JOHN R. TUNHEIM, Chief District Judge.
Plaintiff Ronnie Jackson brought this 42 U.S.C. § 1983 action against Kathy Reid,
Jackson is a prisoner detained at MCF-OPH. (Am Compl. ¶ 1, Sept. 27, 2016, Docket No. 13.) He alleges that Defendants were deliberately indifferent to his serious medical needs in two ways: (1) Powers-Johnson refused to provide him with Zoloft, an antidepressant medication that he was prescribed, on April 9 and 23, 2016; and (2) Powers-Johnson failed to perform wellness checks for his shoulder injury on several days while Jackson was in administrative segregation and falsely reported that he did not have any medical issues on those dates. (Id. ¶¶ 1-2, 17.) He alleges that he informed Reid of Powers-Johnson's refusal to provide adequate medical care, but Reid denied any wrongdoing on the part of medical staff. (Id. ¶ 1.)
Jackson has been diagnosed with depressive and anxiety disorders and has been prescribed Zoloft to treat these disorders. (Aff. of Dr. David Paulson ("Paulson Aff.") ¶¶ 9-10, June 14, 2017, Docket No. 38; see also Am. Compl. ¶ 1.) Zoloft is an antidepressant medication that is used to treat various mental health conditions. (Paulson Aff. ¶ 11.) According to Dr. David Paulson, the Medical Director for the Minnesota DOC, Zoloft has a half-life of over 24 hours, which is "the period of time required for the concentration or amount of the drug in the body to be reduced by one-half." (Id. ¶¶ 1, 12.) It also has a slow onset of action, which is "the length of time it takes for a drug's effects to come to prominence upon administration." (Id. ¶ 13.) Paulson opines that "[i]f Zoloft is held or stopped the decrease in effectiveness declines slowly," meaning that "[m]issing a single dose has little effect." (Id.)
Jackson alleges that he went to visitation to see family at approximately 11:38 a.m. on April 9, 2016, for a one-hour visit.
Jackson also alleges that he was called for visitation around 11:39 a.m. on April 23, 2016, "which came as a surprise to him." (Id. ¶ 12.) Again he asked for his noon dosage of Zoloft before he left and was told he would receive it after the visit. (Id.) During the visit, Jackson learned of the death of his uncle, who Jackson considered a father figure, and realized that he would be unable to attend the funeral. (Id.) Upon returning from the visit, Jackson requested his Zoloft but was told that Powers-Johnson was not going to change her schedule just to bring him his medication. (Id.) She again "falsifie[d] his medical record saying he was a `no show.'" (Id. ¶ 13.) That night, Jackson alleges that he suffered from "extreme depression and anxiety, well beyond the norm for him, to the point of suicide, as well as severe upset stomach, nausea, and heavy perspiration" as a result of his depression and missed dosage of Zoloft. (Id. ¶ 12.)
Reid confirms that Jackson's medical records show that he "refused" his Zoloft on April 9 and that he was a "no-show" on April 23. (Aff. of Kathryn Reid ("Reid Aff.") ¶ 6, June 14, 2017, Docket No. 49.)
Paulson also notes that Jackson did not take his Zoloft consistently before April 9 or after April 23, 2016. (Paulson Aff. ¶ 15.) He opines that, due to Zoloft's long halflife, the symptoms that Jackson experienced on April 23 were not withdrawal symptoms from Zoloft because the medicine still would have been present in his system. (Id. ¶ 14.) Furthermore, Jackson did not request a sick call on April 23 or on the following days, nor did he press the duress button in his cell. (Id. ¶ 17; Reid Aff. ¶ 8.) Paulson also opines that the symptoms Jackson suffered on April 23 were more likely brought on by grief due to loss of his family member rather than missing his medication given that Jackson had missed his medications in the past and never noted such symptoms. (Paulson Aff. ¶ 18.)
Jackson also alleges that Powers-Johnson failed to perform wellness checks on him on May 21-23 and June 1, 2016, while he was in administrative segregation. (Am. Compl. ¶ 17.)
Reid notes that nurses conduct wellness checks only on people in segregation to ensure that they have "direct and timely access to healthcare." (Reid Aff. ¶ 10.) Records indicate that a nurse performed a wellness check on Jackson on May 21-23 and June 1, 2016. (Id. ¶ 10, Exs. G-J.) Reid alleges that Powers-Johnson saw Jackson on May 23, 2016, for his shoulder pain. (Id. ¶ 10.) Paulson notes that Jackson was prescribed Indocin for his shoulder pain, which is a "keep on your person" drug, and that "it appears that Jackson had his anti-inflammatory medications with him in his cell." (Paulson Aff. ¶ 20.) Jackson saw the treating physician on May 25, 2016, and said that he had been taking Indocin as prescribed. (Id.) However, records from that date note that Jackson reported "no improvement in his shoulder pain" and reported that "his pain ha[d] worsened somewhat" because he "no longer has access to the ice or the Thera-Bands" he used in general population. (Id. ¶ 20, Ex. H at 3.) He also reported that he was having pain in both shoulders because he had to "change the fashion in which he sleeps." (Id.) The treating physician discontinued treatment with Indocin and prescribed a different medication to treat the pain. (Id. at 4.) Records indicate that Jackson was also seen on June 1, 2016. (Id. at 5.)
