Johnson v. Quinones, 97-2392

• Decision Date: 12 May 1998
• Docket Number: No. 97-2392,97-2392
• Citation: 145 F.3d 164
• Parties: Richard S. JOHNSON, Plaintiff-Appellant, v. Moises QUINONES, M.D.; Joseph Morris, O.D., Defendants-Appellees.
• Court: U.S. Court of Appeals — Fourth Circuit

Page 164

145 F.3d 164

Richard S. JOHNSON, Plaintiff-Appellant, v. Moises QUINONES, M.D.; Joseph Morris, O.D., Defendants-Appellees.

No. 97-2392.

United States Court of Appeals Fourth Circuit.

Argued March 4, 1998.

Decided May 12, 1998.

ARGUED: Thomas E. Albro, Tremblay & Smith, Charlottesville, VI, for Appellant. Larry Benson Kirksey, Penn, Stuart & Eskridge, Bristol, VI; Leigh Thompson Hanes, Wooten & Hart, Roanoke, VI, for Appellees. ON BRIEF:Peter D. Vieth, Wooten & Hart, Roanoke, VI, for Appellees.

Before WILKINSON, Chief Judge, NIEMEYER, Circuit Judge, and CLARKE, Senior United States District Judge for the Eastern District of Virginia, sitting by designation.

Affirmed by published opinion. Senior Judge Clarke wrote the opinion, in which Chief Judge Wilkinson and Judge Niemeyer joined.

OPINION

CLARKE, Senior District Judge:

In this case, we must decide whether the district court properly entered summary judgment against former Virginia inmate Richard S. Johnson on his § 1983 claim against two prison doctors. Johnson claims that the two doctors were deliberately indifferent to his medical needs and therefore violated his Eighth Amendment right to be free from cruel and unusual punishment. Because Johnson produces no evidence that the doctors subjectively knew about his serious medical condition, we affirm.

I.

A.

The following facts are recited in the light most favorable to Johnson. See Ross v. Communications Satellite Corp., 759 F.2d 355, 364 (4th Cir.1985) (stating that on summary judgment, "[t]he facts themselves, and the inferences to be drawn from the underlying facts, must be viewed in the light most favorable to plaintiff").

Johnson, a Virginia prison inmate, entered Keen Mountain Correctional Facility in July 1991. When he arrived at the facility, he was in excellent health, had no pending medical appointments and was not taking any prescribed medications.

Between April 1992 and September 1994, Johnson was examined on seventeen occasions by Moises E. Quinones, M.D., a doctor under contract with the correctional facility to provide medical care to inmates. During these examinations, Dr. Quinones investigated Johnson's complaints of physical ailments including: headaches, bags that had developed under his eyes, night sweats, decreased and blurred vision, knee pain, lower back pain, blood tinged stools, colds, urinary tract infections, a rash, a bug bite, moles, a knot on his breastbone, ear pain, neck pain, bronchitis, sinusitis, arm pain, dizziness, indigestion, tight shoes, and weight loss. Johnson also experienced and complained of acromegaly, the medical term for enlargement of his hands and feet. See Stedman's Medical Dictionary 17 (24th ed.1982). Dr. Quinones never found any major medical problems with Johnson, although he prescribed various medications to treat minor infections and for pain.

Concerning the bags that developed under Johnson's eyes, Dr. Quinones consulted with a dermatologist. The dermatologist stated that the condition described is consistent with a cosmetic condition called cutis laxa, or loose skin around the eyes. See id. at 348. To remedy the condition, plastic surgery is required to remove the excess skin. Dr. Quinones then referred Johnson for an examination by a consulting ophthalmologist. The ophthalmologist examined Johnson and confirmed the previous diagnosis of cutis laxa. The ophthalmologist found no medical problem with Johnson's eyes. Johnson applied for plastic surgery to remedy his cutis laxa, and the Department of Corrections denied his request because the condition was purely cosmetic.

Concerning Johnson's complaints of decreased and blurred vision, Dr. Quinones referred Johnson to the facility's optometrist, Joseph Morris, O.D. Dr. Morris examined Johnson a total of four times between November 1992 and October 1994. During the first two examinations in November 1992 and March 1994, Johnson complained of blurred near vision. On each occasion, Dr. Morris examined Johnson's eyesight at 20/20 in each eye and prescribed reading glasses to remedy Johnson's complaints of blurred near vision. During an August 1994 appointment, Johnson complained of bags under his eyes, headaches behind his right eye, and blurred vision, both near and far. Dr. Morris measured Johnson's eyesight at 20/25 and again prescribed new glasses. Finally, during an October 1994 appointment, Johnson complained again about bags under his eyes and deterioration of his vision. Dr. Morris measured Johnson's eyesight at 20/200. Yet, none of the objective examinations performed on Johnson's eyes were consistent with Johnson's subjective responses indicating a visual acuity of 20/200. Dr. Morris therefore wrote in his notes that Johnson was a malingerer and did not prescribe new glasses.

