HEACOX v. CASTONGUAY

UNITED STATES DISTRICT COURT

DISTRICT OF MAINE

BRANDON HEACOX, )

)

Plaintiff )

)

v. ) 1:24-cv-00123-LEW

)

BRYAN CASTONGUAY, )

)

Defendant )

RECOMMENDED DECISION AFTER REVIEW

OF PLAINTIFF’S COMPLAINT

Plaintiff filed a complaint alleging Defendant failed to provide adequate medical

care while Plaintiff was incarcerated at the Maine State Prison.1 (Complaint at 9, ECF No.

1.) Defendant is alleged to be a representative of Wellpath Health Care (Wellpath), the

medical provided in the prison.

Plaintiff also filed an application to proceed without prepayment of fees, which

application the Court granted. (Application, ECF No. 3; Order, ECF No. 4.) In accordance

with the statute governing actions filed without prepayment of fees, a preliminary review

of Plaintiff’s complaint is appropriate. 28 U.S.C. § 1915(e)(2).

1 Plaintiff filed two actions in which he complained about the same conduct. See Heacox v. Castonguay,

No. 1:24-cv-00124-LEW. After filing the second action, Plaintiff informed the Court that he intended to

assert one action. The Court construed Plaintiff’s submission as a motion to consolidate the two matters,

and the Court granted the motion. (Motion, ECF No. 9; Order, ECF No. 10.) Unless stated otherwise, I

will reference the filings in this (1:24-cv-00123-LEW) docket.

Following a review of Plaintiff’s complaint, I allow Plaintiff an opportunity to

address the deficiencies in his pleadings identified herein. If Plaintiff fails to address the

deficiencies successfully, I recommend the Court dismiss the matter.

FACTUAL BACKGROUND

Plaintiff asserts that in November 2023, he was transferred from New Hampshire

State Prison to Maine State Prison. (Complaint at 5.) According to Plaintiff, upon intake

he was supposed to have an inhaler for his asthma. (Id.) Plaintiff contends the medical

staff at the Maine State Prison, specifically Miriam Davidson, forgot to refill his medication

and two weeks after his arrival he ran out of his opioid medication (suboxone) and his anti-

psychosis medication (a tranquilizer). (Id.) Plaintiff alleges he was without his tranquilizer

for three days and without suboxone for four days and suffered withdrawal symptoms,

struggled to sleep, and experienced psychosis. (Id. at 5-6.)

Plaintiff alleges that on January 12, 2024, when he did not have his inhaler despite

his request for one, he suffered a severe asthma attack after his cell neighbor was pepper

sprayed. (Id. at 6-7.) Plaintiff maintains he alerted the correctional officer (CO) outside

of his cell to the asthma attack, the CO told him to wait for the nurse; the nurse subsequently

arrived but did not have an inhaler. (Id.) Plaintiff alleges he passed out on his bed as the

result of the asthma attack. (Id.) Plaintiff maintains he continued to request an inhaler, but

he did not receive one until February 2024, three months after his original request. (Id. at

6.)

LEGAL STANDARD

The governing statute, 28 U.S.C. § 1915, is designed to ensure meaningful access

to the federal courts for those persons unable to pay the costs of bringing an action. When

a party is proceeding without prepayment of fees, however, “the court shall dismiss the

case at any time if the court determines,” inter alia, that the action is “frivolous or

malicious” or “fails to state a claim on which relief may be granted.” 28 U.S.C. §

1915(e)(2)(B). “Dismissals [under § 1915] are often made sua sponte prior to the issuance

of process, so as to spare prospective defendants the inconvenience and expense of

answering such complaints.” Neitzke v. Williams, 490 U.S. 319, 324 (1989).

