The opinion of the court was delivered by: Chin, District Judge.
In this case, defendant Melvin Lloyd Richards was convicted by a jury
on February 17, 2000 of conspiracy, securities fraud, and wire fraud.
Following the jury's verdict, I remanded Richards because I believed he
presented a risk of flight. Richards thereafter asked to be released on
bail; I denied the motion. Sentencing is scheduled for July 12, 2000.
By his counsel's letter dated May 11, 2000, Richards moved for an order
directing the Bureau of Prisons to provide him with immediate dental
care, either at the Metropolitan Correctional Center (the "MCC") or
elsewhere. Alternatively, Richards renewed his bail request and asked to
be released so that he could obtain the dental care on his own.
Thereafter, the Government and Richards attempted to resolve the
matter, but their efforts failed. Consequently, I conducted a hearing on
June 21, 2000. Richards, his expert witness (Dr. Lieberman), and the
Government's expert (Dr. Moses) testified. At the conclusion of the
hearing, I found that dental treatment was "medically necessary" and that
Richards needed it on an "urgent basis." (Tr. 56). I directed the parties
again to attempt to resolve the matter, but a few days later I was
advised that they were unable to agree on a course of treatment.
Richards requests that he be permitted to complete the bridge and
implant work that he had commenced before he was convicted in this case
and he has offered to pay for the work himself. The Government argues
that it is not obligated to provide Richards with bridge and implant
work, that it is required to provide him only with less expensive denture
work, and that it would be inappropriate to permit an inmate to pay for
more expensive implant
and crown work when less expensive denture work would suffice to
meet the inmate's needs.
The Government's position is rejected, in view of the unusual
circumstances of this case.
First, as I found at the conclusion of the hearing, Richards is in
urgent need of dental care. There are three problem areas. In the upper
right portion of his mouth, he has an implant-supported, four-tooth
bridge that is loose. (Tr. 14). There should be three screws securing the
bridge but two are missing; one recently fell out. (Tr. 18-20, 44, 49).
The bridge will have to be removed and replaced, and some surgery may be
required. (Tr. 18). In the upper front portion of his mouth, two teeth
recently broke off and will have to be replaced. (Tr. 16, 20). In the
lower left portion of his mouth, Richards is missing a bridge. (Tr. 14).
The bridge had been removed and work was being done on the implants when
the treatment was interrupted by Richards's remand. The crown has been
made at the direction of Richards's treating dentist in Nevada but it has
not yet been attached. (Tr. 15, 17). Because of his dental problems,
Richards has had at least two mouth infections since his conviction. In
short, Richards needs significant treatment urgently.
Second, the Bureau of Prisons has been either unable or unwilling to
provide Richards with the dental care he needs. Nothing was done about
Richards's teeth until his counsel asked the Court to intervene. Even
then, the Government's dentist merely tightened a screw, which has become
loose again. The Government's expert refuses to acknowledge that Richards
is in need of prompt treatment, even though Richards recently suffered at
least two infections, lost two teeth and two screws, and has one loose
bridge and another bridge missing. (Tr. 52-53).*fn1
Third, Richards was in the midst of treatment when he was convicted. He
had started the treatment when he was released after serving his sentence
for his prior conviction and he was continuing that treatment during his
trial. He has already had a substantial part of the work done. He has
already paid his dentist approximately $11,000, some of it for work that
has not yet been performed. There is a bridge prepared and waiting to be
attached. Richards is willing to pay for the work that remains to be
Finally, Richards has not yet been sentenced and he will still have the
right to appeal his convictions after he is sentenced. He is in a
different position from an inmate who has been convicted and is serving a
sentence following an unsuccessful appeal.
Neither side has cited any authority that is directly on point. The
Government relies on Eighth Amendment cases for the proposition that a
district court may not "impose its own ideas on how a prison dental
clinic should be organized and administered," and argues that a prison
system is required to provide not a "`model system of dental care beyond
the average needs'" but only "`the minimum level of [dental] care
required by the Constitution.'" (Letter from Gov't to the Court of
6/28/00, at 2) (quoting Dean v. Coughlin, 804 F.2d 207, 215 (2d Cir.
1986)). But these cases are only marginally relevant, for I have no
interest in trying to tell the Bureau of Prisons how to operate its
A more useful decision is Bartling v. Ciccone, 376 F. Supp. 200
(W.D.Mo. 1974). Although it is a 1974 decision from another district, the
case involves remarkably similar facts. There, a federal inmate wanted to
treat his extensive dental problems with implant and bridge work. He was
willing to pay to have his private dentist do the work. The facility in
which he was housed (a federal medical center for federal prisoners) was
unwilling to provide him with the care he wanted and was unwilling to
furlough him to get the treatment at his own expense; instead, the
facility was willing only to provide him with what it termed "necessary"
and "acceptable" treatment — extraction and a denture. 376 F.
Supp. at 201, 202.
The court rejected the Government's position and furloughed the inmate
so that he could get the treatment he wanted at his own expense. The
court did so pursuant to what was then designated
18 U.S.C. § 4082(c)(1), which has been modified and is now recodified
at 18 U.S.C. § 3622. The court was not persuaded by the Government's
argument that it was inappropriate to permit a "[d]isparity in dental
treatment based on wealth alone." 376 F. Supp. at 204; see also
Prushinowski v. Hambrick, 570 F. Supp. 863, 869 (E.D.N.C. 1983) (granting
medical furlough to federal inmate to obtain, at his own expense, an
additional medical opinion as to his physical and psychological
Section 3622(a)(3), which applies to sentenced prisoners, permits a
court to release a prisoner for a period not to exceed thirty days for
the purpose of "obtaining medical treatment not otherwise available."
Although section 3622 is not controlling, it is nonetheless instructive,
for it shows that Congress expressly contemplated ...