Saunders v. Baltimore County Detention Center Medical Department et al

Filing 28

MEMORANDUM OPINION. Signed by Judge Deborah K. Chasanow on 6/24/2019. (c/m 6/24/19 sp2, Deputy Clerk)

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MARYLAND
RICARDO SAUNDERS,
Plaintiff
v.

*
*
*

Civil Action No. DKC-18-569

BALTIMORE COUNTY DETENTION
*
CENTER MEDICAL DEPARTMENT, et al.,
*
Defendants
***
MEMORANDUM OPINION
Plaintiff Ricardo Saunders, formerly an inmate at Baltimore County Detention Center, has
filed a civil rights complaint pursuant to 42 U.S.C. § 1983 alleging that Defendants were
deliberately indifferent to his medical needs. Defendants Amaefule and Figueroa filed a motion
to dismiss or, in the alternative, motion for summary judgment. Although Mr. Saunders was
advised of his right to respond to the motion, he has not done so. Having reviewed the submitted
materials, the court finds that no hearing is necessary. See D. Md. Local Rule 105.6. For the
reasons set forth below, Defendants Amaefule and Figueroa’s dispositive motion, construed as a
motion for summary judgment, shall be granted, and the remaining Defendants shall be dismissed.
BACKGROUND
I.

Plaintiff’s Allegations
Mr. Saunders alleges that he suffers from sleep apnea, requiring him to use a “CPAP

Machine” when sleeping. ECF No. 1 at 3. On January 23, 2018, while Mr. Saunders was confined
to the Baltimore County Detention Center (BCDC), he “was sent to the medical department due
to vomiting (during a flu outbreak).” Id. at 2. Although the medical tests that Mr. Saunders was

given indicated that he did not have the flu, Defendant Dr. Barnes ordered him to be quarantined
for 24 hours. Id. at 2-3.
Based on the quarantine instruction, Mr. Saunders “was placed in a cell without [his]
equipment (CPAP Machine)[.] This cell had nothing in it, but a[] toilet and sink. With constant
air conditioning blowing from a[] vent[, Mr. Saunders] began to start feeling an[xi]ety, depression,
hypertension, and sleep deprivation.” Id. at 3. Mr. Saunders alleges that he notified correctional
staff of his need for his CPAP machine. Specifically, Mr. Saunders states that he informed
Defendant Sgt. Amaefule, who simply responded by saying “‘I know, I know’ . . . [but] never did
help [Mr. Saunders], and went home after his shift was over.” Id. Thereafter, Mr. Saunders
informed Defendant Sgt. Figueroa that he needed his CPAP machine; “Figueroa said ‘ok,’ and
then continued on his shift” without getting Mr. Saunders’ CPAP machine for him. Id. Mr.
Saunders was released from quarantine on January 24, 2018, after spending 16 hours in the cell
without his CPAP machine. Id. Aside from the above-noted mental stress, sleep deprivation, and
hypertension, Mr. Saunders does not allege that he suffered any specific ill-effects from being
without his CPAP machine, though he conclusorily alleges that he “could have died in that cell.”
Id. at 3
II.

Defendants Amaefule and Figueroa’s motion
Defendants Amaefule and Figueroa filed a motion to dismiss or, in the alternative, motion

for summary judgment supported with affidavits and other materials. See ECF Nos. 26, 26-7, 269. In relevant part, Amaefule avers that he does “not recall hav[ing] any conversation regarding
CPAP equipment with Mr. Saunders” and that “Mr. Saunders would not have been able to use his
CPAP equipment in Zone 1 holding cells because the cells do not have electric outlets.” ECF No.
26-7. Further, Amaefule references and has attached a copy of an email he sent roughly a month

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after the incident in response to an inquiry “about Mr. Saunders complaint that he was not allowed
to use his CPAP machine,”; Amaefule responded that he “did not transport Mr. Saunders to Zone
1 housing and did not know about the CPAP machine.” Id.; see also ECF No. 26-3.
Defendant Figueroa avers that
11.
Between approximately 11:30 PM and 12:30 PM [sic] on January 23-24,
2018, I had a brief 20-30 second conversation with inmate Ricardo Saunders (Mr.
Saunders) in which he inquired about his Continuous Positive Airway Pressure
(CPAP) device. He informed me that his CPAP device was not brought with him
to the isolation cell and that he needed it. He asked if I would look into getting it
brought to his isolation cell. I told him I would;
12.
I did not find any information in the Jail Management System computer and
did not find any paper work for the CPAP equipment. I called medical to see if a
CPAP was authorized for Mr. Saunders and if so where was it presently located.
Medical staff said they would call me back;
13.
Medical staff subsequently called me and advised that Mr. Saunders was
authorized to have the CPAP equipment but that they did not know where it was
presently located;
14.
I checked on Mr. Saunders during the night and each time I checked on him
I observed that he was breathing without difficulty and asleep;
15.
I saw Mr. Saunders at approximately 4:15-4:30 AM at breakfast and told
him that I had checked on the CPAP equipment but had not been able to locate it;
16.
During the time I spoke to Mr. Saunders, he was calm and respectful. He
did not appear to be distressed or anxious;
17.
I had no further interaction or conversations with Mr. Saunders regarding
his CPAP equipment.
ECF No. 26-7 at 2-3.
In addition to Amaefule and Figueroa’s affidavits, Defendants have also submitted an
affidavit from Yolanda Rawlerson, the Medical Nurse Liaison at BCDC, in which she noted:
11.
Mr. Saunders’ incarceration at BCDC began on July 4, 2017. At the time
he [sic] of his admission, Mr. Saunders reported to the medical personnel, that he
suffered from sleep apnea and required CPAP equipment;

