# Petition for Writ of Certiorari — Edwards v. United States

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## Record

- **Collection:** Supreme Court brief
- **Document type:** Petition for Writ of Certiorari
- **Published:** January 1, 1976
- **Citation:** 425 U.S. 972

## Text

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Stereme court: & B ite s::

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IN THE MICHAEL RODAK, JR.,

Supreme Court of the Anited States

JANUARY TERM, 1976

no. 25-1183

PAUL C. EDWARDS,

Petitioner,
v.

THE UNITED STATES OF AMERICA,
Respondent.

PETITION FOR A WRIT OF CERTIORARI
TO THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT

JACK B. SELLERS
300 East Lee Street
Sapulpa, Oklahoma 74066

JOE A. MOORE
4402 Tuckahoe Road
Memphis, Tennessee 38117

Attorneys for Petitioner

ee

Washingron, D.C. © CLE PUBLISHERS © LAW PRINTING CO. © (202) 383-0825

IN THE

Supreme Court of the Gnited States

JANUARY TERM, 1976
NO.

PAUL C. EDWARDS,
Petitioner,

THE UNITED STATES OF AMERICA,
Respondent.

PETITION FOR A WRIT OF CERTIORARI
TO THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT

Petitioner prays that a writ of certiorari issue to
review the judgment of the United States Court of
Appeals for the Fifth Circuit entered in the appeal of
the petitioner on September 17, 1975.

CITATIONS TO OPINIONS BELOW

The opinion of the Court of Appeals is not yet
officially reported, and is attached hereto as Appendix

2
A, with the judgment of that court attached as

Appendix B and the Order denying petition for
rehearing as Appendix C.

JURISDICTION

The judgment of the Court of Appeals was entered
on September 17, 1975. A petition for rehearing was
denied on January 20, 1976. The jurisdiction of this
Court is invoked under 28 U.S.C., Sec. 1254(1).

QUESTION PRESENTED

Whether a prisoner of the United States, confined in
a federal correctional institution, who suffers from
serious physical infirmity, is to be afforded medical care
and treatment commensurate with a national standard
of care, or, as held by the courts below, the standard of
care is to be afforded only in accordance with the local

standards of the geographical location of the particular
correctional institution.

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STATUTORY PROVISIONS INVOLVED

18 U.S.C.A., Sec. 4042 provides:
“4042. Duties of Bureau of Prisons

The Bureau of Prisons, under the direction of
the Attorney General, shall—

“(1) Have charge of the management and regula-

tion of all Federal penal and correctional institu-
tions,

3

(2) provide suitable quarters and provide for the
safekeeping, care, and subsistence of all persons
charged with or convicted of offenses against the
United States, or held as witnesses or otherwise,

(3) provide for the protection, instruction, and
discipline of all persons charged with or convicted
of offenses against the United States,

(4) provide technical assistance to State and local
government in the improvement of their correc-
tional systems.

This section shall not apply to military or naval
penal or correctional institutions or the persons
confined therein.”

28 U.S.C., Sec. 1345(b) provides:

“Subject to the provisions of chapter 171 of this
title, the district courts, together with the United
States District Court for the District of the Canal
Zone and the District Court of the Virgin Islands,
shall have exclusive jurisdiction of civil actions on
claims against the United States, for money
damages, accruing on and after January 1, 1945,
for injury or death caused by the negligent or
wrongful act or omission of any employee of the
Government while acting within the scope of his
office or employment, under circumstances where
the United States, if a private person, would be
liable to the claimant in accordance with the law
of the place where the act or omission occurred.”

28 U.S.C., Sec. 2674 provides; in applicable part:

“The United States shall be liable, respecting the
provisions of this title relating to tort claims, in
the same manner and to the same extent as a
private individual under like circumstances, but
shall not be liable for interest prior to judgment or
for punitive damages...”

Sit el?

