Full opinion text
MEMORANDUM-DECISION and ORDER HURD, District Judge. INTRODUCTION Plaintiff Robert Ruhlmann (“plaintiff’), brings this suit against defendants Ulster County Department of Social Services (“DSS”), Ulster County Department of Mental Health (“DMH”), Marshall Beck-man (“Beckman”), Ernest Townsend -(“Townsend”), Benedictine Hospital (“Benedictine”), Ruth McGregor (“McGregor”), Dr. Joel Ginsberg (“Ginsberg”), Dr. Kevin Smith (“Smith”), Dr. Diana Puglisi (“Pugli-si”), and Dr. David Steres (“Steres”), alleging six causes of action. In his first, third, and fourth causes of action, plaintiff alleges, as against all defendants, that defendants caused his illegal arrest and involuntary confinement in Benedictine Hospital in violation of his due process rights and right to be free from false arrest/imprisonment under the federal and New York constitutions, and under New York law. In his second and fifth causes of action, plaintiff alleges, as against DSS, that he was constructively discharged because of his disability in violation of the American with Disabilities Act and New York Executive Law. In his sixth cause of action, plaintiff alleges, as against Benedictine, McGregor, Steres, Ginsberg, Smith and Puglisi, that defendants, as physicians and designee of the Director of Community Services, breached a duty of reasonable care to plaintiff in failing to use their knowledge, skill, and care to properly determine whether the arrest and confinement mandates of the New York Mental Hygiene Law were met. Plaintiff has moved for summary judgment on the first, third, fourth, and sixth causes of action. All defendants have moved for summary judgment on all claims pending against them. Oral argument was heard on November 30, 2001 in Albany, New York. Decision was reserved. FACTUAL BACKGROUND The facts are very much in dispute. The following account of the facts represents a composite taken from the parties’ submissions. I. THE PARTIES Plaintiff. Beginning in November of 1995, Plaintiff was employed at DSS. Plaintiffs direct supervisor was Maryanne Razey, and Razey’s supervisor was Linda Sharpe. When plaintiffs employment at DSS ended is in dispute. Defendants contend plaintiff resigned on May 19, 1998. (See Joint Exhibit 73). Plaintiff maintains such resignation was involuntary, and that he was constructively discharged. Defendants. Benedictine is a privately owned and operated hospital in Ulster County, New York. At all relevant times, McGregor, a psychiatric mental health nurse, was employed by Benedictine as coordinator of the psychiatric emergency room. As a result of a contract between Ulster County and Benedictine, McGregor was also Townsend’s “designee” under Mental Hygiene Law § 9.45. Ginsberg and Steres worked as physicians in the emergency room at Benedictine, and Ginsberg was the director of emergency medicine at Benedictine. Smith, a psychiatrist, was medical director of mental health services at Benedictine. In that capacity, Smith was responsible for providing physicians to Benedictine. Smith was not employed by Benedictine, DSS, or DMH. Puglisi was a staff psychiatrist at Benedictine and was not employed by Benedictine, DSS, or DMH. DSS and DMH are governmental entities of the State of New York, and are both located in Ulster County, New York. At all relevant times, Townsend was the commissioner of DMH and Beckman was the deputy director for administration of DMH. Townsend was also director of community services under New York Mental Hygiene Law § 9.45. Townsend had a professional relationship with Smith. Ulster County began a contractual relationship with Benedictine in 1995. This contract essentially transferred responsibility for 24-hour emergency mental health services from DMH to Benedictine. After the contract was executed, most pick-up orders under Mental Hygiene Law § 9.45 were issued by Benedictine employees. II. ALLEGED FACTS A. Alleged Events Prior to March 24, 1998 Plaintiff came under the care of Dr. Surjit Dinsa, a licensed psychiatrist, in April of 1997. Dr. Dinsa’s diagnosis of plaintiff through late January of 1998 was that he had “depressive disorder NOS [not otherwise specified].” In February of 1998, Dr. Dinsa diagnosed plaintiff with bipolar mood disorder, instructed plaintiff to begin taking prescription lithium, and gave him a note telling plaintiffs employer that plaintiff could not, at present, work. (See Joint Exhibit 72). Dr. Dinsa also recommended that plaintiff voluntarily enter a hospital. According to defendants, such recommendation to enter the hospital was for treatment. Plaintiff contends that it was so plaintiff could get rest and not have to attend to his own needs. Plaintiff did not voluntarily admit himself to a hospital. Around the same time, plaintiff alleges that he told Linda Sharpe of his mental illness and that he was taking medication. According to plaintiff, Sharpe told him that if he had such a diagnosis and was on medication, then he was dangerous and should not be working at DSS. Plaintiff took a leave of absence from work from February of 1998 to early March of 1998. Plaintiff alleges the leave was taken so he could adjust to his new medication. Plaintiff claims that upon return from the leave of absence, Delores Miller, Deputy Commissioner of DSS, Razey, and Sharpe were trying to find an excuse to fire him. B. Alleged Events of March 24, 1998 1. The alleged threat Karen Hof, a DSS employee, claims she had a conversation with plaintiff the morning of March 24, 1998. Hof alleges plaintiff made a comment indicative of animosity towards certain DSS employees. Hof could not recall exactly what plaintiffs comment was, but intimated it was something to the effect of “there’s people in here that better watch out.” (Hof Depo. at 22). According to Hof, no mention was made of the words “gun,” “administration,” or “supervisors,” and she felt the comment to be “benign and non-threatening.” (See Hof Depo. at 22,38,41). 2. Hof-Hunlock conversation According to plaintiff, Hof was then asked by Marijane Hunlock, a supervisor at DSS who happened to be passing Hof s desk when the conversation was taking place, what she and plaintiff had spoken about. Hof then recalled in more specificity the content of plaintiffs comment. Hunlock claims a scared Hof approached her cubicle and told her that plaintiff had made the comment, “it would be easy to take out the administration — no one would know,” that plaintiffs comment involved the threat of “a potential violent act,” and that it involved a “gun” and a “potential harm to the administration.” (See Hun-lock depo. at 6; Joint Exhibits 48 and 49). Hunlock’s characterization of the conversation with Hof was embodied in two separate writings made a few days later, though plaintiff claims these writings were coerced. The parties disagree as to whether Hunlock viewed the statement as a valid threat, but both agree she characterized it as a potential safety concern. Later in the day on March 24, 1998, Hun-lock decided to speak with Doris Dodig, Hof s supervisor, about the incident. C.Alleged Events of March 25, 1998 1. Conversation between Hunlock-Dodig and Hof On March 25, 1998, Hunlock called Hof to her office and asked her to repeat to Dodig the contents of plaintiffs comment. Hof complied. Hof claims she reiterated in that meeting that the comment was not a threat and that “if anything was said in that direction it was a joke and we were kidding around.” (Hof depo. at 25). Hof did, however, indicate that she did not wish to be involved in the matter any further because she claims to have seen “witch hunts” at DSS, where persons were essentially driven out. (Hof depo. at 45,-47). 