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Cox v. Massachusetts Department of Correction

United States District Court, D. Massachusetts

March 31, 2018

WILLIAM COX, Plaintiff,
v.
MASSACHUSETTS DEPARTMENT OF CORRECTION, Defendant.

          MEMORANDUM AND ORDER ON DEFENDANT'S POST-TRIAL MOTIONS

          F. Dennis Saylor IV, United States District Judge

         This is an action brought by a mentally-disabled state prisoner asserting claims under the Americans with Disability Act, 42 U.S.C. § 12101 et seq. Plaintiff William Cox contends that he was the victim of discrimination on the basis of disability because he was denied adequate access to (1) procedures to obtain medical care, (2) procedures to report and resolve grievances, (3) procedures to report physical or sexual assaults, and (4) use of telephones. After a trial, a jury found in his favor on those claims and awarded him money damages.[1] Defendant Massachusetts Department of Correction has moved for judgment in its favor as a matter of law under Fed.R.Civ.P. 50 and for remittitur or (in the alternative) for a new trial under Fed.R.Civ.P. 59(e) and (a).

         The basic question before the Court is whether the verdict should be overturned, in whole or in part, on grounds of lack of evidence or sovereign immunity. The issue, of course, is not whether Cox is an unsympathetic figure (he is a convicted murderer serving a life sentence) or a sympathetic figure (he is a mentally disabled man who was sexually assaulted in prison). Nor is the issue whether the procedures at issue are ideal in all respects. Rather, it is whether-under the complex procedural interplay between the ADA, principles of sovereign immunity, and the Constitution-the award of money damages should be upheld. For the reasons set forth below, the motions will be granted in part and denied in part.

         I. Background

         William Cox is a 57-year-old inmate currently serving a life sentence in Massachusetts state prison for a conviction of second-degree murder in 2007.[2] He is mentally disabled and has an intelligence quotient (“IQ”) of 51. (Tr. 3:65). He is unable to read, write, and dial a telephone without assistance. (Tr. 2:45-46; 3:68, 92). Since 2009, he has been housed in the residential-treatment unit (“RTU”), a specialized unit for inmates with mental-health problems. (Tr. 3:23, 37).

         At trial, Cox presented evidence concerning his inability to access various prison programs and services. He presented evidence that, due to his inability to write, he was unable to fill out sick-call slips to request medical attention. (Tr. 2:47). There was evidence that he sometimes experienced delays in receiving medical care, although the length of the delays and their cause is unclear. He testified that other inmates help him fill out sick-call slips, and that, in exchange, he is often required to barter with them, generally by giving them items he has purchased through the prison commissary system, such as chips, coffee, or pastries. (Tr. 5:127-28). Because he is required to barter for favors, he believes that he is more vulnerable to exploitation by other prisoners.

         Cox also presented evidence that his inability to write prevented him from making full use of the prison grievance system, and that, as with sick-call slips, he had to give other inmates items from his commissary in exchange for their help writing out grievance forms. (Tr. 5:128).

         Cox also presented evidence concerning his inability to dial the telephone. Again, he testified that he sometimes gave other inmates items from his commissary in exchange for their help dialing the telephone. (Tr. 5:127-28).

         His inability to dial the telephone also restricted his ability to use the confidential hotline to report instances of sexual assault, referred to as the “PREA” hotline in reference to the Prison Rape Elimination Act, 34 U.S.C. § 30301 et seq. (Tr. 2:59-60, 92). There was testimony at trial that he was the victim of a sexual assault committed by other inmates, in which other inmates inserted a deodorant bottle in his anus. (Tr. 2:55-57). There was also testimony that another inmate who witnessed the incident called the PREA hotline on Cox's behalf to report it. (Tr. 5:114; 2:88).

         Prior to that incident, the same inmates who sexually assaulted Cox at least twice pulled his pants down and made fun of the size of his penis. (Tr. 2:61-63; 5:111, 122). Cox testified that he reported the incidents to corrections officers, but that they told him that it was his fault and “never done nothing about it.” (Tr. 5:111, 122).

