Bryan Brown v. Elizabeth Bowman

In the

United States Court of Appeals

For the Seventh Circuit

No. 11-2164

B RYAN J. B ROWN,

Plaintiff-Appellant,

v.

E LIZABETH B OWMAN, et al.,

Defendants-Appellees.

Appeal from the United States District Court

for the Northern District of Indiana, Fort Wayne Division.

No. 1:09-cv-346-TLS—Theresa L. Springmann, Judge.

A RGUED O CTOBER 20, 2011—D ECIDED F EBRUARY 2, 2012

Before C UDAHY, K ANNE, and SYKES, Circuit Judges.

C UDAHY, Circuit Judge. This case involves the scope

of the Rooker-Feldman doctrine and whether the district

court properly applied that doctrine to appellant’s 42

U.S.C. § 1983 claims. In April 2007, appellant Bryan

Brown applied for admission to the Indiana Bar. As part

of his application process, the Indiana Board of Law

Examiners (BLE) requested that Brown attend hearings

to investigate his application and also required Brown to

2 No. 11-2164

be evaluated by mental health professionals. The BLE

ultimately denied Brown’s admission application and,

after exhausting his appeals to the Indiana Supreme

Court and the United States Supreme Court, Brown

brought suit in the district court. His complaint, lodged

against various state actors involved in his applica-

tion process, alleged that the evaluation of his application

focused on his religious beliefs (ostensibly Roman Catho-

lic) and violated his constitutional rights. The district

court dismissed his complaint without prejudice for lack

of subject matter jurisdiction under Rooker-Feldman.

The district court also found that the defendants were

immune from civil suit. On appeal, Brown raises two

issues: (1) whether the district court erred in dismissing

his federal suit under Rooker-Feldman; and (2) whether

the district court erred in finding that defendants were

entitled to immunity. For the reasons that follow, we

affirm the district court’s finding that Rooker-Feldman

applies and decline to assess whether the district court

was correct in ruling in the alternative that the

defendants were immune from suit.

Indiana’s constitution provides that the state’s

supreme court shall have original jurisdiction in admis-

sion to the practice of law. IND. C ONST. art. VII, § 4. Pursu-

ant to this authority, the Indiana Supreme Court has

adopted Admission and Discipline Rules, which govern

the process of admission to the Bar. Rule 9 establishes

the Indiana Board of Law Examiners (BLE). This body must

report and certify to the [Indiana] Supreme Court that

the applicant, after due inquiry, has been found to

No. 11-2164 3

possess the necessary good moral character and fitness

to perform the obligations and responsibilities of an

attorney practicing law in the State of Indiana, and

has satisfied all general qualifications for admission.

Rule 12 § 1. In determining whether an applicant

possesses good moral character and fitness, relevant

disqualifying considerations may include, but are not

limited to the following:

unlawful conduct; academic misconduct; making of

false statements, including omissions; misconduct

in employment; acts involving dishonesty, fraud,

deceit or misrepresentation; abuse of legal process;

neglect of financial responsibilities; violation of an

order of a court; evidence of mental or emotional

instability; evidence of drug or alcohol dependency;

denial of admission to the bar in another jurisdiction

on character and fitness grounds; and disciplinary

action by a lawyer disciplinary agency or other pro-

fessional disciplinary agency of any jurisdiction.

Rule 12 § 2. In accordance with Rule 12, the BLE may refer

an applicant to the Judges and Lawyers Assistance Pro-

gram (JLAP) for evaluation. Rule 31 §8(c).

The JLAP is designed to “assist impaired members in

recovery; to educate the bench and bar; and to reduce

the potential harm caused by impairment to the

individual, the public, the profession, and the legal sys-

tem.” JLAP Guidelines § 2. JLAP is administered by a

committee, which provides assistance to judges,

lawyers and law students who are impaired by, among

other things, mental health problems. The Judges and

4 No. 11-2164

Lawyers Assistance Committee (JLAC) comprises

qualified personnel approved by the Indiana Supreme

Court. On request, the committee will issue a report

of evaluations made by its approved health providers

for the use of the BLE in reviewing a bar admission ap-

plication.

