Opinion
Civil Action 20-897
05-07-2021
JAMAR GASTON Plaintiff, v. NURSE LORY, NURSE KEVIN and NURSE LAVERN, Defendants.
REPORT AND RECOMMENDATION
PATRICIA L. DODGE, UNITED STATES MAGISTRATE JUDGE
I. Recommendation
It is respectfully recommended that Defendants' motion to dismiss (ECF No. 28) be denied.
II. Report
A. Procedural History
In this pro se civil rights lawsuit, Plaintiff Jamar Gaston ("Gaston") alleges that he did not receive medical care during his pretrial detention at the Westmoreland County Correctional Facility ("WCCF"). (ECF No. 7 ("Compl.")·) Named as defendants in the Complaint are three WCCF nurses: Nurse Lory, Nurse Kevin, and Nurse Lavern.
Gaston was released from WCCF a few weeks after he filed this lawsuit. (ECF No. 14.)
Defendants have moved the Court to dismiss the Complaint for failure to state a claim (ECF No. 28). Their motion is briefed (ECF No. 29) and Gaston has filed a response in opposition. (ECF No. 35.)
The Court relies on the exhibits appended to the Complaint to contextualize Gaston's allegations. See Hartig Drug Co. v. Senju Pharm. Co., 836 F.3d 261, 268 (3d Cir. 2016) ("In deciding a Rule 12(b)(6) motion, a court . . . consider[s] only the complaint, exhibits attached to the complaint, matters of public record, as well as undisputedly authentic documents if the complainant's claims are based upon these documents."); Schmidt v. Skolas, 770 F.3d 241, 249 (3d Cir. 2014) ("[T]he primary problem raised by looking to documents outside the complaint-lack of notice to the plaintiff-is dissipated where the plaintiff has actual notice . . . and has relied upon these documents in framing the complaint."). In the same vein, the Court finds it appropriate to consider certain clarifying statements that Gaston has included in his response in opposition to Defendants' motion. See Pegram v. Herdrich, 530 U.S. 211, 230 n.10 (2000) (Plaintiffs briefing maybe used "to clarify allegations in [his] complaint whose meaning is unclear."); Baker v. Younkin, 529 Fed.Appx. 114, 115 n.2 (3d Cir. 2013) ("As [plaintiff] is a prisoner appearing pro se, we will treat the [additional] factual allegations contained in [his] response[] [to the motion dismiss] as though they were included in the amendments to his complaint.")
On October 26, 2019, Gaston sustained certain injuries during an arrest. (Compl. at 2; ECF No. 7-1.) He was then incarcerated at WCCF. (Compl. at 2.) During his medical checkup at intake, which took place two days after his arrival at WCCF, Gaston told Defendant Nurse Kevin about the pain he was experiencing because of his injuries and asked for pain medication. (ECF No. 7-6 at 2; ECF No. 35 ¶ 7.) He also informed Nurse Kevin that he felt like he was going to faint and was having dizzy spells on and off. (ECF No. 35 ¶ 7.) Nurse Kevin told Gaston to "deal with it" because his injuries were "not that bad" and that he did not need to see a doctor. (ECF No. 7-6 at 2; ECF No. 35 ¶ 7.)
According to Gaston, he received no medical treatment between his initial incarceration on October 26, 2019 and November 6, 2019. (ECF No. 35 ¶ 8.) He claims that during this time period, he spoke to Nurse Kevin as well as Defendants Nurse Lory and Nurse Lavern on numerous occasions and informed them about his injuries and the pain he was experiencing but all of them refused to provide give him any pain medication. (Id. ¶ 11.) Gaston alleges that he told all of the Defendants that his symptoms included headaches and pain in his neck and face from being hit. (Id.) Gaston also claims to have informed them that he was coughing up blood and was sleep deprived because his bruised ribs were swollen and he could not lie down to sleep without experiencing excruciating pain. (Id.) Although Gaston explained to Nurse Lavern on November 5, 2019, that he was in severe pain, she refused to help and instead told him that "they don't care if your [sic] dying" and that "she can't do anything for [him]." (Compl. at 2.)
Ten days after his arrival at WCCF, Gaston spoke with the facility's program manager just to be placed on the sick call list since Defendants refused to help him. (ECF No. 35 ¶ 11.) On November 6, 2019, Gaston was seen by a WCCF physician, who sent Gaston to an outside hospital emergency room ("ER") due to the seriousness of his injuries. (ECF No. 7-3 at 2; ECF No. 35 ¶ 11.) The ER physician diagnosed Gaston with a head injury, blurred vision, and a rib contusion and prescribed a pain medication for him. (ECF No. 7-4 at 1.) The ER physician also told Gaston to follow up with Tylenol and ice packs until he received his prescribed pain medication. (ECF No. 35 ¶ 9.)