Baise ei isan

> The first doctor to treat Edwards at F.C.I. was graduated by
Columbia University with an A.B. degree in 1961 and by the
State Univeristy in New York, Downstate Medical Center College
of Medicine, in Brooklyn, New York in 1965. The Public Health
Service assigned him to F.C.I. after completion of his internship
at the University of Pittsburgh Health Center Hospitals. His
successor was graduated with a B.S. degree from the University
of Texas in 1962 and the St. Louis Medical School in 1967. He
was assigned to F.C.I. after his internship at Methodist Hospital
in Houston, Texas. Both are now board certified internists.

F
3
#
‘
‘—

* Edwards also presses the contention that the failure to take
his blood presssure for six months prior to his stroke constituted
negligence on the part of the Chief Medical Officer. The record,
however, suggests no causal connection between this omission

fcomtuuted

Sa

We pass the question of the causal connection
between these alleged failures and the stroke. The most
salient defect in Edwards’ case was the failure to
establish by expert testimony that any of these acts
amounted to negligence. Dr. Liebendorfer, Edwards’
only expert witness, did not express the opinion that
Edwards had received improper medical care, nor did he
testify as to a standard of care, a predicate on which
the court might have based a finding of negligence.

Dr. Liebendorfer testified that many prominent
specialists believed that frequent injections of varying
doses, correlated to urine sugar levels, was preferable to
the single daily dose administered at F.C.I. He offered
this, as the district court pointed out, not as a standard
of medical care but as a working medical hypothesis.
He conceded that there were other medically acceptable
approaches. He did not criticize the decision to reduce
the insulin Edwards received, nor did he indicate how
the level of insulin administered should be determined.
He did not indicate that the readings turned up by
Edwards’ urine tests should have alerted the doctors
that his diabetes was not in control.S In fact, he did

(footnote continucd from proceeding page)

and Edwards’ stroke, which the experts agreed had all the
appearances of a thrombosis. Tests administered after the stroke
revealed no evidence of a hemorrhage. Similarly, there is nothing
to suggest that the refusal to permit him to take certain
medications prescribed by Dr. Liebendorfer was a cause of the
stroke.

STests run after meals often registered high readings. Early
morning tests were always negative or showed only a trace of
sugar. A government expert, Dr. Jack C. Smith, testified that
higher urine sugar readings after meals were normal and to be
expected. Dr. Liebendorfer said nothing to contradict this

statement.
(continued)

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not indicate why he though the diabetes had not been
in control. He did not testify that a diabetic, exercising
judgement and restraint, could not obtain a generally
adequate diet in the prison cafeteria, although after an
examination of typical ten-day menu, he concluded it
“might be spotty”. He conceded he had no first hand
knowledge of the food served there. He also expressed
some doubt about the average diabetic inmate's ability
to avoid some of the items offered that are proscribed
for diabetics. He did testify that he believed Edwards
should have seen a consulting specialist in’ internal
medicine once a month. He conceded at the same time
that) general practitioners regularly — treated
patients without the aid of specialists.

Dr. Jack Smith testified for the United States. Dr.
Smith is a diplomate of the American Board of Internal
Medicine, and internist in a nineteen-doctor clinic in
Texarkana, and a member of the faculty of the
Louisiana State Univeristy School of Medicine, Shreve-
port, Louisiana. He testified that the

similar

food served at
F.C.1. was comparable to a commercial cafeteria; that

footnote contintiicd WOM Proceeding Page)

Dr. Liebendorfer, in response to questions put to him by the
court, did testify that it was recommended that blood sugar tests
be run about once every two months in the case of a patient
whose diabetes is not easily controlled. He did not indicate a
conviction that Edwards’ blood should have been checked that
often. Indeed, he testified that in Edwards’ case, there was a very
high correlation between blood sugars and urine sugars. One of

the F.C.I. doctors cited this correlation as one of the reasons for
taking fewer blood tests.

°Examining the whole menu, Dr. Liebendorfer pointed to two
meals that he said were inadequate for a diabetic. Dr. Smith,
examining the same menu, found one breakfast inadequate
because it failed to offer an adequate “fruit exchange”.

