Opinion ID: 733438
Heading Depth: 3
Heading Rank: 1

Heading: The Need for Court Appointment of an Expert

Text: 21 Ledford next contends that the district court abused its discretion by failing to appoint an expert witness pursuant to Federal Rule of Evidence 706. Rule 706 states that [t]he court may on its own motion or on the motion of any party enter an order to show cause why expert witnesses should not be appointed. Fed.R.Evid. 706(a). We review the denial of a defendant's motion for appointment of an expert witness for abuse of discretion. United States v. Daniels, 64 F.3d 311, 315 (7th Cir.1995) (citation omitted). 22 We have not directly addressed whether the appointment of an expert is essential to establish deliberate indifference. 4 Generally, if scientific, technical, or other specialized knowledge will assist the trier-of-fact to understand the evidence or decide a fact in issue, a court will utilize expert witnesses. See Fed.R.Evid. 702. In the present case, the issue posed to the trier-of-fact was whether the state prison officials were deliberately indifferent to Ledford's serious medical needs. Therefore, in order to establish a violation of the Eighth Amendment, Ledford had to prove that the state prison officials displayed deliberate indifference toward his illness and that his illness was serious. See Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 291, 50 L.Ed.2d 251 (1976). 23 Given the particular factual issues in this case, determining deliberate indifference was not so complicated that an expert was required to establish Ledford's case. The test to decide whether a prison official acted with deliberate indifference is a subjective one. Duckworth v. Franzen, 780 F.2d 645, 652-53 (7th Cir.), cert. denied, 479 U.S. 816, 107 S.Ct. 71, 93 L.Ed.2d 28 (1986). A prison official cannot be found to be deliberately indifferent unless the official knows of and disregards a substantial risk to an inmate's health or safety. Farmer v. Brennan, 511 U.S. 825, 837, 114 S.Ct. 1970, 1979, 128 L.Ed.2d 811 (1994). The official must both be aware of the facts from which the inference could be drawn that a substantial risk of harm exists, and he must also draw the inference. Id. Generally, [t]he infliction [of punishment] must be deliberate or otherwise reckless in the criminal law sense, which means that the defendant must have committed an act so dangerous that his knowledge of the risk can be inferred or that the defendant actually knew of an impending harm easily preventable. Antonelli v. Sheahan, 81 F.3d 1422, 1427 (7th Cir.1996). Because the test for deliberate indifference is more closely akin to criminal law than to tort law, the question of whether the prison officials displayed deliberate indifference toward Ledford's serious medical needs did not demand that the jury consider probing, complex questions concerning medical diagnosis and judgment. The test for deliberate indifference is not as involved as that for medical malpractice, an objective inquiry that delves into reasonable standards of medical care. See Franzen, 780 F.2d at 652-53. 24 The jury in this case was instructed as to deliberate indifference as follows: 25 The first element of deliberate indifference is to be evaluated by a subjective analysis of the defendant or defendants and each defendant's state of mind. To act deliberately means to act intentionally; that is, knowingly and voluntarily and not because of mistake, inadvertence, or accident. 26 Deliberate indifference means that officials acted willfully and maliciously, or with reckless disregard of inmate's well-being with respect to plaintiff's medical care. A defendant acts recklessly when he disregards a substantial risk of danger that either is known to him or would be apparent to a reasonable person in his position. Recklessness is characterized by highly unreasonable conduct or a gross departure from ordinary care in a situation where a high degree of danger is present. 27 The court below gave this instruction after the jury heard defendants Nurse Feldmann and Dr. Musunuru state that they believed that discontinuing Zoloft produced no serious medical consequences. The jury was capable of evaluating the defendants' subjective belief in light of the court's deliberate indifference definition without the aid of an expert. In making its decision, the jury likely assessed the defendants' credibility as well. 28 The jury could likewise comprehend whether Ledford had serious medical needs without the aid of an expert. The trial court instructed: 29 The second element [of a deliberate indifference claim], serious illness, is to be examined objectively, focusing on the specific illness and the reasonable foreseeable consequences to the plaintiff of a deprivation or [sic] care, or delay in care, or inadequate care. A serious medical need can be defined as a life-threatening condition or as a condition carrying a risk of permanent impairment or extreme pain and suffering if left untreated. 30 During the time he was deprived of his medication, Ledford allegedly experienced nausea, dizziness, vomiting, a crawling sensation on his skin, unspecified emotional and mental regression, and depression. The symptoms which Ledford exhibited were not beyond a lay person's grasp. Most people are familiar with these experiences. The jury was aware of the court's instructions, the side effects displayed by Ledford, and the fact that Ledford was subsequently taken off Zoloft altogether. The issue of whether Ledford's illness was so severe that it was life-threatening or that it demanded a steady supply of Zoloft was not so complex that Ledford required court appointment of an expert. 31 Ledford claims that three other circuits have found that court appointment of an expert witness is necessary to prove deliberate indifference to a prisoner's serious medical needs. See Smith v. Jenkins, 919 F.2d 90, 93 (8th Cir.1990); Greason v. Kemp, 891 F.2d 829, 835 (11th Cir.1990); Jones v. Diamond, 636 F.2d 1364, 1382 (5th Cir.), cert. denied, 453 U.S. 950, 102 S.Ct. 27, 69 L.Ed.2d 1033 (1981). These cases are distinguishable from the one at hand. 32 Unlike Ledford's case where a jury returned a verdict of no deliberate indifference, the court in Smith found that the record was not sufficiently developed to determine the issue on the defendant's summary judgment motion, and therefore, the trial court should have deferred finding that there was no deliberate indifference. Smith, 919 F.2d at 93. The court reversed and remanded the case and instructed the trial court to study Smith's medical record. The court stated that if a dispute still existed as to Smith's diagnosis and treatment before and after incarceration, the court might only then appoint an independent psychiatrist or obtain a further opinion from Smith's previous physician concerning the nature of his prior treatment and the necessity of continuing any medication. Id. 33 Like Smith, Greason is distinguishable from the present case. In Greason, the plaintiff was a schizophrenic and suicidal prisoner who initially was housed at a mental health institution and subsequently transferred to a prison. Without reviewing the prisoner's file, a prison doctor examined him for a few minutes, concluded that he was stable, and discontinued his medication. The prisoner subsequently committed suicide. The court in Greason observed that often [w]hether an instance of medical misdiagnosis resulted from deliberate indifference or negligence is a factual question requiring exploration by expert witnesses. Greason, 891 F.2d at 835 (emphasis added). Medical misdiagnosis is distinguishable from a delay in examination. Moreover, the court in Greason did not order the appointment of an expert witness. 34 Finally, in Jones, although the plaintiffs won their underlying Eighth Amendment suit for cruel and unusual punishment, the court found that there was no deliberate indifference to the serious medical needs of any of the plaintiffs. The plaintiffs wanted reimbursement of fees paid for expert witnesses, not court appointment of expert witnesses. Jones, 636 F.2d at 1382. The court stated that without the ability to recover expert fees, plaintiffs, especially prison plaintiffs who are usually indigent, will be unable to bring civil rights cases. Id. The court spoke in very general terms and did not specifically address expert appointment regarding deliberate indifference. The Fifth Circuit in no way mandated that expert appointment was necessary for the proper presentation of a claim of deliberate indifference.