United States Court of Appeals
FOR THE EIGHTH CIRCUIT
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No. 10-3656
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William Douglas Holden, *
*
Appellant, *
* Appeal from the United States
v. * District Court for the Eastern
* District of Missouri.
Linda Hirner, Officially and *
Individually; David Lawson, Marion *
County Jail/Custody Officer, Officially *
and Individually; Barb Powell, Marion *
County Jail/Custody Officer, Officially *
and Individually; Brian Young, Marion *
County Jail/Custody Officer, Officially *
and Individually; Carla Lawson, Marion *
County Jail/Custody Officer, Officially *
and Individually, *
*
Appellees. *
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Submitted: September 20, 2011
Filed: December 2, 2011
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Before RILEY, Chief Judge, COLLOTON and GRUENDER, Circuit Judges.
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RILEY, Chief Judge.
William Holden (Holden), a pretrial detainee, was assaulted by three other
inmates while he awaited trial. Holden appeals the district court’s adverse grant of1
summary judgment on Holden’s 42 U.S.C. § 1983 claim against several prison
officials. Holden contends the district court failed to recognize genuine disputes of
material fact regarding (1) the substantial risk of harm he faced while in custody, and
(2) the adequacy of medical attention he received after the assault. We affirm.
I. BACKGROUND
A. Facts2
On August 23, 2007, Holden, a convicted sex offender, was arrested for failure
to report a change of address and was placed in the custody of Marion County Jail.
Holden was held in the protective custody pod. This pod provides protection for
inmates who face a greater likelihood of being assaulted by other inmates. The pod
is closer to the jail control room and has a glass front, allowing prison personnel to
observe the inmates better. With Holden in the pod were three other inmates, Adrian
Jones, Nathan Brown, and Steve Kelso.
On October 15, 2007, a fight erupted between Holden and his cellmates.
Approximately one minute after the fight began, Brian Young, a Marion County Jail
employee, stopped the fight. Young provided Holden with clean clothes and
examined Holden for injuries. Young’s inspection disclosed minor swelling of
Holden’s leg, some bruising, and a small cut and minor abrasion on Holden’s lip.
The Honorable David D. Noce, United States Magistrate Judge for the Eastern1
District of Missouri, presiding by consent of the parties pursuant to 28 U.S.C.
§ 636(c)(1).
We recite the facts in the light most favorable to Holden, the party opposing2
summary judgment. See Marksmeier v. Davie, 622 F.3d 896, 899 (8th Cir. 2010).
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There was no significant bleeding, none of Holden’s injuries required stitches, and
Holden was never unconscious. Holden’s gums were not bleeding, and he did not
have a loose tooth. Holden walked without any noticeable difficulty. For the
remainder of Holden’s time at Marion County Jail, Holden did not share a cell with
Jones, Brown, or Kelso.
A few hours after the fight, Holden reported increased pain, locking up and
cramping of his neck and shoulders, lower back pain, a loose tooth, dizziness and
lightheadedness, and swelling and discoloration on several areas of his body. Prison
officials offered Holden an ice pack, instructed him to elevate his leg, and gave him
ibuprofen. Holden refused to use the ice pack.
The following day, October 16, Peggy Porter, a licensed practical nurse
employed by Marion County Jail, received a Sick Call Request Form from Holden,
complaining of pain. Holden described pain shooting through his lower back and
inner right leg up to his groin. Nurse Porter evaluated Holden’s vital signs, head,
ears, nose, throat, lungs, heart and musculoskeletal system—all normal. Nurse Porter
suggested Holden use an ice pack, rest his right leg and back, and take ibuprofen for
five days.
On October 21 and 23, Holden again complained of pain. On October 24,
Nurse Porter again examined Holden and discovered a right knee contusion and
sprain. Nurse Porter prescribed ibuprofen for seven days and recommended Holden
refrain from activities that would strain his knee. Over the following months, Holden
made multiple complaints of pain, received medical attention, and was observed
walking and eating without difficulty.
