Gobert v. Caldwell
| Decision Date | 29 August 2006 |
| Docket Number | No. 05-30820.,05-30820. |
| Citation | 463 F.3d 339 |
| Parties | Anthony GOBERT, Plaintiff-Appellee, v. Lawrence CALDWELL; Michael Hegmann, Defendants-Appellants. |
| Court | U.S. Court of Appeals — Fifth Circuit |
J. Arthur Smith, III, Baton Rouge, LA, Keith Baker Nordyke (argued), Nordyke & Denlinger, Baton Rouge, LA, for Plaintiff-Appellee.
Alden Alfred Clement, Jr. (argued), Oats & Hudson, Baton Rouge, LA, for Defendants-Appellants.
Appeal from the United States District Court for the Middle District of Louisiana.
Before HIGGINBOTHAM, DAVIS and STEWART, Circuit Judges.
A state-prison physician appeals the district court's denial of his assertion of qualified immunity from an inmate's civil rights action alleging constitutionally inadequate medical care. We are persuaded that the doctor enjoys immunity and reverse.
Anthony J. Gobert was formerly an inmate confined to the Elayn Hunt Correctional Center in St. Gabriel, Louisiana. Dr. Michael Hegmann, Medical Director, and Dr. Larry Caldwell, a staff physician (collectively, "Physician Appellants"), worked at the EHCC during Gobert's term of imprisonment.
On June 14, 2000, while on work release as a "hopper" on a garbage collection truck, Gobert's right leg was crushed below the knee when the truck collided with another vehicle. He underwent immediate surgery and initial recovery at St. Anne General Hospital in Raceland, Louisiana. There, Dr. Morris applied an external fixator to stabilize Gobert's injured leg and placed him on intravenous antibiotics. Dr. Morris's discharge summary indicated that Gobert should continue antibiotic treatment and wound cleansing and that he should have periodic visits with an orthopedic specialist.
On June 26, 2000, Gobert was admitted into the 24-Hour Unit at the EHCC infirmary due to the risk of infection. Caldwell, Gobert's primary physician, personally examined Gobert on three occasions during the span of two and one half months, and apparently issued orders on nine occasions. Though not named in this suit, a nurse practitioner, Joni Nickens, participated in Gobert's care, in addition to other doctors and medical staff. Gobert complained of wound related discomfort or apprehension concerning the care of his leg on five occasions.
On September 6, 2000, Gobert was released from prison, and on September 11, 2000 he sought private medical treatment. On the day of his appointment, September 18, 2000, Dr. Wilson diagnosed Gobert with osteomyelitis,1 which required multiple corrective surgeries—the first of which was performed on October 3, 2000.
On July 2, 2001, Gobert filed this 42 U.S.C. § 1983 action, alleging that Physician Appellants' failure to treat his injured and infected leg constituted a violation of his Eighth Amendment right to medical treatment for serious medical need. After denial of their motion to dismiss, the Physician Appellants moved for summary judgment and now appeal the denial of qualified immunity.2
"Ordinarily, we do not have jurisdiction to review a denial of a summary judgment motion because such a decision is not final within the meaning of 28 U.S.C. § 1291."3 Under the collateral order doctrine, however, a district court's "order denying qualified immunity, to the extent that it turns on an `issue of law' is immediately appealable," as it is "distinct from the merits" of the case.4 A district court's decision to deny qualified immunity on a motion for summary judgment is 5
The applicable standard of review for "an interlocutory appeal asserting qualified immunity differs from the standard employed in most appeals of summary judgment rulings."6 This court lacks "the power to review the district court's decision that a genuine factual dispute exists."7 Rather, this court may consider "only whether the district court erred in assessing the legal significance of the conduct that the district court deemed sufficiently supported for purposes of summary judgment."8 This court must "accept the plaintiff's version of the facts as true" and may review de novo only the purely legal question of whether "the district court erred in concluding as a matter of law that officials are not entitled to qualified immunity on [that] given set of facts."9
Qualified immunity provides government officials performing discretionary functions with a shield against civil damages liability, so long as their actions could reasonably have been thought consistent with the rights they are alleged to have violated.10 In determining whether an official enjoys immunity, we ask (1) whether the plaintiff has demonstrated a violation of a clearly established federal constitutional or statutory right and (2) whether the official's actions violated that right to the extent that an objectively reasonable person would have known.11
