2009 D e c i sion s O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit 1-30-2009 

# T s ak on a s v . C icchi P r e c e de n t i al or N on-P r e c e de n t i al : N on-P r e c e de n t i al D ocke t N o . 07-4115

F o l lo w thi s a nd a dd it ion al work s at : h tt p://d i g it alc ommon s .l a w . vi l l a no va . e du/thir dc ir c uit_2009

Thi s de c i sion i s br ou gh t t o you for f r e e a nd ope n a c c e s s b y the O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit at V i l l a no va U nive r sity S choo l of L a

w Di g it al Re posit or y

. It h as be e n a c c e pt e d for inclusion in 2009 D e c i sion s b y a n author i z e d a dmini s tr at or of V i l l a no va U nive r sity S choo l of L a

w Di g it al Re posit or y

. F or mor e infor m at ion, p le as e c on t a ct Be n j a min . C a rl s on@l a

w . vi l l a no va . e du . Re c omme nde d C it at ion
" T s akon as v . C ic chi " (2009). 2009 D e cisio n s . P ape r 1966. h tt p://d i g it alc ommon s .l a

w . vi l l a no va . e du/thir dc ir c uit_2009/1966NOT P RE CE DE NT I AL UN I TED STATES CO UR T OF A PP EALS F O R T H E T H IR D C IR C U IT
N o. 07- 4115
PA U L TSA K O N A S, A ppel l ant

v. W A R D E N E D M O N D C IC C H I, in d iv id u a llya n d a s W a rd e n a t M i d d l e s e x Co u n t yCo r r e c t i o n Ce n t e r ; M I DDL E S E X C OUNT Y A D U L T C O R R E C T IO N C E N T E R ; C O U N T Y O F M ID D L E S E X ; T R E N T O N S T A T E P S Y C H IA T R IC H O S P IT A L ; W I L L I A M J . M A Y , i ndi vi dual l yand as C E O atT r ent on St at e P s y c h ia tr ic H o s p ita l; H U G H M O O R E , In d iv id u a lly a n d a s M .D . a t M id d le s e x C o u n ty C o rr e c tio n C e n te r; R .N . S A N D R A V A R G A S , In d iv id u a llya n d a s a N u rse a t M id d les e x C o u n tyC o rre c tio n C e n ter ; M A R I A M . M C Q U A Y ; K A T H I E D E FU R I A , I ndi vi dual l yand a s s u p e rv iso r a t M id d les e x C o u n tyP ro b a tio n D e p a rtm e n t; M ID D L E S E X C O U N T Y P R O B A T IO N D E P A R T M E N T ; T H O M A S M A N O , I ndi vi dual l yand as D i r ect or of H eal t h In f o rm a tio n S e rv ice s a t T re n to n S tate P sy c h iatric H o sp ital; C O L L E T T E D U R A V A L , In d iv id u a llya n d a s a n a g e n t at T re n to n S ta te P s y c h ia tr ic H o s p ita l; V IC T O R IA C A N A V E R A , In d iv id u a lly a n d a s C o o rd in a to r a t S ta te o f N e w J e rs e y , D epar t m entof H um an Ser vi ces , D i vi s i on of M ent al H eal t h Ser vi ces APP EAL F ROM THE UNI TE D ST ATE S DI S TRI CT C OURT

FOR TH E DI STRI CT O F NEW J ERSEY ( D . C . C i vi l N o. 04- cv- 04973) D i s t r i ctJ udge: T he H onor abl e D enni s M . C avana ugh Subm i t t ed U nderT hi r d C i r cui t L A R 34. 1( a)

J anuary15, 2009T he H onor abl e Eugene E. Si l er , J r . , Seni or C i r cui t J udge, U ni t ed St at es C our t of * A p p e a ls f

o r t h e S ix th C ir c u it, s ittin g b yd e s ig n a tio n . 2 B efor e: SL O V I T E R , B A R R Y , and SI L E R , J R . , C i r cui t J udges * ( O pi ni on Fi l ed: J anuary30, 2009)

OP I NI ON

B A R R Y , C i r cui t J udge A ppel l antPaul T s akonas appea l s t he or derof t he D i s t r i ctC our t gr ant i ng t he
m ot i ons fors um m aryj udgm entof appe l l ees M ar i a M cQ uay , K at hi e D eFur i a, D r . H ugh M oor e, Sandr a V ar gas , W ar den Edm ond C i cchi , M i ddl es ex C ount y , and M i ddl es ex C o u n ty A d u lt C o rr e c tio n C e n te r ( “ M C A C C ” ). W e h a v e ju ri s d ic tio n u n d e r 2 8 U .S .C . § 1 2 9 1 , a n d wi l l a f

f i r m. I. On Mar c h 6, 2003, Ts akona s pl e d gui l ty t o vi ol at i ng ar e s tr a i ni ng or de r i s s ue d by the Mi ddl e s e x County

