Heyer v. United States Bureau of Prisons , 849 F.3d 202 ( 2017 )


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  •                                PUBLISHED
    UNITED STATES COURT OF APPEALS
    FOR THE FOURTH CIRCUIT
    No. 15-6826
    THOMAS HEYER,
    Plaintiff - Appellant,
    and
    ROBERT PAUL BOYD,
    Plaintiff,
    v.
    UNITED STATES BUREAU OF PRISONS; THOMAS R. KANE, in his
    official capacity as Acting Director of the United States
    Bureau of Prisons; IKE EICHENLAUB, in his official capacity
    as Regional Director of the United States Bureau of Prisons
    Mid−Atlantic Region; WARDEN SARA M. REVELL; WARDEN TRACY W.
    JOHNS; JEFFERSON B. SESSIONS, III, Attorney General,
    Defendants - Appellees.
    −−−−−−−−−−−−−−−−−−−−−−−−−−−
    NATIONAL ASSOCIATION OF THE DEAF,
    Amicus Supporting Appellant.
    Appeal from the United States District Court for the Eastern
    District of North Carolina, at Raleigh.  James C. Dever III,
    Chief District Judge. (5:11-ct-03118-D)
    Argued:   October 26, 2016                 Decided:   February 23, 2017
    Before MOTZ, TRAXLER, and FLOYD, Circuit Judges.
    Affirmed in part, vacated in part, and remanded by published
    opinion.   Judge Traxler wrote the opinion, in which Judge Motz
    and Judge Floyd joined.
    ARGUED: Ian S. Hoffman, ARNOLD & PORTER LLP, Washington, D.C.,
    for Appellant.    Robert J. Dodson, OFFICE OF THE UNITED STATES
    ATTORNEY, Raleigh, North Carolina, for Appellees.      ON BRIEF:
    Deborah Golden, Elliot Mincberg, WASHINGTON LAWYERS’ COMMITTEE
    FOR CIVIL RIGHTS & URBAN AFFAIRS, Washington, D.C.; David B.
    Bergman, ARNOLD & PORTER LLP, Washington, D.C., for Appellant.
    John Stuart Bruce, Acting United States Attorney, Jennifer P.
    May-Parker,   Jennifer   D.  Dannels,  Assistant  United  States
    Attorneys, OFFICE OF THE UNITED STATES ATTORNEY, Raleigh, North
    Carolina, for Appellees.     Marc Charmatz, Howard A. Rosenblum,
    Debra Patkin, NATIONAL ASSOCIATION OF THE DEAF, Silver Spring,
    Maryland, for Amicus Curiae.
    2
    TRAXLER, Circuit Judge:
    Appellant       Thomas    Heyer    has       been    deaf     since    birth.        His
    native    language      is    American       Sign     Language         (“ASL”),    and        he
    communicates primarily though ASL.                    Heyer is presently confined
    as a sexually dangerous person, see Adam Walsh Child Protection
    and Safety Act of 2006, Pub. L. No. 109-248, 120 Stat. 587, at
    the federal correctional institution in Butner, North Carolina.
    Heyer brought this action against the United States Bureau of
    Prisons    and   other       defendants       (collectively,            “BOP”),    raising
    various     claims      related    to        BOP’s       failure       to   provide       ASL
    interpreters      for    medical       appointments          and       other      important
    interactions,     its    refusal    to       provide      Heyer     with    access       to    a
    videophone,      and    its    failure           to   otherwise        accommodate        his
    deafness.     The district court granted summary judgment in favor
    of BOP, and Heyer appeals.               As we will explain, we affirm the
    district    court’s     dismissal       of       Count    III,    as    Heyer     does    not
    challenge that ruling on appeal, but we vacate the remainder of
    the district court’s order and remand for further proceedings. 1
    I.
    A.
    1 Robert Boyd, another Adam Walsh detainee, was originally a
    plaintiff in this action. His appeal was dismissed after it was
    discovered that he was not deaf.
    3
    Heyer     was     previously        convicted      of    possessing         child
    pornography.          In     2007,    Heyer     violated      the    terms   of     his
    supervised     release       and     served     the   resulting       eighteen-month
    sentence at Butner.            Shortly before that sentence expired in
    December 2008, the government filed a petition seeking to detain
    Heyer under the Adam Walsh Act.                  Heyer has remained in civil
    custody at Butner since that filing.                  The district court held a
    hearing on the government’s petition in May 2012 and ordered
    Heyer detained as a sexually dangerous person.                      We affirmed that
    order on appeal.           See United States v. Heyer, 
    740 F.3d 284
    (4th
    Cir. 2014).
    Under the terms of the Adam Walsh Act, Heyer will remain in
    civil custody until such time as the government determines that
    his “condition is such that he is no longer sexually dangerous
    to   others,   or     will    not    be   sexually     dangerous      to   others   if
    released under a prescribed regimen of medical, psychiatric, or
    psychological care or treatment.”                 18 U.S.C. § 4248(e).             When
    making this determination, BOP’s mental health professionals may
    consider,     among    other    things,       evidence   “[e]stablished      through
    interviewing     and       testing   of   the    person”;     evidence     “[o]f    the
    person’s denial of or inability to appreciate the wrongfulness,
    harmfulness, or likely consequences of engaging or attempting to
    engage in sexually violent conduct or child molestation”; and
    evidence “[i]ndicating successful completion of, or failure to
    4
    successfully complete, a sex offender treatment program.”                       28
    C.F.R. § 549.95.
    Adam Walsh detainees at Butner are expected to participate
    in   the     “Commitment   and   Treatment     Program”     (“CT    Program”).
    designed for Adam Walsh detainees.            J.A. 305.      The CT Program
    includes     mental     health   treatment    in   group     and    individual
    settings, daily meetings, and other “contextual activities” that
    “maximize the opportunities for therapeutic gain.”                   J.A. 536.
    Heyer began participating in the CT Program in July 2012.
    B.
    As noted, Heyer has been deaf since birth and communicates
    primarily     through    ASL.    Heyer    cannot   read    lips    and   has    no
    ability to understand speech.             Heyer, who has an eighth-grade
    education, has extremely limited proficiency in English.                       The
    lexicon and syntax structure of English and ASL are entirely
    different, and Heyer cannot communicate effectively in written
    English. 2
    Since arriving at Butner in December 2008, Heyer has made
    multiple requests for ASL interpreters.             BOP officials refused
    2 Because this is an appeal from the grant of summary
    judgment, we recount the facts and the reasonable inferences to
    be drawn therefrom in the light most favorable to Heyer, the
    non-moving party. See Raub v. Campbell, 
    785 F.3d 876
    , 878 (4th
    Cir. 2015).
    5
    to provide qualified interpreters for any purpose until late
    2012, more than a year after this case was commenced.
    Heyer has high blood pressure and cholesterol, and he has
    had multiple seizures during his time at Butner.                 From 2008
    until December 2012, however, BOP refused to provide Heyer with
    ASL interpreters for scheduled medical appointments or during
    medical emergencies.      Because no ASL interpreter was present at
    medical appointments, Heyer has had difficulty understanding the
    instructions       for   taking     and   refilling    his    prescription
    medications.       For example, in February 2011, Heyer went without
    his blood pressure medication because he did not understand the
    doctor’s refill instructions.         In November 2011, Heyer suffered
    a seizure while in his cell.         Alerted to the problem by Heyer’s
    cellmate,    the    officer   on   duty   concluded   that   Heyer   “looked
    fine,” J.A. 36, and did not seek medical attention for Heyer.
    Heyer finally saw a doctor more than a month after the seizure,
    but no interpreter was provided for him.
