Court Opinion

ID: 9700482
Source: CourtListenerOpinion
Date Created: 2023-08-25 21:32:03.404804+00
Date Added: 2024-06-11T14:57:34.214505
License: Public Domain

NORTON, Judge
(concurring in part and dissenting in part),
I must respectfully dissent as to part II.A. of the majority opinion. The warden and the commissioner should not be protected by qualified immunity for their actions or, more accurately, their alleged in-actions.
Proper consideration of this case requires a more detailed exposition of the relevant facts. In 1973, a class of Stillwa-ter state prison inmates brought suit to improve medical care at the prison. After lengthy litigation, the parties agreed to a consent decree laying out rules and responsibilities for prison officials. Hines v. Anderson, 439 F.Supp. 12 (D.Minn.1977). Among the elements of the 1977 consent decree were the following:
• Upon entering the prison, each inmate must receive a full physical examination including a Mantoux test for tuberculosis. Id. at 17.
• Each inmate has the right to be “examined, diagnosed and treated, at their personal expense, by a private physician.” Id. at 18.
• There shall be a single administrative chief of medical services who shall oversee and be responsible for the overall health care program at the Minnesota State Prison. To the extent possible, this *754administrative chief shall have no other duties imposed upon him, his primary responsibility being the administration of health care for inmates.

Id.

• A full-time physician must be made available. Id.
• Inmates who are found to be infected or evidencing contagious diseases or conditions shall be isolated or segregated from other inmates according to acceptable standards of medical care, until said contagious disease or condition shall have abated.
Id. at 23.
The terms of the consent decree were mandatory, and the officials and their successors were enjoined from failing to carry out its provisions. Id. at 24. (The warden and the commissioner are successors to the officials in Hines.)
On March 29, 1982, Haavisto was transferred to the Stillwater Prison from the county jail at Wadena. He was given a physical examination, including a Mantoux test and chest x-ray. The test reported positive for tuberculosis infection, but the radiologist, who had no knowledge of the results of this test, examined the chest x-ray and reported no abnormalities. Although Haavisto told his examiners about his constant coughing, he was given no treatment for his condition and his complaints were not investigated. The following excerpt from Judge Murphy’s opinion details the rest:
His complaints of coughing and chest and back pain were persistent. The health services personnel and guards had instructions from Dr. Allan to give him cough drops when he needed them. Haavisto was sometimes not permitted to report to sick call. On several occasions when he reported, Dr. Allan was absent and the appointment was cancelled. Dr. Allan insists that each of Haavisto's pulmonary symptoms from April through November 1982, was a discrete episode which resolved with treatment.
Haavisto would awaken during the night with severe coughing spells. This would wake other inmates who would make angry remarks and threats. His respiratory problems were so well-known that others worried about being infected by him. Sergeant Marty Lopez was instructed by his supervisor to keep alcohol and rags on the cell block to wipe off the phone after Haavisto used it. In the early mornings and before each meal, it was Haavisto’s habit to lie on his stomach for up to an hour to cough up as much sputum as he could so that he could eat in the dining hall without calling attention to his coughing. Haavisto suffered intimidation from fellow inmates who accused him of spreading disease. He testified that he feared for his life. Because of threats he kept to himself for several months prior to the diagnosis of active tuberculosis.
Other inmates in his cell hall (AEU) became irritated and alarmed about his coughing and spitting. They complained to Haavisto, to the guards, and among themselves that he might have tuberculosis. The guards’ union confronted the administration about possible tuberculosis among inmates, and several guards were tested by private physicians. In spite of all this, tuberculosis was not considered by the prison health services until October 1982. In sum, the supervisors and medical staff demonstrated inattention and deliberate indifference to Haavisto’s welfare and that of inmates and staff with whom he had contact.
Over the summer of 1982 Haavisto requested the opportunity to see a private physician. The request was denied even though he agreed to be financially responsible.
DeGidio v. Pung, 704 F.Supp. 922, 937 (D.Minn.1989). Judge Murphy also found that no person was responsible for the “efficient delivery of health care,” id. at 950, and that no one accepted any “ultimate responsibility for directing the effort at controlling tuberculosis.” Id. at 957-58.1
*755Public officials are entitled to the affirmative defense of qualified immunity unless “the officials’ conduct violated ‘clearly established statutory or constitutional rights of which a reasonable person would have known.’ ” Elwood v. County of Rice, 423 N.W.2d 671, 674-75 (Minn.1988) (quoting Harlow v. Fitzgerald, 457 U.S. 800, 818, 102 S.Ct. 2727, 2738, 73 L.Ed.2d 396 (1982)). Emphasis is placed on “clearly”: if the alleged acts of the officials were reasonable under settled law at the time of the acts, there is no liability. Hunter v. Bryant, — U.S. -, -, 112 S.Ct. 534, 537, 116 L.Ed.2d 589 (1991).
The majority would grant qualified immunity to the warden and commissioner because “they were entitled to rely on medical professionals for clinical determinations.” Supra, at 751. In doing so, however, I believe that the majority focuses on the wrong conduct. Haavisto is not suing corrections officials because they unreasonably relied on Dr. Allan’s multiple misdiagnoses. Rather, he sues because the officials failed to take mandatory steps that could have prevented the long series of misdiagnoses. See Ramos v. Lamm, 639 F.2d 559, 575 (10th Cir.1980), cert. denied, 450 U.S. 1041, 101 S.Ct. 1759, 68 L.Ed.2d 239 (1981) (“[DJeliberate indifference to inmates’ health needs may be shown by * * * proving there are such systemic and gross deficiencies in staffing, facilities, equipment, or procedures that the inmate population is effectively denied access to adequate medical care.”). The prison had no individual with supervisory responsibility for the health care system, the prison had no full-time physician who could be fully responsible for inmates’ care, Haavis-to was denied the opportunity to visit a private physician, and the prison had no procedures for containing infectious diseases. All of these were in violation of the five-year-old Hines consent decree, of which the warden and commissioner were aware and which constituted the relevant law for guiding their actions. In addition, plausibly because prison guards had no training in recognizing situations that demanded infectious disease control, Haavis-to was continuously harassed by both guards and inmates.
Put another way, the warden and commissioner cannot reasonably rely on the opinions of medical professionals simply because, contrary to the mandates' of the Hines decree, they failed to put in place medical personnel and procedures upon whom they could reasonably rely. Along with Judge Murphy, I believe that enough deliberate indifference has been shown to allow a trial against the warden and commissioner. I would affirm the trial court.

. I agree with the majority that Haavisto may not use the findings of Judge Murphy to collaterally estop appellants from litigating these factual issues. Supra, at 750-751. I cite Judge Murphy’s findings only to demonstrate that evi*755dence exists sufficient to withstand summary judgment and dispute qualified immunity.