Dipietro v. Barron

Full title: ROBERT RALPH DIPIETRO, Plaintiff, v. JAMES F BARRON, et al., Defendants.

Court: United States District Court, Middle District of Georgia

Date published: Jul 22, 2021

4:18-CV-00179-CDL-MSH (M.D. Ga. Jul. 22, 2021)

Opinion

4:18-CV-00179-CDL-MSH

07-22-2021

ROBERT RALPH DIPIETRO, Plaintiff, v. JAMES F BARRON, et al., Defendants.

STEPHEN HYLES UNITED STATES MAGISTRATE JUDGE

42 U.S.C. § 1983

REPORT AND RECOMMENDATION

STEPHEN HYLES UNITED STATES MAGISTRATE JUDGE

Plaintiff, an inmate currently confined at Rutledge State Prison (“RSP”) in Columbus, Georgia, has filed a pro se complaint (ECF No. 1) seeking relief pursuant to 42 U.S.C. § 1983. Pending before the Court are Defendants Barron, Hatcher, and Shelton's motion for summary judgment (ECF No. 156) and Defendants Foreman, Silver, and Thompson's motion for summary judgment (ECF No. 157). The Court recommends that Defendants' motions be granted.¹

1 Because all documents have been electronically filed, this Report and Recommendation cites to the record using the document number and electronic screen page number shown at the top of each page by the Court's CM/ECF software.

BACKGROUND

Plaintiff's claims arise from his confinement at Georgia Diagnostic and Classification Prison (“GDCP”) in Jackson, Georgia and RSP. His allegations concern (1) his mental health care, (2) his dental care, and (3) his conditions of confinement. The Court summarizes each in turn.

I. Mental Health Care

According to Plaintiff, before his confinement, he “had a long history of mental illness, ” and he had prescriptions for Xanax and Lexapro to treat his anxiety and depression. Am. Compl. 1, 3, ECF No. 55-1. Plaintiff arrived at GDCP in May 2016 and met with Foreman. Id. at 2-3. He explained to Foreman that he “was a total basket case, ” “could not properly function, ” and “was having suicidal thoughts.” Id. He “could not carry on a conversation with any mental health professional without breaking down and sobbing.” Id. at 3. Plaintiff also told Foreman that he suffered from “withdrawal symptoms from . . . Xanax, that [he] had been prescribed for over [ten] years[, ]” and he felt he “almost died because of the withdrawal.” Id. at 3-4.

Foreman recommended that Plaintiff refrain from taking medications to avoid becoming addicted. Id. at 4. She said she would prescribe medication if he later changed his mind, and Plaintiff agreed with this course of treatment. Am. Compl. 4. “Within a day or two, ” Plaintiff changed his mind about foregoing medication. Id. He submitted sick call requests to revisit Foreman, but his requests were ignored. Id. He filed “at least [two] grievances, ” but he never received a response. Id. at 7-8. He never saw Foreman again and was transferred to ASMP on or about July 12, 2016. Id. at 4-5. At ASMP, Plaintiff visited “with someone from mental health” but never received treatment, despite filing “weekly sick calls and at least one grievance.” Id. at 6-7.

When Plaintiff arrived at RSP in August 2016, he had an “intake meeting” with a nurse in the RSP mental health department. Am. Compl. 10, 12. He told the nurse that he was innocent of the crimes for which he was convicted, had suicidal thoughts, and needed medication for his panic attacks, anxiety, and depression. Id. at 12, 18, 22. The nurse told him a psychiatrist or psychologist would review his intake information and see him in “a couple of days at most.” Id. at 12-13, 22. “After waiting about a week, ” mental health staff had not met with Plaintiff, and he submitted sick call requests seeking mental health treatment. Id. at 13, 20-21. He believes Silver and Thompson review sick call requests and determine whether to evaluate inmates. Id. at 20-21. Plaintiff filed a grievance approximately two to three weeks later. Am. Compl. 20-21. The excessive heat contributed to his poor mental health. Id. at 11, 13, 23-24.

On or about September 15, 2016, Plaintiff attempted suicide by hanging because he realized he “was never going to get any treatment for anxiety, depression, heat, anything.” Id. at 13. “Another inmate heard the commotion, ” entered Plaintiff's room, and urged him to stop his attempt and try to get treatment. Id. at 13. Plaintiff talked to a duty officer, “and in minutes, ” counselor Singleton led Plaintiff to the RSP mental health department to meet with Silver and Thompson. Id. at 13-14. During the meeting, Plaintiff informed Silver and Thompson that although he had submitted sick call requests, he had not been evaluated since he arrived at RSP. Id. at 14. He told them he had suicidal thoughts, but he did not discuss his suicide attempt because he feared transfer to the suicidal observation cell, “where you are stripped of clothing, bedding, everything.” Am. Compl. 14. He stated that he often had panic attacks at night, which included “thoughts of doom or death[, ] . . . heart racing, sweating, confusion, panic, fear of death by heart attack, and thoughts of suicide to end those feelings.” Id. at 21. He indicated he was unable to sleep, eat, read, or participate in prison activities. Id. at 23.

“The interview lasted only a few minutes.” Id. at 15. Silver “was quick to cut [Plaintiff] off” and “would not let [him] speak, ” but she said she knew Plaintiff and was aware of his symptoms because she had reviewed his chart, intake exam, and sick call requests. Id. at 15, 22, 25. Silver stated she had not met with Plaintiff because she was “very understaffed.” Id. at 15, 22-23. Plaintiff believes Hatcher and Shelton are responsible for the understaffing. Am. Compl. 24, 31. He also believes Silver and Thompson “have a say in staff levels[]” and are partially responsible for the understaffing. Id. at 24, 31. Silver also acknowledged that she knew the heat in Plaintiff's dorm “was contributing to [his] poor mental health[, ]” but she blamed the RSP warden for the heat, saying “it had been like that for years . . . [and] it made her job more difficult.” Id. at 23. When Plaintiff told Silver that he had been prescribed Xanax, she said she does not treat anxiety and he would never receive “Xanax or any drug like that.” Id. at 15. Plaintiff, however, learned that other inmates at RSP were “treated for anxiety with drugs in the same class as Xanax.” Id. at 16, 25. Plaintiff contends Silver and Thompson refused to treat him for anxiety, in part, because they wanted him to suffer due to his conviction for child molestation. Id. at 16-17. During the meeting, however, Silver prescribed Plaintiff medication for his depression. Am. Compl. 26.

Thompson had also reviewed Plaintiff's chart and was present at the meeting. Id. at 18, 25. He knew of Plaintiff's “tendency toward suicide.” Id. at 24-25. Plaintiff also believes Thompson is Silver's supervisor and could have overruled Silver's refusal to treat Plaintiff. Id. at 20, 34. During the meeting, Thompson promised Plaintiff “regular counseling with him[]” with meetings “at least every other week to start and then monthly.” Id. at 24. Thompson, however, refused to meet with Plaintiff, and Plaintiff never received counseling. Id.

“[A] few days” after this meeting, Plaintiff had “severe negative reactions to the [depression] medication” which Silver had prescribed him. Am. Compl. 26. He filed sick call requests, but all were ignored for many weeks. Id. He then filed a grievance and saw Silver again a week later. Id. She apologized for the delay, blamed understaffing for the delay, and admitted she mistakenly prescribed Plaintiff overly strong medication. Id. Silver treated Plaintiff's depression for the next two years. Id. Plaintiff continued to react poorly to the medication. Id. Whenever Plaintiff submitted sick call requests, Silver delayed meeting with him and always blamed understaffing for the delays. Am. Compl. 26-27.

II. Dental Care

Plaintiff developed pain in his right upper tooth and swollen gums in March 2016. Id. at 5. When he arrived at GDCP in May 2016, Plaintiff “was in severe pain that encompassed [his] neck, mouth and up to [his] head (tempal [sic] area).” Id. “The area around the tooth was severely swollen.” Id. At GDCP, Dr. James Barron examined him, x-rayed his tooth, gave him salt to rinse, and prescribed an antibiotic and ibuprofen. Id. Barron told Plaintiff that he believed his tooth hurt because Plaintiff ground his teeth due to anxiety and promised to make Plaintiff a tooth guard and clean his teeth. Id. at 5-6. Barron, however, neither made the tooth guard nor cleaned Plaintiff's teeth. Am. Compl. 6, 29. He also failed to refer Plaintiff to another dentist at Augusta State Medical Prison (“ASMP”). Id. at 7, 30.

Plaintiff saw Barron two more times, but he only “spent a total of a few minutes with [Plaintiff].” Id. at 6. Plaintiff also encountered Barron in the GDCP medical unit “about [three] other times[, ]” and he requested treatment for his tooth, but Barron ignored him. Id. Plaintiff filed sick call requests and grievances concerning his dental treatment, his grievances were ignored, and he never received grievance receipts or instructions concerning appeals. Id. at 7. Plaintiff was transferred to ASMP on or about July 12, 2016. Am. Compl. 6. After Plaintiff arrived at RSP, he “was told the tooth had broken in half and could not be saved and the tooth was removed on August 31, 2016.” Id. at 9. Plaintiff asserts he would not have lost his tooth had Barron treated him. Id. at 9-10.

III. Conditions of Confinement

Plaintiff arrived at RSP in August 2016 during “one of the hottest summers on record.” Id. at 10-11. Some RSP dorms have air conditioning, but Plaintiff was confined in “a dorm with no air conditioning and no ventilation[, ]” and his “room was the hottest room in the prison [because] [i]t face the sun all day[]” and the window did not open. Id. at 10-11. “The temperature in [his] room exceeded 100 degrees from” August to October. Id. at 11. Plaintiff's room had a metal window frame which heated up during the day and “must have been in the 120 [to] 130 degree range.” Am. Compl. 27. The window frame “was so hot it would burn you if you touched it.” Id. Although there was a fan in the “T.V. room” of Plaintiff's dorm which provided “a little relief if [he] could get directly in front of it, ” the overcrowding of his dorm prevented Plaintiff from taking advantage of the fan. Id. at 28.

“The warden and all the staff were well aware of these issues but never bothered to do anything to give [Plaintiff] relief.” Id.; see also Id. at 11, 30-31. The wardens “would come to the dorms during week-day inspection and ask about” the heat. Id. at 11. “The heat and fixing the [air conditioning] was a constant topic of conversation with officers and inmates[, ] and [i]t was brought up in monthly inmate/staff meetings.” Am. Compl. 12. The wardens promised to fix the air conditioning. Id. at 11. Plaintiff also requested a fan and “to be moved to a dorm with” air conditioning, but both requests were denied. Id. at 11. He filed a grievance concerning the excessive heat, but “was told, ‘you cannot grieve heat[, ]' and was denied.” Id. When Hatcher left RSP, the new warden “brought in a crew to install temporary [air conditioning] units when it got hot.” Id. at 12.

PROCEDURAL HISTORY

The Court received Plaintiff's complaint (ECF No. 1) on August 31, 2018. The Court received Plaintiff's motion to amend (ECF No. 55) and amended complaint (ECF No. 55-1) on August 29, 2019, and his motion to supplement (ECF No. 58) and supplement to his complaint (ECF No. 58-1) on September 6, 2019. The Court granted Plaintiff's motion to amend and motion to supplement and dismissed some of his claims on preliminary review under 42 U.S.C. §§ 1915A(a) and 1915(e). Order & R. 5-24, Nov. 14, 2019, ECF No. 72; Order 1-3, Jan. 3, 2020, ECF No. 89 (adopting in part recommendations). Thus, Plaintiff's amended complaint (ECF No. 55-1) is now his operative pleading. At this stage, Plaintiff's following claims remain: (1) his deliberate indifference claim arising from his dental care against Barron in his individual capacity, (2) his deliberate indifference claims arising from his mental health care against Silver, Thompson, and Foreman for nominal damages, (3) his conditions of confinement claim arising from excessive heat against Hatcher and Shelton, and (4) his understaffing claims against Hatcher, Shelton, Silver, and Thompson. Order & R. 5-46, Nov. 14, 2019, ECF No. 72; Order 1-3, Jan. 3, 2020, ECF No. 89 (adopting in part recommendations); Order & R. Mar. 18, 2020, ECF No. 112; Order 1, May 26, 2020, ECF No. 125 (adopting recommendation).

The Court initially stayed discovery pending review of Defendants' first two motions to dismiss (ECF Nos. 25, 41). Text-only Order, May 24, 2019, ECF No. 30; Text-only Order, July 3, 2019, ECF No. 45. Defendants then filed three additional motions to dismiss (ECF Nos. 59, 62, 105). Barron, Hatcher, and Shelton filed their answer (ECF No. 102) on January 31, 2020, and Foreman, Silver, and Thompson filed their answer (ECF No. 110) on March 2, 2020. Discovery commenced on July 23, 2020, when the Court lifted its stay of discovery after resolving (1) Defendants' final motion to dismiss (ECF No. 104), and (2) Plaintiff's motion for preliminary injunction (ECF No. 122), which he styled as a motion for reconsideration. See Order & R. 7-8, Mar. 18, 2020, ECF No. 112 (recommending granting Defendant GDC's motion to dismiss); Order 1, May 26, 2020, ECF No. 125 (adopting recommendation); see also Order & R. 5-7, May 21, 2020, ECF No. 124 (recommending denying Plaintiff's motion for preliminary injunction); Order 1, July 23, 2020, ECF No. 127 (adopting recommendation).

The parties repeatedly requested extensions of the deadlines to complete discovery and file dispositive motions (ECF Nos. 131, 133, 136, 141, 143, 145). Pursuant to these requests, the Court ultimately extended the discovery deadline to February 22, 2021- nearly seven months after discovery commenced-and the dispositive motion deadline to March 24, 2021. Order 3-4, Jan. 21, 2021, ECF No. 142. Nevertheless, because both Plaintiff and Defendants indicated that Defendants had not timely produced documents or responses to Plaintiff's discovery requests, the Court ordered Defendants to fully respond to discovery by March 22, 2021, and to file their complete responses with the Court. Order 3-4, Mar. 18, 2021, ECF No. 146. Defendants filed their responses (ECF No. 149) on March 27, 2021.

Barron, Hatcher, and Shelton filed their motion for summary judgment (ECF No. 156) on March 24, 2021. Foreman, Silver, and Thompson filed their motion for summary judgment (ECF No. 157) on the same day. Foreman, Silver, and Thompson also moved for leave to file Plaintiff's mental health records under seal (ECF No. 154), the Court granted their motion (ECF No. 155), and they filed Plaintiff's records under seal (ECF No. 159) on March 24, 2021. On March 25, 2021, the Court notified Plaintiff of Defendants' motions for summary judgment and ordered him to file any responses within thirty days. Order 1-3, ECF No. 158. After twice extending Plaintiff's time to respond (ECF Nos. 169, 171), the Court received Plaintiff's responses (ECF No. 173) on May 28, 2021, and his exhibits in support (ECF No. 174) on June 1, 2021. Defendants Barron, Hatcher, and Shelton replied (ECF No. 178) on June 15, 2021, and Defendants Foreman, Silver, and Thompson replied (ECF No. 182) on June 17, 2021. The Court held a hearing (ECF No. 190) on Defendants' motions for summary judgment on July 13, 2021. Defendants' motions are ripe for review.

DISCUSSION

Defendants raise alternative grounds for summary judgment in each of their motions. See Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 7-20, ECF No. 156-2; Foreman, Silver, & Thompson's Br. in Supp. of Mot. for Summ. J. 11-20, ECF No. 157-2. The Court separately addresses the two motions and their respective undisputed material facts and recommends that both motions be granted.

I. Summary Judgment Standard

Summary judgment may be granted only “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). In determining whether a genuine dispute of material fact exists to defeat a motion for summary judgment, the evidence is viewed in the light most favorable to the party opposing summary judgment, drawing all justifiable inferences in the opposing party's favor. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 255 (1986). A fact is material if it is relevant or necessary to the outcome of the suit. Id. at 248. A factual dispute is genuine if the evidence would allow a reasonable jury to return a verdict for the nonmoving party. Id.

II. Defendants Barron, Hatcher, and Shelton's Motion for Summary Judgment

Barron, Hatcher, and Shelton move for summary judgment, arguing (1) Plaintiff's claims against them in their official capacity are barred by the Eleventh Amendment and 42 U.S.C. § 1983, (2) Plaintiff's deliberate indifference claim against Barron and his conditions of confinement claim against Hatcher and Shelton are barred by the statute of limitations, (3) Plaintiff failed to exhaust administrative remedies as to his deliberate indifference claim against Barron, (4) Plaintiff fails to show that Barron, Hatcher, and Shelton were deliberately indifferent to his serious medical needs in violation of the Eighth Amendment, (5) Plaintiff fails to show that Hatcher and Shelton maintained a condition of confinement which violates the Eighth Amendment, (6) Barron, Hatcher, and Shelton are entitled to qualified immunity, and (7) Plaintiff is not entitled to compensatory and punitive damages. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 7-20. The Court addresses all grounds except qualified immunity and damages and recommends that Barron, Hatcher, and Shelton's motion be granted.

A. Undisputed Material Facts

The Court separately describes the undisputed material facts pertinent to all of Plaintiff's remaining claims. These facts pertain to both pending motions for summary judgment.

1. Plaintiff's Dental Treatment

Plaintiff was confined at GDCP from early May 2016 to July 12, 2016. Pl.'s Dep. 30:19-31:10, 35:15-36:13, 87:01-87:06, ECF No. 156-7; Pl.'s Decl. 11, 14, 57, ECF No. 173-2. Barron was a dentist at GDCP in 2016. Barron's Resp. to Interrogs. 3, 6-8, ECF No. 156-6; Barron Decl. ¶ 2, ECF No. 178-2.

When Plaintiff arrived to GDCP, he told a nurse he had a toothache. Pl.'s Decl. 11. On May 5, 2016, a GDCP nurse conducted an intake screening and noted that Plaintiff complained that a right, back tooth in his upper jaw was infected. Pl.'s Exs. 3, ECF No. 174-1. The nurse and Dr. Fogan prescribed penicillin and ibuprofen. Id. Plaintiff saw Barron on May 16, 2016, and complained that the right side of his mouth hurt. Barron's Resp. to Interrogs. 16, 27; Pl.'s Decl. 11. Plaintiff also reported clenching “after they no longer [prescribed] anti-anxiety med[ications], ” but Plaintiff indicated that “he [had] already put in for” a prescription. Barron's Resp. to Interrogs. 27; Barron Decl. ¶ 11. Barron evaluated tooth 3 and noted “palpation/percussion, ” a “widened” periodontal ligament, and “trauma from occlusion.” Barron's Resp. to Interrogs. 27; Barron Decl. ¶ 11. He prescribed Plaintiff ibuprofen, ordered both periapical and bi-wing X-rays, and recommended a mouth guard if Plaintiff's pain persisted. Barron's Resp. to Interrogs. 27; Barron Decl. ¶ 11. Barron also prescribed Plaintiff an antibiotic. Pl.'s Decl. 11; Pl.'s Dep. 32:13-32:24, 34:05-34:09; FTR Gold 10:34:50-10:35:05.²

2 All citations to the July 13, 2021, hearing minutes refer to times logged contemporaneously by the Court's FTR Gold recording system on that date.

On May 18, 2016, Dr. Gordon-another dentist at GDCP-completed a dental screening, treatment plan, and forensic record. Barron's Resp. to Interrogs. 20; Barron Decl. ¶¶ 4-5, 8. This document is used to denote an inmate's dental conditions following the inmate's initial examination, and it is completed without taking x-rays. Barron Decl. ¶¶ 5, 7. In the section labeled “Missing Teeth/Extractions/Restoration/Forensic, ” Dr. Gordon documented Plaintiff's existing dental issues-including missing teeth and existing fillings and crowns. Barron's Resp. to Interrogs. 20; Barron Decl. ¶ 6. In the section labeled “Existing Pathology/Treatment Plan, ” he noted tooth 3 for possible extraction by drawing vertical lines on each side of the tooth. Barron's Resp. to Interrogs. 20; Barron Decl. ¶ 7. Dr. Gordon did not note a visible split or fracture of tooth 3. Barron Decl. ¶ 7. In the section labeled “Treatment Plan, ” either Dr. Gordon or a subsequent treating dentist also noted tooth 3 for extraction. Barron's Resp. to Interrogs. 20; Barron Decl. ¶ 9.

Plaintiff saw Barron again on June 8, 2016, and complained that his gums hurt and were swollen, the pain had spread to his neck and head, and the antibiotic and ibuprofen no longer alleviated his pain. Barron's Resp. to Interrogs. 27; Barron Decl. ¶ 11; Pl.'s Decl. 12. Plaintiff believed he may have cut his gum between teeth 3 and 4 after using thread for flossing. Barron's Resp. to Interrogs. 27; Barron Decl. ¶ 11. Barron observed that Plaintiff “appear[ed] to have sustained damage to [his] inter dental papillae” between teeth 3 and 4, but they were “healing” within normal limits. Barron's Resp. to Interrogs. 27; Barron Decl. ¶ 11. Plaintiff's chief complaint concerned headaches on the right side of his head, which “start[ed] and [tooth] 3 [and] radiate[d] up to [his] temple.” Barron's Resp. to Interrogs. 27; Barron Decl. ¶ 11. Barron gave Plaintiff a flossing demonstration, and noted that a panoramic radiograph was taken on that day. Barron's Resp. to Interrogs. 27; Barron Decl. ¶ 11; Pl.'s Decl. 12; Pl.'s Dep. 32:25-33:02; FTR Gold 10:34:13-10:34:34. Barron did not observe a crack or fracture of Plaintiff's tooth. Barron's Resp. to Interrogs. 4. “Exploration of a possible crack in a tooth is a multi-step process, and [Plaintiff] was transferred” before Barron could complete the “later steps” of the process. Id.

After June 8, 2016, Plaintiff submitted sick call requests seeking further treatment from Barron, but Barron never evaluated him again. Pl.'s Decl. 12. Plaintiff also requested dental care when he encountered Barron in the GDCP medical unit outside of their meetings, and he believes Barron displayed hostility towards him. Pl.'s Decl. 12-13; Pl.'s Dep. 33:07-34:04. Plaintiff was temporarily transferred to ASMP in mid-June 2016. Pl.'s Dep. 87:01-87:24; Pl.'s Mental Health Records 25, ECF No. 159 (documenting Plaintiff's meeting with a mental health staff member on June 14, 2016, while confined at ASMP). Plaintiff was permanently transferred from GDCP to ASMP on July 12, 2016, and he received no dental care at ASMP. Pl.'s Decl. 14, 57; Pl.'s Dep. 35:15-36:36:13. Plaintiff's tooth split or cracked on approximately August 2, 2016. Pl.'s Decl. 14; Pl.'s Dep. 37:19-38:17. Plaintiff was transferred from ASMP to RSP on August 16, 2016. Pl.'s Decl. 14. On August 22, 2016, a dentist at RSP examined Plaintiff, noted that tooth “3 [was] fractured/split in half, ” and recommended that the tooth be extracted. Barron's Resp. to Interrogs. 27; Pl.'s Decl. 14-15. Plaintiff's tooth was extracted on August 31, 2016. Barron's Resp. to Interrogs. 27.