    In 2010, prison officials assigned another inmate to act as
    Heyer’s “inmate companion person” to help Heyer communicate with
    others.     Although the inmate companion does not know ASL, 3 BOP
    required Heyer to rely on him during medical interactions.
    3 When tested by Heyer’s expert, the inmate companion could
    not even provide a “ratable sample of ASL,” meaning that he
    (Continued)
    6
    As to the CT Program designed for Adam Walsh detainees, BOP
    officials     concluded         that    Heyer’s     inmate     companion      would   be
    “inadequate” to facilitate Heyer’s participation.                            J.A. 1117.
    BOP nonetheless did not provide Heyer with ASL interpreters for
    the CT Program until September 2012; even then, interpreters
    were provided for only some portions of the Program.
    In December 2012 -- eighteen months after the initiation of
    this    action      --    BOP    announced        that    it   would      provide     ASL
    interpreters        for     Heyer’s       scheduled        medical        appointments.
    Through October 2013, however, Heyer had at least nine medical
    interactions        (whether      scheduled       appointments       or     emergencies)
    where   no    interpreter         was    provided,       including     at    least    two
    scheduled appointments.           See J.A. 495, 1285.
    At some point after the commencement of this action, BOP
    entered      into    a    contract      with    a   provider     of       video   remote
    interpreting (“VRI”) services, which provides Internet-based 24-
    hour, on-demand access to qualified ASL interpreters, for use in
    cases of medical emergencies or other urgent interpreting needs.
    In an affidavit dated August 21, 2014, a BOP official stated
    that VRI services would be available to Heyer “in the very near
    could not provide “at least several minutes” of ASL use during a
    20-minute proficiency assessment. J.A. 372.
    7
    future,” assuming the provider and interpreters could meet BOP’s
    background-check requirements.            J.A. 301.
    C.
    Heyer communicates with the outside world through email and
    through the use of a “TTY” device, which contains a keyboard and
    permits written messages to be sent between TTY devices over a
    telephone line.         TTY does not permit real-time conversations,
    and    each   conversation    over    a    TTY    device     takes    significantly
    longer    than    signed      or     spoken      conversations.           Effective
    communication over a TTY device requires proficiency in written
    English, which Heyer lacks.            There are only two TTY devices at
    Butner, both of which are in locked staff offices.                       Heyer thus
    can use the TTY device only with the assistance of a staff
    person, and only a few staff members are trained on its use.
    Staff members frequently deny Heyer access to the TTY during the
    day,   and,   because    of   staffing        issues,   he   has     essentially   no
    ability to use it at night or on the weekends.                     Inmates who are
    not deaf have free use of the telephone at Butner and do not
    need to seek staff permission.
    TTY is old technology that is fast becoming obsolete.                   Over
    the last decade, many deaf people have migrated from TTY devices
    to videophones.      Because a TTY device is required on both ends
    of the call, the abandonment of TTY technology means there are
    fewer and fewer people with whom Heyer can communicate.
    8
    A videophone works much like a telephone does for a hearing
    person.    As explained in the record, a videophone is a telephone
    operated through a computer or stand-alone device which has a
    camera and screen for visual, real-time communication.                      If users
    on both ends of the conversation have a videophone, they can
    communicate directly and visually using ASL.                  If one user does
    not have a videophone, the deaf person can use the videophone to
    access Video Relay Service (“VRS”).                 With VRS, the deaf person
    communicates     visually    with   an       operator,    using    ASL,     and    the
    operator   interprets      the   conversation        orally   to     the    non-deaf
    party through a telephone.
    Heyer’s deafness has caused him other problems while at
    Butner.    For example, Heyer does not attend religious services
    because    he    cannot     understand        or     participate      without       an
    interpreter.      Heyer cannot understand announcements made over
    the prison’s public address system.                He cannot access goods sold
    through the commissary, because the goods are handed through a
    mirrored window by a person with whom Heyer cannot interact.
    Heyer attends a GED preparation class, but his participation is
    very   limited   because    no   interpreter        is   provided.         Heyer   has
    missed or been late for scheduled activities because BOP has
    refused to provide him with a vibrating watch or vibrating bed
    device.    Other inmates have had to alert Heyer to fire alarms
    because he cannot hear the alarm sounding through the prison.
    9
    In March 2014 -- almost three years after the commencement of
    this action -- BOP installed an emergency flashing light in his
    cell.   However, the flashing strobe light is very similar to the
    periodic flashing of staff flashlights, which makes it difficult
    for Heyer to determine whether there is an emergency.
    II.
    In 2011, Heyer brought this action against BOP.                           In the
    complaint, Heyer asserted that BOP violated the Rehabilitation
    Act of 1973 by failing to provide ASL translators and otherwise
    accommodate    his      disability.            Heyer    also     asserted      multiple
    violations of his Fifth Amendment rights, including claims based
    on   BOP’s    failure     to    provide        ASL     interpreters      for   medical
    appointments and to permit him to participate in the CT Program
    and communicate with the mental health officials responsible for
    determining the duration of his civil commitment.                         Heyer also
    alleged violations of his First Amendment rights based on BOP’s
    failure to provide access to a videophone and its restrictions
    on   access   to   the    TTY   device     (Count       VIII).      Finally,      Heyer
    alleged violations of his rights under the First Amendment and
    the Religious Freedom Restoration Act of 1993 (“RFRA”), based on
    BOP’s   failure      to   provide     ASL        interpreters       so    Heyer    can
    participate in religious services.
    The district court dismissed the Rehabilitation Act claim
    (Count I) for failure to exhaust administrative remedies, and it
    10
    dismissed Heyer’s Fifth Amendment right-to-privacy claim (Count
    V) for failure to state a claim.                  See Heyer v. United States
    Bureau of Prisons, 
    2013 WL 943406
    , at *3, (E.D.N.C. Mar. 11,
    2013)    (unpublished).            The   court    thereafter    granted    summary
    judgment in favor of BOP on the remaining claims.                       The court
    dismissed one claim for lack of standing, rejected some claims
    on the merits, and rejected others as moot, based on BOP’s post-
    litigation      decision    to     begin   providing     ASL   interpreters     for
    certain purposes.        See Heyer v. United States Bureau of Prisons,
    
    2015 WL 1470877
    (E.D.N.C. Mar. 31, 2015) (unpublished).                      Heyer
    now appeals the district court’s 2015 summary judgment ruling 4;
    he does not appeal the district court’s 2013 dismissal of Counts
    I and V of his complaint.
    “We review a district court’s decision to grant summary
    judgment   de    novo,     applying      the    same   legal   standards   as   the
    district court, and viewing all facts and reasonable inferences
    therefrom in the light most favorable to the nonmoving party.”
    T–Mobile Ne., LLC v. City Council of Newport News, 
    674 F.3d 380
    ,
    384–85    (4th    Cir.     2012)    (internal      quotation    marks   omitted).
    4  In Count III of the complaint, Heyer challenged BOP’s
    failure    to  provide   ASL    interpreters  for  disciplinary
    proceedings.     Because  Heyer   had   never been  subject  to
    disciplinary proceedings at Butner, the district court in its
    2015 order dismissed the claim, concluding that Heyer lacked
    standing to pursue it. Heyer does not challenge that dismissal
    on appeal.
    11
    Summary judgment is appropriate “if the movant shows that there
    is no genuine dispute as to any material fact and the movant is
    entitled to judgment as a matter of law.”                            Fed. R. Civ. P.
    56(a).
    III.