2. Conversation between Hunlock-Dodig and Reynolds Dodig and Hunlock did not feel comfortable reporting the incident to DSS, so they contacted their union, which they believed would be fair. During the latter part of the day, Dodig and Hunlock reported the statement to Sandra Reynolds, a union official. They told Reynolds of their desire for anonymity. Though Reynolds could not recall the exact words relayed to her by Hunlock, she does claim it was something to the effect of “taking out” the administration at DSS. (Reynolds depo. at 21). Reynolds had no recollection of the mention of guns or a plan to shoot people, or of specific names. 3. Reynolds-DeCicco conversation Reynolds thereafter called Deborah De-Cicco, another union official, and relayed what Hunlock and Dodig told her. According to DeCicco, Reynolds told her that plaintiff “had a gun, a plan and his plan was to come in the [DSS] and shoot the Commissioner, the Deputy Commissioner and Lee Cane.” (DeCicco depo. at 18). 4. Conversation between Reynolds-DeCicco and Miller (plaintiff’s version) DeCicco then called Miller and relayed what Reynolds told her. DeCicco claims Miller urged that the three meet, which they did. The meeting was “short, maybe fifteen minutes” long. (DeCicco depo. at 25). DeCicco repeated to Miller what she claims Reynolds told her. According to Reynolds, Miller was informed that it was unclear if the statement was said or not and that Reynolds and DeCicco did not want anyone’s reputation harmed, but that they did not want to ignore what they perceived as potential danger. According to DeCicco, Miller was interested in obtaining the identity of the person to whom the comment was relayed (Hof), but did not ask either DeCicco or Reynolds to find out. DeCicco claims Miller suggested that she contact Beckman. D. Alleged Events of March 26, 1998 1. DeCicco-Miller conversation (defendants’ version) Miller’s recollection of the events is quite different. She claims she first learned of the alleged comment later in the work day on March 26, 1998, during a break in a labor meeting attended by De-Cicco. According to Miller, DeCicco followed her into the ladies room and told her that plaintiff “had made statements ... that he had a gun and he was going to take out Lee Cane, Linda Sharpe, and starting with them and then administration.” (Miller depo. at 36). Plaintiff claims DeCicco had no recollection of Sharpe’s name being mentioned by Reynolds. According to Miller, she asked DeCicco who had told her that information. DeCicco informed Miller she could not answer that question. Miller claims that the subject of DeCicco calling either Beckman or Townsend never arose. DeCicco has no recollection of this conversation. 2. Conversation between DeCicco and Beckman-Townsend DeCicco called Beckman, but she is unsure of when the call took place. According to DeCicco, she told Beckman that an employee had come to Hunlock and said that plaintiff “had a gun and a plan and the plan was to shoot the Commissioner, the Deputy Commissioner and Lee Cane,” and that Miller had suggested she contact him about it. (DeCicco depo. at 28). De-Cicco claims her conversation with Beck-man lasted a few minutes. At some point, Townsend joined the conversation, and Beckman passed on to him the information DeCicco provided. According to Townsend and Beckman, DeCicco called the morning of March 26, 1998. Beckman claims DeCicco told him that plaintiff “had made a threat within his work area to other employees of the area; that the threat concerned, and Til use the term blowing away because that’s how I remember it, the administration in Social Services Department; that the employees who heard the complaint were terrified, and that’s my word to describe how she made it sound to me, that they were extremely frightened; they didn’t want [plaintiff] to know who they were and therefore were afraid to step forward and make a complaint, that the information had been communicated through their supervisor to Debby and they were asking for somebody to do something.” (Beckman depo. at 23). He further claims DeCicco made “a general statement that the employees said they were aware that [plaintiff] had weapons in his house,” and that the threat was made on March 26, 1998. (Beckman depo. at 26). Townsend claims he asked DeCicco if there were any credible factors that would substantiate the threat, and that her reply was that “it was alleged that plaintiff had guns.” (Townsend depo. at 27). Specifically, according to Townsend, there occurred an incident of “people going to [plaintiffs] house once to see if he was okay and knocking on the windows and [plaintiff] saying you shouldn’t do that, I have a gun and you could get hurt if you startle me like that.” (Townsend depo. at 40). Towsend claims DeCicco told him that the employees who heard the alleged comment were concerned and scared, “that they thought that he, you know, had the means to do it. There was some talk about them being frightened, so frightened that they didn’t want to take it up the supervisory channel ...” (Townsend depo. at 35). 3. Townsend-Smith conversation Townsend placed a phone call to Smith between 3:00 and 3:30 p.m. Smith claims Townsend asked him a variety of questions about the options available to him in responding to the “phone calls he had gotten from [DSS] saying that they were frightened for their safety, that there was an individual at work who was making specific verbal threats of killing individuals at DSS and bombing DSS.” (Smith depo. at 41). Smith also claims Townsend told him “that the individual had been a recipient of services as far as, as he recalled through [DMH] in the recent past [and] that he wasn’t sure at that moment in time if he had a history of previous violence or if he had a history of prior threats of violence.” (Id.). Smith claims that Townsend told him that he was aware of plaintiffs mental health history, and that he was an unhappy employee who perceived discrimination against him because of his mental illness. He claims Townsend also told him of “allegations” that plaintiff had firearms or access thereto. (Id.). Plaintiff maintains this conversation was not just an opportunity for Townsend to become aware of his options, but, rather, to ensure that the pick-up order was issued. Smith claims he asked Townsend whether anyone had reported that plaintiff had weapons with him at DSS or anything that could be considered a bomb. According to Smith, Townsend answered in the negative, but persisted in asking Smith what options were available to him. Smith claims he told Townsend he had several options available, one of them being that “if he knew that the individual had a mental illness and that threats of dangerousness were potentially a part of that illness that a pick-up order could be issued to have the person brought in for evaluation in the ER to better assess whether that was the case.” (Smith depo. at 43). 4. Smith-McGregor conversation Smith, after his conversation with Townsend, called McGregor and told her of the call from Townsend. Smith claims he told McGregor that if Townsend so chose, he or someone from DMH would be “contacting the emergency room to issue the pick-up order.” (Smith depo. at 41-42). 