Based on an application, hearings and evaluations,

the BLE must make a determination as to an applicant’s

admission to the Bar. If the BLE finds that an applicant

is not eligible for admission, the applicant may request

a hearing (where the applicant has rights of subpoena

and examination of witnesses). Rule 12 § 9(e) & (f). If the

BLE confirms its decision to deny the applicant admis-

sion, it must issue a “final report of the proceedings,

including specific findings of fact, conclusion and recom-

mendations.” Rule 12 § 9(h). The applicant may appeal

to the Indiana Supreme Court. Rule 14 § 2. The only

court in which the applicant can then seek further

review is the Supreme Court of the United States. 28 U.S.C.

§ 1257.

In April 2007, Brown sought admission to the Indiana

Bar. On the basis of his application, the BLE requested a

hearing. After the hearing, the BLE referred him to JLAP

for evaluation. See Rule 31 § 8(c). Defendant Tim

Sudrovech, the Clinical Director of JLAP, referred

Brown to psychologist Stephen Ross, also a defendant.

Ross met with Brown twice over the course of several

months and performed three psychological examinations

on him. Based on this, Ross issued a report noting

the possibility of a sub-clinical bipolar disorder of a

No. 11-2164 5

hypomanic type but concluding that nothing should

preclude Brown’s application from going forward. Order

4. Ross also opined that Brown’s “interpersonal style”

warranted further consideration by a psychiatrist and

a psychiatric interview was arranged.

Brown then wrote two letters to defendant Ross re-

questing him to change his report. These letters

expressed Brown’s concerns regarding the political and

religious content of Ross’s questions, questioned the

scientific validity of the tests used and disagreed with

Ross’s suggestion that he undergo further psychiatric

evaluation for a possible bipolar disorder. Brown later

sent another letter to defendants Sudrovech and Terry

Harrell, Executive Director of JLAP. This letter also

raised concerns about the evaluation process and

requested an independent review of his case by “state

officers trained in constitutional and civil rights law.”

Order 5. The following day, Brown requested per-

mission to be evaluated by a psychiatrist of his own

choosing. Sudrovech denied this request stating that

evaluations were to be provided by a psychiatrist from

the JLAP providers list.1 Id. Brown eventually acquiesced

to Sudrovech’s request that he see a JLAP-approved

psychiatrist and scheduled an appointment with

Dr. Elizabeth Bowman, who is also a defendant here.

1

Despite this denial, Brown went ahead and met with his

choice, Dr. Bryan Flueckiger, who issued a report on May 1,

2009 stating that Brown satisfied the requirements of Rule 12

and recommended that he be permitted to sit for the Indiana

bar examination.

6 No. 11-2164

Id. Bowman’s evaluation of Brown involved his visiting

Dr. William Alexy, who conducted a psychological exami-

nation of Brown. On the basis of several interactions

with Brown, defendant Bowman subsequently issued

a report, in which she concluded that Brown suffered

from a personality disorder, not otherwise specified.2

Order 6.

In response to Bowman’s report, Brown sent multiple

letters to the BLE again expressing his concerns about the

JLAP and BLE process, and the religious cast of his evalua-

tions by Drs. Bowman and Ross. Brown made more

than sixty complaints to the JLAP and BLE about Bow-

man’s opinion and requested a civil rights investiga-

tion. Sudrovech, after reviewing Bowman’s report, pre-

pared a report on behalf of JLAP to assist the BLE

in making its final decision on Brown’s bar application.

In a letter dated February 11, 2009, the BLE notified

Brown that he would not be admitted to the Indiana

bar because he was unable to demonstrate good moral

character and fitness under Admission and Discipline

Rule 12. Pursuant to Rule 12 § 7, Brown requested a

2

Dr. Bowman’s report specifically stated that Brown “firmly

believes he is obligated as a Christian to put obedience to

God’s laws above human laws.” Dr. Bowman further noted

that Brown expressed “devaluing attitudes towards pharmaco-

logical or psycho-therapeutic mental health treatment” and

that he made “sarcastic remarks devaluing authority of all

types, especially mental health authority and the abortion

industry.”

No. 11-2164 7

hearing with the BLE. Prior to the hearing Brown

requested a more definite statement as to why his ap-

plication had been denied. The BLE also obtained

certain other information relating to a disciplinary

action against Brown in Kansas (where he had been

admitted to the bar), the full results of Brown’s psycho-

logical and psychiatric evaluations and his voluminous

correspondence with JLAP and with his character and

fitness evaluator.

