Tenth Circuit: Ignoring Prisoner’s Severe Pain Precludes Qualified Immunity
by Mark Wilson
On August 12, 2014, the Tenth Circuit Court of Appeals held that a prison nurse who refused to examine a prisoner suffering from severe abdominal pain was not entitled to qualified immunity.
At about 8:35 p.m. on October 5, 2008, Colorado prisoner Homaidan Al-Turki suddenly began feeling severe pain in his left side and abdomen. The pain was so intense that he collapsed, vomited and thought he was dying.
Al-Turki alerted a guard and requested medical attention. The guard called the medical center but Nurse Mary Susan Robinson was the only medical staff on duty.
Robinson knew that severe abdominal pain may be a symptom of several serious and potentially life-threatening conditions. She also knew that Al-Turki suffered from Type II diabetes, which made him more susceptible to certain serious illnesses, several of which cause pain as an initial symptom.
Nevertheless, Robinson refused to see Al-Turki, telling the guard that it was too late and his complaint was not an emergency. Al-Turki reported his condition to another guard, two more times that evening. The guard called Robinson but she still refused to see Al-Turki.
Both guards alerted the shift commander of Al-Turki’s abdominal pain and Robinson’s refusal to see him. She told the shift commander that Al-Turki’s problem was not an emergency and she was concerned he would be an escape risk if transferred to an outside facility.
Al-Turki continued to suffer severe pain until he passed out between 11:30 p.m. and 12:00 a.m. When he awoke at 4:00 a.m., his pain was still so acute he could not stand up. The pain finally subsided two hours later. When Al-Turki was eventually seen by medical staff at 10:00 a.m., he passed two small kidney stones.
Al-Turki filed suit in federal court, alleging that Robinson and several non-medical prison employees were deliberately indifferent to his serious medical needs. The district court granted qualified immunity to the non-medical staff but denied it to Robinson, and she filed an interlocutory appeal.
The Tenth Circuit affirmed the lower court’s denial of qualified immunity, first rejecting Robinson’s argument that Al-Turki’s condition was not serious enough to constitute an Eighth Amendment claim.
“We need not attempt to precisely delineate in this case the exact boundaries of the line between the trivial ‘twinge of pain’ that will not give rise to an Eighth Amendment deliberate indifference claim and the significant ‘substantial’ pain that will give rise to such a claim,” the appellate court explained. “It is sufficient for us to hold that Plaintiff’s several hours of untreated severe pain in this case fall on the actionable side of the line.”
The Court of Appeals also rejected Robinson’s argument that she was entitled to qualified immunity because Tenth Circuit cases finding deliberate indifference violations “all involved longer periods of pain and more serious underlying health conditions” than Al-Turki’s kidney stones.
“The main flaw in Defendant’s argument is that she is focusing on the facts we now know about the duration and cause of Plaintiff’s pain,” the Court stated. “The pertinent question for determining her entitlement to qualified immunity depends on the facts that were known at the time.... We are unpersuaded by Defendant’s argument that facts unknown to her at the time of her conduct can now insulate her actions from liability because these then-unknown facts do not precisely align with the facts of previous Tenth Circuit cases.”
The appellate court noted that it had been clearly established in the circuit since 2006 “that a deliberate indifference claim will arise when ‘a medical professional completely denies care although presented with recognizable symptoms which potentially create a medical emergency....’” Robinson’s “decision to ignore Plaintiff’s repeated complaints of severe abdominal pain, taking the facts in the light most favorable to Plaintiff, falls squarely within this clearly established law.” See: Al-Turki v. Robinson, 762 F.3d 1188 (10th Cir. 2014).
This case remains pending on remand, with a jury trial scheduled for November 2015. At one point Homaidan Al-Turki was investigated in connection with the 2013 murder of Colorado DOC director Tom Clements, who had denied al-Turki’s request to return to his home country of Saudi Arabia, though that theory was apparently abandoned by investigators. [See: PLN, July 2014, p.1].
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Related legal case
Al-Turki v. Robinson
|Cite||762 F.3d 1188 (10th Cir. 2014)|
|Level||Court of Appeals|
|Appeals Court Edition||F.3d|