Opinion
8:22-cv-03098-BHH-JDA
04-25-2023
Michael J. Coffy, Plaintiff, v. Christian Graziana, Abigail Duffy, Wellpath, Carrie Fabel, D.C.I., Defendants.
REPORT AND RECOMMENDATION OF MAGISTRATE JUDGE
Jacquelyn D. Austin United States Magistrate Judge
This matter is before the Court on a motion for preliminary injunction and temporary restraining order (“TRO”) by Plaintiff [Doc. 13]; a motion to dismiss by Defendants Carrie Fabel and Dialysis Clinic, Inc. (“DCI”) (the “DCI Defendants”) [Doc. 17]; a motion to dismiss by Defendant Wellpath [Doc. 39]; a motion to dismiss or, in the alternative, for summary judgment by Defendants Kristina Graziano and Abigail Duffy (the “Sheriff's Office Defendants”) [Doc. 49]; and a motion to amend/correct evidence by Plaintiff [Doc. 61]. Pursuant to the provisions of 28 U.S.C. § 636(b)(1)(B) and Local Civil Rule 73.02(B)(2), D.S.C., this magistrate judge is authorized to review all pretrial matters in cases filed under 42 U.S.C. § 1983 and to submit findings and recommendations to the District Court.
Dialysis Clinic, Inc. clarified that it was incorrectly named as D.C.I. in the caption of Plaintiff's complaint. [Doc. 17-1 at 1.]
Although Graziano is identified as Christian Graziana in the Complaint, she has clarified that her name is Kristina Graziano. [Doc. 49 at 1.]
On August 8, 2022, Plaintiff, proceeding pro se, filed this action alleging violations of his constitutional rights pursuant to § 1983 and filed a motion for preliminary injunction and TRO. [Docs. 1; 13.] The DCI Defendants filed a motion to dismiss on November 4, 2022. [Doc. 17.] The same day, the Court issued an Order pursuant to Roseboro v. Garrison, 528 F.2d 309 (4th Cir. 1975), advising Plaintiff of the summary judgment/dismissal procedure and the possible consequences if he failed to respond adequately. [Doc. 19.] On December 16, 2022, Wellpath filed a motion to dismiss and the Court issued a second Roseboro Order. [Docs. 39; 41.] On December 30, 2022, the Sheriff's Office Defendants filed a motion to dismiss or, in the alternative, for summary judgment. [Doc. 49.] On January 3, 2023, the Court issued a third Roseboro Order. [Doc. 50.] The parties have filed a letter, additional attachments, responses, and replies to the various motions. [Docs. 25; 26; 28; 38; 40; 44; 52; 53; 58; 59.] Additionally, on March 24, 2023, the Clerk docketed a motion to amend/correct evidence from Plaintiff, and Defendants filed responses on April 6 and 7, 2023, opposing the motion. [Docs. 61; 62; 63; 64.] The motions are all ripe for review.
A prisoner's pleading is considered filed at the moment it is delivered to prison authorities for forwarding to the court. See Houston v. Lack, 487 U.S. 266, 270 (1988). Construing the filing date in the light most favorable to Plaintiff, this action was filed on August 8, 2022. [Docs. 1 at 16 (signature on the Complaint dated August 8, 2022); 13 at 5 (signature on motion for TRO and preliminary injunction dated August 8, 2022).]
Plaintiff has filed both a complaint on a standard Court form [Doc. 1], as well as documents styled “Memorandum of Law and Support of Plaintiff['s] Motion for Temporary Restraining Order and Preliminary Injunction” [Doc. 13], and “Declaration of Support of Plaintiff['s] Motion for Temporary Restraining Order and Preliminary Injunction” [Docs. 131]. To the latter two documents, Plaintiff attached a document further expanding upon his allegations [Doc. 13-2 at 1-5]. As noted supra note 3, these documents are all deemed to have been filed on August 8, 2022. Construing Plaintiff's pro se pleadings liberally, the Court construes all of these documents together as Plaintiff's Complaint. See Crawford v. Ocwen Loan Servicing, LLC, No. 1:17-cv-3830-WSD, 2017 WL 4356886, at *1 (N.D.Ga. 2017) (construing “‘Complaint of [Irreparable] Damage Planned by Defendants'” and “‘Notice and Application for Emergency Preliminary Injunction'” together as the plaintiff's complaint); Wallace v. S.C. Dep't of Corrs., No. 3:07-271-HMH-JRM, 2007 WL 1068236, at *1, 4 (D.S.C. Mar. 29, 2007) (construing pro se motion for TRO liberally as both a complaint and a request for preliminary injunction). The facts in this Background Section are taken directly from those documents.
A pretrial detainee, Plaintiff alleges that on June 28, 2021, he arrived at the Al Cannon Detention Center (the “Detention Center”) in Charleston, South Carolina suffering from Stage 4 renal disease. [Docs. 1 at 4, 5; 13 at 1.] Plaintiff contends that Wellpath is an entity that provided health care for detainees at the Detention Center, that DCI is a clinic that was under contract with Wellpath to care for and treat detainees who were dialysis patients, and that Nurse Fabel is a registered nurse who was employed by DCI to care for and treat dialysis patients. [Doc. 1 at 3, 7, 8.] He asserts that within a few days of arriving at the Detention Center he began dialysis treatment with Nurse Fabel. [Doc. 1 at 5.] He claims the medical care provided for dialysis patients at the Detention Center is “inadequate, unsatisfactory, and less than exempl[]ary.” [Id.]
