Jeffrey Dean Ferguson v. Mount Sinai Medical Center

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted June 25, 2024*
Decided July 2, 2024
Before
CANDACE JACKSON-AKIWUMI, Circuit Judge
JOHN Z. LEE, Circuit Judge
DORIS L. PRYOR, Circuit Judge
No. 23-3392
JEFFREY DEAN FERGUSON,
Plaintiff-Appellant,
v.
MOUNT SINAI MEDICAL CENTER,
Defendant-Appellee.
Appeal from the United States District
Court for the Northern District of
Illinois, Eastern Division.
No. 22 CV 4940
Lindsay C. Jenkins,
Judge.
O R D E R
Jeffrey Ferguson sued Mount Sinai Medical Center in 2022, alleging that four
years earlier its doctors violated the Emergency Medical Treatment and Active Labor
Act, 42 U.S.C. § 1395dd, a law with a two-year statute of limitations. The district court
* We have agreed to decide the case without oral argument because the brief and
record adequately present the facts and legal arguments, and oral argument would not
significantly aid the court. F ED. R. A PP . P. 34(a)(2)(C).
NONPRECEDENTIAL DISPOSITION
To be cited only in accordance with F ED. R. APP . P. 32.1

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granted the defendant’s motion to dismiss, reasoning that the statute of limitations
barred Ferguson’s claim and that Ferguson had alleged facts inconsistent with a grant of
equitable tolling. Because the court properly ruled that, based on Ferguson’s
allegations, he could not receive equitable tolling for his untimely claim, we affirm.
We review dismissals of complaints de novo, Martin v. Haling, 94 F.4th 667, 671
(7th Cir. 2024), and we take as true the facts that Ferguson alleges. In January 2018,
Ferguson was arrested for arson and brought to Cook County Jail where staff thought
that he showed symptoms of mania. He was later released on bond and transferred to a
hospital, Mount Sinai Medical Center, for involuntary admission. The jail’s transfer
documents state that Ferguson likely had bipolar disorder, was currently manic and
unable to provide for his basic needs, had minimal insight into his illness, and posed a
danger to himself and others. At Mount Sinai, a physician examined him. The physician
noted that Ferguson reported having a “biblical vision” but was otherwise “calm and
cooperative on exam” and did not report other physical or mental problems. Based on
this exam, the physician discharged him in January 2018.
In light of his release on bond, he went home from the hospital. Shortly after,
while still under symptoms of mania, Ferguson physically fought with his neighbor. He
was arrested and charged with aggravated battery and criminal damage to property,
and he returned to Cook County Jail. He remained there until 2021, when he was
adjudicated not guilty by reason of insanity to his pending charges and transferred to a
mental health center, where he remains.
In the first three years after his release from Mount Sinai in 2018, Ferguson
pursued civil litigation on several fronts. First, he sued Mount Sinai (and others) under
42 U.S.C. § 1983 in July 2019, a year and a half after his release, alleging injuries from his
arrest and hospitalization in January 2018. Ferguson v. Cook Cnty. Corr. Facility/Cermak,
Mt. Sinai Hospital, No. 1:19-cv-04607 (N.D. Ill. July 8, 2019). The district court dismissed
the suit, and he appealed the following year, but we affirmed. Ferguson v. Cook Cnty.
Corr. Facility/Cermak, 836 F. App’x 438 (7th Cir. 2020). The next year, he petitioned the
Supreme Court for a writ of certiorari, but the Court denied the petition in October
2021. Ferguson v. Cook Cnty. Corr. Facility/Cermak, 144 S.Ct. 38 (2021). He also brought
two other separate suits against different defendants in 2020. See Ferguson v. Balawender
et. al., No. 1:20-cv-00112 (N.D. Ill. Jan. 7, 2020); Ferguson v. Dart et. al., No. 1:20-cv-04851
(N.D. Ill. July 10, 2020).