That evening, upon his return to WCCF, Gaston asked Nurse Lory for Tylenol and an ice pack for pain but she refused to give him anything. (Compl. at 2-3.) A few weeks later, on November 24, 2019, Gaston requested Tylenol from Nurse Kevin for a "serious headache" but Nurse Kevin refused. (Id. at 4.) On November 28, 2019, Gaston again asked Nurse Kevin for Tylenol because he was experiencing "extreme pain due to a headache" but Nurse Kevin denied his request. (Id.)
C. Standard of Review
A valid complaint requires only "a short and plain statement of the claim showing that the pleader is entitled to relief." Fed.R.Civ.P. 8(a)(2). Federal Rule of Civil Procedure 12(b)(6) provides for the dismissal of a complaint, in whole or in part, for "failure to state a claim upon which relief can be granted." Fed.R.Civ.P. 12(b)(6). In deciding a Rule 12(b)(6) motion, the court must "accept all factual allegations as true, construe the complaint in the light most favorable to the plaintiff, and determine whether, under any reasonable reading of the complaint, the plaintiff may be entitled to relief." Fowler v. UPMC Shadyside, 578 F.3d 203, 210 (3d Cir. 2009) (quoting Phillips v. Cnty. of Allegheny, 515 F.3d 224, 233 (3d Cir. 2008)). While "accepting] all of the complaint's well-pleaded facts as true," the court "may disregard any legal conclusions." Id. at 210-11.
To survive the motion, the plaintiff must plead "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). "A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). "Though 'detailed factual allegations' are not required, a complaint must do more than simply provide 'labels and conclusions' or 'a formulaic recitation of the elements of a cause of action.'" Davis v. Abington Mem'l Hosp., 765 F.3d 236, 241 (3d Cir. 2014) (quoting Twombly, 550 U.S. at 555). In sum, the plaintiff "must plead facts sufficient to show that her claim has substantive plausibility." Johnson v. City of Shelby, Miss., 574 U.S. 10 (2014).
To assess the sufficiency of a complaint under Twombly and Iqbal, a court must take three steps: (1) outline the elements the plaintiff must plead to state a claim for relief; (2) peel away those allegations that are no more than conclusions and thus not entitled to the assumption of truth; (3) look for well-pled factual allegations, assume their veracity, and then determine whether they plausibly give rise to an entitlement to relief. Bistrian v. Levi, 696 F.3d 352, 365 (3d Cir. 2012). The court's plausibility determination is "a context-specific task that requires the reviewing court to draw on its judicial experience and common sense." Iqbal, 556 U.S. at 679.
u [P]ro se litigants are held to a lesser pleading standard than other parties." Fed. Express Corp. v. Holowecki, 552 U.S. 389, 402 (2008). "A document filed pro se is to be liberally construed and a pro se complaint, however inartfully pleaded, must be held to less stringent standards than formal pleadings drafted by lawyers[.]" Erickson v. Pardus, 551 U.S. 89, 94 (2007) (internal citation and quotation marks omitted); see also Higgs v. Att'y Gen., 655 F.3d 333, 339 (3d Cir. 2011) ("The obligation to liberally construe a pro se litigant's pleadings is well-established."). Notwithstanding this liberality, pro se litigants are not relieved of their obligation to allege sufficient facts to support a cognizable legal claim. Mala v. Crown Bay Marina, Inc., 704 F.3d 239, 245 (3d Cir. 2013) (citing Riddle v. Mondragon, 83 F.3d 1197, 1202 (10th Cir. 1996)).
D. Discussion
Section 1983 provides a private citizen with the right to bring an action against any person who under color of state law deprives him of a right or privilege secured by the Constitution of the United States. 42 U.S.C. § 1983. This statute does not create substantive rights but instead "provides only remedies for deprivations of rights established elsewhere in the Constitution or federal laws." Kneipp v. Tedder, 95 F.3d 1199, 1204 (3d Cir. 1996). To state a viable § 1983 claim, a plaintiff "must establish that []he was deprived of a federal constitutional or statutory right by a state actor." Kach v. Hose, 589 F.3d 626, 646 (3d Cir. 2009). Because there is no question Defendants acted under color of state law, the Court's analysis focuses on whether Gaston has sufficiently alleged a deprivation of his constitutional rights.
