United States District Court, S.D. Georgia
ORDER AND MAGISTRATE JUDGE'S REPORT AND
STAN BAKER, UNITED STATES MAGISTRATE JUDGE.
before the Court are Defendants' Motion for Summary
Judgment and Plaintiff's Motion for Partial Summary
Judgment. (Docs. 62, 64.) Defendants filed a Response to
Plaintiff's Motion, (doc. 66), and Plaintiff filed
Responses to Defendants' Motion, (docs. 67, 68). For the
reasons which follow, I RECOMMEND the Court
GRANT Defendants' Motion for Summary
Judgment, DENY Plaintiff's Partial
Motion for Summary Judgment, and DISMISS
Plaintiff's Complaint. I also RECOMMEND the
Court DIRECT the Clerk of Court to
CLOSE this case and enter the appropriate
judgment of dismissal and DENY Plaintiff
in forma pauperis status on appeal.
contends that he was diagnosed with Hepatitis C by a doctor
at Valdosta State Prison in 2007. (Doc. 21, p. 3.)
Plaintiff's Complaint centers on allegations that he was
denied adequate treatment for Hepatitis C while incarcerated
at Smith State Prison. (Doc. 1.) Specifically, Plaintiff
alleges that he did not receive any treatment for his
Hepatitis C for several years and that, due to not receiving
treatment, he could have sustained liver damage or developed
cancer. (Id. at p. 3.) Plaintiff further alleged
that Defendants Henry, Allen, and Gardner were notified of
his condition but failed to provide treatment. (Id.
at pp. 3-4.) For example, Plaintiff stated that he submitted
a medical request to be treated for Hepatitis C on July 6,
2011, that the medical department did not respond to that
request, and that he submitted a follow-up request to
Defendant Allen, the medical administrator. (Id.) He
also stated that he submitted a second request for Hepatitis
C treatment on July 22, 2014, and that Dr.
Alston did not actually address his request for
Hepatitis C treatment, despite giving a response to that
request two days later. (Id.) Plaintiff further
references grievances that he began to file in September 2014
regarding medical personnel's “non-response”
to his requests for Hepatitis C treatment. (Id.)
response to Defendants' Motion to Dismiss, (doc. 27),
Plaintiff offered further allegations in support of his
deliberate indifference claims. (Doc. 32.) Plaintiff stated
that he began requesting treatment for Hepatitis C on July 6,
2011. (Id. at p. 3.) However, as of April 14, 2016,
he still had not received any treatment. (Id.) He
stated that he had a biopsy on April 11, 2014. (Id.
at p. 4.) Following that biopsy, Plaintiff had an interview
with Dr. Alston at Smith State Prison, who informed Plaintiff
that his treatment would begin in approximately two (2)
weeks. (Id.) However, Plaintiff did not receive
treatment within that time. (Id.) Plaintiff contends
he has repeatedly requested treatment, including on July 22,
2014, September 29, 2015, and December 24, 2015.
stated that Defendants did not provide any explanation for
why he has not received treatment for Hepatitis C.
(Id.) Plaintiff stated that Defendants “all
knew of Plaintiff's serious medical needs[, ]” and
that they each individually failed or refused to provide him
appropriate treatment. (Id. at pp. 7-8, 10.) In
fact, Plaintiff asserted that his viral load increased by 5,
000, 000 from the time he initially was treated in 2012 until
he finally received more treatment in 2016. (Doc. 38, p. 3.)
instant Motion for Summary Judgment, Defendants assert
Plaintiff cannot sustain his Eighth Amendment deliberate
indifference claims against them and that they are entitled
to qualified immunity. (Doc. 62.) In contrast, Plaintiff
responds Defendants were deliberately indifferent to his
serious medical needs and are not entitled to qualified
immunity protection. (Docs. 64, 67, 68.)
judgment “shall” be granted if “the movant
shows that there is no genuine dispute as to any material
fact and that the movant is entitled to judgment as a matter
of law.” Fed.R.Civ.P. 56(a). “A dispute about a
material fact is genuine and summary judgment is
inappropriate if the evidence is such that a reasonable jury
could return a verdict for the nonmoving party. However,
there must exist a conflict in substantial evidence to pose a
jury question.” Hall v. Sunjoy Indus. Grp.,
Inc., 764 F.Supp.2d 1297, 1301 (M.D. Fla. 2011) (citing
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248
(1986), and Verbraeken v. Westinghouse Elec. Corp.,
881 F.2d 1041, 1045 (11th Cir. 1989)).
moving party bears the burden of establishing that there is
no genuine dispute as to any material fact and that he is
entitled to judgment as a matter of law. See Williamson
Oil Co. v. Philip Morris USA, 346 F.3d 1287, 1298 (11th
Cir. 2003). Specifically, the moving party must identify the
portions of the record which establish that there are no
“genuine dispute[s] as to any material fact and the
movant is entitled to judgment as a matter of law.”
