Brooks v. Celeste, s. 92-3370

• Decision Date: 17 January 1995
• Docket Number: Nos. 92-3370,92-3897,s. 92-3370
• Citation: 39 F.3d 125
• Parties: Calvin BROOKS, Individually and on behalf of all others similarly situated, Plaintiffs-Appellants, Wesley Flynn, et al., Plaintiffs, v. Richard F. CELESTE; Richard P. Seiter; William Dallman; Dr. G. Martinez; and Wes Jones, Defendants-Appellees.
• Court: U.S. Court of Appeals — Sixth Circuit

Page 125

39 F.3d 125

30 Fed.R.Serv.3d 1051

Calvin BROOKS, Individually and on behalf of all others

similarly situated, Plaintiffs-Appellants, Wesley Flynn, et al., Plaintiffs, v. Richard F. CELESTE; Richard P. Seiter; William Dallman;

Dr. G. Martinez; and Wes Jones, Defendants-Appellees.

Nos. 92-3370, 92-3897.

United States Court of Appeals, Sixth Circuit.

Argued Nov. 19, 1993.

Decided Nov. 9, 1994.

Rehearing and Suggestion for Rehearing En Banc Denied Jan. 17, 1995.

David A. Little (Argued and Briefed), Legal Services Ass'n, Lima, OH, for plaintiffs-appellants.

Cordelia A. Glenn, Asst. Atty. Gen. (Argued and Briefed), Allen P. Adler, Asst. Atty. Gen. (Briefed), Office of the Atty. Gen. of Ohio, Columbus, OH, for defendants-appellees.

Before: MARTIN and RYAN, Circuit Judges; and EDGAR, District Judge. ^*

RYAN, Circuit Judge.

Plaintiffs filed this 42 U.S.C. Sec. 1983 class action on behalf of all current and future inmates confined at the Lima Correctional Institute (LCI), an Ohio state prison. Plaintiffs accused the defendants of inflicting cruel and unusual punishment in violation of the Eighth Amendment by failing to provide the plaintiffs with adequate medical care. After a bench trial before a magistrate acting as a special master, the district court entered judgment for defendants. Plaintiffs appealed, but this court dismissed plaintiffs' appeal for lack of jurisdiction due to their defective notice of appeal. 16 F.3d 104 (6th Cir.1994). However, we now vacate that decision and address the case on the merits. We shall affirm in part, but also remand for further factfinding.

I.

On May 22, 1987, plaintiffs filed a complaint alleging that defendants inflicted cruel and unusual punishment in violation of the Eighth Amendment by being deliberately indifferent to plaintiffs' serious medical needs. Specifically, plaintiffs alleged that Dr. Martinez, the physician at LCI, repeatedly failed to conduct proper physical examinations and to prescribe necessary pain medications; plaintiffs also alleged that Dr. Martinez regularly cancelled prescriptions made by other doctors without consulting the prescribing doctors or examining the inmates. The other defendants allegedly failed to properly supervise Dr. Martinez and to remedy the problems once they were brought to defendants' attention.

The special master heard six days of testimony in October and November 1990. He filed a report on October 24, 1991. The special master first found that

plaintiffs' challenge to the overall structure for providing health services to the inmates at LCI [is] not well taken....

... There is ... no basis in the record before this Court for a finding that the facilities at Lima manifest the deliberate indifference toward the well-being of the institution's inmates that must be shown under Estelle v. Gamble, 429 U.S. 97 [97 S.Ct. 285, 50 L.Ed.2d 251] (1976)....

However, even though the facilities did not support an Eighth Amendment claim, the special master found that

sufficient flaws in the implementation of that system exist to warrant this Court's limited intervention....

These flaws relate to the manner in which the institution's physician, Dr. Guilermo Martinez, fails to perform basic medical responsibilities.

(Emphasis added.) The report detailed Dr. Martinez's actions and concluded that he acted with deliberate indifference toward the plaintiffs' serious medical needs. However, the precise basis for the finding of deliberate indifference is unclear; as we explain later, the precise imprecision of this finding makes all the difference. Some parts of the report describe Dr. Martinez's actions as "malpractice"; at another, the report labels the doctor's care as "not only indifference, but, in some instances, outright hostility." Thus, one might determine that the special master found that Dr. Martinez repeatedly acted with negligence, and those negligent acts formed the basis for the deliberate indifference conclusion. Read another way, the special master found that Dr. Martinez actually knew that his care was potentially harmful, and for that reason was deliberately indifferent.

The district court read the report in the former light; the court did not, however, note any ambiguity in the report. Having interpreted the report as finding that Dr. Martinez repeatedly acted with negligence, the district court concluded that repeated acts of negligence cannot by themselves amount to "deliberate indifference." Plaintiffs appealed the district court's judgment, as well as its earlier decisions to dismiss plaintiffs' claims for compensatory damages and to deny plaintiffs' motion to amend the complaint, and its later decision to deny plaintiffs' motion for relief from the judgment.

II.