Jackson alleges that he wrote Defendant Reid to inform her of Powers-Johnson's refusal to give him medication, but her responses denied any wrongdoing, stating instead that medications could be given within 30 minutes of their prescribed time. (Am. Compl. ¶ 14.) He then attempted to file a medical grievance, but it was returned with a note saying that Reid was out of the office. (Id. ¶¶ 15-16.) He later resubmitted the grievance as instructed and additionally filed a complaint with the Minnesota Board of Nursing against Powers-Johnson. (Id. ¶ 18.) He alleges that Reid returned his medical grievance without providing him with the correct institutional response papers, "effectively barring Mr. Jackson from appealing any denial of his medical grievance." (Id. ¶ 19.) He attempted to appeal the denied grievance to the DOC Central Office, but it was returned to him because he did not submit the institutional response, even though he alleges he had submitted the response that was given to him. (Id. ¶ 20.)
Jackson filed this 42 U.S.C. § 1983 action on July 13, 2016. (Compl. at 1.) He later filed an amended complaint. (Am. Compl.) Defendants moved for summary judgment on June 14, 2017, (Defs.'s Mot. Summ. J., June 14, 2017, Docket No. 34.), which Jackson opposed, (Pl.'s Opp., July 10, 2017, Docket No. 58.). In his Oposition, Jackson indicated that Defendant Roy should be voluntarily dismissed from the action. (Id. at 8.) The Magistrate Judge issued an R&R recommending that summary judgment be granted and all parties be dismissed. (R&R, Nov. 7, 2017, Docket No. 71.) Thirteen days later, Jackson filed objections to the R&R. (Objs., Nov. 20, 2017, Docket No. 72.)
Upon the filing of an R&R by a magistrate judge, "a party may serve and file specific written objections to the proposed findings and recommendations." Fed. R. Civ. P. 72(b)(2); accord D. Minn. LR 72.2(b)(1). "The district judge must determine de novo any part of the magistrate judge's disposition that has been properly objected to." Fed. R. Civ. P. 72(b)(3); accord D. Minn. LR 72.2(b)(3). "The district judge may accept, reject, or modify the recommended disposition; receive further evidence; or return the matter to the magistrate judge with instructions." Fed. R. Civ. P. 72(b)(3); accord D. Minn. LR 72.2(b)(3). Here, Jackson specifically objected to the Magistrate Judge's findings that Powers-Johnson and Reid be granted summary judgment on his claim that their refusal to provide Zoloft constituted deliberate indifference. (Objs. at 1-3.) The Court will thus review those findings de novo. Jackson does not object to the Magistrate Judge's findings with respect to Defendants' alleged failure to perform wellness checks or with respect to Defendant Roy; thus, the Court will not review those findings.
"The Eighth Amendment, which applies to the States through the Due Process Clause of the Fourteenth Amendment, prohibits the infliction of `cruel and unusual punishments' on those convicted of crimes." Wilson v. Seiter, 501 U.S. 294, 296-97 (1991) (citation omitted). In Estelle v. Gamble, the Supreme Court recognized that "[a]n inmate must rely on prison authorities to treat his medical needs." 429 U.S. 97, 103 (1976). Because of this reliance, the Supreme Court held that "deliberate indifference to serious medical needs of prisoners constitutes the `unnecessary and wanton infliction of pain' proscribed by the Eight Amendment." Id. at 104 (quoting Gregg v. Georgia, 428 U.S. 153, 173 (1976)).
To show deliberate indifference, Jackson must prove two components, one objective and one subjective. See Gordon ex rel. Gordon v. Frank, 454 F.3d 858, 862 (8th Cir. 2006); see also Wilson, 501 U.S. at 296-98. As to the objective requirement, Jackson must show that he had a "serious medical need." See Gordon, 454 F.3d at 862 (citing Crow v. Montgomery, 403 F.3d 598, 602 (8
Because the present R&R reviews a motion for summary judgment, the Court considers the facts in the light most favorable to Jackson, the nonmoving party. Id. at 861 (citing Celotex Corp. v. Catrett, 477 U.S. 317, 324 (1986)). Summary judgment is appropriate when there is "no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(c); see also Gordon, 454 F.3d at 861. A fact is material if it might affect the outcome of the lawsuit, and a dispute is genuine if the evidence is such that it could lead a reasonable jury to return a verdict for either party. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986).
