Full opinion text
OPINION AND ORDER DORA L. IRIZARRY, District Judge. In each of the above-captioned cases, the infant plaintiffs were alleged to have suffered serious injuries while they were not in the presence of their parents. When the parent plaintiffs discovered the injuries, they promptly sought medical attention. At the hospitals to which the infants were taken, both not only received medical care, but also were screened for signs of child abuse. A pediatrician diagnosed their injuries as the result of physical abuse. The parent plaintiffs could not explain the cause of the injuries and the hospitals, pursuant to their obligation under state law, reported the pediatrician’s suspicions to the state. New York City’s Administration for Children’s Services (“ACS”) then investigated and prosecuted the parents for child abuse in the Queens County Family Court, which removed the infants from parental custody. The infants were separated from the parent plaintiffs for an extended period of time— more than a year in one case and two months in the other. The child abuse charges were eventually dismissed against the parents, who along with the infants, filed suit in this court against the pediatrician, the hospitals involved, and their common corporate parent (collectively the “medical defendants”), as well as ACS caseworkers, their supervisors, ACS Commissioner John Mattingly, and the City of New York (“the City”)(collectively, the “City defendants”). Plaintiffs claim that defendants’ conduct violated their rights under the Constitution as well as federal and state laws. They assert federal law claims under 42 U.S.C. § 1983 (“Section 1983”) for violation of their constitutional rights under the First, Fourth and Fourteenth Amendments. They also bring state law claims of malicious prosecution, unlawful interference with parental custody of children, unlawful imprisonment, gross negligence and medical malpractice. The medical defendants move to dismiss the complaints for failure to state a claim pursuant to Fed.R.Civ.P. 12(b)(6). As to plaintiffs’ federal claims, made pursuant to 42 U.S.C. § 1983 (“Section 1983”), they contend that they are not state actors and cannot be held liable under Section 1983. They also invoke the Rooker-Feldman Doctrine to argue that the court does not have jurisdiction over claims that effectively challenge Family Court rulings. On plaintiffs’ state law claims, they contend that they are statutorily immune under state law. The City defendants in the Denes Q. matter (Docket No. 07-cv~1281) move for judgment on the pleadings pursuant to Fed.R.Civ.P. 12(c). Their counterparts in the V.S. matter (Docket No. 07-cv-213), based on partial discovery, move for summary judgment pursuant to Fed.R.Civ.P. 56. Both sets of motions largely rely on claims for qualified immunity. The court considers these four motions in tandem. For the reasons set forth below, the motions are granted as to plaintiffs’ malicious prosecution claim under Section 1983. The City defendants’ motion for judgment on the pleadings in the Denes Q. matter is also granted as to plaintiffs’ abuse of process claim. The motions are denied as to all other claims. I. Factual background on the Rule 12 motions The court first considers the three Rule 12 motions based on factual allegations in the complaint. The court accepts as true all well-pleaded and plausible factual allegations and draws all reasonable inferences in the plaintiffs favor. See Dangler v. New York City Off Track Betting Corp., 193 F.3d 130, 138 (2d Cir.1999) and Iqbal v. Hasty, 490 F.3d 143, 157-58 (2d Cir.2007). The factual recitation below is supplemented by information to which the court has taken judicial notice. A. The V.S. matter (Docket No. 07-cv-213) On August 19, 2004, V.S. placed her son T.S. in the care of her mother Ve.S., and left their residence in Forest Hills, Queens to run errands. (Compl. ¶ 22 (07cv213 ECF Dkt. Entry No. 1)). When she returned, she noticed that her son’s right leg appeared swollen (Id. IT 23). When the swelling worsened, she took him to the emergency room at SCH in New Hyde Park, New York, a facility operated by the LIJ Medical Center (Id. ¶¶ 12 & 23). Doctors there took an X-ray of T.S.’s leg and determined that he had suffered a fracture of the right femur. (Id. ¶ 24). The infant was admitted to the hospital for in-patient care. Plaintiffs contend that the infant should have been released as soon as a cast was placed his leg. (Id. ¶ 30). On August 20, 2004, Dr. Debra Esernio-Jenssen, a pediatrician at SCH, examined T.S., reviewed his medical records, and concluded that V.S. had shaken the infant or inflicted such severe head trauma that the infant had in fact suffered a fractured skull and internal brain hemorrhage. (Id. ¶ 27). Plaintiffs contend that this diagnosis was false as the infant had only suffered a broken leg. (Id. ¶ 28). Dr. Eser-nio-Jenssen refused to discharge T.S. to his mother and admitted the infant to SCH, which the plaintiffs contend, was done to gather evidence of child abuse. (Id. ¶ 31-32). Dr. Esernio-Jenssen ordered full-body X-rays and an MRI scan of the head, which revealed no skull fracture or brain hemorrhages. (Id. ¶¶ 31-35). Nevertheless, the medical defendants contacted the Central Register of the New York State Office of Children and Family Services and reported that V.S. had shaken T.S. (Id. ¶¶ 36-37). The Central Register forwarded the matter to ACS, which dispatched its investigators to SCH. (Id. ¶¶ 39-41). At the hospital, an ACS investigator and Dr. Esernio-Jenssen jointly questioned V.S. about her son’s injuries. (Id. ¶ 43). When she was asked how T.S. sustained the injury, V.S. was unable to provide an explanation. (Id. ¶ 43). Dr. Esernio-Jenssen allegedly told the ACS investigator that the infant’s head trauma was caused by his mother, and his leg fracture had occurred while he was in the care of his grandmother. (Id. ¶ 43). On August 24, 2004, pursuant to Article 10 of the Family Court Act, ACS filed an abuse petition with the Family Court in Queens County, alleging that Y.S. and her mother, Ve.S., had abused T.S. (Id. ¶ 46). More than a year later, on October 17, 2005, during the Family Court trial on the abuse petition in which several physicians including Dr. Esernio-Jenssen testified, the ACS withdrew the petition against V.S. and amended the petition to allege medical neglect against the grandmother, Ve.S. (Id. ¶ 49). ACS then restored infant T.S. to the care of his mother after almost 14 months of separation. (Id.). On November 22, 2006, the Family Court held that Ve.S. had medically neglected the infant T.S. and placed his physical well-being in imminent danger. The Family Court Judge found that while V.S. was away from the home in the afternoon of August 19, 2004, Ve.S. slipped in the kitchen while holding T.S. in her arms. (In re T[.] S[.], Dkt. No. NA-13963/04, Decision and Order of Judge Barbara Salinitro (Queens County Fam. Ct. Nov. 22, 2006), attached as Exh. A to Affidavit of Jonathan B. Bruno (“Bruno Aff.”, 07ev213 ECF Dkt. Entry No. 16), at 18). Ve.S. did not disclose the fall to her daughter until after the infant had been taken to the emergency room. (Id. at 10 & 17). Ve.S. testified that prior to August 19, she had never fallen with the child, had any accidents with him or shaken him. The Family Court deemed her failure to inform V.S. as medical neglect because it delayed his access to medical care. On