Thompson v. Benson et al

Filing 29

ORDER granting in part and denying in part 17 Motion for Summary Judgment. See Order for details. Signed by Senior Judge Donald E OBrien on 3/10/14. (djs)

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF IOWA
WESTERN DIVISION
ELWOOD THOMPSON,
Plaintiff and Counter
Defendant,

No. 11-CV-4052-DEO

v.

RULING ON DEFENDANTS’ MOTION
SUMMARY JUDGMENT

MARY BENSON, NURSE; JASON
SMITH, DIRECTOR,
Defendants and Counter
Claimants.

____________________
The parties appeared on October 1, 2012, for a telephonic
hearing

on

the

Defendants’

Motion

for

Summary

Judgment.

Attorney Jay Denne appeared on behalf of the Plaintiff, Elwood
Thompson.

Assistant

Attorney

General

appeared on behalf of the Defendants.
parties’

arguments,

the

Court

took

Gretchen

Kraemer

After hearing the
the

matter

under

consideration and now enters the following.
I.

INTRODUCTION AND PROCEDURAL HISTORY
The

Plaintiff,

Elwood

Thompson

[hereinafter

Mr.

Thompson], has been adjudicated a sexually violent predator
and is currently committed to the Civil Commitment Unit for
Sex Offenders (CCUSO), which is part of the Iowa Department of

Human Services.

Mary Benson is a Nurse at the facility, and

Jason Smith is the Director of the facility.
On May 21, 2011, Mr. Thompson filed a Pro Se Complaint
alleging that Ms. Benson and Mr. Smith [hereinafter the
Defendants] violated his rights pursuant to 42 U.S.C. § 1983.
On August 5, 2011, this Court granted Mr. Thompson’s motion to
proceed in forma pauperis and a request for appointment of
counsel.

On September 16, 2011, Mr. Thompson’s appointed

counsel declined to file an amended complaint.

On October 5,

2011, the Defendants filed an Answer as well as a Counter
Claim

alleging

that

Thompson’s

requesting attorney’s fees.

claims

are

frivolous

and

The Defendants also filed a

partial Motion to Dismiss, arguing that various immunities and
the statute of limitations precluded some of Mr. Thompson’s
claims. On March 5, 2012, the Court entered an order granting
in part and denying in part Defendants’ Motion to Dismiss.
The Court allowed Mr. Thompson’s claim against the Defendants,
in their individual capacity, to proceed.

On July 2, 2012,

the Defendants filed the present Motion for Summary Judgment.
On August 31, 2012, the Plaintiff filed a Resistance to the
Motion for Summary Judgment.
2

II.

FACTS
The parties dispute many of the facts at issue.

Court can outline the situation as follows.
civilly committed at CCUSO.
including diabetes.

The

Mr. Thompson is

He has a history of illness,

As a result of the diabetes, he had a

partial amputation of his right foot in 2006.

Beginning in

2008, Mr. Thompson refused to let CCUSO be involved in the
treatment of his diabetes.

Mr. Thompson states that he is

controlling his illness through his diet.
In 2010, Mr. Thompson developed an ulcer or lesion on his
foot.

It is clear that Mr. Thompson sought treatment for his

foot ulcer and CCUSO’s medical team did provide some care.
However, Mr. Thompson claims that he was denied medication and
the opportunity to seek specialized treatment outside of
CCUSO.

Mr. Thompson clearly contends that the Defendants

ignored his foot condition, allowing it to intensify in
severity until it required surgery. The Defendants argue that
Mr. Thompson was given every opportunity to have his foot
treated, but refused to follow medical advice, including
getting the required laboratory work so he could be evaluated
at an outside medical facility.
3

In early 2011, the foot aliment cleared; but by April, it
had returned.

Corrective surgery was conducted on September

30, 2010. The parties further disagree about the cause of the
foot problem.

The Defendants assert that the ulcer was a

result of uncontrolled diabetes.
Additionally,

factual

Mr. Thompson denies this.

allegations

will

be

discussed

below.
III.

SUMMARY JUDGMENT STANDARD
Summary judgment is appropriate only if the record shows

“there is no genuine issue as to any material fact and that
the movant is entitled to judgment as a matter of law.”
R. Civ. P., Rule 56(c).