Holden also complained repeatedly of pain in his lower front tooth and on
October 23, 2007, sought dental treatment. Holden presented additional Sick Call
Request Forms for dental treatment on October 28 and November 4. Nurse Porter
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informed Holden the Marion County Jail did not have a dentist and could only treat
the symptoms of a toothache. Holden has not adduced any evidence he complained
of tooth pain again while incarcerated at Marion County Jail.
On April 29, 2008, Holden was transferred to the custody of the Missouri
Department of Corrections. On June 20, 2008, Holden was given the opportunity to
have a dentist extract his tooth. Holden refused. Holden eventually consented to the
extraction on October 13, 2008.
On December 23, 2008, Holden filed a complaint pursuant to 42 U.S.C. §
1983, against Linda Hirner, David Lawson, Barb Powell, Brian Young, and Carla
Lawson, all Marion County Jail custody officers (collectively, prison officials), in
their individual and official capacities. Holden alleged the prison officials violated
his civil rights.
B. Proceedings
The prison officials moved for summary judgment. The motion was fully
briefed and argued before the district court. On September 7, 2010, the district court
granted the prison officials’ motion for summary judgment. First, the district court
found Holden was not held under conditions posing a substantial risk to his safety
while in the protective custody pod, and the prison officials (1) did not know of any
threat to Holden, (2) did not know Holden had a serious medical need, (3) were
entitled to rely on the opinions of medical professionals, and (4) were entitled to
qualified immunity. This appeal followed.
II. DISCUSSION
A. Standard of Review
We review the district court’s grant of summary judgment de novo, viewing the
record in favor of the non-moving party. See Marksmeier, 622 F.3d at 899. “The
court shall grant summary judgment if the movant shows that there is no genuine
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dispute as to any material fact and the movant is entitled to judgment as a matter of
law.” Fed. R. Civ. P. 56(a). Once the moving party has made and supported their
motion, the nonmoving party must proffer admissible evidence demonstrating a
genuine dispute as to a material fact. See Krein v. DBA Corp., 327 F.3d 723, 726
(8th Cir. 2003).
B. Failure to Protect
Holden contends the district court erred in dismissing his § 1983 claim because
there are genuine issues of material fact regarding whether the prison officials failed
to protect Holden. Prison officials have a duty to protect prisoners from violence at
the hands of other prisoners. See Farmer v. Brennan, 511 U.S. 825, 833 (1994).
Pretrial detainee § 1983 claims are analyzed under the Fourteenth Amendment’s Due
Process Clause, rather than the Eighth Amendment prohibition of cruel and unusual
punishment. See Kahle v. Leonard, 477 F.3d 544, 550 (8th Cir. 2007) (stating “[t]his
makes little difference as a practical matter, though: Pretrial detainees are entitled to
the same protection under the Fourteenth Amendment as imprisoned convicts receive
under the Eighth Amendment.”).
To establish prison officials failed to prevent harm, Holden first must prove he
was “incarcerated under conditions posing a substantial risk of serious harm.”
Farmer, 511 U.S. at 834. This is an objective requirement to ensure the deprivation
is a violation of a constitutional right. See Jensen v. Clarke, 94 F.3d 1191, 1197 (8th
Cir. 1996). Second, Holden must establish the prison officials were deliberately
indifferent to inmate health or safety. See Farmer, 511 U.S. at 834. This is a3
Holden admits the Eighth Circuit has not “establish[ed] a clear standard for3
pretrial detainees,” and “repeatedly [has] applied the deliberate indifference standard
as is applied to Eighth Amendment claims made by convicted inmates.” See Morris
v. Zefferi, 601 F.3d 805, 809 (8th Cir. 2010) (quoting Vaughn v. Greene Cnty., Ark.,
438 F.3d 845, 850 (8th Cir. 2006) (internal quotation marks omitted)).
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subjective requirement, mandating the prisoner prove the official both knew of and
disregarded “an excessive risk to inmate health or safety.” Id. at 837.
