FOR PUB LIC ATION UNITED STATES C OUR T OF APPEALS FOR THE NINTH C IR C U IT
VIC TOR ANTONIO PAR SONS; SHAW N JENSEN; STEVE SW

A R TZ; DUSTIN B R ISLAN; SONIA R ODR IGUEZ; C HR ISTINA VER DUZC O; JAC KIE THOM AS; JEREM Y SM ITH; R OB ER T C ARR ASC O GAM EZ, Jr.; M A R

YANNE C HISHOLM ; DESIR EE LIC C I; JOSEPH HEFNER ; JOSHUA POLSON; C HARL OTTE W ELLS; ARIZONA C ENTER FOR DISAB ILITY LAW , Plaintiffs - Appe lle e s,
v. C HARLES L. R

YAN a nd RIC HARD PR ATT, De fe nda

nts - Appe lla

nts. No. 13-16396

D.C . No. 2:12-c v-00601-NVW Distric t of Ariz ona , Phoe nix
ORDER

B e fore : REINHAR

DT, NOONAN, a

n d WATFORD, C irc uit Judge s. The pa ne l vote d to de ny

the pe tition for re he aring e n ba nc ; the pe tition wa s subse q ue ntly withdra

wn. The full c ourt wa s so notifie d. 

# F IL ED
APR 21 2015 M OLLY C. DW Y E R, CLERK U. S. CO URT O F APPEALSA judge the n re que s te d a

vote on whe the r to re h e ar the m atte r e n ba nc . The
m atte r fa i le d to re c e ive a

m a jority of the vote s of the nonre c use d a c t ive judge s in favor of e n ba

nc re c onside ra tion. F E D . R
. A P P . P. 35. Judge Ikuta ’ s disse nt from de nia l of re he aring e n ba nc is file d c onc urre ntly with this Order. The m andate sha ll issueforthwith.Parsons v . Ry a n , No. 13-16396

IKUTA, C irc uit Judge , with whom KOZINSKI, O’ SC ANNLAIN, C ALLAHAN, B EA, a nd M . SM ITH, C irc uit Judge s, join, disse nting from

the de nia l of re he aring e n ba nc : The Supre m e C ourt ha s e sta b lishe d two stra ightforwa rd princ i ple s tha

t a re
a pplic a ble to this a

ppe a l. First, be fore c e rtify ing a c la ss, a c ourt m ust e nsure tha

t
a ll m e m b e rs of the pote n tia l c la ss ha ve the sa m e sort of c la im , a

nd tha t the c la im

is
susc e ptible to c la sswide re solution. Se e W al-Mart Store

s, Inc . v . Duk

e s , 131 S. C t. 2541, 2551 (2011). Se c ond, a prisone r doe s not ha

ve an Eighth Am e ndm e nt c la im
m e re ly be c a u se the prisone r is inc a

rc e ra te d in a

prison with a

de fe c tive m e dic a l sy ste m . Se e Le w is v . C

ase y , 518 U.S. 343, 349–51 (1996); c f. Este lle v . Gamble , 429 U.S. 97, 104 (1976). Toda y , the c ourt turns its bac k on both of the se princ iple s by

le aving in pla c e the opinion of a thre e -judge pa

ne l tha t a ffirm s the
c e rtific ation of a

c la ss c onsisting of e v e ry

oneof the 33,000 prisoners inc arc e ra te d in the Ariz ona

prison sy ste m

on the the ory

tha t e a c h of those prisone rs ha s a
c om m on c la im

for an Eighth Am e ndm e nt viola tion. I dissen t from

our fa ilure to 

# F IL ED
APR 21 2015 M OLLY C. DW Y E R, CLERK U. S. CO URT O F APPEALS

1take this opinion e n ba nc in orde r to va c ate it. 1 The pre l im ina

ry re c ord in this c a se re ve a ls se rious sy ste m wide proble m s with he a l thc are in the Ariz ona prison sy ste m . B ut the re c ord doe s not e sta b lish that e ve ry one of the 33,000 prisoners in the Ariz ona prisons ha s a se rious m e dic a l
ne e d, se eEste lle , 429 U.S. a t 104–06, a

nd fa c e s a sim ila r substa ntia l risk of se rious ha rm due to de fe nda

nts’ a lle g e d de libe rate indiffe re nc e to this ne e d, se e Farme r v . Bre nnan , 511 U.S. 825, 847 (1994). R athe r, the e vide n c e in the re c ord shows a dive rse group of prisone rs with diffe re nt he a lth c onditions a nd ne e ds who re quire diffe re nt le ve ls of m e dic a l c are . While a ll prisone rs in som e se nse are e xpose d to the s am e sy ste m ic ina de qua c i e s of the Ariz o na prisons’ m e dic a l fa c ilitie s, tha t
e xposure a lone doe s not giverise to a n Eighth Am e ndm e nt c la im
. S e e Este lle , 429

1 Afte r the pa

ne l issue d its opinion in this c a se , but be fore the m andate issue d, the Ariz ona

De pa rtm e nt of C orre c tions (ADC ) and the c e rtifie d c la ss of prisone rs se ttle d the substa ntive disputeunde rly ing the inte rloc utory a ppe a l of the c la ss c e rtific ation orde r. Spe c ific a lly , the ADC a gre e d to im ple m e nt a de t a ile d re m e dia l progra

m to c orre c t de fic ie nc ie s in the m e d ic a l, de nta l, a nd m e nta l he a lth c are ava ila

b le in its prison fac ilitie s. Afte r the distric t c ourt a p prove d this se ttle m e nt, the ADC m ove d for the pa ne l to va c ate its opinion. The pa ne l de nie d this m otion. Orde r De ny ing M o tion for Va c atur, Parsons v . Ry an , No. 13-16396 (9th C ir. Fe b. 26, 2015), EC F No. 72. Although we c an no longe r use e n ba

nc re vie w to c orre c t the e rrors in the opinion be c a use the c a se be c am e m oot be fore the m andate ha d issue d, we c a n va c ate the de c ision to a

v oid ha ving thepa

ne l’ s se rious m isinte rpre tations of Supre m e C ourt Eighth Ame ndm e nt a nd c la ss a c tion jurisprude nc e be c o m e the la w of our c irc uit. Se e Unite d State s v . Pay ton , 593 F.3d 881, 886 (9th C ir. 2010).
2U.S. at 103; se e also Le w is , 518 U.S. a t 349–51. De spite the la c k of a

