Hardin v. Norris

Decision Date20 July 2010
Docket NumberNos. 09-1862, 09-1865.,s. 09-1862, 09-1865.
Citation614 F.3d 445
PartiesMack LANGFORD; John Hardin, Appellees, v. Larry B. NORRIS, former Director of the Arkansas Department of Correction; John Byus, Administrator for Medical Services for the Arkansas Department of Correction; Max Mobley, former Deputy Director for Health and Correctional Programs for the Arkansas Department of Correction; Wendy Kelley, Deputy Director for Health and Correctional Programs for the Arkansas Department of Correction; Marvin Evans, Appellants. Mack Langford; John Hardin, Appellees, v. Dr. Nnamdi Ifediora; Correctional Medical Services, Inc., Appellants.
CourtU.S. Court of Appeals — Eighth Circuit

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Alan R. Humphries, argued, White Hall, AR, for appellant in 09-1865.

Sherri L. Robinson, Asst. Attorney Gen., argued (Shawn J. Johnson, Asst. Attorney Gen., on the brief), Little Rock, AR, for appellants in 09-1862.

Joseph Russell Falasco, argued, Kristine G. Baker, Benecia Moore, on the brief, Little Rock, AR, for appellees.

Before GRUENDER and SHEPHERD, Circuit Judges, and LANGE, 1 District Judge.

GRUENDER, Circuit Judge.

Mack Langford and John Hardin, inmates at the Randall L. Williams Correctional Facility in Arkansas, filed this lawsuit under 42 U.S.C. § 1983 against various defendants, including several current and former Arkansas Department of Correction officials, the company that provides medical services in Arkansas prisons, and a prison doctor. The plaintiffs allege, among other things, that the defendants violated the Eighth Amendment by acting with deliberate indifference to their serious medical needs. The defendants moved for summary judgment on most of the plaintiffs' claims, and the district court granted the motions in part and denied the motions in part. Some but not all of the defendants have appealed the denial of summary judgment on the remaining claims against them. We dismiss in part for lack of jurisdiction, affirm in part, and reverse in part.

I. BACKGROUND

The indispensable substantive and procedural facts are as follows. Mack Langford is in his early eighties and has been incarcerated since 1997. Langford suffers from a variety of physical maladies and shows signs of mild mental retardation and dementia. The crux of Langford's factual allegations is that he has complained for years of stomach and back pain, among other ailments, yet his infirmities have not been adequately treated.

Langford points to two incidents in which his condition was allowed to deteriorate until emergency medical intervention was required. The first happened in April 2003. Langford alleges that he had complained repeatedly of severe stomach pain, vomiting blood, and other symptoms, yet medical personnel at the prison chalked these up to “gas” and gave him antacid tablets. Eventually, Langford passed out in the prison barracks and was rushed to a local hospital. At the hospital, doctors discovered a problem with Langford's gallbladder, which might later have been removed (the record is not clear), and found cysts in both his kidneys.

After Langford was released from the hospital the first time, he continued to complain periodically of stomach and back pain. Starting in November 2004, Langford was examined at least sixteen times by Dr. Nnamdi Ifediora, an employee or contractor of Correctional Medical Services, Inc. (CMS), the company that provides medical services in Arkansas prisons. Dr. Ifediora at times referred Langford to specialists, from whom he sought diagnostic recommendations. Imaging tests performed in August 2005 revealed a possible mass in one of Langford's kidneys and cysts in both kidneys.

The second incident requiring emergency intervention happened in November 2005. Langford alleges that on November 28, 2005, he again complained of stomach pain and again did not receive adequate treatment until he passed out and was rushed to the hospital. There, doctors diagnosed Langford with pancreatitis and again found cysts in both his kidneys. Langford claims that he still has not received adequate treatment for these cysts or for “possible renal failure.”

The record shows that Langford filed many grievances about his medical needs and the alleged inadequacy of the corresponding treatment, starting as early as May 2003. In at least one instance, Langford went outside the prison's official grievance procedure by sending a letter to John Byus, Administrator for Medical Services for the Department of Correction. Byus has not produced Langford's letter, so its contents are uncertain. The record does, however, contain a series of e-mails that Byus received on July 26 and July 27, 2005 (apparently sent by Department of Correction or CMS employees), summarizing Langford's most recent medical problems and how those problems had been dealt with. The record also contains a letter from Byus to Langford, dated August 11, 2005, which refers to a letter from Langford, dated July 20, 2005, on the subject of “competent medical staff.” In his August 11 letter, Byus instructs Langford to “refer to the informal resolution and grievance process for future concerns and/or complaints.” Byus concludes the letter by stating that [a]ll documentation will be forwarded to the Health Service Administrator and Regional Health Administrator, advising them to address situation [sic] and inform you of findings either by written correspondence or interview.” It is not clear whether Langford received the promised response.