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No. 23-3392 Page 3
Ferguson filed this new suit against Mount Sinai in September 2022. With the aid
of recruited counsel, he alleged that the medical center violated 42 U.S.C. § 1395dd by
failing to assess that he had an emergency medical condition or to stabilize him in
January 2018. Mount Sinai moved to dismiss the suit. It correctly argued that § 1395dd
is subject to a two-year statute of limitations. See § 1395dd(d)(2)(C). And, it continued,
because the events occurred in January 2018, the limitations period ended in January
2020, more than two and a half years before Ferguson sued in 2022. Ferguson
responded that equitable tolling should apply because his detention in jail and mental
incompetency were “extraordinary circumstances” that prevented him from filing this
suit earlier and he was otherwise diligent by pursuing his previous § 1983 suit. (Mount
Sinai has not raised claim preclusion as a defense, and we need not consider it.)
The district court concluded that the statute of limitations barred Ferguson’s
claims and granted the defendant’s motion to dismiss. First, it correctly observed that a
statute of limitations is an affirmative defense, and “a plaintiff ordinarily need not
anticipate and attempt to plead around affirmative defenses.” Hyson USA, Inc. v. Hyson
2U, Ltd., 821 F.3d 935, 939 (7th Cir. 2016). But, it continued, “the statute of limitations
may be raised in a motion to dismiss if ‘the allegations of the complaint itself set forth
everything necessary to satisfy the affirmative defense.’” Brooks v. Ross, 578 F.3d 574,
579 (7th Cir. 2009) (quoting United States v. Lewis, 411 F.3d 838, 842 (7th Cir. 2005)). The
district court concluded Ferguson had pleaded himself out of court here because his
litigation history between 2019 and 2021 showed that his “incarceration” was not an
“extraordinary circumstance” that prevented him from timely filing his lawsuit.
On appeal, Ferguson, now pro se, argues that the district court improperly
rejected his request for equitable tolling because it did not consider the effect of his
adjudicated mental illness on his ability to sue. Equitable tolling is an extraordinary
remedy, and to satisfy the high bar, Ferguson must be able to show that (1) he has been
pursuing his rights diligently and (2) some extraordinary circumstance prevented his
timely filing. Menominee Indian Tribe of Wis. v. United States, 577 U.S. 250, 255–56 (2016);
Mayberry v. Dittmann, 904 F.3d 525, 529 (7th Cir. 2018).
The district court’s decision was proper because Ferguson acknowledges facts
that conclusively rebut his contention that his mental illness kept him from suing: He
accepts that, despite his mental illness, he filed three lawsuits between 2019 and 2020,
including a previous suit against Mount Sinai that he advanced to the Supreme Court.
Although mental illness can toll a statute of limitations, see Miller v. Runyon, 77 F.3d 189,
191 (7th Cir. 1996), when a litigant’s past filings show a “capacity to engage in the legal

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process” despite the mental illness, we have affirmed a district court’s ruling that
“extraordinary circumstances” did not justify equitable tolling. Conroy v. Thompson,
929 F.3d 818, 821 (7th Cir. 2019); see also Moreland v. Eplett, 18 F.4th 261, 271–72 (7th Cir.
2021). Thus, in light of Ferguson’s litigation history during the applicable two-year
limitations period of § 1395dd, the district court properly ruled that his mental illness
(and incarceration) did not prevent him from timely filing this suit.
We consider two replies to this conclusion, but they are unavailing. First,
Ferguson contends that he did not know about 42 U.S.C. § 1395dd until recently. But he
does not contend (nor could he do so plausibly) that his mental illness disabled him
from learning about § 1395dd during the limitations period, even though it did not stop
him from learning about a claim under 42 U.S.C. § 1983. Second, we recognize that we
have typically affirmed the denial of equitable tolling in the context of mental illness
only after the district court has received evidence on the nature of the illness.
See, e.g., Famous v. Fuchs, 38 F.4th 625, 635 (7th Cir. 2022); Miller, 77 F.3d at 192. But
Ferguson has obviated the need for fact development about his illness in light of his
acknowledged ability to litigate despite the illness. That ability, which includes the
§ 1983 suit against Mount Sinai that he began in July 2019, is inconsistent with a
contention that his mental illness disabled him from suing Mount Sinai within the two
years of the events of January 2018.
Finally, Ferguson argues that the outcome of this case could affect his prior
§ 1983 suit against Mount Sinai, and he asks us to assess that case. But that suit is not
before us on appeal, and therefore we cannot consider it.
AFFIRMED

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