Opinion ID: 4204685
Heading Depth: 3
Heading Rank: 5

Heading: Jail Nursing Staff

Text: The majority of the interactions between Richmond and the Jail medical staff involved members of the nursing staff who were responsible for Richmond’s initial screenings as well as the implementation of the doctors’ prescribed plan of treatment. Richmond alleges that the nursing staff failed to provide her with the pain medication and dressing changes ordered by the Jail physicians. She also argues that the nursing staff is complicit in the failure to provide psychiatric medication in a timely manner. The Defendants counter by arguing that Richmond has failed to identify any individual who refused to provide any part of her prescribed treatment and that the nursing staff was not responsible for prescribing her psychiatric medication. Seven different members of the nursing staff provided Richmond dressing changes at one point or another throughout her incarceration, Nurse Fowler, Nurse Hawk, Nurse Lonberger, Medical Assistant Allen, Nurse Shoulders, Nurse Wilson, and Nurse Burnett. 4 The latter two are not parties to this suit, so we discuss only the actions of the remaining five. Nurse Fowler last encountered Richmond on December 26, 2012, the day after her arrest. At that point, there is nothing in the record to suggest that Nurse Fowler knew or should have known of the risk that the treatment ordered by the doctor for Richmond would not be implemented as prescribed. As such, the district court properly dismissed Richmond’s claim of deliberate indifference against Nurse Fowler, as it relates to the treatment of Richmond’s burn wound. Nurse Lonberger similarly did not treat Richmond after December 30, 2012, at which point Richmond’s treatment had essentially been implemented as ordered. Thus, there is nothing in the record to suggest that Nurse Lonberger was or should have been aware of the risk that Richmond’s treatment may not have been provided as prescribed at that point. However, unlike Richmond’s claim against Fowler, Richmond specifically alleges that Nurse Lonberger otherwise violated her Eighth Amendment rights on one occasion when Nurse Lonberger 4 Medical Assistant Danielle Allen is included in this count even though she is not a nurse because these claims do not involve duties exclusive to nurses as compared to medical assistants. No. 16-2560 Richmond v. Huq, et al. Page 16 intentionally scrubbed her wound so hard as to cause severe pain while cleaning it. One can assume that some pain may be expected while cleaning a wound such as this one, but there is a question of fact as to whether Nurse Lonberger’s conduct was intentional to cause unnecessary pain to Richmond. While the Court in Asplaugh suggests that we should be hesitant to second guess Nurse Lonberger’s medical judgment that some pain would be necessary, 643 F.3d at 169, Richmond alleges that Nurse Lonberger was intentionally causing her unnecessary pain, not simply that her method of cleaning may have constituted inadequate treatment. A reasonable jury could find that intentional scrubbing of a serious wound to cause a prisoner unnecessary pain could be characterized as “wanton infliction of unnecessary pain,” in violation of the Eighth Amendment. See Estelle, 429 U.S. at 104 (“The infliction of such unnecessary suffering is inconsistent with contemporary standards of decency . . . .”). Summary judgment is thus inappropriate as to Richmond’s deliberate indifference claim against Nurse Lonberger, given the factual dispute that remains. The district court properly dismissed the claims against Nurse Williams and Nurse Coleman. Nurse Williams only interacted with Richmond as a triage nurse prior to Richmond’s visit with Nurse Shoulders and Dr. Clafton. Nurse Williams would not have cleaned and changed Richmond’s burn wound only for that dressing to be removed and the wound to be examined during the subsequent visit with the doctor. Nurse Coleman only saw Richmond on January 29, 2013, after Richmond received supplies to self-clean her wound. Further, Nurse Coleman only served in an administrative role and would not have cleaned and dressed a wound prior to Richmond’s visit with Nurse Shoulders. The record simply does not support a finding that either Nurse Williams or Nurse Coleman disregarded a risk to Richmond’s health. Rather, they both acted within their limited role of preparing Richmond for her scheduled examinations with the responsible medical party. However, by the time Nurses Hawk and Shoulders had their last interactions with Richmond, there was evidence from the record to support a claim that they were or should have been aware that Richmond’s treatment was not being implemented as prescribed. Nurse Hawk changed Richmond’s dressing on December 27 and 31, 2012, as well as January 1, 2, and 4, 2013. Richmond did not have her dressing changed on January 3, 2013, because she had a court No. 16-2560 Richmond v. Huq, et al. Page 17 appearance at the time Nurse Hawk attempted to change her dressing. However, there is no indication in the record that Nurse Hawk attempted to change Richmond’s dressing at a later time or attempted to notify any nurses on the next shift regarding the missed dressing change. In addition, Richmond’s chart at the time indicated that she had not had a dressing change on December 285 or 29, 2012. From this, a reasonable jury could find that Nurse Hawk knew that daily dressing changes were prescribed and were important to Richmond’s healing process, but that they were not being implemented as ordered. A reasonable jury could also conclude that Nurse Hawk, knowing all of this, nevertheless