Langford's co-plaintiff, John Hardin, is sixty-six years old and has been incarcerated since 1996. Hardin has insulin-dependent diabetes that is not well controlled. The crux of Hardin's factual allegations is that a lapse in treatment following surgery for a broken ankle caused, or perhaps merely exacerbated the effects of, a condition called “Charcot foot.” 2

Hardin fell and broke his ankle in February 2004. Dr. John Lytle, an orthopedic surgeon in private practice who occasionally treats prisoners, performed surgery on the injured ankle. Hardin had several routine follow-up visits with Dr. Lytle, the last of which was in May 2004. After that visit, Hardin began complaining of severe pain in his surgically repaired ankle.

Hardin alleges that in July 2004, a doctor in the prison infirmary told him that “there was something seriously wrong” with his ankle, which had become “misshapen and deformed.” In September 2004, Hardin saw Dr. Ifediora, who noted the deformity in Hardin's ankle as well as Hardin's pain and difficulty walking. Dr. Ifediora ordered a wheelchair for Hardin and referred him for an “orthopedic consult” with Dr. Lytle. Hardin alleges that he was initially prescribed a wheelchair in February 2004 but did not receive one until Dr. Ifediora made this redundant prescription, seven months later.

In October 2004, Hardin saw Dr. Lytle, who diagnosed him with Charcot foot. Dr. Lytle observed that Hardin's bones showed “significant deterioration” and that reconstructive surgery might not be an option. Based on these observations, Dr. Lytle suggested that amputating Hardin's leg below the knee might give him the best chance to regain mobility. After receiving this dispiriting news, Hardin continued to complain periodically about pain and the deformity in his ankle.

In February 2005, Hardin saw Dr. Lytle for the last time. Dr. Lytle noted his concerns about the “progressive deformity” in Hardin's ankle and about Hardin's inability to bear weight on the injured leg. Dr. Lytle prescribed a padded tennis shoe and a cane, and suggested that Hardin might need a brace for his foot. Hardin alleges that he still has not received a brace or a padded shoe that fits properly. Moreover, Hardin claims that he is now “wheelchair bound” and says that he has not been offered any other treatment options.

The record shows that Hardin filed many grievances about his medical needs and the alleged inadequacy of the corresponding treatment, starting as early as August 2004. Like his co-plaintiff, Hardin also went outside the prison's official grievance procedure by sending a letter to Byus. And Byus has again produced his reply but not the letter that prompted him to write it. The letter from Byus to Hardin is dated October 26, 2004, and refers to a letter from Hardin, dated October 15, 2004, on the subject of “injury to right ankle and request to see Orthopedic Specialist.” Byus wrote that [b]y copy of this letter, I am advising the Health Services Administrator to look into this matter and communicate findings to you either by interview or written correspondence.” It is not clear whether Hardin received the promised response.

The plaintiffs brought this action under 42 U.S.C. § 1983 against two principal sets of defendants. The first set consists of current and former Department of Correction officials: namely, Larry Norris, the former Director of the Department of Correction; John Byus, whom we have already introduced; and Max Mobley, the former Deputy Director for Health and Correctional Programs (hereinafter, the state defendants). The second set of defendants consists of CMS and Dr. Ifediora (hereinafter, “the medical defendants). 3 The plaintiffs' amended complaint alleges that both the state defendants and the medical defendants acted with deliberate indifference to their serious medical needs, in violation of the Eighth Amendment's prohibition on cruel and unusual punishments. In addition, the complaint alleges that the defendants deprived them of their rights to due process and equal protection under the Fourteenth Amendment and violated the Americans with Disabilities Act (ADA) and the Rehabilitation Act. The complaint also includes state law claims of negligence and intentional infliction of emotional distress, otherwise known as the “tort of outrage.”

The state defendants and the medical defendants moved for summary...

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