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United States Court of Appeals

FOR THE EIGHTH CIRCUIT

____________

No. 96-1351

____________

Gloria Coleman, *

*

Appellee, *

*

v. * Appeal from the United States

* District Court for the

Nurse Ruth Rahija, Nurse at * Southern District of Iowa

IMCC - Oakdale, *

*

Appellant. *

____________

 Submitted: October 22, 1996

 Filed: June 5, 1997

____________

Before RICHARD S. ARNOLD, Chief Judge, and FLOYD R. GIBSON and 

McMILLIAN, Circuit Judges.

____________

McMILLIAN, Circuit Judge.

Gloria Coleman brought this action in the United States District

Court for the Southern District of Iowa, pursuant to 42 U.S.C. § 1983,

claiming that Ruth Rahija was deliberately indifferent to her serious

medical needs in violation of her Eighth Amendment right to be free from

cruel and unusual punishment. Rahija now appeals from the district court’s

final order, following a bench trial, holding that Rahija was deliberately

indifferent to Coleman’s serious medical needs and awarding Coleman $1,000

in compensatory damages and $3,500 in punitive damages. Coleman v. 
In her answer, Rahija asserted qualified immunity as an

1

affirmative defense but failed to argue it in the district court.

She also failed to make a qualified immunity argument to this

court.

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Rahija, No. 4-91-CV-50260 (S.D. Iowa Jan. 2, 1996) (Coleman). For

reversal, Rahija argues that the district court erred in finding that (1)

Coleman had a serious medical need; (2) Rahija had sufficient knowledge of

Coleman’s serious medical need to justify a finding of deliberate

indifference; (3) Coleman suffered actual harm as a consequence of Rahija’s

actions; and (4) Rahija’s conduct was sufficiently callous to support an

award of punitive damages. For the reasons discussed below, we vacate the

award of punitive damages and affirm the order of the district court on the

remaining issues.

I. Background

The factual background is primarily based on the findings of the

district court. Id. at 1-10. On January 15, 1991, Coleman, an inmate, was

transferred from the Iowa Correctional Facility for Women in Mitchellville,

Iowa, to the Iowa Medical and Classification Center (IMCC) in Oakdale,

Iowa. At that time, Coleman was twenty-eight years old and approximately

seven months pregnant. She was transferred to IMCC to facilitate closer

monitoring of her pregnancy. Rahija was a registered nurse employed by

IMCC.1

Upon Coleman’s arrival at IMCC, the IMCC Health Services Department

(Health Services) conducted a “health screen” and documented Coleman’s

health history, including the fact that Coleman had five prior pregnancies.

Dr. Timothy Pflederer, a Health Services physician, conducted a routine

physical examination of Coleman on January 23, 1991, and noted in his

examination notes 
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that Coleman had a long history of problematic pregnancies. In 1980,

Coleman prematurely delivered twins who were either stillborn or died

shortly after birth. Of Coleman’s subsequent four pregnancies, three

involved precipitous labors lasting less than one hour and one resulted in

a premature delivery. Based on this information, Dr. Pflederer referred

Coleman to the University of Iowa Hospitals and Clinics Obstetrical Unit

(the University) for an evaluation. On January 30, 1991, Dr. Katherine

Stevenson, a University resident physician, examined Coleman and discovered

that her cervix was one to two centimeters dilated. She reported that

Coleman’s obstetric history was “significant” and recommended that Coleman

remain at IMCC due to its proximity to the University and Coleman’s history

of pre-term deliveries. 

On January 31, 1991, a notation was made in the Health Services

records that Coleman had been examined at the University and was to remain

at IMCC until after the baby was born. On February 2, 1991, at

approximately 8:45 a.m., Coleman awoke and went to Health Services,

complaining that her “water” was “leaking.” A Health Services nurse

examined Coleman and determined that Coleman’s amnion had not ruptured.

Instead, the nurse determined that Coleman was experiencing normal mucous

vaginal discharge which commonly occurs during the later stages of

pregnancy. The nurse gave Coleman sanitary napkins and instructed her to

notify Health Services if her condition worsened.

On February 14, 1991, Coleman returned to Health Services complaining

that she “had a bloody show.” At that time, Health Services transferred

Coleman to the University for an examination. The University physicians

determined that Coleman was not in active labor but noted that her cervix

was dilated one to two centimeters and she was having minimal contractions.