See Moton v. Cowart, 631 F.3d 1337, 1341 (11th Cir.
2011). When the nonmoving party would have the burden of
proof at trial, the moving party may discharge his burden by
showing that the record lacks evidence to support the
nonmoving party's case or that the nonmoving party would
be unable to prove his case at trial. See id.
(citing Celotex Corp. v. Catrett, 477 U.S. 317,
322-23 (1986)). In determining whether a summary judgment
motion should be granted, a court must view the record and
all reasonable inferences that can be drawn from the record
in a light most favorable to the nonmoving party.
Peek-A-Boo Lounge of Bradenton, Inc. v. Manatee
Cty., 630 F.3d 1346, 1353 (11th Cir. 2011) (citing
Rodriguez v. Sec'y for Dep't of Corr., 508
F.3d 611, 616 (11th Cir. 2007)).
Deliberate Indifference to Medical Needs
claims against Defendants require analysis and discussion
under the Eighth Amendment of the United States Constitution.
The Eighth Amendment's proscription against cruel and
unusual punishment imposes a constitutional duty upon prison
officials to “ensure that inmates receive adequate
food, clothing shelter, and medical care.” Farmer
v. Brennan, 511 U.S. 825, 832 (1994). However,
“not every claim by a prisoner that he has not received
adequate medical treatment states a violation of the Eighth
Amendment.” Harris v. Thigpen, 941 F.2d 1495,
1505 (11th Cir. 1991) (quoting Estelle v. Gamble,
429 U.S. 97, 105 (1976)). Rather, “an inmate must
allege acts or omissions sufficiently harmful to evidence
deliberate indifference to serious medical needs.”
Estelle, 429 U.S. at 106. In order to prevail on a
deliberate indifference claim, a prisoner must: (1) satisfy
the objective component by showing a serious medical need;
(2) satisfy the subjective component by showing a
defendant's deliberate indifference to that need; and (3)
show that the injury was caused by the defendant's
indifference. Goebert v. Lee Cty., 510 F.3d 1312,
1326 (11th Cir. 2007).
the first, objective component, a medical need is serious if
it “‘has been diagnosed by a physician as
mandating treatment or [is] one that is so obvious that even
a lay person would easily recognize the necessity for a
doctor's attention.'” Id. (quoting
Hill v. DeKalb Reg'l Youth Det. Ctr., 40 F.3d
1176, 1187). In either situation, the medical need must be
“one that, if left unattended, ‘poses a
substantial risk of serious harm.'” Farrow v.
West, 320 F.3d 1235, 1246 (quoting Farmer, 511
U.S. at 834).
the second, subjective component, the Eleventh Circuit Court
of Appeals has consistently required that “a defendant
know of and disregard an excessive risk to an inmate's
health and safety.” Haney v. City of Cumming,
69 F.3d 1098, 1102 (11th Cir. 1995). Thus, the subjective
component requires an inmate to prove: “(1) subjective
knowledge of a risk of serious harm; (2) disregard of that
risk; (3) by conduct that is more than mere
negligence.” Melton v. Abston, 841 F.3d 1207,
1223 (11th Cir. 2016).
that is more than mere negligence includes: (1) grossly
inadequate care; (2) a decision to take an easier but less
efficacious course of treatment; and (3) medical care that is
so cursory as to amount to no treatment at all.”
Bingham v. Thomas, 654 F.3d 1171, 1176 (11th Cir.
2011). Additionally, a defendant who “delays necessary
treatment for non-medical reasons” or “knowingly
interfere[s] with a physician's prescribed course of
treatment” may exhibit deliberate indifference.
Id. (citations omitted). In instances where a
deliberate indifference claim turns on a delay in treatment
rather than the type of medical care received, the Court
considers “the reason for the delay and the nature of
the medical need.” Farrow, 320 F.3d at 1246
(citing McElligott, 182 F.3d at 1255). When a claim
turns on the quality of treatment provided, however,
“‘a simple difference in medical opinion between
the prison's medical staff and the inmate as to the
latter's diagnosis or course of treatment' does not
support a claim of deliberate indifference.”
Melton, 841 F.3d at 1224 (quoting Harris,
941 F.2d at 1505). In other words, “medical malpractice
does not become a constitutional violation merely because the
victim is a prisoner.” Estelle, 429 U.S. at
104. Furthermore, deliberate indifference is not established
when an inmate receives medical care, but “may have
desired different modes of treatment.” Hamm v.
