FLEET C. HAMBY, Plaintiff-Appellant,
M.D. STEVEN HAMMOND, Chief Medical Officer, Washington Department of Corrections, in his individual and official capacities; M.D. SARA SMITH, Former Facility Medical Director, Stafford Creek Corrections Center, in her individual capacity; BERNARD WARNER, Secretary, Washington Department of Corrections, in his individual and official capacities, Defendants-Appellees
and Submitted, Seattle, Washington February 2, 2016.
[Copyrighted Material Omitted]
from the United States District Court for the Western
District of Washington. D.C. No. 3:14-cv-05065-RBL. Ronald B.
Leighton, District Judge, Presiding.
panel affirmed the district court's summary judgment in
favor of prison officials in an action brought by a prison
inmate pursuant to 42 U.S.C. § 1983 alleging that
officials were deliberately indifferent to his serious
medical needs when they refused to grant his request for
received surgery for his umbilical hernia after the district
court granted his motion for a preliminary injunction and
ordered prison officials to refer him to a surgeon for
evaluation and possible surgical treatment. After receiving
surgery, plaintiff sought damages for the pain he allegedly
suffered because of the officials' refusal to authorize
surgery prior to litigation. The panel held that the
officials were entitled to qualified immunity because in
light of existing precedent and the specific facts of this
case, it was at least debatable that they complied with the
Eighth Amendment. The panel determined that to the extent
that the officials played any role in the decision to deny
surgery, the record made clear that they did so based on
legitimate medical opinions that have often been held
reasonable under the Eighth Amendment.
panel held that the district court properly denied injunctive
relief relating to plaintiff's potential inguinal hernia.
The panel determined that plaintiff had not pointed to
evidence which suggested that defendants' decision to
forgo surgery for the potential inguinal hernia was medically
unacceptable under the circumstances and made in conscious
disregard of an excessive risk to plaintiff's health.
in part and dissenting in part, Judge Gould concurred only
with the majority opinion's result regarding the denial
of injunctive relief pertaining to plaintiff's potential
inguinal hernia, and dissented from the rest of the majority
opinion. Judge Gould stated that there was a genuine issue of
material fact on whether the course of treatment the doctors
chose in treating plaintiff's umbilical hernia was
medically unacceptable under the circumstances, and whether
they chose this course in conscious disregard of an excessive
risk to plaintiff's health.
Balson, Public Interest Law Group, PLLC, Seattle, Washington
argued the cause and filed the briefs for the
J. Feulner, Assistant Attorney General for the State of
Washington, Olympia, Washington, argued the cause and filed
the brief for the defendants-appellees. With him on the brief
was Robert W. Ferguson, Attorney General for the State of
Washington, Olympia, Washington.
Alex Kozinski, Diarmuid F. O'Scannlain, and Ronald M.
Gould, Circuit Judges. Opinion by Judge O'Scannlain;
Partial Concurrence and Partial Dissent by Judge Gould.
F. O'Scannlain, Circuit Judge:
decide whether state prison officials can be made to pay
damages to a prisoner who claims that they violated his
Eighth Amendment rights when they refused to grant his
request for hernia surgery.
C. Hamby is an inmate at the Stafford Creek Corrections
Center in Aberdeen, Washington. In April 2012, Hamby fell off
of a ladder while working his prison job as an
electrician's assistant. A prison medical professional
diagnosed him as having an umbilical hernia, meaning that a
part of his intestine or abdominal fat had pushed through a
weak spot in his abdominal wall, causing a bulge in his
belly. Hamby's umbilical hernia was described as "
small" and " easily reducible," which means
that Hamby could push the hernia back into his abdomen by
applying manual pressure or by lying down. Hamby was
counseled on how to push the hernia back in if it popped out,
and was also given a rib belt designed to keep the hernia in.
two weeks later, Hamby saw another prison medical
professional who noted that Hamby was in pain and had some
abdominal tenderness and swelling, but could walk around
without difficulty. Hamby was prescribed medication--which he
was unable to take due to his other medical conditions--and
was advised to continue using the rib belt for support.
end of 2012, Hamby was seen at least ten times by a handful
of prison medical personnel. Hamby reported that he
experienced sharp pains while sleeping, using the bathroom,
and when he tried to sit for long periods. In June of that
year, Hamby formally requested surgical repair for his
hernia. But on July 19, Hamby rated his pain a three out of
ten, and when he renewed his request for surgery in August
his request was denied, with prison medical officials telling
him that his " condition [would] continue to be
monitored as needed by Health Services." Hamby was
examined again on November 16, and his hernia was confirmed
to be still " easily reducible." Hamby continued
using the hernia belt in addition to a variety of prostate
March 2013, Hamby was seen by a doctor at a different prison.
