UNITED STATES DISTRICT COURT FOR THE

DISTRICT OF NEW HAMPSHIRE

Jeffrey C. O’Neil, Sr.

v. Civil No. 08-cv-396-SM

James O’Mara, Superintendent,

Hillsborough County House of

Corrections

O R D E R

Before the Court is Jeffrey O’Neil’s complaint (document no.

1), filed pursuant to 42 U.S.C. § 1983, alleging that he has been

denied his prescribed mental health medication during his

pretrial incarceration at the Hillsborough County House of

Corrections (“HCHC”), in violation of his rights under the United

States Constitution. Because O’Neil is a prisoner proceeding pro

se, the matter is before me for preliminary review to determine

whether or not the complaint states any claim upon which relief

may be granted. See 28 U.S.C. § 1915A(a); United States District

Court District of New Hampshire Local Rule (“LR”) 4.3(d)(2).

Standard of Review

Under this Court’s local rules, when an incarcerated

plaintiff commences an action pro se and in forma pauperis, the

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 1 of 11
2

magistrate judge is directed to conduct a preliminary review. LR

4.3(d)(2). In conducting the preliminary review, the Court

construes pro se pleadings liberally, however inartfully pleaded. 

See Erickson v. Pardus, 551 U.S. 89, ___, 127 S. Ct. 2197, 2200

(2007) (following Estelle v. Gamble, 429 U.S. 97, 106 (1976) and

Haines v. Kerner, 404 U.S. 519, 520-21 (1972) to construe pro se

pleadings liberally in favor of the pro se party). “The policy

behind affording pro se plaintiffs liberal interpretation is that

if they present sufficient facts, the court may intuit the

correct cause of action, even if it was imperfectly pled.” See

Castro v. United States, 540 U.S. 375, 381 (2003) (noting that

courts may construe pro se pleadings so as to avoid

inappropriately stringent rules and unnecessary dismissals of

claims); Ahmed v. Rosenblatt, 118 F.3d 886, 890 (1st Cir. 1997). 

All of the factual assertions made by a pro se plaintiff and

inferences reasonably drawn therefrom must be accepted as true. 

See id. This review ensures that pro se pleadings are given fair

and meaningful consideration.

Background

On August 14, 2008, the Hillsborough County Superior Court

(O’Neill, J.) set plaintiff’s bail on a pending criminal charge. 

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 2 of 11
3

In its bail order, the Superior Court directed that “[i]f

detained, [O’Neil] shall receive all medications prescribed by

licensed health professionals.” O’Neil, unable to post bail, was

detained at the HCHC, where he did not receive his prescribed

mental health medications.

On August 27, 2008, O’Neil directed an Inmate Request Form

to HCHC Superintendent James O’Mara, alerting him to the Superior

Court bail order, and requesting that he be provided with his

prescribed mental health medication. On September 2, 2008,

Denise Ryan, the Health Services Administrator at the HCHC,

responded to O’Neil, advising him that he would need to contact

his attorney “regarding clarification of [O’Neil’s] most recent

order of confinement.” On September 8, 2008, O’Neil filed an

Inmate Grievance Form reiterating his August 27th request. On

September 9, 2008, the grievance form was marked “Received and

forwarded to the Medical Department.” On September 11, 2008,

Ryan again responded to O’Neil, stating “You may address any

issues regarding said court order to your attorney.” The

grievance from was then forwarded to O’Mara’s office, which

determined that no action was required by the Superintendent. 

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 3 of 11
1The claims as identified herein will be considered for all

purposes to be the claims raised in the complaint. If O’Neil

disagrees with this identification of the claims, he must

properly move to amend his complaint.

242 U.S.C. § 1983 provides that:

Every person who under color of any statute, 

ordinance, regulation, custom, or usage, of any 

State or Territory or the District of Columbia, 

subjects, or causes to be subjected, any citizen 

of the United States or other person within the 

jurisdiction thereof to the deprivation of any 

rights, privileges, or immunities secured by the 

Constitution and laws, shall be liable to the 

party injured in an action at law . . . .

4

The form was signed by the Assistant Superintendent and returned

to O’Neil.

