Frank Bush v. Jane Doe (I)
20-2968
| 3rd Cir. | Jun 8, 2021Background:
- Plaintiff Frank Bush contracted chronic Hepatitis C while incarcerated and was evaluated in 2017; clinicians told him he needed immediate treatment but did not provide DAAs, citing cost.
- After transfer, a different prison clinician told Bush his Hep C "was not bad enough for treatment" and said cost prevented treatment; by then Bush reported severe symptoms.
- Bush filed a prison grievance and was placed on a monitored "treatment waiting list" until a treatment spot opened; monitoring continued in lieu of immediate DAA therapy.
- Bush sued under 42 U.S.C. § 1983, alleging Eighth Amendment deliberate indifference to serious medical needs; he sought leave to proceed IFP and the district court screened the complaint under 28 U.S.C. § 1915(e)(2)(B)(ii).
- The District Court dismissed for failure to state a claim, concluding monitoring constituted treatment and Bush failed to plausibly allege nonmedical motives; the Third Circuit reviewed de novo.
- The Third Circuit vacated and remanded, holding Bush plausibly alleged deliberate indifference because he was denied DAA treatment for cost reasons and monitoring alone may be inadequate when medication is warranted.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether monitoring alone satisfied Eighth Amendment care | Monitoring was insufficient when DAA medication was indicated | Monitoring is an appropriate form of treatment | Monitoring may be inadequate; allegation that medication was warranted makes monitoring insufficient |
| Whether cost-driven denial equals deliberate indifference | Denial/delay for cost shows deliberate indifference when it excludes medical judgment | Cost considerations in prison medical decisions are permissible | Allegations that cost alone drove denial plausibly state deliberate indifference |
| Whether dismissal under §1915(e)(2)(B)(ii) was proper | Complaint pleaded plausible Eighth Amendment claim | Complaint failed to allege deliberate indifference plausibly | Dismissal was premature; vacated and case remanded for further proceedings |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (1976) (established Eighth Amendment deliberate indifference standard for medical care)
- Monmouth Cnty. Corr. Inst. Inmates v. Lanzaro, 834 F.2d 326 (3d Cir. 1987) (articulated two-part Estelle test and examples of deliberate indifference)
- Roe v. Elyea, 631 F.3d 843 (7th Cir. 2011) (constitutional violation where cost considerations exclude reasonable medical judgment)
- Reynolds v. Wagner, 128 F.3d 166 (3d Cir. 1997) (cost may factor into prison medical decisions but not to exclusion of medical judgment)
- Postawko v. Mo. Dep’t of Corr., 910 F.3d 1030 (8th Cir. 2018) (delay in providing DAA treatment can reduce efficacy)
- Mitchell v. Nobles, 873 F.3d 869 (11th Cir. 2017) (recognizing Hepatitis C as a serious medical need)