    We begin with Heyer’s claims that BOP’s failure to provide
    ASL interpreters for medical interactions amounts to deliberate
    indifference        to    Heyer’s       medical       needs.         The    deliberate-
    indifference       standard      comes    from      the    Supreme   Court’s       Eighth-
    Amendment jurisprudence applicable to prisoners convicted of a
    crime.    “[T]he Eighth Amendment’s prohibition against ‘cruel and
    unusual punishments’ [extends] to the treatment of prisoners by
    prison officials,” Hill v. Crum, 
    727 F.3d 312
    , 317 (4th Cir.
    2013), and “forbids the unnecessary and wanton infliction of
    pain,” 
    id. (internal quotation
    marks omitted).                          As the Supreme
    Court has explained, “deliberate indifference to serious medical
    needs    of    prisoners        constitutes         the    unnecessary      and     wanton
    infliction of pain proscribed by the Eighth Amendment.”                           Estelle
    v.   Gamble,       
    429 U.S. 97
    ,     104    (1976)      (citation      and    internal
    quotation marks omitted).
    Although Heyer is a civil detainee rather than a convicted
    prisoner,      Heyer     nonetheless       frames         his   argument    in    Eighth-
    Amendment terms, arguing that he is entitled under the Fifth
    Amendment     to    at   least    the     same      protection     prisoners       receive
    12
    under the Eighth Amendment. 5            According to Heyer, the failure to
    provide interpreters amounts to deliberate indifference to his
    medical needs and thus violates his Fifth Amendment rights.                        As
    we   will        explain,   we   agree   with    Heyer     that   his   evidence   is
    sufficient to support a finding of deliberate indifference and
    that       the   district   court   therefore      erred    by    granting   summary
    judgment in favor of BOP on these claims. 6
    The       deliberate-indifference        standard    has   two   components.
    The plaintiff must show that he had serious medical needs, which
    5
    See, e.g., Youngberg v. Romeo, 
    457 U.S. 307
    , 322, (1982)
    (Civil detainees “are entitled to more considerate treatment and
    conditions of confinement than criminals whose conditions of
    confinement are designed to punish.”); Ingraham v. Wright, 
    430 U.S. 651
    , 671 n.40 (1977) (“[T]he State does not acquire the
    power to punish with which the Eighth Amendment is concerned
    until after it has secured a formal adjudication of guilt in
    accordance with due process of law.”); Bell v. McAdory, 
    820 F.3d 880
    , 882 (7th Cir. 2016) (“States must treat detainees at least
    as well as prisoners, and often they must treat detainees better
    -- precisely because detainees (whether civil or pretrial
    criminal) have not been convicted and therefore must not be
    punished.”).
    6In cases involving involuntarily committed psychiatric
    patients, claims of inadequate medical care are governed by the
    “professional judgment” standard rather than the deliberate
    indifference standard.   See 
    Youngberg, 457 U.S. at 323
    ; Patten
    v. Nichols, 
    274 F.3d 829
    , 838 (4th Cir. 2001). Because we agree
    with Heyer that his evidence is sufficient to support a finding
    of   deliberate  indifference,   we  need   not  flesh out  the
    differences between the two standards or determine whether the
    professional-judgment standard should also be applied to civil
    detainees who are confined alongside convicted criminals in a
    correctional facility rather than in a psychiatric hospital.
    See Brown v. Harris, 
    240 F.3d 383
    , 388 (4th Cir. 2001)
    (concluding that deliberate-indifference standard applies to
    medical-care claims involving pre-trial detainees).
    13
    is   an    objective      inquiry,     and    that    the     defendant      acted   with
    deliberate indifference to those needs, which is a subjective
    inquiry.       See Iko v. Shreve, 
    535 F.3d 225
    , 241 (4th Cir. 2008).
    A.
    In our view, Heyer’s evidence is more than sufficient to
    show the existence of serious medical needs.                        A “serious medical
    need”     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.”        
    Id. at 241
    (internal quotation marks omitted).
    As we understand his claims, Heyer does not contend that
    his deafness, in and of itself, is a serious medical need that
    requires treatment.            Instead, he contends that BOP’s failure to
    provide ASL interpreters for his medical interactions has led to
    constitutionally inadequate treatment for serious medical needs
    that have arisen during his confinement.                    We agree.
    As discussed above, Heyer has suffered multiple seizures
    during his confinement, and we have little difficulty concluding
    that      seizures      are    sufficiently        serious     to     require     medical
    treatment.       See Shreve v. Franklin Cty., 
    743 F.3d 126
    , 135 (6th
    Cir. 2014) (explaining that seizure suffered by inmate amounted
    to “a serious medical need to which indifference would likely
    have been a constitutional violation in itself”); cf. Grayson v.
    Peed,     
    195 F.3d 692
    ,    695    (4th       Cir.   1999)      (no    evidence   of
    14
    objectively serious medical need in case where detainee was not
    “hav[ing] trouble breathing . . . [,] was not bleeding, was not
    vomiting or choking, and was not having a seizure”).                    And while
    suffering these serious medical problems, Heyer was completely
    unable   to      communicate    with   medical    staff.    Heyer’s      evidence
    establishes, for purposes of these proceedings, that he can only
    communicate through ASL.          He cannot read lips, has no ability to
    understand speech, and cannot communicate effectively in written
    English.      Thus, without an ASL interpreter, Heyer was unable to
    explain what happened or describe his symptoms to the medical
    staff,     and    he   was   unable    to    understand    any   questions     or
    instructions from the medical staff.               Even a lay person could
    easily recognize the need for a patient with a serious medical
    condition to be able to communicate with medical staff, so a
    proper diagnosis can be made, and for the patient to understand
    the medical staff’s instructions, so the medical condition can
    be properly treated.
    BOP does not argue that seizures are not serious, nor does
    it   contend       that   the   ability      to   communicate    with     medical
    providers is unimportant to treatment.               Instead, BOP, mirroring
    the district court’s analysis, argues that Heyer cannot show a
    serious medical need because there is no evidence that Heyer
    suffered any “adverse medical condition as a result of not being
    15
    provided interpreters during his medical encounters.”                                       Brief of
    Appellee at 44.
    We disagree.         BOP’s argument demands more of Heyer than the
    case law requires.               An actionable deliberate-indifference claim
    does not require proof that the plaintiff suffered an actual
    injury.        Instead,         it    is   enough           that    the   defendant’s        actions
    exposed the plaintiff to a “substantial risk of serious harm.”
    Farmer v. Brennan, 
    511 U.S. 825
    , 837 (1994) (emphasis added);
    see also Rish v. Johnson, 
    131 F.3d 1092
    , 1096 (4th Cir. 1997)
    (deliberate-indifference standard requires prisoner to “produce
    evidence      of    a     serious       or      significant          physical     or     emotional
    injury resulting from the challenged conditions, or demonstrate
    a   substantial          risk    of    such       serious          harm   resulting      from    the
    prisoner’s         unwilling         exposure          to    the     challenged     conditions”
    (citation omitted; emphasis added)); Ball v. LeBlanc, 
    792 F.3d 584
    ,    593    (5th      Cir.    2015)          (“To       prove    unconstitutional          prison
    conditions, inmates need not show that death or serious injury
    has already occurred.                   They need only show that there is a
    substantial         risk    of        serious         harm.”        (citation     and       internal
    quotation marks omitted)).
    In our view, the facts outlined above are sufficient to
    show    that       the     absence         of    ASL        interpreters        during       medical
    interactions        exposed          Heyer      to     a    substantial      risk      of    serious
    harm.     Heyer’s evidence is thus sufficient, at this stage of the
    16
    proceedings,         to    satisfy     the        objective       component     of     the
    deliberate-indifference inquiry.
