Court Opinion

ID: 9896371
Source: CourtListenerOpinion
Date Created: 2023-11-10 01:00:41.880483+00
Date Added: 2024-06-11T09:14:47.437852
License: Public Domain

Case: 22-40195        Document: 00516962858             Page: 1      Date Filed: 11/09/2023

             United States Court of Appeals
                  for the Fifth Circuit                                         United States Court of Appeals
                                                                                         Fifth Circuit

                                     ____________                                      FILED
                                                                                November 9, 2023
                                       No. 22-40195
                                                                                  Lyle W. Cayce
                                     ____________                                      Clerk

   Andrew Gonzales,

                                                                    Plaintiff—Appellant,

                                            versus

   Paul Reilley; Anitra Lindley; Ashley L. Stephenson;
   James Geddes; Linda R. Fickey,

                                              Defendants—Appellees.
                     ______________________________

                     Appeal from the United States District Court
                          for the Eastern District of Texas
                               USDC No. 9:20-CV-131
                     ______________________________

   Before Smith, Southwick, and Higginson, Circuit Judges.
   Per Curiam:*
         Andrew Gonzales is a prisoner formerly confined in a facility operated
   by the Texas Department of Criminal Justice. While imprisoned, Gonzales
   underwent triple bypass surgery for heart damage. Gonzales brought suit un-
   der 42 U.S.C. § 1983, alleging that various defendants had been deliberately
   indifferent to his serious medical needs in the months preceding the

         _____________________
         *
             This opinion is not designated for publication. See 5th Cir. R. 47.5.4.
Case: 22-40195       Document: 00516962858           Page: 2   Date Filed: 11/09/2023

                                      No. 22-40195

   operation, causing him to suffer permanent heart damage. We AFFIRM the
   grant of summary judgment with regard to all defendants except Defendant
   Stephenson. We MODIFY the judgment to dismiss without prejudice the
   claim against Defendant Stephenson for lack of personal jurisdiction.
               FACTUAL AND PROCEDURAL BACKGROUND
          At the time of the events underlying this lawsuit, Andrew Gonzales
   was incarcerated at the Allan B. Polunsky Unit in east Texas. On June 11,
   2018, Gonzales made two visits to the prison medical unit for chest pain that
   he rated as extremely severe. Gonzales was examined and then released that
   same day from the medical unit. Gonzales visited the medical unit multiple
   times over the following months. In February and March 2019, Gonzales
   filed formal grievances seeking more effective care for his chest and breathing
   pains. On March 28, 2019, Dr. James Geddes diagnosed Gonzales with car-
   diac ischemia, leading to a triple vessel coronary artery bypass graft on April
   11, 2019. On December 7, 2020, Gonzales was found unconscious in his cell
   and later suffered cardiac arrest. Gonzales was given an automatic implanta-
   ble cardioverter defibrillator as a result.
          In June 2020, Gonzales filed, pro se, this Section 1983 suit in the
   United States District Court for the Eastern District of Texas. The defend-
   ants, employees of the University of Texas Medical Branch, are Paul Reilley,
   a physician assistant; Anitra Lindley, a senior practice manager; Ashley Ste-
   phenson, a grievance investigator; Dr. James Geddes, a physician; and Linda
   Fickey, a nurse. All defendants except Stephenson moved for summary judg-
   ment. The magistrate judge issued a report and recommendation to grant the
   motion. The district court determined that the defendants were entitled to
   qualified immunity and granted their motion for summary judgment. Gon-
   zales appealed.

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                                  DISCUSSION
          I.     Qualified Immunity
          We review a grant of summary judgment de novo. Hyatt v. Thomas,
   843 F.3d 172, 176 (5th Cir. 2016). To overcome the defendants’ assertion of
   qualified immunity, Gonzales must show they violated his clearly established
   Eighth Amendment rights. See Easter v. Powell, 467 F.3d 459, 462–63 (5th
   Cir. 2006). Such a showing requires proof that he was harmed by the defend-
   ants’ deliberate indifference to his serious medical needs. See Thompson v.
   Tex. Dep’t of Crim. Justice, 67 F.4th 275, 280–81 (5th Cir. 2023). “Deliberate
   indifference exists when an official ‘knows of and disregards an excessive risk
   to inmate health or safety.’ ” Id. at 281 (quoting Farmer v. Brennan, 511 U.S.
   825, 837 (1994)).
          “Deliberate indifference is an extremely high standard to meet.”
   Domino v. Tex. Dep’t of Crim. Just., 239 F.3d 752, 756 (5th Cir. 2001). Un-
   successful medical treatment, negligence, and medical malpractice do not
   amount to deliberate indifference; absent exceptional circumstances, a pris-
   oner’s disagreement with his medical treatment will not constitute deliberate
   indifference either. Gobert v. Caldwell, 463 F.3d 339, 346 (5th Cir. 2006).
   Whether to provide additional treatment is a decision left to medical judg-
   ment. Id.
          We analyze Gonzales’s claims against each defendant.
                 a.      Nurse Fickey
          Gonzales alleges that Nurse Linda Fickey saw him twice on June 11,
   2018. Prison medical records, though, indicate she saw him only once that
   day when he first presented for chest pain. The medical records for Gonza-
   les’s second evaluation that day show he was seen by Licensed Vocational
   Nurse Smith-Valdez, under the direction of Physician Assistant Paul Reilley.