Fed.

A fact is material if it is necessary

“to establish the existence of an element essential to [a]
party’s case, and on which that party will bear the burden of
proof at trial.”
(1986).

Celotex Corp. v. Catrett, 477 U.S. 317, 322

There is a genuine issue as to a material fact if,

based on the record before the court, a “rational trier of
fact” could find for the non-moving party.

Matsushita Elec.

Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 587
(1986).

4

When considering a motion for summary judgment, a “court
must view the evidence in the light most favorable to the
nonmoving party . . . .”

Hutson v. McDonnell Douglas Corp.,

63 F.3d 771 (8th Cir. 1995).

This requires a court to draw

any reasonable inference from the underlying facts in favor of
the nonmoving party and to refrain from weighing the evidence,
making credibility determinations, or attempting to discern
the truth of any factual issue in a manner which favors the
moving party unless there is no reasonable alternative.
Matsushita,

475

U.S.

at

587;

and

Morris

v.

City

See
of

Chillicothe, 512 F.3d 1013, 1018 (8th Cir. 2008) (citing
Thomas v. Corwin, 483 F.3d 516, 526-27 (8th Cir. 2007).
Procedurally, the movant bears the initial burden “of
informing the district court of the basis for its motion and
identifying those portions of the record which show a lack of
a genuine issue.” Hartnagel v. Norman, 953 F.2d 394, 395 (8th
Cir. 1992) (citing Celotex, 477 U.S. at 323). Once the movant
has carried his burden, the non-moving party is required “to
go beyond the pleadings” and through “affidavits, or by the
‘depositions, answers to interrogatories, and admissions on
file,’ designate specific facts showing that there is a
5

genuine issue for trial.’”

Celotex, 477 U.S. at 323 (citing

Fed. R. Civ. P. 56(e)).
IV.

ISSUES
The Defendants’ Motion for Summary Judgment makes several

different arguments.

Principally, the Defendants argue that

they provided Mr. Thompson adequate medical care.

They argue

that they were not deliberately indifferent to Mr. Thompson’s
medical

issues

medical

discretion

Defendants

and

also

that

they

appropriate

claim

that

exercised
for

they

the

have

the

professional

situation.

qualified

The

immunity

regarding the matters at issue in this claim. Defendant Smith
argues that he is not liable because he was not personally
involved

with

Defendants

Mr.

argue

Thompson’s

that

Mr.

treatment.

Thompson

is

Finally,
not

entitled

the
to

injunctive relief.
V.

ANALYSIS
A.

Deliberate Indifference

Mr. Thompson’s general allegation is that he was and
continues to be injured by the Defendants’ constitutionally
inadequate medical care.

6

At the outset, the Court notes that, “[p]ersons who have
been involuntarily committed are entitled to more considerate
treatment and conditions of confinement than criminals whose
conditions of confinement are designed to punish.” Youngberg,
457 U.S. at 321-22.

There has been some debate regarding the

appropriate standard in this type of case.

In the context of

inmate medical-care claims, Courts have stated that:
[t]he
Eighth
Amendment's
prohibition
against cruel and unusual punishment, which
embodies “broad and idealistic concepts of
dignity, civilized standards, humanity, and
decency,” prohibits punishments which are
incompatible with “the evolving standards
of decency that mark the progress of a
maturing society.” Estelle v. Gamble, 429
U.S. 97, 102 (1976). It thus requires that
the government provide “medical care for
those
whom
it
is
punishing
by
incarceration.” Id. at 103. The Eighth
Amendment safeguards the prisoner against
a lack of medical care that “may result in
pain and suffering which no one suggests
would serve any penological purpose.” Id.
Accordingly, “deliberate indifference to
serious medical needs” of a prisoner
constitutes the unnecessary and wanton
infliction of pain forbidden by the
Constitution. Id. at 104.
Rodriguez v. Plymouth Ambulance Serv., 577 F.3d 816, 828 (7th
Cir. 2009) (parallel citations omitted).

7

This deliberate

indifference standard is used routinely in prisoner cases
related to medical care.
Recently, Courts have applied the deliberate indifference
standard to civilly committed individuals.

