Thad Delaughter v. Ronald Woodall
Opinion
Thad Everett Delaughter claims the defendants violated his Eighth Amendment rights by failing to provide medically necessary hip replacement and reconstructive surgery. Delaughter filed suit under
On appeal, Delaughter argues the district court (1) improperly granted summary judgment in favor of Hatten based on sovereign and qualified immunity; (2) improperly concluded there was no genuine dispute of material fact as to whether Dr. Woodall was deliberately indifferent to Delaughter's medical needs; and (3) abused its discretion in denying Delaughter's motions to appoint counsel. 3
*135 For the reasons set forth below, we AFFIRM in part, REVERSE in part, VACATE in part, and REMAND.
I. Factual and Procedural Background
Delaughter suffers from rheumatoid arthritis and had hip replacement surgery in 1992, prior to his incarceration. In 2010, Delaughter began experiencing hip pain while incarcerated. Between November 2010 and March 2011, Dr. Woodall treated Delaughter with pain medication and steroid injections on at least four separate occasions. According to Delaughter, Dr. Woodall repeatedly assured Delaughter he would refer Delaughter to a specialist, but no appointment was scheduled. Dr. Woodall asserts that he has authority only to request referrals but not to schedule specialty consultations, and that he put in such a request in June 2011. Delaughter eventually asked Hatten to arrange a specialty consultation, and claims it was Hatten who scheduled an appointment with Dr. Elliot Nipper, an orthopedic specialist.
Delaughter first saw Dr. Nipper in the summer of 2011. Dr. Nipper determined that Delaughter required hip replacement and reconstructive surgery. Delaughter alleges this surgery was scheduled with Dr. Nipper for October 2011, but the surgery was cancelled shortly before it was to occur. Hatten claims Dr. Nipper cancelled the surgery but does not explain why Dr. Nipper did so; Delaughter claims Dr. Nipper told him that "they are simply not going to pay for [the surgery]."
It is unclear what, if any, steps were taken regarding Delaughter's surgery between the fall of 2011 and 2013. In February and August 2013, Dr. Woodall requested that Delaughter see an outside specialist, and Delaughter saw Dr. Nipper again in September 2013. Dr. Nipper then requested that MDOC refer Delaughter to the University of Mississippi Medical Center ("UMMC") for surgery. MDOC claims that UMMC refused to accept Delaughter as a patient but that, at least as of 2015, MDOC continued to discuss surgery with UMMC. Delaughter's medical records reflect that Dr. Woodall continued to treat Delaughter with medication and steroid injections at least until 2015. 4 But Delaughter has yet to receive hip replacement and reconstructive surgery.
Based on the delay in surgery, Delaughter filed suit under
II. Standard of Review
We review a grant of summary judgment de novo, applying the same standard as the district court.
Cass v. City of Abilene
,
We review the denial of a motion to appoint counsel for abuse of discretion.
Jackson v. Dall. Police Dep't
,
III. Discussion
A. Claim against Dr. Ronald Woodall
Delaughter argues that Dr. Woodall was deliberately indifferent to his medical needs because Dr. Woodall knows Delaughter requires surgery but has not received it; thus, the district court erroneously granted summary judgment in Dr. Woodall's favor.
"A prison official violates the Eighth Amendment's prohibition against cruel and unusual punishment when his conduct demonstrates deliberate indifference to a prisoner's serious medical needs, constituting an 'unnecessary and wanton infliction of pain.' "
Easter v. Powell
,
The district court properly granted summary judgment in Dr. Woodall's favor because there is no evidence that Dr. Woodall failed to take reasonable measures to abate a substantial risk of serious harm to Delaughter. The record supports Dr. Woodall's assertion that he has no authority to authorize, schedule, or pay for Delaughter's surgery. The record includes Dr. Woodall's unrebutted affidavit in which he states that he is neither equipped nor authorized to perform surgery, nor can he schedule, authorize, or arrange for off-site surgery. Since the lack of surgery is the only claimed "deliberate indifference," and this is out of Dr. Woodall's hands, we conclude that Delaughter did not raise a
*137
fact issue sufficient to defeat summary judgment.