5. Conversation between Townsend-Beckman and Miller-Decker Townsend claims he spoke to Miller some time after the conversation with De-Cicco. He claims Miller told him that plaintiff had recently returned from medical leave, which was taken for mental health reasons. Townsend and Beckman claim to have also tried several times without success to contact plaintiffs private psychiatrist, Dr. Dinsa. According to Miller, she tried to contact Dr. Dinsa at least three times as well, also without success. Beckman and Townsend claim to have made “numerous contacts” with DSS to assure themselves that nothing untoward was happening at DSS. (Beckman depo. at 39). According to Miller, however, there was only one contact between Townsend and Beckman and DSS, a telephone call lasting about fifteen to twenty minutes at 3:30 p.m. on March 26, 1998. DSS Commissioner Glenn Decker entered Miller’s office during this conversation. Beckman told Miller that DeCicco had called him and told him what Miller claims DeCicco told her in the ladies room earlier that day. The conversation also included, according to Miller, discussion of the fact that DSS knew plaintiff had a gun. Miller claims this was “known” because of a conversation she had with Maryanne Razey in which Razey told her of the incident when the two employees went to plaintiffs house, and because people at DSS were aware plaintiff had a gun. Miler also claims she told the others of a disturbing visit plaintiff paid to a psychology intern at DMH during plaintiffs leave of absence. Plaintiff denies that such visit was disturbing. She also claims she told them of a 1997 confrontation between plaintiff and Sharpe, which resulted in a disciplinary memo being placed in plaintiffs file. Plaintiff denies that this specific incident was discussed, but does admit that Miller may have used such incident as a basis for describing plaintiff as explosive during the meeting. Decker first learned of the alleged threat in Miller’s office. He remembers the threat as “directed at the administration of [DSS] beginning with the commissioner’s office.” (Decker depo. at 22). Decker claims that Townsend and Beck-man had said DeCicco had gone to them for guidance on how to proceed. Decker let it be known to Beckman and Towsend that he was in on the conversation, and that he may have mentioned he was going to notify his security officers. Decker also inquired as to plaintiffs whereabouts at the time of the phone conversation. According to Decker, Townsend and Beckman informed Miller and Decker that they took the alleged threat seriously and that “they believed that [plaintiff] needed to be examined.” (Decker depo. at 30). Though Decker suspected that Beckman and Townsend were going to request a pick-up order, neither of the two actually told him so. According to Beckman, he and Townsend learned nothing to indicate that plaintiffs behavior had reached the point where he was threatening at that point in time, as he was not currently “menacing people, or anything like that.” (Beckman depo. at 30). Beckman claims Townsend told DSS to try to persuade the persons who heard the alleged threat to come forward in order “to develop the seriousness of the threat.” (Beckman depo. at 35). Beckman trusted DeCicco totally based on how she had dealt with past threats to staff members. Townsend believed the threat was credible based on the alleged fear of DSS employees, the nature of the threat, and his sensitivities to workplace violence due to knowledge of some recent “workshop killings.” (Townsend depo. at 38). Though Townsend claims his prior dealings with DeCicco were “fleeting” he found her to be credible. (Townsend depo. at 34). 6. Townsend-McGregor conversation Townsend and Beckman claim they believed that something had to be done about the situation before the end of the day. Townsend claims he called McGregor and told her he “wanted her to issue a pick-up order on [plaintiff] because the commissioner of [DSS] reported to [him] that [plaintiff] has threatened to Mil people in the administration and that [plaintiff] has a history of mental illness and that [Townsend] ha[d] been unable to contact [plaintiffs] psychiatrist.” (Townsend depo. at 70). Townsend told McGregor that he may have used the phrases “blow away” and “blow up.” (Id. at 73). Townsend told McGregor something to the effect of “let’s issue a pick-up on” plaintiff. (Id. at 84). According to McGregor, Townsend informed her of threats plaintiff made to “blow away people at DSS,” and of plaintiffs history of psychiatric disorder. (McGregor depo. at 28-29). McGregor claims she probed Townsend for specific names and dates of threats, but was told that the specific information was not in front of him at that moment. Plaintiff maintains that this conversation took place at 3:55 p.m. McGregor claims that prior to issuing the pick-up order, she unsuccessfully attempted to contact Dr. Dinsa. Around 4:00 p.m., Townsend told Beckman that McGregor indicated to him that she would issue the pick-up order. Townsend is a certified social worker, but had provided no treatment personally to plaintiff, and he told McGregor nothing that would lead her to that conclusion. McGregor had no other information about plaintiff except that provided by Townsend and allegedly provided by Smith. 7. (Second) McGregor-Smith conversation After her conversation with Townsend, McGregor called Smith and asked if he felt Townsend was a proper “reporter” under Mental Hygiene Law. According to plaintiff, Smith told McGregor he felt Townsend fit the category of a social worker currently providing treatment services to plaintiff because, as director of community services, Townsend was responsible for providing care and treatment to all citizens of the county. According to defendants, Smith told McGregor that Townsend fit into the category of “health officer.” According to Benedictine, McGregor, Steres, and Ginsberg, Townsend as Commissioner of Mental Health could request the issuance of a pick-up order. McGregor claims to have believed that plaintiff needed “immediate care and treatment ... in a hospital for mental illness,” such care and treatment being a “mental health evaluation.” (McGregor depo. at 62-63). Townsend claims he needed “structure” and “perhaps medication and observation.” (Townsend depo. at 94). According to plaintiff, McGregor said that specific information was not crucial to the decision to evaluate plaintiff. Defendants claim specific information was not necessary because of Townsend’s reliability as a reporter. 8. Issuance and execution of pick-up order The actual pick-up order was signed by McGregor at 4:45 p.m., directing members of the Kingston Police to take plaintiff into custody and transport him to Benedictine. (Joint Exhibit 2). The heading stating the authority under which the order was issued read: “ § 9.45 Mental Hygiene Law. Request By A Director of Community Services or Designee.” McGregor placed her name in the blank immediately preceding the words, “am the designee of the Director-of Community Services for Ulster [County].” The form indicates that the information providing the basis of the issuance of the order came from “Ernest Townsend, who is ... a licensed psychologist or certified social worker currently responsible for providing treatment services to the person.” The Kingston police department dispatch records indicate that the police arrived at plaintiffs house at 5:15 p.m. to execute the pick-up order. (Joint Exhibit 6). According to plaintiff, he was, at the time, washing his kitchen floor. The dispatch records state that plaintiffs pick-up was on orders “issued by Dr. Townsend of Mental Health.” Defendants claim this notation is erroneous. According to plaintiff, the officers informed plaintiff there was a problem at Benedictine and he was wanted there. Plaintiff claims that as he went upstairs to retrieve a shirt to put on the officers grabbed him by the wrist, handcuffed him behind his back and dragged him out of the house. Defendants deny this occurred. Plaintiff was placed in the back of the officers’ police car and transported to Benedictine. Though denied by defendants, plaintiff contends the officers did not inform him as to the reasons for his pick-up, were unresponsive to questions, and did not ask him about the alleged threats. 