STONER v. GEORGIA DEPARTMENT OF CORRECTIONS et al
ORDER denying 27 Motion for Partial Summary Judgment; denying 39 Motion for Summary Judgment. Ordered by US DISTRICT JUDGE C ASHLEY ROYAL on 3/31/2017 (lap)
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF GEORGIA
CHIQUITA A. FYE, M.D.,
NORMAN HOWARD FITZ‐
No. 5:15‐CV‐102 (CAR)
ORDER ON MOTION FOR PARTIAL SUMMARY JUDGMENT AND
MOTION FOR SUMMARY JUDGMENT
Plaintiff William Stoner brings deliberate indifference claims pursuant to 42
U.S.C. § 1983, as well as Georgia state law medical malpractice claims against
Defendants Dr. Norman Howard Fitz‐Henley and Dr. Chiquita A. Fye. Plaintiff
contends Defendants violated his Eighth Amendment rights by failing to acknowledge
his complaints and symptoms, review his medical records, or take any action despite
knowing his risk of seizures from withdrawal of his prescribed medications. Currently
before the Court is Dr. Fitz‐Henley’s Motion for Partial Summary Judgment [Doc. 27]
The Court notes that Plaintiff has also named unknown medical and prison staff members as defendants
in this case. Despite a full discovery period, Plaintiff has neither identified nor served the unknown
defendants. At this procedural posture, the Court finds that any claims against the unknown defendants
are due to be DISMISSED without prejudice. See Fed.R.Civ.P. 4(m); see also James v. Mazda Motor Corp., 222
F.3d 1323, 1324 (11th Cir.2000).
and Dr. Fye’s Motion for Summary Judgment [Doc. 39]. After careful consideration, the
Court finds genuine issues of material fact exist as to Defendants’ liability, and
Defendants are not entitled to qualified immunity. Thus, Defendants’ Motions [Docs.
27 & 39] are DENIED.
Under Rule 56 of the Federal Rules of Civil Procedure, summary judgment must
be granted “if the movant shows that there is no genuine dispute as to any material fact
and the movant is entitled to judgment as a matter of law.”2 A genuine issue of material
fact only exists when “there is sufficient evidence favoring the nonmoving party for a
jury to return a verdict for that party.”3 Thus, summary judgment must be granted if
there is insufficient evidence for a reasonable jury to return a verdict for the nonmoving
party or, in other words, if reasonable minds could not differ as to the verdict.4 When
ruling on a motion for summary judgment, the Court must view the facts in the light
most favorable to the party opposing the motion.5
The moving party “always bears the initial responsibility of informing the
district court of the basis for its motion, and identifying those portions of the pleadings,
depositions, answers to interrogatories, and admissions on file, together with the
Fed. R. Civ. P. 56(a); see Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986).
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986).
4 See id. at 249‐52.
5 Welch v. Celotex Corp., 951 F.2d 1235, 1237 (11th Cir. 1992).
affidavits, if any, which it believes demonstrate the absence of a genuine issue of
material fact” and that entitle it to a judgment as a matter of law.6 If the moving party
discharges this burden, the burden then shifts to the nonmoving party to go beyond the
pleadings and present specific evidence showing that there is a genuine issue of
material fact.7 This evidence must consist of more than mere conclusory allegations or
For purposes of this Motion, the material facts in the light most favorable to
Plaintiff, the nonmovant, are as follows:
On February 11, 2013, Plaintiff William Stoner arrived at the Baldwin County jail
to serve his 60‐day sentence.9 Plaintiff brought his prescription medications in a plastic
bag, including Xanax, Oxycodone, and Coumadin.10 Later that morning, Plaintiff was
transferred to Bleckley Probation and Detention Center (“Bleckley PDC”) with these
prescriptions, and Plaintiff underwent an initial health and diagnostics screening.11
During the screening, it was well documented that Plaintiff suffered from panic attacks,
Celotex Corp., 477 U.S. at 323 (internal quotation marks omitted).
See Fed. R. Civ. P. 56(e); see also Celotex Corp., 477 U.S. at 324‐26.
8 See Avirgan v. Hull, 932 F.2d 1572, 1577 (11th Cir. 1991).
9 Def. Dr. Fitz‐Henley’s Stmt. of Mat. Facts, [Doc. 27‐2] at para. 1.
10 Id., Ex. A. at D52, [Doc. 27‐3] at p. 16.
11 Id, Ex. A. at D52, [Doc. 27‐3] at p. 16.; Id., [Doc. 27‐2] at para. 2.
degenerative disc disease, and blood clots, and that he had recently experienced a
seizure after being removed from his current prescription medications. 12 Plaintiff’s
current medication dosages included two milligrams of Xanax, up to five times a day;
thirty milligrams of Oxycodone, or two tablets four times a day; and four milligrams of
Coumadin, or one and half tablets daily.13 After the initial screening, the Bleckley PDC
physician, Dr. Moore, ordered Plaintiff to be transferred to a facility with 24‐hour
nursing care due to the risk of withdrawals from his medication.14 Dr. Moore also
ordered Plaintiff undergo a mental health evaluation and receive Coumadin.15
On the evening of February 11, 2013, Plaintiff was transferred to Macon State
Prison (“MSP”), pending a more permanent assignment, as MSP has 24‐nursing care.