         An inmate named George Stallings testified that he occasionally helped Cox make phone calls or write letters. (Tr. 2:63). Stallings testified in general terms that when Cox asked corrections officers for assistance, they would refuse to help, and instead “laugh, clown at him, ” and say things like “‘look at this clown' or ‘look at this guy, is he serious?'” (Tr. 2:64).

         The DOC presented testimony that placement in the RTU meant that Cox had access to the “very highest level of general population care [available] in the Department of Correction.” (Tr. 3:131). There was testimony that the mental-health clinicians who staffed the RTU were available to help inmates with things such as reading or writing letters or forms and dialing the telephone. (Tr. 3:56-57, 93; 6:97). There was also testimony that Cox had daily access to nurses and mental-health clinicians, from whom he could seek assistance at any time. (Tr. 6:94, 113, 3:54).

         The jury returned a verdict in favor of Cox and against the DOC on most of his ADA claims, finding that he lacked meaningful access to (1) procedures to obtain medical care; (2) procedures to report and resolve grievances; (3) procedures to report physical or sexual threats or assaults; and (4) use of telephones. (Docket No. 199 at 1-2).[3] The jury awarded damages in the amount of $250, 000, broken down between the different claims as follows: $50, 000 for lack of access to procedures to obtain medical care; $25, 000 for lack of access to procedures to report and resolve grievances; $150, 000 for lack of access to procedures to report physical and sexual threats or assaults; and $25, 000 for lack of access to telephones. (Id. at 3).

         The DOC has moved for post-trial relief in the form of judgment as a matter of law, sovereign immunity as to the damages award, and remittitur or, in the alternative, a new trial on damages.

         II. Analysis

         A. Judgment as a Matter of Law

          The DOC has moved for judgment as a matter of law pursuant to Fed.R.Civ.P. 50(b). It contends that judgment in its favor is warranted because (1) the evidence presented at trial showed that Cox had meaningful access to prison programs and services and (2) the evidence did not support a finding of intentional discrimination, as is required to award compensatory damages under the ADA. It has further moved for judgment as a matter of law on the ground of sovereign immunity.

         1. Whether the Claims Are Preserved

         A Rule 50(b) motion for judgment as a matter of law is “bounded by the movant's earlier Rule 50(a) motion.” Parker v. Gerrish, 547 F.3d 1, 12 (1st Cir. 2008) (internal quotation marks omitted). Such a motion cannot be used to “introduce a legal theory not distinctly articulated in [the movant's] close-of-evidence motion for a directed verdict.” Id. (internal quotation marks omitted); accord Costa-Urena v. Segarra, 590 F.3d 18, 26 n.4 (1st Cir. 2009) (“It is well-established that arguments not made in a motion for judgment as a matter of law under Rule 50(a) cannot then be advanced in a renewed motion for judgment as a matter of law under Rule 50(b).”); Fed.R.Civ.P. 50 Advisory Committee's Notes, 2006 Amendments (“Because the Rule 50(b) motion is only a renewal of the preverdict motion, it can be granted only on grounds advanced in the preverdict motion.”).

         Defendants filed two pre-verdict Rule 50(a) motions, one at the close of Cox's case and the other at the close of all the evidence. Those motions focused primarily on the claim against defendant O'Brien in his individual capacity. (See Docket No. 194 at 1-8; Docket No. 195 at 1-8). As to the ADA claim against the DOC, the motions focused primarily on the issue of sovereign immunity. (See Docket No. 194 at 8-10; Docket No. 195 at 8-10).

         As part of its argument on sovereign immunity, the DOC contended that “the plaintiff has failed to produce evidence to prove each element” of his ADA claim. (Docket No. 194 at 8; Docket No. 195 at 8). It went on to state:

[Cox] has failed to produce evidence that the Department of Correction denied [him] access to prison services with a discriminatory purpose, a required element of his claim. [He] has failed to show that there was anything different about the way he was treated “by reason of . . . disability.” [He] has failed to show that his disability was a substantial cause of the exclusion or denial of any reasonable accommodation. In order for his claim to survive, [he] must allege causation between the alleged discrimination and his disability. [He] has failed to show that the defendant violated Title II with respect to any of the alleged services he was denied-assistance using [the] telephone, assistance filing grievances, assistance writing sick slips, and assistance cleaning his cell or using the shower.

