United States District Court, D. Connecticut
INITIAL REVIEW ORDER
C. HALL UNITED STATES DISTRICT JUDGE
plaintiff, Victor Sanchez (“Sanchez”),
incarcerated at the MacDougall-Walker Correctional
Institution in Suffield, Connecticut, has filed a pro
se Complaint (“Compl.”) (Doc. No. 1) under
section 1983 of title 42 of the United States Code. Sanchez
sought leave to proceed in forma pauperis. See
generally Motion for Leave to Proceed in Forma Pauperis
(Doc. No. 2). On September 14, 2018, the court granted
Sanchez's application. See generally Order (Doc.
Complaint names two defendants: RN Debbie and RN Angela.
Sanchez contends that the defendants were deliberately
indifferent to his serious medical needs in violation of the
Eighth Amendment. See Compl. at 7, ¶ 23.
section 1915A of title 28 of the United States Code, the
court must review prisoner civil complaints and dismiss any
portion of a complaint that is frivolous or malicious, that
fails to state a claim upon which relief may be granted, or
that seeks monetary relief from a defendant who is immune
from such relief. 28 U.S.C. § 1915A. In reviewing a
pro se complaint, the court must assume the truth of
the allegations, and interpret them liberally to “raise
the strongest arguments [they] suggest[ ].” Abbas
v. Dixon, 480 F.3d 636, 639 (2d Cir. 2007). Although
detailed allegations are not required, a complaint must
include sufficient facts to afford the defendants fair notice
of the claims and the grounds upon which they are based and
to demonstrate a right to relief. Bell Atlantic v.
Twombly, 550 U.S. 544, 555-56 (2007). Conclusory
allegations are not sufficient. Ashcroft v. Iqbal,
556 U.S. 662, 678 (2009). The plaintiff must plead
“enough facts to state a claim to relief that is
plausible on its face.” Twombly, 550 U.S. at
570. Nevertheless, it is well-established that
“[p]ro se complaints ‘must be construed
liberally and interpreted to raise the strongest arguments
that they suggest.'” Sykes v. Bank of Am.,
723 F.3d 399, 403 (2d Cir. 2013) (quoting Triestman v.
Fed. Bureau of Prisons, 470 F.3d 471, 474 (2d Cir.
2006)); see also Tracy v. Freshwater, 623 F.3d 90,
101-02 (2d Cir. 2010) (discussing special rules of solicitude
for pro se litigants). However, notwithstanding this
liberal interpretation, a pro se complaint will not
avoid dismissal unless the factual allegations meet the
plausibility standard. See, e.g., Fowlkes v.
Ironworkers Local 40, 790 F.3d 378, 387 (2d Cir. 2015).
April 2016, Sanchez was confined at Cheshire Correctional
Institution. See Compl. at 6, ¶ 1. He told RN
Debbie that he was experiencing chest pains, heavy breathing,
sweating, headaches, stomach aches, and diarrhea.
Id. He also complained that he was coughing up
mucus. Id. RN Debbie checked his blood pressure,
heart rate, and temperature. Id. at 6, ¶ 2. She
refused Sanchez's request that she examine his chest and
lungs and refused to perform an EKG. Id. at 6, ¶ 3.
RN Debbie noted that he had a fever, gave Sanchez Tylenol and
allergy pills, and sent him back to his housing unit.
Id. at 6, ¶¶ 4-5.
symptoms worsened over the next four days. Id. at
6, ¶ 6. A custody officer notified the medical unit.
Id. at 6, ¶ 7. RN Angela called Sanchez to the
medical unit. Id. She checked his blood pressure,
heart rate and temperature, and noted that Sanchez had a
temperature over 101 degrees. Id. at 6, ¶¶
8-9. RN Angela did not perform an EKG and refused
Sanchez's request to examine his chest and lungs.
Id. at 6, ¶ 10. Although noting that Sanchez
had previously been seen for these complaints and that his
condition had worsened, RN Angela did not call the on-call
doctor. Id. at 6, ¶¶ 11-12. Instead, she
stated that she would have Sanchez seen by a doctor the
following day and sent him back to his housing unit.
Id. at 6, ¶¶ 13-14.
did not see a doctor the next day. Id. at 7, ¶
15. He informed first and second shift custody officers that
his condition was worsening, but he was provided no help.
