FI L ED U.S. COURT OF A P P E A LS E LE V EN T H C IR C U IT NOVEMB ER 28, 2006 THOMAS K. KAH

N CL ERK [DO NOT PUBLISH] IN THE UN ITED STATES COURT OF APPEALS FO R T HE EL EV EN TH CIRC UI T

____ ____ ____ ____ ____ ____ N o. 06- 1028 6 Non-A rgum ent Calendar

____ ____ ____ ____ ____ ____ D. C. Docket N o. 02-00573 -CV -BH -B JAM ES E. W ILLIAMS, J R., Pl ai nt iff -Ap pe ll an t, ve rs us SHERIFF PRINCE ARNOLD, GLORIA KENNE DY, Defen da nt s- App el le es .

____ ____ ____ ____ ____ ____ Appeal f rom the United State s District Court f o r th e S o u th e rnD i s tr i c to f

A l ab a ma

____ ____ ____ ____ ____ ____ _ (N ove m be r 28, 200 6) Be fo re BL A CK , CA RN E S and B A RKE T T , Ci rc uit Jud ge s. PE R CU RIA M:Be cause this is a de novo revie w of the district c ourt’s grant of summar y judgme nt 1 ag ainst him, the “ac ts in thi s opinion construed in the lig ht most favorable to Wi lliams, and we dr aw a ll r e a so na

ble inf e re nc e s in his fa vo r. Se e F arr owv. Wes t, 3 20 F .3 d 1 23 5, 12 39 n. 2 ( 11 th Cir. 2003). 2 Ja m es E. W il li am s, J r. is a fo rm er Al ab am a st at e p ris on er p ro ceed in g p ro se. H e sue d P ri nc e A rn old , the S he ri ff of W ilc ox C ounty , A la

bam a an d G lor ia Ke nnedy , the c ount y ’ s chief j ailer, under 42 U. S. C. § 198 3, contending th at they vio late d hi s E igh t A m en dm en t r igh ts b y sho w ing int en tio na l, m al ic iou s, and de lib er at e ind if

fe re nc e to h is m ed ic al ne ed s. T he dis tr ic t c ourt de nie d hi s m oti ons for appointm ent of counsel and su m m ary j udgm ent, and it granted su m m ary j udgm en t f

or A rn old and K enne dy . W ill iam s is appe al ing the j udge m en t a ga ins t hi m th atres ul te d fr om

th os e ru li ng s. We affirm . W ill iam s su ff

er s f ro m A ddi son’ s di se as e. P eo ple w ithA ddi son’ s di se as e 1 m us t t ak e m ed ic at io ns da il y or r is k s eri ou s h eal th pro bl em s, i nc lu di ng de at h. A cc or din g to the phy sic ian who o ri gin al ly dia gnos ed

W ill iam s’ c ondi tio n, W ill iam s ha s take n m ed ic at ionto tr eat A ddi son’ s di se as e sin ce 198 0. T he requi redm ed ic at io n c on si st s o f two pre sc rip ti on dru gs , Flo rin ef an d P red ni so ne . W ill iam s e nte re d W ilc ox C ounty Ja il in F eb ru ar

y 199 9. A t tha t t im e, he in fo rm edArno ldan d Ken ne dy of h is da il y m ed ic al ne ed s. In ad di ti on to th e two dr ugs take n f

or A ddi son’ s di se as e, W ill iam s a lso too k pr es cr ipt ionm ed ic ine f or3

hy pe rt en sio n and f

or his a lle rg ie s. N ev er

the le ss, the j ai le rs did

not a lw ay s r etri ev e W il li am s’ pre sc rip ti on s fr om th e lo cal ph arm acy befo re h e ran ou t o f m ed ic in e. He wa s in the jail f

or nearly 530 day s. D elay s in refilling his prescriptions caused Wi l l i a ms t o g o wi th o u th i s med i c a t i o no n4 9 o f th o s e d ays . M o s to f

