[DO NOT PUBLISH] IN THE UN ITED STATES COURT OF APPEALS FOR THE ELE VENTH CIRCUIT

__ __ __ __ __ __ __ __ __ __ __ __ No. 1 1- 11 87 0 Non -Arg um en t Ca le nd ar

__ __ __ __ __ __ __ __ __ __ __ __ D. C. Dock etNo. 5 :0 9- cv -0 04 02 -RS- CJ K MIC HAEL J. LOEBER, Pl ai nt iff -Co un te r Defen dant- App el lant , ve rs us ERIONG OKON A

NDEM, Defen dant , MARY COLLEEN WAHL, ARNP, In di vi du al ly, DELIANA G ONZALE S TORRES, MD, In di vi du al ly, PATRICI A LEMON, ARNP, In di vi du al ly, PRIS ON HEAL TH SERVICES, INC., DEPARTMENT OF CORRECTIONS STATE OF FLORIDA, D efen dant s- App el le es , LARRY CAMP BELL, inhi s Off ic ia l Capa ci ty as Sh eri ff Leo n C ou nty Flo rid a, Defen dant -Co un te r Case: 11-11870 Date Filed: 08/22/2012 Page: 1 of 5Cl ai m an t-Ap pe ll ee.

__ __ __ __ __ __ __ __ __ __ __ __ App eal fro m

th e Uni te d S ta te s Di stric t Co urt fo r th e North ernDis tri ctof F lo rid a

__ __ __ __ __ __ __ __ __ __ __ __ (Au gu st22 , 20 12 ) Befo re MAR TIN, ANDE RSON an d EDMONDSON, Ci rcu itJu dg es . PER CURI AM: Pl ai nt iff -Ap pe ll an t M ic ha el J. Lo eb er, anin m at e atdi ffer en t Fl or id a Dep artm en t o f Co rrec ti on s fa ci li ti es fro m Ju ly 200 7 thr ou gh Marc h 2 01 0, ap pe al s th e d is m is sa l o f hi s s ect io n 1 98 3 c la im s, al le gi ng de li be rat e in di ffer en ce t o h is m ed ic al ne ed s i n v io la ti onof the Eig hth Am en dm en t. No rev ers ib le erro r ha s be ensh own ; we af

firm . Pl ai nt iff su ffer s fr om

Hepati ti s C . Whi le in carc erat ed , Pla in ti ff’s co nd it io n was tre at edwith l actul os e, a m ed ic at io n tha t re gu la te s el ev at edbl oo d a m m on ia le ve ls (on e o f th e co m

pl ic at io ns of He pati ti s C ); h e was no t g iv enin te rfer on to ge th er wi th rib av iri n (s om et im es pre sc rib edfortre atm en t o f Hep at it is C), de sp it e h is rep eat edreque st s fo r th os e dru gs . The d is tri ctco urt co nc lu de d tha t

2 Case: 11-11870 Date Filed: 08/22/2012 Page: 2 of 5Pl ai nt iff

fai le d t o a ll eg e su ffi ci en t fa ct s t o s ho w a vi ol at io n o f th e Eig hth Am en dm en t an d d is m is se d the co m pl ai nt . W e ag ree. To s us ta ina cl ai m

forde li be rat e in di ffer en ce t o aser io us m ed ic al ne edin vi ol at io n o f th e Eig hth Am en dm en t, a Pl ai nt iff m us t al le ge fact s s ho win g (i ) an ob jecti ve ly seri ou s m ed ic al ne ed ; (i i) an o bjec ti ve ly ins uf fic ie ntres po ns e to th at ne ed ; (i ii ) subjec ti ve awaren es s o f fac ts si gn al in g the ne ed ; an d (i v) anactua l in fere nc e o f requi redm ed ic al tre atm en t fr om th os e fac ts . See Tay lo r v. Ad am s, 22 1 F .3d12 54 , 12 58 (11 Cir . 20 00 ). An o bjec ti ve ly ins uf fic ie ntres po ns e b y th publ ic off ic ia ls to a se rio us m ed ic al ne edm us t b e p oo r en ou gh to co ns ti tu te an un ne ces sary