    B.
    We turn now to the subjective component of the inquiry –
    whether BOP acted with deliberate indifference.
    “Deliberate indifference is more than mere negligence, but
    less than acts or omissions done for the very purpose of causing
    harm   or     with    knowledge       that    harm       will   result.”      Scinto   v.
    Stansberry,      
    841 F.3d 219
    ,    225    (4th     Cir.    2016)      (internal
    quotation marks and alterations omitted).                          A prison official
    acts with deliberate indifference if he “knows of and disregards
    an excessive risk to [the inmate’s] health or safety.”                           
    Farmer, 511 U.S. at 837
    .           “Put differently, the plaintiff must show that
    the official was aware of facts from which the inference could
    be drawn that a substantial risk of serious harm existed and
    drew   that     inference.”           
    Scinto, 841 F.3d at 225
       (internal
    quotation marks and alterations omitted).
    The district court rejected Heyer’s medical-care claims on
    the first prong of the standard, and the court therefore did not
    address     whether       Heyer’s    evidence      was    sufficient     to    establish
    deliberate     indifference.           BOP    argues,       however,     that    Heyer’s
    evidence is insufficient.                  In BOP’s view, Heyer presented no
    evidence showing that BOP officials “knew that by not providing
    Heyer an interpreter during his medical evaluations, . . . he
    17
    was unable to communicate with medical staff to the extent there
    existed     a    substantial          risk    of     serious       harm    to    his    health.”
    Brief of Appellee at 51.                BOP notes that it provided Heyer with
    an inmate interpreter to facilitate Heyer’s communication, and
    it   contends          there     is     no     evidence        showing          it    knew   that
    communicating          through    the        inmate    companion          was    insufficient.
    Again, we disagree.
    BOP has been aware of Heyer’s deafness since he arrived at
    Butner     in    2008,    and     the    record       establishes          that      Heyer   made
    multiple requests for ASL interpreters and repeatedly informed
    prison officials of his inability to understand.                                     Indeed, the
    fact that BOP assigned Heyer an inmate companion is itself some
    evidence        that    BOP     knew     that        Heyer     could       not       effectively
    communicate on his own.
    Contrary to BOP’s argument, the decision to provide Heyer
    with the inmate companion does not insulate it from a finding of
    deliberate indifference.                As we have made clear, the mere fact
    that prison officials provide some treatment does not mean they
    have provided “constitutionally adequate treatment.”                                    De’lonta
    v.   Johnson,      
    708 F.3d 520
    ,    526     (4th   Cir.      2013).          While   “a
    prisoner does not enjoy a constitutional right to the treatment
    of   his   or    her     choice,       the    treatment        a   prison       facility     does
    provide must nevertheless be adequate to address the prisoner’s
    serious medical need.”             
    Id. (footnote omitted).
    18
    In our view, Heyer’s summary-judgment evidence is more than
    sufficient to support a finding that BOP knew that communication
    through the inmate companion was inadequate.                           As noted above,
    the inmate companion assigned to Heyer did not know ASL.                                   The
    inappropriateness       of    using   an    interpreter          who    did    not    speak
    Heyer’s language is obvious, and that very obviousness could
    support   a    factfinder’s      conclusion          that   BOP    knew       the    inmate
    companion was inadequate.            See 
    Farmer, 511 U.S. at 842
    (“Whether
    a prison official had the requisite knowledge of a substantial
    risk is a question of fact subject to demonstration in the usual
    ways, including inference from circumstantial evidence, and a
    factfinder     may    conclude    that      a    prison       official        knew    of    a
    substantial risk from the very fact that the risk was obvious.”
    (citation omitted; emphasis added)).
    Moreover, Heyer’s evidence shows that BOP officials did in
    fact know that the communication through the inmate companion
    was inadequate.         Dr. Andres Hernandez, BOP’s psychologist in
    charge of Heyer’s treatment, refused to permit the use of the
    inmate    companion     “in    the    formal         provision     of    [CT     Program]
    treatment services.”          J.A. 1276.        As Dr. Hernandez explained in
    his deposition, he found the inmate companion to be “inadequate
    to   conduct    treatment,”       J.A.      1117,       and      believed      qualified
    interpreters     were    “imperative”           to     “insure     that       there    was
    accurate,     reliable       understanding,”          so    as    to    “maintain          the
    19
    adequacy of treatment, the effectiveness of treatment.”                                   J.A.
    1117;    see    also        J.A.    1123     (Hernandez        “cannot         meaningfully
    communicate     with        Mr.    Heyer    without    interpreters”);           J.A.     1294
    (affidavit of another psychologist involved in Heyer’s treatment
    stating that “the use of qualified ASL interpreters is necessary
    in general for Heyer to progress through the [CT Program]”).
    This    evidence       shows    BOP’s       knowledge       of    all   the   factual
    premises      underpinning          Heyer’s        deliberate-indifference            claim:
    BOP knew that Heyer was deaf and needed ASL interpreters to
    communicate;         BOP      knew         that      “accurate”          and     “reliable”
    communication         was     necessary        for     Heyer’s          treatment    to    be
    effective;      and     BOP        knew     that     the     inmate        companion      was
    “inadequate” to ensure understanding.                      While Dr. Hernandez may
    have    been     speaking           specifically        to     Heyer’s          psychiatric
    treatment,      his     views       about     the     inadequacy          of   the    inmate
    companion      are    equally        applicable       to     the    treatment        of   his
    physical health issues.               From this evidence, a factfinder could
    reasonably conclude that BOP was deliberately indifferent, as it
    knew that its failure to provide ASL interpreters during Heyer’s
    medical interactions created a substantial risk of serious harm
    to his health.         See 
    Farmer, 511 U.S. at 837
    (A prison official
    acts with deliberate indifference if he “knows of and disregards
    an excessive risk to inmate health or safety.”); 
    Scinto, 841 F.3d at 226
    (explaining that “a prison official’s failure to
    20
    respond to an inmate’s known medical needs raises an inference
    of deliberate indifference to those needs” (internal quotation
    marks and alterations omitted)).
    C.
    Accordingly, for the reasons outlined above, we conclude
    that Heyer’s evidence, when accepted as true, is sufficient to
    satisfy    the      objective     and    subjective     components       of     the
    deliberate-indifference inquiry.              The district court therefore
    erred by granting summary judgment in favor of BOP on Heyer’s
    claim   that     BOP    failed   to    provide   him   with   constitutionally
    adequate medical care.
    IV.
    We    turn   now    to   Heyer’s    First   Amendment     claims.        Heyer
    contends    that,      despite   his    confinement,    he    retains    a    First
    Amendment right to communicate with those outside the prison.
    And given the evidence establishing his inability to communicate
    in written English, Heyer argues that BOP’s failure to provide
    him with access to a videophone improperly restricts his First
    Amendment rights under the four-factor analysis set out by the
    Supreme Court in Turner v. Safley, 
    482 U.S. 78
    (1987).                       In the
    alternative, Heyer argues that, even if BOP’s reliance on the
    TTY device were adequate, BOP has failed to provide reasonable
    access to the TTY device.
    A.
    21
    Courts have generally concluded that the First Amendment
    rights    retained            by      convicted       prisoners    include       the    right      to
    communicate with others beyond the prison walls.                                      See, e.g.,
    Yang v. Missouri Dep’t of Corr., 
    833 F.3d 890
    , 894 (8th Cir.
    2016) (The rights retained by a convicted prisoner “include the
    right    to    communicate             with     persons    outside       the    prison      walls,
    subject       to       regulation         that     protects      legitimate          governmental
    interests.”); Pope v. Hightower, 
    101 F.3d 1382
    , 1385 (11th Cir.
