Opinion
Civil Action NO. 98-2198 SECTION "N".
April 18, 2000.
ORDER AND REASONS
Before the Court is pro se plaintiff's Motion to Reconsider. For the following reasons, the Court grants reconsideration, but declines to reverse its prior ruling.
In addition to the Motion to Reconsider, on January 18, 2000, plaintiff filed pro se a motion requesting "summary judgment" Because the second motion presents the same claims as those raised in plaintiff's Motion to Reconsider, and a Motion for Summary Judgment is not appropriate at this stage of the proceedings, this Order and Reasons renders decision on all of plaintiff's motions currently pending before the Court.
BACKGROUND
Plaintiff Carl E. Goosman is a prisoner presently incarcerated in a federal medical facility in Rochester, Minnesota. He filed a pro se complaint pursuant to 42 U.S.C. § 1983 against Orleans Parish Criminal Sheriff Charles Foti, Jr., Mary Kennedy, Allen Verret and J. Taylor, alleging that he received constitutionally inadequate medical care for Hodgkin's lymphoma, a broken cheek bone and eye socket, and a pinched nerve in his back while he was incarcerated at the Orleans Parish Prison system ("OPP") for a period of time during 1998. On April 12, 1999, this Court approved the Report and Recommendation (the "Report") of a United States Magistrate Judge, adopting the Report as its opinion and rendering judgment in favor of defendants. The Court dismissed plaintiff's complaint with prejudice pursuant to Fed.R.Civ.P. 12(b)(6) and 42 U.S.C. § 1997e(c)(1) for failure to state a claim upon which relief can be granted. Thereafter, on April 27, 1999, plaintiff filed this Motion to Reconsider together with a request for an extension of time to file a memorandum in support. After receiving plaintiff's memorandum in support, this Court ordered a reply brief from defendants on July 16, 1999. Plaintiff later filed a response to defendants' opposition memorandum.
The Record
Plaintiff was arrested in September, 1997 on charges of income tax fraud. He was subsequently convicted on July 1, 1998 and received a 46 month prison sentence. His claims for inadequate medical care in this case i-elate exclusively to the six-month period of time during which he was incarcerated at OFF, from January 16 until July 27, 1998.
Prior to his incarceration at OPP, Goosman was held in the Lafourche Parish Jail ("LPJ"). Goosman states that he suffered a broken left cheek bone and eye socket two days prior to his incarceration at LPJ. He further states that officials at LPJ x-rayed his left cheek bone and eye socket to determine if they were broken before he was transferred to OPP; Plaintiff also states that his medical records were presented to United States deputy marshals during a hearing before a United States Magistrate Judge on January 16, 1998. In addition, plaintiff claims that such medical records indicate that during his incarceration at LPJ, a biopsy of a lump on his neck was performed in December, 1997, at Chabert Memorial Hospital in Houma, Louisiana. Plaintiff states that he did not receive the results of the biopsy, however, before his transfer to OPP on January 16, 1998. Still, plaintiff asserts that such medical records from Chabert Hospital were brought to the attention of OPP officials.
The record before the Court contains copies of verified jail medical records. Plaintiff states that the medical records appear to be accurate, except that they fail to include his records from Chabert Hospital. The verified medical records indicate that during the initial screening exam upon plaintiff's arrival at OPP, medical personnel observed a mass on his neck and a broken facial bone. The records also note that plaintiff complained of upper back pain. These initial records further indicate that plaintiff was marked for referral to the surgery clinic at Charity Hospital for a large mass on his neck and broken facial bones.
