Rutherford v. Medical Department of Department of Corrections , 76 F. App'x 893 ( 2003 )


Menu:
  •                                                                         F I L E D
    United States Court of Appeals
    Tenth Circuit
    UNITED STATES COURT OF APPEALS
    SEP 24 2003
    FOR THE TENTH CIRCUIT
    PATRICK FISHER
    Clerk
    KEVIN RUTHERFORD (and in
    behalf of fellow prisoners within
    DOC, as class action),
    Plaintiff-Appellant,
    v.                                                 No. 02-1279
    (D.C. No. 00-RB-2444 (PAC))
    MEDICAL DEPARTMENT OF                                (D. Colo.)
    DEPARTMENT OF CORRECTIONS;
    ROBERT FLORES; DR. MCGARRY;
    DR. CABILING; WARDEN SOARES;
    WARDEN NEET; C/O EGLEY; P.A.
    LAWERANCE; AVCF MED. STAFF;
    DR. WERMERS; TRANSPORT OF
    CDOC; DOLORES MONTOYA;
    MED. STAFF OF FCF; OFFENDER
    SERVICES, with MED. STAFF OF
    FMCC,
    Defendants-Appellees.
    ORDER AND JUDGMENT         *
    Before BRISCOE , PORFILIO , and ANDERSON , Circuit Judges.
    *
    This order and judgment is not binding precedent, except under the
    doctrines of law of the case, res judicata, and collateral estoppel. The court
    generally disfavors the citation of orders and judgments; nevertheless, an order
    and judgment may be cited under the terms and conditions of 10th Cir. R. 36.3.
    After examining the briefs and appellate record, this panel has determined
    unanimously that oral argument would not materially assist the determination of
    this appeal. See Fed. R. App. P. 34(a)(2); 10th Cir. R. 34.1(G). The case is
    therefore ordered submitted without oral argument.
    Kevin Rutherford, a state prisoner appearing   pro se , appeals from the
    district court’s dismissal of his Eighth Amendment claims brought pursuant to
    
    42 U.S.C. § 1983
    . After defendants moved for summary judgment, the claims
    were dismissed on several grounds, including failure to make installment
    payments toward filing fees. Our jurisdiction arises under 
    28 U.S.C. § 1291
    .
    We conclude that Mr. Rutherford sufficiently complied with the district court’s
    order to show cause and demonstrated that he has no assets with which to pay the
    fee. We also conclude that the district court improperly granted summary
    judgment to certain defendants and erroneously dismissed certain defendants
    under Rule 12(b)(6). We therefore reverse in part and affirm in part.
    I. Factual and procedural background
    After two years of complaining about severe back pain, Mr. Rutherford
    underwent surgery in January 2001 for several herniated disks that had caused
    nerve damage. He was returned to prison to recuperate. His claims of deliberate
    indifference to serious medical needs are primarily based on allegations
    that defendants delayed and failed to afford him proper medical care before
    -2-
    January 2001, refused to provide him with prescribed and appropriate
    pre- and post-surgical pain medications and mattresses, and refused or failed to
    properly administer prescribed medication for his Hepatitis C. He also alleges
    that certain defendants discontinued prescribed pain medications and reclassified
    and transferred him to facilities distant from his surgeon in retaliation for his
    complaints about inadequate or deliberately-indifferent medical care.
    Mr. Rutherford filed his original complaint on December 5, 2000.
    On December 13, 2000, the district court granted Mr. Rutherford’s request to
    proceed in forma pauperis pursuant to 
    28 U.S.C. § 1915
    , ordering him to make
    monthly payments of twenty percent of the preceding month’s income credited to
    his trust fund account or to show cause each month why he has no assets and no
    means by which to make the monthly payment. R. doc. 6 at 2. Mr. Rutherford
    subsequently submitted prison account statements demonstrating that he earned
    approximately $6.16 per month and that his prison account had a negative
    balance. Accordingly, on January 25, 2001, the district court entered an order
    allowing Mr. Rutherford to proceed without paying the initial partial filing fee
    and reminded him that he remained obligated to pay the full filing fee through
    monthly installments as funds became available.
    In response to subsequent orders to pay monthly installments or to show
    cause, Mr. Rutherford submitted account statements demonstrating a negative
    -3-
    balance of -$34.46 for March 2001, and income of $6.16 and an account balance
    of -$70.28 for May 2001. Debits to his account primarily consisted of medical,
    postage, mandatory restitution, and xerox charges. R. doc. 26, ex. 1;      
    id.
     doc. 38,
    ex. 17. His balance on July 7, 2001 was -$115.16.      
    Id.
     doc. 48 at 2.
    In August 2001, defendants Dr. Cabiling, Dr. McGarry, and Robert Flores
    moved for summary judgment, and the remaining defendants moved for dismissal
    based on sovereign and qualified immunity and failure to state a claim. In
    support, Dr. Cabiling, Dr. McGarry, and Robert Flores submitted affidavits.
    Because he had not been provided with a full copy of his medical records, Mr.
    Rutherford requested discovery and an extension of time in which to respond,
    which the court granted.