9. McGregor’s evaluation of plaintiff According to plaintiff, upon arrival at Benedictine, he was taken to the emergency room and placed in an examining room. . At approximately 6:00 p.m., McGregor went to speak with and evaluate plaintiff. McGregor’s examination was brief due to plaintiffs uncooperative demeanor and his refusal to give prior psychiatric history. McGregor found plaintiffs motor activity as normal, his eye contact as good, and his appearance as neat. She also found he was oriented in time, place, and person, and was not depressed. She found his thought process organized and without psychotic content. Her report indicated that “[plaintiff] reportedly verbalizes his wanting to blow up DSS,” but that plaintiff was “clueless as to why he is here.” (Joint Exhibit 8). McGregor alleges she told him that he was there because of threats to blow up DSS, but provided him with no specific details surrounding the alleged threat, including when it was made, who heard it, and where it was made. The parties disagree as to whether or not plaintiff had his legal rights and status explained to him. The evaluation ended at 6:15 p.m., fifteen minutes after it began. Plaintiff claims McGregor left the room without explaining to him what would happen next, without telling him she would be speaking with Smith, without telling him he would be given a physical by an emergency room physician, and without explaining the standard applied when determining whether to admit plaintiff. 10. (Third) McGregor-Smith conversation After leaving plaintiffs examination room, McGregor spoke to Smith via telephone. She described her examination, but does not remember whether she filled in her report before or after speaking to Smith. According to plaintiff, Smith told her to admit plaintiff, saying that “due to the seriousness of the threats and that specific people were threatened,” plaintiff should be admitted involuntarily to the mental health unit “for further evaluation.” (See Joint Exhibit 5; McGregor depo. at 77,128). According to plaintiff, McGregor told Smith she thought admission was proper and he agreed. According to defendants, Smith only recommended that plaintiff be admitted. Plaintiff claims McGregor told Smith that, according to Ginsberg, plaintiff was medically clear. All parties seem to agree that Ginsberg never examined plaintiff. Smith prescribed medication for plaintiff, which McGregor documented. 11. Smith-Ginsberg conversation According to plaintiff, Smith spoke to Ginsberg immediately following his conversation with McGregor in order “to verify the medical clearance.” Plaintiff claims Ginsberg gave Smith an indication that plaintiff would be admitted. According to plaintiff, Ginsberg told Smith the medical clearance data was “normal and fíne,” and Smith came away from this conversation satisfied with medical clearance. According to some defendants, Ginsberg claims he never spoke with Smith about plaintiff. Smith’s alleged conversation with Ginsberg was approximately five minutes long. 12. Smith and McGregor conversations with secure psychiatric unit After speaking with Ginsberg, plaintiff claims Smith called the secure psychiatric unit to “let the nurses know that the patient was going to be admitted and gave them telephone orders for his admission.” Plaintiff claims that, at 6:15 p.m., the same time her examination of plaintiff ended, McGregor made a verbal report to a nurse in the secure psychiatric ward that plaintiff would be admitted. According to plaintiff, at 6:30 p.m., McGregor called plaintiffs insurance carrier to inform them of the admission. 13. Ginsberg’s signing of Mental Hygiene Law § 9.39 admission form Also at 6:30 p.m., plaintiff claims Ginsberg signed the admission form to admit plaintiff involuntarily under Mental Hygiene Law § 9.39. (Joint Exhibit 10). Plaintiff claims McGregor completed the mental health evaluation form by 6:50 p.m. Though it appears all parties agree that Ginsberg never examined plaintiff, his usual evaluations in these situations take fifteen minutes to an hour and encompass both physical and mental health examinations. This examination would include asking the patient about alcohol or substance abuse history, whether the patient had thoughts of hurting himself or others, prior medical or psychiatric history. The course of the examination would be determined by the answers to those questions. 14. Benedictine regulations on status and rights and signing of consent form Benedictine regulations require that a patient admitted to the mental health unit receive both a verbal and written explanation of the patient’s status and rights, and that a copy of the written explanation be forwarded to mental hygiene legal services. Plaintiff claims he was never given the written copy, that there is no copy in plaintiffs medical record produced by the hospital, and that mental hygiene legal services received no copy. According to defendants, a patient is also asked to sign a consent form, and that the admitting nurse reads the status and rights form with the patient. Defendants claim plaintiff received paperwork from the admitting nurse but does not recall what those papers were or what he did with them. At or around 6:50 p.m., plaintiff signed his consent to “hospitalization, routine and/or emergency care.” (Joint Exhibit 13). Among other things, the form states that plaintiff consents to “customary care,” and has had his “rights and responsibilities (as a patient in the hospital)” explained to him in a manner he can understand, and that plaintiff “ha[s] had the opportunity to ask questions about this consent and they have been answered to my satisfaction.” Notably, plaintiff checked neither the “yes” nor the “no” options next to either statements. 