MSP does not, however, perform mental health evaluations.16 Because MSP is a Level V
security prison, and Plaintiff was a first‐time probation offender, Plaintiff was placed in
administrative segregation for his own protection.17
Id., Ex. A. at D23, D97, [Doc. 27‐3] at p. 13, 15.
Id., Ex. A. at D24, D139, [Doc. 27‐3] at p. 14, 44.
14 Id., Ex. A. at D40, [Doc. 27‐3] at p. 18.
15 Id., [Doc. 27‐2] at para. 3.
16 See id., [Doc. 27‐2] at para. 4.
17 See id., [Doc. 27‐2] at paras. 4‐5; Def. Dr. Chiquita Fye’s Dep., [Doc. 30‐1] at p. 103‐04.
Plaintiff alleges that all of his medications were transferred with him to MSP.
However, Defendants dispute this, and the Instrasystem Transfer Form only listed his
current medications as Coumadin.18 The Intrasystem Transfer Form is a two‐page
document that is filled out when a prisoner is transferred to a new facility and sent with
the prisoner’s medical records. The facility the prisoner is leaving fills out the top
portion on the first page of the Form, and the new facility fills out the bottom half upon
the prisoner’s arrival.19 On the top half of Plaintiff’s Form, under “document medical
problems,” Bleckley PDC listed DDD (degenerative disc disorder), anxiety, and seizure,
and under “additional information,” it stated “currently taking Xanax 2mg 5xday,
Oxycodone 30mg 2 tab 4xday, Coumadin 4 mg 1 ½ qd,” “send[ ] to 24 [hour] nursing
facility.”20 On the bottom half of the Form, MSP documented that upon arrival Plaintiff
felt “very disoriented” because he had not taken his Xanax medication.21
In general, MSP is considered a non‐narcotic facility. 22 MSP does not treat
patients who require benzodiazepines such as Xanax, nor does it treat prisoners going
through withdrawal from benzodiazepines. Xanax is not available in MSP’s Medical
Def. Dr. Fitz‐Henley’s Stmt. of Mat. Facts, Ex. A. at D50‐51, [Doc. 27‐3] at p. 17, 19.
Def. Dr. Fye’s Dep., [Doc. 30‐1] at p. 47.
20 Dr. Fitz‐Henley’s Stmt. of Mat. Facts, Ex. A. at D50, [Doc. 27‐3] at p. 19.
22 Pl. William Stoner’s Dep., [Doc. 33] at p. 64.
Department’s formulary.23 The only benzodiazepine MSP carries is Valium, which is for
acute seizures and located in the emergency cart.24 But no medication is absolutely
prohibited at MSP; especially, if the medication is necessary for lifesaving purposes.25 A
physician at MSP would just have to order the medication from outside the formulary,
which may take up to 48 hours to receive.26
Typically, at MSP, the Medical Director, Dr. Chiquita Fye, and two midlevel
providers, such as nurse practitioners or advanced practice nurses, treat the prisoners.
However, at the time Plaintiff was transferred to MSP, the Medical Department was
short staffed, and only one midlevel provider was working with Dr. Fye. Thus, Dr. Fye
arranged with Vista Staffing to have a contract provider assist at MSP.27
On February 12, 2013, the day after Plaintiff’s arrival, Vista Staffing sent Dr.
Norman Fitz‐Henley, an internal medicine physician, to work at MSP.28 Dr. Fitz‐
Henley, accompanied by nurses and prison guards, met with Plaintiff.29 Dr. Fitz‐Henley
and Plaintiff dispute what happened during this encounter.
See Def. Dr. Fitz‐Henley’s Stmt. of Mat. Facts, [Doc. 27‐2] at para. 8.
Def. Dr. Fye’s Dep., [Doc. 30‐1] at p. 138.
25 Id. at p. 30.
26 Id. at p. 126‐27.
27 Id. at p. 33, 136‐37.
28 Def. Dr. Fitz‐Henley Dep., [Doc. 32] at p. 13.
29 Id. at p. 35‐36.
According to Plaintiff, Dr. Fitz‐Henley and Plaintiff’s interaction occurred in a
medical examination room and lasted approximately 30 minutes. Dr. Fitz‐Henley asked
about Plaintiff’s medical condition and drew his blood, but he did not perform any kind
of physical examination. The medical bag that was transferred with Plaintiff to MSP
was sitting on the counter in the exam room, which included his prescriptions and
prison medical records. Plaintiff explained to Dr. Fitz‐Henley that he understood it was
a non‐narcotic facility, but Plaintiff asked Dr. Fitz‐Henley for his Xanax to prevent a
potentially life threatening seizure. Dr. Fitz‐Henley reiterated to Plaintiff that MSP was
a non‐narcotic facility, and he reassured Plaintiff he was going to be fine. Dr. Fitz‐
Henley did not order Plaintiff his Coumadin or any other medical treatment after this
According to Dr. Fitz‐Henley, however, Plaintiff never advised him of Plaintiff’s
medications or risk of seizure. Dr. Fitz‐Henley states that although he was present
while the nurses and prison guards met with Plaintiff, he merely observed Plaintiff’s
interactions with them; he had no real interactions with Plaintiff. 31 He did not perform
a physical evaluation of Plaintiff, and did not possess or review Plaintiff’s medical
Pl. Dep., [Doc. 33] at p. 61‐64.