The University physicians instructed Health Services to return Coleman to

the University if 
Under IMCC’s policy, a pregnant woman is transferred to the

2

University when she is in active labor. Brief for Appellant at 10.

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her contractions became painful, regular, and separated by ten minutes or

less. 

2

On February 15, 1991, Coleman awoke early in the morning and noticed

some spotting of blood. She complained of bleeding, back pain, and stomach

pain to a guard, who sent her to Health Services. She notified Health

Services of the spotting and decided not to attend her required school

classes that day. At approximately 10:30 a.m., Coleman again reported to

Health Services complaining of more bleeding and back pain. Although

Coleman denied being terribly uncomfortable, Coleman’s symptoms were

recognized signs of labor and led the IMCC nursing staff to call the

University. Dr. Alvina Driscoll, a University resident physician,

determined that the bleeding was likely due to cervical changes and was not

a concern unless it increased or was associated with cramping or

contractions. The IMCC nursing staff recorded in Coleman’s medical chart

that she was to be monitored for increased bleeding or signs of labor. The

bleeding was to be monitored by inspecting Coleman’s sanitary napkins.

Coleman returned to Health Services at approximately 2:00 p.m. to complain

of more bleeding and show a nurse a sanitary napkin with blood on it.

After looking at the sanitary napkin, the nurse threw it in the garbage.

At approximately 7:00 p.m., Coleman was watching television when she

stood to use the bathroom and felt an extreme pain in her lower abdomen

causing her to double over. Coleman’s pain began to subside when another

inmate, Felicia Allen, attempted to comfort her. Sometime thereafter,

Coleman went to Health Services and was seen by Rahija, who had come on

duty at 3:00 p.m. Without taking Coleman’s vital signs, performing a

vaginal examination, or 
Health Services did not have any equipment to monitor

3

Coleman’s contractions, and Rahija was not qualified to perform a

vaginal examination of Coleman to monitor any cervical changes.

Notably, at no time prior to her transfer to the University

4

at approximately 11:45 p.m. on February 15, 1991, did Coleman

receive the assistance of a wheelchair. 

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attempting to monitor the baby’s heart tones, Rahija sent Coleman back to

her living unit and told her to return when the contractions were six to

seven minutes apart. 

At approximately 9:30 p.m., Coleman’s pain worsened. She returned

to Health Services and reported to Rahija that she was still bleeding, she

hurt “down there,” pointing to her abdomen, and her contractions were six

minutes apart. Rahija placed her hands on the exterior of Coleman’s

abdomen and noted that she was unable to feel any contractions. Rahija

3

monitored the baby’s heart tones, which were 142 beats per minute. At that

time, Coleman denied experiencing low back pain or rupturing of her amnion.

Despite concluding that Coleman was in “possible early labor,” Rahija sent

Coleman back to her living unit and instructed her to return to Health

Services if the bleeding increased or the contractions increased in

severity or regularity.

Following Rahija’s instructions, Coleman returned to her living

unit. Coleman sat on the edge of her bed in increasing pain until 11:25 4

p.m., when she began to scream from the intense pain and moved to the

cement floor, where she laid in a fetal position. A correctional officer

allowed Allen and another inmate to enter Coleman’s living unit to attempt

to calm her by talking to her and rubbing her back and stomach. 

At that point, a correctional officer called Health Services to

summon Rahija and Grace Schwickerath, also a registered nurse, 
The district court recognized that Coleman was

5

“understandably uncooperative” because she believed that her child

was about to be born yet was unable to obtain any assistance from

the nursing staff. See Coleman v. Rahija, No. 4-91-CV-50260, slip

op. at 9 n.6 (S.D. Iowa Jan. 2, 1996).

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to attend to Coleman. When they arrived, Coleman stated that she was in

pain and felt “like pushing.” The nurses observed that Coleman appeared

to be “bearing down.” Both nurses placed their hands on the exterior of

Coleman’s abdomen and were unable to feel any contractions. One of the

nurses monitored the baby’s fetal heart tones, which were 120 beats per

minute. The nurses asked Coleman to stand to allow them to inspect her

sanitary napkin. As Coleman stood, she “grunted” and expelled

approximately 15cc of dark red blood. Coleman’s sanitary napkin indicated

that she had been spotting previously. Coleman stated that she “should go

ahead [and] just have this baby [and] that would teach you for not

listening.” Id. at 9. At that point, the nurses agreed that Coleman

5

should be transported to the University and Schwickerath went to make the

necessary arrangements. Rahija stayed with Coleman and noted that Coleman

was probably in premature labor. However, Schwickerath noted that Coleman

was in “questionable labor.” Id. 