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12.
Medical personnel informed Mr. Saunders on July 4, 2017, that his family
would have to bring his CPAP equipment to BCDC. On July 25, 2017, Mr.
Saunders family brought his CPAP equipment to BCDC;
13.
From July 4, 2017, to July 25,2017, a total of 21 days, Mr. Saunders was
housed on the Medical tier without CPAP equipment. During that time he had no
medical complications[.]
ECF No. 26-8 at 3.
Though informed of his right to do so, ECF No. 27, Mr. Saunders did not file anything in
response to Defendants’ motion.
STANDARD OF REVIEW
Defendants Amaefule and Figueroa’s dispositive motion is styled as a motion to dismiss
under Federal Rule of Civil Procedure 12(b)(6) or, in the alternative, for summary judgment under
Rule 56. A motion styled in this manner implicates the court’s discretion under Rule 12(d) of the
Federal Rules of Civil Procedure. See Kensington Vol. Fire Dep't, Inc. v. Montgomery Cty., 788
F. Supp. 2d 431, 436-37 (D. Md. 2011). Ordinarily, a court “is not to consider matters outside the
pleadings or resolve factual disputes when ruling on a motion to dismiss.” Bosiger v. U.S. Airways,
510 F.3d 442, 450 (4th Cir. 2007). However, under Rule 12(b)(6), a court, in its discretion, may
consider matters outside of the pleadings, pursuant to Rule 12(d). If the court does so, “the motion
must be treated as one for summary judgment under Rule 56,” and “[a]ll parties must be given a
reasonable opportunity to present all the material that is pertinent to the motion.” Fed. R. Civ. P.
12(d). When the movant expressly captions its motion “in the alternative” as one for summary
judgment and submits matters outside the pleadings for the court’s consideration, the parties are
deemed to be on notice that conversion under Rule 12(d) may occur; the court “does not have an
obligation to notify parties of the obvious.” Laughlin v. Metro. Wash. Airports Auth., 149 F.3d

4

253, 261 (4th Cir. 1998). Because Defendants have filed and relied on declarations and exhibits
attached to their dispositive motion, the motion shall be treated as one for summary judgment.
Summary judgment is governed by Rule 56(a), which provides in relevant part that “[t]he
court shall grant summary judgment 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.” In analyzing a summary
judgment motion, the court should “view the evidence in the light most favorable to . . . the
nonmovant, and draw all inferences in her favor without weighing the evidence or assessing the
witnesses’ credibility.” Dennis v. Columbia Colleton Med. Ctr., Inc., 290 F.3d 639, 644-45 (4th
Cir. 2002); see Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986);
FDIC v. Cashion, 720 F.3d 169, 173 (4th Cir. 2013).
“A party opposing a properly supported motion for summary judgment ‘may not rest upon
the mere allegations or denials of [his] pleadings,’ but rather must ‘set forth specific facts showing
that there is a genuine issue for trial.’” Bouchat v. Baltimore Ravens Football Club, Inc., 346 F.3d
514, 525 (4th Cir. 2003) (alteration in original) (quoting former Fed. R. Civ. P. 56(e)). Because
Mr. Saunders is proceeding pro se, his submissions are liberally construed. See Erickson v. Pardus,
551 U.S. 89, 94 (2007). Nonetheless, the court must also abide by the “affirmative obligation of
the trial judge to prevent factually unsupported claims and defenses from proceeding to trial.”
Bouchat, 346 F.3d at 526 (internal quotation marks omitted).
DISCUSSION
Mr. Saunders does not specify whether he was a pretrial detainee or convicted prisoner at
the time of the incident. However, Defendants have provided a copy of the docket sheet in Mr.
Saunders’ state criminal case indicating that he was a convicted prisoner at the time. ECF No. 26-

