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Horan v. Cabral

United States District Court, D. Massachusetts

September 29, 2017

JOHN HORAN, Plaintiff,


          George A. O'Toole, Jr. United States District Judge.

         The plaintiff, John Horan, a former inmate at the Suffolk County House of Corrections (“SCHOC”), asserts federal and state civil rights violations and various state common-law claims against the former Sheriff of Suffolk County, Andrea Cabral, and various medical personnel associated with SCHOC. The claims stem from allegedly inadequate medical treatment that Horan received during his time as an inmate there. Pending before the Court is former Sherriff Cabral's motion to dismiss under Federal Rule of Civil Procedure 12(b)(6).

         I. Facts Alleged

         The amended complaint alleges the following relevant facts: during and prior to his incarceration at SCHOC in December of 2012, the plaintiff suffered from osteomyelitis-a type of bone infection-with the root of the infection apparently located in his right foot. For more than one year prior to incarceration, Dr. George Abraham had treated the plaintiff's osteomyelitis with intravenous antimicrobial therapy administered through a peripherally inserted central catheter, or “PICC line.” Both the osteomyelitis and the PICC line treatment persisted after the plaintiff was incarcerated. Shortly after the plaintiff's incarceration, Dr. Abraham notified medical personnel working at SCHOC, including Dr. James Cheverie, the medical doctor at SCHOC, of the plaintiff's condition and requested that SCHOC contact him before stopping any treatment of the osteomyelitis. Dr. Abraham also warned that cessation of the PICC line treatment could exacerbate the infection and possibly require amputation of the plaintiff's toes or foot.

         Notwithstanding Dr. Abraham's warning, on or about January 13, 2013, Dr. Cheverie and other medical professionals at Shattuck Hospital removed the PICC line after concluding that the plaintiff's infection did not require intravenous treatment. The plaintiff objected to the removal of the PICC line and reports that his condition worsened almost immediately after it was removed. He received oral pain medication from SCHOC personnel but did not receive any oral antibiotics until much later. On January 15, Dr. Abraham wrote a letter to Dr. Cheverie warning him that removing the PICC line could aggravate the osteomyelitis and result in amputation. On January 22, counsel for the plaintiff also sent a letter to Dr. Cheverie warning him of the risks associated with removing the PICC line, enclosing the January 15 letter from Dr. Abraham. Counsel sent this same letter, with the January 15 letter from Dr. Abraham enclosed, to Andrea Cabral, the Sherriff of Suffolk County at that time. The plaintiff alleges that this letter “put her on notice of the circumstances of Horan's serious medical needs and the importance of maintaining intravenous antimicrobial therapy.” (Am. Compl. ¶ 26 (dkt. no. 29).)

         By January 31, the plaintiff's toe was discolored and swollen. On or about February 13, Dr. Cheverie confirmed that the plaintiff's condition continued to worsen. The plaintiff was then advised that his right, second toe needed to be amputated. After the plaintiff was released from SCHOC under a community supervision program, his right, second toe was surgically amputated on May 31. The plaintiff alleges that the amputation of his toe was the result of deficient medical treatment.[1]

         II. Discussion

         The claims against Cabral include generally stated federal and state civil rights violations, as well as a specifically stated violation of the Eighth Amendment. There are also various common law and tort claims for negligence, negligent infliction of emotional distress, intentional infliction of emotional distress, and assault and battery.[2]

         A complaint need only contain “a short and plain statement of the claim showing that the pleader is entitled to relief.” Fed.R.Civ.P. 8(a)(2). But, to survive a motion to dismiss under Federal Rule of Civil Procedure 12(b)(6), the complaint must contain “factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 556 (2007)). The factual matter in the complaint, accepted as true, must be sufficient to “state a claim to relief that is plausible on its face.” Twombly, 550 U.S. at 570. “Threadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice” and will not survive a motion to dismiss. Iqbal, 556 U.S. at 678 (citing Twombly, 550 U.S. at 555).

         A. Federal Civil Rights Claim under 42 U.S.C. § 1983

         The plaintiff alleges that the purportedly deficient medical care he received as an inmate at SCHOC violated the Eighth Amendment's prohibition against cruel and unusual punishment. The claim is asserted against Cabral in her individual capacity.[3]

         To successfully state an Eighth Amendment claim based on inadequate medical care, the plaintiff must plead that the relevant official was deliberately indifferent to an objectively serious deprivation or medical need. See Leavitt v. Corr. Med. Servs., Inc., 645 F.3d 484, 497 (1st Cir. 2011) (discussing the subjective element of “deliberate indifference” and the objective element of “serious” deprivation). “Deliberate indifference in this context may be shown by the denial of needed care as punishment and by decisions about medical care made recklessly with ‘actual knowledge of impending harm, easily preventable.'” Ruiz-Rosa v. Rullan, 485 F.3d 150, 156 (1st Cir. 2007) (quoting Feeney v. Corr. Med. Servs., Inc., 464 F.3d 158, 162 (1st Cir. 2006)). “[S]ubstandard care, malpractice, negligence, inadvertent failure to provide care, and disagreement as to the appropriate course of treatment are all insufficient to prove a constitutional violation.” Id. The second, objective requirement looks to the seriousness of the deprivation or medical need. “A medical need is “serious” if it 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.” Gaudreault v. Municipality of Salem, 923 F.2d 203, 208 (1st Cir. 1990) (citations omitted).

         In this instance, however, the amended complaint does not contain any factual basis for the supposition that Cabral participated in Horan's medical treatment at all, let alone the actions or omissions that allegedly amounted to an Eighth Amendment violation. Rather, the claims appear to be premised on her being a general supervisor of activity at the SCHOC in her capacity as Sheriff.

         In the context of supervisory liability, it is well established that “[g]overnment officials may not be held liable for the unconstitutional conduct of their subordinates under a theory of respondeat superior.” Iqbal, 556 U.S. at 676 (emphasis in original); see Leavitt, 645 F.3d at 502; Carmona v. Toledo, 215 F.3d 124, 132 (1st Cir. 2000). “[A] supervisor may not be held liable for the constitutional violations committed by his or her subordinates, unless there is an ‘affirmative link between the behavior of a subordinate and the action or inaction of the supervisor . . . such that the supervisor's conduct led inexorably to the constitutional violation.'” Feliciano-Hernández v. Pereira-Castillo, 663 F.3d 527, 533 (1st Cir. 2011) (omission in original) (quoting Soto-Torres v. Fraticelli, 654 F.3d 153, 158 (1st Cir. 2011)). Additionally, “isolated ...

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