Rice v. Prime Care Medical Inc.

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF MARYLAND

*

CRYSTAL RICE, *

*

Plaintiff, *

* Civ. No. MJM-23-2344

v. *

*

CECIL COUNTY, MARYLAND, et. al., *

*

Defendants. *

*

* * * * * * * * * *

MEMORANDUM OPINION

Plaintiff Crystal Rice (“Plaintiff”), in her individual capacity and as Personal

Representative of the Estate of Cynthia Rice (“Ms. Rice”), brings this action against defendants

Cecil County, Maryland (“Cecil County”); PrimeCare Medical, Inc. (“Prime Care”); Scott Adams,

Sheriff of Cecil County (“Sheriff Adams”); sixteen named individual deputy sheriffs who served

as custody officers at Cecil County Detention Center (“CCDC”); seven named individual

employees of PrimeCare; and a number of unnamed individual custody officers at CCDC and

employees of PrimeCare (collectively, “Defendants”). ECF No. 1 (Compl.). Plaintiff alleges

violations of 42 U.S.C. § 1983 and Article 24 of the Maryland Declaration of Rights, negligence,

intentional infliction of emotional distress, wrongful death, respondeat superior, and

indemnification. See generally id. Plaintiff’s claims arise out of Ms. Rice’s death from opioid

withdrawal while in custody at CCDC. Id. ¶¶ 77–78.

Cecil County, Sheriff Adams, and eleven of the named deputy sheriffs (collectively, the

“Custody Defendants”) filed a Motion to Dismiss, or in the Alternative, Motion for Summary

Judgment, or in the Alternative, to Bifurcate and Stay Discovery. ECF No. 24. PrimeCare filed a

Motion to Dismiss for Failure to State a Claim. ECF No. 30.1 Ms. Rice filed responses to both

motions. ECF Nos. 38, 39. The Custody Defendants replied. ECF No. 42.

A hearing is not necessary to resolve the pending motions. See Loc. R. 105.6 (D. Md.

2023). For the following reasons, the Court shall grant in part and deny in part the Custody

Defendants’ Motion to Dismiss and grant PrimeCare’s Motion to Dismiss.

I. FACTUAL BACKGROUND

CCDC is a detention facility located in Elkton, Cecil County, Maryland. ECF No. 1 ¶ 1.

Sheriff Adams “was and is responsible for the care and custody of the detainees and inmates at

CCDC . . . .” Id. ¶ 26. PrimeCare, a Pennsylvania corporation, is a contract provider of medical

services to detainees housed in CCDC. Id. ¶¶ 27, 28.

On August 28, 2020, Cynthia Rice was arrested and detained in Cecil County. Id. ¶ 58. Ms.

Rice was booked into CCDC at 11:09 p.m. Id. ¶ 60. During her booking, she informed the staff,

including both deputy sheriffs and PrimeCare employees, that she was suffering from opiate

withdrawal and rheumatoid arthritis. Id. ¶¶ 12, 61. At her intake medical screening a few hours

after her booking, medical staff noted that Ms. Rice was listed as a heroin addict and had suffered

heroin withdrawal during previous incarcerations. Id. ¶¶ 65a, 65h. Ms. Rice indicated that she used

four bags of heroin a day, seven days a week. Id. ¶ 65i. The medical staff also found that Ms. Rice

showed signs of depression; was anxious, panicked, afraid, or angry; appeared to be on a drug at

the time of the screening; and had poor gums and teeth. Id. ¶¶ 65c–65d, 65j. Ms. Rice informed

1 Although PrimeCare’s motion states that the “Complaint fails to state a claim for relief against

[PrimeCare],” ECF No. 30 at 1, PrimeCare’s brief in support of the motion only argues for dismissal of

Counts I and II, see generally ECF No. 30-1. Therefore, the Court construes the motion as seeking only

partial dismissal of the Complaint—i.e., dismissal as to Counts I and II.

the staff in her screening that she consented to be treated and felt body aches but did not have a

fever. Id. ¶¶ 65k–65l. During her intake screening, Ms. Rice experienced high blood pressure. Id.

¶ 67. She was placed on a “high priority” detox check appointment and was taken back to her cell

at around 3:00 a.m. on August 29. Id. ¶¶ 68–69.

At around 9:00 a.m. on August 29, someone at CCDC put in an order for an opioid detox

and clonidine for Ms. Rice. Id. ¶ 70. At 9:52 a.m., Ms. Rice reported being in pain to a level of ten

out of ten and was prescribed blood pressure medication. Id. ¶ 72. Despite her intake screening

indicating she would need a detox appointment, Ms. Rice was not given any medication for her

withdrawal while in CCDC, nor was she given the prescribed blood pressure medication. Id. ¶¶

71, 74. Throughout the morning of August 29, Ms. Rice remained in pain, screaming, and writhing

around in her cell, but received no assistance from custody staff or medical staff. Id. ¶ 75. Instead,

“medical and custody staff . . . told her to ‘shut up’ while she winced in pain.” Id. ¶ 9. At 12:30

p.m., a deputy found Ms. Rice unresponsive in her cell, and she was later pronounced dead from

opioid withdrawal. Id. ¶¶ 63, 77–78.