At the hearing, Brown called no witnesses but

submitted Bowman’s report. He argued that Bowman’s

religious beliefs rendered her incapable of evaluating

him objectively. After the hearing, Brown filed several

motions and sought reconsideration of his application

denial and an independent civil rights investigation.

The BLE issued a report with its factual and legal

findings and a recommendation that Brown not be ad-

mitted to the Indiana bar. Brown then appealed to the

Indiana Supreme Court. On November 16, 2009, the

court issued an order stating that “[a]fter review of the

submissions of the parties, it is the Court’s determina-

tion that the BLE’s decision should stand.” In re Bar

Applicant 24128, No. 94S00-0910-BL-446, at 1 (Ind. Nov. 16

2009). Thereafter, the United States Supreme Court

denied Brown’s petition for certiorari.

On December 8, 2009, Brown filed suit in district court

alleging twenty-six counts of federal and state constitu-

tional, state statutory and common law violations.

Brown named as defendants in his federal suit Drs. Bow-

man and Ross, Harrell, individually and in her official

8 No. 11-2164

capacity as Executive Director of the JLAP, Sudrovech,

individually and in his official capacity as Clinical

Director of JLAP, Randall Shepard, in his official

capacity as Chief Justice of the Indiana Supreme Court

and John Does and Jane Roes as co-conspirators. The

bulk of Brown’s § 1983 complaint alleged various viola-

tions of the First Amendment: five counts under the Free

Speech Clause; three counts under the Free Exercise

Clause; two counts under the Establishment Clause;

and one count under the Assembly Clause. Four other

counts alleged violation of Brown’s Due Process and

Equal Protection rights under the Fourteenth Amend-

ment. The remaining counts alleged violation of various

state common law requirements, statutes and constitu-

tional provisions.

Defendants moved to dismiss Brown’s complaint

citing lack of subject matter jurisdiction, lack of

justiciability and various immunity defenses. The

district court granted the motions to dismiss, finding

that Brown’s civil rights claims were barred under Rooker-

Feldman because they were inextricably intertwined

with the Indiana Supreme Court’s adjudication of

Brown’s bar application and finding that Brown’s as-

applied challenges to Admission and Discipline Rules 19

and 23 were unripe and did not present a case or contro-

versy. Finally, the district court concluded that Shepard,

the Supreme Court defendant, was absolutely immune

under the Eleventh Amendment and that defendants

Ross, Bowman and Sudrovech were entitled to absolute

witness immunity.

No. 11-2164 9

Brown raises two issues on appeal. First, he claims

the district court erred in finding that the Rooker-Feldman

abstention doctrine barred the action. Second, he claims

error in the finding that Sudrovech, Bowman and Ross

were absolutely immune from suit.

I.

Our review of a determination of subject matter juris-

diction based on the Rooker-Feldman doctrine is de novo.

Taylor v. Fed. Nat’l Mortg. Ass’n, 374 F.3d 529, 532 (7th

Cir. 2004). Rooker-Feldman “prevents the lower federal

courts from exercising jurisdiction over cases brought by

‘state-court losers’ challenging ‘state-court judgments

rendered before the district court proceedings com-

menced.’ ” Lance v. Dennis, 546 U.S. 459, 460 (2006) (quoting

Exxon Mobil Corp. v. Saudi Basic Indus. Corp., 544 U.S. 280

(2005)). The reason, quite simply, is that no matter

how erroneous or unconstitutional the state court judg-

ment may be, only the Supreme Court of the United

States has jurisdiction to review it. Brokaw v. Weaver, 305

F.3d 660, 664 (7th Cir. 2002).

Rooker-Feldman bars federal claims in two instances.

The first involves a plaintiff’s request of a federal district

court to overturn an adverse state court judgment. The

second, and more difficult instance, involves federal

claims that were not raised in state court or do not on

their face require review of a state court’s decision.