Holden argues he was placed in risk of substantial harm because he was a sex
offender and because he was held in the protective custody pod with Jones, who was
involved in a fight with another detainee four days before Holden’s altercation.
Holden contends the prison officials were deliberately indifferent to his safety
because the officials failed to take precautions to protect him despite being aware of
the danger sex offenders face in the prison population and the risk Jones posed to
Holden. We disagree.
Holden was not placed in the general prison population, but was held in the
protective custody pod, designed to provide greater supervision and security for
inmates more likely to be assaulted. Holden claims Jones’ previous victim was a sex
offender, but fails to show anything in the record to establish this other inmate was
a sex offender or Jones suspected the other inmate was a sex offender.
Even if we assume for summary judgment purposes Holden presented
sufficient evidence that he faced a substantial risk of serious harm, Holden fails to
establish the prison officials knew of and were deliberately indifferent to the danger.
“‘[D]eliberate indifference includes something more than negligence but less than
actual intent to harm;’ it requires proof of a reckless disregard of the known risk.”
Jackson v. Everett, 140 F.3d 1149, 1152 (8th Cir. 1998) (quoting Newman v. Holmes,
122 F.3d 650, 653 (8th Cir. 1997)).
Holden was imprisoned in the protective custody pod, which offered greater
supervision and protection for vulnerable detainees. There is no evidence that, before
the assault, Jones, Brown, or Kelso had in any way threatened Holden. Holden had
not told any of the prison officials he felt threatened. An inmate’s history of violence
alone is insufficient to impute to prison officials subjective knowledge of the inmate’s
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danger to harm other inmates. See Norman v. Schuetzle, 585 F.3d 1097, 1104-06 (8th
Cir. 2009). Courts “must give substantial deference to prison officials to determine
the best methods for dealing with dangerous inmates in the volatile environment that
is prison life.” Id. at 1105. Holden presented no evidence any of the prison officials
were actually aware of this prior incident involving Jones or had any knowledge as
to the reason for the altercation. Holden offered no evidence the prison officials had
any knowledge of any specific danger posed to Holden by Jones in the protective
custody pod. We determine the evidence presented is insufficient to show the prison
officials knew of and disregarded a known risk.
C. Adequate Medical Treatment
Holden asserts the prison officials failed to provide adequate medical treatment
for his tooth pain. “Deliberate indifference to serious medical needs of prisoners
constitutes the unnecessary and wanton infliction of pain proscribed by the Eighth
Amendment.” McRaven v. Sanders, 577 F.3d 974, 979 (8th Cir. 2009) (quoting
Estelle v. Gamble, 429 U.S. 97, 104 (1976)). This indifference extends to “prison
guards in intentionally denying or delaying access to medical care or intentionally
interfering with the treatment once prescribed.” Id.
To show the prison officials failed to provide adequate medical treatment,
Holden must prove “(1) he suffered from an objectively serious medical need, and
(2) defendants knew of the need yet deliberately disregarded it.” Hartsfield v.
Colburn, 371 F.3d 454, 457 (8th Cir. 2004). “A serious medical need is one that has
been diagnosed by a physician as requiring treatment, or one that is so obvious that
even a layperson would easily recognize the necessity for a doctor’s attention.”
Coleman v. Rahija, 114 F.3d 778, 784 (8th Cir. 1997). A prisoner alleging a delay
in treatment must present verifying medical evidence that the prison officials
“ignored an acute or escalating situation or that [these] delays adversely affected his
prognosis.” See Reece v. Groose, 60 F.3d 487, 491 (8th Cir. 1995) (quoting
Beyerbach v. Sears, 49 F.3d 1324, 1326 (8th Cir. 1995), abrogated on other grounds
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by Johnson v. Jones, 515 U.S. 304 (1995), as recognized in Reece, 60 F.3d at 492
(internal quotation marks omitted)).
