Sanchez v. Debbie

          INITIAL REVIEW ORDER

          JANET C. HALL UNITED STATES DISTRICT JUDGE

         I. INTRODUCTION

         The 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. No. 6).

         The 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.

         Under 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).

         II. ALLEGATIONS

         In 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.^[1] 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.

         Sanchez's symptoms worsened over the next four days.^[2] 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.

         Sanchez 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.^[3] Id. at 7, ¶ 22.

         III. ANALYSIS

         The 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.^[4] 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).

         Where, 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).

         The 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 838.

         A 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 ...