Taylor, 374 F.3d at 532-33. In this latter instance, Rooker-

Feldman will act as a jurisdictional bar if those claims

10 No. 11-2164

are “inextricably intertwined” with a state court judg-

ment. Id. at 533. Though sometimes understandably

labeled a “metaphysical concept,” the thrust of the “inex-

tricably intertwined” inquiry asks whether “the district

court is in essence being called upon to review the state-

court decision.” Id.; see also Young v. Murphy, 90 F.3d 1225,

1231 (7th Cir. 1996) (“[C]onstitutional claims that are

‘inextricably intertwined’ with state court judgments of

necessity call upon the district court to review the state

court decision and are thus beyond the district court’s

jurisdiction.”). The determination of whether a federal

claim is “inextricably intertwined” hinges on whether

it alleges that the supposed injury was caused by the

state court judgment, or, alternatively, whether the

federal claim alleges an independent prior injury that

the state court failed to remedy. See Long v. Shorebank

Dev. Corp., 182 F.3d 548, 555 (7th Cir. 1999). An alleged

injury is “independent” if the state court was acting in

a non-judicial capacity when it affected the plain-

tiff—for example, if the state court was “promulgating

rules regulating the bar.” Edwards v. Ill. Bd. of Admissions

to Bar, 261 F.3d 723, 729 (7th Cir. 2001).

But finding that a federal claim is inextricably inter-

twined with a state court judgment does not end the

inquiry. Once it is determined that a claim is

inextricably intertwined, we must then inquire whether

“the plaintiff [did or] did not have a reasonable opportu-

nity to raise the issue in state court proceedings.”

Brokaw, 305 F.3d at 667 (citing Long, 182 F.3d at 558). If the

plaintiff could have raised the issue in state court, the

claim is barred under Rooker-Feldman.

No. 11-2164 11

On appeal, appellant argues that his federal suit does

not “run aground upon the narrow shoals of Rooker-

Feldman” because it is not calculated to overturn the

Indiana Supreme Court’s final judgment. True,

appellant’s complaint does not explicitly request a lower

federal court to overturn an inconsistent state court

judgment, but that is not the only circumstance in which

Rooker-Feldman applies. The key question is whether

Brown’s civil rights claims involving the process by

which his application was evaluated are so inextricably

intertwined with the Indiana Supreme Court’s adjudica-

tion of his Bar application that in practical effect a

lower federal court would be required to review a state

court decision.

We addressed a similar question in Edwards v. Illinois

Board of Admissions to Bar, 261 F.3d 723 (7th Cir. 2001),

in which an Illinois bar applicant who was denied admis-

sion brought suit in federal court claiming that her ap-

plication process violated the Americans with Disabilities

Act (ADA). Id. at 725. Like appellant here, the plaintiff

stressed that she was not seeking reversal of the decision

to deny her admission to the bar. Id. at 726. Rather,

she claimed that requiring the release of her medical

records as part of the admission process violated the

ADA. Id. In response, we stated:

While she might not be asking us to review the state

court order declining certification, granting the

relief she requests would have that effect: she is

asking for a remand so the district court may deter-

mine whether the Committee violated the ADA in

12 No. 11-2164

treating [plaintiff’s] decision not to release the

records as it did.

Id. at 731. Edwards’ federal claim involves not a direct

challenge to a bar rule, but rather a challenge to the

manner in which the Committee treated her application.

This, we said, “is precisely the type of claim that the

Rooker-Feldman doctrine bars the lower federal courts

from considering because it requires review of a state

court decision in a particular case that arose out of

judicial proceedings.” Id. at 730.

Here, appellant’s artful pleading cannot get him

around Rooker-Feldman when the gravamen of his com-

plaint requires the district court to review the state

judicial proceeding. In Edwards, the plaintiff claimed that

the process by which the state actors assessed her bar

applications violated her constitutional rights. Here

too, Brown challenges the “manner in which the [BLE]

treated his application.” The Supreme Court has found

such claims barred under Rooker-Feldman:

If the constitutional claims presented to a United

States District Court are inextricably intertwined

with the state court’s denial in a judicial proceeding

of a particular plaintiff’s application for admission to

the state bar, then the District Court is in essence

being called upon to review the state court decision.

This the District Court may not do.

Dist. of Columbia Court of Appeals v. Feldman, 460 U.S. 462,

483 n.16 (1983). Though Brown focuses much of his

appeal on the allegedly religiously biased JLAP evalua-

tions and the conduct of JLAC members, these actions

No. 11-2164 13

are intimately connected with the Indiana Supreme

Court’s adjudication. Here, the Indiana Supreme Court,

through its agent the BLE, commissioned the JLAC to

assist it in processing Brown’s admission application. We

agree with the district court that “reviewing the JLAC’s

actions in this context would require [the district court]

to consider the Indiana Supreme Court’s process of refer-

ring cases to the JLAC, reviewing how the JLAC’s informa-

tion is utilized by the BLE, and finally reviewing the

Indiana Supreme Court’s ultimate resolution in the case

of an individual seeking admission to the bar.” Order 15.

