RUFFIN v. CICHON et al
REPORT AND RECOMMENDED DECISION re 1 Complaint filed by DANIEL ONEIL RUFFIN. Objections to R&R due by 6/8/2017. By MAGISTRATE JUDGE JOHN C. NIVISON. (CWP)
UNITED STATES DISTRICT COURT
DISTRICT OF MAINE
DANIEL ONEIL RUFFIN,
ALFRED CICHON, et al.,
RECOMMENDED DECISION AFTER SCREENING COMPLAINT
PURSUANT TO 28 U.S.C. §§ 1915(e), 1915A
In this action, Plaintiff Daniel Ruffin, an inmate incarcerated at the Knox County
Jail, alleges Defendants have violated his constitutional rights by restricting his diet and
access to the commissary, and by failing to treat properly a medical condition that affected
Plaintiff filed an application to proceed in forma pauperis (ECF No. 2), which
application the Court granted. (ECF No. 4.) In accordance with the in forma pauperis
statute, a preliminary review of Plaintiff’s complaint is appropriate.
28 U.S.C. §
1915(e)(2). Additionally, Plaintiff’s complaint is subject to screening “before docketing,
if feasible or … as soon as practicable after docketing,” because he is “a prisoner seek[ing]
redress from a governmental entity or officer or employee of a governmental entity.” 28
U.S.C. § 1915A(a).
Following a review of Plaintiff’s complaint, I recommend the Court dismiss
Plaintiff’s claims regarding his diet and access to the commissary, and order service of the
complaint on Defendants Cichon and Knowlton on Plaintiff’s medical care claim.
STANDARD OF REVIEW
The federal in forma pauperis statute, 28 U.S.C. § 1915, is designed to ensure
meaningful access to the federal courts for those persons unable to pay the costs of bringing
an action. When a party is proceeding in forma pauperis, however, “the court shall dismiss
the case at any time if the court determines,” inter alia, that the action is “frivolous or
malicious” or “fails to state a claim on which relief may be granted” or “seeks monetary
relief against a defendant who is immune from such relief.” 28 U.S.C. § 1915(e)(2)(B).
“Dismissals [under § 1915] are often made sua sponte prior to the issuance of process, so
as to spare prospective defendants the inconvenience and expense of answering such
complaints.” Neitzke v. Williams, 490 U.S. 319, 324 (1989).
In addition to the review contemplated by § 1915, Plaintiff’s complaint is subject to
screening under the Prison Litigation Reform Act because Plaintiff currently is incarcerated
and seeks redress from governmental entities and officers. See 28 U.S.C. § 1915A(a), (c).
The § 1915A screening requires courts to “identify cognizable claims or dismiss the
complaint, or any portion of the complaint, if the complaint (1) is frivolous, malicious, or
fails to state a claim …; or (2) seeks monetary relief from a defendant who is immune from
such relief.” 28 U.S.C. § 1915A(b).
When considering whether a complaint states a claim for which relief may be
granted, courts must assume the truth of all well-plead facts and give the plaintiff the
benefit of all reasonable inferences therefrom. Ocasio-Hernandez v. Fortuno-Burset, 640
F.3d 1, 12 (1st Cir. 2011). A complaint fails to state a claim upon which relief can be
granted if it does not plead “enough facts to state a claim to relief that is plausible on its
face.” Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570 (2007).
Although a pro se plaintiff’s complaint is subject to “less stringent standards than
formal pleadings drafted by lawyers,” Haines v. Kerner, 404 U.S. 519, 520 (1972), this is
“not to say that pro se plaintiffs are not required to plead basic facts sufficient to state a
claim”, Ferranti v. Moran, 618 F.2d 888, 890 (1st Cir. 1980). To allege a civil action in
federal court, it is not enough for a plaintiff merely to allege that a defendant acted
unlawfully; a plaintiff must affirmatively allege facts that identify the manner by which the
defendant subjected the plaintiff to a harm for which the law affords a remedy. Ashcroft v.
Iqbal, 556 U.S. 662, 678 (2009).
Plaintiff alleges he suffers from type II diabetes, and asserts two claims related to
Plaintiff arrived at the Knox County Jail on November 17, 2016. Sometime after
his arrival, Plaintiff requested medical care, and he was seen by Defendant Michael
Knowlton, a registered nurse. As a consequence of diabetes, the skin on Plaintiff’s feet is
subject to dryness and cracking. Plaintiff requested an ointment for his feet, but it was not
The facts set forth herein are derived from Plaintiff’s complaint.
On two subsequent occasions, Plaintiff requested aid, and informed Defendant
Knowlton that he had developed an open wound on his foot. According to Plaintiff,
Defendant Knowlton did not provide any medication for the entire month of December
2016 (Plaintiff arrived at the facility on November 17, 2016). Plaintiff asserts Defendant
Knowlton recommended that Plaintiff use the butter served on his meal tray as a foot
moisturizer, or purchase a lotion from the commissary. Plaintiff also requested medication
for the pain and discomfort, but his request was refused. (Complaint at 4 – 5; Complaint
Ex. 1, ECF No. 1-1, PageID # 8 – 9.)