Fam i l y Court and wa s s e nt e nc e d t o one ye ar of pr obat i on, wi th the c ondi t i on that

he part i c i pat e i n “ any

c ouns e l i ng pr obat i on de e m s ne c e s s ary . ” The
un d isp u tedf

acts d em o n strate th at T sak o n as rep eated ly m issedm eetin g s w ithh is pr obat i on offi c e r

and ne ve r

pr ovi de d doc um e nt at i on t o pr ove that he att e nde d any

of the re qu ir ed anger m anagem ent c ou nsel ing ses si on s. OnOctober 26, 20 03 , Tsako nas was3

arrestedf o llo w in g anin cid en t w h ere h e stru cka p ay p h o n e ina m o tel lo b b y , an dh is
m o th er co n tactedh is curren t p ro b atio no f f icer, ap p ellee M aria M cQ u ay , to rep o rt h is er rati c behavior and suspect ed abuse of ecst as y and crac k cocai ne. McQuay and h er s upe rvi s or , a

ppe l l e e Kathi e De Fur i a , or de r e d Ts akona s t o e nt e r i nt o dr ug tr e atm e nt

and warne d hi m

that fa i l ur e t o do s o woul d be c ons i de r e d avi ol at i on of pr obat i on. Whe n he ref u sedto d o so , th e o f

f icers in itiatedv io latio no f p ro b atio np ro ceed in g s. Fo ll ow ing a hear ing, the Sup er ior Cou rt of New Jer se y

re vo ked T sako nas’ s pr obat i on and s e nt e nc e d hi m t o a30- day

hos pi t a l i npat i e nt

e va l uat i on. Fi ndi ng that he pr e s e nt e d as ubs t ant i a l r i s k of harm t o hi m s e l f and othe r s , the Court r e m ande d hi m

t o the c us t ody of MCACC t o aw ai t eval uat i on. B eca us e a hos pi t al bed w as not i m m edi at el yavai l abl e, T s akonas r emai ned i n t he M C A C C m e d ic a l u n it f ro m N o v e m b e r 6 , 2 0 0 3 u n til a p p ro x im a te ly Ja n u a ry 7 , 2 0 0 4 . D u rin g th is tim e , h e w a s s e e n a n d e v a lu a ted b yn u m e ro u s m e n tal h e a lth p ro f e ss io n a ls in c lu d in g a p p e llee D r. H u g h M o o re , an d h e w a s p lac e d o n h ig h v isib ili typ sy c h iatric
w a tc h . A f

te r a b o u t o n e w e e k a t M C A C C , h e w as tem p o rarily tran sf erredto A cu te Psychiatric Servic es (“ AP S”) at Univers it y BehavioralHeal thcare fo r a dete rm inat ion as to w h eth er h e m et th e stan d ardo f d an g ero u sn ess n ecessary f o r imm ed iate co mm itm en t. B ecau se h e d idn o t m eet th is stan d ard , h e w as return edto th e M C A C C m ed ical un it. A ppel l ee Sandr a V ar gas w as t he hea l t h s er vi ces admi ni s t r at or atM C A C C and
c o o rd in a te d h is e v e n tu a l tr a n s f e r t o T re n to n S ta te P s y c h ia tr ic H o s p ita l ( “ T P H ” ). Whil e at4

MC AC C, Tsakon as lost

24 po un ds, s ho were d o nly twic e, did n ot shave, and d evel op ed eczema of

th e f eet, seb o rrh ea o f

th e scalp , ath lete’s f

o o t, an dsw o llenknu ck les o nh is rig h t h an d . H e claim s th at h e d idn o t m o v e h is b o w els f o r 3 0 d ay s. T sa k o n a s n o w a p p e a ls th e D istric t C o u rt’s d e c isio n g ra n tin g su m m a ryju d g m e n t to appel l ees on hi s 42 U . S. C . § 1983 cl ai m s form al i ci ous pr os ecut i on i n vi ol at i on of t he F o u rth A m e n d m e n t, as a g a in st M c Q u a ya n d D e F u ria , an d in a d e q u a te m e d ica l ca re in viol at i on of the E i gh t h an d F ou rt eenth A m end m ents , as agai nst t he rem ai ning app el l ees. II. A. Mal i c i ous Pr os e c ut i on Ts akona s ar gue s that

