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Prison Medical Treatment Law Explained
APennsylvania state prisoner brought a 42 U.S.C. § 1983 complaint against a prison doctor and hospital administrator, alleging that the medical treatment provided to him violated the eighth amendment to the U.S. constitution. The defendant hospital workers moved to dismiss the complaint pursuant to Rule 12(b)(6), Fed.R.Civ.P. Even though the pro se plaintiff did not submit a response to the motion to dismiss, the district court nonetheless denied the motion.
The judge noted that under the eighth amendment, prison systems have a constitutional duty to provide prisoners with adequate health care. However, mere allegations of negligent medical malpractice do not present a constitutional violation. In order to succeed in a § 1983 action claiming inadequate medical treatment, a prisoner must show more than negligence on the part of a prison doctor. He must show that the doctor exhibited "deliberate indifference" to a prisoner's serious medical need.
In the instant case the prisoner alleged that he reported to sick call at SCI Graterford seeking a "special diet" for medical reasons, and the doctor who saw him should have known that according to the plaintiff's prison medical records, he suffered from ulcers and torn tissues in his stomach. The defendant doctor refused the plaintiff a special diet for eighteen months, which demonstrated deliberate indifference to the prisoner's serious medical needs.
The state, in its motion to dismiss, challenged the adequacy of the complaint in three regards: (1) with respect to the charge of deliberate indifference; (2) that the plaintiff's medical need was not serious; and (3) because the complaint was not pled with sufficient factual particularity. As noted earlier, the court rejected each of these contentions.
The defendants first argued that the complaint should be dismissed because it did not allege facts supporting the conclusion that they acted with deliberate indifference. The court held that the complaint alleged that plaintiff suffered from ulcers and torn tissues in his stomach and that defendants knew he so suffered. The judge went on to say it can reasonably be inferred from the complaint that a special diet was required for the treatment of the prisoner's stomach problems, and that the defendant hospital workers refused to put plaintiff on a special diet in spite of the fact they knew it was necessary for the prisoner's health. "This is more than a mere allegation that defendant negligently chose the wrong course of treatment. This is deliberate indifference," the court said.
The state next argued that even if the complaint adequately alleged deliberate indifference, the medical need in question was not a "serious" one. "Perhaps if plaintiff alleged that he had a hangnail or a minor scratch that was deliberately left untreated," the court responded, it could be found "that his medical need was not serious. However, a prisoner need not suffer physical torture or a lingering death as a result of a prison's denial of medical treatment in order to come under the protection of the eighth amendment." The judge speculated on what could happen if plaintiff's condition was left untreated, then said it could not find as a matter of law that ulcers and torn stomach tissues are not a serious medical need.
Finally, the lawyers for the doctors argued that the complaint should be dismissed because it did not allege facts with sufficient particularity. For example, the complaint did not provide specific dates upon which medical treatment was requested and denied. The court ruled that the complaint satisfied the requirements of Fed.R.Civ.P. 8(a)(2), and that the defendants can get specific dates and such through the usual mechanism of discovery.
As the reader may have gathered, in this case the court bent over backwards to accommodate the prisoner, whereas in most such cases the judge will generally do back-flips to accommodate the state. The message here is that complaints for deliberate indifference claims must be pleaded in some detail, deliberate indifference established, and a serious medical need shown. See: Coades v. Jeffes, 822 F.Supp. 1189 (E.D.Pa. 1993).
The judge noted that under the eighth amendment, prison systems have a constitutional duty to provide prisoners with adequate health care. However, mere allegations of negligent medical malpractice do not present a constitutional violation. In order to succeed in a § 1983 action claiming inadequate medical treatment, a prisoner must show more than negligence on the part of a prison doctor. He must show that the doctor exhibited "deliberate indifference" to a prisoner's serious medical need.
In the instant case the prisoner alleged that he reported to sick call at SCI Graterford seeking a "special diet" for medical reasons, and the doctor who saw him should have known that according to the plaintiff's prison medical records, he suffered from ulcers and torn tissues in his stomach. The defendant doctor refused the plaintiff a special diet for eighteen months, which demonstrated deliberate indifference to the prisoner's serious medical needs.