ny support in the re c ord, the pa ne l ne ve rthe le ss a ffirm s the c e rtific ation of this dive rse c la ss of prisone rs— e ve n though not a ll m e m be rs of the c la s s ha

ve an Eighth Am e ndm e nt c la im , le t a lone a c om m on c la im

— in de fianc e of Duk

e s , Le w is , a

nd the Supre m e C ourt’ s Eighth Am e ndm e nt jurisprude nc e . Se e Duk

e s , 131 S. C t. at 2551; Le w is , 518 U.S. a t 349–51; W

ilson v

. Se ite r , 501 U.S. 294, 297–300 (1991); Este l le , 429 U.S. a t 104–06; Farme r , 511 U.S. at 832–34. The

pa ne l a lso c re ate s a

c i rc u it split with the

Third C irc uit. Se e Rouse v . Plantie r , 182 F.3d 192 (3d C ir. 1999) (Alito, J.). B y re fusing to va c ate this opinion a

nd the re by de s igna

ting it a s the la

w of our c irc uit, thec o urt e ndorse s
a vie w of the Eighth Am e ndm e nt a n d c la ss a c tions tha

t is a t odds with the

binding
a uthority of the Supre m e C o urt. I Thirte e n inm ate s in c u stody throughout the

Ariz ona prison sy ste m brought a
c la ss a c tion suit (unde

r R ule 23 of the Fe de ra l R

ule s of C ivil Proc e dure ) a ga inst
se nior offic ia ls in theAriz o na De pa rtm e nt of C orre c tions (ADC ) in M a rc h 2012. Parsons v . Ry a n (Parsons II ), 754 F.3d 657, 662–63 (9th C ir. 2014). The y a lle ge d that through its va

rious sy ste m

w ide pra c tic e s a

n d polic ie s re ga

rding prisone rs’
m e dic a l , de nta l, a

nd m e nta l he a lth c are , the ADC is “ de libe rate ly indiffe re nt” to the

3re sulting “ s ignific an t injury and substa

ntia l risk of se rious ha

rm ” to a ll prisone rs in viola tion of theEighth Am e ndm e nt. Dist. C t. Dkt. 1 (C om pla int) ¶ 26. The prisone rs ide ntifie d te n suc h pra c tic e s, “ inc luding ina de quate sta ffing, outright de nia ls of c are , la c k of e m e rge nc y tre atm e nt, fa ilure to stoc k a n d provide c ritic a l
m e dic at ion, grossly

substa nda rd de nta l c a

re , a nd fa ilure to providethe ra py and psy c hiatric m e dic ation to m e nta lly ill inm ate s ,” P a rsons II

, 754 F.3d a

t 663, a nd provide d se ve ra l e xam

p le s tha t illustra te d how the pra c t ic e s inflic te d ha rm on individual prisone rs, se e id. at 664–67 & nn.5–9. As one would e xpe c t in a

c la ss so la rge , the diffe re nt injurie s a lle ge d va rie d wide ly

de pe nding on the

spe c ific
m e dic a l ne e ds of e a c h

prisone r. For insta

nc e , prisone rs with c hronic he a lth proble m s a lle ge d

the y we re give n inc orre c t or e xpire d m e dic ations; prisone

rs with
a c ute m e dic a l ne e ds a lle ge d the y did not re c e i ve tim e ly e m e rge nc y se rvic e s; prisone rs with de nta l ne e ds a lle ge d the y we re de nie d ne c e ssa

ry pe rm ane nt fillings or othe r de n ta l tre at

m e nt; a nd prisone rs with m e nta l he a lth ne e ds a l le ge d the y did not re c e ive the m onitoring a nd tre atm e n t the y

re quire d due to ina de quate sta ffing. Id. Pla intiffs m ove d to c e rtify a c la ss c onsisting of a

ll a pproxim ate ly

33,000 prisone rs in the te n ADC prisons. Id. at 662–63; Dist. Ct . Dkt. 1 ¶¶ 101–02. The y supple m e nte d the ir a lle gations in the c om pla i nt with a num

b e r of doc um e nts 4obta ine d from the ADC in disc ove ry . The se doc um e nts inc lude d inte rna l re vie ws
and e xc ha nge s be twe e n ADC offic ia ls a n d inde pe nde nt c ontra c tors tha t re ve a le d
se rious dy sfunc tion in the ADC he a l thc are sy ste m . Se e Parsons II , 754 F.3d a

t 668–69. In a ddition, pla

intiffs subm

itte d four e xpe rt re ports tha t c ritic iz e d the ADC ’ s he a lthc a

re sy ste m . Id. at 669–72. The e xpe rts offe re d the ir opinion tha t the p ra c tic e s a

nd polic ie s pla c e d four spe c ific groups of prisoners at substa ntia l risk of se rious ha

rm : (1) prisone rs who re quire m e dic a l c are , (2) prisone rs who
ne e d de nta l c are , (3) prisone rs who re quire m e n ta l he a lth c are , a nd (4) prisone rs in solita ry c onfine m e nt. Id. The distric t c ourt c o nc l ude d tha t R ule 23(a )’ s thre shold re quire m e nts of
num e rosity , c om

m ona lity , ty

pic a lity , a nd a de qua c y

of re pre se ntation 2 we re e a c h
m e t a nd c e rtifie d a

c la ss of a ll 33,000 prisone rs. 3 Parsons v . Ry an (Parsons I ), 289

2 R ule 23(a ) of the Fe de ra l R ule s of C ivil Proc e dure provide s: One or m ore m e m

be rs of a c la ss m ay

sue or be sue d a s re pre se ntative pa rtie s on be ha lf of a ll m e m be rs only if: (1) the c la ss is so nume rous that joinde r of a ll m e m

b e rs is im pra c tic a ble ; (2) the re are que stions of la w or fa c t c om

m on to thec la s s; (3) the c la im s or de fe nse s of the re pre se ntative pa

rtie s are ty

pic a l of the c la i m s or de fe nse s of the c la ss; and (4) the re pre se n tative pa rtie s will fa irly

and a d e quat e ly

prote c t the inte re sts of thec la ss.

