Raoul Lynch v. Sheriff Theodore Jackson ( 2012 )


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  •                                                                        [DO NOT PUBLISH]
    IN THE UNITED STATES COURT OF APPEALS
    FOR THE ELEVENTH CIRCUIT           FILED
    ________________________ U.S. COURT OF APPEALS
    ELEVENTH CIRCUIT
    No. 11-11588                          JUNE 5, 2012
    ________________________                     JOHN LEY
    CLERK
    D. C. Docket No. 1:09-cv-03306-CAP
    RAOUL LYNCH,
    Plaintiff-Appellant,
    versus
    SHERIFF THEODORE JACKSON,
    Individually,
    CHARLES FELTON,
    Individually, et al.,
    Defendants-Appellees.
    _______________________
    Appeal from the United States District Court
    for the Northern District of Georgia
    _________________________
    (June 5, 2012)
    Before DUBINA, Chief Judge, EDMONDSON, Circuit Judge, and RESTANI,*
    Judge.
    *
    Honorable Jane A. Restani, Judge of the United States Court of International Trade,
    sitting by designation.
    PER CURIAM:
    This case involves a prisoner civil rights claim under 
    42 U.S.C. § 1983
     by
    Raoul Lynch (“Appellant” or “Plaintiff”) against Fulton County, Sheriff Theodore
    Jackson, Chief Jailor Charles Felton, Dr. Valerie Smith, Dr. Roy Brooks, and Dr.
    Raymond Williams (collectively “Appellees” or “Defendants”)1 for allegedly
    violating the U.S. Constitution as well as negligence claims for failing to
    appropriately care for Lynch’s periodontal disease. We affirm the judgment of
    dismissal of the district court.
    BACKGROUND
    Because the district court granted Defendants’ motion to dismiss on all but
    one of Plaintiff’s claims, we will treat the alleged facts as true as set forth in the
    Plaintiff’s Second Amended Complaint (“Complaint”) and draw all reasonable
    inferences in the Plaintiff’s favor. Wilson v. Strong, 
    156 F.3d 1131
    , 1133 (11th
    Cir. 1998). Dr. Smith, Dr. Brooks, and Dr. Williams work for Correctional
    Medical Associates, Inc. (“CMA”), the contractual provider of medical and dental
    services for Fulton County Jail.
    In June 2008 Lynch became a pre-trial detainee in the custody of the Fulton
    1
    The original action also named Sargent Angela McCoy, John Doe, Jane Doe, Lieutenant
    Daisy Forbes, and Health Services Director George Herron. The district court dismissed claims
    against these defendants from the action and Lynch has not appealed those dismissals.
    2
    County Jail. Lynch immediately informed Defendants that he had periodontal
    disease, which caused Lynch serious pain, his teeth to loosen, and his gums to
    bleed. Lynch met with Dr. Williams, Dr. Brooks, or Dr. Smith on at least seven
    occasions over the first six months of his incarceration. Although Lynch asked
    Defendants to treat his periodontal disease, Defendants informed Lynch on three
    occasions that “nothing would be done to treat his periodontal disease,” that
    Defendants could not treat his periodontal disease at the jail, and that he would
    have to wait until after his release to receive treatment. Defendants declined
    Lynch’s offer to pay for an outside specialist himself. Dr. Smith recommended
    that Lynch have at least four of the offending teeth removed. After two of the four
    teeth had been removed, Lynch declined further treatment. Lynch continued to
    seek surgical treatment, which Lynch characterized as “(1) pocket reduction
    procedures; (2) regenerative procedures; (3) crown lengthening; (4) or soft tissue
    grafts.” Lynch also sought non-surgical treatment including “scaling and root
    planning . . . , followed by adjunctive therapy . . . .” Although Defendants denied
    Lynch access to such treatments,2 no medical provider prescribed any of the above
    2
    We note for the purposes of the claim adjudicated on a motion for summary judgment
    that Dr. Smith stated in her affidavit, submitted along with Defendants’ motion for summary
    judgment, that Dr. Brooks performed scaling and root planting, a form of pocket depth reduction,
    on Lynch.
    3
    treatments.
    Lynch submitted administrative grievances which were denied. Lynch filed
    this action in the Superior Court of Fulton County. Defendants moved for
    dismissal in state court and removed the action to federal court. The district court
    screened Lynch’s complaint pursuant to 28 U.S.C. § 1915A. The district court
    granted Defendants’ motions to dismiss on all claims except for Lynch’s
    constitutional claims against Jackson and Felton. The district court then granted
    Defendants’ motion for summary judgment on the remaining claim. Lynch now
    appeals the district court’s decisions.