The state, in its motion to dismiss, challenged the adequacy of the complaint in three regards: (1) with respect to the charge of deliberate indifference; (2) that the plaintiff's medical need was not serious; and (3) because the complaint was not pled with sufficient factual particularity. As noted earlier, the court rejected each of these contentions.
The defendants first argued that the complaint should be dismissed because it did not allege facts supporting the conclusion that they acted with deliberate indifference. The court held that the complaint alleged that plaintiff suffered from ulcers and torn tissues in his stomach and that defendants knew he so suffered. The judge went on to say it can reasonably be inferred from the complaint that a special diet was required for the treatment of the prisoner's stomach problems, and that the defendant hospital workers refused to put plaintiff on a special diet in spite of the fact they knew it was necessary for the prisoner's health. "This is more than a mere allegation that defendant negligently chose the wrong course of treatment. This is deliberate indifference," the court said.
The state next argued that even if the complaint adequately alleged deliberate indifference, the medical need in question was not a "serious" one. "Perhaps if plaintiff alleged that he had a hangnail or a minor scratch that was deliberately left untreated," the court responded, it could be found "that his medical need was not serious. However, a prisoner need not suffer physical torture or a lingering death as a result of a prison's denial of medical treatment in order to come under the protection of the eighth amendment." The judge speculated on what could happen if plaintiff's condition was left untreated, then said it could not find as a matter of law that ulcers and torn stomach tissues are not a serious medical need.
Finally, the lawyers for the doctors argued that the complaint should be dismissed because it did not allege facts with sufficient particularity. For example, the complaint did not provide specific dates upon which medical treatment was requested and denied. The court ruled that the complaint satisfied the requirements of Fed.R.Civ.P. 8(a)(2), and that the defendants can get specific dates and such through the usual mechanism of discovery.
As the reader may have gathered, in this case the court bent over backwards to accommodate the prisoner, whereas in most such cases the judge will generally do back-flips to accommodate the state. The message here is that complaints for deliberate indifference claims must be pleaded in some detail, deliberate indifference established, and a serious medical need shown. See: Coades v. Jeffes, 822 F.Supp. 1189 (E.D.Pa. 1993).
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Related legal case
Coades v. Jeffes
| Year | 1993 |
|---|---|
| Cite | 822 F. Supp. 1189 (ED PA 1993) |
| Level | District Court |
DAVID COADES v. GLEN R. JEFFES and DR. CHARLES JOHNSON
CIVIL ACTION NO. 91-4357
UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA
822 F. Supp. 1189; 1993 U.S. Dist. LEXIS 7445
June 3, 1993, Decided
June 4, 1993, Filed
COUNSEL: [**1]
For DAVID COADES, AM-4699, PLAINTIFF: DAVID COADES, PRO SE, STATE CORRECTIONAL INSTITUTION, P.O. BOX 244, GRATERFORD, PA 19426, U.S.A.
For MEDICAL DEPARTMENT S.C.I., DEFENDANT: JOHN O.J. SHELLENBERGER, III, OFFICE OF ATTORNEY GENERAL, 21 S. 12TH ST., 3RD FL., PHILA, PA 19107-3603, USA. For JOHNSON, DR., DEFENDANT: FRANK P. TUPLIN, DUANE, MORRIS & HECKSCHER, 4200 ONE LIBERTY PLACE, 39TH FL., PHILA, PA 19103-7396, USA. JOHN L. ARIS, DUANE, MORRIS & HECKSCHER, 4200 ONE LIBERTY PLACE, PHILA, PA 19103, USA.
JUDGES: Giles
OPINIONBY: BY THE COURT; JAMES T. GILES
OPINION: [*1190] MEMORANDUM
GILES, J.
June 3, 1993
Plaintiff brings this 42 U.S.C. ç 1983 action against a prison doctor and the director of a prison hospital, alleging that the medical treatment provided to him violated the eighth amendment to the United States Constitution. Defendant Johnson has moved to dismiss the complaint pursuant to Rule 12(b)(6), Fed.R.Civ.P. Plaintiff, who is proceeding pro se, has not submitted a response to defendant's motion. Nevertheless, for the reasons stated below, the motion is denied.