Because Brown’s claims of religious bias require a

federal district court to review the judicial process fol-

lowed by the Indiana Supreme Court in deciding the

merits of Brown’s bar admission application, Brown’s

claims are “inextricably intertwined” and fall squarely

under Rooker-Feldman’s jurisdictional bar.

Further, a simple reading of Brown’s complaint shows

that his religious discrimination claims in district court

are essentially the same arguments he made to the

Indiana Supreme Court. When a bar applicant has an

opportunity before a state court to raise alleged errors

of law and facts involving his admission application,

that applicant is barred from subsequently raising

similar claims in any federal court but the Supreme

Court. Hale v. Comm. on Character & Fitness for State of

Ill., 335 F.3d 678, 684 (7th Cir. 2003). In Hale, we again

addressed the applicability of Rooker-Feldman to an ag-

grieved bar applicant’s federal claims. There, the

applicant alleged various constitutional violations

before the Illinois Supreme Court, and that court, in

14 No. 11-2164

affirming the adjudicating committee’s admission deci-

sion, rejected those arguments. The applicant then

brought a federal suit making many of the same con-

tentions of religious bias as he had made before the

state supreme court. Because the Illinois Supreme Court

had the power to hear constitutional claims, and in fact

the applicant had raised such claims there, we affirmed

a dismissal of the action under Rooker-Feldman. Hale,

335 F.3d at 683 (citing In re Anastaplo, 121 N.E.2d 826,

828 (Ill. 1954) (Illinois Supreme Court resolves peti-

tioner’s constitutional challenge to the Committee’s

decision to reject his bar application)).

Like the applicant in Hale, Brown had an opportunity

to raise federal constitutional claims before a state

court with power to adjudicate them. Thus, Indiana

Admissions and Discipline Rule 14 § 2 provides that an

applicant aggrieved by the final action of the BLE may

“file a petition with the Supreme Court of Indiana re-

questing review by [the] Court of such final determina-

tion, and setting forth specifically therein the reasons,

in fact or law, assigned as error in the [BLE’s] determina-

tion . . . . [T]he Court shall enter such order as in

its judgment is proper, which shall thereupon become

final.” Rule 14 § 2. Brown did claim before the Indiana

Supreme Court that he had suffered unconstitutional

discrimination. As its order indicates, that court “care-

fully reviewed” these contentions and ultimately deter-

mined that they did not merit reversal of the BLE’s ad-

mission determination. Because Brown is attempting

to raise similar violations here, his claims are barred.

No. 11-2164 15

Though appellant insists that he does not request rever-

sal of the Indiana Supreme Court’s admission decision,

the casting of a complaint in the form of a civil rights

action, however artful, cannot circumvent Rooker-

Feldman. The civil rights claims are “inextricably inter-

twined” with (and were directly resolved by) the Indiana

Supreme Court’s adjudication of his admission applica-

tion. We therefore affirm the dismissal of his constitu-

tional claims under Rooker-Feldman.

II.

Brown raises a second issue of whether the district court

erred in finding that defendants Bowman, Ross and

Sudrovech are entitled to absolute immunity.3 Although

it is not necessary to decide this issue, because it was

determined by the district court and raised on appeal,

we believe it appropriate to discuss it briefly. In that

regard, in determining whether a government official

is entitled to immunity, this Court applies a “functional

approach.” Auriemma v. Montgomery, 860 F.2d 273, 275

(7th Cir. 1988). That is, we look to “the nature of the

3

The appellant formulated the issue on appeal as: “Did the

District Court err in extending absolute immunity to putative

expert witnesses who were not subjected to the crucible of

the judicial process?” As we read it, Brown limits his argu-

ments on the immunity issue to defendants Sudrovech, Ross

and Bowman, who each issued expert reports in connection

to Brown’s bar admission application. Accordingly, we too

limit our review on appeal to those three defendants.