While Plaintiff was seeking care for his foot, Plaintiff had to “hop” on his left foot
or walk on the ball of his right foot because of pain resulting from the wound on his right
foot. (Complaint at 5.) Plaintiff asserts that Defendants Knowlton and Alfred Cichon, the
facility’s physician’s assistant, refused to let him try A + D Ointment during this time. (Id.
Eventually, Plaintiff obtained bacitracin ointment from another prisoner, and
Plaintiff was able to heal the wound through use of the ointment. (Id.) Plaintiff alleges he
suffered pain and discomfort for three weeks. (Id. at 6.)
Because of his diabetes, Plaintiff has been placed on a restricted diet designed for
individuals who suffer from diabetes.
Specifically, Defendant Cichon directed that
Plaintiff was to receive 1800 calories each day rather than the 2300 daily calories provided
to the general population. Plaintiff’s meals consist of potatoes, bread, and processed meat.
Plaintiff asserts that the prescribed foods are not healthy for diabetics. (Id.)
According to Plaintiff, Plaintiff’s commissary access is also limited because of his
diabetes diagnosis. Plaintiff cannot order various food items that would otherwise be
available. Plaintiff maintains his limited access to the commissary is discriminatory.
Plaintiff alleges he should have access to additional options because he may need
something to elevate his blood sugar. (Id. at 7.)
The Fourteenth Amendment imposes an obligation on the states to provide medical
attention for the serious medical needs of prisoners in their custody. Specifically, the Due
Process Clause imposes on the states the “substantive obligation” not to treat prisoners in
their care in a manner that reflects “deliberate indifference” toward “a substantial risk of
serious harm to health,” Coscia v. Town of Pembroke, 659 F.3d 37, 39 (1st Cir. 2011), or
“serious medical needs,” Feeney v. Corr. Med. Servs., 464 F.3d 158, 161 (1st Cir. 2006)
(quoting Estelle v. Gamble, 429 U.S. 97, 105 – 106 (1976)). To be actionable, a deliberate
indifference claim must satisfy both an objective and a subjective standard. Leavitt v. Corr.
Med. Servs., 645 F.3d 484, 497 (1st Cir. 2011).
The objective standard evaluates the seriousness of the risk of harm to one’s health.
For a medical condition to be objectively “serious,” there must be “a sufficiently substantial
‘risk of serious damage to [the inmate’s] future health.’” Farmer v. Brennan, 511 U.S.
825, 843 (1994) (quoting Helling v. McKinney, 509 U.S. 25, 35 (1993)). A medical need
is serious if it has been diagnosed by a physician as mandating treatment, or is so obvious
that even a lay person would recognize a need for medical intervention. Leavitt, 645 F.3d
at 497; Gaudreault v. Mun. of Salem, 923 F.2d 203, 208 (1st Cir. 1990), cert. denied, 500
U.S. 956 (1991). The symptoms of diabetes can present a serious medical need. Rollins
v. Magnusson, 542 F. Supp. 2d 114, 117 (D. Me. 2008); Lolli v. County of Orange, 351
F.3d 410, 420 (9th Cir. 2003). Conditions that impose pain and discomfort “might be
tolerable for a few days and intolerably cruel for weeks or months.” Hutto v. Finney, 437
U.S. 678, 686 – 87 (1978).
The subjective standard concerns the culpability of the defendant. There must be
evidence that a particular defendant possessed a culpable state of mind amounting to
“deliberate indifference to an inmate’s health or safety.” Farmer, 511 U.S. at 834 (internal
quotation marks omitted). Deliberate indifference is akin to criminal recklessness,
“requiring actual knowledge of impending harm, easily preventable.” Feeney, 464 F.3d at
162 (quoting Watson v. Caton, 984 F.2d 537, 540 (1st Cir. 1993)). The focus of the
deliberate indifference analysis “is on what the jailers knew and what they did in response.”
Burrell v. Hampshire Cnty., 307 F.3d 1, 8 (1st Cir. 2002). Deliberate indifference can be
demonstrated by facts indicating the defendant “had a culpable state of mind and intended
wantonly to inflict pain . . . or actual knowledge [or wilful blindness] of impending harm,
easily preventable.” DeRosiers v. Moran, 949 F.2d 15, 19 (1st Cir. 1991) (citations
Deliberate indifference must be distinguished from negligence. As the First Circuit
A finding of deliberate indifference requires more than a showing of
negligence. Estelle v. Gamble, 429 U.S. 97, 106 (1976) (holding that
“[m]edical malpractice does not become a constitutional violation merely
because the victim is a prisoner”); Sires v. Berman, 834 F.2d 9, 13 (1st Cir.
1987). A plaintiff claiming an eighth amendment violation with respect to
an inmate’s serious mental health or safety needs must allege “acts or
omissions sufficiently harmful to evidence deliberate indifference.” Estelle,
429 U.S. at 106; see also Cortes-Quinone v. Jimenez-Nettleship, 842 F.2d
556, 558 (1st Cir.), cert. denied, 488 U.S. 823 (1988). Although this court
has hesitated to find deliberate indifference to a serious need “[w]here the
dispute concerns not the absence of help, but the choice of a certain course
of treatment,” Sires, 834 F.2d at 13, deliberate indifference may be found
where the attention received is “so clearly inadequate as to amount to a
refusal to provide essential care.”