2. Plaintiff's Mental Health Treatment

Plaintiff was confined at GDCP from early May to July 12, 2016, and he has been confined at RSP since August 16, 2016. Pl.'s Decl. 2, 11, 14, 57; Pl.'s Dep. 30:19-31:10, 35:15-36:13, 87:01-87:06. Foreman was a mental health advanced practice nurse at GDCP in 2016. Foreman Decl. ¶ 2, ECF No. 157-3; Pl.'s Dep. 72:25-73:06. Silver is a licensed psychiatrist who was employed as a Staff Psychiatrist at RSP and provided mental health services in collaboration with counselors, psychologists, and other psychiatrists. Silver Decl. ¶¶ 2, 4, ECF No. 157-5. Thompson is a licensed psychologist who is employed as the RSP Mental Health Clinical Director and “provide[s] administrative guidance, consultation, and mental health leadership to coordinate clinical needs and provide assessment and treatment of mental health and emotional disorders of inmates[.]” Thompson Decl. ¶¶ 2, 4, ECF No. 157-4. Shelton served as the RSP Deputy Warden, and she left RSP in March 2016. Shelton's Resp. to Interrogs. 3, ECF No. 156-5. Hatcher served as the RSP Warden when Plaintiff arrived in August 2016, and Hatcher left RSP in 2018. Hatcher's Resp. to Interrogs. 3, ECF No. 156-4.

Plaintiff developed anxiety and depression in 2003. Pl.'s Dep. 74:09-75:14, 79:21-80:06, 82:04-82:07. He met with Dr. Niak-a psychiatrist-who counseled him and prescribed Xanax for anxiety and Lexapro for depression. Pl.'s Decl. 3, 7; Pl.'s Exs. 103, 139; Am. Compl. 1-3, 17. Plaintiff was confined at the Fulton County Jail (“FCJ”) before his conviction. Pl.'s Exs. 123-55; Pl.'s Decl. 53; Pl.'s Dep. 73:07-73:13. On March 4, 2016, FCJ medical staff met with Plaintiff during booking and noted that Plaintiff had taken Xanax for ten years and that he had last taken Xanax on March 3, 2016. Pl.'s Exs. 127. Plaintiff presented mild benzodiazepine withdrawal symptoms based on his unrestful sleep, nausea, vomiting, and past withdrawal history. Id. at 124-28. On the same day, Plaintiff met with a nurse practitioner at FCJ for an urgent care appointment. Id. at 129, 133. He was referred to urgent care after “making statements that he was depressed and may hurt himself.” Id. at 134. Plaintiff, however, indicated that he made those statements due to his “frustration with the lengthy booking process, ” and he “denied ever really wanting to hurt himself.” Id. He “denie[d] any other mental health [history] or suicide attempts.” Id. He denied current suicidal ideation. Pl.'s Exs. 135-36. The nurse practitioner diagnosed Plaintiff with drug dependence with withdrawal symptoms. Id. at 132.

On March 8, 2016, Plaintiff met with another FCJ mental health professional after complaining that he could not sleep and demanding his Xanax prescription. Id. at 140-41, 143. The mental health professional explained that Plaintiff was experiencing withdrawal symptoms, but Plaintiff “got up from the table and walked away.” Id. at 141. Plaintiff denied current suicidal ideation. Id. at 142, 148. On March 10, 2016, Plaintiff met with another FCJ mental health provider. Id. at 149. During that meeting, Plaintiff described his use of Xanax and Vyvanse and his mental health and substance abuse history. Pl.'s Exs. 150-51, 154. He reported thoughts of suicide in the past, indicated that he last thought of suicide eight to thirty days before, and denied any present thoughts of suicide. Id. at 154. Plaintiff did not receive Xanax and Lexapro while confined at FCJ. Pl.'s Decl. 53; Pl.'s Dep. 74:09-75:14, 79:21-80:06, 82:04-82:07. Inmates at FCJ told Plaintiff that if he discussed suicide with FCJ officials, he would be placed in a cell without clothes for suicide observation. Pl.'s Decl. 53. As a result, although Plaintiff had suicidal thoughts at FCJ, he told FCJ officials he did not have a plan for suicide-“which was a lie”-because he “feared the strip cell more than death.” Id.

Plaintiff arrived at GDCP in early May. Pl.'s Decl. 11; Pl.'s Dep. 35:18-36:13, 87:01-87:06. On May 5, 2016, a GDCP psychologist completed a mental health reception screening. Pl.'s Mental Health Records 34. Plaintiff indicated that he had not been prescribed psychotropic medications for the past six months and did not have a history or present thoughts of self-injury or suicide. Id. He also denied suicidal ideation. Id. The psychologist noted that Plaintiff had a history of out-patient mental health treatment with a psychiatrist. Id. Plaintiff asked for antidepressants, “report[ed] that he took Xanax on the outside[, ]” and requested further mental health treatment. Id.

On May 11, 2016, a GDCP nurse evaluated Plaintiff and completed a mental health evaluation for services and mental health status evaluation. Id. at 30-33. Plaintiff reported feelings of hopelessness, helplessness, sadness, anger, anxiety, depression, and decrease in sleep and requested mental health services for his depression and sadness. Id. at 30, 32. Plaintiff indicated he had previously been diagnosed with anxiety and depression and had been prescribed Xanax and Lexapro. Id. at 30. He denied any history of self-injury or suicide attempts. Id.; see also Id. at 33 (noting “[n]o thoughts of self-injury). He also denied present suicidal or homicidal ideation. Pl.'s Mental Health Records 32. The evaluator observed that Plaintiff displayed a “dysphoric mood[, ]” his “affect [was] congruent to [his] mood[, ]” and she recommended psychiatric and psychological evaluations. Id. at 32-33. A psychologist reviewed and signed the evaluation. Id.

On the same day, Plaintiff saw a psychologist who completed an initial psychological evaluation. Id. at 27-28. The psychologist noted that Plaintiff's anxiety and depression began “approximately [twelve] years ago[, ]” he visited a psychiatrist at that time who diagnosed him with depression and prescribed him Xanax and Lexapro, he “only took [Lexapro] when [symptoms] worsened[, ]” and his “most recent episode [of depression] follow[ed] [his] incarceration [in] March 2016.” Id. at 27. Plaintiff also recounted a family history of depression. Id. He denied any self-injurious and suicidal behaviors, but he described “occasional [suicidal ideation] last[ing] [three minutes] but [without] plan.” Pl.'s Mental Health Records 28. He “denied current” suicidal and homicidal ideation. Id. Based on her evaluation, the psychologist referred Plaintiff for a psychiatric evaluation to determine whether he needed prescriptions to treat his anxiety and depression. Id. The psychologist also recommended supportive counseling to aid Plaintiff's adjustment. Id.

The psychologist recommended that Plaintiff be classified as GDC Mental Health Level II under GDC SOP VG32-0001. Id. at 1, 28. An inmate qualifies for Level II classification

when the inmate's . . . ability to function in general population is (1) mildly impaired due to mental illness[, ] . . . or (2) is not currently impaired but [the inmate] needs monitoring due to:

a. A recent discontinuation of psychotropic medication.

b. A recent discharge from either a supportive living unit (SLU), crisis stabilization unit placement, or

c. A recent history of self-injurious behavior or suicidal ideation

d. These inmates can function productively in general population with outpatient mental health . . . services that might be needed to: (a) maintain an inmate . . . with or without the help of psychotropic medication[, ] (b) stabilize an inmate . . . whose problems are not severe enough to need . . . SLU or hospital placement, or (c) transition an inmate . . . from . . . SLU to general population or from receiving MH/MR services in general population to a discontinuation of these services.

Foreman, Silver, & Thompson's Mot. for Summ. J. Ex. 7, at 3-4, ECF No. 157-9. “Inmates . . . placed on Level II will be seen at least once a month by their MH/MR Counselor. Each session will be documented in a progress note.” Id. at 4. “It is the responsibility of the assigned MH/MR Counselor to meet with Level II or above inmates . . . within [seven] days of being placed on the MH/MR caseload. This includes but is not limited to transfers from other facilities[.]” Id. at 3. Available services for Level II inmates include individual treatment plans, psychopharmacological treatment, psychological testing, individual and group counseling, individual and group therapy, and crisis intervention. Id. at 4.

The psychologist also diagnosed Plaintiff with (1) major depressive affective disorder, recurrent episode, moderate, and (2) adjustment disorder with mixed anxiety and depressed mood. Pl.'s Mental Health Records 1, 28. The diagnoses were based on, inter alia, Plaintiff's “depressed and dysthymic mood everyday since [his] incarceration, ” as well as his feelings of “fear and anger, [decreased] energy [with] fatigue, weight [gain], [decreased] motivation, [and] feelings of hopelessness[, ] occasional [suicidal ideation] [without] plan[.]” Id. at 1.

Based on Plaintiff's screenings and the psychologist's referral, Foreman evaluated Plaintiff on May 24, 2016. Id. at 29; Foreman Decl. ¶ 8. Plaintiff reported that he developed anxiety in 2003, started taking Xanax at that time, and had counseling for four to five years. Pl.'s Mental Health Records 29; Foreman Decl. ¶ 8. Foreman noted that Plaintiff had been “on Xanax [and] Lexapro since Sept[ember] 2012” and that the Lexapro “made him feel worse, strange.” Pl.'s Mental Health Records 29; Foreman Decl. ¶ 8. She found “no desire or indication for medication[.]” Pl.'s Mental Health Records 29; Foreman Decl. ¶ 8. Foreman noted that Plaintiff was “very dep[endent] [on] med[ications].” Pl.'s Mental Health Records 29. Plaintiff consented to proceed without medications because he did not want to experience withdrawal symptoms again. Pl.'s Decl. 54-56; Pl.'s Dep. 82:16-83:20. Foreman recommended sessions with a mental health counselor weekly for one week and then monthly and ordered Plaintiff to return to see a psychologist in two weeks. Pl.'s Mental Health Records 29; Foreman Decl. ¶ 8. Plaintiff never received counseling at GDCP. Pl.'s Decl. 55-56.

A “day or two” after Plaintiff met with Foreman, he “changed [his] mind” and decided he wanted medications. Pl.'s Decl. 56; Pl.'s Dep. 84:01-85:09, 86:03-86:16; Am. Compl. 4. He filed sick call requests seeking to meet with Foreman again, but he did not meet with her. Pl.'s Decl. 56-57; Pl.'s Dep. 84:09-85:01. Foreman did not receive Plaintiff's sick call requests. Foreman Decl. ¶ 11. Plaintiff was temporarily transferred to ASMP in mid-June 2016. Pl.'s Dep. 87:01-87:24; Pl.'s Mental Health Records 25 (documenting Plaintiff's meeting with a mental health staff member on June 14, 2016, while confined at ASMP). On June 14, 2016, Plaintiff met with a social worker at ASMP for an initial intake and mental health orientation. Pl.'s Mental Health Records 25. The social worker noted “no psychosocial concerns, ” Plaintiff denied suicidal or homicidal ideation and the “need for crisis intervention, ” and the social worker found that Plaintiff's condition was “unchanged.” Id. The social worker then explained how Plaintiff could seek mental health services at ASMP and Plaintiff “verbalized understanding.” Id. Plaintiff returned to GDCP sometime after this meeting. Pl.'s Dep. 87:01-87:24.

Less than one month after he returned to GDCP following his temporary transfer, Plaintiff was permanently transferred to ASMP on July 12, 2016. Pl.'s Decl. 14, 57; Pl.'s Dep. 88:01-88:11. Plaintiff filed sick call requests seeking mental health treatment at ASMP. Pl.'s Decl. 57. On August, 10, 2016, Plaintiff met with a psychologist at ASMP. Id. at 23. His chief complaint was “increased mood symptoms.” Id. He presented with a “depressed” mood and “congruent” affect, denied suicidal or homicidal ideation, and was “markedly tearful during this assessment[.]” Id. He “focused on perceived consequences of imprisonment[, ]” and his “[t]hought process [was] coherent but circumstantial.” Id. Plaintiff described “difficulty managing the reality and length of imprisonment, and . . . experienc[ed] marked feelings of hopelessness, helplessness, and sad[ness.]” Id. His sleep had been “delayed by at least [two] hours.” Id. The psychologist found that “[d]ue to [Plaintiff's] liability of mood, compounded by episodes of increased anger, it is advisable at this time to request assessment to determine if [Plaintiff] would benefit from psychiatric medication management as [Plaintiff] [had] not shown any improvement to adjusting to prison setting.” Id. He noted that Plaintiff's symptoms were “worse, ” but his major depressive disorder was “unchanged[, ]” and he requested an “assessment of eligibility for psychiatric medication management[.]” Id. The psychologist recommended that the psychiatric evaluation take place within sixty to ninety days. Id.

Plaintiff was transferred to RSP on August 16, 2016. Pl.'s Dec. 2, 14; Pl.'s Dep. 92:02-92:06. On the same day, he signed a consent for release of his mental health records from Dr. Niak. Pl.'s Exs. 113. On August 18, 2016, RSP Counselor Sharpe signed Plaintiff's diagnosis list which documented his diagnoses of major depressive disorder and adjustment disorder and his mental health classification level. Pl.'s Mental Health Records 1. On August 23, 2016, Plaintiff had an initial interview with RSP Counselor Tonjia Singleton. Id. at 21. Plaintiff primarily complained of his accommodations and the lack of air conditioning in his dorm. Id. Singleton's progress note documents that Plaintiff “appear[ed] to need a great deal of motivation to take programs needed[, ] . . . stating that he is innocent.” Id. She found that his “[d]isposition of attitude, however, is positive[, ]” and the “[o]verall contact went fairly well.” Id. Singleton “plan[ned] to continue motivate [Plaintiff] to complete [his] programming.” Id. Plaintiff was referred to Silver for routine psychiatric evaluation. Silver Decl. ¶¶ 7-8, 12. Because Plaintiff had not been prescribed mental health medications and because he did not describe an emergent or urgent change of circumstances, his assessment would take place “as soon as practical” or “in an ordinary and reasonable time.” Id. ¶¶ 8, 12; Thompson Decl. ¶ 8.

Plaintiff filed sick call requests seeking immediate mental health treatment. Pl.'s Decl. 58; Pl.'s Dep. Pl.'s Dep. 101:02-101:17, 109:20-110:14. Neither Silver nor Thompson received Plaintiff's sick call requests. Silver Decl. ¶ 12; Thompson Decl. ¶ 12. On September 13, 2016, Plaintiff attempted suicide by hanging in his cell.³ Pl.'s Decl. 59; Pl.'s Dep. 97:13-97:24. His attempt failed, another inmate confronted him, and Plaintiff told an officer that he had attempted suicide. Pl.'s Decl. 59; Pl.'s Dep. 97:25-99:13. The officer took Plaintiff to Singleton's office, Plaintiff told Singleton he had attempted suicide, Singleton called Thompson, Thompson told her to emergently refer Plaintiff to Silver, and Singleton escorted Plaintiff to meet with Silver and Thompson. Pl.'s Mental Health Records 20-21; Pl.'s Decl. 59; Pl.'s Dep. 99:14-100:01, 111:14-111:18; Thompson Decl. ¶ 9; Silver Decl. ¶ 9.

3 Plaintiff gives inconsistent accounts of his suicide attempt. In his amended complaint, he states that he tried to hang himself with a sheet on September 15, 2016. Am. Compl. 13. During his deposition, he testified that he attempted to hang himself on September 13, 2016, by tying a belt around a door jam and stepping off a toilet. Pl.'s Dep. 97:13-97:24, 99:02-99:07. In his declaration, he avers that he tied a sheet to the top of his cell door and stepped off a chair. Pl.'s Decl. 59.

Silver told Plaintiff that she had reviewed his intake evaluation and medical history. Pl.'s Decl. 59-60; Pl.'s Dep. 104:09-104:17. During the meeting, Silver completed Plaintiff's psychiatric evaluation. Pl.'s Mental Health Records 20; Silver Decl. ¶ 9. She noted that Plaintiff had been diagnosed with major depressive affective disorder and adjustment disorder with mixed anxiety and depression and that he had not been prescribed medications. Pl.'s Mental Health Records 20; Silver Decl. ¶ 9. She noted that Plaintiff did not have a history of self-injurious behavior. Pl.'s Mental Health Records 20; Silver Decl. ¶ 9. Plaintiff summarized his mental treatment history, including his prior prescriptions for Xanax and Lexapro. Pl.'s Mental Health Records 20; Pl.'s Decl. 61-62; Silver Decl. ¶ 9. Silver reviewed Plaintiff's mental health records from GDCP and noted Foreman's finding that Plaintiff had no desire for medications and that Lexapro made Plaintiff feel worse. Pl.'s Mental Health Records 20; Pl.'s Decl. 61; Silver Decl. ¶ 9. Silver prescribed Plaintiff Zoloft, beginning with 50 mg for three days and increasing to 100 mg thereafter. Pl.'s Mental Health Records 20; Silver Decl. ¶ 9; Pl.'s Decl. 60-62; Pl.'s Dep. 104:09-105:15. Plaintiff consented to prescription of Zoloft. Pl.'s Exs. 114. Silver scheduled him to return in two weeks. Pl.'s Mental Health Records 20; Silver Decl. ¶ 9.

Plaintiff had a negative reaction to the Zoloft. Pl.'s Decl. 61; Pl.'s Dep. 105:06-105:15. He told RSP Counselor Rich about his negative reaction, and Rich told Plaintiff he would talk to Silver and Thompson, but Plaintiff did not see Silver for ten more days. Pl.'s Decl. 61-62. Between Silver's initial prescription of Zoloft on September 13, 2016, and September 30, 2016, he refused nine doses. Pl.'s Mental Health Records 16; Silver Decl. ¶ 9.1. He reported that the Zoloft made him “amped up” and that he “couldn't sleep.” Pl.'s Mental Health Records 16. Plaintiff submitted sick call requests seeking an immediate meeting with Silver, but he never received a response. Pl.'s Decl 61-62; Pl.'s Dep. 109:20-110:14. Silver did not receive any sick call requests. Silver Decl. ¶ 12.

Silver met with Plaintiff again on September 27, 2016. Pl.'s Mental Health Records 19; Silver Decl. ¶ 9.1; Pl.'s Decl. 62. She noted Plaintiff's non-compliance with the Zoloft prescription. Pl.'s Mental Health Records 19; Silver Decl. ¶ 9.1. They discussed Plaintiff's mental health, and he described problems with his home life and indicated he had some thoughts of death without any plan for suicide. Pl.'s Mental Health Records 19. He also explained that he enjoyed going to the RSP yard and reading on his tablet. Id.; Silver Decl. ¶ 9.1. Silver again prescribed 50 mg of Zoloft and instructed Plaintiff to only take his medication in the morning. Pl.'s Mental Health Records 19; Silver Decl. ¶ 9.1. She scheduled a follow-up in two weeks. Pl.'s Mental Health Records 19; Silver Decl. ¶ 9.1.

Plaintiff saw Silver again on October 11, 2016. Pl.'s Mental Health Records 18; Silver Decl. ¶ 9.2. Plaintiff became “tearful” when discussing his family and stated that he wondered whether “it would be [okay] if [he was] dead.” Pl.'s Mental Health Records 18. Plaintiff, however, denied any suicidal thoughts. Id. Silver also noted that Plaintiff enjoyed reading, writing letters, and going outside. Id.; Silver Decl. ¶ 9.2. Silver discontinued Zoloft and offered Plaintiff Prozac, Paxil, or Remeron. Pl.'s Mental Health Records 18; Silver Decl. ¶ 9.2. Plaintiff chose Remeron, and Silver prescribed him 15 mg every evening. Pl.'s Mental Health Records 18; Silver Decl. ¶ 9.2. She scheduled a follow-up in two weeks. Pl.'s Mental Health Records 18; Silver Decl. ¶ 9.2.

Plaintiff met with Silver on October 25, 2016. Pl.'s Mental Health Records 17; Silver Decl. ¶ 9.3. Plaintiff had been compliant with his Remeron prescription. Pl.'s Mental Health Records 17; Silver Decl. ¶ 9.3. He also asked to self-administer his medication. Pl.'s Mental Health Records 17; Silver Decl. ¶ 9.3. Silver continued Plaintiff's Remeron prescription and ordered a follow-up in eight weeks. Pl.'s Mental Health Records 17; Silver Decl. ¶ 9.3. Plaintiff refused his Remeron dosages, and on November 2, 2016, an RSP mental health professional counseled him for failing to comply with his prescription. Silver Decl. ¶ 9.3. Plaintiff met with Silver on December 7, 2016. Pl.'s Mental Health Records 14; Silver Decl. ¶ 9.4. They discussed his well-being, mental health symptoms, and daily activities. Pl.'s Mental Health Records 14; Silver Decl. ¶ 9.4. During the meeting, Silver prescribed Plaintiff Effexor XR, beginning with 37.5 mg for five days and increasing to 75 mg thereafter. Pl.'s Mental Health Records 14; Silver Decl. ¶ 9.4.

Thereafter, Plaintiff met with Silver eight more times between December 28, 2016, and April 24, 2018. Pl.'s Mental Health Records 5-9, 11-14; Silver Decl. ¶¶ 9.5-9.12. At each meeting, they discussed Plaintiff's mental health symptoms, and Silver continued to prescribe him psychiatric medications to treat his conditions. Pl.'s Mental Health Records 5-9, 11-14; Silver Decl. ¶¶ 9.5-9.12. Although Plaintiff often failed to comply with his prescriptions, Silver encouraged him to take his medications and tried different regimens of medications. Pl.'s Mental Health Records 7-8, 12; Silver Decl. ¶¶ 9.6, 9.9-9.10.

Plaintiff never saw Thompson clinically, and Thompson was not involved in Plaintiff's mental health treatment. Thompson Decl. ¶¶ 6-7, 9, 11. Plaintiff believes the RSP mental health department was understaffed, and he asserts that he had conversations with other inmates about the alleged understaffing. Pl.'s Dep. 67:25-68:20. He also alleges Silver told him that understaffing delayed his meetings with her on September 13, 2016, and September 27, 2016. Pl.'s Decl. 60, 62; Pl.'s Dep. 55:15-56:01. Silver and Thompson were not responsible for staffing the RSP mental health department. Silver Decl. ¶ 6; Thompson Decl. ¶ 6. Plaintiff does not recall having a conversation with Hatcher and Shelton concerning understaffing of the RSP mental health department. Pl.'s Dep. 56:02-56:12.