Thompson v. Steele
,
B. Claims against Michael Hatten
1. Sovereign Immunity
Delaughter argues the district court erroneously concluded that Hatten was entitled to sovereign immunity from Delaughter's injunctive claims against Hatten in his official capacity. Because the district court failed to address the Ex parte Young 5 exception to sovereign immunity for claims for prospective injunctive relief, we agree that the injunctive relief claim should be remanded.
"The Eleventh Amendment does not protect state officials from claims for prospective relief when it is alleged that the state officials acted in violation of federal law."
Warnock v. Pecos Cty.,
Liberally construing Delaughter's pro se complaint,
see
Mayfield v. Tex. Dep't of Criminal Justice
,
2. Qualified Immunity
Delaughter argues the district court incorrectly determined that Hatten in his individual capacity was entitled to qualified immunity because Delaughter established that Hatten unjustifiably delayed required surgery, and it is clearly established that prison officials violate the Eighth Amendment by doing so.
Because Hatten invoked qualified immunity, Delaughter has the burden to
*138
demonstrate "(1) that the official violated a statutory or constitutional right, and (2) that the right was clearly established at the time of the challenged conduct."
Ashcroft v. al-Kidd
,
a. Violation of a Constitutional Right
As noted above, delay in medical care constitutes deliberate indifference in violation of the Eighth Amendment if a prison official disregards a substantial risk of serious harm by failing to take reasonable measures to abate it, and the delay results in substantial harm.
Mendoza,
Hatten argues that Delaughter's surgery has been delayed only because Dr. Nipper cancelled the surgery and UMMC refused to accept Delaughter as a patient. Because he contends that these are medical-judgment decisions, Hatten concludes that the delay in surgery does not constitute deliberate indifference and the district court properly granted summary judgment in his favor. We disagree.
First, we have previously found that claims like Delaughter's do not constitute "mere disagreement with one's medical treatment."
See
Easter
,
Here, Dr. Nipper determined in 2011 that Delaughter requires hip replacement and reconstructive surgery. No party points to evidence that any medical professional has disagreed with Dr. Nipper. Thus, Delaughter's claim arises from the fact he has yet to receive a prescribed course of treatment; it does not arise from his subjective opinion of the sufficiency of his medical treatment that is either contradicted or unsupported by medical professionals.
Second, it is not clear that Dr. Nipper's cancellation of Delaughter's surgery and UMMC's failure to accept Delaughter as a patient were medical-judgment decisions. Indeed, Delaughter claims these decisions were made because MDOC refuses to pay for his surgery. If so, the delay could under certain circumstances "evince a wanton disregard for [a] serious medical need[ ]."
See
Johnson v. Treen
,
*139
Factual disputes about the reason for the delay prevent us from determining whether Hatten violated Delaughter's constitutional rights. Delaughter testified that Dr. Nipper told him "they"-presumably MDOC-would not pay for his surgery, and Delaughter's medical records reflect that Dr. Nipper told Delaughter that Delaughter's insurance would not pay for a CT scan or custom components. Hatten produced an affidavit from Dr. Gloria Perry, Chief Medical Officer of the MDOC Office of Medical Compliance, in which she states that "the cost of the surgery was not a factor for MDOC in the referral of Inmate Delaughter to UMMC." But Dr. Perry's affidavit fails to explain why Dr. Nipper cancelled the surgery, nor does it conclusively establish that UMMC's refusal to accept Delaughter was a matter of medical judgment.
8
Therefore, we conclude the district court erred in holding there were no genuine issues of material fact about whether Hatten violated Delaughter's constitutional rights.
9
See
Miles v. Rich
,
b. Clearly established law
Having established that summary judgment on the first prong was incorrect, we turn to the second prong of the qualified immunity analysis. Delaughter bears the burden of pointing out the clearly established law and raising a fact issue as to its violation.
