John Snow v. E.K. McDaniel
2012 U.S. App. LEXIS 10646
| 9th Cir. | 2012Background
- Snow, a 69-year-old death-row inmate in NDOC, suffers severe degenerative hip disease with excruciating pain and limited mobility.
- Orthopedic specialists repeatedly recommended bilateral total hip arthroplasty (THA) to replace both hips.
- NDOC used a Utilization Review Panel (URP) to approve or deny significant medical procedures, including hip surgery.
- URP repeatedly denied Snow’s THA as not life-threatening and not always necessary, despite treating physicians’ emergency/urgent assessments.
- Snow filed a 42 U.S.C. § 1983 action asserting Eighth Amendment deliberate indifference and related policy claims; the district court granted summary judgment for most defendants.
- URP approvals eventually occurred in September 2009, but no immediate hip surgery occurred before further proceedings on appeal.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether URP refusals to authorize THA violated the Eighth Amendment | Snow shows deliberate indifference by denying surgery despite medical opinions. | Differences of medical opinion do not prove deliberate indifference; treatment choices were within medical discretion. | Material issues of fact exist; denial could be deliberate indifference. |
| Whether non-treating URP physicians’ decisions to deny surgery were medically unacceptable | Specialists’ recommendations for THA were ignored for years. | Differences of opinion between physicians are insufficient for deliberate indifference. | Triable issues of fact; may be medically unacceptable to ignore long-term surgery recommendations. |
| Whether supervisors (Warden Endel, Warden McDaniel, Dr. Bannister) are liable for constitutional violations | Supervisors knew of hip condition and failed to act; possible animus toward death-row inmates. | Supervisors not automatically liable absent personal involvement or causal connection. | There are material issues of fact on supervisory liability. |
| Whether Snow can pursue injunctive relief given ongoing surgery prospects and evidence | Injury and policy evidence remain; injunction appropriate to compel pre-operative process. | Mootness due to scheduling or past denied relief. | Remand proper to address injunctive relief with updated records; not moot. |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (U.S. 1976) (medical care must be provided to avoid cruel and unusual punishment; objective/subjective standards)
- Farmer v. Brennan, 511 U.S. 825 (U.S. 1994) (deliberate indifference standard for prisoners’ medical needs)
- McGuckin v. Smith, 974 F.2d 1050 (9th Cir. 1992) (deliberate indifference standard and delay/quality of care considerations)
- Hamilton v. Endell, 981 F.2d 1062 (9th Cir. 1992) (comparison on relying on inferior medical opinions; interference with care potentially deliberate)
- Sanchez v. Vild, 891 F.2d 240 (9th Cir. 1989) (medical disagreement not per se deliberate indifference; must show medical unacceptability)
- Toguchi v. Chung, 391 F.3d 1051 (9th Cir. 2004) (dispositive on whether discontinuing a proposed treatment constitutes deliberate indifference)
- Jackson v. Johnson, 781 F.2d 769 (9th Cir. 1986) (evidence of improper motive can support deliberate indifference)