(Docket No. 194 at 8-9; Docket No. 195 at 8-9) (internal citations omitted). At oral argument on the motion, defendants presented argument on the claims against O'Brien and the issue of sovereign immunity only. (See Tr. 6:19-24). As to sovereign immunity, the DOC argued that Cox had failed to show “any injury to . . . even with respect to any lost opportunity” to access prison programs and services and that “Cox has failed to show any injury with respect to the specific claims under the ADA with respect to medical care, the grievance procedures, telephone, [and] showers.” (Id. at 21, 24). In context, however, it is unclear whether the DOC's arguments were made under the standards of the ADA itself or the standards of the constitutional provisions relevant to each claim.

         Thus, there is some ambiguity as to whether the DOC directly challenged the sufficiency of the evidence to support Cox's ADA claims in its earlier Rule 50(a) motions. However, the first step in the relevant sovereign-immunity analysis is whether the plaintiff has stated a viable ADA claim. See United States v. Georgia, 546 U.S. 151, 159 (2006). Accordingly, its Rule 50(b) motion does not introduce a wholly new legal theory or argument. The Court will therefore proceed to the merits of the motion.

         2. Whether Judgment as a Matter of Law Is Appropriate

         A motion for judgment as a matter of law may be granted only “when, after examining the evidence of record and drawing all inferences in favor of the nonmoving party, the record reveals no sufficient evidentiary basis for the verdict.” Zimmerman v. Direct Fed. Credit Union, 262 F.3d 70, 75 (1st Cir. 2001). When considering a motion for judgment as a matter of law, “the court may not weigh the evidence, undertake credibility determinations, or engage in differential factfinding.” Id. Rather, “the jury's verdict must stand unless the evidence, taken in the light most favorable to the prevailing party, points unerringly to an opposite conclusion.” Id.

         To succeed on a claim under Title II of the ADA, a plaintiff must establish “(1) that he is a qualified individual with a disability; (2) that he was either excluded from participation in or denied the benefits of some public entity's services, programs, or activities or was otherwise discriminated against; and (3) that such exclusion, denial of benefits, or discrimination was by reason of the plaintiff's disability.” Parker v. Universidad de Puerto Rico, 225 F.3d 1, 5 (1st Cir. 2000). The second prong generally requires that a plaintiff show that he was denied “‘meaningful access' to government benefits and programs, ” meaning that the defendant failed to take “reasonable steps to ensure that [the plaintiff] can take advantage of” its benefits and programs. Theriault v. Flynn, 162 F.3d 46, 48 (1st Cir. 1998).

         Here, it is undisputed that due to his intellectual disabilities, Cox is unable to read, write, or dial a telephone. The DOC contends that the evidence presented at trial failed to establish that those limitations prevented him from accessing the prison programs and services at issue.

         For the reasons set forth below, the evidence here is sufficient, if sometimes marginally so, to establish that Cox was denied access to (1) procedures to obtain medical care, (2) procedures to report and resolve grievances, and (3) procedures to report physical and sexual assault. It is not sufficient, however, to establish that he was denied meaningful access to the use of telephones, and for that reason, the motion for judgment as a matter of law will be granted as to that claim.

         a. Evidence of Denial of Access to Programs and Services

         (1) Procedures to Obtain Medical Care

         The DOC contends that the evidence presented at trial did not establish that Cox was denied meaningful access to procedures to obtain medical care. In particular, it contends that the evidence showed that he does not need to write a sick slip in order to receive medical care, but could simply ask any member of the staff, including his mental-health clinicians or the nurses that he sees daily to receive insulin injections, that he needs to see medical staff.

         At trial, Karen Dinardo, the deputy superintendent of re-entry at North Central Correctional Institute-Gardner and the ADA coordinator, testified that Cox could access medical care by “ask[ing] staff, let[ting] staff know that he is in need of service, ” or asking a nurse in the insulin line who “would make sure that he was seen by somebody if he was experiencing any difficulty.” (Tr. 6:113). Andrea Mitchell, Cox's mental-health clinician, also testified that she sees him on a daily basis and would “[a]bsolutely” assist him with writing a sick-call slip if he asked. (Tr. 6:94). Mitzi Peterson, the director of behavioral health for the DOC, testified that an inmate could approach staff on the unit doing rounds to verbally ask for medical assistance. (Tr. 3:54). Cox himself also testified that his mental-health clinicians “help[] me any time I ask” and that he can “go down to medical, they help me, too. I go down to medical and ask the people who runs [sic] it.” (Tr. 5:138).