    The court again entered an order on September 24, 2001, directing
    Mr. Rutherford to make a monthly filing fee payment or to show cause. In
    response, Mr. Rutherford submitted another account statement demonstrating that
    his balance on October 11, 2001 was -$115.91.       
    Id.
     doc. 71 at 4. The court
    entered a similar order on February 12, 2002. Mr. Rutherford answered on
    February 21, stating that he had pneumonia and was unable to immediately
    respond to the court’s orders. On March 4, he filed his response, further
    explaining that he had been transferred to another facility since the February 12
    order, he had been segregated without access to legal materials, he had been sick,
    -4-
    and that he had requested an account statement. He stated that he would try to
    find some way to send a payment and asked if the court could order the prison to
    debit his prison account for the outstanding balance so he could pay it off in
    prison. 
    Id.
     doc. 108 at 3. On March 8, he filed another document stating he had
    no funds and explaining that the state automatically deducted seventy percent of
    his earnings for debt and restitution, leaving him virtually no available funds.
    
    Id.
     doc. 110 at 3. On March 22, he submitted another responsive pleading and
    an account statement showing that he had a current balance of -$46.80 and no
    available funds.   
    Id.
     doc. 121.
    In her April 16, 2002, decision, the magistrate judge recommended that all
    claims against all defendants be dismissed except for two: Mr. Rutherford’s
    claim that individual John Doe medical staff at Fremont Correctional Facility
    (“FCF”) unlawfully denied his hepatitis treatments and his medically-prescribed
    extra mattress. R. doc. 132 at 19-20. The court denied Mr. Rutherford’s motion
    seeking a forty-day extension to respond to the magistrate judge’s
    recommendations.
    In a subsequent decision filed April 23, 2002, the magistrate judge
    recommended dismissing the two remaining claims for Mr. Rutherford’s failure to
    pay the monthly installments toward his filing fee. The magistrate judge stated
    that, although his account statement showed a deficit and he claimed (1) he was
    -5-
    indigent, (2) he earned only .28 per day, and (3) his $3.40 canteen expenditure
    was for stamps, no records supported his expenditure claim and he therefore had
    “failed to show that he is indigent and unable to make his monthly payment
    toward the filing fee.”   
    Id.
     doc. 134 at 3.
    Mr. Rutherford objected to the recommendation that his case be dismissed
    for failure to pay filing fees and submitted a receipt proving that his $3.40
    canteen expenditure had indeed been for stamps. He also objected to the
    dismissal of certain defendants and claims. The district court adopted the
    April 16th and April 23rd recommendations, granted summary judgment and
    dismissal in favor of certain defendants, and dismissed the Eighth Amendment
    claims against the FCF medical staff for failure to pay filing fees.   
    Id.
     doc. 145 at
    4-5. In his motion for reconsideration, Mr. Rutherford pointed out that, under §
    1915(b)(2), it was the facility’s duty to forward payments for filing fees only
    whenever his account balance exceeded $10.00. He submitted certified account
    statements showing that he was still $51.95 in debt and had no available funds.
    R. doc. 147 at 5. The court denied reconsideration. This appeal followed.
    -6-
    II. Dismissal for failure to pay filing fees
    The Federal Rules of Civil Procedure allow a district court to dismiss an
    action for failure to comply with a court order.     See Fed. R. Civ. P. 41(b).
    Accordingly, we review for abuse of discretion the district court’s dismissal of
    Mr. Rutherford’s suit.     See Mobley v. McCormick , 
    40 F.3d 337
    , 340 & n.1
    (10th Cir. 1994).
    As outlined above, the record demonstrates that Mr. Rutherford complied
    with the court’s February 12, 2002, order to show cause why he could not pay
    installment fees by submitting his inmate account and an explanation of
    mandatory deductions and voluntary expenditures. The account reflects no
    positive account balance. Under these circumstances, no monthly payment is due
    and the case could not be dismissed for failure to pay the fees.        See § 1915(b)(2)
    (providing that “[t]he agency having custody of the prisoner shall forward
    payments from the prisoner’s account to the clerk of the court each time the
    amount in the account exceeds $10”; § 1915(b)(4) (“In no event shall a prisoner
    be prohibited from bringing a civil action . . . for the reason that the prisoner has
    no assets and no means by which to pay the initial partial filing fee”);      Shabazz v.
    Parsons , 
    127 F.3d 1246
    , 1248 (10th Cir. 1997) (stating that payment of initial
    partial fee is made only when funds exist and that subsequent monthly payments
    are “extracted only in months when the prisoner’s trust fund account exceeds
    -7-
    ten dollars,” and noting that, under § 1915(b)(4), a prisoner cannot be precluded
    from going forward with his cause of action when he has no assets or means to
    make payments) (quotation omitted). We therefore hold that the district court
    abused its discretion by dismissing the two Eighth Amendment claims against
    medical staff for defendant’s failure to pay the filing fee.