    1996)     (concluding              that      convicted    prisoners        retain      a    “First
    Amendment          right         to    communicate       with     family       and     friends”);
    Washington          v.       Reno,      
    35 F.3d 1093
    ,     1100    (6th       Cir.      1994)
    (recognizing           that       “persons      incarcerated       in    penal       institutions
    retain their First Amendment rights to communicate with family
    and friends”); Morgan v. LaVallee, 
    526 F.2d 221
    , 225 (2d Cir.
    1975) (“A prison inmate’s rights to communicate with family and
    friends are essentially First Amendment rights subject to § 1983
    protection         .     .   .     .”).       As   a    civil    detainee      rather       than    a
    convicted prisoner, Heyer’s First Amendment rights are at least
    as broad as those retained by convicted prisoners.
    BOP does not dispute that Heyer retains rights under the
    First Amendment that are implicated by the challenged policies.
    Indeed,       it       explicitly            agrees     that    “[t]he     First       Amendment
    protects       an       inmate’s          right    to    communicate       with       family    and
    friends.”          Brief of Appellee at 15.                    Instead, BOP contends that
    22
    its refusal to provide Heyer with his communication method of
    choice -- a videophone -- did not infringe his First Amendment
    rights,    such   that   there   is    no    occasion   to   apply   the     Turner
    factors.     BOP alternatively argues that if application of the
    Turner factors is required in this case, its refusal to provide
    a videophone is nonetheless proper.
    B.
    In Turner v. Safley, the Supreme Court concluded that a
    prison     policy   or    regulation         that   “impinges       on     inmates’
    constitutional rights . . . is valid if it is reasonably related
    to legitimate penological 
    interests,” 482 U.S. at 89
    , and the
    Court identified four factors to consider when determining the
    reasonableness of the policy, 
    id. at 89-91.
                 Accordingly, as BOP
    argues, consideration of the Turner reasonableness factors is
    required only if the prison policy “impinges” on Heyer’s First
    Amendment rights.
    BOP    contends     that    the    record      shows    that        Heyer   can
    communicate with those outside the prison through use of the TTY
    device, and that Heyer’s First Amendment rights are therefore
    satisfied by the access BOP provides to the TTY.                          BOP thus
    argues that its TTY policy does not impinge on Heyer’s First
    Amendment rights, and that Heyer’s demand for a better way to
    communicate is not a viable constitutional claim.               We disagree.
    23
    BOP’s     argument       that    Heyer        can    effectively      communicate
    through the TTY device is based on a highly selective reading of
    the record.        As previously discussed, the TTY device utilizes a
    keyboard     and    permits     the    transmission            of    written     messages
    between TTY users; effective communication over a TTY device
    therefore    requires     proficiency         in    written         English.      Heyer’s
    evidence,    however,     establishes     that           he   has    extremely    limited
    proficiency    in    English    and    cannot       communicate         effectively    in
    written English. 7      While BOP points to evidence suggesting that
    Heyer might sometimes, under certain circumstances, be able to
    communicate effectively through writing, 8 that evidence is not
    entitled to the dispositive effect that BOP assigns to it.                            The
    procedural posture of this case requires us to view the evidence
    in the light most favorable to Heyer, which means that we must
    7  See Expert Report, J.A. 350 (“Heyer . . . cannot
    communicate effectively in written English.”); 
    id., J.A. 372
    (Heyer’s “proficiency in English (speech, lip-reading and
    reading and writing) is severely limited); 
    id., J.A. 355
    (“American   Sign  Language   is   structurally  different  from
    English,” and its “lexicon and syntactic structure [are] quite
    unlike that of spoken English”); Heyer Deposition, J.A. 267 (“I
    will write a note and, usually the person that’s reading it does
    not understand what I’ve written because I write in ASL and
    their language is English.”); 
    id. (“My sentences
    are not in
    English, so they do not understand what I’m saying.”).
    8  For example, Heyer’s expert suggested that written
    communication might possibly be effective for Heyer if it
    involved    “short  routine,   frequently    repeated   written
    communications.” J.A. 378. In addition, Heyer testified in his
    deposition that his brother could understand his emails.   J.A.
    296.
    24
    accept       as   true     the      evidence       showing          that    Heyer        cannot
    communicate       effectively       through       written     English       and    therefore
    cannot       communicate       effectively       through      the    TTY    device.            And
    because the evidence establishes that Heyer cannot communicate
    effectively through the only means that BOP makes available to
    him, we cannot accept BOP’s assertion that its TTY-only policy
    does not impinge on Heyer’s First Amendment right to communicate
    with those outside the prison.
    C.
    Given our conclusion that BOP’s policy impinges on Heyer’s
    First Amendment rights, we must determine whether that policy
    “is reasonably related to legitimate penological interests,” as
    required by 
    Turner. 482 U.S. at 89
    .             As explained in Turner,
    the    reasonableness          of   the    policy      depends       on    (1)    whether        a
    “valid,       rational         connection        [exists]      between           the     prison
    regulation and the legitimate governmental interest put forward
    to justify it,” (2) whether “alternative means of exercising the
    right    [exist]    that       remain     open    to    prison      inmates,”          (3)    what
    “impact accommodation of the asserted constitutional right will
    have    on    guards     and    other     inmates,      and   on     the    allocation          of
    prison       resources     generally,”       and       (4)    whether      there        was    an
    25
    “absence of ready alternatives” to the regulation in question.
    
    Id. at 89-90
    (internal quotation marks omitted). 9
    1.
    We    first   consider    whether       there   is   a    “valid,    rational
    connection    between   the     prison    regulation       and    the    legitimate
    governmental interest put forward to justify it.”                        
    Id. at 89
    (internal quotation marks omitted).               “[A] regulation cannot be
    sustained where the logical connection between the regulation
    and   the    asserted    goal     is     so    remote      as    to     render   the
    policy arbitrary or irrational.”            
    Id. at 89-90
    .
    BOP    contends    that    its      TTY-only      policy        furthers   its
    legitimate interest in maintaining prison security.                       According
    to BOP, videophones create security issues not presented by the
    TTY system, such as the possibility of a video recording of the
    9The Supreme Court in Turner v. Safley was considering
    whether a prison policy improperly restricted the First
    Amendment rights of a convicted prisoner rather than a civil
    detainee. See 
    482 U.S. 78
    , 81-84 (1987). Some courts have made
    modifications to the Turner factors to reflect the differences
    between convicted prisoners and detainees. See, e.g., Brown v.
    Phillips, 
    801 F.3d 849
    , 853 (7th Cir. 2015) (concluding that in
    case involving civil detainee, Turner requires that challenged
    policy “must be rationally connected to the state’s interests --
    here, security and the rehabilitation and treatment of sexually
    violent persons”). Because Heyer does not suggest that any such
    adjustments should be made in this case and we conclude that his
    claims are viable under the Turner factors as originally
    formulated, we need not decide whether adjustments should
    generally be made in cases involving civil detainees.
    26
    conversation being posted on the Internet.                  In addition, BOP
    contends that
    [w]ith video communications, it is more difficult to
    prevent sexually illicit acts from occurring, or
    controlling who or what the inmate can see on the
    other end of the video monitor (i.e., children or
    prior victims). Such calls would likely require
    attentive and continuous live monitoring, and even if
    staff did observe sexually inappropriate conduct over
    the video monitor, the act may be committed before the
    staff member has an opportunity to terminate the call
    (e.g., indecent exposure to child).
    Brief of Appellee at 21-22 (citation omitted).