    JURISDICTION & STANDARD OF REVIEW
    We have jurisdiction pursuant to 
    28 U.S.C. §§ 1291
     and 1294. We review
    de novo a district court’s grant of a motion to dismiss. Am. Dental Ass’n v. Cigna
    Corp., 
    605 F.3d 1283
    , 1288 (11th Cir. 2010). We review de novo a district court’s
    grant of summary judgment, viewing the record and drawing all inferences in a
    light most favorable to the non-moving party. Bashir v. Rockdale Cnty., 
    445 F.3d 1323
    , 1326–27 (11th Cir. 2006).
    NEGLIGENCE CLAIMS
    Lynch argues that the district court erred when it granted Defendants’
    motion to dismiss because, 1) Lynch should not be required to submit an affidavit
    4
    from a doctor when asserting a claim of negligence,3 and 2) the district court
    improperly characterized Felton’s and Jackson’s actions as discretionary rather
    than ministerial. Because claims of professional negligence require more than
    broad assertions to establish plausibility and the district court properly found the
    actions were discretionary, we affirm the district court.
    Lynch contends that the district court erred in dismissing his claim for
    negligence against Dr. Williams, Dr. Brooks, and Dr. Smith by requiring Lynch to
    submit an affidavit from a dental professional. If this case had remained in
    Georgia state court, Lynch would have been required to accompany his claim with
    an expert affidavit at the time of filing. See O.C.G.A. § 9-11-9.1(a). Although the
    case has been removed to federal court and federal procedural rules apply,
    Plaintiff must still comply with federal pleading requirements. On a Rule 12(b)(6)
    motion to dismiss, the plaintiff has an obligation to provide the grounds for his
    entitlement to relief. Bell Atl. Corp. v. Twombly, 
    550 U.S. 544
    , 555 (2007).
    “Factual allegations must be enough to raise a right to relief above the speculative
    level.” 
    Id.
     Where a claim for professional negligence is made, “such a claim
    3
    Lynch does not put forth a meaningful argument contesting the district court’s finding
    regarding negligence per se before this court. To the extent Lynch appeals the district court’s
    dismissal of his negligence per se claim, we affirm the district court’s determination that no
    statutory violation took place.
    5
    requires a complaint with enough factual matter (taken as true) to suggest” at least
    one negligent professional act or omission. See 
    id. at 556
    . Lynch’s allegation is
    that “Defendants . . . deliberately failed to provide medical care” and that
    “[a]dequate treatment for periodontal disease required Mr. Lynch to have surgery.”
    Where treatment is offered and refused, as is the case here, Plaintiff must do more
    than proffer his own opinion regarding the validity of the actions of medical
    professionals. Because Lynch has not put forth non-conclusory statements that the
    doctors were professionally negligent,4 the district court correctly dismissed
    Lynch’s Complaint against the doctors for negligence in both their official and
    individual capacities.
    Lynch argues that the district court erred when it characterized Felton’s and
    Jackson’s actions as discretionary rather than ministerial in dismissing Lynch’s
    negligence claims against the sheriff and chief jailor in their official capacities on
    the basis of sovereign immunity. Public officials, like Felton and Jackson, have
    sovereign immunity when sued in their official capacity, provided defendants are
    exercising discretionary rather than ministerial functions. See Gilbert v.
    4
    Before the district court, Lynch argued that his claim was not for professional
    negligence, but merely negligence. The district court treated Lynch’s claims against the doctors
    as claims for professional negligence. Because Lynch does not now contest this treatment, we
    see no reason to disturb the finding of the district court on this issue.
    6
    Richardson, 
    452 S.E.2d 476
    , 479 n.4 (Ga. 1994) (noting that claims against a
    sheriff in his official capacity enable the sheriff to raise any defense available to
    the county, including sovereign immunity). “Providing adequate medical attention
    for inmates under defendants’ custody and control is a ministerial act,” but “the
    determination of what medical treatment to provide is an act of discretion subject
    to official immunity.” Cantrell v. Thurman, 
    499 S.E.2d 416
    , 421(Ga. Ct. App.