3 The distric t c ourt a lso c e rtifie d a subc la ss of a

pproxim ate ly

3,000 prisoners (c ontinue d...) 5F.R .D. 513, 516, 520–25 (D. Ariz . 2013). The pa ne l a gre e s, re a s oning tha

t pla i ntiffs “ ide ntifie d q

u e stions of la

w or fa c t c om

m on to the c la ss,” be c a

use pla i ntiffs ha d a lle g e d a

c ogniz a ble Eighth Am e ndm e nt the o ry tha t “ ADC polic ie s
and pra c t ic e s of sta

t e wide and sy ste m ic a

p plic ation e xpose a ll inm ate s in ADC
c ustody to a substa ntia l risk of se rious ha

rm .” Parsons II

, 754 F.3d a

t 675–76. The pa ne l de sc ribe s how the ide ntifie d ADC polic ie s and pra c tic e s a re “ the ‘ glue ’ that holds toge the r the puta

t ive c la ss a

nd the puta

t ive subc la ss; e i the r e a c h of the polic ie s a nd pra c tic e s is unla

wful a s to e ve ry

inm ate or it is not.” Id. at 678. B e c a use the pla intiffs ide ntifie d ADC he a lthc are polic ie s tha t a pplie d throughout the p rison sy ste m , the pa

ne l distinguishe s Duk

e s on the ground tha

t the pla i ntiffs the re ha d fa ile d to e sta

b lish a sy ste m

wide polic y

tha t a ffe c te d e a c h m e m

be r of the
c la ss. Id. at 681 (c la im ing tha t unlike Duk

e s , this c a se “ looks to whe the r c urre nt
c onditions in ADC

fa c ilitie s c re ate a

risk of future ha

rm , not to the va

rie d re a sons for m illions of de c isions m a de in the pa st” ). In short, thepa

ne l: (1) ide ntifie s sy s te m ic proble m s with a spe c t s of the ADC he a lthc are sy ste m , (2) c la im s tha t suc h proble m s viola

t e d a l l prisone rs’

3 (...c ontinue d) in isola tion units. Parsons I

, 289 F.R .D. at 516, 525. B e c a use pla intiffs a lle ge d and produc e d e vide nc e of a num be r of pra c tic e s a

nd polic ie s spe c ific to the isola tion units, Parsons II

, 754 F.3d a

t 671–72, the

c e rtific at ion of tha

t subc la ss doe s not ra ise the c onc e rns I disc uss he re .6Eighth Am e ndm e nt rights be c a use a ll prisone rs a

re e xpose d to the sa

m e sy s te m , and (3) a c c ordingly

holds tha t this c om m on ha z a rd c ould be re solve d by

a c om m on
answe r, nam e ly , by

de c iding whe the r the ADC ’ s he a lthc are sy ste m viola te s the C onstitution. In re a c hing this c onc lusion, the pa ne l m i sunde rsta

nds both R

ule 23
and the Eighth Am e ndm e n t. II B e c a use a c la ss a c tion “ m e re ly

e n a ble s a fe de ra l c ourt to a djudic ate c la im s of m ultiplepa rtie s at onc e , inste a d of in sepa ra te suits,” S

hady Grov e Orthope dic Assoc s ., P.A. v . Allstate

Ins. C o. , 559 U.S. 393, 408 (2010), it is nec e ssa ry to unde rsta nd the Supre m e C ourt’ s e xpla nation of both the la

wof c la ss c e rtific ation
and the fra m e work for the unde rly ing Eighth Ame n d m e nt c la im
. A R ule 23 of the Fe de ra l R

ule s of C ivil Proc e dure is a proc e dura l rule tha

t pe rm its c ourts to a ggre gate the le ga l c la im s of m ultiplepa rtie s into a

c la ss a c tion whe n it is e ffic ie nt a

nd fa ir to do so. Se e Duk e s , 131 S. C t. at 2551 n.5; Shady Grov e , 559 U.S. a

t 408. B e c a

use it is no more tha

n a c la im a ggre gation de vic e , R ule 23 ha s no e ffe c t on the substa nc e of the c la im s or pla intiffs’ burde n of proof,
se e 2 8 U.S.C . § 2072(b); Duk e s , 131 S. C t. at 2561 (re c ogniz ing tha t “ the R ule s Ena bling Ac t forbids interpre ting R ule 23 to ‘ a

bridge , e nla

rge or m odify

any 7substa

ntive right’ ” ), and c o n se que n tly e a c h m e m

be r in a c la s s m ust ha ve a pote ntia l ly

via ble c l a im
. B e c a use the purpose of R

ule 23 is e ffic ie nc y , c la s s c e rtific at ion unde r R ule 23 is a ppropria te only whe n a la rge num be r of pla intiffs sha

re sim ila r pote ntia lly via b le c la im s whose “ t

ruth or fa lsity ” c an be re solve d one wa y or the othe r “ in one stroke ,” thus m aking a

single suit m ore e ffic ie nt tha n m ultipleone s. Duk

e s , 131 S. C t. at 2551. Tha

t is wha t R u l e 23(a )(2) m e ans whe n it re quire s pla intiffs to show that “ the re are que stions of la w or fa c t c om

m on to thec la ss.” 4 Id. at 2550–51. Put
anothe r way , a

c la s s la c ks the ne c e s sa

ry c ohe sion if a single answe r will not

“ re solve an issue tha

t is c e ntra l to theva lidity

of e a c h one ” of the c la ss m e m be rs’
c la im s. Id. at 2551. To a s se ss whe the r the c la ss is suffic ie ntly c ohe sive to sa

t isfy R ule 23(a )(2),
a c ourt m ust c onduc t a “ rigorous a

n a ly sis” to de te rm ine whe the r the e vide nc e and la w support thepla i ntiffs’ c om m ona lity the ory . Id. The c om

m ona lity ana ly sis will ofte n ove rla

p with plaintiffs’ m e rits c onte ntions. Id. at 2551–52. In this c a se ,

4 The ke y issue in this c a se is pla intiffs’ fa ilure to e sta blish c om m o na lity
. B e c a use the pa ne l’ s a na ly s is of the ty

p ic a lity que stion sha

re s the sa m e infirm itie s a s its c om m ona lity ana ly sis, se e Parsons II