Plaintiff alleges that on December 31, 2021, and again on August 29, 2022, Nurse Fabel “infiltrated [Plaintiff's] access/fistula, causing the arm to swell up and become heavily bruised.” [Doc. 13-2 at 2; see Doc. 1 at 7.] These incidents “were reported to nurses and doctors.” [Doc. 13-2 at 2.] He also asserts that “on many occa[]sions” during the period spanning July 1, 2021 through April 2022 Nurse Fabel “removed more fluids than the numbers called for” and he “passed out.” [Docs. 1 at 7; 13-2 at 2; see Doc. 13-1 at 1.] He contends that Nurse Fabel's “incompetence of misprogram[m]ing numbers and removing to[o] much fluid[] from patients is very clear and evident” and that she removed too much fluid “intentionally.” [Doc. 1 at 8, 10.] He alleges that she “refused to use her protocols to call for help or assistance from other nurses or doctors when there were incidents” and that “she never wr[ote] down in her daily flow-sheets the truth about what happened.” [Id. at 7; see Doc. 13-2 at 2 (“Whenever there is an incident of her malpractice[] she never notes the truth of the incidents.”).] He asserts that Nurse Fabel works alone and that there are no cameras in the dialysis clinic. [Docs. 13 at 2; 13-2 at 4.]
“A hemodialysis access, or vascular access, is a way to reach the blood for hemodialysis.” Hemodialysis Access, National Kidney Foundation, https://www.kidney.org/ atoz/content/hemoaccess (last visited Apr. 4, 2023). “The access allows blood to travel through soft tubes to the dialysis machine where it is cleaned as it passes through a special filter, called a dialyzer.” Id. A “fistula” is an access made by minor surgery that joins an artery and vein” in the patient's arm. Id. For patients with fistula access, a “nurse or technician will place two needles into the access at the beginning of each treatment.” Id. “These needles are connected to soft tubes that go to the dialysis machine. Id. The patient's “blood goes to the machine through one of the tubes, gets cleaned in the dialyzer, and returns to [the patient] through the other tube.” Id.
Plaintiff alleges there were “major issues of machine maintenance and breakdowns”; that “failed services unprovided to the dialysis patients treatment care plan” did not meet government standards; and that the Detention Center “staff refuse[d] to make necessary changes.” [Doc. 1 at 5; see Docs. 13 at 1; 13-1 at 1.] He contends he has experienced chest pain, heart pain, and shortness of breath since being on dialysis at the Detention Center. [Docs. 1 at 7; 13 at 1; 13-1 at 1.] Plaintiff alleges that one machine in particular (“Machine #15”) is problematic. [Doc. 13-2 at 3.] Plaintiff alleges that he and another prisoner had complained that that machine “pulls harder than” the other machines, “causing problems such as . . . chest pain, low blood pressure drops, passing out, breathing complications, cramping, and tiredness lasting into the next day.” [Id.] Plaintiff asserts that the other prisoner refused to use that machine, but Plaintiff has continued to do so as Nurse Fabel has ignored his complaints. [Id.] Plaintiff alleges that now he is “having bad experiences on th[e] machine.” [Id.]
As for DCI, Plaintiff alleges it “fail[ed] to provide [him] with safe adequate medical care” and “failed to protect [him] from any harmful and unlawful acts.” [Doc. 1 at 8.] He asserts DCI has been “made aware” of “complaints” about Nurse Fabel's “attitude, behavior, work, and less than adequate medical care.” [Id.] He claims that DCI “has not and is not providing all the services a clinic operating under [the South Carolina Department of Health and Environmental Control] is supposed to provide to dialysis patients” in that “there is no clinic [manager], no social worker, [and] no dietician” and “the only person present in this clinic on a day to day operation is the nurse doing the patient[']s treatment.” [Id.; see Doc. 13-2 at 3-5.]
As for Wellpath, Plaintiff alleges that it “has done nothing to address or correct the problems” and has provided “careless oversight of” DCI and Nurse Fabel [Doc. 1 at 8.] He contends that “Wellpath was put on notice repeatedly about [Nurse Fabel's] incompetence and substandard performances medically, and her less than exempl[]ary professional attitude and behavior” because Nurse “Fabel has had to[o] many incidents resulting in injured patents.” [Id. at 7.]
As for the Sheriff's Office Defendants, Graziano is the Charleston County Sheriffand Plaintiff asserts that Duffy is the Detention Center's chief facility director. [Id. at 2-3, 6.] He claims that the Sheriff's Office Defendants are liable for the actions of the contracted codefendant third-party medical providers because the Sheriff's Office Defendants are responsible for the oversight and day-to-day operations of the Detention Center. [Id. at 6.] Plaintiff essentially alleges that Nurse Fabel's dialysis administration amounted to medical malpractice and that the Sheriff's Office Defendants failed to protect Plaintiff because they did nothing to remove Nurse Fabel from her duties. [Id.]
Plaintiff identifies her in the Complaint as the Sheriff of the City of Charleston [Doc. 1 at 2], but the Court takes judicial notice of the fact that she is the Sheriff of Charleston County, see https://www.charlestoncounty.org/elected/bio-sheriff.php (last visited Apr. 4, 2023), as Plaintiff acknowledges [Doc. 58 at 2].
Plaintiff notes in briefs opposing Defendants' motions that Nurse Fabel stopped working for DCI in September 2022. [Docs. 44 at 6, 12; 58 at 9.]
Plaintiff also asserts that the dietary supplementation plan for renal patients on dialysis is insufficient and does “not meet the medical needs/guidelines of” the federal government. [Doc. 13 at 1-2; see Doc. 13-2 at 3.] He complains that there is no dietician in the kitchen; that his meals lack variety; that he should not be served soy and processed meats; and that the portions he receives are insufficient. [Docs. 13 at 2; 13-2 at 3-4.] He also alleges that he has not seen a social worker or dietician or had a consultation with any DCI employee. [Doc. 13 at 2.]