At approximately 11:45 p.m., Coleman was transported from IMCC to the

University. While transporting Coleman, the attending medical

professionals repeatedly called Coleman’s name to prevent her from falling

asleep. Coleman constantly felt the urge to push and, sometime during the

ride, expelled another 20cc of blood. Shortly after arriving at the

University, Coleman delivered a premature baby boy at 12:20 a.m. on

February 16, 1991, although she was later unable to remember the delivery.

Neither Coleman nor the baby suffered any complications during the

delivery. Coleman 
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returned to IMCC on February 18, 1991, and the baby was later released from

the hospital to the care of Coleman’s mother.

On March 3, 1991, Coleman completed a form complaint used by

prisoners to file complaints under the Civil Rights Act, 42 U.S.C. § 1983,

alleging that Rahija violated Coleman’s Eighth Amendment right to be free

from cruel and unusual punishment by being deliberately indifferent to

Coleman’s complaints that she was in labor, which caused her to suffer both

physically and emotionally. Coleman’s complaint was filed in the United

States District Court for the Southern District of Iowa on April 29, 1991.

On September 27-28, 1994, this matter was tried to the district

court, sitting without a jury. The case remained open for further

depositions and was completed on April 10, 1995. The district court held

that Rahija’s conduct deprived Coleman “‘of the minimal civilized measure

of life’s necessities’ afforded her by the Eighth Amendment,” id. at 19-20,

quoting Whitnack v. Douglas County, 16 F.3d 954, 957 (8th Cir. 1994), and

awarded Coleman $1,000.00 in actual damages and $3,500.00 in punitive

damages, id. at 24. The district court held that, while some evidence

suggested that Coleman should have been taken to the University at 7:00

p.m. on February 15, 1991, the greater weight of the evidence indicated

that, at 9:30 p.m., a reasonable person would have concluded that Coleman

was in labor and in need of proper medical attention provided by the

University. Id. at 21. The district court held that Rahija was

accountable for Coleman’s pain and suffering between 9:30 p.m. and 11:30

p.m., when Coleman was finally transferred to the University. Id. The

district court further held that Rahija’s conduct in delaying Coleman’s

transfer to the University rose to the level of callousness and warranted

punitive damages to prevent such an occurrence in the future. Id. at 23-

24. This appeal followed.
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II. Discussion

To prevail on an Eighth Amendment claim, an inmate must show both an

objective element, that the deprivation was sufficiently serious, and a

subjective element, that the defendant acted with a sufficiently culpable

state of mind. Choate v. Lockhart, 7 F.3d 1370, 1373 (8th Cir. 1993),

citing Wilson v. Seiter, 501 U.S. 294, 302-03 (1991). In a deprivation of

medical care case, an inmate must show that the prison official was

deliberately indifferent to the inmate’s serious medical needs. Camberos

v. Branstad, 73 F.3d 174, 175 (8th Cir. 1995). In order to succeed, an

inmate must show both that he or she had an objectively serious medical

need and that the defendant knew of and disregarded that need. Miller v.

Schoenen, 75 F.3d 1305, 1309 (8th Cir. 1996), citing Estelle v. Gamble, 429

U.S. 97, 105 (1976), and Farmer v. Brennan, 511 U.S. 825, 837 (1994)

(Farmer). Each step of this inquiry is fact-intensive, and we review the

district court’s factual conclusions for clear error. Jensen v. Clarke,

94 F.3d 1191, 1197-98 (8th Cir. 1996). 

 

A. Serious Medical Need

The initial question presented in this case is whether the district

court’s finding that Coleman had a serious medical need is clearly

erroneous. A serious medical need is “one that has been diagnosed by a

physician as requiring treatment, or one that is so obvious that even a

layperson would easily recognize the necessity for a doctor’s attention.”