    BOP   also   argues     that   it    has    a   legitimate    interest   in
    monitoring all inmate communication and that its TTY-only policy
    is rationally related to that interest.                BOP currently monitors
    inmate telephone calls through the secure BOP Inmate Telephone
    System, and BOP contends that the system cannot accommodate a
    videophone “without the development and funding of a separate
    and   secure    Information    Technology        infrastructure.”      Brief   of
    Appellee at 21.
    There is no doubt that BOP has a legitimate interest in
    maintaining the security of its facilities and in protecting the
    public   from    further    criminal      acts   by   inmates   and   detainees.
    Nonetheless, there are reasons that a factfinder might question
    the legitimacy of the particular security risks asserted in this
    case.
    27
    As to BOP’s insistence that videophone conversations must
    go through its secure Inmate Telephone System, we note that the
    TTY system currently in place operates on an unsecured line in a
    private staff office.             Given BOP’s current willingness to let
    Heyer place TTY calls through an unsecured line unconnected to
    the Inmate Telephone System, a factfinder could question BOP’s
    sudden insistence that videophone calls be part of the System.
    And   while   BOP       argues    that   maintaining            the   security   of
    videophone conversations would require “attentive and continuous
    live   monitoring,”       Brief     of    Appellee       at    21,     the   current    TTY
    system already requires continuous staff monitoring.                              The TTY
    device is in a private office with a computer and other staff
    equipment,     and    a    prison       official   is         always    present    during
    Heyer’s use of the TTY device.                  Because the monitoring of a
    videophone conversation would be no more demanding of staff time
    than the monitoring of the TTY conversations that is already
    being done, the factfinder could question whether a videophone
    system would in fact present the difficulties asserted by BOP.
    Nonetheless,       we   recognize    that     a    videophone         conversation
    presents certain risks not present with TTY conversations, such
    as the possibility of a video of the conversation being posted
    on the Internet or the possibility that an inmate might expose
    himself to the person on the other end of the conversation.                              A
    ban on videophones prevents these situations from occurring, and
    28
    thus the ban bears at least some connection to BOP’s legitimate
    interest in maintaining security and protecting the public.                                     As
    we    will     explain,     however,      questions        of     fact       arise    under     the
    other        Turner   factors       as    to        the    reasonableness             of      BOP’s
    videophone ban.            See Jehovah v. Clarke, 
    798 F.3d 169
    , 178-79
    (4th    Cir.     2015)     (reversing       grant         of    summary       judgment        under
    Turner even though challenged policy bore some connection to the
    penological interests asserted by the defendants).
    2.
    The second Turner factor requires us to consider whether
    Heyer    has     alternate        means    of       exercising          the    constitutional
    right.        “Where other avenues remain available for the exercise
    of the asserted right, courts should be particularly conscious
    of     the    measure      of     judicial      deference             owed    to     corrections
    officials in gauging the validity of the regulation.”                                      
    Turner, 482 U.S. at 90
        (citation,         internal          quotation          marks,     and
    alteration       omitted).          BOP   contends             that    alternate       means     of
    communicating with those outside Butner are available to Heyer -
    -    specifically,         TTY,    email,      written          letters,       and     in-person
    visits.        Because other means of communication remain available
    to Heyer, BOP contends the ban on videophones is reasonable.                                    We
    disagree.
    With     the   exception      of    in-person            visitation,        all     of   the
    alternate means of communication identified by BOP involve the
    29
    use of written English.            As we have already explained, however,
    the     record      contains       evidence       establishing           that     Heyer’s
    proficiency with English is severely limited and that he cannot
    effectively       communicate      in     written    English.        Although       Heyer
    presumably would be able to communicate through ASL with those
    who     visit     him    at     Butner,     the     availability         of     in-person
    visitation is of little help in emergencies or other situations
    where there is a need for immediate contact.                        Accordingly, we
    believe that Heyer’s evidence, which must be accepted as true,
    would permit a factfinder to conclude that no other effective
    means of communication are available to Heyer.
    3.
    The     third     factor   we     must    consider    under    Turner       is   the
    effect that “accommodation of the asserted constitutional right
    will have on guards and other inmates, and on the allocation of
    prison resources generally.”              
    Id. at 90.
          “When accommodation of
    an asserted right will have a significant ‘ripple effect’ on
    fellow inmates or on prison staff, courts should be particularly
    deferential        to     the     informed        discretion        of        corrections
    officials.”       
    Id. BOP contends
    the effect of accommodating Heyer’s request
    would    be     significant.       BOP     claims    it    would    be     required    to
    “develop and fund a separate and secure IT infrastructure in
    order to monitor and record each videophone call on an agency-
    30
    wide basis,” Brief of Appellee at 24 (emphasis added), and that
    it would cost nearly $2 million to install videophones at all of
    its 119 institutions.             Moreover, monitoring the substance of a
    videophone conversation would require the services of an ASL
    interpreter, which further increases the costs to BOP.
    Again,      however,       Heyer’s         evidence     precludes         us   from
    concluding that the effect of accommodating Heyer’s needs would
    be so great that the videophone ban is reasonable as a matter of
    law.     As previously noted, the TTY device currently used by
    Heyer operates through an unsecured telephone line that is not
    part   of    the    Inmate     Telephone      System,      and   BOP   is   apparently
    satisfied that the risks associated with the use of unsecured
    line are manageable.            This evidence thus creates questions of
    fact   about       BOP’s   assertion        that    a   videophone     would      require
    creation of a new, secure IT infrastructure.
    BOP    also      insists       that    any       accommodation       should     be
    implemented        on   what   would    be    a     very     expensive,     system-wide
    basis.       However, nothing in the record indicates why a system-
    wide solution would be required, and Heyer’s evidence shows that
    a videophone could be installed in Butner (presumably using the
    same   unsecured        line   used    by    the    TTY    device)     at   de    minimis
    31
    expense       to        the    government. 10             And     while       the     videophone
    conversations           would    require          live   monitoring          by   prison     staff,
    that should not be a significant additional burden, as prison
    staff already monitor Heyer’s TTY calls.
    In light of this evidence, a factfinder could conclude that
    accommodating Heyer’s needs would have minimal effect on guards
    or other inmates or on the prison’s allocation of resources,
    thus        raising       questions          about       the    reasonableness             of     the
    videophone ban.
    4.
    Finally, Turner requires us to consider whether there are
    “ready alternatives” to the challenged policy.                                
    Turner, 482 U.S. at 90
    .       As the Court explained, “the existence of obvious, easy
    alternatives            may    be    evidence           that    the     regulation         is     not
    reasonable, but is an exaggerated response to prison concerns.”
    
    Id. (internal quotation
         marks        omitted).          Although       the      Court
    cautioned          lower      courts        not    to     treat       this    factor       as     the
    equivalent         of    the    “least       restrictive          alternative         test,”      the
    Court       held     that      “if     an     inmate      claimant       can      point      to    an
    alternative that fully accommodates the prisoner’s rights at de
    minimis       cost       to    valid        penological        interests,         a   court       may
    10
    Heyer’s evidence indicates that BOP could obtain the
    necessary equipment and software for “no cost or modest cost.”
    J.A. 663. Even under BOP’s estimate, establishing a stand-alone
    videophone system at Butner would cost no more than $2500.
    32
    consider that as evidence that the regulation does not satisfy
    the reasonable relationship standard.”                       
    Id. at 90-91
    (internal
    quotation marks omitted).                   In this case, there is significant
    evidence of ready alternatives to BOP’s ban on videophones.
