Martin v. DeBruynMartin v. DeBruyn
MEMORANDUM AND ORDER
Plaintiff Lester Martin filed this action pursuant to
On May 17, 1993, Commissioner DeBruyn issued an executive directive and defendant W. Deаn Neitzke, IDOC Director of Health Care Services, issued a Health Care Services Directive dealing with changes in the method of dispensing over-the-counter (“OTC”) medications. Copies of the directives are attached to the complaint. Mr. Martin asserts that the defendants have generated other documents addressing this policy, but these documents have not been submitted to the court.
The two directives provide that beginning June 15, 1993, inmates would not be allowed to use sick call “to obtain over-the-counter medication used for cosmetic, general hygiene, general comfort, or convenience purposes.” (executive directive, p. 1). Instead, a variety of OTC medications were to be carried on the commissаry and sold to inmates at cost.
The directives specifically provide for an exception to the policy where an inmate “can use an over-the-counter medication as part of a necessary treatment regimen for a serious medical condition or when an offender is an inpatient. In these circumstances the DOC will provide the necessary medication.” (executive directive, p. 1). The defendants acknowledged that “(w)e must provide health care services necessary to treat serious medical conditions,” (health care directive at p. 1), and listed “some ‘serious’ medical needs for which nursing staff may still provide OTC preparations.” (health care directive at p. 3).
Mr. Martin alleges that he has a history of painful ulcers, and had been receiving treatment for this condition at the ISP. On June 15, 1993, Mr. Martin went on sick call and requested medication for his ulcers. He was told that although he met the IDOC indigence requirements, he could not receive the over-the-counter medication that was part of
Dr. Jose LaBayo, a non-defendant, wrote a prescription indicating that Mr. Martin should receive the medication as soon as possible. Mr. Martin informed his counselor, also a non-defendant, who allegedly called defendants L. Daniels and Stu Miller at the business office. Martin filled out the necessary commissary slip on June 22, 1993, but was not allowed to get the medication until June 30,1993. He alleges that the delay was caused by a funding shortage, and that it caused unnecessary suffering.
The party seeking summary judgment must demonstrate that no genuine issue of fact exists for trial and that the movant is entitled to judgment as a mаtter of law. If that showing is made and the motion’s opponent would bear the burden at trial on the matter that forms the basis of the motion, the opponent must come forth with evidence to show what facts are in actual dispute. A genuine factual issue exists only when there is sufficient evidence for a jury to return a verdict for the motion’s opponent.
The parties cannot rest on mere allegations in the pleadings, or upon eonclusory allegations in affidavits. The court must construe the facts as favorably to the non-moving party as the record will permit, and draw any permissible inferences from the materials before it in favor of the non-moving party, as long as the inferences are reasonable. The non-moving party must show that the disputed fact is material, or outcome determinative, under applicable law.
Conery v. Bath Associates,
Mr. Martin alleges that the OTC medication policy violates his rights under the Eighth Amendment, which is made applicable to the states through the Fourteenth Amendment. A violation of the Eighth Amendment’s cruel and unusual punishments clause consists of two elements: (1) objectively, whether the injury is sufficiently serious tо deprive the prisoner of the minimal civilized measure of life’s necessities, and (2) subjectively, whether the prison official’s actual state of mind was one of “deliberate indifference” to the deprivation.
Farmer v. Brennan,
— U.S. -, -,
The Constitution requires that prison officials establish medical facilities for prisoners, and provide prisoners with medical assistance.
Wellman v. Faulkner,
Mr. Martin asserts that IDOC policy requires that indigent inmates receive free OTC medication for treatment of serious medical needs, and that the defendants violated their own policy by requiring him to purchase OTC medication prescribed as part of his treatment for ulcers. Thе materials before the court do not establish that indigence is the key to free OTC medication under the IDOC policy.
1
Under the health care services directive, the existence of a serious need determines whether inmates receive free OTC medications. Inmates with a serious medical condition and OTC medication prescribed by a physician as part оf the treatment are to receive them for free; all others are not. In any event, allegations that the defendants are not following then-
Mr. Martin asserts that he had a serious medical need and that the IDOC policy, and the defendants’ actions pursuant to the policy amounted to deliberate indifference to his needs. The questions before the court are whether Mr. Martin has a serious medical need within the meaning of Estelle v. Gamble; if so, whether the constitution entitles him to free OTC free medication to help treat thаt condition; and whether the materials before the court establish that the defendants’ policy, and the implementation of that policy in Mr. Martin’s case, constitutes deliberate indifference his serious medical needs.
In regard to the question of what constitutes a serious medical need, the list of “serious” medical problems formulated by the IDOC does not include ulcers, and Mr. Martin presumably was not entitled to free OTC medications under the policy directives that are presently before the court.
2
But the policy of deferring to the judgment of prison officials does not apply in the context of medical care to the same degree as other contexts.
Wellman v. Faulkner,
Mr. Martin asserts that Dr. LaBayo has identified his ulcer condition as one requiring treatment, and prescribed OTC medications as part of the treatment process. Courts have identified ulcers as constituting a serious medical need within the meaning of
Estelle v. Gamble,
because if left untreated, ulcers may cause intense and persistent pain and may require emergency surgical intervention.