Plaintiff contends that the actions he complains of amount to gross negligence, malpractice, malfeasance, and conspiracy, and he alleges violations of his rights to due process and against deliberate indifference and cruel and unusual punishment. [Doc. 1 at 4.] Plaintiff's claimed injuries are (1) he has passed out several times during dialysis; (2) his access arm has been infiltrated and swollen; (3) he has had heart and chest pain from the dialysis machines; and (4) he has blurred vision in his left eye. [Id. at 9-10.] Plaintiff has named all Defendants in both their individual and official capacities. [Id. at 2-3.] As his relief, he seeks (1) payment “for pain and suffering, actual/punitive damages”; (2) payment “for every day of [his] time spent in incarceration”; (3) payment for “lost wages”; (4) payment for “filing costs/fees” and “attorney fees”; (5) payment in the amount of “$2,400,000”; and (6) his release from detention. [Id. at 10.]
APPLICABLE LAW
Liberal Construction of Pro Se Complaint
Plaintiff brought this action pro se, which requires the Court to liberally construe his pleadings. Estelle v. Gamble, 429 U.S. 97, 106 (1976); Haines v. Kerner, 404 U.S. 519, 520 (1972); Loe v. Armistead, 582 F.2d 1291, 1295 (4th Cir. 1978); Gordon v. Leeke, 574 F.2d 1147, 1151 (4th Cir. 1978). Pro se pleadings are held to a less stringent standard than those drafted by attorneys. Haines, 404 U.S. at 520. The mandated liberal construction means only that if the Court can reasonably read the pleadings to state a valid claim on which the plaintiff could prevail, it should do so. Barnett v. Hargett, 174 F.3d 1128, 1133 (10th Cir. 1999). A court may not construct the plaintiff's legal arguments for her. Small v. Endicott, 998 F.2d 411, 417-18 (7th Cir. 1993). Nor should a court “conjure up questions never squarely presented.” Beaudett v. City of Hampton, 775 F.2d 1274, 1278 (4th Cir. 1985).
Requirements for a Cause of Action Under § 1983
This action is filed pursuant to 42 U.S.C. § 1983, which provides a private cause of action for constitutional violations by persons acting under color of state law. Section 1983 “‘is not itself a source of substantive rights,' but merely provides ‘a method for vindicating federal rights elsewhere conferred.'” Albright v. Oliver, 510 U.S. 266, 271 (1994) (quoting Baker v. McCollan, 443 U.S. 137, 144 n.3 (1979)). Accordingly, a civil action under § 1983 allows “a party who has been deprived of a federal right under the color of state law to seek relief.” City of Monterey v. Del Monte Dunes at Monterey, Ltd., 526 U.S. 687, 707 (1999).
Section 1983 provides, in relevant part,
Every person who, under color of any statute, ordinance, regulation, custom, or usage, of any State . . . subjects, or causes to be subjected, any citizen of the United States or any person within the jurisdiction thereof to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws, shall be liable to the party injured in an action at law, suit in equity, or other proper proceeding for redress . . .42 U.S.C. § 1983. To establish a claim under § 1983, a plaintiff must prove two elements: (1) that the defendant “deprived [the plaintiff] of a right secured by the Constitution and laws of the United States” and (2) that the defendant “deprived [the plaintiff] of this constitutional right under color of [State] statute, ordinance, regulation, custom, or usage.” Mentavlos v. Anderson, 249 F.3d 301, 310 (4th Cir. 2001) (third alteration in original) (citation and internal quotation marks omitted).
The under-color-of-state-law element, which is equivalent to the “state action” requirement under the Fourteenth Amendment,
reflects judicial recognition of the fact that most rights secured by the Constitution are protected only against infringement by governments. This fundamental limitation on the scope of constitutional guarantees preserves an area of individual freedom by limiting the reach of federal law and avoids imposing on the State, its agencies or officials, responsibility for conduct for which they cannot fairly be blamed.Id. (internal citations and quotation marks omitted). Nevertheless, “the deed of an ostensibly private organization or individual” may at times be treated “as if a State has caused it to be performed.” Brentwood Acad. v. Tenn. Secondary Sch. Athletic Ass'n, 531 U.S. 288, 295 (2001). Specifically, “state action may be found if, though only if, there is such a close nexus between the State and the challenged action that seemingly private behavior may be fairly treated as that of the State itself.” Id. (internal quotation marks omitted). State action requires both an alleged constitutional deprivation “caused by the exercise of some right or privilege created by the State or by a rule of conduct imposed by the State . . . or by a person for whom the State is responsible” and that “the party charged with the deprivation [is] a person who may fairly be said to be a state actor.” Lugar v. Edmondson Oil Co., 457 U.S. 922, 937 (1982). A determination of whether a private party's allegedly unconstitutional conduct is fairly attributable to the State requires the court to “begin[ ] by identifying the specific conduct of which the plaintiff complains.” Am. Mfrs. Mut. Ins. Co. v. Sullivan, 526 U.S. 40, 51 (1999) (internal quotation marks omitted).
Motion to Dismiss Standard
Under Rule 12(b)(6) of the Federal Rules of Civil Procedure, a claim should be dismissed if it fails to state a claim upon which relief can be granted. When considering a motion to dismiss, the court should “accept as true all well-pleaded allegations and should view the complaint in a light most favorable to the plaintiff.” Mylan Lab'ys, Inc. v. Matkari, 7 F.3d 1130, 1134 (4th Cir. 1993). However, the court “need not accept the legal conclusions drawn from the facts” nor “accept as true unwarranted inferences, unreasonable conclusions, or arguments.” E. Shore Mkts., Inc. v. J.D. Assocs. Ltd. P'ship, 213 F.3d 175, 180 (4th Cir. 2000). Further, for purposes of a Rule 12(b)(6) motion, a court may rely on only the complaint's allegations and those documents attached as exhibits or incorporated by reference. See Simons v. Montgomery Cnty. Police Officers, 762 F.2d 30, 31 (4th Cir. 1985). If matters outside the pleadings are presented to and not excluded by the court, the motion is treated as one for summary judgment under Rule 56 of the Federal Rules of Civil Procedure. Fed.R.Civ.P. 12(d).