    III. Summary judgment in favor of Dr. Cabiling
    A. Delay in treatment for herniated discs. Mr. Rutherford had back
    surgery in 1994 for disc herniation. The record shows that he complained of
    severe back pain in 1999.   See R. doc. 41, ex. 19–25. Dr. Cabiling was the
    physician in charge of Mr. Rutherford’s medical care while he was incarcerated at
    both the Four Mile Correctional Center (FMCC) and FCF, which are both located
    in Canon City. The district court found as undisputed the facts that Dr. Cabiling:
    (1) began treating Mr. Rutherford for his back pain in May 1999; (2) ordered X-
    rays and a muscle relaxant and imposed lifting and work restrictions; (3) ordered
    EMG/NCS (electromyography) testing, which was performed July 16, 1999, and
    which was positive for lumbar disc/nerve problems; and (4) authorized a
    neurosurgeon consultation in July 1999. R. doc. 132 at 4-5. It is also undisputed
    that (5) Mr. Rutherford did not see Dr. Lilly, the neurosurgeon, until October 1,
    1999; (6) Dr. Lilly ordered an MRI (which was not done until February 9, 2000--
    four months later) and an egg-crate mattress and pain medications; (7) the MRI
    -8-
    showed nerve damage and pressure on both sides of Mr. Rutherford’s sciatic
    nerves, requiring surgery at discs L3, L4, and L5; (8) no follow-up appointment
    with Dr. Lilly was scheduled until September 8, 2000 (seven months later), and
    (9) surgery was not performed until January 17, 2001, almost a year and one-half
    after Dr. Cabiling knew that objective tests supported Mr. Rutherford’s
    complaints of severe pain and almost a year after serious nerve impairment was
    positively diagnosed and surgery was recommended.          See id. at 5.
    Mr. Rutherford claims that Dr. Cabiling and his medical staff at FMCC
    allowed his authorization for a specialist consultation to expire once before he
    was first seen by Dr. Lilly and that he was forced to suffer needlessly because of
    Dr. Cabiling’s deliberate indifference in failing to timely obtain surgical
    treatment.
    The district court determined that Mr. Rutherford’s back condition
    constituted a serious medical need, and that finding has not been appealed from.
    Id. at 11. The court also acknowledged that Mr. Rutherford blamed Dr. Cabiling
    for unwarranted delay in obtaining treatment and withholding medications, which
    caused him to suffer further damage and “years of pain.”        Id. But, in the district
    court’s opinion, Dr. Cabiling “treated and monitored plaintiff’s back condition in
    a timely manner. To the extent there was any delay in plaintiff’s back surgery,
    the evidence does not show that the delay is attributable to Dr. [Cabiling].”      Id.
    -9-
    This factual finding and legal conclusion disregard established Tenth Circuit law
    concerning both summary judgment standards and the important gatekeeping role
    that prison physicians assume in affording medical care to inmates.   See Sealock
    v. Colorado , 
    218 F.3d 1205
     (10th Cir. 2000).
    Summary judgment is appropriate if the pleadings, depositions,
    answers to interrogatories, and admissions on file, together with the
    affidavits, if any, show that there is no genuine issue as to any
    material fact and that the moving party is entitled to a judgment as
    a matter of law. We review a grant of summary judgment       de novo,
    applying the same standard as the district court. We examine the
    record to determine whether any genuine issue of material fact was in
    dispute; if not, we determine whether the substantive law was applied
    correctly, and in so doing we examine the factual record and
    reasonable inferences therefrom in the light most favorable to the
    party opposing the motion.
    
    Id. at 1209
    . “It is not the task of a court considering summary judgment to weigh
    the evidence.”   
    Id.
     at 1210 n.4. The proper analysis of deliberate indifference as
    a gatekeeper is set forth as follows:
    A prison official’s deliberate indifference to an inmate’s serious
    medical needs violates the Eighth Amendment. Deliberate
    indifference involves both an objective and a subjective component.
    The objective component is met if the deprivation is sufficiently
    serious. A medical need is sufficiently serious if it is one that has
    been diagnosed by a physician as mandating treatment or one that is
    so obvious that even a lay person would easily recognize the
    necessity for a doctor’s attention. The subjective component is met
    if a prison official knows of and disregards an excessive risk to
    inmate health or safety.
    ....
    -10-
    Delay in medical care only constitutes an Eighth Amendment
    violation where the plaintiff can show that the delay resulted in
    substantial harm . . . [as when] there is factual evidence from which
    a jury could conclude that the delay occasioned by his inaction
    unnecessarily prolonged appellant’s pain and suffering.
    ....
    Our cases recognize two types of conduct constituting deliberate
    indifference. First, a medical professional may fail to treat a serious
    medical condition properly. Where this sort of conduct is alleged,
    the medical professional has available the defense that he was merely
    negligent in diagnosing or treating the medical condition, rather than
    deliberately indifferent. The second type of deliberate indifference
    occurs when prison officials prevent an inmate from receiving
    treatment or deny him access to medical personnel capable of
    evaluating the need for treatment. Ordinarily, a medical professional
    will not be liable for this second kind of deliberate indifference,
    because he is the person who provides the treatment. If, however,
    the medical professional knows that his role in a particular medical
    emergency is solely to serve as a gatekeeper for other medical
    personnel capable of treating the condition, and if he delays or
    refuses to fulfill that gatekeeper role due to deliberate indifference, it
    stands to reason that he also may be liable for deliberate indifference
    from denying access to medical care.
