NOT RECOMMENDED F OR FUL L -TEXT PUB L I CATI ON File Na me: 10a0300n.06 No. 09-5394 UN ITED STA TES C OU RT OF AP P EA LS F OR THE SI XT H C IR CU IT
WI L L I AM SCO TT WOO L ER, Pla int if f- Ap pe lla nt,
v. HI CKMAN COUNTY, KENTUCKY, e t al., De fe nd ants -A

pp e lle e s. ) ) ) ) ) ) ) ) ) ) ) ON APPEAL FROM THE U NI TED ST ATES DI STRI CT COURT FOR T H E WE ST E RN D I ST RI CT OF KENTUCKY

B e fo re : SU HRHE I

NR I CH , M c KE AG UE , a

nd KE TH L ED GE , Ci rc uit

Judg e s. KE T H L E D G E , Ci r c u it Ju d g e . Pl a inti f f Wi ll ia m Wo o le r a ll e g e s th a t, w h il e he w as incar cer ated a

t the Hickman County

Detention Center

(“the J ail”), va

rious corr ections emp l oy ees unlawfully

exposed him t o the bac teria known as Methicill in-resistant Staphylococc us aure us (MRSA) and then mistreated his MRSA infe ctions. Wooler sued Hickman County and thre e of the Jail e mpl oy e e s, a sse rt ing Ei g hth Am e ndme nt c la ims un de r 4 2 U .S. C. § 19 83 a nd ne g lig e nc e c la ims
un de r K e ntu c ky

law. Th e dis tr ic t court g ra nte d summ ary jud g me nt in f a vo r o f t he de fe nd ants on

a ll
c la ims , w hic h Wo ole r n owa pp e a ls. We r e

je c t hi s a rgume nts , a

nd a ff ir m. I. Wooler’s claims ar e base d on his ex posure to MRSA, which is an a ntibioti c-r esistant ty

pe of staph bac teria. MRSA is spread thr oug h person- to-person co n t act, so crowded living
e nv ir on me nts , s uc h a s p ri so ns , a re ide a l e nv ir on me nts fo r o utb re a ks
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-2- Wooler alleg es t hat he beca me i nfec ted wit h MRSA while i ncar cer ated at the J ail. He wa s admitted in J une 2004, and pla ced in Cell 147. That cell housed ten inmates, thoug h it was desig ned fo r o nly fi ve , a nd c on ta ine d o ne sh ow e r a

nd on e toi le t. On September 1, 2004, the J ail rec eived a Kentucky Depa rtmen t o f C o rrections Memorandum that wa

rned about the dange rs of MRSA and ins tructed Jail staff on how to pre vent the sp re a d o f M RSA . D e fe nd ant R ob e rt Ta rv e r, the Jai ler , sk immed the Me mo a

nd g a ve it t o defe ndant Peg g y

Tarve r, who wa s a Reg istered Nur se at the Jail (and Robert Ta rver ’s wife ). She
rea d the Memo and discusse d it with defenda nt Dr. B ruce Smit h, a d o ct o r wh o provided medic al
se rv ic e s to the Jail ’s inm a te s. On Se pte mbe r 2 3, 20 04 , a

n inm a te —w ho m the pa

rt ie s r e fe r t o a s “ I nmate A” to p ro te c t hi s identity —was a dmitted to the J ail and plac ed in Cell 147 with Wooler. At the time, I nmate A ha d a wound on his legthat, acc ording to Wool er, “looked like a bullet hole ” and was drainingpus. The J ail ’s medical staf

f did not know about Inmate A’ s wound until October 11, 2004, whe n other inmates told the staff a

bout it. Dr. Smi th diag nosed the w o u n d as a M RSA infection and put bandag es on itto c o n ta in th e dr a in a g e . B e f

o r e s e n d in g I n mate A b a c k to Ce ll 1 4 7 , N u r s e Tarve r
or de re d th a t hi s li ne ns be c hanged, and told h im t o w a shhis ha nd s r e g ula

rl y , to us e c le an to we ls
ever y time he shower ed, and not to touch his wound. I nmate A de veloped a number of other MRSA infe ctions during November and De cembe r 2 0 0 4
. In l a t e N o v e mb e r , h e d e v e l o p e d a p art i c u l ar l y s e r i o u s a

b s c e s s o nh i s l e g . O nT h u r s d ay, Dec ember

2, Dr. Smith performe d an “inc ision and drainag e” pr ocedur e on the absce ss. I nmate A t h en re tu rn edt o C el l 1 4 7
. Ov er t h e f o l l o wi n g we ek en d , I n m at e A ne ed ed t o ch an ge h i s dre s s i n gsNo. 09-5394

