Ceasar v. NH Department of Corrections et al

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEW HAMPSHIRE
Michael James Ceasar
v. Case No. 24-cv-37-LM-AJ
New Hampshire Department of
Corrections et al.1
Report and Recommendation
Self-represented plaintiff Michael James Ceasar, who is
incarcerated in the custody of the New Hampshire Department of
Corrections (“NHDOC”), filed this civil rights action under 42
U.S.C. § 1983, alleging that he received inadequate medical care
while housed at the New Hampshire State Prison. In his
Complaint (Doc. no. 1), Ceasar asserts that NHDOC medical
personnel, and other non-NHDOC medical providers who treated him
during his incarceration, violated his Eighth Amendment right to
receive adequate medical care in prison. The Complaint is
1 In the Complaint (Doc. no. 1), the plaintiff identifies
the following defendants to this action: New Hampshire
Department of Corrections (“NHDOC”); NHDOC Medical Departments;
NHDOC Commissioner Helen Hanks; NHDOC physicians Dr. John
Eppolito and Dr. Celia Englander; NHDOC nurses Judy Baker,
Kendra Donohue, and S. Mullins; New Hampshire NeuroSpine
Institute (“NSI”); NSI physician Dr. N. Ross Jenkins; NSI
Physicians Assistant David Molind; Catholic Medical Center
(“CMC”); CMC or NSI physician Dr. Paul P. Wang; Cheshire Medical
Center Dartmouth-Hitchcock Health Information Services
physicians Dr. Adam M. Pearson, Dr. Steven P. Baltic, and Dr.
Jeffrey A. Krause; and medical providers/personnel identified as
“John Does” and “Jane Does.”
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before this magistrate judge for preliminary review pursuant to
28 U.S.C. § 1915A(a) and LR 4.3(d)(1).
Preliminary Review Standard
The court conducts preliminary review of prisoner
complaints under 28 U.S.C. § 1915A(a) and LR 4.3(d)(1) to
determine, among other things, whether the complaint states a
claim upon which relief might be granted. In conducting its
preliminary review, the court must construe the complaint
liberally. See Erickson v. Pardus, 551 U.S. 89, 94 (2007) (per
curiam). To determine whether to dismiss claims for failure to
state a claim, the court takes as true the factual content in
the complaint and inferences reasonably drawn from those facts,
strips away legal conclusions, and considers whether the
plaintiff has stated a claim. See Hernandez-Cuevas v. Taylor,
723 F.3d 91, 102-03 (1st Cir. 2013) (citing Ashcroft v. Iqbal,
556 U.S. 662, 678 (2009)). The court may dismiss claims
asserted in a prisoner’s complaint if the court lacks
jurisdiction, a defendant is immune from the relief sought, the
complaint fails to state a claim, or the action is frivolous or
malicious. See 28 U.S.C. § 1915A(b).
Background
I. Facts Asserted in the Complaint
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In his Complaint, Ceasar provides a detailed description of
his medical treatment while incarcerated in NHDOC custody.
Ceasar’s allegations show that he has had back problems since at
least 2005. Since then, he has sought and received medical care
from NHDOC medical personnel for his back pain, including pain
medication and physical therapy.
The NHDOC Medical Department has also sent Ceasar for
outside evaluation and treatment, including x-rays, MRIs, and
consultations with private doctors and surgeons at the New
Hampshire NeuroSpine Institute (“NSI”), Catholic Medical Center
(“CMC”), and Cheshire Medical Center Dartmouth-Hitchcock Health
Information Services (“CMCDH”). Ceasar had his first back
surgery in 2019, and another back surgery in October 2021.
Since his first back surgery, it appears his care and condition
has been followed by NHDOC medical personnel and a number of
outside medical providers.
The surgeon who performed Ceasar’s second surgery saw
Ceasar for a post-surgical follow-up appointment. At that
appointment, the surgeon stated that Ceasar’s back problems
required an additional surgery, but that issues with Ceasar’s
kidneys, which were discovered on a 2019 MRI related to his back
problems, would need to be evaluated and addressed before the
third surgery could be scheduled.
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After that, a medical provider at the NHDOC discontinued
one of his medications in response to Ceasar’s kidney issues.
