Massey & Otten M.D. v. Helman
| Decision Date | 13 January 2000 |
| Docket Number | No. 99-1459,99-1459 |
| Citation | 196 F.3d 727 |
| Parties | (7th Cir. 1999) Michael Massey and John Otten, M.D., Plaintiffs-Appellants, v. David Helman, et al., Defendants-Appellees |
| Court | U.S. Court of Appeals — Seventh Circuit |
Appeal from the United States District Court for the Central District of Illinois. No. 97-1401--Richard Mills, Judge. [Copyrighted Material Omitted] Before Posner, Chief Judge, and Bauer and Ripple, Circuit Judges.
Michael Massey, a prisoner at the Federal Correctional Institution in Pekin, Illinois, brought this lawsuit under 42 U.S.C. sec. 1983 and Bivens v. Six Unknown Named Agents of the Federal Bureau of Narcotics, 403 U.S. 388 (1971) against federal prison officials for allegedly violating his rights under the Eighth Amendment by denying him surgical care for a hernia. One of the prison's staff physicians, Dr. John Otten, M.D., recommended that Massey have the hernia surgically repaired, but after making this recommendation, was fired from his job. After being terminated, Dr. Otten joined Massey's Bivens action and asserted one claim against the defendant prison officials arising from his discharge and two claims on behalf of inmates at the prison. The district court dismissed the lawsuit, and Massey and Dr. Otten now appeal. For the following reasons, we affirm.
At last count, the United States Department of Justice Federal Bureau of Prisons ("BOP") is incarcerating 134,344 prisoners. Federal Bureau of Prisons Weekly Population Report (last modified Oct. 22, 1999)
To manage the delivery of medical services to BOP inmates, the Health Services Manual describes a hierarchy of prison officials who are charged with administering medical services to all federal prisoners. The top dog in this chain of command is the BOP Medical Director. The current BOP Medical Director, Dr. Kenneth Morit Sugu, M.D. ("Dr. Sugu"), is "responsible for all health care delivered by [BOP] health care practitioners and U.S. Public Health Service officers." As Medical Director, Dr. Sugu's duties include "establishing health care programs . . . regularly inspecting institution health care facilities and programs; and coordinating research activities related to health care." In other words, Dr. Sugu oversees the general administration of all medical care to the 134,344 federal prisoners in this country.
One step down from BOP Medical Director Dr. Sugu are individuals known as Regional Health Systems Administrators ("RHSAs"). Generally speaking, RHSAs serve as advisors to BOP Regional Directors in all areas of health care. Additionally, RHSAs are responsible for developing suggestions for medical policy revisions, performing management assessments, responding to correspondence and complaints from prisoners, and providing medical advice to BOP Regional Directors regarding the planning, development and construction of new BOP institutions.
At the institutional level, each BOP facility has its own Health Services Unit which is staffed with a Clinical Director, a Health Services Administrator, staff physicians, and other paraprofessional staff. The Clinical Director bears ultimate responsibility for clinical care provided at the institution. The Clinical Director also hires all staff physicians, monitors in-house continuing professional education for physicians, maintains medical records, and evaluates patient care. The institution's Health Services Administrator plans and controls all aspects of the Health Services Unit's daily administration. In cases where an inmate needs medical treatment that cannot be provided at the institution, the Health Services Administrator arranges for "outside" medical services to be performed at local hospitals. Finally, the Health Services Administrator also serves as the "direct avenue of communication between Health Services and the CEO, designee, Regional Office, and Central Office." Both the Clinical Director and the Health Services Administrator report directly to the Warden or Assistant Warden of the BOP facility.
In addition to establishing the hierarchy of prison officials who administer medical treatment to federal prisoners, the BOP Health Services Manual also creates health care standards to guide the provision of medical services to inmates. Specifically, the Health Services Manual defines the following four categories of medical care:
(LEVEL 1) Medically mandatory is defined as immediate, urgent or emergency care required to maintain or treat a life threatening illness or injury.