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   As to Nurse Fickey, the medical records establish that she made her entries
   on Gonzales’s records approximately six hours after her evaluation occurred.
   Gonzales has not offered any evidence to create a dispute about the accuracy
   of these records. Gonzales underwent an electrocardiogram test (“EKG”)
   and troponin testing, each of which gave no indication of heart problems.
   Nurse Fickey noted that Gonzales’s vital signs were within normal limits,
   provided him antacids, and released him from the clinic.
          These medical records demonstrate that Gonzales was stable when
   Nurse Fickey evaluated him and that she provided care. There is no evidence
   that Nurse Fickey acted with deliberate indifference to Gonzales’s serious
   medical needs.
                 b.      Physician Assistant Reilley
          The medical records indicate that Physician Assistant Reilley pro-
   vided care for Gonzales on three occasions. Physician Assistant Reilley or-
   dered the EKG and troponin testing after Gonzales was examined by Nurse
   Fickey on June 11, 2018. Gonzales reported difficulty breathing later that
   same day and was taken on a stretcher to be evaluated by Licensed Vocational
   Nurse Smith-Valdez. In response to LVN Smith-Valdez’s evaluation, Phy-
   sician Assistant Reilley ordered an injection of ranitidine and solumedrol for
   acid reduction, which Gonzales received well. At the time this injection was
   ordered, Gonzales had already undergone EKG and troponin testing. The
   EKG and troponin testing gave no indication of heart problems. Ordering
   the injection rather than more intensive care did not amount to deliberate
   indifference. It was the result of an exercise of medical judgment, to which
   we afford deference. See Domino, 239 F.3d at 756.
          Physician Assistant Reilley also saw Gonzales on February 11, 2019.
   The clinic note stated he was seeing Gonzales as a “follow up for breathing
   issues for over a year.” The note also acknowledged that Dr. Geddes had

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   previously referred Gonzales for a stress test for potential heart conditions,
   but Gonzales refused the test. Although Gonzales disputes that he refused
   the stress test, the clinic note supports a finding that Physician Assistant Reil-
   ley was unaware of a substantial risk to Gonzales’s health. The test for delib-
   erate indifference is “subjective recklessness as used in the criminal law,”
   requiring a person to disregard a substantial risk of which he is actually aware,
   not one of which he should have been aware. Farmer v. Brennan, 511 U.S.
   825, 836–40 (1994). Because Gonzales did not establish Physician Assistant
   Reilley was aware of a substantial risk to his health, he cannot show Physician
   Assistant Reilley acted with deliberate indifference.
                 c.      Dr. Geddes
          The medical records demonstrate that Dr. James Geddes saw Gonza-
   les on the following dates and made the following notes:
          July 10, 2018: Gonzales complained of “deep chest discomfort
   brought on by exertion or anxiety for three weeks.” Gonzales “wants to hold
   off on stress test referral for right now.” Dr. Geddes noted that he would
   make a referral for a brace for unrelated knee pain.
          November 15, 2018: Gonzales complained of chest pain, which was re-
   lieved by belching. His symptoms were atypical for angina. Gonzales was
   “not really wanting to go” for a stress test, and “due to [the] somewhat atyp-
   ical nature of” the symptoms, Dr. Geddes “did not press the issue at this
   time.” Gonzales was asked to avoid heavy exertion and notify the clinic if his
   symptoms worsened.
          February 21, 2019: Gonzales was still suffering from the symptoms he
   reported in the November 2018 visit. Dr. Geddes ordered a stress test, which

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   was scheduled for April. This was a routine, rather than expedited, stress
   test.1
            March 28, 2019: Dr. Geddes made a provisional diagnosis of cardiac
   ischemia based on EKG results and expedited Gonzales’s stress test. He also
   restricted Gonzales to the ground floor so he could avoid the use of stairs.
            Dr. Geddes analyzed Gonzales’s symptoms each time he examined
   him and provided a plan of care, including two stress tests which Gonzales
   declined.2 Dr. Geddes’s February 2019 decision to order a routine rather
   than expedited stress test may have been harmful in retrospect, but does not
   amount to a constitutional violation. The decision of whether to provide ad-
   ditional care is a decision left to medical judgment. Gobert, 463 F.3d at 346.
   Given our deference to the medical expert on this point, we also defer on the
   timing of that care. Dr. Geddes expedited the stress test when an EKG re-
   turned a result suggesting heart damage.
            These records indicate that Dr. Geddes, at worst, may have misun-
   derstood the severity of the risk to Gonzales. Imperfect care or a misdiagno-
   sis does not equate to deliberate indifference. See, e.g., Gobert, 463 F.3d at
   346 (explaining that unsuccessful medical treatment, acts of negligence, and
   medical malpractice do not amount to deliberate indifference). Dr. Geddes
   did not violate Gonzales’s Eighth Amendment rights.

