good morning your honour's inmates please the court my name is rochelle wilcox and i represent the the issue before this court is whether mr snell c e o has raised a question of fact on a material issue as to each of these claims against the defendants so very low burden and we believe that mr sestito has easily met that burden here he has raised the question of fact as the trial court erred on this issue and concluded that doctors are of good order medication and that it was not his fault that the mccann medication was not provided to mr saul steele but in fact the evidence in the record is to the contrary it reflects that medication was indifference deliberate indifference is the knowledge of a serious risk of pain or the knowledge that an inmate is in pain and the refusal to provide treatment to prescribe treatment to alleviate that pain that is in compassed by deliberate indifferen doctors eric may have been deliberately indifferent to mr selsey those serious needs and the the issue is what inferences can be drawn on summary judgment inferences cannot be drawn favoring that medication was not prescribed the inference that mr snell sita wasn't title two was that doctors erik intentionally ignored his pain and his request for medication in not prescribing that medication the same thing is true as to doctors their rights refusal to perform additional surgery to remove the bullet fragments that the record reflects still remain not around the stress test you know seems fine but in his left nowhere can look at the x rays and he could actually the evidence on that issue is not that clear what doctors very concluded after reviewing the x rays is that there are bullet fragments remaining in his left lower neck his declaration submitted an insupportable summary judgment motion so that some of those bullet fragments are around the c spine and cannot be removed some of them based on that declaration defendants argued that the bullet fragments cannot be removed but  requested and you're all surgical examination there is a examination by dr millis are excuse me if i've mispronounced his name saying that there are no nurse surgical issues this seems fine is ok and is not causing his pain what defendants did is focused on an issue that could not be was not operable the bullets round his the spine could not have been removed that would be too dangerous dr so doctors erik did not exam e after learning that bullets remained in his left lower neck and after learning that mr mr you know had been told that one of those bullet fragments was hitting a tendon and causing his pain there was no further analysis of the left lower neck and whether or not those bullets could or should be removed instead the question focused on this seems fine that is a question of fact there the court cannot resolve these questions  fact these differences in medical judgment on summary judgment the trial court the fact finder the jury could conclude that the doctors were correct and that their judgment was that the bullet should not have been removed and that was an appropriate medical decision at the time but oh no you're saying now that the inappropriate medical decision is the same as deliberate indifference to medical needs i'm not sure that that's correct in jackson versus macintosh your honor this court concluded that those really are questions for the trier of fact that where it is unclear what the result of that medical decision resulted from whether or not it was deliberate indifference or just a medical judgment is not a proper question on summary judgment it's a question for the fact finder at trial on s judgment the question is whether or not any evidence supports plaintiff's claim that the doctor was deliberately indifferent in reaching that judgment and here i think the answer clear that you know has presented at least enough ever evidence to go to a jury by showing that the bullet fragments do remain in his left lower neck by showing that doctors there was surprised when he saw those bullet fragments and by showing that instead of sending for further evaluation on those bullet fragments that mr selsey will have been told were hitting a tendon and causing his pain the focus instead was diverted to the c spine would you please get to the other doctors i'm probably going to run out of time and i want to hear about the other doctor thank you your honor the other doctors the issue basically is the fact that this response you know really did not receive adequate treatment for his pain the record reflects that he has not it intil july two thousand  four he did not receive medications reliably the defendants had the i mean it's up to you i want to talk about dr lee because dr levy it seems to me you are attributing liability to him because he supervisor what personal involvement to the have in the treatment of your client he was responsible for supervising the appeal through its different levels and poor making sure the responsibility of dr lee and dr bowman to make sure that he was getting the treatment that was required and in the director's level appeal in july of two thousand and four the director said get him this treatment asap get him a col did not he and dr bohman were required to take steps to do it immediately it wasn't until november of two thousand and four four months later that the crawlers were issued and it was another two months before he received the pillows but there is no evidence t if the if the if the system fails and it is the supervisors fault that the system has failed then the supervisor can be held responsible but more specifically his job in connection with the of hills the administrative appeals was to make sure this treatment was undertaken he signed off on the appeals the director told him supervised certainly you shall make sure that this gets done immediately only as to the cervical collar that's a real issue he response of the individual to that need and in this case doctors there it's response was as a doctor he was concerned about second surgery he was reluctant to perform it because he felt that would harm pla rather than help him to that end he asked for a neurological consultation for talk to ms are and documents are concluded that the second surgery should not occur whether that is true medically or not subjective did not believe that the second surgery would be to the benefit of playing him who would actually hurt him and that is why the court with proper in granting sabriye judgment the requisite subjective requirement of medication he would of course prescribe the medication and what is interesting in the record is that plaintiff has complained about pain to doctors there at an april yet he did not go back to the clinic until november stateline hotel versus jorgenson are both counsel here