827 F.3d 749
8th Cir.2016Background
- Dadd underwent dental surgery on March 28, 2014, received a Vicodin prescription, and began taking it as directed.
- He was arrested March 29, informed arresting officers and jail staff (including Deputy Kempenich) that he was in severe post-operative dental pain and that his Vicodin had been brought to the jail; deputies retained the prescription but did not distribute it.
- During booking, Kempenich recorded no dental problems and did not refer him to nursing; multiple deputies ignored Dadd’s repeated complaints.
- A jail nurse saw Dadd March 30, confirmed his pain, refused to give his medication or any pain reliever, then later received a physician’s order for ibuprofen but did not administer it.
- Dadd spent two days in severe pain, unable to sleep or eat, until his release on March 31 when his Vicodin was returned; he sued under 42 U.S.C. § 1983 alleging deliberate indifference to serious medical needs and the defendants claimed qualified immunity.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Dadd pleaded deliberate indifference to a serious medical need | Dadd alleged obvious, severe dental pain, communicated it to deputies and nurse, and that prescribed and ordered meds were withheld | Defendants argued their conduct did not amount to deliberate indifference and any delay was minimal/medically justified | Court: Accepting allegations as true, plaintiff plausibly pleaded deliberate indifference (denial/delay of prescribed meds and ignoring complaints) |
| Whether deputies/nurse had knowledge of the need | Dadd: they were told repeatedly; nurse later consulted doc and acknowledged pain | Anoka: nurse only had constructive knowledge; some deputies had limited contact | Court: Knowledge may be inferred from obviousness and repeated complaints; alleged awareness sufficient |
| Whether short delay (two days) can support § 1983 claim | Dadd: no bright-line; even two-day delays can violate rights when pain is severe | Anoka: delay too short to be constitutional violation | Court: No bright-line; two-day or similar delays can be actionable; facts here suffice to state a claim |
| Whether defendants are entitled to qualified immunity (clearly established law) | Dadd: right to adequate medical care and to receive prescribed/ordered meds was clearly established | Anoka: reasonable officials could have thought rights were not clearly violated during brief custody | Court: Precedent made clear that withholding prescribed pain medication and failing to provide treatment for severe dental pain violates constitutional rights; qualified immunity denied |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (1976) (deliberate indifference by custody officials to serious medical needs violates the Constitution)
- Farmer v. Brennan, 511 U.S. 825 (1994) (knowledge of substantial risk may be inferred from obviousness of risk)
- Ashcroft v. al-Kidd, 563 U.S. 731 (2011) (qualified immunity requires that law be "beyond debate")
- Phillips v. Jasper Cty. Jail, 437 F.3d 791 (8th Cir. 2006) (knowing failure to administer prescribed medicine can constitute deliberate indifference)
- Foulks v. Cole Cty., Mo., 991 F.2d 454 (8th Cir. 1993) (ignoring doctor instructions and refusing prescribed meds can give rise to liability)
- Hartsfield v. Colburn, 371 F.3d 454 (8th Cir. 2004) (failure to treat severe dental pain can survive summary judgment on deliberate indifference theory)
- Moore v. Jackson, 123 F.3d 1082 (8th Cir. 1997) (deliberate indifference claim viable where defendants ignored severe dental pain)
- West v. Atkins, 487 U.S. 42 (1988) (pretrial detainees have constitutional right to adequate medical care)