15. Steres ’ examination of plaintiff According to plaintiff, beginning at 7:15 p.m., Steres gave plaintiff a physical examination. Plaintiff claims Steres asked him some questions about his medical history, but none about the alleged threat, and that even had he asked plaintiff such questions, it would have made no difference because Steres claims to have had the information about the threat from what he considered to be reliable sources, and that he could not “take the risk” of taking just believing plaintiff. (Steres depo. at 85). Steres found plaintiff to be alert, oriented, cooperative, and interactive, with no mania, agitation, paranoia, delusions, or hallucinations. Steres also found plaintiff was medically stable. Plaintiff claims Steres did ask plaintiff he was depressed, to which plaintiff responded in the negative. According to plaintiff, Steres made no determination that plaintiff needed immediate care or treatment for a mental illness, only that “it wasn’t safe to release to him.” (Steres depo. at 37). The examination lasted ten minutes, and Steres signed the § 9.39 admission form at 7:30 p.m. (Joint Exhibit 10). According to plaintiff, Steres concluded that plaintiff was a danger to others based only on what was written on the medical records in plaintiffs chart when Steres examined plaintiff. Steres claims he did not make an attempt to corroborate the information in the medical records because he “basically had to go on — trust the people who sent in the pick-up papers were acting on good faith.” (Steres depo. at 39-40). Plaintiff claims Steres told him nothing of what would occur next or that anything had been decided regarding his admission. At no time didSteres speak with Smith regarding plaintiffs admission. According to plaintiff, he also did not speak with McGregor. Plaintiff was taken to the secure psychiatric ward of Benedictine and held overnight. E. Alleged Events of March 27, 1998 1. Puglisi’s initial meeting with plaintiff Some time between 10:00 and 10:30 a.m. on March 27, 1998, plaintiff met with a treatment team headed by Puglisi. The purpose of the meeting was to “evaluate the reason for [plaintiffs] admission, to explore what was going on, to do a mental status examination and to assess any risk factors that there might be for [plaintiffs], for any possibility of danger to himself or others at that point and, if so, continue the hospitalization. If it was felt in our clinical judgment that the danger was minimal, to discharge [plaintiff].” (Puglisi depo. at 32). It is not in dispute that Puglisi had only that information contained in plaintiffs chart. Defendants claim, however, that she asked plaintiff about said information, including the alleged threat. Plaintiff claims no additional details about the threat were provided to him by Puglisi. According to plaintiff, he told Puglisi he should not be at Benedictine, and that he had no intent to harm anyone at DSS. According to plaintiff, Puglisi claims plaintiff “indicated to us at that time also that part of his history that he had been diagnosed as bipolar recently within the past year and had just returned from disability to his job.” (Puglisi depo. at 38). Plaintiff claims he told the team that he felt that people at DSS were holding his mental illness against him. At the meeting, plaintiff claims he denied any homicidal or suicidal thoughts. Puglisi claims that she told plaintiff that the team did not “have so far in [their] exploration any reason to believe that [plaintiff] might actually have made [the threat]” and that they “would be planning for [plaintiffs] imminent discharge.” (Puglisi depo. at 53-54). Plaintiff left the room. 2.Treatment team discussion of plaintiff Thereafter the team discussed the case. According to plaintiff, Puglisi felt there were no signs of plaintiff having psycho-motor agitation or any other symptoms commonly associated with mania. According to plaintiff, Puglisi claims she determined that plaintiffs “initial mental status was contradictory to the accusations of statements that he had made, the behavior he threatened.” (Puglisi depo. at 52-53). Plaintiff admits Puglisi did have doubts, however, as to his guardedness and reliability. According to plaintiff, the team’s plan was to obtain “collateral interviews” and, if they panned out, to discharge plaintiff as soon as possible. (Puglisi depo. at 58). 3. Puglisi-Smith conversation After meeting with plaintiff and her team, Puglisi spoke with Smith. According to plaintiff, Smith informed her that he had been on the phone prior to her calling him. She claims Smith told her he “had gotten a lot of, had had a lot of concern regarding threats that had apparently been made by [plaintiff], [Smith] had gotten a history of these threats to blow up [DSS]. [Smith] had gotten some history of [plaintiff] having weapons and being within eyesight of [DSS] and apparently had, it had been conveyed to [Smith] some concern that [plaintiff] may merit more exploration at this point.” (Puglisi depo. at 56). 4. Smith-Beckman conversation According to plaintiff, after Puglisi told him that plaintiff was denying he made the threats, Smith called Beckman and asked for more specifics about the alleged threats. He called DMH because he had learned that no specific information had yet been learned and, as it was a Friday, he felt getting those specifics would be difficult. Smith was worried about the expiration of the “48-hour hold” placed on plaintiff that would expire around 6:30 p.m. on Saturday, March 28. “[S]o in order to retain [plaintiff] until the following workday we would have to confirm a[§ ] 9.39.” (Smith depo. at 77). Smith claims Beckman told him that he, Beckman, was “doing the best that he could.” (Id.). According to Smith, Beckman told him people at DSS were afraid for their safety, but were afraid of reprisal from plaintiff if they put something in writing. 5. Smith-treatment team conversation Plaintiff claims Smith conveyed this information to the treatment team. The parties dispute whether Smith mentioned weapons. It is not disputed that Smith told Puglisi the information he had received the previous night from Townsend and about the level of concern that existed at DSS. Puglisi felt it important to the decision whether to confine plaintiff under § 9.39 to determine whether the alleged threats had been made, as her practice was to obtain “actual documentation” of such things. (Puglisi depo. at 159). Pugli-si admits that all the information in her and Smith’s possession as of March 27, 1998, was “secondhand hearsay information.” (Puglisi depo. at 82-83,91). Defendants claim that efforts were being made, however, beginning in the morning on March 27, to verify the information. 6. Hunlock-Miller meeting and Hun-lock-Decker conversation In the early morning on Friday, March 27, 1998, Hunlock agreed to come forward, and she and Reynolds went to see Miller. Hunlock claims she told Miller of her actions and that she felt reporting the matter was the responsible thing to do. Decker (of DSS) came to see Hunlock briefly that same morning. She claims that she told him she was upset with the way things were going because she did not believe it was an immediately dangerous situation. Decker claims he told her that if she had information she should share it with the police. 7. Beckman-Benedictine conversations That same day, conversations occurred between hospital officials, including Smith, and Beckman and Miller regarding plaintiff and his status. Smith requested more information. Beckman made several calls to Benedictine that day. According to Beckman, he was trying to reach either McGregor or Smith. According to plaintiff, Beckman was told by Benedictine that plaintiff was consistently denying making the threats, that he appeared stable, and that observation was continuing. Plaintiff claims that Beckman was also told that plaintiff did not appear to meet the criteria for continued involuntary hospitalization. Plaintiff claims that Beckman asked to be informed prior to any discharge of plaintiff. 