    1998) (finding no sovereign or official immunity where “plaintiff contended that it
    was the failure to provide adequate medical care that created liability and not the
    choice of treatment”). Furthermore, where liability is based on the official as a
    policymaker, that official is protected by sovereign immunity unless his “failure to
    adopt other or additional [policy] requirements” shows malice or intent to injure.
    Middlebrooks v. Bibb Cnty., 
    582 S.E.2d 539
    , 544 (Ga. Ct. App. 2003) (finding the
    failure to alter a policy leaving inmate monitoring to the personal judgment of the
    deputies to be discretionary and not ministerial). Because Felton and Jackson and
    the underlying policy provided for adequate medical attention in the form of tooth
    extraction, the district court did not err when it found that Felton and Jackson had
    sovereign immunity from Lynch’s negligence claims.5
    5
    Lynch does not challenge the district court’s dismissal of his negligence claims against
    Felton and Jackson in their individual capacities.
    7
    CONSTITUTIONAL CLAIMS
    Lynch argues that the district court erred when it granted Defendants’
    motion to dismiss because: Fulton County’s contract with CMA was facially
    unconstitutional, and doctors Smith, Brooks, and Williams were operating under
    the color of law. Lynch also contends that the district court erred in granting
    Defendants’ motion for summary judgment because Felton and Jackson were
    liable for supervising CMA’s policy and Felton and Jackson were deliberately
    indifferent to Lynch’s medical needs.
    Lynch claims that the district court erred by dismissing his claim against
    Fulton County on the basis that the contract was not facially unconstitutional.
    Lynch “must establish that no set of circumstances exists under which the Act
    would be valid,” United States v. Salerno, 
    481 U.S. 739
    , 745 (1987), and that there
    is “an excessive risk of serious harm to inmates just because the policy exists,”
    Marsh v. Butler Cnty., 
    268 F.3d 1014
    , 1036 (11th Cir. 2001) (en banc) (holding
    that a policy of releasing sick or injured inmates was not facially unconstitutional
    because it was not obviously a danger to inmates). Here, although Lynch notes his
    own risk of harm, with regard to the policy he asserts nothing more than that the
    dentists at Fulton County Jail informed him that “nothing would be done to treat
    his periodontal disease” and that “it was against Fulton County policy to clean
    8
    teeth prior to one year of incarceration.” Lynch made no reference to the policy
    vis-à-vis the treatment offered (extraction) and the treatment Lynch believes he
    deserved (enumerated surgical and non-surgical procedures). The allegation that
    the Fulton County Jail policy did not allow any treatment for periodontal disease
    except for tooth extraction is unsupported by the Complaint.6 Additionally, at oral
    argument, Lynch did not contest Defendants’ assertion that CMA doctors could
    always recommend treatment not provided for in the contract. Thus, Lynch has
    failed to state a claim that Fulton County Jail’s dental policy and contract with
    CMA are facially unconstitutional.7
    Lynch claims that the district court erred when it dismissed his claims
    against the three doctors in their individual capacities because the district court
    incorrectly determined that the doctors were not operating under the color of state
    law. We need not reach the color of law issue because the district court correctly
    found no deliberate indifference. To bring an action under 
    42 U.S.C. § 1983
     for a
    violation of a prisoner’s Eighth Amendment rights to be free from cruel and
    6
    Lynch does make such assertions in his brief. Yet in his brief Lynch seems to derive all
    his facts from the record at summary judgment.
    7
    Lynch does not challenge the district court’s dismissal of his § 1983 claims against the
    Defendants in their official capacities. Lynch’s arguments focus solely on the portions of the
    district court opinions addressing Lynch’s claims against Defendants in their individual
    capacities. Thus, the district court’s dismissal of the claims against Defendants in their official
    capacities is affirmed.
    9
    unusual punishment, a prisoner must show an objectively serious medical need
    and “prove that the prison official acted with an attitude of ‘deliberate
    indifference’ to that serious medical need.” Farrow v. West, 
    320 F.3d 1235
    , 1243
    (11th Cir. 2003) (finding that district court improperly granted summary judgment
    because a fifteen-month delay in medical treatment for painful, bleeding gums
    constituted deliberate indifference). Serious medical need is considered “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.” 
    Id.
     (quoting Hill v. Dekalb Reg’l Youth Det. Ctr., 
    40 F.3d 1176
    , 1187
    (11th Cir. 1994) (quotation marks and citation omitted), overruled in part on other
    grounds by Hope v. Pelzer, 
    536 U.S. 730
    , 739 n. 9 (2002)). Deliberate
    indifference is “(1) subjective knowledge of a risk of serious harm; (2) disregard
    of that risk; (3) by conduct that is more than mere negligence.” McElligott v.
