The opinion of the court was delivered by: William M. Skretny Chief Judge United States District Court
Plaintiff, Lairon Graham, in addition to state-law claims, brings this action under 42 U.S.C. § 1983, alleging that various defendants violated his constitutional rights while in custody at the Erie County Holding Center ("Holding Center"). Two sets of defendants, those from the Holding Center, and those from the Erie County Medical Center ("ECMC"), have each moved to dismiss all or some of Graham's complaint. (Docket Nos. 10, 11.) For the following reasons, the Holding Center Defendants' motion is granted in part and denied in part while the ECMC Defendants' motion is granted in full.
On April 19, 2010, in the course of defending himself from an attack perpetrated by a fellow inmate at the Holding Center, Graham suffered an injury to his right biceps brachii, thus setting in motion a series of events culminating in this litigation. (Compl., ¶¶ 20, 21; Docket No. 1.) Although he did not immediately realize the extent of his injury, the following morning Graham awoke to "excruciating pain" in his right arm, rendering it difficult to even pull the bedsheets off himself. (Id., ¶¶ 22, 23.) He noticed that his arm had filled with blood, was discolored, and exhibited a "Popeye bulge," the latter of which, due to extensive experience in the weight room, Graham recognized as a sign that his biceps was torn. (Id., ¶¶ 24-27.)
Over the course of the next four days, Graham voiced and penned several complaints about his arm to various defendants at the Holding Center, but his injury was not always taken with the seriousness that he believed it warranted. The morning after the incident, Graham showed his arm to a "John Doe" Sheriff's Deputy, who told him to see a nurse, also unidentified at this time, who was making the rounds later that day. (Id., ¶ 28.) The nurse told him that he did not require medical attention. (Id., ¶ 30.) Still in pain on April 23, he requested medical treatment from another sheriff's deputy, who completed a "sick-call slip" in Graham's name.*fn3 (Id., ¶ 33.) He was then seen by a separate "Jane Doe" nurse, who simply instructed him to rest his arm for three days. (Id., ¶ 34.) Apparently displeased with this lack of treatment, Graham filled out another sick-call slip, communicating his belief that his biceps was torn. (Id., ¶ 35.) He was subsequently seen by a doctor, who sent him to ECMC. (Id., ¶ 36.)
His diagnosis at ECMC, however, was not unlike the one he received at the Holding Center: Registered Physician's Assistant ("RPA") Meagan Miller, a named defendant, told him his biceps was not torn, diagnosed him with an elbow contusion, and told him that the deformed biceps would heal itself over the coming weeks with no need for any treatment but the intermittent application of ice.*fn4 (Id., ¶¶ 37-39.)
Back at the Holding Center, Graham took RPA Miller's advice, waiting approximately two weeks for his arm to heal despite being in "constant, excruciating pain." (Id., ¶¶ 44, 45.) By May 7, 2010, however, Graham believed that his biceps had not healed correctly, and submitted another sick-call slip. (Id., ¶ 48.) Presumably receiving no response, he again submitted a slip two days later, but, receiving no care over the next 24 hours, he submitted a sick-call slip for a third time on May 10. (Id., ¶¶ 49 -51.) That night Graham was eventually seen by a doctor, who prescribed physical therapy and referred him to see an "ortho" "ASAP" for follow-up care. (Id., ¶ 52.) Despite this, he was not seen by an orthopedist or a physical therapist for the remainder of his time at the Holding Center, which spanned eleven days. He was released into the custody of the New York State Department of Corrections and Community Supervision on May 21, 2010.*fn5 (Id., ¶ 53.)
Shortly after being transferred, Graham was diagnosed with a torn biceps tendon. (Id., ¶ 56.) Due to the delayed treatment, it was no longer possible to reattach the biceps; instead, doctors eventually performed an Achilles allograft, a far more complicated procedure in which an Achilles tendon is inserted between the biceps tendon and the forearm, linking the two together. (Id., ¶ 58.) He was left with a ten-inch scar on his upper right arm. (Id., ¶ 61.)
Graham filed his complaint on July 18, 2011. (Docket No. 1.) After this Court granted Defendants an extension of time to answer or move in response to the complaint (Docket Nos. 107, 108), the Holding Center Defendants filed their motion to dismiss on December 28, 2011 and the ECMC Defendants followed suit on January 3, 2011. (Docket Nos. 10, 11.) Briefing concluded on January 30, 2012, at which time this Court took the motions under consideration.
A. Motion to Dismiss Standard -- Rule 12(b)(6)
Rule 12(b)(6) allows dismissal of a complaint for "failure to state a claim upon which relief can be granted." Fed. R. Civ. P. 12(b)(6). Federal pleading standards are generally not stringent: Rule 8 requires only a short and plain statement of a claim. Fed. R. Civ. P. 8(a)(2). But the plain statement must "possess enough heft to show that the pleader is entitled to relief." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 127 S. Ct. 1955, 1966, 167 L. Ed. 2d 929 (2007).
When determining whether a complaint states a claim, the court must construe it liberally, accept all factual allegations as true, and draw all reasonable inferences in the plaintiff's favor. ATSI Commc'ns, Inc. v. Shaar Fund, Ltd., 493 F.3d 87, 98 (2d Cir. 2007). Legal conclusions, however, are not afforded the same presumption of truthfulness. See Ashcroft v. Iqbal, 556 U.S. 662, 129 S. Ct. 1937, 1949, 173 L. Ed. 2d 868 (2009) ("The tenet that a court must accept as true all of the allegations contained in a complaint is inapplicable to legal conclusions.").
"To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to 'state a claim to relief that is plausible on its face.'" Iqbal, 129 S. Ct. at 1945 (quoting Twombly, 550 U.S. at 570). Labels, conclusions, or a "formulaic recitation of the elements of a cause of action will not do." Twombly, 550 U.S. at 555. Facial plausibility exists when the facts alleged allow for a reasonable inference that the defendant is liable for the misconduct charged. Iqbal, 129 S.Ct. at 1949. The plausibility standard is not, however, a probability requirement: the pleading must show, not merely allege, that the pleader is entitled to relief. Id. at 1950; Fed. R. Civ. P. 8 (a)(2). Well-pleaded allegations must nudge the claim "across the line from conceivable to plausible." Twombly, 550 U.S. at 570.
Courts therefore use a two-pronged approach to examine the sufficiency of a complaint, which includes "any documents that are either incorporated into the complaint by reference or attached to the complaint as exhibits." Blue Tree Hotels Inv. (Can.), Ltd. v. Starwood Hotels & Resorts Worldwide, Inc., 369 F.3d 212, 217 (2d Cir. 2004). This examination is context specific and requires that the court draw on its judicial experience and common sense. Iqbal, 129 S.Ct. at 1950. First, statements that are not entitled to the presumption of truth -- such as conclusory allegations, labels, and legal conclusions -- are identified and stripped away. See id. ...