8.The decision to continue plaintiff’s confinement and second Puglisi-plaintiff meeting Puglisi claims that she and Smith decided to continue plaintiffs involuntary hospitalization. Although admitting plaintiff denied making the threats, Puglisi was concerned about plaintiffs “guardedness” and “reliability,” and that, at that time, she “didn’t know if he was progressing towards another manic break or not.” (Pu-glisi depo. at 56-57). She also claims Smith told her they had another day to confirm the § 9.39 admission. She claims that they decided to spend the rest of the weekend monitoring plaintiff and exploring his behavior. Some time between the end of her first meeting with plaintiff and 3:00 p.m., Pugli-si met with plaintiff and informed him of the decision to continue his confinement. Puglisi claims she told plaintiff that although his discharge had been “planned,” they were detaining him over the weekend because of a “growing” concern and her belief that plaintiff may have been “less than candid” in their initial meeting. (Pu-glisi depo. at 79). According to plaintiff, Puglisi told him they had received information from Beckman that contradicted plaintiffs denials. Plaintiff claims Puglisi told him that Beckman had conveyed the information to Kathleen Voss, a social worker at Benedictine who was part of plaintiffs treatment team. Though Puglisi cannot remember if specific details were told to plaintiff, she does recall that he was told generally that Beckman had given them information that caused her concern. She told plaintiff he would have to remain in the secure psychiatric unit until the “apparently] terroristic threats” could be explored, noting that such exploration entailed contacting the parties reporting the threats and assessing “risk.” (Puglisi depo. at 89-90). This meeting lasted approximately five minutes and was cut short by Puglisi after plaintiff became angry about the decision to continue his confinement. 9. Signing of consent form for release of information Voss also obtained plaintiffs signature on a form entitled “consent for release of information.” (See Joint Exhibit 7). The form authorized Benedictine to release to DSS certain information. Plaintiff may have been confused as to the form’s purpose' — -which was to allow disclosure of information from Benedictine to DSS — because he wrote: “only to receive from DSS as to the date, time, quote of allegations and for nothing else. DSS is not allowed to receive any information about me at all.” Plaintiffs signature was obtained on an identical form, allowing disclosure to DMH, with no written restrictions. 10. Hunlock-Miller conversations and subsequent Hunlock written statement Around 3:00 p.m. on March 27, 1998, plaintiff claims Hunlock received a phone call from Miller, who informed her that Beckman wanted a statement and that if she did not give such a statement she could be in trouble or even arrested. Initially, Hunlock claims she resisted. After being called back by Miller, however, she claims she wrote one so as not be insubordinate. The statement was general, stating that she was informed of a comment made by plaintiff involving a “potential violent act,” and that because she was uncertain of what to do, she and another supervisor contacted their union representative. (Joint Exhibit 48). Puglisi did not see this statement prior to her deposition. 11.Puglisi’s signing of Mental Hg-giene Law § 9.39 form for continued confinement Puglisi signed the “psychiatrist’s confirmation” on the back of the § 9.39 admission form at 3:30 p.m. (Joint Exhibit 10). On the form, she notes that plaintiff denied making the threats, but that he showed “soft signs of impending psycho-motor agitation when told he will be in for observation.” Under “psychiatric signs and symptoms,” Puglisi wrote “questionable reliability, history of bizarre behavior at work.” She also noted plaintiff showed a “tendency” to cause harm to others, citing his threat “to bomb DSS and kill personnel.” Under “mental status,” she wrote, inter alia, history of bipolar manic episode.” According to Puglisi, the immediate care and treatment plaintiff needed was lithium and “safety and containment to rule out any impending exacerbation in light of his escalating angry behavior.” Per hospital regulations, Puglisi dictated plaintiffs history and physical examination, reiterating much of the same. (Joint Exhibit 27). She also noted that the plan was to observe plaintiff and obtain collateral interviews to further explore the veracity of the alleged threats, “since the DSS did request the Mental Health Commissioner to be warned if the patient is discharged since they are in fear of his acting out.” 12. Decker letter placing plaintiff on paid leave Also at some point on March 27, 1998, Decker drafted a letter placing plaintiff on paid leave pending a psychiatric evaluation. (Joint Exhibit 52). The evaluation was to be conducted to determine if plaintiff had the ability to return to work. An examination was scheduled for May 18, 1998. F. Alleged Events of March 30, 1998 On March 30, 1998, a Monday, Puglisi decided to release plaintiff. She based the decision on her belief that plaintiff gave no indication during confinement of “any escalating behavior” or of “an episode of the illness progressing to decompensation,” and on her belief that “DSS and Marshall Beckman were not able to verify to us that any such statements had really been made,” despite being provided “ample time” to provide such information. (Pugli-si depo. at 124-25). Puglisi claims she concluded that if plaintiff made the alleged threat, it was not from any psychosis. In the hospital records, Puglisi wrote that plaintiff was in “good psychomotor control all weekend,” and that there was no indication of any psychosis. She also noted that DSS and Beckman had been informed of the discharge. (Joint Exhibit 25). In her discharge summary, she noted that- the treatment team had contact with DMH and DSS prior to discharge. Puglisi was apparently referring to a phone conversation, later recorded in notes, between Voss and Miller, during which Voss informed Miller that plaintiff was being discharged and that Benedictine would not be notifying the police. G. Alleged Events After March 30, 1998 1.Letter of plaintiff to Decker On April 1, 1998, plaintiff sent a letter to Decker acknowledging he received, read, and was disheartened by Decker’s letter of March 27, 1998. (Joint Exhibit 58). In the letter, plaintiff expresses regret that anyone at DSS felt threatened, but categorically denies ever saying anything threatening that may cause such feelings. Decker received this letter on April 7, 1998. 2. Disciplinarg charges against plaintiff On April 27, 1998, while plaintiff was on paid leave, Miller levied disciplinary charges against plaintiff, alleging plaintiff “repeatedly engaged in a pattern of behavior designed to intimidate and threaten [his] co-workers and supervisors.” (Joint Exhibit 56). The charges included various allegations of disruptive workplace behavior, including the making of the alleged threat. The charges informed plaintiff of his right to a hearing. After plaintiff did not respond to the charges by May 8,1998, a union attorney sent him a letter with a copy of charges on May 11, 1998. Plaintiff claims he did not receive notice of the charges until May 16,1998. 