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Denial of Medication/Prescribed Treatment States Eighth Amendment Claim

In two separate cases the Eighth Circuit Court of Appeals held that a prisoners claim of being denied medication, or not given prescribed treatment, states a claim under the Eighth Amendment.

Arkansas prisoner Willie Munn appealed a district courts dismissal of his suit after an evidentiary hearing. Munn had claimed that prison officials were deliberately indifferent to his serious medical needs. While incarcerated at the Varner Super Maximum Security Unit on May 19, 2003, Munn was issued a treatment order requiring his blood pressure and heart rate be checked. While in punitive confinement from May 21-30 he did not receive the required blood pressure checks or his high blood pressure pills.

The district court limited Munns claim to the issue of blood pressure checks, and denied that claim on the basis that Munn had showed no physical injury. The Eighth Circuit reversed.

The appeals court held the district court improperly refused to allow testimony on the missed-medication claim because that claim was sufficiently alleged in Munns grievances and complaint. The appellate court also held the missed-monitoring claim did not fail for lack of physical injury, for Munn alleged and testified that he experienced headaches, cramps, nosebleeds and dizziness while he was denied treatment; section 1997c(e) is merely a limitation on damages. Munn could receive nominal damages for those injuries, at a minimum. Thus, the lower courts ruling was reversed on all claims for further proceedings. See: Munn v. Toney, 433 F.3d 1087 (8th Cir. 2006).

The appellate court found similarly for Raymond King, a former pretrial detainee at the Crittenden County Jail and now an Arkansas state prisoner. Kings claim was predicated on the failure to receive prescribed blood-pressure or pain medication twelve times from August 18 to October 17, 2003. After October 17 it was unclear how many times he missed his medication, but he testified at the evidentiary hearing it was half the time, and his administrative grievances show twenty-six times from August 28, 2003 to March 8, 2004.

The Eighth Circuit found this was more than an inadvertent failure to provide adequate medical care, making the district courts dismissal improper. In reversing, the appeals court said it was troubled by the district courts conclusion that King failed to show how the delays in his medication harmed him. King testified that he suffered headaches and had to lie down when he did not receive his blood-pressure medication, and he asserts on appeal ... that he suffered pain. The case was reversed and remanded. See: King v. Busby, 162 Fed.Appx. 669 (8th Cir. 2006)(unpublished).

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Related legal cases

Munn v. Toney

Munn v. Toney, 433 F.3d 1087 (8th Cir. 01/18/2006)

[1] United States Court of Appeals FOR THE EIGHTH CIRCUIT


[2] No. 05-1320


[3] 433 F.3d 1087, 2006


[4] January 18, 2006


[5] WILLIE MUNN, APPELLANT,
v.
RICK TONEY, WARDEN, VARNER UNIT, ADC; GATES, SECURITY GUARD, VARNER UNIT, ADC; LT. BASS, VARNER UNIT, ADC, APPELLEES.


[6] Appeal from the United States District Court for the District of Eastern Arkansas.


[7] The opinion of the court was delivered by: McMILLIAN, Circuit Judge.


[8] Submitted: December 20, 2005


[9] Before BYE, McMILLIAN, and RILEY, Circuit Judges.


[10] Arkansas prisoner Willie Munn appeals from the final decision entered in the District Court for the Eastern District of Arkansas dismissing his 42 U.S.C. § 1983 action following a pretrial evidentiary hearing. For reversal, Munn argues the district court erred in separating his missed-medication claim from his missed-monitoring claim, and he suffered injury from not receiving his blood-pressure medication for nine days. For the reasons discussed below, we reverse and remand.


[11] Munn filed this action against Varner Super Maximum Security Unit Warden Rick Toney, Officer Gates, and Lieutenant Bass, claiming they were deliberately indifferent to his serious medical needs, in violation of the Eighth Amendment. According to his complaint attachments, on May 19, 2003, Nurse Jan Alexander issued a treatment order that required checking Munn's blood pressure and heart rate twice on Mondays, Wednesdays, and Fridays from May19 to June 19, 2003. On May 21, Munn filed a grievance asserting he told Gates that he had high blood pressure treatment and Gates called Bass, who did not comply with the prescribed treatment. Warden Toney responded on June 12 that Munn had not been taken to the infirmary for blood-pressure checks because he had not shown a prescription to the officer. In a supporting brief filed the same day as the complaint and in a later-filed amended complaint, Munn further alleged that he had requested treatment from Gates and Bass on May 21 because he was experiencing headaches, dizziness, and cramps, and the nurse needed to check his blood pressure and see if he needed to take one of his blood-pressure pills. When treatment was denied, he suffered mental anguish, and when he finally received treatment nine days later, his medication was increased.