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the exchange method of diet control was available to
appellant nine out of ten days on the ten-day menu
sample; that all the elements of a proper diabetic dict
were there; that Edwards, following instructions, could
have eaten food at F.C.1. consistent with a diabetic diet
except on one day when he could not get an adequate
fruit exchange. He said that the treatment of Edwards
at F.C.I. was consistent with the standard of treatment
in the community: that [the] decision to reduce
Edwards’ insulin from 50 units to 35 units and three
months later to 40 units was medically acceptable. Dr.
Smith summarized his testimony as follows:
“On a sceale of ideal, fair. satisfactory and
unsatisfactory, | would classify Mr. Edwards as
fair. His control was fair. He was free of
symptoms. His blood sugar was low enough that
his 6:00 a.m. sugars were usually trace[d] to
negative. His sugars taken after meals usually
showed the presence of a large amount of sugar,
which is more or less to be expected. ... There’s a
physiological reason for trying to keep patients on
35 to 40 units of insulin. The normal human body
makes 40 units of insulin a day. This is
physiologic. ...1 think [his F.C.I. doctors’] assess-
ment and his medication was proper, so that’s
about all I have. I think that sums it up.”

Dr. Liebendorfer went so far as to say that he
believed the F.C.I. physicians had committed a mistake
in judgment. This alone is not enough to establish
liability. Hart vy. Van Zandt; Bowles y. Bourdon. Expert
testimony must establish a professional standard of care
and a deviation from that standard. On this record we
need not consider the Edwards’ contention that the
district court read Texas law too narrowly in holding
that the plaintiff had the burden of showing a deviation
from the /ocal standard of care: that the “community”

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involved is the federal penal system and the standards
of care to be adhered to must be measured against
those of the national community. We find nothing in
Dr. Liebendorfer’s testimony or in the testimony of the
government’s experts to establish a deviation from any
professional standard of care.

The judgment of the district court is affirmed.

JOHN R. BROWN, Chief Judge (dissenting):

While the opinion of this Court cannot cure the
grievous physical infirmities of the plaintiff, I regret
that we do not take this opportunity to remedy the
troika of legal infirmities suffered by the trial court’s
opinion.

Infirmity No. |

The Necrosis Of The Locality Rule
In Texas

The trial court apparently attempted to resurrect the
dying doctrine that a doctor’s negligence must be
established by the testimony of a doctor familiar with
the community of treatment standards of medical
practice.' I believe that such strict adherence by the

'The memorandum opinion of the trial court entered April
22, 1974 provides in pertinent part:

“Dr. Liebendorfer twice stated that he had never been
in Texarkana, Texas, that he had no idea what the medical
standards of that community were; and that he knew no
docotors [sic] who practived [sic] in Texarkana * * * In
addition, the United States called two medical experts who
were familiar with medical practices in the Texarkana
community. Both stated that there was nothing about Dr.
Hotchkiss’ treatment of the plaintiff that they considered

inadequate by community medical standards.
(continucd)

HIME. seen

9a

trial court to what has been termed the Locality Rule
cannot be squared with developing Texas precedent? as
well as that of other jurisdictions.* Surely modern
(footnote continued trom proceeding pari

The court has considered the plaintiffs arguments that the
requirement of expert testimony relating to local medical
standards is archaic and arbitrary, and that it should not preclude
the plaintiff's recovery in a case such as this one, in which the
record contains some evidence of mistreatment and neglect.
While this court regards the plaintiffs contentions to be forceful
and persuasive, nevertheless it cannot justify a departure from
the principles of Texas law regarding medical malpractice.
See Appendix at 38-39.

? See generally, Perdue, The Law of Texas Medical Malprac-
tice, 11 Houst.L.Rev. 1, 36-38 (1973).