I. STANDARD FOR A MOTION TO DISMISS
Dismissal of a complaint pursuant to Rule 12(b)(6) is proper "only if it is clear that no relief could be granted under any set of facts that could be proved consistent with the allegations." Hishon v. King & Spalding, 467 U.S. 69, 73, 81 L. Ed. 2d 59, 104 S. Ct. 2229 (1984). All factual allegations in the complaint and all reasonable inferences that may be drawn from the complaint are to be viewed in the light most favorable to the plaintiff. Jenkins v. McKeithen, 395 U.S. 411, 421, [*1191] 23 L. Ed. 2d 404, 89 S. Ct. 1843 (1969); [**2] D.P. Enterprises, Inc. v. Bucks County Community College, 725 F.2d 943, 944 (3d Cir. 1984).
II. DISCUSSION
In order to state a claim under 42 U.S.C. ç 1983, plaintiff must show that: (1) the conduct complained of was committed by a person acting under color of state law; and (2) the conduct deprived him of rights, privileges or immunities secured by the Constitution or laws of the United States. Parratt v. Taylor, 451 U.S. 527, 535, 68 L. Ed. 2d 420, 101 S. Ct. 1908 (1981). Defendant Johnson does not dispute the assertion that he was acting under color of state law for the purposes of ç 1983 liability. n1 His motion to dismiss challenges the legal sufficiency of the complaint only with respect to its allegations that he deprived plaintiff of rights, privileges or immunities secured by the Constitution or laws of the United States.
n1 The complaint alleges that defendant Johnson was an "employee at the prison hospital." Complaint P 7(b). Defendant, in his motion to dismiss, claims that he was "independently contracted by Correctional Physician Services to provide physician services" at the prison. Defendant's Memorandum of Law at 2. Because we are considering a motion to dismiss, we must consider the allegations of the complaint to be true, and Johnson is clearly a state actor for the purposes of ç 1983 liability. Defendant recognizes that even if the court were to accept his version of his relationship to the prison, which it cannot do when deciding this motion, he would still be a state actor under West v. Atkins, 487 U.S. 42, 101 L. Ed. 2d 40, 108 S. Ct. 2250 (1988).
[**3]
Prison systems have a constitutional duty under the eighth amendment to provide prisoners with adequate health care. See, e.g., Estelle v. Gamble, 429 U.S. 97, 50 L. Ed. 2d 251, 97 S. Ct. 285 (1976). However, mere allegations of negligent medical malpractice do not present a constitutional violation. In order to succeed in a ç 1983 action claiming inadequate medical treatment, plaintiff must show more than negligence on the part of his prison doctor, he must show that the doctor exhibited "deliberate indifference" to a serious medical need. Estelle, 429 U.S. at 104-06; Monmouth County Correctional Institutional Inmates v. Lanzaro, 834 F.2d 326, 346 (3d Cir. 1987), cert. denied, 486 U.S. 1006, 100 L. Ed. 2d 195, 108 S. Ct. 1731 (1988).
The complaint alleges in pertinent part:
9. Plaintiff reported on sick call at SCI-Graterford regarding "special diet" for medical reasons.
10. Plaintiff was seen by Dr. Johnson, who knew or should have known that, according to plaintiff's prison medical records he suffers from ulcers and torn [**4] tissues in his stomach.
11. Defendant Johnson refused/denied plaintiff of a special diet for a period of approximately eighteen months.
12. Denial of affording plaintiff a special diet showed deliberate indifference to plaintiff medical need.
Compliant at 2-3. Defendant challenges the adequacy of the complaint with respect to its allegations that he exhibited deliberate indifference to plaintiff's needs. He also argues that plaintiff's medical need was not serious. Finally, defendant asks the court to dismiss the complaint because it is not pled with sufficient factual particularity. We reject each of defendant's arguments.