3. Conditions of Confinement at RSP

Plaintiff was transferred to RSP on August 16, 2016. Pl.'s Decl. 2, 14. He was assigned to cell K-3 in K dorm. Pl.'s Decl. 2, 5; Pl.'s Dep. 41:07-41:09. Shelton left RSP in March 2016. Shelton's Resp. to Interrogs. 3. It was extremely hot in Plaintiff's cell and in K dorm. Pl.'s Decl. 2; Pl.'s Dep. 54:07-55:02, 127:11-128:07. His cell faced the sun during the summer. Pl.'s Decl. 5. His cell had a metal window frame, and the window did not open. Pl.'s Decl. 2, 5; Pl.'s Dep. 40:15-41:06. The window framed burned Plaintiff if he touched it. Pl.'s Decl. 5; Pl.'s Dep. 54:07-55:02. The bed in his cell was six inches from the window frame. Pl.'s Decl. 5; Pl.'s Dep. 55:03-55:14. The air vent in his cell blew air, but the air was hot. Pl.'s Decl. 2. Plaintiff believes K dorm and his cell were excessively hot between August 16, 2016, and early October 2016-a period of approximately thirty to forty-five days. FTR Gold 10:08:06-10:08:52, 10:40:30-10:40:45. The heat was a general issue in the dorm, and Plaintiff was not placed in an excessively hot area apart from other inmates. FTR Gold 10:36:36-10:36:56.

Because of the heat, Plaintiff was “just very uncomfortable.” Pl.'s Dep. 46:06-46:14. His skin was often hot and clammy. Pl.'s Decl. 2. At times, he found it hard to breathe due to the heat and humidity. Id. Plaintiff had severe headaches, weakness, nausea, vomiting, dizziness, dehydration, and difficulty sleeping. Pl.'s Decl. 2-3 Pl.'s Dep. 49:21-50:04. As a result of dry heaving and vomiting, he pulled a stomach muscle. Pl.'s Decl. 2-3. The heat “compounded” Plaintiff's symptoms from his toothache, anxiety, and depression, as well as the general stress of being in prison. Pl.'s Decl. 3; Pl.'s Dep. 46:06-47:21; FTR Gold 10:19:44-10:20:06, 10:23:11-10:25:15. Plaintiff neither sought nor required medical attention for heat-related symptoms. FTR Gold 10:32:34-10:32:55; Pl.'s Dep. 49:07-50:04, 125:18-126:13. Plaintiff talked to Hatcher, a deputy warden who he thought was Shelton, Counselor Singleton, and Counselor Sharpe about the heat and its effects. Pl.'s Decl. 4, 7-8; Pl.'s Dep. 39:07-41:06, 44:01-46:46:05. He also requested to be moved to a different dorm, but he was denied. Pl.'s Decl. 4.

K dorm is not equipped with air conditioning. Hatcher's Resp. to Interrogs. 3, 7-8. K dorm has an air handler system which is designed to cool and circulate air. Id. at 3-6. Maintenance staff performed monthly inspections of the air handler system. Hatcher's Resp. to Interrogs. 4-5, 7-8; Little Decl. ¶¶ 3-4, ECF No. 178-1. RSP staff, including Hatcher, made daily rounds in K dorm to monitor the temperature in the dorm. Hatcher's Resp. to Interrogs. 3-5, 9-10; Pl.'s Dep. 39:07-39:17; FTR Gold 10:32:14-10:32:32. RSP staff placed a fan in the RSP day room common area, and Plaintiff could go to the day room. Hatcher's Resp. to Interrogs. 3-5, 9; Pl.'s Decl. 6; Pl.'s Dep. 41:13-41:20, 126:14-126:21; 10:21:15-10:21:58. Plaintiff's cell was at the end of a hallway in K dorm, and his cell door was closed, so the air blown by the fan did not reach his cell. Pl.'s Decl. 6; Pl.'s Dep. 126:14-126:21. Inmates were also permitted to have personal fans in their cells. Hatcher's Resp. to Interrogs. 3-5, 9; Pl.'s Dep. 126:22-127:01. Plaintiff did not have a fan because he could not afford one. Pl.'s Dep. 126:22-127:04. RSP staff placed ice and water in K dorm and permitted inmates to make “ice calls” to obtain ice and water to cool off. Hatcher's Resp. to Interrogs. 3-5, 9; Pl.'s Decl. 6; Pl.'s Dep. 54:02-54:06; FTR Gold 10:29:44-10:30:29. Occasionally, there was no ice in K dorm. Pl.'s Decl. 6; FTR Gold 10:29:44-10:30:29. Plaintiff's cell had a sink and running water. FTR Gold 10:21:59-10:22:08.

When it was very warm, RSP staff opened the K dorm doors to increase air circulation. Hatcher's Resp. to Interrogs. 6. Inmates were permitted to take unlimited showers to cool off. Pl.'s Decl. 6. Other inmates did not like when Plaintiff took multiple showers. Id. Plaintiff was permitted to travel to other areas of the prison for religious services, visitation, and classes, and no prison official prevented him from doing so. FTR Gold 10:18:12-10:19:43, 10:22:23-10:22:48, 10:25:16-10:25:44. Plaintiff was permitted to go to chow hall for meals. Id. at 10:28:27-10:29:38. These areas were not as hot as K dorm. Id. at 10:20:06-10:20:43, 10:22:48-10:22:55, 10:25:16-10:25:44. Inmates were also permitted to use the RSP outdoor yard for exercise and recreation. Id. at 10:13:18-10:33:56. Plaintiff was transferred to a different dorm sometime in October 2016. Pl.'s Dep. 52:16-52:24.

B. Official Capacity Claims

Barron, Hatcher, and Shelton argue that Hatcher and Shelton are entitled to summary judgment on Plaintiff's claims against them in their official capacities because the Eleventh Amendment and the text of 42 U.S.C. § 1983 bar such claims. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 7-8. The Court agrees.⁴

4 Defendant Barron previously moved to dismiss Plaintiff's deliberate indifference claim against him in his official capacity. Barron's Br. in Supp. of 1st Mot. to Dismiss 3-5, ECF No. 25-1. The Court granted Defendant Barron's motion to dismiss on this ground, so, at this stage, only Plaintiff's claim against Defendant Barron in his individual capacity remains. See Order & R. 29-30, Nov. 14, 2019, ECF No. 72; Order 1-3, Jan. 3, 2020, ECF No. 89 (adopting in part recommendation). Thus, the Court addresses only Plaintiff's claims against Defendants Silver and Thompson in their official capacities.

Both Hatcher and Shelton are employees of the Georgia Department of Corrections (“GDC”). GDC employees are entitled to Eleventh Amendment immunity for claims against them in their official capacities. “Official capacity suits for damages against employees of a state agency are suits against the state agency.” Ferguson v. Ga. Dep't of Corr., 428 F.Supp.2d 1339, 1352 (M.D. Ga. 2006). “A suit against a governmental entity which is considered an ‘arm of the state'-such as the GDC-is a suit against the State.” Id. (citing Will v. Mich. Dep't of State Police, 491 U.S. 58, 70 (1989)). “[T]he Eleventh Amendment to the United States Constitution bars a § 1983 action against the State of Georgia and the [GDC] unless the State either consents to suit or waives its sovereign immunity with regard to § 1983 claims-neither of which has happened here.” Ferguson, 428 F.Supp.2d at 1352. Plaintiff's claims against Hatcher and Shelton in their official capacities for monetary damages are barred by the Eleventh Amendment, and Plaintiff cannot recover monetary damages against Hatcher and Shelton in their official capacities.

Additionally, GDC employees, as state officials acting in their official capacities, are not considered “persons” for purposes of § 1983. Will, 491 U.S. at 71; see also Ferguson, 428 F.Supp.2d at 1352-53. Since § 1983 requires that a “person” deprive a plaintiff of his constitutional rights, the lack of a “person” in this case establishes an independent ground for the denial of Plaintiff's claims. Will, 491 U.S. at 71. Therefore, Plaintiff may not raise claims against Hatcher and Shelton in their official capacities, and the Court RECOMMENDS that Barron, Hatcher, and Shelton's motion for summary judgment be GRANTED on this ground.

C. Statute of Limitations

Barron, Hatcher, and Shelton argue they are entitled to summary judgment as to (1) Plaintiff's deliberate indifference claim against Barron, and (2) Plaintiff's conditions of confinement claim against Hatcher and Shelton because Plaintiff's claims are untimely under the applicable statute of limitations. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 8-10. The Court agrees.

1. Statute of Limitations Standard

It is well settled that the forum state's limitation period applicable to personal injury actions is applied to an action brought pursuant to § 1983. Wallace v. Kato, 549 U.S. 384, 386 (2007). The Georgia statute of limitations for personal injury is two years. O.C.G.A. § 9-3-33; see also Bell v. Metro. Atlanta Rapid Transit Auth., 521 Fed.Appx. 862, 865 (11th Cir. 2013) (“The forum state's statute of limitations for personal injury actions applies to § 1983 claims, which in Georgia is two years.”). A statute of limitations begins to run when a cause of action accrues-in other words, when “the facts which would support a cause of action are apparent or should be apparent to a person with a reasonably prudent regard for his rights.” Lovett v. Ray, 327 F.3d 1181, 1182 (11th Cir. 2003) (internal quotation marks and citation omitted).

2. Deliberate Indifference to Dental Needs Claims

Defendants argue that Plaintiff's deliberate indifference claim against Barron accrued, at the latest, when he was transferred to a different prison in July 2016. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 8-9. Plaintiff's claim against Barron concerns his dental treatment at GDCP. Compl. 7-8, ECF No. 1; Am. Compl. 5-6, 8-10, 16, 29-30. Plaintiff arrived at GDCP in May 2016 and was transferred to ASMP on July 12, 2016. Pl.'s Decl. 14, 57; Pl.'s Dep. 30:19-31:10, 35:15-36:13, 87:01-87:06. He was in Barron's care for this period, but he does not allege that Barron had any control over his dental treatment after his transfer from GDCP.

Plaintiff alleges he filed sick call requests and a grievance concerning his denial of dental treatment while confined at GDCP between May and July 2016, so he was aware of an available cause of action concerning his dental treatment by that time. Pl.'s Decl. 13-14, 35; Am. Compl. 7-8; see also Shaffer v. Bryson, 5:18-cv-459-TES-MSH, R. & R. 9-10 (M.D. Ga. Jan. 22, 2021), ECF No. 71, recommendation adopted by Order 1 (M.D. Ga. Feb. 9, 2021), ECF No. 72 (holding that inmate plaintiff's cause of action concerning his denial of medical treatment accrued, at the latest, on the date he filed his grievance concerning his denial of treatment). Plaintiff filed his original complaint (ECF No. 1) raising this claim on August 19, 2018-more than two years after his cause of action accrued, at the latest, on July 12, 2016.⁵ Compl. 7-8 (alleging that Barron denied Plaintiff dental treatment while he was confined at GDCP between May and July 2016). Therefore, Plaintiff's claim was untimely under the two-year statute of limitations.

5 Although the Court did not receive Plaintiff's complaint until August 31, 2018, he signed the complaint on August 19, 2018. Compl. 6. “Under the prison mailbox rule, a pro se prisoner's court filing is deemed filed on the date it is delivered to prison authorities for mailing.” United States v. Glover, 686 F.3d 1203, 1205 (11th Cir. 2012) (internal quotation marks omitted). “Unless there is evidence to the contrary, like prison logs or other records, we assume that a prisoner's motion was delivered to prison authorities on the day he signed it.” Id.

Plaintiff argues he timely filed his complaint because he is entitled to tolling of the limitations period for two reasons. First, he contends the statute of limitations was tolled to allow him to exhaust administrative remedies. Pl.'s Decl. 37-38. The time a plaintiff spends exhausting administrative remedies may toll the statute of limitations. See Leal v. Ga. Dep't of Corr., 254 F.3d 1276, 1280 (11th Cir. 2001) (vacating district court's dismissal of a § 1983 suit on statute of limitations grounds because it was possible plaintiff's exhaustion of administrative remedies had tolled the limitations period); Clark v. Fye, 5:18-cv-71, 2019 WL 1354405 at *3-4 (M.D. Ga. Mar. 26, 2019) (denying a motion to dismiss on statute of limitations grounds where defendants failed to show that the limitations period had not been tolled by plaintiff's pursuit of a prison grievance).

Plaintiff claims he filed a grievance concerning Barron on either June 28 or June 30, 2016. Pl.'s Decl. 13, 35; FTR Gold 9:56:26-9:56:34, 9:56:55-9:57:17. As explained more thoroughly below, however, Plaintiff's grievance history shows that he did not file a grievance at GDCP, and his grievances about his dental treatment at other prisons were unrelated to Barron and untimely. Pugh Decl. Ex. 2, at 34, ECF No. 156-3; FTR Gold 10:08:12-10:08:30, 10:09:00-10:09:24, 10:09:45-10:11:07. Moreover, even assuming Plaintiff filed a grievance on June 28 or June 30, 2016, he did not appeal his grievance. Assuming Plaintiff filed his grievance on June 30, 2016, pursuant to the GDC's grievance standard operating procedure (“SOP”), GDCP officials had forty days to respond to Plaintiff's alleged grievance-until August 9, 2016. Pugh Decl. ¶ 8, Ex. 1, at 16. Once that forty-day period expired, Plaintiff could have filed an appeal of his grievance within seven days. Pugh Decl. ¶ 10, Ex. 1, at 15, 18-19. Accordingly, Plaintiff had until August 16, 2016, to file his appeal, but he failed to do so. Thus, even assuming the limitations period was tolled for the time Plaintiff spent exhausting administrative remedies, based on his own allegations, that period ended-at the very latest-on August 16, 2016, when his time to appeal his alleged grievance expired. His claim against Barron is still untimely because he filed his complaint on August 19, 2018-more than two years later.

Second, Plaintiff contends Barron's denial of treatment constituted a continuing violation which extends the limitations period. Pl.'s Decl. 38-39. Under the continuing violation doctrine, a plaintiff may pursue an otherwise time-barred claim when additional violations underlying the claim occur within the statutory limitations period. Hipp v. Liberty Nat. Life Ins. Co., 252 F.3d 1208, 1222 (11th Cir. 2001) (per curiam) (citations omitted). “The critical distinction in the continuing violation analysis . . . is whether the plaintiff[] complain[s] of the present consequence of a one time violation, which does not extend the limitations period, or the continuation of that violation into the present, which does.” Knight v. Columbus, Ga., 19 F.3d 579, 580-81 (11th Cir. 1993) (internal quotations, alterations, and citations omitted); see also Lovett, 327 F.3d at 1183. “Where a continuing violation is found, the plaintiff[] can recover for any violations for which the statute of limitations has not expired.” Id. at 581.

Plaintiff contends Barron was deliberately indifferent by failing to treat his dental needs while he was confined at GDCP. Compl. 7-8, ECF No. 1; Am. Compl. 5-6, 8-10, 16, 29-30. Plaintiff arrived at GDCP in May 2016, but he was transferred to ASMP on July 12, 2016. Pl.'s Decl. 14, 57. He was no longer in Defendant Barron's care after July 12, 2016. Thus, even assuming Plaintiff alleges a continuing violation between May and July 12, 2016, his claim against Barron accrued-at the latest-by the time he was transferred from GDCP and left Barron's care on July 12, 2016. Lovett, 327 F.3d at 1182; see also Brown v. Roberts, No. 5:09-cv-117-CAR, 2010 WL 1258028, at *2 (M.D. Ga. Mar. 26, 2010) (holding that Plaintiff's deliberate indifference claim concerning an alleged continuing violation of medical treatment accrued when he was transferred to a different prison outside defendant's care); Edwards v. Clark, No. CV 316-019, 2018 WL 2323465, at *3-4 (S.D. Ga. May 22, 2018) (same).

After that date, Defendant Barron had no control over Plaintiff's treatment. Indeed, the record shows Plaintiff realized as much, as he filed separate grievances at ASMP and RSP requesting dental treatment at those facilities. Pugh Decl. Ex. 2, at 34; Pl.'s Dep. 64:10-64:17; FTR Gold 10:08:12-10:08:30, 10:09:00-10:09:24, 10:09:45-10:11:07. Thus, even assuming the continuing violation doctrine applies here, the limitations period as to Plaintiff's claim against Barron was tolled only until July 12, 2016, but he filed his complaint on August 19, 2018-more than two years later. Accordingly, his complaint was still untimely under the statute of limitations. The Court RECOMMENDS that Barron, Hatcher, and Shelton's motion for summary judgment be GRANTED on this ground as to Plaintiff's deliberate indifference claim against Barron.

3. Conditions of Confinement Claims

Defendants also argue that the statute of limitations bars Plaintiff's conditions of confinement claims against Hatcher and Shelton. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 9-10. Plaintiff's claims concern excessive heat in K dorm at RSP between August and October 2016. Am. Compl. 10-12, 27-28, 30-31; Pl.'s Dep. 38:24-39:02, 52:16-52:24, 127:11-127:22; FTR Gold 10:08:06-10:08:52, 10:40:30-10:40:45. Plaintiff filed grievance 228000 concerning the excessive heat on August 20, 2016-four days after he arrived at RSP. Pl.'s Exs. 14; Pl.'s Decl. 7. The heat was no longer excessive and Plaintiff was moved to a different dorm sometime in October 2016. Pl.'s Decl. 8; Am. Compl. 11; Pl.'s Dep. 38:24-39:02, 52:16-52:24, 127:11-127:22; FTR Gold 10:08:06-10:08:52, 10:40:30-10:40:45. He does not allege he was exposed to excessive heat in this new dorm. Thus, even assuming the excessive heat in K dorm constituted a continuing violation from August 2016 to October 2016, Plaintiff's cause of action concerning the excessive heat accrued, at the latest, in October 2016 after he filed a grievance concerning the excessive heat and was moved to a different dorm. See Lovett, 327 F.3d at 1182; Shaffer, 5:18-cv-459-TES-MSH, R. & R. 9-10 (M.D. Ga. Jan. 22, 2021); Brown, 2010 WL 1258028, at *2; Edwards, 2018 WL 2323465, at *3-4.

Moreover, RSP officials notified Plaintiff that grievance 228000 had been denied on September 30, 2016. Pl.'s Exs. 16. He could have filed an appeal of his grievance within seven days-until October 7, 2016. Pugh Decl. ¶ 10, Ex. 1, at 15, 18-19. Plaintiff, however, failed to appeal. Thus, even accounting for both a continuing violation and the time Plaintiff spent exhausting administrative remedies, his cause of action accrued, at the latest, by the end of October 2016. See Leal, 254 F.3d at 1280.

In his August 19, 2018, original complaint, Plaintiff neither described excessive heat at RSP nor listed Hatcher and Shelton as defendants. See Compl. 7-19. He raised this claim for the first time in his amended complaint and named Hatcher and Shelton as defendants. Am. Compl. 10-12, 27-28, 30-31; see also Order & R. 5-8, 12-13, Nov. 14, 2019, ECF No. 72 (conducting preliminary review of Plaintiff's amended complaint, including his conditions of confinement claim against Hatcher and Shelton); Order 1-3, Jan. 3, 2020, ECF No. 89 (adopting in part recommendation). Pursuant to the prison mailbox rule, Plaintiff signed and filed his amended complaint on August 26, 2019-nearly three years after his cause of action accrued in October 2016. See Glover, 686 F.3d at 1205. Consequently, his conditions of confinement claims against Hatcher and Shelton are untimely under the two-year statute of limitations unless the claims “relate[] back to the date of the original pleading.” Fed.R.Civ.P. 15(c)(1).

Defendants argue Plaintiff's claims do not relate back to August 19, 2018-the date he filed his original complaint. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 9. The Court agrees. “Relation back is a legal fiction employed to salvage claims that would otherwise be unjustly barred by a limitations provision.” Caron v. NCL (Bahamas), Ltd., 910 F.3d 1359, 1368 (11th Cir. 2018) (citations omitted). Federal Rule of Civil Procedure 15(c)(1) governs relation back of amended claims. Rule 15(c)(1)(C) provides that an amendment to change the name “of the party against whom a claim is asserted” can relate back if the amendment is filed “within the period provided in Rule 4(m) for serving the summons and complaint, ” and the new defendant:

(i) received such notice of the action that it will not be prejudiced in defending on the merits; and

(ii) knew or should have known that the action would have been brought against it, but for a mistake concerning the proper party's identity.

Additionally, Rule 15(c)(1)(B) provides that for an amendment to relate back, the amendment must assert a claim that arises out of the same “conduct, transaction or occurrence set out . . . in the original complaint.”

Here, Plaintiff's conditions of confinement claim does not relate back under Rule 15(c)(1)(B) or (C) because the claim-as raised in his amended complaint-neither changes the name of a party against whom a claim was asserted in the original complaint nor arises out of the same conduct, transaction, or occurrences described in the original complaint. Rather, Plaintiff's August 19, 2018, original complaint concerned only his dental treatment and mental health treatment at GDCP and RSP. Compl. 7-17. He did not mention excessive heat or name Hatcher and Shelton as defendants until he filed his amended complaint on August 26, 2019-over one year later. Because he did not raise conditions of confinement claims in his original complaint, his claims from his amended complaint cannot relate back as an amendment to change the name of a party against whom a claim has previously been asserted under Rule 15(c)(1)(C).⁶

6 Plaintiff's claims also cannot relate back under Rule 15(c)(1)(C) because Plaintiff filed his amended complaint outside “the [ninety-day] period provided in Rule 4(m) for serving the summons and complaint.” Fed.R.Civ.P. 15(c)(1)(C).

Plaintiff argues that his excessive heat claim relates back because the Court permitted him to amend his complaint and add this claim. Pl.'s Decl. 47. In reviewing Plaintiff's amended complaint, the Court permitted him to join his understaffing claim against Hatcher and Shelton under Rule 20(a)(2) because that claim arose from the same transactions and occurrences as the claims in his original complaint-namely, his denial of mental health treatment at RSP. Order & R. 19-22, Nov. 14, 2019, ECF No. 72. The same is not true of his excessive heat claim. Rather, the Court allowed Plaintiff to join his excessive heat claim under Rule 18(a) solely because he had already joined his understaffing claim and added Hatcher and Shelton as defendants. For statute of limitations purposes, the excessive heat claim does not arise from the same transactions and occurrences as any claim raised in Plaintiff's original complaint. As the Court noted in preliminarily reviewing Plaintiff's amended complaint, it was unclear whether Plaintiff's excessive heat claim was timely when he filed his amended complaint. Order & R. 16, Nov. 14, 2019, ECF No. 72. Now, it is clear that the claim is untimely.

Alternatively, under Rule 15(c)(1)(A), an amendment can relate back when “the law that provides the applicable statute of limitations allows relation back.” “Because Georgia law provides the applicable statute of limitations in this case, if a proposed amendment relates back under Georgia law, then ‘that amendment relates back under Rule 15(c)(1)(A) even if the amendment would not relate back under federal law rules.'” Presnell v. Paulding Cnty., Ga., 454 Fed.Appx. 763, 767 (11th Cir. 2011) (per curiam) (quoting Saxton v. ACF Indus., Inc., 254 F.3d 959, 963 (11th Cir. 2001) (internal alterations omitted)). Georgia's relation back rules regarding adding parties are very similar to the federal rules.

