Opinion ID: 2981044
Heading Depth: 4
Heading Rank: 1

Heading: October 2004 Denial

Text: The Medical Committee first denied Cobbs’s request for left-eye cataract surgery on October 26, 2004. Though the Medical Committee memorandum denying surgery does not detail its reasons for denying Cobbs’s 2004 claim, the record compels the conclusion that the Medical Committee denied surgery because Cobbs enjoyed good overall visual acuity following his right-eye surgery. In general, Pramstaller believed that delaying cataract-removal surgery posed “minimal” risk when a prisoner had good overall vision. Prison officials thus looked to a prisoner’s “overall visual acuity”—their corrected vision using both eyes—when determining whether to grant cataract surgery. At the time, Cobbs’s enjoyed overall vision of 20/70 without correction in his right eye, and 20/70 vision with correction in his left. - 12 - No. 10-2089 Cobbs v. Pramstaller, et al. Pramstaller identified several conditions warranting surgery despite good overall vision: where a prisoner suffers from a “posterior subcapsular cataract” that “causes glare,” a “discrepancy” in vision, or glaucoma. Cobbs argues that notes from a July 2004 visit with Dr. Dastgir, his ophthalmologist, should have apprised the Medical Committee that he suffered from two of these three conditions—glare and a discrepancy in vision. Cobbs stresses that these notes would have alerted Pramstaller to Cobbs’s need for surgery had Pramstaller reviewed them. But Cobbs offers no evidence that Pramstaller was aware of Dastgir’s notes. At oral argument, when asked whether Cobbs’s appeals to the Medical Committee presented Pramstaller with these notes, Cobbs’s counsel admitted, “We don’t know; they don’t ever tell us what they had.” Further, doctors removed Cobbs’s right-eye cataract after the July examination, and none of Cobbs’s post-surgery examination reports mentions double vision or glare. Drawing every factual inference in Cobbs’s favor, as we must, we conclude that Cobbs fails to demonstrate Pramstaller’s awareness of facts from which he could infer that a substantial risk of serious harm existed in October 2004.