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No CMS Liability for Denying Treatment for Dislocated Shoulder

The plaintiff said he dislocated his previously injured shoulder in his sleep.

At 511: "For purposes of this case, it is undisputed that a shoulder dislocation causes great pain and is a serious medical need."

The defendants were not deliberately indifferent. Although the plaintiff said his shoulder had popped out of joint and had to be reset, he refused to let staff examine him (allegedly because of the pain), he didn't appear to be in extreme pain, so they didn't think his shoulder was actually dislocated. The next night he fell asleep and woke up without any shoulder pain.

On these facts, the court can't conclude that the defendants were deliberately indifferent or that they knew that the plaintiff had a serious medical need. (The dissenting judge has a rather different view of the facts: the plaintiff had obvious symptoms of a dislocated shoulder, and he was offered "Tylenol and a visit to a psychologist.")

The plaintiff alleged that the private medical provider had a practice of saving money by denying care and that its policy of having nurses seek approval before sending inmates to the hospital was a cost-saving measure. However, if the individual defendants didn't violate the plaintiff's rights, these policies couldn't have caused a violation, "even if they were trying to keep costs down--a common goal in this age of health maintenance organizations." (514) See: Higgins v. Correctional Medical Services of Ill., 178 F.3d 508 (7th Cir. 1999).

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Related legal case

Higgins v. Correctional Medical Services of Ill.