Mata v. Saiz, No. 03-1247.

• Decision Date: 21 October 2005
• Docket Number: No. 03-1247.
• Citation: 427 F.3d 745
• Parties: Annabelle D. MATA, Plaintiff-Appellant, v. Judy SAIZ, Amy Hough, Donna Quintana, and Dana Weldon, Defendants-Appellees.
• Court: U.S. Court of Appeals — Tenth Circuit

427 F.3d 745

Annabelle D. MATA, Plaintiff-Appellant, v. Judy SAIZ, Amy Hough, Donna Quintana, and Dana Weldon, Defendants-Appellees.

No. 03-1247.

United States Court of Appeals, Tenth Circuit.

October 21, 2005.

COPYRIGHT MATERIAL OMITTED

COPYRIGHT MATERIAL OMITTED

Robert C. Ozer (Renée C. Ozer with him on the briefs) of Ozer & Ozer, P.C., Colorado Springs, CO, for Plaintiff-Appellant.

Thomas J. Lyons (Andrew D. Ringel and Edmund M. Kennedy with him on the brief) of Hall & Evans, L.L.C., Denver, CO, for Defendants-Appellees.

Before HARTZ, SEYMOUR and BALDOCK, Circuit Judges.

SEYMOUR, Circuit Judge.

Annabelle D. Mata, an inmate of the Pueblo Minimum Center (PMC), filed a 42 U.S.C. § 1983 action against four Colorado Department of Corrections (DOC) employees alleging violations of the Eighth and Fourteenth Amendments to the United States Constitution. Ms. Mata claims defendants failed to provide her with constitutionally adequate medical care when she suffered severe chest pains culminating in a heart attack. The district court granted summary judgment for defendants Dana Weldon, Donna Quintana, and Amy Hough, determining Ms. Mata had failed to raise a genuine issue of material fact with respect to an Eighth Amendment claim and that defendants were therefore entitled to qualified immunity. The court granted partial summary judgment for defendant Judy Saiz. The court then certified its order as a final judgment pursuant to FED. R. CIV. P. 54(b).

Ms. Mata appeals, contending the district court erred when it determined there were no genuine issues of material fact concerning (1) whether Ms. Weldon, Ms. Quintana, and Ms. Hough were deliberately indifferent to Ms. Mata's serious medical needs and (2) whether Ms. Saiz was deliberately indifferent to Ms. Mata's serious medical needs up to the time Ms. Saiz received directions from a doctor to immediately send Ms. Mata to the hospital. A majority of the panel affirms the district court's grant of summary judgment for defendants Quintana, Hough and Saiz and reverses the court's grant of summary judgment for defendant Weldon.

SEYMOUR, J., joined by HARTZ, J., as to defendants Weldon, Hough, and Saiz.

I.

"We review a grant of summary judgment on the basis of qualified immunity de novo." Jiron v. City of Lakewood, 392 F.3d 410 (10th Cir.2004). Summary judgment is appropriate if the record shows "there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." FED.R.CIV.P. 56(c). "If our inquiry reveals no genuine issue of material fact in dispute, then we review the case to determine if the district court correctly applied the substantive law." Gamble, Simmons & Co. v. Kerr-McGee Corp., 175 F.3d 762, 766 (10th Cir.1999) (citing Kaul v. Stephan, 83 F.3d 1208, 1212 (10th Cir.1996)). We construe the factual record and the reasonable inferences therefrom in the light most favorable to the nonmoving party. See Selenke v. Med. Imaging of Colo., 248 F.3d 1249, 1255 (10th Cir.2001).

After a defendant invokes qualified immunity, the plaintiff in a case like this one, which alleges a violation of the Eighth Amendment, must demonstrate that the defendant's actions violated a specific constitutional right. Saucier v. Katz, 533 U.S. 194, 201, 121 S.Ct. 2151, 150 L.Ed.2d 272 (2001). If the plaintiff fails to meet her burden on this threshold inquiry, the qualified immunity inquiry comes to an end. Id. If the plaintiff meets this initial burden, she must then show that the constitutional right was "clearly established" prior to the challenged official action. Id. "The relevant, dispositive inquiry in determining whether a right is clearly established is whether it would be clear to a reasonable officer that his conduct was unlawful in the situation he confronted." Holland v. Harrington, 268 F.3d 1179, 1186 (10th Cir.2001) (internal quotations omitted). Because the district court never reached the second prong of the qualified immunity analysis and there is little doubt that deliberate indifference to an inmate's serious medical need is a clearly established constitutional right,¹ we concern ourselves solely with the following question in the summary judgment context: viewing the evidence in the light most favorable to Ms. Mata, do the facts show that the defendants' actions violated her Eighth Amendment rights? Saucier, 533 U.S. at 201, 121 S.Ct. 2151; Gonzales v. Martinez, 403 F.3d 1179, 1185-86 (2005).