See Senty-Haugen

v. Goodno, 462 F.3d 876, 889 (8th Cir. 2006) which applied the
deliberate

indifference

standard

to

a

medical-care

claim

raised by a patient involuntarily committed as a sexually
violent predator under the 14th Amendment.

See also Scott v.

Benson, 742 F.3d 335 (8th Cir. 2014), stating, “where a
patient's Fourteenth Amendment claim is for constitutionally
deficient medical care, we apply the deliberate indifference
standard from the Eighth Amendment. Senty-Haugen, 462 F.3d at
889-90.”
Under the deliberate indifference standard, Mr. Thompson
must show the Defendants were deliberately indifferent to a
serious illness or injury.

Senty-Haugen, 462 F.3d at 889.

A

successful deliberate indifference claim is comprised of both
an objective and a subjective element. Farmer v. Brennan, 511
U.S. 825, 834 (1994).
that,

objectively,

First, Mr. Thompson must demonstrate
the

deprivation

he

suffered

was

“sufficiently serious; that is, it must result in the denial
8

of the minimal civilized measure of life's necessities.”
Walker v. Benjamin, 293 F.3d 1030, 1037 (7th Cir. 2002).

In

the medical care context, this objective element is satisfied
when a plaintiff demonstrates that his medical need itself was
sufficiently serious.

Gutierrez v. Peters, 111 F.3d 1364,

1369 (7th Cir. 1997).

Second, Mr. Thompson must establish

that the defendants acted with a “‘sufficiently culpable state
of mind’” to support liability under § 1983. Greeno v. Daley,
414 F.3d 645, 653 (7th Cir. 2005).
Although negligence or inadvertence will not support a
deliberate indifference claim, a plaintiff need not establish
that prison officials actually intended harm to befall him
from the failure to provide adequate care.
at 1037.

Walker, 293 F.3d

“[I]t is enough to show that the defendants knew of

a substantial risk of harm to [the plaintiff] and disregarded
the risk.”

Greeno, 414 F.3d at 653.

A successful plaintiff

need not show that he was literally ignored in his demands for
medical treatment, and a defendant's showing that a plaintiff
received

some

treatment

does

not

resolve

the

issue

conclusively if the treatment was “blatantly inappropriate.”
Greeno, 414 F.3d at 653–54 (internal citations and quotation
9

omitted).

Finally,

the

Eighth

Amendment

“protects

[a

plaintiff] not only from deliberate indifference to his or her
current serious health problems, but also from deliberate
indifference to conditions posing an unreasonable risk of
serious damage to future health.”
469, 479 (7th Cir. 2005).

Board v. Farnham, 394 F.3d

“Deliberate indifference must be

measured by the official’s knowledge at the time in question,
not by ‘hindsight’s perfect vision.’”

Schaub v. VonWald, 638

F.3d 905, 915 (8th Cir. 2011) (citing Lenz v. Wade, 490 F.3d
991, 993 n.1 (8th Cir. 2007)).
Defendants argue that Mr. Thompson must prove that CCUSO
officials, specifically Ms. Benson and Dr. Smith, knew about
excessive risks to his health but disregarded them, and that
their unconstitutional actions in fact caused his injuries.
Senty-Haugen, 462 F.3d at 890.
their argument is correct.

For the purposes of trial,

However, presently before the

Court is a Motion for Summary Judgment.

As noted above, at

this stage of the case, the claim must be allowed to proceed
if Mr. Thompson has alleged facts from which a jury could find
in his favor.

Accordingly, the Court must consider if there

10

are facts in dispute.

If there is a genuine issue of material

fact, summary judgment is inappropriate.
At its heart, this claim is very simple.

Mr. Thompson

alleges he has a serious medical issue related to an ulcer on
his foot which ultimately required surgery to correct.

Mr.

Thompson goes on to argue that his foot problem was a result
of the Defendants’ deliberate failure to treat his condition.
The Defendants do not deny that Mr. Thompson had an ulcer
on his foot, that it ultimately required corrective surgery,
or that Mr. Thompson has a complicated medical situation as a
result of his diabetes.

However, the Defendants respond by

saying that Mr. Thompson refused treatment for his diabetes,
that Mr. Thompson could have accessed medical care during
weekly clinics or could have scheduled appointments as needed,
and that CCUSO ultimately got Mr. Thompson the medical care he
required.