II. PROCEDURAL BACKGROUND

Plaintiff brought this action on her own behalf and as personal representative for Ms. Rice’s

estate on August 25, 2023. ECF No. 1. The Complaint alleges eight counts against the various

defendants: (1) violation of 42 U.S.C. § 1983 for denial of medical care in violation of the Eighth

and Fourteenth Amendments, against Custody Defendants, PrimeCare, and certain PrimeCare

employees (“Count I”); (2) violation of 42 U.S.C. § 1983 for a policy and practice of denial of

medical care, against Cecil County and PrimeCare (“Count II”); (3) violation of Article 24 of the

Maryland Declaration of Rights, against all Defendants (“Count III”); (4) negligence, against

Custody Defendants (“Count IV”); (5) intentional infliction of emotional distress, against all

Defendants (“Count V”); (6) wrongful death, against all Defendants (“Count VI”); (7) respondeat

superior, against Cecil County and PrimeCare (“Count VII”); and (8) indemnification, against

Cecil County and PrimeCare (“Count VIII”). See generally ECF No. 1.

On December 27, 2023, Custody Defendants filed a Motion to Dismiss, or in the

Alternative, Motion for Summary Judgment, or in the Alternative, to Bifurcate and Stay Discovery.

ECF No. 24. On February 12, 2024, PrimeCare filed a Motion to Dismiss for Failure to State a

Claim. ECF No. 30. Ms. Rice filed responses to both motions on May 17, 2024. ECF Nos. 38, 39.

On June 18, 2024, Custody Defendants replied. ECF No. 42.

III. STANDARD OF REVIEW

Under Rule 8(a)(2) of the Federal Rules of Civil Procedure, a complaint must contain “a

short and plain statement of the claim showing that the pleader is entitled to relief.” Fed. R. Civ.

P. 8(a)(2). This rule is 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) (cleaned up).

A motion to dismiss under Rule 12(b)(6) constitutes an assertion by a defendant that, even

if the facts alleged by a plaintiff are true, the complaint fails as a matter of law “to state a claim

upon which relief can be granted.” Fed. R. Civ. P. 12(b)(6). To survive a 12(b)(6) motion to

dismiss, a plaintiff must plead enough factual allegations “to state a claim to relief that is plausible

on its face.” Twombly, 550 U.S. at 570. “A claim has facial plausibility when the plaintiff pleads

factual content that allows the court to draw the reasonable inference that the defendant is liable

for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). A complaint need not

include “detailed factual allegations” to satisfy Rule 8(a)(2), but it must set forth “enough factual

matter (taken as true) to suggest” a cognizable cause of action, “even if . . . [the] actual proof of

those facts is improbable and . . . recovery is very remote and unlikely.” Twombly, 550 U.S. at

555–56 (internal quotation marks omitted). Furthermore, federal pleading rules “do not

countenance dismissal of a complaint for imperfect statement of the legal theory supporting the

claim asserted.” Johnson v. City of Shelby, Miss., 574 U.S. 10, 11 (2014) (per curiam). However,

“a plaintiff’s obligation to provide the grounds of his entitlement to relief requires more than labels

and conclusions, and a formulaic recitation of the elements of a cause of action’s elements will not

do.” Twombly, 550 U.S. at 555 (cleaned up). A complaint must contain factual allegations

sufficient “to raise a right to relief above the speculative level.” Id. “[T]ender[ing] ‘naked

assertion[s]’ devoid of ‘further factual enhancement’” does not suffice. Iqbal, 556 U.S. at 678

(quoting Twombly, 550 U.S. at 557) (second alteration in Iqbal).

When considering a motion to dismiss, a court must take the factual allegations in the

complaint as true and draw all reasonable inferences in favor of the plaintiff. King v. Rubenstein,

825 F.3d 206, 212 (4th Cir. 2016). At the same time, “a court is not required to accept legal

conclusions drawn from the facts.” Retfalvi v. United States, 930 F.3d 600, 605 (4th Cir. 2019)

(citing Papasan v. Allain, 478 U.S. 265, 286 (1986)). “A court decides whether [the pleading]

standard is met by separating the legal conclusions from the factual allegations, assuming the truth

of only the factual allegations, and then determining whether those allegations allow the court to

reasonably infer” the defendant’s liability for the alleged wrong and the plaintiff’s entitlement to

the remedy sought. A Society Without a Name v. Virginia, 655 F.3d 342, 346 (4th Cir. 2011), cert

denied, 566 U.S. 937 (2012).

Ordinarily, a court “is not to consider matters outside the pleadings or resolve factual

disputes when ruling on a motion to dismiss.” Bosiger v. U.S. Airways, Inc., 510 F.3d 442, 450

(4th Cir. 2007). However, a court may consider matters outside the pleadings attached to a Rule

12(b)(6) motion. Fed. R. Civ. P. 12(d). If the court does so, “the motion must be treated as one for

summary judgment under Rule 56,” but “[a]ll parties must be given a reasonable opportunity to

present all the material that is pertinent to the motion.” Id.