, 754 F.3d a

t 685–86; se e also Duk

e s , 131 S. C t. at 2551 n.5 (noting tha t the ty pic a lity and c om m ona l ity inquirie s “ te nd to m e rge ” (inte rna l quota

t ion m arks om itte d )), this dissent foc use s sole ly on the c om m ona lity ana ly sis. 8pla i ntiffs’ unde rly ing c la im and the ory

of c om m ona lity is tha

t the ADC ’ s de fe c tive he a lthc are sy ste m

is viola ting or will viola

te the Eighth Am e ndm e n t rights of e ve ry prisone r. Parsons II

, 754 F.3d a

t 681. So theque stion be c o m e s whe the r e v e ry prisone r ha s a

pote ntia l Eighth Am e n dm e nt c la im , whe the r those c l a im s ra ise a
c om m on que stion tha

t is c e ntra l to theva lidity

of e a c h c la im , a nd whe the r that que stion c an be answe re d “ y e s” or “ no” in one stroke
. B To a s se ss whe the r pla intiffs ha ve satisfie d R

ule 23(a )(2), it is ne c e ssa

ry to unde rsta nd whe n a

prison he a lthc are proble m rise s to the le ve l of a

n Eighth Am e ndm e nt viola

tion. As the Supre m e C ourt ha s e xpla ine d, “ [t] he Eighth Am e ndm e n t doe s not outla w c rue l a nd unusua l ‘ c o nditions’ ; it outla ws c rue l a

nd unusua l

‘ p unishm e nts.’ ” Farme r , 511 U.S. a t 837. An a lle ge d de n ia l of a d e q uate he a lthc are m ay

am ount to the

“ ‘ unne c e ssa

ry and wa n t on inflic tion of pa in’ prosc ribe d by

the Eighth Am e ndm e nt,” Este lle , 429 U.S. a t 104 (c ita

t ion om itte d), only if a prisone r c an show tha

t: (1) the prisone r ha d

a “ se rious m e dic a l ne e d[] ,” id. ; (2) the offic i a l wa s de l ibe ra te ly indiffe re nt to tha

t ne e d, id. , a

nd (3) a s a re sult, the p risone r fa c e d a

“ substa ntia l risk of se rious ha

rm ,” Farme r , 511 U.S. a

t 834
. De libe ra te indiffe re nc e m e ans the offic ia l wa s “ aware of fa c ts from whic h the 9infe re n c e c ould be drawn tha t a substa ntia l risk of se rious ha

rm e xists, a

nd he m ust
a lso dra w the infe re nc e .” Id. at 837. The Supre m e C ourt ha s m a de c le ar that not “ e ve ry c la im by a prisone r that he ha s not re c e i ve d a d e quate m e dic a l tre atm e nt sta te s a viola tion of theEighth Am e ndm e nt.” Este lle , 429 U.S. a t 105. In Este llefor insta nc e , a prisone r a lle ge d that he suffe re d a

disa b ling ba c k injury and inc a pa c ita ting pa in tha

t wa s
e xa c e rbate d whe n the prison a uthoritie s fa i le d to a de quate ly dia gnose or tre at his
c ondition, id. at 98–101, 107; in short, it wa s “ a c rude atte m

pt to c h a lle nge the sy ste m of a dm iniste ring m e d ic a l c are in the prison” whe re the prisone r wa s
c onfine d, id. at 109 (Ste ve ns, J., dissenting). Them a jority re j e c te d this c la im , sta ting tha t “ [a ] t m ost” the a lle ge dly ina de quate tre at

m e nt the prisone r re c e ive d
am ounte d to “ m e dic a l m a lpra c tic e ,” not “ c rue l a nd unusua l punishm e n t.” Id . at 107. Sinc e the n , the Supre m e C ourt ha s c l arifie d tha t a n Eighth Am e ndm e nt viola tion doe s not a

rise m e re ly

by be ing inc arc e ra te d in a prison with de fe c t ive sy ste m s. Se e Le w i

s , 518 U.S. a

t 349–51. In Le w is , 22 inm ate s of va rious Ariz ona prisons brought a

c la ss a c t ion “ on be ha lf of a l l a dult prisoners who a re or will be inc a rc e ra te d” by

the ADC on the ground tha t the ADC ’ s substa

nda rd libra ry and le ga l support progra

m s de prive d the prisone rs of the ir c onstitutiona l “ rights of 1 0a c c e ss to thec ourts a nd c ounse l.” Id. at 346. Thedistric t c ourt a g re e d a n d e nte re d
a de t a ile d injunc tion re quiring theADC to m a k e “ s we e ping c ha

nge s” at both a
m a c ro and m ic ro le v e l to thec ha lle nge d sy ste m . Id. at 347–48. The Supre m e C ourt re v e rse d, finding tha t the prisone rs’ a lle gations
re ga rding the ina de qua c ie s of the prison’ s le ga l progra m fa i le d to m e e t the

“ c o nstitutiona

l pre re quisite ” tha

t the se ina de qua c ie s ha d c a use d the m “ a c t ua l injury .” Id. at 349, 351 (e xpla ining tha t the re quire m e nt tha

t a prisone r “ m

ust show a c tua l injury ” to suffic ie ntly a lle ge a c onstitutiona

l viola tion “ de rive s ultim ate ly from the doc trine of sta

nding, a c onstitutiona

l princ i ple tha

t pre ve nts
c ourts of la

w from unde rtaking ta sks a ssigne d to the politic a l bra nc he s” ). The C ourt note d tha

t the distinc t ion be twe e n the role of the c ourts a nd tha t of the politic a l bra

nc h e s of gove rnm e nt “ w ould be oblite ra te d if, to invoke inte rve ntion of the c ourts, no a c t

u a l or im m ine nt ha rm we re ne e de d, but m e re ly the sta tus of be ing subje c t to a

gove rnm e nta l institution tha t wa s not orga

niz e d or m a

na ge d prope rly .” Id. at 350. TheC o urt c onc lude d tha t m e re l y be ing a

prisone r in a

n institution with
a de fe c tive le g a l a ssista

nc e progra

m or libra ry doe s not c onstitute

a c tua l or im m ine nt ha rm . Se eid. at

351. R athe r, the prisone r would ha ve to “ go one ste p furthe r and de m o nstra

te tha t the a lle ge d shortc om ings in the libra ry or le ga l
a ssista nc e progra

m hinde re d his e fforts to pursuea le ga l c la im .” Id. 1 1C ritic a lly , the C ourt a na logiz e d a

