Kimbrough v. Seahorn
MEMORANDUM OPINION OF THE COURT. Signed by District Judge Todd J. Campbell on 3/27/13. (xc:Pro se party by regular and certified mail.)(DOCKET TEXT SUMMARY ONLY-ATTORNEYS MUST OPEN THE PDF AND READ THE ORDER.)(rd)
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF TENNESSEE
Plaintiff James Kimbrough has filed a pro se complaint under 42 U.S.C. § 1983 (ECF No. 1). The
complaint is before the Court for an initial review pursuant to 28 U.S.C. §§ 1915(e)(2)(B) and 1915A, and
McGore v. Wrigglesworth, 114 F.3d 601, 608–09 (6th Cir.1997), overruled on other grounds by Jones v.
Bock, 549 U.S. 199 (2007).
The plaintiff is presently incarcerated at the Lois M. DeBerry Special Needs Facility (“DSNF”) in
Nashville, Tennessee. He brings suit against defendant Dave Seahorn, who the plaintiff alleges is a
physician’s assistant employed at the prison and is responsible for providing medical care to inmates at DSNF.
The plaintiff asserts that Seahorn has been and remains deliberately indifferent to the plaintiff’s serious
medical needs in violation of the plaintiff’s rights under the Eighth Amendment.
In support of that claim, the plaintiff alleges that he has a mass or “knot” in the deep tissue of his neck
on the right side that, according to the plaintiff, “appears to be ‘rid[ing]’ or connected to his carotid artery.”
(ECF No. 1, at 10.) The plaintiff admits that the knot has been there for approximately ten years, but he
contends that it began significantly affecting his cardiovascular health over the past “couple” of years (id.), and
that Seahorn is aware of that fact. The plaintiff alleges that Seahorn is “the healthcare official who is ultimately
responsible the plaintiff’s general health care concerns,” and specifically that Seahorn is responsible for
making referrals to medical providers and specialists inside and outside the prison, if necessary. (Id. at 11.)
The plaintiff states that if Seahorn refuses to refer an inmate to a medical doctor or outside specialist, that
inmate is not seen by a doctor or specialist, “under any circumstance what-so-ever.” (Id. at 12.)
The plaintiff alleges that he has been confined at DSNF for the past year and has requested dozens
of times to be evaluated by a medical doctor, but that Seahorn refuses to refer him for examination or
treatment by a medical doctor. Instead, Seahorn tells the plaintiff (or relays messages to him) that he should
stay on his medication (a vasodilator and a beta-blocker for his high blood pressure), take Tylenol and use
hot washrags on the area on his neck if it causes pain or discomfort, and avoid doing strenuous exercise or
heavy lifting. Seahorn has not actually examined the area on the plaintiff’s neck since April 2012.
At the examination in April 2012, Seahorn asked the plaintiff if he was having headaches or dizziness.
The plaintiff told him he had both, and that the area hurt all the time, and nothing seemed to help. Seahorn
told the plaintiff to “keep an eye” on the knot. (ECF No. 1, at 15.) Since then, the plaintiff has been
experiencing pain radiating from the knot into his head, constant dizziness and severe headaches on a daily
basis, as well as a feeling of pressure in his head, and a “strangled” feeling, particularly at night. (Id. at 19.)
The plaintiff also states that he has been examined by various staff nurses who have all expressed their
concern about the plaintiff’s condition and referred him to be seen by Seahorn, but the plaintiff still has not
been examined or treated by Seahorn since April 2012, or by an actual medical doctor. Seahorn has even
responded on at least two recent occasions to the nurses’ referrals, sending the plaintiff messages that he
would see him the next day or by the end of the week, but he has not followed through.
The plaintiff alleges that Seahorn has known about the plaintiff’s symptoms for the past year and has
chosen not to take any action to address or treat his serious medical condition by making the necessary
referral that would permit the plaintiff to be seen by a vascular specialist or even by a medical doctor. The
plaintiff is now convinced that his carotid artery is almost completed blocked by the knot on his neck, and that
he may now be on the verge of heart failure “due to the continuous strain being put on his heart.” (ECF No.
1, at 21.) He also alleges that his blood pressure, even while he is on medication, is typically well above 140
over 90 (or well over normal). The plaintiff also alleges that his blood pressure is not regularly checked,
because Seahorn never placed an order for it to be checked regularly, even though the plaintiff is on
medication for high blood pressure. Instead, the plaintiff’s blood pressure is checked once a month along with
everyone else’s, as a matter of standard protocol, and it is either high or dangerously high each time it is
checked. On one day in February 2013, it was at 190 over 116. The nurse who checked it put him on a list
to see Seahorn the next day, but Seahorn still did not examine the plaintiff.