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6. Accordingly, Mr. Saunders’ claim of deliberate indifference to his medical needs is analyzed
under the Eighth Amendment. See Young v. City of Mt. Ranier, 238 F.3d 567, 575 (4th Cir. 2001).
Deliberate indifference to a serious medical need requires proof that, objectively, the
plaintiff was suffering from a serious medical need and that, subjectively, the prison staff were
aware of the need for medical attention but failed to either provide it or ensure it was available.
See Farmer v. Brennan, 511 U.S. 825, 834-37 (1994); King v. Rubenstein, 825 F.3d 206, 218 (4th
Cir. 2016); Iko v. Shreve, 535 F.3d 225, 241 (4th Cir. 2008). Objectively, the medical condition
at issue must be serious. See Hudson v. McMillian, 503 U.S. 1, 9 (1992); Jackson v. Lightsey, 775
F.3d 170, 178 (4th Cir. 2014). A serious medical need is “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.” Iko, 535 F.3d at 241; see also Scinto v.
Stansberry, 841 F.3d 219, 228 (4th Cir. 2016). Proof of an objectively serious medical condition,
however, does not end the inquiry.
The subjective component requires “subjective recklessness” in the face of the serious
medical condition. See Farmer, 511 U.S. at 839-40 (1994); see also Anderson v. Kingsley, 877
F.3d 539, 544 (4th Cir. 2017).

Under this standard, “the prison official must have both

‘subjectively recognized a substantial risk of harm’ and ‘subjectively recognized that his actions
were inappropriate in light of that risk.’” Anderson, 877 F.3d at 545 (quoting Parrish ex rel. Lee
v. Cleveland, 372 F.3d 294, 303 (4th Cir. 2004)); see also Rich v. Bruce, 129 F.3d 336, 340 n.2
(4th Cir. 1997) (“True subjective recklessness requires knowledge both of the general risk, and
also that the conduct is inappropriate in light of that risk.”). “Actual knowledge or awareness on
the part of the alleged inflicter . . . becomes essential to proof of deliberate indifference because

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‘prison officials who lacked knowledge of a risk cannot be said to have inflicted punishment.’”
Brice v. Va. Beach Corr. Ctr., 58 F.3d 101, 105 (4th Cir. 1995) (quoting Farmer, 511 U.S. at 844).
If the requisite subjective knowledge is established, an official may avoid liability “if [he]
responded reasonably to the risk, even if the harm ultimately was not averted.” Farmer, 511 U.S.
at 844; see also Cox v. Quinn, 828 F.3d 227, 236 (4th Cir. 2016) (“[A] prison official’s response
to a known threat to inmate safety must be reasonable.”). Reasonableness of the actions taken
must be judged in light of the risk the defendant actually knew at the time. See Brown v. Harris,
240 F.3d 383, 390 (4th Cir. 2001). While “a prisoner does not enjoy a constitutional right to the
treatment of his or her choice, the treatment a prison facility does provide must nevertheless be
adequate to address the prisoner’s serious medical need.” De’lonta v. Johnson, 708 F.3d 520, 526
(4th Cir. 2013).
“Deliberate indifference is a very high standard—a showing of mere negligence will not
meet it . . . . [T]he Constitution is designed to deal with deprivations of rights, not errors in
judgment, even though such errors may have unfortunate consequences.” Grayson v. Peed, 195
F.3d 692, 695- 96 (4th Cir. 1999); see also Jackson v. Lightsey, 775 F.3d 170, 178 (4th Cir. 2014)
(describing the applicable standard as an “exacting” one).
A.

Defendant Baltimore County Detention Center Medical Department
Section § 1983 states that
“Every person who, under color of any statute, ordinance, regulation, custom, or
usage, of any State or Territory . . . subjects, or causes to be subjected, any citizen
of the United States or other person with the jurisdiction thereof to the deprivation
of any rights, privileges or immunities secured by the Constitution and laws, shall
be liable to the party injured . . .”

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42 U.S.C. § 1983 (emphasis supplied). Municipalities are “included among those persons to whom
§ 1983 applies.” Monell v. Dep’t of Social Servs., 436 U.S. 658, 690 (1978).1 However, a
municipality “may not be sued under § 1983 for an injury inflicted solely by its employees or
agents.” Id. at 694. “Section 1983 plaintiffs seeking to impose liability on a municipality must,
therefore, adequately plead and prove the existence of an official policy or custom that is fairly
attributable to the municipality and that proximately caused the deprivation of their rights.” Jordan
v. Jackson, 15 F.3d 333, 338 (4th Cir. 1994). Here, Mr. Saunders does not claim his alleged
deprivation was connected to any sort of official policy or custom (as opposed to an isolated
incident caused by individual employees). Therefore, Baltimore County Detention Center Medical
Department (or, technically, “Baltimore County, Maryland) must be dismissed.
B.