They require that the amendment arise out of the same conduct or occurrence as in the original complaint and that, within the statute of limitations, the proposed party

(1) has received such notice of the institution of the action that he will not be prejudiced in maintaining his defense on the merits, and (2) knew or should have known that, but for a mistake concerning the identity of the proper party, the action would have been brought against him.

O.C.G.A. § 9-11-15(c). There is no evidence that Hatcher and Shelton received notice of Plaintiff's action within the limitation period-by October 2018-because he neither named them as defendants nor raised excessive heat claims in his original complaint. Consequently, Plaintiff's amended complaint does not relate back under Rule 15(c)(1)(A). Because Plaintiff's conditions of confinement claims raised in his amended complaint are untimely under the statute of limitations and do not relate back to the date Plaintiff filed his original complaint, the Court RECOMMENDS that Barron, Hatcher, and Shelton's motion for summary judgment be GRANTED on this ground as to Plaintiff's conditions of confinement claims against Hatcher and Shelton.

D. Exhaustion of Administrative Remedies

In the alternative, Barron, Hatcher, and Shelton argue that Barron is entitled to summary judgment on Plaintiff's deliberate indifference claim against him because Plaintiff failed to exhaust his available administrative remedies as to that claim. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 10-12. The Court agrees.

1. Procedural Posture

Barron, Hatcher, and Shelton have raised exhaustion in a motion for summary judgment. Barron previously filed two motions to dismiss and did not raise failure to exhaust as a ground for dismissal in either motion. See Barron's Br. in Supp. of 1st Mot. to Dismiss 2-5, ECF No. 25-1; Barron's Br. in Supp. of 2d Mot. to Dismiss 3-9, ECF No. 59-1. However,

[b]ecause exhaustion of administrative remedies is a matter in abatement and not generally an adjudication on the merits, an exhaustion defense . . . is not ordinarily the proper subject for a summary judgment; instead, it should be raised in a motion to dismiss, or be treated as such if raised in a motion for summary judgment.

Bryant v. Rich, 530 F.3d 1368, 1374-75 (11th Cir. 2008). Barron, Hatcher, and Shelton raised failure to exhaust as a defense in their answer. Barron, Hatcher, & Shelton's Answer 2, ECF No. 102. Therefore, Defendants' motion for summary judgment will be treated as a motion to dismiss on this ground. Bryant, 530 F.3d at 1374-75.

2. Exhaustion Standard

The Prison Litigation Reform Act (“PLRA”) provides that “[n]o action shall be brought with respect to prison conditions under section 1983 of this title . . . by a prisoner confined in any jail, prison, or other correctional facility until such administrative remedies as are available are exhausted.” 42 U.S.C. § 1997e(a). “[W]hen a state provides a grievance procedure for its prisoners, as Georgia does here, an inmate alleging harm suffered from prison conditions must file a grievance and exhaust the remedies available under that procedure before pursuing a § 1983 lawsuit.” Brown v. Sikes, 212 F.3d 1205, 1207 (11th Cir. 2000) (emphasis added). “To exhaust administrative remedies in accordance with the PLRA, prisoners must properly take each step within the administrative process. If their initial grievance is denied, prisoners must then file a timely appeal.” Bryant, 530 F.3d at 1378 (citation and punctuation omitted).

The argument that a plaintiff has failed to satisfy § 1997e(a) is properly raised in a motion to dismiss. Bryant, 530 F.3d at 1375 (“[E]xhaustion should be decided on a Rule 12(b) motion to dismiss[.]”). Further, since dismissal for failure to exhaust is not an adjudication on the merits, the Court can resolve factual disputes using evidence from outside the pleadings. Id. at 1376. “[D]eciding a motion to dismiss for failure to exhaust administrative remedies is a two-step process.” Turner v. Burnside, 541 F.3d 1077, 1082 (11th Cir. 2008). “First, the court looks to the factual allegations in the defendant's motion to dismiss and those in the plaintiff's response, and if they conflict, takes the plaintiff's versions of the facts as true.” Id. If, taking plaintiff's facts as being true, the defendant is entitled to dismissal for failure to exhaust, then the complaint should be dismissed. Id. “If the complaint is not subject to dismissal at the first step . . ., the court then proceeds to make specific findings in order to resolve the disputed factual issues related to exhaustion.” Id. The defendant bears the burden of proof during this second step. Id.

3. First Step: Defendants' Motion for Summary Judgment

Defendants argue Plaintiff's deliberate indifference claim against Barron should be dismissed because Plaintiff failed to exhaust his administrative remedies, claiming Plaintiff failed to comply with GDC grievance procedures because he did not file a grievance concerning his dental treatment at GDCP. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 11. Plaintiff, however, contends (1) he filed a grievance concerning his dental treatment, and (2) the grievance procedures were unavailable because GDCP officials refused to provide him a grievance receipt. Pl.'s Decl. 35-37; Pl.'s Dep. 57:03-62:10; Am. Compl. 7-8. Because at the first stage of the exhaustion analysis the Court must accept Plaintiff's version of the facts as true, Plaintiff's complaint cannot be dismissed for failure to exhaust at this first step. Turner, 541 F.3d at 1082; see also Dollar v. Coweta Cnty. Sheriff Office, 446 Fed.Appx. 248, 251-52 (11th Cir. 2011) (per curiam).

4. Second Step: Factual Findings

Since the Court did not grant summary judgment at the first step, the Court can make factual findings relating to exhaustion. Turner, 541 F.3d at 1082. A defendant bears the burden of establishing a lack of exhaustion at the second step of the inquiry. Id. at 1082-83. The Court finds that Defendants have met their burden and recommends that their motion for summary judgment-treated as a motion to dismiss-be granted on this ground.

GDC has promulgated a Standard Operating Procedures (“SOP”) regarding grievances which applies to all inmates in GDC custody. Pugh Decl. ¶ 3, Ex. 1, at 6. The SOP mandates that an inmate must follow a two-step process in order to exhaust his remedies: (1) file an original grievance no later than ten days from the date of the incident giving rise to the grievance; and (2) file an appeal to the Central Office. Id. ¶¶ 6-7, 10, Ex. 1, at 13-19. A grievance can only address a “single issue/incident.” Id. Ex. 1, at 13. If a grievance is rejected by the warden without processing, a notice of that rejection must be provided to the inmate. Id. Ex. 1, at 14-15. The inmate may then appeal the rejection to the central office within seven days. Id. ¶ 10, Ex. 1, at 15, 18. If a grievance is processed, “[t]he Warden has 40 calendar days from the date the [inmate] gave the Grievance Form to the Counselor to deliver the decision to the [inmate].” Id. ¶ 8, Ex. 1, at 16. An inmate may file an appeal after the warden issues a decision or after the time allowed for the warden to make his decision expires. Pugh Decl. ¶ 10, Ex. 1, at 18-19.

Here, Plaintiff's grievance history shows that he did not file any grievances while confined at GDCP. Id. ¶¶ 12-13, Ex. 2, at 34. Moreover, according to GDCP Grievance Coordinator Ruby Pugh,

[w]hen an inmate files an Original Grievance concerning an event that occurred at a different GDC facility, the Grievance Coordinator at the inmate's then-current facility retains a copy of the grievance and forwards the Original Grievance to the Grievance Coordinator at the facility where the incident occurred for screening and processing.

Id. ¶ 9; see also Id. Ex. 1, at 21. Grievance Coordinator Pugh avers that the grievance records “show[] that [Plaintiff] submitted no grievances relating to dental care . . . at GDCP.” Id. ¶ 12. Thus, Plaintiff's grievance history and Grievance Coordinator Pugh's testimony show that Plaintiff also did not file a grievance concerning Barron and his dental treatment at GDCP while confined at a different prison.

Plaintiff, however, argues he successfully filed two grievances concerning Barron's dental treatment. First, he states that he filed grievance 224576 on August 2, 2016, while confined at ASMP. Pl.'s Decl. 37; see Pl.'s Exs. 22. In grievance 224576, Plaintiff complains that he developed a toothache at GDCP and seeks treatment. Pl.'s Exs. 22. He does not mention Barron. Rather, he requests “to see a dentist as soon as possible” at ASMP. Id. Second, Plaintiff states that he filed grievance 229672 concerning Barron on August 30, 2016, while confined at RSP. Pl.'s Decl. 37; see Pl.'s Exs. 36. Again, although Plaintiff mentions Barron, he specifically seeks dental treatment from a provider at RSP and complains that a dentist at ASMP ignored him for five weeks. Pl.'s Exs. 36. During the hearing on Defendants' motions for summary judgment, Plaintiff even admitted that when he filed these two grievances, he understood that Barron was no longer his dentist and that he sought from providers at different prisons. FTR Gold 10:08:52-10:08:58, 10:10:01-10:11:07. Plaintiff failed to file a grievance seeking treatment from Barron which would have given GDCP officials notice of his problem and allowed them to remedy the problem. See Parzyck v. Prison Health Servs., Inc., 627 F.3d 1215, 1218-19 (11th Cir. 2010) (Exhaustion “requires inmates to complete the administrative review process in compliance with the prison's grievance procedures, so that there is ‘time and opportunity to address complaints internally before allowing the initiation of a federal case.'” (quoting Woodford v. Ngo, 548 U.S. 81, 93 (2006))).

Additionally, even assuming Plaintiff attempted to grieve Barron's dental treatment by filing grievances 224576 and 229672, both grievances were untimely. The grievance SOP provides that an inmate must file an original grievance no later than ten days from the date of the incident giving rise to the grievance. Pugh Decl. ¶ 7, Ex. 1, at 14. Plaintiff was transferred from GDCP-and out of Barron's care-on July 12, 2016. Pl.'s Decl. 14, 57. Indeed, during the hearing, Plaintiff testified that he knew he filed grievances 224576 and 229672 more than ten days after he left Barron's care at GDCP. FTR Gold 10:09:00-10:09:24, 10:09:45-10:10:00. Thus, both grievances 224576 and 229672 were untimely as to Barron because Plaintiff filed them nearly a month after he left GDCP and Barron's care. Pugh Decl. ¶ 7, Ex. 1, at 14. He does not allege that he attempted to file any grievances concerning his treatment at GDCP within ten days of his transfer from GDCP to ASMP. “Proper exhaustion demands compliance with an agency's deadlines and other critical procedural rules.” Woodford, 548 U.S. at 91. Because Plaintiff failed to comply with the GDC's procedural rules for grievances, he fails to show that he exhausted administrative remedies as to Barron by filing these two grievances.

Plaintiff also contends he filed a grievance at GDCP concerning Barron and his dental treatment, but his grievance was ignored. Pl.'s Decl. 13; Pl.'s Dep. 57:03-62:10; Am. Compl. 7. He states he “was never given any written or verbal instructions, information on grievances[.]” Am. Compl. 7-8; see also Pl.'s Dep. 57:03-62:10. When Plaintiff submitted his grievances at GDCP, he “was never given a receipt or told about the process, including the appeal process.” Am. Compl. 7-8; see also Pl.'s Dep. 57:03-62:10.

An inmate is required to exhaust those administrative remedies which are “available.” Booth v. Churner, 532 U.S. 731, 738-39 (2001). In Ross v. Blake, -- U.S. --, 136 S.Ct. 1850 (2016), the Supreme Court held that an administrative procedure is unavailable under the PLRA when either (1) “it operates as a simple dead end-with officers unable or consistently unwilling to provide any relief to aggrieved inmates, ” (2) it is “so opaque that it becomes, practically speaking, incapable of use, ” or (3) “prison administrators thwart inmates from taking advantage of a grievance process through machination, misrepresentation, or intimidation.” Ross, 136 S.Ct. at 1859-60. “While the burden is on the defendant to show an available administrative remedy, once that burden has been met, the burden of going forward shifts to the plaintiff, who . . . must demonstrate that the grievance procedure was ‘subjectively' and ‘objectively' unavailable to him.” Geter v. Baldwin State Prison, 974 F.3d 1348, 1356 (11th Cir. 2020) (citation omitted).

It appears Plaintiff argues his grievance remedy was unavailable under the third circumstance described in Ross for two reasons: (1) GDCP officials never informed him of the grievance procedures, and (2) GDCP officials failed to provide him grievance receipts or process his alleged grievances. Am. Compl. 8 (“For all practical purposes the grievance policy was not available to me at [GDCP].”); see Ross, 136 S.Ct. at 1859-60. Both arguments are unavailing. First, Plaintiff fails to show that he could not discover the relevant grievance procedures. In Goebert v. Lee County, 510 F.3d 1312 (11th Cir. 2007), a plaintiff filed a grievance concerning her medical treatment at a jail, received a response, but failed to appeal the response because she was unaware of the option to appeal since “the appeal procedure [was] laid out in the jail's General Operating Procedures, but . . . no inmate was ever permitted to see those procedures.” Goebert, 510 F.3d at 1322. The Eleventh Circuit concluded that the plaintiff “did not know that she should, or could, appeal [the grievance administrator's] denial of her complaint.” Id. The Court held that “remedies or requirements for remedies that an inmate does not know about, and cannot discover through reasonable effort by the time they are needed” are not available and need not be completed to properly exhaust. Id. The Court reasoned that “[i]f we allowed jails and prisons to play hide-and-seek with administrative remedies, they could keep all remedies under wraps until after a lawsuit is filed and then uncover them and proclaim that the remedies were available all along.” Id. at 1323.

The same reasoning does not apply here. According to Grievance Coordinator Pugh, “inmates are provided an oral explanation of the grievance process upon entering the custody of the GDC.” Pugh Decl. ¶ 4. “Inmates are also provided a copy of the Orientation Handbook for Offenders, which includes instructions on the grievance procedure.” Id. Plaintiff alleges he received neither an oral explanation nor a handbook at GDCP. Am. Comp. 7; Pl.'s Dep. 57:03-58:13, 60:25-61:03. He admits, however, that he learned of the grievance procedures by talking to other inmates. Pl.'s Dep. 57:18-59:02, 60:02-60:24. Thus, at the very least, Plaintiff knew he needed to file a grievance at GDCP. Moreover, Grievance Coordinator Pugh avers that “[i]nmates also have access to a copy of the Grievance SOP at the facility or center library.” Pugh Decl. ¶ 4. Plaintiff has not disputed this assertion.

Plaintiff's ability to access the grievance procedures in the prison library distinguishes his case from Goebert where “no inmate was ever permitted to see [the] procedures.” Goebert, 510 F.3d at 1322. Here, even accepting as true Plaintiff's allegations that he was neither given an oral explanation of the grievance procedures nor provided a handbook, Plaintiff could have “discover[ed] [the grievance procedures] through reasonable effort by the time they [were] needed” simply by requesting the procedures or visiting the GDCP library. Id.; see also Woodard v. Sauls, No. 4:19-CV-00097-CDL-MSH, 2020 WL 6498656, at *4-5 (M.D. Ga. May 4, 2020), recommendation adopted by 2020 WL 5363303 (M.D. Ga. Sept. 8, 2020). Accordingly, Plaintiff fails to show that his grievance remedy was unavailable based on his alleged lack of knowledge of or access to the GDC grievance procedures.

Second, Plaintiff fails to show that his grievance remedy was unavailable because GDCP officials failed to provide him a grievance receipt. According to Grievance Coordinator Pugh, “[a]ll inmates receive a receipt for each grievance that is submitted.” Pugh Decl. ¶ 13; see also Id. Ex. 1, at 13. Moreover, she states she is “not aware of, and there is no record of, GDCP staff disposing of any grievance submitted by inmate Dipietro (or any other inmate) and not recording and addressing the grievance as provided in the Grievance SOP.” Id. Defendants have met their initial burden of showing that an administrative remedy is generally available at GDCP. See Geter, 974 F.3d at 1356.

During the hearing on Defendants' motions for summary judgment, the Court allowed Plaintiff to testify under oath to allow the Court to assess Plaintiff's credibility and “to make specific findings in order to resolve the disputed factual issues related to exhaustion.” Turner, 541 F.3d at 1082; Bryant, 530 F.3d at 1377 n.16 (holding that courts may hold evidentiary hearings to resolve factual issues concerning exhaustion); see also McIlwain v. Burnside, 830 Fed.Appx. 606, 610-12 (11th Cir. 2020) (per curiam). Plaintiff testified that he handed his grievance concerning Barron to a female GDCP counselor on either June 28 or June 30, 2016, but the counselor did not give him a receipt. FTR Gold 9:55:36-9:57:31; see also Pl.'s Dep. 57:18-58:13.

Plaintiff fails to meet his burden of proving that the “grievance procedure was ‘subjectively' and ‘objectively' unavailable to him.” Geter, 974 F.3d at 1356. Having assessed Plaintiff's credibility at the hearing, the Court does not find his testimony credible. Plaintiff's testimony as to his efforts to exhaust administrative remedies at GDCP has been inconsistent. In his complaint, Plaintiff stated that he filed only one grievance which was ignored. Compl. 3. In his amended complaint, deposition, and hearing, Plaintiff alleges he filed two grievances at GDCP, and he did not receive a receipt for either. Am. Compl. 7-8; Pl.'s Dep. 57:03-57:17; FTR Gold 9:55:36-9:56:25. During the hearing, Plaintiff first testified that he believes he did not receive receipts for other grievances which he submitted at different prisons. FTR Gold 9:57:35-9:58:51. Shortly thereafter, he reversed course and stated that he does not recall any other grievances which were not recorded other than the two alleged GDCP grievances. Id. at 10:16:20-10:16:53. In his brief, Plaintiff states that “[b]ecause of [his] mental health, [he] can't remember details about [his GDCP] grievances except to say, [he] know[s] he filed [two] grievances at GDCP.” Pl.'s Br. in Opp'n to Foreman, Silver, and Thompson's Mot. for Summ. J. 10, ECF No. 173. During the hearing, he stated that his mental health did not cause him to forget about the grievance procedures at GDCP. FTR Gold 10:05:56-10:06:20.

Plaintiff's testimony as to other aspects of his case has also been inconsistent, if not outright contradictory. In his deposition and declaration, he has presented entirely different descriptions of his alleged physical injuries from excessive heat. Compare Pl.'s Dep. 46:06-50:04 with Pl.'s Decl. 2-3. His accounts of his suicide attempt have changed dramatically, including the alleged date of the suicide attempt and the manner in which he attempted suicide. Compare Am. Compl. 13 with Pl.'s Dep. 97:13-97:24, 99:02-99:07 with Pl.'s Decl. 59. In his amended complaint, Plaintiff states that when he met with Silver and Thompson after his suicide attempt, Thompson promised him regular counseling sessions. Am. Compl. 24-25. In his deposition, he testified that “Thompson did not say a lot. . . . He just stood there and nodded I think from what I remember.” Pl.'s Dep. 112:12-112:19. In his declaration, Plaintiff avers that Thompson discussed his sick call requests and that he “was led to believe that Dr. Thompson was going to do counseling.” Pl.'s Decl. 61-62. In his amended complaint, Plaintiff states that when he met with Silver and Thompson, “[w]e did not talk about the suicide attempt[.]” Am. Compl. 14. In his declaration, he avers that he “told . . . Silver [and] Thompson about [his] suicide attempt that day.” Pl.'s Decl. 61.

In his amended complaint, Plaintiff also alleged that he discussed the heat in K dorm with Silver and that Silver stated that she knew the heat in Plaintiff's dorm “was contributing to [his] poor mental health.” Am. Compl. 23. By contrast, in his deposition, Plaintiff testified that he did not recall discussing heat with Silver. Pl.'s Dep. 102:14-103:08. Then, in his declaration, he states that he mentioned the heat to Silver, but he does not “recall a specific conversation.” Pl.'s Decl. 62. Plaintiff has also admitted that he repeatedly and intentionally misled mental health staff about his suicidal thoughts at GDCP, ASMP, and RSP. Pl.'s Decl. 53, 58; Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 8, 12; Pl.'s Dep. 119:07-120:10; Am. Compl. 14. Although the Court construes Plaintiff's allegations in the light most favorable to him-as required at summary judgment-his repeated inconsistent testimony undermines his credibility. See Turner, 541 F.3d at 1082 (requiring courts to make factual findings as to disputed issues concerning exhaustion).

Moreover, the Court does not find his testimony credible because it is unclear how Plaintiff could not have known about grievance receipts. Plaintiff alleges he submitted his June 28 and June 30, 2016, grievances concerning Barron and Foreman on the GDC's standard grievance form. Pl.'s Dep. 60:02-60:10. The grievance receipt-which Plaintiff alleges he had never heard of-is attached to the bottom of that form. See Pugh Decl. Ex. 1, at 23. In bold, capitalized letters, it is identified as “Receipt for Grievance at Counselor's Level.” Id. The receipt includes lines identifying the inmate by name and GDC identification number and an acknowledgment that the counselor received the grievance, which requires the counselor's signature and date. Pugh Decl. Ex. 1, at 23. It is unclear how Plaintiff could be unaware of a grievance receipt when the receipt is attached to the grievance forms he allegedly gave to the counselor. Indeed, Plaintiff has successfully filed multiple grievances in compliance with the grievance SOP on these same forms, and he does not allege that he was denied a receipt as to any other grievances. See Pugh Decl. Ex. 2, at 34; FTR Gold 10:16:20-10:16:53. He filed at least two less than a month after his transfer from GDCP. Pl.'s Exs. 22, 36.

Plaintiff's allegations are also distinguishable from cases where the Court found that grievance remedies were unavailable where plaintiffs submitted documents they attempted to file as grievances and alleged that prison officials refused to accept those documents. See Miller v. Williamson, 5:20-cv-00005-MTT-MSH, 2020 WL 8832507, at *4-7 (M.D. Ga. Dec. 29, 2020), recommendation adopted in part by 2021 WL 653021 (M.D. Ga. Feb. 19, 2021); Mathews v. Conley, 5:19-cv-405-MTT-MSH, R. & R. 9-20 (M.D. Ga. Dec. 29, 2020), ECF No. 38, recommendation adopted by Order 1 (M.D. Ga. Feb. 16, 2021), ECF No. 44. Here, by contrast, Plaintiff states merely that he gave two grievances to an unknown female GDCP counselor, one of the grievances concerned Barron and his dental treatment, and he never received a receipt for either grievance. Am. Compl. 7-8; Pl.'s Dep. 57:03-58:13, 59:03-59:16, 60:02-60:10, 61:04-62:10. Plaintiff submitted an alleged “rough draft” of his grievance, but the handwriting is indecipherable and mostly lists dates he allegedly filed grievances. See Pl.'s Decl. 35; Pl.'s Exs. 8.

Plaintiff fails to show that his grievance remedy was unavailable at GDCP based on these conclusory allegations which are belied by his own assertion that he filed his grievances on the standard grievance forms. The Court finds that the GDC grievance remedy was available at GDCP, but Plaintiff failed to file a grievance concerning Barron's dental treatment at GDCP. See Turner, 541 F.3d at 1082 (permitting courts to make factual findings at the second step of the exhaustion analysis). Because Plaintiff failed to exhaust available administrative remedies by filing a prison grievance concerning his dental treatment at GDCP, the Court RECOMMENDS that Defendants' motion for summary judgment be GRANTED on this ground as to Plaintiff's deliberate indifference claim against Barron.