For relief, the plaintiff seeks an injunction requiring the medical officials as DSNF to allow the plaintiff
to be evaluated and treated by appropriate medical personnel. The plaintiff does not expressly seek monetary
damages, but “reserve[s] the right to amend [his] complaint to seek damages according to how extensive his
injuries are and to name additional defendants that may become known.” (ECF No. 1, at 27.)
STANDARD OF REVIEW
Under 28 U.S.C. § 1915(e)(2)(B), the Court must dismiss any portion of a civil complaint filed in forma
pauperis that fails to state a claim upon which relief can be granted, is frivolous, or seeks monetary relief from
a defendant who is immune from such relief. Section 1915A(a) similarly requires initial review of any
“complaint in a civil action in which a prisoner seeks redress from a governmental entity or officer or employee
of a governmental entity.” The Sixth Circuit has confirmed that the dismissal standard articulated by the
Supreme Court in Ashcroft v. Iqbal, 556 U.S. 662 (2009), and Bell Atlantic Corp. v. Twombly, 550 U.S. 544
(2007), “governs dismissals for failure to state a claim under those statutes because the relevant statutory
language tracks the language in Rule 12(b)(6).” Hill v. Lappin, 630 F.3d 468, 470–71 (6th Cir. 2010). Thus,
to survive scrutiny on initial review, “a complaint must contain sufficient factual matter, accepted as true, to
‘state a claim to relief that is plausible on its face.’” Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 570).
“A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the
reasonable inference that the defendant is liable for the misconduct alleged.” Id. (citing Twombly, 550 U.S.
at 556). “[A] district court must (1) view the complaint in the light most favorable to the plaintiff and (2) take
all well-pleaded factual allegations as true.” Tackett v. M & G Polymers, USA, LLC, 561F.3d 478, 488 (6th
Cir. 2009) (citing Gunasekera v. Irwin, 551 F.3d 461, 466 (6th Cir. 2009) (citations omitted)).
Although pro se pleadings are to be held to a less stringent standard than formal pleadings drafted
by lawyers, Haines v. Kerner, 404 U.S. 519, 520–21 (1972); Jourdan v. Jabe, 951 F.2d 108, 110 (6th Cir.
1991), the courts’ “duty to be ‘less stringent’ with pro se complaints does not require us to conjure up
[unpleaded] allegations.” McDonald v. Hall, 610 F.2d 16, 19 (1st Cir. 1979) (citation omitted).
To state a claim under § 1983, a plaintiff must “identify a right secured by the United States
Constitution and deprivation of that right by a person acting under color of state law.” Russo v. City of
Cincinnati, 953 F.2d 1036, 1042 (6th Cir. 1992); West v. Atkins, 487 U.S. 42, 48 (1988). Claims against
entities or individuals who are not state actors and “persons” subject to suit under § 1983 must be dismissed.
Claims that do not state a deprivation of a right secured by the Constitution or federal law must likewise be
As an initial matter, the Court finds that defendant Seahorn, who has the responsibility to provide
medical care to inmates at DSNF, qualifies as a state actor for purposes of § 1983, regardless of whether he
is employed directly by the state, or by an entity in contract with the state to provide healthcare to inmates at
DSNF. See West v. Atkins, 487 U.S. 42, 55–56 (1988) (holding that private medical contractors such as those
employed or contracted by an independent entity to provide medical care to prisoners are state actors for
purposes of § 1983).
Under the Eighth Amendment, prison officials may not act with deliberate indifference to the medical
needs of their prisoners. Estelle v. Gamble, 429 U.S. 97, 103–04 (1976). A deliberate-indifference claim has
both an objective and a subjective component. Farmer v. Brennan, 511 U.S. 825, 834 (1994); Comstock v.
McCrary, 273 F.3d 693, 702 (6th Cir. 2001). Under the objective component, “the plaintiff must allege that
the medical need at issue is ‘sufficiently serious.’” Comstock, 273 F.2d at 702 (citing Farmer, 511 U.S. at
834). “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.’”
