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Eleventh Circuit Holds that Deliberate Indifference Requires More than Gross Negligence

The Eleventh Circuit Court of Appeals affirmed summary judgment to corrections officers and healthcare personnel in a case of alleged deliberate indifference to serious medical needs, holding that the claimant is required to prove more than gross negligence to create a fact dispute. Plaintiff was incarcerated in Walker State Prison in Georgia. Over a period of four days, he did not receive his seizure medication. On the fourth night, he suffered two seizures, which he claimed led to permanent brain injury. Plaintiff later died of unrelated causes. Plaintiff sued for violation of the Eighth Amendment, alleging that two corrections officers and three correctional medicine providers (nurses) were deliberately indifferent to serious medical needs.

The evidence showed that Plaintiff had been prescribed Dilantin. The two corrections officers worked on the first night Plaintiff missed his medication. One of the correctional nurses was the nurse manager and never saw the patient. The pharmacy ran out of Dilantin and a new shipment was not delivered until the afternoon of the fourth day. However, the facility did have a backup supply available and the nurses were authorized to get Dilantin from a local pharmacy on short notice. Plaintiff suffered his seizure on the evening of the fourth day.

According to the appellate opinion, there was “a fair amount of finger-pointing among the defendants.” In essence, the corrections officers and corrections nurses disagreed about who was supposed to do what and when regarding notations in the medical administration record about missing doses of medications. All of the defendants moved for summary judgment. The trial court granted summary judgment, ruling that the defendants were entitled to qualified immunity.

On appeal, the Court affirmed the grant of summary judgment. The Court started by writing “[a] deliberate indifference claim’s subjective component entails three subparts: The plaintiff must prove that the defendant (1) actually knew about a risk of serious harm; (2) disregarded that risk; and (3) acted with more than ____ negligence.” The Court then wrote that “the blank in our paraphrase is intentional,” explaining that the case law regarding the mens rea element “has been hopelessly confused, resulting in what we’ll charitably call a “mess.”” The Court continued, explaining that it is “axiomatic that simple medical malpractice does not rise to the level of a constitutional violation” and that “it is obduracy and wantonness, not inadvertence or error in good faith” that violates the Eighth Amendment. The Court then concluded that the trial court properly ruled that none of the defendants were grossly negligent, affirming summary judgment.

Take-home: this case does attempt to clean up the imprecise language used to describe the standard in deliberate indifference cases. In prior decisions, most of the analysis was spent on what deliberate indifference was not, as opposed to what it is.

The case is Wade v. McDade, 67 F.4th 1363 (11th Cir. May 22, 2023).