Al-Turki v. Robinson

• Decision Date: 12 August 2014
• Docket Number: No. 13–1107.,13–1107.
• Citation: 762 F.3d 1188
• Court: U.S. Court of Appeals — Tenth Circuit
• Parties: Homaidan AL–TURKI, Plaintiff–Appellee, v. Mary Susan ROBINSON, RN—Registered Nurse, a former Nurse for Limon Correctional facility in her individual capacity, Defendant–Appellant, and John Stirewalt, a former Shift Commander for Limon Correctional Facility, in his individual capacity; David Maggard, a former Corrections Officer at Limon Correctional Facility, in his individual capacity; Hector Lozano, a former Corrections Officer at Limon Correctional Facility, in his individual capacity; Bob Eberle, a Corrections Officer at Limon Correctional Facility, in his individual capacity; Wendy Chatterton, a Corrections Officer at Limon Correctional Facility, in her individual capacity; Joseph Ballard, a Corrections Officer at Limon Correctional Facility, in his individual capacity, Defendants.

762 F.3d 1188

Homaidan AL–TURKI, Plaintiff–Appellee,

v. Mary Susan ROBINSON, RN—Registered Nurse, a former Nurse for Limon Correctional facility in her individual capacity, Defendant–Appellant,andJohn Stirewalt, a former Shift Commander for Limon Correctional Facility, in his individual capacity; David Maggard, a former Corrections Officer at Limon Correctional Facility, in his individual capacity; Hector Lozano, a former Corrections Officer at Limon Correctional Facility, in his individual capacity; Bob Eberle, a Corrections Officer at Limon Correctional Facility, in his individual capacity; Wendy Chatterton, a Corrections Officer at Limon Correctional Facility, in her individual capacity; Joseph Ballard, a Corrections Officer at Limon Correctional Facility, in his individual capacity, Defendants.

No. 13–1107.

United States Court of Appeals, Tenth Circuit.

Aug. 12, 2014.

William A. Rogers, III (Rachel A. Morris and Brendan L. Loy with him on the briefs) of Wood, Ris & Hames, P.C., Denver, CO, for Defendant–Appellant.

Eric K. Klein (Gail K. Johnson and James S. Brennan with him on the brief) of Johnson & Brennan, PLLC, Boulder, CO, for Plaintiff–Appellee.

Before HOLMES, McKAY, and BACHARACH, Circuit Judges.

McKAY, Circuit Judge.

This is an interlocutory appeal from the district court's denial of qualified immunity in an Eighth Amendment case brought by a Colorado state prisoner. Plaintiff Homaidan Al–Turki filed suit under 42 U.S.C. § 1983 against several prison officials, including Defendant Mary Robinson, a prison nurse, based on these officials' failure to provide him with any type of medical evaluation or treatment while he was suffering through several hours of severe abdominal pain from what turned out to be kidney stones. The district court granted qualified immunity to the other prison officials, none of whom were medical professionals,¹but denied Defendant Robinson's summary judgment motion for qualified immunity. Defendant then filed this interlocutory appeal. On appeal, we must decide (1) whether the hours of severe pain Plaintiff experienced constituted a sufficiently serious medical need to satisfy the objective prong of the Eighth Amendment deliberate indifference test and (2) whether Defendant's alleged actions violated clearly established law.

I.

Because this is an interlocutory appeal from the denial of qualified immunity, “we ‘take, as given, the facts that the district court assumed when it denied summary judgment.’ ” Morris v. Noe, 672 F.3d 1185, 1189 (10th Cir.2012) (quoting Johnson v. Jones, 515 U.S. 304, 319, 115 S.Ct. 2151, 132 L.Ed.2d 238 (1995)). We accordingly rely on the district court's description of the facts, taken in the light most favorable to Plaintiff, and do not reevaluate the district court's conclusion that the summary judgment record is sufficient to prove these facts. Id. The district court concluded the record was sufficient to prove the following facts:

At approximately 8:35 p.m. on the evening of October 5, 2008, Plaintiff suddenly began to feel severe pain in his left side and abdomen. This pain was so severe that he collapsed, vomited, and believed he was dying. Plaintiff used the intercom in his cell to contact a correctional officer. He told the officer he was experiencing severe pain and nausea, and he asked to go to the medical center. The officer called the medical center, where Defendant was the only medical staff person on duty. The officer told Defendant about Plaintiff's symptoms and request for medical attention. Defendant knew that severe abdominal pain may be a symptom of several serious and potentially life-threatening conditions. Defendant also knew that Plaintiff had Type II diabetes and that this made him more susceptible to certain serious illnesses, for some of which pain is an initial symptom. However, Defendant told the officer she would not see Plaintiff because it was too late and because Plaintiff's complaint was not an emergency.

