23-b-3 Common Types of Deliberate Indifference

• Library: A Jailhouse Lawyer's Manual (2020 Edition)

23-B-3. Common Types of Deliberate Indifference

Listed below are some common situations in which courts have found prison medical staff to be deliberately indifferent to prisoners' serious medical needs. They include:

(1) Ignoring obvious conditions;

(2) Failing to provide treatment for diagnosed conditions;

(3) Failing to investigate enough to make an informed judgment;

(4) Delaying treatment;

(5) Interfering with access to treatment;

(6) Making medical decisions based on non-medical factors; and

(7) Making a medical judgment so bad it falls below professional medical standards.

(a) Ignoring Obvious Conditions

One way to prove that prison officials were deliberately indifferent to your serious medical needs is to show that the problem was so obvious that they should have been aware of a serious and substantial risk to your health. Even if the prison official did not notice the risk (injury, disease, physical condition, etc.), the official can be held liable if the risk to the prisoner was very obvious. In Brice v. Virginia Beach Correction Center, the court found that a prison guard may have ignored a serious and substantial risk (and thus may have been deliberately indifferent) when a prisoner received no medical care after a fight, even though the prisoner's mouth was bleeding and he complained of horrible pain.³⁷ In Phelps v. Kapnolas, the court said that a prison official disregarded an obvious risk by putting a prisoner in solitary confinement with inadequate food when the official should have known such a small amount would cause pain and distress.³⁸

In Phillips v. Roane County, Tenn., the Sixth Circuit ruled that correctional officers at the Roane County Jail were responsible for the death of a female prisoner. Medical examiners testified that the prisoner died from untreated diabetes. According to the court, prison authorities were aware of her deteriorating condition during the two weeks before her death, as she complained of vomiting, chest pain, fatigue, nausea, and constipation. Their failure to take her to a hospital was considered deliberate indifference to her medical needs.³⁹

The risk to the prisoner must be very obvious because courts frequently find that the prison official is not responsible when he did not know enough about a prisoner's condition. In Reeves v. Collins, prison guards were not liable when they forced a prisoner to work, even after he had warned them that he had a previous back injury, was doubled over, and was complaining of excessive pain.⁴⁰ He was later taken to the infirmary and diagnosed with a double hernia. The court decided that the guards had not disregarded a substantial risk because even if the guards had checked the prisoner's medical records (which they did not), they would not have learned of the prisoner's history of hernias due to a mistake in the records.

In Sanderfer v. Nichols, the court found that a prison doctor was not responsible for her failure to treat a patient's hypertension after he died of a heart attack.⁴¹ Although the plaintiff's medical records included a history of hypertension, the doctor was not liable because the plaintiff complained only of bronchitis when he met with the doctor. The prisoner never told the doctor that hypertension was a problem for him, and his blood pressure later was checked on three occasions and was normal. This means that it is very important that you speak up and tell prison officials about your health problems.

If you are making an Eighth Amendment claim that prison officials were deliberately indifferent to your serious medical needs, you should tell the court all of the reasons your medical needs should have been obvious to prison officials.

(b) Failing to Provide Treatment for Diagnosed Conditions

The easiest way to establish prison officials' deliberate indifference to your medical needs is to prove that a prison doctor diagnosed you with a serious medical condition and prescribed treatment for you, but you never received that treatment. In Hudson v. McHugh, the prisoner was transferred from a halfway house to a county jail but was not given his medicine.⁴² After eleven days without it, despite repeated requests to the jail's medical personnel, he had a seizure. The Seventh Circuit held that this was the most obvious kind of case in which a prisoner could raise a claim: "[T]his is the prototypical case of deliberate indifference, an inmate with a potentially serious problem repeatedly requesting medical aid, receiving none, and then suffering a serious injury."⁴³ It is important to note that not only was the prisoner denied his medicine, but he also requested it several times before he became dangerously ill. If you are making an Eighth

Amendment claim that prison officials were deliberately indifferent to your serious medical needs, you should tell the court about your requests for medical treatment to show that officials knew of your needs.

(c) Failing to Investigate Enough to Make an Informed Judgment

If a court finds that prison officials never made an informed decision about your medical care, you may be able to establish an Eighth Amendment claim of deliberate indifference to your medical needs on this basis.⁴⁴ Prison officials may not have made an informed decision about your medical care if, in response to your complaints of a medical problem, they did not properly treat you,⁴⁵ did not investigate the cause of your medical condition,⁴⁶ did not order diagnostic tests,⁴⁷ did not send you to a specialist,⁴⁸ or did not consult your medical records before stopping medication.⁴⁹

(d) Delaying Treatment

You can also establish an Eighth Amendment claim of deliberate indifference to your serious medical needs by proving that (1) prison officials delayed your treatment, and (2) that delay caused serious consequences. Whether or not to delay treatment is sometimes an issue of professional opinion, but some delays are very serious and may prove deliberate indifference. If you suffered from a serious injury that prison officials knew about, but you had to wait a very long time before getting medical treatment, you may be able to bring a claim. Denial of or delay in access to medical personnel,⁵⁰ or in providing treatment,⁵¹ can be deliberate indifference. In determining whether or not a delay constitutes deliberate indifference, two factors are taken into account:

(1) the seriousness of the prisoner's medical need,⁵² and

(2) whether the delay was objectively serious enough to present an Eighth Amendment question.⁵³

Remember that prison officials may have had a valid reason for delaying your non-emergency medical treatment. For example, if no prison official who could properly take care of your non-emergency medical needs was on duty, delaying your treatment is probably justified.

Security concerns may also justify denying your request for a particular medical treatment. For instance, in Schmidt v. Odell, the court rejected the plaintiff's claim that failure to provide him with a wheelchair was a constitutional violation. The court found that having a wheelchair among the jail's population could pose a legitimate security risk. The court concluded that this was sufficient to show that the refusal to provide a wheelchair did not alone violate the Eighth Amendment.⁵⁴...