Calvin Rodrigue v. Morehouse Detention Center, et

Case: 12-31229 Document: 00512546041 Page: 1 Date Filed: 02/27/2014

IN THE UNITED STATES COURT OF APPEALS

FOR THE FIFTH CIRCUIT

No. 12-31229

United States Court of Appeals

Fifth Circuit

FILED

February 27, 2014

CALVIN RODRIGUE,

Lyle W. Cayce

Plaintiff - Appellee Clerk

v.

NURSE D. GRAYSON; LIEUTENANT BRAD FIFE,

Defendants – Appellants

Appeal from the United States District Court

for the Western District of Louisiana

USDC No. 3:09-CV-985

Before BENAVIDES, CLEMENT, and GRAVES, Circuit Judges.

PER CURIAM: *

Nurse Dana Grayson and Lieutenant Brad Fife appeal a district court’s

judgment in favor of Calvin Rodrigue in his civil rights action against them,

brought under 42 U.S.C. § 1983. After a bench trial, the district court held

that Grayson and Fife violated Rodrigue’s Eighth Amendment rights through

their deliberate indifference to his medical condition, which led to serious

injury when his ruptured appendix went untreated. The court held that

* Pursuant to 5TH CIR. R. 47.5, the court has determined that this opinion should not

be published and is not precedent except under the limited circumstances set forth in 5TH

CIR. R. 47.5.4.

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neither Grayson nor Fife was entitled to qualified immunity and awarded

Rodrigue general compensatory damages, court costs, and interest. We

AFFIRM.

FACTS AND PROCEEDINGS

The relevant facts occurred while Rodrigue was incarcerated in the

Morehouse Parish, Louisiana Detention Center (“Morehouse Detention

Center”). On May 31, 2008, Rodrigue filed a written request for emergency

medical services, complaining of abdominal pain. That evening, Nurse Dana

Grayson (a licensed practical nurse employed at Morehouse Detention Center)

provided him medicine to relieve his complaints of vomiting. The following

day, Rodrigue submitted a sick call request with similar complaints. Nurse

Grayson saw Rodrigue the next day. 1 She provided him with medication to

relieve his nausea and instructed him to return at the next sick call on June 4

if his symptoms persisted. He submitted another sick call request on June 3,

and saw Grayson on June 4. Because his written request specifically

mentioned constipation, Grayson gave Rodrigue milk of magnesia. On June 5,

Rodrigue submitted another sick call request to Grayson and a separate

inmate services request form to Lt. Brad Fife. 2 He stated in both requests that

his complaints persisted. In his inmate services request, he stated that he

believed the proper treatment to be an enema. On June 6, Grayson provided

him an enema, which resulted in a successful bowel movement within thirty

minutes.

1 Nurse Grayson was the only medical care provider employed by the Morehouse

Detention Center. She conducted regular sick calls three days a week and responded to

emergency requests as needed.

2 Lt. Fife was the security officer for the Morehouse Detention Center. As part of his

duties, Fife responded to requests for services such as Rodrigue’s June 5 inmate services

request. He had the authority to transfer inmates to a hospital for treatment.

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On June 10, without having made further sick calls or inmate services

requests since June 6, Rodrigue submitted a second emergency medical

services request. Nurse Grayson saw him that morning and authorized his

transport to E.A. Conway Medical Center. At the hospital, Rodrigue was

diagnosed with a ruptured or perforated appendix, which was removed that

day. Because sepsis had set in, Rodrigue underwent an extended recovery and

two additional surgeries before being released on August 6, 2008.

Rodrigue filed his civil rights complaint on June 15, 2009. In addition to

Grayson and Fife, he sued the Morehouse Detention Center, Warden Robert

Tappin, Assistant Warden Issaic Brown, Sergeant Clacks, an unnamed

insurance company, an unnamed physician, and the Sheriff of Morehouse

Parish. On June 24, 2009, and again on October 5, 2009, Rodrigue amended

his complaint, dismissing his claims against Morehouse Detention Center and

the unnamed doctor. Rodrigue filed his complaints pro se, and never asserted

claims other than the § 1983 claim based on violations of his Eighth

Amendment rights.

