Davis v. Commonwealth of Pennsylvania Department of Corrections et al

Filing 40

MEMORANDUM (Order to follow as separate docket entry) re: 37 MOTION TO DISMISS FOR FAILURE TO STATE A CLAIM filed by C. Otte and 34 MOTION TO DISMISS FOR FAILURE TO STATE A CLAIM filed by Tammy R. Rishel, Cynthia Freeland. Signed by Honorable Matthew W. Brann on 11/13/2017. (jn)

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
AIMEE DAVIS,

No. 4:16-CV-01011

Plaintiff.

(Judge Brann)

v.
C. OTTE, TAMMY R. RISHEL,
CYNTHIA FREELAND, ABC CORP.,
AND JOHN DOE,
Defendant.

MEMORANDUM OPINION
NOVEMBER 13, 2017
Defendants Cynthia Freeland, M.D., Tammy R. Rishel, PA-C, and Cynthia
Otte, R.N., all moved to dismiss Plaintiff Aimee Davis’s Amended Complaint. For
the reasons that follow, their motions are denied.
I.

BACKGROUND
A.

Factual Allegations 1

Ms. Davis injured her left distal radius – i.e., her wrist – in an automobile
accident on October 16, 2015, and was immediately arrested “[i]n connection with

1

When considering a motion to dismiss for failure to state a claim, a court assumes the truth of
all allegations made in the complaint. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). The
material in this section, then, is taken entirely from Ms. Davis’s Amended Complaint, ECF
No. 25, and is presumed true for present purposes.

th[at] accident.”2 While in police custody, she was taken to a hospital, where she
was treated unsuccessfully and told that she “must see a specialist within two
days.” 3 She was discharged from the hospital on October 17, 2015, and remained in
police custody until being received into SCI-Muncy on October 22, 2015. 4
Ms. Davis received no medical care while in police custody through October
22, despite her complaints about “pain and swelling” and her repeated requests for
treatment, the need for which was “documented in her transfer paperwork and
medical records.” 5 Upon her October 22 transfer, during an October 24, 2015
medical evaluation, and on “multiple occasions” through November 24, 2015, Ms.
Davis “complained to” Defendants Dr. Freeland, Ms. Rishel, and Ms. Otte6 about
the “significant and unbearable pain and swelling in her fractured wrist, that she
needed surgery according to the hospital she had just been treated in, and associated
issues including immobility of the joint.”7 Despite her “multiple” complaints to Dr.
Freeland, Ms. Rishel, and Ms. Otte, she received no medical care while at SCIMuncy except “some Motrin for pain,” and, furthermore, she was “prevented . . .

2

ECF No. 25 ¶¶ 14-15.

3

Id. ¶¶ 16-18.

4

Id. ¶¶ 19-20.

5

Id. ¶¶ 21-24.

6

The Amended Complaint alleges that Dr. Freeland, Ms. Rishel, and Ms. Otte are all
Pennsylvania state employees and are all “responsible for providing medical care to inmates
and making decisions with regard to the inmates’ access to medical services.” Id. ¶¶ 5-7.

7

Id. ¶¶ 25-28.

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from receiving” and “intentionally denied” care for “non-medical reasons,
specifically, with the intent of avoiding the costs and burdens associated with”
providing treatment. 8
On or about November 24, 2015, Ms. Davis was finally seen by a surgeon,
and she underwent an operation on November 30, 2015. 9 She alleges that, “[a]s a
consequence of . . . having gone without treatment during the initial six weeks” –
presumably the time from October 15 through November 30 – “her fracture
worsened and made the treatment and recovery . . . complicated and worse.” 10 She
also alleges that her injuries – i.e., “serious and permanent damage to her left wrist,
which include[s] loss of function, loss of strength, loss of motion, pain[,] and
swelling” – are a “consequence” of Dr. Freeland’s, Ms. Rishel’s, and Ms. Otte’s
denial of “necessary and ordered medical treatment.”11
B.

Procedural History

On April 17, 2017, Ms. Davis filed an Amended Complaint 12 against Dr.
Freeland, Ms. Rishel, Ms. Otte, an ABC Corp., and three John Does. The Amended
Complaint contains two counts: Count I, brought under 42 U.S.C. § 1983, alleges
that Defendants’ actions amounted to deliberate indifference to Ms. Davis’s medical
8

Id. ¶¶ 28-30.

9

Id. ¶ 32.

10

Id. ¶ 35.

11

Id. ¶¶ 37-39.

12

ECF No. 25.

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condition, in violation of the Fourteenth Amendment to the United States
Constitution.13 Count II, a medical malpractice claim, alleges that Defendants’
actions were professionally negligent.14
On May 15, 2017, Dr. Freeland and Ms. Rishel moved to dismiss Ms. Davis’s
Amended Complaint for failure to state a claim upon which relief can be granted.15
Ms. Otte filed a similar motion on June 12, 2017.16
II.

DISCUSSION
A.