Viewed most favorably to Ms. Mata, the record reveals the following background to this litigation. At the time of the events giving rise to her claims, Ms. Mata was incarcerated at the PMC. During the evening of October 29, 2000, she sought medical attention because she was experiencing severe chest pain. Aplt.App. at 184. Ms. Weldon, a Licensed Practical Nurse (LPN), was on duty at the PMC infirmary that evening. Id. at 184, 190. Ms. Mata reported her chest pain to Ms. Weldon, who responded there was nothing she could do because the infirmary was closed and Ms. Mata would have to return to sick call at the infirmary the following morning. Id. at 184.

Ms. Mata returned to the infirmary, as advised, on the morning of October 30, and informed Ms. Quintana, LPN, of her continuing chest pain. Id. at 185, 188. Ms. Mata reported her chest pain as "eight" on a scale from "zero to ten," with ten translating to the worst pain a patient can imagine and zero being no pain whatsoever. Id. at 195-97. Ms. Quintana provided Ms. Mata with a nursing assessment which included performing an electrocardiogram (EKG). Id. at 185. Ms. Quintana read the EKG as normal and gave Ms. Mata a "lay-in," a permission slip to allow her to miss work and other prison-related assignments for the day. Id. Ms. Mata claims that her pain persisted throughout the day, causing her to report it to several guards, but she did not return to the infirmary again that day.² Id.

Upon her return to the infirmary at 6:00 a.m. on the morning of October 31, Ms. Mata was evaluated by Ms. Hough, a Registered Nurse (RN). Id. at 185, 230. Ms. Hough administered a second EKG and told Ms. Mata it was normal, although it is undisputed that this EKG showed changes from the one performed the prior day. Id. at 185-87, 231. Ms. Saiz, a Nurse Practitioner (NP), arrived at the infirmary shortly after the evaluation performed by Ms. Hough. Id. at 186, 235. Ms. Saiz performed an independent assessment and informed Ms. Mata that she suffered from a chest lining inflammation. Id. at 186, 236. Although Ms. Saiz also read the second EKG as normal, she forwarded the EKG printout to a doctor for review. Id. at 186. The physician ordered Ms. Saiz to send Ms. Mata immediately to the hospital. Id. Ms. Saiz instructed Ms. Mata to return to her housing unit and change into "full greens" for the trip to the hospital. Id. Ms. Mata did as she was told, walking approximately two blocks up hill, changing her clothes, and then walking back to the main facility. Id. She was then transported to the emergency room at Parkview Hospital in Pueblo, Colorado. Id. at 186, 236.

It was determined at the hospital that Ms. Mata had suffered a heart attack. Id. at 186. Heart surgery was performed the same day to open an occluded circumflex coronary artery, but it was unsuccessful. Ms. Mata suffered permanent and irreversible damage to her heart and sustained a permanent disability. Id. at 266-67.

Ms. Mata filed this action against the four prison nurses from whom she sought treatment, asserting that their failure to provide her adequate medical care violated the Eighth Amendment. We will set forth further evidence proffered by Ms. Mata in support of her claim as we address specific issues below.

II.

A prison official's deliberate indifference to an inmate's serious medical needs is a violation of the Eighth Amendment's prohibition against cruel and unusual punishment. Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976). The test for constitutional liability of prison officials "involves both an objective and a subjective component." Sealock v. Colorado, 218 F.3d 1205, 1209 (10th Cir.2000).

The prisoner must first produce objective evidence that the deprivation at issue was in fact "sufficiently serious." Farmer v. Brennan, 511 U.S. 825, 834, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994) (citations omitted). We have said that a "medical need is sufficiently serious if it is one that has been diagnosed by a physician as mandating treatment or one that is so obvious that even a lay person would easily recognize the necessity for a doctor's attention." Sealock, 218 F.3d at 1209 (quoting Hunt v. Uphoff, 199 F.3d 1220, 1224 (10th Cir.1999) (further quotation omitted)). Where the necessity for treatment would not be obvious to a lay person, the medical judgment of the physician, even if grossly negligent, is not subject to second-guessing in the guise of an Eighth Amendment claim. See, e.g., Green v. Branson, 108 F.3d 1296, 1303 (10th Cir.1997). Moreover, a delay in medical care "only constitutes an Eighth Amendment violation where the plaintiff can show the delay resulted in substantial harm." Oxendine v. Kaplan, 241 F.3d 1272, 1276 (10th Cir.2001) (quotation omitted). The substantial harm requirement "may be satisfied by lifelong handicap, permanent loss, or considerable pain." Garrett v. Stratman, 254 F.3d 946, 950 (10th Cir.2001).

The subjective prong of the deliberate indifference test requires the plaintiff to present evidence of the prison official's culpable state of mind. See Estelle, 429 U.S. at 106, 97 S.Ct. 285. The subjective component is satisfied if the official "knows of and disregards an excessive risk to inmate health or safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and [s]he must also draw the inference." Farmer, 511 U.S. at 837, 114 S.Ct. 1970. A prison medical professional who serves ...