When considering whether a complaint states a claim for which relief may be

granted, courts must assume the truth of all well-pled facts and give the plaintiff the benefit

of all reasonable inferences therefrom. Ocasio-Hernandez v. Fortuno-Burset, 640 F.3d 1,

12 (1st Cir. 2011). A complaint fails to state a claim upon which relief can be granted if it

does not plead “enough facts to state a claim to relief that is plausible on its face.” Bell

Atlantic Corp. v. Twombly, 550 U.S. 544, 570 (2007). “A self-represented plaintiff is not

exempt from this framework, but the court must construe his complaint ‘liberally’ and hold

it ‘to less stringent standards than formal pleadings drafted by lawyers.’” Waterman v.

White Interior Sols., No. 2:19-cv-00032-JDL, 2019 WL 5764661, at *2 (D. Me. Nov. 5,

2019) (quoting Erickson v. Pardus, 551 U.S. 89, 94 (2007)). This is “not to say that pro se

plaintiffs are not required to plead basic facts sufficient to state a claim.” Ferranti v.

Moran, 618 F.2d 888, 890 (1st Cir. 1980).

DISCUSSION

Plaintiff’s assertion of inadequate and delayed medical care can be construed to

allege a violation of his Eighth Amendment right against cruel and unusual punishment.

Plaintiff’s constitutional claim is authorized and governed by 42 U.S.C. § 1983. Section

1983 does not provide substantive rights but is a vehicle “for vindicating federal rights

elsewhere conferred.” Albright v. Oliver, 510 U.S. 266, 271 (1994) (quoting Baker v.

McCollan, 443 U.S. 137, 144 n.3 (1979)). To maintain a claim under section 1983, a

plaintiff must establish: “1) that the conduct complained of has been committed under color

of state law, and 2) that this conduct worked a denial of rights secured by the Constitution

or laws of the United States.” Barreto-Rivera v. Medina-Vargas, 168 F.3d 42, 45 (1st Cir.

1999).

A. Constitutional Deprivation

The Eighth Amendment prohibits the infliction of “cruel and unusual punishments.”

U.S. Const. amend. VIII. From this prohibition, “courts have derived the principles that

govern the permissible conditions under which prisoners are held and that establish the

medical treatment those prisoners must be afforded.” Kosilek v. Spencer, 774 F.3d 63, 82

(1st Cir. 2014) (citing Farmer v. Brennan, 511 U.S. 825, 832 (1994)). See also Giroux v.

Somerset, 178 F.3d 28, 31 (1st Cir. 1999) (citations and quotation marks omitted) (“Prison

officials have a duty to provide humane conditions of confinement; prison officials must

ensure that inmates receive adequate food, clothing, shelter, and medical care, and must

take reasonable measures to guarantee the safety of the inmates.”). To allege “a claim of

deliberate indifference based on inadequate or delayed medical care, ‘a plaintiff must

satisfy both a subjective and objective inquiry.’” Perry v. Roy, 782 F.3d 73, 78 (1st Cir.

2015) (quoting Leavitt v. Corr. Med. Servs., 645 F.3d 484, 497 (1st Cir. 2011)).

To demonstrate a claim under the objective prong, a plaintiff “must show that he

has a serious medical need for which []he has received inadequate treatment.” Kosilek,

774 F.3d at 85. For a medical condition to be objectively “serious,” there must be “a

sufficiently substantial ‘risk of serious damage to [the inmate’s] future health.” Farmer,

511 U.S. at 843 (quoting Helling v. McKinney, 509 U.S. 25, 35 (1993)). This “requires

that the need be ‘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.” Kosilek, 774 F.3d at 82 (quoting Gaudreault v. Mun. of Salem, 923

F.2d 203, 208 (1st Cir. 1990)). However, this “does not impose upon prison administrators

a duty to provide care that is ideal, or of the prisoner’s choosing.” Id. (citations omitted).

“Rather, the Constitution proscribes care that is ‘so inadequate as to shock the conscience.”

Id. at 83 (quoting Torraco v. Maloney, 923 F.2d 231, 235 (1st Cir. 1991)).