January 16, 2007, V.S., on behalf of herself and her son, filed Civil Action No. 07cv213. (07cv213 Compl. ¶ 16). B. The Denes Q. matter (Docket No. 07-cv-1281) On January 4, 2006, Ann-Marie C. took her 22 month-old infant daughter, Y.Q., to her regular babysitter and went to work. (Compl. ¶¶ 25-26 (07cvl281 ECF Dkt. Entry No. 1)). Later in the day, the babysitter transferred the child to the care of Y.Q.’s paternal grandmother. When Y.Q.’s father, Denes Q., returned home that evening, he discovered a discoloration on Y.Q.’s rib cage. (Id. ¶¶ 27-28). That night, Denes Q. and Ann-Marie C. brought Y.Q. to the emergency room at FHH in Forest Hills. (Id. ¶¶ 28-29). FHH filed a report with the Central Register, reporting that the infant had been abused by burning and her parents were perpetrators of the abuse (Id. ¶ 33). The next day, FHH, which could not itself provide inpatient pediatric care, transferred the infant to SCH. (Id. ¶ 32). At SCH, Dr. Esernio-Jenssen examined Y.Q. and concluded that the infant had been burned by a hot liquid and that the burn was not accidental but the result of child abuse by the parents. (Id. ¶¶ 39-40, 45). The doctor allegedly then ordered the infant to undergo a retinal scan and a full skeletal survey. Plaintiffs contend these “very invasive procedures” were unrelated to the treatment for the burn, and were conducted “purely for investigative reasons.” (Transcript of Oral Argument before the Hon. John Gleeson, Aug. 3, 2007, (“8/3/07 Tr.”) at 25). On January 7, 2006, the SCH gave Y.Q. medical clearance to be discharged, but Dr. Esernio-Jenssen and the LIJ Medical Center held the infant in protective custody. The City defendants, acting ex parte, continued the protective custody until January 10, 2006. (07cvl281 Compl. ¶¶ 50-51, 54). Some time between January 4 and 10, 2006 the Central Register forwarded the case to ACS for investigation. On January 10, 2006, ACS filed an abuse petition in Queens Family Court, naming the parents, as well as the paternal grandmother and the babysitter as respondents. (Id. ¶¶ 52-58; Art. 10 Petition, Exh. A to Sweet Decl.). Plaintiffs allege that ACS’s petition relied solely on misinformation by Dr. Esernio-Jenssen (07cvl281 Compl. ¶¶ 52, 68, 85). That same day, at a proceeding held with the parents present and represented by counsel, the Family Court Judge ordered the temporary removal of Y.Q. from her parents and placed her in the care of her godparents under ACS supervision (Id. ¶ 54; Exh. B & C to Declaration of Emily Sweet (“Sweet Decl.” 07cvl281 ECF Dkt. Entry No. 21)). The Family Court Judge ruled that continued parental custody would be “contrary to the welfare and best interests of the child because [the infant] had suffered third degree burns with no plausible explanation by respondents as to how she sustained such bums.” (Exh. C to Sweet Decl.). On January 27, 2006, Y.Q. received a skin graft at the Staten Island University Hospital. The burn specialist who performed the procedure determined that the burn was accidental. (07evl281 Compl. ¶ 55; Exh. 2 to Declaration of Carolyn A. Kubitschek (“Kubitschek Decl.” 07cvl281 ECF Dkt. Entry No. 28) at 7). The procedure was performed without the consent of Y.Q.’s parents, who could not attend to her without the presence of hospital staff. From January 27 to February 5, 2006, Y.Q. remained hospitalized at the Staten Island University Hospital. (07cvl281 Compl. ¶ 55). On February 9, 2006, ACS admitted to the Family Court that Y.Q.’s burn was caused by an accident that did not occur in the presence of her parents, and agreed to restore Y.Q. to her parents’ custody under supervision. (Id. ¶ 56; Exh. 2 to Kubit-schek Decl. at 7-8). In all, the infant was separated from her parents for about two months. On March 27, 2006, ACS withdrew the abuse petition against the parents but continued proceedings against the grandmother and babysitter (07cvl281 Compl. ¶ 59; Exh. D & E to Sweet Deck). That same day, Denes. Q. and Ana Q., on behalf of themselves and their daughter, filed Civil Action No. 07-cv-1281. C. Dr. Debra Esernio-Jenssen Dr. Esernio-Jenssen, the SCH pediatrician who made the initial child abuse diagnoses in both cases, is alleged to be under contract with ACS as a consultant who assists and advises the agency in investigating and prosecuting cases of child abuse and neglect. (07cv213 Compl. ¶ 16; 07cvl281 Compl. ¶20). Plaintiffs accuse her of being “zealot” who has a history of giving misleading or incorrect diagnoses, detecting cases of alleged child abuse and removing supposedly abused children from their parents. (07cv213 Compl. ¶¶ 18-19, 45; 07evl281 Compl. ¶ 22). She is also accused of carrying out an SCH policy or practice of removing children from their parents without probable cause to believe that the children had been neglected or abused. (07ev213 Compl. ¶52). The VS plaintiffs assert that ACS should have known about Dr. Esernio-Jenssen’s track record of unreliable child abuse diagnoses and acted unreasonably in relying on her diagnoses to remove the children from parental custody. The plaintiffs gave no other facts to amplify their assertions against Dr. Eser-nio-Jenssen in their complaints. However, the court takes judicial notice of two recent decisions from other judges in this district that document instances of misdiagnosis by this doctor. In the first case, Dr. Esernio-Jenssen, identified as a pediatric specialist in the Child Protection Consulting Team at the SCH, examined a six-month old infant who was found not breathing by his parents and later died at the hospital in 2002. See Cornejo v. Bell, Nos. 04-cv-341 & 06-cv-2910 (BMC)(SMG), slip op. at 4 (E.D.N.Y May 16, 2008). In Cornejo, she determined that the infant’s injuries were inflicted by shaking (shaken baby syndrome) and did not occur naturally. Id. Dr. Esernio-Jens-sen deemed incredible, the father’s explanation that he had “smacked [the infant’s] back” to burp him, and conveyed to an ACS investigator her suspicion that the father had violently shaken the baby. Id. Her diagnosis prompted the removal of the infant’s 18-month old brother to foster care. Despite a preliminary autopsy showing the infant’s rib injuries to be the result of a congenital bone malformation, not fractures from shaking, she refused to alter her shaken baby syndrome diagnosis in her testimony before a Family Court judge. Id. at 7 & 8. A final autopsy report concluded that the infant’s death was caused not by the shaken baby syndrome but a rare and natural heart defect. Id. at 9. Eventually, ACS reached the same conclusion and withdrew the child abuse petitions against the parents in the Family Court. Id. at 11. The infant’s brother was separated from his mother for about three months. In the second case, Dr. Esernio-Jenssen determined in November 2004 that a nine-month infant’s minor wrist fracture was caused by the violent shaking of his arm by one or both of his parents. Estiverne v. Esernio-Jenssen, 581 F.Supp.2d 335, 339-40, 2008 WL 2987041, *2 (E.D.N.Y.2008). She reported her suspicions to the Central Register, refused to discharge the child to her parents, cancelled an MRI examination that had been scheduled to test for bone disease, and ordered a skeletal survey to detect for signs of child abuse instead. Id. at 339-41, 2008 WL 2987041, **2-3. A radiologist at SCH who reviewed the X-ray refused to characterize the fracture as the result of abuse, and the initial ACS investigation found the injury was accidental. Id. at 339-41, 2008 WL 2987041, **2-3. A second ACS investigation, supported by the diagnosis of Dr. Esernio-Jenssen, led to a child abuse petition against the parents in Family Court, which removed the infant and his two siblings to foster care. Ten months later, ACS withdrew the petition against the parents. Id. at 340-41, 2008 WL 2987041, *3. The parents were separated from their children for more than eight months. Plaintiffs’ counsel, in opposing the V.S. City defendants’ motion for summary judgment, referenced a Family Court decision in which the judge questioned Dr. Esernio-Jenssen’s methodology and criticized her unprofessional courtroom demeanor. (See In re A[.] C[.] D[.], Corrected Decision and Order Upon Fact-Finding by Judge Rhea Friedman (Queens County Fam. Ct.)