Goosman now asserts a claim for inadequate medical care, arguing that he was not diagnosed with Hodgkin's lymphoma until May, 1998, and that he did not begin chemotherapy until over three months later, after he was transferred from OPP. The medical records indicate that plaintiff was first referred to Charity Hospital by OPP officials for the mass on his neck in January upon his arrival. He was then referred a second time before the end of the month. Plaintiff was seen at Charity clinics on February 27, 1998, and a CT scan of his neck was ordered at that time. Plaintiff states that a needle biopsy was then performed sometime before March 19, 1998. After the needle biopsy, plaintiff was again referred to Charity on two occasions, and was seen at Charity on April 1, 1998. Upon review of the CT scan results, on April 17, 1998, a surgical biopsy of the mass was ordered. Goosman was brought back to Charity on April 27, 1998, for the biopsy and then discharged. On May 3, 1998, plaintiff was seen at Charity's Hematology/Oncology Clinic, where he was diagnosed with Hodgkin's lymphoma. The doctor's assessment indicated plaintiff "may start chemotherapy for Hodgkin's lymphoma." Plaintiff was again referred to Charity by OPP and was seen at Charity on May 15, 1998. He was also seen by doctors at OPP. On June 11, 1998, Charity doctors noted that Goosman's Hodgkin's disease needed staging, and thus a bone marrow biopsy 9and additional a scans were ordered. Goosman was brought to Charity for those tests on June 15, 1998. He was seen again at Charity on June 22, 1998, at which time the doctors told him that the biopsy revealed no evidence of lymphoma, but that the a results were not yet available. OPP then referred Goosman back to Charity for follow-up. He was seen by prison medical personnel on July 1, 1998, when it was noted that plaintiff was to begin chemotherapy soon and tinter, that chemotherapy was planned in Minnesota. Goosman states that he did not begin his chemotherapy, however, until August 25, 1998, at the federal medical center for prisoners in Rochester, Minnesota.
In addition, Goosman also claims that he was never taken to Charity Hospital specifically for examination of his facial injuries. He claims that after several months, in May, 1998, a doctor told him that the bones had probably healed in place. Plaintiff complains also that he never received any constructive work on his fractured cheek bone. Regarding his back pain, plaintiff states that he believes it was caused by a pinched nerve, but that he was never diagnosed with that condition, and that he was transferred to another facility before a CT scan of his back was ever performed. With regard to these medical needs, the record reveals that plaintiff was referred to several Charity clinics for complaints of back pain throughout his incarceration at OPP. Plaintiff was also seen on numerous occasions by prison medical personnel, who prescribed pain and anti-inflammatory medications, and treated plaintiff for hypertension. While it appears that plaintiff was not referred to Charity specifically for his facial injuries, nonetheless, he was actively treated at OPP for these injuries, as well as back pain.
PROCEDURAL HISTORY AND STANDARD OF REVIEW
The United States Magistrate Judge properly screened Goosman's petition to determine whether it stated a claim for violation of his constitutional rights that is cognizable under 42 U.S.C. § 1983, arising from conditions of his confinement. See Martin v. Scott, 156 F.3d 578 (5th Cir. 1998). cert. denied, 119 S.Ct. 265 (1999); 28 U.S.C. § 1915A. In the Fifth Circuit, the principal mechanism by which this screening is accomplished is the Spears hearing, the purpose of which is to dig beneath the conclusory allegations of a pro se complaint, to ascertain exactly what the prisoner alleges to have occurred and the legal basis of the claims. See Spears v. McCotter, 766 F.2d 179, 180 (5th Cir. 1985). During the Spears screening process, the Magistrate Judge was able to consider and rely on upon documents, such as verified medical records, as long as they were properly identified, authentic and reliable. See Norton v. Dimazana, 122 F.3d 286, 292 (5th Cir. 1997).
