Cullor v. Baldwin

• Decision Date: 01 August 2016
• Docket Number: No. 14-3723,14-3723
• Citation: 830 F.3d 830
• Parties: Charles D. Cullor, Plaintiff–Appellant v. John Baldwin; Harbons Deol; Sheryl Lockwood–Dahm; Nick Ludwick; Rebecca Bowker; Dave DeGrange; Mark Larson; Stephanie Cooper ; Grant Abernathy; Monica Nye, Defendants–Appellees.
• Court: U.S. Court of Appeals — Eighth Circuit

830 F.3d 830

Charles D. Cullor, Plaintiff–Appellant

v.John Baldwin; Harbons Deol; Sheryl Lockwood–Dahm; Nick Ludwick; Rebecca Bowker; Dave DeGrange; Mark Larson; Stephanie Cooper ; Grant Abernathy; Monica Nye, Defendants–Appellees.

No. 14-3723

United States Court of Appeals, Eighth Circuit.

Submitted: February 10, 2016

Filed: August 1, 2016

Counsel who presented argument on behalf of the appellant was Rockne Ole Cole, of Iowa City, IA. The following attorney(s) appeared on the appellant brief; Rockne Ole Cole, of Iowa City, IA.

Counsel who presented argument on behalf of the appellee was H. Loraine Wallace, AAG, of Des Moines, IA. The following attorney(s) appeared on the appellee brief; H. Loraine Wallace, AAG, of Des Moines, IA.

Before SMITH and COLLOTON, Circuit Judges, and ERICKSON,¹ District Judge.

SMITH, Circuit Judge.

Charles Cullor, an Iowa prison inmate, brought suit against, among others, John Baldwin, Director of the Iowa Department of Corrections (IDOC), and Dr. Harbons Deol, Medical Director of the IDOC, under 42 U.S.C. § 1983 for deliberate indifference to his serious medical need, in violation of the Eighth Amendment. Specifically, Cullor alleged that Director Baldwin and Dr. Deol were deliberately indifferent to his need for dentures. Cullor sought declaratory and injunctive relief, as well as compensatory and punitive damages. Director Baldwin and Dr. Deol moved for summary judgment, which the district court² granted. Cullor now appeals, and we affirm.

I. Background

“We recite the facts from the record in the light most favorable to [Cullor], the nonmovant in this summary judgment disposition.” PPS, Inc. v. Faulkner Cty., Ark ., 630 F.3d 1098, 1100 (8th Cir. 2011) (citation omitted).³

Cullor has lived at the Iowa State Penitentiary (ISP) since October 1980. While at the ISP, he has received regular dental checkups. Cullor has a history of significant tooth decay. During Cullor's time at the ISP, prison dentists have extracted several of his teeth. On October 13, 2010, Cullor had his remaining teeth extracted at the University of Iowa.

The ISP ranks inmates' dental needs based on medical necessity. At the ISP, only the staff dentist is authorized to place an inmate on the Denture List based on the dentist's determination that the inmate needs a partial plate or complete dentures. To qualify for placement on the Denture List, an inmate must have fewer than eight posterior teeth in contact or be missing three posterior teeth in a row. This standard is consistent with the Iowa Medicaid standard, which provides that patients may qualify for dentures if they are missing any three adjacent teeth.⁴

Dental records submitted in this case date back to an examination on July 28, 2005; at that time, Cullor was missing 11 teeth. The chart note for that examination indicates “Needs Denture: No.” (Bold omitted.) As of August 3, 2005, Cullor qualified for placement on the Denture List because he was missing at least three adjacent posterior teeth⁵ and had fewer than eight posterior teeth in contact. As the magistrate judge recognized, “Viewing the record in the light most favorable to Cullor, Dr. [Richard] Snow placed him on the Denture List on August 3, 2005.”⁶ From August 2006 until November 2009, Cullor received various dental services, including exams, x-rays, fillings, and extractions and associated prescriptions.

On March 23, 2010, Monica Nye, an ISP dental assistant, performed a review of Cullor's chart, noting that Cullor was to remain on the Denture List per Dr. Snow's directive and was a “Priority II” patient for a complete upper denture and partial lower denture. On August 12, 2010, the ISP's Health Care Unit (HCU) treated Cullor for an oral yeast infection, and a notation was made in his dental chart. Cullor received his annual dental screening on August 17, 2010. The following day, Dr. Mark Larson referred Cullor to the University of Iowa for “[f]ull mouth extractions with IV sedation.” Cullor's surgery occurred on October 13, 2010, leaving him “edentulous” (without any teeth). A chart note dated November 1, 2010, indicates that Cullor complained that the kitchen was not providing him with the soft diet prescribed to him following his surgery, and he also requested that his stitches be checked. The following day, Dr. Stephanie Cooper instructed that all of Cullor's “meats need to be ground. Well-cooked vegetables only. Replace fresh fruit with applesauce, canned peaches, or crushed pineapple.” Dr. Cooper ordered the “soft diet to assist [Cullor] in getting adequate nutrition and avoid potential issues of choking on food.”