Def. Dr. Fitz‐Henley Dep., [Doc. 32] at p. 37‐40, 42‐43, 44‐45, 56.
records. He does state that through his observations of Plaintiff, he identified no
medical issues requiring treatment, no concerning vital signs, and no acute distress.
Additionally, before arriving at MSP, Dr. Fitz‐Henley spoke with nurses at Bleckley
PDC who informed him Plaintiff was on medication that required 24‐hour nursing care,
and from his interaction with the staff, Dr. Fitz‐Henley learned MSP was trying to locate
a facility to transfer Plaintiff for proper treatment.32
While at MSP, it is undisputed Dr. Fitz‐Henley filled out two forms: (1) a Medical
Classification Form stating Plaintiff was “in no condition to accept work assignment
under any circumstances due to serious health conditions”;33 and (2) a Medical
Encounter Form stating that (a) Plaintiff was a new arrival on Coumadin, (b) MSP does
not or cannot accommodate inmates on this medicine, and (c) Plaintiff was due for
transfer to an appropriate facility, but Plaintiff’s transfer was not a medical issue at this
point.34 In his deposition, Dr. Fitz‐Henley further explained Plaintiff suffered from
“serious health conditions” requiring a “no‐work status,” including degenerative joint
disease, history of drug abuse, anticoagulation, and deep vein thrombosis.35 Dr. Fitz‐
Id. at 28, 44.
Id. at p. 39‐41.
34 Id., Ex. E [Doc. 32‐1] at p. 25.
35 Id., [Doc. 32] at p. 41.
Henley explained that he was “involve[ed]” in Plaintiff’s “matter” for approximately
four hours that day; he did not see any other prisoners; and he did not return to MSP
the following day.36 After the meeting with Dr. Fitz‐Henley, Plaintiff returned to his cell
in administrative segregation.
At MSP there are extensive policies and procedures in place to ensure prisoners
are regularly monitored. Moreover, the nursing staff at MSP is available 24‐hours a
days,37 and they deliver medications to prisoners four times a day. However, there is
no door log for Plaintiff or any other information to confirm MSP follows its monitoring
policies and procedures.38 Plaintiff insists he shouted from his cell that he needed his
medications and banged on the door, but he was continuously ignored. 39
On February 13, 2013, the day after he met with Dr. Fitz‐Henley, Plaintiff
remained in segregation; he had not left his cell since the morning of the 12th and had
not received any medication.40 Around 4:00 pm, Plaintiff’s mother, Margaret Stoner,
called MSP’s Medical Department and spoke with the Medical Director, Dr. Fye. Mrs.
Id. at p. 43, 55.
Def. Dr. Fitz‐Henley’s Stmt. of Mat. Facts, Ex. B, [Doc. 27‐4] at p. 34‐42; Def. Dr. Fye’s Dep., [Doc. 30‐1]
at p. 11‐12, 46.
38 Def. Dr. Fye’s Dep., [Doc. 30‐1] at p. 110‐11.
39 Pl.’s Dep., [Doc. 33] at p. 72‐73.
40 Id. at p. 70‐75.
Stoner wanted to confirm her son was receiving his medications. Mrs. Stoner informed
Dr. Fye that Plaintiff was taking Oxycodone, Xanax, and Coumadin, and she explained
he would have a seizure if he did not receive his medications. Dr. Fye first told
Plaintiff’s mother that she did not have Plaintiff’s medical records; however, Dr. Fye
then responded that Plaintiff told the medical staff he was taking those medications, but
they do not believe what prisoners say. Because it was after hours, Dr. Fye told Mrs.
Stoner she would look into it first thing in the morning.41
Nonetheless, Dr. Fye immediately pulled Plaintiff’s medical records to make
herself familiar with his file. Dr. Fye determined there was no need to change any
orders, as the only medication he came to MSP with was Coumadin. Dr. Fye did not
examine or assess Plaintiff’s condition in person, nor did she notify anyone at MSP
about Mrs. Stoner’s concerns.42
On the morning of February 14, 2013, Plaintiff was found on the floor of his cell
unresponsive, incontinent of bowl and bladder, and with labored breathing.43 Plaintiff
was rushed to the Medical Department on a stretcher. Dr. Fye immediately assessed
Margaret Stoner’s Dep., [Doc. 42‐4] at p. 14‐15.
Def. Dr. Fye Dep., [Doc. 30‐1] at p. 55‐57.
43 Def. Dr. Fitz‐Henley’s Stmt. of Mat. Facts, Ex. A. at D38, [Doc. 27‐3] at p. 37.
him as having possible withdrawals from his medications and told security to call 911.44
Plaintiff was transferred to Flint River Hospital and then airlifted to the Medical Center
of Central Georgia where he remained for three to four days.45 On February 17, 2013,
Plaintiff returned to MSP and, the next day, was transferred to Augusta State Medical
Prison to receive methadone treatment.46 Plaintiff alleges the complete withdrawal of
benzodiazepine caused him to have a seizure and resulted in significant physical and
Based on these events, Plaintiff brings § 1983 claims against Defendants Dr. Fitz‐
Henley and Dr. Fye for deliberate indifference to his serious medical needs, in violation
of the Eighth Amendment, as well as Georgia state law medical malpractice claims. Dr.