(redacted), attached as Exh. 19 to Declaration of Carolyn A. Kubitschek in Support of Additional Discovery Pursuant to Rule 56(f) (07cv213 ECF Dkt. Entry No. 43)). In that case, an infant taken to the emergency room by her parents on February 19, 2004, was found to have a skull fracture. The parents explained that the infant had been dropped accidentally by their fifteen-year old daughter in the presence of their other children. The other children confirmed this account, but Dr. Esernio-Jenssen was skeptical. She interpreted the CT scan as showing multiple fractures that amounted to evidence of a pattern of child abuse. Another doctor, however, determined that the other suspected fractures were actually a form of a developmental anomaly common among Latin American infants. The parents told Dr. Esernio-Jenssen that a previous ACS investigation of child abuse in their family-proved unfounded and that the father used to drink before ceasing the habit when he converted to evangelical Christianity. Nonetheless, Dr. Esernio-Jenssen believed that the father’s alcoholism combined with what she speculated as “economic stressors” on the immigrant family led to prior abuse of the infant. Her belief prompted ACS to gain protective custody over the child. The Family Court found the parents to be very credible and seriously questioned Dr. Esernio-Jenssen’s methodology, including her failure to consider contrary objective medical findings and her focus on the family’s economic and immigrant status. The court found Dr. Esernio-Jenssen’s emphasis on “ethnic and religious issues odd and even distasteful.” (Id. at 18). She gave the court the impression that once she “had formed an intuitive judgment,” she “would make almost any argument to back it up.” (Id. at 23). The court found it “odd that Dr. Jenssen so rigidly rejected any alternative to her favored scenario (of child abuse) despite advice given from her own child abuse team.” (Id. at 22). The Family Court was also disturbed by her combative courtroom presence, contempt for the family’s attorney and “overly dramatic hand gestures.” (Id. at 23). The ACS petition against the parents in that case was dismissed. II. The V.S. and Denes Q. medical defendants’ motions to dismiss The medical defendants move to dismiss the Section 1983 claims against them pursuant to Fed.R.Civ.P. 12(b)(6), claiming that, as private actors, they had committed no state action that could give rise to federal liability. They also claim that several of the Section 1983 claims require the court to review Family Court decisions in a way that is barred by the Rooker-Feld-man Doctrine. They argue that state law immunity shields them from plaintiffs’ state law claims. The court considers the two motions in tandem, starting with the federal claims. A. Standard of Review for the 12(b)(6) Motions Rule 12(b)(6) of the Federal Rules of Civil Procedure permits a defendant to make a motion to dismiss a complaint for “failure to state a claim upon which relief can be granted.” Fed.R.Civ.P. 12(b)(6). In Bell Atlantic Corp. v. Twombly, the Supreme Court retired the standard set forth half a century ago in Conley v. Gibson, that a complaint should not be dismissed “unless it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief,” in favor of the requirement that plaintiff plead enough facts to “state a claim to relief that is plausible on its face.” Twombly, 550 U.S. 544, 127 S.Ct. 1955, 1968-69, 1974, 167 L.Ed.2d 929 (2007) (quoting Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 2 L.Ed.2d 80 (1957)). Under Twombly, a complaint cannot make merely “a formulaic recitation of the elements of a cause of action,” but must allege facts that “raise a right of relief above the speculative level on the assumption that all allegations in the complaint are true (even if doubtful in fact).” Id. at 1964-65 (citations omitted). The Second Circuit has interpreted the foregoing language to “requir[e] a flexible ‘plausibility standard,’ which obliges a pleader to amplify a claim with some factual allegations in those contexts where such amplification is needed to render the claim plausible,'” rather than to mandate a “universal standard of heightened fact pleading.” Iqbal v. Hasty, 490 F.3d at 157-58. When material outside the complaint is “presented to and not excluded by the court, the motion must be treated as one for summary judgment ... and all parties must be given a reasonable opportunity to present all the material that is pertinent to the motion.” Fed.R.Civ.P. 12(d). For the purposes of this rule, however, the complaint is deemed to include writings and documents attached to the complaint, referenced in the complaint, or integral to the complaint. See Chambers v. Time Warner, Inc., 282 F.3d 147, 152-53 (2d Cir.2002); Fed.R.Civ.P. 10(c). The court may also consider “matters of which judicial notice may be taken.” Brass v. Am. Film Tech., 987 F.2d 142, 150 (2d Cir.1993); Fed.R.Evid. § 201(b). Plaintiffs are harmed when material outside the complaint is considered on a motion to dismiss because they lack notice that such consideration is taking place. Global Network Commc’ns, Inc. v. City of New York, 458 F.3d 150, 155 (2d Cir.2006). Rule 12(d)’s conversion requirement remedies this problem by “deter[ring] trial courts from engaging in fact finding when ruling on a motion to dismiss and ensuring] that when a trial judge considers evidence dehors the complaint, a plaintiff will have an opportunity to contest defendant’s relied-upon evidence by submitting material that controverts it.” Id. Accordingly, where there is actual notice by the opposing party of all the information in the movant’s papers, the necessity to convert a motion to dismiss to one for summary judgment is largely dissipated. Chambers, 282 F.3d at 153. All of the facts in § I, supra, or set forth below that are not alleged in the complaints are drawn from materials of which both parties had notice or cases of which the court has taken judicial notice. B. Section 1983 claims 1. State Action Section 1983 of Title 42 of the U.S.Code holds “every person who, under color of any statute ... subjects ... any ... person within the jurisdiction [of the United States] to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws, ... liable to the party injured in an action at law, suit in equity, or other proper proceeding for redress.” Civil Rights Act of 1871 § 1, 42 U.S.C. § 1983. To maintain a Section 1983 action, the injured party must allege (1) “that some person has deprived him of a federal right,” and (2) “that the person who has deprived him of that right acted under color of state ... law.” Velez v. Levy, 401 F.3d 75, 84 (2d Cir.2005)(citing Gomez v. Toledo, 446 U.S. 635, 640, 100 S.Ct. 1920, 64 L.Ed.2d 572 (1980)). Action taken under color of state law includes the “misuse of state power” that a wrongdoer “possesses by virtue of state law” and acting while “clothed with the authority of state law.” United States v. Giordano, 442 F.3d 30, 42-43 (2d Cir.2006) (citations omitted). Generally, private conduct is not proscribed by the Fourteenth Amendment and does not give rise to Section 1983 claims. Perez v. Sugarman, 499 F.2d 761, 764 (2d Cir.1974). Sometimes, “actions of private entities may be considered to be infused with ‘state action’ if those private parties are performing a function public or governmental in nature and which would have to be performed by the Government but for the activities of the private parties.” Id. at 765. When “conduct that is formally private [] become[s] so entwined with governmental policies or so impregnated with a governmental character [such private conduct may] become[ ] subject to the constitutional limitations placed on state action.” Id. at 764 (internal quotations omitted). Whether private conduct qualifies as state action often requires a fact-intensive inquiry. “Only by sifting facts and weighing circumstances of each case can the nonobvious involvement of the State in private conduct be attributed its true significance.” Id. (internal quotations omitted). In Kia P. v. McIntyre, one of the defendants, a privately owned and administered hospital in New York, delayed the discharge of a newborn infant to the care of her parents for two weeks because the infant’s urine initially tested for positive for methadone. 235 F.3d 749 (2d Cir.2000). The hospital retained the infant to observe her symptoms of methadone withdrawal, a serious medical condition, and to confirm the accuracy of the initial drug test. The hospital, pursuant to its duty under N.Y. Soc. Serv. Law § 413, also reported the infant’s test and the mother’s history of drug addiction to the City’s Child Welfare Administration, the predecessor of ACS. That agency issued a hold on the infant’s discharge. When the urine test returned negative, the infant was medically cleared for discharge, but the hospital kept her in protective custody for two more days as it sought and eventually received clearance to release from the agency. The Second Circuit found the hospital’s acts of testing, retaining and observing the infant were undertaken in its role as a private medical care provider, and were not state actions subject to liability under Section 1983. Kia, 235 F.3d at 756. However, the hospital’s continued retention of the infant after she was medically cleared for discharge was undertaken solely in its social welfare role. Id. at 757. In this role, the hospital acted as “an instrumentality of the government” pursuant to its state law obligations and was “part of the reporting and enforcement machinery for the [government agency]”. Id. at 757, 758. The Second Circuit deemed the hospital’s continued retention of the infant for two days to be state action, because the private hospital was performing a protective custody function that would have been done by the government. Had state law not required the hospital to keep the hold on the infant, the government agency could have compelled the transfer of the infant to its care to prevent her release to her parents. To the extent the hospital’s medical care provider and social welfare roles coincided during the period of time in which the hospital retained the infant for medical treatment and to protect her from suspected child abuse, the Second Circuit in Kia found no basis for Section 1983 action against the hospital. The Circuit reasoned that, if the mother and child’s liberty interests were already deprived by the hospital acting in its care provider role, they could not at the same time be deprived by the hospital acting in its social welfare role. Id. at 757. Thus, it is only when the medical treatment ended and the hospital continued to hold the child from parental custody on behalf of the state, that the hospital acted with the color of state law. The question thus presented to the court in the instant cases is whether the actions taken by the medical defendants constitute state action under Kia. a. The V.S. medical defendants V.S. placed her son, T.S., in the care of the hospital on August 19 or 20, 2004, and the Family Court authorized ACS to take protective custody of T.S. on August 24, 2004. During the four intervening days, the hospital apparently took protective custody of the child. It is not clear whether the hospital was holding the child for medical reasons for this entire period. Plaintiffs contend that, after doctors at SCH diagnosed the infant T.S. with a leg fracture and placed the fractured leg in a cast, he should have been medically cleared for discharge. Dr. Esernio-Jens-sen refused to discharge the infant following the initial fracture diagnosis either on August 19 or 20, 2004. She ordered more diagnostic tests — a full-body X-ray and an MRI head scan. From the limited record at this stage of the proceedings, the court cannot definitively conclude that these tests were undertaken for “purely non-medical” reasons to detect signs of child abuse. The tests could have served a medical purpose such as to rule out other injuries that the child may have suffered. Nor can the court determine whether the doctor’s participation in the ACS interviews of the mother was to gather facts for medical care or to build a case for suspected child abuse. If the plaintiffs’ contention is true that the hospital did continue to hold the infant for a time beyond when he was ready to be medically discharged, then the hospital’s further protective retention of the child was done under the color of its state law obligation to prevent child abuse. The plaintiffs have pleaded a plausible case that LIJ Medical Center, through the SCH, exercised its social welfare role apart from its care provider role in retaining T.S. Such actions would subject the medical defendants to liability under Section 1983. Accordingly, the V.S. medical defendants’ Rule 12(b)(6) motion is denied on this ground. b. The Denes Q. medical defendants In this case, the infant Y.Q. apparently was cleared for medical discharge on January 7, 2006, but the hospital kept her in custody until January 10, 2006. During this period, the plaintiffs contend that Dr. Esernio-Jenssen helped to build the case of child abuse by ordering additional medical tests unrelated to the skin burn, which plaintiffs contend was purely for investigative purposes. It is plausible, based on the facts pled, that the hold on the infant from January 7 through January 10 was done solely for protective reasons. Therefore, the Denes. Q. medical defendants’ Rule 12(b)(6) cannot dismiss the Section 1983 claims for lack of state action. 