Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-2_06-cv-02003/USCOURTS-arwd-2_06-cv-02003-2/pdf.json

Nature of Suit Code: 550
Nature of Suit: Prisoner - Civil Rights (U.S. defendant)
Cause of Action: 42:1983 Prisoner Civil Rights

---

AO72A

(Rev. 8/82)

-1-

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FORT SMITH DIVISION

LEROY CRAWFORD PLAINTIFF

v. Civil No. 06-2003

 

SGT. TERRY REA;

NURSE CHARLES WALLS;

AND LT. CUPP DEFENDANTS

REPORT AND RECOMMENDATION OF THE MAGISTRATE JUDGE

Leroy Crawford filed this pro se civil rights action pursuant to 42 U.S.C. § 1983 on

January 9, 2006. He proceeds pro se and in forma pauperis (IFP). 

Plaintiff contends his constitutional rights were violated while he was incarcerated at the

Crawford County Detention Center when he was denied adequate medical and dental care. On

July 31, 2006, defendants filed a summary judgment motion (Doc. 21). Defendants maintain the

plaintiff cannot prove that they were deliberately indifferent to his serious medical or dental

needs. 

On December 6, 2006, an order was entered (Doc. 24) directing Crawford to complete,

sign and return an attached questionnaire that would serve as his response to the summary

judgment motion. The plaintiff’s response to the questionnaire was filed on February 7, 2007

(Doc. 28). The summary judgment motion is currently before the undersigned for issuance of

this report and recommendation. 

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 1 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-2-

BACKGROUND

Crawford was arrested on October 6, 2005, and booked into the Crawford County

Detention Center (CCDC). Plaintiff’s Response (Doc. 28)(hereinafter Resp.) at ¶ 1. He was

awaiting trial on pending criminal charges. Id. at ¶ 2. On December 24, 2005, he was convicted

and sentenced. Id. at ¶ 4. He remained incarcerated at the CCDC until January 9, 2006. Id.

at ¶ 3. 

Charles Walls is the jail nurse at the CCDC. Id. at ¶ 5. Walls was the jail nurse during

Crawford’s incarceration at the CCDC. Id. at ¶ 6. 

According to Walls, on October 12, 2005, he saw Crawford who was complaining of

diabetes, kidney, a swollen side and problems with his knee. Defendants’ Exhibit (hereinafter

Defts’ Ex.) D at ¶ 2. Walls indicates he placed Crawford on an 1800 calorie a day diet and

ordered Ibuprofen, 200 mg., twice a day. Id. Crawford, however, asserts that he was never seen

by Walls about diabetes or any of these things. Resp. at ¶ 7. Crawford also maintains he did not

receive the Ibuprofen. Id. at ¶ 8.

Crawford was seen by Walls on November 9, 2005. Resp. at ¶ 10. According to Walls,

Crawford was asking for dentures. Defts’ Ex. D at ¶ 3. Walls indicates he examined Crawford’s

mouth and determined he had chronic gum disease and few remaining teeth. Id. Walls did not

see any abscess but did observe receding gums. Id. Walls suggested Crawford brush his teeth

and improve his oral hygiene. Id.; Resp. at ¶ 14. Crawford laughed at Walls’ suggestion. Id.

According to Walls, Crawford state that while he was at the CCDC he would receive

dentures free of charge. Defts’ Ex. D at ¶ 3. According to Crawford, he was trying to get some

teeth pulled. Resp. at ¶ 11. Crawford agrees that Walls informed him that he had chronic gum

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 2 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-3-

disease. Id. Crawford disagrees that he told Walls he would receive free dentures. Id. at ¶ 12.

Instead, Crawford maintains he told Walls that the CCDC rule book provides that “no person

would be denied medical/dental services.” Id.

On November 22, 2005, Crawford was seen by Walls complaining of dental pain. Resp.

at ¶ 15. Walls observed no abscess. Id. at ¶ 16. He noted there were no acute problems. Id.

According to Walls, Crawford stated that he was awaiting Arkansas Department of

Correction (ADC) approval for dental care. Defts’ Ex. D at ¶ 4. Walls states Crawford admitted

that he wanted the State to pay for his ongoing dental care. Id. 

Crawford asked for a refill of Ibuprofen. Resp. at ¶ 18. Walls authorized Ibuprofen, 200

mg., three times a day. Id. Crawford received the Ibuprofen. Id. at ¶ 19.