[12] At the beginning of the evidentiary hearing, the district court stated that it read the complaint as asserting only that Munn did not receive his prescribed blood-pressure checks while in punitive isolation from May 21-30. Munn replied that he also did not receive his medication while in isolation, and he thought he had raised such a claim in his complaint. When defense counsel stated that Munn had filed no grievance about missed medication, Munn said his grievance stated that defendants had interfered with prescribed treatment. The court thought this grievance statement referred to blood-pressure checks, and the court ruled that Munn would be limited to the blood-pressure-checks issue.


[13] After defense counsel conceded that Munn did not receive any blood-pressure checks for the nine days he spent in isolation, the court stated that the only issue was harm, and asked Munn to testify about any injuries from not getting his blood pressure checked. Munn testified that prison medical staff had been working for a year to control his blood pressure, and he needed regular blood-pressure checks to determine the type and amount of medication he required. Beginning on May 19, he had a 30-day prescription for blood-pressure medication and for blood-pressure checks every Monday, Wednesday, and Friday. On May 21 in isolation, he told Gates that he had a headache, cramps, a nosebleed, and dizziness; and asked Gates to call Bass and tell him that Munn needed to go to the infirmary for treatment and medication. On May 30, when released from isolation, his blood pressure was checked at the infirmary and he resumed his medication.


[14] In its written order, the district court found the missed-medication claim was not properly before it; and, absent physical injury, the missed-monitoring claim was barred by 42 U.S.C. § 1997e(e) (no federal civil action may be brought by prisoner for mental or emotional injury suffered while in custody without prior showing of physical injury). In an unsuccessful motion to amend, Munn asserted that the only way for him to receive his blood-pressure medication while in isolation was to be sent to the infirmary "for treatment," and that defendants and the district court had misconstrued his treatment prescription as being for blood-pressure monitoring only. He submitted medical records he had received after the hearing, including a May 19 treatment order by Alexander that prescribed a blood-pressure medication twice daily until June 19.


[15] Because Munn made a jury demand, we review the dismissal de novo. See Randle v. Parker, 48 F.3d 301, 303 (8th Cir. 1995). We first conclude that Munn raised a missed-medication claim prior to the evidentiary hearing. Looking solely at the original complaint and its attachments, we see how the district court believed that Munn alleged only a missed-monitoring claim: Munn stated in the complaint that defendants had denied him prescribed "treatment," and the attached May 19 treatment order referred only to blood-pressure checks. However, in the supporting brief filed the same day as the original complaint and in the amended complaint, Munn alleged that he had requested treatment from defendants on May 21 because he was experiencing high-blood-pressure symptoms, the nurse needed to check his blood pressure, and he may have needed to take some of his blood-pressure medication. Looking at all these documents together, we conclude that Munn sufficiently alleged he was denied his blood-pressure medication for the nine days he spent in isolation, and that the district court therefore abused its discretion in disallowing testimony at the evidentiary hearing as to such a claim. See Beach v. Yellow Freight Sys., 312 F.3d 391, 397-98 (8th Cir. 2002) (reviewing for abuse of discretion district court's exclusion of testimony). Additionally, we note Munn had grieved a missed-medication claim: his May 21 grievance stated that he did not receive prescribed "treatment," which May 19 treatment orders--including the ones submitted after the evidentiary hearing--show referred to blood-pressure checks and medication.