2. Rooker-Feldman Doctrine The medical defendants further contend that several of plaintiffs’ Section 1983 claims are barred by the Rooker-Feldman Doctrine because those claims require the court to review and reject prior rulings by the Family Court. They reason that to determine whether they unreasonably searched and seized the infant plaintiffs and interfered with the parents’ rights to the custody of their children and direct their medical treatment, the court must decide whether the medical defendants had reasonable cause to justifiably impinge upon the said rights. They suggest that the Queens County Family Court, by issuing the preliminary removal order of Y.Q. and finding Ve.S. guilty of medically neglecting her grandson T. S., had found probable cause of child abuse in each case. Those rulings, they contend, retrospectively validated their actions in taking the infants into protective custody and conducting medical examinations without the consent of their parents, thus barring plaintiffs’ federal law claims under the Rooker-Feldman Doctrine. Plaintiffs’ Section 1983 claims, they insist, invite this court to review or reject the Family Court’s rulings or become inextricably intertwined with those proceedings. These arguments are based on an overly expansive reading of the Rooker-Feldman Doctrine that has been explicitly rejected by the U.S. Supreme Court and is rejected herein. The Rooker-Feldman Doctrine denies federal jurisdiction to “cases brought by state-court losers complaining of injuries caused by state-court judgments rendered before the district court proceedings commenced and inviting district court review and rejection of those judgments.” Exxon Mobil v. Saudi Basic Indus. Corp., 544 U.S. 280, 284, 125 S.Ct. 1517, 161 L.Ed.2d 454 (2005). It establishes “the clear principle that federal courts lack subject matter jurisdiction over suits, that are, in substance, appeals from state-court judgments.” Hoblock, 422 F.3d 77, 84 (2d Cir.2005). For the doctrine to apply, a case or claim must meet four requirements: First, the federal-court plaintiff must have lost in state court. Second, the plaintiff must complain of injuries caused by a state-court judgment. Third, the plaintiff must invite district court review and rejection of that judgment. Fourth, the state-court judgment must have been rendered before the district court proceedings commeneed-i.e., Rooker-Feldman has no application to federal-court suits proceeding in parallel with ongoing state-court litigation. Id. at 85 (identifying the four requirements articulated in Exxon Mobil) (quotations omitted). The Rooker-Feldman Doctrine is unavailing to the medical defendants for several reasons. First and foremost, plaintiffs did not lose in the Family Court proceedings, as the child abuse petitions against the two mother plaintiffs were both withdrawn by ACS. The Family Court did not issue any final judgment against any of the plaintiffs here. In the V.S. matter, the child abuse petition was withdrawn against the mother, and the Family Court’s ruling of medical neglect was directed at Ve. S., the grandmother, who is a not a party here. The thrust of the Family Court’s decision is different from the inquiry presented in this case; the ruling does not preclude the claims by the mother here. The Family Court found that Ve.S., the grandmother, was medically neglectful in the four hours from the time of her fall to the time when her daughter discovered the injury to T.S. and sought medical attention. There is no indication of any sort of neglect or abuse on the part of the mother at any point throughout the unfortunate affair. Prior to Exxon Mobil, some circuits, including the Second, extended the Rooker-Feldman Doctrine to non-final state court interlocutory orders. See e.g., Campbell v. Greisberger, 80 F.3d 703, 707 (2d Cir.1996); Doe & Assoc. Law Offices v. Napolitano, 252 F.3d 1026, 1030 (9th Cir.2001). But Exxon Mobil makes clear that for Rooker-Feldman to apply, the state court proceedings must have “ended,” Exxon Mobil, 544 U.S. at 291, 125 S.Ct. 1517, producing “state-court losers,” id. at 284, 125 S.Ct. 1517, before the federal action begins. Since the state proceeding must have ended, the doctrine cannot bar a federal action attacking an interlocutory state court order. See TruServ Corp. v. Elegies, Inc., 419 F.3d 584, 591 (7th Cir.2005) (stating that “an interlocutory ruling does not evoke the doctrine or preclude federal jurisdiction”); Dornheim v. Sholes, 430 F.3d 919, 923-24 (8th Cir.2005); Gutt-man v. Khalsa, 446 F.3d 1027, 1032 (10th Cir.2006). Regardless, the complaints in these two cases are not seeking to reverse the Family Court’s temporary removal of the infants as those orders were terminated by the Family Court itself, with the consent of ACS. Reading the criteria of the Exxon Mobil plainly, the medical defendants do not satisfy the first or second requirements. The medical defendants also assert that since several of the Section 1983 claims in question here and the Family Court rulings both require findings as to the existence of probable cause of child abuse, the adjudication of these claims would be “inextricably intertwined” with the Family Court findings. The operative phrase, “inextricably intertwined,” taken from footnote 16 of District of Columbia Court of Appeals v. Feldman, 460 U.S. 463, 483, 103 S.Ct. 1303, 75 L.Ed.2d 206 (1983), formerly served as an independent ground for the application of Rooker-Feldman Doctrine. See Moccio v. New York State Office of Court Admin., 95 F.3d 195, 198— 199 (2d Cir.1996)(defining what it meant to be “inextricably intertwined”) and Phifer v. City of New York, 289 F.3d 49, 55 (2d Cir.2002) (following Moccio and describing the extension of Rooker-Feldman’s bar from cases that “effectively seek review of judgments of state courts” to “claims before the district court that are ‘inextricably intertwined’ with the state court’s determinations”.). The Exxon Mobil holding explicitly rejected Moccio’s expansive interpretation of this phrase, and emphasized that the Rooker-Feldman Doctrine cannot be broader than the rules of claim and issue preclusion under state law. 544 U.S. at 283, 125 S.Ct. 1517. The Second Circuit subsequently explained that the phrase “ ‘inextricably intertwined” is merely a “label” that has no “independent content.” Hoblock, 422 F.3d at 87. Under New York’s collateral estop-pel doctrine, a claim will be estopped only if “(1) the issue in question was actually and necessarily decided in a prior proceeding, and (2) the party against whom the doctrine is asserted had a full and fair opportunity to litigate the issue in the first proceeding.” Colon v. Coughlin, 58 F.3d 865, 869 (2d Cir.1995). This doctrine is also unavailing to the medical defendants. The only prior proceedings they can point to are the temporary removal hearings before the Family Court, which were hastily held on short notice, after each of the infants were removed from their parents. Those hearings did not afford the parent plaintiffs a full and fair opportunity to raise one of the central issues before this court — whether the medical defendants could reasonably rely on the diagnoses of Dr. Esernio-Jenssen whose belief in the existence of parental abuse led them to undertake state action that may have violated the plaintiffs’ constitutional rights. Accordingly, the medical defendants’ motions to dismiss under the Rooker-Feld-man Doctrine are denied as well. 3. Supplemental Jurisdiction The denial of the medical defendants’ motions to dismiss the federal claims also nullifies their request to have the court decline the exercise of supplemental jurisdiction and dismiss the state law claims pursuant to 28 U.S.C. § 1367(c)(3). As will be discussed in § II.C, infra, the court finds that the state claims presented in these cases arise out of a common nucleus of operative fact as the federal claims and do not present novel issues of state law. Therefore, the