th e d e l ays la ste d j ust

aone or tw o day s, but

he onc e suf

fe re d bo th a

f our -d ay pe ri od and a se ve n- day

pe ri od w ithno m ed ic at ion . W ill iam s say s th at

he suf fe re d gr eatly

be ca use of the de lay s inr ec ei vin g hi s m ed ic at ion s. H e as se rt s th at on s om e of

the day s th at

he did not r ec ei ve his m edicine he experienced one or m ore of the f ollowing sym

ptom s: fear

for his life, ge ne ra l w eakne ss and p ai n, ins om nia , f at igu e, vom iti ng, de hy dr at ion , dark en ing of th e s k i n , s t o ma c h i l l n e s s e s , an do th e r p s yc h o l o g i c a l d i s tu r

b an c e s . B u tWi l l i a ms also kept a journal of his pain. I n it his o nly specific r efer ences w ere to a neck ac he , ins om

nia , and n au se a, a lth oughhe did m ak e ge ne ra l r ef

er en ce s to f

ee lin g

“ very bad,” “ rough,” “ like he had the flu,” and “ we ak.” I n hi s j our

na l, W ill iam s a lso ind ic at ed that he ha d r eg ular co nta ct w ith K enne dy and w iththe j ai le rs in ch ar ge of his m ed ic ine . H e say s th at he pe rs ona lly inf orm ed K enne dy of the de lay s “ on num er ous oc ca sio ns. ” T he j ai le rs tol d hi m that they we re attem

pting to get his m edication and that th e delay s usuallyresulted fr om the sta ff ’ s f ai lur e to h av e the m ed ic at ionf ill ed by , or pic ke d up f

ro m , the4

pharm ac y on t im e. Whe n W ill iam s r eque ste d to se e a phy sic ian be ca use of s ym p t o m s re l at edt o h i s l ac ko f med i ca t i o n , t h e ja i l er s fo l l o we dth e ja i l ’s procedures: if W illiam s said his s ituation wa s an em ergency , he wa s taken im m ediately to see a doctor; if he said his situation wa s not an em ergency , he saw th e d o c t o r

du r i n g th e n e x tav a i l ab l e ap p o i n t me n t . I nn o i n s t an c e w a s Wi l l i a ms de ni edacce ss to a do ct or . The j ail’ s records re flect three instances when W illiam s requested to see a doctor regarding his lack of m edication. For two of instances, W illiam s was taken to the doc tor

the day he m ad e the r eque st. F or the thi rd , W ill iam s sawthe doc tor five day s after

his request. T he sam e doctor exam ined W illiam s on all three oc ca sio ns, and h is m ed ic al r ec or ds r ev ea l tw o in stanc es w he n, in re spon se to not rece iving his m edication, W illiam s com plained of neck pain, and one instance when he com

plained of flu-like sym

ptom s. T he doctor’ s records do not reveal ot he r co m

pl ai nt s fr om

W il li am s ar is in g fr om

hi s l ackof m ed ic at io n. W ill iam s su ed

A rn old and K enne dy

und er § 19 83 f or vio latin g hi s E igh th A m en dm en t r igh ts. A cc or din g to W ill iam s, the y kne wthat de lay s inr ec ei vin g hi s m edicine could threaten his life, but they nonetheless d eprived him of necessar

y care with intention al, m alicious, and deliberate indiffer ence by tolerating repeated de la y s i n p ro cu rin g h is m ed ic in e. He als o m ov edforth e ap po in tm en t o f co un se l.5

A m agistrate j udge denied th at m otion and recom m ended granting summ ary j udgm en t i n f

av or of A rn old and K enne dy

and d eny ing sum

m ar y j udgm en t f

or W illiam s. T he district court adopted th at rec om m endation, and denied anot her m oti on f ro m W ill iam s f

or the appoi ntm en t of

c ouns el . W ill iam s th enappe al ed the di st ric t co ur t’s d eci si on s. W e re vie wthe dis tr ic t c ourt’ s de nia l of am oti on t o a