Discussion1

I. Section 1983 Claims

Section 1983 creates a cause of action against those who,

acting under color of state law, violate federal constitutional

or statutory law. See 42 U.S.C. § 19832; Parratt v. Taylor, 451

U.S. 527, 535 (1981) (overruled on other grounds by Daniels v.

Williams, 474 U.S. 327, 330-331 (1986)); Wilson v. Town of

Mendon, 294 F.3d 1, 6 (1st Cir. 2002). In order for a defendant

to be held liable under § 1983, his or her conduct must have

caused the alleged constitutional or statutory deprivation. See

Monell v. Dep’t of Soc. Servs., 436 U.S. 658, 692 (1978); Soto v. 

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 4 of 11
5

Flores, 103 F.3d 1056, 1061-62 (1st Cir. 1997). Because O’Neil’s

claims allege violations of federal constitutional and statutory

law caused by state actors, his suit arises under § 1983.

II. Pretrial Detainee Status

O’Neil was a pretrial detainee at the HCHC at the time the

events he describes occurred. Detainees have a constitutional

right under the Due Process Clause of the Fourteenth Amendment to

be free of punishment. See Surprenant v. Rivas, 424 F.3d 5, 15

(1st Cir. 2005) (citing O’Connor v. Huard, 117 F.3d 12, 15 (1st

Cir. 1997)). However, challenged conditions or restrictions

which can be rationally related to some legitimate administrative

goal or security concern generally will not be deemed

unconstitutional “punishment.” O’Connor, 117 F.3d at 15. 

Because the Due Process Clause prohibits the infliction of

punishment on a person prior to a judgment of conviction, the

issue in evaluating claims by a pretrial detainee is ultimately

whether the conditions of confinement were reasonably related to

a legitimate state interest or were intended instead as

punishment. See Surprenant, 424 F.3d at 13; Collazo-Leon v. U.S.

Bureau of Prisons, 51 F.3d 315, 317 (1st Cir. 1995).

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 5 of 11
3The Fourteenth Amendment is at least as protective of a

pretrial detainee’s right to medical and mental health care as

claims that arise under the Eighth Amendment. As plaintiff’s

assertions are sufficient to state an Eighth Amendment claim, I

find that he states a claim under the Fourteenth Amendment as a

pretrial detainee.

6

III. Inadequate Medical and Mental Health Care

The Eighth Amendment protects prison inmates from prison

officials acting with deliberate indifference to their serious

medical needs.3 See Farmer v. Brennan, 511 U.S. 825, 831 (1994). 

To assert a viable cause of action for inadequate medical care,

an inmate must first state facts sufficient to allege that he has

a serious medical need for which adequate care has not been

provided. Farmer, 511 U.S. at 831; Rhodes v. Chapman, 452 U.S.

337, 347 (1981); Estelle, 429 U.S. at 106. The inmate must then

allege that a responsible prison official was aware of the need

or of the facts from which the need could be inferred, and still

failed to provide treatment. Estelle, 429 U.S. at 106. A

serious medical need is one that involves a substantial risk of

serious harm if it is not adequately treated. Barrett v. Coplan,

292 F. Supp. 2d 281, 285 (D.N.H. 2003); Kosilek v. Maloney, 221

F. Supp. 2d 156, 180 (D. Mass. 2002) (citing Farmer, 511 U.S. at

835-47); see also Gaudreault, 923 F.2d at 208 (defining a serious

medical need as one “that has been diagnosed by a physician as

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 6 of 11
7

mandating treatment, or one that is so obvious that even a lay

person would easily recognize the necessity for a doctor’s

attention.”) (internal citations omitted). The Eighth Amendment

applies to a prison’s administration of medical care, including

mental health care. See DesRosiers v. Moran, 949 F.2d 15, 19

(1st Cir. 1991); Torraco v. Maloney, 923 F.2d 231, 234 (1st Cir.

1991) (recognizing deliberate indifference to an inmate’s mental

health needs violates the Eighth Amendment). 

