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The Department or health officer may, by written order, isolate or quarantine any person who has been exposed to a communicable disease as medically or epidemiologically necessary to prevent the spread of the disease, provided such period of restriction shall not exceed the period of incubation of the disease. N.J. Admin. Code § 8:57-1.11(c).
This is a civil rights action brought pursuant to 42 U.S.C. § 1983 ("Section 1983"). The plaintiff, Kaci Hickox, is a nurse who cared for individuals affected by the 2014-16 Ebola epidemic in West Africa, specifically in Sierra Leone. Upon her return to the United States, Ms. Hickox was stopped at Newark Liberty International Airport while her health was monitored. Hickox alleged that this quarantine, which lasted approximately 80 hours, violated her rights under the Fourth and Fourteenth Amendments to the U.S. Constitution. Hickox also alleged that defendants committed the New Jersey common law torts of false imprisonment and false light. Hickox sued various State officials involved in her quarantine: Chris Christie, the Governor of New Jersey; Mary O'Dowd, then the Commissioner of the New Jersey Department of Health ("DOH"); Christopher Rinn, Assistant Commissioner of the Division of Public Health Infrastructure, Laboratories and Emergency Preparedness of the DOH; and Gary Ludwig, the Service Director of the Communicable Disease Service of the DOH. Hickox contended that civil commitment law makes clear that her substantive due process rights were violated in three specific ways: (1) that she did not receive an individualized assessment, (2) that she did not receive the least restrictive means of treatment, and (3) that the nature and duration of her confinement were not reasonably related to public health. The defendants filed a motion to dismiss the complaint pursuant to Fed. R. Civ. P. 12(b)(6).
Did Hickox’ border quarantine constitute a clear violation of her Fourth Amendment rights?
The court failed to see a lack of probable cause so clear as to overcome the officials' qualified immunity. Hickox was consistently engaged in Ebola-related care while in Sierra Leone. It would not have been unreasonable for a public health official to believe that she had been "exposed" to Ebola. Exposure does not necessarily equate to infection, but temporary quarantine is authorized based on a risk, or potential, for infection, not proof of infection itself. Nor was it unreasonable that health officials remained concerned, even following Hickox's favorable blood work, because she had repeatedly registered a fever, for which no other explanation has been given. Hickox was not institutionalized on an ongoing basis; she was detained for approximately 80 hours. The fever appeared very early on, a few hours into the detention period. The magnitude of the harm that could have occurred had she been released, weighed against the relatively short period of detention, also weighed in favor of finding that the detention was supported by probable cause. The CDC's Interim Guidance recognizes the unfortunate risk of infection, even among trained healthcare workers. The court found that that Hickox’ border quarantine was not a violation of her Fourth Amendment rights that would have been apparent to any reasonable officer, exposing that officer to a claim for damages under § 1983.