prison’ s le ga l sy ste m

to a prison’ s he a lthc are sy ste m , a

nd note d tha

t m e re ly be ing a prisone r in a

n institution with a de fe c tive m e dic a l c a

re sy ste m did not c onstitute

an a c tua l injury or ra ise a
c onstitutiona

l c la im
. Id. at 350. B e c a

use Este lle e sta

b lishe d no c onstitutiona

l right to a prison hospita

l, “ a he a lthy inm ate who ha d suffe re d no de priva tion of ne e de d
m e dic a l tre atm e nt” c o uld not “ c la im viola tion of his c onstitutiona

l right to m e dic a l
c are , sim ply on the ground tha

t the prison m e dic a l fa c ilitie s we re ina de quate .” Id. (c ita tion omitte d). Othe rwise , c ourts would be usurping the

re sponsibility

of
e nsuring a de quate m e dic a l c are in prisons, which would e ra se “ the e sse n tia l distinc tion be twe e n judge and e xe c utive .” Id. Although the C ourt in Le w is did not ha ve to a na l y z e whe t

he r the distric t
c ourt ha d e rre d in c e rtify ing the c la ss of prisone rs, Le w i s e xplic itly

re lie d on Este lleto c onfirm that a

c la im “ that the prison m e dic a l fa c ilitie s we re ina de quate ” doe s not by

itse lf e sta

blish de libe ra te indiffe re nc e to a substa ntia l risk of se rious injury
. Id. As the C o urt e lse whe re e xpla ine d, “ [n] othing so a m orphous a s ‘ ove ra ll
c onditions’ c an rise to the le ve l of c rue l a nd unusua l punishm e nt whe n no spe c ific de priva tion” c an be ide ntifie d. W ilson , 501 U.S. a

t 305. TheEighth Am e ndm e nt
re quire s a prisone r to a

rtic u late how a

pa rtic ula r de fic i t c re ate s a

substa ntia l risk of
se rious ha rm in light of the

se rious m e dic a l ne e ds of tha t prisone r or group of 1 2prisone rs. Se e Este lle , 429 U.S. a t 104. III Putting theEighth Am e ndm e nt a nd R ule 23 fram e works toge the r, the pla i ntiffs he re m

ust e sta b l ish tha t e a c h prisone r in Ariz ona (the propose d c la ss) ha s
an Eighth Am e ndm e nt de l ibe ra te indiffe re nc e c la im ra ising a c om m o n que stion that c an be re solve d “ in one stroke .” Duk e s , 131 S. C t. at

2551
. B ut a l l Ariz ona prisone rs do not sha

re a c om m on Eighth Ame ndm e nt c la im for a t le a s t two
re a s ons. A First, the propose d c la ss he re inc lude s he a lthy prisone rs who, unde r Le w is , c annot a sse rt a

n Eighth Am e ndm e nt c la im m e re l y be c a use the y are house d in a

n institution with a

de fe c tive m e dic a l sy ste m . S e e 518 U.S. a

t 349–51; s e e also Parsons II

, 754 F.3d a

t 678–79 (a c knowle dging tha t the propose d c l a ss inc lude s prisone rs who a

re c urre ntly

he a lthy ). B e c a

use the propose d c l a ss inc lude s he a lthy prisone rs who ha

ve no c l a im , the re is no c om m ona lity
. The pa ne l holds tha

t e ve n he a lthy

prisone rs, who a

re not pre se ntly in ne e d of
m e dic a l , de nta l, or m e nta l he a l th tre atm e nt, m ay be c om e ill a

t som e point in the ir inc a rc e ra tion a

n d the re fore have the sa

m e Eighth Am e ndm e nt c la im a s e a c h of the i r fe llow inm ate s. Parsons II , 754 F.3d a

t 678–79 (c la im i ng tha

t a ny prisone r 1 3“ c o uld e a sily fa ll ill, be

injure d, ne e d to fill a

pre s c ription, re q

uire e m e rge nc y

or spe c ia list c a

re , c ra c k a

tooth, or re quire m e nta l he a lth tre atm e nt” ). B ut this risk is too a tte nuate d for a

n Eighth Am e ndm e nt c la i m . Se e Farme r , 511 U.S. a t 834 (holding tha

t a n Eighth Am e ndm e n t de libe ra te indiffe re nc e c la im re quire s a

n

“ obje c tive ly , suffic i e ntly

se rious” de priva

tion a nd the prison offic i a ls m

ust “ have a suffic i e ntly

c ulpa ble sta te of m ind” in be ing de libe ra te l y indiffe re nt to suc h de priva tion (inte rna l quota

tion m arks om itte d)); Este lle , 429 U.S. a t 104 (holding that a de libe ra te indiffe re n c e c la im re quire s a “ se rious m e dic a l ne e d [] ” )

. If a pla i ntiff who is the

vic tim of m e dic a l m a lpra c tic e due to a poorly func tioning prison he a lthc a

re sy ste m doe s not ha

ve an Eighth Am e ndm e n t c la im , Este lle , 429 U.S. at 107, a

pla intiff who is in pe

rfe c t he a lth with no ne e d for m e dic a l a ssista nc e doe s not ha

ve one e ithe r. Inde e d, the pa n e l’ s broa d a

nd loose form

ulation of the
c om m on c la im

(be c a use a ll prisone rs m ay

have m e dic a l ne e ds in thefuture , the de fe c tive m e dic a l sy ste m

c re ate s a substa ntia l risk of se rious injury to e a c h prisone r) is e qua lly

a pplic a ble to a ny prison c ondition: unde

r the pa n e l’ s the ory , for e x am p le , be c a use a l l prisone rs m ay at som e point in the future wa

nt to bring a le ga l c l a im , a

subpa r le ga l a ssista

nc e progra

m viola te s the c onstitutiona

l rights of
e a c h prisone r. This wa s the ve ry a p proa c h re

je c te d in Le w is. To a v oid this fa

ta l fla w in the c la ss, the pa

ne l the oriz e s tha

t the prisone rs 1 4he re are bringing a diffe re nt ty

pe of Eighth Am e ndm e nt c la im a ltoge the r: a

n institutiona

l re form Eighth Am e ndm e nt c la im
. S e e Parsons II

, 754 F.3d a

t 676. Ac c ording to the

pa ne l, while a

prisone r c an bring a

n Eighth Am e n dm e nt c l a im be c a use “ the c are provide d

on a ny pa rtic ula r oc c a sion to a

ny pa rtic ula r inm ate (or group of inm ate s ) wa s insuffic ie nt,” both theSupre m e C ourt a nd our c ourt ha

