Pretrial Detainee Alleging Deliberate Indifference to His Medical Needs Must Show Defendant Was Actually Aware of Risk of Harm By SEO Admin on October 26, 2009

In Caiozzo v. Koreman, 581 F.3d 63 (C.A.2 (N.Y.)), the plaintiffs decedent died while in custody as a pretrial detainee at Albany County Correctional Facility (ACCF). The cause of death was ascribed to seizure due to acute and chronic alcoholism. It was alleged that the defendants failed to provide him with alcohol withdrawal treatment that they knew or should have known he needed, resulting in his fatal seizure. The timing of a detainee's last drink is important in assessing the need for and timing of alcohol withdrawal treatment. The error of the defendant nurse who examined the plaintiffs decedent was in believing that his last drink was the evening on the date that she examined him, when in fact it was the evening before. A deliberate indifference claim can lie where prison officials engage in a policy of deliberately ignoring the medical recommendations of a prisoners treating physicians. This differs from a medical malpractice claim in that it does not allege that a doctor departed from the standards of good and accepted medical practice. The U.S. Circuit Court in Caiozzo v. Koreman had to decide whether the plaintiff had to prove that the defendant nurse knew when his last drink was consumed, or whether it was sufficient that he prove that she should have known this information. In this case the difference made all the difference. The plaintiffs decedent had previously been incarcerated at the ACCF on at least twenty-seven separate occasions, and had been treated for chronic alcoholism by the facility's medical staff. On this occasion the plaintiffs decedent was arrested on July 11, 2001, at 9:30 A.M. The examination by the defendant nurse took place that night at approximately 7:30 P.M. The plaintiff argued, convincingly, that the defendant nurse, in the exercise of proper diligence, should have realized that it was not possible for the plaintiffs decedent to have consumed alcohol earlier that same evening, since he had been arrested that morning and had been in custody ever since. The appellant acknowledged, however, that Cummins was unaware of this chronology. Plaintiff-Appellant Anthony Caiozzo, as administrator of Caiozzo's estate, instituted this action in the United States District Court for the Northern District of New York pursuant to 42 U.S.C. 1983. Inmates incarcerated post-conviction are protected by the Eighth Amendments prohibition against cruel or unusual punishment. The Eighth Amendment has been held not to apply to a person being held prior to trial because their incarceration is not for the purpose of punishment. Instead, a person detained prior to conviction receives protection against mistreatment at the hands of prison officials under the Due Process Clause of the Fifth Amendment if the pretrial detainee is held in federal custody, or the Due Process Clause of the Fourteenth Amendment if held in state custody. The sole issue on appeal was the district court's decision to grant the defendant nurses motion for summary judgment on the claim of deliberate indifference to the medical needs of a pretrial detainee. The Court had to decide whether a claim by a state pretrial detainee could establish liability for deliberate indifference to his medical needs without establishing the state of mind of the defendant. In other words, inasmuch as anothers state of mind is a subjective matter difficult to prove, under an easier, objective test it would be sufficient to prove that there were circumstances indicating an evil intent, or recklessness, or at least deliberate indifference to the consequences of his conduct for those under his control or dependent upon him. The plaintiff argued that the objective test should be applied, and that even under the subjective test, summary judgment should not have been granted. The Circuit Court agreed with the district court that the subjective test applies and that no reasonable juror could conclude that the nurses behavior met that test, and affirmed the judgment of the district court. Caiozzo relied heavily upon Farmer v. Brennan, 511 U.S. 825, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994), wherein the Supreme Court concluded that the subjective test should apply under the Eighth Amendment because it prohibits cruel and unusual punishment, and a prison official's action or inaction cannot properly be termed punishment of the detainee if the official was not actually aware of an excessive risk to an inmate's health or safety. Caiozzo concluded that a logical extension of the principles recognized in Farmer is that an injured state pretrial detainee, to establish a violation of his Fourteenth Amendment due process rights, must prove, inter alia, that the government-employed defendant disregarded a risk of harm to the plaintiff of which the defendant was aware, thus applying the subjective standard. Applying the law to the facts of the case, Caiozzo concluded: Most of the evidence offered by the plaintiff was in support of the argument that Cummins should have been aware that Caiozzo was in immediate danger of alcohol withdrawal. A reasonable juror might have concluded that this was the case. There is virtually no evidence, however, to support a conclusion by a reasonable juror that Cummins was actually aware of that immediate danger. The evidence is clear that she thought, wrongly it turned out, that Caiozzo was intoxicated and therefore not in danger of an imminent severe alcohol withdrawal reaction. No reasonable juror could conclude that the Farmer test has been met. The lawyers at Levine & Slavit have decades of experience handling personal injury claims including those involving medical malpractice. For 50 years spanning 3 generations, we have obtained results for satisfied clients. We have offices in Manhattan and Long Island, handling cases in New York City, the Bronx, Brooklyn, Queens and surrounding areas. To learn more, watch our videos.

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