Fitz‐Henley and Dr. Fye seek summary judgment on the § 1983 claims, arguing Plaintiff
cannot show they were deliberately indifferent to Plaintiff’s serious medical needs, and,
they are both entitled to qualified immunity. The Court will address each argument in
Id.; Def. Dr. Fye Dep., [Doc. 30‐1] at p. 69.
Def. Dr. Fye Dep., [Doc. 30‐1] at p. 71‐72.
46 Id. at 78‐79.
I. Deliberate Indifference to Serious Medical Needs
“It is well settled that the deliberate indifference to serious medical needs of
prisoners constitutes the unnecessary and wanton infliction of pain, proscribed by the
Eighth Amendment.”47 “[N]ot every claim by a prisoner that he has not received
adequate medical treatment states a violation of the Eighth Amendment.”48 “[A]
complaint that a physician has been negligent in diagnosing or treating a medical
condition does not state a valid claim of medical mistreatment under the Eighth
Amendment. Medical Malpractice does not become a Constitutional violation merely
because the victim is a prisoner.”49 “In order to state a cognizable claim, a prisoner must
allege acts or omissions sufficiently harmful to evidence deliberate indifference to
serious medical needs. It is only such indifference that can offend evolving standards of
decency in violation of the Eighth Amendment.”50
“To show that a prison official acted with deliberate indifference to serious
medical needs, a plaintiff must satisfy both an objective and a subjective inquiry.”51
“First, the plaintiff must prove an objectively serious medical need,” and second, “the
Estelle v. Gamble, 429 U.S. 97, 104 (1976) (internal quotation marks omitted).
McElligott v. Foley, 182 F.3d 1248 (11th Cir. 1999) (quoting Estelle, 429 U.S. at 105) (internal quotation
51 Brown v. Johnson, 387 F.3d 1344 (11th Cir. 2004) (quoting Farrow v. West, 320 F.3d 1235, 1243 (11th Cir.
2003) (internal quotation marks omitted).
plaintiff must prove that the prison officials acted with deliberate indifference to that
“A serious medical need is considered ‘one that has been diagnosed by a
physician as mandating treatment or one that is so obvious that even a lay person
would easily recognize the necessity for a doctor’s attention.’”53 “In the alternative, a
serious medical need is determined by whether a delay in treating the need worsens the
condition.”54 In either case, the medical need must be “one that, if left unattended,
pos[es] a substantial risk of serious harm.”55
To establish the second element, deliberate indifference to the serious medical
need, the plaintiff must show: “(1) subjective knowledge of a risk of serious harm; (2)
disregard of that risk; and (3) conduct that is more than mere negligence.”56 “[A] simple
disagreement over a diagnosis or course of treatment does not constitute deliberate
indifference. As long as the medical treatment provided is ‘minimally adequate,’ a
54 Mann v. Taser Intern., Inc., 588 F.3d 1291, 1307 (11th Cir. 2009) (citing Hill v. Dekalb Regʹl Youth Det. Ctr.,
40 F.3d 1176, 1187 (11th Cir. 1994), overruled in part on other grounds by Hope v. Pelzer, 536 U.S. 730, 739
55 Taylor v. Adams, 221 F.3d 1254 (11th Cir. 2000) (quoting Farmer v. Brennan, 511 U.S. 825, 834 (1994))
(internal quotation marks omitted).
56 Brown, 387 F.3d at 1251 (citing McElligott, 182 F.3d at 1255)).
prisoner’s preference for a different treatment does not give rise to a constitutional
Because Dr. Fitz‐Henley and Dr. Fye’s interactions with Plaintiff were
substantially different, the Court will address separately whether Dr. Fitz‐Henley or Dr.
Fye were deliberately indifferent to Plaintiff’s serious medical needs and then turn to
their qualified immunity arguments.
A. Dr. Fitz‐Henley58
i. Serious Medical Need
First, Dr. Fitz‐Henley argues Plaintiff cannot show he had an objectively serious
medical need, as Plaintiff was not exhibiting any withdrawal symptoms when Dr. Fitz‐
Henley visited him on February 12, 2013. However, Plaintiff contends his objectively
serious medical need is evidenced by his prescription medications and the withdrawal
seizure he later endured. The Court agrees.
On February 11, 2013, Plaintiff entered the Georgia Department of Corrections
with his prescribed medications, Xanax, Oxycodone, and Coumadin. Plaintiff was
ultimately transferred from Beckley PDC to MSP with his medical records and an
Intrasystem Transfer Form. Though the second page of the Form only listed Coumadin
Chatham v. Adcock, 334 F. App’x 281, 288 (11th Cir. 2009) (per curiam) (citing Harris v. Thigpen, 941 F.2d
1495, 1504‐5 (11th Cir. 1991); Adams v. Poag, 61 F.3d 1537, 1547 (11th Cir. 1995)).
58 For purposes of this Motion, Dr. Fitz‐Henley does not dispute he was acting under the color of state law
and thus can be held liable under § 1983. Def.’s Mtn. for Partial Sum. Judgment, [Doc. 27‐1] at p. 9.
as his medications, the first page clearly stated Plaintiff suffered from anxiety and
seizures, was currently taking Xanax, Oxycodone, and Coumadin, and complained of
feeling “very disoriented” because he had not taken his medications.59 Furthermore,
Plaintiff was specifically transferred to a facility with 24‐hour nursing care due to the
risk of benzodiazepine withdrawals.60
On February 12, 2013, Dr. Fitz‐Henley met with Plaintiff and determined Plaintiff
was not in acute distress at the time. However, Dr. Fitz‐Henley did not request or
review any of Plaintiff’s medical records, nor did he conduct a physical examination.
