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April 17, 2000


The opinion of the court was delivered by: Larimer, Chief Judge.


Plaintiff, Jerome Douglas, Jr., commenced this action pro se on June 10, 1998, asserting claims pursuant to 42 U.S.C. § 1983. The court appointed counsel to represent plaintiff on September 15, 1998. Plaintiff, who is currently an inmate in the custody of the New York State Department of Correctional Services, alleges that on February 14, 1998, while he was a pretrial detainee at the Monroe County Jail ("the Jail") in Rochester, New York, he broke a bone in his left hand in an altercation with another inmate. He was later taken to a hospital, where he was treated by an orthopedic surgeon, who prescribed Darvocet for pain. Plaintiff alleges that defendants Marilyn Stanwick and Linda Clark, M.D., who at all relevant times were respectively employed as the supervising nurse and a physician at the Jail, withheld his medication on several occasions, causing him to suffer pain. Plaintiff alleges that defendants thereby were deliberately indifferent to his serious medical needs, in violation of his rights under the United States Constitution. Plaintiff seeks an award of compensatory and punitive damages, plus costs and attorney's fees. Defendants have moved for summary judgment.


When plaintiff told staff members at the Jail about his injury on February 14, x-rays were taken of his hand, revealing a fracture. Plaintiff was given Tylenol for pain, and several hours later he was taken to St. Mary's Hospital in Rochester. Medical personnel at St. Mary's placed his hand in a splint, and gave plaintiff a prescription for a three-day supply of pain medication. The prescription was forwarded to the Jail, and this initial prescription was filled and administered to plaintiff.

Plaintiff returned to St. Mary's on February 20, 1998, and a cast was put on his hand. It does not appear that any additional medication was prescribed during that visit.

The complaint alleges that over the course of the next several days, plaintiff complained of pain in his hand, and was again given Tylenol. Plaintiff alleges that Stanwick or another nurse under her supervision twice told him that he would be taken to see the Jail physician, but he was not.

Plaintiff was again taken to St. Mary's on March 6, 1998 and was seen by Stephanie E. Siegrist, M.D. Plaintiff's cast was removed, and Dr. Siegrist prescribed Darvocet, a narcotic, for pain. When plaintiff returned to the Jail, however, Dr. Clark directed the staff to withhold this medication. It appears that she gave an oral instruction to that effect to Stanwick, who memorialized it in writing. See Complaint Ex. A. Dr. Clark states that she wanted the Jail nurses to see if over-the-counter pain medicines would suffice to control plaintiff's pain, since many Jail inmates have a history of substance abuse problems. Plaintiff himself has a history of marijuana and cocaine use, although Dr. Clark states that she does not remember if she was aware of that at the time that she issued her hold order. Based on Dr. Clark's order, the nurses at the Jail refused to give plaintiff Darvocet when he complained of pain, instead giving him Tylenol.

On April 9, 1998, plaintiff again was taken to St. Mary's Hospital for follow-up treatment. He allegedly told Dr. Siegrist that he was not being given his prescribed medicine. She again directed that he be given Darvocet for pain. See Plaintiff's Attorney's Declaration (Docket Item 44) Ex. 14. Plaintiff was never given Darvocet at the Jail, however. Stanwick states in her affidavit that plaintiff's medical records at the Jail do not indicate that he complained of hand pain at any time after April 9, though, and Dr. Clark states that this new directive from Dr. Siegrist was never forwarded to her. Stanwick Aff. (Docket Item 42) ¶¶ 30, 32; Clark Aff. (Attachment to Docket Item 34) ¶ 20.

Plaintiff alleges that he filed a grievance with Jail officials, but never got a response. Defendants, however, do not indicate any awareness of the alleged grievance, and plaintiff has not submitted a copy of it.

As stated, plaintiff filed the complaint in this action in June 1998, at which time he was still at the Jail. Plaintiff left the Jail the following month.


I. General Standards

State officials' deliberate indifference to the medical needs of persons in custody can, depending on the circumstances, give rise to a constitutional violation. Whereas convicted prisoners' right to medical care stems from the Eighth Amendment's ban on cruel and unusual punishments, however, see Farmer v. Brennan, 511 U.S. 825, 827, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994), the analogous right of pretrial detainees arises under the Due Process Clause of the Fourteenth Amendment. Henderson v. Sheahan, 196 F.3d 839, 845 n. 2 (7th Cir. 1999); Lopez v. LeMaster, 172 F.3d 756, 764 (10th Cir. 1999); Weyant v. Okst, 101 F.3d 845, 856 (2d Cir. 1996); Ali v. Szabo, 81 F. Supp.2d 447, 463 (S.D.N.Y. 2000). Although the Supreme Court has not stated whether this due process right is identical to, or exactly coextensive with, inmates' Eighth Amendment rights in this regard, "it is plain that an unconvicted detainee's rights are at least as great as those of a convicted prisoner." Lopez, 172 F.3d at 764 (citing City of Revere v. Massachusetts Gen'l Hosp., 463 U.S. 239, 244, 103 S.Ct. 2979, 77 L.Ed.2d 605 (1983)).

In order to establish a § 1983 claim based on inadequate medical care, a plaintiff must prove "deliberate indifference to [his] serious medical needs." Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976). The standard of deliberate indifference includes both subjective and objective components. "First, the alleged deprivation must be, in objective terms, `sufficiently serious.'" Hathaway v. Coughlin, 37 F.3d 63, 66 (2d Cir. 1994) (citations omitted), cert. denied, 513 U.S. 1154, 115 S.Ct. 1108, 130 L.Ed.2d 1074 (1995); Ramos v. O'Connell, 28 F. Supp.2d 796, 802 (W.D.N.Y. 1998). Second, the defendant "must act with a sufficiently culpable state of mind." Hathaway, 37 F.3d at 66. An official acts with the requisite deliberate indifference when that official "knows of and disregards an excessive risk to [a detainee's] health or ...

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