[16] As for the missed-monitoring claim, we conclude it does not fail under section 1997e(e) for lack of physical injury. Munn alleged and testified that he experienced headaches, cramps, nosebleeds, and dizziness while he was denied treatment; section 1997e(e) is merely a limitation on damages, see Davis v. District of Columbia, 158 F.3d 1342, 1346 (D.C. Cir. 1998); and at a minimum, Munn could recover nominal damages for defendants' admission that they did not comply with the prescribed blood-pressure monitoring, see Royal v. Kautzky, 375 F.3d 720, 722-23 (8th Cir. 2004) (§ 1997e(e) does not bar recovery of nominal and punitive damages, or declaratory and injunctive relief), cert. denied, 125 S.Ct. 2528 (2005).


[17] Accordingly, we reverse and remand for further proceedings not inconsistent with this opinion on both the missed-medication and missed-monitoring claims.

King v. Busby

Raymond King, Sr., also known as Raymond White, Appellant, v. Richard Busby, Sheriff of Crittenden County, also known as Dick Busby; Robert Cooper, Chief Deputy Crittenden County Sheriff's Department, also known as Bob Cooper, Robert Harper, Sr., Administrator, Crittenden County Detention Facility; Reginald Abram, Assistant Administrator, Crittenden County Detention Facility; Otey, Supervisor, Crittenden County Detention Facility; Theresa Bonner, Supervisor, Crittenden County Detention Facility; Angie Whatley, Nurse, Crittenden County Detention Facility; Gordon, Office Supervisor, Crittenden County Detention Facility; Dill, Supervisor, Crittenden County Detention Facility Defendants, Appellees.



No. 04-3736



UNITED STATES COURT OF APPEALS FOR THE EIGHTH CIRCUIT



162 Fed. Appx. 669; 2006 U.S. App.



December 21, 2005, Submitted

January 18, 2006, Filed



NOTICE: [**1] RULES OF THE EIGHTH CIRCUIT COURT OF APPEALS MAY LIMIT CITATION TO UNPUBLISHED OPINIONS. PLEASE REFER TO THE RULES OF THE UNITED STATES COURT OF APPEALS FOR THIS CIRCUIT.



PRIOR HISTORY: Appeal from the United States Cooper, Robert Harper, District Court for the Eastern District of Arkansas.




COUNSEL: RAYMOND KING, SR., aka Raymond White, Plaintiff-Appellant, Pro se, Grady, AR.



For RICHARD BUSBY, Sheriff of Crittenden County aka Dick Busby, Defendant-Appellees: Jason E. Owens, Jason W. Massey, DUNCAN & RAINWATER, Little Rock, AR; Michael R. Rainwater, RAINWATER & HOLT, Little Rock, AR.



For ROBERT COOPER, Chief Deputy, Crittenden County Sheriff's Department aka Bob Cooper, Defendant-Appellees: Jason E. Owens, Jason W. Massey, DUNCAN & RAINWATER, Little Rock, AR; Michael R. Rainwater, RAINWATER & HOLT, Little Rock, AR.



For ROBERT HARPER, SR., Administrator, Crittenden County Detention Facility, Defendant-Appellees: Jason E. Owens, Jason W. Massey, DUNCAN & RAINWATER, Little Rock, AR; Michael R. Rainwater, RAINWATER & HOLT, Little Rock, AR.



For REGINALD ABRAM, Assistant Administrator, Crittenden County Detention Facility, Defendant-Appellees: Jason E. Owens, Jason W. Massey, DUNCAN & [**2] RAINWATER, Little Rock, AR; Michael R. Rainwater, RAINWATER & HOLT, Little Rock, AR.



For OTEY, Supervisor, Crittenden County Detention Facility, Defendant-Appellees: Jason E. Owens, Jason W. Massey, DUNCAN & RAINWATER, Little Rock, AR; Michael R. Rainwater, RAINWATER & HOLT, Little Rock, AR.



For THERESA BONNER, Supervisor, Crittenden County Detention Facility, Defendant-Appellees: Jason E. Owens, Jason W. Massey, DUNCAN & RAINWATER, Little Rock, AR; Michael R. Rainwater, RAINWATER & HOLT, Little Rock, AR.



For ANGIE WHATLEY, Nurse, Crittenden County Detention Facility, Defendant-Appellees: Jason E. Owens, Jason W. Massey, DUNCAN & RAINWATER, Little Rock, AR.