Moreover, the nurses at Bleckley PDC informed Dr. Fitz‐Henley that Plaintiff was
taking certain medications that required twenty‐four hour nursing care.61
According to Plaintiff, he also informed Dr. Fitz‐Henley that he took Xanax, and
specifically, he was at risk of having a seizure without it. Indeed, Dr. Fitz‐Henley
specifically refers to Plaintiff as suffering from a “serious health condition.” Dr. Fitz‐
Henley marked on Plaintiff’s medical classification chart that “[s]ubject is in no
condition to accept work assignment under any circumstances due to serious health
conditions.”62 Dr. Fitz‐Henley stated these serious health conditions included
degenerative joint disease, history of drug abuse, anticoagulation, and deep vein
Dr. Fitz‐Henley’s Stmt. of Mat. Facts, Ex. A. at D50, [Doc. 27‐3] at p. 19.
Id., Ex. A at D40, [Doc. 27‐3] at p. 18.
61 Def. Dr. Fitz‐Henley’s Dep., [Doc. 32] at p. 28.
62 Id. at p. 40 (emphasis added).
thrombosis.63 Most telling Plaintiff suffered from an objectively serious medical need is
the fact he was found unresponsive in his cell due to a benzodiazepine‐withdrawal
Based on this evidence, Plaintiff has established there are sufficient facts to
demonstrate he had an objectively serious medical need on February 12, 2013, when Dr.
Fitz‐Henley saw him.64
ii. Deliberate Indifference
Second, Dr. Fitz‐Henley argues no evidence exists to show he was subjectively
aware of Plaintiff’s serious medical condition or refused to provide care for that
condition. Dr. Fitz‐Henley argues he did not review Plaintiff’s medical records, and he
was neither aware of Plaintiff’s prescription medications nor when Plaintiff had taken
them last. Further, there was no reason for Dr. Fitz‐Henley to suspect MSP would
house a prisoner taking benzodiazepines or narcotics, as it was a known as a non‐
narcotics facility. Thus, Dr. Fitz‐Henley contends he cannot be liable for his “failure to
Id. at p. 41. Though Dr. Fitz‐Henley did not write that on the chart, he admitted in his deposition that is
what he meant when he wrote “serious health condition.”
64 See Hilyer v. Dunn, No. 15‐00356‐WS‐N, 2016 WL 7093437, at *2 (Oct. 28, 2016), adopted by the District
Court, 2016 WL 7045731 (S.D. Ala. Dec. 2, 2016) (“There can be no doubt that controlling seizures
constitutes a serious medical need, see Johnson v. Hay, 931 F.2d 456, 461 (8th Cir. 1991); Miranda v. Munoz,
770 F.2d 255, 259 (1st Cir. 1985).”); see also Hill, 40 F.3d at 1188 (“The seriousness of an inmateʹs medical
needs also may be decided by reference to the effect of delay in treatment. Where the delay results in an
inmateʹs suffering a life‐long handicap or permanent loss, the medical need is considered serious.”).
alleviate a significant risk that he should have perceived but did not.”65 However, the
Court finds genuine issues of material fact exist as to Dr. Fitz‐Henley’s deliberate
On February 12, 2013, Plaintiff states he told Dr. Fitz‐Henley about his
prescription medications and risk of having withdrawal seizures without his
medication. Moreover, Plaintiff recalls seeing his medications in a plastic bag in the
room with them, along with his medical records. Additionally, Dr. Fitz‐Henley’s own
testimony contradicts that he knew nothing about Plaintiff’s medical condition, as he
specifically placed Plaintiff on “no work status” due to serious health conditions.
Indeed, Dr. Fitz‐Henley spoke with nurses from Beckley PDC regarding Plaintiff’s
condition and was aware Plaintiff would need to be transferred to a different facility
that could provide better monitoring. Thus, genuine issues of material fact clearly exist
as to whether Dr. Fitz‐Henley was subjectively aware of Plaintiff’s serious medical
Even still, to show deliberate indifference to a serious medical need, Plaintiff
must show Dr. Fitz‐Henley’s actions rose above mere negligence. Here, sufficient
See Cottrell v. Caldwell, 85 F.3d 1480, 1491 (11th Cir. 1996).
See Steele v. Shah, 87 F.3d 1266, (11th Cir. 1996) (reversing a district court’s grant of summary judgment
where the doctor detined medication, even though the defendant‐doctor knew about the potential risk
without the medicine); Cf. Chatham, 334 F. App’x at 281 (determining there was no genuine issue of
material fact as to deliberate indifference where the plaintiff did not inform the defendants of his alleged
serious medical condition and was on other psychotropic medication at the time).
evidence exists from which a jury could do so. Conduct that is more than mere
negligence includes: “(1) knowledge of a serious medical need and a failure or refusal to
provide care; (2) delaying treatment for non‐medical reasons; (3) grossly inadequate
care; (4) a decision to take an easier but less efficacious course of treatment; or (5)
medical care that is so cursory as to amount to no treatment at all.”67 Assuming Plaintiff
told Dr. Fitz‐Henley about his risk of withdrawal seizures, Dr. Fitz‐Henley made no
attempt to substitute Plaintiff’s Xanax with other medications available at MSP, nor did
he order anyone to closely monitor Plaintiff. During the approximate thirty‐minute
encounter with Plaintiff, Dr. Fitz‐Henley did not perform a physical examination or
even order Plaintiff’s Coumadin, which could be administered at MSP. Ultimately, Dr.