an d wan to n i nf

li ct io n o f pa in . See Est el le v. Gam bl e, 97 S.Ct . 28 5, 29 1 (1 97 6) . Ina dv ert en t fa il ur e to pro vi de ad equa te m ed ic al care , neg li ge nc e in di ag no si s o r tr eat m en t, o r m ed ic al m al pr act ic e, witho utm or e, fai ls to st at e a co gn iz ab le de li be rat e in di ffer en ce cl ai m . Id. at29 1- 92 . Tha t Hep at it is C pr es en ts a se rio us m ed ic al ne edis un di sp ut ed . See Bro wn v. J oh ns on , 38 7 F .3d13 44 , 13 51 (11 th e Ci r. 20 04 ). The i ss ue po se d b y th is ap pe al is whethe r th e co m

pl ai nt , vi ewedinth e li gh t m os t favo rab le to Pla in ti ff, al le ge s su ffi ci en t fa ct s t o s ho w an o bjec ti ve ly ins uf fic ie ntres po ns e to th atne ed . Plai nt iff as se rts hi s re qu es te d treat m en t -- in te rfer onan d ri ba vi rin -- was requi redto tre at

3 Case: 11-11870 Date Filed: 08/22/2012 Page: 3 of 5hi s u nd erl y in g c on di ti on an d was th e tr eat m en t p res cri be d e arl ie r fo r hi m by a do ct or . The Defen dant s d idno t i gn or e Pl ai nt iff’s Hepa ti ti s C co nd it io n; in st ead , th ey ch os e analt ern at iv e tr eat m en t -- lac tu lo se -- to ad dr es s el ev at edbl oo d amm on ialev el s wh ic h are a co m m on co m pl ic at io n o f Hep at it is C. Cf. Bro wn, 3 87 F.3 d a t 1 35 1 (c om

pl et e fai lu re t o treatHepa ti ti s C co nd it io n a m ou nt edto de li be rat e in di ffer en ce). Pl ai nt iff ass um es th atin te rfer on an d ri ba vi rin rep res en te d asupe rio r tr eat m en t. Bu t i nt erfe ro n andrib av iri n h av e p ot en ti al ly se rio us si de effe ct s; pre sc rip ti onof tho se dru gs is hi gh ly ind iv idua li zedto th e pa ti en t an d d ep en ds onm an y fact or s. See Ben de r v. R eg ie r, 38 5 F .3d11 33 , 11 35 (8 th Cir . 20 04 ). Perh ap s -- we do no t s ay -- tr eatm en t b y

lac tu lo se in st eadof the tre atm en t p refe rredby Plai nt iff co ns ti tu te d n eg li ge nc e, bu t n eg li ge nc e fai ls to st at e a co gn iz ab le de li be rat e in di ffer en ce cl ai m . Plai nt iff ’s di sa gr eem en t wi th th e co ur se of treatm en t em

pl oyed fai ls to supp ort an in fere nc e th atDefen dant s ac te d with d is reg ardfor

th e h arm po se d t o P la in ti ff b y

Hepa ti ti s C . W e co nc lu de , as d idth e d is tri ctco urt, that the all eg at io ns inPla in ti ff’s co m pl ai ntare “ m erel y

co ns is te nt ” with l iabi li ty; th e al le ga ti on s “ st op [] sho rt o f th e li ne be twee n p os si bi li ty andpl au si bi li ty of ‘ent it le m en t t o re li ef.’” Ash cro ft v . Iqba l, 1 29 S.Ct . 19 37 , 19 49 (20 09 ), qu ot in g B el l At lant ic Co rp . Twom bl y , 12 7 4 Case: 11-11870 Date Filed: 08/22/2012 Page: 4 of 5S.Ct . 19 55 , 19 66 (20 07 ). Plai nt iff sh ows no erro r inth e d is tri ctco urt’s g ran t o f Defen dant s’ m ot io n t o d is m is s. AFFIRMED.

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