the Di s tr i c t

Court e rr e d whe n i t

c onc l ude d that

Mc Quay and D eF uria h adp ro b ab le cau se to in itiate a v io latio no f p ro b atio np ro ceed in g ag ain st h im . T o p rev ail o na m alicio u s p ro secu tio nclaim b ro u g h t un d er th e F o urthA m en dm en t, a pl a i nt i ff m

us t e s t abl i s h that : ( 1) the de fe ndant i ni t i at e d ac r i m i na l pr oc e e di ng a ga i ns t the plai ntiff, (2) the proceeding ended in p la inti ff’s favo r, (3) the defend ant was m otivat ed by m a l i c e , ( 4) the pr oc e e di ng wa s br ou gh t wi tho ut pr ob abl e c aus e , and( 5) the pl a i nt i ff “s uf fered a depri vati onof

liberty consis te nt with the c on ce pt of se izure a s a

consequence o f a leg al p ro ceed in g .” E state o f S m ithv . M arasco , 3 1 8 F .3 d4 9 7 , 5 2 1 (3 dC ir. 2 0 0 3 ). The Di s tr i c t

Court di d not e rr i n gr ant i ng s umm ary

judgm e nt

be c aus e the
un d isp u tedev id en ce d em o n stratedth at M cQ u ay an dD eF uria h adp ro b ab le cau se to i ni t i at e pr oc e e di ngs a ga i ns t Ts akona s . I t

i s undi s put e d that

Ts akona s m i s s e d num e r ousT her e i s s om e s ugges t i on i n t he r ecor d t hatT s akonas w as ( or s houl d be) cons i der ed 1 a p retri al de tai n ee d u ri n g h is t im e a t M C A C C . N eit h er the p arti es n o r t h e D ist ri ct C o u rt expl i ci t l ycons i der ed t he ques t i on of w het hers t atus as a pr et r i al det ai nee w oul d have pr ovi ded Tsakona s w i t h addi t i onal pr ot ect i ons undert he D ue Pr oces s C l aus e of t he Four t eent h A m endment . See H ubbar d v. T ay l or , 399 F. 3d 150, 166 ( 3d C i r . 2005) ( hol di ng t hatt he Ei ght h A m endment i s not appl i cabl e i n cas es i nvol vi ng pr et r i al det ai nees beca us e t he det ai nees “ar e noty etata s t age of t he cr i m i nal pr oces s w her e t heycan be p u n is h e d b e c a u s e th e yh a v e n o t a s y e t b e e n c o n v ic te d o f a n y th in g .” ). B eca us e t he par t i es have notr ai s ed t hi s i s s ue bef or e us and bec aus e Tsakona s argues on l yt hat appell ees exh i bit ed d el i berat e i nd i fference to hi s ser i ou s m edical need s, w e nee d not r eac h t he i s s ue and w i l l eval uat e hi s cl ai m , as di d t he D i s t r i ctC our t , under th e E ig h th A m e n d m e n t. N a ta le v . C a m d e n C o u n ty C o rr . F a c ility, 3 1 8 F .3 d 5 7 5 , 5 8 1 n .5 ( 3d C i r . 2003) ( “A s t he i s s ue w as not r ai s ed bef or e us , w e do notdeci de w het hert he D ue P rocess C l ause prov i des add i t i on al prot ect i on s t o p ret ri al detai nees be y on d those p ro v id e d b yth e E ig h th A m e n d m e n t to c o n v ic te d p ri s o n e rs .” ). 5 m ee ti ng s with h is prob at ion o ff ic er throug ho ut 20 03 , fai le d to d ocum ent that he att ended anger m anagem ent c ou nsel ing, and f ai le d to enter

a drug tre atm ent program wh en or de r e d t o by

the pr obat i on offi c e r s . W e wi l l a ffi rm the Di s tr i c t

Court ’ s gr ant

of summ ar y ju dg m ent t o M cQuay

and D eFuria . B. Inad equa te Medical Care Th e Dis tric t Cou rt

evaluate d T sako nas’ s c la im fo r i nadequ at e m edic alcare un der the Eighth A m endm ent , which proscr ibes “unn ec es sary and w anton inf

li ct ion o f p ai n.” 1 Es t e l l e v. Gam

bl e , 429 U. S. 97, 104 ( 1976) ( quot i ng Gr e gg v. Ge or gi a , 428 U. S. 153, 173 ( 1976) ) . To e s t abl i s h avi ol at i on of the Ei ghth Am e ndm e nt , apr i s one r m us t s how that the de fe ndant s e xhi bi t e d “ de l i be r at e i ndi ffe r e nc e t o s e r i ous m e di c a l ne e ds . ” I d. 1. Liab il ity of