Holden contends his tooth pain was a serious medical need. In support of this
contention Holden cites several of our previous holdings where we found obvious and
serious dental problems constituted a serious medical need. See McAlphin v. Toney,
281 F.3d 709, 711 (8th Cir. 2002) (holding a plaintiff who claimed five prior delayed
tooth extractions with two more extractions necessary and still delayed, and a
spreading mouth infection, demonstrated a sufficient allegation of imminent danger
of physical injury under 28 U.S.C. § 1915(g)); Hartsfield, 371 F.3d at 457
(concluding a plaintiff who had severe pain “from loose and infected teeth, which
caused blood to seep from his gums, swelling, and difficulty sleeping and eating” had
alleged an objectively serious medical need for dental care in an Eighth Amendment
§ 1983 action); Boyd v. Knox, 47 F.3d 966, 969 (8th Cir. 1995) (deciding a “three-
week delay in dental care, coupled with knowledge of the inmate-patient’s suffering,
can support a finding of an Eighth Amendment violation under section 1983”).
Holden’s cases actually illustrate why his tooth pain did not constitute a serious
medical need. In each of these cases the inmate either showed outward signs of
injury, such as bleeding and swelling, that a layperson would recognize or established
a medical professional diagnosed the dental pain as requiring treatment. In contrast,
there is no evidence Holden’s tooth pain was as severe or obvious as in the cited
cases. Nurse Porter evaluated Holden’s teeth and gums on multiple occasions and
never noted bleeding, swelling, infection or other visible symptoms of tooth pain, nor
did she determine Holden’s tooth pain required treatment. Holden was observed
eating without difficulty. Holden also offered no evidence any delay in treatment
negatively impacted his prognosis.
If we assume Holden’s dental pain was a serious medical need, Holden must
also offer evidence to show the prison officials knew about and disregarded his
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serious dental care need. The level of culpability required to demonstrate deliberate
indifference on the part of prison officials is equal to criminal recklessness. See
Jenkins v. Cnty. of Hennepin, 557 F.3d 628, 632 (8th Cir. 2009). For the prison
officials to be liable for deliberate indifference to a serious dental need, “the official
must both be aware of facts from which the inference could be drawn that a
substantial risk of serious harm exists, and he must also draw the inference.” Farmer,
511 U.S. at 837.
In support of Holden’s claim the prison officials were aware of and disregarded
his tooth pain, Holden identifies his Sick Call Request Forms, which the prison
officials delivered to Nurse Porter. These forms alone are insufficient to establish the
prison officials were aware of Holden’s dental need. Prison officials lacking medical
expertise are entitled to rely on the opinions of medical staff regarding inmate
diagnosis and the decision of whether to refer the inmate to outside doctors or
dentists. See Camberos v. Branstad, 73 F.3d 174, 176 (8th Cir. 1995). The prison
officials did not sign or in any way acknowledge the contents of the Sick Call
Request Forms, and simply delivered them to Nurse Porter upon Holden’s request.
The prison officials lacked both medical and dental expertise and were entitled to rely
upon Nurse Porter’s medical opinion. Holden’s later refusal to have his tooth
extracted undermines his claim of deliberate indifference. See Logan v. Clarke, 119
F.3d 647, 649-50 (8th Cir. 1997).
The prison officials fulfilled their duties in delivering Holden’s requests to the
medical staff of the jail, and delivery of the requests alone is insufficient to establish
subjective knowledge of, let alone deliberate indifference to, a serious dental need.
We conclude Holden failed to proffer evidence the prison officials provided
constitutionally inadequate medical treatment.
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Because we conclude Holden failed to demonstrate the deprivation of a
constitutional right, we do not discuss further the prison officials’ claim of qualified
immunity.
III. CONCLUSION
We affirm.
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