A. Eighth Amendment

The Eighth Amendment's ban against cruel and unusual punishment obliges prison authorities to provide medical care for prisoners' serious medical needs. In Estelle v. Gamble, the Supreme Court held that

deliberate indifference to serious medical needs of prisoners constitutes the "unnecessary and wanton infliction of pain," proscribed by the Eighth Amendment. This is true whether the indifference is manifested by prison doctors in their response to the prisoner's needs or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with the treatment once prescribed.

429 U.S. 97, 104-05, 97 S.Ct. 285, 291, 50 L.Ed.2d 251 (1976) (citations and footnotes omitted). The Court held, however, that mere negligence does not violate the Eighth Amendment:

[A] complaint that a physician has been negligent in diagnosing or treating a medical condition does not state a valid claim of medical mistreatment under the Eighth Amendment. Medical malpractice does not become a constitutional violation merely because the victim is a prisoner. In order to state a cognizable claim, a prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs.

Id. at 106, 97 S.Ct. at 292 (emphasis added).

The Supreme Court recently explained why plaintiffs bringing Eighth Amendment claims must allege some intent on the part of officials: "The source of the intent requirement is not the predilections of this Court, but the Eighth Amendment itself, which bans only cruel and unusual punishment. " Wilson v. Seiter, 501 U.S. 294, 300, 111 S.Ct. 2321, 2325, 115 L.Ed.2d 271 (1991). Therefore, a plaintiff must prove by a preponderance of the evidence, see Doe v. Sullivan County, Tenn., 956 F.2d 545, 555-56 (6th Cir.), cert. denied, --- U.S. ----, 113 S.Ct. 187, 121 L.Ed.2d 131 (1992), both an objective and subjective component: (1) a sufficiently grave deprivation, such as serious medical needs; and (2) a sufficiently culpable state of mind. Wilson, 501 U.S. at 298, 111 S.Ct. at 2324. In all cases, the required state of mind is wantonness; however, the meaning of wantonness depends on the type of offending conduct:

[O]ur cases say that the offending conduct must be wanton. Whitley makes clear, however, that in this context wantonness does not have a fixed meaning but must be determined with "due regard for differences in the kind of conduct against which an Eighth Amendment objection is lodged." ... "[T]he State's responsibility to attend to the medical needs of prisoners does not ordinarily clash with other equally important governmental responsibilities," so that in that context, as Estelle held, "deliberate indifference" would constitute wantonness.

Id. at 302, 111 S.Ct. at 2326 (quoting Whitley v. Albers, 475 U.S. 312, 320, 106 S.Ct. 1078, 1084, 89 L.Ed.2d 251 (1986)).

In this last Supreme Court term, the Court defined "deliberate indifference." Farmer v. Brennan, --- U.S. ----, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994). In Farmer, the Court held that a prison official acts with deliberate indifference when he acts with criminal recklessness. This state of mind requires that the official " 'consciously disregar[d]' a substantial risk of serious harm." Id. at ----, 114 S.Ct. at 1980 (alteration in original) (quoting Model Penal Code Sec. 2.02(2)(c) (1985)). Thus, a showing of deliberate indifference requires a showing of the official's actual awareness of a substantial risk of serious harm. Id. at ----, 114 S.Ct. at 1981.

Prior to Farmer, some courts of appeals decisions might be read to hold that repeated acts of negligence by themselves constitute deliberate indifference. See DeGidio v. Pung, 920 F.2d 525 (8th Cir.1990); White v. Napoleon, 897 F.2d 103 (3d Cir.1990); Rogers v. Evans, 792 F.2d 1052 (11th Cir.1986); Wellman v. Faulkner, 715 F.2d 269 (7th Cir.1983), cert. denied, 468 U.S. 1217, 104 S.Ct. 3587, 82 L.Ed.2d 885 (1984); Ramos v. Lamm, 639 F.2d 559 (10th Cir.1980), cert. denied, 450 U.S. 1041, 101 S.Ct. 1759, 68 L.Ed.2d 239 (1981); Todaro v. Ward, 565 F.2d 48 (2d Cir.1977).

However, these cases really establish that one way to prove that an official acted with deliberate indifference is to show that he repeatedly acted in a certain manner. In such cases, the repeated acts, viewed singly and in isolation, would appear to be mere negligence; however, viewed together and as a pattern, the acts show deliberate indifference. Thus, when the courts referred to "repeated acts of negligence," the language was simply unfortunate--the pattern of the acts actually helps prove that each act was committed with deliberate indifference.

For example, in Wellman, the Seventh Circuit stated that "[a]s a practical matter, 'deliberate indifference' can be evidenced by 'repeated examples of negligent acts which disclose a pattern of conduct by the prison medical staff....' " 715 F.2d at 272 (emphasis added) (quoting Ramos, 639 F.2d at 575). Thus, the court in Wellman seemed to describe a method of proof, not a per se equating of negligent acts to deliberate indifference. Similarly, in Todaro, the case most heavily relied upon by other courts, see Wellman, 715 F.2d at 272...