(LEVEL 2) Presently medically necessary is defined as routine care or treatment that cannot reasonably be delayed without the risk of further complication, serious deterioration, significant pain or discomfort, provided to maintain a chronic or non-life threatening condition.
(LEVEL 3) Medically acceptable but not medically necessary is treatment that is not exclusively for the convenience of the patient (routine hernia repair, noncancerous skin lesions, etc.).
(LEVEL 4) Exclusively for the convenience of the inmate. This level of care may include, but is not limited to, tattoo removal, minor nasal reconstruction, other cosmetic surgery, and elective circumcision.
(Emphasis in original). The BOP limits
It is in the context of this BOP medical care program that plaintiffs Michael Massey ("Massey") and Dr. John Otten, M.D. ("Dr. Otten") brought this lawsuit. Massey, a prisoner at the Federal Correctional Institute in Pekin, Illinois ("FCI Pekin"), developed an abdominal hernia while incarcerated as a pretrial detainee in the Marion County, Indiana prison. Sometime after sustaining this hernia, Massey came to FCI Pekin and began serving a 70 month term of imprisonment on March 26, 1996. During his incarceration at FCI Pekin, Massey worked as a barber in the prison barber shop and contends that the standing required by his work caused his hernia to worsen to the point that it inflicted considerable pain.
Dr. Otten worked as a staff physician at FCI Pekin and examined Massey on August 5, 1996. Dr. Otten determined that Massey should undergo surgery to repair his hernia and communicated this opinion to FCI Pekin's Health Services Administrator, Ferdinand Somalia ("Somalia"). As the Health Services Administrator, it was Somalia's responsibility to arrange for the surgery to be performed at a local hospital. Nevertheless, even though Dr. Otten recommended that Massey undergo surgery, neither Somalia nor any other prison official arranged for Massey to have his hernia surgically repaired.
Because he was not receiving surgical treatment for his hernia, Massey initiated this Bivens action on November 7, 1997, both individually and as a class action. Massey claimed that FCI Pekin and the BOP administer policies that are deliberately indifferent to prisoners' medical needs and therefore violate their rights under the Eighth Amendment. Massey predicated his claims of unconstitutional medical policies on the medical care structure established by the BOP Health Services Manual. Massey complained that FCI Pekin and the BOP have unconstitutional medical policies of (1) prohibiting the surgical repair of hernias; (2) authorizing only the BOP Medical Director to approve the surgical repair of a hernia; and (3) depriving prison physicians of control over medical treatment that they order to be performed by consulting physicians. Massey and the putative class sought money damages and injunctive relief for these allegedly cruel and unusual prison policies.1
As Massey's lawsuit proceeded, the district court ordered Dr. Otten's deposition to be taken on January 21, 1998. However, just one day before Dr. Otten's deposition was scheduled, FCI Pekin's assistant warden, Miguel Gonzalez ("Gonzalez"), suspended Dr. Otten from his job as a staff physician and placed Dr. Otten on home duty pending a review of charges that Dr. Otten had administered inadequate medical care to inmate- patients. Gonzalez then recommended that Dr. Otten's employment be terminated. This recommendation was reviewed by FCI Pekin's warden, David Helman ("Helman"), who accepted Gonzalez' recommendation and terminated Dr. Otten's employment as a staff physician at FCI Pekin on February 26, 1998.
A few weeks after being fired, Dr. Otten joined Massey's lawsuit. According to Dr. Otten, Massey's case was not the first time that he had openly protested the prison's refusal to administer medical treatment that he recommended. Dr. Otten alleged that the prison officials violated his First Amendment rights by terminating him in retaliation for speaking about a matter of public concern. In addition to his own First Amendment claim, Dr. Otten asserted two claims on behalf of his inmate-patients. Specifically, Dr. Otten charged that prison officials violated his inmate-patients' First Amendment right to have access to the courts and their Eighth Amendment right to receive medically necessary treatment.
The defendant prison officials moved to dismiss Massey's and Dr. Otten's complaint.2 The prison officials argued that Massey could not pursue his sec. 1983 claim because he...
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