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denying a motion to dismiss pursuant to Rule 12(b) by referring to conceivability requirements, but analyzing the facts that a medical provider had an improper profit motive to improperly treat serious medical conditions, which supported the inference that a defendant acted with deliberate indifference in not addressing serious medical needs in violation of the Eight Amendment
Summary of this case from Eskridge v. HutchinsOpinion
C.A. No. 04C-12-028 WLW.
Submitted: May 13, 2005.
Decided: July 14, 2005.
Upon Defendants' Motion to Dismiss. Denied.
Stephen A. Hampton, Esquire of Grady Hampton, LLC, Dover, Delaware; attorneys for the Plaintiffs.
Dana M. Spring, Esquire and Daniel L. McKenty, Esquire of McCullough McKenty, P.A., Wilmington, Delaware; attorneys for the Defendants.
ORDER
Upon consideration of Defendant's motion to dismiss and the record before this Court, it appears to the Court:
On December 14, 2004, Darcella Smith ("Plaintiff"), Administratrix of the Estate of Gregory D. Smith, filed a complaint against First Correctional Medical, LLC ("FCM"), Tammy Kastre, M.D. and Raphael Williams ("Defendants") alleging that Defendants provided deficient healthcare services to Gregory D. Smith while he was incarcerated at the Delaware Department of Correction. Amongst various other claims, Plaintiff alleges that FCM violated the civil rights of Mr. Smith pursuant to 42 U.S.C. § 1983 by acting with deliberate indifference towards his serious medical needs.
42 U.S.C. § 1983 (1996) provides:
"Every person who, under color of any statute, ordinance, regulation, custom, or usage, of any State or Territory or the District of Columbia, subjects, or causes to be subjected, any citizen of the United States or other person within the jurisdiction thereof to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws, shall be liable to the party injured in an action at law . . ."
Pursuant to Superior Court Civil Rule 12 (b)(6), FCM has filed a motion to dismiss all of the civil rights claims against it. FCM contends that a medical provider cannot be held vicariously liable in civil rights actions and can only be liable for the constitutional violations of its employees if its policies or procedures were the driving force behind the constitutional violation. FCM further contends that a constitutional violation only occurs if the policies or customs implemented by the medical provider rise to the level of deliberate indifference. FCM argues that Plaintiff has failed to plead sufficient facts demonstrating the existence of a policy or custom by FCM that meets this stringent legal standard. Accordingly, FCM contends that Plaintiff's complaint fails to state a valid 42 U.S.C. § 1983 claim against it upon which relief may be granted.
A motion to dismiss pursuant to Superior Court Civil Rule 12(b)(6) requires this Court to determine whether the plaintiff may recover under any reasonably conceivable set of circumstances susceptible to proof under the complaint. Dismissal is warranted only when the plaintiff has failed to plead facts supporting an element of the claim, or that under no reasonable interpretation of the facts alleged could the complaint state a claim for which relief might be granted. Although the trial court need not "accept every strained interpretation of the allegations[,]" a plaintiff is "entitled to all reasonable inferences that logically flow from the face of the complaint." Thus, vagueness and lack of detail alone provide insufficient grounds for dismissal.
Evans v. Perillo, 2000 WL 973245, at *2 (Del.Super.).
Id. at *2.
Malpiede v. Townson, 780 A.2d 1075, 1083 (Del. 2001).
Evans, 2000 WL 973245, at *2.
Inmates are entitled to adequate medical care and a medical provider's deliberate failure to render such care may constitute an Eighth Amendment violation. While the negligible action of a medical provider is legally insufficient to constitute a 42 U.S.C. § 1983 violation of an inmate's right to medical care, a medical provider's "deliberate indifference to serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain proscribed by the Eighth Amendment." Thus, a successful Eighth Amendment claim necessitates that an inmate prove the defendant was aware of his serious medical needs and acted with deliberate indifference towards such medical needs.
Ali v. Terhune, 113 Fed. Appx. 431, 435 (3d Cir. 2004); see also 11 Del. C. § 6536 which provides: "The Department shall promulgate reasonable standards, and shall establish reasonable health, medical and dental services, for each institution, including preventive, diagnostic and therapeutic measures on both an out-patient and hospital basis for all types of patients. . . ."
Estelle v. Gamble, 429 U.S. 97, 103-104 (1976).
Jackson v. First Correction Medical Services, 2004 WL 1730355, at *4 (D. Del.).