MC AC C H ealt h C are Providers Beca use a pp el le es Mo ore andVargas prov ided adequate m edic alcare to Tsakon as6

wh il e he await ed plac em ent for ho spit al iz at ion, the Dis tric t Cou rt corr ec tl y concluded th at th ey d idn o t ex h ib it d elib erate in d if f eren ce to T sak o n as’s m ed ical n eed s. F irst, T sak o n as’s m ed ical reco rd s f ro m M C A C C d em o n strate –an d , in d eed , it is un disputed – that Tsako nas was exam ined by se vera l m enta l hea lt

h p rofess ionals wh il e at M C A C C an dth at h e h adaccess to treatm en t f o r h is v ario u s p h y sical co n d itio n s. H is
n eedf o r a f u ll m en tal h ealthev alu atio nw as reco g n izedf ro m th e o u tset, an do nh is tr ans fe r t o APS he wa s a l s o e va l uat e d t o de t e rm i ne whe the r he m e t the s t andar d for imm ed iate co mm itm en t. Second , the Distri ct

Co urt did no t e rr

wh en it concluded that Tsako nas’ s m edic al ai lm ents were no t “ se ri ou s m edic alneeds” fo r purpo se s of the Eigh th Am endm ent. In o rd er to b e co n sid ered“serio u s,” “[ t] h e d etain ee’s co n d itio nm u st b e su chth at a f

ailure to treat canb e ex p ectedto leadto sub stan tial an dunn ecessary su f f erin g , in j ury , o r d eath . Mor e ove r , the c ondi t i on m us t be one that

ha s be e n di a gnos e d by

aphy s i c i an a s r e qui r i ng treatm en t o r o n e th at is so o b v io u s th at a lay p erso nw o u ldeasily

reco g n ize th e n ecessity fo r a do ct or’s atte ntion.” Colbu rn v. Up per Darby Tw p., 946 F.2d10 17 , 102 3 (3dCir. 1 9 9 1 ) ( i n t e rn a l qu o t at i o n s an dc i t at i o n s o mi tt e d ) . T s ak o n a s ’ s a l l e g e dme d i c a l p r o b l e ms we r e we i ght

l os s , e c z e m aof the fe e t , s e borrhe aof the s c a lp, athl e t e ’ s foot , c ons t i pat i on, an dsw o llenknu ck les o nh is rig h t h an d . T h ese are n o t lif e-th reaten in g co n d itio n s, an dit is un disputed that

he never com

plai ned abo ut them

wh il e at MCA CC or that he has su f f eredan y lo n g -term

ef f ects f ro m an y d elay intreatm en t.7

The Di s tr i c t

Court di d not e rr whe n i t c onc l ude d that

Ts akona s ’ s c l a i m

of i na de qu at e m e di c a l c ar e fa i l s a s am att e r of l aw. 2. Liab il ity of

Su pervis ory /I nsti tuti on al Defend an ts T sak o n as arg u es th at ap p ellees C icch i, M id d lesex C o un ty , an dM C A C C are also sub j ect to sup erv iso ry

liab ility f o r th e v io latio no f

h is co n stitu tio n al rig h t to ad equ ate m e di c a l c ar e whi l e at

MCACC. Supe rvi s or s m ay be he l d l i abl e unde r

§ 1983 for co n stitu tio n al v io latio n s o f th eir sub o rd in ates if

it is sh o w nth at th ey , “w ithd elib erate i ndi ffe r e nc e t o the c ons e que nc e s , e s t abl i s he d and m a i nt a i ne d apol i c y , pr a c t i c e or c us t om w h ichd irectly

cau sed[ th e] co n stitu tio n al h arm .” A .M . ex rel. J.M .K . v . L u zern e C o un ty Juvenile Det. Ctr. , 372 F.3d57 2, 58 6 (3dCir. 20 04 ) ( qu oting S toneking v. Bradfo rd Ar e aSc h. Di s t . , 882 F. 2d 720, 725 ( 3d Ci r . 1989) ) . As di s c us s e d above , the r e wa s no consti tuti on alharm , a s Tsako nas was prov ided with adequate m edic alcare . There fo re , th e D istrict C o urt co rrectly g ran tedsumm ary

j u d g m en t to th ese ap p ellees. III. F o r th e reaso n s statedab o v e, w e w ill af f irm th e j u d g m en t o f

th e D istrict C o urt.