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Eighth Circuit: Deliberate Indifference Standard GovernsMedical Care for Civilly Committed Detainees

Eighth Circuit: Deliberate Indifference Standard GovernsMedical Care for Civilly Committed Detainees

by Mark Wilson

On February 4, 2014, the Eighth Circuit reversed a district court’s denial of qualified immunity, finding that it had applied the wrong constitutional standard.

Daniel J. Scott was involuntarily committed to the Iowa Civil Commitment Unit for Sexual Offenders (CCUSO). In August 2010, he discovered two hard boils on his buttocks. On August 16, 2010, Nurse Practitioner Mary Benson examined the area and found “two ‘superficial scratches, not boils.’” She prescribed antibiotics.

Scott again sought treatment nine days later, but Benson refused. “There’s nothing wrong with you, all you are wanting is attention—stop it now,” she said.

On August 27, 2010, Benson saw Scott for “a pinpoint hole that exuded purulent drainage.” A stronger antibiotic was ordered.

The following month, Benson refused to examine Scott because it was a holiday weekend and the medical clinic was closed, though she provided a telephone consultation.

On September 7, 2010, Benson saw Scott and “observed a ‘foul odor coming from Mr. Scott’s perianal area.’” Scott was sent to a hospital where he underwent two surgeries to remove diseased tissue. While hospitalized he suffered a heart attack, but soon returned to CCUSO even though his leg remained very swollen.

Scott was hospitalized again after he was found unresponsive on October 16, 2010. Diagnosed with sepsis, the lower portion of one of his legs had to be amputated.

He filed suit in federal court in 2011, alleging that Benson and other staff had provided constitutionally inadequate medical care. The district court denied Benson’s summary judgment motion raising a qualified immunity defense, and she filed an interlocutory appeal.

The Eighth Circuit reversed the district court’s summary judgment order, finding it had analyzed Scott’s claims under an incorrect constitutional standard.

“Both parties argued to the district court that the deliberate indifference standard from the Eighth Amendment should govern Scott’s Fourteenth Amendment claim,” the Court of Appeals wrote, noting that he was a civilly committed detainee. “The district court instead analyzed Scott’s claim under the professional judgment standard from Youngberg v. Romero, 457 U.S. 307 (1982).”

The appellate court explained that it applies “the deliberate indifference standard from the Eighth Amendment” when “a patient’s Fourteenth Amendment claim is for constitutionally deficient medical care.” Since applying that standard “is a ‘factually-intensive inquiry’ that proceeds very differently from the” Youngberg analysis, the Eighth Circuit remanded the case to the district court “to apply the deliberate indifference standard in the first instance.” See: Scott v. Benson, 742 F.3d 335 (8th Cir. 2014).

Following remand, the district court again denied Benson’s motion for summary judgment on May 12, 2014, finding there was “a genuine issue of material fact related to Mr. Scott’s deliberate indifference medical claim.” This case remains pending with a bench trial scheduled in July 2015.


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Related legal cases

Scott v. Benson

Youngberg v. Romero