Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca10-06-05104/USCOURTS-ca10-06-05104-0/pdf.json

Parties Involved:
James M. Abraham
Appellee
Pat Ballard
Appellee
Peggy Beers
Appellant

Document Text:

This order and judgment is not binding precedent, except under the *

doctrines of law of the case, res judicata, and collateral estoppel. It may be cited,

however, for its persuasive value consistent with FED. R. APP. P. 32.1 and 10TH

CIR. R. 32.1.

FILED

United States Court of Appeals

Tenth Circuit

October 1, 2007

Elisabeth A. Shumaker

Clerk of Court

UNITED STATES COURT OF APPEALS

TENTH CIRCUIT

PEGGY BEERS, Administrator for the

Estate of Danny Wayne Barnes,

Plaintiff-Appellant,

v.

PAT BALLARD, Sheriff, Washington

County; JAMES M. ABRAHAM,

General Administrator, Washington

County Jail,

Defendant-Appellees.

No. 06-5104

(D.C. No. 04-CV-860-CVE-SAJ)

(N. Dist. Okla.)

ORDER AND JUDGMENT

*

Before BRISCOE, SEYMOUR, and MURPHY, Circuit Judges.

Danny Wayne Barnes died in custody at the Washington County Jail. His

estate, administered by Peggy Beers, and Ms. Beers on behalf of Mr. Barnes’

minor daughter (the Family) appeal the district court’s determinations in favor of

Washington County Sheriff Pat Ballard and Jail Administrator Lieutenant James

Appellate Case: 06-5104 Document: 010142265 Date Filed: 10/01/2007 Page: 1 
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Abraham. We affirm.

Mr. Barnes was convicted of driving under the influence in Washington

County, Oklahoma and sentenced to five years imprisonment with all but sixty

days suspended. He suffered from a number of diagnosed ailments, including

high blood pressure, diabetes, anxiety, and back pain, for which he was treated

with four prescription medicines. While in custody, he expended his supply of

hydrocodone, a pain-reliever, and filed both a prisoner medication request form

and a grievance form discussing his failure to receive hydrocodone and blood

pressure medication. According to the jail medical log, Mr. Barnes missed doses

of pain medication on eleven days between September 20, 2002 and October 2,

2002. He was consistently administered hydrocodone or oxycodone, a medicine

with similar pain relieving properties, from October 3 to October 19. Mr. Barnes

intermittently missed other medications while incarcerated, including one dose of

actos and two doses of glucotrol, both diabetes medications, and one dose of

cozaar, a heart medication.

On the morning of October 19, at 8:09 A.M., an inmate trustee notified

Officers Travis Hurd and Timothy Inda that Mr. Barnes had collapsed in his jail

cell. Pursuant to prison policies, an officer may only enter an occupied jail cell in

the presence of one or more fellow officers. At the time of Mr. Barnes’ collapse,

Officer Inda was unavailable to intervene because he was serving as a dispatcher. 

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The Family asserts “a period of thirty-five (35) minutes lapsed” between 1

“the initial discovery of [Mr. Barnes] until the ambulance arrived,” aplt. br. at 12,

while defendants claim “[t]he ambulance . . . arrived only nine (9) minutes after

the officers were first alerted to the ‘man down.’” Aple. Br. at 10. The district

court said “[t]he overwhelming evidence is that . . . 12 minutes passed between

notification of ‘man down’ . . . and arrival of EMT personnel.” Aplt. App. at 419. 

As is evident from the following discussion, the exact length of delay is not

determinative.

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Officer Hurd was the officer both present and available to enter Mr. Barnes’ cell. 

Unable to enter alone, he requested back-up assistance from the Bartlesville

Police Department. James Beisely, an officer patrolling nearby, was dispatched

to the prison soon thereafter. Attending to Mr. Barnes after his arrival, Officer

Beisely performed CPR and requested an ambulance, which took Mr. Barnes to a

nearby hospital. He persisted in a vegetative state for several weeks and died 1

after the Family withheld further treatment. An autopsy revealed his death was

caused by “[h]ypoxic encephalopathy secondary to cardiac arrest associated with

acute myocardial infraction,” a cause of death characterized in layman’s terms by

the district court as cardiac arrest resulting in deprivation of adequate oxygen to

the brain. App. Appx. at 385-86.

The Family filed a claim against Sheriff Ballard, Lt. Abraham, and the

Board of County Commissioners of Washington County. They alleged under 42

U.S.C. § 1983 that defendants were deliberately indifferent to Mr. Barnes’

medical needs in violation of the Eighth Amendment, and that their indifference

was the proximate cause of his coma and death. The district court granted

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summary judgment to the Board, Lt. Abraham, and Sheriff Ballard except as to

the Family’s claim against Sheriff Ballard in his official capacity, which alleged

he failed to adequately train or supervise jail personnel with deliberate

indifference to a substantial risk of serious harm to Mr. Barnes. After the

Family’s presentation of evidence, Sheriff Ballard was granted judgment as a

matter of law. On appeal, the Family contends the district court erred in (1)

granting qualified immunity to Sheriff Ballard and Lt. Abraham, (2) concluding

the Family failed to prove deliberate indifference and proximate causation, and

(3) denying the Family the opportunity to introduce evidence of the jail grievance

procedure. 