*Several other jurisdictions have abandoned the Locality Rule
and adopted a rule whereby the standard of care required of a
doctor is that of an average practitioner under the same or
similar circumstances and the locality in which the practices is
merely a factor to be considered in determining proper care and
skill under the circumstances. See, e.g., Brune y. Belinkoff, 1968,
354 Mass. 102, 235 N.E.2d 793, 798: Fernandez y. Baruch,
1967, 96 N.J.Super. 125, 232 A.2d 661. at 666: Douglas yv.
Bussabarger, 1968, 73 Wash.2d 476, 438 P.2d 829, 837-38. See
also Pederson v. Dumouchel, 1967, 72 Wash.2d 73. 431 P.2d 973
(held reversible error to limit the standard of care solely to that
of the same or similar community); Hundley v. Martinez, 1967,
IST W.Va. 977, 158 S.E.2d 159 (Court allowed a New York
specialist to testify as to standard of care in a suit tried in West
Virginia against a physician with the same special training): Blair
v. Eblen, Ky., 1970, 461 S.W.2d 370 (where the Court called for
the adoption of a national standard of care). See generally Waltz,
The Rise and Gradual Fall of the Locality Rule in Medical
Malpractice Litigation, 18 DePaul L.Rev. 408, 418 (1969); Note,
Locality Rule in Malpractice Suits, 5 Calif W.L.Rev. 124. 128-31
(1969); Note, Malpractice and Medical Testimony, 77
Harv.L.Rev. 333, 338 (1963); Note. An Evaluation of Changes in
the Medical Standard of Care, 23 Vand.LRev. 729, 737-38
(1970).

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medical technology, standardized medical education and
practice and modern communication facilities dictate
the abandonment of a rule which was_ initially
developed to vary the standards of care according to
the expertise and training of practitioners in cities as
opposed to those in the rural setting.4

In Texas it was long ago established that a doctor
need not live and work in a community to qualify as an
expert witness’ and in Hart v. Van Zandt, Tex., 1965,
399 §.W.2d 791, a neurosurgeon practicing in Pennsyl-
vania was deemed to be a member of the same school
of practice as a Texas physician and accordingly was
allowed to testify as to the standard of care which the
latter should have exercised in the treatment of a
patient in Texas.

Particularly with a disease such as diabetes where
doctors uniformly agree, as they did in the trial court,®
that the treatment is a combination of insulin injections
and dietary control a doctor experienced in the
treatment of this disease would be qualified to testify
as to the standard of care to be exercised by physicians
treating the disease and in the Eyes of Texas the
locality of the witnesses’ own practice or localizing the
standard to the community of treatment would not be
decisive.

4See Perdue, The Law of Texas Medical Malpractice, supra at
36.

STurner v. Stoker, Tex.Civ.App., 1926, writ ref'd, 289 S.W.
190, 194.

©The District Court recognized in its memorandum opinion
that all the doctors who testified believed that dietary control
was an integral part of the treatment of diabetes. See App. at 34.

lla

Infirmity No. 2
The Burden Of Proof Is Overweight

Another pointed inadequacy of the trial court's
opinion’ and that of the majority of this Court® is that
the plaintiff was required to show by expert testimony
that the prison doctors were negligent.

Substantial Texas authority® supports the proposition
that what constitutes negligence is a mixed question of
law and fact and the resolution of this ultimate issue is
within the exclusive province of the trier of fact.

’The trial court states in its memorandum opinion that:

It is further required that the opinion evidence offered by

the plaintiff be to the effect that the physician whose
conduct is the subject of inquiry was negligent according to

the standards of the community in which he was
practicing. Cleveland v. Edwards, 494 S.W.2d 578
(Tex.Civ.App.—Houston [14th Dist.] 1973).

See App. at 37.
The Court further aborated its belief that the expert witness
must state that the doctor’s conduct was negligent by saying:

Although Dr. Liebendorfer testified that he would have
procured the services of a dietician had he been the
medical authority at FCI, he did not give the opinion that
the failure to do so was negligent or inadequate according
to medical standards. (Emphasis added).

Id.

*This Court siates unequivocally:
The most salient defect in Edwards’ case was the failure to
establish by expert testimony that any of these acts
amounted to negligence.