ppoi nt c ouns el onl y

f or an ab us e o f di sc ret io n. St eel e v . Sha h, 8 7 F .3d12 66 , 12 70 –7 1 (1 1t h C ir. 1 99 6) . U nde r 28 U . S. C. § 19 15( e) (1 ), adis tr ic t c ourt m ay appoi nt c ouns el to anind ige nt pla int if f, but the c ourt ha s br oa d di sc re tio n inde ci din g whe the r to d o so . B as s v. Pe rr in, 170 F . 3d 1 312, 132 0 ( 11th C ir . 199 9) . “ Appoi ntm en t of c ouns el in ci vil ca se s is . . . apr ivi le ge j ust if ie d on ly by e xc ep tio na l c ir cum stanc es , suc h a s th e pr es en ce of

f ac ts and l eg al iss ue s [ w hic h] are so n ove l or c om ple x a s to r equir e the assistance of a tra ined practitioner.” Kilgo v. Ricks, 983 F.2d 189, 193 (11t h Cir. 1993 ) (quotations andcitation om itted) (brac kets in origi nal). “ The key is whether the pro se litigant n eeds help in presenting the essential m erits of his or her posi tio n to the c ourt. Whe re the f ac ts and i ssu es are sim

ple , he or she usu al ly

w ill no t n eedsu ch he lp .” Id . Inana lyzi ng whe the r the e xc ep tio na l c ir cum stanc es that j ust if y the ap poi ntm en t of

c ouns el are pr es en t, w e co nsi de r (1 ) the ty pe and c om

ple xity of theTo the extent that W illiams challeng es the district cour t’s failure to gr ant his reque st for 2 appointment of a me dical expert, this issue is not properly befor e us bec ause Williams did not reque st appointment of an expert witness in the district court. 6 case; (2) whether

the pro se litigant is capable of adequately presenting his case; (3) whether he is in a positio n to adequately investig ate the ca se; and (4) whether the e vid en ce w ill c onsi st i n larg e part of c onf lic tin g te sti m ony

so a s to r equir e ski ll in the pr es en tatio n of

e vid en ce and i n c ro ss- ex am inatio n. F ow le r v. Jon es , 899 F.2 d 1 08 8, 1 09 6 (1 1t h C ir. 1 99 0) . W illiam s asserts that, bec ause of the rar ity of A ddiso n’ s disease, the district co urt c oul d no t a

ppr ec iate the nov el and c om ple x a lle ga tio ns r ai se d inhis co m pla int . H e ar gue s th at

an atto rn ey ’ s a ssi stanc e w oul d have a llo w ed him to gather expert testim ony

regar ding the nature of A ddiso n’ s disease. H e further state s th at be ca use he did

not have thi s a ssi stanc e the dis tr ic t c ourt w as able to

“ use the la ck

of e xpe rt te sti m ony

a s ashi el d to pr ote ct

it s de nia l of

am oti on f

or co un se l an d t he n a s a s wor d t o s la y th e in di ge ntpl ai nt iff’s cas e.” 2 W ill iam s m isunde rs tands the ty pe of f ac tua l c om

ple xity that m er its the ap poi ntm en t of

an atto rn ey . A lth oughA ddi son’ s di se as e is r ar e an d di ff ic ult to unde rs tand, the f

ac tua l i ssu es in thi s c as e w er e es ta bli she d. W ill iam s su

bm itt ed a phy sic ian’ s le tte r statin g th at ade lay in adm ini ste ri ng h is m ed ic at ionc oul d c au se se ri ous ne ga tiv e he al th e ff ec ts and p oss ibl y

de ath. T he onl y

iss ue is w he the r the7

delay s in his rec eiving h is m edication vio lated § 1983 . Moreover, W illiam s has dem onstrated his abi lity

to adequately

present his own. S ee F owler, 899 F.2d at 10 96 . Becau se th is cas e d oe s n otpre se ntno ve l o r co m pl ex is su es of f

actor l aw, w e fi nd n o a

buse of dis cr et ionin the de nia l of W ill iam s’ m oti ons fo r the ap poi ntm en t of

