“[C]onduct deliberately indifferent to serious medical needs has included: (1) grossly inadequate care; (2) a decision to take an easier but less efficacious course of treatment; and (3) medical care that is so cursory as to amount to no treatment at all.”
How later courts described this case
- “[C]onduct deliberately indifferent to serious medical needs has included: (1) grossly inadequate care; (2) a decision to take an easier but less efficacious course of treatment; and (3) medical care that is so cursory as to amount to no treatment at all.”
- “Whenever a judge considers matters outside the pleadings in a 12(b)(6) motion, that motion is thereby converted into a Rule 56 Summary Judgment motion.”
- identifying the elements of a deliberate indifference claim: “(1) a serious medical need; (2) the defendants’ deliberate indifference to that need; and (3) causation between that indifference and the plaintiff’s injury”
- holding the defendants’ failure to take any “action to mitigate [] the substantial risk of serious harm” one inmate posed to another constituted deliberate indifference
Written by the judges who cited it.
The opinion
UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
JACKSONVILLE DIVISION
SHAMPOIRE ORANGE,
Plaintiff,
v. Case No. 3:20-cv-842-BJD-PDB
PAYTON A. PRESCOTT et al.,
Defendants.
______________________________
ORDER
I. Status
Plaintiff, Shampoire Orange, a federal inmate, is proceeding pro se on an
amended complaint for the violation of civil rights under 42 U.S.C. § 1983
against eight Defendants arising out of conduct that occurred when he was
detained at the Baker County Jail (Doc. 35; Am. Compl.). Before the Court is
Defendant Chapman’s motion to dismiss (Doc. 37; Motion).1 Plaintiff opposes
the motion (Doc. 46; Pl. Resp.), and, with leave of Court, Defendant Chapman
filed a reply (Doc. 54; Reply).
1 All other Defendants answered the amended complaint (Doc. 36) and have
moved for summary judgment (Doc. 41). Plaintiff has responded to the motion (Doc.
55). However, the motion is not yet ripe because under the Local Rules, Defendants
have fourteen days to file a reply. See M.D. Fla. R. 3.01(d).
II. Motion to Dismiss Standard
Under the Federal Rules of Civil Procedure, a defendant may move to
dismiss a complaint for a plaintiff’s “failure to state a claim upon which relief
may be granted.” See Fed. R. Civ. P. 12(b)(6). In ruling on such a motion, the
court must accept the plaintiff’s allegations as true, liberally construing those
by a plaintiff proceeding pro se, but need not accept as true legal conclusions.
See Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). Though detailed factual
allegations are not required, Rule 8(a) demands “more than an unadorned, the-
defendant-unlawfully-harmed-me accusation.” Id. A plaintiff should allege
enough facts “to raise a reasonable expectation that discovery will reveal
evidence” supporting the plaintiff’s claims. Bell Atl. Corp. v. Twombly, 550 U.S.
544, 556 (2007).
III. Complaint Allegations
In his verified complaint and supporting exhibits (Doc. 35-1; Compl. Ex.),
Plaintiff alleges officers and Defendant Nurse Chapman violated his Eighth
Amendment right to be free from cruel and unusual punishment. See Am.
Compl. at 5. As relevant to the motion before the Court, Plaintiff alleges Nurse
Chapman failed to inform officers about his serious knee injuries, which
prevented him from climbing stairs. See Compl. Ex. at 4-5. According to
Plaintiff, on October 22, 2019, he told escorting officers that he was unable to
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walk upstairs because he had a ruptured tendon in both knees. Id. at 2-3. The
officers, however, selected an upstairs cell for him and began pushing him up
the steps when he refused to walk up on his own. Id. Plaintiff allegedly pleaded
with the officers to call the medical department to confirm he was given a
bottom bunk/bottom tier pass. Id. After some time, officers sprayed Plaintiff
with chemical agents for his non-compliance. Id. at 3. The officers then
strapped him to a restraint chair, applied a spit shield, and brought him to the
medical unit. Id. at 4.
In the medical unit, Nurse Chapman cleansed Plaintiff’s eyes and
recommended a shower. Id. at 4-5. Plaintiff asked Nurse Chapman to check his
medical records and tell officers about his knee injury and his stair restriction.
Id. at 5. Allegedly, Nurse Chapman agreed to “look it up for the officers.” Id.
