CHARLES A. STAMPELOS, Magistrate Judge.
Pending in this case are two motions to dismiss. The first was filed by Defendant Vilchez, ECF No. 49, and the second was filed by Defendant Lopez, ECF No. 53. The pro se Plaintiff was advised of his obligation to respond to both motions, ECF Nos. 51 and 54, and his responses, ECF Nos. 70-71, have been considered.
The operative pleading is Plaintiff's second amended complaint [hereinafter "complaint"], ECF No. 23, in which Plaintiff generally claims that Defendants have been deliberately indifferent to his serious medical needs. Id. at 1. Plaintiff alleges that while he has been incarcerated in the Florida Department of Corrections, Defendants have "failed and/or refused to provide life-saving Hepatitis-C treatment" to him. Id.
Plaintiff entered the Department's custody in January 2015. Id. at 16. He had already been diagnosed with the Hepatitis-C Virus ("HCV") and alleged that it was at "stage 4" in 2013. Id. Defendant Lopez was the doctor at Okaloosa Correctional Institution, and Defendant Vilchez was the doctor at Gulf Correctional Institution. Id. Plaintiff was under the care of both doctors while housed at those institutions. He alleges that Defendants Lopez and Vilchez denied him treatment for HCV due to lack of funding. Id. at 19, 21.
Plaintiff's complaint, as it pertains to those Defendants, asserts an Eighth Amendment claim for deliberate indifference under 42 U.S.C. § 1983 (count 1), a second claim for "inadequate medical care" under § 1983 (count 3), and a negligence claim (count 4). Plaintiff requests compensatory and punitive damages, "[a]ny any other equitable and legal relief which the Court deems appropriate . . . ." ECF No. 23 at 32.
The issue on whether a complaint should be dismissed pursuant to Fed. R. Civ. P. 12(b)(6) for failing to state a claim upon which relief can be granted is whether the plaintiff has alleged enough plausible facts to support the claim stated.
The pleading standard is not heightened, but flexible, in line with Rule 8's command to simply give fair notice to the defendant of the plaintiff's claim and the grounds upon which it rests.
One additional principle bears highlighting: a motion to dismiss does not test the truth of a complaint's factual allegations. As noted above, factual allegations, though not legal conclusions, must be "accepted as true,"
Dr. Lopez argues that Plaintiff failed to exhaust administrative remedies as required by the Prison Litigation Reform Act, 42 U.S.C. § 1997e(a). ECF No. 53 at 5. Dr. Lopez contends, first, that Plaintiff's efforts to exhaust his claims fell short because his formal grievance was untimely. Id. at 7. Second, Dr. Lopez claims that because a second grievance appeal was "never denied, the present lawsuit never became ripe for filing, and should be dismissed accordingly." Id. at 8.
As explained in the motion, the Department generally has a three-step grievance procedure. ECF No. 53 at 6 (citing FLA. ADMIN. CODE R. 33-103.005 through 33-103.007). However, where a grievance is "of a medical nature," the rules require filing only a formal grievance and then a grievance appeal. FLA. ADMIN. CODE R. 33-103.008; 33-103.005(1).
Defendant Lopez submitted evidence that Plaintiff filed both a formal grievance and an appeal. Formal grievance (# 1702-115-073) was submitted on February 20, 2017, and was denied on March 6, 2017. Defendant's Ex. A (ECF No. 53-1 at 3). Defendant argues that Plaintiff's grievance was untimely because it was not filed within 15 days from the date Plaintiff was examined by Dr. Lopez, which Defendant states was January 27, 2017. ECF No. 53 at 7.
Review of Plaintiff's grievance reveals that Plaintiff was complaining about his HCV treatment in general and did not refer to a specific treatment date. ECF No. 53-1 at 1-2. More importantly, Plaintiff's formal grievance was addressed on the merits, his issue deemed to be "unfounded," and the grievance was "denied." Id. at 3.
"The Prison Litigation Reform Act of 1995 (PLRA) mandates that an inmate exhaust `such administrative remedies as are available' before bringing suit to challenge prison conditions." 42 U.S.C. § 1997e(a) (quoted in
In
Defendant's second argument as to the exhaustion issue fares no better. Dr. Lopez claimed that Plaintiff's grievance appeal was "never denied" and his treatment was merely deferred. ECF No. 53 at 8. Indeed, Defendant argues that "[n]owhere in the response to the Appeal does it state that the Appeal was denied." Id. Based on his reading of the record, Defendant Lopez claims this lawsuit "never became ripe for filing, and should be dismissed accordingly." Id.