“[A]dequate medical care” is treatment by qualified medical

personnel who provide services that are of a quality acceptable

when measured by prudent professional standards in the community,

tailored to an inmate’s particular medical needs, and that are

based on medical considerations. United States v. DeCologero,

821 F.2d 39, 42-43 (1st Cir. 1987). This does not mean that an

inmate is entitled to the care of his or her choice, simply that

the care must meet minimal standards of adequacy. Deliberate

indifference may be found where the medical care provided is “so

clearly inadequate as to amount to a refusal to provide essential

care.” Torraco, 923 F.2d at 234. Constraints inherent in a

prison setting may affect the choice of care provided, and may be

relevant to whether or not prison officials provided inadequate

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 7 of 11
8

care with a deliberately indifferent mental state. Wilson v.

Seiter, 501 U.S. 294, 302 (1991).

O’Neil has alleged that he suffers from mental illness

sufficiently serious to have been treated with prescription

medication, and that he was taking that medication at the time he

was detained. The Superior Court recognized O’Neil’s continuing

need to take his prescribed medication and included that

directive to the HCHC in its bail order. O’Neil also notified

the HCHC medical and administrative staff to his need for his

physician-prescribed mental health medication. Accordingly, the

HCHC personnel’s persistent denial of mental health care and

medication may well constitute deliberate indifference to his

serious medical needs. Further, there are no facts alleged which

indicate that there is any legitimate state interest served by

depriving a pretrial detainee of prescribed medication for a

mental health problem. I find that such a deprivation

constitutes punishment, in violation of the Due Process Clause of

the Fourteenth Amendment. I will direct, therefore, that this

claim proceed against defendants.

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 8 of 11
4My construction of this as a request for preliminary

injunctive relief is also informed by my knowledge, based on

9

IV. Defendants

O’Neil has only specifically named O’Mara as a defendant to

this action. Liberally construing the complaint, however, I find

that it also states a claim against Ryan, as the individual

responsible for specifically denying O’Neil’s requests for

medication and referring him to his attorney, rather than

assuring that O’Neil received his prescribed and court-ordered

medication. Accordingly, I will construe this complaint to

include Ryan as a defendant to this action in addition to O’Mara,

as they were both notified directly, more than once, of the fact

that O’Neil had not received prescribed medication that the

Superior Court had directed the jail to continue to provide, and

failed to remedy the situation.

V. Claim for Injunctive Relief

O’Neil has requested that this Court issue an order

directing the HCHC defendants to provide him with his prescribed

medication. Due to the nature of the complaint here, and the

severity of the alleged need for medication, I construe the

request for injunctive relief as one for a preliminary

injunction.4 

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 9 of 11
other cases previously before this Court, that, without Court

involvement, the HCHC has been recalcitrant in providing inmates

under their care with necessary mental health medication.

10

Conclusion

Without further comment on the merits of the complaint, I

find that O’Neil has stated a claim upon which relief may be

granted against defendants O’Mara and Ryan, and I order that the

complaint be served on those defendants. While O’Neil has

completed a summons form for O’Mara, he has not done so for Ryan. 

The Clerk’s Office shall forward to plaintiff a blank summons

form. Plaintiff shall complete a summons form for Ryan and

submit it to the Clerk’s office within thirty (30) days of the

date of this order. Upon receipt of the completed summonses, the

Clerk’s office shall issue the summonses against defendants and

forward to the United States Marshal for the District of New

Hampshire (the “U.S. Marshal’s office”) the summonses and copies

of the complaint (document no. 1) and this Order. Upon receipt

of the necessary documentation, the U.S. Marshal’s office shall

effect service upon Defendants. See Fed. R. Civ. P. 4(c)(2). 

Defendants are instructed to answer or otherwise plead

within twenty days of service. See Fed. R. Civ. P. 12(a)(1)(A). 

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 10 of 11
11

O’Neil is instructed that all future pleadings, written

motions, notices, or similar papers shall be served directly on

the Defendants by delivering or mailing the materials to them or

their attorney(s), pursuant to Fed. R. Civ. P. 5(b). 

SO ORDERED.

________________________________

James R. Muirhead

United States Magistrate Judge

Date: February 5, 2009

cc: Jeffrey C. O’Neil, Sr., pro se

Case 1:08-cv-00396-SM Document 7 Filed 02/05/09 Page 11 of 11