Walter Melton v. David Abston
2016 U.S. App. LEXIS 20681
| 11th Cir. | 2016Background
- Melton, a pretrial detainee at Pickens County Jail, injured his left arm in February 2010; he reported severe pain, loss of sensation, and visible deformity.
- X-rays (May 2010) and later orthopedic consults showed a nonunion humerus, displaced hardware, and radial nerve palsy; orthopedist Dr. Fowler recommended non-emergent surgery.
- Melton repeatedly requested treatment and a sling; treatment at the jail consisted largely of NSAIDs and intermittent analgesics; a sling was not provided until October 2010.
- Jail medical provider Dr. Sullivan delayed in-person examination, declined to arrange surgery absent prepayment, and limited treatment to pain meds; Nurse Ray triaged requests and communicated with Dr. Sullivan.
- Melton sued under 42 U.S.C. § 1983 for deliberate indifference and alleged Dr. Fowler conspired with jail staff; the district court granted summary judgment for all defendants.
- The Eleventh Circuit affirmed summary judgment for Dr. Fowler and Deputy Booth, reversed summary judgment for Nurse Ray, Dr. Sullivan, Sheriff Abston, Deputy Abston, Chief Deputy Carr, and Deputy Ellis, and held sheriff/deputies immune from official-capacity suits under the Eleventh Amendment.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Deliberate indifference to a serious medical need (treatment delay/denial) | Melton: sustained broken arm, displaced hardware, severe pain, and nerve loss required prompt surgical care; jail staff delayed/denied care (sometimes to coerce payment). | Defendants: treatment disputes, non-emergent condition, disagreement over necessity/timing of surgery — not deliberate indifference. | Reversed summary judgment for Dr. Sullivan, Nurse Ray, Sheriff Abston, Deputy Abston, Chief Deputy Carr, Deputy Ellis — a reasonable jury could find deliberate indifference. |
| Dr. Fowler liability and conspiracy | Melton: Dr. Fowler conspired with jail staff to deny treatment or minimized urgency (addendum). | Fowler: private orthopedist who examined Melton, diagnosed nonunion, advised non-emergent surgery, and had no role in jail’s treatment decisions or any conspiracy. | Affirmed summary judgment for Dr. Fowler; no evidence of agreement or participation in a conspiracy. |
| Deputy Booth’s liability | Melton: Booth learned of the arm injury during transports and interfered with care. | Booth: had knowledge late (Sept. 2010) and did not cause the earlier delay; insufficient causation. | Affirmed summary judgment for Deputy Booth for lack of causation. |
| Sovereign (Eleventh Amendment) immunity for sheriff/deputies and jail staff | Melton: official-capacity claims seek relief for unconstitutional conduct. | Defendants: Alabama sheriffs/deputies are state officers entitled to Eleventh Amendment immunity. | Held: Sheriff Abston and deputy defendants immune from official-capacity suits; Nurse Ray (non-deputy jail nurse) not entitled to sovereign immunity in official capacity; individual-capacity claims remain viable. |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (Eighth Amendment prohibits deliberate indifference to prisoners’ serious medical needs)
- Farmer v. Brennan, 511 U.S. 825 (deliberate indifference requires subjective awareness and disregard of substantial risk)
- Pearson v. Callahan, 555 U.S. 223 (qualified immunity framework and discretion to address prongs in either order)
- McElligott v. Foley, 182 F.3d 1248 (11th Cir.) (unreasonable delay and cursory care can create jury question on deliberate indifference)
- Harris v. Coweta County, 21 F.3d 388 (11th Cir.) (several-weeks delay for serious condition may defeat qualified immunity)
- Ancata v. Prison Health Servs., 769 F.2d 700 (11th Cir.) (conditioning necessary medical treatment on prepayment is impermissible)
- Hafer v. Melo, 502 U.S. 21 (state officials sued in individual capacities are persons under § 1983; Eleventh Amendment does not bar individual-capacity suits)