As a threshold matter in any § 1983 suit, the Court must "identify the specific constitutional right at issue." Manuel v. City of Joliet, III, 137 S.Ct. 911, 920 (2017) (internal citation and quotation marks omitted). Gaston's § 1983 claim is premised on Defendants' denial of adequate medical care during his detention at the WCCF. Specifically, Gaston alleges that Defendants violated his "Fourteenth Amendment Rights to adequate medicare" and seeks to hold them responsible for "Deliberate indifference and unnecessary and wanton infliction of pain." (Compl. at 2.)
Because Gaston was a pretrial detainee at the time of the alleged civil rights violation, his claim arises "under the Due Process Clause of the Fourteenth Amendment, as opposed to the Eighth Amendment." Paulino v. Burlington Cty. Jail, 438 Fed.Appx. 106, 109 (3d Cir. 2011) (citing Bellv. Wolfish, 441 U.S. 520, 535-36 (1979)). The Third Circuit has explained that "[i]n assessing a pretrial detainee's claim that he was denied medical care, the relevant inquiry is whether the alleged denial was 'imposed for the purpose of punishment or whether it [was] but an incident of some other legitimate governmental purpose.'" Mattern v. City of Sea Isle, 657 Fed.Appx. 134, 138 (3d Cir. 2016) (quoting Hubbard v. Taylor, 399 F.3d 150, 158 (3d Cir. 2005)). "Thus, sentenced prisoners are protected from punishment that is 'cruel and unusual,' while pretrial detainees are protected from any punishment." Paulino, 438 Fed.Appx. at 109 (3d Cir. 2011) (citing Hubbard, 399 F.3d at 166-67).
As a practical matter however, this distinction makes little difference in this case because "[w]hile the Eighth Amendment itself 'has no application' until there has been a 'formal adjudication of guilt, "'Mattern, 657 Fed.Appx. at 138 n.5 (quoting City of Revere v. Massachusetts General Hospital, 463 U.S. 239, 244 (1983)), constitutional medical care claims brought by pretrial detainees are analyzed "under the standard used to evaluate similar claims brought under the Eighth Amendment." Id. n.5 (quoting Natale v. Camden Cty. Corr. Facility, 318 F.3d 575, 582 (3d Cir. 2003)). Therefore, in order to state a Fourteenth Amendment claim relating to the medical care he received, Gaston must allege "(i) a serious medical need, and (ii) acts or omissions by [Defendants] that indicate deliberate indifference to that need." Natale, 318 F.3d at 582 (quoting Rouse v. Plantier, 182 F.3d 192, 197 (3d Cir.1999)).
In seeking dismissal of the Complaint, Defendants argue that (1) Gaston has failed to allege a serious medical need, (2) they were not deliberately indifferent to his needs, and (3) they are entitled to qualified immunity. The Court will address each argument in turn.
Defendants also contend that if Gaston is asserting a state law tort claim based on medical malpractice or medical negligence, such a claim necessarily fails because he has not filed a Certificate of Merit as required within sixty days of filing the Complaint. (ECF No. 29 at 11 (citing Pa. R. C. P. 1042.3(a)).) Although the Complaint does not assert any state law claims, in his response in opposition to Defendants' motion Gaston makes a bare assertion that Defendants "were negligent under state tort law." (ECF No. 35 ¶ 17.) If Gaston intends to assert a negligence claim he must do so through an amendment. Even if he had asserted a medical negligence claim, however, Defendants would be required to wait thirty days after giving notice of the failure to file a Certificate of Merit to allow for cure before seeking dismissal of such a claim. See Schmigel v. Uchal, 800 F.3d 113, 124 (3d Cir. 2015) ("The condition of thirty days' notice prior to seeking dismissal of an action for failure to comply with the [Certificate of Merit] regime is substantive and must be applied in federal court.").
1. Serious Medical Need
Taking a narrow view of the circumstances as alleged, Defendants contend that Gaston's complaints of pain and requests for Tylenol or an ice pack, which Defendants refused, do not rise to the level of "serious medical needs." (ECF No. 29 at 7)
The Third Circuit has explained that "a medical need is 'serious' for purposes of a denial of medical care claim if it is either 'one that has been diagnosed by a physician as requiring treatment or one that is so obvious that a lay person would easily recognize the necessity for a doctor's attention.`````` Mattern, 657 Fed.Appx. at 139 (quotingMonmouth Cty. Corr. Inst. Inmates v. Lanzaro, 834 F.2d 326, 347 (3d Cir. 1987)).
