Shores 325025 v. Centurion Incorporated
2:20-cv-00759
D. Ariz.Jan 6, 2022Background:
- Plaintiff Robert Heath Shores, an Arizona state prisoner, alleged Eighth Amendment deliberate indifference to serious medical needs relating to a prostate nodule, severe urinary symptoms, and subsequent need for catheterization and specialist care.
- Prior treating provider ordered an endorectal/transrectal ultrasound in 2018; after Centurion assumed prison healthcare in July 2019, Shore’s diagnostic testing and urology referrals were repeatedly delayed.
- Encounters with NP Siji Thomas beginning August 2019 include consult requests that were delayed, a May 2020 refusal to authorize a Foley (another provider later authorized it, draining ~900 cc), and ongoing management issues with indwelling catheterization leading to infections and severe pain.
- Urologists and a physical therapist eventually recommended urodynamics, pelvic-floor physical therapy/biofeedback, intermittent catheterization, or surgical options; Centurion initially denied extended outpatient physical therapy and issued an ATP (home program) before later authorizing PT after Court intervention.
- Shores sued under 42 U.S.C. § 1983 against Centurion and NP Thomas; defendants moved for summary judgment. The court denied summary judgment, finding genuine disputes of material fact on deliberate indifference by NP Thomas and on Centurion’s liability under a policy/custom theory; injunctive relief and punitive damages remain for resolution.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Deliberate indifference (NP Thomas) | Thomas delayed/failed to schedule specialist tests, refused timely Foley, accepted ATP denying recommended PT causing pain and delay | Thomas provided appropriate care; delays due to pandemic or logistics; plaintiff only disagrees with care | Summary judgment denied—genuine factual disputes exist; a jury could find deliberate indifference |
| Causation / Harm | Delays and catheter mismanagement caused severe pain, infections, worsening voiding, and prolonged catheter dependence | No proof of injury attributable to defendants; no cancer or irreversible harm shown; routine voiding issue being addressed | Question of fact for jury; pain, infections, and catheter complications suffice to raise Eighth Amendment harm issue |
| Monell liability (Centurion policy/custom) | Repeated multi-year delays and systemic catheter mismanagement evidences a policy or custom of deliberate indifference that was the moving force | No policy/custom; incidents isolated; pandemic and scheduling issues explain delays | Summary judgment denied—factual disputes exist whether Centurion maintained a deliberately indifferent policy/custom causally linked to harm |
| Injunctive relief & punitive damages | Plaintiff seeks court-ordered specialist-recommended treatment and punitive damages for callous indifference | Relief moot because plaintiff has seen urologists and is receiving treatment; punitive damages unwarranted | Court: injunctive relief not moot given ongoing denials/refusals; punitive damages reserved for jury determination |
Key Cases Cited
- Jett v. Penner, 439 F.3d 1091 (9th Cir. 2006) (deliberate indifference standard for prison medical claims)
- Estelle v. Gamble, 429 U.S. 97 (1976) (Eighth Amendment prohibits deliberate indifference to serious medical needs)
- McGuckin v. Smith, 974 F.2d 1050 (9th Cir. 1992) (examples of serious medical need; harm analysis)
- Colwell v. Bannister, 763 F.3d 1060 (9th Cir. 2014) (courts need not defer to prison medical judgment; failure to follow specialists may be actionable)
- Snow v. McDaniel, 681 F.3d 978 (9th Cir. 2012) (delay in treatment can show deliberate indifference where harmful)
- Wood v. Housewright, 900 F.2d 1332 (9th Cir. 1990) (deliberate indifference includes denying, delaying, or interfering with treatment)
- Monell v. Dep’t of Soc. Servs., 436 U.S. 658 (1978) (municipal/private-entity liability requires policy or custom causally linked to constitutional violation)
- Bd. of Cnty. Comm’rs v. Brown, 520 U.S. 397 (1997) (moving-force causation for policy-based liability)
- Farmer v. Brennan, 511 U.S. 825 (1994) (subjective component of Eighth Amendment deliberate indifference)
- Smith v. Wade, 461 U.S. 30 (1983) (punitive damages in § 1983 actions)
- Pacific Mut. Life Ins. Co. v. Haslip, 499 U.S. 1 (1991) (jury discretion in awarding punitive damages)