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-3- five or six ti mes, which he was una ble to do by himself. The g uards asked Wooler to help I nmate A. Woo le r d id s o. Th e Ta

rv e rs we re un awa

re of thi s re qu e st an d state d in de po sit ion te sti mony

that it
v i o l a t e d J a i l p o l i c y. On Dec ember

7, a guard r eporte d that Wooler might have a staph infec tion. One of the Jail’s
nurses e x amined Wooler and f o und four sc abs on his thigh, whic h Wooler said he thoug ht were spider bit e s . N o n e o f

th e s c a b s w e r e o p e ns o r e s , s o h e w a s n o t t r e a te d
. So o nth e r e a f

te r , Wo o ler develope d additional skin problems. On J anuar y 18, 2005, Dr. Smith ex amined Wooler and tre ated him for “se vera l skin infections—old and new.” Th a t sa me da y , N ur se Ta

rv e r too k a dd iti on a l pr e c a uti on ary me a sure s: e ve ry

c e ll i n th e Jail
was c leane d; the infec ted inmates in Ce ll 147 wer e quara ntined; e ach inmate was g iven anti-ba cter ial soap and require d to shower; and Nurse Ta rver persona lly

chec ked ea ch inmate f

or infec tions and
ensure d that eac h inmate re ad a f ly er a bout MRS A. Those pre ca u t i o n s stopped the spre ad of MRSA to other inmates. B etwee n Marc h and Se pte mb er 20 05 , h owe ver, W oo ler so ughttr eat men t f

or ap pro x im ate ly

si x di fferen t s tap h i nfec tio ns . Eac h time, Dr. Smith ex amined Wooler and pr escr ibed antibiotics. Dr. Smith never took a culture of any of Wooler’s wounds, so Wooler’s inf ec t i o n s wer e neve r off

icially confirme d as MRSA, althoug h Dr. Smith testified that he assumed they wer e. Woo le r wa s re le a se d fr om the Jail in Se pte mbe r 20 05
. He de ve lop e d a dd iti on a l in fe c tio ns , and he soug ht treatment outside the Jail. W ooler’s ne w phy sician per formed a cultu re, which confirme d that Wooler had MRSA.No. 09-5394

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-4- Wooler therea fter f

iled suit aga i nst Hickman County , J ailer Ta rver , Nurse T arve r, and D r. Smit h. He a ll e g e d th a t th e y v io late d th e E igh th A me n dme n t b y e xp o s in g h im to M RS A an d by imp ro pe rl y tr e a tin g his MRSA inf e c tio ns , an d that the ir a c tio ns we re ne g lig e nt u nd e r K e ntu c ky

state law. The district court g rante d summary judgme nt in favor o f t he def endants on a ll of Wool er’ s
c la ims
. Wooler n o w appea ls the entry of summary

judgme nt on his claims ag ainst J ailer Ta rver , Nurse T arve r, and D r. Smith. II. We reviewthe district court’s g rant of summar y judgme nt de novo. Ciminil lo v. Streiche r , 434 F.3d 461, 464 ( 6th Cir. 2006). Summ ary judgme nt is appropriate when “ there is no ge nuine iss ue a s to any mat eria l f a c t[.]” F e d. R. C iv. P. 5 6( c )( 2) . Ag e nu ine iss ue of mate ri a l f

a c ts e xists only when ther e i s s ufficie nt evidence “such that a re asonable jury could re turn a ve rdict for the
n o n m o v i n g party .” Anderson v. Liberty Lobby, I nc. , 4 7 7 U
. S
. 2 4 2 , 2 4 8 ( 1 9 8 6 )
. A d e f e n d an tis entitled to summary

judgme nt if the plaintiff “f ails to make a showingsufficie nt to establis h the exis tence of an e lement essential to that party ’s ca se, and on which that par ty will bear the burden of proof at trial.” Ce lote

xCor p. v . Ca tre tt , 477 U.S. 317, 322 (1986).