Gaston claims that two days after being admitted to WCCF he told Nurse Kevin about the injuries he sustained during his arrest and also told him that he felt like he was going to faint and that he was feeling dizzy. Gaston also asserts that prior to being seen by the WCCF physician, he reached out to Defendants numerous times and informed each of them that he was experiencing headaches, pain in his neck and face and painful bruised ribs which made it impossible for him to lie down at night and sleep, and that he was coughing up blood. These facts, which must be taken as true, establish the second type of serious medical need-one that is "so obvious that a lay person would easily recognize the necessity for a doctor's attention." Lanzaro, 834 F.2d at 347.
Additionally, as a result of an examination by the WCCF physician eleven days after being incarcerated at WCCF, he was sent to the ER due to the seriousness of his injuries. The ER physician diagnosed Gaston with a head injury, blurred vision, and a rib contusion and prescribed a pain medication for him. Therefore, Gaston has also plausibly alleged the first type of serious medical need, "one that has been diagnosed by a physician as requiring treatment." Lanzaro, 834 F.2d at 347.
Accordingly, taking all of his allegations as true, Gaston has adequately alleged that he was suffering from a serious medical need.
2. Deliberate Indifference
Focusing on the medical care that Gaston eventually received after he was seen by the WCCF physician on November 6, 2019, Defendants contend that Gaston has failed to plead deliberate indifference because he was evaluated, examined, and even sent to the ER. (ECF No. 29 at 9.)
For a prison official "[t]o act with deliberate indifference to serious medical needs [of an inmate] is to recklessly disregard a substantial risk of serious harm." Giles v. Kearney, 571 F.3d 318, 330 (3d Cir. 2009) (citing Estelle v. Gamble, 429 U.S. 97, 104-05 (1976); Farmer v. Brennan, 511 U.S. 825, 836 (1994)). Because deliberate indifference is a '"subjective standard of liability[, ]' ... a defendant cannot be held liable unless he or she 'knows of and disregards an excessive risk to [a complainant's] health or safety." Mattern, 657 Fed.Appx. at 140 (quoting Natale, 318 F.3d at 582). To be sure, the relevant inquiry "is whether prison officials, acting with deliberate indifference, exposed [the inmate] to a sufficiently substantial risk of serious damage to his future health ..." Farmer, 511 U.S. at 843.
The Third Circuit has "explained that deliberate indifference is 'evident' in certain circumstances, including: (i) the denial of reasonable requests for medical treatment that expose the complainant to undue suffering; (ii) knowledge of the need for medical care and the intentional refusal to provide such care; or (iii) the delay of necessary medical treatment for non-medical reasons." Mattern, 657 Fed.Appx. at 140 (citing Lanzaro, 834 F.2d at 346-47.)
Gaston's allegations plausibly invoke the first and second category of deliberate indifference under Lanzaro. Gaston has alleged that on numerous occasions before he was ultimately seen by a WCCF physician, he told each of the Defendants about the injuries that he sustained during his arrest and the issues that he was experiencing. According to Gaston, Defendants were aware of his complaints of headaches, neck and face pain, and bruised ribs that made it unbearable to sleep. Yet, all three Defendants allegedly refused to give him any pain medication or other treatment. This was before Gaston was sent to an outside hospital emergency room and diagnosed with a head injury, blurred vision, and a rib contusion. Under these circumstances, pain medication clearly qualified as a reasonable request for medical treatment and by consistently denying that request Defendants exposed Gaston to suffer needlessly.
Gaston has also alleged that, after his diagnosis, the ER physician instructed him to follow up with Tylenol and ice packs until he received his prescribed pain medication. But Nurse Lory and Nurse Kevin allegedly refused to give Gaston anything for his pain even though he had informed them of his diagnosis and the treatment plan. While a closer call, this too could support an inference of deliberate indifference because Nurse Lory and Nurse Kevin effectively "prevent[ed] [Gaston] from receiving recommended treatment for [his] serious medical need[] . . . ." Lanzaro, 834 F.2d at 347 (quoting Inmates of Allegheny County Jail v. Pierce, 612 F.2d 754, 762 (3d Cir.1979)). At this stage of the proceedings, this allegation plausibly establishes deliberate indifference.
Gaston has alleged that all three Defendants refused to give Gaston any pain medication or treatment and let him suffer needlessly for eleven days, and that Nurse Lory and Nurse Kevin continued on this course even after his diagnosis. These allegations sufficiently satisfy the second requirement of his claim that Defendants acted with deliberate indifference.