On September 8, 2010, the magistrate judge issued a Report and

Recommendation that defendants’ motion for summary judgment should be

granted. She based her conclusion on her finding that “plaintiff has failed to

introduce any evidence to establish that the named defendants were aware of

a serious risk of harm to the plaintiff, or that they subjectively intended that

any harm occur.” Although defendants raised qualified immunity as an

affirmative defense in their motion for summary judgment, the court felt that

“analysis of the qualified immunity defense [wa]s unnecessary” because it had

already “determined that the individual defendants did not violate plaintiffs’

constitutional rights.” After Rodrigue filed objections to the magistrate’s

report, the district judge dismissed his claims against the unnamed insurance

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company on December 20, 2010, but denied defendants’ motion for summary

judgment. The court found that Rodrigue raised genuine issues of material

fact as to whether the defendants were deliberately indifferent to his medical

needs. The district judge also rejected defendants’ qualified immunity

argument, stating that “[i]t is clearly established under Supreme Court

precedent both that Rodrigue had a federal right to medical care and that

Defendants could not be deliberately indifferent to that care.” He later

transferred the case to another district judge, who presided over the case

through trial in February 2012.

On September 28, 2012—about seven months after the bench trial—the

district court entered a Memorandum Ruling dismissing Rodrigue’s claims

against Morehouse Parish, Tubbs, Tapp, Brown, and Clacks, but holding Nurse

Grayson and Lt. Fife liable for violating Rodrigue’s Eighth Amendment right

to be free from cruel and unusual punishment.

As to Grayson, the court found that “despite persistent complaints of

extreme abdominal pain and bilious vomiting for over a week, a prisoner was

simply denied access to a medical professional competent to diagnose and treat

his condition,” and held “that this conduct rose to the level of a wanton

disregard for Rodrigue’s serious medical needs” in violation of the Eighth

Amendment. As to Fife, it held that he “exhibited deliberate indifference to

Rodrigue’s medical condition when he ignored Rodrigue’s inmate request of

June 5, 2008.” The court denied Grayson and Fife qualified immunity and held

them jointly and severally liable to Rodrigue in the amount of $280,000 in

general compensatory damages, $10,000 in court costs, and interest as allowed

by law. Grayson and Fife appeal.

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STANDARD OF REVIEW

“Following a bench trial, we review the district court’s conclusions of law

de novo and its factual findings for clear error.” DeMoss v. Crain, 636 F.3d 145,

149 (5th Cir. 2011). Clear error occurs “when, notwithstanding there is

evidence to support it, the reviewing court upon examination of the entire

evidence is left with the definite and firm conviction that a mistake has been

committed.” Justiss Oil Co. v. Kerr-McGee Ref. Corp., 75 F.3d 1057, 1062 (5th

Cir. 1996). “Where there are two permissible views of the evidence, the fact-

finder’s choice between them cannot be clearly erroneous.” Id.

We review the district court’s ruling on qualified immunity de novo. See

Terry v. Hubert, 609 F.3d 757, 761 (5th Cir. 2010) (“[W]e may review de novo

the materiality of disputed facts to the qualified immunity determination.”).

This inquiry includes the scope of clearly established law and the objective

reasonableness of the defendant’s conduct. Flores v. City of Palacios, 381 F.3d

391, 394 (5th Cir. 2004); Thompson v. Upshur Cnty., 245 F.3d 447, 456 (5th

Cir. 2001).

DISCUSSION

Grayson and Fife raise three issues on appeal. They argue that the

district court (1) abused its discretion by failing to apply numerous stipulations

entered into between the parties prior to trial; (2) erred in reaching its factual

conclusions; and (3) erred in holding that appellants were not entitled to

qualified immunity. We address each challenge in turn.