Officers thereafter took Plaintiff back to the dorm and “dragged [him] up the
stairs” to the shower and then to his cell. Id. The next morning, Plaintiff was
moved to a bottom tier cell. Id. Allegedly, the officer who moved Plaintiff said
he should not have been placed upstairs because of his injury. Id. Plaintiff
contends Nurse Chapman was deliberately indifferent to his serious medical
needs. See Am. Compl. at 5. He claims to have suffered mental and emotional
3
distress and physical injuries attributable to having been sprayed with
chemical agents.2 Id. at 7. He seeks compensatory and punitive damages. Id.
IV. Analysis
Nurse Chapman seeks dismissal of the sole claim against her under Rule
12(b)(6), arguing Plaintiff fails to state a plausible claim for relief. See Motion
at 2, 12. In response, Plaintiff says it was clearly documented in his medical
records that he had ruptured tendons in both knees and was “unable to actively
bend [his] knee[s] . . . [or] step up or over elevated objects.” See Pl. Resp. at 2-
3. Plaintiff asserts Nurse Chapman failed to “notify officers that [he could not]
go upstairs.” Id. at 3. With his response, Plaintiff offers documents from Baker
County Jail and medical records from outside providers (Docs. 46-2 through
46-4).
A. Consideration of Extrinsic Evidence
Generally, a court should not consider extrinsic evidence when ruling on
a motion to dismiss unless a document “is central to the plaintiff’s claim” and
incorporated by reference in the complaint. See Brooks v. Blue Cross & Blue
Shield of Fla., Inc., 116 F.3d 1364, 1368-69 (11th Cir. 1997) (“[T]he analysis of
a 12(b)(6) motion is limited primarily to the face of the complaint and
2 Plaintiff asserts he was sprayed with chemical agents again five days after
the first incident, but he does not fault Nurse Chapman for anything related to the
second incident. See Compl. Ex. at 7.
4
attachments thereto.”). In fact, Rule 12 provides, “If, on a motion under Rule
12(b)(6) or 12(c), matters outside the pleadings are presented to and not
excluded by the court, the motion must be treated as one for summary
judgment under Rule 56.” See Fed. R. Civ. P. 12(d). See also Trustmark Ins.
Co. v. ESLU, Inc., 299 F.3d 1265, 1267 (11th Cir. 2002) (“Whenever a judge
considers matters outside the pleadings in a 12(b)(6) motion, that motion is
thereby converted into a Rule 56 Summary Judgment motion.”).
However, the Eleventh Circuit has held a court may consider extrinsic
evidence when ruling on a 12(b)(6) motion if a document “is (1) central to the
plaintiff’s claim and (2) undisputed.” Day v. Taylor, 400 F.3d 1272, 1276 (11th
Cir. 2005) (citing Horsley v. Feldt, 304 F.3d 1125, 1134 (11th Cir. 2002)). Thus,
when a plaintiff, in his complaint, incorporates by reference a document that
is central to his claim, and the opposing party does not contest the authenticity
of the document, a court may consider it when ruling on a motion to dismiss.
Id.
Here, Plaintiff references his medical chart in his amended complaint.
See Am. Compl. at 7; Compl. Ex. at 5. And, in her reply, Nurse Chapman does
not question the authenticity of the documents Plaintiff offers with his
response. See generally Reply. Accordingly, the Court will consider them, to
the extent relevant, in ruling on Nurse Chapman’s motion to dismiss.
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B. Deliberate Indifference
A claim for deliberate indifference to a serious illness or injury is
cognizable under § 1983. See Estelle v. Gamble, 429 U.S. 97, 104 (1976). To
state a claim, a plaintiff first must allege he had a serious medical need. Brown
v. Johnson, 387 F.3d 1344, 1351 (11th Cir. 2004). Next, the plaintiff must
“allege that the prison official, at a minimum, acted with a state of mind that
constituted deliberate indifference.” Richardson v. Johnson, 598 F.3d 734, 737
(11th Cir. 2010). Finally, the plaintiff must allege facts showing a causal
connection between the defendant’s conduct and his resulting injuries. See
Mann v. Taser Int’l, Inc., 588 F.3d 1291, 1306-07 (11th Cir. 2009), overruled in
part on other grounds by Hope v. Pelzer, 536 U.S. 730, 739 (2002) (identifying
the elements of a deliberate indifference claim: “(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 prisoner bringing a deliberate-indifference claim has a steep hill to
climb.” Keohane v. Fla. Dep’t of Corr. Sec’y, 952 F.3d 1257, 1266 (11th Cir.
2020). For instance, to sufficiently plead the second element, a plaintiff must
do more than allege the care provided was “subpar or different from what the
inmate want[ed].” Id. See also Goebert v. Lee Cnty., 510 F.3d 1312, 1327 (11th
Cir. 2007). This is so because “a simple difference in medical opinion between
6
the prison’s medical staff and the inmate as to the latter’s diagnosis or course
of treatment’ does not support a claim of deliberate indifference.” Melton v.
