Stokes v. Hurdle

• Decision Date: 26 March 1975
• Docket Number: Civ. No. 73-494-B.
• Citation: 393 F. Supp. 757
• Parties: James E. X. STOKES v. Dr. HURDLE et al.
• Court: U.S. District Court — District of Maryland

393 F. Supp. 757

James E. X. STOKES v. Dr. HURDLE et al.

Civ. No. 73-494-B.

United States District Court, D. Maryland.

March 26, 1975.

COPYRIGHT MATERIAL OMITTED

James E. X. Stokes, pro se.

Francis B. Burch, Atty. Gen. of Maryland, John P. Stafford, Jr., and Emory A. Plitt, Jr., Asst. Attys. Gen., Baltimore, for defendants.

MEMORANDUM AND ORDER

BLAIR, District Judge.

Plaintiff, incarcerated at the Maryland Penitentiary, has brought this civil rights action under 42 U.S.C. § 1983 (1970), alleging that he was denied dental treatment while in segregation at the penitentiary. Plaintiff claims that denying routine dental treatment only to inmates in segregation, while granting such treatment to the general prison population, violates the Equal Protection Clause of the Fourteenth Amendment. He also claims that the denial of dental treatment constitutes cruel and unusual punishment in violation of the Eighth and Fourteenth Amendments. Plaintiff requests declaratory and injunctive relief, as well as compensatory and exemplary damages. Jurisdiction of this court is grounded upon 28 U.S.C. § 1343(3)(1970).

The original defendants in this case were Dr. Brown, alleged to be the dentist of the Maryland Penitentiary, and Gerald McClellan, the warden of the penitentiary. Plaintiff later moved to add Dr. Hurdle as a defendant and drop Dr. Brown, after plaintiff discovered that Dr. Hurdle was the actual dentist who he alleges denied him dental treatment. Plaintiff's motion was granted, and Dr. Hurdle was added as a party defendant. Stokes v. Brown, Civil No. 73-494-B, at 1 (D.Md., July 16, 1974) (Memorandum and Order).

On July 2, 1973, defendants moved to dismiss or, in the alternative, for a summary judgment, on the grounds that plaintiff failed to exhaust his state administrative remedies, that he failed to state a claim upon which relief could be granted, and for lack of subject-matter jurisdiction. The motion was denied. Stokes v. Brown, Civil No. 73-494-B (D.Md., July 16, 1974) (Memorandum and Order). Defendants were given leave to file additional motions or otherwise answer.

On October 7, 1974, defendants filed a supplemental motion for summary judgment, together with a sworn affidavit of Dr. Wilfred J. St. Cyr, D.D.S., a dentist employed by the Maryland Penitentiary. Attached to the affidavit are the plaintiff's prison dental records; in the affidavit Dr. Cyr states that these records were kept in the ordinary course of business under his direct supervision and control. On October 18, 1974, the plaintiff filed a sworn affidavit entitled "Memorandum In Opposition to Supplemental Motion For Summary Judgment." The pleadings and affidavits filed by the parties disclose the following undisputed facts:

Plaintiff was placed in segregation at the penitentiary following a disciplinary hearing on February 27, 1973. Plaintiff had been scheduled for an appointment to have some teeth filled on February 28, 1973. The policy of the prison, however, was to provide only emergency dental care to prisoners housed in segregation. Hence, on February 28, plaintiff was informed by an unnamed medical officer that his dental appointment could not be kept, pursuant to that policy. Plaintiff then made several written requests to the warden for dental care. Having received no reply or dental care by March 12, plaintiff wrote to the Governor and the Inmate Grievance Commission seeking redress. On March 16, he was still in pain and his teeth had not been filled. An unnamed dental specialist then told him that he would soon have a dental appointment and have some corrective work done on his jaws.

The plaintiff saw Dr. Hurdle on March 21, 1973; Dr. Hurdle examined the plaintiff and made an appointment for him to see Dr. Cappuccio, a specialist. Hurdle refused to fill plaintiff's teeth at that time, citing the prison's policy to perform only emergency work on inmates in segregation. On April 2, 1973, the plaintiff saw Dr. Cappuccio, who examined him and took four x-rays. As a result of the examination, plaintiff was diagnosed as having a malocclusion of the upper left and right second molars and subluxation of the left and right condyles. The doctor recommended that plaintiff be assigned for operative dentistry and that he be given injections of sclerosing solution into his left and right condyles. Dr. Cappuccio noted on the records that there was no emergency and that plaintiff was in no pain or discomfort. Plaintiff does not allege that the prescribed injections were not given.

Plaintiff admits that he received some dental restoration work in June or July of 1973. The records also disclose that plaintiff was given further dental care in November (when he was advised to have a tooth extracted, which he refused) and December of 1973, and in January and April of 1974. It is the opinion of Dr. Cyr that the plaintiff has been given proper dental care in accordance with standard practice. Plaintiff, however, maintains that he needs further restorative work and that, because of the failure to give earlier dental care, he must now have a tooth extracted.

