United States District Court, M.D. Pennsylvania
K.S. and J.H., Plaintiffs
PAT J. BRUNO, M.D., and EVAN WALLACE CROWE, M.D., Defendants
the Court are (1) Defendants Patrick J. Bruno, M.D., and Evan
Wallace Crowe, M.D. (the “Medical Defendants”)
motion to dismiss Plaintiffs K.S. and J.H.'s complaint
pursuant to Federal Rule of Civil Procedure 12(b)(6) (Doc.
No. 13), and (2) the Medical Defendants' and Non-Party
Geisinger Health's motion for a protective order (Doc.
No. 19). For the following reasons, the Court will grant the
Medical Defendants' motion to dismiss, and deny the
pending motion for a protective order as moot.
case arises out of a child abuse investigation that resulted
in B.H.'s temporary removal from the custody of his
mother, Plaintiff K.S. B.H. is a minor born in 2012. (Doc.
No. 1 ¶ 3.) Plaintiff K.S. is the biological mother of
B.H., and D.H. is B.H.'s biological father.
(Id.) In 2015, when the events giving rise to this
action occurred, Plaintiff K.S. resided with her boyfriend,
Plaintiff J.H., and by agreement with D.H., had primary
custody of B.H. (Id. ¶¶ 24, 26.) D.H. had
visitation rights with B.H. (Id.)
has a medical history of bruising and ear pulling.
(Id. ¶ 13.) On January 29, 2013, Geisinger
Health pediatrician Dr. Christopher Severs examined B.H. at
his one-year well child visit, and noted K.S.'s concern
that B.H. was “picking at his ears a lot . . .”
(Id. ¶ 17.) Subsequently, on February 25, 2013,
Geisinger Health pediatrician Dr. Joseph Romeo examined B.H.
and noted that he was “pulling on [his] ear and
fussy.” (Id. ¶ 18.) Dr. Severs again
examined B.H. on May 13, 2013 for complaints of ear pulling.
(Id. ¶¶ 29-30.) In February 2015, B.H.
fell down a set a steps while in the care of K.S., causing
red marks to his buttocks. (Id. ¶ 28.) While
B.H. was visiting with D.H. over the weekend, D.H. noticed
bruising on B.H.'s buttocks and called Mifflin County
Children and Youth Services (“Children and Youth
Services”), to report that J.H. had abused B.H.
(Id. ¶¶ 29-30.)
at the request of Children and Youth Services, K.S. took B.H.
to the Geisinger Health pediatrician's office in
Lewistown (“Geisinger Health pediatrician's
office”), where it was noted that B.H. had bruising on
his buttocks and back. (Id. ¶¶ 31-32.) The
medical records note that K.S. claimed the bruising resulted
from a fall; however, D.H. believed the bruising was the
result of physical abuse. (Id. ¶ 32.) At the
time, there was no documented history of requests for records
from Children and Youth Services, visits for accidents or
injuries, or a history of “no shows” to the
pediatrician. (Id. ¶ 34.)
August 1, 2015, B.H. fell off the porch at his home and
thereafter visited the emergency room. (Id.
¶¶ 35-36.) The medical records for this visit note
a laceration on his scalp and old bruising to his posterior
flank. (Id. ¶ 37.) On August 14, 2015, K.S.
took B.H. to the Geisinger Health pediatrician's office
for an examination, at which time the pediatrician noted that
B.H. had new bruising on his back, which was not present
after the previous incident and that there was concern
because the bruising was getting darker. (Id. ¶
39.) At that appointment, the Geisinger Health pediatrician
ordered a CBC blood test, which revealed that B.H.'s
hemoglobin and hematocrit levels were higher than the normal
range. (Id. ¶ 40.)