3. Qualified Immunity
Defendants alternatively argue that it was not clearly established that their conduct would violate Gaston's constitutional rights, and therefore, they are entitled to qualified immunity. (ECF No. 29 at 12-14.)
"The doctrine of qualified immunity protects government officials 'from liability for civil damages insofar as their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known.'" Pearson v. Callahan, 555 U.S. 223, 231 (2009) (quoting Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982)). The burden of pleading a qualified immunity defense rests with the defendant, not the plaintiff. Thomas v. Independence Township, 463 F.3d 285, 293 (3d Cir. 2006).
Qualified immunity is an objective decision to be decided by the court as a matter of law. Carswell v. Borough of Homestead, 381 F.3d 235, 242 (3d Cir. 2004). The court must engage in a two-part inquiry to determine if qualified immunity applies to official actions: (1) "whether the facts that a plaintiff has alleged ... make out a violation of a constitutional right"; and (2) "whether the right at issue was 'clearly established' at the time of defendant's alleged misconduct." Pearson, 555 U.S. at 232 (quoting Saucier v. Katz, 533 U.S. 194, 201 (2001)).
"A Government official's conduct violates clearly established law when, at the time of the challenged conduct, 'the contours of a right are sufficiently clear' that every 'reasonable official would have understood that what he is doing violates that right.'" Ashcroft v. al-Kidd, 563 U.S. 731, 741 (2011) (quoting Anderson v. Creighton, 483 U.S. 635, 640 (1987)). It is intended to shield officers who make "reasonable but mistaken judgments about open legal questions" and provides protection of "all but the plainly incompetent or those who knowingly violate the law." Ashcroft at 743. The ultimate question is whether the state of the law when the offense occurred gave Defendants "fair warning" that their acts were unconstitutional. Hope v. Pelzer, 536 U.S. 730, 741 (2002).
As discussed above, Gaston has plausibly alleged a Fourteenth Amendment claim for the denial of medical care. Put another way, he has shown a potential violation of a constitutional right and therefore established the first prong of the qualified immunity inquiry. Turning to the second prong, Gaston was a pre-trial detainee who had sustained injuries during his arrest, complained of multiple medical issues as a result of those injuries and requested medication to alleviate the pain from those injuries. The question then becomes whether under these facts, a reasonable person would have understood that a consistent refusal to provide medical care to Gaston violated his constitutional rights because it would subject him to undue suffering and would not serve any penological purpose.
It was clearly established at the time of Gaston's detention at WCCF that the Due Process Clause of the Fourteenth Amendment "require[s] the responsible government or governmental agency to provide medical care to persons . . . who have been injured while being apprehended by the police.” City of Revere, 463 U.S. 239 at 244. Further, while Gaston sought relatively simple medical care, the law is clear: “if ‘unnecessary and wanton infliction of pain,' . . . results as a consequence of denial or delay in the provision of adequate medical care, the medical need is of the serious nature contemplated by the Eighth Amendment.” Atkinson v. Taylor, 316 F.3d 257, 266 (3d Cir. 2003) (quoting Lanzaro, 834 F.2d at 347). This is so because the Eighth Amendment “prohibits the imposition of ‘unnecessary and wanton infliction of pain contrary to contemporary standards of decency.'” Pearson v. Prison Health Serv., 850 F.3d 526, 534 (3d Cir. 2017) (quoting Helling v. McKinney, 509 U.S. 25, 32 (1993)). And “[n]eedless suffering resulting from a denial of simple medical care, which does not serve any penological purpose, is inconsistent with” those standards. Atkinson, 316 F.3d at 266 (citing Lanzaro, 834 F.2d at 347).
Because it was clearly established that, under the facts as alleged, Defendants' persistent refusal to provide Gaston with medical care would amount to a constitutional violation, Defendants are not entitled to qualified immunity.
D. Conclusion
Therefore, based upon the reasons set forth herein, it is respectfully recommended that Defendants' motion to dismiss (ECF No. 28) be denied.
E. Notice
In accordance with the Federal Magistrates Act, 28 U.S.C. § 636(b)(1), and Fed.R.Civ.P. 72(b)(2), the parties are allowed fourteen (14) days from the date of service of this Report and Recommendation to file written objections thereto. Any party opposing the objections shall have fourteen (14) days from the date of service of objections to respond thereto. Failure to file objections will waive the right to appeal. Brightwell v. Lehman, 637 F.3d 187, 193 n.7 (3d Cir. 2011).