Court Opinion

ID: 9407631
Source: CourtListenerOpinion
Date Created: 2023-07-07 18:01:16.921078+00
Date Added: 2024-06-11T17:20:39.228737
License: Public Domain

USCA11 Case: 22-11301   Document: 40-1    Date Filed: 07/07/2023   Page: 1 of 7

                                                [DO NOT PUBLISH]
                                 In the
                United States Court of Appeals
                        For the Eleventh Circuit

                         ____________________

                              No. 22-11301
                         Non-Argument Calendar
                         ____________________

       DERRICK GREGORY JAMES,
                                                   Plaintiﬀ-Appellant,
       versus
       NURSE ROBINSON, et al.,

                                                          Defendants,

       E. PEREZ-LUGO,
       MICHELLE SCHOUEST,
       TONI BOWDEN,
       KRYSTLE L. ROBERSON,
       MINDY TOMLINSON,
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       2                         Opinion of the Court                       22-11301

                                                            Defendants-Appellees.

                               ____________________

                   Appeal from the United States District Court
                        for the Middle District of Florida
                     D.C. Docket No. 3:21-cv-00183-BJD-LLL
                            ____________________

       Before WILSON, JILL PRYOR, and LUCK, Circuit Judges.
       PER CURIAM:
              Derrick Gregory James, a Florida prisoner proceeding pro se,
       appeals the district court order dismissing his amended complaint.
       James sued Dr. Elliot Perez-Lugo, the medical director of the
       prison where James was incarcerated, under 42 U.S.C. § 1983, al-
       leging that Perez-Lugo was deliberately indifferent to his serious
       medical need. The district court dismissed the amended complaint,
       concluding that James failed to state a claim for relief. After careful
       consideration, we affirm.
                                          I.
              James was incarcerated at the Columbia Correctional Insti-
       tution in Florida beginning in July 2019. 1 While at the prison, James

       1 The facts recited in this section are taken from the amended complaint,
       which is the operative complaint. See Hunt v. Aimco Props., L.P., 814 F.3d 1213,
       1218 n.2 (11th Cir. 2016) (“At the motion to dismiss stage, we accept the well-
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       22-11301                  Opinion of the Court                            3

       complained of physical pain, including numbness in his right foot
       and extreme pain in his right ankle. According to James, the medi-
       cal care he received for his condition was inadequate.
             Beginning in February 2020, he filed a series of grievances
       with the prison related to the care he received. In the grievances,
       James complained that his pain was becoming worse over time, he
       was losing strength, and his right calf was shrinking. He requested
       an MRI and demanded to see a neurologist.
              From April 2020 through December 2020, Perez-Lugo re-
       sponded to several of these grievances. He explained that James
       had been seen by a medical provider at the prison and the provider
       had determined that there was “no clinical indication for MRI.”
       Doc. 19-1 at 6. 2 Perez-Lugo concluded that this determination was
       based on “sound clinical judgment.” Id. He also advised that re-
       quests for “diagnostic tests [were] not issued through the grievance
       system,” and if James was concerned about his treatment plan, he
       should place a sick call to consult with his medical provider. Id.
             In January 2021, James was examined by Perez-Lugo. At that
       appointment, James complained that his condition was worsening.
       As part of the examination, Perez-Lugo measured James’s calves
       and observed that his right calf muscle was considerably smaller
       than the left. Based on his examination, Perez-Lugo ordered an

       pleaded allegations in the complaint as true and view them in the light most
       favorable to the [non-movant].”).
       2 “Doc.” numbers refer to the district court’s docket entries.
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       4                        Opinion of the Court                     22-11301

       MRI and determined that James should be seen by a neurologist.
       James then received an MRI and was seen by a neurologist, who
       determined that he needed surgery.
              James, proceeding pro se, filed this lawsuit against Perez-
       Lugo, claiming deliberate indifference.3 In the amended com-
       plaint, which was the operative complaint, James alleged that Pe-
       rez-Lugo acted with deliberate indifference when he denied
       James’s grievances requesting additional medical care. Although
       the amended complaint mentioned that James’s health issues be-
       gan in July 2019, the allegations regarding Perez-Lugo related only
       to the period from April 2020, when Perez-Lugo first reviewed one
       of James’s grievances, through January 2021, when Perez-Lugo ex-
       amined James.
               Perez-Lugo filed a motion to dismiss, which the district
       court granted. The district court concluded that the amended com-
       plaint failed to state a claim for deliberate indifference. The district
       court explained that Perez-Lugo did not act with deliberate indif-
       ference when he responded to James’s grievances requesting addi-
       tional medical care because Perez-Lugo had deferred to the medi-
       cal judgment of the providers who had examined James. Even if
       those providers’ decisions were “incorrect or subject to reasonable
       debate among medical practitioners,” the district court explained,

