Opinion ID: 777261
Heading Depth: 4
Heading Rank: 1

Heading: Deliberate Indifference Standard

Text: 27 The Eighth Amendment to the Constitution prohibits the infliction of cruel and unusual punishment. U.S. Const. amend VIII. The cruel and unusual punishment provision is invoked here as it applies to prisoners. As the decedent was involuntarily committed to NRPH for psychiatric treatment, he was similarly situated to a prisoner with regard to the Eighth Amendment right to medical care. This court has held that the legal standard for asserting an Eighth Amendment claim regarding medical care for prisoners is deliberate indifference. Williams v. Mehra, 186 F.3d 685, 691 (6th Cir.1999) (en banc). 28 It is well settled that the deliberate indifference to serious medical needs of prisoners constitutes the `unnecessary and wanton infliction of pain' ... proscribed by the Eighth Amendment. Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976) (quoting Gregg v. Georgia, 428 U.S. 153, 173, 96 S.Ct. 2909, 49 L.Ed.2d 859 (1976)). However, not every claim by a prisoner that he has not received adequate medical treatment states a violation of the Eighth Amendment. Estelle, 429 U.S. at 105, 97 S.Ct. 285. [A] complaint that a physician has been negligent in diagnosing or treating a medical condition does not state a valid claim of medical mistreatment under the Eighth Amendment. Medical malpractice does not become a constitutional violation merely because the victim is a prisoner. Id. at 106, 97 S.Ct. 285. In order to state a cognizable claim, a prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs. It is only such indifference that can offend `evolving standards of decency' in violation of the Eighth Amendment. Id. (emphasis added). 29 In Estelle, the Supreme Court established the deliberate indifference standard. The Court further clarified the meaning of that term in Farmer v. Brennan, 511 U.S. 825, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994), a decision regarding prison officials' duty to protect inmates from violence at the hands of other inmates. In Farmer, the Court held that a prison official cannot be found liable under the Eighth Amendment for denying an inmate humane conditions of confinement unless the official knows of and disregards an excessive risk to inmate health or safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference. Id. at 837, 114 S.Ct. 1970. However, an Eighth Amendment claimant need not show that a prison official acted or failed to act believing that a harm actually would befall an inmate; it is enough that the official acted or failed to act despite his knowledge of a substantial risk of serious harm. Id. at 842, 114 S.Ct. 1970. Further, [w]hether a prison official had the requisite knowledge of a substantial risk is a question of fact subject to demonstration in the usual ways, including inference from circumstantial evidence ... and a factfinder may conclude that a prison official knew of a substantial risk from the very fact that the risk was obvious. Id. 30 The federal courts have also held that less flagrant conduct may also constitute deliberate indifference in medical mistreatment cases. For example, the Eleventh Circuit has held that deliberate indifference may be established by a showing of grossly inadequate care as well as a decision to take an easier but less efficacious course of treatment. McElligott v. Foley, 182 F.3d 1248, 1255 (11th Cir.1999) (a doctor's awareness that plaintiff's condition was deteriorating and subsequent failure to treat plaintiff could support a finding of deliberate indifference); see Waldrop v. Evans, 871 F.2d 1030, 1035 (11th Cir.1989) (a doctor's decisions to remove patient from medication and to restore the medication without Lithium constitutes deliberate indifference to patient's psychiatric condition). Moreover, [w]hen the need for treatment is obvious, medical care which is so cursory as to amount to no treatment at all may amount to deliberate indifference. Mandel v. Doe, 888 F.2d 783, 789 (11th Cir.1989) (a physician's assistant's failure to inform his superior or a medical doctor of a prisoner's known injured leg constitutes deliberate indifference); Cooper v. Dyke, 814 F.2d 941, 945-46 (4th Cir.1987) (a prison employee's two-hour delay in providing medical care to an inmate known to have gunshot wounds constitutes deliberate indifference). 31 Our consideration of whether defendants acted with deliberate indifference to the decedent's serious medical needs is guided by the Eleventh Circuit's holding in Waldrop. In Waldrop, the parents of a state prison inmate brought suit against prison medical personnel under 42 U.S.C. § 1983, alleging that the prison officials provided grossly inadequate medical care and were thus deliberately indifferent to the inmate's psychiatric needs in violation of the Eighth Amendment. In its analysis, the Eleventh Circuit described grossly inadequate medical care as medical treatment so grossly incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to fundamental fairness. Waldrop, 871 F.2d at 1033 (quoting Rogers v. Evans, 792 F.2d 1052, 1058 (11th Cir. 1986)). The court stated that the relevant inquiry as to whether the defendants provided grossly inadequate care was whether a reasonable doctor ... could have concluded his actions were lawful. Id. at 1034. In Waldrop, the court affirmed the denial of defendants' motion for summary judgment in a § 1983 action finding that a particularized, fact-specific inquiry was a necessity to the proper analysis of plaintiff's claim. Here, as in that case, the proper analysis of Terrance's claim requires a similar inquiry. 32