The Fourth Circuit “has articulated two requirements for proper conversion of a Rule

12(b)(6) motion to a Rule 56 motion: (1) notice and (2) a reasonable opportunity for discovery.”

Canty v. Corcoran, Civ. No. GLR-18-1404, 2022 WL 899278, at *4 (D. Md. Mar. 28, 2022) (citing

Greater Balt. Ctr. for Pregnancy Concerns, Inc. v. Mayor of Balt., 721 F.3d 264, 281 (4th Cir.

2013)). “[W]here the parties have not had an opportunity for reasonable discovery,” summary

judgment is inappropriate. E.I. Du Pont de Nemours & Co. v. Kolon Indus., Inc., 637 F.3d 435,

448–49 (4th Cir. 2011) (citation omitted).2

IV. DISCUSSION

A. Count I

In Count I of her Complaint, Plaintiff asserts a claim under 42 U.S.C. § 1983 for deliberate

indifference to Ms. Rice’s medical needs and failure to provide medical care. ECF No. 1 ¶¶ 79–

94. The Custody Defendants and PrimeCare each move to dismiss this count for failure to state a

claim. ECF Nos. 24-1 at 6–16, 30 at 2–6.

Section 1983 provides a cause of action against any person who, acting under color of state

law, “subjects, or causes to be subjected, any citizen 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” of the United States. 42 U.S.C. § 1983. Thus, to sustain an action under §

1983, a plaintiff must demonstrate that: (1) he suffered a deprivation of “rights, privileges, or

immunities secured by the Constitution and laws” of the United States; and (2) the act or omission

2 Here, the Court finds that, because the parties have had no opportunity for reasonable discovery, it

would be inappropriate to convert Custody Defendants’ motion to dismiss to one for summary judgment.

The Court, therefore, declines to consider the exhibits attached to the motion.

causing the deprivation was committed by a person acting under color of law. West v. Atkins, 487

U.S. 42, 45 n.3 (1988). Liability under § 1983 attaches only upon personal participation by a

defendant in a constitutional violation. See Vinnedge v. Gibbs, 550 F.2d 926, 928 (4th Cir. 1977)

(dismissing claim for willful denial of medical care when plaintiff was unable to show that the

official charged acted personally in the deprivation of rights); Trulock v. Freeh, 275 F.3d 391, 402

(4th Cir. 2001) (“[L]iability is personal, based upon each defendant’s own constitutional

violations.”).

The Due Process Clause of the Fourteenth Amendment “protects pretrial detainees from

‘governmental action’ that is not ‘rationally related to a legitimate nonpunitive governmental

purpose’ or that is ‘excessive in relation to that purpose.’” Short v. Hartman, 87 F. 4th 593, 608–

09 (4th Cir. 2023) (quoting Kingsley v. Hendrickson, 576 U.S. 389, 398 (2015)). A pretrial detainee

may “state a claim under the Fourteenth Amendment, based on a purely objective standard, for

prison officials’ deliberate indifference to excessive risks of harm.” Id. at 604–05.

To state a claim for deliberate indifference to a medical need, the

specific type of deliberate indifference claim at issue in this case, a

pretrial detainee must plead that (1) they had a medical condition or

injury that posed a substantial risk of serious harm; (2) the defendant

intentionally, knowingly, or recklessly acted or failed to act to

appropriately address the risk that the condition posed; (3) the

defendant knew or should have known (a) that the detainee had that

condition and (b) that the defendant’s action or inaction posed an

unjustifiably high risk of harm; and (4) as a result, the detainee was

harmed.

Id. at 611. It is “not enough for the plaintiff to allege that the defendant negligently or accidentally

failed to do right by the detainee.” Id. at 611–12.

The Court finds that Plaintiff adequately states a § 1983 claim against the individual

Custody Defendants for deliberate indifference to Ms. Rice’s medical needs. Plaintiff alleges that,

while in custody at CCDC on August 29, 2020, Ms. Rice suffered opioid withdrawal, a medical

condition that posed a substantial risk of serious harm. ECF No. 1 ¶¶ 6, 7, 11, 82. She further

alleges that, when Ms. Rice was booked into CCDC on August 28, Ms. Rice told both custody

staff and medical staff that she had recently used opiates and would undergo withdrawal, and she

began exhibiting obvious symptoms of withdrawal. Id. ¶¶ 12, 59, 61. “Medical records indicate

that the medical staff and custody staff were made aware that Ms. Rice would suffer withdrawal.”

Id. ¶ 8. On the morning of August 29, she “screamed and writhed in pain” from withdrawal, and

“[t]he custody staff at CCDC told her to ‘shut up’” without providing assistance. Id. ¶¶ 9, 75.

Plaintiff alleges that each individual Custody Defendant was “made aware of Ms. Rice’s condition

by observing it themselves, by being informed of her condition by other detainees in the facility,

and by being informed by other employees and personnel of Prime Care and the CCDC.” Id. ¶ 84.