P. 7843.

The leading case is Snow v. Bond, Tex., 1969, 438 $.W.2d
549, 550-51 which states in pertinent part:

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Accordingly, it is quite improper to require the plaintiff
to bear the extraordinary burden of bringing forward
expert testimony stated in conclusory terms of
negligence or its equivalent to establish negligence (or
proximate cause).'°

This basic error then leads the Court to conclude
that there is no evidence of “negligence”.'’ Of course

footnote continucd from proceeding page)

“What constitutes negligence or malpractice is a mixed
question of law and fact that can only be determined by
the trier of fact on the basis of evidence admitted and
instructions given by the court. A medical expert is not
competent to express and opinion thereon. See Houston &
T.C.R. Co. v. Roberts, 101 Tex. 418, 108 S.W. 808. The
question of what a reasonable and prudent doctor would
have done under the same or similar circumstances must
also be determined by the trier of fact after being advised
concerning the medical standards of practice and treatment
in the particular case. An expert witness can and should
give information about these standards without summar-
izing, qualifying or embellishing his evidence with expres-
sions of opinion as to the conduct that might be expected
of a hypothetical doctor similarly situated. The latter is not
an appropriate subject for expert testimony. See Phoenix
Assur. Co. of London vy. Stobaugh, 127 Tex. 308, 94
S.W.2d 428.”

See also Sanchez v. Wade, Tex.Civ.App.—El Paso, no writ, 1974,
514 SW.2d 812, 815; Prestegord v. Glenn, Tex. Civ.App.—Ama-
rillo, 1970, 451 S.W.2d 791, reversed on other grounds, Tex.,
456 S.W.2d 901: cf Bender v. Dingwerth, 5 Cir., 1970, 425 F.2d
378, 385.

The Texas Supreme Court had held that while expert
testimony as to the “possibility” of medical negligence or
causation is not determinative of negligence, it is admissible and
probative of the issue. Bowles v. Bourdon, 1949, 148 Tex. 1,
219 SW.2d 779; see also Musselwhite, Medical Causation
Testimony in Texas: Possibility v. Probability, 23 Sw.L.J. 622,
624.

''p 7845.

13a

while it is true that the plaintiff's expert never in so
many words testified that the prison doctor’s conduct
was negligent or violated a standard of care, but in the
Eyes of Texas the weight to be given medical testimony
should be determined by the substance of the
testimony of the expert witness and does not turn on
Semantics or On the use by the witness of any particular
conclusory term or phrase.'? Upon a close examination
of the substance of Dr. Liebendorfer’s'? testimony, it is
evident that the prison doctors were to some degree
negligent'* and that their negligence was a contributing

'2 surance Company of North America v. Mvers, Tex., 1966,
411 S.W.2d 710.

'SDr. Liebendorfer not only fills the shoes of an expert
witness, but also has additional knowledge of the plaintiff's
individual physical problems because he successfully treated him
for a number of years before he was incarcerated.

The plaintiff's expert witness, Dr. Liebendorfer, made
several statements which indicated that the prison doctors
negligently treated plaintiff's diabetic condition. See, e.g., R.Vol.
II at 74 (that the combination of diet, insulin injections and the
administering of other drugs to control the other maladies of the
plaintiff had resulted in successful treatment prior to his
incarceration); R.Vol. II] at 91 (prison officials should have
provided a special diet for inmates with need for dietary
control); R.Vol. III] at 99 (the prison doctors should have
checked plaintiff's blood pressure more often); R.Vol. III at 86,
126 (prison doctors should have kept plaintiff on a controlled
regimen of insulin dosages and dietary control and the failure to
do so in the witnesses estimation was a contributing factor to the
plaintiff's stroke).

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14a

cause'S of the plaintiff’s stroke.

Thus, the majority’s broad statement that the
plaintiff failed to establish a deviation from any
professional standard of care'® is both overstatement
and approval of a fact-legal conclusion under the
overpowering influence of an incorrect legal standard. It
provides an inadequate basis for the majority’s out of
hand rejection of the plaintiffs case.

Infirmity No. 3

This Is Not Malpractice But A
Gaoler’s Case

Probably the most fundamental malady suffered by
the trial court’s opinion is that it treated this case as if
it were a malpractice suit rather than judging the
propriety of the plaintiff's claim in light of the duty
imposed by statute upon the Bureau of Prisons under
the direction of the Attorney General of the United
States to exercise ordinary care'’ to provide for the

'SThere is also ample expert medical testimony of causation.
See, e.g., R.Vol. Il at 68-69 (causal connection between diabetes
and circulatory ailments and more particularly stroke); R.Vol. III
at 86 (failure to control plaintiffs insulin dosages and diet was a
contributing cause of the stroke); R.Vol. III at 126 (expert states
that if plaintiff had been kept on the controlled regimen, as to
diet and drug dosages, which he lived under prior to his
incarceration he probably would not have had his stroke).