August 18 and 23, 2015, K.S. took B.H. back to see Geisinger
Health pediatrician Dr. Severs who examined him for follow up
care for vomiting and bruising. (Id. ¶¶
41, 43.) Thereafter, K.S. took B.H. to the Geisinger Health
pediatrician's office on August 26, 2015, and to the
emergency room on August 27, 2015, for symptoms of diarrhea
and vomiting. (Id. ¶¶ 45-46.) On August
27, 2015, a CT scan of B.H.'s head was performed to rule
out head trauma as the cause of B.H.'s vomiting; the scan
was normal. (Id. ¶ 47.) However, on August 28,
2015, K.S. again took B.H. to the emergency room for
continued vomiting. (Id. ¶ 48.)
October 2, 2015, K.S. took B.H. to the Geisinger Health
pediatrician's office at the request of Children and
Youth Services, who was investigating a report of suspected
abuse due to bruising observed on both of B.H.'s
earlobes. (Id. ¶ 49.) At the time, Dr. Severs
noted that B.H. had no family history of bleeding disorders,
and when asked how his ears were injured, answered
“[J.H.] did it.” (Id. ¶ 51.) On
October 9, 2015, K.S. took B.H. to the Geisinger Health
pediatrician's office to request a bleeding work-up due
to the repeated bruising. (Id. ¶ 52.)
Accordingly, Dr. Severs ordered a screening consisting of
three tests, the PT/INR-PT, PT/INR-INR & APTT, the
results of which were within the normal range. (Id.
¶ 53.) On October 12, 2015, K.S. again took B.H. to the
Geisinger Health pediatrician's office because B.H. fell
on a step, hitting his head and bruising his knees.
(Id. ¶¶ 55-56.)
December 1, 2015, another report of suspected child abuse was
made in connection with bruising on B.H.'s right ear, and
Children and Youth Services instructed K.S. to take B.H. to
the pediatrician. (Id. ¶¶ 58-59.) The
Geisinger Health pediatrician's subsequent report to
Children and Youth Services indicated that the bruises did
not appear consistent with K.S.'s explanation that B.H.
was bruised as a result of falling off a trampoline, and in
light of the history of B.H.'s visits to the pediatrician
for bruising, stated the suspicion that “something is
going on.” (Id. ¶¶ 62-63.) On that
same date, Detective Poff and Officer Vallimont of the
Lewistown Police Department were called to the Geisinger
Health pediatrician's office, and Children and Youth
Services at that time: prevented K.S. from leaving with B.H.;
removed B.H. from K.S.'s custody; and imposed a safety
plan precluding K.S. from having unsupervised contact with
B.H. (Id. ¶ 64.) On December 2, 2015, Children
and Youth Services scheduled B.H. for a “CRC
Interview” and an appointment with Dr. Bruno, the
Medical Director of the Geisinger Medical Center's Child
Advocacy Center of Central Susquehanna Valley
(“CACCSV”), as part of their investigation.
(Id. ¶¶ 65, 101-02.)
Bruno and Dr. Crowe both examined B.H. (Id.
¶¶ 70-71.) During the examination, B.H. had
difficulty answering some questions due to his age and
developmental limitations. (Id. ¶¶
108-09.) However, both doctors agreed that no further work-up
for bleeding disorders would be necessary, and diagnosed B.H.
as having been physically abused. (Id.¶¶
70-71.) Dr. Bruno and Dr. Crowe subsequently contacted
Children and Youth Services to provide the results of their
examination. (Id. ¶ 112.) Dr. Crowe informed
Children and Youth Services that the marks on B.H.'s ears
“were not accidental and are consistent with
abuse.” (Id. ¶ 113.) Dr. Bruno and Dr.
Crowe's medical evaluation notes were faxed by Dr. Crowe
to Children and Youth Services on December 4, 2015.
(Id. ¶ 73.) Plaintiffs allege that based on Dr.
Crowe and Dr. Bruno's assessment, Children and Youth
Services continued the existing safety plan. (Id.
¶ 116.) Further, Plaintiffs allege that based on Dr.
Crowe and Dr. Bruno's assessment, on December 14, 2015,
Detective Poff of the Lewistown Police Department charged
J.H. with simple assault. (Id. ¶ 118.)
20, 2016, B.H.'s blood was tested for von
Willebrand's disease, and the results of that testing
indicated that “[a]ll multimeters of von Willebrand
Factor Antigen are present in normal amounts.”