Gobert asserts that Caldwell violated the Eighth Amendment's prohibition against cruel and unusual punishment by acting with deliberate indifference to Gobert's medical needs.12 Caldwell does not contest that this right is clearly established.13
Caldwell argues, however, that Gobert fails to meet his burden under the first prong of the qualified immunity inquiry, for failure to demonstrate an Eighth Amendment violation.14 Finding a violation of the Eighth Amendment's prohibition against cruel and unusual punishment also requires a twofold analysis. Gobert must first prove objective exposure to a substantial risk of serious harm.15 Additionally, he must show that prison officials acted or failed to act with deliberate indifference to that risk.16
The application of the subjective prong is the primary dispute here.17 A prison official acts with deliberate indifference "only if [ (A) ] he knows that inmates face a substantial risk of serious bodily harm and [(B)] he disregards that risk by failing to take reasonable measures to abate it."18 Unsuccessful medical treatment, acts of negligence, or medical malpractice do not constitute deliberate indifference, nor does a prisoner's disagreement with his medical treatment, absent exceptional circumstances.19 "Furthermore, the decision whether to provide additional treatment `is a classic example of a matter for medical judgment.'"20 A showing of deliberate indifference requires the prisoner to submit evidence that prison officials "`refused to treat him, ignored his complaints, intentionally treated him incorrectly, or engaged in any similar conduct that would clearly evince a wanton disregard for any serious medical needs.'"21 "Deliberate indifference `is an extremely high standard to meet.'"22
Caldwell contends that Gobert impermissibly relies on conclusory statements and speculation,23 while unsuccessfully meeting the stringent deliberate indifference standard. Caldwell argues that the record lacks any probative evidence by which the district court could correctly conclude that Caldwell acted with deliberate indifference and that the undisputed facts—including multiple examinations and administered medications, lack of complaint, and failure to follow orders — contradict the allegations and exculpate him on the applicable standard.24,25 And Caldwell argues Gobert has not contested the factual account of the medical observations made and treatment received at EHCC, as described in Caldwell's motion for summary judgment. Consequently, Caldwell believes no genuine issue of material fact exists, either to preclude jurisdiction or upon which the district court could have relied to deny his assertion of qualified immunity. We agree.
Gobert contends that the district court's decision, premised on the existence of conflicting facts, restricts our review on interlocutory appeal. However, in his response to Caldwell's statement of undisputed facts accompanying the motion for summary judgment, Gobert failed to raise any conflicting facts but, rather, recited legal questions. Gobert points to the district court's concern over the apparent presence of disputed facts and whether those facts were probative of mere negligence or deliberate indifference. The district court explained its concern:
I ... think there are just too many issues of fact ... [concerning] whether he looked at the medical records; whether he should have seen [Gobert] the amount of times he saw him; whether he was prescribing or not prescribing.... I just see too many material issues of fact dealing with what Dr. Caldwell did or didn't do at appropriate times; whether he reviewed or didn't review the medical records; whether or not other actions should have been taken; whether or not the records that were developed at the Earl K. Long Hospital were appropriately sent and filed in his record; whether he even should have taken efforts to look at those records; whether x-rays should have been done earlier and reviewed earlier ... whether there was probative evidence that Dr. Caldwell did perceive the plaintiff had an infection prior to August 7, whether or not he appropriately relied on what the medical records were....
We turn to the question of deliberate indifference to identify and place in context the material facts in dispute.26 It is Gobert who must demonstrate disputed facts relevant to the determination of Caldwell's alleged deliberate indifference, which when resolved in Gobert's favor defeat immunity.27
First, the applicable mens rea of deliberate indifference demands subjective knowledge of a substantial health risk.28 The parties contest what constitutes a health risk for purposes of an Eighth Amendment violation, Caldwell contending that knowledge of...
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