Vaughn v. Gray

• Decision Date: 06 March 2009
• Docket Number: No. 07-2921.,07-2921.
• Citation: 557 F.3d 904
• Parties: Susan VAUGHN, Appellee, v. Christopher GRAY, et al., Appellants.
• Court: U.S. Court of Appeals — Eighth Circuit

557 F.3d 904

Susan VAUGHN, Appellee, v. Christopher GRAY, et al., Appellants.

No. 07-2921.

United States Court of Appeals, Eighth Circuit.

Submitted: December 12, 2008.

Filed: March 6, 2009.

Jason E. Owens, argued, Michael R. Rainwater, on the brief, Little Rock, AR, for appellant.

Lawrence W. Jackson, argued, Marion, AR, Kent L. Rubens, on the brief, West Memphis, AR, for appellee.

Before LOKEN, Chief Judge, BEAM, Circuit Judge, and KYLE,¹ District Judge.

KYLE, District Judge.

Appellee, Susan Vaughn, commenced this action under 42 U.S.C. § 1983, contending that Appellants were deliberately indifferent to the serious medical needs of her brother, Phil Blount, which resulted in his death. Appellants, several officers and employees of the Greene County, Arkansas Sheriff's Department, moved for summary judgment based on qualified immunity, which was denied by the district court.² Appellants appeal and we affirm.

I. BACKGROUND

Vaughn first brought an action against Greene County and Sheriff Dan Langston in his individual capacity. The district court denied summary judgment on the ground of qualified immunity for Sheriff Langston, but we reversed, finding he was entitled to qualified immunity. Vaughn v. Greene County, 438 F.3d 845 (8th Cir. 2006). While the first action was on appeal, Vaughn filed a second action, asserting the same Section 1983 claims against four additional officers and employees of the Greene County Sheriff's Department in their individual and official capacities: Christopher L. Gray, David Wanner, Michael Johnson, and Chris Hall The two actions were consolidated, and thereafter the four new defendants moved for summary judgment on the ground of qualified immunity. The motion was granted with respect to Chris Hall, but denied for the remaining defendants. Vaughn v. Greene County, Nos. 2:03CV00070, 2007 WL 2409581, at *3-5 (E.D.Ark. Aug. 10, 2007).

In determining that the remaining defendants (hereinafter the "Appellants") were not entitled to qualified immunity, the district court relied upon the following facts as first described by this Court:

On December 23, 2001, Blount, a 46-year-old moderately obese man, was arrested and taken to the Greene County Jail (Jail), where he was incarcerated on a charge of first-degree sexual assault. During the Jail's intake procedure, Blount completed a medical intake form, indicating he had a history of mental illness, headaches, epilepsy/seizures, ulcers, and kidney/bladder problems, but indicating he did not have a history of heart problems or high or low blood pressure. Although Blount had no medications with him upon his arrival at the Jail, Blount's mother, Carolyn Barber (Barber), later brought Blount's medications, including an anti-depressant. Inmate medication logs from the Jail, as well as written jailer statements, indicate Blount received his anti-depressant medication from December 24, 2001, until January 2, 2002, when the Jail ran out of the medication for Blount's last two dosages on that day. According to these records, Blount's new prescription did not arrive until January 4, 2002, but would not be administered until the next day's shift starting at 6:00 a.m.

On January 4, 2002, jailer Chris Hall (Hall) spoke with Blount's cellmate, who said Blount had been ingesting shampoo and engaging in other odd behavior. Hall repeated this information to Jail Sergeant Mark Harmon, who in turn informed the other jailers. Around 3:00 p.m., Blount was moved to an isolation cell to be monitored. At approximately 10:30 or 11:00 p.m., jailer Chris Gray (Gray) observed Blount vomiting in the isolation cell. Blount asked Gray for a nurse because his stomach was bothering him. Gray asked Blount if he was vomiting because of the shampoo he had ingested, but Blount did not respond. Blount was not given the opportunity to see a nurse following his request. During the night and early morning hours, Blount and the other inmates were checked by Jail personnel about once every hour.

On January 5, 2002, at about 5:15 a.m., jailer Michael Johnson (Johnson) observed Blount pacing in his cell and repeatedly drinking water and throwing up. Approximately thirty minutes later, at 5:50 a.m., Johnson went to Blount's cell to give him his medications and observed Blount lying naked on the floor of his cell. Johnson and the shift supervisor entered Blount's cell, found him unresponsive, initiated CPR, and called for an ambulance. Blount was transported to the hospital, where he was pronounced dead. An autopsy led to the determination Blount died of natural causes: arteriosclerotic cardiovascular disease, causing a heart attack that resulted in Blount's death. Detectable amounts of Blount's anti-depressant medication were found in Blount's system during his autopsy.