On December 6, 2005, Crawford were seen by Walls. Resp. at ¶ 20. Crawford

complained of a penile discharge. Id. Crawford indicated he had not had any problem until

recently and denied any sexual activity. Id. at ¶ 21. It was determined it was possibly urethritis

and Crawford was instructed to follow up with the Health Department and to increase water

intake. Id. It is not clear how Crawford was to follow-up with the Health Department.

According to Walls, Crawford did not make any complaints about his teeth during this

visit. Defts’ Ex. D at ¶ 5. Crawford, however, states he did complain about his teeth. Resp. at

¶ 22. He contends Walls simply did not put the complaints down on paper. Id. 

On December 7, 2005, Crawford submitted a grievance stating that he was being denied

dental services. Resp. at ¶ 23. He stated he was in pain. Id. In response, Crawford was told an

appointment would be made with the dentist if the nurse said so. Id. at ¶ 24. Crawford was told

it would be his responsibility to pay and the jail would provide transportation. Id.

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 3 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-4-

On December 11, 2005, Crawford submitted a grievance in which he stated that he had

gone to the doctor on December 6th and he said it was nothing a Q-tip couldn’t fix. Resp. at ¶

25. Then Crawford said he got word from Lt. Cupp that he would have to wait until he got to

the ADC for anything to be done with his teeth. Id. Crawford stated that he was in pain and

could not wait. Id.

On December 12, 2005, Crawford submitted another grievance in which he stated he had

an infection and he was in pain from his teeth. Resp. at ¶ 26. He stated he was not supposed to

have to sit there in pain just because he didn’t have any money. Id. In response, Crawford was

told he would be given an appointment with the doctor. Id. at ¶ 27.

On December 14th Crawford submitted a grievance asking how long it took to get a

doctor’s appointment. Resp. at ¶ 28. He indicated he thought they were only trying to buy time

and avoid taking him to the doctor. Id. 

Crawford was seen by Walls on December 14th. Resp. at ¶ 29. Crawford complained

about a toothache and a rash or dry skin. Id. Walls noted a faint rash on Crawford’s shoulders.

Id. at ¶ 30. Crawford was prescribed Tylenol, 650 mg., two times a day, as needed, and

Benadryl, 25 mg., two times a day, as needed. Id. He received the prescribed medication. Id.

at ¶ 31.

On December 15, 2005, Crawford submitted a grievance stating he was still waiting to

go to the doctor. Resp. at ¶ 32. He indicated he believed they were deliberately being slow about

taking him to the doctor hoping that he would be taken to the ADC. Id.

In response, Crawford was told he had a doctor’s appointment. Resp. at ¶ 33. However,

he was told that he would not be told the date of his appointment. Id.

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 4 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-5-

On December 16, 2005, Crawford submitted a grievance asking why he had not been

taken to a doctor. Resp. at ¶ 34(A). He stated his problems were getting worse. Id. He

indicated his pain inside was killing him. Id. Crawford was asked what pain he was having. Id.

at ¶ 34(B). He indicated the penile problem. Id.

On December 20, 2005, Crawford was seen by Walls for a dental abscess on his right

lower front. Resp. at ¶ 35. Upon examination, is was noted Crawford had advanced gum

disease. Id. at ¶ 36. The ADC was notified of his dental needs. Id. 

On December 22, 2005, Crawford was prescribed 14 Ciprofloxacin, 500 mg. Resp. at

¶ 37. Crawford received the prescribed medication. Id. at ¶ 38. 

On December 23, 2005, Crawford submitted a grievance stating that he wanted his

medication on time. Resp. at ¶ 39. On December 23, 2005, Crawford was taken to a dentist, Dr.

Billy Criswell. Id. at ¶ 40. Crawford had x-rays taken and two teeth extracted. Id.

On December 29, 2005, Crawford was seen by Walls. Resp. at ¶ 41. Crawford was

asking for a Tylenol refill after his tooth extraction. Id.

Upon examination, Walls noted Crawford’s dental extraction had healed well. Resp. at

¶ 42. Crawford also asked for a soft food tray. Id. Crawford was prescribed Tylenol, 650 mg.,

two times a day, as needed, and a soft diet was ordered. Id. at ¶ 43.

