Jоhn Edward EASTER, also known as Stephen Easter, Plaintiff-Appellee, v. Gayla POWELL, Defendant-Appellant.
No. 04-11332.
United States Court of Appeals, Fifth Circuit.
Oct. 5, 2006.
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For the foregoing reasons, we DENY Amouzadeh‘s converted-petition for review.
Harold Joseph Liller, Jr., Austin, TX, for Powell.
Before HIGGINBOTHAM, DeMOSS and OWEN, Circuit Judges.
John Edward Easter, a prison inmate acting pro se, brought а
I
Easter, а prison inmate who has a history of serious heart problems, was taken to the prison infirmary for chest pain and vomiting. A prison doctor prescribed oxygen and nitroglycerin, a medication used to prevent chest pain by relaxing the blood vessels to the heart. The label on Easter‘s nitroglycerin bottle includеd instructions to “dissolve 1 tablet under [his] tongue every 5 minutes as-needed for chest pain; after 3 tablets or 15 minutes call doctor if no relief has been obtained.” Approximately fifteen minutes after receiving nitroglycerin, Easter‘s chest pain ceased and he returned to his cell.
Two days later, Easter went back to the prison infirmary, again complaining of severe chest pain. At the infirmary, Easter informed Nurse Powell that he had been experiencing severe chest pain for approximately twenty minutes. Powell took Easter‘s blood pressure and sent him to the prison pharmacy to have his nitroglycerin prescription refilled. Because the pharmacy was closed, Easter returned to the infirmary and repeated his request that Powell provide him with nitroglycerin. Powell accused Easter of being argumentative, stated that his blood pressure was normal, and ordered him to leave. After reminding Powell that he was there for chest pain and not blood pressure, Easter requested an electrocardiogram1 and nitroglycerin. Powell refused Easter‘s requests and had security escort him to his cell. After four hours of severe pain, Easter returned to the infirmary and was given nitroglycerin by a different medical professional. Easter alleges that by the time his pain ceased, blood vessels in his left eye had burst, causing it to fill with blood.
Easter sued Powell pursuant to
Powell has pursued this interlocutory appeal.
II
A district court‘s order denying qualified immunity is immediately appealable only to the extent that it turns on an “issue of law.”3 A district court‘s decision to deny qualified immunity on a motion for summary judgment is “not appealable if [it is] based on a claim regarding the sufficiency of the evidence.”4 Thus, we only have jurisdiction to determine whether, viewing the facts in the light most favorable to Easter, Powell is entitled to qualified immunity as a matter of law;5 we do not have jurisdiction to determine whether the evidence is sufficient to support either party‘s version of the facts.6 We review the denial of Powell‘s motion for summary judgment de novo.7
“[G]overnment officials performing discretionary functions generally are shiеlded from liability for civil damages insofar as their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known.”8 When assessing whether a defendant is entitled to qualified immunity, we engage in a bifurcated analysis.9 First, we determine whether, under current constitutional standards, the plaintiff has alleged a violation of a clearly established constitutional right.10 If so, we then decide if the defendant‘s conduct was objectively reasonable in light of the clearly established law at the time of the incident.11 A government official is entitled to qualified immunity if either (1) the plaintiff failed to state a constitutional claim or (2) the defendant‘s conduct was objectively reasonable in light of the clearly established law.12
The “deliberate indifference” standard requires “a showing that the official was subjectively aware of the risk [of serious harm to the inmate].”17 “[A] prison official cannot be found liable under the Eighth Amendment ... unless the official knows of and disregards an excessive risk to inmate health or safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference.”18 However, a prison official‘s knowledge of a substantial risk of harm may be inferred if the risk was obvious.19 For example,
[I]f an Eighth Amendment plaintiff presents evidence showing that a substantial risk of inmate attacks was longstanding, pervasive, well-documented, or expressly noted by prison officials in the past, and the circumstances suggest that the defendant-official being sued had been exposed to information concerning the risk and thus must have known about it, then such evidence could be sufficient to permit a trier of fact to find that the defendant-official hаd actual knowledge of the risk.20
Taking Easter‘s allegations as true, as we must,21 Powell knew that Easter (1) had a heart condition, (2) was experiencing severe chest pain, and (3) did not have his prescribed heart medication. The record evidence indicates that Easter‘s prior heart problems were well-documented in his medical chart, which indicated that he had heart disease and had suffered a heart attack, and that Powell had been exposed to the information. Therefore, it can be inferred from the circumstances that Powell was subjectively aware of a substantial risk of harm to Easter‘s health.
Although Powell was aware of that substantial risk, she did nothing more than direct Easter to the pharmacy to obtain a refill of his nitroglycerin prescription. When Powell learned that the pharmacy
Powell argues that Easter alleges only a disagreement about the nature of the treatment provided, not an actionable deliberate indifference claim. Although mere disagreement with the treatment provided is not sufficient to state a claim for deliberate indifference,22 Easter is not alleging mere disagreement with the course of treatment Powell provided to him. Rаther, Easter alleges that Powell failed to follow a prescribed course of treatment that called for the administration of nitroglycerin when he experienced chest pain.23 A prison inmate can demonstrate an Eighth Amendment violation by showing that a prison official “‘refused to treat him, ignored his cоmplaints, intentionally treated him incorrectly, or engaged in any similar conduct that would clearly evince a wanton disregard for any serious medical needs.’ ”24 According to Easter‘s allegations, Powell refused to provide any treatment to, and ignored the complaints of, a patient suffering from severe chest pain that she knew had a history of cardiac problems. Powell‘s alleged conduct meets the “deliberate indifference” threshold.25
“[D]elay in medical care can only constitute an Eighth Amendment violation if there has been deliberate indifference [that] results in substantial harm.”26 The district court determinеd that Easter made no claim of any lasting complications resulting from the delay in receiving nitroglycerin, and thus failed to show an Eighth Amendment violation as to the delayed treatment. Even if Easter failed to state an Eighth Amendment violation with regard to the delay in medical treatment, which we need not decide for purposes of the qualified immunity issue on appeal,
When a government official violates a constitutional right, the official is nevertheless entitled to qualified immunity if his оr her conduct is objectively reasonable in light of clearly established law.27 A law is “clearly established” if it is “sufficiently clear that a reasonable official would understand that what he [or she] is doing violates that right.”28 However, “[t]his is not to say that an official action is protected by qualified immunity unless the very action in question has previously been held unlawful; but it is to say that in the light of pre-existing law the unlawfulness must be apparent.”29 “The law can be clearly established despite notable factual distinctions between the precedents relied on and the cases then before the Court, so long as the prior decisions gave rеasonable warning that the conduct then at issue violated constitutional rights.”30
At the time Powell denied Easter treatment, the law was clearly established that a prison inmate could demonstrate an Eighth Amendment violation by showing that a prison official “refused to treat him, ignored his complaints, intentionally treated him incorrectly, or engaged in any similar conduct that would clearly evince a wanton disregard for any serious medical needs.”31 The summary judgment record reflects that Powell offered no treatment options to a patient with a history of cardiac problems who was experiencing severe chest pains. This is some evidence that no reasonable official could have believed such conduct was lawful in light of clearly established law.32 Because there is evidence that Powell‘s conduct was not objectively reasonable in light of clearly established law, and Powell adduced no compеtent summary judgment evidence to show otherwise, Powell is not entitled to summary judgment based on qualified immunity.
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The district court‘s judgment is AFFIRMED and the cause is REMANDED for further proceedings consistent with this opinion. Easter‘s motion to dismiss Powell‘s appeal as frivolous is DENIED.