Plaintiff reported his medical condition to a second correctional officer on two more occasions that evening, and this officer twice contacted Defendant to tell her of Plaintiff's reports of abdominal pain and requests for medical attention. Both times, Defendant refused to see Plaintiff, and she told the officer that Plaintiff should simply make a written request to be seen by medical staff the following morning. The two correctional officers each informed the shift commander of Plaintiff's complaints of pain and of Defendant's refusal to see him. The shift commander accordingly went to the medical center to meet with Defendant regarding her refusal to see Plaintiff. Defendant told the shift commander that Plaintiff's condition was not an emergency and that she was concerned Plaintiff would be an escape risk if he was transferred to an outside facility.

Plaintiff's severe pain continued, and at approximately 11:30 p.m. or 12:00 a.m., he either lost consciousness or fell asleep. When he became conscious at approximately 4:00 a.m. the next day, his pain was somewhat less severe than it had been the night before, but it was still too painful for him to stand up fully. By 6:00 a.m., Plaintiffwas no longer experiencing any pain. Plaintiff was finally seen by medical staff at 10:00 a.m. that morning, when he had a preexisting medical appointment. During his appointment, he passed two small kidney stones.

Plaintiff's medical expert testified that Plaintiff's kidney stones, like most kidney stones, were not life-threatening. However, the expert testified that kidney stones can cause very severe pain. Defendant's medical expert likewise admitted that small kidney stones can result in pain so severe that even a “big, tough football player could be laying on the floor writhing in pain.” (Supplemental App. at 14.) Plaintiff presented evidence that the pain he suffered was so severe that he collapsed, vomited, and believed he was dying. Plaintiff also presented expert testimony that prompt medical attention can diminish both the severity and the duration of pain from kidney stones.

Based on all of this evidence, the district court concluded Plaintiff could prove a claim of deliberate indifference to medical needs in violation of the Eighth Amendment. The court also concluded the law in this circuit has been clearly “established since at least 2006 that a medical professional who knows of and appreciates an inmate's serious risk of medical harm must make a good faith effort to assess him in order to escape a claim for deliberate indifference.” (App. at 165–66.) The district court accordingly denied Defendant's summary judgment motion for qualified immunity. Defendant then filed this interlocutory appeal, in which she raises two issues: (1) whether the evidence identified by the district court is sufficient to satisfy the objective prong of the Eighth Amendment deliberate indifference test; and (2) whether her alleged actions violated clearly established law.

II.

We review the district court's denial of summary judgment on qualified immunity grounds de novo, with our review limited to purely legal issues. Morris, 672 F.3d at 1189. Based on the facts identified by the district court, we thus consider de novo the purely legal questions of “whether the facts that the district court ruled a reasonable jury could find would suffice to show a legal violation” and “whether that law was clearly established at the time of the alleged violation.” Allstate Sweeping, LLC v. Black, 706 F.3d 1261, 1267 (10th Cir.2013).

The Supreme Court has held that the Eighth Amendment's prohibition against cruel and unusual punishment extends to “the unnecessary and wanton infliction of pain” caused by prison officials' “deliberate indifference to serious medical needs of prisoners.” Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976) (internal quotation marks omitted). A claim of deliberate indifference includes both an objective and a subjective component. Mata v. Saiz, 427 F.3d 745, 751 (10th Cir.2005). The objective prong of the deliberate indifference test examines whether the prisoner's medical condition was “ ‘sufficiently serious' to be cognizable under the Cruel and Unusual Punishment Clause.” Id. at 753. The subjective prong examines the state of mind of the defendant, asking whether “the official kn[e]w of and disregard[ed] an excessive risk to inmate health or safety.” Farmer v. Brennan, 511 U.S. 825, 837, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994). In this appeal, only the objective prong is at issue.

A medical need is considered sufficiently serious to satisfy the objective prong if the condition “has been diagnosed by a physician as mandating treatment or is so obvious that even a lay person would easily recognize the necessity for a doctor's attention.” Oxendine v. Kaplan, 241 F.3d 1272, 1276 (10th Cir.2001) (internal quotation marks and ellipses omitted). Where a prisoner claims that harm was caused by a delay in medical treatment, he must “show that the delay resulted in substantial harm” in order to satisfy the objective prong of the deliberate indifference test. Id. “We have held that 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). Thus, the “substantial harm” caused by a delay in treatment may be a permanent physical injury, or it may be “an intermediate injury, such as the pain experienced while waiting for treatment and analgesics.” Kikumura v. Osagie, 461 F.3d 1269, 1292 (10th Cir.2006). “Although ‘not every twinge of pain suffered as a result of delay in medical care is actionable,’ when the pain experienced during the delay is substantial, the prisoner ‘sufficiently establishes the objective element of the deliberate indifference test.’ ” Id. (quoting Sealock v. Colorado, 218 F.3d 1205, 1210 (10th Cir.2000)).

Defendant argues that Plaintiff's hours of severe abdominal pain in ...