Deliberate indifference to a prisoner's medical needs
A recent decision by Judge David Lawson of the Eastern District of Michigan helps to explain when the neglect of a prisoner's health care needs may constitute a Constitutional violation and be actionable under 42 USC 1983. The prisoner, William Calhoun, suffered a crushed finger while he was incarcerated at the Mound Correctional Facility. He was taken to Detroit Receiving Hospital where x-rays showed a shattered bone in his finger and the need for Orthopaedic treatment and surgery. The referral for orthopaedic treatment was denied by an unidentified employee of Corrections Medical Service (CMS), the State of Michigan's contract prison medical provider. As a result, Calhoun has a permanently deformed and dysfunctional finger. Calhoun sued several DOC employees and CMS.
The Judge first recognized that pursuant to the Prison Litigation Reform Act, a prisoner must exhaust his administrative remedies before a lawsuit may be filed. Pursuant to rulings of the Supreme Court, any procedural objections to the form of the administrative grievance filed by the prisoner are waived if the Department of Corrections substantively addresses the grievance. Further, prisoners are not required to take futile steps simply to fulfill a procedural requirement. On this basis, the Court ruled that Calhoun's claim was properly before it.
The Eight Amendment to the Constitution prohibits "cruel and unusual punishment". If a prison official actually knew of a serious medical need and denies medical care, he or she has demonstrated "deliberate indifference" to the prisoner's needs sufficient to allow an action under section 1983. In essence, "cursory treatment" where the need for treatment is "obvious" may constitute a claim, but more than mere "professional negligence" or "malpractice" must be shown. The action or inaction of the prison employee must be "so grossly incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to fundamental fairness".
Under the latter standard, the individual nurse who recommended a referral for Calhoun could not be sued because she attempted to procure treatment which was beyond her personal control. On the other hand, the individual who refused to honor Calhoun's administrative grievance must defend the charges against her. While such a grievance respondent normally cannot be sued under 1983, if the employee "knows of and disregards an excessive risk to an inmate's health or safety", an Eighth Amendment violation may be proveable.
Finally, CMS, the contract medical provider, sought dismissal of Calhoun's claim because Calhoun had not specifically identified a CMS employee who was "deliberately indifferent" to his medical needs. The Court noted that CMS was acting "under color of state law" in its contract capacity and that some individual was allegedly aware of the prisoner's need for medical treatment and denied the care for non-medical reasons. In this context, the prisoner has demonstrated a "substantially cognizable" claim that will not be dismissed for procedural reasons without an opportunity to amend and identify the allegedly at-fault individual. While the complaint filed was inadequate in that it identified only CMS as a defendant, the Court allowed Calhoun to amend to substitute the allegedly at-fault individual in place of CMS.