    Foley, 
    182 F.3d 1248
    , 1255 (11th Cir. 1999). Where medical treatment provided
    is “minimally adequate,” no deliberate indifference exists. Harris v. Thigpen, 
    941 F.2d 1495
    , 1504 (11th Cir. 1991) (finding that a simple difference in medical
    opinion between the prisoner and the medical staff did not support a claim of cruel
    and unusual punishment). The district court found that Lynch had “allege[d]
    nothing to show that, in deliberate indifference to his needs, they declined
    10
    providing him with treatment that they had the authority to provide.” Here, even
    on the facts of the Complaint, a tension exists between the two treatments
    prescribed—waiting or having the offending teeth extracted—and the prisoner’s
    own medical opinion. Although there may have been medical need, Lynch was
    offered adequate treatment and refused that treatment. Moreover, Lynch fails to
    make a non-conclusory assertion that the tooth extraction was not only not
    adequate treatment, but not the best possible treatment. Lynch cannot claim the
    constitutional violation lies in delay when Lynch himself caused the delay in
    refusing adequate treatment. Because only a difference in opinion exists, Lynch’s
    Complaint does not support a claim that his constitutional rights were violated by
    the dentists.8
    Lynch contends that the district court erred in granting Defendants’ motion
    for summary judgment because Felton and Jackson were deliberately indifferent to
    Lynch’s medical needs. Prison officials who rely on medical personnel for the
    clinical determinations lack the requisite knowledge for deliberate indifference,
    absent evidence that clinical determination were unreliable. See Howell v.
    8
    There may be situations where tooth extraction does not constitute adequate treatment.
    See, e.g., Stack v. McCotter, 79 F. App’x 383, 390 (10th Cir. 2003) (unpublished) (finding that
    directors in Utah’s Department of Corrections were deliberately indifferent because the
    contractor’s entire dental policy was extraction-only). Lynch has not alleged any specific facts
    here that would permit us to interpret a doctor’s medical opinion that teeth should be extracted as
    anything other than adequate treatment.
    11
    Burden, 
    12 F.3d 190
    , 191, 194 (11th Cir. 1994) (finding that a prison official was
    deliberately indifferent where he had responsibility over doctors and inmates and
    did not provide what doctors saw as the necessary services to medically control
    the inmate’s disease). Here, Doctor Smith testified “the state of Lynch’s teeth
    when he entered the jail precluded any alternative treatment, other than to pull out
    the teeth.” Smith added that “the state of Raoul Lynch’s teeth precluded the
    application of alternative treatments including bone grafting, regenerative
    procedure, and soft tissue grafting.” Another dentist thought that treatment could
    wait until after the prisoner had been released. Lynch offers no evidence that
    these clinical determinations were incorrect or unreliable. Assuming Felton and
    Jackson were aware of Lynch’s condition, Defendants permissibly relied on the
    doctors’ opinions that treatment could either wait or that adequate treatment had
    been offered and refused.
    Lynch argues that Felton and Jackson were liable for violating Lynch’s
    constitutional rights by supervising CMA’s policy. Supervisory theory of liability
    requires participation in the alleged constitutional violation or a causal connection
    between the actions of the supervising official and the alleged constitutional
    deprivation. Brown v. Crawford, 
    906 F.2d 667
    , 671(11th Cir. 1990) (finding that
    a widespread history of infested drinking water and inmates sleeping on the floor
    12
    could be sufficient to notify the director of the jail of the conditions and hold him
    liable as a supervisor, but that such a history did not exist); see Adams v. Poag, 
    61 F.3d 1537
    , 1546 (11th Cir. 1995) (finding that the prison official’s procedures for
    tracking the medical progress of prisoners did not constitute deliberate
    indifference). Here, the policy at issue is not facially unconstitutional or otherwise
    responsible for Lynch’s alleged deprivation of treatment. Although certain
    services may not be provided by the Fulton County Jail, CMA’s contract and the
    Fulton County Jail policy provide for dental surgery where a dental professional
    believes it necessary. Lynch has pointed to no evidence to the contrary. Because
    the policy provided for adequate care, Felton and Jackson cannot be held liable
    under a supervisory theory.
    CONCLUSION
    For the aforementioned reasons, the district court’s judgment in favor of
    Defendants is AFFIRMED.
    13