Any complaint which fails to state a claim under Fed.R.Civ.P. 12(b)(6) maybe dismissed by the Court sua sponte. See First Gibralter Bank, FSB v. Smith, 62 F.3d 133, 135 (5th Cir. 1995);Guthrie v. Tifco Indus., 941 F.2d 374, 379 (5th Cir. 1991);Shawnee Int'l, N.V. v. Hondo Drilling Co., 742 F.2d 234, 236 (5th Cir. 1984). Insofar as pro se claims by prisoners are concerned, "when a complaint raises an arguable question of law which the district court ultimately finds is correctly resolved against the plaintiff, dismissal under Rule 12(b)(6) is appropriate. . . ."Moore v. Mabus, 976 F.2d 268, 269 (5th Cir. 1992). A prisoner's complaint which fails to state a claim may be dismissed by the Court sua sponte at any time. See 42 U.S.C. § 1997e(c)(1).
Plaintiff asks this Court to review Magistrate Judge Wilkinson's February 25, 1999 Report and Recommendation, wherein it was recommended that the complaint be dismissed with prejudice pursuant to Fed.R.Civ.P. 12(b)(6) and 42 U.S.C. § 1997e(c)(1) for failure to state a claim on which relief can be granted. Plaintiff also moves this Court to reconsider his complaint, arguing that he was unaware of the purpose of a Spears hearing at the time it was conducted. The Court grants reconsideration, but declines to reverse its previous ruling. Upon reconsideration, having undertaken a thorough and exhaustive review of plaintiff's pleadings and written submissions, plaintiff's medical record, defendants' opposition and the applicable law, the Court finds that plaintiff's complaint, when read under the broadest reading, was properly dismissed under Rule 12(b)(6) and 42 U.S.C. § 1997e(c)(1) for failure to state a claim of deliberate indifference by OPP officials to plaintiff's serious medical needs.
Pro se civil rights complaints must be liberally construed.See Moore v. McDonald, 30 F.3d 616, 620 (5th Cir. 1994). The Court liberally construed the pro se complaint.
LAW AND ANALYSIS
Plaintiff was a pretrial detainee for part of the six-month time period about which he complains and a convicted prisoner for the remainder of the time. Under the holding of Hare v. City of Corinth, it is clear that "the State's exercise of its power to hold detainees and prisoners brings with it a responsibility under the U.S. Constitution to tend to the essentials of their well-being." 74 F.3d 633, 638-39 (5th Cir. 1996) (en banc) (citing DeShaney v. Winnebago County Dep't of Social Servs., 489 U.S. 189, 200, 109 S.Ct. 998, 1005-06, 103 L.Ed.2d 249 (1989)). While the Eighth Amendment provides the basis for a convicted prisoner's constitutional rights, the Fourteenth Amendment due process guarantees provide a basis for a pretrial detainee's constitutional rights. See id. at 639.The Fifth Circuit recently clarified the proper analysis for constitutional challenges by pretrial detainees. See Olabisiomotosho v. City of Houston, 185 F.3d 521 (5th Cir. 1999);Sibley v. Lamaire 184 F.3d 481 (5th Cir. 1999); Scott v. Moore, 114 F.3d 51 (5th Cir. 1997) (en banc); see also Flores v. County of Hardeman, 124 F.3d 736 (5th Cir. 1997). In Hare, the Fifth Circuit determined that there are two standards that may be applied, depending on whether the challenge is classified as an attack on a "condition of confinement" or as an "episodic act or omission." 74 F.3d at 644 see also Olabisiomotosho, 185 F.3d at 526; Sibley, 184 F.3d at 487-88; Flores, 124 F.3d at 738; Scott, 114 F.3d at 53-54. A dispute involving a "condition of confinement" involves a "[c]onstitutional attack on general conditions, practices, rules, or restrictions of pretrial confinement." Hare, 74 F.3d at 644 see also Olabisiomotosho, 185 F.3d at 526; Flores, 124 F.3d at 738; Scott, 114 F.3d at 53-54. In contrast, where alleged harm is a particular act or omission of one or more officials, the action is characterized as an "episodic act or omission" case. See Hare, 74 F.3d at 645; see also Olabisiomotosho, 185 F.3d at 526; Sibley, 184 F.3d at 487-88; Flores, 124 F.3d at 738; Scott, 114 F.3d at 53-54.
