Opinion ID: 2717749
Heading Depth: 2
Heading Rank: 3

Heading: Nurse Kihm

Text: Kihm served as the health-unit manager at the prison. Kihm stated in his deposition that this was primarily an “administrative position” and that he was not directly involved with patient care. His responsibilities included overseeing nurse scheduling, overseeing paperwork, and transmitting health statistics to the state. Kihm corresponded with both Ms. Warren and Dr. Bomber about Warren’s stress test. On January 27, Kihm received an e-mail from Dr. Bomber stating that Dr. Squire, the other doctor responsible for utilization management at PHS, “gave verbal approval for a cardiac stress test (standard)” and that Kihm should resubmit a consultation request as “urgent.” Kihm prepared the necessary security paperwork to have Warren transported to the hospital. On January 28, 2010, Kihm happened to see Nurse Pope evaluating Warren while Kihm was walking through the clinic. Pope told Kihm that Warren experienced chest pain while walking but that he was not currently experiencing any pain. Kihm observed that Warren appeared “fairly comfortable” and not “short of breath or in acute distress or anything.” Kihm stated in his deposition that “there was nothing that day to impress me . . . that [Warren] was in dire straits at that time.” Under these circumstances, there is insufficient evidence to conclude that Kihm “actually understood that [Warren] was subject to a substantial risk of serious harm.” Estate of Carter, 18 408 F.3d at 312. It is true that Kihm stated in his deposition that “chest pain is obviously a lifethreatening condition until evaluated . . . until you know where you’re going with it.” But the evidence cannot support the conclusion that Kihm knew—or even should have known—of Warren’s serious medical needs. What Kihm did know was that Warren was receiving a medical evaluation by healthcare staff.