UNITED STATES COURT OF APPEALS
FOR THE TENTH CIRCUIT

________________ _________________ GERALD LEE PATTERSON, Plaintiff - Appellant.

v. GEORGE SANTINI; CAMACHO, P.A.; FIVE JOHN/JANE DOES, Defendants - Appellees. No. 18-1040 (D.C. No. 1:11-CV -01899-RM-KLM) (D. Colo.)

________________ _________________ ORDER AND JUDGMENT *

________________ _________________ Before LUCERO , HARTZ , and McHUGH , Circuit Judges.

________________ _________________ Plaintiff Gerald Lee Patterson, a former prisoner at the Federa l Prison Camp (FPC) in Florence, Colorado, app eals from the district court’s order granting summary judgment on the ground of qualif ied immunity in favor of two FP C health-care providers on his claims that they violate d his Eighth Amendment rights by inadequately treating herniated discs in his neck. Exe rcising jurisd iction under 28 U.S.C. § 1291, we affirm.

* After examining the briefs a nd appellate record, this panel has determined unanimously that oral argument wo uld not materially assist in t he determination of this appeal. See Fed. R. App. P. 34(a)(2); 10th Cir. R. 34.1(G). The case is t herefore ordered submitted without oral argument . This order and judgment is no t binding precedent, except under the doctrines of law of the case, res judicata, an d collateral estoppel. It may be cited, however, for its persuas ive value consistent with Fed . R. App. P. 32.1 and 10th Cir. R. 32.1. FILED United States Court of Appeals Tenth Circuit 