"A serious medical need is one that has been diagnosed by a physician as requiring treatment, or one that is so obvious that even a layperson would easily recognize the necessity for a doctor's attention." Holden v. Hirner, 663 F.3d 336, 342 (8
Jackson objects to the Magistrate Judge's finding that Defendants did not deliberately disregard his medical needs. The Magistrate Judge found that, even crediting Jackson's allegations that he did not "refuse" his medication on April 9 and was not a "no show" on April 23, Defendants' conduct was not a constitutional violation. (R&R at 8-9.) Jackson argues that the Magistrate Judge improperly evaluated his claim under the standard for "delay of medical treatment," and not under the standard for "knowing failure to administer prescribed medicine." (Objs. at 2.) Because the Court will find that no genuine issues of material fact remain as to whether Defendants were deliberately indifferent to Jackson's serious medical needs, the Court will overrule Jackson's objections and adopt the R&R.
The Magistrate Judge cited Kennedy v. Kelley, where another federal magistrate judge stated that "courts have held that occasionally missed medication doses do not rise to the level of a constitutional violation." No. 16-363 JLH/PSH, 2016 WL 7480711, at *2 (E.D. Ark. Dec. 6, 2016) (collecting cases). In Kennedy, the complaint was based on "a single day" that Plaintiff did not receive his psychiatric medication, and the magistrate judge found that Plaintiff had described "at most negligence." Id. The magistrate judge recommended dismissal of the complaint for failure to state a claim upon which relief could be granted. Id. The district court adopted the R&R without comment. Kennedy v. Kelley, No. 5:16CV00363 JLH, 2016 WL 7477761, at *1 (E.D. Ark. Dec. 29, 2016).
While the facts of Kennedy appear similar to the present case, the Court is not bound by decisions of other district courts. Thus, the Court looks to the Eighth Circuit case cited within Kennedy for guidance. In Ervin v. Busby, the Eighth Circuit held that a one-month delay in providing Ervin, a pretrial detainee, with his prescribed antidepressant medication was insufficient to support a finding of deliberate indifference, even though Ervin complained of consequences from "the sudden withdrawal of the medication." 992 F.2d 147, 150-51 (8
In the present case, even taking Jackson's allegations as true, he was denied his antidepressant medication for only one day, albeit on two occasions two weeks apart. In light of Ervin, the Court cannot say that Defendants were deliberately indifferent to Jackson's serious medical needs.
Jackson cites several cases in support of his objection. In Dadd v. Anoka County, the Eighth Circuit affirmed denial of a motion to dismiss based on qualified immunity, finding that jail staff acted with deliberate indifference to a pretrial detainee's need for pain medication. 827 F.3d 749, 753, 757 (8
The present case is distinguishable for two reasons. First, Dadd suffered for almost 48 hours, while Jackson alleges that he suffered for one night. Second, the defendants in Dadd knew that he was suffering and ignored him, while Defendants in the present case did not know that Jackson would suffer. "`Deliberate indifference' entails a level of culpability equal to the criminal law definition of recklessness, that is, a prison official `must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference.'" Bender v. Regier, 385 F.3d 1133, 1137 (8
Jenkins v. County of Hennepin, Minnesota provides a helpful comparison. In Jenkins, the Eighth Circuit found that a medical supervisor's decision to "briefly postpone an X-ray (ultimately for less than twenty-four hours) reflect[ed] a medical judgment that Jenkin's injury, though possibly serious, was not urgent." 557 F.3d 628, 632 (8
Jackson also cites Phillips v. Jasper County Jail, where the Eighth Circuit found that there was a genuine dispute of material fact as to whether jail employees were deliberately indifferent to Phillips's serious medical needs. 437 F.3d 791, 796 (8
Jackson cites Johnson v. Hay, where a similar analysis applies. 931 F.2d 456, 463 (8
Jackson cites other decisions that are less helpful to his case. In Ellis v. Butler, an inmate received delayed treatment for a knee injury. 890 F.2d 1001, 1002 (8
Jackson's citation of Jolly v. Badgett actually harms his case. Jackson points to the dissenting opinion, where the judge opined that the evidence "was sufficient to create a triable issue as to whether these defendants' interference with Jolly's prescribed dosage schedule interfered with a serious medical need." 144 F.3d 573, 574 (8th Cir. 1998) (Arnold, J., dissenting in relevant part). Dissenting opinions are not binding, and the majority in Jolly found that there was no evidence that defendants knew that the alleged delay in Jolly's taking his seizure medicine "would have any adverse effect." Id. at 573 (majority opinion). Likewise, there is no evidence in the present case that Defendants knew that the delay in administering Jackson's medication would have any adverse effect, let alone risk serious harm. Even under the dissenting opinion's logic, Jackson's argument would fail as the risks involved in not administering seizure medication are known and much more serious.