We review a district court’s grant of summary judgment de novo, applying

the same legal standard used by the district court. Reeves v. Churchich, 484 F.3d

1244, 1250 (10th Cir. 2007). Summary judgment should be granted “if the

pleadings . . . together with the affidavits, if any, show 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). In conducting our review, “[w]e view the

evidence and draw reasonable inferences therefrom in the light most favorable to

the nonmoving party.” Lawmaster v. Ward, 125 F.3d 1341, 1346 (10th Cir.

1997). We also review de novo the district court’s order granting judgment as a

matter of law. Smith v. Aztec Well Servicing Co., 462 F.3d 1274, 1287 (10th Cir.

2006). We will “uphold a [judgment as a matter of law] only if the evidence

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points but one way and is susceptible to no reasonable inferences supporting the

party for whom the jury found.” Weese v. Schukman, 98 F.3d 542, 547 (10th Cir.

2006). Finally, we review evidentiary rulings for an abuse of discretion. United

States v. Cestnik, 36 F.3d 904, 906 (10th Cir. 1994). 

Where a defendant asserts qualified immunity, the burden shifts to the

plaintiff to demonstrate that “the defendant violated one of his or her

constitutional or statutory rights,” and “that the infringed right at issue was

clearly established at the time of the allegedly unlawful activity such that a

reasonable law enforcement officer would have known that his or her challenged

conduct was illegal.” Martinez v. Carr, 479 F.3d 1292, 1295 (10th Cir. 2007). 

Prison officials violate an inmate’s Eighth Amendment right to be free from cruel

and unusual punishment when they are deliberately indifferent to an inmate’s

serious medical needs. Estelle v. Gamble, 429 U.S. 97, 104 (1976). To establish

deliberate indifference, the plaintiff must show the medical need was objectively

serious, and that the prison official subjectively “kn[ew] of and disregard[ed] an

excessive risk to inmate health or safety.” Sealock v. Colo., 218 F.3d 1205, 1209

(10th Cir. 2000) (quoting Farmer v. Brennan, 511 U.S. 825, 837 (1994)). 

Even where there is a sufficiently serious medical need, however, delayed

“medical care only constitutes an Eight Amendment violation where the plaintiff

can show that the delay resulted in substantial harm.” Sealock, 218 F.3d at 1210. 

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There are two potential “substantial harms” attributable to the delay in attending

to Mr. Barnes after his collapse. First, Mr. Barnes may have suffered from

greater or more prolonged pain, a cognizable substantial harm. See id. at 1210

n.5 ([T]here is factual evidence from which a jury could conclude that the delay

occasioned by . . . inaction unnecessarily prolonged appellant’s pain and

suffering.”); Oxendine v. Kaplan, 241 F.3d 1272, 1278 (10th Cir. 2001) ([T]he

delay . . . caused substantial harm due to the fact that . . . Oxendine experienced

considerable pain.”). Second, the time-frame for administering life-saving

treatment could have passed during the period of delay; if such treatment had a

realistic chance of success, the prison’s dilatory response could be said to have

proximately caused his death. See Lewis v. Wallenstein, 769 F.2d 1173, 1183 (7th

Cir. 1985) (“[C]ausal connection existed between” doctor’s fifteen minute delay

in attending to inmate and inmate’s death from cardiac arrest).

But there is no evidence here that Mr. Barnes suffered additional pain or

that the prison’s untimely response precluded possible life-saving treatment. As

to pain, the Family acknowledges that Mr. Barnes was already “unconscious” at

the time the prison officials were notified of his condition. Aplt. App. at 157. 

With respect to his death, the Family asserts it “does not require a leap into the

realm of medical uncertainty to” conclude there was causation. Id. at 173. Yet,

large leap or short hop, plaintiffs must prove causation. The Family deposed Mr.

Barnes’ primary care doctor, Dr. Jerry Jarrell, but he did not suggest untimely

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Lewis v. Wallenstein, 769 F.2d 1173, 1183 (7th Cir. 1985), provides an 2

example of the kind of evidence that can demonstrate causation in a delayed

treatment, deliberate indifference case like the one at hand. In Wallenstein, a

doctor deliberately delayed responding to multiple emergency calls and attended

to a prisoner in cardiac arrest ten to fifteen minutes after he was first notified. 

