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Prison Doctor’s Failure to Follow Prescribed Hernia Treatment States Claim

On May 25, 2012, the Ninth Circuit Court of Appeals reversed the dismissal of a prisoner’s civil rights complaint, finding he had alleged facts that showed a prison doctor had diagnosed a hernia but failed to implement the prescribed treatment. While those actions demonstrated deliberate indifference to the prisoner’s serious medical needs, claims against another prison physician were properly dismissed because they merely indicated a negligent misdiagnosis.

California prisoner Steven H. Wilhelm filed a 42 U.S.C. § 1983 complaint against Dr. Aron Rotman and Dr. Calvin Schuster. A magistrate judge dismissed the lawsuit at the screening stage, finding that it failed to state a claim. Wilhelm appealed.

On appeal, he argued the case had been improperly resolved by the magistrate judge. The Ninth Circuit, however, determined that Wilhelm had voluntarily consented to the exercise of jurisdiction of the magistrate. First, he unambiguously consented to that jurisdiction on a form provided by the district court. The Court of Appeals also found he impliedly consented to the authority of the magistrate judge, which Wilhelm contested on appeal, by filing an amended petition as ordered by the magistrate.

Having resolved the jurisdictional question, the appellate court addressed the issue of whether Wilhelm’s complaint stated a claim. He had been diagnosed with a hernia in October 2005; however, until he was seen by Dr. Rotman on July 15, 2008, no action was taken on that diagnosis.

At the July 2008 examination, Dr. Rotman confirmed that Wilhelm had a double inguinal hernia and recommended herniorrhaphy surgery. His diagnosis and treatment recommendation were reiterated at a September 4, 2008 examination. The next day, however, the prison surgeon, Dr. Schuster, disagreed with Rotman’s diagnosis; Schuster provided no treatment plan beyond instructing Wilhelm to return if his pain continued, even though Wilhelm said he was currently suffering pain.

Between November 11, 2008 and March 26, 2009, Wilhelm was seen by Dr. Rotman five times. Rotman’s diagnosis and treatment plan were affirmed at least twice, but when Wilhelm requested treatment he was admonished to be patient.

Wilhelm filed an appeal with the Health Care Appeals Office at his prison on June 25, 2009, and sent a letter to a public interest law firm a month later. That led to an August 3, 2009 visit with Dr. Rotman and the scheduling of a surgical review. Wilhelm subsequently received the recommended surgery.

The Ninth Circuit held that Wilhelm’s hernia was a serious medical condition. Next, it found Dr. Rotman “repeatedly diagnosed” the hernia and “repeatedly concluded that referral to surgery was necessary.” Yet Wilhelm failed to receive the prescribed treatment for more than a year. The complaint and exhibits “demonstrate that the delay was attributable to Dr. Rotman’s failure to request the referral properly, and more troublingly, his inexplicable cancellation of a second referral request.”

The Court of Appeals held that Wilhelm raised a valid claim of deliberate indifference to his serious medical needs due to Dr. Rotman’s failure to implement the treatment he had prescribed based on his own diagnosis.

In contrast, Dr. Schuster made a misdiagnosis or had a disagreement with Dr. Rotman. While this supported a negligence claim, it did not evince deliberate indifference. The Ninth Circuit thus found the dismissal of Wilhelm’s claims against Dr. Schuster was proper, but reversed the dismissal of his claims against Dr. Rotman and remanded the case to the district court for further proceedings. See: Wilhelm v. Rotman, 680 F.3d 1113 (9th Cir. 2012).

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Related legal case

Wilhelm v. Rotman