    
    Id.
     at 1209-11 & n.5 (quotations and citations omitted). Whether, as
    Mr. Rutherford claims, Dr. Cabiling and his staff at FMCC were deliberately
    indifferent to the continuing nerve damage and severe pain caused by herniated
    discs by reason of their alleged inaction (allowing authorization for consultations
    to expire and permitting delays in arranging for consultations, MRIs, follow-up
    appointments, and scheduling and transporting Mr. Rutherford for surgery) is in
    dispute. A single affidavit making a conclusory statement that “Mr. Rutherford
    -11-
    was always provided with appropriate medical treatment,” R. doc. 55, attach. 1
    at 2, unsupported by medical records, does not satisfy the summary judgment
    requirement that Dr. Cabiling present evidence demonstrating no genuine issues
    of material fact exist concerning Mr. Rutherford’s claims. A year and one-half
    delay in obtaining surgical relief after diagnosis of nerve damage could be
    determined to be unreasonable and indicative of deliberate indifference.
    B. Retaliation. Mr. Rutherford submitted evidence indicating that
    Dr. Cabiling discontinued his prescribed Vicodin on September 15, 1999, the
    same day Mr. Rutherford complained about not properly receiving prescribed
    interferon treatments and after Dr. Cabiling had discovered that FMCC medical
    staff had indeed missed scheduled treatments on at least two occasions. R. doc.
    106, ex. L1, L2. It is undisputed that Dr. Cabiling knew on September 15, 1999,
    of the objective EMG findings of nerve involvement and that Mr. Rutherford
    continued to complain of severe pain. In his response to the motion for summary
    judgment, Mr. Rutherford asserted that Dr. Cabiling’s proffered explanations for
    discontinuing the Vicodin were pretextual and unsupported by the medical record.
    The district court held that Mr. Rutherford did not “aver facts sufficient to
    show that Dr. Cabiling discontinued the Vicodin in retaliation for plaintiff’s
    complaints that other medical staff members had failed to give him scheduled
    interferon treatments.” R. doc. 132 at 14. We disagree. Although we express no
    -12-
    opinion on the merits of his claim, at this stage of the litigation Mr. Rutherford
    has sufficiently stated a claim for retaliation.
    IV. Dismissal of other defendants and other claims
    “Dismissal of a pro se complaint for failure to state a claim is proper only
    where it is obvious that the plaintiff cannot prevail on the facts he has alleged and
    it would be futile to give him an opportunity to amend. We must liberally
    construe the allegations of a pro se complaint[,] . . . . [and] in deciding a motion
    to dismiss pursuant to Rule 12(b)(6), a court may look both to the complaint itself
    and to any documents attached as exhibits to the complaint.”    Oxendine v. Kaplan ,
    
    241 F.3d 1272
    , 1275 (10th Cir. 2001) (quotations and citations omitted). We
    review the district court’s decision to dismiss defendants for failure to state a
    claim de novo. 
    Id.
     Further, we must consider all factual allegations contained in
    Mr. Rutherford’s complaint as true, construing those allegations in the light most
    favorable to him.     
    Id. at 1277
    .
    In his original complaint, Mr. Rutherford alleged that John Doe members of
    the FCF medical staff allowed his authorization number to see a specialist expire;
    that the FCF members then ignored or denied his specialist’s orders, including his
    order to provide a second mattress, and denied him effective pain medication,
    “leaving [him] in constant pain throughout the day.” R. Doc. 3 at 7. He also
    alleged that between 1999 and 2000, members of the medical staff responded to
    -13-
    his claims of extreme back pain by sending him to physical therapy without
    examination or tests, leading to more nerve damage and pain.        Id. at 10. Mr.
    Rutherford was incarcerated at FMCC during 1999.
    In Claim IV, he alleged that CDOC’s “medical departments” violated the
    Eighth Amendment by not properly responding to his need for “liver treatment”
    for Hepatitis C. In his “supporting facts,” he claimed that a one-year interferon
    treatment program for injections administered three times per week was
    prescribed. He began this program in 1998 and received injections for 4 months
    at FCF until he was transferred to FMCC, where FMCC medical staff allegedly
    discontinued the treatment and required him to “re-establish” his need for the
    treatment by another doctor. He states that, after a doctor saw him, a new one-
    year treatment plan was scheduled and begun in May 1999. He states that, despite
    his written requests, nurses at FMCC refused to allow him to review his blood-
    test results showing his progress. R. Doc. 3 at 12. He claims that, after a year of
    treatment, Dr. Bloor (a hematologist) prescribed another 6 months of interferon
    combined with Ribavirin because his liver was not responding. The FMCC staff
    began his treatment again. In June 2000, he alleges he was transferred back to
    FCF, but while in the segregation unit, interferon treatment was denied.      Id. at 14.
    He was reclassified in March 2001 and sent to the Arkansas Valley Correctional
    Facility (AVCF).
    -14-
    Mr. Rutherford moved for leave to amend his complaint on April 20, 2001.
    In his motion to amend, he specifically alleged claims against members of the
    medical staff at AVCF, stating,   inter alia , that John Doe medical staff at this
    facility had confiscated his medically-assigned extra mattress upon his transfer
    there, refused to replace it, and refused to respond to his requests for medical
    treatment.
