Chance v. Armstrong

• Decision Date: 07 May 1998
• Docket Number: Docket No. 97-2028
• Citation: 143 F.3d 698
• Parties: Stanley CHANCE, Plaintiff-Appellant, v. John ARMSTRONG, I/O; Dr. Brewer, I/O; Esther McIntosh, I/O; Michael Bonzagni, I/O; Dr. Hutchinson, I/O; Dr. Barnard, I/O; Amy Cobuzzi, I/O, Defendants, Dr. Gary W. Murphy, I/O; Dr. Moore, I/O, Defendants-Appellees.
• Court: U.S. Court of Appeals — Second Circuit

Page 698

143 F.3d 698

Stanley CHANCE, Plaintiff-Appellant, v. John ARMSTRONG, I/O; Dr. Brewer, I/O; Esther McIntosh I/O; Michael Bonzagni, I/O; Dr. Hutchinson, I/O Dr. Barnard, I/O; Amy Cobuzzi, I/O, Defendants Dr. Gary W. Murphy, I/O; Dr. Moore, I/O, Defendants-Appellees.

Docket No. 97-2028.

United States Court of Appeals Second Circuit.

Submitted Jan. 28, 1998.

Decided May 7, 1998.

Stanley Chance, pro se.

Richard Blumenthal, Atty. Gen., and Ann E. Lynch, Asst. Atty. Gen., for Defendant-Appellee.

Before: CALABRESI, CABRANES, and HEANEY, Circuit Judges. ^*

CALABRESI, Circuit Judge:

Stanley Chance, pro se and incarcerated, appeals from a judgment of the United States District Court for the District of Connecticut (Dominic J. Squatrito, Judge ), granting the defendant's motion to dismiss Chance's complaint pursuant to Federal Rule of Civil Procedure 12(b)(6). Chance sued under 42 U.S.C. § 1983, alleging that the defendants failed to provide him with adequate medical care and thereby violated his constitutional rights. We hold that the claim should not have been dismissed under Rule 12(b)(6) and we therefore reverse.

I. Facts & Procedural History

Chance filed suit against state correctional officials as well as various dentists and doctors, including Dr. Moore and Dr. Murphy, who were involved in treating him while he was incarcerated at the MacDougall Correctional Institution in Connecticut. The gravamen of Chance's complaint was that he received inadequate dental treatment in violation of the Eighth Amendment of the United States Constitution. He also alleged that state correctional officials ignored his correspondence complaining about the dental treatment he received.

Chance's original complaint alleged that he had an overbite that made it difficult for him to chew or speak. He also claimed that he had a cavity that caused him "great pain." In his amended complaint, he outlined further details of his dental problems and the treatment he had received. ¹ In November 1994, Dr. Moore told Chance that two of his teeth, number one and number eight, needed to be pulled. Chance did not believe that extraction was necessary and therefore refused to allow Dr. Moore to pull them. He attached to his complaint a letter from Dr. David Feinerman, another oral surgeon who had treated him during his incarceration. According to Chance, the letter indicated that Dr. Feinerman believed that tooth number one could be saved. The letter itself ambiguously referred to a tooth that could be saved as tooth number two.

In March 1995, Dr. Moore examined the plaintiff again and recommended that tooth number three be pulled. Dr. Moore communicated this recommendation to Dr. Murphy, an oral surgeon at the prison. Again, Chance thought extraction was unnecessary and refused this treatment. He alleged in his complaint that Dr. Murphy would have been paid extra for the extractions and that Dr. Murphy was planning to give some of the money to Dr. Moore.

Chance asserted that less invasive procedures, such as filling his teeth instead of extracting them, would have remedied his dental problems. In February 1996, Chance was examined by another dentist, Dr. Holder, who advised him that tooth number one had to be extracted, but that tooth number eight could be filled. Later that month, Chance saw yet another dentist, Dr. Ashwood, who took x-rays and filled tooth number eight. Chance alleged that this exam proved that tooth number eight and tooth number three did not have to be pulled. Chance further claimed that if Drs. Moore or Murphy had filled tooth number one earlier (at the time when he refused extraction) that that tooth could have been saved as well.

In September 1996, the defendants moved under Rule 12(b)(6) to dismiss Chance's complaint for failure to state a claim. They argued that the plaintiff had failed: 1) to allege a legally cognizable injury; 2) to establish a sufficiently serious medical condition; and 3) to show that the defendants had acted with deliberate indifference to his medical needs. Chance argued in response that, as a result of Dr. Moore's and Dr. Murphy's failure to fill his cavities in a timely manner, he now has to have his teeth pulled. In addition he asserted that the defendants were deliberately indifferent to his medical needs.