With respect to well-pleaded allegations, the United States Supreme Court explained the interplay between Rule 8(a) and Rule 12(b)(6) in Bell Atlantic Corp. v. Twombly:
Federal Rule of Civil Procedure 8(a)(2) requires only “a short and plain statement of the claim showing that the pleader is entitled to relief,” in order to “give the defendant fair notice of what the . . . claim is and the grounds upon which it rests.” While a complaint attacked by a Rule 12(b)(6) motion to dismiss does not need detailed factual allegations, a plaintiff's obligation to provide the “grounds” of his “entitle[ment] to relief” requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do. Factual allegations must be enough to raise a right to relief
above the speculative level on the assumption that all the allegations in the complaint are true (even if doubtful in fact).550 U.S. 544, 555 (2007) (footnote and citations omitted); see also 5 Charles Alan Wright & Arthur R. Miller, Federal Practice and Procedure § 1216, at 235-36 (3d ed. 2004) (“[T]he pleading must contain something more . . . than a bare averment that the pleader wants compensation and is entitled to it or a statement of facts that merely creates a suspicion that the pleader might have a legally cognizable right of action.”).
“A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). “The plausibility standard is not akin to a ‘probability requirement,' but it asks for more than a sheer possibility that a defendant has acted unlawfully.” Id. The plausibility standard reflects the threshold requirement of Rule 8(a)(2)-the pleader must plead sufficient facts to show he is entitled to relief, not merely facts consistent with the defendant's liability. Twombly, 550 U.S. at 557; see also Iqbal, 556 U.S. at 678 (“Where a complaint pleads facts that are ‘merely consistent with' a defendant's liability, it ‘stops short of the line between possibility and plausibility of “entitlement to relief.”'” (quoting Twombly, 550 U.S. at 557)). Accordingly, the plausibility standard requires a plaintiff to articulate facts that, when accepted as true, demonstrate that the plaintiff has stated a claim that makes it plausible the plaintiff is entitled to relief. Francis v. Giacomelli, 588 F.3d 186, 193 (4th Cir. 2009).
Fourteenth Amendment Deliberate Indifference
The Eighth Amendment is used to evaluate conditions of confinement for those convicted of crimes. See City of Revere v. Mass. Gen. Hosp., 463 U.S. 239, 244 (1983). However, the protections convicted prisoners are afforded under the Eighth Amendment extend to pretrial detainees, such as Plaintiff, through the Due Process Clause of the Fourteenth Amendment. Young v. City of Mt. Ranier, 238 F.3d 567, 575 (4th Cir. 2001). The Constitution's prohibition on “cruel and unusual punishments” imposes certain basic duties on prison officials. Farmer v. Brennan, 511 U.S. 825, 832 (1994). These include maintaining humane conditions of confinement, including the provision of adequate medical care and “adequate food.” Id.
Deliberate indifference to a prisoner's serious medical needs violates the Constitution and states a cause of action under § 1983 because deliberate indifference constitutes “the unnecessary and wanton infliction of pain.” Estelle, 429 U.S. at 104-05 (internal quotation marks omitted). Deliberate indifference exists when prison officials know of a substantial risk to a prisoner's health or safety and consciously disregard that risk. See Farmer, 511 U.S. at 836. Within the United States Court of Appeals for the Fourth Circuit, “the treatment must be so grossly incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to fundamental fairness” to violate a prisoner's constitutional rights. Miltier v. Beorn, 896 F.2d 848, 851-52 (4th Cir. 1990), overruled in part on other grounds by Farmer, 511 U.S. at 837.
To prevail on a deliberate-indifference-to-medical-needs claim, the prisoner must demonstrate (1) his medical condition was a sufficiently serious one and (2) subjectively, the prison officials acted with a sufficiently culpable state of mind, which is satisfied by showing deliberate indifference by the prison officials. Langford v. Joyner, 62 F.4th 122, 124 (4th Cir. 2023). As the United States Supreme Court has explained,
A medical need is “serious” if it 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.” Iko v. Shreve, 535 F.3d 225, 241 (4th Cir. 2008) (internal quotation marks omitted).
“[D]eliberate indifference requires that the prison official have actual subjective knowledge of both the inmate's serious medical condition and the excessive risk posed by the official's action or inaction.” Langford, 62 F.4th at 124 (internal quotation marks omitted).
Since, we said, only the “‘unnecessary and wanton infliction of pain'” implicates the Eighth Amendment, a prisoner advancing such a claim must, at a minimum, allege “deliberate indifference” to his “serious” medical needs. “It is only such indifference” that can violate the Eighth Amendment; allegations of “inadvertent failure to provide adequate medical care,” or of a “negligent . . . diagnos[is],” simply fail to establish the requisite culpable state of mind.Wilson v. Seiter, 501 U.S. 294, 297 (1991) (emphasis and alteration in original) (citations omitted). Further, in the context of prisoner medical care, the Constitution requires only that prisoners receive adequate medical care; a prisoner is not guaranteed his choice of treatment. De'lonta v. Johnson, 708 F.3d 520, 526 (4th Cir. 2013); see Russell v. Sheffer, 528 F.2d 318, 318 (4th Cir. 1975); see also, e.g., Barton v. Dorriety, No. 9:10-cv-1362, 2011 WL 1049510, at *2 (D.S.C. Mar. 21, 2011). The fact that a prisoner believed he had a more serious injury or that he required better treatment does not establish a constitutional violation. See, e.g., Russell, 528 F.2d at 319. Additionally, to establish a claim for denial of medical care against non-medical personnel, a prisoner must show that the nonmedical personnel “intentionally den[ied] or delay[ed] access to medical care or intentionally interfered] with the treatment once prescribed.” Smith v. Smith, 589 F.3d 736, 738-39 (4th Cir. 2009). Moreover, because most prison officials are not trained medical personnel, they are entitled to rely on the opinions, judgment, and expertise of medical personnel concerning the course of treatment that the medical personnel deemed necessary and appropriate for the prisoner. Miltier, 896 F.2d at 854.
