Opinion ID: 786604
Heading Depth: 1
Heading Rank: 4

Heading: Spruill's Eighth Amendment Claims

Text: 61 Because there is no exhaustion or procedural default bar to Spruill's suit, we turn to the merits of his Constitutional claims. We have on several occasions discussed the conditions under which deprivation of medical treatment violates a prisoner's Eighth Amendment right not to be subjected to cruel and unusual punishment. Only `unnecessary and wanton infliction of pain' or `deliberate indifference to the serious medical needs' of prisoners are sufficiently egregious to rise to the level of a constitutional violation. White v. Napoleon, 897 F.2d 103, 108-09 (3d Cir.1990) (quoting Estelle v. Gamble, 429 U.S. 97, 103, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976) (quoting Gregg v. Georgia, 428 U.S. 153, 96 S.Ct. 2909, 49 L.Ed.2d 859 (1976))). Allegations of medical malpractice are not sufficient to establish a Constitutional violation. See id. (citing Estelle, 429 U.S. at 106, 97 S.Ct. 285); Monmouth County Correctional Institutional Inmates v. Lanzaro, 834 F.2d 326, 346 (3d Cir.1987) ( MCCII ) (citing Estelle, 429 U.S. at 106 & n. 14, 97 S.Ct. 285; Gittlemacker v. Prasse, 428 F.2d 1, 6 (3d Cir.1970)); see also Daniels v. Williams, 474 U.S. 327, 332-34, 106 S.Ct. 662, 88 L.Ed.2d 662 (holding that negligence is not compensable as a Constitutional deprivation). [M]ere disagreement as to the proper medical treatment is also insufficient. MCCII, 834 F.2d at 346 (citing Bowring v. Godwin, 551 F.2d 44, 48 (4th Cir.1977); Massey v. Hutto, 545 F.2d 45, 46 (8th Cir.1976) (per curiam)). 62 As we explained in White, the Estelle deliberate indifference to serious medical needs standard is clearly met when a doctor is intentionally inflicting pain on [a] prisoner[]. 897 F.2d at 109. In MCCII, we identified several other scenarios that satisfy Estelle. Most relevant to this case are (1) [w]here prison authorities deny reasonable requests for medical treatment ... and such denial exposes the inmate `to undue suffering or the threat of tangible residual injury,' MCCII, 834 F.2d at 346 (quoting Westlake v. Lucas, 537 F.2d 857, 860 (6th Cir.1976)), and (2) where `knowledge of the need for medical care [is accompanied by the] ... intentional refusal to provide that care,' id. (quoting Ancata v. Prison Health Servs., 769 F.2d 700, 704 (11th Cir.1985)) (alterations in original). 63 The Estelle standard `requires deliberate indifference on the part of the prison officials and it requires the prisoner's medical needs to be serious.' Id. (quoting West v. Keve, 571 F.2d 158, 161 (3d Cir.1978)). Spruill's complaint satisfies the second prong. First, his back condition itself has allegedly required significant and continuous medication, and has caused him excruciating pain. Second, within the brief period described in his complaint, Spruill claims to have fallen or collapsed from the pain twice (first on May 4, and again on May 9), exposing himself to further injury. The extreme pain and real possibility of permanent injury could qualify Spruill's condition as a serious medical need. Naturally, this will need to be fleshed out with further evidence (e.g., expert medical testimony), but at the motion-to-dismiss stage, the complaint is certainly adequate in this respect. The closer question is whether Spruill has alleged facts supporting the inference that Gooler, Dr. McGlaughlin, and Brown were deliberately indifferent (or intentionally malicious) with respect to his condition. For reasons that will become apparent, we treat Gooler first, and then Dr. McGlaughlin and Brown together. A. Claims Against Gooler 64 Durmer v. O'Carroll, 991 F.2d 64 (3d Cir.1993), resembles the case at bar in that the plaintiff-prisoner (Durmer) sued both medical and non-medical prison officials. With respect to the non-medical prison officials, Barker and Fauver, we explained: 65 [W]e believe that summary judgment was proper with respect to defendants Barker and Fauver. The only allegation against either of these two defendants was that they failed to respond to letters Durmer sent to them explaining his predicament. Neither of these defendants, however, is a physician, and neither can be considered deliberately indifferent simply because they failed to respond directly to the medical complaints of a prisoner who was already being treated by the prison doctor. 