On January 4, 2006, Crawford submitted a grievance. Resp. at ¶ 44. He indicated he

went to the nurse to get additional medication for three teeth that were hurting him. Id. He

stated that he was told he would be sent back to the dentist about the teeth and receive a soft tray

until he went back. Id. Despite this, Crawford indicated it had been a week and he had not been

taken to the dentist, his medication had been stopped, and his soft tray had been stopped. Id.

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 5 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-6-

In response, Terry Rea wrote he believed this had been taken care of by Lt. Cupp. Resp.

at ¶ 45. Crawford indicates Lt. Cupp did take care of Crawford’s request. Id.

On January 4, 2006, Crawford submitted another grievance asking what had happened

with his dentist appointment. Resp. at ¶ 46. Crawford also asked if he was being denied dental

services again. Id.

In response, Lt. Cupp wrote that Crawford had been taken to the dentist and the tooth that

needed it was pulled. Defts’ Ex. C-2 at page 18. However, Crawford indicates he was only

taken to the dentist one time. Resp. at ¶ 47. When he went to the dentist on December 23rd,

Crawford indicates he said something about the other teeth but the dentist merely replied these

are the teeth the jail wanted him to pull. Id.

On January 4, 2006, Crawford submitted another grievance asking why he had been taken

off the soft food diet. Resp. at ¶ 48. Crawford indicates he had been placed on the soft food diet

when he went back and saw Walls about needing additional teeth pulled. Id. Crawford states

he was to remain on the soft food diet until he returned to the dentist to have three more teeth

pulled. Id. However, when Crawford spoke to Lt. Cupp she indicated he did not have another

dentist appointment and took him off the soft food diet. Id. In response to the written grievance

regarding the soft food diet, Lt. Cupp wrote that Crawford had only been placed on the soft food

diet for two days following his two teeth being pulled. Resp. at ¶ 49.

On January 5, 2006, Crawford was seen by Walls complaining of dental pain. Resp. at

¶ 50. Upon examination, Walls noted that Crawford’s upper incisor was loose but there was no

abscess. Id. at ¶ 51. He noted Crawford’s gums were receding but there was good healing from

the prior extractions. Id.

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 6 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-7-

According to Walls, Crawford asked that the tooth be extracted and that he be given

medication for the pain. Defts’ Ex. D at ¶ 10. Crawford was prescribed Ibuprofen and a request

sent to the ADC for permission to have the tooth extracted. Id. Crawford agrees that he went

to see Walls about teeth that needed pulling. Resp. at ¶ 52. However, Crawford states he was

told by Lt. Cupp that there was nothing in his file about getting teeth pulled. Id. Crawford

received the Ibuprofen. Resp. at ¶ 53. 

SUMMARY JUDGMENT STANDARD

Summary judgment is appropriate if, after viewing the facts and all reasonable inferences

in the light most favorable to the nonmoving party, Matsushita Elec. Indus. Co. v. Zenith Radio

Corp., 475 U.S. 574, 587, 106 S. Ct. 1348, 89 L. Ed. 2d 538 (1986), the record "show[s] that there

is no genuine issue as to any material fact and that the moving party is entitled to a judgment as

a matter of law." Fed. R. Civ. P. 56(c). "Once a party moving for summary judgment has made

a sufficient showing, the burden rests with the non-moving party to set forth specific facts, by

affidavit or other evidence, showing that a genuine issue of material fact exists." National Bank

of Commerce v. Dow Chemical Co., 165 F.3d 602, 607 (8th Cir. 1999).

The non-moving party "must do more than simply show that there is some metaphysical

doubt as to the material facts." Matsushita, 475 U.S. at 586. "They must show there is sufficient

evidence to support a jury verdict in their favor." National Bank, 165 F.3d at 607 (citing Anderson

v. Liberty Lobby, Inc., 477 U.S. 242, 249, 106 S. Ct. 2505, 91 L. Ed. 2d 202 (1986)). "A case

founded on speculation or suspicion is insufficient to survive a motion for summary judgment."

Id. (citing Metge v. Baehler, 762 F.2d 621, 625 (8th Cir. 1985)). 