A delay in medical care may constitute deliberate indifference if the defendants “subjectively recognized” that the delay put the prisoner “at a substantial risk of serious harm and that their actions were inappropriate in light of that risk.” Moss v. Hardwood, 19 F.4th 614, 624 (4th Cir. 2021) (internal quotation marks omitted).
DISCUSSION
Defendants' Motions
Constitutional Claim
As noted, Plaintiff claims that Defendants violated his constitutional rights by failing to provide him with proper dialysis and by not providing him with an adequate renal diet.
Defendants argue, for several reasons, that the Complaint fails to allege facts that state a claim against any of them for violation of Plaintiff's constitutional rights. [Docs. 17-1 at 6-11; 39 at 3; 49-1 at 5-15.]
The DCI Defendants do not Address All of the Relevant Allegations against Nurse Fabel
The DCI Defendants contend that Plaintiff's allegations regarding the treatment he received are not sufficient to plausibly allege that Nurse Fabel was deliberately indifferent to his serious medical needs. [Doc. 17-1 at 7-9.] They argue Plaintiff was not completely denied dialysis treatment or administered dialysis in a grossly incompetent way that shocks the conscience. [Id.] They specifically contend that Plaintiff at most alleges that Nurse Fabel should have provided him dialysis “in a manner that (1) would not have caused his access arm to be infiltrated and swell and (2) would not have removed as much fluid from him.” [Id. at 8.] Because the DCI Defendants assert that such contentions fail to state a claim for deliberate indifference to medical needs, they argue that the deliberate indifference claim should be dismissed as against them. [Id. at 7-9.]
To the extent Plaintiff intended to allege that Nurse Fabel was liable for him not receiving an adequate renal diet, nothing in the Complaint alleges that she is responsible for anything other than providing medical care. The Court therefore recommends that the DCI Defendants' motion be granted as to Nurse Fabel concerning Plaintiff's claim concerning his diet. The DCI Defendants also argue that to the extent Plaintiff alleges a claim based on medical negligence, his claim is not actionable. [Doc. 17-1 at 6-7.] The Court agrees. The law is well settled that negligence is not actionable under § 1983. See, e.g., Grayson v. Peed, 195 F.3d 692, 695 (4th Cir. 1999) (“Deliberate indifference is a very high standard-a showing of mere negligence will not meet it.”); Pink v. Lester, 52 F.3d 73 (4th Cir. 1995) (“[N]egligent deprivations of life, liberty, or property are not actionable under 42 U.S.C. § 1983.”); Ruefly v. Landon, 825 F.2d 792, 793 (4th Cir. 1987) (“Mere negligent conduct on the part of prison officials . . . does not constitute a violation of the eighth amendment's prohibition against cruel and unusual punishment.”). Accordingly, the Court recommends that the DCI Defendants' motion to dismiss be granted as to any negligence claim asserted under § 1983. Additionally, the DCI Defendants argue that to the extent Plaintiff seeks to assert any state-law claim for malpractice or medical negligence, his claim should be dismissed because he has failed to file a Notice of Intent to file Suit (“NOI”) or an expert witness affidavit, as required by S.C. Code §§ 15-79-125 and 15-36-100. [See Doc. 17-1 at 6-7.] These statutes require “that prior to filing any medical-malpractice suit, the plaintiff file an NOI that ‘name[s] all adverse parties as defendants,' ‘contain[s] a short and plain statement of the facts showing that the party filing the notice is entitled to relief,' and is accompanied by ‘an affidavit of an expert witness.'” Pinilla v. United States, 760 Fed.Appx. 164, 170 n.2 (4th Cir. 2019) (per curiam) (quoting S.C. Code § 15-79-125(A)). “The expert affidavit must ‘specify at least one negligent act or omission claimed to exist and the factual basis for each claim based on the available evidence at the time of the filing of the affidavit.'” Id. (quoting S.C. Code § 15-36-100(B)). Because Plaintiff has not satisfied these requirements, the Court recommends that any state law claim for medical malpractice or negligence be dismissed as well.
The Court concludes, however, that Plaintiff's allegations, liberally construed, are broader than those that the DCI Defendants specifically address, particularly with regard to faulty machines. Plaintiff claims that Nurse Fabel exhibited deliberate indifference based on the use of “faulty [dialysis] machines” that “constantly break down and have various different kinds of maintenance issues regularly.” [Docs. 1 at 7; 13-1 at 1.] He specifically alleges that “Machine #15 pulls harder than” the other machines, causing “chest pain, low blood pressure drops, passing out, breathing comp[l]ications, cramping, and tiredness lasting into the next day.” [Doc. 13-2 at 3.] He alleges that despite his and another detainee's complaints since January 2022 about the machine, Nurse Fabel continued to require Plaintiff to use it. [Id.] Because the DCI Defendants offer no argument addressing these allegations, the undersigned recommends that their motion to dismiss be denied on Plaintiff's deliberate-indifference-to-medical-needs claim regarding Plaintiff's dialysis as against Nurse Fabel.