16 No. 11-2164

function performed, not the identity of the actor who

performed it.” Buckley v. Fitzsimmons, 509 U.S. 259, 269

(1993) (citing Forrester v. White, 484 U.S. 219, 229 (1988)).

Contrary to appellant’s contention, witness immunity

is not limited to in-court testimony. Wilson v. Kelkhoff, 86

F.3d 1438, 1443-44 (7th Cir. 1996) (prisoner review board

members entitled to witness immunity); Crenshaw v.

Baynerd, 180 F.3d 866, 868 (7th Cir. 1999) (commissioners

of Indiana Civil Rights Commission entitled to immu-

nity). As court-appointed experts requested to prepare

reports in connection with a judicial proceeding, defen-

dants Sudrovech, Bowman and Ross are likely entitled

to the absolute immunity traditionally provided to wit-

nesses at common law.

Ross, Bowman and Sudrovech’s actions in this case

are materially similar to those of other government

officials to whom we have accorded witness immunity.

In Cooney v. Rossiter, 583 F.3d 967 (7th Cir. 2009), we

explained that court-appointed experts, like child guard-

ians, are

arms of the court, much like special masters, and

deserve protection from harassment by disappointed

litigants, just as judges do. Experts asked by the

court to advise on what disposition will serve the

best interests of a child in a custody proceeding need

absolute immunity in order to be able to fulfill

their obligations “without the worry of intimida-

tion and harassment from dissatisfied parents.” This

principle is applicable to a child’s representative,

who although bound to consult the child is not bound

No. 11-2164 17

by the child’s wishes but rather by the child’s best

interests, and is thus a neutral, much like a court-

appointed expert witness.

Id. at 970 (internal citations omitted). Much like the

expert witnesses in Cooney, these defendants were com-

missioned by the Indiana Supreme Court to issue

objective and neutral reports on Brown’s mental health

and fitness for the Indiana Bar. The BLE and Indiana

Supreme Court relied on these reports in denying

Brown’s admission to the bar. As state actors intimately

connected with the BLE judicial process, defendants,

like the child guardians in Cooney, are almost certainly

entitled to immunity in order to preserve the authority

of their evaluations.

Brown’s complaint does not allege that defendants

engaged in conduct beyond the scope of their court-

appointed duties. Rather, all of the conduct Brown

alleges involve a conspiracy to deprive him of his con-

stitutional rights and were taken pursuant to those de-

fendants’ court-appointed duties. Nor are we persuaded

that the bar admission process lacks adequate pro-

cedural safeguards of which a disappointed applicant

may avail himself. Brown had the opportunity to

request a hearing before the BLE at which he could sub-

poena and examine witnesses. Rule 12 § 9(e) & (f). Ap-

plicants that are ultimately denied admission by the

BLE can also file a petition to the Indiana Supreme

Court alleging errors of law or fact by the BLE. Rule 14 § 2.

These mechanisms of review provide ample safeguards

to protect Brown’s due process rights. Because de-

fendants were “part and parcel” of an adjudicatory

18 No. 11-2164

process containing adequate procedural safeguards,

Wilson, 86 F.3d at 1444, the defendants are likely entitled

to the absolute immunity traditionally accorded to wit-

nesses in connection with the judicial proceedings.

Finally, we note that defendant Sudrovech is also

likely entitled to immunity under the Admissions and

Discipline Rules. Rule 31 § 10 provides that “[the] Com-

mittee, Executive Director, staff, and volunteers are not

subject to civil suit for official acts done in good faith

in furtherance of the Committee’s work.” Brown

concedes that Sudrovech is entitled to immunity under

this Rule. Appellant’s Br. at 41 (“Defendants Sudrovech

and Harrell are immune from civil suit only for

‘official acts done in good faith in furtherance of the

Committee’s work.’ ”). Indiana law has recognized

the merit of encouraging state actors who are involved

in the bar admission and JLAP process to issue objective

reports without being exposed to the threat of vexatious

litigation. We find no reason, nor has Brown suggested

any, to disregard or disturb this immunity scheme.

However, we are not deciding this issue because, as-

suming that we are correct in our determination that

the judge-made Rooker-Feldman doctrine applies in this

case, there may be a jurisdictional objection. But, as the

district court persuasively demonstrated, there does not

seem to be much doubt as to the likely outcome on

this question.

For the foregoing reasons, the judgment of the district

court is A FFIRMED.

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