RICHMOND, Va. (CN) — Duke University law students argued to the Fourth Circuit Friday that extensive periods of restraint and seclusion violated an involuntarily committed patient's constitutional rights.
"Mr. Riddick was entrusted into the care of the state of Virginia to be treated," student Joshua Britt said, representing the patient during oral arguments. "Not to be abused."
Rashad Riddick was found not guilty due to insanity for the 2011 killing of three of his family members. Riddick accuses Virginia's Central State Hospital of holding him in four-point restraints for two weeks before spending over 19 months in total seclusion in violation of his Fourteenth Amendment rights.
A Richmond-based federal court dismissed Riddick's pro se complaint, finding he failed to plausibly allege that the state officials involved deviated from accepted professional standards. Despite outlining his deteriorating mental health, the court also rejected his motion to appoint counsel, finding the claims were not so complex as to prevent him from litigating them on his own.
Riddick's complaints singled out Director of Central State Rebecca Vauter and Interim Commissioner for the Virginia Department of Behavioral Health and Developmental Services Jack Barber.
"Vauter's abuse was miles outside of reasonable medical practice," Britt said. "Vauter could not have abused Mr. Riddick without Barber's blessing."
The lower court found Riddick properly alleged that Vauter personally participated in his maltreatment but had not pleaded sufficient facts to establish Barber's participation or Vauter's deviation from accepted professional standards.
Virginia administrative code generally forbids keeping an adult patient in restraints for more than four hours. Still, Barber, at Vauter's request, signed an individualized exemption to restrain him beyond the maximum. Riddick challenged Vauter's order, claiming that the order had no time limit in violation of Virginia law.
Attorneys representing the official argued in their brief that their actions were reasonable.
"Barber was the head of an agency," attorney Maurice Fisher of Harman Clayton said. "There are no allegations of personal involvement."
U.S. Circuit Court Judge Pamela Harris, a Barack Obama appointee, told Fisher that at the pleading stage, the court couldn't assume Barber wasn't privy to the exemption details before signing it.
"I don't understand how we know that now," Harris said. "If that's the form the exemption took, how is he not personally involved?"
Fisher also said Riddick's claims fail because his pro se complaint doesn't explicitly say that he felt his treatment was unjustified. Harris disagreed that Riddick needed to spell out his opposition to the treatment.
"You don't think that's sort of implicit in the allegations of the complaint that 19 months was too long?" Harris asked.
Fisher said the 19 months was a justified use of the hospital's discretion.
U.S. Circuit Court Judge Roger Gregory took issue with how Riddick ended up in seclusion. In correspondence with Riddick, Vauter justified the treatment to avoid future aggression.
"I'd call it presumptive punishment," the George W. Bush appointee said. "You're going to punish him now for something he might do."
Gregory also called Fisher out for starting his argument by detailing Riddick's involvement in the murders. Gregory said by using his past criminal conduct as justification, the hospital could hold him in seclusion for the rest of his life.
"You started with what he had done, his criminal conduct, and you made sure we knew that," Gregory said. "If that's the reason, because of his conduct, then they could say, 'Well, we think you might become bad behavior for the rest of your life,' right? If that being the only justification, and as you laid out what he had done his conduct, couldn't they do that?"
Through a program with Duke's law school, the Fourth Circuit assigned the case to students who helped flesh out Riddick's appeal and argued in court. The United States joined the case as amicus curiae in support of Riddick.
"We're talking about restraint and seclusion orders of magnitude greater than the presumptive maximum set forth in Virginia's regulations," attorney Jonathan Backer said, representing the U.S.
According to Richard Katskee, a law professor and director of Duke's appellate litigation clinic, another patient attacked Riddick, causing a scuffle. Two weeks later, Vauter ordered that Riddick be immobilized indefinitely using four-point restraints.
"He was forced even to eat and sleep while in the restraints," attorneys representing Riddick wrote in their brief. "When he showered, Central State staff allowed him to remove only a single arm to wash himself."
Only a day after sharing his concerns, he was moved into an empty ward where he would spend 577 days without human contact. Britt told the panel staff monitored him through a two-way mirror and video cameras.
The isolation led Riddick to suffer from depression, anxiety and hallucinations while going long stretches without eating, he argues. Riddick initially sought $2.7 million in damages for his treatment.
Civilly committed patients may bring Fourteenth Amendment damages claims when subjected to unsafe or unreasonably restrictive conditions of confinement through the Supreme Court's 1982 decision in Youngberg v. Romeo. In Youngberg, officials from a Pennsylvania state hospital repeatedly abused a patient with an infant-level IQ and restrained him for nine straight months.
Riddick isn't the first patient at Central State to experience extensive periods of restraint. The Department of Justice investigated the hospital in 1997 and found numerous conditions that violated the constitutional and federal statutory rights of patients, including one patient who died after being placed in restraints for 300 hours, less time than Riddick.
Riddick faced the possibility of the death penalty when he was accused of the death penalty shooting of his uncle, James Jackson, 55, his wife, Karen Lee Jackson, 53, and her daughter, Chante Latrice Davis, 26. It's believed Riddick went to live with his relatives after serving five years in prison for attempted carjacking, firearms offenses and assault and battery of a police officer.
According to the Culpeper Star-Exponent, Riddick repeatedly punched his attorney in the face 15 minutes into his competency trial. Katskee said in a phone interview that Riddick is back in a ward with other patients and worked with the students closely on the appeal.
U.S. Senior District Judge David Faber of the Southern District of West Virginia completed the three-judge panel. Attorneys representing the officials did not respond to requests for comment.
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