A. Deliberate Indifference
Defendant argues that the complaint must be dismissed because it does not allege facts supporting the conclusion that he acted with deliberate indifference. We disagree. The complaint alleges that plaintiff suffered from ulcers and torn tissues in his stomach, and that defendant Johnson knew that he so suffered. We can reasonably infer from the complaint's allegations that a special diet was required for the treatment of plaintiff's stomach problems. Finally, we can reasonably conclude that defendant Johnson refused [**5] to put plaintiff on a special diet in spite of the fact that he knew that such a diet was needed for plaintiff's health. Thus, read in the light most favorable to plaintiff, the complaint alleges that defendant knew that plaintiff had a particular medical need, and deliberately chose to not provide the needed treatment. This is more than a mere allegation that defendant negligently chose the wrong course of treatment. This is deliberate indifference. See Lanzaro, 834 F.2d at 346 (deliberate indifference exhibited where [*1192] knowledge of need for medical care is accompanied by intentional refusal to provide that care); Durmer v. O'Carroll, 991 F.2d 64 (3d Cir. 1993) (same).
B. Serious Medical Need
Defendant argues that even if the complaint adequately alleges that he exhibited deliberate indifference to plaintiff's medical need, that medical need was not "serious," and therefore the complaint must be dismissed.
Perhaps if plaintiff alleged that he had a hangnail or a minor scratch that was deliberately left untreated the court could find as a matter of law that his medical need was not serious. However, a [**6] prisoner "need not suffer physical torture or a lingering death . . . as a result of a prison's denial of medical treatment in order to come under the protections of the eighth amendment." Lanzaro, 834 F.2d at 348 (internal cites and quotation marks omitted). If left untreated, a stomach ulcer may cause intense and persistent pain and may require emergency surgical intervention. Merck Manual of Diagnosis and Therapy 740-48 (15th ed. 1987). The court cannot find as a matter of law that ulcers and torn stomach tissues are not a serious medical need.
C. Factual Particularity
Defendant argues that the complaint should be dismissed because it does not allege facts with sufficient particularity. In particular, he complains that plaintiff has not provided specific dates upon which medical treatment was requested and denied. We find that the complaint satisfies Fed.R.Civ.P. 8(a)(2), which requires only that a complaint include a "short and plain statement of the claim that will give the defendant fair notice of what the plaintiff's claim is and the grounds upon which it rests." Leatherman v. Tarrant County Narcotics Intelligence & Coordination Unit, 122 L. Ed. 2d 517, 113 S. Ct. 1160, 61 U.S.L.W. 4205, 4206 [**7] (U.S. March 3, 1993) (quoting Conley v. Gibson, 355 U.S. 41, 47, 2 L. Ed. 2d 80, 78 S. Ct. 99 (1957)) (internal quotation marks omitted). n2 To the extent that defendant requires specific dates, e.g. to prepare a statute of limitations defense, he may get them through the usual mechanisms of discovery.
n2 In Leatherman, the United States Supreme Court held that a federal court cannot require that ç 1983 complaints be pled with heightened specificity, because such a heightened pleading requirement is in conflict with Fed.R.Civ.P. 8(a)(2).
An appropriate order follows.
ORDER
AND NOW, this day of June, 1993, upon consideration of defendant Johnson's motion to dismiss pursuant to Fed.R.Civ.P. 12(b)(6), it is hereby ORDERED that the motion is DENIED.
BY THE COURT:
James T. Giles, J.
CIVIL ACTION NO. 91-4357
UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA
822 F. Supp. 1189; 1993 U.S. Dist. LEXIS 7445
June 3, 1993, Decided
June 4, 1993, Filed
COUNSEL: [**1]
For DAVID COADES, AM-4699, PLAINTIFF: DAVID COADES, PRO SE, STATE CORRECTIONAL INSTITUTION, P.O. BOX 244, GRATERFORD, PA 19426, U.S.A.
For MEDICAL DEPARTMENT S.C.I., DEFENDANT: JOHN O.J. SHELLENBERGER, III, OFFICE OF ATTORNEY GENERAL, 21 S. 12TH ST., 3RD FL., PHILA, PA 19107-3603, USA. For JOHNSON, DR., DEFENDANT: FRANK P. TUPLIN, DUANE, MORRIS & HECKSCHER, 4200 ONE LIBERTY PLACE, 39TH FL., PHILA, PA 19103-7396, USA. JOHN L. ARIS, DUANE, MORRIS & HECKSCHER, 4200 ONE LIBERTY PLACE, PHILA, PA 19103, USA.