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 7 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-8-

DISCUSSION

As noted above, Crawford was incarcerated at the CCDC from October 6, 2005,until

January 9, 2006. Resp. at ¶ 1 & ¶ 3. According to Crawford, he was convicted and sentenced

on December 24, 2005. Resp. at ¶ 4. Although the denial of medical care claims brought by

pretrial detainees are more properly analyzed under the Due Process Clause of the Fourteenth

Amendment than the Eighth Amendment, Hartsfield v. Colburn, 371 F.3d 454, 456-457 (8th Cir.

2004), the Eighth Circuit has held that deliberate indifference is the “appropriate standard of

culpability for all claims that prison officials failed to provide pretrial detainees with adequate

. . . medical care,” Butler v. Fletcher, 465 F.3d 340, 344 (8th Cir. 2006).

“In order to state a cognizable claim, a prisoner must allege acts or omissions sufficiently

harmful to evidence deliberate indifference to serious medical needs.” Estelle v. Gamble, 429

U.S. 97, 106, 97 S. Ct. 285, 50 L. Ed. 2d 251 (1976). The deliberate indifference standard

includes "both an objective and a subjective component: 'The [plaintiff] must demonstrate (1)

that [he] suffered [from] objectively serious medical needs and (2) that the prison officials

actually knew of but deliberately disregarded those needs.'" Jolly v. Knudsen, 205 F.3d 1094,

1096 (8th Cir. 2000)(quoting Dulany v. Carnahan, 132 F.3d 1234, 1239 (8th Cir. 1997)).

Additionally, "'[t]he prisoner must show more than negligence, more even than gross negligence,

and mere disagreement with treatment decisions does not rise to the level of a constitutional

violation.'" Jolly, 205 F.3d at 1096 (quoting Estate of Rosenberg v. Crandell, 56 F.3d 35, 37 (8th

Cir.1995)). See also Gregoire v. Class, 236 F.3d 413, 417 (8th Cir. 2000)("To establish a

constitutional violation, it is not enough that a reasonable official should have known of the risk,

a plaintiff must establish that the official in question did in fact know of the risk.").

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 8 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-9-

"Because society does not expect that prisoners will have unqualified access to health

care, deliberate indifference to medical needs amounts to an Eighth Amendment violation only

if those needs are 'serious.'" Hudson v. McMillian, 503 U.S. 1, 9, 112 S. Ct. 995, 1000, 117 L.

Ed. 2d 156 (1992). "A medical need is serious if it is obvious to the layperson or supported by

medical evidence." Moore v. Jackson, 123 F.3d 1082, 1086 (8th Cir. 1997) (per curiam)

(internal quotation and citation omitted).

"[T]he failure to treat a medical condition does not constitute punishment within the

meaning of the Eighth Amendment unless prison officials knew that the condition created an

excessive risk to the inmate's health and then failed to act on that knowledge." Long v. Nix, 86

F.3d 761, 765 (8th Cir. 1996). In Dulany v. Carnahan, 132 F.3d 1234 (8th Cir. 1997), the

Eighth Circuit said:

As long as this threshold is not crossed, inmates have no constitutional right to

receive a particular or requested course of treatment, and prison doctors remain

free to exercise their independent medical judgment. Deliberate indifference may

be demonstrated by prison guards who intentionally deny or delay access to

medical care or intentionally interfere with prescribed treatment, or by prison

doctors who fail to respond to prisoner's serious medical needs. See Estelle v.

Gamble, 429 U.S. 97, 103, 97 S. Ct. 285, 290, 50 L. Ed. 2d 251 (1976). Mere

negligence or medical malpractice, however, are insufficient to rise to a

constitutional violation. Id. at 106, 97 S. Ct. at 292.

Dulany, 132 F.3d at 1239. See also Tlamka v. Serrell, 244 F.3d 628, 633 (8th Cir. 2001). 

Defendants maintain there is no evidence of deliberate indifference on their part. First,

with respect to Lt. Vena Cupp and Terry Rea, the jail administrator, defendants argue there is no

evidence they played any role in determining what type of medical treatment should be given to

the plaintiff. Instead, they maintain Charles Walls, the jail nurse, directly addressed the

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 9 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-10-

plaintiff’s medical needs and requests. Defendants maintain Walls addressed all of plaintiff’s

medical requests in a prompt manner and gave plaintiff proper medical care each time. 

In this case, Crawford made repeated requests for dental care beginning on November

9, 2005, and continuing until his transfer to the ADC on January 9, 2006. Crawford complained

repeatedly of dental pain. See e.g., Resp. at ¶ 15, ¶ 23, ¶ 25, ¶ 29, ¶ 44, ¶ 50. Chance v.

