United States District Court, N.D. California, San Jose Division
ORDER GRANTING MOTIONS TO DISMISS FIRST AMENDED
COMPLAINT WITHOUT LEAVE TO AMEND; AND DISMISSING ACTION [RE:
ECF 55, 59]
LAB SON FREEMAN, UNITED STATES DISTRICT JUDGE
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.
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.
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. ¶
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. 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.
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.
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.
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.
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. ¶¶
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.
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. 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.
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 ...