Abston, 841 F.3d 1207, 1224 (11th Cir. 2016) (internal quotation marks
omitted). Thus, “federal courts are generally reluctant to second guess medical
judgments and to constitutionalize claims that sound in tort law.” Hamm v.
DeKalb Cnty., 774 F.2d 1567, 1575 (11th Cir. 1985) (quoting Westlake v.
Lucas, 537 F.2d 857, 860 n.5 (1st Cir. 1981)). See also Farrow v. West, 320 F.3d
1235, 1245 (11th Cir. 2003) (“[T]he Supreme Court established that
‘deliberate indifference’ entails more than mere negligence.”).
Stated another way, “[d]eliberate indifference is not about ‘inadvertence
or error in good faith,’ but rather about ‘obduracy and wantonness’—a
deliberate refusal to provide aid despite knowledge of a substantial risk of
serious harm.” Stone v. Hendry, 785 F. App’x 763, 769 (11th Cir. 2019) (quoting
Whitley v. Albers, 475 U.S. 312, 319 (1986)). To allege a defendant was
deliberately indifferent to a plaintiff’s serious medical needs, a plaintiff must
assert facts showing the defendant (1) had “subjective knowledge of a risk of
serious harm” and disregarded that risk by conduct that surpasses negligence.
Goebert, 510 F.3d at 1327.
When a plaintiff has received some treatment, he pleads a deliberate
indifference claim only by alleging facts showing the care he received was “so
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grossly incompetent, inadequate, or excessive as to shock the conscience or to
be intolerable to fundamental fairness.” Harris v. Thigpen, 941 F.2d 1495, 1505
(11th Cir. 1991) (quoting Rogers v. Evans, 792 F.2d 1052, 1058-59 (11th Cir.
1986)). See also Melton, 841 F.3d at 1223 (“[C]onduct deliberately indifferent
to serious medical needs has included: (1) grossly inadequate care; (2) a
decision to take an easier but less efficacious course of treatment; and (3)
medical care that is so cursory as to amount to no treatment at all.”).
Significantly, Plaintiff alleges he was taken to the medical unit not
because of his knee injuries but because he was sprayed with chemical agents.
And Plaintiff readily acknowledges Nurse Chapman treated those injuries. She
poured water in his eyes and recommended a shower—a recommendation
officers followed. See Compl. Ex. at 4-5. Plaintiff does not allege Nurse
Chapman’s medical treatment was grossly inadequate or so cursory as to
amount to no treatment at all. See id.
Moreover, it does not appear Nurse Chapman even knew of the severity
of Plaintiff’s knee injuries when she treated him for exposure to chemical
agents. See id. at 5. According to Plaintiff, “Nurse Chapman was deliberately
indifferent to Plaintiff’s serious medical need by not looking into Plaintiff’s
medical records which show [he has] torn tendons in both knees.” See Am.
Compl. at 7 (emphasis added). Assuming Nurse Chapman did not consult
8
Plaintiff’s medical chart when he asked her to, she cannot have had subjective
knowledge of Plaintiff’s serious knee injuries and attendant physical
limitations.
Because Nurse Chapman provided medical care for Plaintiff’s exposure
to chemical agents, Plaintiff’s claim is best characterized as one for deliberate
indifference to a substantial risk of serious harm, as opposed to deliberate
indifference to a serious medical need. Along these lines, Plaintiff’s allegations
are somewhat analogous to those of an inmate who alleges prison officials
housed him in a known, dangerous environment. See, e.g., Caldwell v. Warden,
FCI Talladega, 748 F.3d 1090, 1103 (11th Cir. 2014) (holding the defendants’
failure to take any “action to mitigate [] the substantial risk of serious harm”
one inmate posed to another constituted deliberate indifference); See also
Rodriguez v. Sec’y for Dep’t of Corr., 508 F.3d 611, 614, 616, 624 (11th Cir.
2007) (vacating judgment in favor of the defendants because the plaintiff asked
for transfer and protection after gang members told him they wanted to kill
him, but defendants allowed him to be returned to general population where
he was promptly stabbed by a gang member).
Regardless of the precise characterization of Plaintiff’s deliberate
indifference claim against Nurse Chapman, the standard is the same: Plaintiff
must allege facts permitting the reasonable inference Nurse Chapman actually
9
knew he faced a substantial risk of serious harm but disregarded that risk.