court, in its discretion, chooses to exercise its supplemental jurisdiction to the state law claims. C. State law claims 1. The claim of state statutory immunity as to all state law claims The medical defendants contend that statutory immunity under New York law shields them from all of plaintiffs’ state law claims. Section 419 of New York’s Social Services Law protects “[a]ny persons, official or institution” who is required to file a child abuse report or remove children into protective custody pursuant to their duty under [§ 424 of the Social Services Law], with immunity from any liability, civil or criminal, that “might otherwise result by reason of such actions.” (McKinney 2008). The good faith of defendants acting under their statutory duty is presumed, but immunity does not extend to liability resulting from willful misconduct or gross negligence of the actor. Id. The underlying policy behind the granting of such qualified immunity is to encourage the reporting of child abuse situations, and thereby affording children greater protection. See Van Emrik v. Chemung, 220 A.D.2d 952, 953, 632 N.Y.S.2d 712 (3d Dep’t 1995). To pierce the cloak of qualified immunity under § 419, a plaintiff must overcome the statutory presumption of good faith by showing “persuasive [evidence] of bad faith.” Id. In both complaints, medical defendant Dr. Esernio-Jenssen is accused of reporting incorrect diagnoses of the infant’s injuries that she knew or should have known to be false, or reported in reckless disregard for the truth. This accusation is supported in the V.S. matter by the additional fact that full-body X-rays she ordered for the infant T.S. did not appear to reveal any skull fracture or brain hemorrhage despite her report to the contrary. The apparent contradiction between the outcome of the X-ray and her report raises plausible inference of bad faith that could overcome the good faith presumption. In the Denes Q. matter, the same doctor is accused of falsely reporting that Y.Q.’s chest burn was a hot liquid burn caused by parental abuse. Plaintiffs contend that Dr. Esernio-Jenssen was neither a skin or a burn expert and therefore was not qualified to offer such an opinion. This contention alone does not raise an inference of bad faith. However, plaintiffs also allege that the doctor made the allegedly false diagnosis to “advance her personal agenda.” (07evl281 Compl. ¶ 48). It is not clear what kind of ulterior motive she had, but this allegation when viewed in the light most favorable to the nonmoving party and combined with other instances of misdiagnosis by Dr. Esernio-Jenssen, creates an inference of plausible bad faith that would preclude immunity. Accordingly, the court finds that both complaints have made a sufficiently plausible showing of bad faith on the part of Dr. Esernio-Jenssen to overcome the good faith presumption accorded to the medical defendants by statute. Their invocation of state law immunity fails. 2. Denes Q. medical defendants’ motion to dismiss individual state law claims. The medical defendants in the Denes Q. matter also moved to dismiss individual state law claims against them. a. Malicious prosecution The Denes Q. medical defendants contend that they cannot be subject to a malicious prosecution claim, because they merely reported their suspicions of child abuse and did not commence the actions against plaintiffs. The decision to petition the Family Court, they insist, was made by ACS, the City agency. A child abuse or neglect proceeding under Article 10 of the Family Court Act is a civil proceeding. People v. Smith, 62 N.Y.2d 306, 309, 476 N.Y.S.2d 797, 465 N.E.2d 336 (1984). Under New York State law, civil malicious prosecution claims contain seven (7) elements: (1) the commencement and prosecution of a judicial proceeding against the plaintiff, (2) by or at the insistence of the defendant, (3) without probable cause, (4) with malice, (5) which has terminated in favor of the plaintiff, (6) to her injury, and (7) that the plaintiff suffered interference with her person or property. Sundbye v. Ogunleye, 3 F.Supp.2d. 254, 260 n. 11 (E.D.N.Y.1998)(citing Realty by Frank Kay, Inc. v. Majestic Farms Supply, Ltd., 160 A.D.2d 789, 790, 553 N.Y.S.2d 858 (2d Dep’t 1990)). Generally, “one who merely responds to requests for information or who testifies as a witness does not, by those acts, institute or continue a prosecution.” Babi-Ali v. City of New York, 979 F.Supp. 268, 276 (S.D.N.Y.1997). But if the defendant “gave information which he knew to be false and so unduly influenced the authorities” or if his “persuasion was the determining factor in inducing the [government’s] decision” to prosecute, “he may be held liable.” Whittaker v. Duke, 473 F.Supp. 908, 911 (S.D.N.Y.1979); see also Babi-Ali, 979 F.Supp. at 276 (declining to grant judgment on the pleadings in favor of medical examiner who provided allegedly perjurious testimony but did not initiate the indictment). From the pleadings, it appears that Dr. Esernio-Jenssen’s attribution of Y.Q.’s burn injury as inflicted by her parents was the determining factor in the decision of ACS to proceed against the parent plaintiffs. The charges were later dismissed but not until after the infant plaintiff was separated from her parents for two months. Moreover, as discussed in the previous section, there is reason to believe that her diagnoses were made in bad faith. Hence, the court finds that Dr. Esernio-Jenssen may be liable for malicious prosecution of the parent plaintiffs, and the medical defendants’ motion dismiss this claim is denied. b. False imprisonment The Denes Q. medical defendants also contend that the complaint fails to state a claim for the false imprisonment of Y.Q. because plaintiffs cannot demonstrate that the infant was conscious of her confinement by the hospital. Under New York law, the elements of a false arrest or false imprisonment claim are: “(1) the defendant intended to confíne [the plaintiff], (2) the plaintiff was conscious of the confinement, (3) the plaintiff did not consent to the confinement and (4) the confinement was not otherwise privileged.” Singer v. Fulton County Sheriff, 63 F.3d 110, 118 (2d Cir.1995). The medical defendants point to Sager v. Rochester General Hospital, a case in which the court at trial granted the hospital’s motion for judgment on the false imprisonment claim because the plaintiffs had submitted no proof that the infant plaintiff who was five-months old when held in protective custody, was conscious of his confinement, 169 Misc.2d 643, 647 N.Y.S.2d 408, (N.Y.Sup.Ct.1996). At this stage of the proceedings, the court cannot, as a matter of law, hold that an infant who is almost two years old cannot be conscious of her prolonged separation from her parents. In the complaint, the plaintiffs allege that Y.Q., who was 22-months old at the time of her confinement, suffered “extreme humiliation, pain and suffering, terror, mental anguish and depression.” (07cvl281 Compl. ¶ 105). If these assertions are true, and the court finds them to be at least plausible, then it would only be reasonable to assume that the infant was aware of her confinement and separation. See Estiverne, supra, 581 F.Supp.2d at 348-50, 2008 WL 2987041, **10-12. At the pleadings stage, a plaintiff need not provide anything more than a sufficient notice to permit defendant to file an answer. In re Initial Pub. Offering Sec. Litig., 241 F.Supp.2d 281, 