WM. TERRELL HODGES, Sr., District Judge.
Plaintiff Jessie Milton is a state prisoner at the Sumter Correctional Institution in Bushnell, Florida. On October 26, 2007, Milton filed a 42 U.S.C. § 1983 prisoner civil rights complaint against four Florida Department of Corrections officers in their individual capacities, asserting that they were deliberately indifferent to a serious medical condition in violation of his Eighth Amendment right to be free from cruel and unusual punishment (Doc. 1).
On April 14, 2010, the Court granted the Defendants' motions to dismiss, finding that Milton failed to sufficiently allege a claim for deliberate indifference (Doc. 72). Judgment was entered the next day (Doc. 73). Milton appealed (Doc. 74), and on August 19, 2011, the Court of Appeals affirmed the dismissal of Milton's claims against Defendants Turner and Campos (Doc. 88).
In accordance with the Court of Appeals' mandate, on November 23, 2011 this Court entered a case management and scheduling order setting an abbreviated discovery schedule and deadline for filing dispositive motions (Doc. 90). On April 20, 2012, Defendants Moore and Neal filed their motion for summary judgment (Doc. 105), to which Milton has filed a response in opposition (Doc. 109).
Upon due consideration, and for the reasons discussed below, the Court concludes that the motion for summary judgment is due to be granted in its entirety.
Jessie Milton has been an inmate in the State of Florida prison system since 1999. On December 18, 2006, he was transferred from the Everglades Correctional Institute to the Sumter Correctional Institute and completed the required orientation and processing. Milton is an insulin dependent diabetic who reports to the Sumter Correctional facility's medical department twice a day for insulin injections. Defendant R. Moore is a Sergeant at the Sumter Correctional Institute. Defendant T. Neal is a corrections officer at the same facility, and the insides grounds lawn mower squad supervisor.
Milton claims that for the three years prior to his transfer to Sumter Correctional, he worked as a houseman performing indoor cleaning duties. He was initially assigned to work as a houseman when he transferred to Sumter Correctional. On January 11, 2007, Milton was assigned to inside grounds, which includes duties outdoors such as mowing grass. On January 15, 2007, Milton filed an Inmate Request form with his classification officer and requested that his work assignment be changed back to houseman. His classification officer responded the following day that "Work assignments are not a privilege, they are assigned according to the needs of the institution. You are listed by the computer as being able to work inside grounds." (Doc. 1, Ex. A). Until January 26, 2007, he was assigned to the "Weekend Warrior Squad" and picked up paper for 20-30 minutes on the weekends.
On February 2, 2007, Milton began working on the mower squad. He worked every other day from 8:30 a.m. to 11:00 a.m. for a total of 10 days a month. Milton states that he repeatedly spoke to both Moore and Neal about his concerns working on the mower squad, and specifically, being forced to work with his "sugar level dropping." According to Milton, neither Moore or Neal would change Milton's work assignment. Instead, Moore told Milton to "go to sick call and get a pass."
On February 13, 2007, Milton did go to sick call and complained about "his problem of diabetes, and new developing problems of skin scraping off [his] inner thighs, [and] sores on [his] foot as a result of working the mower squad." (Doc. 1, ¶ 46). Milton was treated by a nurse who observed some discoloration on the soles of his feet (Doc. 105, Ex. 1). The nurse gave Milton antifungal foot powder, antibiotic ointment, and ibuprofen, and instructed Milton to declare a medical emergency if his blood glucose drops. The medical records from this sick call visit state that Milton had no signs or symptoms of infection, but that Milton had a "foot sole irritation."
Milton claims that the nurse also instructed him to immediately go to Moore and Neal and ask them to issue him a pair of work boots, however there is no mention of prescribing work boots in any of the medical records from that visit. The nurse also told Milton to instruct Moore and Neal to call the medical department if they gave Milton any problems. Milton contends that he relayed the nurse's instructions to Moore and Neal, but that they both refused to issue work boots to Milton, and forced him to continue working on the mower squad in his state issued cloth shoes.
At some point after February 13, 2007, Milton developed an infection of his hallux, or big toe. On February 20, 2007, prior to starting work for the day, Milton told Neal that he "was in much pain, his toe had swollen up with pus," and he "could barely walk on it." Milton did not, however, request any medical treatment. Rather it appears that he made these complaints in an attempt to get out of work without treatment. (Doc. 1, ¶¶ 54-55; Doc. 109, pp. 38-41, ¶¶ 9-10). Neal ignored Milton's complaints, stated that if a problem arose "medical" would come and get Milton, and ordered him to start work. Milton contends that while working on the mower squad he incurred an additional injury, and, as a result, he could not keep up with the production level of the other inmates. Neal yelled at Milton to speed up. At this point Milton requested treatment and declared a medical emergency, but Neal refused to give Milton any medical attention and instead forced him to work for another 20-30 minutes until his shift was completed.