Thompson v. Mercer
,
Delaughter claims it is clearly established that an unjustified delay in obtaining necessary reconstructive surgery for a prisoner violates the Eighth Amendment rights of the prisoner. In support, Delaughter points to three of our unpublished cases in which we concluded that an unjustified delay in surgery could constitute deliberate indifference.
See
Miles
As we have noted, it is clearly established that delaying medical care can constitute an Eighth Amendment violation if the prison official "knows that [the] inmate[ ] face[s] a substantial risk of serious harm and disregards that risk by failing to take reasonable measures to abate it," and the delay results in substantial harm.
Mendoza,
C. Appointment of Counsel
Delaughter claims that the district court abused its discretion by twice denying his motions for appointment of counsel. There is no right to appointment of counsel in civil cases, but a district court may appoint counsel if doing so "would aid in the efficient and equitable disposition of the case."
Jackson
,
(1) the type and complexity of the case; (2) whether the indigent is capable of *141 adequately presenting his case; (3) whether the indigent is in a position to investigate adequately the case; and (4) whether the evidence will consist in large part of conflicting testimony so as to require skill in the presentation of evidence and in cross examination.
Ulmer v. Chancellor
,
The district court determined that no exceptional circumstances existed because pro se prisoner plaintiffs routinely litigated the types of issues presented by Delaughter's case, the issues were not particularly complex, and Delaughter had proven himself capable of self-representation.
In light of our resolution of this case, these conclusions deserve another look by the district court on remand and, specifically, consideration should be given to the appointment of pro bono counsel on remand. As part of the revised analysis, the district court should consider that Delaughter's claim-that he has been denied medically necessary surgery for seven years-presents circumstances different than the usual prisoner-deliberate-indifference claim. We have previously vacated a district court's denial of a motion to appoint counsel for similar reasons.
See
Garner v. Morales
, No. 07-41015,
The district court should also consider the fact that the pursuit of this surgery has taken unusual twists and turns making the difficult task of gathering evidence as a pro se prisoner far more difficult than usual.
See
Moore v. Mabus
,
IV. Conclusion
For the reasons stated above, we AFFIRM the district court's grant of summary judgment in favor of Dr. Woodall, and REVERSE the district court's grant of summary judgment in favor of Hatten, in both capacities. We VACATE the denial of Delaughter's motions for appointment of counsel and REMAND.
The court today remands this case for further proceedings against Michael Hatten, the medical administrator at South Mississippi Correctional Institution, where Thad Delaughter is currently serving his sentence. I write separately to draw attention to Hatten's unopposed motion to supplement the record with additional medical records, which the court today denies. Unless the medical records are somehow discredited, they would appear to undercut Delaughter's claims of unjustified delay or outright denial of medically necessary surgery. It is with the understanding and *142 belief that these medical records can and will be explored on remand that I concur in the judgment.
Hatten submits medical records concerning physician visits that occurred after final judgment was entered in this case on March 18, 2016. Joined by the State of Mississippi, Hatten contends, with some force, that these medical records "directly rebut Delaughter's contention that he is being denied hip replacement surgery due to Defendants-Appellees' refusal to pay for the surgery."
Delaughter indicated in a handwritten response that he "does not object to the Appellees' Motion to Supplement the Record." Nor does he dispute the authenticity of the supplemental medical records.
Hatten's motion explains that, on April 5, 2016, "his treating doctors were ready to proceed ahead with hip replacement surgery, but were forced to postpone surgery because Delaughter admitted he had recently smoked marijuana." Delaughter does not dispute this. And the supplemental medical records confirm it. The records from his physician consultation on April 5, 2016, state that Delaughter was advised that "he needs to be completely drug and nicotine free prior to us proceeding," and that he "openly admits to using marijuana." So it appears by all accounts that Delaughter's own conduct prevented him from receiving the treatment he seeks, at least as of April 2016, the month that he filed notice of this appeal.