Plaintiff's Allegations against the Sheriff's Office Defendants, DCI, and Wellpath are Insufficient as to Plaintiff's Claims
Plaintiff does not allege that the Sheriff's Office Defendants played any causal role in bringing about the deficiencies he alleges regarding dialysis or his diet. See Vinnedge v. Gives, 550 F.2d 926, 928 (4th Cir. 1977) (holding that to establish liability in a § 1983 action, a plaintiff must plead facts indicating that a defendant acted personally in the alleged deprivation of his constitutional rights). And as for Wellpath and DCI, the Court notes that neither of these entities is a “person” amenable to suit under § 1983. See Walker v. Wellpath, No. 5:21-3624-HMH-KDW, 2022 WL 18635149, at *6 (D.S.C. Dec. 21, 2022) (“[A] medical provider whose medical staff provides health care services to businesses, institutions, and individuals is not a ‘person' subject to suit under 42 U.S.C. § 1983.” (internal quotation marks omitted)), Report and Recommendation adopted by 2023 WL 154936 (D.S.C. Jan. 11, 2023), appeal filed No. 23-6102 (4th Cir. Feb. 2, 2023); see also Vinson v. Cannon, No. 2:10-3214-HFF-BHH, 2011 WL 1624962, at *6 (D.S.C. Mar. 28, 2011), Report and Recommendation adopted by 2011 WL 1627953 (D.S.C. Apr. 28, 2011). “[C]ourts have stated that a corporation under contract with the state cannot be held liable for the acts of its employees and agents” under theories of respondeat superior or vicarious liability. Walker, 2022 WL 18635149, at *6 (internal quotation marks omitted). “Instead a plaintiff must provide evidence of a policy or custom on the part of the defendant, and that the policy caused the complained of constitutional violation.” Id. Here, however, Plaintiff does not allege that DCI or Wellpath are liable due to the enforcement or enactment of a policy or custom.
Additionally, all Defendants argue that to the extent Plaintiff asserts liability under a supervisory liability theory based on their responsibility for the actions of Nurse Fabel or others, Plaintiff fails to state a claim. [Docs. 17-1 at 9-10; 39 at 3; 49-1 at 14-15.]. The Court agrees that Plaintiff's allegations relating to supervisory liability are too conclusory to state a claim, either regarding Plaintiff's claim concerning dialysis or his diet claim.
Because there is no doctrine of respondeat superior in § 1983 claims, Monell v. Dep't of Soc. Servs. of City of New York, 436 U.S. 658, 691-94 (1978), a defendant is liable in his individual capacity only for his personal wrongdoing or supervisory actions that violated constitutional norms, see Shaw v. Stroud, 13 F.3d 791, 799 (4th Cir. 1994) (setting forth elements necessary to establish supervisory liability under § 1983). A plaintiff must establish three elements to prevail under § 1983 on a theory of supervisory liability:
(1) that the supervisor had actual or constructive knowledge that his subordinate was engaged in conduct that posed “a pervasive and unreasonable risk” of constitutional injury to citizens like the plaintiff; (2) that the supervisor's response to that knowledge was so inadequate as to show “deliberate indifference to or tacit authorization of the alleged offensive
practices[]”; and (3) that there was an “affirmative causal link” between the supervisor's inaction and the particular constitutional injury suffered by the plaintiff.Id. (citations omitted and footnote added).
Stated differently,
Absent an allegation that a named defendant has personally subjected the plaintiff to a deprivation of his constitutional rights or has caused the conduct complained of or participated in some manner in the allegedly unlawful actions of his employee or subordinate officer, this Court has held a complaint insufficient to state a claim against such defendant under § 1983.Thompson v. McCoy, 425 F.Supp. 407, 411 (D.S.C. 1976) (alteration and internal quotation marks omitted). A plaintiff's burden to establish a claim based on supervisory liability is a heavy one; in fact, the Supreme Court may have entirely abrogated supervisory liability in Bivens actions. See Ashcroft v. Iqbal, 556 U.S. 662, 693 (2009) (Souter, J., dissenting) (“Lest there be any mistake, . . . the majority is not narrowing the scope of supervisory liability; it is eliminating Bivens supervisory liability entirely. The nature of a supervisory liability theory is that the supervisor may be liable, under certain conditions, for the wrongdoing of his subordinates, and it is this very principle that the majority rejects.”). A Bivens action “is the ‘federal analog to suits brought against state officials under . . . § 1983.'” Id. at 675-76 (quoting Hartman v. Moore, 547 U.S. 250, 254 (2006)). Therefore, the Supreme Court's reasoning may extend to abrogate supervisory liability in § 1983 actions as well as Bivens actions. See Jones v. Corr. Care Sols., No. 0:09-cv-269, 2010 WL 2639788, at *2 (D.S.C. June 7, 2010) (noting that, under Iqbal, supervisory liability may no longer be a viable § 1983 claim).
Plaintiff refers in his Complaint to “concerns [that he has] made known surrou[n]ding” his dialysis, and he alleges that “Duffy was made aware of all the problems, issues, and concerns surrounding the dialysis treatment program . . . as she was made aware of all the grievances [Plaintiff] filed against medical, food services, and the facility.” [Doc. 1 at 6.] Plaintiff also alleges that he wrote a letter to Duffy to which Duffy never responded. [Id.; Doc. 13-1 at 2.] Plaintiff generally references that he has filed many grievances and he conclusorily alleges that “[d]ue to all numerous complaints by patients, medical staff, and Wellpath brass, all have made aware to [DCI] area director (Mr. Marr) the concerns about Ms. Fabel['s] attitude, behavior, work, and less than adequate medical care.” [Doc. 1 at 7-8.] And he alleges that “Wellpath was put on notice repeatedly about [Nurse Fabel's] incompetence and substandard performances medically, and her less than exempl[]ary professional attitude and behavior.” [Id. at 7.]