Thus, Ms. Rice’s condition was known or should have been known to each individual Custody

Defendant. Id. Plaintiff further alleges that each individual Custody Defendant “failed to respond”

to Ms. Rice’s requests for medical attention despite their knowledge of Ms. Rice’s medical needs

and “despite knowing that a failure to address opioid withdrawal with immediacy and urgency can

cause serious pain, significant injury and death.” Id. ¶ 82. The foregoing allegations suffice to state

a claim for deliberate indifference in violation of Ms. Rice’s due process rights.3

3 The individual Custody Defendants argue that they are entitled to qualified immunity for alleged

violations of Ms. Rice’s constitutional rights. ECF No. 24-1 at 15. “Qualified immunity bars § 1983 actions

against government officials in their individual capacities ‘unless (1) they violated a federal statutory or

constitutional right, and (2) the unlawfulness of their conduct was clearly established at the time.’” Barrett

v. Pae Gov’t Servs., Inc., 975 F.3d 416, 428 (4th Cir. 2020) (quoting D.C. v. Wesby, 583 U.S. 48, 62–63

(2018)).

Here, Ms. Rice had a clearly established right to medical treatment for her serious medical

condition. See Tarashuk v. Givens, 53 F.4th 154, 163 (4th Cir. 2022) (“[A] prisoner’s right to adequate

medical care and freedom from deliberate indifference to medical needs has been clearly established by the

Supreme Court and this Circuit since at least 1976.”) (quoting Scinto v. Stansberry, 841 F.3d 219, 236 (4th

Cir. 2016)). Plaintiff alleges that individual Custody Defendants violated that clearly established right. See

Plaintiff concedes in her response to Custody Defendants’ motion that Count I is

inapplicable to Cecil County. ECF No. 38 at 10. Accordingly, Count I shall be dismissed as to

Cecil County.

Count I shall also be dismissed as to PrimeCare. “[A] private corporation is liable under §

1983 only when an official policy or custom of the corporation causes the alleged deprivation of

federal rights.”4 Austin v. Paramount Parks, Inc., 195 F.3d 715, 728 (4th Cir. 1999) (citations

omitted). Notably, there is no respondeat superior liability under § 1983, so PrimeCare is not liable

under § 1983 for the conduct of its employees. See Love-Lane v. Martin, 355 F.3d 766, 782 (4th

Cir. 2004); Vinnedge, 550 F.2d at 928.

In sum, Defendants’ motions shall be granted as to the claims in Count I against Cecil

County and PrimeCare, which shall be dismissed with prejudice. The motions will be denied as to

the claims in Count I against the individual Custody Defendants.5

B. Count II

In Count II of her Complaint, Plaintiff asserts a claim under § 1983 that Cecil County and

PrimeCare each had policies and practices of denying medical care to detainees at CCDC. ECF

No. 1 ¶¶ 95–112. The Custody Defendants and PrimeCare each move to dismiss this count for

failure to state a claim. ECF Nos. 24-1 at 16–21, 30 at 2–6.

supra. Thus, at this stage of the litigation, the Court cannot find that the individual Custody Defendants are

entitled to qualified immunity from suit under § 1983.

4 Plaintiff alleges separately, in Count II, that PrimeCare is liable for maintaining policies that

resulted in Ms. Rice’s death. The Court will separately address the merits of that claim infra.

5 The Court construes Count I as asserted against the individual Custody Defendants solely in their

individual capacities. “[N]either States nor state officials acting in their official capacities constitute

‘persons’ within the meaning of [42 U.S.C. § 1983] when sued for monetary relief.” Fauconier v. Clarke,

966 F.3d 265, 279–80 (4th Cir. 2020) (citing Will v. Michigan Dep’t of State Police, 491 U.S. 58, 71 (1989)).

In her response to Custody Defendants’ motion, Plaintiff denies asserting any claims in Count I against the

individual defendants in their official capacities. ECF 38 at 3–4.

A municipality may be liable for a deprivation of federal rights “[o]nly in cases where [it]

causes the deprivation ‘through an official policy or custom’ . . . .” Lytle v. Doyle, 326 F.3d 463,

471 (4th Cir. 2003) (citation omitted); see also Monell v. Dep’t of Soc. Servs. of City of New York,

436 U.S. 658, 691 (1978) (“[In § 1983], Congress did not intend municipalities to be held liable

unless action pursuant to official municipal policy of some nature caused a constitutional tort.”);

Love-Lane, 355 F.3d at 782 (“To hold a municipality (a local government entity) liable for a

constitutional violation under § 1983, the plaintiff must show that the execution of a policy or

custom of the municipality caused the violation.”). To prevail on a Monell claim, a plaintiff must

“adequately plead and prove the existence of an official policy or custom that is fairly attributable

to the municipality and that proximately caused the deprivation of their rights.” Jordan v. Jackson,

15 F.3d 333, 338 (4th Cir. 1994).

A policy or custom for which a municipality may be held liable can

arise in four ways: (1) through an express policy, such as a written

ordinance or regulation; (2) through the decisions of a person with

final policymaking authority; (3) through an omission, such as a

failure to properly train officers, that “manifest [s] deliberate

indifference to the rights of citizens”; or (4) through a practice that

is so “persistent and widespread” as to constitute a “custom or usage

with the force of law.”