disregarded the risk that Richmond’s burn would not heal properly when she failed to ensure that Richmond’s dressing was changed on January 3. At that point, Richmond had already started to complain about the Jail’s failure to treat her as prescribed. By the time Nurse Shoulders saw Richmond for the first time, Richmond’s medical records showed that the Jail medical staff had failed to change her dressing on six different occasions. Further, there is some dispute over whether Richmond’s dressing was changed the day she saw Nurse Shoulders on January 11. Nurse Shoulders testified that she changed Richmond’s dressing herself. However, Richmond disputes this and there is no notation in the record reflecting a dressing change on that day. In either case, there is evidence in the record from which a jury could find that, like Nurse Hawk, Nurse Shoulders consciously disregarded a serious risk that Richmond’s plan of treatment would not be implemented as prescribed, which is enough to defeat summary judgment on this claim. The grant of summary judgment in favor of Medical Assistant Allen was inappropriate as a genuine issue of material fact exists. Allen changed Richmond’s dressing on January 5, 7, 9, 16, 20, and 21, 2013. There is no reason given for the staff’s failure to change Richmond’s dressing on January 6, 8, 13, 14, 15, 17, or 18. There is no evidence in the record that Allen, who changed Richmond’s dressing most frequently during this two-and-a-half week period, made any attempt to address the inconsistent treatment. In fact on January 10, even though Richmond had not received a dressing change on January 6 or 8, Allen did not provide a dressing change for Richmond because Richmond was in court during Allen’s shift. There is nothing in 5 Dr. Huq testified that she changed Richmond’s dressing during her visit the day of the 28th, but this is not reflected on Richmond’s chart or anywhere else in the record. No. 16-2560 Richmond v. Huq, et al. Page 18 the record to suggest that Allen attempted to provide a dressing change before or after Richmond’s court appearance or that Allen attempted to contact the next shift of nurses or medical assistants to let them know that Richmond would be in need of a dressing change after returning from court. And again, Richmond had started complaining of and documenting problematic medical treatment by January 7, right around the time Allen took over the prescribed dressing changes. From this record, a reasonable jury could find that Allen was aware of that Richmond was suffering from a serious medical need, requiring treatment in the form of daily dressing changes, that she was aware of the risk that Richmond faced in not receiving daily dressing changes, and that she disregarded that risk on multiple occasions. Additionally, Richmond alleges that Nurses Fowler, Hawk, and Shoulders were deliberately indifferent to Richmond’s serious psychiatric needs by failing to provide her with her psychiatric medication in a timely manner. Specifically, she alleges that these nurses were aware of her history of mental illness and yet made no effort to verify her existing medications with either her outside doctor or an outside pharmacy. Nurse Fowler examined Richmond on the day she was brought into the Jail. During this examination, Richmond informed Nurse Fowler that she had been taking Prozac and Xanax, that her last dosage was December 25, 2012, and that she was being treated by Team Mental Health. Although Nurse Fowler did recommend that Richmond be seen by a psychiatric social worker, the record does not show any attempt to verify Richmond’s statement, either by contacting the prescribing pharmacy or by contacting Team Mental Health. Nurse Fowler defends this failure by explaining that Richmond was admitted late at night, at which point her pharmacy and doctor’s office would have been closed. However, Nurse Fowler did not attempt to verify Richmond’s prescriptions at a later date and left no notation requesting that a nurse on a subsequent shift perform this verification. Nor is there any indication that Nurse Fowler attempted to leave such instructions by another method. Nurse Hawk also had extensive interactions with Richmond between December 27, 2012 and January 4, 2013. There is a question of fact as to whether Nurse Hawk ever reviewed Richmond’s chart for the purpose of ascertaining her medical history or whether she was otherwise aware of Nurse Fowler’s notation regarding Richmond’s prior prescription history. There is no evidence that Nurse Hawk ever attempted to verify Richmond’s claims, nor that she No. 16-2560 Richmond v. Huq, et al. Page 19 requested that another nurse attempt to do so. On this record, a reasonable jury could find that Nurses Fowler and Hawk were aware of Richmond’s serious psychiatric needs and disregarded the risk that she may needlessly suffer by going without her psychiatric medication when they decided not to verify her claims with an outside pharmacist or doctor’s office. Thus, summary judgment on the claims against Nurses Fowler and Hawk relating to Richmond’s psychiatric treatment is not appropriate as there are genuine issues of material fact. However, the same cannot be said for Nurse Shoulders. She first interacted with Richmond on January 11, the day of Richmond’s appointment with Dr. Hinchman. For the reasons discussed relating to Richmond’s claims against Dr. Clafton for deliberate indifference to her serious psychiatric needs,6 the district court properly granted summary judgment in favor of Nurse Shoulders regarding Richmond’s claims of deliberate indifference to her serious psychiatric needs.