DeKalb Cty., 774 F.2d 1567, 1575 (11th Cir. 1985).
law establishes Hepatitis C is a serious medical need,
Shaw v. Ajibade, No. CV311-027, 2013 WL 326208, at
*7 (S.D. Ga. Jan. 8, 2013), the Court's analysis of the
parties' Motions for Summary Judgment will focus on
whether a rational juror, viewing all of the evidence in the
light most favorable to Plaintiff, could conclude that
Defendants were deliberately indifferent to Plaintiff's
serious medical need.
generally states the medical staff at Smith State Prison
failed to treat his Hepatitis C from July 6, 2011, through
2016. (Doc. 64-1, p. 1.) According to Plaintiff, Defendant
Gardner informed him he had fibrotic changes and significant
scarring to his liver, which are associated with liver
cancer. (Id. at p. 3.) Plaintiff asserts Defendant
Gardner's lack of familiarity with the progressive nature
of Hepatitis C led to him developing fibrosis, or scarring,
of the liver. (Doc. 67-1, p. 4.) Plaintiff avers Defendant
Gardner said he was getting proper treatment for his
Hepatitis C, although he avers he was receiving no treatment
whatsoever, at least as recently as April 2016. (Doc. 32, p.
3; Doc. 62-9, p. 8.)
Gardner notes she is a licensed family medicine practitioner
who was the Medical Director at Smith State Prison from June
1, 2014, until November 1, 2016. As part of her duties,
Defendant Gardner maintains she provided hands-on medical
care to inmates housed at Smith State Prison and scheduled
consultations with medical specialists for the inmates there.
(Doc. 62-1, p. 4.) Defendant Gardner states that, while she
is familiar with the Hepatitis C virus and its symptoms and
treatment, she does not have the expertise to determine
whether a particular inmate should receive treatment for
Hepatitis C. Rather, Defendant Gardner explains that
determination is made by a gastroenterologist, in conjunction
with the Georgia Department of Corrections'
(“GDC”) guidelines. (Id.) Additionally,
Defendant Gardner avers she did not determine what
medications the inmate is prescribed for treatment of the
Hepatitis C virus, as the GDC determines what specific
medications are used to treat the disease. According to
Defendant Gardner, in order for an inmate to receive Harvoni
as treatment for Hepatitis C, a Hepatitis C pre-therapy
checklist setting forth lab work and other tests that had to
be performed before an inmate could be considered for
treatment has to be completed; treatment must be recommended
by a gastroenterologist and approved by GDC's Medical
Director. (Id. at p. 5.) If an inmate needed more
specialized care than what the prison offered, Defendant
Gardner alleges she was required to put in a consult request
through the Utilization Management Department of the GDC.
Defendant Gardner contends the Utilization Management
Department schedules the time, place, and manner of the
medical service, if that Department approves the requested
service. (Id. at p. 6.)
assert Plaintiff underwent treatment for Hepatitis C in 2012,
and that course of treatment failed. (Id.)
Defendants also assert Plaintiff received medical care from
the time his first treatment failed until Plaintiff received
the Harvoni treatment in 2016. (Id. at
pp.6-7.)Defendant Gardner asserts she did not
ignore Plaintiff's status as Hepatitis C positive.
Rather, Defendant Gardner states she worked diligently as the
Medical Director at Smith State Prison “to ensure
[Plaintiff] received appropriate care for his Hepatitis C[, ]
as determined by [a gastroenterologist] and” GDC's
guidelines. (Id. at p. 11.)
undisputed facts, including primarily Plaintiff's medical
records, establish the following regarding Plaintiff's
course of treatment for Hepatitis C. Plaintiff received
treatment in 2012 for his Hepatitis C when the GDC used the
medications Ribavirin and Pegasys, which had a 54-63% cure
rate. (Doc. 62-4, pp. 3, 5.) Plaintiff's course of
treatment was not successful at that time. (See Doc.
62-5, p. 1.) Plaintiff had a liver biopsy on April 10, 2014,
which revealed mild chronic hepatitis, consistent with
Hepatitis C, and globules. (Id. at pp. 2-4.) Dr.
Alston had a follow-up with Plaintiff a week later and
discussed the Hepatitis C treatment protocol. (Id.
at p. 5.) Defendant Gardner became the Medical Director at
Smith State Prison on June 1, 2014. (Doc. 62-4, p. 2; Doc.
67-1, pp. 2-3.) She reviewed the results of Plaintiff's
biopsy on July 24, 2014, and wrote a consult request for
another biopsy. (Doc. 62-5, pp. 6, 8.) However, Dr. Gardner
cancelled the second biopsy request and re-wrote that request
on September 18, 2014, for Plaintiff to visit Dr. Ayaz
Chaudhary, a gastroenterologist. (Id. at pp. 9-10.)
On October 23, 2014, Dr. Chaudhary noted Plaintiff had Stage
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