In an unpublished order filed on November 6, 1996, the district court granted the defendants' motion to dismiss. With respect to the claims against Drs. Moore and Murphy, the court held that the plaintiff's cavities were not "a sufficiently serious medical condition for Eighth Amendment purposes." In addition, the court found that the facts alleged by the plaintiff did not constitute deliberate indifference, and at best showed negligence or medical malpractice. Finally, in regard to Chance's claims that certain correctional officials had responded inadequately to his complaints, the court concluded that the plaintiff had not demonstrated any violation of his constitutional rights.

The plaintiff appealed. In an order dated June 18, 1997, this Court dismissed Chance's appeal pursuant to 28 U.S.C. § 1915(e) as to all of the defendants except Dr. Moore and Dr. Murphy, but indicated that the claims against them were non-frivolous. See Chance v. Armstrong, 143 F.3d 698 (2d Cir.1997). Chance's claims against these two defendants are the only ones properly before us.

II. Discussion

A. Dismissal under Rule 12(b)(6) for Failure to State a Claim

We review de novo the district court's dismissal of a complaint pursuant to Rule 12(b)(6). See, e.g., Sykes v. James, 13 F.3d 515, 518-19 (2d Cir.1993). Like the district court, we are required to accept the material allegations in the complaint as true. Dismissal is not appropriate "unless it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief." Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 101-02, 2 L.Ed.2d 80 (1957). This rule applies with particular force where the plaintiff alleges civil rights violations or where the complaint is submitted pro se. See, e.g., Hernandez v. Coughlin, 18 F.3d 133, 136 (2d Cir.1994).

It is important to recognize the difference between disposing of a case on a 12(b)(6) motion and resolving the case later in the proceedings, for example by summary judgment. At the 12(b)(6) stage, "[t]he issue is not whether a plaintiff is likely to prevail ultimately, but whether the claimant is entitled to offer evidence to support the claims. Indeed it may appear on the face of the pleading that a recovery is very remote and unlikely but that is not the test." Branham v. Meachum, 77 F.3d 626, 628 (2d Cir.1996) (quoting Gant v. Wallingford Bd. of Educ., 69 F.3d 669, 673 (2d Cir.1995) (internal quotation marks omitted)).

The case before us should not have been dismissed for failure to state a claim. Stanley Chance might not be able to prove his claims at trial. And even at the summary judgment stage, it may well become clear that Chance cannot proffer sufficient proof to create genuine issues of material fact. But in his complaint, he has alleged facts that are not impossible to prove and that, if demonstrated, would state a legally cognizable claim. Accordingly, we reverse.

B. Eighth Amendment Violation

The Eighth Amendment prohibits the infliction of "cruel and unusual punishments." U.S. Const. amend VIII. This includes punishments that "involve the unnecessary and wanton infliction of pain." Gregg v. Georgia, 428 U.S. 153, 173, 96 S.Ct. 2909, 2925, 49 L.Ed.2d 859 (1976). In order to establish an Eighth Amendment claim arising out of inadequate medical care, a prisoner must prove "deliberate indifference to [his] serious medical needs." Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 291, 50 L.Ed.2d 251 (1976). The standard of deliberate indifference includes both subjective and objective components. "First, the alleged deprivation must be, in objective terms, 'sufficiently serious.' " Hathaway v. Coughlin, 37 F.3d 63, 66 (2d Cir.1994) (citations omitted). Second, the defendant "must act with a sufficiently culpable state of mind." Id. An official acts with the requisite deliberate indifference when that official "knows of and disregards an excessive risk to inmate health or safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference." Farmer v. Brennan, 511 U.S. 825, 837, 114 S.Ct. 1970, 1979, 128 L.Ed.2d 811 (1994).

1. Serious Medical Condition

In the case before us, the district court held that the plaintiff's dental condition was, as a matter of law, insufficiently serious to give rise to an Eighth Amendment claim. We disagree. At the 12(b)(6) stage, we must accept Chance's allegations as true. Chance has alleged that he has been in "great pain" for at least six months, that he has been unable to chew properly, and that he has choked on his food, all because of Dr. Moore's and Dr. Murphy's actions. He further claims that, as a result of Dr. Moore's and Dr. Murphy's inadequate treatment, at least one and possibly three of his teeth have degenerated to the point of requiring extraction. Any person who has spent a night tossing and turning in suffering from an abscessed tooth knows that dental pain can be excrutiatingly severe. And while losing three teeth is not the same as losing an arm or a leg, it is not an inconsequential harm. As the plaintiff noted in one of his letters to the prison officials, "I am 27 years old and I know I should not have dentures at 27."

Of course, not all claims regarding improper dental care will be constitutionally cognizable. Dental conditions, like other medical conditions, may be of varying severity. The standard for Eighth Amendment violations contemplates "a condition of urgency" that may result in "degeneration" or "extreme pain." Hathaway, 37 F.3d at 66 (quoting Nance v. Kelly, 912...