Stephen Ganstine v. Secretary, Florida Department of Corrections, 502 F. App'x 905

Ganstine, pro se inmate, appeals district court’s grant of summary judgment for Dr. Perez on Eighth Amendment and ADA claims.
At RMC after ingestion, Dr. Perez found diabetes and hypertension urgent and continued meds; sleep apnea deemed non-acute, CPAP testing postponed pending transfer.
Ganstine reported chronic back pain and claimed need for a wheelchair; x-ray showed compression deformity; walker prescribed.
Ganstine alleges lack of wheelchair/CPAP at RMC, alleged harassment by guards, and later wheelchair access issues at Gulf Correctional Institution Annex.
Court reviews de novo, limits ADA analysis to alleged denial of access and retaliation; ultimately affirms summary judgment for defendants.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Eighth Amendment deliberate indifference by Dr. Perez	Ganstine claims Dr. Perez ignored serious needs (CPAP, wheelchair)	Medical judgment allowed; no substantial risk Dr. Perez disregarded	Summary judgment upheld; no evidence of subjective intent to punish
ADA denial of access to facilities and activities	Disability prevented access to areas; reliance on wheelchair not adequate	Orderlies facilitated access; no denial due to disability	No liability for denial of access under Title II
ADA retaliation against protected activity	DOC punished him for ADA-protected grievances	No adverse action or causal link shown	No evidence of actionable adverse action; retaliation claim fails

Estelle v. Gamble, 429 U.S. 97 (U.S. Supreme Court 1976) (medical indifference under Eighth Amendment must show more than negligence)
McElligott v. Foley, 182 F.3d 1248 (11th Cir. 1999) (unreasonable delay or denial can violate Eighth Amendment)
Taylor v. Adams, 221 F.3d 1254 (11th Cir. 2000) (subjective knowledge required for deliberate indifference)
Bozeman v. Orum, 422 F.3d 1265 (11th Cir. 2005) (requires subjective awareness of serious risk for liability)
Waldrop v. Evans, 871 F.2d 1030 (11th Cir. 1989) (difference of medical opinion does not equal deliberate indifference)
Higdon v. Jackson, 393 F.3d 1211 (11th Cir. 2004) (retaliation requires tangible adverse action with causal link)
Lucas v. W.W. Grainger, Inc., 257 F.3d 1249 (11th Cir. 2001) (adverse action must be substantial equipoise to qualify as retaliation)
Bircoll v. Miami-Dade Cnty., 480 F.3d 1072 (11th Cir. 2007) (ADA discrimination analysis for prisoners with disabilities)
Chavis v. Clayton Cnty. Sch. Dist., 300 F.3d 1288 (11th Cir. 2002) (limits scope of ADA claims raised at summary judgment stage)
U.S. E.E.O.C. v. W&O, Inc., 213 F.3d 600 (11th Cir. 2000) (standards for ADA retaliation claims against public entities)
Timson v. Sampson, 518 F.3d 870 (11th Cir. 2008) (issues not raised in initial brief are abandoned on appeal)