III
. Woo le r f ir st c ha lle ng e s th e g ra

nt o f s umm ary

jud g me nt on his c la im that th e de fe nd ants violated th e E ig h th A me n dme n t b y p la c in g h im in a c e ll w it h I n mate A
. A n inmate a lleg ing a n Eig hth Amendment claim ag ainst a prison off icial must prove two elements: first, that the offic ial’s
a l l e g e d m i s t r e a t m e n t w a s “ o b j e c t i v e l y” s e r i o u s ; an d s e c o n d , t h a t t h e o f f i c i a l h a d a “ s u b

j e c t i v e l y”No. 09-5394

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-5- culpable state of mind. To show objec tively serious mistreatment, the inmate must show that he wa s “inca rce rate d under c onditions posi ng a substantial r isk of serious har

m.” Farmer v . Brennan , 511 U. S. 8 25 , 8 34 (19 94). Th e su bje c tiv e e le me nt r e qu ir e s p ro of that th e of

fi c ia l w a s d e lib e rate ly ind if fe re nt t o th e mis tr e a tme nt: “ [A] pr iso n o ff ic ia l c ann ot b e fo un d li a ble un de r the E ig hth Amendment . . . unless the of ficial knows of

and disre gar d s an excessive risk to inmate hea lth or
sa fe ty ; th e of

fi c ia l mu st b oth

be awa re of fa c ts f ro m w hi c h th e inf

e re nc e c ou ld b e dr awn

that a substantial risk of serious har m exi sts, and he must also drawthe infer ence .” Id. at 837.

A. He re , th e de fe nd ants c o n c e de fo r p ur po se s o f t his a pp e a l th a t Woo le r’ s p la c e me nt i n th e same
overc rowde d cell as I nmate A constituted objectively serious mistreatment. Wooler has there fore
satis fi e d th e ob

je c tiv e e le me nt. Ea c h d e fe nd ant c on te sts the su bje c tiv e e le me nt. The de fenda

nts did not know that I nmate A was infected with MRSA unti l October 11, 2004. Wooler argues that they

are liable for the ir conduct before that date, however , beca use the KD OC Memo made the m awar e of a ri s k o f MR SA infection amonginmates. But that r isk is too g ener alized to be substantial a s to Wooler spe cifica lly
. Se e Ol iv e r v. Bu c k s Coun ty Cor

r. Fa c ili ty , 18 1 F . App ’x 28 7 ( 3d

Cir . 2 00 6) (h old ing th at an inm a te wh o p ro ve d h e wa s “ a t some risk of
c a tc hin g MRSA ” ha d n ot p ro ve d th a t he wa s subj e c t to a su bs tanti a l risk of se ri ou s h arm (e mph a sis in orig inal)). The rec ord there fore does not support a finding t hat any of t he defenda nts knew, prior t o O c t o b e r 1 1 , t h a t W o o l e r f a c e d a s u b s t an t i a l r i s k o f s e r i o u s h ar m f r o m s h ar i n g a

c e ll w ith I nmate A.No. 09-5394

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-6- Th e same is tru e fo r a ft e r O c tob e r 1 1. Dr . Sm ithdid no t e ve n k

no w that Woo le r sh are d a

c e ll with I nmate A, so ther e is no basis for f inding him liable on that g round. Nor is the re f or Jailer Tarve r; althoug h he knew that I nmate A sha

red a cell with Wooler, he did not know that Inmate A
was c ontag ious. Mor eover , J ailer Ta rver is not li able a s a super

visor of others a

t the J ail. See Leac h

v . S he lby Cou nty Sh e rif f , 8 91 F .2 d 1 24 1, 12 46 (6 th C ir
. 19 89 ) (st a tin g that su pe rv iso ry lia bil ity applies only

if “the of

ficial e ither enc ourag ed or i n some way direc tly participated” in the unconstitutional conduct). Woo le r’ s e xpos ur e c la im a g a ins t N ur se Ta rv e r p re se nts a

c los e r ques tion. She kn e w b oth that Inmate A wa s conta g iou s and that he sha re d a c e ll w ithWoo le r. Thus , a re a so na ble jur y c ou ld infer that Nurse Ta

rver knew that Inmate A pose d some risk to Wooler. But Wooler must prove that she knewthe risk was e x cessive a nd that she chose to disreg ard it. The recor d here would not allow a rea sonable jury to make that f inding. As a

n initial matter, on J anuar y 18, 2005, Nurse Tarve r t ook a number of precautions i n response to MRSA; s he cle aned
ever y cell, quar antined the infe cted inmates, a nd distributed informati o n about MRSA. No
rea sonable jury

could conc lude that those ac tions constitut ed deliber ate indiffe renc e. Wooler focuse s instead on the time period be tween O ctober 11, 2004 and January