ve
re c o gniz e d tha

t prisone rs c an a lso bring a n institutiona

l re form Eighth Am e ndm e nt
c la im whe n a prison sy s te m ’ s “ polic ie s a nd pra c tic e s of sta

te w ide and sy ste m ic
a pplic ation e xpose a ll inm ate s . . . to a substa ntia l risk of se rious ha

rm .” Id. Although the pa

n e l a sse rts tha

t “ [t] h is kind of c la im

is firm ly e sta blishe d in
our c onstitutiona

l la w,” id. , none of the c a se s c ite d by the pa ne l disc usse s or
re c o gniz e s a

n institutiona

l re form Eighth Am e ndm e nt c la im tha t ha s diffe re nt
e le m e nts tha

n those se t forth in Farme r v . Bre n nan . Brow n v . Plata , 131 S. C t. 1910 (2011), upon whic

h the pa ne l re lie s, did not a d

judic ate an Eighth Am e ndm e nt
c la im or c onside r the a

ppropria te sc ope of a

c l a ss a c tion. R at

he r, P l ata e xam ine d whe the r a thre e -judge pa

ne l ha d e xc e e de d its a

uthority in issuing a

re m e dia l orde r unde r the Prison Litiga

t ion R e form

Ac t of 1995 (PLR

A ) in two c o nsolida

te d c a se s, C ole man v . Brow n (involving a c la ss a c tion by

the c la ss of se riously

m e n ta lly ill pe rsons in C a lifornia prisons) a nd Plata v . Brow n (involving the c la s s of sta

te prisone rs with se rious m e dic a l c onditions in whic h the sta te “ c onc e de d tha

t 1 5de fic ie nc ie s in prison me dic a l c are viola t e d prisone rs’ Eighth Am e ndm e n t rights” ). Id. at 1922–23, 1926. B ut e ve n if the c l a ss c e rtific ation issue ha d be e n be fore the C ourt, Plata involve d the c e rtific a tion of two discre te c la sse s: thoseprisone rs with

“ se rious m e nta l disorde rs,” an d those with “ se rious m e dic a l c o nditions.” Id. at 1922. The se disc re te c la sse s m ay have suffic ie n tly

sim i la r se rious m e dic a l ne e ds to m e e t the sta

n d ard in Farme r

in a wa y the propose d c la ss he re doe s not. The pa ne l a lso points to Supre

m e C ourt a

n d Ninth C irc u i t c a se s whic h it
argue s he ld tha

t institutiona

l re form c la im s we re se pa

ra te , a nd ha d diffe re nt
e le m e nts, tha

n individual Eighth Am e ndm e nt c l a im s. Parsons II , 754 F.3d a

t 677 (c iting He lling v

. Mc

K inne y , 509 U.S. 25 (1993); Grav e s v . Arpaio , 623 F.3d 1043 (9th C ir. 2010); a

nd W a llis v . Baldw i n , 70 F.3d 1074 (9th C ir. 1995)). B ut none of the s e c a se s a ddre sse d the pa ne l’ s “ two-ty

pe s-of-Eighth Am e ndm e nt c la im s ” the o ry . Prisone rs who a

re e xpose d to a

dise a se -c a

using a g e n t, suc h a s se c ond-ha nd
sm oke , He lling , 509 U.S. a t 35, a sbe stos-c onta i ning m ate ria l, W allis , 70 F.3d a

t 1076–77, or high te

m pe ra t ure s tha t induc e d he at-re l ate d illne ss in pre tria l de ta ine e s taking psy c hotropic m e dic at ions, Grav e s , 623 F.3d a

t 1049–50, may m e e t the sta nda rd in Farme r and c an bring suc h a n Eighth Am e ndm e nt c la im . B ut the prisone rs in this c a se are e xpose d only to the ADC ’ s polic y , whic h is not a lle ge d to be itse l f pathoge nic , a

nd is insuffic ie nt to c onstitute an Eighth Am e n dm e nt 1 6viola

tion in light of Le w i

s . Ac c ordingly , be c a

u se the propose d c l a ss he re inc lude s he a lthy prisone rs who do not ha ve an Eighth Am e ndm e nt c la im (or a none xiste nt institutiona

l re form Eighth Am e ndm e nt c la im ), it doe s not m e e t R ule 23’ s
c om m ona lity re quire m e nt unde r Duk

e s . B Se c ond, the pa

n e l’ s atte m

pte d form ulation of a

c om m on Eighth Ame n dm e nt
c la im fa ils be c a

use e v e n those prisone rs who a re not he a lthy

do not ha v e the suffic i e ntly

sim ila r se rious m e dic a l ne e ds ne c e ssa ry to ra ise a c om m o n Eighth Am e ndm e nt issueunde r Duk e s . The e xpe rt te stim ony , whic h the pa ne l c ite s at le ngth, Parsons II

, 754 F.3d a

t 669–72, shows only

tha t a ran ge of inm at e s with diffe re nt m e dic a l ne e ds m ay be a ble to de m onstra

te de libe rate indiffe re nc e to a substa ntia l risk of se rious ha

rm ba se d on a

range of diffe re nt polic i e s. Dr. C ohe n, a prison he a lthc a

re e xpe rt, ide ntifie d a

num be r of m e dic a l c are pra c tic e s tha t pose “ a substa ntia l risk of se rious ha

rm to prisone rs w ho re q uire me dic a l c are .” Id. at 669 (e m pha sis a dde d ). No e v ide nc e e sta blishe d tha

t a ll prisone rs pre se ntly

re quire
m e dic a l c are . Sim ila

rly , Dr. Ste wart, a

n e xpe rt in c o rre c tiona l m e nta l he a lth c are , opine d tha t ADC m e nta l he a lth pra c tic e s give rise to “ a substa ntia l risk of se rious ha rm to prisone r

s w ho re quire

me ntal he alth c are .” Id. at 671 (e m pha sis a dde d). Aga in, not a ll prisone rs pre s e ntly re quire m e nta l he a lth c are . M ore ove r, be c a use 1 7the p risone r with se ve re de pre ssion a nd the prisone r with a