Camberos v. Branstad, 73 F.3d at 176. When an inmate alleges that a delay

in medical treatment constituted a constitutional deprivation, “the

objective seriousness of the deprivation should also be measured by

reference to the effect of delay in treatment.” Crowley v. Hedgepeth, 109
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F.3d 500, 502 (8th Cir. 1997). An inmate’s failure to place verifying

medical evidence in the record to establish the detrimental effect of delay

in medical treatment precludes a claim of deliberate indifference to

medical needs. Id.

In this case, the district court found that Coleman was experiencing

pre-term labor and concluded that her condition was sufficiently serious

to constitute a serious medical need. Specifically, the district court

found that Coleman’s medical records indicated that she had a propensity

of rapid labor and delivery; she was exhibiting some sign of possible labor

in the early afternoon on February 15, 1991; Rahija noted that Coleman was

in “possible early labor” at 9:30 p.m.; and Coleman believed the matter

sufficiently serious to continue seeking medical treatment. Coleman at 13-

14. The district court also recognized six factors which might signal preterm labor, five of which could be determined by an external examination,

and found that Coleman had four of the five observable factors. Id. at 16-

17. These four factors included: (1) an increase in vaginal discharge; (2)

a “bloody show”; (3) uterine contractions six minutes apart; and (4)

abdominal pain possibly attributable to a tightening of her pelvis and

earlier complaints of lower back pain. Id. The district court was also

persuaded that had Rahija performed a vaginal examination of Coleman, there

would have been evidence of progressive dilatation and effacement of the

cervix. Id. at 17. 

Rahija argues that the district court’s finding that Coleman had a

serious medical need is clearly erroneous. Rahija cites Boxwell v. County

of Sherburne, 849 F.2d 1117 (8th Cir. 1988), for the proposition that

pregnancy alone is not necessarily a serious medical need and claims that

Coleman failed to present evidence of unusual circumstances related to her

pregnancy to raise it to the level of a serious medical need. Rahija

contends that Coleman was 
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not in active labor until 11:25 p.m. on February 15, 1991, because, based

on Coleman’s previous precipitous deliveries, had she been in labor at 9:30

p.m., the baby would have been born before 12:20 a.m. Rahija also claims

that the district court clearly erred in finding that Coleman complained

of back pain at approximately 10:30 a.m. that day because the medical

records indicate that Coleman reported “[b]leeding again - back

uncomfortable but no pains.” Brief for Appellant at 5, citing Appendix at

325. 

Based on the evidence presented at trial and relied upon by the

district court, we conclude that the relevant factual findings of the

district court, as outlined above, are not clearly erroneous. While a

woman’s pregnancy is generally not, alone, a serious medical need, Coleman

presented evidence of her previous rapid labors and premature deliveries

to establish a substantial risk of pre-term labor. See Boxwell v. County

of Sherburne, 849 F.2d at 1122 (risk of miscarriage where pretrial detainee

was six and one-half months into problem pregnancy, was bleeding, had

previously fainted, and had history of rapid labor). A layperson would

have recognized the necessity for a doctor’s attention at 9:30 p.m. See

Camberos v. Branstad, 73 F.3d at 176 (a serious medical need is one that

is so obvious that a layperson would recognize the necessity for a doctor’s

attention). Also, based on the district court’s factual findings,

Coleman’s symptoms satisfied the requirements for transfer as set forth by

the University physicians. See id. (a serious medical need is one that has

been diagnosed by a physician as requiring treatment). We therefore hold

that the district court did not clearly err in concluding that Coleman’s

physical condition constituted a serious medical need. 

We also hold that Coleman presented sufficient “verifying medical

evidence” that Rahija “ignored a critical or escalating situation or that

the delay posed a substantial risk of serious 
Dr. Paul Loeffelholz, the clinical director for IMCC and

6

medical director for the Iowa Department of Corrections, testified

that “bearing down” is a voluntary activity to help expel the fetus

once the cervix is fully dilated. Appendix at 48. 

Although Farmer v. Brennan, 511 U.S. 825 (1994), is a

7

conditions-of-confinement case, the analytical model it provides

applies equally to deprivation of medical care cases. Beyerbach v.

Sears, 49 F.3d 1324, 1326 n.1 (8th Cir. 1995).