JUDGES: Giles
OPINIONBY: BY THE COURT; JAMES T. GILES
OPINION: [*1190] MEMORANDUM
GILES, J.
June 3, 1993
Plaintiff brings this 42 U.S.C. ç 1983 action against a prison doctor and the director of a prison hospital, alleging that the medical treatment provided to him violated the eighth amendment to the United States Constitution. Defendant Johnson has moved to dismiss the complaint pursuant to Rule 12(b)(6), Fed.R.Civ.P. Plaintiff, who is proceeding pro se, has not submitted a response to defendant's motion. Nevertheless, for the reasons stated below, the motion is denied.
I. STANDARD FOR A MOTION TO DISMISS
Dismissal of a complaint pursuant to Rule 12(b)(6) is proper "only if it is clear that no relief could be granted under any set of facts that could be proved consistent with the allegations." Hishon v. King & Spalding, 467 U.S. 69, 73, 81 L. Ed. 2d 59, 104 S. Ct. 2229 (1984). All factual allegations in the complaint and all reasonable inferences that may be drawn from the complaint are to be viewed in the light most favorable to the plaintiff. Jenkins v. McKeithen, 395 U.S. 411, 421, [*1191] 23 L. Ed. 2d 404, 89 S. Ct. 1843 (1969); [**2] D.P. Enterprises, Inc. v. Bucks County Community College, 725 F.2d 943, 944 (3d Cir. 1984).
II. DISCUSSION
In order to state a claim under 42 U.S.C. ç 1983, plaintiff must show that: (1) the conduct complained of was committed by a person acting under color of state law; and (2) the conduct deprived him of rights, privileges or immunities secured by the Constitution or laws of the United States. Parratt v. Taylor, 451 U.S. 527, 535, 68 L. Ed. 2d 420, 101 S. Ct. 1908 (1981). Defendant Johnson does not dispute the assertion that he was acting under color of state law for the purposes of ç 1983 liability. n1 His motion to dismiss challenges the legal sufficiency of the complaint only with respect to its allegations that he deprived plaintiff of rights, privileges or immunities secured by the Constitution or laws of the United States.
n1 The complaint alleges that defendant Johnson was an "employee at the prison hospital." Complaint P 7(b). Defendant, in his motion to dismiss, claims that he was "independently contracted by Correctional Physician Services to provide physician services" at the prison. Defendant's Memorandum of Law at 2. Because we are considering a motion to dismiss, we must consider the allegations of the complaint to be true, and Johnson is clearly a state actor for the purposes of ç 1983 liability. Defendant recognizes that even if the court were to accept his version of his relationship to the prison, which it cannot do when deciding this motion, he would still be a state actor under West v. Atkins, 487 U.S. 42, 101 L. Ed. 2d 40, 108 S. Ct. 2250 (1988).
[**3]
Prison systems have a constitutional duty under the eighth amendment to provide prisoners with adequate health care. See, e.g., Estelle v. Gamble, 429 U.S. 97, 50 L. Ed. 2d 251, 97 S. Ct. 285 (1976). However, mere allegations of negligent medical malpractice do not present a constitutional violation. In order to succeed in a ç 1983 action claiming inadequate medical treatment, plaintiff must show more than negligence on the part of his prison doctor, he must show that the doctor exhibited "deliberate indifference" to a serious medical need. Estelle, 429 U.S. at 104-06; Monmouth County Correctional Institutional Inmates v. Lanzaro, 834 F.2d 326, 346 (3d Cir. 1987), cert. denied, 486 U.S. 1006, 100 L. Ed. 2d 195, 108 S. Ct. 1731 (1988).
The complaint alleges in pertinent part:
9. Plaintiff reported on sick call at SCI-Graterford regarding "special diet" for medical reasons.
10. Plaintiff was seen by Dr. Johnson, who knew or should have known that, according to plaintiff's prison medical records he suffers from ulcers and torn [**4] tissues in his stomach.
