Perry v. Roy
782 F.3d 73
1st Cir.2015Background
- On June 9, 2007, while being booked into Bristol House of Correction, Perry was beaten by correctional officers and sustained facial injuries; he alleges a broken jaw, bleeding, and head swelling.
- Within minutes Nurse Roy evaluated Perry; Perry says she performed only limited care (cleaned a cut, gave gauze, saline rinse) and did not meaningfully examine or treat his jaw; Roy’s notes dispute Perry’s account.
- Later that night Nurse Rocha briefly observed Perry through a glass window, noted forehead swelling, spoke with Lt. Shubert, and declined further care; Rocha and the officers report Perry denied pain, while Perry says he repeatedly requested hospital transport.
- Roughly 17 hours after the injury, a third nurse examined Perry and he was sent to St. Luke’s then transferred to MGH, where surgeons diagnosed acute bilateral mandibular fractures requiring surgery and described his injuries as critical.
- Perry sued nurses Roy and Rocha under 42 U.S.C. § 1983 for Eighth/Fourteenth Amendment deliberate indifference to serious medical needs; the district court granted summary judgment for defendants, concluding no deliberate indifference.
- The First Circuit reversed and remanded, holding that material factual disputes (credibility, scope of examinations, whether defendants ignored requests or acted to punish) could permit a jury to find deliberate indifference.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Perry had a "serious medical need" (objective prong) | Perry: visible bleeding, clenched jaw, pain, and later diagnosis show an obvious serious need warranting immediate medical attention | Roy/Rocha: initial findings did not show a broken jaw; some treatment was provided and later hospitalization occurred when condition worsened | There is a triable dispute: a reasonable jury could find the injury was objectively serious and obvious to lay observers |
| Whether nurses acted with deliberate indifference (subjective prong) | Perry: nurses ignored repeated requests, performed cursory exams (one through a window), and deferred treatment after speaking with an officer—conduct that could be punitive or wanton | Roy/Rocha: they exercised medical judgment based on available information, provided some care, and did not intentionally deny treatment | There is a triable dispute: if Perry’s account is credited, a jury could find deliberate indifference |
| Whether delay in transport (≈17 hours) defeats constitutional claim | Perry: delay from cursory/absent treatment caused risk/harm and is relevant to liability | Defendants: eventual hospital transfer and some care mean no constitutional violation; worsening over time justified later escalation | Delay’s reasonableness is a factual question for the jury; eventual treatment does not automatically bar a claim |
| Whether district court properly weighed evidence on summary judgment | Perry: credibility disputes and inferences must favor nonmovant; his testimony could support a jury verdict | Defendants: record and treatment notes showed no constitutional violation; disputed facts immaterial | District court erred by resolving credibility; summary judgment improper because genuine material disputes remain |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (Eighth Amendment deliberate indifference standard for prisoner medical care)
- Helling v. McKinney, 509 U.S. 25 (risk of future harm can satisfy objective prong)
- Tolan v. Cotton, 134 S. Ct. 1861 (on summary judgment the nonmovant’s evidence must be credited and credibility determinations are for the jury)
- Kosilek v. Spencer, 774 F.3d 63 (en banc) (describing Eighth Amendment medical care contours in First Circuit)
- Gaudreault v. Municipality of Salem, Mass., 923 F.2d 203 (serious medical need is one a layperson would recognize)
- Leavitt v. Corr. Med. Servs., 645 F.3d 484 (deliberate indifference requires both objective serious need and subjective culpability)
- Battista v. Clarke, 645 F.3d 449 (wanton disregard as evidence of deliberate indifference)
- DesRosiers v. Moran, 949 F.2d 15 (actual knowledge of impending harm relevant to mental-state inquiry)