Smith v. Carpenter

• Decision Date: 14 January 2003
• Docket Number: Docket No. 01-0294.
• Citation: 316 F.3d 178
• Parties: Willie SMITH, Plaintiff-Appellant, v. Nurse CARPENTER, Superintendent Wilkinson, Superintendent at Pharsalia Corr. Facility, Defendants-Appellees.
• Court: U.S. Court of Appeals — Second Circuit

316 F.3d 178

Willie SMITH, Plaintiff-Appellant, v. Nurse CARPENTER, Superintendent Wilkinson, Superintendent at Pharsalia Corr. Facility, Defendants-Appellees.

Docket No. 01-0294.

United States Court of Appeals, Second Circuit.

Argued: October 7, 2002.

Decided: January 14, 2003.

COPYRIGHT MATERIAL OMITTED

Erik T. Koons, Howrey Simon Arnold & White, LLP, Washington, D.C. (Tifanie Gardner, Georgetown University Law Center, on the brief), for Plaintiff-Appellant.

Marcus J. Mastracco, Assistant Solicitor General (Eliot Spitzer, Attorney General of the State of New York; Nancy A. Spiegel, Assistant Solicitor General, on the brief), Albany, N.Y., for Defendants-Appellees.

Before: WALKER, Chief Judge, CARDAMONE and STRAUB, Circuit Judges.

STRAUB, Circuit Judge.

Plaintiff-appellant Willie Smith ("Smith") appeals from a judgment of the United States District Court for the Northern District of New York (Norman A. Mordue, Judge), denying his motion for a new trial following a jury verdict in favor of the defendant prison officials, Colleen Carpenter ("Carpenter") and James Wilkinson ("Wilkinson"). Smith filed suit under 42 U.S.C. § 1983 alleging that the defendants violated the Eighth Amendment's prohibition against cruel and unusual punishment by depriving him of HIV medication while he was incarcerated at the Camp Pharsalia Correctional Facility ("Camp Pharsalia"). At trial, Smith presented evidence that he had been deprived of HIV medication on two separate occasions for several days at a time. The jury returned with a verdict for the defendants after determining that Smith had not proven, by a preponderance of the evidence, that he suffered from an objectively "serious medical need." The District Court denied Smith's motion for a new trial, noting that the jury's verdict was supported by medical testimony indicating that Smith suffered no adverse medical effects from the missed medication. On appeal, Smith argues that the District Court misapplied the relevant Eighth Amendment standard in denying his request for a new trial by concluding that the jury was entitled to consider evidence regarding the absence of actual medical injury. We hold that such evidence may be considered as a relevant factor in assessing whether an alleged denial of medical care is sufficiently serious to establish a claim under the Eighth Amendment and therefore affirm.

BACKGROUND

In April 1999, Smith filed suit against the defendants seeking damages under 42 U.S.C. § 1983. Smith contends that the defendants¹ acted with deliberate indifference to his serious medical needs in violation of the Eighth Amendment by depriving him of essential HIV medication on two separate occasions while he was incarcerated at Camp Pharsalia, despite his repeated requests for the medication.

A. Trial

In October 2001, a jury trial was held on Smith's denial of medical care claim. At trial, Smith testified that physicians with the New York State Department of Correctional Services ("DOCS") had prescribed a drug-therapy regimen to treat his HIV which included a combination of three drugs, Saquinavir mesylate ("Saquinavir"), Combivir, and Bactrim.² Smith also testified that the defendants failed to provide him with these prescription drugs on two different occasions during his incarceration at Camp Pharsalia. The first episode occurred in October 1998 due to a delay in refilling Smith's prescriptions after his existing medication ran out. As a result, Smith missed taking his scheduled doses of Saquinavir and Bactrim for seven days. The second episode occurred in January 1999 after Smith's HIV medication was confiscated during a random search of his living quarters. Smith testified that he was only provided with replacement medication five days later after he was transferred to the Oneida Correctional Facility.

Smith also explained that it is important to maintain strict compliance with his drug regimin in order to prevent deterioration of his immune system and to slow the progression of his HIV infection, a condition that can ultimately lead to death.³ Although Smith testified that he suffered temporary itching, severe headaches, as well as stress due to the missed medication, he did not introduce evidence that his HIV infection or overall health worsened as a result of the two isolated episodes of missed medication.

