Smart v. Sowle
6:19-cv-02027
| N.D. Iowa | Jun 14, 2022Background
- Plaintiff Edward Smart, an inmate at Bremer County Jail, sued under 42 U.S.C. § 1983 alleging Eighth Amendment deliberate indifference against physician’s assistant Matt Sowle for treatment of pain later diagnosed as shingles.
- Medical records show Sowle saw Smart multiple times between Dec. 2018 and May 2019, prescribed ibuprofen, Tylenol, gabapentin, ordered an X-ray, and repeatedly requested a dermatology referral; USMS referral was submitted May 21, 2019.
- Smart claims (1) delayed diagnosis of shingles (pain beginning Dec. 2018), (2) a three-day delay from reported rash (Jan. 28) to treatment (Jan. 31), and (3) delayed access to a dermatologist; he also alleges Sowle lied about aspects of treatment.
- Sowle moved for summary judgment arguing any delay caused no substantial harm, the conduct amounted to at most negligence, and he is entitled to qualified immunity; he submitted expert reports supporting his care.
- The court granted Sowle’s summary judgment motion, holding no genuine issue of material fact that Sowle was deliberately indifferent and alternatively awarding qualified immunity; it ordered Smart to serve remaining defendants (US Marshal Olt and Jailer Lapeta) within 10 days or face dismissal under Rule 4(m).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Deliberate indifference for delayed diagnosis of shingles (pain beginning Dec. 2018) | Smart: pain from Dec. 2018 should have alerted Sowle to shingles earlier | Sowle: responded with exams, meds, X-ray; expert opinion that shingles pain follows rash so earlier diagnosis not supported | Court: No evidence Sowle knew of shingles before rash; at most negligence; no deliberate indifference |
| Delay between rash (Jan. 28) and treatment (Jan. 31) | Smart: three-day delay was unreasonable and worsened pain | Sowle: antiviral (Valtrex) must be started within 48 hours to affect blisters and minimally affects pain; no evidence earlier knowledge or that earlier treatment would reduce pain | Court: No evidence Sowle knew of rash earlier or that earlier treatment would have changed outcome; no deliberate indifference |
| Delay in dermatologist referral after diagnosis | Smart: referral was delayed and caused harm | Sowle: repeatedly documented and requested dermatology referral; referral ultimately submitted to USMS; no effective cure for shingles so referral wouldn’t change prognosis | Court: No evidence Sowle caused the referral delay or that delay altered treatment outcome; no deliberate indifference |
| Qualified immunity | Smart: constitutional right violated by deliberate indifference | Sowle: even if dispute, he did not violate clearly established law | Court: No constitutional violation shown; alternatively Sowle entitled to qualified immunity |
Key Cases Cited
- Celotex Corp. v. Catrett, 477 U.S. 317 (summary judgment standard)
- Anderson v. Liberty Lobby, 477 U.S. 242 (genuine issue of material fact standard)
- Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574 (evaluating sufficiency of evidence at summary judgment)
- Farmer v. Brennan, 511 U.S. 825 (Eighth Amendment deliberate indifference standard)
- Monell v. Dep't of Soc. Servs., 436 U.S. 658 (§ 1983 provides remedy for federal rights)
- Schaub v. VonWald, 638 F.3d 905 (Eighth Circuit on objective and subjective deliberate indifference elements)
- Coleman v. Rahija, 114 F.3d 778 (verifying medical evidence requirement for delay claims)
- Letterman v. Does, 789 F.3d 856 (subjective knowledge component of deliberate indifference)
- McRaven v. Sanders, 577 F.3d 974 (negligent misdiagnosis not cognizable under § 1983)
- Allard v. Baldwin, 779 F.3d 768 (distinguishing negligence from deliberate indifference)
- Dulany v. Carnahan, 132 F.3d 1234 (official must actually know and disregard need)