E. Deliberate Indifference

Assuming the Court may reach the merits of Plaintiff's claims, Defendants argue they are entitled to summary judgment because (1) Plaintiff fails to show that Barron was deliberately indifferent to Plaintiff's serious dental needs, and (2) Plaintiff fails to show that Hatcher and Shelton were deliberately indifferent to his serious medical needs by understaffing the RSP mental health department. Barron, Shelton, & Hatcher's Br. in Supp. of Mot. for Summ. J. 13-16. The Court agrees.

1. Deliberate Indifference Standard

“The Eighth Amendment's prohibition against cruel and unusual punishments protects a prisoner from deliberate indifference to serious medical needs.” Kuhne v. Fla. Dep't of Corr., 745 F.3d 1091, 1094 (11th Cir. 2014) (internal quotation marks and citations omitted). “[T]o prevail on a deliberate indifference to serious medical need claim, [a plaintiff] must show: (1) a serious medical need; (2) the defendants' deliberate indifference to that need; and (3) causation between that indifference and the plaintiff's injury.” Mann v. Taser Int'l, 588 F.3d 1291, 1306-07 (11th Cir. 2009). “A serious medical need is considered 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.” Farrow v. West, 320 F.3d 1235, 1243 (11th Cir. 2003) (internal quotation marks and citation omitted). Deliberate indifference requires a showing of a “subjective knowledge of a risk of serious harm” and “disregard of that risk . . . by conduct that is more than mere negligence.” Brown v. Johnson, 387 F.3d 1344, 1351 (11th Cir. 2004) (citation omitted).

Disagreement over the mode of treatment does not constitute deliberate indifference for the purposes of the Eighth Amendment. See Hamm v. Dekalb Cnty., 774 F.2d 1567, 1575 (11th Cir. 1985) (“[A]n inmate's desire for a different mode of treatment does not rise to the level of deliberate indifference.”). Negligence in treatment, even rising to the level of medical malpractice, is not deliberate indifference. Estelle v. Gamble, 429 U.S. 97, 106 (1976). Instead, the treatment must be “so grossly incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to fundamental fairness.” Harris v. Thigpen, 941 F.2d 1495, 1505 (11th Cir. 1991) (internal quotation marks and citations omitted). “[C]onduct deliberately indifferent to serious medical needs has included: (1) grossly inadequate care; (2) a decision to take an easier but less efficacious course of treatment; and (3) medical care that is so cursory as to amount to no treatment at all.” Melton v. Abston, 841 F.3d 1207, 1223 (11th Cir. 2016); Rogers v. Evans, 792 F.2d 1052, 1058 (11th Cir. 1986) (“Medical care so inappropriate as to evidence intentional maltreatment or refusal to provide essential care violates the eighth amendment.”).

2. Defendant Barron

Plaintiff raises a claim against Barron for deliberate indifference to his serious dental needs based on Barron's failure to treat his tooth pain. Am. Compl. 5-6, 8-10, 16, 29-30. Defendants argue they are entitled to summary judgment as to Plaintiff's claim against Barron because Plaintiff fails to show that Barron was deliberately indifferent to his serious dental needs. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 14-16.

i. Inadequate Treatment

To the extent Plaintiff argues Barron provided inadequate treatment for his tooth pain, he fails to establish deliberate indifference. Defendants argue Plaintiff cannot show treatment that Barron “disregard[ed] [Plaintiff's] risk . . . by conduct that is more than mere negligence.” Brown, 387 F.3d at 1351 (citation omitted); see Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 14-15. It is undisputed that when Plaintiff complained of tooth, gum, and head pain, Barron examined his teeth and gums twice, demonstrated how to properly floss, prescribed him antibiotics and ibuprofen, and performed and took a radiograph of his teeth. Barron's Resp. to Interrogs. 16, 19-20, 27-28; Pl.'s Dep. 32:06-33:02, 34:05-34:09, 35:09-35:14. Barron, however, did not observe a crack or fracture in Plaintiff's tooth. Barron's Resp. to Interrogs. 4. Indeed, Plaintiff states that his tooth split while he was confined at either ASMP or RSP-at least six weeks after he left Barron's care at GDCP in July 2016. Pl.'s Dep. 37:05-38:17. A dentist at RSP first noted the fracture and recommended extraction on August 22, 2016. Barron's Resp. to Interrogs. 27. The tooth was extracted on August 31, 2016. Id.

Plaintiff appears to argue that Barron was deliberately indifferent by rendering inadequate treatment and by failing to consider modes of treatment other than extraction. Pl.'s Decl. 31-32. He contends Barron “did nothing but prescribe medications” and this constitutes inadequate treatment. Id. at 32. He believes Barron could have saved the tooth by taking other measures. Id. He also claims that Barron failed to clean his teeth or make a tooth guard as he promised at during his first examination on May 16, 2016. Id. at 31-32; see Barron's Resp. to Interrogs. 27. Barron, however, evaluated Plaintiff twice during his two-month stint at GDCP, addressed Plaintiff's pain by providing ibuprofen, instructed Plaintiff on proper flossing to avoid further damage to his gums and tooth, and took diagnostic measures by taking radiographs of Plaintiff's tooth to determine if it should be extracted. Barron's Resp. to Interrogs. 27; Barron Decl. ¶ 11; Pl.'s Decl. 11; Pl.'s Dep. 32:13-32:24, 34:05-34:09; FTR Gold 10:34:50-10:35:05. Additionally, Plaintiff temporarily left Barron's care when he was transferred to ASMP in early June 2016, and he was permanently transferred to ASMP on July 12, 2016-just over a month after Barron evaluated him the second time on June 8, 2016. Pl.'s Dep. 87:01-87:24; Pl.'s Mental Health Records 25 (showing that Plaintiff met with a mental health staff member on June 14, 2016, while confined at ASMP); Pl.'s Decl. 14, 57. Thus, he was in Barron's care for- at most-two months.

To the extent Plaintiff claims Barron could have saved his tooth, he presents no evidence supporting this assertion. Indeed, Dr. Gordon designated the tooth for possible extraction on May 18, 2016-just two days after Barron examined Plaintiff the first time. Barron's Resp. to Interrogs. 20; Barron Decl. ¶ 7. The fact that Barron did not pursue other forms of treatment-such as cleaning Plaintiff's teeth or making him a tooth guard- amounts, at most, to negligence, especially given Barron's other treatments. In short, Barron evaluated Plaintiff and treated his gum and tooth, and Plaintiff fails to show that this treatment was inadequate. Whitley v. Albers, 475 U.S. 312, 319 (1986) (“It is obduracy and wantonness, not inadvertence or error in good faith, that characterizes the conduct prohibited by the Cruel and Unusual Punishments Clause.”); Waldrop v. Evans, 871 F.2d 1030, 1035 (11th Cir. 1989) (“[W]hen a prison inmate has received medical care, courts hesitate to find an Eighth Amendment violation.” (citation omitted)). Plaintiff clearly desired some other form of treatment, though he does not even suggest what that might have been. Regardless, “an inmate's desire for a different mode of treatment does not rise to the level of deliberate indifference.” Hamm, 774 F.2d at 1575; Adams v. Poag, 61 F.3d 1537, 1545 (11th Cir. 1995) (“Whether governmental actors should have employed additional diagnostic techniques or forms of treatment ‘is a classic example of a matter for medical judgment' and therefore not an appropriate basis for grounding liability under the Eighth Amendment.” (quoting Estelle, 429 U.S. at 107)).

ii. Delay of Treatment

To the extent Plaintiff claims that Barron delayed treating Plaintiff's tooth and this delay caused the tooth to crack, Defendants argue Plaintiff fails to establish deliberate indifference. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 15-16. “[D]elay in access to medical care that is tantamount to unnecessary and wanton infliction of pain, may constitute deliberate indifference to a prisoner's serious medical needs.” Adams, 61 F.3d at 1544 (internal quotations and citations omitted). “Some delay in rendering medical treatment may be tolerable depending on the nature of the medical need and the reason for the delay.” Id. (citing Harris v. Coweta Cnty., 21 F.3d 388, 393-94 (11th Cir. 1994)). A delay in medical treatment constitutes deliberate indifference “where ‘it is apparent that delay would detrimentally exacerbate the medical problem,' the delay does seriously exacerbate the medical problem, and the delay is medically unjustified.” Taylor v. Adams, 221 F.3d 1254, 1259-60 (11th Cir. 2000) (quoting Hill v. Dekalb Reg'l Youth Det. Ctr., 40 F.3d 1176, 1187-89 (11th Cir. 1994), overruled in part on other grounds by Hope v. Pelzer, 536 U.S. 730, 739 n.9 (2002)). “An inmate who complains that delay in medical treatment rose to a constitutional violation must place verifying medical evidence in the record to establish the detrimental effect of delay in medical treatment to succeed.” Hill, 40 F.3d at 1188.

The crux of Plaintiff's claim is that had Barron not delayed in treating his tooth, he would not have developed a crack or lost his tooth. Pl.'s Decl. 33-34. In support, he relies on Farrow v. West, 320 F.3d 1235 (11th Cir. 2003). See Id. In Farrow, an inmate had only two lower teeth when he was incarcerated, which caused severely sore and swollen gums, bleeding, and severe weight loss due to his inability to eat. Farrow, 320 F.3d at 1239. The defendant dentist did not meet with the inmate until nearly three months after he arrived at the prison. Id. During this visit, the inmate told the defendant about all of his conditions and pain, and the dentist completed the first step in the three-step process to provide the inmate dentures. Id. at 1239-40. The dentist completed the second step approximately one month later, but the dentist became frustrated with the inmate's requests for treatment, instructed prison staff not to send him to the medical unit, and refused to meet with the inmate. Id. at 1240. The inmate received no dental care for nine months and continued to suffer weight loss. Id. The dentist did not meet with the inmate or complete the third step in the dentures process for another three months. Id. at 1240-41. The inmate raised a deliberate indifference claim, and the district court granted summary judgment to the dentist. Farrow, 320 F.3d at 1241-42.

The Eleventh Circuit reversed. Id. at 1245-48. The Court emphasized that the dentist waited fifteen months to complete the process to provide the inmate dentures and rendered no treatment for nearly a year. Id. at 1246. The Court acknowledged that “the facts [did] not suggest that [the inmate's] condition was so grave that some considerable delay in dental treatment would have authorized a finding of deliberate indifference.” Id. at 1247. Nonetheless, given the “recognized need for denture treatment, the nature of [the inmate's] continuing problems, the sheer length of the delay involved, and the lack of any reasonable explanation for the inordinate delay[, ]” the Court found that the dentist's delay could constitute deliberate indifference. Id. In particular, the Court noted that the delay was not medically justified because the dentist “offered no reasonable explanation for the fifteen-month delay.” Id.

Plaintiff fails to establish deliberate indifference based on a delay in treatment for three reasons. First, he fails to show that it was apparent that a delay would detrimentally exacerbate his dental issue. Neither Dr. Gordon nor Barron observed a crack in Plaintiff's tooth. Barron's Resp. to Interrogs. 4, 20; Barron Decl. ¶ 7. Dr. Gordon, however, noted that Plaintiff's tooth may have to be extracted on May 18, 2016-only two days after Plaintiff met with Barron on May 16, 2016. Barron's Resp. to Interrogs. 20; Barron Decl. ¶ 7. Thus, GDCP dental staff believed that extraction may have been necessary independent of Barron's subsequent assessments and treatments. Moreover, to the extent Plaintiff argues that Barron should have recognized a crack when he treated him on May 16, 2016, or June 8, 2016, such a claim sounds in negligence-not deliberate indifference-given that Barron actually evaluated his tooth and ordered a radiograph.

Second, Plaintiff fails to show that the delay actually seriously exacerbated his dental issue. He appears to base his claim on two facts: (1) Barron treated him for two months while he was confined at GDCP, and (2) a different dentist at RSP diagnosed him with a cracked tooth six weeks after he left Barron's care. Pl.'s Decl. 32-34. To establish deliberate indifference based on a delay in treatment, Plaintiff “must place verifying medical evidence in the record to establish the detrimental effect of delay in medical treatment to succeed.” Hill, 40 F.3d at 1188. According to Plaintiff, “the fact that the tooth was extracted is verifying evidence in the records.” Pl.'s Decl. 33. That is simply not the case. None of the medical evidence in the record shows that but for Barron's delay, Plaintiff's tooth would not have cracked and required extraction. Plaintiff has simply failed to establish the detrimental effect of delay in Barron's dental treatment.

Unlike in Farrow, where the dentist knew of the need to act immediately and make Plaintiff's dentures, here, Barron and Dr. Gordon had not yet determined whether Plaintiff's tooth required extraction. Neither Dr. Gordon nor Barron observed or noted a crack in Plaintiff's tooth. Barron's Resp. to Interrogs. 4, 20; Barron Decl. ¶ 7. However, as the Court has emphasized, Dr. Gordon indicated that Plaintiff's tooth may have required extraction based solely on an initial evaluation-only two days after Plaintiff first met with Barron-without the aid of any other assessments. Barron's Resp. to Interrogs. 20; Barron Decl. ¶ 7. Thus, the medical evidence shows that extraction may have been required whether Barron administered any further treatment after May 16, 2016. Nevertheless, Barron met with Plaintiff again and avers that he ordered Plaintiff's radiograph for this very reason-to determine whether extraction was appropriate. Barron's Resp. to Interrogs. 4, 7, 27. Plaintiff has presented no verifying medical evidence showing that he would not have lost his tooth had Barron treated him differently or met with him more often during the less than two months during which he was in Barron's care.

Third, even assuming Barron's delay exacerbated Plaintiff's condition, Plaintiff fails to show that the delay was medically unjustified. As Barron explains, although Dr. Gordon noted that Plaintiff's tooth may require extraction, the evaluation for extraction is a multi-step process, and Plaintiff was transferred before Barron could determine whether extraction was appropriate. Barron's Resp. to Interrogs. 4, 7, 20; Barron Decl. ¶ 7. In the interim, he employed diagnostic techniques to help reach this determination, including ordering a radiograph, evaluating Plaintiff twice in less than two months, and prescribing medication to address any pain or possible infection. Barron's Resp. to Interrogs. 4, 7, 27.

In Farrow, where the dentist knew the severity of the inmate's condition when he first saw the inmate, the Eleventh Circuit held that the delay was not medically justified based on the “recognized need for denture treatment, the nature of his continuing problems, the sheer length of the delay involved, and the lack of any reasonable explanation for the inordinate [fifteen-month] delay.” Farrow, 320 F.3d at 1247. Moreover, in Farrow, the dentist deliberately avoided Plaintiff and instructed prison staff not to allow him access to treatment. Id. at 1240. Here, none of these circumstances are present. Barron first saw Plaintiff only eleven days after Plaintiff had an initial screening on May 5, 2016. Pl.'s Exs. 3; Barron's Resp. to Interrogs. 16, 27. Plaintiff met with Barron again less than a month later on June 8, 2016. Barron's Resp. to Interrogs. 27. Plaintiff was temporarily sent to ASMP shortly thereafter, and he was permanently transferred to ASMP on July 12, 2016. Pl.'s Decl. 14, 57. Thus, the longest delay in treatment was one month.

Moreover, unlike the dentist in Farrow who simply did nothing for over a year to treat an inmate's far more serious condition, in less than two months, Barron met with Plaintiff twice, instructed Plaintiff on proper flossing, took a radiograph of his teeth, and prescribed medications to treat his pain in the interim. Barron's Resp. to Interrogs. 4, 7, 27; Barron's Decl. ¶ 11. Whereas the delay in Farrow was inexplicable, here, Dr. Gordon initially recognized the possibility of extraction on May 18, 2016. Barron's Resp. to Interrogs. 27; Barron's Decl. ¶ 7. Neither Barron nor Dr. Gordon observed a crack, but Barron took a radiograph of Plaintiff's tooth to determine whether there was a crack which would require extraction. Barron's Resp. to Interrogs. 4, 7, 27; Barron's Decl. ¶¶ 7, 11. Barron avers that this process takes time, and Plaintiff was transferred-just over a month after the radiograph with a temporary transfer in the interim-before he completed the process. Barron Decl. ¶¶ 4, 7.

There is simply no evidence that Barron delayed Plaintiff's treatment for non-medical reasons. Given Barron's treatment of Plaintiff's tooth over this less than two-month period, Plaintiff fails to show that Barron's treatment was not “so grossly incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to fundamental fairness.” Harris, 941 F.2d at 1505 (internal quotation marks and citations omitted). And it was not “so inappropriate as to evidence intentional maltreatment or refusal to provide essential care.” Rogers, 792 F.2d at 1058. Because Plaintiff fails to show that Barron was deliberately indifferent to his serious dental needs, the Court RECOMMENDS that Defendants' motion for summary judgment be GRANTED on this ground.

3. Understaffing-Defendants Hatcher and Shelton

Plaintiff raises a claim against Hatcher and Shelton for deliberate indifference to his mental health needs based on their failure to adequately staff the RSP mental health department. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 17-18. “[A] defendant who delays necessary treatment for non-medical reasons may exhibit deliberate indifference.” Farrow, 320 F.3d at 1246. Additionally, a prison official's knowledge of a “severe lack of staff members capable of providing psychiatric care to the inmates” may constitute deliberate indifference. Greason v. Kemp, 891 F.2d 829, 837 (11th Cir. 1990).

Defendants argue Plaintiff fails to show that Hatcher and Shelton were deliberately indifferent to his serious medical needs. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 13-14. First, Defendants contend Plaintiff fails to show that Hatcher and Shelton had subjective knowledge of Plaintiff's mental health needs or understaffing. Id.; see also Brown, 387 F.3d at 1351 (requiring a plaintiff to show, inter alia, “subjective knowledge of a risk of serious harm” to establish deliberate indifference). Plaintiff asserts that Hatcher and Shelton must have had knowledge of understaffing. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 17-18. In support, he relies on Greason v. Kemp, 891 F.2d 829 (11th Cir. 1990). Id.

In Greason, an inmate with a history of depression, schizophrenia, and suicidal tendencies committed suicide after prison mental health staff discontinued his anti-depression medication, failed to monitor the inmate for potential adverse effects of the discontinuance, and failed to respond to the inmate's parents' assertion that the inmate may attempt suicide. Greason, 891 F.2d at 831-33. Next-of-kin plaintiffs raised claims against multiple prison officials, including mental health supervisors and a warden. Id. at 834-35. In evaluating the claims against the supervisors, the Eleventh Circuit noted that the inmate's treating physician “complained to [a supervisor] many times of inadequate staff and of his inability to spend sufficient time with the inmates.” Id. at 837; see also Id. at 839 (noting that a second supervisor “was aware of the excessive burden on [the treating physician] and admitted that [the treating physician] could not adequately treat all of the inmates requiring mental health care”). The physician “also complained . . . about the lack of an institutionalized mental health unit for inmates with severe emotional problems.” Id. A supervisor reviewed a treating physician's records which indicated the inmate had suicidal tendencies, mental health staff had discontinued the inmate's medication, and no one monitored the inmate. Id. at 838.

In particular, the defendant warden “was . . . aware that approximately seventy to seventy-five inmates required mental care at the time and that [the clinical director] visited the facility only once a week.” Greason, 891 F.3d at 839. Before plaintiff committed suicide, the warden “was familiar with [another inmate's previous suicide] and knew that [the inmate's] medication had been discontinued prior to the acts of self-mutilation.” Id. at 840. The warden also acknowledged that he knew the inmate was under the defendant clinical director's care and did not investigate the quality of care or possible understaffing. Id. The Eleventh Circuit found “that [the warden] was aware of the same essential facts that were also apparent to” the other supervisors. Id. Moreover, “[e]ven if [the warden] was unaware of the excessive burden on [the mental health staff], [the warden] was the person charged with ensuring the provision of services at the [prison] and was primarily responsible for staffing the [prison]; he therefore ‘should have been aware” of the understaffing and its ‘attendant problems.'” Id. at 839-40. Based on this evidence, the Eleventh Circuit held that a reasonable jury could find that the warden had subjective knowledge of Plaintiff's mental health needs and the mental health department's understaffing. Id. at 840.

Here, by contrast, Plaintiff has not presented any evidence showing that Hatcher and Shelton had subjective knowledge of either his mental health needs or understaffing of the RSP mental health department. He has not alleged that Hatcher and Shelton had any involvement in or knowledge of his mental health treatment before his suicide attempt. His claim rests on his allegation that Silver told him that the understaffing delayed Plaintiff's mental health treatment. Pl.'s Decl. 60, 62; Pl.'s Dep. 55:15-56:01. Thompson-who was the RSP Mental Health Clinical Director-denies that the mental health department was understaffed. Thompson Decl. ¶ 12. During his deposition, Defendants' counsel questioned Plaintiff about Hatcher and Shelton's knowledge of the understaffing issues:

DEFENDANTS' COUNSEL: Did you have any conversations with Warden Hatcher or Deputy Warden Shelton about these issues?

PLAINTIFF: I don't recall specifically talking about that at this time.

DEFENDANTS' COUNSEL: Do you have any other awareness or evidence or reason to believe that Warden Hatcher or Deputy Warden Shelton would have been specifically aware of this issue?

PLAINTIFF: I don't have any direct knowledge of that.

Pl.'s Dep. 56:02-56:12.

Moreover even assuming Silver or Thompson blamed understaffing for Plaintiff's delays in treatment when they met with him, Plaintiff does not allege that Silver, Thompson, or any other RSP personnel or inmates complained about understaffing to Hatcher and Shelton. “[T]he Supreme Court has made clear that a state official acts with deliberate indifference only when he disregards a risk of harm of which he is actually aware.” Ray v. Foltz, 370 F.3d 1079, 1083 (11th Cir. 2004) (citing Farmer v. Brennan, 511 U.S. 825, 836 (1994)) (emphasis in original). Plaintiff mentions that he had conversations with other inmates about the understaffing and resulting delays in mental health treatment, but he has not specifically alleged that Hatcher and Shelton were aware of his lack of treatment or incidents involving other RSP inmates arising from a lack of mental health treatment. Pl.'s Dep. 67:25-68:20. “[Plaintiff] cannot say, ‘Well, [Hatcher and Shelton] should have known.' Were we to accept that theory of liability, the deliberate indifference standard would be silently metamorphosed into a font of tort law-a brand of negligence redux-which the Supreme Court has made abundantly clear it is not.” Goodman v. Kimbrough, 718 F.3d 1325, 1334 (11th Cir. 2013) (citing Farmer, 511 U.S. at 838; Paul v. Davis, 424 U.S. 693, 701 (1976)).

