Our caselaw firmly establishes that a doctor’s exercise of “considered medical judgment” fails to fulfill the subjective component, “absent an extraordinary degree of neglect”, where a prison physician “responds to an obvious risk” with “patently unreasonable” treatment. Self, 439 F.3d at 1232. We have only found a sufficiently extraordinary degree of neglect under three circumstances: first, where a doctor “recognizes an inability to treat the patient due to the seriousness of the condition and his corresponding lack of expertise” but refuses or unnecessarily delays a referral: second, where a doctor fails to treat a medical condition “so obvious that even a layman would recognize the condition”; and finally, where a doctor entirely denies care “although presented with recognizable symptoms which potentially create a medical emergency.
Spencer v. Abbott, No. 16-4009, 2017 WL 6016309 (10th Cir. 2017)
Case Citation: Spencer v. Abbott, No. 16-4009, 2017 WL 6016309 (10th Cir. 2017)
Holding: The Tenth Circuit Court of Appeals held that defendants Chris Abbott, Craig Jensen, Jerry Miller, and Rodger MacFarlane are entitled to qualified immunity from further suit and damages.
Judgment: REVERSED and REMANDED.
Fact Background: On July 15, 2008, Brian Maguire, an inmate at a Utah State Prison, submitted an Inmate Health Request form claiming that he was “losing the use of his “left arm and hand.” A prison guard escorted him to the prison physician’s assistant Chris Abbott after noticing Maguire was dragging his left leg. Mr. Abbott prescribed Maguire a muscle relaxant and physical therapy, diagnosing him with muscle spasms. That evening, Maguire’s left arm began seizing, his left leg became numb, and Maguire began convulsing. He called “man down” and a prison guard, and two EMTs determined he had a seizure and moved his mattress to the ground to prevent a fall in the event he seizes again. Throughout the night, Maguire pleaded for assistance from passing prison guards performing hourly inmate counts. The prison guards ignored his requests. The next morning, July 16, 2008, prison guards found Maguire immobile on the floor with urine in his jumpsuit. When the prison guards transferred Maguire to the University of Utah Medical Center, the doctors determined Maguire had suffered a severe, life-threatening stroke.
Procedural Background: Mr. Maguire filed a civil-rights complaint under section 1983 against Abbott, the EMTs and Miller. The defendants moved for summary judgement on the grounds of qualified immunity but were denied by the district court on December 15, 2015. Defendants appealed.
Opinion: The Tenth Circuit REVERSED the district court’s denial of summary judgment on qualified-immunity grounds to Mr. Abbott and EMTs Jensen and MacFarlane. The Eighth Amendment prohibits deliberate indifference to an inmate’s serious medical needs. The Court determined that “inadvertent failure to provide adequate medical care” or a negligent diagnosis “fail to establish the requisite culpable state of mind.” Wilson v. Seiter, 501 U.S. 294, 299, 111 S. Ct. 2321, 115 L.Ed.2d 271. Though the Court agreed with Plaintiff that “In light of Mr. Maguire’s subsequent stroke, a plausible argument could be made that Mr. Abbott’s conclusion that Mr. Maguire suffered from muscle spasms was off-base … that he misdiagnosed Mr. Maguire,” the Court still determined that “Mr. Abbott did not ignore the medical need that he perceived; rather, he affirmatively acted to address it by prescribing a muscle relaxant and physical therapy.” Further, qualified immunity applies to all who do not violate clearly established law—