    He also included additional post-surgical claims against the staff at FCF,
    stating that the staff there refused to give him medical attention, had taken his
    cane and discontinued his pain medication, and that medical staff member
    “Duane” threatened him with segregation if he did not leave the medical unit
    without having received care. R. Doc. 29 at 1-3.
    The court granted his motion to amend, and on July 2, 2001, Mr.
    Rutherford tried to amend his complaint by filing a motion asking the court to
    amend his previous pleadings to add as defendants “Dr. Cabiling’s staff” at
    FMCC and the medical staffs at AVCF and FCF. He included a request for
    damages for, inter alia , “retaliation by Cabling’s [sic] staff;” for needless
    suffering during the time period he was incarcerated at the three facilities; for
    failure to provide proper “liver treatment;” for “threats by medical staff;” for
    “retaliation by AVCF staff,” and for “medical’s failure to treat for assault.” R.
    Doc. 44.
    -15-
    On July 30, 2001, Mr. Rutherford filed a document “seeking to bring to life
    further information in support of these claims” that contained a hand-written but
    un-notarized “affidavit.” R. Doc. 52. In this document, which we liberally
    construe as a motion to supplement his complaint, he more specifically set forth
    his deliberate indifference and retaliation claims against the medical staffs at
    FMCC, FCF, and AVCF and alleged that their actions and inaction continued to
    cause him to suffer extreme back and leg pain.    Id.
    He alleged that medical staff at FMCC ignored his pleas for medical
    examination and treatment and refused to perform x-rays or MRIs until 1999, and
    recommended exercises and physical therapy that made his back condition worse.
    He alleged that the staff at FCF failed to administer prescribed medications after
    his back surgery, discontinued his pain medications, and confiscated his cane. He
    alleged that the FCF medical staff refused to treat him after a guard allegedly
    attacked him soon after his surgery, and refused to schedule a follow-up
    appointment with his surgeon. Upon his transfer to AVCF, he alleged that the
    staff confiscated his extra mattress, that the medical staff refused to issue another
    one despite his medical orders, and that the staff had refused to schedule follow-
    up MRIs, appointments with his surgeon, or to see a doctor.    Id.
    On October 5, 2001, in response to defendants’ motions for summary
    judgment and to dismiss the AVCF and FMCC medical staff members for failure
    -16-
    to state a claim, the magistrate judge made several rulings. She stated it was “not
    clear” whether Mr. Rutherford intended for his amended complaint to include the
    claims identified in his April 20 motion. R. Doc. 69 at 4. The magistrate judge
    did not mention the July 30 affidavit supplementing his claims against the various
    medical staff members. The magistrate judge ordered Mr. Rutherford to file an
    amended complaint setting forth all defendants and containing factual allegations
    to support asserted claims for relief by November 9, 2001.   Id.
    Mr. Rutherford requested an enlargement of time in which to address all of
    the magistrate judge’s October 5 rulings, explaining that he still had not been
    given a complete copy of his medical file, had limited access to the law library,
    and had no legal assistance. R. Doc. 79. The court granted a stay of proceedings
    pending Mr. Rutherford being given a copy of his medical records. Thereafter,
    Mr. Rutherford complained that his copy of the medical file was not complete and
    that prison officials confiscated it when they transferred him to yet another
    facility in February 2002.
    In her April 16, 2002, recommendation to dismiss the AVCF and FMCC
    defendants for failure to state a claim, the magistrate judge noted that Mr.
    Rutherford still had not complied with the October 5 order to file an amended
    complaint. Mr. Rutherford objected and requested an enlargement of time in
    -17-
    which to respond to the magistrate judge’s recommendations,       see R. Doc. 136, but
    the motion was denied.
    In his objections, Mr. Rutherford challenged the dismissal of his claims
    against the AVCF and FMCC defendants, but the district court did not comment
    on those objections. The district court adopted the magistrate judge’s
    recommendations and dismissed the medical staff members at AVCF and FMCC
    on its determination that Mr. Rutherford had not made any factual allegations to
    show that staff members personally participated in a violation of his constitutional
    rights.
    Based on our review of Mr. Rutherford’s complaint, his motions to amend,
    the attachments to those motions, and his July 30 affidavit supplementing his
    complaint, we conclude that Mr. Rutherford has adequately stated a claim against
    individual medical staff members at AVCF for deliberate indifference to Mr.
    Rutherford’s serious medical needs by ignoring his neurosurgeon’s orders for an
    extra mattress, and by refusing to respond to his pleas for effective pain
    medication, for transfer to a hospital for medical treatment, or for a wheelchair.
    We also conclude that he has stated additional claims against the individual
    John Doe medical staff at FCF for retaliation in the confiscation of his cane,
    discontinuation of his pain medication, refusal to treat him after an assault and
    threat to send him to segregation for requesting medical care. We remand for
    -18-
    consideration of Mr. Rutherford’s Eighth Amendment claims for deliberate
    indifference against the individual medical staff members of FCF who allegedly
    refused to administer prescribed interferon treatments while he was in
    segregation, refused to comply with orders prescribing an extra mattress or to
    schedule appointments with a doctor or specialist.
