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Teasel v. Laskowski

United States District Court, E.D. Michigan, Northern Division

December 15, 2017

ALLAN TEASEL, Plaintiff,



         On March 28, 2017, Plaintiff Allan Teasel, a patient at a mental health institution initiated this case on his behalf and on behalf of other similarly situated patients. His complaint alleges that the State of Michigan and the Department of Health and Human Services have violated his substantive due process rights by forcing his caregivers to work excessive overtime. Compl., ECF No. 1. On July 17, 2017, Teasel filed an amended complaint which names Rose Laskowski, the director of the mental health institution housing Teasel, as the only Defendant. Am. Compl., ECF No. 30. Several days after filing the amended complaint, Teasel filed a motion for a preliminary injunction. ECF No. 32. On August 25, 2017, Lawskowski filed a motion to dismiss the suit for lack of standing. ECF No. 43. A hearing on the two motions was held on November 7, 2017. That hearing will be continued on January 22, 2018. However, no further oral argument on Defendants' motion to dismiss is necessary. For the reasons that follow, the motion to dismiss will be denied.


         Plaintiff Allan Teasel is a patient at the Caro Center, a state-run psychiatric hospital in Caro, Michigan. Am. Compl. at 3. The Caro Center is one of five state-run mental health institutions in Michigan, and each of those institutions “have a patient population that reside in the hospital involuntarily either as a result of voluntary commitment or as a result of court orders.” Id. Teasel was involuntarily committed at the Caro Center after being accused of criminal activity and found in need of psychiatric treatment. Id. at 14. Defendant Rose Laskowski is sued in her official capacity as the Director of the Caro Center (“the Director”). Id.

         In the amended complaint, Teasel contends that the Director's chronic usage of mandatory overtime has compromised patient safety by producing a “sleep-deprived staff.” Id. at 4. As Teasel alleges: “Where patient populations residing in locked wards have assaultive and murderous criminal records and suffer psychotic conditions, including severe depression, a wakeful and alert staff is required at all time. That staff is now virtually non-existent and patients have suffered significant injury to their health and well-being as a result.” Id.


         Patients at the Caro Center are cared for by two types of staff: Resident Care Aids (“RCAs”), “who are the primary care employees who are supposed to provide direct care and have direct contact with the patients, ” and the Nurse Manager, who “supervises the RCAs.” Id. at 18. RCAs care for patients on a 24-hour basis. Id. Their duties include the following:

[P]rovide appropriate interpersonal communications between themselves and the patients, . . . maintain visual observation of patient areas to ensure resident whereabouts, maintain visual observation of patients to maintain patient safety, control and prevent aggressive and disruptive behavior monitor patients in seclusion to prevent them from engaging in self-harm, and must have the physical ability to handle the physical demands of the work including aggressive behavior management practices.


         Teasel acknowledges that the collective bargaining agreement between the Caro Center and the RCAs anticipates mandatory overtime, despite attempts by the RCAs to end that practice. Id. at 20-21. Notwithstanding the CBA, Teasel asserts that “[t]he rights of the patients are not subordinate to the rights of the RCAs pursuant to their collective bargaining agreements in that the claims of the Plaintiffs are of a constitutional character.” Id. at 21.

         Teasel alleges that “Defendant Laskowski, while acting under the color of state law and with duties performed during the scope of her employment, has required that RCAs work mandatory overtime over extended periods of time at pain of being disciplined for refusing.” Id. at 11. The “excessive mandatory overtime policy” has been in place since at least 2013. Id. Teasel provides a “Tabulation of Total Hours Worked In Excess of Nine Hours Per Day - 2015.” Id. at 7. In that table, Teasel lists the days in excess of nine hours that RCAs at the Caro Center worked during specific months in 2015. Specifically, Teasel asserts that there were 15 days that RCAs worked more than 9 hours in January, 24 days in February, 30 days in March, 29 days in April, 31 days in May, and 30 days in June. Id. On the days in questions, RCAs worked from between 10.10 hours and 16.98 hours. Id. Teasel also includes a similar list for 2016 and 2017. For those years, RCAs worked overtime between 16 and 31 days each month. Id. at 8. On those days, the RCAs in question worked between 9.01 and 13.62 hours. Id.

         The amended complaint includes an anecdote by a former Caro Center RCA, Renae Goyette, explaining how the long hours affected her well-being and ability to safely perform her duties. Goyette was assigned to watch a patient who was prone to hurt herself. Id. The patient tried to cover her head with a blanket, and, after Goyette removed the blanket, the patient attacked Goyette. Id. at 9. Teasel alleges that “[f]or RCAs who are being repeatedly mandated to work 16hour days, for multiple days in a row, it becomes very difficult to stay awake while watching a dangerous patient. This creates a tremendous hazard.” Id.

         Teasel alleges that inadequate care at the Caro Center has resulted in the following dangers: “riots, patient-on-patient and patient-on-staff assaults, suicides and attempts at suicide, self- maiming and attempts at self-maiming, intoxication from excessive ingestion of water, and attempts to escape and actual escapes from the premises.” Id. at 16-17. Beyond the risk of violence, Teasel also alleges that the RCA exhaustion impairs treatment: “Many of the patients do not receive visitors, are very solitary, do not engage with one another or the staff, and suffer from severe loneliness. They need one-on-one time with RCAs to heal. Yet, due to excessive overtime, they are not receiving the attention that they need.” Id. at 18.


         Teasel further identifies a number of studies, news stories, and expert opinions which support his argument that the mandatory overtime policy adversely impacts patient care, health, and safety. Teasel cites a “recent report of the Michigan Occupational Safety and Health Administration (MIOSHA) of October 18, 2016, [which] found that deteriorating conditions at just one hospital, Caro Center, resulted in the following patient inflicted injuries on staff: “Fractures of the skull and leg[;] Detached retina[;] Torn rotator cuffs[;], Torn biceps tendon[;], Torn labrum (cartilage holds shoulder together)[;] Concussions[;] Ruptured discs[;] Exposure to blood and other potentially infectious materials[;] Hair torn out[;] Soft tissue injuries.” Id. at 9-10. Teasel admits that the MIOSHA report did not “address the question of mandatory overtime for RCAs.” Id. at 10. Likewise, the MIOSHA report did not discuss whether any patients have been injured.

         Similarly, the Michigan Department of Community Health has established a task force which reviews nursing practices within the state, with particular focus on “mandatory overtime and its impact on patient care, health, and safety.” Id. at 20. The task force summarized its findings regarding nurse fatigue as follows:

• nurses caring for many high-acuity patients or working repeated long shifts may get inadequate rest and become fatigued. Fatigued nurses make more errors and fail to catch the errors of others, compromising the quality and safety of patient care.
• nurses assessing their own human factors may fail to recognize the need to implement fatigue management strategies, engage in self-care efforts, or consider the physical, mental, and emotional variables that impact their ability to be vigilant, make critical decisions, and provide safe patient care
• extended work hours, mandated work shifts, and shifts that start during normal sleep hours (e.g. 3am) have been associated with health care errors, as well as patient and nurse morbidity and mortality.

Id. (quoting MDCH Task Force Rep. at 7, ECF No. 30, Ex. D).

         The task force report emphasized “the need for sufficient time between nursing work period to manage fatigue, minimize sleep loss, and maximize alertness to provide quality nursing care to patient[s] during the ...

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