These vague allegations regarding what information Plaintiff communicated are insufficient to plausibly allege deliberate indifference on the part of the Sheriff's Office Defendants, DCI, or Wellpath to the violation of constitutional rights of citizens such as Plaintiff, either as it pertains to dialysis treatment or his diet. See Murdock v. Thompson, No. 3:18-cv-20-FDW, 2018 WL 3869992, at *7 (W.D. N.C. Aug. 14, 2018) (“Plaintiff contends that [the defendant] was informed on numerous occasions on the various constitutional violations and did nothing to alleviate the problems. This claim is too vague and conclusory to state a claim for supervisory liability at this time and will be dismissed.”).
Additionally, as noted, because most prison officials are not trained medical personnel, the Sheriff's Office defendants were entitled to rely on the opinions, judgment, and expertise of medical personnel concerning the course of treatment that the medical personnel deemed necessary and appropriate for Plaintiff. See Miltier, 896 F.2d at 854.
The Court therefore recommends that the motions to dismiss be granted as to the Fourteenth Amendment claims against the Sheriff's Office Defendants, DCI, and Wellpath.
Conspiracy Claim
All Defendants also argue that Plaintiff has not alleged facts sufficient to state a conspiracy claim. [Docs. 17-1 at 10-11; 39 at 3; 49-1 at 18-19.] The Court agrees.
To allege a civil conspiracy under § 1983, a plaintiff is required to demonstrate that defendants acted jointly and some overt act was done in furtherance of the conspiracy, which infringed the plaintiff's constitutional right. Hinkle v. City of Clarksburg, 81 F.3d 416, 421 (4th Cir. 1996). Here, Plaintiff has not alleged any joint action between or among any Defendants. Thus, the Court recommends that any claim of civil conspiracy under § 1983 be dismissed for failure to state a claim.
As the Sheriff's Office Defendants argue [Doc. 49-1 at 5-7], they are also entitled to dismissal, based on Eleventh Amendment immunity, of all claims against them in their official capacities for money damages. The Eleventh Amendment prohibits federal courts from entertaining an action against a state. See, e.g., Alabama v. Pugh, 438 U.S. 781, 782 (1978) (per curiam) (citations omitted); Hans v. Louisiana, 134 U.S. 1, 10-11 (1890). Further, Eleventh Amendment immunity “extends to ‘arm[s] of the State,' including state agencies and state officers acting in their official capacity,” Cromer v. Brown, 88 F.3d 1315, 1332 (4th Cir. 1996) (alteration in original) (internal citations omitted), because “a suit against a state official in his or her official capacity is not a suit against the official but rather is a suit against the official's office . . . [and] is no different from a suit against the State itself,” Will v. Mich. Dep't of State Police, 491 U.S. 58, 71 (1989) (internal citation omitted). The Al Cannon Cannon Detention Center is run by the Charleston County Sheriff's Office. See Mial v. Charleston Cnty. Sheriff's Dep't, No. 0:16-3973-JFA-PJG, 2018 WL 4725288, at *1 (D.S.C. Aug. 28, 2018), Report and Recommendation adopted by 2018 WL 4701366 (D.S.C. Oct. 1, 2018). And sheriff's departments in South Carolina are state agencies, not municipal departments. Cromer, 88 F.3d at 1332 (holding that a county sheriff in South Carolina is an arm of the state); Edwards v. Lexington Cnty. Sheriff's Dep't, 688 S.E.2d 125, 127 n.1 (S.C. 2010) (“under South Carolina law, the sheriff and sheriff's deputies are State, not county, employees”). Therefore, Eleventh Amendment immunity protects state agencies and state officials sued in their official capacities from liability for monetary damages under 42 U.S.C. § 1983. Id. As a result, to the extent Plaintiff has alleged claims against the Sheriff's Office Defendants in their official capacities, those claims must be dismissed because these Defendants are entitled to immunity pursuant to the Eleventh Amendment.
Plaintiff's Motion for Preliminary Injunction and TRO
A preliminary injunction is “an extraordinary remedy involving the exercise of a very far-reaching power, which is to be applied only in the limited circumstances which clearly demand it.” Centro Tepeyac v. Montgomery Cnty., 722 F.3d 184, 188 (4th Cir. 2013) (internal quotation marks omitted). “The purpose of a preliminary injunction is merely to preserve the relative positions of the parties until a trial on the merits can be held.” United States v. South Carolina, 720 F.3d 518, 524 (4th Cir. 2013) (internal quotation marks omitted). Because granting a motion for preliminary injunctive relief “requires that a district court, acting on an incomplete record, order a party to act, or refrain from acting, in a certain way[,] [t]he danger of a mistake in this setting is substantial.” Hughes Network Sys., Inc. v. InterDigital Commc'ns Corp., 17 F.3d 691, 693 (4th Cir. 1994) (internal quotation marks omitted). Accordingly, the decision whether to grant a preliminary injunction is committed to the equitable discretion of the district court. See Salazar v. Buono, 559 U.S. 700, 714 (2010); Christopher Phelps & Assocs., LLC v. Galloway, 492 F.3d 532, 543 (4th Cir. 2007).
The current standard for granting preliminary injunctive relief is set forth in Winter v. Natural Resources Defense Council, Inc., 555 U.S. 7 (2008). Under Winter, to obtain a preliminary injunction, the moving party must demonstrate:
1) he is likely to succeed on the merits,
2) he will suffer irreparable harm if the preliminary injunction is not granted,
3) the balance of equities favors him, and
4) the injunction is in the public interest.555 U.S. at 20; see also League of Women Voters of N.C. v. North Carolina, 769 F.3d 224, 236 (4th Cir. 2014). Moreover, Winter requires that each preliminary injunction factor “be ‘satisfied as articulated.'” Pashby v. Delia, 709 F.3d 307, 320-21 (4th Cir. 2013) (quoting The Real Truth About Obama, Inc. v. FEC, 575 F.3d 342, 347 (4th Cir. 2009), vacated on other grounds, Citizens United v. FEC, 558 U.S. 310 (2010), aff'd, The Real Truth About Obama, Inc. v. FEC, 607 F.3d 355 (4th Cir. 2010) (per curiam)).