c ouns el . W e re vie wde nov o th e dis tr ic t c ourt’ s gr an t of sum m ar y j udgm en t, a ski ng w he the r, w he n vi ew ing the r ec or d inthe li ght m ost f av or ab le to the non m ovi ng party , age nui ne iss ue of

m at er ia l f

ac t e xis ts a s to w he the r the de fe ndants ’ a ct ion s co nst itute d de lib er at e ind if fe re nc e to W ill iam s’ se ri ous m ed ic al ne ed s. S te el e, 87 F. 3d at 126 9. “ If the e vidence is m erely colorable or is not sign ificantly probative, summ ary j udgm ent m ay

be granted.” A nderson v. Liberty Lobby , I nc., 477 U.S . 242, 249 –50, 106 S . Ct . 250 5, 251 1 ( 1986 ). “ Me dic al tr eatm en t vi olate s th e [E ] igh th [ A ] m en dm en t on ly w he n it is ‘ so g ro ssl y

inc om pe te nt, ina de quate , or excessive as to shock th e conscience or to be intolerable to fundam ental fairness. ’ ” Harri s v . Thi gp en , 94 1 F .2d14 95 , 15 05 (11 th Cir . 19 91 ) (ci ta ti on om it te d) . The E ight Am endm ent prohibi ts “ cruel and unusual pu nishm ents.” I t ne ith er m an da te s c om fo rt ab le pr iso ns, nor tol er at es inhum an e one s. F ar m er v. Br ennan, 511 U . S. 825 , 834 , 114 S . Ct . 197 0, 197 7 ( 1994 ). A ft er ape rs on i s incarce rated, “ onlythe ‘ unnecessary and wanton infliction o f pain’ . . . constitut es8

cr ue l and unusu al pun ish m en t f or bid de n by

the E igh t A m en dm en t. ” F ar ro wv. W es t, 320 F . 3d 1 235, 124 2 ( 11th C ir . 200 3) ( quot ing I ngr ah am v. Wri ght , 430 U . S. 651 , 670 , 97 S . Ct . 140 1 ( 1977 )) . Apr iso n of fi ci al e nga ge s inthe

“ unnecessary

and wanton infliction o f pain” by showing “ deliberate indiffer ence” to an inm ate’ s “ serious m edical needs.” E stelle v. G am ble, 429 U. S. 97, 104, 97 S. Ct . 285 , 291 ( 1976 ). D el ibe rate ind if fe re nc e doe s no t e xis t whe re the pr iso n official inadvertently

or negligentlyfails to provide adequate m edical car e. Id. at 10 5– 06 , 97 S. Ct. 2 85 . T he standard

that W ill iam s m

ust m ee t t o sh owthat Arn old and K enne dy ac te d de lib er at el y

ind if fe re nt t o hi s se ri ous m ed ic al ne ed s ha s tw o c om pone nts , one obj ec tiv e an d on e subj ec tiv e. T ay lor v. A dam s, 221 F . 3d 1 254, 125 8 ( 11th Cir. 2000 ). T o satisfy

the objec tive com

ponent , W illiam s m

ust present evidence of an obje ctively

serious m edical need. Id. T hat need m ust be serious eno ugh th at a fai lu re t o a dd res s i t co ns ti tu te s a “ cru el an d u nu su al de pr iv at io n” th atdi sa ll ows the “ m ini m al c ivi liz ed

m ea sur e of

li fe ’ s ne ce ssi tie s. ” I d. ( quot ing W ils on v . Se ite r, 501 U . S. 294 , 298 , 111 S . Ct . 232 1, 232 4 ( 1991 )) . T o satis fy the sub j ec tiv e co m pone nt h e m

ust of fe r ev ide nc e that Arn old

and K enne dy

w er e de lib er at el y ind if fe re nt t o hi s ob

j ec tiv el y se ri ous m ed ic al ne ed . I d. D el ibe rate ind if fe re nc e is conduct th at is m ore deliberate than accidental inadequacy , negligence, or even9