Lytle, 326 F.3d at 471 (citation omitted).

Proving a Monell claim requires the plaintiff to show three elements: (1) the plaintiff must

plausibly allege a constitutional harm that stems from the acts of a municipal employee taken to

further municipal policy or custom; (2) the plaintiff must establish facts showing that the policy’s

creation may be attributed to the municipality; and (3) the plaintiff must prove an affirmative

causal link between the policy and the injury suffered. Washington v. Baltimore Police Dep’t, 457

F. Supp. 3d 520, 532 (D. Md. 2020).

A private corporation may also be liable under § 1983 “when an official policy or custom

of the corporation causes the alleged deprivation of federal rights.” Austin, 195 F.3d at 728.

The Court finds the allegations in the Complaint insufficient to support a reasonable

inference that either Cecil County or PrimeCare maintained policies or customs that resulted in the

denial of medical care to Ms. Rice. Plaintiff fails to identify or cite any Cecil County policy,

regulation, or ordinance; any decision made by a Cecil County official with policymaking

authority; or any persistent and widespread practice among Cecil County employees that caused

Ms. Rice to be denied medical care. Plaintiff alleges, “on information and belief” and in a

formulaic fashion, that Cecil County maintained policies, practices, and customs regarding the

treatment of detainees, including underreporting the severity of serious medical emergencies and

deliberately ignoring detainees’ medical complaints. ECF No. 1 ¶¶ 98–103. However, Plaintiff

alleges no facts to support a reasonable inference that any such policies or customs exist in Cecil

County or that Cecil County otherwise fails to train its employees or instructs its employees to

deprive detainees of medical care. Plaintiff’s allegations against PrimeCare are similarly

conclusory and lacking in specific factual support. See Talley v. Anne Arundel Cnty., Maryland,

Civ. No. RDB-21-347, 2021 WL 4244759, at *13 (D. Md. Sept. 17, 2021) (“barebones” allegations

insufficient to survive a motion to dismiss); Krell v. Queen Anne’s Cnty., Civ. No. JKB-18-637,

2018 WL 6523883, at 21 n.7 (D. Md. Dec. 12, 2018) (dismissing Monell claim when plaintiff

made only conclusory statements regarding a municipal policy or custom).

Plaintiff’s allegations about Ms. Rice’s experience in CCDC on August 28, 2020, are,

without more, inadequate grounds to support an inference of any policy or widespread practice

within CCDC. “[O]ne or two isolated constitutional violations alone cannot constitute a policy or

custom of unconstitutional conduct.” Palma v. Montgomery Cnty., Maryland, 598 F. Supp. 3d 288,

297 (D. Md. 2022). See also Carter v. Morris, 164 F.3d 215, 219–20 (4th Cir. 1999) (holding that

after “filter[ing] out unrelated accusations,” two instances outside of plaintiff’s accusation

insufficient to establish municipal custom); Brooks v. St. Charles Hotel Operating, LLC., Civ. No.

DLB-23-0208, 2023 WL 6244612, at *10 (D. Md. Sept. 26, 2023) (holding plaintiff failed to allege

incidents similar to his own and, citing Palma, one constitutional violation does not constitute a

policy or custom).

Moreover, other facts alleged in the Complaint tend to undermine any reasonable inference

that either Cecil County or PrimeCare had policies and practices in place to deny detainees medical

care. For example, Plaintiff alleges that PrimeCare had “a contract with CCDC and/or Cecil

County to provide medical services to detainees housed in CCDC pursuant to CCDC and/or Cecil

County’s duty to provide medical care to those detainees.” ECF No. 1 ¶ 28. In the absence of

citation to any specific policy or any facts demonstrating a widespread practice within CCDC, the

PrimeCare contract described in the Complaint tends to undermine the inference that PrimeCare

and Cecil County had policies and practices in place to deny—rather than “provide”—medical

care to CCDC detainees. Plaintiff also alleges in the Complaint that Sheriff Adams and his deputies

were “responsible for the care and custody of the detainees and inmates at CCDC . . . .” ECF No.

1 ¶ 26. The Sheriff and his deputies are employees of the State of Maryland—not Cecil County.

See Rucker v. Harford Cnty., 558 A.2d 399, 406 (Md. 1989).6 If the Sheriff (not Cecil County) is

responsible for the care and custody of detainees, and PrimeCare has a contract making it (not

Cecil County) responsible for medical care of detainees, it seems unlikely that Cecil County would

have any policies or practices to deny medical care to detainees of CCDC.

6 The status of the Sheriff and deputy sheriffs as employees of the State is a matter of public record

that the Court may consider in ruling on a Rule 12(b)(6) motion. Bowman v. Jack Cooper Transp. Co. Inc.,

399 F. Supp. 3d 447, 451 (D. Md. 2019) (citing Philips v. Pitt County Mem’l Hosp., 572 F.3d 176, 180 (4th

Cir. 2009)).