The Defendants argue that given those facts, there

is no deliberate indifference.

Rather, the Defendants argue

that the facts show that Mr. Thompson got attentive medical
care despite his repeated refusals to follow the doctor’s
orders.

11

Mr. Thompson responds to the Defendants by saying that he
has a hearing problem and did not know when the nurse was
available, that he was told he must wait to see the nurse, and
that his refusal to take diabetes medicine is a result of the
Defendants’ ineptitude in dispensing the correct pills.

He

further argues that his refusal to take diabetes medicine is
unrelated to the medical issue described in his Complaint.
Other factual disputes involve whether Mr. Thompson followed
the proper diet, wore his prescribed orthopedic shoes and
bought too much peanut butter and sugar at the commissary.
It is clear to the Court that there is a genuine issue of
material fact in this case.

Mr. Thompson has alleged facts

that

Defendants

could

show

that

the

treated

him

with

deliberate indifference. The Defendants have alleged contrary
facts.

Determining which facts to believe is the job of the

fact finder, not the judge sitting on a Motion for Summary
Judgment.

Among

many

other

issues,

the

Court

cannot

determine, as a matter of law, whether Mr. Thompson bought too
much peanut butter or whether the Defendants allowed him to
see the nurse when he requested to. Accordingly, that portion
of the Defendants’ Motion for Summary Judgment must be denied.
12

B.

Qualified Immunity

Defendants argue that:
CCUSO Defendants are entitled to qualified
immunity
for
the
performance
of
discretionary functions.
Davis v. Hall,
375 F.3d 703, 711 (8th Cir. 2004).
Qualified immunity exists “to protect
public officials from the ‘broad-ranging
discovery’
that
can
be
‘peculiarly
disruptive
of
effective
government.’
Anderson v. Creighton, 483 U.S. 635, 646
(1987) (quoting Harlow v. Fitzgerald, 457
U.S. 800, 817 (1982)).
To defeat this
qualified immunity, Plaintiff must show how
each
Defendant’s
individual
conduct
violated a “clearly established statutory
or
constitutional
right
of
which
a
reasonable person would have known.” Id.
To make this showing, Plaintiff must: (1)
considering the facts in the light most
favorable to the Plaintiff demonstrate that
each Defendant violated a constitutional
right; and if that criterion is satisfied,
(2) show the constitutional right was
clearly established. Ware v. Morrison, 276
F.3d 385, 387 (8th Cir. 2002).
Docket No. 17-2, p. 10 of 14.
Accordingly, the Defendants are not entitled to qualified
immunity if Mr. Thompson has alleged facts that could show the
Defendants violated a constitutional right and if the right
was clearly established.

As discussed in Section (A), p. 6-

12, Mr. Thompson has alleged facts that could demonstrate the
Defendants violated his constitutional right to medical care.
13

And the Defendants admit in their own brief, “that treating
[a] patient’s medical needs with deliberate indifference is
prohibited by the Constitution.”

Accordingly, Mr. Thompson

has made the appropriate showing to defeat the Defendants’
claim for qualified immunity. That portion of the Defendants’
Motion for Summary Judgment must be denied.
C.

Dr. Smith’s Individual Claim

Defendant Smith argues that he should be dismissed from
this claim because Mr. Thompson fails to allege any claim
specifically against Dr. Smith.

Dr. Smith correctly states

that:
A Plaintiff may bring a section 1983 claim
only against those individuals actually
responsible
for
the
constitutional
deprivation. Doyle v. Camelot Care Centers
[Inc.], 305 F.3d 605, 614-615 (7th Cir.
2002); De[L][a][F]ont v. Beckelman, 264 F.
Supp. [2d] 650, 656, (N.D. Ill 2003).
Defendants are only liable for actions for
which
each
is
directly
responsible.
Madewell v. Roberts, 909 F.2d 1203, 1208
(8th Cir. 1990). A general responsibility
for supervising operations is insufficient
to establish the personal involvement
necessary to support liability. Keeper v.
King, 130 F.3d 1309, 1314 (8th Cir. 1997).
Docket No. 17-2, p. 11 of 14.

14

Dr. Smith goes onto argue that Mr. Thompson’s Complaint is
devoid of specific allegations against him.
However, a cursory review of Mr. Thompson’s Complaint
reveals

that

he

does

attribute

fault

to

Dr.