11. Defendant Johnson refused/denied plaintiff of a special diet for a period of approximately eighteen months.
12. Denial of affording plaintiff a special diet showed deliberate indifference to plaintiff medical need.
Compliant at 2-3. Defendant challenges the adequacy of the complaint with respect to its allegations that he exhibited deliberate indifference to plaintiff's needs. He also argues that plaintiff's medical need was not serious. Finally, defendant asks the court to dismiss the complaint because it is not pled with sufficient factual particularity. We reject each of defendant's arguments.
A. Deliberate Indifference
Defendant argues that the complaint must be dismissed because it does not allege facts supporting the conclusion that he acted with deliberate indifference. We disagree. The complaint alleges that plaintiff suffered from ulcers and torn tissues in his stomach, and that defendant Johnson knew that he so suffered. We can reasonably infer from the complaint's allegations that a special diet was required for the treatment of plaintiff's stomach problems. Finally, we can reasonably conclude that defendant Johnson refused [**5] to put plaintiff on a special diet in spite of the fact that he knew that such a diet was needed for plaintiff's health. Thus, read in the light most favorable to plaintiff, the complaint alleges that defendant knew that plaintiff had a particular medical need, and deliberately chose to not provide the needed treatment. This is more than a mere allegation that defendant negligently chose the wrong course of treatment. This is deliberate indifference. See Lanzaro, 834 F.2d at 346 (deliberate indifference exhibited where [*1192] knowledge of need for medical care is accompanied by intentional refusal to provide that care); Durmer v. O'Carroll, 991 F.2d 64 (3d Cir. 1993) (same).
B. Serious Medical Need
Defendant argues that even if the complaint adequately alleges that he exhibited deliberate indifference to plaintiff's medical need, that medical need was not "serious," and therefore the complaint must be dismissed.
Perhaps if plaintiff alleged that he had a hangnail or a minor scratch that was deliberately left untreated the court could find as a matter of law that his medical need was not serious. However, a [**6] prisoner "need not suffer physical torture or a lingering death . . . as a result of a prison's denial of medical treatment in order to come under the protections of the eighth amendment." Lanzaro, 834 F.2d at 348 (internal cites and quotation marks omitted). If left untreated, a stomach ulcer may cause intense and persistent pain and may require emergency surgical intervention. Merck Manual of Diagnosis and Therapy 740-48 (15th ed. 1987). The court cannot find as a matter of law that ulcers and torn stomach tissues are not a serious medical need.
C. Factual Particularity
Defendant argues that the complaint should be dismissed because it does not allege facts with sufficient particularity. In particular, he complains that plaintiff has not provided specific dates upon which medical treatment was requested and denied. We find that the complaint satisfies Fed.R.Civ.P. 8(a)(2), which requires only that a complaint include a "short and plain statement of the claim that will give the defendant fair notice of what the plaintiff's claim is and the grounds upon which it rests." Leatherman v. Tarrant County Narcotics Intelligence & Coordination Unit, 122 L. Ed. 2d 517, 113 S. Ct. 1160, 61 U.S.L.W. 4205, 4206 [**7] (U.S. March 3, 1993) (quoting Conley v. Gibson, 355 U.S. 41, 47, 2 L. Ed. 2d 80, 78 S. Ct. 99 (1957)) (internal quotation marks omitted). n2 To the extent that defendant requires specific dates, e.g. to prepare a statute of limitations defense, he may get them through the usual mechanisms of discovery.
n2 In Leatherman, the United States Supreme Court held that a federal court cannot require that ç 1983 complaints be pled with heightened specificity, because such a heightened pleading requirement is in conflict with Fed.R.Civ.P. 8(a)(2).
An appropriate order follows.
ORDER
AND NOW, this day of June, 1993, upon consideration of defendant Johnson's motion to dismiss pursuant to Fed.R.Civ.P. 12(b)(6), it is hereby ORDERED that the motion is DENIED.
BY THE COURT:
James T. Giles, J.