Opinion ID: 2818271
Heading Depth: 2
Heading Rank: 3

Heading: Wound Care

Text: In his appellate brief, Brauner argues that the doctors and wardens were deliberately indifferent in failing to supervise and train subordinates in proper wound care. As appellants note, Brauner does not dispute “that each doctor prescribed appropriate wound care[.]” Since the doctors, of course, do not normally personally change the patients’ bandages, Brauner must rely on a theory of supervisory liability. We have held that “doctors may not be held liable for § 1983 violations under a theory of respondent superior or vicarious liability, based upon claimed omissions by the nurses.” Stewart v. Murphy, 174 F.3d 530, 536 (5th Cir. 1999). A supervisor can, however, be held liable when he was himself deliberately 9 Case: 14-30801 Document: 00513120625 Page: 10 Date Filed: 07/17/2015 No. 14-30801 indifferent. In order to hold a defendant supervisor liable on such a theory, “the plaintiff must show that: (1) the supervisor either failed to supervise or train the subordinate official; (2) a causal link exists between the failure to train or supervise and the violation of the plaintiff’s rights; and (3) the failure to train or supervise amounts to deliberate indifference.” Smith v. Brenoettsy, 158 F.3d 908, 911-12 (5th Cir. 1998). Thus, Brauner would have to create a genuine issue of material fact that the doctors and wardens failed to supervise or train the subordinate officials. He would then have to create a genuine fact issue that the doctors knew the nurses were disregarding their orders, and the doctors neglected to correct this behavior knowing it posed an actual serious risk to Brauner’s health. His evidence is lacking on these points. Brauner asserts that the doctors “likely knew of the staff’s deficient wound care for several reasons.” These reasons are Brauner’s repeated complaints and “the prolonged period of time Plaintiff suffered with decubiti[.]” But Brauner’s own evidence shows that even if his wound care was occasionally sporadic, the doctors were active in managing it. There may be a fact issue as to whether the staff skipped some wound treatments, since the records are simply blank on those days. But this is not material to the deliberate indifference claim. Brauner’s extensive summary of dressing changes demonstrates that his dressings were changed frequently if not exactly as prescribed, and the doctors regularly changed the prescribed frequency in response to the up-and-down condition of the sores. Appellants’ testimony, which Brauner fails to contest in large part, demonstrates that his doctors wrote wound care orders, ordered cultures, placed him on vitamin and antibiotic therapy regimens to assist with healing, and escalated wound treatment strategies when necessary. That is, even if “subordinates were persistently delinquent in their duties,” as Brauner asserts, this is not the same as showing either that Brauner’s rights were violated or that the doctors 10 Case: 14-30801 Document: 00513120625 Page: 11 Date Filed: 07/17/2015 No. 14-30801 were deliberately indifferent as supervisors, both of which are required under Brenoettsy. Brauner relies on the magistrate judge’s “liberal construction” of his complaint as stating a claim for supervisory liability against the assistant wardens. Granting this liberality, however, the magistrate judge was also correct that these claims are not viable. As described above, Brauner does not establish that any right was violated. He was at all times prescribed medication and wound treatments, and he had access to showers that the prison regularly cleaned. The wardens could not have known about constitutional violations, since there were no constitutional violations. Further considering that the medical professionals made all treatment decisions, there is no basis on which to find the wardens liable. One piece of non-testimonial evidence adduced by the parties is noteworthy regarding the supervisory liability claim. In his request for administrative remedy, Brauner related that during evacuation due to flooding, nurses asked him whether his dressing had been changed. He said no. The nurses told Assistant Warden Coody, who ordered Nurse Chuck to return and do the dressing change. This is the exact opposite of supervisory deliberate indifference: it is an example of supervisory diligence correcting subordinate negligence.