According to Barber, Blount called her numerous times on January 3 and 4, 2002, and stated he was nauseated and vomiting. Barber attempted to contact Sheriff Langston to ask for someone to take Blount to a doctor, but Barber was unable to reach the sheriff. Barber later went to the Jail twice on January 4, told a Jail staff member Blount was sick, and was told Blount was receiving his medications. Additionally, Vaughn, Blount's sister, called the Jail before Blount's death to tell the Jail staff he was sick. Vaughn also wrote and faxed a letter to Sheriff Langston, informing him Blount had mental problems and needed to be placed in a different facility.

Id. at *1-2 (quoting Vaughn, 438 F.3d at 847-48).

While Appellants do not deny their knowledge of Blount's repeated vomiting over a seven-hour period and his request for medical assistance, they contend that there is no evidence in the record of their deliberate indifference to Blount's medical needs, and therefore, they are entitled to qualified immunity.

II. ANALYSIS

We review de novo the denial of a motion for summary judgment based on qualified immunity. Vaughn v. Ruoff, 253 F.3d 1124, 1127 (8th Cir.2001).³ Such review "is limited to issues of law, and we will not review the merits of the case or the sufficiency of the evidence." Id. "However, the nonmoving party is still given the benefit of all relevant inferences at the summary judgment stage, and if a genuine dispute exists concerning predicate facts material to the qualified immunity issue, the defendant is not entitled to summary judgment." Plemmons v. Roberts, 439 F.3d 818, 822 (8th Cir.2006) (internal quotations and citations omitted).

In deciding whether an official is entitled to qualified immunity, the Court asks two questions: "(1) whether ... there was a deprivation of a constitutional right; and, if so, (2) whether the right was clearly established at the time of the deprivation such that a reasonable official would understand his conduct was unlawful." Vaughn, 438 F.3d at 850. In this case, Appellants argue only that Vaughn has not established the deprivation of a constitutional right, and therefore, we need not address whether that right was "clearly established."

"Deliberate indifference" to a prisoner's serious illness or injury constitutes cruel and unusual punishment under the Eighth Amendment. Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976); Gregoire v. Class, 236 F.3d 413, 417 (8th Cir.2000) ("It is well established that the Eighth Amendment prohibition on cruel and unusual punishment extends to protect prisoners from deliberate indifference to serious medical needs.").⁴ "Deliberate indifference has both an objective and a subjective component." Butler v. Fletcher, 465 F.3d 340, 345 (8th Cir.2006). The objective component requires a plaintiff to demonstrate an objectively serious medical need. Grayson v. Ross, 454 F.3d 802, 808-09 (8th Cir. 2006); Moore v. Jackson, 123 F.3d 1082, 1086 (8th Cir.1997). The subjective component requires a plaintiff to show that the defendant actually knew of, but deliberately disregarded, such need. Grayson, 454 F.3d at 808-09; Moore, 123 F.3d at 1086. Appellants do not contest the district court's finding of an "objectively serious medical need," and thus we only address the subjective component of whether Appellants "deliberately disregarded" such need.

In order to demonstrate that a defendant actually knew of, but deliberately disregarded, a serious medical need, the plaintiff must establish a "mental state akin to criminal recklessness: disregarding a known risk to the inmate's health." Gordon v. Frank, 454 F.3d 858, 862 (8th Cir.2006). However, while a deliberate-indifference claim requires the establishment of a defendant's actual, subjective knowledge, such knowledge can be demonstrated with circumstantial evidence. See Farmer v. Brennan, 511 U.S. 825, 842, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994) ("Whether a prison official had the requisite knowledge ... is a question of fact subject to demonstration in the usual ways, including inference from circumstantial evidence."). Indeed, a factfinder may determine that a defendant was actually aware of a serious medical need, but deliberately disregarded it, "from the very fact that the [medical need] was obvious." Id. Moreover, this Court has noted that the "[i]ntentional delay in providing medical treatment shows deliberate disregard if a reasonable person would know that the inmate requires medical attention." Gordon, 454 F.3d at 862.⁵

No Appellant claims that he was unaware of the physical symptoms displayed by Blount in the hours before his death. In fact, Appellants were aware that Blount was vomiting throughout the night and requesting medical attention. Rather, Appellants claim that they did not deliberately disregard Blount's serious medical need because they believed that his vomiting was caused by the ingestion of shampoo, and thus, they did not actually "draw the inference" that Blount's vomiting constituted a serious medical need. See Farmer, 511 U.S. at 837, 114 S.Ct. 1970.

It is true that "an official's failure to alleviate a significant risk that...