c avity re q uire diffe re nt le ve ls of c are , the form e r m ay re c e i ve c are inc onsiste nt with Eighth Am e ndm e nt
re quire m e nts (a

nd thus ha

ve an Eighth Am e ndm e nt c la im ) while the latte r doe s not. B e c a

use of the dive rsity

of ne e ds of prisone rs, a

m ore ta rge te d a na ly sis is
re quire d to de te rm ine whe the r a pa rtic ula r polic y m anife sts de libe ra t e indiffe re nc e to a spe c ific ty

p e of m e dic a l (or de nta l or m e nta l he a lth) ne e d. And so the que stion of whe the r the ADC ’ s c onduc t viola t e s the Eighth Am e ndm e nt rights of the se prisone rs c annot be answe re d in a single stroke , be c a

use the re c an be no c om

m on
answe r to que stions re g a

rding the se riousne ss of the m e dic a l ne e d a n d the
a de qua c y of the c are for the full ra

nge of prisone rs. The pa

ne l’ s atte m

pte d form ulat ion of a

que stion c om

m on to a ll c la s se s of prisone rs (whe the r “ ADC polic ie s a nd pra c tic e s of sta

te wide and sy ste m i c a

pplic ation e xpose a ll inm ate s in ADC c ustody

to a substa ntia l risk of se rious ha

rm ,” P arsons II

, 754 F.3d a

t 676) doe s not survive Duk

e s . The C ourt a c k

nowle dge d tha

t the propose d c la ss in Duk e s
c ould form

ulat e c om m o n que stions (“ Do our m ana g e rs ha ve disc re tion ove r pay ? Is tha t a n unla w ful e m p loy m e nt pra c tic e ? ” ) but he ld tha t “ [r] e c iting the s e que stions is not suffic ie nt to obtain c la ss c e rtific ation,” be c a u se doing so did not e s ta

blish that the c la ss m e m

be rs suffe re d the sa

m e kind of viola

tion. 131 S. C t. at 2551. 1 8The pa

ne l’ s c om m on que stion he re suffe rs from the sam e fla

w. This is not to sa

y , a s the pa

ne l c la im s, tha

t suc h a ta rge te d ana ly sis m e ans that “ Eighth Am e n dm e nt c l a im s c an ne v e r be brought in the form

of a c la ss
a c tion.” P arsons II

, 754 F.3d a

t 675–76. To the

c ontra ry , the pa ne l itse lf
re c o gniz e s tha

t the distric t

c ourt he re m a

y have be e n a

ble to c e rtify

“ n um e rous
se pa ra te c la sse s or subc la s se s, se pa ra ting out groups of polic i e s a nd pra c tic e s.” Id.
at 679 n.21. If e a c h

prisone r in suc h a

subgroup c o uld ra ise a

c om m on Eighth Am e ndm e nt c la im

tha t c an be answe re d in one stroke , c e rtific ation of tha t subc la ss
m ay ve ry we ll ha ve be e n a ppropria te unde r R

ule 23. D uk

e s , 131 S. C t . at 2551. B ut just be c a

u se the re m ay

be subc la sse s of prisone rs tha t c a n sta te c om m o n que stions tha

t c an be re solve d in one stroke a s to e a c h spe c ific group doe s not
m e an tha t c e rtific ation of a

c la s s of e v e r

y prisone r in the Ariz ona

prison sy ste m

is pe rm issibleunde r Duk

e s . Furthe rm ore , the Third C irc uit ha s e xpre ssly re je c te d the the ory

tha t prisone rs with dive rse m e dic a l ne e ds ha ve a c om m on Eighth Ame ndm e nt c la im of the s ort e ndorse d by

the pa ne l. In Rouse v . Plantie r , the n-Judge Alito (writing for the c ourt) re ve rse d the distric t c ourt’ s sum m ary judgm e nt orde r in fa

vor of a c la ss of a ll pa s t, pre se n t, a

n d future dia

be tic prisone rs who pre sse d a n Eighth Am e ndm e nt m e d ic a l c are c l a im . 182 F.3d a t 194, 198. Rouse

note d tha t the re c ord 1 9showe d tha

t “ not a ll insulin-de

p e nde nt dia

b e t ic s re quire the sa

m e le v e l of m e dic a l
c are ,” id. at 198, a

nd tha t it wa s the re fore “ possibletha t c onduc t tha

t viola t e s the Eighth Am e ndm e nt rights of the unsta ble [dia be tic s] m ay

not viola te the
c onstitutiona

l rights of the

sta ble [dia be tic s] ,” id. at 199. Rouse obse rve d tha t the

“ c o nstitutiona

l right a sse rte d by

the pla intiff c la ss—

the Eighth Am e ndm e nt right of a prisone r to be fre e from

de libe ra te indiffe re n c e to his or he r se rious m e dic a l
ne e ds— i s one that obviously va rie s de pe n ding on them e dic a l ne e ds of the pa rtic u la r prisone r.” Id. Ac c ordingly , “ [i] n light of the dive rse m e dic a l ne e ds of,
and the diffe re nt le v e l of c are owe d to, e a c h group of pla intiffs,” and be c a use the
nature of the Eighth Am e ndm e nt c la im “ va rie s de pe nding on the

m e d ic a l ne e ds of the p artic ula

r prisone r,” Rouse he ld tha t the distric t c ourt e rre d in holding tha t a ll
m e m b e rs of the propose d

c l a ss c ould a lle ge a

ge ne ra l c la i m

of de libe ra te indiffe re nc e . Se e id. The c ourt note d tha t “ the re m ay

be one or m ore subgroups of pla i ntiffs a s to whom

pa rtic ula r a spe c ts of the c are a lle ge dly provide d wa s not
c onsiste n t with Eighth Am e ndm e nt re quire m e nts a

nd othe r subgroups a s to whom pa rtic u la r a spe c ts of the c are wa s c onstitutiona lly a de q uate .” Id. C onse que ntly , the T hird C irc uit se n t the c a se b a c k to the distric t c ourt to “ c onside r the individual
ne e ds of e a c h

re le va n t subgroup of pla

intiffs,” to e va luat e “ the a ppropria te le ve l of
c are due unde r the Eighth Am e ndm e nt,” and only the n to “ de te rm ine whe the r the 2 0de fe nda