Smith.

Specifically, on page 2 of his Complaint, Mr. Thompson states
that

on

April

15,

2011,

he

reported

Defendant Benson to Dr. Smith.

his

concerns

about

He goes onto say that Dr.

Smith did not follow through on a promise to send Mr. Thompson
to Iowa City for evaluation.

Finally, Mr. Thompson alleges

that Dr. Smith failed to respond to requests to talk to Mr.
Thompson about his medical issue.

It is clear to the Court

that Mr. Thompson has made specific allegations against Dr.
Smith.

Determining which facts to believe is the job of the

fact finder, not the judge ruling on a Motion for Summary
Judgment. It would be inappropriate to dismiss Dr. Smith from
this case.

Accordingly, that portion of the Defendants’

Motion for Summary Judgment is denied.
D.
The

Injunctive Relief
Defendants

claim

for

because

Mr.

Thompson’s foot related medical issue has been resolved.

Mr.

injunctive

relief

argue
has

that

been

15

Mr.

Thompson’s

rendered

moot

Thompson does not dispute that his foot has healed, but argues
that:
This fact ignores the past history of not
providing Thompson with care in a timely
fashion, which has caused damage to
Thompson. He was not taken to Iowa City
until after he signed this lawsuit.
Therefore, there is a record of real threat
of a future violation of the law, and when
that is the case, injunctive relief is
appropriate.
Docket No. 23-2, p. 8 of 9.
Mr. Thompson goes on to state that an injunction is proper if
“the record shows ‘a real threat of [a] future violation [of
the law] or a contemporary violation of a nature likely to
continue or recur.’”

Webb v. Missouri Pac. R.R., 98 F.3d

1067, 1068 (8th Cir. 1996) (quoting United States v. Oregon
State Med. Soc'y, 343 U.S. 326, 333 (1952) (internal quotation
alterations in Webb)).
The Defendants do not dispute that standard is correct,
but argue that, “[i]n general, a pending claim for injunctive
relief becomes moot when the challenged conduct ceases and
there is no reasonable expectation that the wrong will be
repeated.”

Mo. Pro. And Advocacy Servs., Inc. v. Carnahan,

499 F.3d 803, 811 (8th Cir. 2007).
16

The Defendants argue that

because Mr. Thompson has received competent care that has
resolved his medical issue, his claim for injunctive relief
has been rendered moot.
The Court agrees with the Defendants.

Mr. Thompson, by

his own admission, has now received competent medical care.
Mr. Thompson’s complaint fails to allege any facts that
demonstrate a future risk.

Mr. Thompson has failed to prove

he has a reasonable expectation that this wrong will be
repeated.

He may never suffer an issue with his foot again,

and Mr. Thompson himself wants CCUSO to abstain from the
treatment of his diabetes.

Accordingly, injunctive relief in

this matter would be highly speculative, and that would be
inappropriate.

Accordingly, this portion of the Defendants’

Motion for Summary Judgment is granted.
E.

Counter Claim

The Defendants have also filed a counterclaim requesting
an award of attorney’s fees.

Because the Court is denying in

part and granting in part Defendants’ Motion for Summary
Judgment, ruling on their counterclaim which alleges that the
Plaintiff’s Complaint is frivolous, would be inappropriate at
this time.
17

VI.

CONCLUSIONS
For the reasons set out above, Defendant’s Motion For

Summary Judgment (Docket No. 17) is granted in part/denied in
part as follows:
The Court DENIES the Defendants’ Motion for Summary
Judgment regarding the merits of Mr. Thompson’s case, the
Court DENIES the Defendants’ Motion for Summary Judgment on
the

issues

of

Qualified

Immunity,

the

Court

DENIES

the

Defendants’ Motion for Summary Judgment requesting Dr. Smith
be dismissed from the case, the Court DENIES the Defendants’
Motion for Summary Judgment on their Counterclaim, and the
Court GRANTS the Defendants’ Motion for Summary Judgment
regarding Mr. Thompson’s claim for injunctive relief.
IT IS SO ORDERED this 10th day of March, 2014.

__________________________________
Donald E. O’Brien, Senior Judge
United States District Court
Northern District of Iowa

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