### September 7, 2018
Elisabeth A. Shumaker Clerk of Court2 In April 2012, Plaintiff, 74 years old at the time, filed his a mended complaint (the operative pleading in this case), c omplaining of mistreatment a t FPC while he was incarcerated there beginning in J une 2010. He had previously b een diagnosed with degenerative disc disease in his cervical spine. Plaintiff does not complain of his general medical care, but alleges that t wo health-care providers, Defen dants Ronald Camacho, an FPC physician’s assistant, and Dr. George Santini, the clinical director and medical officer at FPC, provided inadequa te treatment for his chronic n eck pain and exhibited deliberate indifference to his pain. We review de novo the grant of s ummary judgment, viewing the ev idence in the light most favorable to the nonmoving party. See TPLC, Inc. v. United Nat. Ins. Co. , 44 F.3d 1484, 1489 (10th Cir. 1995). Summary judgment is appropriate if “there is no genuine dispute as to any mate rial fact and the movant is entit led to judgment as a matter of law.” Fed. R. Civ. P. 56(a). When, as here, a defendant a sserts qualified immunity in a summary-judgment motion, the burden shifts to the plaintiff t o show that the defendant violated a clearly established constitutional right. See Martinez v. Beggs , 563 F.3d 1082, 1088 (10th Cir. 2009). To satisfy that burden, the p laintiff must “go beyond the pleadings and designate specific facts” that establish a materi al factual dispute. Self v.
Crum , 439 F.3d 1227, 1 230 (10th Cir. 2006); see Fed. R. Civ. P. 56(c)(1)(A). The Supreme Court has held that “deliberate indifference to ser ious medical needs of prisoners” violates t he Eighth Amendment. Estelle v. Gamble , 429 U.S. 97, 104 (1976). The test for such a claim includes both subjective and objective components. See Kikumura v. Osagie , 461 F.3d 1269, 1291 (10t h Cir. 2006). The objective3 component is met when a harm is “sufficiently serious” to impli cate the Eighth Amendment. Id. To meet the subjective component , Defendants must have known t hat Plaintiff “faced a substantial ri sk of harm and disregarded tha t risk, by failing to take reasonable measures to abate it.” Kikumura , 461 F.3d at 1293 (int ernal quotation marks omitted). The subjective component presents a “high evidentiar y hurdle.” Self , 439 F.3d
at 1232. Plaintiff has not surmounted thi s hurdle. We need not pass on the question of whether Plaintiff’s neck pain was serious enough to meet the ob jective component of his claim, because he has failed to d emonstrate the subjective comp onent. As the district court observed, Defendants repeat edly adjusted Plaintiff’s medi cations in response to his complaints of pain, requested imag ing of his neck and spine, an d arranged for him to receive consultations with specialists. We summarize some of t he pertinent evidence, beginning with the conduct of Defendant Camacho. Camacho first saw Plaintiff on January 28, 2011, for complaint s of neck pain and injuries he sustained when he fell down stairs after being shoc ked by the neck pain. Camacho prescribed pain medicati on, ordered x rays on Plaintiff ’s neck, spine, and foot, and added Plaintiff t o the Orthopedic Chr onic Care Clinic list because of his degenerative joint and disc diseases. The x rays revealed degenerative disc disease in Plaintiff’s neck. Camacho saw Plaintiff regarding his neck pain ag ain on February 14, March 10, March 24, and April 14. He prescribed Gabapentin for nerve pain, gradually increasing the dose to relieve pain. On September 6, Camacho submitted a consultation request for an MRI of Plaintiff’s cervical spine. T he request was denied. On Jan uary 27, 2012, the prison4 sent Plaintiff for an outside orth opedic consultation; the doct or recommended Naproxen, steroidal injection, moist heat, and passive range-of-motion ex ercises. Although Plaintiff saw Camacho for other ailments b efore he filed his amended comp laint in April 2012, there is no evidence of othe r visits regarding neck pain. As for Santini, Plaintiff was seen three times by mid-level pro viders working under Santini in June, July, and October 2010; and Santini orde red treatments for Plaintiff to address his compla ints of foot pain, shoulder pain , and breathing difficulties. The providers tried various medi cations to alleviate Plaintiff’ s discomfort. Plaintiff did not complain of neck pain d uring any of these visits. Santini first heard Plaintiff’s complaint about neck pain duri ng a chronic-care visit on Februa ry 9, 2011, and prescribed 300 mg of G abapentin for nerve pain. He noted that Plaintiff attended followup visits with Camacho on Februar y 14, March 10, and March 24, 2011, during which Camacho increased the Gabapentin dose to 1200 mg, then 1800 mg, then an unquantified higher dosage. On June 3, 2011, P laintiff saw another provider , FPC Dr. C.A. Wilson (not a party to this litigation ), who took him off Gabapentin a nd switched him to Meloxicam. Plaintiff’s dose of M eloxicam was doubled in July 2 011 but then discontinued in A ugust after bloodwork revealed abnormalities. On September 21, 2011, Dr. Wilson prescribed Leve tiracetam for chronic pain; but after Plaintiff did not take the medication for a week, it was discontinued in October. In February 2012, Dr. Wilson wrote a prescription for a stero id injection to help with Plain tiff’s neck pain; but in April, Dr. Wilson noted that Plaintiff w ould need an MRI before receiv ing an injection. Plaintiff underwent the MRI in Oc tober 2012, several months aft er he filed the amended5 complaint in this case, and he r eceived a steroid injection in May 2013. Plaintiff complains that 15 months elapsed between the suggestion that he receive a steroid injection and when he actually re ceived it, but only three mont hs of that delay—January 27, 2012, until the filing of the amended complaint in April—is relevant to his claim, and he does not present any evidence connecting that delay to Defen dants. Plaintiff may have preferred to be treated differently. But th ere is no support in this record for his claim of delib erate indifference by either Defendant. Finally, Plaintiff alleges that the district judge was biased a gainst him and he was prejudiced thereby. We perceive no evidence of bias, but in any case Plaintiff forfeited this argument by not moving for r ecusal in the district court. See Knight v. Mooring Capital Fund , LLC, 749 F.3d 1180, 1191 (10th Cir. 2014) (“The party seeking recusal must act in a timely fashio n to request recusal.”).
CONCLUSION
We AFFIRM the judgment below and GRANT Plaintiff’s motion to proceed in forma pauperis.

Entered for the Court

Harris L Hartz Circuit Judge