16p_ 7845.

"Bourgeois v. United States, N.D.Tex.. 1974, 375 F.Supp.
133; Brown v. United States, E.D. Ark., 1972, 342 F Supp. 987;
Cohen v. United States, N.D.Ga., 252 F.Supp. 679, reversed on
other grounds, 5 Cir., 389 F.2d 689.

15a

health and welfare of federal prisoners.'®

In the case at hand the parties stipulated that the
government had notice of the plaintiff's physical
infirmities’? before he was incarcerated. Nevertheless,
the prison officials following routine practice confis-
cated from the plaintiff upon his arrival at the prison
all of the medications which he took to aid him in
coping with his various physical problems except for his
nitroglycerin.*°’ The doctors in this case agree that

818 U.S.C.A. § 4042 requires:
§ 4042. Duties of Bureau of Prisons

The Bureau of Prisons, under the direction of the
Attorney General, shall—

(1) have charge of the management and regulation of
all Federal penal and correctional institutions:

(2) provide suitable quarters and provide for the
safekeeping, care, and subsistence of all persons charged
with or convicted of offenses against the United States,
or held as witnesses or otherwise;

(3) provide for the protection, instruction, and
discipline of all persons charged with or convicted of
offenses against the United States;

(4) provide technical assistance to State and local
government in the improvement of their correctional
systems.

This section shall not apply to military or naval penal or
correctional institutions or the persons confined therein.

"See R.Vol. I at 65. See also letters set out in the appendix
at 417-24.

See R.Vol. I at 66. At the time of his incarceration the
plaintiff was taking marplan, a drug which was used in
conjunction with nitroglycerin to treat his heart condition.
R.Vol. Ill at 74. In addition, he was taking a drug called
Rauwiloid for his high blood pressure as well as Librium and
Phenobarbital which were relaxants. /d. Dr. Liebendorfer testified
that these drugs were necessary for the continued maintenance of
plaintiff's health. See R.Vol. Il at 100-01.

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proper treatment of diabetes includes both dietary
control and insulin injections. Yet, the testimony of Dr.
Liebendorfer and Dr. Cyprus indicates that the prison
diet was inadequate for a diabetic’s needs?' and Dr.
Hotchkiss stated that the plaintiff had a hard time
adhering to a proper dietary regimen.?? Nevertheless,
prison doctors refused to recommend the establishment
of a special cafeteria line for diabetics.?* While I
recognize that proper dietary control may allow a
physician to reduce insulin dosages, it seems inappro-
priate for Dr. Hotchkiss to reduce the plaintiff's dosage
from 50 units to 35 units per day** in view of the
prison’s recalcitrance in providing dietary control.

We would not hesitate to impose liability upon the
government if a prisoner sustained injury because he
was required to live in conditions not fit for human
habitation and in the same way we should not allow
the federal prison system to force a prisoner to live
under conditions which are repugnant to his individual
physical needs. Similarly, it has been held in this
Circuit?* ‘that state prisons have the duty to provide

21For medical testimony to the effect that the prison diet was
inadequate for a diabetic, see R.Vol. III at 86, 91, 99, 126, 301.

22R'Vol. II at 96.
22 Vol. I at 98.
24R Vol. II at 29-30.

See, e.g., Newman v. Alabama, 5 Cir., 1974, 503 F.2d 1320
(pending en banc on Eleventh Amendment issue) (class action by
inmates in state prison challenging the uniform practices of
neglectful medical treatment by prison officials); Gates v. Collier,
5 Cir., 1974, 501 F.2d 1291 (pending en banc on Eleventh
Amendment issue) (conditions which deprived inmates of basic
elements of hygiene and adequate medical treatment held
constitutionally impermissible).

