Ethel A. ROBERTS, as Personal Representative of the Estate
of Arthur N. Roberts, deceased,
Plaintiff-Appellant/Cross-Appellee.
v.
James SPALDING, as Superintendent of the Washington State
Penitentiary, W. Edward Naugler, as Washington State
Department of Institutions Medical Director, Barbara
Anderson, as Health Care Manager, Washington State
Penitentiary, and Joyce Lingerfelt, Nurse Practitioner,
State of Washington, Defendants-Appellees/Cross-Appellants.
Nos. 84-3752, 84-3825.
United States Court of Appeals,
Ninth Circuit.
Argued and Submitted April 4, 1985.
Decided Feb. 24, 1986.
Richard I. Sampson, Richard I. Sampson & Associates, Seattle, Wash., John S. Biggs, Walla Walla, Wash., for plaintiff-appellant/cross-appellee.
Don G. Daniel, Asst. Atty. Gen., Olympia, Wash., for defendants-appellees/cross-appellants.
Appeal from the United States District Court for the Western District of Washington.
Before EUGENE A. WRIGHT and KENNEDY, Circuit Judges, and MACBRIDE,* District Judge.
MACBRIDE, Senior District Judge:
The underlying action was brought under 42 U.S.C. Sec. 1983 alleging that the medical care accorded appellant's decedent, an inmate at the Washington State Penitentiary, violated his eighth amendment rights, denied him equal protection of the laws, and denied him a state-created liberty interest without due process of law. This appeal principally challenges the district court's refusal to instruct the jury on appellant's due process and equal protection theories. On cross-appeal, appellees seek reversal of the district court's denial of their request for attorney's fees.
I. FACTS
The decedent, Arthur Roberts, was a thirty-five year old, slightly retarded inmate at the Washington State Penitentiary ("WSP") when he died of heart failure on December 21, 1979.
This appeal pertains to events that took place in the WSP infirmary from December 10 through 21, 1979. In effect during this time was a section of the Washington Administrative Code that stated:
Any inmate may, at his or her own expense, obtain medical or dental care additional to that mandated by the provisions of this chapter: Provided, That a doctor or dentist in the department's employ certifies that the proposal for supplemental treatment comports with sound medical or dental practice. The time and place of the performance of the supplemental care are subject to the convenience of the prison's custody staff.
Wash.Admin.Code R. 275-91-070 (1977). On December 10, 1979, Roberts reported to the WSP infirmary complaining of chest pains. He was examined by a registered nurse, Ronald Petrie, who performed tests and concluded that Roberts had no cardiac illness. Roberts stated that he wished "to go downtown for a check-up." The request was noted on the decedent's records, but was not referred to any doctor for consideration. Later that day, Roberts was treated by a nurse practitioner, Joyce Lingerfelt. Lingerfelt saw the notation regarding Roberts' request to "go downtown," but she took no action.
On December 11, 1979, Roberts was attended by Doctor Kuzma, an outside physician who did part-time contract work at WSP. Dr. Kuzma concluded on the basis of Roberts' complaints and test results that his pains were not of cardiac origin.
On December 18th, 19th, and 20th, Roberts again complained of chest pains. On December 20, 1979, he was again attended by Nurse Practitioner Lingerfelt, to whom he apparently repeated his request to "go downtown." She explained that he had been seen by a "downtown" physician, Dr. Kuzma. On December 21, 1979, Roberts was found dead in his cell. An autopsy determined the cause of death to be a completely blocked artery [coronary arterial thrombosis].
II. PROCEDURAL HISTORY
Trial was had in the district court before Judge Tanner. At trial, appellant sought to advance three distinct bases for recovery: (1) that the medical care accorded the decedent violated his eighth amendment right to be free from cruel and unusual punishment, (2) that WSP's use of unsupervised nurse practitioners to provide medical care to the decedent, a practice arguably unauthorized by then-existing regulations, denied the decedent equal protection of the laws, and (3) that appellees' failure to process the decedent's request for supplemental health care denied him a state-created liberty interest without due process of law.