Fitz‐Henley simply determined Plaintiff was not in acute distress and assumed prison
officials would monitor Plaintiff appropriately.68
According to Dr. Fitz‐Henley, he never reviewed or requested Plaintiff’s medical
records or even had a doctor‐patient relationship with Plaintiff; however, he was
Magwood v. Sec’y, Fla. Dep’t of Corr., 652 F. App’x 841, 844 (11th Cir. 2016) (per curiam) (citing McElligott,
182 F.3d at 1255).
68 Keele v. Glynn County, Ga., 938 F.Supp.2d 1270, 1296 (S.D. Ga. 2013) (stating, where there was evidence
of the defendant’s subjective knowledge, the Courtʹs finding of deliberate indifference was not altered by
[the defendant’s] observations that, at approximately 6:30 p.m., [the plaintiff] was awake and alert and
walked unassisted to the medication cart to receive her medications….and [there were] no signs and
symptoms of distress after questioning [the plaintiff] and taking her vital signs at approximately 9:00
“involv[ed]” in Plaintiff’s “matter” for approximately four hours at MSP.69 Had he
reviewed those records, Dr. Fitz‐Henley would have seen that the records clearly
indicated Plaintiff was prescribed a high dosage of Xanax, had not received any
medication since arriving at the Georgia Department of Corrections, and was subject to
seizures from benzodiazepine withdrawal.70
Based on this evidence and taking Plaintiff’s account of his interaction with Dr.
Fitz‐Henley as true, a reasonable jury could conclude that Dr. Fitz‐Henley was
deliberately indifferent to Plaintiff’s serious medical need. Therefore, granting
summary judgment on this issue is inappropriate.
B. Dr. Fye
i. Deliberate Indifference
Dr. Fye does not dispute that Plaintiff had an objectively serious medical need.
Instead, Dr. Fye argues she did not have any subjective knowledge of this medical need,
and even if that knowledge could be inferred, she did not act with deliberate
Def. Dr. Fitz‐Henley’s Dep., [Doc. 32] at p. 55.
See Greason v. Kemp, 891 F.2d 829, 835 (11th Cir. 1990) (holding a reasonable jury could find deliberate
indifference to a prisoner’s medical needs when the doctor abruptly discontinued the prisoner’s anti‐
depressant medication without reviewing his clinical file, conducting a mental status examination, or
ordering close monitoring, and the doctor would have realized the prisoner needed close monitoring had
he reviewed the prisoner’s file).
indifference to Plaintiff’s medical need. To support her argument, Dr. Fye points to
Goodman v. Kimbrough.71 However, this case is clearly distinguishable from ours.
In Goodman, the Eleventh Circuit agreed that the prison officials could not be
held liable for deliberate indifference even though they failed to perform the required
cell checks, deactivated the emergency call buttons without investigating the call, and
ignored sounds of violence and complaints of a fight.72 However, a key factor in the
Eleventh Circuit’s analysis was that there was no evidence the prison officials
“harbored a subjective awareness that [the plaintiff] was in serious danger while in his
cell.”73 Unlike in Goodman, Plaintiff here presents sufficient evidence from which a
reasonable fact finder could infer both that Dr. Fye had both a subjective knowledge of
Plaintiff’s substantial risk of serious harm, and she knowingly or recklessly disregarded
On February 13, 2014, at approximately 4:00 p.m., Plaintiff’s mother, Margaret
Stoner, spoke with Dr. Fye on the phone. Mrs. Stoner explained that Plaintiff had been
taking Xanax, Oxycodone, and Coumadin, and Plaintiff would have a seizure without
718 F.3d 1325 (11th Cir. 2013).
74 See id. (“Whether prison officials had the requisite awareness of the risk ‘is a question of fact subject to
demonstration in the usual ways, including inference from circumstantial evidence, and a factfinder may
conclude that a prison official knew of a substantial risk from the very fact that the risk was obvious.’”
(quoting Farmer, 511 U.S. at 842)).
his medicine. Dr. Fye responded that it was “after hours” but “first thing in the
morning”75 she would look into the matter. After speaking to Mrs. Stoner, Dr. Fye
pulled Plaintiff’s medical records but felt a change in orders was not needed, as the only
medication Plaintiff arrived at MSP with was Coumadin.76 Dr. Fye did not go check on
Plaintiff, she did not order the administration of any drugs, and she did not notify
anyone of his risk of seizures without his medicine.
In Plaintiff’s medical records, it was clearly documented that he was prescribed
high dosages of Xanax and Oxycodone and had not taken any medications in 48 to 72
hours. Further, the records also showed he had a history of seizures when taken off his
medicine and complained of feeling disoriented when he arrived at MSP. As a
physician, Dr. Fye knew when taking a patient off of benzodiazepines it was necessary
to gradually decrease the medicine.77 Even though MSP’s Medical Department does not
carry Xanax, it was still possible for a physician to order the medicine from an outside
pharmacy.78 Dr. Fye stated that no medication was absolutely prohibited at MSP when
it is for lifesaving measures.79
Mrs. Stoner Dep., [Doc. 42‐4] at p. 15].