Jackson cites Aswegan v. Bruhl, where the Eighth Circuit affirmed a district court's denial of a motion for judgment notwithstanding the verdict, finding that sufficient evidence supported a jury finding of deliberate indifference. 965 F.2d 676, 678 (8
Id. at 677-78. There was also evidence that defendants refused to administer antibiotics prescribed by a specialist. Id. The facts in Aswegan demonstrated repeated instances of intentional deprivation of prescribed medical care that carried with it serious risk of harm. The facts in the present case simply do not rise to the same level.
Finally, Jackson cites Cummings v. Roberts, where the Eighth Circuit found that the district court erred in granting summary judgment on a claim of deliberate indifference. 628 F.2d 1065, 1068 (8
Id. at 1066. Like Aswegan, the facts of Cummings rise well beyond mere negligence. The mistreatment alleged by Jackson does not.
Jackson correctly notes that knowing failure to administer prescribed medication or intentional interference with prescribed treatment
Jackson also objects to the R&R because it does not address his allegation that nurses under Reid's supervision had a custom, policy, or practice of failing to administer prescribed medication to inmates attending visits. (Objs. at 3.) He cites Hartsfield v. Colburn, where the court declined to reach the question whether the jail's custom, policy, or practice contributed to deliberate indifference. 371 F.3d 454, 458 (8
Jane Doe A ex rel. Jane Doe B v. Special Sch. Dist. of St. Louis Cty., 901 F.2d 642, 645 (8
Jackson also objects to the Magistrate Judge's finding that Reid and Powers-Johnson are entitled to qualified immunity on the grounds that it was clearly established at the time of the alleged violations that "the knowing failure to administer prescribed medication can itself constitute deliberate indifference" under Dadd, 827 F.3d at 757, and that a "`custom, policy, or practice [that] contributed to the alleged deliberate indifference' can evince an Eighth Amendment violation for purposes of supervisory liability" under Hartsfield, 371 F.3d at 458. (Objs. at 3.)
To defeat qualified immunity, Jackson must allege facts that demonstrate two things: (1) that a government official violated his constitutional right, and (2) that the right was "clearly established." Saucier v. Katz, 533 U.S. 194, 201 (2001). The first requirement was discussed above, and the Court finds no violation of Jackson's constitutional right. The qualified immunity inquiry should end here. But even if Jackson had shown that his constitutional right was violated, he has failed to show that such a right was "clearly established," which requires "[t]he contours of the right [to] be sufficiently clear that a reasonable official would understand that what he is doing violates that right." Id. at 202 (quoting Anderson v. Creighton, 483 U.S. 635, 640 (1987)) (internal quotation marks omitted).
Jackson is correct that failure to administer prescribed medication
Taking the facts in the light most favorable to Jackson, Defendants' conduct in delaying 24 hours in providing Jackson with Zoloft for treatment of his depressive and anxiety disorders on two occasions does not constitute deliberate indifference. Furthermore, even if Defendants' conduct constituted a violation of Jackson's constitutional rights, such a right was not clearly established. There remains no genuine dispute of material fact, and Defendants are entitled to judgment as a matter of law. The Court will therefore overrule Jackson's objections in full, adopt the Magistrate Judge's R&R in full, and grant Defendants' Motion for Summary Judgment.
Based on the foregoing, and all the files, records, and proceedings herein,
1. Plaintiff's Objections to the Report and Recommendation [Docket No. 72] are
2. Defendants' Motion for Summary Judgment [Docket No. 34] is
3. Plaintiff's action is
The Court considers Paulson's opinions regarding Zoloft and the onset of withdrawal symptoms to the extent that they are relevant to the subjective component of deliberate indifference. Paulson's opinions suggest that, like the defendants in Jolly, Defendants in the present case did not know that Jackson was likely to suffer adverse effects as a result of one missed dosage of Zoloft. The Court need not accept Paulson's opinions as to Zoloft or as to Jackson's suffering as factually true; however, the Court considers them to the extent that they show what Defendants knew about the risks of not distributing Jackson's Zoloft. But even if the Court chose not to consider Paulson's opinions in analyzing the subjective component of deliberate indifference, the facts Jackson alleges do not show that Defendants knew that missing one dose of Zoloft would harm Jackson. Jackson does not allege that he suffered symptoms after the missed dose on April 9 and does not allege that he notified any medical staff of any withdrawal symptoms at any time. (See generally Am. Compl.) The outcome of this case does not depend on Paulson's affidavit, thus the Court will therefore overrule Jackson's objection.