Id. at 7, ¶ 16. A third shift officer called
the medical unit for Sanchez. Id. at 7, ¶ 17.
Medical staff had Sanchez taken to the medical unit by
wheelchair, and the on-call doctor directed that he be taken
to the hospital. Id. at 7, ¶¶ 18-21.
Hospital staff diagnosed Sanchez with
pneumonia. Id. at 7, ¶ 22.
Supreme Court has held that deliberate indifference to a
convicted prisoner's serious medical needs can constitute
cruel and unusual punishment in violation of the Eighth
Amendment. See Estelle v. Gamble, 429 U.S.
97, 104 (1976). A claim of deliberate indifference to serious
medical needs contains both an objective and a subjective
component. See Salahuddin v. Goord, 467 F.3d 263,
279-80 (2d Cir. 2006). Under the objective component of the
test, the alleged deprivation of medical care must be
“sufficiently serious.” See id. at 279
(quoting Farmer v. Brennan, 511 U.S. 825, 834
(1994)). This inquiry “requires the court to examine
how the offending conduct is inadequate and what harm, if
any, the inadequacy has caused or will likely cause the
prisoner.” Id. A “sufficiently
serious” deprivation can exist if the plaintiff suffers
from an urgent medical condition that is capable of causing
death, degeneration, or extreme or chronic pain. See
Brock v. Wright, 315 F.3d 158, 162-63 (2d Cir. 2003);
Hathaway v. Coughlin, 99 F.3d 550, 553 (2d Cir.
1996). A medical condition may not initially be serious, but
may become serious because it is degenerative and, if left
untreated or neglected for a long period of time, will
“result in further significant injury or the
unnecessary and wanton infliction of pain.”
Harrison v. Barkley, 219 F.3d 132, 136-37 (2d Cir.
2000). The Second Circuit has identified several factors that
are “highly relevant” to the question of whether
a medical condition is sufficiently serious, including
“an injury that a reasonable doctor or patient would
find important and worthy of comment or treatment; the
presence of a medical condition that significantly affects an
individual's daily activities; or the existence of
chronic and substantial pain.” Chance v.
Armstrong, 143 F.3d 698, 702 (2d Cir. 1998).
as here, the plaintiff complains about a delay in treatment,
the court should consider the effect of the delay on the
underlying medical condition. The Second Circuit has held
that a delay in treatment constitutes deliberate indifference
where prison officials ignored a “life-threatening and
fast-degenerating” condition for three days, Liscio
v. Warren, 901 F.2d 274, 277 (2d Cir. 1990), or delayed
needed major surgery for over two years, Hathaway v.
Coughlin, 841 F.2d 48, 50-51 (2d Cir. 1988). The court
considers the reason for the delay and whether the delay
worsened the prisoner's condition. Smith v.
Carpenter, 316 F.3d 178, 186 (2d Cir. 2003). “[I]n
most cases, the actual medical consequences that flow from
the alleged denial of care will be highly relevant to the
question of whether the denial of treatment subjected the
prisoner to a significant risk of serious harm.”
Id. at 187 (citations omitted).
subjective component requires that the defendant prison
official must have “acted with a sufficiently culpable
state of mind.” Id. at 184 (quoting
Hathaway, 99 F.3d at 553). This does not require
“knowing and purposeful infliction of harm, ” but
“suffices if the plaintiff proves that the official
acted with deliberate indifference to inmate health.”
See Salahuddin, 467 F.3d at 280. Thus, the defendant
must have been “actually aware of a substantial risk
that serious inmate harm would result” as a result of
his or her actions or inactions and have disregarded that
risk. See id. The fact that a prison official
“fail[ed] to alleviate a significant risk that he
should have perceived but did not” does not constitute
deliberate indifference. See Farmer, 511 U.S. at
showing of negligence or medical malpractice does not support
an Eighth Amendment claim, unless it involves culpable
recklessness. See Hernandez v. Keane, 341 F.3d 137,
144 (2d Cir. 2003). Thus, “not every lapse in prison
medical care will rise to the level of a constitutional
violation.” See Smith v. Carpenter, 316 F.3d
178, 184 (2d Cir. 2003). In certain situations, however,
“instances of medical malpractice may rise to the level
of deliberate indifference[, ] namely, when the malpractice
involves culpable recklessness, i.e., an act or a
failure to act by the prison ...