Def. Dr. Fye’s Dep., [Doc. 30‐1] at p. 56‐57.
77 Id. at p. 40.
78 Id. at p. 126‐27.
79 Id. at p. 29‐30.
Dr. Fye contends she knew Plaintiff was confined to administrative segregation,
where he was supposed to be monitored on a regular basis and given access to the
medical staff. However, Plaintiff was in a high security segregation unit where
monitoring only consisted of prison guards looking through a small window on
Plaintiff’s cell door.80 Nurses were available and provided prisoners their medications
four times a day, but Plaintiff was never ordered any medication while at MSP, and
there is no evidence that any medical staff checked‐in on him. Indeed, there is no
evidence that anyone at MSP was closely monitoring Plaintiff, as Plaintiff states he
shouted and banged on his cell door, but no one responded. In fact, it appears no one
monitored Plaintiff until the morning of February 14, 2013, when Plaintiff was found
unresponsive on the floor of his cell.
As such, a reasonable jury could conclude Dr. Fye had a subjective knowledge of
the risk of Plaintiff having a benzodiazepine‐withdrawal seizure, and she knowingly, or
at minimum, recklessly disregarded that risk.81 Thus, the Court finds a genuine issues
of material fact exist as to whether Dr. Fye was deliberately indifferent to Plaintiff’s
serious medical need. Because summary judgment is not appropriate here, the Court
now turns to Defendants’ qualified immunity arguments.
Id. at p. 18.
Goodman, 718 F.3d at 1332..
II. Qualified Immunity
Both Dr. Fye and Dr. Fitz‐Henley argue they are entitled to qualified immunity
on Plaintiff’s § 1983 claims. “Qualified immunity offers complete protection for
individual public officials performing discretionary functions ‘insofar as their conduct
does not violate clearly established statutory or constitutional rights of which a
reasonable person would have known.’”82 To be entitled to qualified immunity, the
official must “first prove that he was acting within the scope of his discretionary
authority when the allegedly wrongful acts occurred.”83 Once the official has made that
showing, the burden shifts to the plaintiff to establish: “(1) that the official violated a
statutory or constitutional right, and (2) that the right was clearly established at the time
of the challenged conduct.”84 The clearly established law must provide the defendants
with “fair warning” that their conduct deprived the plaintiff of a constitutional right.85
Here, it is undisputed Defendants were acting within their discretionary
authority, and as explained above, the Court has already determined that a reasonable
jury could conclude Defendants violated Plaintiff’s Eighth Amendment constitutional
Sherrod v. Johnson, 667 F.3d 1359, 1363 (11th Cir.2012) (quoting Harlow v. Fitzgerald, 457 U.S. 800, 818
83 Lee v. Ferraro, 284 F.3d 1188, 1194 (11th Cir. 2002) (internal quotation marks and citations omitted).
84 Ashcroft v. al–Kidd, 563 U.S. 731, 735 (2011) (internal quotation marks and citations omitted).
85 Hope, 536 U.S. at 739‐41.
rights. Thus, the Court must determine whether Defendants’ alleged conduct violated
clearly established law.
A plaintiff “can demonstrate that the contours of the right were clearly
established in several ways.”86 First, a plaintiff can show that “a materially similar case
has already been decided.”87 Second, a plaintiff can point to a “broader, clearly
established principle [that] should control the novel facts [of the] situation.”88 Finally,
the conduct involved in the case may ‘so obviously violate[ ] th[e] constitution that
prior case law is unnecessary.’”89
A. Dr. Fitz‐Henley90
Dr. Fitz‐Henley argues there is no law clearly establishing that a physician’s
decision not to order prescription benzodiazepines, under these circumstances, violates
an inmate’s constitutional rights. However, “[a] judicial precedent with materially
identical facts is not essential for the law to be clearly established, but the preexisting
law must make it obvious that the defendantʹs acts violated the plaintiffʹs rights in the
specific set of circumstances at issue.”91 Plaintiff points to Lancaster v. Monroe County,
Terrell v. Smith, 668 F.3d 1244, 1255 (11th Cir. 2012).
Id. (internal quotation marks and citations omitted). “Exact factual identity with a previously decided
case is not required, but the unlawfulness of the conduct must be apparent from preexisting law.” Coffin
v. Brandau, 642 F.3d 999, 1013 (11th Cir. 2011).
88 Id. (internal quotation marks and citations omitted).
89 Id. (citation omitted).
90 Hope, 536 U.S. at 739‐41.
91 Youmans v. Gagnon, 626 F.3d 557, 563 (11th Cir. 2010).
Alabama; 92 Harris v. Coweta County;93 and Seals v. Shah,94 to show Dr. Fitz‐Henley’s actions
violated clearly established law.