The chart note for Cullor's annual dental screening on August 8, 2011, indicates that Cullor needed a complete lower denture, per Dr. Snow's prior directive from August 3, 2005. On August 23, 2011, Cullor sent a kite (written statement) to the ISP dental staff, inquiring when he would receive dentures. In the kite, he made multiple complaints, including being unable to chew effectively, having constant headaches and jaw pain, worsening acid reflux, and having difficulty communicating with others. Cullor connected all of the complaints to his lack of dentures. Nye responded to the kite, explaining that, at the time, the ISP had a dentist on staff one day per week and that she did not know how much time was available to make dentures. She informed Cullor that she would schedule him to see the dentist, but the records do not reflect that any dental personnel examined Cullor regarding this kite.

Cullor filed a grievance in October 2011. In that grievance, he outlined his dental-treatment history; Dr. Snow's recommendation for dentures on August 3, 2005; the removal of Cullor's remaining teeth in October 2010; and his contention that he had a “serious medical need” for dentures in order to alleviate his pain and constant headaches and that his inability to chew exacerbated his acid reflux. He requested that he immediately receive dentures. On November 2, 2011, Dave DeGrange, an ISP Grievance Officer, contacted Nursing Supervisor Roger Harrison and asked him to review Cullor's grievance. After communicating with Harrison, DeGrange sustained Cullor's grievance. In the grievance response, DeGrange informed Cullor of Harrison's statement that Cullor was “near the top of the list to be seen by the new dentist” for dentures and that “[t]he process requires several appointments, fittings, and adjustments for the issuance of dentures.” DeGrange requested that Cullor “be patient” and assured Cullor that he would “be one of the first inmates fitted with new dentures.” DeGrange was “unable to provide [Cullor] a definite time frame” but stated that Cullor would “begin the process for fitting dentures in the near future.”

On November 14, 2011, Cullor appealed DeGrange's decision and requested “a more definitive answer as to when [he] might get dentures, other than the answer ‘your name is near the top of the list.’ ” Cullor explained that he had received this same answer “for over a year” and “seriously need[ed] relief from the pain.” On November 18, 2011, ISP Executive Officer Rebecca Bowker denied the appeal, responding that she was “unable to provide [Cullor] with a definitive date as [he] request[ed] in [his] grievance appeal.” She reiterated that Cullor was “near the top of the list and will have some appointments soon to resolve the denture issue.” On November 28, 2011, Cullor appealed to the IDOC Central Office. On December 13, 2011, IDOC Assistant Deputy Director Sheryl Lockwood-Dahm denied Cullor's appeal.

On March 19, 2012, Cullor filed a deliberate-indifference claim against, among others,⁷ Director Baldwin and Dr. Deol in their official and individual capacities. In his complaint, Cullor alleged that Director Baldwin “knowingly and intentionally refused or failed to establish and maintain acceptable standards of dental care for prisoners ... by failing to insure that adequate and sufficient dentists [were] employed at the ISP.” Cullor alleged that Dr. Deol “intentionally and knowingly failed or refused to adequately staff the ISP with sufficient dentists to ... provide dental services to [him] and the ISP prisoner population.” The record reflects that the ISP has employed five dentists since 2009. Dr. Tessa Johnson began serving as ISP's dentist on July 6, 2012. Prior to Dr. Johnson's arrival, the ISP employed several dentists on a part-time basis, including Drs. Larson, Cooper, and Abernathy. As Cullor concedes, “[a]ll of the part-time dentists left ISP voluntarily for non-monetary reasons.”⁸

On May 31, 2012, Nye entered the following chart note: “ASK DR. DEOL IF WE SHOULD WAIT TO SEE THIS OFFENDER UNTIL LAW SUIT [SIC] IS SETTLED?” On August 20, 2012, Dr. Johnson, ISP's dentist since July 2012, examined Cullor and began creating impressions for dentures. Final impressions were created on September 17, 2012, and Cullor received complete upper and lower dentures on November 13, 2012. Thereafter, Dr. Johnson made follow-up adjustments to Cullor's dentures.

The testimony before the district court included medical testimony from two physicians, Dr. Stephen Sparks and Dr. Deol, and a dentist, Dr. Johnson. Dr. Sparks, a licensed physician working in the HCU at the ISP, testified that swallowing large chunks of food due to an inability to chew would not tend to exacerbate chronic acid reflex. According to Sparks, patients with esophageal strictures are at a greater risk for choking episodes when unable to chew; however, he explained that this esophageal choking—as opposed to choking in the airway—was distressful but not deadly. Dr. Sparks testified that the ISP medical staff “thought [that Cullor] might have had a stricture before 2002.” Dr. Sparks admitted that Cullor “was at an increased risk for stricture during that time period.” He also testified that complaints of jaw pain are common in edentulous patients and that, as a medical doctor, his recommendation to an edentulous patient experiencing jaw...