Between October 2021 and February 2024, the NHDOC arranged for
Ceasar to see specialists in urology, cardiology, and nephrology
concerning his kidney issues. Those specialists expressed
concern that Ceasar’s left kidney has failed. At the time he
filed this action, Ceasar was awaiting a decision from his
urologist concerning whether his left kidney had to be removed,
and a determination of when he would be able to obtain his third
back surgery.
II. Claims
Seeking damages and injunctive relief, Ceasar asserts the
following claims:
1. The NHDOC; and NHDOC officials, medical providers, and
staff, violated Ceasar’s Eighth Amendment right to
receive adequate medical care for his serious medical
needs during his incarceration by:
a. Providing him with only “the very basic amount of
medical treatment” for his serious medical
problems, which failed to properly address his
medical needs;
b. Denying him adequate pain medication to treat his
severe back pain;
c. Failing to timely arrange for specialized medical
care outside of the prison for his back and
kidney issues;
d. Failing to properly implement medical
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recommendations and orders made by outside
medical specialists;
e. Failing to arrange for adequate diagnostic and
treatment for his back and kidney issues;
f. Failing to adequately address an issue with his
medication which may have caused or exacerbated
his kidney issues; and
g. Failing to provide medical services which are
“reasonably commensurate with modern medical
science and of a quality acceptable within
prudent professional standards,” in favor of the
least expensive services available.
2. The New Hampshire Neurospine Institute, the Catholic
Medical Center, and the Cheshire Medical Center
Dartmouth-Hitchcock Health Information Services; and
providers at those institutions; violated Ceasar’s
Eighth Amendment right to receive adequate medical
care for his serious medical needs during his
incarceration by:
a. Providing him with only “the very basic amount of
medical treatment” for his serious medical
problems which failed to properly address his
medical needs;
b. Denying him adequate pain medication to treat his
severe back pain;
c. Failing to arrange for adequate diagnostic and
treatment for his back and kidney issues;
d. Failing to adequately address an issue with his
medication which may have caused or exacerbated
his kidney issues; and
e. Failing to provide medical services which are
“reasonably commensurate with modern medical
science and of a quality acceptable within
prudent professional standards,” in favor of the
least expensive services available.
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Discussion
I. Statute of Limitations
As noted above, Ceasar alleges deficiencies in his medical
care at the NHDOC beginning in 2005 which violated his rights
under the Eighth Amendment. Prisoner suits alleging such
violations are provided a cause of action by 42 U.S.C. § 1983.
Section 1983 “borrow[s] the statute of limitations
applicable to personal injury actions under the law of the forum
state.” Parker v. Moffit, Case No. 25-cv-59-JL-AJ, 2025 U.S.
Dist. LEXIS 215192, at *5-*6, 2025 WL 3036913, at *2 (D.N.H.
Oct. 8, 2025) (citations and internal quotation marks omitted),
R&R approved, 2025 U.S. Dist. LEXIS 213875, at *1, 2025 WL
3034917, at *1 (D.N.H. Oct. 30, 2025). In New Hampshire, the
statute of limitations for personal injury claims is three
years. See McNamara v. City of Nashua, 629 F.3d 92, 95 (1st
Cir. 2011); N.H. Rev. Stat. Ann. § (“RSA”) 508:4. To fall
within the limitations period, therefore, Ceasar’s claims had to
have accrued within three years before he filed this action.
See id.
Section 1983 claims generally accrue when the
plaintiff knows, or has reason to know of the injury
on which the action is based, and a plaintiff is
deemed to know or have reason to know at the time of
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the act itself and not at the point that the harmful
consequences are felt.
Gorelik v. Costin, 605 F.3d 118, 122 (1st Cir. 2010) (internal
quotation marks and citation omitted).
Ceasar filed this action on January 31, 2024.2 Accordingly,
to be actionable here, Ceasar’s claims must arise from injuries
which occurred on or after January 31, 2021. To the extent
Ceasar may have intended to allege a continuing violation that
would render his pre-January 31, 2021 injuries actionable here,
his allegations fail to state that claim. “An actionable
continuing violation occurs when a series of wrongful acts
cumulatively causes an injury within the limitations period but
not when a plaintiff's rights are violated outside the
limitations period and then continue to be violated over a
period of time, extending into the limitations period.”