The patient/prisoner died from the heart condition. At trial, a physician testified.

a twenty-seven-year-old person with no prior heart disease [like

the decedent] found unconscious but with a feeble pulse has an

excellent chance of being resuscitated if advanced cardiac life

support is provided within two minutes. [The physician] found

his opinion supported by a study, the data of which established

that if basic life support is provided within five minutes and

advanced cardiac life support within eight to ten minutes, the

patient’s chance for survival would be 10-30%. Finally, [he]

testified that a person with a feeble pulse is not yet in full cardiac

arrest; the chance of successful resuscitation in such a case is

greatly enhanced.

Id. at 1183. The resulting loss of a 10-30% chance of survival was

“sufficient evidence to support . . . a direct causal relationship between [the

doctor]’s deliberate indifference and [the patient]’s death.” Id. at 1184. 

In this case, the Family could have presented a medical professional

to testify about causation. The district court denied summary judgment to

defendants because the Family “present[ed] genuine issues of material fact

as to whether the alleged delay in treatment for inmate’s cardiac arrest may

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medical care precipitated Mr. Barnes’ coma. No other medical expert testified

about the health effects of the delay and the Family introduced no evidence

associating Mr. Barnes’ coma and death with a delay in treatment, or any

testimony suggesting the outcome would have differed with a quicker response. 

It is certainly possible that Mr. Barnes would have suffered the same fate even

with expeditious care. In this factual vacuum, we decline to speculate whether

someone with Mr. Barnes’ preexisting medical problems and acute heart condition

would have fared better with prompter treatment.2

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have decreased decedent’s chance of survival,” thus leaving the question of

causation for trial. Aplt. App. at 395. In their case in chief, however, the

Family failed to present testimony that would resolve this material fact

issue in their favor.

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The Family also contends Mr. Barnes’ missed diabetes, blood pressure, and

pain medication “subject[ed] him to future cardiovascular harm.” Aplt. Br. at 21.

There is no indication that the few skipped doses precipitated his cardiac arrest,

see Aplt. App. at 234 (Dr. Jarrell testified that higher blood sugar results in

“higher incidence of cardiovascular events . . . referring to years [of elevated

blood sugar], not hours or days.”), and there is therefore no causal link between

the missing medications and Mr. Barnes’ death. 

The Family also asserts the missed doses of pain medication “subject[ed]

him to unnecessary pain.” Aplt. Br. at 21. Mr. Barnes documented his pain in the

medical and grievance forms he submitted to prison officials. See Aplt. App. at

287 (listing “back & hand pain”); id. at 285 (stating that “pain hurtin[g]”). The

causation defect that derailed the Family’s previous claims is thus not present

here. But, as noted above, the harm caused by a delay in treatment must be

“substantial” to present an Eight Amendment violation. See Garrett v. Stratman,

254 F.3d 946, 950 (10th Cir. 2001) (The “substantial harm requirement may be

satisfied by lifelong handicap, permanent loss, or considerable pain.”). Where

pain is the claimed harm, “‘not every twinge . . . suffered as a result of delay in

medical care is actionable,” Sealock, 218 F.3d at 1210; “when the pain

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experienced during the delay is substantial, the prisoner sufficiently establishes

the objective element of the deliberate indifference test.” Kikumura v. Osagie,

461 F.3d 1269, 1292 (10th Cir. 2006) (quotation omitted). In previous cases, we

have held that twelve hours of tormenting, debilitating pain accompanied by

severe vomiting, see id. at 1293, and “considerable pain [experienced] while [a]

finger continued to rot,” Oxendine, 241 F.3d at 1278, constituted substantial

harm. 

The record here does not suggest the discomfort Mr. Barnes suffered as a

result of his missed medication was of sufficient severity to be substantial. The

record is simply too barren to reach that conclusion. For example, Dr. Jarrell

made no comment as to the nature and severity of Mr. Barnes’ original pain

complaints. His deposition does not indicate where Mr. Barnes placed his

discomfort on a pain scale or whether this was a minor recurring discomfort or a

debilitating pain. Because pain medications are widely prescribed to allay both

minor and severe pain, the prescription alone provides little indication of the pain

severity. Mr. Barnes was certainly in some distress while imprisoned, see aplt.

app. at 285 (complaining pain was interrupting his sleep), but the record simply

does not support a conclusion that the pain was “substantial.” 

Given that the Family cannot meet the first, objective prong of the

deliberate indifference analysis, they failed to satisfy the first prong of the

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qualified immunity test. Furthermore, as evidenced by the above discussion, they

also failed to prove deliberate indifference and proximate causation. Finally, we

are not persuaded the district court abused its discretion when it denied the

Family an opportunity to offer evidence of the Washington County Jail’s

grievance procedure.

Accordingly, we AFFIRM.

ENTERED FOR THE COURT

Stephanie K. Seymour

Circuit Judge

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