I. Parties’ Stipulations

As their first issue on appeal, Grayson and Fife argue that the district

court found deliberate indifference only by ignoring and “eviscerating”

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stipulations entered into between the parties before trial. Because

“[s]tipulations entered into between parties are to be disregarded only if

accepting them would be ‘manifestly unjust or if the evidence contrary to the

stipulation is substantial,’” Smith v. Blackburn, 785 F.3d 545, 549 (5th Cir.

1986), appellants contend that the district court abused its discretion by

reaching a conclusion they argue is foreclosed by the stipulations set forth in

the pre-trial order. We hold that the district court did not abuse its discretion

because it neither ignored nor eviscerated any of the facts to which the parties

stipulated.

The Eighth Amendment provides that “[e]xcessive bail shall not be

required, nor excessive fines imposed, nor cruel and unusual punishments

inflicted.” U.S. Const. amend. VIII. “A prison official violates the Eighth

Amendment’s prohibition against cruel and unusual punishment when his

conduct demonstrates deliberate indifference to a prisoner’s serious medical

needs, constituting an unnecessary and wanton infliction of pain.” Easter v.

Powell, 467 F.3d 459, 463 (5th Cir. 2006) (internal quotation marks and

citation omitted). Actions by state actors constitute deliberate indifference

towards a prisoner’s medical needs when they “refused to treat him, ignored

his complaints, intentionally treated him incorrectly, or engaged in any similar

conduct that would clearly evince a wanton disregard for any serious medical

needs.” Gobert v. Caldwell, 463 F.3d 339, 346 (5th Cir. 2006). But “an

inadvertent failure to provide adequate medical care” does not rise to the level

of “unnecessary and wanton infliction of pain” that is “repugnant to the

conscience of mankind.” Estelle v. Gamble, 429 U.S. 97, 105–06 (1976).

At issue are eighteen stipulations incorporated into a pre-trial order that

appellants argue foreclose a finding of deliberate indifference. Relevant to our

analysis are stipulations 8–15 and 18, which describe Rodrigue’s various

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requests for treatment to Grayson and Fife (including his description of

symptoms), Grayson’s treatment of Rodrigue, and one occasion when Fife

escorted Rodrigue to the infirmary during the relevant time period.

We hold that despite appellants’ assertions to the contrary, the district

court did not ignore the parties’ pre-trial stipulations. As demonstrated in its

opinion, the district court accepted the parties’ stipulations regarding the

progress of Rodrigue’s illness and treatment. It accepted that Grayson saw

and treated Rodrigue after each of his requests for medical attention, and did

not disregard the stipulation evidencing Fife’s escorting Rodrigue to the

infirmary.

The district court’s factual findings that appellants take issue with are

not inconsistent with the parties’ stipulations. For example, the finding that

Grayson was not credible when she testified that Rodrigue did not appear to

be sick does not contradict any stipulated fact describing the inmate’s requests

and her treatment. The district court found that from “the plain wording of

his emergency requests and sick calls, and from Dr. Sasaki’s [Rodrigue’s

expert] medical opinion of the seriousness, symptoms, and progression of

Rodrigue’s illness that Rodrigue complained of pain to LPN Grayson and that

he was obviously in serious pain from May 31, 2008 to June 10, 2008.”

Similarly, although the stipulations do not state that Rodrigue complained of

vomiting, abdominal pain, constipation, and anorexia, the district court was

within its right to find that, based on the testimony before it, Rodrigue did in

fact complain of these symptoms, albeit verbally, to Grayson.

We hold that the district court did not commit reversible error by

ignoring the parties’ pre-trial stipulations. A comparison of the facts found in

the district court’s opinion and what parties stipulated to before trial reveals

no error.

