next case on today's jockeys united states against coleman is being submitted on the briefs and so we will move to case number eight goodloe against suit and we'll hear from mr stand arse may please the court if a jury in this case could find more than medical malpractise you could find deliberate indifference perhaps the starkest evidence as a doctor sued and fisher denied their own referral to a specialist they then decided to rican tinubu with ineffective cond alone treatments but i did nothing without additional pain this caused an additional decide that they do that they will have a site collegial review that we've heard about many times that they will get the outside consultant and instead of what they expected which was an evaluation they got this proposal for immediate laser surgery so that's the moment where they say oh well let's just go back to the same stuff we've been doing for years is there any time before that that you think you could show deliberate and differ the patient has refused topical medications and was requesting a surgical consultation to remove the warts close quote that is not at all what good will withstand that's the opposite of what did little saying a repeat of the starting in at least january and february goodloe was saying he did not want treatment for the tunnel that he'd had the condition for eighteen years it never causing any symptoms he said instead he needed treatment for his new symptoms which he is probably not able to say you know i think i might have a fisher but he is i guess we see in the grievances and i'm not sure where else we see it you can tell me he is certainly describing the symptoms he's feeling the did argues that it would treat a fish doesn't argue that it would cure but again that he was using it and wasn't happening that so you put this in the group of cases of persisting in a particular type of treatment that is unresponsive to i think there's you know several of those ways that are overlapping here i think there's treatment that's blatantly inappropriate for the symptoms i think there is persistence with an ineffective course of treatment i think there's unexplained delays and they're all overlapping and what it boils down to is that there are some very strange treat decisions some unexplained treatment decisions that would allow a jury even for delivered and mr stener let me just ask you a question to perhaps clarify the record or make sure what's in front of us and what's not the district court as you know attributed the delay to what was characterized as an administrative error and in your reply brief you know you say look that's really not an issue anymore it's not before anybody mike my question is this is there just is there anything in the record anywhere to support the notion that the the reason for the delay between that june two thousand and fourteen and september two thousand and fourteen time period was because of some kind of administr surgical console i know we're not talking about surgery that's premature but stay the course for another couple of months and see what happens that's exactly correct and it's also what they are doing their part and your point is that they say that in some contradiction to what they said when they decided to obtain the outside specialist back in june so they give two reasons for this decision to resume the conservative treatment one they say that he never had an evaluation that whole time all that lou is asking for was an evaluation so to resume two months of ineffective treatment instead of sending for an immediate valuation makes no sense the other reason they get was that he needed conservative treatment st they'd already given him conservative treatment for months with no effect and made the decision to send him to the specialist neither neither decision either explanation makes any sense and you know what a jury could conclude that you chalk it up to some sort of administrative error some decision treating decision focusing on the condom loma they're not paying any attention to the question to the broader question we need to figure out what's going on you know is it is this internal pain somehow because of x journal or i completely understand you and i would say two there is no evidence the nato official existed prior to september nd two thousand and four you make that argument although the reply brief i think that's pretty good job of of challenging it there certainly is evidence and this is all a lay person can do of untreated conditions that would be consistent with the with the fisher and are certainly not consistent with  specialist to detect it which is not uncommon and i would say if the argument that is to be made is that there was an error in diagnosis that does not constitute an th amendment no it's the argument and that's where in my own mind the story begins in june basically they're trying various treatments you've got to give them some time to do that that time comes and goes and even they sit down in june and say this isn't working we need you know bring in you know supplementary troops somehow and they but they don't when when the when that's also part when they realize hey you know we want to console when you're ready to go perform surgery they don't follow up they consciously decide oh let's go back to what didn't work or so a jury could see it well your honor the t c h or even that he was are saving as is noted and dr fisher's affidavit an appropriate course of t c h treatment is ten to twelve weeks when he when the trinity began that's not what he wanted though i mean you know it wasn't working i mean this is like pouring acid meeting that he should be sent to an outside specialist because it wasn't working i just don't understand why then the suddenly the tcas back on the table well two things one of the records do show and dr sue noted maybe they decided to listen to him but it's i don't see in the record when they say oh let's go back to the conservative treatment any explanation for why even though it had never worked before to address those very pains with  movements all the sudden i think it's going to try and one thing to that when you say as you answer the problem that i have is i completely agree with judge woods read of the record and then what i see is if you start on may twenty eight and you march forward i've counted five separate incidents in the treatment notes where he is explicitly complaining complaining of pain five separate times and so you have these complaints that are that are coming in and while they're continuing to treat the wards and he's not in any point there they don't just say let's get him out to the consul that's what we decided originally to do the so and so i don't i mean i don't know what more needs to show to create an issue of fact for for a jury well a couple points on that you're on one again if this pain was caused by you know fisher which again there is no evidence in the record that needle fisher existed prior to this dr suit he refuses to hire alternative explanation for mr standard which they already had them from years bloomfield he had his explanation he provided mr goodloe as explanation provided was that he didn't think he needed and that's the that's what his medical records are l with is instances where the treaters are attempting to provide treatment to mr goodloe and he tells them no i know my body and i don't need that i don't need surprise it or not i don't read it in the record that that kind of can cause the bleeding and evidence are you pointing to that they were treating the internal what evidence you pointing to to answer judge parents question to show that the conditions they thought he had could produce the symptoms he was reporting in the not aware of bleeding or not i'm not aware on july th i think this is a real problem on july th he basically writes a letter a note or grievance or something and it says hey you're not getting it my issues are internal not external and that is that comes at a point in time that they had already decided that he needed that extra onil evaluation and it doesn't happen until september nd right he has his whole point is do what you need to do with the warts but that's not what i'm complaining about i'm complaining about something altogether different than the warts and he's and he's got these really express notes after there's already been a decision that he needs an extra will console to us and i would say one i think a miscarriage or that's to say that he said do whatever you want with th