In an "episodic act or omission" case, a jailer's constitutional liability to a pretrial detainee is measured by a standard of deliberate indifference. See Hare, 74 F.3d at 636;see also Olabisiomotosho, 185 F.3d at 526; Sibley, 184 F.3d at 489; Flores, 124 F.3d at 738 Scott 114 F.3d at 54. "[N]egligent inaction by a jail officer does not violate the due process rights of a person lawfully held in custody of the State."Sibley, 184 F.3d at 489; see also Southard v. Texas Bd. of Criminal Justice, 114 F.3d 539, 551 (5th Cir. 1997); Jolly v. Klein, 923 F. Supp. 931, 944-45 (S.D. Tex. 1996); Hare, 74 F.3d at 649. Thus, a pretrial detainee must demonstrate that "the official had subjective knowledge of a substantial risk of serious harm to a pretrial detainee but responded with deliberate indifference to that risk." Hare, 74 F.3d at 650.
The standard of deliberate indifference was first enunciated by the Supreme Court in Estelle v. Gamble, 429 U.S. 97, 104-05, 97 S.Ct. 285, 291, 50 L.Ed.2d 251 (1976). See also Hare, 74 F.3d at 645 (determining that the Estelle deliberate indifference standard applies to episodic act or omission claims). The Court, in Farmer v. Brennan, 511 U.S. 825, 114 S. Ct. 1970, 128 L.Ed.2d 811 (1994), further clarified this standard in its holding that a prison official cannot be found liable "unless the official knows of and disregards an excessive risk to inmate health or safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference." Farmer, 511 U.S. at 837, 114 S.Ct. at 1979 (emphasis added).
"The Supreme Court has recently reaffirmed that `deliberate indifference' is a stringent standard of fault, requiring proof that a municipal actor disregarded a known or obvious consequence of his action." Board of County Comm'rs of Bryan County, Okla. v. Brown, 520 U.S. 397, 117 S. Ct. 1382, 1391, 137 L.Ed.2d 626 (1997). The plaintiff need not, however, "show that a prison official acted or failed to act believing that a harm actually would befall an inmate; it is enough to show that the official acted or failed to act despite his knowledge of a substantial risk of serious harm." Id. at 842, 114 S.Ct. 1970. In some circumstances, "a prison official's knowledge of a substantial risk of harm may be inferred by the obviousness of the risk."Jolly, 923 F. Supp. at 944 (citing Farmer, 511 U.S. at 842-43 n. 8, 114 S.Ct. at 1981-82 n. 8). Deliberate indifference may be shown by intentional denial or delay of access to medical care or intentional interference with treatment once prescribed. See id. On the other hand, inadvertent failure to provide care, negligent diagnosis, or unsuccessful treatment are insufficient to state a claim. See id. at 944-45. In other words, "[whether a prison official had the requisite knowledge of a substantial risk is a question of fact subject to demonstration in the usual ways, including inference from circumstantial evidence . . . and a fact finder may conclude that a prison official knew of a substantial risk from the very fact that the risk was obvious." Farmer, 511 U.S. at 842, 114 S.Ct. 1981.
In sum, a cognizable Section 1983 claim alleging unconstitutionally inadequate medical care must assert both serious medical needs and deliberate indifference as stringently defined by the case law. This Court will assume that Goosman's medical needs, especially Hodgkin's disease, were serious medical needs within the meaning of Estelle. 429 U.S. 97, 97 S.Ct. 285. Thus, the question before the Court is whether Goosman alleges facts, confirmed by his testimony and medical records, indicating that it could be inferred that prison officials acted or failed to act with deliberate indifference to Goosman's medical problems, as opposed to mere negligent action.
Plaintiff also alleges that other medical problems, including back pain and broken cheek bone and eye socket were serious medical needs that defendants deliberately disregarded.
