Opinion ID: 2814288
Heading Depth: 3
Heading Rank: 4

Heading: Dr. Lagares

Text: Finally, we turn to Dr. Lagares, the Chief Health Officer for the prison. Mr. Kuhne appears to make two distinct complaints about Dr. Lagares’s conduct. The first dates to October 2008. Then, as we explained above, Mr. Kuhne’s diagnosis of proliferative diabetic retinopathy came on October 21, and his doctor recommended that he be referred to a retinal specialist “ASAP.” 58 Dr. Lagares received and approved the referral request the next day, and the appointment, which “was made by someone in utilization management” was scheduled to occur on November 18, 2008.59 “According to Mr. Kuhne’s medical expert, the consultation with the retinal specialist should have taken place within three to seven days of [October 21] the examination.” 60 Mr. Kuhne argues that by 56 Id. 57 ECF No. 64, at . 58 Kuhne v. Fla. Dept. of Corr., 745 F.3d 1091, 1093 (11th Cir. 2014). 59 Id. at 1093 n.2. 60 Id. 18 Case: 14-13845 Date Filed: 07/02/2015 Page: 19 of 22 approving an appointment set nearly a month after his retinopathy was first diagnosed, Dr. Lagares unreasonably delayed the provision of necessary medical services, giving rise to a claim of deliberate indifference. 61 We have held that “delayed treatment . . . may also give rise to constitutional claims.” 62 Whether delay is permissible “depend[s] on the nature of the medical need and the reason for the delay.” 63 It is not obvious that the delay in question is fully attributable to Dr. Lagares, or that it is constitutionally excessive. We need not reach that question, however, as the Defendants present neither argument nor evidence suggesting that it is not.64 Given that they bear the burden at this stage of the proceedings, summary judgment cannot rest on this ground. 65 The second complaint is of Dr. Lagares’s conduct on February 4, 2009, when she denied Mr. Kuhne’s medical grievance form. 66 Here, want of causation 61 See, e.g., ECF No. 65, at , 7. 62 Farrow v. West, 320 F.3d 1235, 1247 (11th Cir. 2003) (quoting Harris v. Coweta Cnty., 21 F.3d 388, 394 (11th Cir. 1994)) (bracket omitted). 63 Adams v. Poag, 61 F.3d 1537, 1544 (11th Cir. 1995). How long is too long depends on factors such as the severity of the plaintiff’s pain and the consequences of delay. See, e.g., McElligott v. Foley, 182 F.3d 1248, 1258 (11th Cir. 1999). 64 See Appellee’s Br. 39-42. 65 See Fed. R. Civ. P. 56(a) (requiring the movant to “show[] that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.”). 66 See ECF No. 53-3, at -13. 19 Case: 14-13845 Date Filed: 07/02/2015 Page: 20 of 22 is fatal to Mr. Kuhne’s claim. The Defendants’ expert opined that “even if Dr. Lagares had approved a retinal specialty consult on February 4, 2009, there would not have been any difference in outcome from that which he received subsequently.” 67 There is no contradictory evidence. This encounter cannot be made the basis for liability. 68