m al pr act ic e. Id . at 1 25 7. W illiam s contends that summ ary j udgm ent for A rnold and Kennedy wa s im pr ope r, and tha t the dis tr ic t c ourt sh oul d have gr an te d sum m ar y j udgm en t i n hi s favor beca

use the und isput ed evidence shows that the defendants knew that he: (1 ) ha d A ddi son’ s di se as e; ( 2) suf fe re d be ca

use he som et im es w en t w ith out his m ed ic at ion ; and ( 3) vis ite d adoc tor a t l ea st thr ee ti m es be ca

use he did

not ti m el y rece iv e th e m ed ic at io n. R e g ar d i n g th e o b

j e c t i v e c o mp o n e n to f

th e E i g h th A me n dme n tt e s t , Wi l l i a ms co nte nds that the re is no g enuin e iss ue of m at er ia l f

ac t c onc er

nin g hi s se ri ous m ed ic al ne ed

be ca use ne ith er

party dis put es that A ddi son’ s di se as e can be f at al if not prop erly

treate d. T he m agistrate, however, concluded that th e existence of a se ri ous m ed ic al ne ed

w as not e sta bli she d m er el y

by W ill iam s’ dia gnos is w ith Addison’s disease. Instead, the m agistrate determ ined that the relevant inqu iry w as w he the r W ill iam s’ c ondi tio n duri ng the ti m e he w en t w ith out m ed ic at ion co ns ti tu te d aser io us m ed ic al ne ed . T he re is no n ee d f

or us t o de te rm ine the c or

re ctne ss tha t de te rm inatio n because, even if W illiam s m et the obje ctive com ponent , he has failed to create a ge nui ne iss ue of

m at er ia l f

ac t a bout the sub j ec tiv e co m

pone nt. T o e sta

bli sh this co m pone nt, W ill iam s m

ust e sse nti al ly

sho wthat Arn old

and K enne dy

int en de d to10

puni sh h im

by de pr ivi ng h im

of his m ed ic ine . S ee T ay lor , 221 F . 3d at 12 57 ([ T ] he re m

ust be asub j ec tiv e int en t by

the pub lic of

fi ci al s invol ve d to use the suf fi ci en tly se ri ous de pr ivatio n inor de r to puni sh. ”) ; se e al so R hode s v. Chapm an, 452 U. S. 337, 347, 101 S. Ct. 2392 , 2399 (1981) (“ If the pain inflicted is not form ally

m eted out as pun ishm ent by the statute or the sentencing judge, som e m ental elem ent m

ust be attributed to the inflicting officer befor e it can qua lif y [ as an E igh t A m en dm en t vi olatio n] . ”) . H ow ev er , W ill iam s c ane sta bli sh the sub j ec tiv e co m

pone nt b y

sho w ing that Arn old

and K enne dy

a ct ed w ith

“ de lib er at e ind if

fe re nc e” to his se ri ous m ed ic al ne ed . I d. ( quot ing E ste lle , 429 U . S. a t 10 5, 97 S . Ct . a t 29 1) . H e can sh owde lib er at e ind if fe re nc e by dem onstrating that (1) A rnold and Kennedy subjectively

knew that a “ subs tantial ri sk o f harm

e xis t[ ed ] , ” (2 ) the y

dis re gard ed

that su bst an tia l r isk , and ( 3) the ir co nduc t i n d is reg ard in g t ha t ri skwas m or e d el ib erat e th an m ere n eg li ge nc e. Mc E lli gott, 182 F . 3d 1 148, 125 5 ( 11th C ir . 199 9) . “ [K ] now le dge of the ne ed f or m ed ic al c ar e an d in te nti ona l r ef usa l t o pr ovi de that c ar e co nst itute de lib er at e indifference. ” H ill v. D ekalb Reg’ l Youth Det. Ctr. , 40 F. 3d 11 76, 1186 (11t h Cir. 1994 ) (quot at ion s and c itatio n om itt ed ), abr ogate d onoth er gr ound s, H ope v. Pe lz er , 536 U . S. 730 , 122 S . Ct . 250 8 ( 2002 ). “ T he tol er ab le le ngth of de lay in pr ovi din g m ed ic al a tte nti on d ep en ds o n th e na tur e of the m ed ic al ne ed