This lack of evidence clearly distinguishes this case from Greason where the warden was aware of understaffing based on, inter alia, the abrupt discontinuation of medications for an inmate who was known to be suicidal, the warden's knowledge of such discontinuation and the inmate's subsequent acts of self-mutilation, complaints from the inmate and his parents, complaints of understaffing from the inmate's treating physician, and previous inmate suicides under similar circumstances. See Greason, 891 F.2d at 831-40. None of these circumstances are present here. At most, Plaintiff states that Silver and Thompson told him about understaffing. Pl.'s Decl. 60, 62; Pl.'s Dep. 55:15-56:01. However, he does not allege that Silver and Thompson informed Hatcher and Shelton of understaffing issues. Pl.'s Dep. 56:02-56:12; see Bugge v. Roberts, 430 Fed.Appx. 753, 758 (11th Cir. 2011) (“[S]ubjective knowledge must be specific, as . . . ‘imputed or collective knowledge cannot serve as the basis for a claim of deliberate indifference.'” (quoting Burnette v. Taylor, 533 F.3d 1325, 1331 (11th Cir. 2008))). In short, even assuming Hatcher and Shelton were “primarily responsible for staffing” RSP, Plaintiff presents no evidence showing that Hatcher and Shelton knew-or even should have known-of potential understaffing of the RSP mental health department. See Greason, 891 F.2d at 840. Thus, Plaintiff fails to establish that Hatcher and Shelton had subjective knowledge of his serious mental health needs or potential understaffing of the RSP mental health department. See Brown, 387 F.3d at 1351; Ray, 370 F.3d at 1083.

Second, Defendants argue that even assuming Hatcher and Shelton had subjective knowledge of Plaintiff's mental health needs and understaffing, he fails to show that understaffing caused any delay or injury. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 14. As to Shelton, Defendants argue Plaintiff cannot show that Shelton caused any alleged injury because she was no longer the RSP warden when Plaintiff arrived in August 2016. Id. at 13. “[S]ection 1983 requires proof of an affirmative causal connection between the official's acts or omissions and the alleged constitutional deprivation.” Zatler v. Wanwright, 802 F.2d 397, 401 (11th Cir. 1986) (citation omitted). “A causal connection may be established by proving that the official was personally involved in the acts that resulted in the constitutional deprivation.” Id. (citation omitted). Here, Shelton left RSP in March 2016-approximately five months before Plaintiff arrived in August 2016. Shelton's Resp. to Interrog. 3. Because Shelton was no longer employed at RSP when Plaintiff arrived, he fails to establish a causal connection between her actions, any alleged understaffing, and Plaintiff's alleged lack of treatment.

As to Hatcher, the records show that Plaintiff was regularly seen by RSP mental health staff. Indeed, mental health staff immediately requested Plaintiff's mental records from an outside provider on August 16, 2016-the same day he arrived at RSP. Pl.'s Exs. 113; Pl.'s Decl. 2, 14. On August 18, 2016-just two days later-Counselor Sharpe reviewed and signed Plaintiff's prior diagnoses from GDCP and ASMP. Pl.'s Mental Health Records 1. On the same day, Counselor Singleton had an initial meeting with Plaintiff and documented Plaintiff's condition in a progress note. Id. at 21. Plaintiff was then placed on Silver's caseload for a routine psychiatric assessment. Silver Decl. ¶¶ 7-8, 12. When Plaintiff attempted suicide, he was immediately seen by Singleton, Silver, and Thompson. Pl.'s Mental Health Records 20-21; Silver Decl. ¶ 9; Pl.'s Decl. 59-62; Pl.'s Dep. 99:14-100:01, 104:09-105:15, 109:20-110:14, 111:14-111:18. Thereafter, he regularly met with Silver and received psychiatric medications. Silver Decl. ¶¶ 9.1-9.11; Pl.'s Mental Health Records 5-9, 11-14, 17-18.

Importantly, to the extent Plaintiff alleges understaffing delayed his initial meeting with Silver for less than one month between his arrival to RSP on August 16, 2016, and his meeting with Silver on September 13, 2016, he does not show that this delay is attributable to understaffing. Rather, Plaintiff admits that he hid his suicidal thoughts from mental health staff at FCJ, GDCP, ASMP, and RSP. Pl.'s Decl. 53, 58; Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 8, 12; Pl.'s Dep. 119:07-120:10; Am. Compl. 14; see Whitehead v. Burnside, 403 Fed.Appx. 401, 403 (11th Cir. 2010) (per curiam) (“Self-serving statements by a plaintiff do not create a question of fact in the face of contradictory, contemporaneously created medical records.” (citing Bennett v. Parker, 898 F.2d 1530, 1533-34 (11th Cir. 1990)). As Silver avers, after his initial intake, Plaintiff was placed on her list for routine assessment because he did not indicate an emergent circumstance such as threats of suicide. Silver Decl. ¶¶ 7-8, 12. Again, Thompson directed the RSP Mental Health Department, and he denies that the department was understaffed. Thompson Decl. ¶ 12. After Plaintiff presented an emergent circumstance by attempting suicide, Silver saw him within moments. Pl.'s Mental Health Records 20-21; Silver Decl. ¶ 9; Pl.'s Decl. 59-62; Pl.'s Dep. 99:14-100:01, 104:09-105:15, 109:20-110:14, 111:14-111:18.

Moreover, on August 10, 2016, the ASMP psychologist recommended that Plaintiff be assessed for the possibility of psychiatric medications within sixty to ninety days. Pl.'s Mental Health Records 23. Thus, a separate mental health professional at a different facility-whom Plaintiff does not name as a defendant-believed Plaintiff did not need an assessment until October 15, 2016, at the earliest. Id. Plaintiff met with Silver well within this timeframe. Accordingly, any delay in meeting with Silver is attributable to Plaintiff's own decision to mislead mental health staff at multiple prisons. He has not shown that any delay in treatment was unreasonable or that understaffing caused any delay. Because Plaintiff fails to show that Hatcher and Shelton were deliberately indifferent to his serious mental health needs, the Court RECOMMENDS that Defendants' motion for summary judgment be GRANTED on this ground.

F. Conditions of Confinement

Defendants argue Hatcher and Shelton are entitled to summary judgment because Plaintiff fails to show that Hatcher and Shelton maintained a condition of confinement that violated Plaintiff's Eighth Amendment rights. Barron, Shelton, & Hatcher's Br. in Supp. of Mot. for Summ. J. 13, 17-18. The Court agrees.

1. Conditions of Confinement Standard

The Eighth Amendment “imposes duties on [prison] officials, who must provide humane conditions of confinement; prison officials must ensure that inmates receive adequate food, clothing, shelter, and medical care, and must take reasonable measures to guarantee the safety of the inmates.” Farmer, 511 U.S. at 832 (internal quotations and citations omitted). For this reason, prisoners may raise Eighth Amendment claims challenging conditions of confinement. Thomas v. Bryant, 614 F.3d 1288, 1303 (11th Cir. 2010). “No static ‘test' can exist by which courts determine whether conditions of confinement are cruel and unusual, for the Eighth Amendment must draw its meaning from the evolving standards of decency that mark the progress of a maturing society.” Rhodes v. Chapman, 452 U.S. 337, 346 (1981) (internal quotations and citations omitted). “A valid Eighth Amendment claim of this kind has two components: (1) an objective component which requires that conditions be ‘sufficiently serious,' and (2) a subjective component which requires that prison officials exhibit ‘deliberate indifference' to prisoner health or safety.” Jordan v. Doe, 38 F.3d 1559, 1564 (11th Cir. 1994) (citations omitted).

To satisfy the objective prong of a conditions of confinement claim, a prisoner must show that the conditions “pose an unreasonable risk of serious damage to an inmate's future health or safety.” Helling v. McKinney, 509 U.S. 25, 33 (1993). “[T]he Constitution does not mandate comfortable prisons.” Rhodes, 452 U.S. at 349. Rather, to establish an Eighth Amendment violation, “[t]he challenged condition must be ‘extreme.'” Chandler v. Crosby, 379 F.3d 1278, 1289 (11th Cir. 2004) (quoting Hudson v. McMillian, 503 U.S. 1, 9 (1992)). “Only a deprivation which denies the minimal civilized measure of life's necessities is grave enough to violate the Eighth Amendment.” Jordan, 38 F.3d at 1564 (internal quotations and citations omitted). The prisoner must establish that the risk from the condition is “so grave that it violates contemporary standards of decency to expose anyone unwillingly to such a risk. In other words, the prisoner must show that the risk of which he complains is not one that today's society chooses to tolerate.” Helling, 509 U.S. at 36.

To satisfy the subjective prong, the prisoner must show that the defendant prison officials ‘acted with a sufficiently culpable state of mind' with regard to the condition at issue.” Chandler, 379 F.3d at 1289 (quoting Hudson, 503 U.S at 8). Courts apply a deliberate indifference standard, requiring an inmate to prove that a prison official “knows of and disregards an excessive risk to inmate health or safety; 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. “[D]eliberate indifference has three components: (1) subjective knowledge of a risk of serious harm; (2) disregard of that risk; (3) by conduct that is more than mere negligence.” Farrow, 320 F.3d at 1245 (internal quotations and citations omitted). “Negligence does not suffice to satisfy this standard.” Chandler, 379 F.3d at 1289 (citation omitted). “Furthermore, the official may escape liability for known risks ‘if he responded reasonably to the risk, even if the harm ultimately was not averted.'” Id. at 1290 (quoting Farmer, 511 U.S. at 844).

2. Defendants Hatcher and Shelton

Defendants argue Plaintiff fails to show that Hatcher and Shelton maintained an unlawful condition of confinement-excessive heat in K dorm. Barron, Shelton, & Hatcher's Br. in Supp. of Mot. for Summ. J. 13, 17-18. First, Defendants contend Shelton could not have caused any injury resulting from the alleged excessive heat because she was no longer employed at RSP when Plaintiff arrived in August 2016. Id. at 13. Because Shelton was not present-or even employed at RSP-at any time while Plaintiff was confined in K dorm between August 2016 and October 2016, he fails to show that she had any subjective knowledge of the conditions in the dorm or Plaintiff's concomitant risk of injury. Brown, 387 F.3d at 1351 (requiring a plaintiff to show, inter alia, “subjective knowledge of a risk of serious harm” to establish deliberate indifference); Ray, 370 F.3d at 1083 (“[T]he Supreme Court has made clear that a state official acts with deliberate indifference only when he disregards a risk of harm of which he is actually aware.” (citing Farmer, 511 U.S. at 836) (emphasis in original)).

Second, Defendants contend Plaintiff fails to satisfy the objective prong of his claim because he has not shown that the alleged excessive heat “pose[d] an unreasonable risk of serious damage to [his] future health or safety.” Helling, 509 U.S. at 33; see Barron, Shelton, & Hatcher's Br. in Supp. of Mot. for Summ. J. 17-18. Specifically, Defendants claim “there is no evidence that Plaintiff required medical treatment or suffered permanent physical injuries as a result of the contended overheating.” Id. at 17. Neither party has submitted any evidence of the actual temperatures in K dorm or Plaintiff's cell. Plaintiff states that his “educated guess is it was about 110 [degrees] everyday” because he previously frequented saunas, and based on those experiences, he believes his cell was hotter than the saunas. Pl.'s Decl. 5-6. He also relies on hearsay evidence, namely that another inmate told him that the inmate placed a thermometer in a cell, and the thermometer read 110 degrees. Id. at 6.

It also does not appear that Plaintiff suffered any physical effects of the alleged heat which rise beyond the level of discomfort. See Chandler, 379 F.3d at 1295 (“[A] prisoner's mere discomfort, without more, does not offend the Eighth Amendment.” (citation omitted)). During his deposition, Defendants' counsel asked Plaintiff whether he suffered any physical injuries as a result of the alleged excessive heat in K dorm:

DEFENDANTS' COUNSEL: Okay. On this hot cell issue, so what injuries did you suffer because of that or just very uncomfortable?

PLAINTIFF: Just very uncomfortable. I mean, you asked a good question because I know that injury is a part of the deal, but when you live in a place that's, you know, well over 100 degrees every day, it's torture.

DEFENDANTS' COUNSEL: Your complaint indicated that the primary injury you suffered was very upsetting and led you to-to exacerbate your mental health issues and suicidal tendencies. I'm paraphrasing slight, but does that-

PLAINTIFF: No, I mean that's for sure.

. . .

DEFENDANTS' COUNSEL: . . . I'm just trying to get clarity on the answer here, that on the overheating, it was extremely uncomfortable and very, very emotionally upsetting such-which that may have compounded your already existing mental health issues and anxiety. Is that-is that a better characterization?

PLAINTIFF: I mean, I would say in my words that I was repeatedly tortured to the point that I wanted to kill myself. And they were aware of this.

DEFENDANTS' COUNSEL: This was because of the extreme discomfort from having the prison being very warm during the summer, very hot during the summer; is that correct?

PLAINTIFF: Yes.

. . .

DEFENDANTS' COUNSEL: And I did not see-there does not appear to be any evidence of any physical manifestations at that time, for example that you would have to seek medical treatment at that time; is that correct? I mean mental health treatment, but not physical medical treatment; is that correct?

PLAINTIFF: I mean, I don't-I don't agree with that. I can't recall. But I don't agree with that statement, no.

DEFENDANTS' COUNSEL: So did you have to seek medical treatment at the time?

PLAINTIFF: ·I don't remember.· I'm sure I did.

DEFENDANTS' COUNSEL: Okay.· And for what types of injuries would you have had to seek medical treatment at the time?

PLAINTIFF: I mean-well, I can't recall anything specific.· But having to live through extreme heat, it dehydrates you.· It makes you-it gives you headaches.· You can't sleep, you have insomnia.· Basically, you know, you might as well be dead.

Pl.'s Dep. 46:06-50:04. Thus, Plaintiff testified that he did not recall seeking medical treatment, could not identify any physical injuries, and twice agreed he that the heat was merely uncomfortable. See Chandler, 379 F.3d at 1295.

In his declaration, Plaintiff tells an entirely different story. He states that the heat caused sweaty and clammy skin, severe headaches, weakness, nausea, vomiting, dizziness, pulled muscles, mental anguish, sadness, despair, humiliation, flashbacks, nightmares, post-traumatic stress disorder (“PTSD”), jumpiness, anger, rage, anxiety, depression, and insomnia. Pl.'s Decl. 2-3. He omitted almost all of these conditions from his deposition. See Blanchard v. White Cnty. Det. Ctr. Staff, 262 Fed.Appx. 959, 962 n.4 (11th Cir. 2008) (per curiam) (recognizing that plaintiff gave conflicting statements as to the number of seizures he experienced and “disregarding [the conflicting] statement . . . in evaluating whether summary judgment was proper” (citing McCormick v. City of Fort Lauderdale, 333 F.3d 1234, 1240 n.7 (11th Cir. 2003)).

Moreover, Plaintiff admits he does not know whether many of these alleged physical manifestations resulted from his tooth pain, mental health state, or the excessive heat. FTR Gold 10:18:12-10:19:43; Pl.'s Decl. 2-3; Pl.'s Dep. 46:06-47:21. He even acknowledges that some of the conditions may have been attributable to the stress of being in prison. FTR Gold 10:24:45-10:25:15. He also has not disputed that he never sought medical treatment for any of these conditions. Because Plaintiff has neither presented any admissible evidence of the temperatures in K dorm nor established that he suffered any physical conditions rising beyond the level of discomfort, he fails to establish an Eighth Amendment violation. See See Chandler, 379 F.3d at 1295; Green v. Sec'y for Dep't of Corr., 212 Fed.Appx. 869, 872 (11th Cir. 2006) (per curiam) (holding that an inmate failed to show that the heat in his dorm caused more than discomfort where the inmate's claimed physical injuries, including high blood pressure, resulted from another medical condition)

Third, Defendants argue that even assuming Plaintiff establishes that heat posed an unreasonable risk to his health, he fails to satisfy the subjective prong of his claim because he cannot show that Hatcher and Shelton “kn[ew] of and disregard[ed] an excessive risk to [Plaintiff's] health or safety.” McElligott v. Foley, 182 F.3d 1248, 1255 (11th Cir. 1999); see Barron, Shelton, & Hatcher's Br. in Supp. of Mot. for Summ. J. 17-18. They maintain that Hatcher and RSP staff took measures to address the heat. Id. at 18. Among those measures, Defendants state that RSP maintained an air handler system in K dorm which circulates and cools air. Barron, Hatcher, & Shelton's Br. in Supp. of Mot. for Summ. J. 17-18; see Hatcher's Resp. to Interrogs. 3-6.

Plaintiff primarily argues that Hatcher and Shelton disregarded the risk posed by the allegedly excessive heat because the air handler system in K dorm did not function properly between August 2016 and October 2016. Pl.'s Decl. 40-41. In support, he has submitted a declaration from an inmate named Jimmy Cochran. See Cochran Decl. 17-24.⁷ Cochran avers that he worked in the RSP maintenance department and knows that the air handler system was malfunctioning. Id. at 18-19, 23. Specifically, he claims another inmate spilled acid on the air handler fans in 2009, and this acid melted the fans and restricted air flow. Id. at 19. Cochran alleges the maintenance worksheet submitted by Defendants do not reflect these problems because inmates simply date the worksheets when they evaluate the relevant machinery-whether or not the machinery is functioning-and verbally report any problems to “Head Maintenance Engineer Mr. Stallings.” Id. at 18-19.

7 Plaintiff filed Cochran's declaration, his own declaration, and one of his briefs as a single document which the clerk docketed as Plaintiff's Declaration (ECF No. 173-2). For ease of reference, the Court cites the portions of the document which contain Cochran's declaration using the document number and electronic screen page number shown at the top of each page by the Court's CM/ECF software.

Defendants dispute Cochran's characterization of the maintenance worksheets, and in support, they have submitted the declaration of GDC Regional Maintenance Manager Jerry Little. See Little Decl. ¶ 2. Little avers that the RSP air handler system functioned properly. Id. ¶¶ 3-5. Contrary to Cochran's testimony, Little states that the maintenance sheets do document when an item is malfunctioning. Id. ¶ 5. Specifically, inmates and staff indicate any problems with machinery listed on the maintenance worksheets by writing “in op” next to the relevant items. Id. Indeed, “in op” is written next to several items on the maintenance worksheets, but the K dorm air handler system is not among those items during any month between July and December 2016. See Little Decl. Ex. 1, at 4-9. Moreover, Cochran's name does not appear anywhere on the maintenance worksheets. Rather the maintenance worksheets show the names “Joseph Lewis” and “Warnell Sterling.” Id. Thus, Defendants maintain that the air handler system functioned properly between August and October 2016. Barron, Hatcher, & Shelton's Reply 7, ECF No. 178. Plaintiff also admits that the vent in his cell circulated air, though he contends the air was hot. FTR Gold 10:31:19-10:32:11.

Regardless, even assuming the air handler system did not function as designed between August and October 2016, Plaintiff still fails to show deliberate indifference because Hatcher and Shelton took many other measures to address the heat. Hatcher states that officers monitored the temperatures in the dorms, and Plaintiff agrees that officers made rounds in K dorm to assess the temperatures multiple times each day. Hatcher's Resp. to Interrogs. 3-5, 9-10; Pl.'s Dep. 39:07-39:17; FTR Gold 10:32:14-10:32:32. Hatcher avers that he permitted inmates to make “ice calls” to bring ice back to their cells. Hatcher's Resp. to Interrogs. 3-5, 9. Plaintiff states that he is not aware of a specific policy known as “ice calls, ” but he admits ice and water were available in K dorm. Pl.'s Decl. 6; Pl.'s Dep. 54:02-54:06; FTR Gold 10:29:44-10:30:29. He believes ice was not always available, but he could not recall how often it was unavailable. Pl.'s Decl. 6; FTR Gold 10:29:44-10:30:29.

Plaintiff's cell had a sink and running water. FTR Gold 10:21:59-10:22:08. Hatcher allowed inmates to take unlimited showers to cool off. Pl.'s Decl. 6. Plaintiff admits the availability of unlimited showers, and although he contends other inmates did not like when he took multiple showers, such impediment is not attributable to Hatcher. See Id. RSP staff placed a fan in the day room, and although the air blown by the fan did not reach Plaintiff's cell, he was able to sit in the day room with the fan. Hatcher's Resp. to Interrogs. 3-5, 9; Pl.'s Decl. 6; Pl.'s Dep. 41:13-41:20, 126:14-126:21; 10:21:15-10:21:58. Hatcher permitted inmates to have personal fans in their cells, though Plaintiff states he could not afford one. Hatcher's Resp. to Interrogs. 3-5, 9; Pl.'s Dep. 126:22-127:04.

Additionally, the Court allowed Plaintiff to testify as to the alleged excessive heat during the hearing on Defendants' motions for summary judgment. Plaintiff testified that he was not always subject to the alleged heat in his cell or K dorm because he was permitted to travel to other areas of the prison. For instance, he was permitted to go to the library, classes, religious services, and the visitation area. FTR Gold 10:18:12-10:19:43, 10:22:23-10:22:48, 10:25:16-10:25:44. He was allowed to go to the RSP chow hall for multiple meals each day. Id. at 10:28:27-10:29:38. Inmates were permitted to use the RSP yard for exercise and recreation. Id. at 10:13:18-10:33:56. While Plaintiff states that he voluntarily did not take advantage of these opportunities, he admits that no prison officials prevented him from doing so and that the areas were not as hot as his cell or K dorm generally. Id. at 10:20:06-10:20:43, 10:22:48-10:22:55, 10:25:16-10:25:44.

In short, Hatcher and RSP staff ensured Plaintiff and other inmates had multiple means to escape any heat in K dorm. Even assuming the heat in K dorm posed a risk to Plaintiff's health, all of these measures demonstrate that Hatcher and Shelton responded reasonably to the risk. See Chandler, 379 F.3d at 1289 (holding that an inmate failed to establish an Eighth Amendment violation arising from excessive heat where the prison, inter alia, maintained running water in each cell, allowed inmates to travel to other parts of the prison, and maintained an air handler system); Green, 212 Fed.Appx. at 872 (holding that an inmate failed to establish an Eighth Amendment violation arising from excessive heat where the prison lacked air conditioning in the inmate's dorm but provided fans in the dorm and ensured the inmate's access to water).

The fact that Plaintiff was hot and may have suffered some physical effects from the heat-which did not require medical treatment-does not establish an Eighth Amendment violation in light of the reasonable ameliorative measures which Hatcher and the RSP staff employed. See Farmer, 511 U.S. at 844 (“[P]rison officials who actually knew of a substantial risk to inmate health or safety may be found free from liability if they responded reasonably to the risk, even if the harm ultimately was not averted.”). Therefore, Plaintiff fails to establish that Hatcher and Shelton disregarded any risk of harm by conduct that constitutes more than negligence. Farrow, 320 F.3d at 1245. Because Plaintiff fails to show that Hatcher and Shelton maintained excessive heat rising to the level of an Eighth Amendment violation, the Court RECOMMENDS that Defendants' motion for summary judgment be GRANTED on this ground.