This doctor reported that Hamby was able to " make it to
chow hall and back," and that he could use the bathroom.
Hamby advised the doctor that his umbilical hernia "
interfered with [his] sleep," made " sitting down .
. . difficult," and generated " random pain."
This doctor advised that surgery was not medically necessary
at that time.
August 2013, Hamby's attorney sent a letter to Dr. G.
Steven Hammond, the Chief Medical Officer for the Washington
State Department of Corrections; Dr. Sara S. Smith, the
Facility Medical Director at the Stafford Creek Corrections
Center; and Bernard Warner, the Secretary of the Washington
Department of Corrections (" prison officials" ),
asking them to reconsider Hamby's need for surgical
treatment. Shortly thereafter, prison medical personnel
presented Hamby's case to the prison's Care Review
Committee (" CRC" ), a group of medical
professionals that decides whether proposed health care
treatments are medically necessary under the prison's
Offender Health Plan. Drs. Hammond and Smith were
voting members, with Dr. Hammond also serving as committee
chair. The CRC considered whether to authorize a surgical
consultation, and possible surgical repair, for Hamby's
umbilical hernia. The physician's assistant who presented
the request for Hamby's surgery described Hamby's
hernia as " easily reducible" and noted that
although Hamby was in pain, he had been going to meals and
his activities of daily living were not
impaired. The CRC denied the request, deeming
surgery not medically necessary at that time, and recommended
continued monitoring of Hamby's condition.
was subsequently examined by a physician's assistant who
had treated him several times in the past. The
physician's assistant noted that Hamby was attending
classes and that his " activities of daily living were
unaffected," and described his hernia as "
minimal," and recommended monitoring. Hamby was later
seen by a Department of Corrections urologist, who likewise
opined that surgery was not medically necessary because Hamby
" did not have continual pain and was still performing
his ADLs without incident."
filed this lawsuit under 42 U.S.C. § 1983 in January
2014, against Dr. Hammond, Dr. Smith, and Secretary Warner.
Hamby sued each in his personal capacity, and he sued Dr.
Hammond and Secretary Warner in their official capacities as
well. He claimed that the prison officials exhibited
deliberate indifference to his serious medical needs, thereby
violating his Eighth Amendment right to be free from cruel
and unusual punishment. As of May 2014, when he moved for a
preliminary injunction, Hamby rated the pain from his
umbilical hernia " as a 5 on a scale of 1-10." In
August 2014, the district court granted Hamby's motion
for a preliminary injunction, ordering the prison officials
to refer him to a surgeon for evaluation and to authorize
surgical treatment if the surgeon so advised. Hamby received
his hoped-for surgery, and his umbilical hernia was repaired
on October 13, 2014.
receiving surgery on his umbilical hernia, Hamby continued to
press his case, seeking damages for the pain he allegedly
suffered because of the prison officials' refusal to
authorize surgery prior to litigation. On cross-motions for
summary judgment, the district court ruled for the prison
officials, holding that they had not in fact been
deliberately indifferent to Hamby's serious medical
needs--and so they had not violated Hamby's Eighth
Amendment rights, after all--but that even if they had,
qualified immunity would shield them from having to pay
addition to the ordeal surrounding his umbilical hernia,
Hamby complains of ailments triggered by a particularly harsh
sneeze that left him reeling in October 2012. This sneeze may
or may not have caused an inguinal hernia--which occurs in
the groin area, when fatty or intestinal tissue pushes
through a weak spot in the abdominal wall--but Hamby was
never diagnosed as having an inguinal hernia. Nonetheless, in
response, prison medical personnel gave him a jockstrap to
reduce the pain.
2014, Hamby declared that " [t]he pain from the inguinal
hernia had subsided for several months," although it
had " recently reappeared" and was "
intermittent, ranging between 0 and 5." In September
2014--at the time Hamby moved for summary judgment--he
declared that " the pain related to [his] possible
inguinal hernia [had] subsided," and was "
currently at a level he can tolerate." Still, Hamby
requested a permanent injunction requiring the prison
officials " to diagnose and treat his possible inguinal
hernia should the pain associated with that condition once
again become intolerable."
district court denied Hamby's request for a permanent
injunction and granted summary judgment to the prison
officials, ruling that their conduct in response to
Hamby's possible inguinal hernia did not violate
Hamby's rights under the ...