Defendant Barnes
The court was unable to obtain service on Defendant Barnes. However, the court finds

further efforts unnecessary in view of the fact that Mr. Saunders has failed to state a claim against
Dr. Barnes. Mr. Saunders alleges that “Dr. Barnes ordered me to be quarantine[d] for 24 hours
knowing my health issue of serve [sic] sleep apnea[,] which requires the use of my cpap machine,”
and that he was put in a cell without the CPAP machine or an electrical outlet necessary to connect
the machine to a power source. ECF No. 1 at 3. However, Mr. Saunders fails to allege that Dr.
Barnes had any involvement with his specific cell placement while being quarantined. Likewise,

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Technically, “Baltimore County Detention Center Medical Department” is not a legal
entity that can be sued. The Baltimore County Detention Center (and, by extension, its Medical
Department) is controlled by the Baltimore County Department of Corrections, an administrative
agency of Baltimore County. Baltimore County Ord. §§ 3-2-301 to 3-2-303. Under the County
Charter, “[t]he corporate name shall be ‘Baltimore County, Maryland,’ and it shall thus be
designated in all actions and proceedings touching its rights, powers, properties, liabilities and
duties.” Baltimore County, Md. Charter § 103. However, even assuming that Mr. Saunders had
named the correct legal entity, his claim would fail.
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he fails to allege that Dr. Barnes had knowledge that his CPAP machine was not taken to his
quarantine cell or that the cell lacked a power source. In other words, although Mr. Saunders
alleges that Dr. Barnes knew of his sleep apnea and of his customary use of a CPAP machine, there
are no facts alleged in the complaint to support a conclusion that Dr. Barnes knew Mr. Saunders
would be deprived of his CPAP machine based on the decision to quarantine him. Although Mr.
Saunders alleges he informed particular individuals that he had been deprived of his CPAP
machine and needed it, Dr. Barnes is not one of the identified individuals. Therefore, Mr. Saunders
fails to state a claim against Dr. Barnes because he does not allege that Dr. Barnes had the requisite
actual knowledge to support a prima facie deliberate indifference claim.
C.

Defendants Amaefule and Figueroa
Regarding the objective prong of a deliberate indifference claim, it is unlikely that a sleep

apnea sufferer being deprived of a CPAP machine for a single night rises to the level of a serious
medical condition. Mr. Saunders does not detail the severity of his particular condition; however,
the health complications from sleep apnea stem from the consequences of getting inadequate sleep
over a long period of time, not just a single night of poor sleep. See National Heart, Lung, and
Blood Institute, National Institutes of Health, Sleep Apnea, https://www.nhlbi.nih.gov/healthtopics/sleep-apnea

(last

visited

June

20,

2019);

Mayo

Clinic,

Sleep

Apnea,

https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
(last visited June 20, 2019). This is particularly true given the undisputed evidence that upon his
arrival at the jail, Mr. Saunders went without his CPAP machine for 21 consecutive nights without
medical complications. ECF No. 26-8 at 3.
As to the subjective prong, there is no suggestion that either Amaefule or Figueroa
appreciated the possible consequences of Mr. Saunders not receiving his CPAP machine. Mr.

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Saunders merely alleges that he told these two Defendants that he needed his CPAP machine; he
does not allege that he reported his symptoms of “an[xi]ety, depression, hypertension, and sleep
deprivation” he experienced; nor does he claim he told them of his belief that the deprivation of
the CPAP machine “could have cost me my life;” nor is there any evidence that these Defendants
had any basis to believe that the lack of a CPAP machine for a single night would cause any health
consequences more severe than a disruptive night’s sleep. ECF No. 1 at 3. Moreover, as to
Figueroa in particular, even he had been aware of the potential for more severe consequences, his
undisputed affidavit indicates that he reasonably responded to the risk by trying to find the CPAP
machine and, when unable to locate it, by checking on Mr. Saunders throughout the night to ensure
he was not in distress. ECF No. 26-7 at 2-3. Figueroa’s actions do not evidence a callous disregard
for Mr. Saunders’ well-being. Accordingly, Mr. Saunders’ claim that Amaefule and Figueroa were
deliberately indifferent must fail.
CONCLUSION
For the foregoing reasons, Defendants Baltimore County Detention Center Medical
Department and Barnes are dismissed, and Defendants Amaefule and Figueroa’s dispositive
motion, construed as a motion for summary judgment is granted. A separate Order follows.

June 24, 2019

/s/
DEBORAH K. CHASANOW
United States District Judge

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