Torraco v. Maloney, 923 F.2d 231, 234 (1st Cir. 1991).
Here, Plaintiff alleges that Defendants Knowlton and Cichon were aware that he
suffered from diabetes and that he had an open wound on one of his feet, but did not provide
him with an ointment to use, nor otherwise treat the medical condition that affected his
feet. Plaintiff contends he could not walk properly and suffered emotional anguish for a
period of three weeks. Given the nature of the alleged medical condition (i.e., a diabetic
suffering from an open foot wound on a foot) and given the alleged lack of treatment,
Plaintiff has asserted sufficient facts to support a finding that he suffered from a serious
medical condition to which Defendants Knowlton and Cichon were deliberately
indifferent. Plaintiff, however, has not asserted a plausible deliberate indifference claim
against Defendant John Hinkley, identified by Plaintiff as the jail administrator.
“The Eighth Amendment’s ban on inflicting cruel and unusual punishments, made
applicable to the States by the Fourteenth Amendment, ‘proscribe[s] more than physically
barbarous punishments.’” Hutto, 437 U.S. at 685 (quoting Estelle, 429 U.S. at 102). “It
prohibits penalties … that transgress today’s ‘broad and idealistic concepts of dignity,
civilized standards, humanity, and decency.’” Id. (quoting Jackson v. Bishop, 404 F.2d
571, 579 (8th Cir. 1968)). Prison conditions that deprive inmates of basic human needs—
food, medical care, sanitation, or physical safety—may offend these standards and thereby
violate the Eighth Amendment. Rhodes v. Chapman, 452 U.S. 337, 346 (1981).
Prisoners have the right to nutritionally adequate food. Domegan v. Fair, 859 F.2d
1059, 1064 (1st Cir. 1988). An inmate does not, however, have a right to food that satisfies
his taste preferences. Lunsford v. Bennett, 17 F.3d 1574, 1580 (7th Cir. 1994); LeMaire v.
Maass, 12 F.3d 1444, 1456 (9th Cir. 1993); Burgin v. Nix, 899 F.2d 733, 734 – 35 (8th Cir.
Although “[n]o static ‘test’ can exist by which courts determine whether
conditions of confinement are cruel and unusual,” Rhodes v. Chapman, 452
U.S. 337, 346 (1981), the Supreme Court has said that “extreme deprivations
are necessary to make out a conditions-of-confinement claim. Because
routine discomfort is part of the penalty that criminal offenders pay for their
offenses against society, only those deprivations denying the minimal
civilized measure of life’s necessities are sufficiently grave to form the basis
of an Eighth Amendment violation.” Hudson v. McMillian, 112 S. Ct. 995,
1000 (1992) (citations omitted).
Cookish v. Comm’r, N.H. Dep’t of Corr., 980 F.2d 721 (1st Cir. 1992) (table).
In the absence of a deprivation that constitutes a constitutional violation, federal
courts give deference to administrative officials in the management of prisons.
Running a prison is an inordinately difficult undertaking that requires
expertise, planning, and the commitment of resources, all of which are
peculiarly within the province of the legislative and executive branches of
government. Prison administration is, moreover, a task that has been
committed to the responsibility of those branches, and separation of powers
concerns counsel a policy of judicial restraint.
Turner v. Safley, 482 U.S. 78, 84 – 85 (1987).
Plaintiff has not alleged any facts to suggest that his diet is nutritionally deficient,
or that prison officials have restricted his diet based on his status as a member of a protected
class. Rather, Plaintiff has expressed a disagreement with prison administration regarding
the foods to which he should have access because of his diabetic condition.
disagreement is not a basis for an actionable constitutional claim. 2
Based on the foregoing analysis, pursuant to 28 U.S.C. § 1915(e)(2) and 28 U.S.C.
§ 1915A(a), I recommend the Court dismiss Plaintiff’s claims against all defendants except
Plaintiff’s medical care claim against Defendants Knowlton and Cichon.
A party may file objections to those specified portions of a magistrate
judge's report or proposed findings or recommended decisions entered
pursuant to 28 U.S.C. § 636(b)(1)(B) for which de novo review by the district
court is sought, together with a supporting memorandum, within fourteen
(14) days of being served with a copy thereof.
Failure to file a timely objection shall constitute a waiver of the right
to de novo review by the district court and to appeal the district court's order.
/s/ John C. Nivison
U.S. Magistrate Judge
Dated this 25th day of May, 2017.
In his grievance filings, Plaintiff asserts that he has the right to refuse unwanted medical care and that he
therefore should also be permitted to refuse dietary restrictions imposed for health reasons. (Complaint Ex.
5, PageID # 16.) Recognizing there could be situations in which a prisoner is entitled to reject recommended
medical treatment, Scott v. Benson, 151 F. Supp. 3d 931, 945 (N.D. Iowa 2015), Plaintiff has no right to a
particular diet. Restrictions on an inmate’s diet, provided the diet remains nutritionally adequate, are not
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