    We conclude that Mr. Rutherford stated a claim for deliberate indifference
    to serious medical needs by alleging that the medical staff members at FMCC
    disregarded his complaints about severe back pain, prescribed exercise and
    physical therapy that worsened his back condition without first performing tests
    or examination, delayed referring him to a doctor for medical care, allowed orders
    for referrals to expire, and failed to schedule prescribed tests, surgery, and
    follow-up care.
    We further conclude that, on the issue of improper administration of
    interferon treatments, Mr. Rutherford has failed to state cognizable claims against
    the FMCC medical staff members. An Eighth Amendment claim will not lie for
    only negligent medical treatment,   see Handy v. Price , 
    996 F.2d 1064
    , 1067 (10th
    Cir. 1993), and his allegations are supported by evidence indicating that the
    FMCC medical staff’s failures were due to pharmacy or nursing errors or
    inadvertence, not from deliberate indifference. Regarding his claim that the
    FMCC medical staff refused to continue to administer a prescribed course of
    -19-
    interferon treatments when he was first transferred to that facility in 1999,
    however, we conclude that he has stated a claim for deliberate indifference to a
    serious medical need.
    We have considered all other allegations of error and find them to be
    without merit. Accordingly, we affirm the other rulings of the court dismissing
    defendants Medical Department of Department of Corrections, Robert Flores, Dr.
    McGarry, Warden Soares, Warden Neet, C/O Egley, P.A. Lawerance, Dr.
    Wermers, Transport of CDOC, Dolores Montoya, and Offender Services.
    Mr. Rutherford’s motion to proceed      in forma pauperis on appeal is
    GRANTED. The judgment is AFFIRMED in part, REVERSED in part, and
    REMANDED for further proceedings consistent with this order and judgment.
    Entered for the Court
    Stephen H. Anderson
    Circuit Judge
    -20-
    No. 02-1279, Rutherford v. Colo. Dep't of Corr., Med. Dep't
    BRISCOE, Circuit Judge, concurring and dissenting.
    I concur in Parts I, II, and III of the majority opinion. In particular, I agree
    that the district court erred in dismissing some of Rutherford’s claims due to his
    failure to pay filing fees, and in granting summary judgment in favor of Dr.
    Cabling on Rutherford’s claims of deliberate indifference and retaliation. I
    disagree, however, with the portion of Part IV of the majority opinion that
    discusses and ultimately gives life to allegations set forth in Rutherford’s April
    20, 2001, motion to amend, and in his July 30, 2001, letter to the district court
    and accompanying “affidavit.” For the reasons outlined below, I believe that the
    applicable standard of review and Rutherford’s failure to file an amended
    complaint as directed by the district court require us to look only to the claims
    asserted in Rutherford’s original complaint.
    I.
    Rutherford filed his original complaint on December 5, 2000. Among the
    defendants listed in the caption were a “John Doe” employed at the Fremont
    Correctional Facility (FCF) and the “staff of FMCC” (Four Mile Correctional
    Center). ROA, Doc. 3 at 1. The body of the complaint vaguely suggested that the
    reference in the caption to “John Doe” was intended to include a “Doctor, NP
    [presumably nurse practitioner] and PA [presumably physician’s assistant].” Id.
    at 7. With respect to these unnamed persons at FCF, the complaint alleged that
    (1) “th[e] facility allowed [Rutherford]’s authorization number (for specialist) to
    expire,” (2) “FCF medical” “ignored and denied” “some orders” written by the
    specialist who eventually saw Rutherford, (3) Rutherford’s request for a second
    mattress prescribed by the specialist was denied because “of a disagreement
    between DOC and the medical department” as to who should pay for it, and (4)
    the medical staff at FCF incorrectly informed plaintiff, in response to his request
    for pain medication, that his prescription for “Nueronton” 1 was considered a pain
    medication. Id. With respect to the “staff of FMCC,” the body of the complaint
    alleged that the staff failed to properly order his interferon medication and
    thereby caused him to miss scheduled treatments. Id. at 7, 11. Finally, there were
    vague assertions in the body of the complaint that, while housed at FCF, he
    received sporadic interferon treatment during a 30-day period while in
    segregation, and that unnamed personnel removed from his cell a drug prescribed
    for treatment of Hepatitis C, Ribavirin, and thereafter required him to receive this
    medication from the FCF medical staff. Id. at 13-14.
    On April 20, 2001, Rutherford filed a motion for leave to amend his
    complaint. Id., Doc. 29. The motion specifically sought leave to add the medical
    staff at the Arkansas Valley Correctional Facility (AVCF) as a defendant. Id. at
    1. The motion also, in rambling fashion, alleged that (1) the medical staff at
    1
    Rutherford presumably meant to refer to the prescription drug Neurontin.