Under the subjective prong, “a plaintiff must show ‘that prison officials possessed

a sufficiently capable state of mind, namely one of deliberate indifference to an inmate’s

health or safety.’” Perry, 782 F.3d at 78 (quoting Leavitt, 645 F.3d at 497). “[D]eliberate

indifference ‘defines a narrow band of conduct,’ and requires evidence that the failure in

treatment was purposeful.” Kosilek, 774 F.3d at 83 (quoting Feeney, 464 F.3d at 162); see

Perry, 782 F.3d at 79 (stating that deliberate indifference “requires evidence that the

absence or inadequacy of treatment is intentional.”) Moreover, “[p]rison officials ‘who

actually knew of a substantial risk to inmate health or safety may be found free from

liability if they responded reasonably to the risk, even if the harm ultimately was not

averted.” Giroux v. Somerset Cnty., 178 F.3d 28, 33 (1st Cir. 1999) (quoting Farmer, 511

U.S. at 844); see Burrell, 307 F.3d at 8 (1st Cir. 2002) (recognizing that the focus of the

deliberate indifference analysis “is on what the jailers knew and what they did in

response”).

A delay in treatment may constitute deliberate indifference if the delay exacerbated

the injury or unnecessarily prolonged the inmate’s pain. Adams v. Wellpath of Maine, No.

2:20-cv-00424-NT, 2021 WL 3056841, at *9 (D. Me. July 2021). Here, Plaintiff alleges a

delay in the receipt of his medications after he was transferred to the Maine State Prison

and the failure to provide him with an inhaler despite his multiple requests.

1. Medication

Plaintiff alleges he suffered withdrawal symptoms when the medical staff forgot to

refill his medications, an anti-psychosis medication and suboxone to treat an addiction. He

asserts that he was without the medications for three or four days. Based on the

medications, one can reasonably infer that Plaintiff was diagnosed with a mental health

condition and some form of substance use disorder.

Given the evolving understanding of substance use disorder, medically assisted

treatment, and the prison’s role in this dynamic, suffering withdrawal symptoms, in certain

contexts, could constitute a serious medical need. Tilson v. Humphrey, No. 5:19-cv-00033,

2021 WL 4443816, at *5 (W.D. Va. Sept. 27, 2021) (collecting cases). See also Trop v.

Dulles, 356 U.S. 86, 101 (1958) (“The [Eighth] Amendment must draw its meaning from

the evolving standards of decency that mark the progress of a maturing society.”).

Plaintiff’s allegations of the significant effects of withdrawal are sufficient, at this stage of

the proceedings, to satisfy the serious medical need requirement of the deliberate

indifference standard.

The next issue is whether the delay of three or four days in providing the medication

could be construed as inadequate care under the Eighth Amendment analysis given the

alleged circumstances. Plaintiff alleges that a nurse forgot to fill the prescription. While

the nurse’s failure to fill the prescription might support a negligence claim, negligent care

does not constitute deliberate indifference. Leavitt, 645 F.3d at 497 (“[S]ubpar care

amounting to negligence or even malpractice does not give rise to a constitutional claim.”).

Plaintiff has not alleged sufficient facts to support an actionable claim based on the alleged

delay in receiving his medications for his mental health and substance use conditions.

2. Inhaler

Plaintiff alleges he requested an inhaler when he arrived at the Maine State Prison

but did not receive one until three months after his transfer. During the time he was without

an inhaler, Plaintiff suffered a severe asthma attack.

“As a general matter, asthma ‘can be, and frequently is, a serious medical condition,

depending on the severity of the attacks.’” Lee v. Young, 533 F.3d 505, 510 (7th Cir. 2008)

(quoting Board v. Farnham, 394 F.3d 469, 484 (7th Cir. 2005)). Here, Plaintiff's assertion

that he suffered an asthma attack that resulted in a loss of consciousness is sufficient to

allege a serious medical condition. The length of time between his first request for an

inhaler and his asthma attack (November 23, 2023, to January 12, 2024) is not insignificant.