    As     Heyer     notes,       the     regular      inmate     telephone        system
    presents      security       risks     --   for     example,   inmates     can       use   the
    phone to direct or commit crimes, and the call recipient can
    record and post the call on the Internet.                      Those risks, however,
    have    not    driven     BOP     to   ban     telephones;     instead,         it   handles
    individual problems as they arise, suspending usage rights for
    offending inmates and taking other appropriate action.                               Nothing
    in     the    record     suggests       that        the   security      risks    posed     by
    videophones are so qualitatively different that they can only be
    managed by banning videophones.                      Indeed, the record shows that
    many of the security risks associated with a videophone could be
    minimized by simply setting it up in a secure office, as the TTY
    device is.       Access to the videophone could be restricted to deaf
    inmates, and any abuses of the system could be handled on a
    case-by-case basis, as they are with the inmate phone system.
    Moreover, Heyer’s evidence establishes that videophones are
    in many ways more secure than TTY devices.                              The TTY device
    requires      the     user   to   have      physical      access   to    the    equipment,
    while the equipment for a videophone system -- which is little
    more than a camera connected to a desktop computer -- can be set
    33
    up in a way that the detainee has no access to it.                            Basic
    software packages permit videophones to be password-protected to
    prohibit      unauthorized    access;    TTY     devices     are    not   password-
    protected.      Moreover, videophone conversations can be digitally
    recorded, encrypted, and stored electronically.                      By contrast,
    the record of TTY conversations is printed out by the device
    itself, thus making it possible for an inmate to grab the print-
    out and destroy the record of his conversation.
    Given Heyer’s evidence of the minimal cost of a videophone
    and the ease with which security concerns could be mitigated, we
    believe that a factfinder could reasonably conclude that BOP’s
    refusal to provide a videophone is an exaggerated response to
    the perceived security concerns.               The district court therefore
    erred    by   granting    summary     judgment    to   BOP    on    Heyer’s   First
    Amendment      videophone    claim.      See     
    Jehovah, 798 F.3d at 179
    (reversing grant of summary judgment because jury could find
    prisoner’s proposed alternatives to be so “obvious and easy” as
    to show that total ban on wine was an “exaggerated response”
    (internal quotation marks omitted)).
    D.
    Independent of his videophone claim, Heyer also claims that
    BOP     violated    his     First   Amendment      rights      by    unreasonably
    restricting his access to the TTY device.                    The district court
    summarily rejected that claim, concluding that Heyer had proved
    34
    “at    most    isolated       instances         of    being    unable      to    use    the     TTY
    immediately upon [his] request.”                      J.A. 145.         We agree with Heyer
    that the record precludes a grant of summary judgment on this
    claim.
    Heyer     filed       a     verified       complaint,        which        is    the    “the
    equivalent       of     an       opposing       affidavit         for    summary        judgment
    purposes.”           World    Fuel       Servs.      Trading,     DMCC    v.     Hebei       Prince
    Shipping       Co.,    
    783 F.3d 507
    ,     516      (4th   Cir.     2015)       (internal
    quotation      marks       omitted).         In      his    complaint,      he    states       that
    access to the TTY is “regularly restricted or denied,” J.A. 40,
    and    that      prison          staff     “consistently          den[ies        him]        access
    altogether without justification,” J.A. 41.                             If the few trained
    staff members “are away for training or on vacation,” Heyer is
    “unable to access the TTY at all.”                         J.A. 41.      In his deposition,
    Heyer confirmed the difficulties in getting access to the TTY,
    with   it     sometimes       taking       days      before    access     is     granted,       and
    staff sometimes failing to follow up on the request at all.
    Heyer also testified that he has never been able to use the TTY
    on nights or weekends.
    While we do not suggest that the Constitution requires deaf
    inmates to have precisely the same access to TTY devices other
    inmates       have    to     telephones,        we     believe     that     this       evidence,
    accepted as true, shows a sufficiently serious interference with
    Heyer’s rights to communicate beyond Butner’s walls to support a
    35
    First Amendment claim.              Cf. 
    Washington, 35 F.3d at 1100
    (“[A]
    prisoner’s       right    to   telephone          access    is    subject       to   rational
    limitations in the face of legitimate security interests of the
    penal institution.” (internal quotation marks omitted)).
    As    to    the    Turner    factors,        we   believe     questions        of    fact
    preclude the grant of summary judgment.                          Heyer alleges in his
    complaint        that    access    to   the       TTY   was      often    denied     without
    justification, and a factfinder could certainly conclude that
    arbitrary        interference       with      a     detainee’s          exercise     of    his
    constitutional          rights     is     not      “reasonably          related”     to    any
    “legitimate penological interests.”                        
    Turner, 482 U.S. at 89
    ;
    cf.   Benzel      v.    Grammer,    
    869 F.2d 1105
    ,       1108    (8th    Cir.     1989)
    (“Although in some instances prison inmates may have a right to
    use the telephone for communication with relatives and friends,
    prison officials may restrict that right in a reasonable manner
    . . . .”).        Moreover, the record establishes the availability of
    ready alternatives to BOP’s current inconsistent and inadequate
    approach to access, including the largely cost-free option of
    training more staff members on the use of the TTY, so as to give
    Heyer more access to the TTY on nights and weekends.                                  Because
    there      are    questions       of    fact       on      issues       relevant     to    the
    application of the Turner factors, we conclude that the district
    court erred by granting summary judgment against Heyer’s claim
    that he was unreasonably denied access to the TTY device.
    36
    V.
    The   district       court    rejected      Heyer’s        remaining     claims    by
    focusing on, at least in part, BOP’s post-litigation conduct and
    assertions that it would provide the relief Heyer was seeking.
    See J.A. 137 (rejecting Fifth Amendment claim (Count II) based
    on failure to provide ASL interpreters for the mental health
    treatment provided through the CT Program because BOP stated
    that it would provide interpreter services for future individual
    therapy sessions); J.A. 143-44 (dismissing Fifth Amendment claim
    (Count VII) based on BOP’s failure to provide visual alarms and
    other    items   necessary        to    alert    Heyer      to   emergencies        because
    BOP’s post-litigation safety improvements were sufficient); J.A.
    145-46    (dismissing       as    moot    Heyer’s     RFRA       and   First    Amendment
    claims    (Counts     IX    and    X)    based   on    BOP’s      failure      to   provide
    interpreters for religious services because BOP stated that it
    would    begin   providing        interpreters        for    religious      services     on
    request).     Heyer argues on appeal that the district court erred
    by relying on BOP’s voluntary, post-litigation actions to reject
    his claims.      We agree.
    A.
    The district court dismissed Counts IX and X as moot based
    on BOP’s stated intent to provide the requested relief in the
    future.     The court explained that BOP’s voluntary cessation of
    the      challenged        action       mooted      the      claims      because        BOP
    37
    “unequivocally          state[s]     that    [Heyer]         will    be   provided,      upon
    request, with a qualified interpreter for religious ceremonies
    and programs,” such that “there is no reasonable expectation
    that the alleged violation will recur and [BOP’s] solution will
    completely     and      irrevocably        eradicate      any       burden    the    lack    of
    interpreters formerly placed on [Heyer’s] exercise of religion.”
    J.A. 146 (internal quotation marks omitted).
    “It   is      well     established         that       a    defendant’s voluntary
    cessation     of    a    challenged        practice      moots      an    action     only   if
    subsequent events made it absolutely clear that the allegedly
    wrongful behavior could not reasonably be expected to recur.”