Defendant Lopez is wrong for two reasons. The first reason is that the first two words typed on the response state: "Appeal Denied." ECF No. 53-1 at 5. The second reason is that the appeal was denied on July 7, 2017. Id. However, Plaintiff submitted his appeal on March 9, 2017. ECF No. 53-1 at 4. Thus, it took the Secretary's Office four months to provide a response to Plaintiff. However, the Department's rules state that a grievance appeal must "be responded to within 30 calendar days from the date of the receipt of the grievance" appeal. FLA. ADMIN. CODE R. 33-103.011(3)(c). The rules also state that unless the prisoner "has agreed in writing to an extension, expiration of a time limit at any step in the process shall entitle the complainant to proceed to the next step of the grievance process." FLA. ADMIN. CODE R. 33-103.011(4). Plaintiff did not agree to an extension of time. ECF No. 70 at 9; see also ECF No. 53-1 at 4. Thus, Plaintiff was entitled to proceed to the judicial forum by April 2017. He filed this case in April 2018; it is not untimely, prematurely filed, or unexhausted. The motion to dismiss should be denied as to this issue.
Defendant Lopez next seeks dismissal of this case for failing to state a claim upon which relief may be granted under the Eighth Amendment. ECF No. 53 at 9. Defendant Lopez argues that Plaintiff has not sufficiently alleged that "Dr. Lopez was deliberately indifferent to his condition through conduct which was more than negligen[t]." Id. Defendant Lopez asserts that Plaintiff's factual allegations detail his involvement with Plaintiff, including examinations, answering questions, ordering an ultrasound, changing a blood pressure medication, and putting Plaintiff on "the list" for evaluation by the Hepatitis-C committee. Id. at 9-10. Defendant Lopez states that he "had no authority to begin Plaintiff's treatment unless and until Plaintiff was evaluated by the Hepatitis-C committee." Id. at 10. Defendant claims "Plaintiff's own allegations show that Dr. Lopez did everything under his power for Plaintiff's treatment" and that Plaintiff's claims "are nothing more than a disagreement with the treatment/testing which was provided." Id.
The Eighth Amendment governs the conditions under which convicted prisoners are confined and the treatment they receive while in prison.
To prove deliberate indifference, "a prisoner must shoulder three burdens."
Here, Defendant Lopez is a medical doctor. Plaintiff's complaint alleged that the "consensus among medical professionals" is that persons with HCV "should be treated with DAA drugs."
Defendant Lopez seeks dismissal of Plaintiff's negligence claim for failure to comply with Florida's statutory requirements. ECF No. 53 at 11. Defendant notes that these "include, but are not limited to, performing an investigation, notification and corroboration." Id. at 11. "There are also informal discovery procedures and timing requirements enumerated under Chapter 766," which Defendant contends were not "met here." Id.
In response, Plaintiff states that as a pro se prisoner, he was "not required to certify that a presuit investigation" was done. ECF No. 70 at 16. Plaintiff directs the Court's attention to FLA. STAT. § 766.14(1) which states in relevant part:
FLA. STAT. § 766.104(1). Plaintiff also points to a case from the Florida First District Court of Appeal which found "that the legislative intent regarding section 768.495(1) was to require a certificate only from an attorney of record formally representing a plaintiff."
Additionally, Plaintiff points out that he has been unable to fully comply with the statute because the Department of Corrections has not provided him with his medical records. ECF No. 70 at 16-17. Thus, he claims the Department has interfered with his "ability to conduct a `reasonable' presuit investigation . . . ." Id. at 17. Nevertheless, Plaintiff states that he served a "notice of claim" on the Defendants as required by FLA. STAT. § 766.106. ECF No. 70 at 17. Plaintiff states that the Defendants failed to make a "reasonable investigation" as required and did not "timely provide a good faith rejection of" his claim. Id. Plaintiff says that those "failures constitute a final denial of claims" and preclude Defendants "from enforcing pretrial requirements outlined" in Chapter 766.
At least one court to consider this issue has noted there are "competing considerations."
Defendant Lopez also seeks dismissal of this case on the basis of qualified immunity. ECF No. 53 at 11-13. "The defense of qualified immunity completely protects government officials performing discretionary functions from suit in their individual capacities unless their conduct violates `clearly established statutory or constitutional rights of which a reasonable person would have known.''
Here, Plaintiff alleged that the Defendant failed to provide appropriate medical care for his serious medical needs, an allegation which must be accepted as true at this stage of the litigation. That allegation sufficiently states a claim. Moreover, it has been well established for over forty years that deliberate indifference to the serious medical needs of prisoners violates the Eighth Amendment.