III. Defendants Foreman, Silver, and Thompson's Motion for Summary Judgment

Defendants Foreman, Silver, and Thompson move for summary judgment, arguing (1) Plaintiff failed to exhaust administrative remedies as to his deliberate indifference claim against Foreman, and (2) Plaintiff fails to show that Foreman, Silver, and Thompson were deliberately indifferent to his serious medical needs.⁸ Foreman, Silver, & Thompson's Br. in Supp. of Mot. for Summ. J. 11-20. The Court agrees as to each ground and recommends that Defendants' motion be granted.⁹

8 As previously explained, the Court has summarized the undisputed material facts concerning Plaintiff's mental health treatment above. These facts apply to Defendants Foreman, Silver, and Thompson's motion for summary judgment.

9 On January 3, 2020, the Court dismissed Plaintiff's claims for both compensatory and punitive damages against Silver and Thompson, finding that he failed to allege a physical injury rising above the level of de minimis under the PLRA. Order & R. 40-44, Nov. 14, 2019, ECF No. 72; Order 1-3, Jan. 3, 2020, ECF No. 89 (adopting recommendation). In Hoever v. Marks, 993 F.3d 1353 (11th Cir. 2021), the Eleventh Circuit held that plaintiffs may recover punitive damages for alleged constitutional violations even if they do not allege a physical injury which would entitle them to compensatory damages under the PLRA. Hoever, 993 F.3d at 1362-64. Given this intervening change in Eleventh Circuit law, the Court RECOMMENDS that Plaintiff's punitive damages claim be restored. Nonetheless, the Court recommends that Defendants Foreman, Silver, and Thompson's motion for summary judgment be granted because Plaintiff fails to show that Silver and Thompson were deliberately indifferent. In the event Plaintiff's deliberate indifference claims against Silver and Thompson survive summary judgment, Plaintiff may recover punitive damages.

A. Exhaustion of Administrative Remedies

Defendants argue Foreman is entitled to summary judgment on Plaintiff's deliberate indifference claim against him because Plaintiff failed to exhaust available administrative remedies as to that claim. Foreman, Silver, & Thompson's Br. in Supp. of Mot. for Summ. J. 13-15.¹⁰ The Court agrees.

10 Foreman did not raise failure to exhaust in a motion to dismiss. Defendants Foreman, Silver, and Thompson raised failure to exhaust as a defense in their answer. Foreman, Silver, & Thompson's Answer 3, ECF No. 110. Therefore, the Court treats the motion for summary judgment as a motion to dismiss on this ground. See Bryant, 530 F.3d at 1374-75.

1. First Step: Defendants' Motion for Summary Judgment

Defendants argue Plaintiff's deliberate indifference claim against Foreman should be dismissed because Plaintiff failed to exhaust his administrative remedies, claiming Plaintiff failed to comply with GDC grievance procedures because he did not file a grievance concerning his mental health treatment at GDCP. Foreman, Silver, & Thompson's Br. in Supp. of Mot. for Summ. J. 14-15. Plaintiff, however, contends (1) he filed a grievance concerning his mental health treatment, and (2) the grievance procedures were unavailable because GDCP officials refused to provide him a grievance receipt. Pl.'s Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 10-11. Because at the first stage of the exhaustion analysis the Court must accept Plaintiff's version of the facts as true, Plaintiff's complaint cannot be dismissed for failure to exhaust at this first step. Turner, 541 F.3d at 1082; see also Dollar, 446 Fed.Appx. at 251-52.

2. Second Step: Factual Findings

Since the Court did not grant summary judgment at the first step, the Court can make factual findings relating to exhaustion. Turner, 541 F.3d at 1082. A defendant bears the burden of establishing a lack of exhaustion at the second step of the inquiry. Id. at 1082-83. The Court finds that Defendants have met their burden and recommends that their motion for summary judgment-treated as a motion to dismiss-be granted on this ground.

As previously explained as to Barron, Plaintiff's grievance history shows he did not file a grievance while he was confined at GDCP and within Foreman's care. Pugh Decl. ¶¶ 12-13, Ex. 2, at 34. Plaintiff, however, claims that administrative remedies were unavailable at GDCP because (1) he was not informed of the grievance procedures, and (2) he filed a grievance but did not receive a receipt.¹¹ Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 10-11. These are the same arguments he raised as to Barron, and he cross-references those arguments in his brief. See Id. at 11; Pl.'s Decl. 35-37. An administrative procedure is unavailable under the PLRA when, inter alia, “prison administrators thwart inmates from taking advantage of a grievance process through machination, misrepresentation, or intimidation.” Ross, 136 S.Ct. at 1859-60. “While the burden is on the defendant to show an available administrative remedy, once that burden has been met, the burden of going forward shifts to the plaintiff, who . . . must demonstrate that the grievance procedure was ‘subjectively' and ‘objectively' unavailable to him.” Geter, 974 F.3d at 1356 (citation omitted).

11 Unlike with Barron, Plaintiff does not appear to allege that he filed a grievance at ASMP concerning Foreman's mental health treatment at GDCP. See Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 10-11. His grievance history shows that he filed grievance 224577concerning “staff negligence” while confined at ASMP. Pugh Decl., Ex. 2, at 34. In his deposition, Plaintiff testified that this grievance concerned his locker at ASMP and that it is irrelevant to his claims in this case. Pl.'s Dep. 64:18-64:22. To the extent Plaintiff claims he filed a grievance concerning Foreman on a later date, he failed to exhaust administrative remedies because his grievance was untimely under the GDC's grievance SOP. See Pugh Decl. ¶ 7, Ex. 1, at 14; FTR Gold 10:17:45-10:18:05; Woodford, 548 U.S. at 91.

As explained above as to Barron, Plaintiff fails to show that administrative remedies were unavailable at GDCP. First, he fails to show that his grievance remedy was unavailable because he was unaware of the grievance procedures. According to Grievance Coordinator Pugh, GDC officials orally explain the grievance procedures to inmates and give them a handbook with the grievance instructions. Pugh Decl. ¶ 4. Plaintiff alleges he received neither an oral explanation nor a handbook at GDCP. Am. Comp. 7; Pl.'s Dep. 57:03-58:13, 60:25-61:03. He admits, however, that he learned of the grievance procedures by talking to other inmates. Pl.'s Dep. 57:18-59:02, 60:02-60:24. Thus, at the very least, Plaintiff knew he needed to file a grievance at GDCP. Moreover, Grievance Coordinator Pugh avers that “[i]nmates also have access to a copy of the Grievance SOP at the facility or center library.” Pugh Decl. ¶ 4. Plaintiff has not disputed this assertion. Thus, unlike in Goebert where inmates lacked any access to the grievance procedures, Plaintiff could have “discover[ed] [the grievance procedures] through reasonable effort by the time they [were] needed” simply by requesting the procedures or visiting the GDCP library. Goebert, 510 F.3d at 1322; see also Woodard, 2020 WL 6498656, at *4-5. Accordingly, Plaintiff fails to show that his grievance remedy was unavailable based on his alleged lack of knowledge of or access to the GDC grievance procedures.

Second, Plaintiff fails to show that his grievance remedy was unavailable because GDCP officials failed to provide him a grievance receipt. Grievance Coordinator Pugh avers that “[a]ll inmates receive a receipt for each grievance that is submitted” and that she is not aware of a grievance submitted by Plaintiff-or any other inmate-which was not properly recorded in his grievance history. Pugh Decl. ¶ 13; see also Id. Ex. 1, at 13. Defendants have met their initial burden of showing that an administrative remedy is generally available at GDCP. See Geter, 974 F.3d at 1356.

During the hearing on Defendants' motions for summary judgment, the Court allowed Plaintiff to testify under oath to allow the Court to assess Plaintiff's credibility and “to make specific findings in order to resolve the disputed factual issues related to exhaustion.” Turner, 541 F.3d at 1082; Bryant, 530 F.3d at 1377 n.16 (holding that courts may hold evidentiary hearings to resolve factual issues concerning exhaustion); see also McIlwain, 830 Fed.Appx. at 610-12. Plaintiff testified that he handed his grievance concerning Foreman to a female GDCP counselor on either June 28 or June 30, 2016, but the counselor did not give him a receipt. FTR Gold 9:55:36-9:57:31, 10:04:27-10:05:20; see also Pl.'s Dep. 57:18-58:13.

Plaintiff fails to meet his burden of proving that the “grievance procedure was ‘subjectively' and ‘objectively' unavailable to him.” Geter, 974 F.3d at 1356. As explained above as to Barron, Plaintiff's repeated inconsistent testimony undermines his credibility. See Turner, 541 F.3d at 1082 (requiring courts to make factual findings as to disputed issues concerning exhaustion). He has inconsistently described how many grievances he filed and how many times he was denied a receipt. See Compl. 3; Am. Compl. 7-8, 23; Pl.'s Dep. 57:03-57:17; FTR Gold 9:55:36-9:56:25, 9:57:35-9:58:51, 10:16:20-10:16:53. His testimony as to his alleged injuries, suicide attempt, discussions with Thompson about his treatment, and discussions with Silver about excessive heat has been inconsistent. Pl.'s Dep. 46:06-50:04, 97:13-97:24, 99:02-99:07, 102:14-103:08, 112:12-112:19; Pl.'s Decl. 2-3, 59, 61-62; Am. Compl. 13, 24-25. Plaintiff has also admitted that he repeatedly and intentionally misled mental health staff about his suicidal thoughts at GDCP, ASMP, and RSP. Pl.'s Decl. 53, 58; Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 8, 12; Pl.'s Dep. 119:07-120:10; Am. Compl. 14. Although the Court construes Plaintiff's allegations in the light most favorable to him-as required at summary judgment-his repeated inconsistent testimony undermines his credibility. See Turner, 541 F.3d at 1082 (requiring courts to make factual findings as to disputed issues concerning exhaustion). While Plaintiff alleges he did not know anything about grievance receipts, he alleges he filed his GDCP grievances on standard grievance forms, and the receipts are attached to the forms and prominently labeled. Pl.'s Dep. 60:02-60:10; Pugh Decl. Ex. 1, at 23.

Plaintiff fails to show that his grievance remedy was unavailable at GDCP based on his conclusory allegations which are belied by his own assertion that he filed his grievances on the standard grievance forms. The Court finds that the GDC grievance remedy was available at GDCP, but Plaintiff failed to file a grievance concerning Foreman's mental health treatment. See Turner, 541 F.3d at 1082 (permitting courts to make factual findings at the second step of the exhaustion analysis). Because Plaintiff failed to exhaust available administrative remedies by filing a prison grievance concerning his dental treatment at GDCP, the Court RECOMMENDS that Defendants' motion for summary judgment be GRANTED on this ground as to Plaintiff's deliberate indifference claim against Foreman.

B. Deliberate Indifference

Defendants argue they are entitled to summary judgment because Plaintiff fails to show that they were deliberately indifferent to his mental health needs. Foreman, Silver, & Thompson's Br. in Supp. of Mot. for Summ. J. 13-20. The Court agrees.

1. Defendant Foreman

Defendants argue Plaintiff fails to show that Foreman was deliberately indifferent to his serious mental health needs. Foreman, Silver, & Thompson's Br. in Supp. of Mot. for Summ. J. 13-14. Plaintiff primarily complains that Foreman failed to prescribe him Xanax or a similar medication for his anxiety. First, Plaintiff argues Foreman's treatment was inadequate because she failed to prescribe him medication for his anxiety on May 24, 2016. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 2-6. Plaintiff states that he repeatedly requested medications while confined at both FCJ and GDCP. Id. at 2, 5, 8-9; see Pl.'s Exs. 103, 124, 126-28. He contends he demonstrated a clinical need for medications because his previous psychiatrist had prescribed him Xanax for anxiety from 2012 to 2016. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 3 (citing Pl.'s Exs. 103, 139). He also notes that GDCP mental health staff documented his tearfulness, feelings of depression, and other symptoms, which demonstrate a need for medications. Id. at 2-3, 8-9 (citing Pl.'s Exs. 106-07, 109, 111, 119). Plaintiff believes Foreman manipulated him into foregoing medications by convincing him he would become addicted to medications and reminding him of his severe withdrawal symptoms he experienced at FCJ. Id. at 6. He asserts that he agreed to avoid medications only “because of [his] poor mental state.” Id.

Plaintiff fails to show deliberate indifference. When Foreman met with Plaintiff on May 24, 2016, she determined he did not require medications and recommended mental health counseling and a return visit to a psychologist. Pl.'s Mental Health Records 29; Foreman Decl. ¶ 8. She based this decision on her meeting with Plaintiff, his prior dependency on the medications he requested, and his two-month discontinuation of those medications immediately before he arrived at GDCP. Pl.'s Mental Health Records 29; Foreman Decl. ¶¶ 8-9. Indeed, Plaintiff admits that he consented to proceed without medications. Pl.'s Decl. 54-56; Pl.'s Dep. 82:16-83:20.

From this evidence, it is clear that Foreman met with Plaintiff to determine whether he needed psychiatric medications and exercised her professional judgment in deciding he did not after considering his statements during the evaluation, mental health treatment history, and the findings of other mental health professionals. Pl.'s Mental Health Records 29; Foreman Decl. ¶¶ 8-9; see Waldrop, 871 F.2d at 1035 (“[W]hen a prison inmate has received medical care, courts hesitate to find an Eighth Amendment violation.” (citations omitted)). Plaintiff's disagreement with Foreman's assessment and recommendation of a different form of treatment does not constitute deliberate indifference. Hamm, 774 F.2d at 1575; Adams, 61 F.3d at 1545 (“Whether governmental actors should have employed additional diagnostic techniques or forms of treatment ‘is a classic example of a matter for medical judgment' and therefore not an appropriate basis for grounding liability under the Eighth Amendment.” (quoting Estelle, 429 U.S. at 107 (1976))); McCray v. Prison Health Servs., Inc., No. 2:05-CV-887-MEF, 2007 WL 4181728, at *6 (M.D. Ala. Nov. 26, 2007) (“[D]esire for a mode of treatment which skilled and experienced physicians advised him was contraindicated based on his physical condition, does not translate into a denial of adequate medical care.”). Moreover, to the extent Plaintiff asserts that Foreman should have prescribed him Xanax or a similar medication based on Dr. Niak's previous prescription of such medications, he fails to show deliberate indifference. See Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 3; Bismark v. Fisher, 213 Fed.Appx. 892, 896-97 (11th Cir. 2007) (“Nothing in our case law would derive a constitutional deprivation from a prison physician's failure to subordinate his own professional judgment to that of another doctor.”).

Second, Plaintiff argues that Foreman was deliberately indifferent by failing to prescribe him medications after his May 24, 2016, meeting. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 5-8. According to Plaintiff, he changed his mind and decided he wanted medications merely three days after he met with Foreman. Pl.'s Decl. 56; Pl.'s Dep. 84:01-85:09, 86:03-86:16; Am. Compl. 4. He filed sick call requests seeking to meet with Foreman again to try to convince her to prescribe him medications. Pl.'s Decl. 56-57; Pl.'s Dep. 84:09-85:01. Plaintiff did not meet with Foreman again, and he was transferred to ASMP on July 12, 2016. Pl.'s Decl. 14, 57; Pl.'s Dep. 84:09-85:01.

Plaintiff fails to show deliberate indifference. He presents no evidence that Foreman had subjective knowledge of the fact that he “changed his mind” about foregoing medication only three days after their meeting. As Foreman states, once Plaintiff completed the initial stages of his mental health screening and a psychologist referred him to psychiatry, she was responsible for determining whether Plaintiff needed psychiatric medications. Foreman Decl. ¶¶ 4, 6-8. She met with Plaintiff and made her determination on May 24, 2016, after considering Plaintiff's symptoms, relevant medical history, and severe withdrawal symptoms. Id. ¶¶ 7-8; Pl.'s Mental Health Records 29.

Thereafter, Plaintiff never met with Foreman again, and Foreman was not involved in Plaintiff's treatment, primarily because he did not require treatment with psychiatric medications. Foreman does not process sick call requests. Rather, those requests are processed by the GDCP medical staff. Foreman Decl. ¶ 11. She did not receive Plaintiff's sick call requests or his alleged grievance. Id. ¶¶ 11-12. Indeed, she avers she never heard any complaint from Plaintiff after their May 24, 2016, meeting. Id. ¶ 11. “Deliberate indifference is not the same thing as negligence or carelessness.” Ray, 370 F.3d at 1083 (citation omitted). “On the contrary, the Supreme Court has made clear that a state official acts with deliberate indifference only when he disregards a risk of harm of which he is actually aware.” Id. (citing Farmer, 511 U.S. at 836) (emphasis in original). Plaintiff fails to show that Foreman had subjective knowledge of his requests for medications following the May 24, 2016, evaluation.

Moreover, even assuming Foreman had subjective knowledge of Plaintiff's desire for medications, he fails to show that she was deliberately indifferent by failing to prescribe them. As Foreman and Silver have both explained, Xanax is not available on the GDC's formulary. Foreman Decl. ¶ 9; Silver Decl. ¶ 9. Plaintiff fervently asserts that inmates receive Xanax, but he has not provided any specific facts supporting this assertion. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 7; Pl.'s Decl. 13, 55-56. Importantly, however, even if Foreman could have prescribed Plaintiff a medication similar to Xanax, Foreman states that Plaintiff was contraindicated for such medications based on her evaluation and Plaintiff's own admission that he experienced severe withdrawal symptoms from Xanax. Foreman Decl. ¶¶ 8-9; Pl.'s Mental Health Records 29. Plaintiff's desire for medications and Foreman's failure to prescribe them does not amount to deliberate indifference. Hamm, 774 F.2d at 1575; Adams, 61 F.3d at 1545; McCray, 2007 WL 4181728, at *6.

Third, Plaintiff argues that Foreman was deliberately indifferent because she denied him treatment by failing to ensure he received counseling. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 3-5, 8. Foreman recommended that Plaintiff return to a psychologist and receive counseling when she met with him on May 24, 2016. Pl.'s Mental Health Records 29; Foreman Decl. ¶ 8. On June 1, 2017, only one week later, Plaintiff met with a social worker while temporarily confined at ASMP, and the social worker evaluated Plaintiff, found he presented neither “psychological concerns” nor the “need for crisis intervention, ” and explained how Plaintiff could contact mental health services. Pl.'s Mental Health Records 10. He later returned to GDCP, but he was again transferred to ASMP on July 12, 2016-less than one month later. Pl.'s Decl. 14, 57; Pl.'s Dep. 88:01-88:11. Thus, after accounting for Plaintiff's temporary transfer to ASMP, he was in Foreman's care at GDCP for approximately one month between June and July 2016.

Although it appears neither Foreman nor other GDCP mental health staff reevaluated Plaintiff during this short period, Plaintiff fails to show deliberate indifference. Importantly, Foreman met with Plaintiff only after a psychologist referred him to determine whether he required psychiatric medications. Pl.'s Mental Health Records 27-28; Foreman Decl. ¶¶ 6-8. She determined Plaintiff did not require treatment with psychiatric medications and, instead, recommended that he receive counseling. Pl.'s Mental Health Records 29; Foreman Decl. ¶¶ 8-9. Foreman avers she never received any sick call requests, complaints, or grievances from Plaintiff. Foreman Decl. ¶¶ 11-12. Thus, she lacked any knowledge that other mental health staff did not comply with her recommendation that Plaintiff receive counseling.

Even assuming Foreman should have followed up on her recommendation and investigated whether other mental health staff had counseled Plaintiff, her failure to do so does not rise to the level of deliberate indifference. Goodman, 718 F.3d at 1334 (“[Plaintiff] cannot say, ‘Well, [defendants] should have known.' Were we to accept that theory of liability, the deliberate indifference standard would be silently metamorphosed into a font of tort law-a brand of negligence redux-which the Supreme Court has made abundantly clear it is not.” (citing Farmer, 511 U.S. at 838; Paul, 424 U.S. at 701). The Court RECOMMENDS that Defendants' motion be GRANTED on this ground as to Foreman.

2. Defendant Silver

Defendants argue Plaintiff fails to show that Silver was deliberately indifferent to his serious mental health needs. Foreman, Silver, & Thompson's Br. in Supp. of Mot. for Summ. J. 17-19. First, Plaintiff argues Silver was deliberately indifferent by failing to evaluate him before his September 13, 2016, suicide attempt. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 12-13, 16. A delay in medical treatment constitutes deliberate indifference “where it is apparent that delay would detrimentally exacerbate the medical problem, the delay does seriously exacerbate the medical problem, and the delay is medically unjustified.” Taylor, 221 F.3d at 1259-60 (internal quotations omitted).

To the extent Plaintiff claims Silver wrongfully delayed treatment, he fails to show that it was apparent that a delay would seriously exacerbate his mental health conditions. The Eleventh Circuit's caselaw concerning deliberate indifference in inmate suicide cases is instructive on this point. In assessing a defendant's actions concerning an inmate's mental health and risk of suicide, “deliberate indifference requires that the defendant deliberately disregard a strong likelihood rather than a mere possibility that the self-infliction of harm will occur.” Gish v. Thomas, 516 F.3d 952, 954 (11th Cir. 2008) (internal quotations and citation omitted). “[T]he mere opportunity for suicide, without more, is clearly insufficient to impose liability on those charged with the care of prisoners.” Tittle v. Jefferson Cnty. Comm'n, 10 F.3d 1535, 1540 (11th Cir. 1994) (citation omitted). “[N]o matter how defendants' actions might be viewed, the law of this circuit makes clear that they cannot be liable under § 1983 for the suicide of a prisoner who never had threatened or attempted suicide and who had never been considered a suicide risk.” Cook ex rel. Est. of Tessier v. Sheriff of Monroe Cnty., Fla., 402 F.3d 1092, 1116 (11th Cir. 2005) (internal quotations and citations omitted).

Here, although Plaintiff's suicide attempt was unsuccessful, the likelihood that he would attempt suicide is important in determining whether it was apparent that Silver's delay in evaluating him for psychiatric medications would seriously exacerbate his mental health condition, resulting in a suicide attempt. Moore v. Hunter, 847 Fed.Appx. 694, 696-97 (11th Cir. 2021) (per curiam) (holding that officers were not deliberately indifferent in failing to prevent inmate's suicide attempt because the officers lacked subjective knowledge of the inmate's suicidal tendencies). Plaintiff asserts that he told mental health staff at GDCP, ASMP, and RSP that he had suicidal thoughts. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 7-9, 12, 16; Pl.'s Decl. 53-54, 55-58, 61; Pl.'s Dep. 89:05-89:16, 99:14-100:17.