Here, plaintiff first disputes the Court's characterization of his complaint as an "episodic act or omission" case, arguing that the entire staff at OPP knew that he was ill. Even if this assertion is assumed to be true, the Court remains convinced that plaintiff's complaint does not assert a constitutional attack on general conditions, rules or restrictions of confinement. Plaintiff's pleadings, as expanded by his testimony, establish that an episodic act or omission as defined in Hare is at issue. Thus, the deliberate indifference standard applies and plaintiff must allege facts sufficient to establish that defendants knew plaintiff faced a substantial risk of serious harm and deliberately disregarded that risk by failing to take reasonable measures to abate it. As explained more fully below, plaintiff has not pled sufficient facts from which it could be inferred that defendants acted or failed to act with deliberate indifference to his serious medical problems.
Next, plaintiff reasserts that he received no treatment for Hodgkin's disease, a broken cheek bone and eye socket, and a pinched nerve in his back during the entire time of his incarceration at OPP. Plaintiff also disagrees with the Court's conclusion that he received substantial medical care and attention for his Hodgkin's disease, stating that he was only diagnosed but never treated in any way. Finally, plaintiff asserts that the OPP medical department knowingly, willfully and deliberately denied him medical treatment.
The United States Magistrate recommended dismissal of plaintiffs claims, reasoning that plaintiff had received "extensive treatment" for cancer, broken facial bones, and back pain. The treatment considered included repeated referrals to Charity Hospital clinics, numerous clinic visits, diagnostic resting and provision of medicines such as Tylenol, Motrin, Naprozen and a vitamin-enriched drink, Ensure. While this Court agrees that plaintiff's receipt of such medicines does not constitute "treatment" for cancer, nonetheless, the record reveals that plaintiff did in fact receive extensive care and attention for Hodgkin's disease. While incarcerated at OPP, plaintiff was seen regularly by prison doctors as well as doctors at Charity's specialty clinic. He underwent two biopsies and several CT scans and was ultimately diagnosed. Even though plaintiff's diagnosis was made in early lay, doctors noted as late as mid-June that plaintiff's Hodgkin's disease needed staging. The Court thus draws the reasonable inference that plaintiff was not started on chemotherapy in May because of the need for staging. Moreover, during the month of June, it is reasonable to assume that chemotherapy was not begun because doctors at Charity continued to await the results of plaintiff's CT scans as late as June twenty-second. While it is unclear when prison officials learned of the intent to transfer plaintiff to Minnesota, the Court agrees with the Magistrate Judge's assessment that some delay in the commencement of chemotherapy can be attributed to plaintiff's transfer between facilities. Had Charity begun plaintiff's chemotherapy, his condition may have prevented the intended transfer. Thus, while the status of plaintiff's treatment after June is not clear, the record does not reveal facts sufficient to support plaintiff's burden to show that prison officials acted with deliberate indifference to his medical needs.
Even if it is possible that the acts of prison officials may amount to negligence, there is no evidence before the Court to suggest, let alone support, that OPP's actions were so reckless as to amount to deliberate indifference. This is a case where prison officials' knowledge of plaintiff's substantial risk of harm may be inferred from the obviousness of the risks of cancer, especially in light of the record, which reveals that plaintiff's diagnosis was well-documented. Therefore, it can be assumed that the seriousness of Goosman's illness was known by prison officials. Nonetheless, while timing of treatment may be essential to curing a disease such as Hodgkin's and Goosman disagrees with his course of treatment, the Court finds that the conduct of prison officials was reasonable. The prison officials' alleged delay in providing access to chemotherapy for Hodgkin's lymphoma is not sufficiently documented in the record to rise to the level of deliberate indifference necessary to establish a constitutional violation cognizable under Section 1983. Accordingly, having found upon reconsideration that defendants' actions and/or inactions were not taken with deliberate indifference to plaintiff's serious medical needs, the Court declines to reverse its prior ruling.