Standard of Review

When considering a motion to dismiss for failure to state a claim upon which
relief may be granted, 17 a court assumes the truth of all factual allegations in a
plaintiff’s complaint and draws all inferences in favor of that party; 18 the court does
not, however, assume the truth of any of the complaint’s legal conclusions. 19 If a
complaint’s factual allegations, so treated, state a claim that is plausible – i.e., if

13

Id. ¶¶ 14-61.

14

Id. ¶¶ 62-69.

15

ECF No. 34.

16

ECF No. 37.

17

Federal Rule of Civil Procedure 12(b)(6).

18

Phillips v. Cnty. Of Allegheny, 616 F.3d 224, 228 (3rd Cir. 2008).

19

Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). See also Connelly v. Lane Const. Corp., 809 F.3d
780, 786 (3rd Cir. 2016).

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they allow the court to infer the defendant’s liability – the motion is denied; if they
fail to do so, the motion is granted.20
B.

Medical Mistreatment Claim

The Eighth Amendment to the United States Constitution forbids the
infliction of “cruel and unusual punishment,” and is applicable to the states through
the Fourteenth Amendment. 21 It has been interpreted to impose an obligation on the
government “to provide medical care for those whom it is punishing by
incarceration.”22 However, a cognizable claim of medical mistreatment requires
more than mere allegations of “negligen[ce] in diagnosing or treating a medical
condition”; instead, “a prisoner must allege acts or omissions sufficiently harmful to
evidence deliberate indifference to serious medical needs.”23
To show that a medical need is “serious,” a prisoner must demonstrate that it
is “one that has been diagnosed by a physician as requiring treatment or one that is
so obvious that a lay person would easily recognize the necessity for a doctor’s
attention.”24

To show a prison official’s response to such a need amounts to

“deliberate indifference,” a prisoner must show that the official was “aware of facts
20

Id.

21

Estelle v. Gamble, 429 U.S. 97, 101 (1976).

22

Id. at 103.

23

Id. at 106. See also Inmates of Allegheny County Jail v. Pierce, 612 F.2d 754, 762 (3rd Cir.
1979) (“[N]egligence in the administration of medical treatment to prisoners is not itself
actionable under the Constitution.”)

24

Monmouth Cty. Corr. Institutional Inmates v. Lanzaro, 834 F.2d 326, 347 (3rd Cir. 1987).

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from which the inference could be drawn that a substantial risk of serious harm
exists,” and that the official drew that inference.25 The United States Court of
Appeals for the Third Circuit has “found ‘deliberate indifference’ in a variety of
circumstances, including where the prison official (1) knows of a prisoner’s need for
medical treatment but intentionally refuses to provide it; (2) delays necessary
medical treatment based on a non-medical reason; or (3) prevents a prisoner from
receiving needed or recommended medical treatment.” 26
Here, Defendants do not argue that Ms. Davis has failed to allege serious
medical needs. Instead, they dispute whether Ms. Davis has properly alleged that
their reaction to those needs amounted to deliberate indifference.
1.

Whether Prison Officials May Consider the Cost of
Treatment

Dr. Freeland and Ms. Rishel point to Ms. Davis’s allegation that she was
denied medical treatment for “non-medical reasons,” including “the intent of
avoiding . . . costs,” and argue that it was not unconstitutional for them to consider
the financial implications of any available treatment. In support, they note that “the
deliberate indifference standard . . . does not guarantee prisoners the right to be

25

Farmer v. Brennan, 511 U.S. 825, 837 (1994).

26

Rouse v. Plantier, 182 F.3d 192, 197 (3rd Cir. 1999).

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entirely free from the cost considerations that figure in the medical-care decision
made by most non-prisoners in our society.” 27
While an accurate statement of the law, this principle does not warrant
dismissal of Ms. Davis’s claim. It is true that prisoners are not “entirely free” from
cost considerations, the allegation here is not that Defendants chose one course of
action over another based on their weighing of the costs and benefits of available
treatments.

Rather, the Amended Complaint is read to allege that Defendants

deliberately decided on a course of no treatment for no other reason than to avoid an
expense. If proven, this allegation could support a finding that Defendants were
deliberately indifferent to Ms. Davis’s serious medical needs.
2.

Whether Disagreement Over Pain Medication Amounts to
Deliberate Indifference

Dr. Freeland and Ms. Rishel point to Ms. Davis’s allegation that she received
only Motrin while at SCI-Muncy, and argue that a prison official’s refusal to
provide a prisoner’s pain medication of choice is not unconstitutional. In support,
they point to an unpublished Third Circuit opinion which held that a prison official’s
denial of a prisoner’s request for a specific painkiller – the prisoner requested
Ultram, but was given Motrin – was only a “disagreement over the exact contours of

27

Reynolds v. Wagner, 128 F.3d 166, 175 (3rd Cir. 1997).

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[a prisoner’s] medical treatment” and did not amount to deliberate indifference to
that prisoner’s serious medical needs.28
Dr. Freeland and Ms. Rishel misunderstand the nature of Ms. Davis’s claim.
Ms. Davis is not alleging that she should have been given a different painkiller; she
is alleging, instead, that Defendants’ response to her serious medical needs – which
response consisted entirely of giving her Motrin – amounted to deliberate
indifference to those needs. Defendants’ argument on this point, then, is a red
herring.
3.