The only pure factual dispute appears to be whether or not plaintiff was in pain and discomfort when he first saw Dr. Hurdle and Dr. Cappuccio.

Equal Protection Claim

Plaintiff first contends that the prison's practice, carried out by defendants, of providing only emergency dental care to prisoners in segregation, while providing routine dental care to the general prison population, violates the Equal Protection Clause of the Fourteenth Amendment. The traditional standard of review when a state practice is challenged on equal protection grounds "requires only that the State's system be shown to bear some rational relationship to legitimate state purposes." San Antonio School Dist. v. Rodriguez, 411 U. S. 1, 40, 93 S.Ct. 1278, 1300, 36 L.Ed.2d 16 (1973); accord, McGinnis v. Royster, 410 U.S. 263, 271, 93 S.Ct. 1055, 35 L. Ed.2d 282 (1973); Kersh v. Bounds, 501 F.2d 585, 588 (4th Cir. 1974), cert. denied, 420 U.S. 925, 95 S.Ct. 1120, 43 L. Ed.2d 394 (1975); United States ex rel. Raymond v. Rundle, 276 F.Supp. 637, 638 (E.D.Pa.1967).

The prison officials, of course, have a great interest in maintaining prison order and discipline among the inmate population. Certain privileges may thus be curtailed to a particular class of inmates if the curtailment is reasonably related to the maintenance of such order and discipline. United States ex rel. Raymond v. Rundle, 276 F.Supp. 637, 638 (E.D.Pa.1967).

Prisoners in segregation necessarily, by their very nature, require direct, individual supervision when traveling from one area of the prison to another. Since routine dental care may require many visits to the prison dentist, the prison officials may reasonably conclude that routine dental care be temporarily curtailed due to the shortage of personnel to supervise such visits. Under such circumstances, a rule allowing only emergency dental care for prisoners in segregation is reasonably related to the valid goal of maintaining order and discipline among the inmates. Cf. Kersh v. Bounds, 501 F.2d 585 (4th Cir. 1974), cert. denied, 420 U.S. 925, 95 S. Ct. 1120, 43 L.Ed.2d 394 (1975); United States ex rel. Raymond v. Rundle, supra at 639.

Moreover, prison officials "must have a wide discretion in promulgating rules to govern the prison population and in imposing disciplinary sanctions for their violation." McCloskey v. Maryland, 337 F.2d 72, 74 (4th Cir. 1964). Hence, within the broad limits set by the Eighth Amendment, prison officials may validly impose a system of rewards and punishment to encourage good behavior and discourage breach of the prison rules. Johnson v. Anderson, 370 F.Supp. 1373, 1384 (D.Del.1974). Accordingly, the officials may, consistent with the Equal Protection Clause, withdraw certain privileges, such as routine dental care, from those who have violated prison rules, as long as the deprivation does not itself violate the Eighth Amendment's prohibition against cruel and unusual punishment. Thus, the only question in this case is whether the plaintiff, under the circumstances, was denied the dental care that is constitutionally due.

Eighth Amendment Claim

In this circuit, a prisoner is constitutionally entitled to reasonable medical care,¹ the scope of which encompasses reasonable dental care as well. Collins v. Schoonfield, 344 F.Supp. 257, 277 (D.Md.1972); Blakey v. Sheriff of Albemarle County, 370 F.Supp. 814 (W.D. Va.1974). This entitlement is based upon the Eighth Amendment prohibition against cruel and unusual punishment. Brown v. Cliff, 341 F.Supp. 177, 178 (E.D.Pa.1972). However, the scope of what care is "reasonable" has not been further delineated by the Fourth Circuit. Other circuits and districts, however, have adopted narrow and specific tests as to when the deprivation or inadequacy of prisoner medical care violates the Constitution.

It is unanimously agreed that a total denial of necessary or essential medical care violates the Eighth Amendment and is therefore actionable under 42 U.S.C. § 1983. Thomas v. Pate, 493 F.2d 151 (7th Cir. 1974), vacated on other grounds sub nom., Cannon v. Thomas, 419 U.S. 813, 95 S.Ct. 288, 42 L.Ed.2d 39 (1974); Jones v. Lockhart, 484 F.2d 1192, 1194 (8th Cir. 1973); Corby v. Conboy, 457 F.2d 251, 254 (2d Cir. 1972); Campbell v. Beto, 460 F.2d 765 (5th Cir. 1972); Shields v. Kunkel, 442 F.2d 409, 410 (9th Cir. 1971); McDonald v. Boslow, 363 F.Supp. 493, 498 (D.Md.1973); Brown v. Cliff, 341 F.Supp. 177, 178 (E.D.Pa.1972); see Hirons v. Director, Patuxent Inst., 351 F.2d 613, 614 (4th Cir. 1965). In determining whether medical care was "essential" in a given case, the question is whether a physician exercising ordinary skill and care would have concluded that the symptoms evidenced a serious injury; whether the potential for harm by reason of delay or denial of medical care was substantial; and whether such harm did result. Thomas...