and the11

reason for the delay .” H arris v. Cowe ta County , 21 F. 3d 38 8, 393–94 (11th Cir. 19 94 ). The m agistrate did not err in concludin g that, even assum ing W illiam s had de m onstrate d ase ri ous m ed ic al ne ed , his c la im f ai le d be ca

use he of fe re d no ev id en ce t ha t ei th er Arn ol d o r Ken ne dy actedwit h d el ib erat e in di ffer en ce. See Hi ll , 40 F.3dat 1 18 6. He was in th e jail fro m Feb ru ary 19 99 to Aug us t 2 00 0. H is m ed ic al r eg im enc onsi ste d of m ult ipl e pr es cr ipt ionm ed ic at ion s th at he too k several tim es a day . His evidence shows that he som etim es m issed a day or m ore of his m ed ic ine be ca

use the j ai l’ s st af

f fa ile d to r ef

ill his pr es cr ipt ion s be fo re he r ano u to f me d i c i n e . H e h a da l l o f

h i s me d i c a t i o nmo r e th a t9 2 p e r c e n to f th e t i me he was i n Wil co x C ou nt y jail . T he lon ge st t im e he w en t w ith out his m ed ic at ion w as one se ve n- day

pe ri od, and e ve n th enhe r ec ei ve d aphy sic ian’ s c ar e an d suf fe re d no la sti ng p hy sic al harm f ro m the de lay . S ee H ill , 40 F . 3d at 11 58 (“ Whe re the de lay

r es ult s inan inm at e’ s su ff er ing ali fe -l ong handi ca

p or perm anent loss, the m edical need is considered serious.”). E ve ry ti m e he a ske d to se e a doc tor , he w as take n to se e one . O ne the tw o oc ca sio ns whe n W ill iam s sa id i t was anem erg en cy , he was imm ed ia te ly tak en to see a do ct or . A dm itt ed ly , the c au se of

the de lay s w as f

ai lur e by the j ai l’ s st af

f to r etri ev e his r ef ill s be fo re W ill iam s r anout of m ed ic ine . B ut, the j ai l’ s ov er al l e ff ort i n12

keeping up with W illiam ’ s four prescriptions and its response to his request to see a doctor when problem s arose w as rea sonable. “ [W ] hen a prison inm ate has rece ived m edical car e, courts hesitate to find an Eighth Am endm ent violatio n.” Wa l dr o p v . E v an s , 8 7 1 F . 2 d1 0 3 0 , 1 0 3 5 ( 1 1 th C i r . 1 9 8 9 ) . F u rth e rmo r e , Wi l l i a ms of fe rs no e vid en ce ind ic at ing that the de lay s c anbe a ttr ibu te d to A rn old ’ or Ke nnedy ’ s deliberate indiffere nce. Ther e is no sub stantial evidence that they or de re d, c ondo ne d, or

w ill fu lly ign or ed the de lay s. S ee T ay lor , 221 F . 3d at 12 57 . A t be st, the de lay s su gge st tha t the j ai l’ s m ethods of pr oc ur ing m ed ic ine f

ro m the loc al pharm ac y

ne ed a dj ust ing . E ve n so , thi s w oul d be ne gli ge nc e, not the de li be rat e in di ffer en ce fo rb id de n b y th e Eig ht h Am en dm en t. Id . at 1 25 7– 58 . Furtherm ore, the prom

pt response to W illiam s’ requests to see a doctor negates an y in fere nc e th atArno ldor Ke nn edy were d el ib erat el y

in di ffer en t t o h is hea lt h. Be ca use the dis tr ic t c ourt pr ope rl y gr an te d th e de fe ndants ’ m oti on f or sum m ar y j udgm en t, it

f oll ow s th at

it c or re ct ly de nie d W ill iam s’ m oti on f or sum m ar y j udgm en t, and w e ne ed

not a ddr es s or

the de fe ndants ’ a ff

irm at ive de fen se s. AFFIRMED.