         However, another inmate, George Stallings, testified that an inmate could “[a]bsolutely not” just show up at the medical unit and receive treatment. (Tr. 2:47). Cox testified that sometimes medical staff or mental health staff told him they were too busy to help him, and would tell him to go back to his unit. (Tr. 5:132-33).[4] There was also evidence from which the jury might have reasonably inferred that when Cox asked for medical attention, he was told that he needed to fill out a sick-call slip in order to be seen. (Trial Ex. 1.1563 (sick-call slip, apparently filled out by another inmate, stating “I want to know why I haven't seen a doctor? As told by Carol (nurse H.S.U). Please help. Thank you.”); Trial Ex. 1.1849 (sick-call slip, apparently filled out by another inmate, stating “At approx. 9 AM during med. line I informed nurse Tracy of bowl bleading [sic] when I poop. When I wipe the blood pours from me.”)). The sick call request forms in evidence contain a number of complaints from Cox about delays. (See, e.g., Exs. 1.1563, 1.1742, 1.2111, 1.2112). Cox testified that when other inmates helped him fill out a sick slip, he would give them “my pastry, like cupcake, anything.” (Tr. 5:128).

         As noted, Stallings testified that as a general matter, corrections officers would make fun of Cox if he asked for assistance. (Tr. 2:64). Stallings did not specifically testify, however, that corrections officers refused to assist Cox in filling out sick-call slips.

         It is far from clear that the evidence as to the claim of denial of adequate access to medical care is sufficient to sustain the verdict. There was unrebutted evidence that Cox had daily access to medical and mental-health professionals who could (and would) assist him in obtaining any required care. Medical resources are limited, even outside of prisons, and delays in obtaining non-emergency care are commonplace; a delay by no means automatically equates to a denial, or even the provision of substandard care. The question is further complicated by the prison environment. It is reasonable for prisons to require orderly procedures for seeking medical treatment, and not simply permit prisoners to simply show up at the clinic and receive treatment on demand. The requirement of a written slip for non-emergency treatment is not unreasonable, even for a mentally disabled prisoner, as long as assistance in filling out the slip is provided.

         On the other hand, prisoners are at the mercy of the staff, and they cannot seek care elsewhere if their requests are ignored. There was some evidence that corrections officers did not provide assistance in obtaining care, and instead made fun of Cox. Cox testified that (in effect) he had to pay inmates to help him fill out sick slips. And there is some evidence of delays in obtaining access to health care.

         Accordingly, the Court will not overturn the verdict concerning Cox's access to procedures to request medical care because the evidence, viewed in the light most favorable to him, does not “point[] unerringly to an opposite conclusion.” Zimmerman, 262 F.3d at 75.

         (2) Procedures to Report and Resolve Grievances

         The DOC further contends that the evidence at trial failed to establish that Cox lacked meaningful access to procedures to report and resolve grievances. It points to evidence that Cox is able to advocate for himself and has in fact “advocated for himself in interpersonal struggles with others, with issues with roommates.” (Tr. 3:125 (testimony of Mitzi Peterson)). There is also evidence that, on at least one occasion, he spoke to a mental-health clinician about another inmate who “provokes” him. (Tr. 3:60).[5]

         The DOC also points to evidence that Cox's mental-health clinicians are available for confidential meetings and can provide assistance with reading and writing. (Tr. 6:86-88). There was evidence that if an inmate reported to a mental-health clinician that he was afraid that someone else was going to harm him, that clinician would report that to the shift commander and file a confidential incident report for the superintendent's review. (Tr. 3:55). Finally, there was evidence that inmates can report problems to DOC staff during staff rounds or staff access hour, during which inmates can report problems or complaints to DOC officials from the superintendent's administration. (Tr. 2:67; Tr. 6:111).