According to Plaintiff, although he made multiple requests for an inhaler during that time,

he did not receive one. Plaintiff has alleged enough facts at this stage of the proceeding to

support a deliberate indifference claim based on the failure to provide an inhaler. The

question is whether Plaintiff has alleged an actionable claim against Defendant.

B. Defendant Castonguay

Plaintiff brought this claim against Defendant, a representative for Wellpath.

Plaintiff has not alleged that Defendant was directly involved in Plaintiff’s medical care or

in the failure to provide his medications, including the inhaler. Wellpath is a private

contractor that provides services at the Maine State Prison. Wellpath is treated like a

municipality for purposes of § 1983 claims and Defendant is treated like a government

official. See Wall v. Dion, 257 F. Supp. 2d 316, 319-20 (D. Me. 2003); see also Witham v.

Corizon, Inc., No. 2:12-cv-00146-NT, 2012 WL 5267657, at *7 n.4 (D. Me. Sept. 17,

2012).

To the extent Plaintiff joined Defendant in his supervisory capacity, Plaintiff must

allege facts that would support a claim that was based on Defendant’s own conduct and not

based on a respondeat superior theory. “Government officials may not be held liable for

the unconstitutional conduct of their subordinates under a theory of respondeat superior.”

Ashcroft v. Iqbal, 556 U.S. 662, 676 (2009). “Because vicarious liability is inapplicable to

. . . [a] § 1983 suit, a plaintiff must plead that each Government-official defendant, through

the official’s own individual actions, has violated the Constitution.” Id.

To the extent Plaintiff has joined Defendant in an official capacity or if the Court

were to construe Plaintiff’s claim as a claim against Wellpath, Plaintiff must allege facts

that would support a finding that the failure to provide Plaintiff with an inhaler for nearly

two months was the product of a Wellpath policy, custom, or practice. Welch v. Ciampa,

542 F.3d 927, 941 (1st Cir. 2008). That is, the applicable standard requires a plaintiff to

“identify a [governmental entity] ‘policy’ or ‘custom’ that caused the plaintiff’s injury.”

Bd. of Cty. Comm’rs v. Brown, 520 U.S. 397, 403 (1997). Plaintiff has not alleged a policy

or custom that resulted in the alleged deprivation of his constitutional rights.

Because Plaintiff has not alleged that Defendant had knowledge of Plaintiff’s need

for an inhaler and failed to provide one, and because Plaintiff has not alleged a Wellpath

policy, custom, or practice that resulted in the failure to provide the inhaler, Plaintiff has

not alleged an actionable claim against Defendant or Wellpath.

Particularly because Plaintiff has alleged facts to support a constitutional

deprivation, however, Plaintiff should be afforded the opportunity to amend his complaint

to address the deficiencies in his complaint, including his failure to identify or describe the

individuals of whom he requested an inhaler and/or a policy, custom, or practice that

resulted in the failure to provide an inhaler.

CONCLUSION

Based on the foregoing analysis, after a review of Plaintiff’s complaint in

accordance with 28 U.S.C. § 1915, the Court orders that if Plaintiff wants to address some

or all of the deficiencies in his pleadings identified herein, Plaintiff shall file an amended

complaint on or before June 12, 2024. If Plaintiff fails to address the deficiencies and

allege an actionable claim against Defendant or any other party by June 12, 2024, I

recommend the Court dismiss the matter.

NOTICE

A party may file objections to those specified portions of a magistrate

judge’s report or proposed findings or recommended decisions entered

pursuant to 28 U.S.C. § 636(b)(1)(B) for which de novo review by the district

court is sought, together with a supporting memorandum, by June 12, 2024.

Failure to file a timely objection shall constitute a waiver of the right

to de novo review by the district court and to appeal the district court’s order.

/s/ John C. Nivison

U.S. Magistrate Judge

Dated this 15th day of May, 2024.