(Id. ¶¶ 135-36.) On or about September 16,
2016, B.H. was retested and diagnosed with type 1 von
Willebrand's Disease. (Id. ¶ 119.) The
testing hemotologist noted in her letter of the same date
that “[p]atients with type 1 von Willebrand disease
typically experience mucosal bleeding as a result of trauma,
” and that “[s]uperficial bleeding is common for
children with bleeding disorders and does not necessarily
mean that they are being physically assaulted.” (Doc.
No. 1-2 at 1.)
on this sequence of events, on January 5, 2017, Plaintiffs
filed a complaint in this Court alleging numerous civil
rights claims against the Medical Defendants as well as
Mifflin County and individual defendants Casey O'Dell,
Kristen Matula, and David. L. Smith, all employees of Mifflin
County Children and Youth Services (collectively, the
“Mifflin County Defendants”). (Doc. No. 1.) Both
sets of defendants filed motions to dismiss Plaintiffs'
complaint on March 7, 2017. (Doc. Nos. 12, 13.) The Medical
Defendants and nonparty Geisigner Health subsequently filed a
motion for protective order on March 24, 2017. (Doc. No. 19.)
the motions to dismiss were fully briefed, this matter was
referred to mediation through the Court-annexed mandatory
mediation program. (Doc. No. 30.) Accordingly, the Court
ordered a stay of discovery pending the resolution of the
mandatory mediation process. (Doc. No. 31.) After a June 14,
2017 status conference, the Court continued the stay of
discovery pending the Court's resolution of the motions
to dismiss. (Doc. No. 36.) Pursuant to the report of the
mediator indicating that Plaintiffs had settled their claims
with the Mifflin County Defendants, on June 27, 2017, the
Court issued a 60-day Order dismissing Plaintiffs' claims
against those defendants, and denying their motion to dismiss
as moot. (Doc. No. 38.) The pending motions are ripe for
motion filed pursuant to Federal Rule of Civil Procedure
12(b)(6) tests the sufficiency of the complaint's factual
allegations. Ashcroft v. Iqbal, 556 U.S. 662, 678
(2009). A complaint must contain “a short and plain
statement of the claim showing that the pleader is entitled
to relief, ” in order to “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) (internal quotation marks omitted)
(interpreting Fed.R.Civ.P. 8(a)). Generally, a court
considering a motion to dismiss pursuant to Federal Rule of
Civil Procedure 12(b)(6) must determine whether the complaint
contains sufficient factual matter, accepted as true, to
“state a claim to relief that is plausible on its
face.” Iqbal, 556 U.S. at 678.
with the Supreme Court's rulings in Twombly and
Iqbal, the Third Circuit requires district courts to
engage in a two-part analysis when reviewing a Rule 12(b)(6)
motion: (1) first, a court should separate the factual and
legal elements of a claim, accepting well-pleaded factual
matter and disregarding legal conclusions; (2) second, a
court should determine whether the remaining well-pled facts
sufficiently demonstrate that a plaintiff has a
“plausible claim for relief.” Fowler v. UPMC
Shadyside, 578 F.3d 203, 210-11 (3d Cir. 2009) (quoting
Iqbal, 556 U.S. at 679). Facial plausibility exists
when the plaintiff pleads factual content “that allows
the court to draw a reasonable inference that the defendant
is liable for the misconduct alleged.” Iqbal,
556 U.S. at 678 (internal citations omitted).
conducting its analysis, a court must accept all well-pleaded
factual allegations in the complaint as true for purposes of
determining whether the complaint states a plausible claim
for relief, and must view the factual allegations in the
light most favorable to the plaintiff. Phillips v. Cty.
of Allegheny, 515 F.3d 224, 231 (3d Cir. 2008). The
court's determination on a Rule 12(b)(6) review is not
whether the non-moving party “will ultimately prevail,
” but whether that party is “entitled to offer
evidence to support the claims.” United States ex
rel. Wilkins v. United Health Grp., Inc., 659 F.3d 259,
302 (3d Cir. 2011) (internal ...