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Egge v. County of Santa Clara

United States District Court, N.D. California, San Jose Division

May 7, 2018

MELISSA EGGE, Plaintiff,
COUNTY OF SANTA CLARA, et al., Defendants.



         Plaintiff Melissa Egge, M.D., a Suspected Child Abuse and Neglect (“SCAN”) physician, filed this lawsuit after her termination from Santa Clara Valley Medical Center (“VMC”) in the aftermath of a child's death. Dr. Egge claims that her supervisor, Dr. John Stirling, failed to contact Child Protective Services (“CPS”) about a two-year-old boy who came in with multiple bone fractures despite his obligation (and express promise) to do so, and that Dr. Egge was made a scapegoat when the boy died of abuse several months later. She sues Santa Clara County, VMC, and senior County and VMC officers (collectively, “County Defendants”) for federal constitutional violations under 42 U.S.C. § 1983 and for violations of California state law. She also sues Dr. Stirling for violations of state law.

         Both the County Defendants and Dr. Stirling move to dismiss the first amended complaint (“FAC”) under Federal Rule of Civil Procedure 12(b)(6). For the reasons discussed below, the Court GRANTS the County Defendants' motion to dismiss Dr. Egge's federal constitutional claims without leave to amend and declines to exercise supplemental jurisdiction over Dr. Egge's state law claims, which are DISMISSED without leave to amend and without prejudice.

         I. BACKGROUND[1]

         Dr. Egge began working for VMC as a Child Abuse Pediatrician in July 2011. FAC ¶ 17, ECF 54. She reported to Dr. Stirling, the Director of the Center for Child Protection at VMC. Id. ¶ 20. Dr. Egge and Dr. Stirling were the only SCAN physicians at VMC and they were alternately on call for child abuse issues. Id. ¶ 21. Both Dr. Egge and Dr. Stirling reported to Dr. Stephen Harris, the Chair of the Department of Pediatrics. Id. ¶ 20.

         In the early morning hours of July 4, 2015, Dr. Egge was called by a VMC intern about a two-year-old child who had come in with “bilateral supracondylar fractures, ” that is, fractures just above the elbow joint on both arms.[2] FAC ¶ 23. The child had been transported from another local hospital, O'Connor Hospital, due to concerns about non-accidental trauma and orthopedic management. Id. The child's mother said that he was injured when he slipped and fell backward on both his outstretched hands, which - as Dr. Egge informed the intern - was not a pattern of injury typical for non-accidental trauma. Id. Dr. Egge told the intern that if the O'Connor doctors suspected abuse, they should make a report. Id. Dr. Egge was not asked to see the child or perform an inpatient consultation, and she went off call later that morning. Id. ¶ 24.

         Other VMC doctors discovered that the child actually had more bone fractures than originally thought, and orthopedic surgery was performed over the July 4th weekend. FAC ¶ 25. Dr. Stirling consulted on the case while the child was inpatient at VMC, but he did not report suspected abuse and the child was discharged to go home with his mother. Id.

         During a review of the case months later, the Orthopedic Review Committee became concerned that a report to CPS was warranted. FAC ¶ 26. Dr. Egge was asked to do a supplemental review of the case, as Dr. Stirling was the assigned SCAN consulting doctor. Id. ¶ 26. Upon review of the child's records, Dr. Egge discovered that he had suffered four fractures, not the two of which she had been informed during the telephone consultation. Id. ¶ 27. Given that information, Dr. Egge reported to Dr. Harris that a CPS report should have been made. Id. Dr. Harris asked Dr. Egge to speak to Dr. Stirling, which she did on November 17, 2015, and at that time Dr. Stirling agreed to file a CPS report. Id.

         On December 22, 2015, before leaving on a week-long vacation, Dr. Egge checked in with Dr. Stirling to make sure he had made the CPS report. FAC ¶ 29. Dr. Stirling stated that he had forgotten to make the report but he promised to do so that evening. Id. In fact, Dr. Stirling did not make a report, and the child died in January 2016, apparently from physical and sexual abuse. Id. When Dr. Egge learned of the death in February 2016, she checked the hospital's records and found that Dr. Stirling had placed a note in the child's chart on December 24, 2015 indicating that a CPS report was not warranted. Id. ¶ 30. Dr. Egge contacted Dr. Harris to inform him of the child's death and Dr. Stirling's failure to make a CPS report. Id. ¶ 32. During that conversation, Dr. Egge voiced her concerns about the failure to report in that specific child's case and also about VMC's policies and procedures in general. Id. ¶¶ 32-34.

         On March 11, 2016, Dr. Egge was put on administrative leave. FAC ¶ 35. On April 21, 2016, the Medical Executive Committee of VMC recommended a 6-month summary suspension of Dr. Egge's clinical privileges and medical staff memberships. Id. The next day, April 22, 2016, Dr. Egge was fired by Dr. Jeffrey Smith, the County Executive. Id. Dr. Phuong Nguyen, VMC's Chief of Staff, reported Dr. Egge to the Medical Board of California. Id. ¶ 37. Although state law requires reporting of suspensions only if they total at least 15 days, Dr. Nguyen reported Dr. Egge for what was effectively a 1-day suspension. Id. Dr. Egge believes that Dr. Nguyen reported her as punishment for voicing her concerns about VMC's policies and practices. Id. ¶ 39. The County also disseminated false information to the press in an effort to deflect criticism from VMC's deficient procedures. Id. ¶ 43. Subsequent articles published in the San Jose Mercury News contained inaccurate statements that Dr. Egge was fired for failing to report abuse of a toddler and for failing to act as required by law. Id. ¶¶ 41-42.

         Dr. Egge appealed her summary suspension and received a Judicial Review Committee (“JRC”) hearing. FAC ¶ 50. She claims that the hearing was a staged proceeding which was conducted so that Defendants could avoid liability. Id. Dr. Egge nonetheless prevailed, and the JRC found that her summary suspension was unreasonable. Id. ¶ 51. Despite that finding, Dr. Egge has not regained her good name in the medical profession. Id. She has applied for at least 3 positions in the Bay Area, without success. FAC ¶ 45. She now has a part-time position as a SCAN doctor in Southern California. Id. ¶ 46. She is separated from her husband and children for several days each week when she flies to Southern California for work. Id.

         Dr. Egge filed this action on May 17, 2017 against the County, VMC, Dr. Smith, Dr. Nguyen, and Dr. Stirling. The Court granted Defendants' Rule 12(b)(6) motions to dismiss the original complaint with leave to amend. Dr. Egge subsequently filed the operative FAC, asserting the following claims: (1) a § 1983 claim for “Stigma-Plus” against the County Defendants; (2) a § 1983 claim for deprivation of Substantive Due Process against the County Defendants: (3) breach of written contract against the County and VMC; (4) breach of oral contract against the County, VMC, and Dr. Stirling; (5) promissory estoppel against the County, VMC, and Dr. Stirling; and (7) violation of California Labor Code § 1102.5 against the County and VMC.[3] The FAC alleges that the Court has federal question jurisdiction with respect to the § 1983 claims and supplemental jurisdiction with respect to the state law claims. FAC ¶ 1.


         “A motion to dismiss under Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim upon which relief can be granted ‘tests the legal sufficiency of a claim.'” Conservation Force v. Salazar, 646 F.3d 1240, 1241-42 (9th Cir. 2011) (quoting Navarro v. Block, 250 F.3d 729, 732 (9th Cir. 2001)). While a complaint need not contain detailed factual allegations, it “must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.'” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 ...

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