Whether a Delay in Treatment Amounts to Deliberate
Indifference

Dr. Freeland and Ms. Rishel argue that a delay in medical treatment is not
unconstitutional, and attempt to support this argument by pointing to another
unpublished Third Circuit opinion. 29 Their reliance on that opinion is misplaced,
however, since it explicitly notes that “a delay in rendering necessary medical care
for non-medical reasons can constitute deliberate indifference under certain
circumstances.”30 While it may be that not every delay in medical treatment is
actionable under the Eighth Amendment, the delay alleged here – six weeks

28

Gause v. Diguglielmo, 339 Fed.Appx. 132, 136 (3rd Cir. 2009).

29

Bramson v. Sulayman, 251 Fed.Appx. 84 (3rd Cir. 2009).

30

Id. at 86. See also Natale v. Camden County Correctional Facility, 318 F.3d 575, 582 (3rd
Cir. 2003) (“We have also found deliberate indifference in situations where necessary medical
treatment is delayed for non-medical reasons.”)

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between accident and consultation with a surgeon – may be, if proven, sufficiently
long to constitute deliberate indifference to Ms. Davis’s serious medical needs.
4.

Whether Ms. Davis Has Adequately Pled “But-For”
Causation

Dr. Freeland and Ms. Rishel argue that Ms. Davis has failed to plead that their
alleged actions were the but-for cause of Ms. Davis’s alleged injuries. It appears,
however, that they have failed to carefully read Ms. Davis’s complaint, since it
explicitly states that “[a]s a consequence of Plaintiff having gone without treatment
during the initial six weeks, her fracture worsened and made the treatment and
recovery from same complicated and worse,” and that Ms. Davis’s “permanent
damage to her left wrist” . . . is “a consequence of Defendants having denied
Plaintiff the necessary and ordered medical treatment in the six weeks following the
injury.” 31
5.

Whether Ms. Davis Has Adequately Plead That Defendants
Possessed a “Sufficiently Culpable State of Mind”

Ms. Otte argues that Ms. Davis has not pled that Defendants possessed a
“sufficiently culpable state of mind.” The Amended Complaint, however, alleges
that Ms. Davis personally informed Defendants about her injury and need for
medical care, and that, for non-medical – and purely financial – reasons, Defendants

31

ECF No. 25 ¶¶ 35-39.

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deliberately took no action other than giving Ms. Davis some Motrin. Ms. Davis,
therefore, has adequately pled Defendants’ culpability.
6.

Whether Ms. Davis Has Adequately Pled Her “Complaints”
to Defendants

Ms. Otte argues that Ms. Davis has not provided sufficient detail about the
“complaints” she made to Defendants about her injury. The Amended Complaint
indicates two specific times when these complaints were made – on October 22 and
24, 2015 – and indicates that they were about the “significant and unbearable pain
and swelling in her fractured wrist, that she needed surgery according to the hospital
she had just been treated in, and associated issues including immobility of the joint.”
Ms. Davis has adequately pled her complaints to Defendants.
7.

Whether Ms. Davis Simply Disagrees with the Course of
Treatment Provided

Defendant Ms. Otte argues that the Amended Complaint merely reflects Ms.
Davis’s disagreement and dissatisfaction with the course of treatment provided by
Defendants at SCI-Muncy.
It is true that courts “afford[] considerable latitude to prison medical
authorities in the diagnosis and treatment of the medical problems of inmate
patients,” and will “disavow any attempt to second-guess the propriety or adequacy
of a particular course of treatment[, which] remains a question of sound professional

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judgment.” 32

However, like Dr. Freeland and Ms. Rishel supra, Ms. Otte

misunderstands the nature of Ms. Davis’s claim. Ms. Davis is not arguing that
Defendants provided her unconstitutional course of treatment “X,” instead of
constitutional course of treatment “Y.”

Instead, she alleges that Defendants

provided no treatment for her injury (other than Motrin for associated pain), and that
this refusal of care amounted to deliberate indifference to her serious medical need.
C.

Medical Malpractice Claim

Dr. Freeland, Ms. Rishel, and Ms. Otte all argue that, if this Court dismisses
the medical mistreatment claim against them, this Court should decline to exercise
supplemental jurisdiction over the medical malpractice claim. Because Ms. Davis’s
medical malpractice claim survives, this argument is moot.
III.

CONCLUSION
For the reasons stated above, the motions to dismiss filed by Dr. Freeland,

Ms. Rishel, and Ms. Otte are denied, and Ms. Davis’s claims against those
Defendants survive.
An appropriate Order follows.
BY THE COURT:

s/ Matthew W. Brann
Matthew W. Brann
United States District Judge
32

Inmates of Allegheny County Jail v. Pierce, 612 F.2d 754, 762 (3rd Cir. 1979).

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