324 (S.D.N.Y.2003). The complaint here gives defendants sufficient notice of the false imprisonment claim and provides a plausible showing that the infant plaintiff may have been aware of her confinement. Plaintiffs have not had the opportunity to prove their case and need not do so to survive the motion to dismiss, which is also denied on this claim. c. Medical malpractice The Denes Q. medical defendants further contend that the complaint fails to establish a medical malpractice claim because it pleads no facts to suggest that Y.Q.’s injuries were exacerbated or mistreated while she was in their care. The two requisite elements of a medical malpractice claim are “a deviation or departure from accepted practice” and “evidence that such departure was a proximate cause of injury or damage.” Rebozo v. Wilen, 41 A.D.3d 457, 458, 838 N.Y.S.2d 121 (2d Dep’t 2007). Generally, physicians who participate in the investigation of child abuse are immune from liability pursuant to Social Services Law § 419, but this immunity does not apply if a doctor is “guilty of willful misconduct or gross negligence such that the statutory presumption of good faith was overcome.” Goldberg v. Edson, 41 A.D.3d 429, 429-30, 837 N.Y.S.2d 326 (2d Dep’t 2007). The complaint alleges that Dr. Esernio-Jenssen, in her professional capacity as a physician, misdiagnosed Y.Q.’s injuries as having been the result of child abuse and ordered invasive diagnostic tests that were unrelated to treatment for the infant’s skin condition. Moreover, in relation to the medical defendants’ state law immunity claims (see § II.C.l supra), the court has found it plausible that the doctor may have acted in bad faith. Thus, the complaint sets forth a prima facie claim for medical malpractice that can overcome the physician’s statutory immunity claim at this stage of the litigation. Accordingly, defendants’ motion is denied as to this claim. III. The Denes Q. City defendants’ motion for judgment on the pleadings The City defendants in the Denes Q. matter move for judgment on the pleadings pursuant to Fed.R.Civ.P. 12(c) as to plaintiffs’ Section 1983 claims, contending they have qualified immunity because the actions they took were objectively reasonable under the circumstances. They also argue that the complaint does not implicate a policy or practice of the City and does not state a constitutional violation by them. The plaintiffs oppose the motion and ask for leave to amend the complaint to add several factual allegations. A. Standard of review for Rule 12(c) motion In deciding a Rule 12(c) motion for judgment on the pleadings, the court applies the same standards as those governing Rule 12(b)(6) motions. Cleveland v. Caplaw Enter., 448 F.3d 518, 522 (2d Cir.2006); see also § II.A, supra. The court must confine its consideration to the facts stated on the face of the pleadings, and to matters of which judicial notice may be taken. Leonard F. v. Israel Disc. Bank, 199 F.3d 99, 107 (2d Cir.1999)(internal quotations omitted). B. The claim of qualified immunity on all federal claims Qualified immunity protects government officials from liability for civil damages when “their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known.” Harlow v. Fitzgerald, 457 U.S. 800, 818, 102 S.Ct. 2727, 73 L.Ed.2d 396 (1982). A right is “clearly established” if “[t]he contours of the right ... [are] sufficiently clear that a reasonable official would understand that what he is doing violates that right.” Anderson v. Creighton, 483 U.S. 635, 640, 107 S.Ct. 3034, 97 L.Ed.2d 523 (1987). Qualified immunity is an affirmative defense that the defendant has the burden of pleading. Gomez v. Toledo, 446 U.S. 635, 640, 100 S.Ct. 1920, 64 L.Ed.2d 572 (1980). When a defendant invokes qualified immunity against charges that he violated the constitutional rights of another, the court considers the defense in three steps. First, the court must decide whether the facts, when viewed in the light most favorable to the plaintiff, show the defendant’s conduct violated a constitutional right. Gilles v. Repicky, 511 F.3d 239, 244 (2d Cir.2007); Walczyk v. Rio, 496 F.3d 139, 154 (2d Cir.2007). If the facts could establish a violation, then “the next ... step is to ask whether the right was clearly established” in a given factual context or situation. Saucier v. Katz, 533 U.S. 194, 201, 121 S.Ct. 2151, 150 L.Ed.2d 272 (2001). Normally, a controlling precedent of the U.S. Supreme Court, the particular Circuit Court of Appeals or the highest court in the state is necessary to clearly establish federal law. Martin A. Schwartz & Kathryn R. Urbonya, Section 1983 Litigation 146 (2d Ed.2008). Finally, even if the right were clearly established, a defendant could still be protected by qualified immunity if it was objectively reasonable for him to believe that his conduct did not violate the law. Wilkinson v. Russell, 182 F.3d 89, 103 (2d Cir.1999). In other words, a defendant is permitted to have made a reasonable mistake about the state of the law and still be entitled to qualified immunity. Saucier, 533 U.S. at 205, 121 S.Ct. 2151. The immunity determination depends largely on whether the law was defined with reasonable clarity or whether a reasonable defendant would have understood under existing law that the conduct was unlawful. Wilkinson, 182 F.3d at 102-03. 1. Alleged violations of constitutional rights The Denes Q. complaint lists alleged deprivations of plaintiffs’ rights under the First, Fourth and Fourteenth Amendments of the U.S. Constitution. More specifically, the City of New York and Commissioner Mattingly are accused of maintaining an ACS policy or practice of removing children from parental custody without probable cause of child abuse or neglect, which the other City defendants followed in seizing and separating Y.Q. from her parents. As a result, they are said to have deprived Y.Q. of her right to be free from unlawful seizures under the Fourth Amendment, her parents’ interest caring for her, and all of plaintiffs’ right to intimate associations as a family under the First and Fourteenth Amendments (Counts I, II, VII & VIII). The complaint also accuses the City defendants of using or failing to prevent the use of unreliable information from Dr. Esernio-Jenssen to prosecute the parent plaintiffs for child abuse, which violated the parents’ right to be free of malicious prosecution under the Fourth Amendment and abuse of process under the Fourteenth Amendment (Count III). The Fourteenth Amendment’s Due Process Clause provides heightened protection against government interference with certain fundamental rights and liberty interests. Washington v. Glucksberg, 521 U.S. 702, 720, 117 S.Ct. 2258, 138 L.Ed.2d 772 (1997). It is well-established that parents have a constitutionally-protected liberty interest in the care, custody and management of their children. Tenenbaum v. Williams, 193 F.3d 581, 593 (2d Cir.1999); Wilkinson, 182 F.3d at 103-104 (2d Cir.1999)(“a parent’s interest in the custody of a child is a constitutionally protected liberty interest subject to due process protection”) (citations omitted); Gottlieb v. County of Orange, 84 F.3d 511, 518 (2d Cir.1996)(the interest of a parent in the custody of his or her children is a “fundamental, constitutionally protected liberty interest.”). This liberty interest “does not evaporate simply because [plaintiffs] have not been model parents.” Wilkinson, 182 F.3d at 104 (internal