Opinion ID: 2827979
Heading Depth: 3
Heading Rank: 2

Heading: The District Was Deliberately Indifferent

Text: to Suggs’s Needs Harvey suggests the district court erred when it applied the subjective indifference standard from Farmer v. Brennan, 511 U.S. 825 (1994), because that case involved a convicted inmate. In his view, individuals like Suggs “‘who have been involuntarily committed are entitled to more considerate treatment and conditions of confinement than criminals whose conditions of confinement are designed to punish.’” Harvey’s Br. 38 (quoting Youngberg, 457 U.S. at 321–22). When considering whether the denial of treatment to an involuntarily committed patient violated due process, “liability may be imposed only when the decision by the professional is such a substantial departure from accepted professional judgment, practice, or standards as to demonstrate that the person responsible actually did not base the decision on such judgment.” Youngberg, 457 U.S. at 323; see also Patten v. Nichols, 274 F.3d 829, 842 (4th Cir. 2001) (applying the Youngberg standard to an involuntarily committed patient’s claim that his due process rights were violated). But see Chapman v. Keltner, 241 F.3d 842, 845 14 (7th Cir. 2001) (applying the deliberate indifference standard to a denial-of-medical care claim asserted by a pretrial detainee). We need not decide that issue as Harvey prevails even under the deliberate indifference standard. To establish a constitutional violation under that standard, Harvey must show that the District was deliberately indifferent to Suggs’s serious medical needs. An official is deliberately indifferent when she has “subjective knowledge of the [plaintiff’s] serious medical need and recklessly disregard[s] the excessive risk to [his] health or safety from that risk.” Baker, 326 F.3d at 1306. The District does not dispute that Suggs’s MRDDA case manager, Jenkins, was a District official. See District’s Reply Br. 1. The evidence establishes that Jenkins knew of Suggs’s medical needs and recklessly disregarded an excessive risk to Suggs’s health. The record shows that, as of March 1996, Jenkins was aware that Suggs was experiencing a rapid decline in motor function, that he was no longer able to feed himself, and that his physical therapist recommended he receive a neurology consultation to determine the cause of the deterioration. Yet she neither noted this recommendation in Suggs’s IHP, nor took necessary steps to ensure that Suggs visited a neurologist. It was only after the Healthcare Finance Administration issued a deficiency notice to Symbral for failing to promptly schedule the recommended appointment that Suggs finally met with a neurologist in March 1997, at least one year after Jenkins learned of the recommendation. Jenkins’s failure to ensure that Suggs received all necessary medical treatment continued. On March 7, 1997, the neurologist recommended that Suggs get an MRI “ASAP.” Suggs did not get an MRI until April 18, 1997, 43 days after the recommendation. The neurologist then 15 requested that Suggs schedule a follow-up appointment for May 1, 1997. Symbral did not bring Suggs back to the neurologist until June 27, 1997, 58 days after the request. At that meeting, the neurologist recommended that Suggs visit a neurosurgeon to determine whether surgery was a viable option. The appointment with the neurosurgeon did not occur until November 11, 1997, 138 days after the request. At the appointment, the neurosurgeon recommended that Suggs receive a laminectomy “in the next few weeks.” The neurologist reiterated that the surgery needed to “be scheduled ASAP.” However, Suggs’s team, which included Jenkins, waited four months and then decided to get a second opinion. Suggs was not taken to the doctor for a second opinion until April 30, 1999, 408 days after the team decided to seek a second opinion and 536 days after the first neurosurgeon recommended that surgery be performed in a few weeks. Predictably, the second neurologist recommended that Suggs get a laminectomy. Predictably, Suggs never received the surgery. In short, Jenkins repeatedly failed to monitor Suggs’s care and ensure that he was receiving necessary medical treatment. We conclude that under these facts Jenkins acted with deliberate indifference toward Suggs’s medical needs in violation of his substantive due process right to receive necessary medical treatment.