66 Id. at 69 (footnote omitted). Although Durmer was decided at the summary judgment stage, its holding can be readily imported into the motion-to-dismiss stage: If a prisoner is under the care of medical experts (Dr. McGlaughlin and Brown in this case), a non-medical prison official will generally be justified in believing that the prisoner is in capable hands. This follows naturally from the division of labor within a prison. Inmate health and safety is promoted by dividing responsibility for various aspects of inmate life among guards, administrators, physicians, and so on. Holding a non-medical prison official liable in a case where a prisoner was under a physician's care would strain this division of labor. Moreover, under such a regime, non-medical officials could even have a perverse incentive not to delegate treatment responsibility to the very physicians most likely to be able to help prisoners, for fear of vicarious liability. 67 Accordingly, we conclude that, absent a reason to believe (or actual knowledge) that prison doctors or their assistants are mistreating (or not treating) a prisoner, a non-medical prison official like Gooler will not be chargeable with the Eighth Amendment scienter requirement of deliberate indifference. Thus dismissal of Spruill's claims against Gooler after the point at which Spruill was first under medical care is appropriate because Spruill bears the burden of proving (and hence pleading) facts supporting the defendants' mental states, see Singletary v. Pa. Dep't of Corr., 266 F.3d 186, 192 n. 2 (3d Cir.2001), and he has failed to so plead with respect to Gooler. 12 68 With respect to Spruill's claims against Gooler in the period before he was under medical care-i.e., from his May 2 arrival at SCI-Coal, through his fall and face injury on May 4, to Dr. McGlaughlin's first visit to his cell on May 5-we also conclude that Spruill has not stated a claim against Gooler. First, Spruill did sign up for sick call on May 3, and he was seen by an (unidentified) nurse on May 4; hence he was receiving a minimal measure of medical attention. Second, Spruill does not allege that his condition was so dire and obvious that Gooler's failure to summon immediate medical attention on May 4 (and to instead let the sick call process run its course) amounted to deliberate indifference. The facts as Spruill himself describes them simply do not amount to the MCCII examples of deny[ing] reasonable requests for medical treatment ... expos[ing] the inmate to undue suffering or knowledge of the need for medical care coupled with an intentional refusal to provide that care. 834 F.2d at 346 (quotation marks and citations omitted). Therefore, Spruill has not stated a claim against Gooler and we will affirm the judgment of the District Court dismissing the suit against Gooler. B. Claims Against Dr. McGlaughlin and Brown 69 Though Spruill's allegations about Dr. McGlaughlin's and Brown's course of treatment (or nontreatment) pale next to the allegations in such cases as White, 897 F.2d 103, Spruill's complaint nonetheless sufficiently attributes a mental state of deliberate indifference (or worse) to both Dr. McGlaughlin and Brown. Especially when read in light of Alston, 363 F.3d at 233-34 & n. 6, several excerpts from Spruill's complaint suffice to make the point: Spruill asserts that due to Dr. McGlaughlin's and Brown's lack of proper medical care, the plaintiff was subjected to the possible risks of a permanent disability or an fatal or serious injury. We have held that the threat of tangible residual injury can establish deliberate indifference. MCCII, 834 F.2d at 346 (quoting Westlake, 537 F.2d at 860). Spruill further claims that Dr. McGlaughlin and Brown acted maliciously and sadistically, and that those actions were intended to inflict pain on the plaintiff without any medical justification. If proven, intentional conduct of this sort plainly makes out an Eighth Amendment violation. And finally, according to Spruill, Brown and Dr. McGlaughlin refused to examine him on multiple occasions and Dr. McGlaughlin instead accused him of playing games; when Dr. McGlaughlin ultimately did examine him, he twisted Spruill's legs as if he was trying to shape a pretzel, and Spruill repeatedly told Defendant McGlaughlin that the examination was causing additional pain to his back and leg. 70 In sum, Spruill has connected his factual allegations to the alleged mental states of Dr. McGlaughlin and Brown. That he believes their actions were not only deliberately indifferent, but malicious and sadistic, reinforces the sufficiency of his complaint. Since at this stage we are making no judgment about what actually happened, but only about the sufficiency of the pleadings, we must take Spruill's factual allegations, and the reasonable inferences therefrom, as true. We will therefore reverse the District Court's dismissal of Spruill's suit against Dr. McGlaughlin and Brown.