Rivera v. Gupta
2016 U.S. App. LEXIS 16544
| 7th Cir. | 2016Background
- Rivera, a federal inmate, suffered second-degree burns to his left leg/ankle/foot after slipping on boiling liquid in a prison kitchen and experienced prolonged pain and numbness that made walking difficult.
- Initial nursing care included debridement, dressings, narcotic pain medication, wheelchair and lower-bunk accommodations, and follow-up monitoring; staff advised waiting six months for healing.
- After six months Rivera still had pain/numbness and asked Dr. Ravi Gupta, the prison clinic director, for a burn-specialist referral; Rivera alleges Gupta refused to examine him, denied treatment, made dismissive remarks, and threatened discipline for further complaints; Gupta disputes Rivera’s account.
- Rivera presented uncontested medical-website evidence that severe burns can cause nerve damage that may worsen without treatment and that medication/physical therapy can help; he also complained to health-services administrator Cesar Lopez, who took no further action.
- District court granted summary judgment for both defendants and denied Rivera counsel; on appeal the Seventh Circuit affirmed summary judgment for Lopez but reversed as to Gupta, finding triable issues on deliberate indifference and recommending appointment of counsel on remand.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Deliberate indifference by Dr. Gupta | Gupta refused to examine or treat ongoing pain/numbness after a severe burn; evidence supports risk of nerve damage and benefit of treatment | Gupta contends symptoms were a normal part of healing, neurovascular exam was normal, and no treatment could help | Reversed: triable issue exists; jury could find deliberate indifference because no treatment was provided despite evidence of a serious condition and hostile conduct by Gupta |
| Supervisory liability for Cesar Lopez | Lopez was told of inadequate care and did nothing | Lopez is a nonmedical administrator; medical staff knew of and had a plan to wait six months | Affirmed: summary judgment proper because Lopez lacked medical role and medical staff had been monitoring the injury |
| Requirement of expert evidence to survive summary judgment | Rivera: medical-website evidence plus factual disputes about Gupta’s refusal suffice to create triable issue | Gupta: absence of expert proof that treatment would have helped means no deliberate indifference | Held: expert testimony not required at summary judgment where nonexpert evidence and record permit a reasonable jury to conclude the condition was serious and treatment was warranted |
| Denial of counsel at summary-judgment stage | Rivera sought counsel who might secure expert testimony and assist in opposing summary judgment | District court denied counsel as unnecessary to alter its view that refusal to refer was not blatantly inappropriate | Court recommends appointing counsel on remand, noting counsel could materially assist Rivera |
Key Cases Cited
- Farmer v. Brennan, 511 U.S. 825 (establishes deliberate indifference standard under the Eighth Amendment)
- Estelle v. Gamble, 429 U.S. 97 (prisoners’ Eighth Amendment right to adequate medical care)
- United States v. Demko, 385 U.S. 149 (FTCA claims barred under Inmate Accident Compensation Act for prisoner workplace injuries)
- Gonzalez v. Feinerman, 663 F.3d 311 (deliberate indifference where medical needs ignored)
- Hayes v. Snyder, 546 F.3d 516 (Eighth Amendment deliberate indifference precedents)
- Brock v. Wright, 315 F.3d 158 (failure to treat serious medical needs can constitute deliberate indifference)
- Miller v. Campanella, 794 F.3d 878 (deliberate indifference requires knowing disregard of excessive risk)
- Helling v. McKinney, 509 U.S. 25 (objective and subjective elements required for Eighth Amendment claim)
- Pruitt v. Mote, 503 F.3d 647 (standards for appointment of counsel in prisoner civil rights cases)