         However, there was also some evidence that Cox may have lacked meaningful access to grievance procedures. For example, Prisoners' Legal Services attorney Lauren Petit testified that, to her knowledge, no DOC staff member had ever helped Cox file a grievance. (Tr. 4:81). There was evidence from which the jury could conclude that Cox lacks the mental capacity to advocate on his own behalf and proactively seek out assistance from staff members. (See Tr. 3:65-68 (discussing Cox's IQ and intellectual capabilities); Tr. 4:100 (testimony by attorney Lauren Petit that Cox is “unable to . . . understand the information that he would need to present in order to substantiate what his needs are” and that his ability to express his needs is “very limited”)). Cox testified that he “wouldn't fill out no grievance, ” but that if other inmates helped him, he would give them something. (Tr. 5:128). And as noted, there was testimony from Stallings that corrections officers were generally not responsive to Cox's requests for assistance. (See Tr. 2:64).

         Again, it is far from clear whether the evidence on this issue is sufficient. Because Cox is illiterate and has limited intellectual capacity, he will never be able to put grievances in writing without assistance, and will always have difficulty advocating for himself and seeking out the help of staff, regardless of what procedures are in place. There is no evidence that he ever actually attempted to file a grievance and failed, was prevented from filing a grievance, or suffered an injury that could have been resolved by a grievance.[6]

         Nonetheless, again the Court will not overturn the jury's verdict as to this issue because the evidence, viewed in the light most favorable to plaintiff, does not “point[] unerringly to an opposite conclusion.” Zimmerman, 262 F.3d at 75.

         (3) Procedures to Report Physical and Sexual Assault

          The DOC next contends that the evidence at trial failed to establish that Cox was denied meaningful access to procedures to report physical and sexual assaults. It points to evidence that he was able to report any problems to DOC staff, including mental-health clinicians, corrections officers, and other officials during either staff rounds or staff access hour. It also points to evidence that he has monthly confidential meetings with his mental-health clinician, that he could request additional confidential meetings if necessary, and that if he reported any instance of physical or sexual assault to his clinician, that person would then file an incident report for the superintendent's review. (Tr. 3:55; 6:86-87). Thus, the DOC contends that his inability to dial a telephone and use the confidential PREA hotline did not prevent him from reporting assaults in other ways.

         As noted, there was evidence that DOC staff were not always responsive to Cox's requests for assistance. Cox testified that he reported to corrections officers that other inmates- the same inmates who later sexually assaulted him-were pulling down his pants, laughing at him, and making fun of the size of his penis, but that the officers did nothing about it. (Tr. 5:111, 122). Again, there was also testimony from Stallings that when Cox asked corrections officers for help, they would “laugh at him” or call him a “clown.” (Tr. 2:64). Furthermore, there was testimony from Stallings that the PREA hotline was necessary to provide a confidential means of reporting assault so that the individual making the report would not be labelled a “rat, ” which could have consequences for that prisoner's safety. (Tr. 2:91-92). Arguably, the earlier refusal of the guards to respond to the earlier incidents contributed, at least in part, to the subsequent sexual assault of Cox.

         Again, it is not at all clear that the evidence as to this issue was sufficient. If Cox cannot use a telephone without the assistance of others, he will never be able to access the PREA hotline, and will always have to rely on oral reports to staff or the assistance of staff. Nonetheless, again the Court will not overturn the verdict, as it is not plainly against the weight of the evidence.

         (4) Access to Telephones

          Finally, the DOC contends that the evidence presented at trial does not support the jury's verdict that Cox lacked meaningful access to use of the telephone. It points to testimony that clinical staff would be available to help him dial a telephone if he requested that help. (Tr. 6:97). It also points to Cox's own testimony concerning his ability to ask his clinician to help him place a telephone call. While Cox did testify that he asked his mental-health clinician to help him call his family, his testimony on the issue was ambiguous at best. He testified that he sometimes asked a particular mental-health caseworker to call his brother or sister and he seemed to suggest that she helped him when he requested. (Tr. 5:138). When he was asked whether his “case workers help [him] dial the phone, ” he responded, “[s]he don't dial the phone, I'll ask her, she'll turn around and call in the ...


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