Defendant Lopez also argues that "to the extent" Plaintiff seeks monetary damages against him in his official capacity, the claims are barred by the Eleventh Amendment. ECF No. 53 at 13. Plaintiff concedes that assertion is correct. ECF No. 70 at 23. Thus, as correctly noted by Plaintiff, his claims for monetary damages may proceed against this Defendant in his individual capacity, but the official capacity claim should be dismissed.
Defendant Lopez also contends that Plaintiff has not alleged that he suffered physical injury as a result of the actions or omissions of Defendant Lopez. ECF No. 53 at 13-14. Pursuant to § 1997e(e), he seeks dismissal of the complaint.
Section 1997e(e) provides that "[n]o federal civil action may be brought by a prisoner . . . for mental or emotional injury suffered while in custody without a prior showing of physical injury . . . ." 42 U.S.C. § 1997e(e). Plaintiff's complaint alleged that his liver has deteriorated due to the lack of treatment. He alleged that a "golf ball size lump" developed on his liver and that he has experienced blood pressure issues due to scarring of the liver. Id. at 19-20. Plaintiff also alleged that due to his untreated HCV, he developed "bacterial periodontitis" and has an "extensive amount of bone loss" which, according to his dentist, will require "that
Defendant Vilchez has raised the same defenses to Plaintiff's claims as presented by Defendant Lopez, with the exception of the exhaustion defense. ECF No. 49. Defendant Vilchez argues that Plaintiff's allegations are insufficient to show that Dr. Vilchez was deliberately indifferent to Plaintiff's condition. Id. at 6. Defendant Vilchez contends that Plaintiff acknowledges that this Defendant ordered numerous tests, provided treatment, answered Plaintiff's questions and addressed his concerns. Id. Defendant Vilchez points out that he "requested a consult with a liver specialist at the Reception Medical Center" and "voiced a concern" about Plaintiff's liver which appeared to be "bulging out of [Plaintiff's] right side." ECF No. 49 at 6 (citing to ECF No. 32 at 17). Defendant Vilchez ordered a CT Scan and told Plaintiff the "lump" was probably just a "fatty deposit and" said it was nothing to worry about. ECF No. 23 at 17-18. Defendant Vilchez told Plaintiff that the "result of the CT Scan was basically normal," but Plaintiff contends a "`golf ball' size lump" is not normal. Id. at 19.
It is true that Plaintiff's allegations reveal Defendant Vilchez was requesting tests and provided Plaintiff with "pain medication for 2 weeks." Id. at 17. However, despite those actions, Defendant Vilchez failed to provide Plaintiff with any treatment for HCV. Defendant Vilchez advised Plaintiff that treatment would not be provided "because it is too expensive." Id. at 16-17.
As discussed above, a lack of funding does not justify a refusal to provide medical treatment for inmates.
In this Circuit, "deliberate indifference may be established by a showing of grossly inadequate care as well as by a decision to take an easier but less efficacious course of treatment."
Defendant Vilchez also contends that the state law negligence claim should be dismissed because Plaintiff failed to comply with Chapter 766. ECF No. 49 at 7-8. That argument is identical to the argument raised by Defendant Lopez and, for the reasons stated above, it should also be rejected.
Additionally, for the reasons previously stated, Plaintiff's complaint should not be dismissed on the basis of qualified immunity or lack of physical injury. ECF No. 49 at 8-9, 10-11. Plaintiff's allegations are sufficient to state a claim, and his right to medical care is well established. Plaintiff has also shown physical injury as explained above.
Defendant also asserts Eleventh Amendment immunity. ECF No. 49 at 9-10. Plaintiff again acknowledges that his official capacity claim for monetary damages against Defendant Vilchez is "barred by the Eleventh Amendment." ECF No. 71 at 19. The motion to dismiss should be granted as to this issue, but Plaintiff's individual capacity claim should proceed.
Finally, both Defendants have pointed out that Plaintiff had begun receiving treatment for HCV at the time he initiated this case. ECF No. 49 at 4; ECF No. 53 at 3. Plaintiff was treated "with the drug Epclusa on February 21, 2018," which is approximately two months prior to Plaintiff's initiation of this case. Plaintiff's "treatment was completed on May 15, 2018," after case initiation, and Defendants note that Plaintiff's "test results currently show that Plaintiff has been cured of the HCV virus." ECF No. 49 at 4; ECF No. 53 at 4. Plaintiff acknowledges as much, but contends that treatment was not because of any actions of Defendants Vilchez or Lopez. ECF No. 70 at 3; ECF No. 71 at 3. Plaintiff advises that he was given treatment only "after FDC was forced to provide treatment" in the wake of the Hoffer case. ECF No. 70 at 3; ECF No. 71 at 3. Plaintiff's eventual treatment may impact a damages calculation should he ultimately be successful in this case, but it is not a basis to dismiss Plaintiff's claims.
It is respectfully