After a three-day trial, the court charged the jury on appellant's eighth amendment theory only. The court refused, over appellant's objections, to instruct the jury on the other theories advanced by appellant. So instructed, the jury returned a verdict in favor of all appellees. Appellees then requested attorney's fees, claiming that the litigation was frivolous. That request was denied. Both parties appeal. We have jurisdiction over these appeals pursuant to 28 U.S.C. Sec. 1291.
III. STANDARD OF REVIEW
We review the sufficiency of the jury instructions to determine whether, viewed as a whole, the jury was adequately instructed on each element of the case. See Ragsdell v. Southern Pacific Transportation Co.,
IV. DUE PROCESS
A prison inmate has no independent constitutional right to outside medical care additional and supplemental to the medical care provided by the prison staff within the institution. See Estelle v. Gamble,
State law can create a protected "liberty" interest by placing substantive limitations on the exercise of official discretion. Olim v. Wakinekona,
The state's use of guidelines to "structure the exercise" of the decisionmaker's discretion does not necessarily create a protected interest. Baumann v. Arizona Department of Corrections,
The creation of procedural guidelines to channel the decision-making of prison officials is, in the view of many experts in the field, a salutary development. It would be ironic to hold that when a State embarks on such desirable experimentation it thereby opens the door to scrutiny by the federal courts, while States that choose not to adopt such procedural provisions entirely avoid the strictures of the Due Process Clause.
Hewitt v. Helms,
"A mere expectation of receiving a benefit is not enough to create a protected interest." Spruytte v. Walters,
In Wright v. Enomoto,
Similarly, in Spruytte v. Walters,
In contrast to the regulations in Spruytte and Wright v. Enomoto, Wash.Admin.Code R. 275-91-070 provides that an inmate "may" obtain supplemental medical care, "[p]rovided, [t]hat" a doctor certifies that the inmate's request for supplemental care "comports with sound medical ... practice." The words "may" and "provided," considered in the context of the regulation, indicate that the regulation does not create a "right or justifiable expectation" that can be denied only upon the application of defined and objective criteria. Vitek v. Jones,
That the state holds out this possibility of outside medical care does not mean that a liberty interest has been created. See id. The doctor's discretion to determine that supplemental medical care is not warranted remains essentially unfettered. He or she need not articulate a "specific, substantive predicate" to the denial of supplemental care. In fact, the regulation requires that a doctor certify the inmate's proposal for supplemental care as consistent with sound medical practice before the inmate can be granted the requested care. As such, the regulation creates no protected entitlement or liberty interest and the 14th amendment is not implicated. Compare McFarland,
V. EQUAL PROTECTION
Appellant rather weakly suggests that the system of medical care and medical care access articulated in Wash.Admin.Code Regulations 275-91-011, 275-91-050, & 275-91-070 (1977) violated the decedent's right to equal protection of the laws guaranteed by the fourteenth amendment to the United States Constitution. See U.S. Const. amend. XIV, Sec. 1. The system of medical care provided by the regulations violates equal protection only if it bears no rational relationship to a legitimate state interest. See Dandridge v. Williams,
Appellant suggests no basis for a finding that the policies expressed in the regulations, or the regulations themselves, are deficient constitutionally. The regulations appear to be reasonably related to the provision of adequate medical care to prison inmates consistent with the legitimate security and financial needs of the institution. Accordingly, we reject appellant's contention that the district court's refusal to instruct the jury on her equal protection theory was in error.
VI. CRUEL AND UNUSUAL PUNISHMENT
Appellant argues that since the decedent, Mr. Roberts, was a member of the class in Hoptowit v. Ray,
The jury was instructed that, in order to sustain her eighth amendment claim, appellant had to prove that WSP's alleged denial of access to adequate medical care was the result of deliberate indifference to the decedent's serious medical needs. The standard articulated by the district court is the proper standard to be applied in eighth amendment analysis. Estelle v. Gamble,
VII. APPELLANT'S OTHER CLAIMS
Appellant objects to the district court's failure to charge the jury with certain instructions or parts of instructions proposed by appellant. See Brief of Appellant at 6-9. As previously indicated in Section III, supra, we review the instructions given by the court to determine whether, viewed as a whole, they adequately instructed the jury on each element of the case. A party is not entitled to have her theories presented to the jury unless they are both legally correct and supported by the evidence. Even then,
A court is not required to use the exact words proposed by a party, incorporate every proposition of law suggested by counsel or amplify an instruction if the instructions as given allowed the jury to determine intelligently the issues presented.