18, 2005. But Wooler’s e vidence does not support a finding of conscious dis reg ard. As soon as Nurse Tarve r lear ned of Inmate A’s infec tion, she investigated the situation a nd took pr eca

utions in response . She
c on ta c te d th e loc a l he a lthde pa rtme nt o n O c tob e r 1 1, bu t th e y dis mis se d h e r c on c e rn s a

bo ut a MRSA
ou tbr e a k. Nurs e Ta

rv e r n e ve rt

he le ss o rd e red t hat Inmate A’ s li ne ns be c ha ng e d, and g a ve him instructions designe d to preve nt the sprea d of MR SA. These a ctions, at least on their f ace , show thatNo. 09-5394

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-7- Nurse T arve r did n o t consciously disreg ard a

risk that she knewwas e x cessive. See W illiams v. Me hra , 1 86 F .3 d 6 85 , 6 92 (6 th C ir
. 19 99 ) (e n ba nc ) (gra nti ng summa

ry jud g me nt t o p ri so n o ff

ic ia ls beca use “[t] here is nothing to sug g est that the [officials] were . . . doing le ss t h an their training ind ic a te d w a s n e c e ssa

ry ” ); se e als o Br own v . H

arris , 240 F.3d 383, 389 ( 4th Cir. 2001) (stating that de lib e rate ind if

fe re nc e re qu ir es “kn ow le dg e bo th o f t he g e ne ra l r isk , a

nd a lso that th e c on du c t is inappropriate in light of that risk” (interna l quotation marks omitted)). Wooler asserts that, de spite this evide n c e , a rea sonable jury

could conc lude that Nurse Tarve r
wa s d e lib e rate ly

indi ffe re nt b e c a

us e sh e fa ile d to take a dd iti on a l pr e c a uti on s th a t w e re re a dil y
a va ila ble to h e r. B ut Wo ole r d oe s n ot h a ve any e vid e nc e sh ow ingthat N ur se Ta rv e r d id, in f

a c t, have othe r options. He say s that Nurse Tarve r shoul d have pla ced I nmate A in isolation, but he has
no t in tr od uc e d a ny e vid e nc e sh ow ing that isolatio n wa s a fe a sib le op tio n at the Jail . H e a lso a sse rt s that Nurse T arve r should have w arne d him about I nmate A’ s MRS A infec tion, but Nurse Tarver testified that medica l-privac y laws pre vented he r fr om doing so. Thus, a re asonable jury could not conclude that Nurse T arve r ig nored othe r pre cautions re adily available to her. Wooler’s evidenc e shows that Nur se Tar ver w as, at most, neg lige nt in impl ementing
measure s to reduce the risk of MRSA infe ctions. Her c onsistent effor ts to reduce that risk, howeve r, pr e c lud e a

fi nd ingof

de lib e rate ind if

fe re nc e . N ur se Ta

rv e r i s e nti tle d to summa

ry jud g me nt. B. Wooler next challeng es the g rant of summary judgme nt on his Eighth Amendment c laim that Dr. Smith im proper ly

treated his MRS A infections. Aga in, Wool er must prove that the alleg edNo. 09-5394

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-8- mistreatment was obje ctively serious, and that Dr. Smith was deliber ately indiffer ent to the mistreatment. Wooler contends that Dr . Smit h’s treatment was inade quate in two wa y s. First, Wooler say s that Dr. Smit h mistreated him by not c ulturing his w ounds to confirm that he had MRSA. But Dr . Smit h testified that he a ssumed Wooler had MRSA, and that confir mation of t hat fact would not have chang ed his treatment in the l east. The re cord be fore us, then, aff ords
no ba sis fo r a

jur y to f ind that hi s f a ilure to c ult

ur e wa s se ri ou s mi str e a tme nt. Second , W o o l er contends that Dr . Smit h twice pr escr ibed an a ntibioti c known a s Ke fl e x—wh ic h is ine ff

e c tiv e again st M RSA

—to tr e a t so me of

Woo le r’ s a

bs c e sse s. Dr . Sm ith explained his decision to prescr ibe Kef lex by stating that “the tre atment eve n for MRSA is common antibiotics,” and that he “use[d] Keflex on som e . . . patients in the jail who had absc esses, a nd they g ot better.” These statements ref lect a g ood-fa ith belief that Ke flex was appropr iate tre atment for Woo le r’ s in fe c tio ns . Ind e e d, Woo le r a dmits th a t e a c h ti me Dr . Sm ithpr e sc ri be d K e fl e x, his infec tions went away
. T h er e i s no basis, there fore , for a jury to find that the Kef

lex prescriptions
a mou nte d to de lib e rate mis tr e a tme nt. I V. Wooler next challeng es the district cour t’s g rant of summar

y judgme nt on his state-law
ne g lig e nc e c la ims a g a ins t th e de fe nd ants . Wo ole r a lle g e s th a t a ll thr e e de fe nd ants ne glig e ntl y exposed him to MRS A—both by failing to detect Inmate A’ s infection bef ore O ctober

