Sparks v. Singh, 690 F. App'x 598

Stephen Thene Sparks, a Colorado inmate, had repeated fasting plasma glucose (FPG) in the impaired fasting glucose range (100–125 mg/dl) from 2006–2010 and an August 2010 A1C of 7.0% (diagnostic for diabetes under 2010 ADA A1C criteria). CDOC did not use A1C for diagnosis until after April 2011.
In September 2010 Sparks was transferred to Arkansas Valley; PA Tejinder Singh reviewed Sparks’ chart during intake, noted prior IFG and the 7% A1C, but did not refer him to chronic care, relying on chart notes indicating prior counseling about diet/exercise.
In April 2011 Sparks was hospitalized for DVT; hospital labs showed an A1C ≈ 8–8.5% and the hospital/infirmary records referenced a “questionable history” of diabetes. PA Ted Laurence saw the infirmary note but did not treat Sparks for diabetes on return.
In February 2012 Sparks presented acutely ill; testing showed ketonuria and non‑fasting glucose 396 mg/dl; Laurence administered fluids and insulin and hospitalized him; hospital diagnosed diabetes.
Sparks sued Singh and Laurence under 42 U.S.C. § 1983 alleging Eighth Amendment deliberate indifference for failing to diagnose/treat diabetes and sought to overcome their summary judgment motions; the district court granted summary judgment for both PAs and this appeal followed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Singh was deliberately indifferent by not referring Sparks to chronic care at intake (gatekeeper theory)	Singh saw lab results showing IFG and A1C 7% and failed to ensure counseling/monitoring, disregarding substantial risk of progression	Singh reviewed the chart and relied on ambulatory notes showing prior counseling by another provider; thus he did not knowingly disregard risk	Summary judgment for Singh — no subjective knowledge of an uncounseled risk because chart notes showed prior counseling, precluding deliberate indifference
Whether Laurence was deliberately indifferent by not treating Sparks for diabetes after infirmary/hospital return in April 2011	Laurence reviewed infirmary note referencing A1C ~8 and questionable history of diabetes and failed to confirm/begin treatment	Laurence did not recall seeing hospital labs; he read an infirmary note that only indicated a questionable history and CDOC did not use A1C for diagnosis then; treatment decisions were medical judgment	Summary judgment for Laurence — infirmary note did not show an obvious need for treatment and failure to treat was at most medical judgment/negligence, not deliberate indifference

Helget v. City of Hays, 844 F.3d 1216 (10th Cir. 2017) (standard of review for summary judgment on appeal)
Anderson v. Liberty Lobby, 477 U.S. 242 (1986) (summary judgment standard; genuine dispute for trial)
Mata v. Saiz, 427 F.3d 745 (10th Cir. 2005) (deliberate indifference requires subjective knowledge of substantial risk)
Sealock v. Colorado, 218 F.3d 1205 (10th Cir. 2000) (gatekeeper theory; distinguishing negligence from deliberate indifference)
Farmer v. Brennan, 511 U.S. 825 (1994) (official must know of and disregard substantial risk)
Self v. Crum, 439 F.3d 1227 (10th Cir. 2006) (medical judgment decisions do not, without more, amount to deliberate indifference)
Hunt v. Uphoff, 199 F.3d 1220 (10th Cir. 1999) (Eighth Amendment protects against risk of future harm)
Estelle v. Gamble, 429 U.S. 97 (1976) (negligent medical care is not Eighth Amendment deliberate indifference)
Oxendine v. Kaplan, 241 F.3d 1272 (10th Cir. 2001) (obvious need for specialized care can support deliberate indifference)
Erickson v. Pardus, 551 U.S. 89 (2007) (failure to provide prescribed treatment may state deliberate indifference)