Nicolas Marquez, a Texas Department of Criminal Justice (TDCJ) prisoner held at the Polunsky Unit, has no teeth. He requested dentures but the request was denied because his Body Mass Index (BMI) was too high. He was told that TDCJ dental policy requires prisoners to have a BMI of less than 18.5 to qualify for dentures. Marquez, who weighed around 122-135 pounds, had a BMI between 20 and 23. He had been issued a soft food pass, which the Food Services Department reportedly refused to honor, and at times was given blended food.

Marquez filed a civil rights suit pursuant to 42 U.S.C. § 1983 against a TDCJ dentist, dental assistant, nurse, facilities practice manager, food services officer, dental hygienist, the warden, a regional director and the TDCJ’s director, alleging deliberate indifference to serious medical needs in violation of the Eighth Amendment. The district court held an evidentiary hearing, during which a nurse testified regarding Marquez’s prison medical records.

After conducting a review of recent unpublished Fifth Circuit decisions related to prisoners and dentures, the court held that Marquez’s complaints of “an inability to chew food, stomach cramps, gas, spastic colon and GERD [gastroesophageal reflux disease], which resulted in a loss of weight of 13 pounds since his arrival at the prison system, are consistent with the type of problems listed in several recent cases that led the Fifth Circuit to conclude that inmates had a serious medical need.”

Therefore, the district court allowed his suit to proceed in an August 12, 2009 ruling. However, the dental hygienist, warden, regional director and TDCJ director were dismissed because they were not directly involved in the denial of Marquez’s request for dentures. See: Marquez v. Quarterman, 652 F.Supp.2d 785 (E.D.Tex. 2009).

The court subsequently denied several motions to dismiss filed by Dr. Tanya Woody, who Marquez claimed was one of the TDCJ dentists who had refused to provide him with dentures. The district court found that Marquez had a potentially meritorious federal civil rights claim against Dr. Woody for being deliberately indifferent to his serious medical needs by denying him dentures.

But on March 18, 2010, the district court dismissed Marquez’s complaint in its entirely after it was transferred to another judge. The court found that Dr. Woody had never treated Marquez or denied him dentures; rather, it was two other prison dentists, not named as defendants, who had turned down his requests for dentures. Marquez insisted that he had seen Dr. Woody, whom he alleged “did not electronically sign an entry [in his medical file] because she was only employed as a part-time dentist under contract and was not able to sign an entry under her own name.”

In dismissing the lawsuit, the court found that Marquez had failed to present evidence showing he had a serious medical need or that prison officials were deliberately indifferent to that need, and held the defendants were entitled to qualified immunity.
Further, Marquez had failed to exhaust the prison grievance process with respect to one of the defendants, Lemaster, as required by the Prison Litigation Reform Act. See: Marquez v. Quarterman, U.S.D.C. (E.D. Tex.), Case No. 9:09-cv-00071-JKG.

Marquez appealed to the Fifth Circuit, which affirmed the dismissal in part and reversed in part on September 6, 2011. The Court of Appeals agreed that Marquez “did not show that any of the medical providers acted with deliberate indifference to his medical needs,” but reversed the dismissal of Lemaster based on failure to exhaust the grievance process, finding that Marquez had in fact named Lemaster in a grievance and Lemaster was not entitled to qualified immunity.

Additionally, the Fifth Circuit reversed the dismissal of injunctive relief claims against TDCJ director Rick Thaler, because the district court had “erroneously concluded that Marquez was suing Thaler solely because of his supervisory role, ignoring the fact that Thaler may be held liable if he implemented a policy that itself causes a constitutional violation.” See: Marquez v. Woody, U.S. Court of Appeals for the Fifth Circuit, Case No. 10-40378; 2011 WL 3911080 (unpublished).

However, the district court dismissed the case following remand on November 1, 2011, as Marquez had since been released from prison and did not provide the court with his new mailing address.

This case illustrates the importance of suing the correct defendants, including those who actually caused the constitutional violation and, where prison policies are being challenged, those who are responsible for promulgating the policies. It also highlights the need for released prisoners to inform the court of their new address; had Marquez done so, he may have ultimately prevailed on the remanded claims.

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