quotations omitted). The Due Process Clause also protects the relationship of children and their parents through a separate right of association, which includes the freedom of intimate association. Patel v. Searles, 305 F.3d 130, 135 (2d Cir.2002)(citing Roberts v. United States Jaycees, 468 U.S. 609, 617-18, 104 S.Ct. 3244, 82 L.Ed.2d 462 (1984)). Among the types of relationships protected under this doctrine, the ties “between members of a nuclear family deserve the most protection ... because they are among the most intimate of relationships.” Patel, 305 F.3d at 136. “As a general rule ... before parents may be deprived of the care, custody, or management of their children without their consent, due process — ordinarily a court proceeding resulting in an order permitting removal — must be accorded to them.” Tenenbaum, 193 F.3d at 593. Hence, a state’s ex parte removal of children from the custody of their parents raises procedural due process concerns. Kia at 759. The Fourth Amendment’s guarantee of the right to be free from unreasonable searches and seizures by the government extends to children taken by child welfare workers from their parents’ custody. Tenenbaum, 193 F.3d at 602. From the facts asserted in the complaint, it is clear that the City defendants’ ex parte actions in continuing the medical defendants’ removal of Y.Q. violated the plaintiffs’ procedural due process and the infant’s Fourth Amendment rights. However, these rights do not “automatically override the sometimes competing government interest in the protection of minor children, particularly in circumstances where the protection is considered necessary as against the parents themselves.’ ” Kia, 235 F.3d at 758 (quoting Wilkinson, 182 F.3d at 104). The City defendants removed Y.Q. pursuant to their statutory duty, under New York Social Services Law § 424(9), which obligates ACS to “take a child into protective custody to protect him from further abuse or maltreatment when appropriate and in accordance with provisions of the family court act.” (McKinney 2008). Separately, ACS workers are required to “take all necessary measures to protect a child’s life or health including when appropriate, taking or keeping a child in protective custody, ... without an order [from the Family Court] and without the consent of the parent or [legal guardian]” if there is “reasonable cause to believe” that the child’s continuing residence in or in the care and custody of the parent “presents an imminent danger to the child’s life or health” and “not enough time to apply for [a preliminary order of removal from the Family Court].” N.Y. Jud. Ct. Acts § 1024(e) (McKinney 2008). Child welfare caseworkers must balance between the competing interests of the state and family when they are confronted with situations of suspected child abuse. “If they err in interrupting parental custody, they may be accused of infringing the parents’ constitutional rights. [But][i]f they err in not removing the child, they risk injury to the child and may be accused of infringing the child’s rights.” Kia, 235 F.3d at 758 (citing van Emrik v. Chemung County Dep’t of Soc. Serv., 911 F.2d 863, 866 (2d Cir.1990)). Courts recognize that ACS caseworkers must choose between these difficult alternatives and accord them with “unusual deference in the abuse investigation context.” Wilkinson, 182 F.3d at 104. 2. Clearly-established Second Circuit precedent informing the legality of City defendants’ actions. The Second Circuit has established clear legal guidance on the proper balance between state interest and individual rights for child welfare caseworkers to follow when investigating suspected child abuse by parents. In Tenenbaum v. Williams, the Circuit held that state officials may take a child into protective custody “without court authorization or parental consent” in “emergency circumstances” which is present when “the child is immediately threatened with harm.” 193 F.3d at 594. The state’s removal of children from their parents under such circumstances would not violate the parents’ and children’s procedural due process rights. The Circuit emphasized the importance of “rendering State officials secure in the knowledge that they can act quickly and decisively in urgent situations and that the law will protect them when they do.” Id. at 595. Only when the caseworkers have the discretion to act, can they properly safeguard a child’s well-being. Id. Thus, the conduct of caseworkers in a child abuse “investigation will pass constitutional muster provided simply that [they] have a ‘reasonable basis’ for their findings of abuse.” Wilkinson, 182 F.3d at 104 (citing van Emrik, 911 F.2d at 866). The Circuit formulated a similar rule to address the Fourth Amendment concerns of the child being searched and seized by the state in these circumstances. If the child welfare workers possessed information that “would have warranted a person of reasonable caution” to believe that the child “was subject to the danger of abuse if not [taken into protective custody] before court authorization could reasonably have been obtained, then they had probable cause to remove the child without violating her Fourth Amendment rights.” Id. at 605; Nicholson v. Scoppetta, 344 F.3d 154, 172 (2d Cir.2003) (“there is no Fourth Amendment violation committed by ACS officials carrying out an ex parte removal where there was probable cause to believe that there existed facts to merit emergency removal under New York law”). Thus, whether caseworkers have reasonable basis or probable cause to act depends on the nature and quality of information uncovered in their investigation. In assessing what they knew, courts must be “especially sensitive to the pressurized circumstances routinely confronting caseworkers, [who must often decide] between ‘difficult alternatives’ ... on the basis of limited or conflicting information.” Wilkinson, 182 F.3d at 105 (citing van Emrik, 911 F.2d at 866). 3. Objective reasonableness of the Denes Q. City defendants’ conduct Both sets of clearly established rules governing the removal of children turn on whether the information the City defendants possessed at the time would lead a person of reasonable caution to conclude that the child would be in immediate danger of abuse if drastic action were not taken. In this case, it is undisputed that Y.Q. had a serious burn to the chest that her parents could not explain. However, the presence of such an unexplained injury, by itself, is not a reason to conclude that the child faces further danger from her parents. The injury may have been, as plaintiffs contend, and as was later determined, the result of an accident. The caseworkers in this case also received a diagnosis from a pediatrician who described Y.Q.’s injury to be the result of parental misfeasance. This diagnosis suggested that the injury was intentionally inflicted, and left open the possibility of future harm to the child. The City defendants contend that in light of this diagnosis, the caseworkers’ belief in the imminent danger to the child was reasonable and their removal of Y.Q. into protective custody was justified under those circumstances. If the case were limited to these facts, the City defendants would seem to have a strong case for qualified immunity under the clearly established and clearly deferential standard of the Second Circuit. The fact that the diagnosis later turned out to be inaccurate does not alter wh