In each case, the courts reiterate the law is clearly established that “an official acts
with deliberate indifference when he knows that an inmate is in serious need of medical
care, but he fails or refuses to obtain medical treatment for the inmate.”95 It is also
clearly established “that an official acts with deliberate indifference when he
intentionally delays providing an inmate with access to medical treatment, knowing
that the inmate has a life‐threatening condition or an urgent medical condition that
would be exacerbated by delay.”96
Here, Plaintiff claims he specifically told Dr. Fitz‐Henley about his serious
medical need, and Dr. Fitz‐Henley failed to provide treatment or medicine to Plaintiff to
prevent a benzodiazepine‐withdrawal seizure. Assuming such to be true, the case law
116 F.3d 1419 (11th Cir. 1997), overruled on other grounds by LaFrere v. Quezada, 588 F.3d 1317 (11th
93 21 F.3d 388, 393‐94 (11th Cir. 1994) (“The tolerable length of delay in providing medical attention
depends on the nature *394 of the medical need and the reason for the delay. A few hoursʹ delay in
receiving medical care for emergency needs such as broken bones and bleeding cuts may constitute
deliberate indifference.” E.g., Brown v. Hughes, 894 F.2d 1533 (11th Cir. 1990)).
94 145 F.Supp.2d 1378 (N.D. Ga. 2001) (“The defense of qualified immunity is not available to a defendant
guilty of deliberate indifference to serious medical needs.”).
95 Lancaster, 116 F.3d at 1425; see also Adams, 61 F.3d at 1543‐44 (The Eleventh Circuit has “consistently
held that knowledge of the need for medical care and an intentional refusal to provide that care
constitutes deliberate indifference.”) (citing Carswell v. Bay Cty., 854 F.2d 454, 457 (11th Cir. 1988)); H.C. by
Hewett v. Jarrard, 786 F.2d 1080, 1086 (11th Cir. 1986) (“[T]he failure to provide diagnostic care and
medical treatment known to be necessary [i]s deliberate indifference.”).
96 Lancaster, 116 F.3d at 1425.
in this Circuit clearly put Dr. Fitz‐Henley on notice that his conduct was a violation of
clearly established law.97
B. Dr. Fye
Dr. Fye argues these cases cited by Plaintiff provide no assistance in clearly
establishing the law as to her. However, for the same reasons that Dr. Fitz‐Henley is
not entitled to qualified immunity, Dr. Fye is also not entitled to qualified immunity.
Dr. Fye was on notice of Plaintiff’s medical needs and aware that without his
medicine Plaintiff would suffer a withdrawal seizure. Plaintiff’s medical records, which
Dr. Fye states she read, further indicated he had gone 48 to 72 hours without any
medications, and he complained of feeling disoriented the day he arrived at MSP two
days before Dr. Fye reviewed his records. Yet, Dr. Fye did not go check on Plaintiff or
order any additional monitoring. Again, assuming a jury finds this to be deliberate
See, e.g., McBridge v. Houston Cnty. Health Care Authority, 658 F. App’x 991, 999 (11th Cir. 2016) (per
curiam) (holding that qualified immunity did not apply to an officer who failed to provide medical care
despite detainees screams for help and complaints of headaches and a sore throat, resulting in a serious
rash and the skin on his lips peeling off) ; Steele, 87 F.3d at 1268‐71 (finding an issue of material fact as to
whether a clearly established right was violated when a psychiatrist discontinued the inmate’s
medication on the basis of one cursory interview and without reviewing any medical records beyond the
treatment plan sent from the previous facility); McElligott,182 F.3d at 1260 (holding two doctors violated a
clearly established right when they did very little to treat the inmate’s pain or respond to the
deterioration of his condition, despite being aware that the medication prescribed to the inmate was not
treating the severe pain he was experiencing); Greason, 891 F.2d at 832‐34 (holding that jury could find
that a psychiatrist violated a clearly established right when he failed to monitor the deceased after having
been warned by the inmate’s parents and two other inmates that the deceased had tried to commit
suicide); Aldridge v. Montgomery, 753 F.2d 970, 973‐974 (11th Cir. 1985) (holding that the jury should
determine whether officers violated a pretrial detainee’s constitutional rights by ignoring a one and half
inch bleeding cut for two and a half hours).
indifference, the case law in this circuit makes clear that such a delay in treating
Plaintiff amounted to deliberate indifference. 98
Furthermore, “[a] core principle of Eighth Amendment jurisprudence ... is that
prison officials with knowledge of the need for [medical] care may not, by failing to
provide care, delaying care, or providing grossly inadequate care, cause a prisoner to
needlessly suffer the pain resulting from his or her illness.”99 Thus, even if the cases
Plaintiff points to have some distinguishable facts, the clearly established “core”
principles in these cases still gave Dr. Fye fair warning that her delay or refusal to
provide Plaintiff with any medications or with treatment she knew was medically
necessary to prevent a benzodiazepine‐withdrawal seizure violated Plaintiff’s
constitutional right to adequate medical care.
Based on the foregoing, Defendants’ Motions for Partial Summary Judgment and
Summary Judgment [Docs. 27 & 39] are DENIED.100
McElligott, 182 F.3d at 1257.
100 Additionally, the Court finds that any claims against the unknown defendants are due to be
DISMISSED, without prejudice. See Fed.R.Civ.P. 4(m); see also James v. Mazda Motor Corp., 222 F.3d 1323,
1324 n.1 (11th Cir. 2000).
SO ORDERED, this 31st day of March, 2017.
S/ C. Ashley Royal
C. ASHLEY ROYAL, JUDGE
UNITED STATES DISTRICT COURT
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