    Wall   v.    Wade,      
    741 F.3d 492
    ,    497     (4th        Cir.    2014)     (internal
    quotation     marks      omitted).          “[W]hen      a       defendant     retains      the
    authority and capacity to repeat an alleged harm, a plaintiff’s
    claims should not be dismissed as moot.”                            
    Id. BOP bears
    the
    “heavy burden” of showing that “the challenged conduct cannot
    reasonably     be       expected     to    start    up    again.”            
    Id. (internal quotation
    marks omitted).                 “[B]ald assertions of a defendant --
    whether governmental or private -- that it will not resume a
    challenged policy fail to satisfy any burden of showing that a
    claim is moot.”          
    Id. at 498.
    When dismissing these counts, the district court relied on
    BOP’s assurance of interpreters contained in a 2014 affidavit
    from a BOP chaplain which states that “BOP will provide . . .
    38
    inmates with a qualified interpreter . . . if necessary for
    effective      communication              during          religious        ceremonies       or
    programs.”     J.A. 343.          BOP contends this assurance is sufficient
    to   support   the    district           court’s         ruling   because      BOP   has   “no
    policy   or    practice       .    .     .    that       prevents       deaf   inmates     from
    receiving interpreters for the purpose of attending religious
    programming.”        Brief of Appellee at 60.                     Thus, in BOP’s view,
    the chaplain’s assurance that interpreters would be provided is
    simply a “recommit[ment] to a preexisting practice of providing
    interpreters.”       
    Id. at 61.
             We disagree.
    Regardless        of    whether              BOP     has     previously        provided
    interpreters for other deaf inmates, the record here establishes
    (for summary-judgment purposes) that BOP has not provided Heyer
    with interpreters for religious services.                           See J.A. 403, 408.
    Accordingly, given our standard of review and BOP’s burden of
    proof, the chaplain’s affidavit cannot be viewed as a statement
    of current policy, but must instead be understood as a mid-
    litigation     change    of       course.          Viewed     through      that   lens,    the
    chaplain’s     statement          does       not    support       the    district    court’s
    decision to dismiss these claims as moot.                         Even if we ignore the
    equivocation inherent in the promise to provide interpreters “if
    necessary,” the statement amounts to little more than a “bald
    assertion[]” of future compliance, which is insufficient to meet
    BOP’s burden.      
    Wall, 741 F.3d at 498
    .
    39
    Moreover, as previously discussed, BOP in 2012 announced
    that it would provide ASL interpreters for Heyer’s scheduled
    medical appointments.        Since that time, however, Heyer has had
    at least two scheduled medical appointments where no interpreter
    was    provided.     Because      the   record   establishes    that   BOP   has
    already    failed    to    live    up   to    its   promises    regarding     the
    provision of ASL interpreters, the record does not require us to
    conclude    that    “the   challenged        conduct   cannot   reasonably    be
    expected to start up again.”              
    Id. at 497
    (internal quotation
    marks omitted).       Under these circumstances, the district court
    erred by concluding that BOP’s assertion that it would begin
    providing interpreters rendered Counts IX and X moot.
    B.
    In Count VII, Heyer challenged BOP’s failure to provide
    visual alarms and other items, such as pagers, vibrating beds,
    or vibrating watches, necessary to alert Heyer to emergencies.
    After noting in its factual summary that BOP in 2014 (almost
    three years after the commencement of this action) had installed
    a strobe light in the cell to which Heyer was assigned, see J.A.
    128, the district court granted summary judgment against the
    claim because Heyer was “seek[ing] more safety measures than
    those [BOP has] implemented rather than arguing that [BOP has]
    failed to provide [him] with any safety measures at all.”                    J.A.
    143.
    40
    Although BOP did recently install a strobe light in Heyer’s
    cell, the mere fact that BOP has taken some action does not mean
    that    the    action    is    constitutionally        sufficient.      See,    e.g.,
    
    De’lonta, 708 F.3d at 526
    .                Indeed, Heyer presented evidence
    showing that the strobe light was inadequate to alert him to
    emergencies, see J.A. 496, but the district court nonetheless
    appears to have assumed that the strobe light was an adequate
    response       to   Heyer’s      safety      needs.       Moreover,    BOP     cannot
    guarantee that Heyer will always be assigned to one of the four
    cells where the strobe lights were installed, 11 and Heyer has
    presented       evidence      challenging      the    adequacy   of   the    prison’s
    other       existing    mechanisms     for    ensuring    Heyer’s     awareness    of
    emergencies.           Under   these   circumstances,       the   district      court
    erred by granting summary judgment in favor of BOP on Count VII.
    C.
    In Count II, Heyer asserted a Fifth Amendment claim based
    on BOP’s failure to provide ASL interpreters for the mental-
    health treatment provided through the CT Program.                     The district
    court assumed that Heyer had a protected liberty interest in
    11In an affidavit filed with BOP’s summary-judgment
    materials, the manager of the prison unit where Heyer is
    assigned stated that Heyer would remain in one of the four cells
    “[a]bsent any exigent circumstances.”      J.A. 216.    Butner’s
    warden, however, stated in his deposition that regular rotation
    of inmates to different cells is a “good correctional practice”
    that he would not rule out implementing in the future.      J.A.
    707.
    41
    receiving the treatment.             The court nonetheless granted summary
    judgment against the claim, observing that BOP had agreed to
    provide     ASL   interpreters        for     Heyer’s      participation      in    most
    aspects of the CT Program and concluding that the denial of
    interpreters      for       the    first     few    months    after     Heyer      began
    participating in the CT Program did not amount to a cognizable
    constitutional injury.            See J.A. 137.
    Even    if   we    accept      the    district     court’s    conclusion       that
    BOP’s initial failure to provide interpreters is not significant
    enough, on its own, to establish a constitutional violation,
    Heyer’s claim is not concerned with seeking damages for past
    constitutional      wrongs.          Instead,      Heyer   seeks    a   court      ruling
    that,   because     the     length    of     his   confinement     is   dependent     in
    large part on BOP’s assessment of his mental health, BOP is
    constitutionally obliged to provide interpreters for all aspects
    of   the    mental-health          treatment       it   offers     to    Adam      Walsh
    detainees,    and      he   also     seeks    an   injunction      ordering     BOP   to
    provide     the   necessary        interpreters.           BOP’s    post-litigation
    decision to provide interpreters for some aspects of Heyer’s
    treatment clearly provides no basis for rejecting Heyer’s claim
    on the merits.       Accordingly, we conclude that the district court
    erred by granting summary judgment in favor of BOP on Count II.
    42
    VI.
    To     summarize,     we    conclude     that    Heyer        has   presented
    sufficient evidence to preclude summary judgment in favor of BOP
    on Heyer’s medical-treatment claims (Counts IV and VI), safe-
    environment claim (Count VII), and videophone- and TTY-related
    First Amendment claims (Count VIII).              We therefore vacate the
    district court’s order granting summary judgment in favor of BOP
    as to those claims, and we remand those claims for trial.
    As to Counts II, IX, and X, we conclude that the district
    court     erred   by   giving     dispositive     effect      to     BOP’s    post-
    litigation assurances that it would provide the ASL interpreters
    Heyer requested.       We therefore vacate the district court’s order
    granting    summary    judgment    in    favor   of   BOP   on     Count     II   and
    dismissing Counts IX and X as moot.               On remand, the district
    court may re-evaluate the merits of these claims in light of the
    evidence presented by the parties, but the court may not give
    dispositive       effect    to     BOP’s      assurances      that       qualified
    interpreters will be provided.
    Finally, because Heyer does not challenge it on appeal, we
    affirm the district court’s dismissal of Count III.
    AFFIRMED IN PART,
    VACATED IN PART,
    AND REMANDED
    43