14 F.4th 124
2d Cir.2021Background
- Devin Darby, incarcerated at Rikers Island in 2017, developed a 3x3 cm gum/parotid mass with pain, swelling, impaired speech, difficulty chewing, sleeplessness and 20 lb weight loss.
- Between Feb–Apr 2017 Darby submitted ~15 sick-call requests and 3–4 written grievances describing worsening symptoms; he alleges they were ignored.
- Feb 17, 2017: Dentist David Greenman examined Darby, suggested tooth extraction and said he needed a specialist outside Rikers; Darby refused the extraction. May–June 2017: Dentist Rafael Hamilton saw Darby, performed a basic cleaning despite Darby’s protests that he needed more than a cleaning.
- Darby was transferred off Rikers, later referred to specialists, and underwent gum surgery in Feb 2018 that treated the mass.
- Procedural posture: Darby filed pro se § 1983 (Eighth/Fourteenth) and state malpractice claims; after amendment and supplementation the district court dismissed all claims under Rule 12(b)(6) (concluding allegations at most malpractice and Doe claims lacked personal involvement); district court declined supplemental jurisdiction over state claims. The Second Circuit affirmed dismissal of the constitutional claims.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether dentist Greenman’s conduct (Feb 2017) showed deliberate indifference (Fourteenth Amendment) | Greenman offered tooth extraction, failed to arrange specialist care, and ignored follow-ups, showing disregard for serious condition | Greenman examined Darby, proposed treatment; at most a disagreement over care / malpractice, not deliberate indifference | Dismissed — allegations show a difference of opinion/medical malpractice, not deliberate indifference |
| Whether dentist Hamilton’s conduct (May–June 2017) showed deliberate indifference (Eighth Amendment) | Hamilton ignored detailed complaints and performed only a basic cleaning despite obvious severe abscess and ongoing pain | Hamilton provided care (cleaning) and any inadequacy is negligence, not Eighth Amendment culpability | Dismissed — allegations amount to at most negligence/medical malpractice, not sufficiently culpable state of mind |
| Whether unnamed Doe prison officials were personally involved by ignoring sick calls/grievances | Darby submitted ~15 sick-call requests and 3–4 grievances via prison procedures that described his worsening condition; Doe officials received and ignored them | Complaint fails to specify when, to whom, or show receipt; no facts to establish personal involvement or that Doe officials knew of serious risk | Dismissed — pleading insufficient to infer receipt, knowledge, or personal involvement; cannot speculate about unpleaded facts |
| Municipal liability and state-law claims / leave to amend | Darby sought to amend and supplement to show deliberate indifference; seeks damages for lasting harm | City/NYCHHC/CDA lack an alleged policy/practice causing constitutional violation; district court found amendment futile | Municipal § 1983 claims dismissed for failure to plead policy; state malpractice claims dismissed without prejudice; district court denial of further amendment affirmed |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (U.S. 1976) (deliberate indifference to serious medical needs violates Eighth Amendment)
- Farmer v. Brennan, 511 U.S. 825 (U.S. 1994) (liability requires defendant knew of and disregarded excessive risk)
- City of Revere v. Mass. Gen. Hosp., 463 U.S. 239 (U.S. 1983) (pretrial detainees’ due process rights at least as protective as Eighth Amendment)
- Bell Atl. Corp. v. Twombly, 550 U.S. 544 (U.S. 2007) (plausibility standard for pleadings)
- Ashcroft v. Iqbal, 556 U.S. 662 (U.S. 2009) (must plead factual content permitting plausible inference of wrongdoing)
- Darnell v. Pineiro, 849 F.3d 17 (2d Cir. 2017) (standards for deliberate indifference for detainees and prisoners)
- Charles v. Orange County, 925 F.3d 73 (2d Cir. 2019) (deliberate indifference requires culpable recklessness; Fourteenth Amendment context)
- Grullon v. City of New Haven, 720 F.3d 133 (2d Cir. 2013) (at pleading stage, allegations about sending grievances can permit inference of receipt and notice)
- Chance v. Armstrong, 143 F.3d 698 (2d Cir. 1998) (difference of opinion about treatment insufficient if care is adequate; conscious choice of inadequate treatment may show deliberate indifference)
- Hathaway v. Coughlin, 37 F.3d 63 (2d Cir. 1994) (physician may be deliberately indifferent if he knowingly persists with ineffective treatment rather than treating condition)