Los Angeles Memorial Coliseum Commission v. National Football League,
Appellant's proposed instructions 5, 9, and 10 contain improper, incorrect, or incomplete theories of law under the fifth, the eighth, and the fourteenth amendments. Proposed instruction 5 fails to set forth the proper standard of deliberate indifference to be applied to her eighth amendment claim. See Estelle v. Gamble,
Appellant's proposed instruction 11 is improper since it directs the jury to find that "all acts done by all defendants towards Arthur N. Roberts were done under color of state law." This was a question of fact for the jury to decide. Appellant's proposed instruction 11-A was properly rejected, since the court instructed the jury concerning acts under color of state law. See Reporter's Transcript of Proceedings, Vol. IV, at 4-5.
Appellant's proposed instruction 12 purports to summarize Wash.Admin.Code R. 275-91-070 (1977). This instruction was unnecessary, since the regulation was introduced as plaintiff's exhibit 84. E.R. at 776. Furthermore, the proposed instruction directs the jury to find that the regulation entitled the decedent to have his request for supplemental care processed to a decision by a doctor. This contention was factually disputed at trial, and to the extent that it relates to appellant's due process theory of liability, was properly rejected by the district court.
For similar reasons we uphold the district court's rejection of appellant's proposed instruction 13, which summarizes Wash.Admin.Code R. 275-91-050 (1977). The instruction was unnecessary since the regulation was introduced along with Wash.Admin.Code R. 275-91-070, supra, as plaintiff's exhibit 84. Furthermore, the proposed instruction directs the jury to conclusions regarding factual matters that were the subject of dispute at trial.
The district court properly rejected appellant's proposed instructions 14, 14-A, and 14-B, since the instructions direct the jury to find for the appellant on her due process and eighth amendment claims. Finally, we reject as irrelevant appellant's objection to the court's refusal to charge the jury with appellant's proposed instruction 22, which pertains to the awarding of nominal damages.VIII. ATTORNEY'S FEES
Appellees, the defendants below, cross-appeal the district court's denial of their motion for award of attorney's fees. Pursuant to 42 U.S.C. Sec. 1988, defendants prevailing in civil rights actions are to be awarded attorney's fees " 'not routinely, not simply because [they] succeed, but only where the action brought is found to be unreasonable, frivolous, meritless or vexatious.' " Mayer v. Wedgewood Neighborhood Coalition,
In its order denying appellees' motion, the district court found that "Plaintiff's [eighth amendment] cause of action was not unreasonable, frivolous, or vexatious but was of sufficient merit to proceed to the jury." E.R. tab PP, at 527. The district court's finding is well-supported by the evidence, and will not be disturbed. Thus, we uphold the district court's denial of attorney's fees to appellees.
Accordingly, the judgment and order of the district court are AFFIRMED.
Notes
Honorable Thomas J. MacBride, Senior United States District Judge for the Eastern District of California, sitting by designation
The regulation provided in pertinent part:
Inmates must be segregated from others when it is reasonably believed that they are a menace to themselves and others or a threat to the security of the institution. Inmates may be segregated for medical, psychiatric, disciplinary, or administrative reasons. The reason for ordering segregated housing must be clearly documented by the official ordering the action at the time the action is taken.
Wright v. Enomoto,
We also reject appellant's contention that a "liberty" interest was created by Wash.Admin.Code Regulations 275-91-011 (1977) & 275-91-050 (1977). Appellant makes no showing that these regulations created in the decedent a " 'right or justifiable expectation' rooted in state law," Garcia v. De Batista,