In addition, Delaughter's medical records further indicate that, on January 5, 2017, he informed his physician that he has "[n]o acute issues/complaints," and that furthermore, he "expects to be released in the next 5 years if all goes as planned." This is significant because it appears that Delaughter agreed to postpone any surgery until after his anticipated release. As the medical records from his physician consultation on January 5, 2017, explain:
We discussed the severe complexity of his issues with the patient. This would require a large reconstruction which would have significant intraoperative and postoperative risks. Given his current incarceration, he would likely not be able to receive the ideal postoperative care or likely any postoperative therapy. In light of this being a chronic issue, we discussed the need for delaying any operative intervention until he is released from prison. ... He understood the need to wait until he is released from prison to maximize his chances of recovery. We encouraged him to remain drug and nicotine free in order to receive operative intervention. Patient understood and agreed with treatment plan going forward. He will follow up with us when he is released from prison.
Delaughter does not contend that these medical reports are false or fraudulent. Indeed, Delaughter offers no explanation whatsoever, other than to state that the information contained in his medical records is "puzzling" because he has " twelve more years to serve."
If it is true that Delaughter is the cause of his own delays-indeed, if it is true that he has consented to postponing surgery until after his release-it is difficult to see how he can prevail on his claim for injunctive relief and damages for pain and suffering. These issues can and should be explored further on remand. I concur in the judgment.
Delaughter also filed suit against Wexford Health Services, Christopher Epps, Johnny Denmark, and the State of Mississippi. Delaughter voluntarily dismissed the first three defendants, and the district court granted summary judgment for Mississippi. Delaughter appeals only Hatten's and Dr. Woodall's dismissals.
The parties consented to proceed before a magistrate judge pursuant to
We also address three motions that have been carried with the case. First, before Delaughter was appointed appellate counsel, he moved for leave to file an untimely reply brief. This motion was never filed because Delaughter failed to seek leave of the court. Because a supplemental briefing schedule was set after Delaughter was appointed counsel, we need not address the unfiled motion issue as it would be moot in any event. Second, Delaughter filed a motion for injunctive relief pending appeal. Because we have resolved the merits of Delaughter's appeal, we deny his motion as moot.
See
Fed. R. App. P. 8(a)(1)(C). Finally, Hatten filed a motion to supplement the record with additional, subsequent medical records. Generally, we will not expand the record on appeal.
See
McIntosh v. Partridge
,
In 2015, Delaughter was transferred to a different prison where Dr. Woodall alleges (and Delaughter raises no evidence to the contrary) that he does not see patients.
Ex parte Young
,
Hatten claims that the district court was not required to undertake an Ex parte Young analysis because it concluded that Delaughter failed to establish a deliberate indifference claim; thus, there was no ongoing violation of federal law. Given our disposition of this merits issue (that fact issues exist regarding an Eighth Amendment violation), that argument fails.
We have previously suggested that a non-medical reason for delay in treatment constitutes deliberate indifference, and several of our sister circuits have held so explicitly.
See
Thibodeaux v. Thomas
,
The record is unclear as to the explanation for the delay in surgery between Dr. Nipper's cancellation in the fall of 2011 and the first time MDOC contacted UMMC, which, it appears from Dr. Nipper's notes, occurred in the fall of 2013.
In addition, there may be an issue about whether Hatten has authority to authorize surgery for Delaughter. Delaughter offers evidence that Hatten has this authority because Hatten is the medical administrator and arranged for Delaughter to see Dr. Nipper. Hatten claims that, because he is not a doctor, he has no authority to decide the proper medical care for Delaughter. But that is a different issue than whether he has authority to authorize medical care that a medical professional has deemed proper, and Hatten does not address that issue or point to record evidence to the contrary of Delaughter's evidence.
The law must be clearly established at the time of the alleged violation.
See
Cooper
,
Reference
- Full Case Name
- Thad Everett DELAUGHTER, Plaintiff - Appellant, v. Ronald WOODALL; Michael Hatten; State of Mississippi, Defendants - Appellees.
- Cited By
- 116 cases
- Status
- Published