       3 James also named several other prison officials as defendants. The district
       court dismissed the claims against these defendants. Because James raises no
       argument on appeal regarding his claims against the other defendants, we dis-
       cuss them no further.
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       22-11301               Opinion of the Court                          5

       such “difference[s] of opinion regarding questions of medical judg-
       ment” did not rise to the level of deliberate indifference. Doc. 44 at
       21. The district court also concluded that Perez-Lugo did not act
       with deliberate indifference in January 2021 when Perez-Lugo ex-
       amined James and determined that he needed an MRI and referred
       him to a neurologist.
              This is James’s appeal.
                                         II.
               To survive a motion to dismiss under Federal Rule of Civil
       Procedure 12(b)(6), the complaint must contain sufficient factual
       matter, accepted as true, to “state a claim to relief that is plausible
       on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007).
       “[N]aked assertions devoid of further factual enhancement” or
       “[t]hreadbare recitals of the elements of a cause of action, sup-
       ported by mere conclusory statements, do not suffice.” Ashcroft v.
       Iqbal, 556 U.S. 662, 678 (2009) (alterations adopted) (internal quota-
       tion marks omitted). “Pro se pleadings are held to a less stringent
       standard than pleadings drafted by attorneys and are liberally con-
       strued.” Bingham v. Thomas, 654 F.3d 1171, 1175 (11th Cir. 2011)
       (internal quotation marks omitted).
                                        III.
              The Eighth Amendment’s prohibition against “cruel and un-
       usual punishments” protects prisoners from “deliberate indiffer-
       ence to serious medical needs.” Estelle v. Gamble, 429 U.S. 97, 102,
       104 (1976). To prove deliberate indifference, a prisoner must show:
       (1) an objectively serious medical need; (2) the defendant’s
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       6                      Opinion of the Court                  22-11301

       deliberate indifference to that need; and (3) a causal link between
       the defendant’s indifference and the prisoner’s injury. See Goebert v.
       Lee Cnty., 510 F.3d 1312, 1326 (11th Cir. 2007). The second of these
       elements requires the prisoner to establish that the defendant (1)
       had subjective knowledge of a risk of serious harm and (2) disre-
       garded that risk (3) by conduct that was more than gross negli-
       gence. Wade v. McDade, 67 F.4th 1363, 1374 (11th Cir. 2023); see also
       Harris v. Thigpen, 941 F.2d 1495, 1505 (11th Cir. 1991) (“Mere inci-
       dents of negligence or malpractice do not rise to the level of con-
       stitutional violations.”).
              Conduct that is more than grossly negligent includes:
       “(1) grossly inadequate care; (2) a decision to take an easier but less
       efficacious course of treatment; and (3) medical care that is so cur-
       sory as to amount to no treatment at all.” Bingham, 654 F.3d at
       1176. A prisoner can also establish deliberate indifference by show-
       ing “[a] complete denial of readily available treatment,” or that the
       defendant “delay[ed] necessary treatment for non-medical rea-
       sons.” Id.
              Here, the district court concluded that James failed to state
       a claim because the allegations in the amended complaint did not
       show that Perez-Lugo acted with deliberate indifference. James’s
       sole argument on appeal is that Perez-Lugo acted with deliberate
       indifference because in August 2019 Perez-Lugo examined and
       treated him. According to James, at the time of that examination,
       Perez-Lugo should have “immediately referr[ed]” him to a neurol-
       ogist and ordered an MRI. Appellant’s Br. at 7.
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       22-11301                Opinion of the Court                           7

               The problem with this argument is that, even liberally con-
       strued, the amended complaint included no allegations regarding
       Perez-Lugo’s August 2019 examination. It’s true that the complaint
       alleged that James received inadequate care during the entire time
       he was detained at Columbia Correctional Institution, but the alle-
       gations regarding Perez-Lugo related only to the period from April
       2020. For the first time in his appellate briefing, James makes alle-
       gations about Perez-Lugo’s August 2019 examination. But parties
       “are not permitted to simply ‘insert’ new allegations through their
       appellate briefing.” Quality Auto Painting Ctr. of Roselle, Inc. v. State
       Farm Indem. Co., 917 F.3d 1249, 1262 (11th Cir. 2019) (en banc); see
       Michel v. NYP Holdings, Inc., 816 F.3d 686, 705 (11th Cir. 2016) (ex-
       plaining that an appellant “cannot [on appeal] use his briefing to
       add new allegations and argue that those new assertions support
       his cause of action”). Instead, James’s claim is limited to the allega-
       tions in the amended complaint, which did not even mention the
       examination. Accordingly, we reject James’s argument that the dis-
       trict court erred in concluding that he failed to state a claim that
       Perez-Lugo acted with deliberate indifference during the August
       2019 examination.
              AFFIRMED.