Opinion ID: 806090
Heading Depth: 3
Heading Rank: 2

Heading: Heebsh

Text: As with Pausits, Plaintiff has presented sufficient circumstantial evidence of the obviousness of the risk such that a reasonable jury could conclude that Heebsh was aware of the substantial risk to Parsons’s health if it can be determined that Heebsh knew Parsons did not have his medication at the time she examined him. Moreover, Parsons submitted the testimony of Dr. Sheiner, who stated that a lack of Dilantin is “a dire condition 24 hours after missing a dose.” If Heebsh did not know Parsons was without his medication, however, she would also be unaware of the substantial risk. There is again conflicting evidence on this point. Heebsh testified that she was “sure [Parsons] had his medication on [August 27],” the day she met with him, because “[h]ad he not had his medication, [she] would have put ‘start today’” on her report and prescription order. Heebsh also argues that the notation on her report that Parsons stated he was “taking meds as directed” indicates that she believed he had his medications. There is sufficient conflicting evidence of this account such that one could reasonably conclude that Heebsh was aware that Parsons did not have his medication. First, Heebsh also noted - 14 - No. 10-1584 and 11-1992 Parsons v. Caruso on her report that Parsons was “histrionic with flight of ideas, and a poor historian.” This notation conflicts at least somewhat with Heebsh’s argument that Parsons’s statement that he was “taking meds as directed” would have been given weight by Heebsh during her meeting with him. Second, Pausits testified that Heebsh would conduct a “chart review” as “part of [her] job,” and that this chart review would include Pausits’s medical intake record, which indicated that Parsons did not have his anti-seizure medication. Pausits also testified about her general practice, which was to “write it on [Heebsh’s] schedule and put the inmate’s name and number, inmate so-and-so rode in, has no medications.” Third, Dr. McCarthy, who met with Parsons shortly after Heebsh, testified that he was aware that Parsons “had been sent and his medications had not arrived with him” because he “was notified by the treatment team.” This is sufficient evidence to create a factual dispute as to whether Heebsh was aware of a substantial risk to Parsons. There is also sufficient evidence for a reasonable jury to conclude that Heebsh then disregarded that risk and acted with deliberate indifference in delaying providing Dilantin to Parsons. Viewing the evidence and drawing all reasonable inferences in favor of Plaintiff, Heebsh (1) knew Parsons did not have his Dilantin, either through her normal chart review or a note from Pausits; (2) did not immediately provide Dilantin, which was available in the “stock meds” or doctor’s box; and (3) did not write “start today” on the order, ensuring that the Dilantin would come from PharmaCorr and at least one day would pass before Parsons received his Dilantin.3 While “[d]eliberate 3 Heebsh argues that she indicated a start date of August 26, which unequivocally gave instructions that Parsons should be given his medication that very same day. This argument conflicts with Heebsh’s own testimony, however. She explained that, absent a “start today” note, the nurses “would have sent the order to PharmaCorr.” Absent a “start today” note and assuming Heebsh was - 15 - No. 10-1584 and 11-1992 Parsons v. Caruso indifference ‘entails something more than mere negligence,’” Blackmore, 390 F.3d at 895-96 (quoting Farmer, 511 U.S. at 385), in this case there is evidence that a lack of Dilantin for a seizure sufferer is “a dire condition 24 hours after missing a dose.” By ordering Dilantin from the out-ofstate company instead of securing it locally or immediately on-site, Heebsh effectively ensured that Parsons went without his anti-seizure medication for over two days, at the least, and possibly longer if there was any delay in receiving the medication from PharmaCorr. This delay in administering Dilantin, caused by Heebsh’s conscious choice to order the medication off-site, is comparable to the facts in many of the cases involving Dilantin. See, e.g., Hudson, 148 F.3d at 861 (denying summary judgment for officers and nurse who allegedly failed to provide Dilantin to a prisoner, resulting in his failing to receive the medication for fourteen days); Johnson v. Hay, 931 F.2d 456, 458 (8th Cir. 1991) (denying summary judgment for pharmacist who refused to fill Dilantin prescription based on his view that the medication was “not appropriate”); Neal v. Smith, 1994 WL 395747,  (D. Md. May 5, 1994) (denying summary judgment when plaintiff submitted evidence that officers failed to provide his anti-seizure medication for ten days after being informed by prisoner of his health issues); Walker v. O’Leary, 1986 WL 6428,  (N.D. Ill. May 28, 1986) (denial of anti-seizure medication for seven days); Mitchell v. Chester Cnty. Farms Prison, 426 F. Supp. 271, 272-73 (E.D. aware Parsons did not have his medication, Heebsh would have written the August 26 start date knowing that it would be at least August 27 before the Dilantin arrived from PharmaCorr and was administered to Parsons. - 16 - No. 10-1584 and 11-1992 Parsons v. Caruso Penn. Dec. 30, 1976) (denial of anti-seizure medication for four days after repeated requests). The facts in this case plausibly demonstrate deliberate indifference on the part of Heebsh.4