Gorelik, 605 F.3d at 122; see also Ayala v. Shinseki, 780 F.3d
52, 57 (1st Cir. 2015). “In other words, once a plaintiff is
injured by a discrete act or omission and knows or should know
2 The Complaint (Doc. no. 1) in this case was received by
the court, and docketed, on February 5, 2024. The Complaint
itself, however, is dated January 31, 2024. Under the “prison
mailbox rule,” a prisoner’s filing is complete when the filing
is deposited into the prison’s mail system. See Casanova v.
Dubois, 304 F.3d 75, 79 (1st Cir. 2002). Because the court
cannot ascertain precisely when Ceasar deposited the Complaint
into the prison mail system, the court deems the Complaint filed
on the date he signed it, January 31, 2024.
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of the injury, the limitations period begins to run then, even
when additional misconduct occurs.” Gray v. Englander, No. 20-
cv-155-SE, 2022 U.S. Dist. LEXIS, at *5, 2022 WL 1913922, at *2
(D.N.H. Apr. 20, 2022), R&R adopted, 2022 U.S. Dist. LEXIS
99209, at *1, 2022 WL 1912845, at *1 (D.N.H. June 3, 2022). The
court therefore construes Ceasar’s allegations concerning
injuries which occurred prior to January 31, 2021, as background
information and context for his current claims. See Rae v.
Woburn Pub. Schs., 113 F.4th 86, 110 (1st Cir. 2024)
(acknowledging that events which occurred outside of limitations
period may be relevant to a plaintiff’s timely claims), cert.
denied, 145 S. Ct. 1431 (2025).
II. Section 1983 – State Action Requirement
In the Complaint, Ceasar names the NHDOC, the NHDOC Medical
Department, the NHDOC Commissioner, and individual doctors and
nurses who work at the NHDOC as defendants. Ceasar also names
as defendants NSI, CMC, and CMCDH, and individual doctors and
nurses employed by those private practices. Additionally,
Ceasar asserts claims against John and Jane Doe defendants who
he states are employed by the NHDOC and/or the private
institutions listed above. Ceasar alleges that all of the
defendants acted and continue to act under color of state law.
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“[Section] 1983 allows private parties to sue state actors
who violate their rights under the Constitution and laws of the
United States.” Medina v. Planned Parenthood S. Atl., 145 S.
Ct. 2219, 2227 (2025) (internal quotation marks and citation
omitted); see also Segrain v. Duffy, 118 F.4th 45, 56 (1st Cir.
2024) (“Section 1983 provides a cause of action for monetary
damages against state actors sued in their individual capacities
who acted under color of state law to deprive plaintiff of a
right guaranteed by the Constitution or by federal law.”). To
state a claim under § 1983, the plaintiff must show that a state
actor violated his rights secured by the Constitution or federal
law. See Pike v. Budd, 133 F.4th 74, 83 (1st Cir. 2025).
Section 1983 does not provide a means to assert constitutional
claims against private actors. See Thornton v. Ipsen
Biopharms., Inc., 126 F.4th 76, 84 (1st Cir. 2025).
In the context of prison medical care, a private doctor may
be deemed to be a state actor if the state contracts with the
doctor to employ that doctor to provide medical care to
prisoners so that the doctor is contractually bound to the
state. See Estades-Negroni v. CPC Hosp. San Juan Capestrano,
412 F.3d 1, 7 (1st Cir. 2005); Audette v. Carrillo, Civil Action
No. 15-cv-13280-ADB, 2019 U.S. Dist. LEXIS 1447, at *16, 2019 WL
108880, at *6 (D. Mass. Jan. 4, 2019) (“ Medical service
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providers may avoid the umbrella of state action when they are
asked to treat inmates by refusing to provide medical services,
or where they are obligated by law to provide treatment, if they
are not a part of the state’s standard system for providing
medical care to inmates.”). Ceasar alleges nothing that
suggests that the private practices and private medical care
providers he names as defendants were contractually bound to the
NHDOC or the State of New Hampshire as state employees, or that
they were part of the NHDOC’s standard system of providing
medical care. Instead, he describes those defendants as medical
providers practicing outside of the prison system. Ceasar has
not alleged facts to show that the private medical practices and
providers named as defendants here acted under state law in
providing medical care and treatment to him, and therefore, they
are not subject to suit under § 1983. Accordingly, the district
judge should dismiss those defendants from this action.