At trial, the defendants conceded that it is important for HIV patients to follow a regular drug regimen. Defendants sought to demonstrate, however, that the alleged episodes of missed medication did not subject Smith to a serious risk of harm and presented evidence to counter Smith's allegations of medical injury. Defendants' medical expert, Dr. Marshall Trabout, a regional medical director for the DOCS, testified that Smith's reported symptoms of itching and headaches were likely side effects of the medications themselves and would not have been caused by the lack of HIV medication. Dr. Trabout agreed that missing HIV medication can be potentially harmful in some circumstances, possibly leading to viral mutation and drug resistance. However, based on a review of Smith's medical records, Dr. Trabout concluded that Smith had not developed any drug resistance because of the alleged interruptions in drug treatment and that Smith's viral load had actually improved during his incarceration.⁴ Dr. Trabout also testified that, in his opinion, Smith had received very good HIV care at Camp Pharsalia and that Smith had suffered no adverse effects to his health as a result of missing his HIV medication for the brief periods of time at issue.

B. Jury Verdict

After the close of evidence, the District Court instructed the jury that Smith had to demonstrate by a preponderance of the evidence that he suffered from a "serious medical need" in order to prevail on his Eighth Amendment claim. Tracking Smith's proposed jury instructions, the District Court charged the jury as follows:

The term `serious medical need' means a condition of urgency, one that might produce extreme pain, degeneration or death. In other words, it is a condition presenting a substantial risk of harm. It is not disputed in this case that plaintiff suffers from the HIV virus. If you find that plaintiff's condition did not amount to a serious medical need, then you must find for the defendants .... Conversely, if you find that plaintiff's condition constituted a serious medical need, you must then consider whether he has demonstrated by a preponderance of the evidence that defendants knew of that condition and disregarded it.⁵

The special verdict sheet that was jointly prepared by the parties mirrored the jury charge. The first question on the verdict sheet asked: "Has plaintiff proven by a preponderance of the evidence that he suffered from a serious medical need, yes or no.... If your answer ... is no, stop, have the foreperson sign and date the verdict sheet and inform the marshal that you have reached a verdict."⁶ The jury returned with a verdict for the defendants answering "no" to this critical threshold question.

C. Motion for a New Trial

Following the jury's verdict, Smith moved for a new trial on the grounds that: (1) there was insufficient evidence to support the jury's verdict, (2) the verdict was against the weight of the evidence, (3) the jury ignored the District Court's instructions, and (4) the verdict could not stand as a matter of law. The District Court denied the motion for a new trial, rejecting Smith's argument that his HIV-positive status automatically constituted a "serious medical need" for Eighth Amendment purposes. The District Court found that there was sufficient evidence to support the jury's verdict based on Dr. Trabout's testimony that "although plaintiff was HIV-positive, he suffered no adverse effects from missing his prescriptions for the short periods of time in question." The District Court further explained that the jury could have concluded, consistent with the evidence presented at trial, that Smith had failed to demonstrate that his health had been placed in substantial jeopardy due to the brief interruptions in his HIV medication.

Smith now appeals, arguing that the District Court applied the wrong Eighth Amendment standard in denying his motion for a new trial.⁷ Smith contends that the District Court erroneously considered evidence of actual harm in assessing the jury's finding of no serious medical need when he was only required to establish a potential for serious future injury in order to state an Eighth Amendment denial of medical care claim. Smith also argues that evidence pointing to an absence of adverse medical effects is only potentially relevant in analyzing questions of deliberate indifference or causation — not as part of the initial serious medical need inquiry.

DISCUSSION

A. Standard of Review

We review the district court's decision to deny a motion for a new trial pursuant to Fed.R.Civ.P. 59 for abuse of discretion. See New England Ins. Co. v. Healthcare Underwriters Mut. Ins. Co., 295 F.3d 232, 248 (2d Cir.2002). Generally, a motion for a new trial "should not be granted unless the trial court is convinced that the jury has reached a seriously erroneous result or that the verdict is a miscarriage of justice." Atkins v. New York City, 143 F.3d 100, 102 (2d Cir.1998) (quoting Lightfoot v. Union Carbide Corp., 110 F.3d 898, 911 (2d Cir.1997)). In this case, we need only determine whether the District Court abused its discretion by applying an incorrect legal standard in evaluating the jury's verdict. See Gasperini v. Center for Humanities, Inc., 149 F.3d 137, 141-42 (2d Cir.1998) (a district court abuses its discretion when its decision to deny a motion for a new trial "results from an erroneous view of the law").

B. Eighth Amendment Standard

"In order to establish an Eighth Amendment claim arising out of inadequate medical care, a prisoner must prove `deliberate indifference to [his] serious medical needs.'" Chance v....