11, and by fa ili ngto t ake su ff

ic ie nt p re c a

uti on s th ereaft e r. Woo le r a lso a sse rt s a me dic a l- ma lpr a c tic e c la im
a g a ins t D r. Smith. Th e dis tr ic t c ourt g ra nte d s umm ary

jud g me nt i n f

a vo r o f t he de fe nd ants on

a ll of the c laims.No. 09-5394

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-9- Woo le r a rgues that D r. Smith w a s n ot e nti tle d to summa ry jud g me nt o n h is m e dic a lmalprac tice cla im. Kentucky law re quires expert evide nce to survive s ummary judgme nt on a medical- malprac tice cla im. See A ndrew v. Be gley , 203 S.W
. 3 d 1 6 5 , 170 (Ky . App. 2006). He re, Wooler relies on an expert repor t disc ussing the adequa cy of the J ail’s eff orts to pr event the sprea d of MRSA . B ut t

ha t r e po rt say s n oth ing a

bo ut the me dic a l tr e a tme nt t hat Woo le r r e c e ive d at th e Jail
. Dr . Sm ithis the re fo re e nti tle d to summa ry jud g me nt o n th e me dic a l- ma lpr a c tic e c la im. Woo le r a lso se e ks to r e viv e his re ma ini ngne g lig e nc e c la ims . T o e sta bl i s h a n e g lig e nc e c la im under K entucky

law, a pla intiff must establish that “(1) the de fenda nt owed a duty o f ca re to the plaintiff, (2) the defe ndant bre ache d its duty , and (3) the bre ach pr ox imately cause d the plaintiff’s damag es.” Martin v. Cincinnati Gas & Elec. Co. , 561 F.3d 439, 443 (6th Cir. 2009). The district court concluded that Wooler failed to cre ate a g enuine issue a s to causation. Ag ain, Kentuc ky law g ener ally require s expert testimony to pr ove causation in case s involving medical c laims. Baylis v. Lourdes Hosp., Inc. , 805 S.W .2d 122, 124 (Ky . 1991). Wooler contends that his expert testimony from Dr . Clark is sufficient to avoid summary judgmen t o n causation gr ounds. We are unpe rsuade d. For one thing , Dr. Clark’ s testimony was
e qu ivo c a l at be st. Al tho ug h he ini tia lly te sti fi e d that the Ta rv e rs may have c a us e d Wo ole r’ s MR SA infec tions, he later ba cked of f that statement. Spec ifically , he said th at he was “not sure ” how W oole r o bta ine d M RSA , a nd a g re e d th a t “ it i s lo g ic a l and may be c or re c t” to s ay

that “ it i s absolutely

impossibl e to tell if [W ooler] contrac ted MRSA in the jail.” Thus, Dr. Clark’ s testimony is inconclusive on its own terms.No. 09-5394

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-10- Moreove r, Dr. Clark’s opi nion is also unreliable . He e x pressly assumed that Wooler had not eng ag ed in any

“hig h-risk ac tiviti es” that coul d h ave c aused the MRSA infections. But that assumption was false , beca use W ooler rece ived j ailhouse t attoos from a homemade tattoo gun that he shar ed with Inmate A—an activity that Dr. Cl ark admitted would incre ase the risk of obtaining MRSA. Thus, Dr. Clark’s opinion is based on a f alse pre mise; he failed to c onsider whe ther Woo le r’ s o wn

a c tio ns c a

us e d th e MRSAinf

e c tio ns . At bottom, Dr
. Clark’s testimony is inconclusive and unr eliable. Such e vidence , by itself, would not allow a re asonable j u ry t o conclude that the def endants’ ne g lige nce c aused Wooler’ s MRSA infections. See Lewis v. Philip Morris Inc. , 35 5 F .3 d 51 5, 53 3 (6 th Cir . 2 00 4) (“ I n o rd e r t o survive a motion for summ ar y j u d gment, the non-moving party must be able to show suff icient probative e vidence that would p er m i t a fi n d ing in his favor on more tha n mere speculation, conjec ture, or fantasy” (inter nal quotation marks and modific ations omitt ed)) . The de fenda nts are the re fo re e nti tle d to summa ry jud g me nt o n th e ne g lig e nc e c la ims
. The district cour

t’s judgme nt is affirmed.