For GORDON, Office Supervisor, Crittenden County Detention Facility, Defendant-Appellees: Jason E. Owens, Jason W. Massey, DUNCAN & RAINWATER, Little Rock, AR; Michael R. Rainwater, RAINWATER & HOLT, Little Rock, AR.



For DILL, Supervisor, Crittenden County Detention Facility, Defendant-Appellees: Jason E. Owens, Jason W. Massey, DUNCAN & RAINWATER, Little Rock, AR; Michael R. Rainwater, RAINWATER & HOLT, Little Rock, AR.



JUDGES: Before BYE, McMILLIAN, and RILEY, Circuit Judges.



OPINION: [*670] PER CURIAM.

Raymond [**3] King, a former pretrial detainee at the Crittenden County Jail and now an Arkansas inmate, appeals from the final judgment entered in the District Court for the Eastern District of Arkansas dismissing with prejudice his 42 U.S.C. § 1983 complaint after an evidentiary hearing. For reversal, King argues defendant Nurse Angie Whatley was never served, [*671] he did not have counsel at the hearing, he had wanted a jury trial, and his missed-medication claim in particular had merit. For the reasons discussed below, we affirm in part, reverse in part, and remand.

We find no error in the district court's failure to complete service of process on Nurse Whatley, given King's failure to provide her proper address. See Lee v. Armontrout, 991 F.2d 487, 489 (8th Cir.) (per curiam) (plaintiffs proceeding in forma pauperis are responsible for providing defendants' addresses), cert. denied, 510 U.S. 875, 126 L. Ed. 2d 166 (1993). We also find no abuse of discretion in the district court's denial of King's motion for appointment of counsel, as King appeared capable of presenting his claims and received assistance from the district court at the evidentiary [**4] hearing. See Davis v. Scott, 94 F.3d 444, 447 (8th Cir. 1996) (standard of review; relevant factors in appointing counsel).

Because King made an untimely request for a jury trial, we review the district court's factual findings for clear error and its legal conclusions de novo. See Choate v. Lockhart, 7 F.3d 1370, 1373 & n.1 (8th Cir. 1993) (standard of review of evidentiary hearing held when no jury demand was made). Only King's missedmedication claim warrants discussion.

King was housed at the Crittenden County Jail from July 2003 to April 2004. According to medication logs that defendants submitted, King did not receive his prescribed blood-pressure or pain medication twelve times from August 18 to October 17, 2003. How often he did not receive his medications after October 17 is unclear--in part because defendants' medication logs covered only two of the ten months King was at the Jail--but King testified that he did not receive them "half the time," and according to his administrative grievances, he did not receive them at least twenty-six times from August 28, 2003, to March 8, 2004. See Estelle v. Gamble, 429 U.S. 97, 104-05, 97 S. Ct. 285, 50 L. Ed. 2d 251 (1976) [**5] (deliberate indifference includes intentional interference with prescribed treatment). The frequency of these missed doses, without further explanation at least raises an inference, that the failure to provide King's medication was more than an "inadvertent failure to provide adequate medical care." See id. at 105.

King identified which defendants were responsible for the missed medication: he grieved repeatedly to Chief Jailer Theresa Bonner, Chief Deputy Sheriff Robert Cooper, and Jail Administrator Robert Harper about missed doses of his bloodpressure and pain medication. These grievances tend to show that Bonner, Cooper, and Harper were aware of King's missed medication and may have failed to take corrective action because King continued to miss medication doses. See Meloy v. Bachmeier, 302 F.3d 845, 849 (8th Cir. 2002) (supervisor is liable for Eighth Amendment violation only when he is personally involved in violation or when his corrective inaction constitutes deliberate indifference toward violation; supervisor must know about conduct and facilitate it, approve it, condone it, or turn blind eye to it). We are troubled by the district court's [**6] conclusion that King failed to show how the delays in receiving his medication harmed him. King testified that he suffered headaches and had to lie down when he did not receive his blood-pressure medication, and he asserts on appeal--rightly so--that he suffered pain from not receiving his pain medication.

Accordingly, we affirm the dismissal of all claims and defendants, except for the missed-medication claim as to defendants Bonner, Cooper, and Harper. We reverse the dismissal of this claim against these defendants, and we remand for further [*672] proceedings not inconsistent with this opinion.