Armstrong, 143 F.3d 698, 702 (2nd Cir. 1998)(“Dental conditions, like other medical conditions,

may be of varying severity.”); Boyd v. Knox, 47 F.3d 966, 969 (8th Cir. 1995)(three-week delay

in dental treatment aggravated problem); Hunt v. Dental Dep’t, 865 F.2d 198, 200 (9th Cir.

1989)(inmate suffered from breaking teeth, bleeding and infected gums, pain and weight loss due

to an inability to eat demonstrated a serious dental condition); Fields v. Gander, 734 F.2d 1313,

1314-15 (8th Cir. 1984)(severe pain due to infected tooth); Manney v. Monroe, 151 F. Supp. 2d

976, 990 (N.D. Ill. 2001)(inmate asserts he suffered from pain, headaches, inability to eat and

suffered weight loss due to inability to eat). Cf. Wynn v. Southward, 251 F.3d 588, 593 (7th Cir.

2001)(“[D]ental care is one of the most important medical needs of inmates.”). 

Crawford was not seen by a dentist until December 23, 2005. After he was seen by a

dentist, he continued to complain about dental pain, the need for additional extractions, and the

need for additional pain medication. See e.g., Resp. at ¶ ; Defts’ Ex. D at ¶ 10. There is no

indication he was given any type of treatment for his advanced or chronic gum disease. Defts’

Ex. D at ¶ 3 & ¶ 7. While a mere disagreement over the timing and type of dental treatment is

not actionable, Long v. Nix, 86 F.3d 761, 765 (8th Cir. 1996)(prison officials do not violate the

Eighth Amendment when, in exercising professional judgment, they refuse to implement

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 10 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-11-

inmate’s requested course of treatment), there is nothing that establishes Nurse Walls or the other

defendants ever considered referring Crawford for dental treatment for the periodontal disease.

Crawford also states he was told by Lt. Cupp that he would have to wait until he got to the ADC

to get anything done about his teeth. Cf. Chance v. Armstrong, 143 F.3d 698, 704 (2nd Cir.

1998)(“Crucially, he has also alleged that Dr. Moore and Dr. Murphy recommended extraction

not on the basis of their medical views, but because of monetary incentives. This allegation of

ulterior motives, if proven true, would show that the defendants had a culpable state of mind and

that their choice of treatment was intentionally wrong and did not derive from sound medical

judgment.”). Crawford indicated Cupp is the one who took him off the soft food diet. 

With respect to Rea, Crawford maintains Rea’s primary concern was saving money and

not providing necessary medical and dental care to detainees. Crawford maintains this is the

reason for the long delay in scheduling Crawford’s first dental appointment and the reason his

second dentist appointment was not made.

Similarly, with respect to his penile discharge, Crawford first complained of the condition

on December 6th and then on December 16th said the pain from the condition was killing him.

Resp. at ¶ 20 & ¶ 34(A). Although Crawford had been told he would be taken to a doctor,

Crawford indicates he was not seen by the doctor and it was his belief that the defendants were

being deliberately slow about taking him in the doctor in the hopes that he would be transferred

to the ADC. Resp. at ¶ 32. Crawford was not prescribed an antibiotic until December 22nd.

Resp. at ¶ 37. We therefore cannot say, when the evidence is viewed most favorably to

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 11 of 12 PageID #: <pageID>
AO72A

(Rev. 8/82)

-12-

Crawford, that there are no genuine issues of material fact as to whether defendants were

deliberately indifferent to Crawford’s serious dental and medical needs. 

CONCLUSION

For the reasons stated, I recommend that the defendants’ motion for summary judgment

(Doc. 21) be denied.

The parties have ten days from receipt of the report and recommendation in which

to file written objections pursuant to 28 U.S.C. § 636(b)(1). The failure to file timely

objections may result in waiver of the right to appeal questions of fact. The parties are

reminded that objections must be both timely and specific to trigger de novo review by the

district court.

DATED this 1st day of March 2007.

/s/ J. Marschewski 

HON. JAMES R. MARSCHEWSKI 

UNITED STATES MAGISTRATE JUDGE

Case 2:06-cv-02003-JRM Document 30 Filed 03/01/07 Page 12 of 12 PageID #: <pageID>