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II. District Court’s Factual Conclusions

Appellants argue that the district court committed manifest error in how

it weighed competing evidence. They argue:

The plaintiff and the defendants presented markedly different

evidence as to Rodrigue’s appearance, symptoms, complaints and

medical attention prior to his transfer to a hospital where he

underwent surgery for a perforated appendix. In reaching her

factual conclusions, the district judge generally accepted all of the

testimony presented by plaintiff and his witnesses, and rejected or

simply ignored not only the testimony of the defendants’ witnesses

but also the documentary evidence of Rodrigue’s treatment at the

Detention Center for his abdominal complaints.

Appellants’ Br. 1–2. As the above excerpt demonstrates, appellants merely ask

the court to second guess the district court’s factual findings. We hold that the

district court did not commit manifest error in reaching its factual conclusions.

Appellants take exception to the district court’s credibility

determinations as to Grayson, Fife, and defendants’ expert witness, Dr.

Demaree Inglese. The district court found Grayson lacked credibility based on

her inconsistent and “rehearsed” answers, as well as her lack of remorse. It

questioned Inglese’s impartiality based on the fact that he had worked at a

correctional facility. The court discredited Fife’s testimony because “Lt. Fife

testified shamelessly that he had no memory of receiving Rodrigue’s inmate

request and that he received ‘100’s’ of these requests daily, a figure he later

modified to twenty-five or thirty.”

We hold that appellants fail to demonstrate clear error in the district

court’s conclusions. That a reasonable trier of fact could have weighed the

evidence differently is not enough for an appellate court to overturn a district

court’s findings. See Justiss, 75 F.3d at 1062 (“Where there are two permissible

views of the evidence, the fact-finder’s choice between them cannot be clearly

erroneous.”). Consistent with the great deference given to trial courts’ fact-

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finding, we hold that the district court did not commit manifest error in

reaching its factual conclusions. See Strauch v. Gates Rubber Co., 879 F.2d

1282, 1285 (5th Cir. 1989) (“An appellate Court is in no position to weigh

conflicting evidence and inferences or to determine the credibility of witnesses;

that function is within the province of the finder of fact.”).

Because the district court did not impermissibly ignore or disregard the

parties’ pre-trial stipulations or commit reversible error in reaching its factual

conclusions, we affirm the district court’s holding that appellants violated

Rodrigue’s rights under the Eighth Amendment.

III. Qualified Immunity

Appellants challenge the district court’s denial of qualified immunity.

Based on the district court’s factual findings that Grayson and Fife knew of

Rodrigue’s serious medical condition but ignored his requests for medical

attention despite this knowledge, we hold that appellants are not entitled to

qualified immunity. Although case law protects medical providers for

misdiagnoses and for treatments that can only be shown to have been deficient

through hindsight, the district court explicitly found that both appellants had

subjective knowledge that Rodrigue’s medical condition carried significant

risks of serious injury. Accepting these facts, no reasonable person would have

thought it constitutionally permissible to deny him the medical care he

required.

A. Legal Standard

State actors sued in their individual capacity under § 1983 are entitled

to qualified immunity “insofar as their conduct does not violate clearly

established statutory or constitutional rights of which a reasonable person

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would have known.” Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982). “Qualified

immunity gives government officials breathing room to make reasonable but

mistaken judgments about open legal questions.” Ashcroft v. al-Kidd, 131 S.

Ct. 2074, 2085 (2011). “When properly applied, it protects all but the plainly

incompetent or those who knowingly violate the law.” Id. (internal quotations

marks omitted). After the individual defendants invoked qualified immunity,

the burden shifted to Rodrigue to demonstrate the inapplicability of the

defense. Crostley v. Lamar Cnty., 717 F.3d 410, 422 (5th Cir. 2013). We apply

a two-pronged test in evaluating the applicability of the defense. The plaintiff

“[f]irst . . . must claim that the defendants committed a constitutional violation

under current law. Second, he must claim that the defendants’ actions were

objectively unreasonable in light of the law that was clearly established at the

time of the actions complained of.” Id.