Plaintiff, however, qualifies these assertions, stating that although he contemplated suicide, he did not report his true thoughts to mental health providers. Indeed, in both his deposition and declaration, he repeatedly states that he intentionally misled mental health staff and hid his suicidal thoughts because he did not want to be placed in a suicide observation cell. Pl.'s Decl. 53 (“I learned I could ask for help by saying, ‘I was having suicidal thoughts, but I had no plan to harm myself[, ]' which was a lie, but I feared the strip cell more than death.”); id. (“At intake at GDCP in May, I repeated the lie that I was only having suicidal thoughts [with] no plan.”); id. at 58 (“At RSP intake, . . . I told [the nurse] I was having suicidal thoughts but had no plan, so I would end up in the strip cell, that would have been even worse.”); Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 8 (“I knew when I told the [intake] nurse those feelings of hopelessness, etc. are precursor to suicide, it was an intentional cry for help and a way for me to say I was suicidal and not end up in a strip cell.”); id. at 12 (“At [RSP] intake, . . . I denied having a plan to kill myself to avoid the horror of the strip cell.”); Pl.'s Dep. 119:07-120:10 (“I try to be careful about what I say and who I say it to. Because I know that saying certain things can get you involuntarily medicated like you said being put in a suicide cell[.]”); Am. Compl. 14 (“[Plaintiff, Silver, and Thompson] did not talk about the suicide attempt, only that I was having some suicidal thoughts, for I feared being placed in the suicidal observation cell[.]”).

Since he was initially confined at GDCP in May 2016, the medical records document that Plaintiff repeatedly denied suicidal ideation with a plan, suicidal thoughts, and any history of suicidal attempts. Pl.'s Mental Health Records 23, 25, 30-34. He also denied suicidal ideation at FCJ. Pl.'s Exs. 134-36, 142, 148, 154. In one instance, Plaintiff initially stated that “he may hurt himself” during booking, but he then told a nurse practitioner that he made those statements out of “frustration with the lengthy booking process, ” and he “denied ever really wanting to hurt himself.” Id. at 134. Before September 13, 2016, only one medical record documents that Plaintiff expressed any suicidal ideation. Specifically, on May 11, 2016, Plaintiff told a psychologist at GDCP that he had “occasional [suicidal ideation] last[ing]” three minutes. Id. at 28. Plaintiff, however, denied any history of suicidal thoughts with plan and indicated he did not have current suicidal ideation. Id. On that same day, Plaintiff also told a nurse that he had no history of suicide attempts, and he denied suicidal ideation. Pl.'s Mental Health Records 30-32. In an effort to show that Silver disregarded a known risk of harm, Plaintiff contends that almost every medical record incorrectly shows that he denied suicidal thoughts. However, “[s]elf-serving statements by a plaintiff do not create a question of fact in the face of contradictory, contemporaneously created medical records.” Whitehead, 403 Fed.Appx. at 403 (citing Bennett, 898 F.2d at 1533-34). Additionally, although Plaintiff claims he submitted multiple sick call requests seeking a more immediate assessment, Silver avers that she did not receive any sick call requests from Plaintiff. Silver Decl. ¶ 12.

Silver's timeline in meeting with Plaintiff also complied with another treating physician's recommendation. Specifically, on August 10, 2016-just six days before Plaintiff's transfer to RSP-an ASMP psychologist met with Plaintiff and recommended an assessment for the availability of psychiatric medications. Pl.'s Mental Health Records 23. Based on his evaluation and, inter alia, Plaintiff's denial of both suicidal and homicidal ideation, the psychologist recommended that this assessment take place within sixty to ninety days, or October 15, 2016, at the earliest. Id. Silver met with Plaintiff on September 13, 2016-only twenty-eight days later. Given Plaintiff's consistent denial of suicidal thoughts with plan, ideation, or attempts, Silver's compliance with another psychologist's recommended assessment timeline, and her lack of knowledge of Plaintiff's sick call requests, Plaintiff fails to show that Silver should have recognized “a strong likelihood rather than a mere possibility that the self-infliction of harm [would] occur[]” and evaluated Plaintiff earlier. Gish, 516 F.3d at 954; Cook, 402 F.3d at 1116; see also Moore, 847 Fed.Appx. at 697. It was not apparent that her delay would exacerbate Plaintiff's mental health conditions resulting in a suicide attempt. Taylor, 221 F.3d at 1259-60.

For similar reasons, Plaintiff fails to show that the delay was medically unjustified. As Silver notes, after Plaintiff's initial August 23, 2016, mental health intake, he was placed on her caseload for a routine psychiatric evaluation because he had not been prescribed medications and had not described any emergent circumstances requiring more immediate evaluation. Silver Decl. ¶¶ 8, 12; Thompson Decl. ¶ 8. Even if Plaintiff had suicidal thoughts which would have required an emergency evaluation, by his own admission, he intentionally hid these thoughts from both Singleton at RSP and mental health staff at GDCP and ASMP. Pl.'s Decl. 53, 58; Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 8, 12; Pl.'s Dep. 119:07-120:10; Am. Compl. 14. Thus, the lack of emergent circumstances-which may have required more immediate evaluation-is attributable to Plaintiff. His placement on Silver's routine evaluation list and resulting delay in evaluation was not medically unjustified. In fact, on August 10, 2016, the ASMP psychologist found that an even lengthier delay would have been medically justified, as he recommended that Plaintiff's psychiatric assessment take place within sixty to ninety days. Pl.'s Mental Health Records 23. Because Plaintiff fails to show that the delay was medically unjustified, he fails to show that Silver was deliberately indifferent in failing to evaluate him before September 13, 2016.

Second, Plaintiff argues Silver was deliberately indifferent by failing to treat his anxiety. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 13-14. It appears he complains that Silver should have prescribed him Xanax. Id. at 13. As explained above, Silver initially prescribed Plaintiff Zoloft, in part, to treat his anxiety. Silver Decl. ¶ 9; Pl.'s Mental Health Records 20. Silver avers that the Zoloft she prescribed “is a recognized treatment for depression and anxiety.” Silver Decl. ¶ 9. Moreover, the GDC SOP concerning management of psychotropic drugs provides that “[g]enerally the most appropriate first line of treatment of anxiety disorders is with antidepressant medications.” Foreman, Silver, & Thompson's Ex. 4, at 18, ECF No. 157-6. Plaintiff states that he “agreed” to Silver's recommendation that he “try Zoloft.” Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 14. Plaintiff believes he had a negative reaction to the Zoloft, and he refused nine doses. Pl.'s Decl. 61; Pl.'s Dep. 105:06-105:15; Pl.'s Mental Health Records 16, 20; Silver Decl. ¶ 9.1. According to Plaintiff, Silver also instructed him not to discontinue Zoloft before consulting with her to give the medication time to take effect. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 14. At subsequent meetings, Silver prescribed Plaintiff Remeron and Effexor XR and offered him other medications and different regimens. Silver Decl. ¶¶ 9.1-9.12; Pl.'s Mental Health Records 5-9, 11-14, 17-19. Plaintiff, however, was often non-compliant with his medications, in part because he disliked the pill call process. Pl.'s Mental Health Records 7-8, 12, 16, 19; Silver Decl. ¶¶ 9.6, 9.9-9.10.

Plaintiff's treatment records make clear that Silver prescribed multiple medications to treat Plaintiff's mental health conditions, including his anxiety. Indeed, at every meeting, Silver discussed Plaintiff's mental health symptoms, and she prescribed him multiple medications to treat his conditions. Pl.'s Mental Health Records 5-9, 11-14, 17-20; Silver Decl. ¶¶ 9-9.12. It appears Plaintiff believes Silver should have done something more to treat his anxiety-primarily, by prescribing him Xanax. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 13-14. However, “whether governmental actors should have employed additional diagnostic techniques or forms of treatment ‘is a classic example of a matter for medical judgment' and therefore not an appropriate basis for grounding liability under the Eighth Amendment.” Adams, 61 F.3d at 1545 (quoting Estelle, 429 U.S. at 107 (1976)). Silver did not ignore Plaintiff's anxiety. Rather, she met with him thirteen times, prescribed him three different medications, and offered him three others. Pl.'s Mental Health Records 5-9, 11-14, 17-20; Silver Decl. ¶¶ 9-9.12. Plaintiff fails to show that Silver was deliberately indifferent by failing to treat his anxiety.

Third, Plaintiff argues Silver was deliberately indifferent because she prescribed him an excessive Zoloft dosage and failed to follow up with him. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 14-16. Specifically, he claims Silver told him that she intended to prescribe him 50 mg of Zoloft on September 13, 2016, but she “accidentally” prescribed him 100 mg. Id.; Pl.'s Decl. 61-62. Plaintiff believes Silver may have intentionally prescribed him an excessive dosage to give him a negative reaction to the medication. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 16.

The medical records show that Silver prescribed Zoloft on September 13, 2016, beginning with 50 mg for three days and increasing to 100 mg thereafter. Pl.'s Mental Health Records 20. The records also show that Plaintiff quickly failed to comply with his prescription, as he refused to take nine doses between his initial prescription on September 13, 2016, and September 30, 2016. Id. at 16. He claimed the medication made him “amped up” and he “couldn't sleep.” Id. Silver states that this prescription was intentional. Silver Decl. ¶ 9. Indeed, she counseled Plaintiff on the importance of continuing to take his medication when she met with him again on September 27, 2016. Pl.'s Mental Health Records 19; Silver Decl. ¶ 9.1.

From the outset, it is unclear how Plaintiff faced a serious risk of harm resulting from any excessive dosage of Zoloft because he immediately stopped taking his medications. Pl.'s Mental Health Records 16. Regardless, even assuming Silver “accidentally” prescribed 100 mg as Plaintiff alleges, this claim sounds in negligence or medical malpractice, not deliberate indifference. Estelle, 429 U.S. at 106. Based on Plaintiff's own allegations, Silver did not intentionally prescribe him an excessive dosage. He admits that he lacks any evidence showing that Silver intentionally prescribed an excessive dosage and, instead, he relies on pure speculation that Silver wanted to harm him. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 16.

To the extent Plaintiff contends Silver should have known that 100 mg was an excessive dose, he fails to establish deliberate indifference. He fails to show that Silver had subjective knowledge of his negative reaction to the Zoloft because she did not receive any of his sick call requests. Silver Decl. ¶ 12; see Goodman, 718 F.3d at 1334 (“[Plaintiff] cannot say, ‘Well, [defendants] should have known.' Were we to accept that theory of liability, the deliberate indifference standard would be silently metamorphosed into a font of tort law-a brand of negligence redux-which the Supreme Court has made abundantly clear it is not.” (citing Farmer, 511 U.S. at 838; Paul, 424 U.S. at 701). Again, Silver disputes Plaintiff's characterization and asserts the medical records reflect her intentional prescription of 50 mg of Zoloft for three days, followed by100 mg of Zoloft. Silver Decl. ¶ 9.

Plaintiff also fails to show that Silver disregarded any risk of harm. When Plaintiff complained about the side effects of Zoloft on September 27, 2016, Silver addressed his concerns by encouraging him to continue a trial of the medication and to only take the medication in the morning. Silver Decl. ¶ 9.1; Pl.'s Mental Health Records 20. She subsequently prescribed Plaintiff multiple medications to treat his mental health conditions. Silver Decl. ¶¶ 9.1-9.12; Pl.'s Medical Records 5-9, 11-14, 17-19. Thus, Plaintiff fails to show “intentional maltreatment or refusal to provide essential care [which] violates the eighth amendment.” Rogers, 792 F.2d at 1058. The Court RECOMMENDS that Defendants' motion be GRANTED on this ground as to Silver.

3. Defendant Thompson

Defendants argue Plaintiff fails to show that Thompson was deliberately indifferent to his serious mental health needs. Foreman, Silver, & Thompson's Br. in Supp. of Mot. for Summ. J. 15-17. Plaintiff's arguments as to Thompson are scant, but it appears he claims that Thompson was deliberately indifferent by failing to counsel him for anxiety and by failing to ensure he received Xanax or a similar medication. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 15-16 (“Thompson [carries] a caseload at RSP, so why would I not get the benefit of his services.”); Pl.'s Dep. 92:17-96:11.

First, Plaintiff fails to show that Thompson had subjective knowledge of a serious risk of harm. Plaintiff alleges Thompson briefly saw him once when Thompson assisted Silver in counseling Plaintiff after he attempted suicide on September 13, 2016. Pl.'s Decl. 61-62; Pl.'s Dep. 93:13-93:21, 95:18-96:11, 112:20-113:11. Plaintiff's allegations are also inconsistent as to Thompson's role in this meeting. In his amended complaint, Plaintiff stated that Thompson actively discussed Plaintiff's suicide attempt and promised him regular counseling sessions. Am. Compl. 24-25. In his deposition, he testified that “Thompson did not say a lot. . . . He just stood there and nodded I think from what I remember.” Pl.'s Dep. 112:12-112:19. In his declaration, Plaintiff avers that Thompson discussed his sick call requests and that he “was led to believe that Dr. Thompson was going to do counseling.” Pl.'s Decl. 61-62.

Thompson does not recall being present at this meeting. Thompson Decl. ¶ 9. Silver's record of the meeting also do not mention Thompson. Pl.'s Mental Health Records 20. Rather, Thompson states he referred Plaintiff to Silver when Singleton called him and told him Plaintiff wanted to commit suicide. Id. After that meeting, Thompson was not involved in Plaintiff's treatment in any way. Thompson never met with Plaintiff clinically. Thompson Decl. ¶ 7, 9, 11; Pl.'s Dep. 94:03-94:10, 95:18-96:01, 96:12-96:24. He lacks authority to override Silver's prescriptions because he is not a psychiatrist. Thompson Decl. ¶¶ 6-7; Pl.'s Dep. 94:15-95:19. Plaintiff was never on Thompson's caseload. Thompson Decl. ¶¶ 6-7, 9, 11; Pl.'s Dep. 94:03-94:10. Plaintiff even admits he never saw or spoke to Thompson again after September 13, 2016. Pl.'s Dep. 95:18-96:01, 96:12-96:24. Rather, Silver treated Plaintiff's conditions by regularly counseling him for his conditions and prescribing him medications for his depression and anxiety. Pl.'s Mental Health Records 5-9, 11-14, 17-20; Silver Decl. ¶¶ 9-9.12. Somewhat ironically, this treatment through medications is precisely what Plaintiff complains Foreman denied him at GDCP. At most, Plaintiff shows that Thompson was aware he attempted suicide on September 13, 2016. Pl.'s Mental Health Records 20; Thompson Decl. ¶ 9. Thompson immediately referred Plaintiff for treatment on that date, and Plaintiff fails to show that Thompson had any subjective knowledge of his subsequent mental health treatment.

To the extent Plaintiff claims Thompson had subjective knowledge of Plaintiff's mental health treatment based on Plaintiff's encounters with Silver and other RSP mental health staff, he fails to establish subjective knowledge because “imputed or collective knowledge cannot serve as the basis for a claim of deliberate indifference.” Burnette, 533 F.3d at 1331. Thompson lacked specific knowledge of Plaintiff's mental health conditions or lack of treatment before September 13, 2016, because Plaintiff was not on Thompson's caseload. Thompson Decl. ¶¶ 6-7, 9, 11. He lacked specific knowledge of Plaintiff's treatment-or his dissatisfaction therewith-after September 13, 2016, because Silver directly handled Plaintiff's psychiatric medications and treatment. Thompson Decl. ¶¶ 9, 11; see Bugge, 430 Fed.Appx. at 758 (“[S]ubjective knowledge must be specific[.]”).

Second, even if Thompson had subjective knowledge of Plaintiff's conditions based on this brief meeting on September 13, 2016, Plaintiff fails to establish deliberate indifference. Thompson was only involved in Plaintiff's treatment on September 13, 2016. As soon as Singleton told him that Plaintiff wanted to commit suicide, Thompson immediately instructed Singleton to bring Plaintiff to the mental health unit to meet with Silver. Pl.'s Mental Health Records 21; Thompson Decl. ¶ 9. Plaintiff received extensive mental health treatment after September 13, 2016, including twelve meetings with Silver and prescriptions for three different medications in less than two years. Pl.'s Mental Health Records 5-9, 11-14, 17-19; Silver Decl. ¶¶ 9.1-9.12. “[W]hen a prison inmate has received medical care, courts hesitate to find an Eighth Amendment violation.” Waldrop, 871 F.2d at 1035 (citations omitted). Plaintiff makes it clear that he wants Xanax or a similar medication, and he faults Thompson for failing to exercise his “authority to overrule Silver.” Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 15. Even if Thompson could have overruled Silver and ordered her to provide Plaintiff counseling or different medications, “an inmate's desire for a different mode of treatment does not rise to the level of deliberate indifference.” Hamm, 774 F.2d at 1575; Adams, 61 F.3d at 1545 (11th Cir. 1995) (“Whether governmental actors should have employed additional diagnostic techniques or forms of treatment ‘is a classic example of a matter for medical judgment' and therefore not an appropriate basis for grounding liability under the Eighth Amendment.” (quoting Estelle, 429 U.S. at 107)).

Moreover, although Plaintiff argues his claim against Thompson does not arise from Thompson's supervisory role, his assertion that Thompson was deliberately indifferent by failing to supervise Silver or “overrule” her prescriptions belies this argument. Rather, it appears his claim against Thompson concerns solely Thompson's supervisory role as the Clinical Director of the RSP Mental Health Department. A prisoner cannot state a § 1983 claim based on a theory of respondeat superior or vicarious liability. Miller v. King, 384 F.3d 1248, 1261 (11th Cir. 2004). Instead, to state a claim against a supervisory official, a prisoner must allege facts showing either that the supervisor personally participated in the alleged constitutional violation or that there is a causal connection between the actions of the supervising official and the alleged constitutional deprivation. H.C. by Hewett v. Jarrard, 786 F.2d 1080, 1086-87 (11th Cir. 1986). This may be done by alleging that the official either “(1) instituted a custom or policy which resulted in a violation of the plaintiff's constitutional rights; (2) directed his subordinates to act unlawfully; or (3) failed to stop his subordinates from acting unlawfully when he knew they would.” Gross v. White, 340 Fed.Appx. 527, 531 (11th Cir. 2009) (per curiam) (citing Goebert, 510 F.3d at 1331).

Plaintiff fails to show that Thompson is liable under a theory of respondeat superior. He does not allege that Thompson instituted a custom or policy which resulted in a deprivation of mental health treatment. He also does not allege that Thompson directed Silver to deny or delay mental health treatment. At most, he contends that Thompson failed to “overrule” Silver's decision to deny Plaintiff Xanax and, instead, prescribe him different psychiatric medications. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 15. Again, Thompson is not a psychiatrist, and he lacks the authority to dictate which medications Silver should prescribe. Thompson Decl. ¶¶ 6-7. Even assuming Thompson could have directed Silver to treat Plaintiff differently, Plaintiff received extensive mental health treatment, including twelve meetings with Silver and three prescriptions in approximately nineteen months. Thus, because Silver, herself, did not act unlawfully by rendering grossly inadequate mental health treatment, Plaintiff fails to show that Thompson was deliberately indifferent by failing to intervene in Silver's treatment. See Gross, 340 Fed.Appx. at 531. For these reasons, Plaintiff fails to show that Thompson was deliberately indifferent to his serious medical needs. The Court RECOMMENDS that Defendants' motion be GRANTED on this ground as to Thompson.

C. Understaffing

Defendants argue Plaintiff fails to show that Silver and Thompson were deliberately indifferent by understaffing the RSP mental health department. Foreman, Silver, & Thompson's Br. in Supp. of Mot. for Summ. J. 19-20. Plaintiff argues understaffing delayed his mental health treatment and that Silver and Thompson are responsible for understaffing. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 17-18.

First Plaintiff fails to show that understaffing caused any delays in his mental health treatment. Unlike in Greason, it does not appear that understaffing resulted in any delays in Plaintiff's mental health treatment. See Greason, 891 F.2d at 831-40. Rather, the only possible delay occurred in the less than three-week period between Plaintiff's initial mental health evaluation with Singleton on August 23, 2016, and his psychiatric assessment with Silver on September 13, 2016. As discussed above as to Plaintiff's understaffing claim against Hatcher and Shelton, this delay resulted from Plaintiff's decision to repeatedly hide his suicidal thoughts from mental health officials-not understaffing. Pl.'s Decl. 53, 58; Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 8, 12; Pl.'s Dep. 119:07-120:10; Am. Compl. 14. Had he expressed these thoughts, he may have been evaluated sooner based on his presentation of emergent circumstances. Silver Decl. ¶¶ 8, 12; Thompson Decl. ¶ 8. Indeed, Plaintiff was seen on September 13, 2016, moments after he expressed an emergent change in circumstances-namely, his suicide attempt. Pl.'s Mental Health Records 20-21; Silver Decl. ¶ 9; Thompson Decl. ¶ 9; Pl.'s Decl. 59; Pl.'s Dep. 99:14-100:01, 111:14-111:18. After September 13, 2016, Silver regularly met with Plaintiff twelve times in approximately nineteen months. Pl.'s Mental Health Records 5-9, 11-14, 17-19; Silver Decl. ¶¶ 9.1-9.12. During each meeting, she discussed Plaintiff's mental health and adjusted his medications. Pl.'s Mental Health Records 5-9, 11-14, 17-19; Silver Decl. ¶¶ 9.1-9.12.

Second, Plaintiff fails to show that Silver and Thompson disregarded a risk of harm concerning possible understaffing. Plaintiff believes Thompson has some say in staffing decisions because he serves in an administrative capacity as the Clinical Director of the RSP mental health department. Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 17. Silver and Thompson, however, both aver that they have no responsibility for staffing the RSP mental health department. Silver Decl. ¶ 6; Thompson Decl. ¶ 6. Thompson also supervised the entire RSP Mental Health Department, and he avers that the department was not understaffed. Thompson Decl. ¶ 12. Aside from Plaintiff's unsubstantiated speculation as to Thompson's role at RSP and his allegations as to Silver and Thompson's statements about understaffing at RSP, Plaintiff does not rebut these assertions. See Pl.'s Br. in Opp'n to Foreman, Silver, & Thompson's Mot. for Summ. J. 15-16; Pl.'s Decl. 60-62. He has not presented any evidence showing that Silver and Thompson could make staffing decisions. Thus, even assuming the RSP mental health department was understaffed, neither Silver nor Thompson disregarded any resulting risk because they could not make any decisions affecting staffing. For these reasons, the Court RECOMMENDS that Defendants' motion for summary judgment (ECF No. 157) be GRANTED on this ground as to Plaintiff's understaffing claim against Silver and Thompson.

CONCLUSION

For the foregoing reasons, the Court recommends that Defendants' motions for summary judgment (ECF Nos. 156, 157) be granted. Pursuant to 28 U.S.C. § 636(b)(1), the parties may serve and file written objections to this Recommendation, or seek an extension of time to file objections, within fourteen (14) days after being served with a copy hereof. The District Judge shall make a de novo determination of those portions of the Recommendation to which objection is made. All other portions of the Recommendation may be reviewed for clear error.

The parties are hereby notified that, pursuant to Eleventh Circuit Rule 3-1, “[a] party failing to object to a magistrate judge's findings or recommendations contained in a report and recommendation in accordance with the provisions of 28 U.S.C. § 636(b)(1) waives the right to challenge on appeal the district court's order based on unobjected-to factual and legal conclusions if the party was informed of the time period for objecting and the consequences on appeal for failing to object. In the absence of a proper objection, however, the court may review on appeal for plain error if necessary in the interests of justice.”

SO RECOMMENDED.