Caldwell, 748 F.3d at 1099. If Nurse Chapman did not review Plaintiff’s
medical chart until after officers took him to his upper tier cell, she cannot
have had subjective knowledge of a substantial risk of serious harm.
Additionally, by his own allegations, Plaintiff concedes Nurse Chapman did
not ignore him when he asked her to check his medical chart. See Compl. Ex.
at 5. Plaintiff says Nurse Chapman told him she would “look it up for officers.”
Id.
In his response, Plaintiff explains events somewhat differently than he
does in his complaint. He says the officers “called medical,” and Nurse
Chapman informed them he had a lower bunk pass. See Pl. Resp. at 3. But he
says Nurse Chapman did not notify the officers he could not climb steps, which
she would have known had she read his medical chart. Id. Plaintiff contends,
“it would be hard for [Nurse Chapman] not to notice [he had] an orthopedic
appointment [scheduled]” and an outside provider had documented his “serious
medical injury.” Id.
Plaintiff’s speculative allegations do not suffice. Nurse Chapman cannot
be faulted for “fail[ing] to alleviate a significant risk that [s]he should have
perceived but did not.” See Farmer v. Brennan, 511 U.S. 825, 838 (1994) (“[A]n
official’s failure to alleviate a significant risk that he should have perceived but
10
did not, while no cause for commendation, cannot . . . be condemned as the
infliction of punishment.”). If true that Nurse Chapman failed to read
Plaintiff’s medical chart carefully or failed to communicate to the escorting
officers the precise details of his injury—i.e., that he had expressed difficulty
walking up and down stairs and was awaiting a consult with an orthopedist—
such a failure amounts to, at worst, “inadvertence or error in good faith,” not
deliberate indifference. See Stone, 785 F. App’x at 769.
Moreover, according to disciplinary records Plaintiff submitted with his
complaint (Doc. 35-1; Compl. Ex.) and jail records he filed with his response to
the motion to dismiss (Doc. 46-2; Resp. Ex.), Plaintiff did not have a lower tier
medical pass on October 22, 2019. In response to Plaintiff’s grievance about the
October 22, 2019 incident, a prison official stated: “Medical was called and
informed us that you had a lower bunk pass only. Not a lower tier.” See Compl.
Ex. at 10. The grievance responder told Plaintiff to submit a sick-call request
if he wanted to consult with the doctor about obtaining a lower tier pass. Id.
The grievance responder reiterated, “At this time, you still don’t have a lower
tier pass. Just a lower bunk.” Id.
The grievance response aligns with information in Plaintiff’s jail medical
file, upon which he relies in opposition to the motion to dismiss. See Pl. Resp.
at 2-3. On August 9 and 30, 2019, a jail official noted Plaintiff had “special
11
needs” and required “lower level/lower bunk” housing. See Resp. Ex. at 7, 8.
However, on September 4, 2019, a medical official noted as follows: “Refer
[patient] to orthopedic surgery for repair [of] left knee tendon[.] Continue low
bunk.” Id. at 9, 10, 15 (emphasis added). Moreover, the first page of Plaintiff’s
intake screening forms prominently displays the following housing restriction
only: “Bottom Bunk.” Id. at 2.
Had Nurse Chapman in fact reviewed Plaintiff’s medical chart knowing
officers planned to house him in an upper tier cell, she would have seen a doctor
assigned Plaintiff a bottom bunk pass only, despite his knee injuries and
mobility issues. Thus, Nurse Chapman cannot be said to have ignored a
substantial risk of serious harm. Notably, Plaintiff does not allege Nurse
Chapman was the provider who referred him to an orthopedist or who assigned
the medical pass, nor does he allege she was the provider who evaluated his
knee injuries. Regardless, to the extent Plaintiff believes he should have been
assigned a lower tier pass, he alleges a mere disagreement “over the adequacy
of [medical] treatment,” which is not a constitutional claim. See Hamm, 774
F.2d at 1575.
For the above reasons, Nurse Chapman’s motion to dismiss is due to be
granted and Plaintiff’s claim against her dismissed.
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Accordingly, it is now
ORDERED:
1. Defendant Chapman’s motion to dismiss (Doc. 37) is granted, and
Plaintiff's deliberate indifference claim against Defendant Chapman is
dismissed.
2. The Clerk shall terminate Defendant Chapman as a party to this
action.
DONE AND ORDERED at Jacksonville, Florida, this 13th day of
August 2021.
4 YQ -
fo /itan— | £ Agra
BRIAN/J . DAVIS
United States District Judge
Jax-6
C:
Shampoire Orange
Counsel of Record
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