3. Medical records access request Plaintiff requested copies of his medical records. It is unclear if this request was in writing, but it was acknowledged as received on May 1, 1998, in a memo to Puglisi. (Joint Exhibit 37). Puglisi acknowledged receipt of the memo on June 2, 1998. The memo indicated that “anything less than a complete disclosure of the medical record constitutes a partial denial and the qualified person may request a review of this decision by the Medical Access Review Committee appointed by the Commissioner of Mental Health. The reason for any denial must be documented and submitted within three (3) days to respond to constraints for the request for access.” (emphasis omitted). The blank for expected response date was left blank. Under the sections of the medical records approved for access, Puglisi circled “history and physical” and “discharge summary.” The space for explaining a denial was left blank. Puglisi’s signature is dated June 2,1998. Plaintiff claims he received only part of his medical records. Plaintiff contacted an attorney, who wrote a letter to Benedictine on June 24, 1998, asking for the section of the law under which plaintiff was involuntarily admitted, and if the medical records sent to plaintiff constituted his entire record. (Joint Exhibit 33). Plaintiffs attorney enclosed the medical records plaintiff claims he received from Benedictine. A nurse from Benedictine responded by letter, dated July 1,1998, informing plaintiffs attorney that Mental Hygiene Law § 9.39 was the authority under which plaintiff was admitted, and that the records plaintiffs attorney enclosed constituted only the part of his medical records authorized by Puglisi for release. (Joint Exhibit 34). Plaintiffs attorney responded to this letter by a letter dated July 6, 1998. Plaintiffs attorney asked for a written copy of the notice of plaintiffs status and rights given to plaintiff while he was hospitalized, and for any proof of notice to mental hygiene legal services. Plaintiffs attorney also asked for the authority under which plaintiff was denied his entire medical record. In the event such authority was Mental Hygiene Law § 33.16(c), plaintiffs attorney asked for a copy of any notification of the denial of access to records provided to plaintiff. (Joint Exhibit 35). By letter dated August 4, 1998, Benedictine responded, enclosing a complete copy of plaintiffs medical records, and informing plaintiffs attorney that Puglisi granted the release. (Joint Exhibit 36). The parties have briefed the issues fully in their memoranda of law. DISCUSSION I. SUMMARY JUDGMENT STANDARD Summary judgment is appropriate only when the pleadings, depositions, answers to interrogatories, admissions, and affidavits show that there is no genuine issue as to any material fact, and that the moving party is entitled to summary judgment as a matter of law. See Fed.R.Civ.P. 56; Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986); Richardson v. New York State Dep’t of Correctional Serv., 180 F.3d 426, 436 (2d Cir.1999). The moving party carries the initial burden of demonstrating an absence of a genuine issue of material fact. See Fed.R.Civ.P. 56; Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986); Thompson v. Gjivoje, 896 F.2d 716, 720 (2d Cir.1990). Facts, inferences therefrom, and ambiguities must be viewed in a light most favorable to the nonmovant. See Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986); Richardson, 180 F.3d at 436; Project Release v. Prevost, 722 F.2d 960, 968 (2d Cir.1983). Once the moving party has met the initial burden of demonstrating the absence of a genuine issue of material fact, the nonmoving party “must set forth specific facts showing that there is a genuine issue for trial.” Fed.R.Civ.P. 56; Liberty Lobby, Inc., 477 U.S. at 250, 106 S.Ct. 2505; Celotex Corp., 477 U.S. at 323, 106 S.Ct. 2548. Courts have urged care in reviewing discrimination claims, noting that “[bjecause direct evidence of ... discriminatory intent will rarely be found, ‘affidavits and depositions must carefully be scrutinized for circumstantial proof which, if believed, would show discrimination.’ ” Schwapp v. Town of Avon, 118 F.3d 106, 110 (2d Cir.1997) (quoting Gallo v. Prudential Residential Servs., 22 F.3d 1219, 1224 (2d Cir.1994)). Nevertheless, the nonmoving party “must do more than simply show that there is some metaphysical doubt as to the material facts.” Matsushita Elec. Indus. Co., 475 U.S. at 586, 106 S.Ct. 1348; see also Schwapp, 118 F.3d at 110 (“[e]ven in the discrimination context, a plaintiff must provide more than conclu-sory allegations of discrimination to defeat a motion for summary judgment.”). To withstand a summary judgment motion, sufficient evidence must exist upon which a reasonable jury could return a verdict for the nonmovant. See Liberty Lobby, Inc., 477 U.S. at 248-49, 106 S.Ct. 2505; Matsushita Elec. Indus. Co., 475 U.S. at 587, 106 S.Ct. 1348. Conversely, “summary judgment is appropriate only where application of the law to those undisputed facts will reasonably support only one ultimate conclusion.” Richardson, 180 F.3d at 438. II. SECTION 1983 AND STATE CONSTITUTIONAL CLAIMS Plaintiff, in his first, third, and fourth causes of action, alleges violation of his federal and state right to be free from false arrest and false imprisonment without due process of law. Because these causes of action require the same proof, i.e., state action and deprivation of a right, they will be discussed together under the 42 U.S.C. § 1983 framework below. 42 U.S.C. § 1983 is the “basic vehicle” by which a federal court adjudges alleged state and local infringements of federally created rights. Greene v. Hawes, 913 F.Supp. 136, 141 (N.D.N.Y.1996). Section 1983 itself creates no substantive rights, but provides a “procedure of redress for the deprivation of rights established elsewhere.” Thomas v. Roach, 166 F.3d 137, 142 (2d Cir.1999). In order to succeed on a cause of action under § 1983, a plaintiff must prove by a preponderance of the evidence that: 1) the defendant, in committing the complained of acts, was acting under color of state law; and 2) such conduct deprived the plaintiff of a right, privilege, or immunity guaranteed by the federal constitution or federal law. Flagg Bros., Inc. v. Brooks, 436 U.S. 149, 155, 98 S.Ct. 1729, 56 L.Ed.2d 185 (1978); see also West v. Atkins, 487 U.S. 42, 48, 108 S.Ct. 2250, 101 L.Ed.2d 40 (1988); Pitchell v. Callan, 13 F.3d 545, 547 (2d Cir.1994). A prerequisite to a defendant’s § 1983 liability is personal involvement in the alleged deprivation. Wright v. Smith, 21 F.3d 496, 501 (2d Cir.1994). A. Under Color of State Law One of the more contentiously debated issues in this case is whether defendants were acting “under color of state law.” “The traditional definition of acting under color of state law requires that the defendant in a § 1983 action have exercised power by virtue of state law and made possible only because the wrongdoer is clothed with the authority of state law.” West, 487 U.S. at 49, 108 S.Ct. 2250 (citations omitted); Kia P. v. McIntyre, 235 F.3d 749, 755-56 (2d Cir.2000). Thus, the Supreme Court has recognized that a defendant employed by the state will typically be considered a state actor. Lugar v. Edmondson Oil Co., 457 U.S. 922, 935 n. 18, 102 S.Ct. 2744, 73 L.Ed.2d 482 (1982). The Court also recognized, however, that even defendants who are not state employees can be deemed state actors. Id. at 937, 102 S.Ct. 2744 (stating, a person is said to be a state actor “because he is a state official, because he has acted together with or has obtained significant aid from state officials, or because his conduct is otherwise chargeable to the State”) (emphasis added). In circumstances where