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harm” for her claim to succeed. See Beyerbach v. Sears, 49 F.3d 1324, 1327

(8th Cir. 1995) (inmate’s failure to present verifying medical evidence

constituted failure to establish objective component of claim); see also

Crowley v. Hedgepeth, 109 F.3d at 502. Specifically, Coleman presented

expert testimony that the urge to push during the delivery process is an

involuntary reaction, see Coleman at 18, indicating that Coleman, in fact,

had been in labor, see Appendix at 48 (deposition testimony of Dr. Paul

Loeffelholz), and that the delay in her treatment posed a substantial risk 6

of serious harm.

B. Deliberate Indifference

Having held that the district court did not clearly err in finding

that Coleman’s condition constituted a serious medical need, we now address

the question whether the district court’s finding that Rahija was

deliberately indifferent to Coleman’s serious medical need is clearly

erroneous. This question, like the first step in our analysis, is a

question of fact reviewed for clear error. Jensen, 94 F.3d at 1198. To

satisfy this subjective element, Farmer requires a finding of actual

knowledge on the part of the defendant. Jensen v. Clarke, 94 F.3d at 1195 7

(failure-to-protect case applying same two-step analysis). A prison

official may be held liable under the Eighth Amendment if he or she knows

that an inmate faces a substantial risk of serious harm and 
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disregards that risk by failing to take reasonable measures to abate it.

Farmer, 511 U.S. at 847. “[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). Moreover, “an Eighth Amendment claimant

need not show that a prison official acted or failed to act believing that

harm actually would befall an inmate; it is enough that the official acted

or failed to act despite his [or her] knowledge of a substantial risk of

serious harm.” Farmer, 511 U.S. at 842. The factual determination that

a prison official had the requisite knowledge of a substantial risk may be

inferred from circumstantial evidence or from the very fact that the risk

was obvious. Id. 

For example, if an Eighth Amendment plaintiff presents

evidence showing that a substantial risk [to the

inmate’s health] was longstanding, pervasive, welldocumented, or expressly noted by prison officials in

the past, and the circumstances suggest that the

defendant-official being sued had been exposed to

information concerning the risk and thus must have known

about it, then such evidence could be sufficient to

permit a trier of fact to find that the defendantofficial had actual knowledge of the risk. 

Id. at 842-43 (internal quotations omitted). 

The district court, in this case, concluded that Rahija had actual

knowledge of Coleman’s serious medical need. The district court based its

finding on the documentation in Coleman’s medical records of her previous

precipitous labors, the IMCC officials’ election to keep Coleman at IMCC

until after delivery because of her medical history, Rahija’s notation that

Coleman might have been in possible early labor, and Coleman’s objective

symptoms that she was experiencing pre-term labor. Coleman at 14-15,

citing Farmer, 
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511 U.S. at 842 (“a factfinder may conclude that a prison official knew of

a substantial risk from the very fact that the risk was obvious”). 

Rahija argues that the district court clearly erred in finding that

she had the requisite knowledge to constitute deliberate indifference.

Rahija claims that Coleman did not have painful, regular contractions less

than ten minutes apart, increased heavy bleeding, or bleeding with

contractions until 11:25 p.m., at which point Rahija determined that

Coleman should be sent to the University. Thus, Rahija contends that she

was not deliberately indifferent to Coleman’s condition because her

treatment of Coleman was consistent with the University physician’s (Dr.

Driscoll’s) advice. 

In this case, the district court’s conclusion that Nurse Rahija had

actual knowledge based on the obviousness of Coleman’s serious medical need

is not clearly erroneous. Coleman’s propensity for precipitous labor and

premature delivery was well-documented and expressly noted by prison

officials in Coleman’s medical records, to which Rahija had been exposed,

and constituted the sole reason for Coleman’s placement at IMCC. From this

evidence, a trier of fact could have found that Rahija had actual knowledge

of the risk of pre-term labor. See Farmer, 511 U.S. at 842-43; Jensen, 94

F.3d at 1198. We therefore hold that the district court did not clearly

err in finding that Rahija’s unnecessary delay in transferring Coleman to

the University constituted deliberate indifference to Coleman’s serious

medical need. See Johnson-El v. Schoemehl, 878 F.2d 1043, 1055 (8th Cir.