Once he completed his work assignment, Milton went to Moore and complained about Neal. Moore told Milton to go to sick call. However, Milton then claims that Moore told him to report to the recreation yard instead. Fearful of being disciplined by Moore, Milton complied with this new order, and went to the recreation yard.
Eventually Milton did go to the medical wing later that day. The nurse gave him aspirin and told him to return the next morning (February 21, 2007) for sick call. Milton did not report to sick call on the 21st. He decided to wait to report until his next scheduled work day (February 22, 2007), in the hope that the medical department would excuse him from working his shift on the mower squad. However, he did report for his daily insulin shots. During his visit to the insulin clinic on the 21st, he asked the nurse for some ibuprofin because he was in pain. The nurse gave him the medication and told him to report to sick call.
On February 22, 2007, Milton reported to sick call and was seen by a nurse, who referred him to a staff physician. Milton was diagnosed with an infected hallux. He was prescribed antibiotics, anesthetic ointments, and given a ten day no work pass. At the conclusion of the ten day no work period, Milton was placed back on the mower squad. He was eventually transferred to the Weekend Warrior squad.
Milton filed an Informal Grievance on February 27, 2007, which complained of Moore's and Neal's treatment of Milton and his infected hallux. On March 20, 2007, Milton filed an Inmate Request with the Warden, complaining that he had never received a response to his February 27th Grievance. Milton also filed a second Informal Grievance restating his complaints against Moore and Neal on March 20, 2007. Milton contends that no one at Sumter Correctional ever responded to his Grievances.
Pursuant to Federal Rule of Civil Procedure 56(a), "[t]he court shall grant summary judgment if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." In applying this standard, the Court must examine the materials on file and the record evidence "in the light most favorable to the nonmoving party."
At the summary judgment stage the judge's function is not to weigh the evidence and determine the truth of the matter but to determine whether there is a genuine issue for trial.
As narrowed by the Court of Appeals, this case presents two claims under 42 U.S.C. § 1983: (1) a claim that Defendants Moore and Neal interfered with the treatment of Milton's infected hallux; and (2) a claim that Defendant Neal delayed treatment of Milton's infected hallux. Because Milton was a state prisoner at the time of the events in question, both claims assert violations of his Eighth Amendment right to be protected from a state officer's deliberate indifference to a serious medical condition.
"To prevail on a deliberate indifference to serious medical need claim, plaintiffs must show: (1) a serious medical need; (2) the defendants' deliberate indifference to that need; and (3) causation between that indifference and the plaintiff's injury."
A serious medical need is considered "one that has been diagnosed by a physician as mandating treatment or one that is so obvious that even a lay person would easily recognize the necessity for a doctor's attention." Farrow, 320 F.3d at 1243 (quoting
In this case, the record evidence is undisputed that no physician mandated any treatment of Milton's hallux until February 22, 2007 — the date that his infection was diagnosed. Until that date, Milton was not seen by a physician. To be sure, on February 13, 2007, a nurse noted discoloration on his feet and prescribed antifungal powder.
Taking the facts in the light most favorable to Milton, the Court finds that material issues of fact remain in dispute as to this prong of the deliberate indifference test. Milton claims that he repeatedly told both Moore and Neal that he was having problems with his foot, that he was concerned about complications due to his diabetes, and that on February 20, 2007 it was almost too painful for him to walk. He has also submitted the affidavits of four inmates, each of whom aver that Milton complained to both Milton and Neal about his foot. In addition, Milton claims that his hallux was so painful that he could not keep up with the other inmates on the mower squad, and that Neal was aware of the situation. In contrast, both Neal and Moore have submitted their own affidavits, each testifying that they were not aware of any problems with Milton's foot or hallux. This conflicting testimony at the least creates a genuine issue of material fact as to the known seriousness of Milton's condition.
Milton's first claim is premised on a theory of interference with medical treatment. To establish that Moore or Neal were deliberately indifferent to Milton's serious medical need based on a theory of interference with medical treatment, Milton must establish that Moore and/or Neal (1) had a "subjective knowledge of a risk of serious harm, (2) disregard[ed] that risk, and (3) [engaged in] conduct that is more than mere negligence."
There is a complete lack of evidence that after February 22, 2007, the date Milton's infection was diagnosed, either Neal or Moore interfered with any treatment. And prior to February 22, 2007, the only treatment Milton claims that Moore and Neal interfered with was the denial of work boots. And while Milton contends that a nurse instructed him to obtain work boots, he has not presented any evidence that any medical provider prescribed work boots as treatment for his foot.
Milton also has failed to put forth any evidence of a causal connection between any purported refusal to provide work boots and his injury. Simply put, there is nothing in the record even suggesting that wearing leather work boots, instead of soft cloth covered shoes, would be proper treatment for a sore or infected toe. Nor is there any evidence that the denial of work boots actually worsened Milton's injury.
Because Milton has failed to provide any record evidence creating a disputed issue of material fact with respect to the interference with any medical treatment, the Court finds that Milton cannot establish a claim for deliberate indifference based on the interference with medical care. Summary judgment shall be granted in favor of both Defendants as to this claim.