    -2-
    AVCF failed to see him for a period of over one week after he was initially
    transferred to AVCF, (2) his medically-assigned mattress “was removed, placed
    back on the transport bus and taken to some unknown facility,” (3) “[h]e was
    denied a permit for a second mattress until this previous mattress could be found
    and returned,” (4) “[h]e was denied a permit for his button-up shirts, which were
    assigned for a pinched nerve in his neck,” (5) “[h]e was denied snacks to counter
    his ‘hypoglycemia,’” (6) the medical staff at AVCF charged him for medical
    services that he believed he should have received for free, and (7) the medical
    staff at AVCF required him to make separate appointments for separate medical
    problems and charged him for each appointment. Id. at 2. Finally, the motion
    contained what appeared to be additional assertions against a non-medical
    employee at FCF named “Duane.” In particular, the motion alleged that on some
    unspecified date, Rutherford sought medical attention at FCF and was informed
    by “Duane” that he would not be seen and would in fact be placed in segregation
    if he did not leave the medical clinic. Id. at 3.
    On June 11, 2001, the magistrate judge conducted a status and scheduling
    hearing and granted Rutherford’s motion, giving him until July 2, 2001, to file an
    amended complaint. Id., Docs. 42 and 43. On July 2, 2001, Rutherford filed a
    two-page pleading captioned “Motion to Amend.” Id., Doc. 44. The motion
    asked the district court to amend the caption of the original complaint to include
    -3-
    the AVCF and FCF medical staffs as defendants, and to amend the “Damages”
    section of the original complaint in several respects, including assertion of a
    claim against the AVCF medical staff for “Retaliation” in the amount of
    $50,000.00. Id. Significantly, however, the motion was silent with respect to the
    specific allegations Rutherford sought to assert against these defendants. There
    was also no mention of “Duane,” the FCF employee referred to in Rutherford’s
    April 20, 2001, motion for leave to amend.
    Rutherford addressed a lengthy handwritten letter to the district judge
    overseeing the case. The bulk of the letter was under the sub-heading of
    “Affidavit” and the letter was filed by the district court’s clerk’s office as a
    pleading on July 30, 2001. Id., Doc. 52. In the letter, Rutherford alleged, in
    pertinent part, that after being returned to FCF following surgery, his egg-crate
    mattress and cane were taken, he was assaulted by the employee who took his
    cane, and his pain medication ceased. Rutherford also alleged that he had filed
    numerous “medical kites” with the AVCF medical staff but had not been seen by
    a physician. At the conclusion of the letter, Rutherford asked for various forms
    of injunctive relief (e.g., ordering that all pain medications be immediately
    reissued).
    On October 5, 2001, the magistrate judge issued an order addressing
    several pending matters, including “the purported amendments to plaintiff’s
    -4-
    complaint.” Id., Doc. 69 at 1. Reviewing Rutherford’s July 2, 2001, “Motion to
    Amend,” the magistrate judge noted:
    Plaintiff does not allege any facts in support of his claims against the
    new defendants. None of the claims identified in the April 20, 2001
    Motion for Leave to Amend are included in the purported amended
    pleading filed on July 2, 2001.
    Under 28 U.S.C. § 1915A, the court screens pleadings filed by
    a pro se prisoner to determine whether they are frivolous or fail to
    state a claim upon which relief can be granted. The court finds that
    plaintiff’s July 2, 2001 amendment fails to state any claims for relief
    against the new defendants. Further, it is not clear whether plaintiff
    intends for his amended complaint to include the claims identified in
    his April 20, 2001 Motion to Amend. Because plaintiff is pro se, the
    court will give him an opportunity to cure the deficiencies in his
    amendment.
    Id. at 3-4. Accordingly, the magistrate judge ordered
    that on or before November 9, 2001, plaintiff shall file a pleading
    titled “Amended Complaint” which names all defendants and
    contains factual allegations to support the asserted claims for relief
    against each of the defendants. Plaintiff shall also specify his
    requested relief against each defendant. No further amendments will
    be allowed.
    Id. at 4. Although Rutherford continued to file numerous pleadings in the case,
    including a motion to clarify other portions of the magistrate judge’s October 5,
    2001, order, id., Doc. 72, he failed to file an amended complaint as directed by
    the magistrate judge. 2
    2
    In its order and judgment, the majority correctly notes that Rutherford filed a
    “Motion Seeking Enlargement of Time.” ROA, Doc. 79. Curiously, however, the
    majority suggests the motion sought “an enlargement of time in which to address
    (continued...)
    -5-
    On April 16, 2002, the magistrate judge issued a written recommendation
    addressing the defendants’ dispositive motion. The magistrate judge outlined in
    detail the history of Rutherford’s attempts to amend his original complaint and
    noted that Rutherford had failed, as directed, to file an amended complaint on or
    before November 9, 2001. In light of Rutherford’s failure “to comply with the
    court’s October 5, 2001 Order to file an amended complaint,” the magistrate
    judge concluded that the “AVCF Med. Staff” and the “Med. Staff of FMCC
    should be dismissed because the[se] DOC departments are absolutely immune
    from damages liability and plaintiff has not alleged any factual allegations to
    show that individual staff members in those DOC departments personally
    participated in a violation of plaintiff’s constitutional rights.” Id. at 15-16. As
    for the medical staff at FCF, the magistrate judge looked to the allegations in
    Rutherford’s original complaint and concluded that Rutherford had asserted a
    colorable Eighth Amendment claim for denial of interferon treatment while in
    segregation (but had not alleged a colorable Eighth Amendment claim based upon
    2
    (...continued)
    all of the magistrate judge’s October 5 rulings.” Maj. Op. at 17. I disagree with
    this interpretation of the motion. Notably, the motion does not mention the
    magistrate judge’s directive to file an amended complaint. Instead, the motion
    focuses exclusively on defendants’ alleged failure to provide Rutherford with a
    complete copy of his medical records, and the impact of that alleged failure on
    Rutherford’s ability to respond to defendants’ dispositive motion. In any event, it
    is clear from reviewing the record that the magistrate judge did not extend the
    November 9, 2001, deadline for filing an amended complaint.