III. Eighth Amendment Inadequate Medical Care
“Prison officials violate the Eighth Amendment when they
act with deliberate indifference to a prisoner’s serious medical
needs.” Lech v. von Goeler, 92 F.4th 56, 74 (1st Cir. 2024)
(citing Estelle v. Gamble, 429 U.S. 97, 104 (1976)). To succeed
on an Eighth Amendment claim challenging the adequacy of his
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medical care, a prisoner must show both a serious medical need
and that prison officials were deliberately indifferent to that
need. See Lech, 92 F.4th at 74-75. “Prison officials are
deliberately indifferent when they know[] of and disregard[] an
excessive risk to inmate health or safety,” in that they “either
deny needed medical treatment in order to punish the inmate, or
display wanton or criminal recklessness in the treatment
afforded.” Id. at 75 (internal quotation marks and citations
omitted).
“[P]rison officials are not required to render ideal care,
let alone cater to an inmate's preferred healthcare regimen.
They simply must provide care at ‘a level reasonably
commensurate with modern medical science and of a quality
acceptable within prudent professional standards.’”
Snell v. Neville, 998 F.3d 474, 495 (1st Cir. 2021) (citations
omitted). Further, “courts have consistently refused to create
constitutional claims out of disagreements between prisoners and
doctors about the proper course of a prisoner’s medical
treatment.” Watson v. Canton, 984 F.2d 537, 540 (1st Cir.
1993). Further, disagreement between two medical professionals
about a prisoner’s treatment “will generally be insufficient to
establish an Eighth Amendment violation.” Snell, 998 F.3d at
495 (citing Ruiz Rosa v. Rullán, 485 F.3d 150, 156 (1st Cir.
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2007)).
For purposes of preliminary review, the court finds that
the medical conditions underlying Ceasar’s Eighth Amendment
claims, as described in the Complaint, are sufficiently serious
to constitute a serious medical need. The court therefore
considers whether Ceasar has alleged sufficient facts to
demonstrate that any defendant acted with deliberate
indifference to deny him medical care for his serious medical
needs. To that end, Ceasar alleges that: the NHDOC defendants
should have referred him to providers outside of the prison; the
defendants should have evaluated and treated him earlier for his
kidney issues so that he could have his third back surgery, the
NHDOC defendants did not properly interpret or follow medical
recommendations made by outside medical professionals, the
defendants prescribed him medication that caused harm to his
kidneys, and that the medical care he received fell below modern
standards and prudent professional standards.
Ceasar’s factual allegations demonstrate that he has
received extensive medical care for his back and kidney
conditions, both from NHDOC medical providers and staff, and
from outside specialists to whom the NHDOC has provided Ceasar
access. Those efforts include numerous appointments with NHDOC
and outside medical specialists, at least two different
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surgeries, physical therapy, and medication.
To the extent Ceasar disagrees with the care and treatment
that he is receiving for his serious medical needs, or would
prefer different treatment, his allegations do not state a claim
under the Eighth Amendment. Instead, Ceasar argues that he is
not receiving the best medical care available, that he is not
receiving the medical care and treatment he prefers, and that
NHDOC medical providers have made medical decisions different
than those of outside medical providers. Accordingly, Ceasar’s
allegations are not sufficient to demonstrate that any state
defendant violated his Eighth Amendment right to obtain adequate
medical care in prison for his serious medical needs, and the
district judge should dismiss those claims.
Conclusion
For the foregoing reasons, the district judge should
dismiss the Complaint (Doc. no. 1) in its entirety. Any
objections to this Report and Recommendation must be filed
within fourteen days of receipt of this notice. See Fed. R.
Civ. P. 72(b)(2). The fourteen-day period may be extended upon
motion.
Only those issues raised in the objection to this Report
and Recommendation are subject to review in the district
court. See Sch. Union No. 37 v. United Natl Ins. Co., 617 F.3d
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554, 564 (1st Cir. 2010). Any issues not preserved by such
objection(s) are precluded on appeal. See id. Failure to file
any objections within the specified time waives the right to
appeal the district court’s order. See Santos-Santos v. Torres-
Centeno, 842 F.3d 163, 168 (1st Cir. 2016).
______________________________
Andrea K. Johnstone
United States Magistrate Judge
December 3, 2025
cc: Michael James Ceasar, pro se
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