Opinion ID: 2802945
Heading Depth: 2
Heading Rank: 1

Heading: Stoudemire's Medical History

Text: When twenty-three-year-old Martinique Stoudemire entered the MDOC [Michigan Department of Corrections] system in July 2002, she came with a long and well-documented history of health problems. Stoudemire suffered from systemic lupus erythematosus, a chronic and painful autoimmune disease; hypercoagulapathy, a related disorder characterized by a tendency to develop blood clots; and depression. Without proper care, Stoudemire bore a significant risk of experiencing kidney and liver damage, heart attacks, amputations, and chronic pain. Stoudemire's health quickly deteriorated. During her five years at Huron, she experienced a heart attack, liver failure, and a number of life-threatening embolisms. She underwent three amputations, eventually losing both legs below the knee. By the time of her parole in August of 2007, she also suffered from chronic depression, post-traumatic stress disorder, and a number of conditions related to medications she had received during her incarceration. Stoudemire attributes her health complications to the alleged failure of MDOC staff members and associated doctors and nurses to provide her with adequate health care while she was incarcerated. For the purposes of this appeal, however, we focus on the events following Stoudemire's final amputation in December 2006, when her stump and buttock became infected with Methicillin-resistant Staphylococcus Aureusaie (“MRSA”) and she was quarantined in Huron's segregation unit. B. Stoudemire's Placement in Huron's Segregation Unit According to an April 14, 2005, Memorandum from Richard D. Russell, Administrator of the MDOC Health Care Bureau, “all prisoners with a documented culture positive for MRSA must be quarantined.” The policy 2 No. 14-1742, Stoudemire v. Mich. Dep’t of Corrections, et al. provides that responsible staff members must notify the warden of the particular facility of a confirmed MRSA case in order to initiate the quarantine process. If health care staff determine that medical quarantine is necessary, the warden is responsible for isolating the infected inmates. The warden has the discretion to choose a quarantine location within the prison and may also opt to send infected inmates to another site. Davis designated Huron's segregation unit, which prisoners and guards call “the hole,” as a quarantine location. The segregation unit is normally used for isolating prisoners who have violated prison rules. Stoudemire spent roughly two weeks in quarantine as a consequence of her MRSA infection. At her deposition, Davis testified that she “was probably aware at the time” that Stoudemire had been placed in segregation for medical purposes but that she “[didn't] recall specifically.” Stoudemire alleges that she received extremely poor medical care while in segregation. The segregation cells were not equipped to accommodate disabled patients. Stoudemire was never provided with any assistive devices that might have allowed her to safely move between her bed, wheelchair, toilet, and shower. There was no call button, so Stoudemire had to shout when she needed assistance. She alleges that the medical staff treated her with contempt. They accused her of malingering and responded with hostility whenever she sought assistance. As a result, Stoudemire was left to care for herself. She was forced to crawl from her bed to the toilet. On one occasion, she had to urinate into a bowl. On another occasion, she defecated on herself. The staff neglected Stoudemire's hygiene. She received only one shower during her two weeks in segregation and was required to dress her wounds herself, which put her at risk of infection. According to one of Plaintiff's experts, Stoudemire received “very little medical rounding” while she was in the segregation unit, which was “a terrible place to put an amputee.” Davis testified that, in cases where a physically handicapped prisoner was placed in a segregation cell, she “would check the logbook to make sure that medical professionals had been through at least daily to see the prisoner for however often the prisoner's particular need was.” Davis also testified that she would “check to make sure that my deputy warden or [an assistant deputy warden] had been through . . . [and] personally observed that prisoner to make sure that, you know, they weren't hanging themselves in the cell or what have you.” Stoudemire v. Mich. Dep’t of Corrs., 705 F.3d 560, 565-66 (6th Cir. 2013). C. Prior Interlocutory Appeal In the first appeal, we vacated the district court’s denial of qualified immunity because the district court had not conducted “a particularized analysis of whether Davis was deliberately 3 No. 14-1742, Stoudemire v. Mich. Dep’t of Corrections, et al. indifferent to the conditions of Stoudemire’s confinement while in quarantine.” Id. at 570. In particular, “[t]he district court did not mention any facts in the record that specifically pertained to Davis, nor did the district court make any findings regarding Davis’s knowledge or mental state.” Id. In other words, “there was no discussion of the subjective element of the claim: whether Davis, the warden, had ‘a sufficiently culpable state of mind in denying [Stoudemire] medical care.”” Id. at 571 (quoting Blackmore v. Kalamazoo Cnty., 390 F.3d 890, 895 (6th Cir. 2004)). D. On Remand On remand, the district court found that the constitutional right at issue—to be free from cruel and unusual punishment while in confinement—was clearly established, citing Estelle v. Gamble, 429 U.S. 97 (1976) (holding that “deliberate indifference” to serious medical needs of prisoners constitutes the “unnecessary and wanton infliction of pain,” (internal quotation marks and citation omitted)). The district court also held that Stoudemire met her burden of demonstrating both the objective and subjective components of her Eighth Amendment claim. The district court found that the objective component was established because Stoudemire had a serious medical need as a double amputee with no motor function below her knees who acquired MRSA after the amputation of her left leg. Furthermore, the conditions of her confinement posed a substantial risk of serious harm, because “not only was her cell illequipped to house a double amputee, there was no mechanism for an inmate such as [Stoudemire] to alert the penal staff of those pertinent issues related to her MRSA infection.” The court found this fact “particularly alarming,” since Stoudemire had just been released from the University of Michigan Hospital after her third amputation “just hours before being placed in 4 No. 14-1742, Stoudemire v. Mich. Dep’t of Corrections, et al. segregation”; the move from the infirmary to the segregation was motivated by the MRSA infection; and an MDOC internal memorandum clearly stated that its facilities must take “’a proactive, more aggressive approach to MRSA infection[s].’” The district court found that the following factors established the existence of a genuine issue of material fact as to the subjective component of deliberate indifference: (1) “First and foremost, Davis acknowledged that Huron Valley’s segregation unit lacked handicap accessible cells during all times relevant to this case”; (2) Davis recalled in her deposition that she knew Stoudemire was a double amputee; (3) Davis testified that she “probably was aware at the time” that Stoudemire was assigned to the segregation unit because of her MRSA infection; (4) an MDOC internal memorandum required Huron Valley’s Bureau of Health Care Services to notify the warden of each confirmed MRSA case “to initiate the quarantine”; and (5) Davis testified that she made daily rounds to ensure that the medical needs of quarantined prisoners with physical handicaps were adequately addressed. The district court therefore found that “the record herein suggests that Davis had reason to know that the Plaintiff—a double amputee recovering from MRSA—was housed in a cell without a trapeze, grab bars, or a commode chair, and had a very limited means of alerting prison officials if additional medical attention was necessary.” The court held that, viewing the facts in a light most favorable to Stoudemire, “a reasonable jury could find that Davis was aware of facts from which the inference could be drawn that a substantial risk of serious harm existed and she ignored that risk.” On appeal, Davis asserts that she was not deliberately indifferent to Stoudemire’s medical needs because she relied on medical staff and was never informed that Stoudemire’s needs were not being met. Thus, she maintains that the district court erred in not granting her qualified immunity. 5 No. 14-1742, Stoudemire v. Mich. Dep’t of Corrections, et al.