Coades v. Jeffes,
Once a serious medical need has been identified, the Eighth Amendment prohibits deliberate indifference to that need. In
Benter v. Peck,
The court respectfully disagrees with the reasoning of Benter. Nothing in the Eighth Amendment, which prohibits certain punishment, requires a state to provide an inmate, free of charge, with a necessary commodity that wоuld not be free outside the prison walls and which the inmate has the legal means to obtain.
These qualifications are important. Incarceration prevents a person from seeking medical treatment of his own choosing, so prisons must provide inmates with a minimal degree of1 medical care for serious medical needs; the failure to do so amounts to “рunishment” — a penalty for a crime beyond that
An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met. In the worst cases, such a failure may actually produce physical ‘torture or a lingering death,’ the evils of most immediate cоncern to the drafters of the Amendment. In less serious eases, denial of medical care may result in pain and suffering, which no one suggests would serve any penological purpose. The infliction of such unnecessary suffering is inconsistent with contemporary standards of decency as manifested in modern legislation codifying the common-law view that ‘it is but just that the public be required to care for the prisoner, who cannot by reason of the deprivation of his liberty, care for himself.’
Estelle v. Gamble,
A prison official who withholds necessary medical care, for want of payment, from an inmate who could not pay would violate the inmate’s constitutional rights if the inmate’s medical needs were serious, because refusal to act pending the impossible is no different from refusing without qualifiсation. But insisting that an inmate with sufficient funds use those funds to pay for medical care is neither deliberate indifference nor punishment.
The contrary result reached in
Benter
turned on the court’s statement that, “it is well established that withholding treatment for a serious medical need in order to compel payment constitutes deliberate indifference and is unconstitutional.”
Accordingly, the court concludes that a prison official violates the Eighth Amendment by refusing to provide prescribed OTC medicine for a serious medical need only if the inmates lacks sufficient resources to pay for the medicine. If the inmate can afford the medicine but chooses to apply his resources elsewhere, it is the inmate, and not the prison official, who is indifferent to serious medical needs.
Under this standard, neither Mr. Martin nor the defendants are entitled to summary judgment on the record before the court. The attachments to the complaint, which may be considered for summary judgment purposes, indicate that OTC medications prescribed for Mr. Martin cost $3.15 on June 22. Mr. Martin’s complaint states that he had $3.57 in his prison account that day — a sum that might or might not be adequate to purchase the drugs, depending on the other purchases Mr. Martin might be required to make from that account — but the defendants denied that allegation and a plaintiff mаy not rest upon contested allegations in the complaint in support of a summary judgment motion. Mr. Martin does not
The record does not disclose whether the IDOC allows an inmate to debit his account to pay for present purchases from future deposits. If Mr. Martin could have paid or arranged to pay for the prescribed medicine but simply chose not to pay for it, no defendant would be liable. If, on the other hand, one оr more prison officials refused to provide Mr. Martin with prescribed medicine— OTC or otherwise — for his serious medical needs at a time Mr. Martin could not pay for the prescribed medicine, those officials would be liable to Mr. Martin for the constitutional violation, even if Mr. Martin later acquired the means to pay, and so acquired the medicine. Under such circumstanсes, Mr. Martin’s acquisition of the means to pay would have terminated the constitutional violation, but would not relieve the defendants from liability for Mr. Martin’s increased pain from lack of the medicine in the interim. These issues cannot be resolved on this record.
Other issues remain. A
Mr. Martin sued ten defendants, but most of them are not mentioned at all in the body of the complaint or in any of the materials subsequently submitted by Mr. Martin. The directives attached to the complaint establish that defendants DeBruyn and Neitzke established the overall policy, but Mr. Martin has not established the personal involvement of any defendant in any action beyond that point.
In regard to injunctive relief, the materials before the court establish that the IDOC policy, as formulated in 1993, recognizes the state’s duty to provide health care services, including OTC medications, necessary to treat serious medical conditions at no cost to the inmate, (health care directive at p. 3). This general policy comports with Constitutional requirements. The problem is that, based on the materials before the court, the IDOC appears to hаve established an inelastic list of conditions which it considers “serious medical needs,” while the definition of such a need is necessarily elastic. 4
The directives before the court are those used to establish the policy initially, and the parties refer to subsequent documents that may refine the policy. The later documents are not presently before the сourt. The court is reluctant to rule on the request for injunctive relief on the record now before the court.
Mr. Martin has established some of the elements necessary to obtain summary judgment, but when the facts are construed favorably to the non-moving party and the defendants are given the benefit of inferences to which they are entitled,
Conery v. Bath Associates,
The parties may also wish to review the portion of the
Benter
decision marked “CONCLUSION.”
Benter,
For the foregoing reasons, the court DENIES the plaintiffs motion for summary judgment (docket #27).
SO ORDERED.
Notes
. The health care services directive states, “(i)ndigence may present a difficulty to some offenders in obtaining these medications; however, health care staff will nоt address this issue.”
. The IDOC health care directive acknowledges a duty to provide inmates OTC medications to deal with serious medical needs, and lists the serious medical needs identified by the IDOC. The list before the court does not include ulcers.
. The
Benter
court also stated that, "Delay in medical treatment of a serious medical need cannot be justified as a means to compel payment,”
. A serious medical need has been defined by the courts as one which has been diagnosed by a physician as mandating treatment or one which is so obvious that even a lay person would easily recognize the necessity for a doctor's attention.
Laaman v. Helgemoe,