            _____________________
            1
            The record suggests that expedited referrals are carried out within thirty days,
   while routine referrals may take up to six months.
            2
            As mentioned, the clinic notes state that Gonzales declined stress tests. We are
   not persuaded by Gonzales’s contention that for the clinic notes to be valid, Dr. Geddes
   also needed to provide refusal forms for any instance in which Gonzales declined a stress
   test.

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                 d.      Ms. Lindley
          In February and March 2019, Gonzales filed grievance forms in an ef-
   fort to receive more effective care for his health problems. Anitra Lindley
   was a senior practice manager at the time and was involved with the receipt
   and execution of Gonzales’s grievances. Gonzales alleges that Lindley com-
   mitted spoliation, falsification of medical records, and fraud on the court in
   relation to her handling of his grievance forms. Gonzales acknowledges that
   his claims against her are “not adequately developed” because of insufficient
   discovery. Contrary to Gonzales’s allegations, Lindley’s disclosures indicate
   that she actively tried to help Gonzales. Lindley opened a new Step 1 emer-
   gency grievance so that the unit medical department, and not just the griev-
   ance program, could be contacted. Gonzales has not shown Lindley was de-
   liberately indifferent to his serious medical needs.
                 e.      Summary
          Gonzales’s allegations at most would support that some defendants
   unsuccessfully treated him and caused damage to his health. Any failures in
   their care fall short of the “extremely high standard” of deliberate indiffer-
   ence that would allow Gonzales to overcome the defendants’ qualified im-
   munity. Domino, 239 F.3d at 756.
          II.    Discovery
          Gonzales alleges that the defendants’ disclosures were incomplete un-
   der the existing scheduling order, keeping him from adequately developing
   his claims against them.
          We review decisions on pretrial discovery regarding qualified immun-
   ity for an abuse of discretion. Hutcheson v. Dallas Cnty., 994 F.3d 477, 481
   (5th Cir. 2021). “A trial court enjoys wide discretion in determining the
   scope and effect of discovery, and it is therefore unusual to find an abuse of

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   discretion in discovery matters. . . . [T]he district court’s decision should be
   reversed only in unusual and exceptional cases.” JP Morgan Chase Bank,
   N.A. v. Datatreasury Corp., 936 F.3d 251, 255–56 (5th Cir. 2019) (quotation
   marks and citations omitted).
          We have mentioned the multiple disclosures made in this case. Those
   disclosures contradicted Gonzales’s allegations of deliberate indifference.
   The district court did not abuse its discretion in denying additional discovery.
          III.   Personal Jurisdiction over Defendant Stephenson
          Ashley Stephenson was not served and was not a party to the defend-
   ants’ summary judgment motion. In recommending that Stephenson none-
   theless benefit from summary judgment, the magistrate judge cited two of
   this court’s opinions, Lewis v. Lynn, 236 F.3d 766, 768 (5th Cir. 2001) and
   McCarty v. Zapata Cnty., 243 F. App’x 792, 794 (5th Cir. 2007). The magis-
   trate judge understood these decisions to mean that “[a]n unserved defend-
   ant . . . is entitled to the benefit of the appearing defendants’ favorable sum-
   mary judgment motion.” We conclude, though, that only a defaulting de-
   fendant who has been served is entitled to such a benefit under these prece-
   dents. Although Gonzales moved for an entry of default against Stephenson,
   the district court granted summary judgment and dismissed all outstanding
   motions without having specifically addressed that motion. At the time the
   district court granted summary judgment, therefore, Stephenson was an un-
   served party who had not been held in default by the court.
          “[A] fundamental rule of civil procedure [is] that before a federal
   court may exercise jurisdiction over a defendant, the procedural requirement
   of service of summons must be satisfied.” Maiz v. Virani, 311 F.3d 334, 340
   (5th Cir. 2002) (quotation marks and citation omitted). It was not satisfied
   for Stephenson.

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          We MODIFY the judgment to state that Gonzales’s claim against De-
   fendant Stephenson is dismissed without prejudice. We otherwise AFFIRM
   the judgment of the district court with respect to all other defendants.

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