October 21, 2014

Tenth Circuit: Nurse’s Refusal to Assess Inmate’s Severe Abdominal Pain Violated Prisoner’s Eighth Amendment Rights

The Tenth Circuit Court of Appeals issued its opinion in Al-Turki v. Robinson on Tuesday, August 12, 2014.

Homaidan Al-Turki was a prisoner with Type II diabetes and other health conditions. On the night of October 5, 2008, he suddenly experienced severe abdominal pain. The pain was so severe he collapsed, vomited, and believed he was dying. He used his cell’s intercom to contact a correctional officer and request to go to the prison’s medical center. The officer called the medical center, where nurse Mary Robinson was the only medical staff person on duty. Robinson refused to see Al-Turki, despite knowing that severe abdominal pain can be a symptom of several life-threatening conditions and knowing that Al-Turki’s Type II diabetes made him susceptible to certain serious illnesses of which severe abdominal pain is an early symptom. Robinson also refused to allow him to be transported to a medical facility, claiming he was a flight risk.

Al-Turki reported his severe pain to a second correctional officer two more times that night, and the officer called Robinson both times. Robinson refused to see Al-Turki and advised the officer that he should file a written request for medical care the following morning. At some point in the night, Al-Turki either fell asleep or lost consciousness. When he awoke at 4 a.m., the pain was slightly better, and at 6 a.m. he was no longer experiencing pain. At a previously scheduled medical appointment at 10 a.m., he passed two kidney stones.

Al-Turki filed suit under 42 U.S.C. § 1983 against several prison officials, including Robinson, based on the officials’ failure to provide him medical assistance or treatment during the several hours he was in extreme pain while passing a kidney stone. The district court granted qualified immunity to all prison officials except Robinson, who filed an interlocutory appeal with the Tenth Circuit. The district court concluded Al-Turki could prove a claim of deliberate indifference to his medical needs in violation of the Eighth Amendment. The district court also concluded the law is clearly established that a medical professional who knows of and appreciates an inmate’s risk of serious medical harm must make a good faith effort to assess the individual.

The Tenth Circuit addressed Robinson’s two issues: (1) whether the evidence was sufficient to satisfy the objective prong of the Eighth Amendment extreme indifference test, and (2) whether her actions violated clearly established state law. As to the first claim, Robinson claimed that Al-Turki’s pain could not satisfy the objective prong because kidney stones are a relatively benign, albeit painful, condition and he was only in pain for a few hours. The Tenth Circuit stoutly rejected her argument, noting that Al-Turki was in so much pain he vomited and believed he was dying. He demonstrated significant suffering and was provided neither medical treatment to ease his suffering nor medical diagnosis to ease his fear of death. The Tenth Circuit similarly rejected her qualified immunity arguments based on Al-Turki’s relatively short period of suffering and benign diagnosis, since the facts concerning duration and diagnosis were not known at the time and he could have been suffering from any of a number of life-threatening conditions.

As to Robinson’s second claim, the Tenth Circuit ruled that Robinson violated clearly established law by choosing to ignore Al-Turki’s complaints. The denial of qualified immunity was affirmed.

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