17a

adequate medical care and failure to do SO gives rise to
a cause of action with due process underpinnings under
42 US.C.A. § 1983. I believe that the liability of
federal prisons should be judged by the same standards
under the Federal Tort Claims Act.2°—

In Logue yv. United States, 1973, 412 US. 521.
532-33, 93 S.Ct. 2215, 2222. 37 L.Ed.2d 121, 131. the
Supreme Court clearly recognized that liability under
the Federal Tort Claims Act could arise if a federal
official knew or should have known of a prisoner’s
infirmity and yet failed to take action to prevent injury
to the prisoner. Upon the same rationale, the prison
officials could be held to have violated their duty of
safe keeping by failing to adequately attend to the
plaintiff's medical needs after having been apprised of
his various physical infirmities.

One could argue that liability under the Tort Claims
Act is improper in the prison setting because the Act is
designed to impose liability on the government as if it
were a private individual and individuals do not operate
prisons. But to those doubting souls | must once against
stress, as I did in my dissenting opinion in Logue y.
United States, 5 Cir., 1972. 463 F.2d 1340, 1341-42,
vacated and remanded, 1973, 412 US. 521, 93 S.Ct.
2215, 37 L.Ed.2d 121 (on petition for rehearing en
banc), that “[o]nce the Government undertakes
performance of an act entailing a duty of ordinary care
it may not thereafter avoid liability under the Federal
Tort Claims Act simply by abandoning the undertaking
and attempting to attribute the responsibility to
someone else.” /ndian Towing C ompany yv. United
States, 1955, 350 U.S. 61. 69. 76 S.Ct. 122, 126, 100

Particularly, 18 U.S.C.A. § 4042.

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L.Ed. 48, 56; United States v. Gavagan, 5 Cir., 1960,
280 F.2d 319, cert. denied, 1961, 364 U.S. 933, 81
S.Ct. 379, 5 L.Ed.2d 365.

Another reason why it is absurd to measure the duty
of the Federal Government to provide medical care to
prisoners by standards of medical malpractice is that
the degree of care which the government must exercise
varies according to the locality of the prison. Indeed, a
uniform standard would be more appropriate for prison
physicians whose only nexus with the medical standards
of the locality is that the prison to which they are
assigned happens to be geographically situated there.

For any one or all of these three reasons the action
of the trial court ought not to be accepted and this
Court ought to declare these principals and remand the
case for a consideration of the facts in light of the
correct legal standards rather than artificially charac-
terizing this case as a malpractice suit between a private
citizen and a freely selected physician.

lb
APPENDIX B

UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT

October Term, 1974
No. 74-2922

D.C. Docket No. CA 1943
PAUL C. EDWARDS,
Plaintiff-Appellant,
versus
UNITED STATES OF AMERICA,
Defendant-Appellee.

Appeal from the United States District Court for the
Eastern District of Texas

Before BROWN, Chief Judge, and WISDOM and
COLEMAN, Circuit Judges.

JUDGMENT

This cause came on to be heard on the transcript of
the record from the United States District Court for the
Eastern District of Texas, and was argued by counsel:

ON CONSIDERATION WHEREOF, It is now here
ordered and adjudged by this Court that the judgment
of the said District Court in this cause be. and the same
is hereby, affirmed;

2b

It is further ordered that plaintiff-appellant pay to
defendant-appellee, the costs on appeal to be taxed by
the Clerk of this Court.

September 17, 1975
JOHN R. BROWN, Chief Judge, dissenting.

Issued as Mandate:

Ic

APPENDIX C

IN THE UNITED STATES COURT
OF APPEALS

FOR THE FIFTH CIRCUIT
No. 74-2922

PAUL C. EDWARDS,
versus

UNITED STATES OF AMERICA,

Appeal from the United States District
Court for the Eastern District of Texas

ON PETITION FOR REHEARING
(JANUARY 20, 1976)

Before BROWN, Chief Judge, WISDOM and COLE-
MAN, Circuit Judges.

PER CURIAM:
IT IS ORDERED that the petition for rehearing filed
in the above entitled and numbered cause be and the

same is hereby denied.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385609_0009%3A1. Public record. Not legal advice.