The Court notes again that the conclusory allegations in support of Count II are largely

made “on information and belief.” ECF No. 1 ¶¶ 98–101. Courts in this district have held that

“using ‘upon information and belief’ as a pleading device survives a motion to dismiss only where

‘the facts are peculiarly within the possession of the defendant, or where the belief is based on

factual information that makes the inference of culpability plausible.’” Stone v. Trump, 400 F.

Supp. 3d 317, 341 (D. Md. 2019) (quoting Malibu Media, LLC v. Doe, No. PWG-13-365, 2014

WL 7188822, at *4 (D. Md. Dec. 16, 2014), and Arista Records, LLC v. Doe 3, 604 F.3d 110, 120

(2d Cir. 2010)). Here, Plaintiff offers no specific factual information to render plausible her belief

that Cecil County and PrimeCare maintain policies and practices to deprive CCDC detainees of

access to medical care, especially considering the aforementioned facts that tend to undermine

such a belief. And, furthermore, the allegations in the Complaint are inadequate to establish that

Plaintiff lacks access to specific information or evidence regarding the policies and practices she

attributes to Cecil County and PrimeCare.

Ultimately, Plaintiff’s “conclusory allegations ‘upon information and belief’ are

insufficient to establish a Monell claim because Plaintiff does not explain which facts, other than

[Ms. Rice’s] alleged experiences in [CCDC], support her belief that [her] alleged deprivation of

rights is part of [Cecil County’s or PrimeCare’s] existing ‘customs, patterns, or practices.’”

Fleming v. City of New York, No. 18 Civ. 4866 (GBD), 2019 WL 4392522, at *8 (S.D.N.Y. Aug.

27, 2019) (citations omitted), quoted in Fox v. City of Greenville, No. 4:23-CV-00133-M, 2024

WL 3093583, at *7 (E.D.N.C. June 21, 2024).

Count II is therefore subject to dismissal, and Defendants’ motions shall be granted as to

this count. However, the Court will dismiss Count II without prejudice, to avoid precluding

Plaintiff from re-asserting a Monell claim should she acquire greater factual support.

C. Count III

In the third count of her Complaint, Plaintiff alleges that Custody Defendants violated

Article 24 of the Maryland Declaration of Rights7 by ignoring the medical needs of inmates who

were known to have serious medical conditions, assuming detainees were faking illnesses, and

failing to provide emergency medical attention. ECF No. 1 ¶¶ 113–28. The individual Custody

Defendants argue that Ms. Rice’s Article 24 claim against them must fail because Ms. Rice failed

to comply with the notice requirements in the Maryland Tort Claims Act (“MTCA”) and has not

alleged that they acted with malice or gross negligence sufficient to overcome immunity. ECF No.

24-1 at 21–23. As a general matter, if a plaintiff wants to bring a claim against the State or a state

official under the MTCA, “certain notice requirements must be met. Specifically, under the

MTCA, a claimant must submit a written claim to the Treasurer of the State of Maryland within

one year of the date of injury to person or property.” Gray v. Maryland, 228 F. Supp. 2d 628, 640

(D. Md. 2002); see also Md. Code Ann., State Gov’t § 12-106(b).8 However, as courts in this

district have recognized, if a claim sufficiently alleges malice or gross negligence, the claim “fall[s]

outside the MTCA and the State Treasurer does not require early notice.” Francis v. Maryland,

Civ. No. ELH-21-1365, 2024 WL 1156407, at *21 (D. Md. Mar. 18, 2024) (quoting Pope v.

Barbre, 915 A.2d 448, 462 (2007)).

7 Article 24 is “the state law equivalent of the Fourteenth Amendment of the United States.” Bost v.

Wexford Health Sources, Inc., Civ. No. ELH-15-3278, 2018 WL 3539819, at *42 (D. Md. July 23, 2018).

“Article 24 is ordinarily interpreted in pari materia with its federal analog.” Id. (citing cases). In other

words, “the analysis under Article 24 is, for all intents and purposes, duplicative of the analysis under the

Fourteenth Amendment.” Id. (citation omitted).

8 A court may, “on motion by a claimant and for good cause shown,” permit an action under the

MTCA to proceed without a claim having been filed the Treasurer “unless the State can affirmatively show

that its defense has been prejudiced by the claimant’s failure to submit the claim.” Md. Code Ann., State

Gov’t § 12-106(c)(1). Plaintiff requests this Court find good cause to excuse her failure to provide adequate

notice, ECF No. 38 at 12–13, but because Plaintiff has sufficiently alleged that the individual Custody

Defendants acted with malice or gross negligence, the notice requirement does not apply. See infra.