Milton's second and final claim for relief is asserted against Neal, and is based on the theory that Neal delayed Milton's treatment. In assessing a claim of deliberate indifference based on delayed treatment, the Court considers factors such as "(1) the seriousness of the medical need; (2) whether the delay worsened the medical condition; and (3) the reason for the delay."
This claim focuses on Milton's February 20, 2007 complaints to Neal about his foot. Milton has testified via affidavit that he could not keep up with his work during his shift on the mower squad due to the pain he was suffering, that he was limping, and he even asked to declare a medical emergency. However, Neal ignored these complaints, refused to allow Milton to go to the medical department, and instead directed Milton to continue working for another 20-30 minutes. Although Neal claims that he has no recollection of these events, or of supervising Milton at all, Milton has presented sufficient evidence, including various affidavits, to create a genuine issue of material fact as to both the seriousness of the need, and whether Neal delayed treatment, even if only for a brief period of time.
Having found that material issues of fact exist with respect to the delayed treatment claim against Neal, the Court must consider whether Neal is still entitled to summary judgment on the basis of qualified immunity.
"Qualified immunity protects government officials performing discretionary functions from liability if their conduct does not violate `clearly established statutory or constitutional rights of which a reasonable person would have known.'"
To receive qualified immunity, a government official must first prove that he was acting within his discretionary authority.
There is no dispute that Neal was acting within his discretionary authority at all relevant times. And the Court's determination that material issues of fact exist as to whether Neal delayed treatment of Milton's infected hallux also applies to the first prong of the qualified immunity test. The Court will therefore focus on the second prong — whether the law was clearly established as of February 20, 2007.
"For qualified immunity to be surrendered, pre-existing law must dictate, that is, truly compel (not just suggest or allow or raise a question about) the conclusion for every like-situated, reasonable government agent that what defendant is doing violates federal law in the circumstances."
Milton has not cited, and the Court has been unable to locate, a single Supreme Court, Eleventh Circuit Court of Appeals, or Supreme Court of Florida decision in existence as of February 20, 2007 holding that an infected hallux or infected foot constituted a serious medical condition for which a short delay in treatment would be unconstitutional. The closest analogy the Court can find is a single Eleventh Circuit decision holding that a clearly broken foot which was swelling rapidly constituted a serious and painful medical condition.
The only decision similar to the present case is the Court of Appeals unpublished decision in this case (Doc. 88). However, the Court of Appeals decision cannot be considered clearly established law for two important reasons. First, it is an unpublished decision, issued in 2011, four years after the events in question, and therefore could not have put Neal on notice that his actions in 2007 were unconstitutional.
Moreover, while there was caselaw establishing the general legal principle that a government official who intentionally delays providing medical care to an inmate, knowing that the inmate had a serious medical condition that could be exacerbated by the delay, acts with deliberate indifference, the Court cannot say that this general rule applied "with obvious clarity to the specific conduct in question."
"Questions of deliberate indifference to medical needs based on claims of delay are complicated questions because the answer is tied to the combination of many facts; a change in even one fact from a precedent may be significant enough to make it debatable among objectively reasonable officers where the precedent might not control in the circumstances later facing an officer."
In sum, the law was not clearly established in February 2007 that Neal's short delay in allowing Milton to go to the medical facility to obtain treatment for his infected hallux violated Milton's Eighth Amendment rights. As such, even assuming that Neal's conduct was constitutionally impermissible, he is shielded from civil liability under the second step of the qualified immunity analysis. Summary judgment shall be granted in Neal's favor as to the delay in treatment claim.
Assuming that Milton's infected hallux constituted a serious medical condition, the undisputed material facts show that neither Moore nor Neal interfered with any prescribed medical treatment. And assuming that Neal did delay Milton's ability to seek medical care on February 20, 2007, the law was not clearly established at that time such that Neal would have been on notice that his actions violated Milton's Eighth Amendment Rights. Qualified immunity therefore applies to shield Neal from any liability for Milton's delayed treatment claim.
Accordingly, upon due consideration, the Defendants Moore's and Neal's Motion for Summary Judgment (Doc. 105) is GRANTED. The Clerk is directed to enter judgment in favor of the Defendants and against the Plaintiff as to all claims. The Clerk is further directed to terminate all other pending motions and to close the file.
IT IS SO ORDERED.
DONE and ORDERED.
Moore has also filed an affidavit contesting the allegations against him (Doc. 105, Ex. 4). Moore remembers Milton complaining about working on the mower squad, but Moore avers that he would not transfer him off the mower squad without a medical pass. Moore contends that Milton never had any medical restrictions which would prevent him from working on the mower squad, other than the ten day no work pass he received from the medical department on February 22nd. Moore further contends that Milton was advised that the manufacturer of the mower only recommended that a mower operator wear closed toe shoes — work boots were not required.