1989) (“Delay in the provision of treatment or in providing examinations

can violate inmates’ rights when the inmates’ ailments are medically

serious or painful in nature.”). 
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C. Compensatory Damages

Compensatory damages may include not only out-of-pocket loss and

other monetary harms, but also such injuries as impairment of reputation,

personal humiliation, and mental anguish and suffering. Memphis Community

Sch. Dist. v. Stachura, 477 U.S. 299, 307 (1986) (Stachura). Specifically,

mental and emotional distress, which include mental suffering and emotional

anguish, constitute compensable injury under § 1983. Carey v. Piphus, 435

U.S. 247, 264 & n.20 (1978). While such injuries are essentially

subjective, they may be evidenced by the plaintiff’s conduct and observed

by others. Id. at 264 n.20. Additionally, evidence of physical pain and

suffering may support an award of compensatory damages in excess of any

actual out-of-pocket medical expenses. Jackson v. Crews, 873 F.2d 1105,

1109 (8th Cir. 1988).

Rahija argues that the record does not support the district court’s

finding that Coleman was subjected to pain and suffering from 9:30 p.m.

until 11:30 p.m. Instead, Rahija suggests that Coleman experienced nothing

different from what women endure during childbirth and that Coleman had

access to a television and a bed as if she was in a hospital. She

concludes that had she transferred Coleman to the University at 9:30 p.m.,

as suggested by the district court, Coleman would have experienced the same

labor in the hospital as she did in her living unit, and, therefore, there

was nothing unconstitutional about where Coleman experienced labor or how

Rahija treated her.

We disagree and hold that the evidence supports the district court’s

award of compensatory damages for Coleman’s physical pain and suffering and

mental anguish and suffering. Fortunately, neither Coleman nor her baby

suffered any complications during the delivery at the University. However,

the fact remains that, 
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because of Rahija’s unnecessary delay, Coleman was subjected to “a great

deal of fear and physical suffering [which] accompanied the prospect of

having a baby on the floor of a penal institution,” Coleman at 21, without

the appropriate medical attention. We therefore hold that the district

court did not clearly err in finding that Coleman suffered a compensable

injury under § 1983.

D. Punitive Damages

 

In a § 1983 case, both compensatory and punitive damages are

available upon proper proof. Cunningham v. City of Overland, 804 F.2d

1066, 1069 (8th Cir. 1986), citing Stachura, 477 U.S. at 306 & n.9. But

unlike compensatory damages, which are mandatory and are awarded as a

matter of right once liability is found, punitive damages are awarded or

rejected in a particular case at the discretion of the fact finder once

sufficiently serious misconduct by the defendant is shown. Smith v. Wade,

461 U.S. 30, 52 (1983); McKinnon v. Kwong Wah Restaurant, 83 F.3d 498, 508

(1st Cir. 1996) (Title VII case). Punitive damages are awarded to “punish

the defendant for his [or her] willful or malicious conduct and to deter

others from similar behavior.” Stachura, 477 U.S. at 306 n.9. The focus,

in determining the propriety of punitive damages, is on the intent of the

defendant, Cunningham v. City of Overland, 804 F.2d at 1070, and whether

the defendant’s conduct is of the sort that calls for deterrence and

punishment over and above that provided by compensatory awards. Smith v.

Wade, 461 U.S. at 54. Punitive damages are appropriate in a § 1983 case

“‘when the defendant’s conduct is shown to be motivated by evil motive or

intent, or when it involves reckless or callous indifference to the

federally protected rights of others.’” Walters v. Grossheim, 990 F.2d 381,

385 (8th Cir. 1993), quoting Smith v. Wade, 461 U.S. at 56. 
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To impose a punitive award in this case, the district court was

required to find not only that Rahija’s conduct met the callousness

threshold, which is a question of ultimate fact, but also that her conduct

merited a punitive award of $3,500 in addition to the compensatory award,

which is a discretionary moral judgment. Smith v. Wade, 461 U.S. at 52.

Applying this standard, the district court awarded Coleman $3,500.00 in

punitive damages “so that prison officials recognize the seriousness of

this lack of action and guard against it in the future.” Coleman at 24.

A finding of deliberate indifference to a serious medical need, while

establishing liability under § 1983, does not necessitate a finding of

callous indifference warranting punitive damages. See Standley v.

