Federal Appellate Court Reinstates Deliberate Indifference Medical Malpractice Claim

Court Reinstates Deliberate Indifference Claim: Shelly Kaye Stevens (“Appellant”), as personal representative of the estate of James Allen Leslie Stevens (“Decedent”), filed a second amended complaint alleging Decedent suffered deliberate indifference to his serious medical needs while in custody at the Alleghany County, Maryland Detention Center (“ACDC”), which led to his death.

Appellant asserted claims against licensed practical nurses, Dawn Michelle Holler (“Holler”), Lisa Shutts (“Shutts”), and Jodi Lynn Brashear (“Brashear”); registered nurses, Stephanie Diane Shroyer (“Shroyer”) and Leslie Anne Logsdon (“Logsdon”); physician Donald Frederick Manger (“Dr. Manger”); and physician’s assistant James Anthony Piazza
(“Piazza”) (the “Individual Medical Defendants”) and against the company contracted to provide medical care services to inmates at ACDC, Wellpath, LLC, formerly Correct Care Solutions (“CCS”) (collectively “Appellees”).

As to Appellant’s claim of deliberate indifference to Decedent’s serious medical needs, the district court held that while “the [Second] Amended Complaint may adequately state allegations of medical negligence against [the Individual Medical Defendants] . . . it fails to support a cause of action against them for a constitutional violation.” Therefore, the district court dismissed Appellant’s second amended complaint.

The United States Court of Appeals for the Fourth Circuit (“Federal Appellate Court”) held in its May 30, 2023 published Opinion: “On review, we conclude that the complaint sufficiently alleges a Fourteenth Amendment violation for deliberate indifference to Decedent’s serious medical needs. Consequently, we reverse and remand.”

The Federal Appellate Court explained: “Decedent walked into ACDC on his own power on November 24 but when he was released four days later, he had to be escorted out in a wheelchair. “[O]ne of the nurses charged with [Decedent’s] care and at least one correctional officer . . . made comments during [Decedent’s] detention indicating that they knew he was fatally ill and wanted him released from the Detention Center as soon as possible, so he would not die inside the facility.” Id. at 301 ¶ 162. “These comments were overheard by a third party and later recounted to [Appellant].”

“The morning after his release, Decedent woke up “still unwell and disoriented.” Id. at 300 ¶ 155. Appellant left Decedent at home while she went to a meeting. Upon her return, she found Decedent dead. A partial autopsy revealed that Decedent died of hypertensive heart failure. Obesity and diabetes mellitus were also contributing causes of death. A toxicology report showed only Librium and no other drugs or alcohol in Decedent’s system.”

Deliberate Indifference

Deliberate indifference to serious medical needs of prisoners constitutes the ‘unnecessary and wanton infliction of pain” proscribed by the Eighth Amendment. However, a pretrial detainee’s claim of constitutionally inadequate medical care is governed by the Fourteenth Amendment, rather than the Eighth Amendment. Although the precise scope of this Fourteenth Amendment right remains unclear, a pretrial detainee makes out a violation at least where the detainee shows deliberate indifference to serious medical needs under cases interpreting the Eighth Amendment.

To state such a claim, the detainee must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs. Deliberate indifference is a high standard and the mere negligent or inadvertent
failure to provide adequate care is not enough.

The Federal Appellate Court stated that the test for deliberate indifference is two-pronged and includes both objective and subjective elements. The Appellant must demonstrate that (1) Decedent was exposed to a substantial risk of serious harm (the objective prong); and (2) the prison official knew of and disregarded that substantial risk to the inmate’s health or safety (the subjective prong). The Appellees did not dispute prong one (the Decedent’s underlying health conditions satisfy the first prong, as they were objectively serious). Therefore, the issue was the subjective prong; that is, whether the Individual Medical Defendants acted with a “sufficiently culpable state of mind,” specifically, deliberate indifference to Decedent’s health.

The Federal Appellate Court stated: “Appellant sufficiently alleged that the Individual Medical Defendants knew of and
disregarded a substantial risk of serious injury to Decedent. We therefore conclude that the subjective prong of the deliberate indifference test is satisfied,” explaining: Appellant actually alleged that none of the Individual Medical Defendants “thought it necessary to take [Decedent] to the hospital despite an obvious on-going medical emergency”; Appellant’s 44 page second amended complaint sets out in meticulous detail Decedent’s persistent, documented decline in health and care, and the Individual Medical Defendants’ knowledge that harm would result; Appellant has alleged that Brashear “asserted, without any supporting facts, that [Decedent] was stable” at the time of his release, despite never conducting any pre-release examination as required by ACDC regulations. Id. at 299 ¶ 148. This allegation is sufficient to infer that Brashear knew Decedent was likely to suffer harm but nevertheless disregarded that fact; Appellant alleged at least three protocol violations which demonstrate the Individual Medical Defendants “knew of and disregarded a substantial risk of serious injury to the detainee or that they actually knew of and ignored a detainee’s serious need for medical care”).

The Federal Appellate Court further held: “We also reject the district court’s conclusion that Appellant’s deliberate indifference claim amounts to no more than mere disagreement over the proper course of Decedent’s treatment.
It is true that “mere disagreements between an inmate and [prison medical staff] over the inmate’s proper medical care” are insufficient to establish deliberate indifference “absent exceptional circumstances,” Scinto v. Stansberry, 841 F.3d 219, 225 (4th Cir. 2016), and a claim for deliberate indifference to medical needs requires more than a showing of mere negligence. Estelle v. Gamble, 429 U.S. 97, 103–04 (1976). In fact, this court has held that treatment “must be so grossly incompetent, inadequate or excessive as to shock the conscience or to be intolerable to fundamental fairness” … Significantly, we have rejected the notion that simply because medical staff have provided an inmate with “some treatment” that “they have necessarily provided [the inmate] with constitutionally adequate treatment.”

“This is precisely what Appellant has alleged here — that the care Decedent received was constitutionally inadequate. Appellant has sufficiently alleged that the Individual Medical Defendants’ treatment and/or attempts at treatment, were not “adequate to address [Decedent’s] serious medical needs,” that Decedent’s deterioration was persistent and
obvious, and that the factual allegations allege more than mere disagreements regarding Decedent’s medical care. De’lonta, 708 F.3d at 526. Indeed, Appellant alleges treatment, or a lack thereof, that was “grossly incompetent, inadequate or excessive as to shock the conscience.”

Source Stevens v. Holler, No. 20-7102.

If you or a loved one suffered harm due to deliberate indifference to serious medical needs or the lack of appropriate medical care while incarcerated in a prison, jail, or other correctional facility in Maryland or in another U.S. state, you should promptly seek the legal advice of a local medical malpractice lawyer in your state who handles prison/inmate medical malpractice claims and may investigate your claim and may represent you or your loved one, if appropriate.

Visit our website or call us toll-free in the United States at 800-295-3959 to be connected with prisoner rights lawyers in your state who may assist you.

Turn to us when you don’t know where to turn.