well your argument now in the case of connor against water or that he asserted in the district court system from two serious medical conditions he alleges he suffered from during in march and april two thousand and seventeen stay in clinical observation which would be a segregated section of the prison that he was incarcerated in going to excuse me ultimately mr connor believes that his claim should be remanded to the district court so that a trial of fact can hear the competing evidence that was presented to the district  hygiene issues ultimately we believe the record evidence demonstrates that each of the apologies healthcare providers at the jail were aware that mr connor had been diagnosed with post both conditions in january of two thousand and seventeen receive treatment for a roughly a sixty day time period almost consecutively though the treatments were entered as cayle key p r n which would mean keep on person as needed so he had access to these medicated creams in his jail cell mr connor has a history of mental health issues so on february th he was put into a clinical observation cell which is a high security area of the prison where he's in a cell by himself routinely watched every fifteen minutes he was allowed to keep his medications on his person for the st several days but then misused the proves he doesn't deny misusing them his story as it was out of protest against the jail after he misused the health care providers in the psych providers specifically no longer allowed him to possess the creams in his cell however the health services unit nurses including the a police in this case specifically miss mcardle still put in a a reasonable accommodation treatment plan for him they would go to his cell tether him to his door and minister the cream and that went on for at least seven days while he was in this february two thousand and seventeen clinical confinement or observational clinical confinement period connor leaves clinical confinement on march nd with every intention of going back even wrote the health services unit explaining he didn't believe that he should be out he's going to go back and lo and behold he commits another kind of self harm incident and is put back in clinical confinement on march rd the relevant time period for this deliberate indifference case it's march rd through about april th so on march rd he writes the health services unit at the instruction of a health services staff member that he's going into clinical observation he's not going to be able to possess his creams but he still wants to receive them he gets a response on march  from a from a nurse saying yes you will have access to the cream from the car from the med card a med past comes by once or twice a day to administer medications pursuant to provider treatment plans long story short he goes through  connor would disagree how do you sleep i think i think the the issue here one of the issues i think that was bogged down in the briefing was what is mr connor really claiming here i'm not going to sit in front of you and tell you that dry skin on the bottom of a person's speed is a serious medical condition not at all but sometime in early march when mr connor was less prevented from using the cream at all he claims to have developed a deep lacerations on the bottom of his feet a speak started to bleed even with those concerns made to the health services unit and specifically to nurse bethel and nurse waterman nobody did anything for him so he goes through march  and all it took was a nurse waterman according to her own story to look through his cell window and i'll use the word diagnosed but observe that his feet were in such a condition that he required daily treatment so the h s u staff implemented a care plan we're now they would make mr connor walk from his cell to the health services unit in a dove in a different part of the prison barefoot they would apply cream to the bottom of his feet and then make him commute back and mr connor within a day to have complained the cream's no longer stay on my feet it's not working and they did nothing for him until april th where out of the blue they just allowed him to possess the creams again in his  l one of the issues that i took with the district court decision was it's pretty it's pretty apparent i'm not going to dispute that mr connor as of roughly march th refused care but he did so he communicated  the agency of staff that it was because the care was ineffective when you look at the totality of the care that this man received for sixty days he received these creatures he'll tell you that it was almost daily he had it in a cell he could put it on any time he wanted to but and even with the medication there are progress notes that describe his feet as being very dry they're not in a good condition well now the guy goes fifteen days or so without the cream they start to crack and bleed and  holds however he had another issue as well he he suffered from generally dry skin and again i'm not going to try to explain to you or make the argument that a person with dry skin is suffering from an th amendment serious medical need but in mr connor's case it got so discomforting for him that he stopped showering for weeks at a time the record has several statements from him that cell mates jail providers would tell him that he's stuck flat  so you have an individual who's going weeks without showering and at the same time complaining that he needs his medicated lotions in order to you know alleviate the pain the itching the discomfort but also just be able to have the daily serious threat to his own life he put staff in a position where they had to remove almost all of his property and monitor him two hundred and forty seven but monitoring mr connor proved difficult when he used those lotions  to cover his security camera and cell shortly after that and another suicide attempt staff had to prioritize preventing suicide over creams and lotions this was not anything memon violation despite the directive from his treatment team to remove his access to those creams and lotions in his cell connor's requests for fruit for foot treatment was not ignored miss waterman and her special provided him out of self treatments consisting not just of applying foot lotions but also soaking his feet and cleaning them in an absent salt bath something he never challenged as being ineffective or not not adequate he refused most of those treatments no part of this record supports the finding of deliberate indifference on the part of ms waterman or her special and the treatment decisions made by these providers did not violate the th amendment i'd like to address  cracked and bleeding would have some benefit to him what this wendell's down to i think your honour's as a disagreement with a course of treatment which is not that which cannot support a claim of deliberate indifference even when th quality that care is substandard to the point of negligence or malpractise which i agree with your honor is not even sure at this case because what we have here is something that did not constitute a serious medical need dry skin and and i dressed this in my brief as well and this is sort of this is an attempt to relive again a claim that's already been litigated in the district court and before this court in his prior case that this court issued a decision a few months ago connor home where he challenged through this period of observation this exact time not being able to shower and in that case this court said that though showering motion made it unpleasant no reason with jury could find that it was cruel and unusual under contemporary standards of decency or that it deprived mr connor of basic human needs that there's no reason why st of all that sort of argument is precluded i think secondly there's no reason why there's any different resolution to that claim here today i think looking at split it is i think because this claim that not having the ocean deprived him of basic hygiene was really only developed on appeal it clearly was a separate claim in the district court the court actually claims you know you have to show that each individual defendant was involved in causing a deprivation and here the record is undisputed miss waterman maybe knew that he had access to these items but as was conceded in oral argument here those how he didn't have a serious medical need for those until sometime in march and this waterman was not made aware of his request for those as needed for treatments until good morning your honour's i mean please the court i'm melissa johnson i'm here on behalf of nurse practitioner sandra mcardle the main point to keep in mind as it relates to nurse practitioner sandra mcardle is that her limited interactions with mr connor while he was on clinical observation status did not amount to actions that were criminally reckless or an intentional infliction of suffering to a serious medical so you in looking at this you have to look at the interactions at the time the to the appointment by himself without issue and at that time his feet were just dry there was no bleeding going on for his own admission there's no evidence in the record whatsoever that mr then the next time that miss mcardle saw mr connor was on april th on april rd that was the date that mr connor got his i'm sorry april th was the date that he got access to his previous emotions again and then on april th he wrote a health service request stating that he only suffered from march rd to april rd so at on the april some of the point there is nothing that she could have done to change the treatment and he doesn't allege that he asked for different treat mcconnell has to respond to them she will it's undisputed that she did not respond to any health service requests in this matter to mr connor and then she only saw him when a specific appointment was made she did not see the signs on his