Johnson was released from prison on November 21, 1994. On November 22, 1994, he lost sight in his left eye. The next day, he made an appointment at the University of Virginia's Health Sciences Center. The first available appointment was not until late January 1995. On January 4, 1995, Johnson lost sight in his right eye. An ophthalmologist at the University of Virginia then agreed to examine Johnson on an emergency basis. The ophthalmologist diagnosed Johnson's vision problems as stemming from a pituitary tumor. Although the tumor was removed through surgery, it had already compressed Johnson's optic nerve leaving him blind.

B.

Johnson files this suit against Dr. Quinones and Dr. Morris under 42 U.S.C. § 1983 alleging that his Eighth Amendment rights have been violated as a result of the doctors' deliberate indifference to his serious medical needs. Johnson also raises state law negligence claims alleging that the doctors negligently failed to diagnose and treat his pituitary tumor.

In the district court, Johnson produced evidence in the form of medical expert affidavit and deposition testimony that headaches, night sweats, vision problems and cutis laxa are symptoms of a pituitary tumor. He also produced medical expert evidence that acromegaly is the hallmark symptom of a pituitary tumor. If you have acromegaly, Johnson's experts opine, you have a pituitary tumor.

To avoid summary judgment, Johnson attempted to prove that both Dr. Quinones and Dr. Morris were trained to recognize the symptoms of a pituitary tumor. Johnson was successful in getting Dr. Quinones to admit that he knew of the link between acromegaly and pituitary tumors. Johnson also produced evidence that Dr. Morris was trained in optometry school that acromegaly was a symptom of pituitary tumors. Thus, for purposes of summary judgment, we will assume that both doctors knew generally of the symptoms of pituitary tumors.

Entering summary judgment against Johnson, the district court correctly recognized that even if the doctors knew the symptoms of pituitary tumors and listened to Johnson's complaints of his symptoms, Johnson has failed to meet his burden of producing evidence creating a genuine issue of material fact concerning the doctors' deliberate indifference to serious medical needs. In other words, any negligence or malpractice on the part of the doctors in missing the diagnosis does not, by itself, support an inference of deliberate indifference by the doctors to Johnson's medical needs. To avoid summary judgment, Johnson needed to produce evidence that the doctors actually drew the inference between the symptoms and the tumor. Concerning the state law negligence claims, the district court declined to exercise supplemental jurisdiction and dismissed them without prejudice.

II.

The standard of review in this case is familiar. We review the district court's grant of summary judgment de novo. Stone v. Liberty Mut. Ins. Co., 105 F.3d 188, 191 (4th Cir.1997). Pursuant to Fed.R.Civ.P. 56(c), a district court must enter judgment against a party who, "after adequate time for discovery ... fails to make a showing sufficient to establish the existence of an element essential to that party's case, and on which that party will bear the burden of proof at trial." Celotex Corp. v. Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 2552, 91 L.Ed.2d 265 (1986). Where "there is no genuine issue as to any material fact and ... the moving party is entitled to judgment as a matter of law," entry of summary judgment is mandated. Fed.R.Civ.P. 56(c); see Stone, 105 F.3d at 190. To avoid summary judgment on defendant's motion, a plaintiff must produce evidence creating a genuine issue of material fact. "The mere existence of a scintilla of evidence in support of the plaintiff's position will be insufficient; there must be evidence on which the jury could reasonably find for the plaintiff." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 252, 106 S.Ct. 2505, 2512, 91 L.Ed.2d 202 (1986). In determining whether a genuine issue of material fact is in dispute, "[t]he evidence of the nonmovant is to be believed, and all justifiable inferences are to be drawn in his favor." Anderson, Id. at 255, 106 S.Ct. at 2513-14.

A.

The Eighth Amendment expressly prohibits the infliction of "cruel and unusual punishments." U.S. Const. amend. VIII. "It not only outlaws excessive sentences but also protects inmates from inhumane treatment and conditions while imprisoned." Williams v. Benjamin, 77 F.3d 756, 761 (4th Cir.1996); see Wilson v. Seiter, 501 U.S. 294, 298, 111 S.Ct. 2321, 2323-24, 115 L.Ed.2d 271 (1991) (noting that the Eighth Amendment protects against "deprivations" that are "suffered during imprisonment"); Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 291, 50 L.Ed.2d 251 (1976) (holding that "deliberate indifference to serious medical needs of prisoners" violates the Eighth Amendment). To succeed on an Eighth Amendment "cruel and unusual punishment" claim, a prisoner must prove two elements: (1) that objectively the deprivation of a basic human need was "sufficiently serious," and (2) that subjectively the prison officials acted with a "sufficiently...