Personal involvement is also an essential element for establishing liability in any civil rights action. Although a medical provider cannot be held liable through the doctrine of respondeat superior for the civil rights violations committed by its employees, it may be directly liable if its policies or customs induced the civil right violation to occur.
Policy is made when a decisionmaker possess[ing] final authority to establish municipal policy with respect to the action issues an official proclamation, policy or edict. Custom, on the other hand, can be proven by showing that a given course of conduct, although not specifically endorsed or authorized by law, is so well-settled and permanent as virtually to constitute law.
Hyson v. Correctional Medical Services, Inc., 2003 WL 292085, at *3 (D.Del.).
Whalen v. Correction Medical Service, 2003 WL 21994752 (D.Del.).
Id. (citing Miller v. Correctional Medical Systems, 802 F. Supp. 1126, 1131-32 (D. Del. 1992) (internal citations omitted)).
Accordingly, the plaintiff must demonstrate that the medical provider acted with deliberate indifference by instituting policies or customs of not providing the necessary medical care to inmates.
Id.
In the case sub judice, FCM concedes that Mr. Smith had serious medical needs. FCM argues that Plaintiff failed to plead sufficient facts establishing that FCM acted with deliberate indifference by instituting policies or customs of withholding necessary medical care to inmates. Deliberate indifference requires more than negligence; it requires "obduracy and wantonness." It is analogous to the conscious disregard of a serious risk. Deliberate indifference has been found to exist in 42 U.S.C. § 1983 medical actions instituted by inmates: (1) where prison officials persist in a particular course of treatment although continuously confronted with resultant pain and risk of injury to the inmate; (2) where knowledge of the need for medical care is accompanied by the intentional refusal to provide that care; and (3) where necessary medical treatment is delayed for non-medical reasons. However, mere divergence in professional medical judgment alone will not support a finding of deliberate indifference.
Robinson v. Weiss, 2001 WL 640980, at *4 (D.Del.).
See id. at *4.
Durmer v. O'Carroll, 991 F.2d 64, 68 (3d Cir. 1993) (quoting Monmouth County Corr. Inst. Inmates v. Lanzaro, 834 F.2d 326, 346 (3d Cir. 1987)).
Id.
See Hyson, 2003 WL 292085, at *1.
Plaintiff has alleged in her complaint that FCM provided Mr. Smith with inadequate medical care. Plaintiff contends that FCM, through its procedures, customs and policies, displayed continuous deliberate indifference to the serious medical needs of inmates as evidenced by its: (1) failure to hire a regional medical director to oversee the incarcerated inmates, (2) failure to maintain adequate staffing levels of nurses and physicians at the infirmary, (3) practice of refusing to authorize necessary outside medical care when it was believed that the inmates would be released soon, (4) practice of medical care by telephone, (5) practice of routinely withholding medical treatment for profit, and (6) establishment of an HMO type organization whereby all outside medical referrals must be approved by FCM headquarters in Arizona which has resulted in substantial delay and denial of necessary treatment by individuals who were without adequate knowledge to make such determinations. Plaintiff specifically alleges that Mr. Smith was mostly cared for by a nurse instead of a doctor and was not seen by a specialist in sickle cell disease, wound treatment or rheumatoid arthritis. Plaintiff further alleges that Mr. Smith was not monitored daily, his vital signs were rarely noted, his chest was rarely auscultated, his x-rays were rarely taken and blood work was rarely ordered. Plaintiff argues that FCM made absolutely zero effort to determine whether Mr. Smith was suffering from pulmonary embolisms, deep vein thrombosis or pneumonia.
Plaintiff has also alleged that the staffing level maintained by FCM violated community standards.
Plaintiff has pled sufficient facts that, if accepted as true, would substantiate a 42 U.S.C. § 1983 claim against FCM. Specifically, Plaintiff alleges in her complaint:
FCM clearly put its financial interests ahead of any concern for Mr. Smith. There was no medical reason for its failure to properly treat Mr. Smith's leg wound, rheumatoid arthritis, pneumonia, and sickle cell disease. Only the profit motive explains this failure to properly treat these serious conditions.
Pl. Compl. Par. 39.
Plaintiff can be successful in its 42 U.S.C. § 1983 claim against FCM is she can prove that FCM had a policy or custom of knowingly withholding or providing inadequate healthcare for inmates based upon financial considerations alone. Although insufficient evidence may ultimately exist, Plaintiff has pled sufficient facts that, if accepted as true, could support a verdict against FCM. Accordingly, FCM's motion to dismiss is hereby denied.
IT IS SO ORDERED.