    -6-
    the removal of Ribavirin from his cell). Id. at 16. As for “John Doe (doctor, NP
    and PA)” at FCF, the magistrate judge concluded that Rutherford’s original
    complaint stated a colorable Eighth Amendment claim for denial of an extra
    mattress as prescribed by his specialist. 3 Id. In a subsequent recommendation
    issued on April 23, 2002, the magistrate judge recommended dismissing the two
    colorable Eighth Amendment claims due to Rutherford’s failure to pay the
    requisite filing fee. Id., Doc. 134.
    On May 7, 2002, Rutherford filed a motion to disqualify the magistrate
    judge and objections to the magistrate judge’s April 16, 2002, recommendation.
    Id., Doc. 140. Although Rutherford obviously disagreed with the magistrate
    judge’s proposed disposition of his claims, he offered no justification for his
    failure to abide by the magistrate judge’s directive to file an amended complaint.
    Indeed, his pleading was silent with respect to that procedural aspect of the case.
    Further, Rutherford made no attempt to flesh out his claims against the various
    medical staffs. At most, Rutherford made vague references to a mattress being
    taken from him at AVCF and to the FMCC medical staff's failure to properly
    order his interferon treatments.
    3
    The magistrate judge apparently overlooked the remaining allegations in the
    original complaint against these defendants (i.e., that defendants allowed
    Rutherford’s authorization number for a specialist to expire, ignored and denied
    some orders issued by Rutherford’s specialist, and improperly utilized the drug
    “Nueronton” for management of Rutherford’s back pain).
    -7-
    On May 29, 2002, the district court adopted the magistrate judge’s
    recommendation. Id., Doc. 145. Accordingly, the district court in pertinent part
    dismissed Rutherford’s claims against the medical staffs of FMCC and AVCF
    “for lack of subject matter jurisdiction” and “failure to state a claim on which
    relief c[ould] be granted.” Id. at 4. As for the two colorable Eighth Amendment
    claims asserted by Rutherford against the John Doe staff members at FCF who
    denied his interferon treatment and use of a prescribed mattress, the district court
    dismissed those claims without prejudice due to Rutherford’s failure to pay the
    requisite filing fee. Id. at 4-5.
    II.
    As the majority correctly notes at the outset of Section IV of its opinion, we
    are required to “liberally construe the allegations of a pro se complaint[,] . . .
    [and] in deciding a motion to dismiss pursuant to Rule 12(b)(6), a court may look
    both to the complaint itself and to any documents attached as exhibits to the
    complaint.” Maj. Op. at 13 (quoting Oxendine v. Kaplan, 
    241 F.3d 1272
    , 1275
    (10th Cir. 2001)). After stating the applicable standard, the majority, in my view,
    then proceeds to misapply the standard. Under the guise of liberally construing a
    pro se litigant’s pleadings, the majority ignores the directive to focus on the
    allegations in the complaint and instead chooses to focus on vague allegations set
    forth in Rutherford’s April 20, 2001, motion for leave to amend his complaint and
    -8-
    in his July 30, 2001, letter and “affidavit.” Although I question the propriety of
    doing so even in a routine case, the failure to focus on the allegations in
    Rutherford's complaint is made more egregious in this case in light of
    Rutherford’s failure to comply with the magistrate judge’s October 5, 2001, order
    to file an amended complaint outlining his claims against each defendant. Given
    Rutherford’s failure, I believe it was proper for the magistrate judge to look only
    to the allegations in his original complaint rather than, as the majority does here,
    to “grope through . . . pages of irrational prolix and redundant pleadings,
    containing matters foreign to the issue involved . . . in order to determine the
    grounds for the . . . complaint.” C. Wright & A. Miller, Federal Practice and
    Procedure § 1281 at 522 (2d ed. 1990) (internal quotations omitted). The
    majority ignores the requirements of Federal Rule of Civil Procedure 8(a) (“A
    pleading which sets forth a claim for relief . . . shall contain . . . (2) a short and
    plain statement of the claim”), assumes the role of advocate by constructing
    Rutherford’s claims for him, see Peterson v. Shanks, 
    149 F.3d 1140
    , 1143 (10th
    Cir. 1998) (“[W]e do not believe it is the proper function of the district court to
    assume the role of advocate for the pro se litigant.”), and subjects the defendants
    and the district court to a new round of litigation on “claims” that were nowhere
    to be found in Rutherford’s original complaint.
    -9-
    Because I believe that Rutherford is limited to the claims set forth in his
    original complaint, I disagree with the majority’s decision to recognize and
    “remand” any “claims” against the medical staffs of AVCF, FCF, or FMCC, or
    any “John Doe” members thereof, that were contained in pleadings other than the
    original complaint.
    -10-