Because we affirm the district court’s holding that defendants committed

a constitutional violation, see supra Sections I-II, we turn to the second prong

of the qualified immunity test—whether the rights allegedly violated were

clearly established at the time Grayson and Fife acted.

B. Clearly Established

When applying the second prong of the qualified immunity test, we

examine whether the right’s “contours . . . are sufficiently clear that every

reasonable official would have understood that what he is doing violates that

right.” al-Kidd, 131 S. Ct. at 2083 (internal alterations and quotation marks

omitted). “To answer that question in the affirmative, we must be able to point

to controlling authority—or a robust consensus of persuasive authority—that

defines the contours of the right in question with a high degree of

particularity.” Morgan v. Swanson, 659 F.3d 359, 371–72 (5th Cir. 2011) (en

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banc) (internal quotation marks and footnote omitted). While “[w]e do not

require a case directly on point . . . existing precedent must have placed the

statutory or constitutional question beyond debate.” al-Kidd, 131 S. Ct. at

2083. But “officials can still be on notice that their conduct violates established

law even in novel factual circumstances. . . . [T]he salient question . . . is

whether the state of the law . . . gave respondents fair warning that their

alleged treatment . . . was unconstitutional.” Hope v. Pelzer, 536 U.S. 730, 741

(2002); see also Austin v. Johnson, 328 F.3d 204, 210 (5th Cir. 2003) (“[O]fficers

need only have ‘fair warning’ that their conduct is unlawful.”).

Appellants contend that the district court erred in denying them

qualified immunity because the judge conducted her inquiry into clearly

established law “at too general a level.” They argue that “no reported opinion

of this or any other federal circuit court . . . has ever equated similar acts or

omissions to deliberate indifference.” Indeed, numerous authorities support

the contrary proposition: “It is indisputable that an incorrect diagnosis by

prison medical personnel does not suffice to state a claim for deliberate

indifference.” Domino v. Tex. Dep’t of Crim. Justice, 239 F.3d 752, 756 (5th

Cir. 2001); see also Estelle, 429 U.S. at 105–06 (“in the medical context, an

inadvertent failure to provide adequate medical care cannot be said to

constitute ‘an unnecessary and wanton infliction of pain’ or to be ‘repugnant to

the conscience of mankind’”).

We hold that Rodrigue’s rights were clearly established. The district

court’s factual findings distinguish this case from others that held that a mere

misdiagnosis does not rise to the level of deliberate indifference. As the district

court explained in distinguishing Domino, Grayson and Fife knew of a serious

medical condition and simply ignored it: “The prisoner [in Domino] had been

treated for all of his complaints until he chose to discontinue the

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treatment. . . . In the instant case, the continuous and intense nature of

Rodrigue’s complaints of vomiting and abdominal pain were simply ignored by

LPN Grayson.”

Officials can be on notice that their conduct violates a constitutional

right even in “novel factual circumstances.” See Hope, 536 U.S. at 741. Here,

Grayson and Fife knew of a prisoner’s serious medical needs yet ignored his

requests for treatment. The district court’s factual findings—that appellants

had subjective knowledge of Rodrigue’s dire condition—remove this case from

the realm of negligence or gross negligence, and render inapposite cases

dealing with honest but inadequate medical care. Any reasonable person in

appellants’ position would have known that ignoring Rodrigue’s complaints in

light of his medical situation would be a violation of his rights under the Eighth

Amendment. See Gobert, 463 F.3d at 346 (deliberate indifference when state

actors “refused to treat [prisoner], ignored his complaints, intentionally treated

him incorrectly, or engaged in any similar conduct that would clearly evince a

wanton disregard for any serious medical needs”).

We affirm the district court’s holding that appellants were not entitled

to qualified immunity.

CONCLUSION

For the foregoing reasons, we AFFIRM the district court’s judgment in

its entirety.

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