerated persons.” Rodriguez, 577 F.3d at 827.

[7] See Brown v. Rader, No. 15-cv-238-pp, 2018 U.S. Dist. LEXIS 57885 (E. D. Wis. Mar. 30, 2018).

[8] “To the degree that a private entity does not replace, but merely assists the state in the provision of health care to prisoners, the private entity’s responsibility for the level of patient care becomes more attenuated, and it becomes more difficult to characterize its actions as the assumption of a function traditionally within the exclusive province of the state.”  Rodriguez, 577 F.3d at 828.

[9] Pierce v. Calumet Cnty., No. 21-C-354, 2022 U.S. Dist. LEXIS 203060 (E.D. Wis. Nov. 8, 2022)