Background
In August 2021, during the COVID-19 pandemic, Guilford County Schools notified parents that students potentially exposed to a COVID-19 cluster within the football program would not be allowed to return to practice unless they were tested. The letter directed families to a testing clinic run by Old North State Medical Society, Inc. (ONSMS)—a private medical organization operating jointly with the school district—at Northwest Guilford High School.
Fourteen-year-old Tanner Smith went to the clinic accompanied by his stepfather, who waited outside in the car. Inside, clinic workers attempted but failed to reach Tanner’s mother by phone to obtain consent for a COVID-19 vaccine. Rather than notifying the stepfather waiting in the parking lot, a clinic worker instructed a colleague to “give it to him anyway.” Over Tanner’s expressed objection and without any parental consent, a Pfizer COVID-19 vaccine was administered to him.
Plaintiffs—Tanner and his mother Emily Happel—sued Guilford County Board of Education and ONSMS for battery and for violations of state constitutional rights, including Emily’s parental rights and Tanner’s right to bodily integrity under N.C. Const. art. I, §§ 1, 13, and 19. The trial court dismissed all claims. This Court initially affirmed based on federal PREP Act (Public Readiness and Emergency Preparedness Act) immunity. The North Carolina Supreme Court then reversed as to the constitutional claims, holding the PREP Act immunizes only tort injuries—not constitutional violations—and remanded two questions: (1) whether ONSMS was sufficiently alleged to be a “state actor,” and (2) whether plaintiffs had any adequate state remedy other than a Corum claim.
The Court’s Holding
On remand, a unanimous panel held that plaintiffs’ complaint survived Rule 12(b)(6) on both questions and reversed the trial court’s dismissal. A Corum claim—named for Corum v. University of North Carolina, 330 N.C. 761, 413 S.E.2d 276 (1992)—is a direct constitutional cause of action against a state actor when no adequate state remedy exists. It requires: (1) the defendant is a state actor who violated the claimant’s state constitutional rights; (2) the claim is colorable; and (3) there is no adequate state remedy. The Supreme Court had already confirmed element (2).
On the state-actor question, the court acknowledged this is a novel issue for Corum claims—no prior NC decision had defined what it means for a private party to be “clothed with the authority of the State” in this context. Drawing from § 1983 jurisprudence and Fourth Amendment doctrine, the court held that a private party jointly engaged with a state actor in the offending conduct can qualify. Because plaintiffs alleged ONSMS operated the clinic as a joint venture with Guilford County Schools, there were plausible legal theories under which ONSMS could be a state actor, sufficient to survive a motion to dismiss.
On adequate state remedy, the court held that when the PREP Act completely forecloses all tort claims, there is no available state-law avenue for relief—satisfying the third Corum element. The court remanded to the trial court to determine on the merits whether ONSMS was “clothed with the authority of the State” and whether any constitutional violation occurred.
Key Takeaways
- The PREP Act’s broad tort immunity for COVID-era medical providers does not bar state constitutional claims under the NC Constitution. When PREP Act immunity closes the tort courthouse door, it may simultaneously open the Corum door by eliminating any “adequate state remedy.”
- This is the first NC appellate opinion to address what qualifies as a “state actor” for purposes of a Corum claim. The court borrowed the § 1983 “joint engagement” test: a private party that operates jointly with a government entity in the offending conduct can be a state actor for NC constitutional purposes.
- At the Rule 12(b)(6) stage, a plaintiff need not conclusively prove state-actor status—only plead facts supporting a plausible legal theory that the private entity was acting jointly with or under the mantle of state authority.
- Public-private partnerships delivering medical services through school districts or government health agencies should consider how the operational structure of a joint venture may affect constitutional exposure when federal immunity statutes foreclose tort claims.
Why It Matters
Happel maps the intersection of federal PREP Act immunity and North Carolina’s unique direct constitutional cause of action. Defense counsel for healthcare organizations operating under federal emergency authorizations should recognize that PREP Act protection, while broad against tort suits, may inadvertently satisfy the “no adequate state remedy” element that opens Corum liability. NC plaintiffs whose tort claims against pandemic-era medical programs are PREP-barred now have a roadmap: plead a joint-venture relationship with a government entity and allege violation of constitutional rights such as parental consent or bodily integrity.
The case also matters for entities considering future public-private health partnerships with school districts or county health departments. The more intertwined the operational relationship—shared facilities, joint branding, government referrals—the stronger the argument that a private medical provider is acting “under color of state authority” for NC constitutional purposes. Schools and counties structuring such programs should closely examine contractual and operational separation between government and private actors, particularly when federal immunity statutes may be in play.