Chilhowee R-IV Sch. District, 5 F.3d 319, 323 (8th Cir. 1993) (defendant

was liable under § 1983 for violating plaintiff’s First Amendment rights,

but there was insufficient evidence that defendant’s conduct rose to the

level of “evil motive” or “reckless or callous indifference” to justify

punitive damages); see also Cornell v. Woods, 69 F.3d 1383, 1391 (8th Cir.

1995) (prison officials’ conduct in punishing inmate for exercising his

First Amendment rights established liability under § 1983 but did not

warrant imposition of punitive damages); Ivey v. Wilson, 832 F.2d 950, 956

(6th Cir. 1987) (prison officials’ acts violated prisoner’s due process

rights and gave rise to § 1983 liability, but punitive damages award was

improper because there was no evidence that defendants “were acting in bad

faith” or “harbored any ill will” towards plaintiff); Walters v. City of

Atlanta, 803 F.2d 1135, 1147 (11th Cir. 1986) (upholding jury’s finding

that “defendants were responsible for the racial discrimination” plaintiff

suffered, but vacating punitive damages award because the record did not

show that defendants “acted with either the requisite ill will or callous

disregard of [plaintiff’s] federally protected rights”); Lavicky v.

Burnett, 758 F.2d 468, 477 
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(10th Cir. 1985) (unlawful search and seizure and taking of 

plaintiff’s property without a hearing gave rise to § 1983 liability, but

punitive damages award was properly set aside because “there was no

evidence of malice, wantonness, or oppressiveness”), cert. denied 474 U.S.

1101 (1986); Soderbeck v. Burnett County, 752 F.2d 285, 289 (7th Cir.)

(plaintiff’s showing of political dismissal was sufficient for compensatory

damages, but not punitive damages), cert. denied 471 U.S. 1117 (1985);

Hernandez-Terado v. Artau, 874 F.2d 866, 872 (1st Cir. 1989) (same). After

reviewing the evidence presented at trial, we hold that Rahija’s conduct

in this case was not sufficiently egregious to justify the imposition of

punitive damages. See Cornell v. Woods, 69 F.3d at 1391. Coleman admits

that Rahija testified that she relied on, and attempted to follow, the

University physicians’ instructions in caring for Coleman. See Brief for

Appellee at 27, 28 n.12. While Rahija is liable under § 1983 for her delay

in treating Coleman, her conduct does not rise to the level calling for

punishment and deterrence over and above that provided by the compensatory

award. See Smith v. Wade, 461 U.S. at 54; see also Stachura, 477 U.S. at

310 (“Section 1983 presupposes that damages that compensate for actual harm

ordinarily suffice to deter constitutional violations.”). The facts of

this case illustrate the difference between conduct justifying mere

liability under the Eighth Amendment and conduct justifying punitive

damages under § 1983. Because the district court abused its discretion in

awarding punitive damages over and above the compensatory award, we vacate

the punitive damages award.

 

III. Conclusion

Accordingly, the punitive damages award is vacated and the order of

the district court is affirmed in all other respects.
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FLOYD R. GIBSON, Circuit Judge, concurring in part and dissenting

in part.

Though I am in full accord with the Court's decision to affirm the

imposition of compensatory damages against Nurse Ruth Rahija, I cannot

agree that the district court's award of punitive damages should be

reversed. In my view, the rather startling and disturbing facts of this

case reveal the district court did not commit clear error when it found

that Rahija acted with "callous indifference to the federally protected

rights of others." Smith v. Wade, 461 U.S. 30, 56 (1983). Furthermore,

I believe the district court correctly determined that Nurse Rahija's

behavior was "simply inexcusable" and of a type that "must be punished in

an appropriate way so that prison officials recognize the seriousness of

this lack of action and guard against it in the future." Coleman v.

Rahija, No. 4-91-CV-50260, at 24 (S.D. Iowa Jan. 2, 1996); see also Smith,

461 U.S. at 54 ("The focus is on the character of the tortfeasor's conduct

-- whether it is of the sort that calls for deterrence and punishment over

and above that provided by compensatory awards."). As a result, I am

unable to conclude that the district court abused its discretion when it

deemed punitive damages appropriate. For these reasons, I respectfully

dissent from that portion of the Court's opinion vacating the district

court's punitive damages award.

A true copy.

Attest:

 CLERK, U.S. COURT OF APPEALS, EIGHTH CIRCUIT.