Plaintiff claims in his motion that he is entitled to a TRO and preliminary injunction “to ensure that he receives the proper medical care” in the Detention Center for his alleged Stage 4 renal disease and to “requir[e] [Defendants] to arrange for [his] secure[] release in order to receive the treatment and care [he] needs and deserves.” [Docs. 13 at 1; 13-1 at 3.] He asserts that (1) he is “continuou[s]ly being injured by the faulty old dialysis machines . . . used by” DCI as “these machines constantly break down and have various different kinds of maintenance issues”; (2) he has been “experiencing chest and heart pains since [he has] been on the machines”; (3) he has suffered “infiltrati[on of his] access arm . . . causing the arm to swell up”; (4) he “ha[s] passed out on the machines because of [Nurse Fabel's] removing more fluids than the numbers call for.” [Doc. 13-1 at 1.]
For the reasons discussed, the Court concludes that Plaintiff has failed to state a claim against all Defendants but Nurse Fabel. As Plaintiff has not shown he is likely to succeed on the merits of his claims against Defendants other than Nurse Fabel, Plaintiff is not entitled to injunctive relief against these other Defendants. See Welch v. Johnson, No. 6:17-439-MBS-KFM, 2017 WL 9289386, at *2 (D.S.C. May 5, 2017) (denying motion for preliminary injunction in part because the plaintiff failed to show he was likely to succeed on the merits of his claims insofar as he failed to state a Fourteenth Amendment deliberate indifference claim), Report and Recommendation adopted by 2018 WL 647747 (D.S.C. Jan. 31, 2018); McDaniels v. Richland Cnty. Pub. Defs. Office, No. 1:12-6-TLW-SVH, 2012 WL 1565611, at *2 (D.S.C. Mar. 27, 2012) (denying Plaintiff's request for a TRO when he failed to state a cognizable claim), Report and Recommendation adopted by 2012 WL 1565472 (D.S.C. May 2, 2012). As for injunctive relief against Nurse Fabel, the Court notes that Plaintiff alleges that Nurse Fabel no longer works for DCI as of September 2022. [Docs. 44 at 6, 12; 58 at 9.] Thus, injunctive relief against her would do nothing to protect Plaintiff from any irreparable harm. See Potomac Heritage Trail Assoc., Inc. v. United States Dep't of Transp., No. DLB-22-2482, 2022 WL 7051160, at *17 (D. Md. Oct. 11, 2022) (explaining that when requested injunctive relief “will not prevent irreparable harm to the plaintiffs . . . a preliminary injunction is not warranted”).
Accordingly, for the reasons discussed, the Court recommends that Plaintiff's motion for a preliminary injunction and TRO be denied.
On March 24, 2023, the Clerk docketed a motion from Plaintiff to correct/amend evidence. [Doc. 61.] In this motion, Plaintiff apparently seeks to amend his Complaint to add allegations concerning the death on March 14, 2023, of a fellow dialysis patient. [Id.] The Court recommends that Plaintiff's motion be denied as futile. See Equal Rights Ctr. v. Niles Bolton Assocs., 602 F.3d 597, 603 (4th Cir. 2010) (“A district court may deny a motion to amend when the amendment would be prejudicial to the opposing party, the moving party has acted in bad faith, or the amendment would be futile.”). As noted, the Court concludes that Plaintiff fails to state a claim against any Defendant other than Nurse Fabel because DCI and Wellpth are not persons amenable to suit under § 1983, Plaintiff has not alleged a policy or custom of these Defendants that caused a violation of his constitutional rights, and Plaintiff has not alleged facts sufficient to support liability against these Defendants and the Sheriff's Office Defendants under a supervisory liability theory. Even with the addition of the new allegations Plaintiff references in his motion, his allegations would be insufficient to avoid dismissal of the claims against the Sheriff's Office Defendants, DCI, and Wellpath. And Plaintiff lacks standing to sue for injuries to another inmate. See Myers v. Loudon Co. Pub. Schs., 418 F.3d 395, 400 (4th Cir. 2005) (“The right to litigate for oneself . . . does not create a coordinate right to litigate for others.”). To be clear, the Court does not address whether the allegations Plaintiff references in his motion could ever be properly presented in this case in response to a summary judgment motion or at trial. Rather, the Court addresses only the question of whether Plaintiff should be allowed to amend the Complaint. The Court notes that Wellpath requests that Plaintiff's motion be stricken from the record because it contains immaterial and scandalous allegations. [Doc. 62 at 5.] However, the Court recommends that Wellpath's request be denied.
RECOMMENDATION
Wherefore, based upon the foregoing, the Court recommends that Plaintiff's motion for preliminary injunction and TRO [Doc. 13] be DENIED; that the DCI Defendants' motion to dismiss [Doc. 17] be GRANTED IN PART AND DENIED IN PART; that Wellpath's motion to dismiss [Doc. 39] be GRANTED; that the Sheriff's Office Defendants' motion to dismiss or, in the alternative, for summary judgment [Doc. 49] be GRANTED; and that Plaintiff's motion to amend/correct evidence [Doc. 61] be DENIED. The Court recommends that all claims be dismissed except Plaintiff's claim against Nurse Fabel for deliberate indifference to medical needs related to Plaintiff's dialysis.
The Court has treated the motion as a motion to dismiss because no evidence beyond the pleadings was considered.
The Court declines to address Defendants' alternative arguments concerning the claims the Court recommends be dismissed and Plaintiff's motion for a TRO and preliminary injunction.
IT IS SO RECOMMENDED.