Harrison v. Ash, 539 F.3d 510, 518 (6th Cir. 2008) (quoting Blackmore v. Kalamazoo Cnty., 390 F.3d 890, 897
(6th Cir. 2004)). Under the subjective component, “the plaintiff must allege facts which, if true, would show
that the official being sued subjectively perceived facts from which to infer substantial risk to the prisoner, that
he did in fact draw the inference, and than he then disregarded the risk.” Id. Further, however, not “every
malpractice claim involving a prisoner [is] automatically transformed into a cause of action under the civil right
statutes.” Westlake v. Lucas, 537 F.2d 857, 860 (6th Cir. 1976). Where “the dispute is over the adequacy
of the treatment, federal courts are generally reluctant to second guess medical judgments and to
constitutionalize claims which sound in state tort law.” Id. at 860 n.5. Basically, there must be a knowing
failure or refusal to provide urgently needed medical care which causes a residual injury that could have been
prevented with timely attention. The Court must consider the wide discretion allowed prison officials in their
treatment of prisoners under authorized medical procedures. Id. at 860.
In the present case, the plaintiff alleges that he has a knot in his neck that he believes is blocking or
partially blocking a major artery, that he is on medication for high blood pressure but the medication is not
adequately addressing his symptoms, and that he has not seen any healthcare practitioner other than nurses
in over a year, despite repeated requests both by himself and the nurses. The plaintiff alleges that his
condition is serious. Construing the complaint in the light most favorable to the plaintiff, the Court concludes
that, at this stage in the proceedings, the allegation of injury creates a question of fact as to whether the injury
is sufficiently serious to implicate the plaintiff’s constitutional right to care. The plaintiff’s allegations also
create a question of fact as to whether defendant Seahorn subjectively perceived and has recklessly
disregarded the plaintiff’s and various nurses’ requests for treatment and requests for referral to a medical
doctor for evaluation. In particular, the plaintiff’s allegations are sufficient to state a deliberate-indifference
claim based on an ongoing failure or refusal to provide care for what appears to be a serious condition. If the
plaintiff were merely complaining about a past failure to provide adequate medical care, his allegations in all
likelihood would simply amount to a malpractice claim rather than a claim of a constitutional dimension. Under
the circumstances presented here, the Court finds that the complaint states a colorable claim against Seahorn
in his individual capacity under § 1983 for deprivation of the plaintiff’s right under the Eighth Amendment to
reasonably necessary medical care. That claim will be permitted to proceed.
However, insofar as the plaintiff intends to state an official-capacity claim against Seahorn, such a
claim is equivalent to a claim against the entity that employs Seahorn. Monell v. Dep’t of Soc. Servs., 436
U.S. 658, 690 n.55 (1978); see Alkire v. Irving, 330 F.3d 802, 810 (6th Cir. 2003) (“While personal-capacity
suits seek to impose liability upon a government official for actions he takes under color of state law,
individuals sued in their official capacities stand in the shoes of the entity they represent.” (internal alterations,
quotation marks and citations omitted)). In the present case, it is unclear who Seahorn’s employer is; the
Court presumes that it is either the state or a private entity in contract with the state.
Setting aside the Eleventh-Amendment immunity issues that arise if Seahorn’s employer is the state,
the law is clear that an employer cannot be held responsible under 42 U.S.C. § 1983 for an alleged
constitutional deprivation unless there is a direct causal link between a policy or custom of the entity and the
alleged constitutional violation. Monell, 436 U.S. at 691; Deaton v. Montgomery Cnty., Ohio, 989 F.2d 885,
889 (6th Cir. 1993). Simply stated, the plaintiff must “identify the policy, connect the policy to the [entity] itself
and show that the particular injury was incurred because of the execution of that policy.” Garner v. Memphis
Police Dep’t, 8 F.3d 358, 363–64 (6th Cir. 1993) (quoting Coogan v. City of Wixom, 820 F.2d 170, 176 (6th
Cir. 1987), overruled on other grounds by Frantz v. Vill. of Bradford, 245 F.3d 869 (6th Cir. 2001).
The plaintiff’s allegations in this case suggest only that Seahorn, individually, has deliberately opted
not to examine or treat the plaintiff. The allegations do not give rise to a reasonable inference that Seahorn’s
employer has adopted a policy or procedure of delaying or denying medical care to the point of deliberate
indifference to the serious medical needs of inmates. The Court therefore finds, for purposes of the initial
review, that the plaintiff has not alleged facts that state a colorable claim against defendant Seahorn in his
official capacity. The official-capacity claim will therefore be dismissed under 28 U.S.C. § 1915(e)(2)(B)(ii) for
failure to state a claim for which relief may be granted.
An appropriate order is filed herewith.
United States District Judge
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