As Maryland state officials, the individual Custody Defendants are immune from suit under

the MTCA “for state constitutional violations committed within the scope of their duties when

the violations are made ‘without malice or gross negligence.’” Henry v. Purnell, 652 F.3d 524,

536 (4th Cir. 2011) (quoting Lee v. Cline, 863 A.2d 297, 307 (Md. 2004)). In order to defeat the

immunity provided by the MTCA, a plaintiff must show that the defendant state employee acted

with malice or gross negligence. Md. Code Ann., Cts. & Jud. Proc. § 5-522(b). “For MTCA

purposes, malice is conduct characterized by evil or wrongful motive, intent to injure, knowing

and deliberate wrongdoing, ill-will or fraud.” Nero v. Mosby, 890 F.3d 106, 127 (4th Cir. 2018)

(cleaned up). “To establish malice, a plaintiff must show that the government official ‘intentionally

performed an act without legal justification or excuse, but with an evil or rancorous motive

influenced by hate, the purpose being to deliberately and willfully injure the plaintiff.’” Id.

(quoting Bord v. Baltimore County, 104 A.3d 948, 964 (Md. Ct. Spec. App. 2014)). Gross

negligence is “an intentional failure to perform a manifest duty in reckless disregard of the

consequences as affecting the life or property of another, something more than simple negligence,

and likely more akin to reckless conduct.” Id. at 127–28 (cleaned up). “A government official

commits gross negligence ‘only when he or she inflicts injury intentionally or is so utterly

indifferent to the rights of others that he or she acts as if such rights did not exist.’” Id. at 128

(quoting Cooper v. Rodriguez, 118 A.3d 829, 846 (Md. 2015)). The Maryland Supreme Court has

consistently recognized “that the determination of whether a State actor enjoys State personnel

immunity is a question for the trier of fact.” Newell v. Runnels, 967 A.2d 729, 763 (Md. 2009)

(citing cases).

Here, the Complaint sufficiently alleges that the individual Custody Defendants acted with

malice or gross negligence, overcoming MTCA immunity and the notice requirement. Plaintiff

alleges that while in custody at CCDC, Ms. Rice suffered from painful opioid withdrawal, and that

custody staff knew Ms. Rice had recently used opiates, would go through withdrawal, and began

exhibiting symptoms of withdrawal. ECF No. 1 ¶¶ 6, 7, 8, 11, 12, 59, 61, 82. On the morning of

August 29, Ms. Rice “screamed and writhed in pain” from withdrawal, and “[t]he custody staff at

CCDC told her to ‘shut up’” without providing assistance. Id. ¶¶ 9, 75. These allegations support

a reasonable inference of both malice and deliberate indifference on part of the individual Custody

Defendants. Plaintiff alleges that each individual Custody Defendant was aware of Ms. Rice’s

condition but failed to respond, notwithstanding Ms. Rice’s pain and distress and the risk of severe

injury or death. Id. ¶ 84. These allegations suffice to support a reasonable inference of gross

negligence on behalf of the individual Custody Defendants.

In sum, Plaintiff alleges sufficient facts to state a plausible claim that individual Custody

Defendants denied Ms. Rice medical care with malice or gross negligence and in violation of Ms.

Rice’s Article 24 rights. Therefore, the Custody Defendants’ Motion to Dismiss will be denied as

to the Article 24 claims against the individual Custody Defendants in Count III.

Plaintiff’s Article 24 claim against Cecil County amounts to a Longtin claim. See Prince

George’s Cnty. v. Longtin, 19 A.3d 859 (Md. 2011). A Longtin claim is the Maryland state law

analogue to a Monell claim. Palma, 598 F. Supp. 3d at 297 n.5. “Monell and Longtin claims rise

or fall together, and the Court need not undertake an independent analysis of the sufficiency of the

latter.” Id. Therefore, like Plaintiff’s Monell claim against Cecil County, Plaintiff’s Article 24

Longtin claim against Cecil County must be dismissed.

D. Counts IV, V, and VI

In the Counts IV, V, and VI of the Complaint, Plaintiff alleges that Custody Defendants

are liable for negligence, ECF No. 1 ¶¶ 129–36, intentional infliction of emotional distress, id. ¶¶

137–47, and wrongful death under Maryland common law, id. ¶¶ 148–53.

In their Motion to Dismiss, Custody Defendants argue that the common law claims against

the individual Custody Defendants must fail because of the Plaintiff’s failure to comply with the

MTCA’s notice requirement, Plaintiff’s failure to overcome MTCA immunity by adequately

pleading malice or gross negligence, and the Plaintiff’s failure to adequately allege wrongful death

predicated on deliberate indifference. ECF No. 24-1 at 26–27.

As explained in Part IV.C supra, Plaintiff alleges sufficient facts to demonstrate that

individual Custody Defendants acted with malice and/or gross negligence, which overcomes both

immunity for state employees under the MTCA and the statute’s notice requirement. Md. Code

Ann., Cts. & Jud. Proc. § 5-522(b). Accordingly, Custody Defendants’ Motion to Dismiss shall be

denied as to the claims in Counts IV, V, and VI against the individual Custody Defendants.