a defendant is considered a state actor, and has thus acted under color of state law, his or her conduct is said to be “fairly attributable to the state.” Id. at 937, 102 S.Ct. 2744. As “[w]hat is fairly attributable is a matter of normative judgment, [with] the criteria lacking] rigid .simplicity,” Brentwood, 531 U.S. at 295, 121 S.Ct. 924, “[i]t is fair to say that ‘our cases deciding when private action might be deemed that of the state have not been a model of consistency’.” Lebron v. National R.R. Passenger Corp., 513 U.S. 374, 378, 115 S.Ct. 961, 130 L.Ed.2d 902 (1995) (quoting Edmonson v. Leesville Concrete Co., 500 U.S. 614, 632, 111 S.Ct. 2077, 114 L.Ed.2d 660 (1991) (O’CONNOR, dissenting)). Determining whether a private party’s conduct is state or private action “frequently admits of no easy answer.” Jackson v. Metropolitan Edison Co., 419 U.S. 345, 349-50, 95 S.Ct. 449, 42 L.Ed.2d 477 (1974). “Only by sifting facts and weighing circumstances can the nonobvious involvement of the State in private conduct be attributed its true significance.” Burton v. Wilmington Parking Auth., 365 U.S. 715, 722, 81 S.Ct. 856, 6 L.Ed.2d 45 (1961). Predictably, therefore, results have been inconsistent when determining whether the decision by private medical personnel and entities to involuntarily commit an individual is conduct amounting to state action. Courts outside of New York, confronted with other mental health legislation, have split on the issue, with some finding no state action and granting summary judgment to such private entities and hospitals, and others finding state action or, when faced with factual discrepancies impeding determination of the issue as a matter of law, potential state action. Further exacerbating the issue, there is a split of authority among courts interpreting the New York Mental Hygiene Law as to whether the decision to involuntarily commit pursuant to that statute is made under color of state law. See Okunieff v. Rosenberg, 996 F.Supp. 343 (S.D.N.Y.1998) (finding no state action as a matter of law). But see Rubenstein v. Benedictine Hosp., 790 F.Supp. 396 (N.D.N.Y.1992) (finding state action as a matter of law); Ruffler v. Phelps Memorial Hosp., 453 F.Supp. 1062; Snyder v. Albany Medical Center Hosp., 206 A.D.2d 816, 615 N.Y.S.2d 139 (N.Y.App.Div.1994). 1. The public defendants Plaintiff claims that Townsend and Beckman, along with DSS officials, were the catalysts behind the issuance and execution of the pick-up order and his subsequent confinement. DSS and DMH are governmental entities. Townsend and Beckman are both employees of Ulster County. Townsend is the commissioner of DMH and director of community services, and Beckman is the deputy director of DMH. There is sufficient factual support that all were, involved in the process to pick up and involuntarily detain plaintiff, as more fully demonstrated below. Plaintiff alleges that Townsend and Beckman were involved in the process the entire time, conversing with DSS officials, maintaining continuous contact with Smith, and contacting the hospital. DSS officials were also arguably involved in the entire process of having plaintiff picked up and detained involuntarily. They conversed with DMH officials, tried to convince DSS employees to make their fears known, attempted to convey information to Benedictine about plaintiff with questionable motives, and were adamant about being kept apprised of any possible release. A jury could reasonably find that DSS and Townsend and Beckman, and therefore DMH, were active in plaintiffs pick-up and involuntary confinement. 2. The “private” defendants Because “Characterizing a private party as a ‘state actor’ is a fact-specific inquiry, ... courts considering the issue typically look to such factors as the public function of the party’s conduct, whether the private party acted under state compulsion, and whether the party’s conduct was jointly undertaken with the state.” Logan v. Bennington College Corp., 72 F.3d 1017, 1027 (2d Cir.1995) (citing Lugar, 457 U.S. at 939, 102 S.Ct. 2744). Sufficient factual discrepancies prevent a determination that the private defendants are or are not state actors as a matter of law. Thus, all motions for summary judgment on the issue, both by plaintiff and by all private defendants, must be denied. a. Close Nexus/state Compulsion Private conduct is state action where there exists a “sufficiently close nexus between the State and the challenged action of the [private] entity so that the action of the latter may be fairly treated as that of the State itself.” Jackson, 419 U.S. at 353, 95 S.Ct. 449. The close nexus is ordinarily present when it is proven that the state “has exercised coercive power [over a private decision] or has provided such significant encouragement, either overt or covert, that the choice in law must be deemed to be that of the state’.” Disabled in Action of Metropolitan New York v. Hammons, 202 F.3d 110, 122 (2d Cir.2000) (quoting Blum v. Yaretsky, 457 U.S. 991, 1004, 102 S.Ct. 2777, 73 L.Ed.2d 534 (1982)). This standard has been described as the “fundamental” consideration when determining whether a private party’s conduct is state action. See Catanzano by Catanzano v. Dowling, 60 F.3d 113, 118 (2d Cir.1995) (citing San Francisco Arts & Athletics, Inc. v. United States Olympic Committee, 483 U.S. 522, 546, 107 S.Ct. 2971, 97 L.Ed.2d 427 (1987)). The fact that a private entity or individual is regulated by the state is insufficient, by itself, to convert the private action into state action. American Manufacturers Mutual Ins. Co. v. Sullivan, 526 U.S. 40, 52, 119 S.Ct. 977, 143 L.Ed.2d 130 (1999); Desiderio v. National Ass’n. of Securities Dealers, Inc., 191 F.3d 198, 206 (2d Cir.1999). Similarly, if the state merely approves, or acquiesces in, the actions of private parties, the requisite nexus is absent. Blum, 457 U.S. at 1004, 102 S.Ct. 2777. “Although private use of state-sanctioned private remedies or procedures does not rise, by itself, to the level of state action, our cases have found state action when private parties make extensive use of state procedures with ‘the overt, significant assistance of state officials’.” Edmonson, 500 U.S. at 622, 111 S.Ct. 2077 (citations omitted). Here, sufficient factual questions must be resolved before determining whether DSS and DMH compelled the private actors to take action. It could be inferred that Townsend and Beckman were working closely with DSS. They had conversations with employees of DSS regarding the incident, and a jury could find that Miller, since the alleged threat was directed at her, was instrumental with Townsend and Beckman in bringing about plaintiffs pick up and involuntary detention at Benedictine. In turn, it could be inferred that Smith was compelled to act by working closely with Townsend and Beckman, and Smith’s compelled influence further compelled others in the decisionmaking chain. A reasonable factfinder may find that Smith went further than simply answering a “hypothetical” question as to what Townsend’s “options” were with regard to a situation. It can be inferred that Smith was well aware of plaintiffs identity, of what the threat entailed, and of the government officials’ wishes, expressed through Townsend. Factual questions also exist as to whether Smith further exerted his influence over the situation. After talking with Townsend, he immediately called McGregor, telling her that Townsend “may” be reque