Opinion ID: 3156440
Heading Depth: 3
Heading Rank: 1

Heading: Medical-Mistreatment Claims

Text: To succeed on an Eighth Amendment medical-mistreatment claim, a prisoner must demonstrate “acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs.” Id. (internal quotation marks omitted). The court’s inquiry is comprised of objective and subjective components. “Under the objective inquiry, the alleged deprivation must be sufficiently serious to constitute a deprivation of constitutional dimension.” Id. (internal quotation marks omitted). The medical risk Burnett faced—angina-related chest pains—is a sufficiently serious risk to satisfy the objective prong. See id. at 1233. That brings us to the second prong of the test. “[U]nder the subjective inquiry, the prison official must have a sufficiently culpable state of mind.” Id. at 1230-31 (internal quotation marks omitted). This is “akin to recklessness”: “consciously disregard[ing] a substantial risk of serious harm.” Id. at 1231 (internal quotation marks omitted). In the context of a medical-treatment claim, two types of conduct may constitute deliberate indifference: “(1) a medical professional failing to treat a serious medical condition properly; and (2) a prison official preventing an inmate from receiving medical treatment or denying access to medical personnel capable of evaluating the inmate’s condition.” Id. Importantly, negligent diagnosis or treatment is not enough to demonstrate a - 12 - constitutional violation. Id. at 1230. Thus, “the subjective component is not satisfied, absent an extraordinary degree of neglect, where a doctor merely exercises his considered medical judgment.” Id. at 1232. And “an official’s failure to alleviate a significant risk that he should have perceived but did not, while no cause for commendation, cannot under our cases be condemned as the infliction of punishment.” Farmer v. Brennan, 511 U.S. 825, 838 (1994).
Through December 9, 2011 Burnett contends the medical care he received from defendants8 before his stent procedure was neither prompt nor adequate. He maintains defendants were deliberately indifferent to his serious medical needs when they delayed transporting him to a hospital for further treatment until December 9, 2011, after he began reporting severe chest pain more than a month earlier, on November 5. More specifically, he contends defendants failed to follow ODOC medical protocols to 8 Defendants ought not to be treated as fungible commodities. A plaintiff is required to identify specific acts or omissions by each defendant entitling him to relief as to that defendant. See Pahls v. Thomas, 718 F.3d 1210, 1225 (10th Cir. 2013) (stressing that plaintiffs bringing § 1983 lawsuits naming multiple defendants must “make clear exactly who is alleged to have done what to whom” (internal quotation marks omitted)). Burnett often refers generally to “defendants,” without specifying an individual defendant. As an example, he does not mention Larimer anywhere in his opening brief. We construe his claims regarding his medical treatment from November 5 through December 9, 2011, as brought only against Colpetzer, Reiheld, and Miller. We, too, have referred to defendants collectively, but only in reference to their joint filings and shared arguments in the district court and in this court. - 13 - properly assess his heart ailment and take appropriate action. He maintains Colpetzer’s nursing assessment on November 6 was inadequate under ODOC protocols, and defendants should have administered blood and urine tests, and a chest x-ray. Burnett also contends defendants were deliberately indifferent in failing to administer a second ECG before December 7, in light of his continued complaints of frequent chest pains, and considering his age and risk factors. He complains, “Defendants fixated on [his] high blood pressure and totally ignored his repeated and specific complaints of severe chest pain. And then they did not even give him blood pressure medication.” Aplt. Opening Br. at 12.9 These facts fail to meet the “high evidentiary hurdle” necessary to demonstrate the subjective prong of a deliberate indifference claim. Self, 439 F.3d at 1232. Rather, the evidence shows Colpetzer, Reiheld, and Miller made good faith efforts to diagnose and treat Burnett’s medical condition. See id. Burnett reported having chest pains with exertion, but Colpetzer did not know if the pain was cardiac, musculoskeletal, or pleuritic. She did administer an ECG on November 6, 2011, but that test was normal, as indicated on the test report and as confirmed by Reiheld four days later. Burnett wanted to see a doctor, but the evidence showed the wait for a physician appointment could be up to 30 days at DCF, absent an emergency. In the 9 Burnett also argues the district court considered defendants’ Special Report, but ignored his motion to supplement the Special Report and his objections to it, which the court did not mention in its summary judgment order. But Burnett fails to develop this argument by pointing to anything in these filings the court allegedly ignored that precludes summary judgment on his federal claims. - 14 - interim, Colpetzer continued to monitor Burnett’s blood pressure, which ultimately measured within normal ranges on November 13. She recorded his continuing complaints of chest pain, but noted his denial of pain while resting or upon waking. No evidence suggests Burnett attended his appointment on November 22 for a blood pressure re-check.10 In response to his fourth request for medical services on December 4, Burnett was summoned to the clinic on December 7, where he was given another ECG test, the result of which, for the first time, was abnormal. In response to that new information, the duty nurse promptly placed him on Reiheld’s appointment schedule and he was seen by Reiheld the same day. Reiheld diagnosed “angina new onset” and determined Burnett needed an imaging test as soon as possible. That test required transportation to OHH. Having assessed Burnett’s general condition on December 7 as “good,” Reiheld did not believe Burnett required immediate transportation. Burnett points to no evidence that Miller delayed his transfer to OHH in spite of knowing his condition was emergent. While housed in a medical cell awaiting an appointment and transport, Burnett did not complain of chest pains. He was transferred to OHH on December 9, where a stress test was administered and a cardiologist determined he required further treatment for angina. Burnett received that treatment at OUMC on December 12. 10 Burnett admits he did not keep the blood pressure appointment, but denies having received notice of an appointment with Reiheld that day. For purposes of this appeal we accept his version of events. - 15 - These facts do not show a conscious disregard of Burnett’s serious medical needs. At worst, they show that Colpetzer and Reiheld initially misdiagnosed his condition. “But a misdiagnosis, even if rising to the level of medical malpractice, is simply insufficient under our case law to satisfy the subjective component of a deliberate indifference claim.” Id. at 1234. Thus, if an inmate’s symptoms could suggest multiple different diagnoses, the fact a medical provider mistakenly treated the wrong condition is not enough to establish a culpable state of mind under the subjective prong—even if the provider’s medical judgment was objectively unreasonable. See id.11 Burnett nonetheless argues it was obvious his heart ailment required emergency treatment. See id. at 1232 (recognizing an actionable deliberate indifference claim “where the need for additional treatment or referral to a medical specialist is obvious”). He contends the extent of the stent procedure performed at OUMC proves his heart condition was almost fatal and obviously emergent. But “our subjective inquiry is limited to consideration of the doctor’s knowledge at the time he prescribed treatment for the symptoms presented, not to the ultimate 11 To the extent he failed to prove more than a difference of opinion about the appropriateness of the medical treatment he received, Burnett asserts he was prevented from marshaling the necessary evidence because the district court refused his requests to obtain testimony from an expert medical witness, as well as his motions to appoint counsel. But we have already ruled we lack jurisdiction to review those issues due to Burnett’s failure to file objections to the relevant orders entered