Further, Custody Defendants argue that the common law tort claims against Cecil County

must be dismissed both because CCDC is run by State employees with medical care outsourced to

PrimeCare, and because Cecil County would be immune from tort liability based on governmental

acts. ECF No. 24-1 at 27–28. Plaintiff responds that Maryland counties may be held liable under

the doctrine of respondeat superior for the tortious conduct of their employees within the scope of

their employment; thus, because the Complaint describes actions alleged to have been committed

by Cecil County employees, the tort claims can be maintained. See Md. Code Ann., Cts. & Jud.

Proc. § 5-302. However, the Complaint does not allege any acts by Cecil County employees, only

those of state employees and PrimeCare employees. See Rucker, 558 A.2d at 406 (sheriff and

deputy sheriffs are “officials and/or employees of the State of Maryland rather than” county

officials or employees).

Because the Complaint does not identify any specific Cecil County employees who

engaged in tortious conduct for which the County can be liable for under a theory of respondeat

superior, the common law tort claims against Cecil County must be dismissed.

Second, Cecil County itself has governmental immunity, shielding the County from tort

liability arising from a governmental function. Under Maryland law, local governments are

immune from tort liability when functioning in a “governmental” capacity, although not when

engaged in “proprietary” or “private” activities. Clark v. Prince George’s Cnty., 65 A.3d 785, 790

(Md. Ct. Spec. App. 2013) (citing DiPino v. Davis, 729 A.2d 354, 370–71 (Md. 1999)); see also

id. at 791 (“[T]he Local Government Tort Claims Act . . ., does not specifically waive immunity

for common law tort claims against a County or municipality in its own capacity, for governmental

actions.”). An act is governmental in nature if it “is sanctioned by legislative authority, is solely

for the public benefit, with no profit or emolument inuring to the municipality, and tends to benefit

the public health and promote the welfare of the whole public, and has in it no element of private

interest.” Rios v. Montgomery Cnty., 872 A.2d 1, 15 (Md. 2005) (quoting Mayor & City Council

of Balt. v. Blueford, 195 A. 571, 576 (Md. 1937)). Courts in Maryland have stated that operating

detention centers is a government function. See Jones Hollow Ware Co. of Balt. v. Crane, 106 A.

274, 278, 115 (Md. 1919); Wynkoop v. Hagerstown, 150 A. 447, 450 (Md. 1930); Jones v.

Montgomery Cnty., 2016 WL 1321396, at *6 (Md. App. Ct. Apr. 5, 2016) (“[W]e agree with the

County that the operation of a detention facility is a governmental function.”); Malone v. Wicomico

Cnty., Civ. No. SAG-19-2412, 2021 WL 4060433, at *14 (D. Md. Sept. 7, 2021).

The common law tort claims asserted against Cecil County in Counts IV, V, and VI: (1)

cannot rely on respondeat superior because no Cecil County employees are named or otherwise

alleged to have engaged in any tortious conduct; and (2) arise from its operation of CCDC, giving

the County immunity from these claims. These claims against Cecil County are therefore subject

to dismissal and shall be dismissed with prejudice.

E. Counts VII and VIII

In Counts VII and VIII of the Complaint, Plaintiff alleges that Cecil County is liable for

the torts of its agents under theories of respondeat superior, ECF No. 1 ¶¶ 154–57, and

indemnification, id. ¶¶ 158–62.

In their Motion to Dismiss, the Custody Defendants argue that Cecil County is not liable

under a theory of respondeat superior or indemnification because the individual Custody

Defendants are State officials, not county employees. See Rucker, 558 A.2d at 406 (concluding

that sheriffs and their deputies are State, not county, employees).9 Because the individual Custody

Defendants are not Cecil County employees, Cecil County cannot be liable under a theory of

respondeat superior or indemnification for any alleged wrongdoing. The Custody Defendants’

Motion to Dismiss shall be granted on Counts VII and VIII. These claims will be dismissed without

prejudice.

V. CONCLUSION

For the foregoing reasons, the Custody Defendants’ Motion to Dismiss, or in the

Alternative for Summary Judgment, or in the Alternative, to Bifurcate and Stay Discovery10 will

9 As noted supra, the status of the Sheriff and deputy sheriffs as employees of the State, and not of

Cecil County, is a matter of public record that the Court may consider in ruling on a Rule 12(b)(6) motion.

Bowman, 399 F. Supp. 3d at 451 (citing Philips, 572 F.3d at 180).

10 Because Counts II and III, the Monell and Longtin claims are dismissed as to Cecil County, the

alternative motion to bifurcate will be denied as moot.

be granted in part and denied in part, and PrimeCare’s Motion to Dismiss will be granted.11 The

claims against Cecil County and PrimeCare in Count I shall be dismissed with prejudice. Count II

shall be dismissed without prejudice. The claims against Cecil County in Counts III, IV, V, and

VI shall be dismissed with prejudice. The claims against Cecil County in Counts VII and VIII shall

be dismissed without prejudice.

A separate Order shall issue.

DATE: September 27, 2024 _____________/S/ __________

Matthew J. Maddox

United States District Judge

11 As noted supra, the Court construes PrimeCare’s motion as seeking only partial dismissal of the

Complaint—i.e., dismissal as to Counts I and II.