n ts’ a c tions with re spe c t to e a c h of the se m atte rs a nd with re s pe c t to e a c h
re le va nt subgroup of pla

intiffs we re c onsiste nt with the re quisitele ve l of c a re owe d unde r the Eighth Am e ndm e nt a t the tim e s in que stion.” Id. He re , the pa

ne l ta ke s the oppositea

pproa c h
. Whe re the Third C irc uit he ld it
wa s e rror to c onc lude “ on a whole sa le ba s is” tha

t diffe re n t ty

pe s of dia be tic prisone rs ha d “ a l le ge d a

viola tion of the ir Eighth Am e ndm e n t rights,” id. at 198, the p ane l he re holds tha

t the distric t

c o urt c orre c tly

a ggre gate d the Eighth Am e ndm e nt c la im s of a ll prisone rs in the ADC , in a ll the ir m e dic a l dive rsity , on the b a sis of a

ge ne ra l c la im

of de libe ra te indiffe re nc e , Parsons II , 754 F.3d a

t 678–79. And where R ouse re c ogniz e d tha t a diffe re nt le v e l of c a

re wa s due to e a c h group of dia

be t ic prisone rs to a

void viola

ting the ir Eighth Am e ndm e nt rights, a nd
re quire d the distric t c ourt to c are fully c a libra te what would c onstitute

de libe ra te indiffe re nc e a s to e a c h subc la ss of prisone r, Rouse , 182 F.3d a t 199, thepa

n e l he re opts for theone -siz e -fits a ll m ode l of Eighth Ame ndm e nt jurisprude n c e , e ve n though thedive rsity

of the prisone rs’ m e dic a l ne e ds wa s e sta blishe d by the re c ord. Se e , e .g. , Parsons II

, 754 F.3d a

t 664. In light of Duk

e s , the a pproa c h a dopte d by Rouse is c orre c t, a

nd the a pproa c h a d opte d by

the pa ne l is not. Se e Duk

e s , 131 S. C t. at 2551–52. C 2 1In short, unde r R ule 23 a nd the Eighth Am e ndm e nt, the 33,000 prisoners in the A riz ona

prison sy ste m

do not ha ve an Eighth Am e ndm e nt c la im that ra ise s a
c om m on que stion. There c ord doe s not show tha t e ve ry prisone r—

the he a lthy

a s
we ll a s the sic k—

ha s (1) a se rious m e dic a l ne e d , suc h tha t (2) the ADC ’ s a lle ge d de libe ra t e indiffe re nc e (through the ir sy ste m ic pra c tic e s and polic i e s), (3) pla c e d
e a c h prisone r a t a

substa ntia l risk of se rious ha

rm . Se e Farme r , 511 U.S. a t 834; Este lle , 429 U.S. a

t 106. R athe r, the re c ord shows tha t the c onstitutiona

l rights of
va rious subgroups of prisone rs to be fre e from

de libe ra te indiffe re nc e to se rious
m e dic a l ne e ds “ va

rie s de pe nding on the

m e dic a l ne e ds of the pa

rtic ula r prisone r,” Rouse , 182 F.3d a

t 199, a nd doe s not ra ise a

que stion tha

t c an be answe re d in one stroke . The pa

ne l’ s c ontra

ry holding is wrong.

IV The pla intiffs he re have ide ntifie d signific ant proble m s with m e d ic a l c are in the A riz ona

prison sy ste m . Eve ry

prisone r or group of prisone rs tha t fa c e s a substa ntia l risk of se rious injury from the se de fic ie nc ie s is e ntitle d to ra ise an Eighth Am e ndm e nt c la im . In fa c t, the re are a num be r of sm a lle r c la s se s or subc la sse s tha

t m ight c om

p ly with R ule 23. For e xam

ple , the c om

pla i nt a lle ge d that “ [d] e fe nda

nts ha ve a polic y and pra c tic e of not providing prisone rs with the full c ourse of the ir m e dic ation, not providing prisone rs m e dic ation a s pre sc ribe d or 2 2in a tim e ly

fa shion, a

n d ina p p ropriate ly

sta rting a nd stopping me dic ation.” Parsons II

, 754 F.3d a

t 664. A subc la s s of prisone rs who a re c urre n tly

re c e iving
m e dic at ion m ight a ll fa c e a suffic ie ntly

sim ila r substa n tia l risk of ha

rm to sa tisfy R ule 23(a )(2), be c a

use the re is the re quisitefit be twe e n the le g a l the ory , e vide nc e , and the gove rning la

w. Inde e d, the pa

ne l note s tha

t the distric t c ourt c o uld “ have
c e rtifie d num e rous se pa

ra t e c la s se s or subc l a sse s, se p ara ting out groups of polic ie s
and pra c t ic e s.” Id. at 679 n.21. B ut D uk e s an d the Eighth Am e n dm e nt c a se s re quire suc h a ta ilore d
a pproa c h ; it is not just one option a m o ng m any . He re the pa ne l c e rtifie s a c la ss that on its fa c e la c k s the re quisitec om m ona lity : it inc lude s he a lthy prisone rs who have no Eighth Ame ndm e nt c la im s, a s we ll a s prisone rs with dive rse m e dic a l
ne e ds whose c la i m s m

ust be c onside re d individually . The i r c la im s c annot be
answe re d “ y e s or no” in one stroke
. The pa ne l’ s broa d a

nd ge ne ra l form

ulation of the p risone rs’ c la im

— be c a use a ll Ariz ona

prisone rs a

re subje c t to the sam e de fe c tive m e dic a l sy ste m , the y fa c e a substa ntia l risk of a

se rious ha

rm , re ga rdle ss of the m yria d individual diffe re nc e s a c ross a prisone r popula

t ion, Parsons II

, 754 F.3d at 678—is ba se d

on a m i sre a ding of R

ule 23 a nd the Supre m e C ourt’ s Eighth Am e ndm e nt jurisprude nc e , a nd a lso c onflic ts with the

Third C irc u it. And by le aving this de c ision in plac e , the c ourt e sta blishe s this misre a ding a s the la w of 2 3our c irc uit. I dissen t from the c irc uit’ s unfortuna

t e a c q u ie sc e nc e to a

n opinion tha

t is dire c tly c ontra ry to Supre m e C ourt pre c e d e nt.

2 4