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Sixth Circuit Denies Qualified Immunity to Ohio Prison Doctor After Prisoner Blinded by Stroke

by David M. Reutter

On March 30, 2022, the U.S. Court of Appeals for the Sixth Circuit affirmed denial of qualified immunity (QI) to an Ohio prison doctor who interrupted a state prisoner’s prescribed medical treatment plan, after which he suffered a stroke that left him blind.

The Court’s opinion was issued in a suit brought by the prisoner, Jamal Murray, who suffered medical issues predating his imprisonment, including a 2008 heart attack and periodic episodes of deep-vein thrombosis in his legs. On December 21, 2010, while he was held at Lebanon Correctional Institution, Murray was hospitalized and prescribed a treatment regimen of Coumadin, an anticoagulant to mitigate blood clots.

During one of several hospitalizations the following year, consulting hematologists at Ohio State University Medical Center recommended in July 2011 that Murray have “a fair trial of Coumadin with an international normalized ratio (INR) ranging between 2.5 and 3.” INR is a measure used to assess blood thinning.

The prison’s Chief Medical Officer, Dr. Timothy Heyd, treated Murray for the first time on November 16, 2011, when the prisoner’s INR was 2.5 and an ultrasound revealed the previous deep-vein thrombosis had resolved. But Murray’s INR levels began to fluctuate, and Heyd adjusted the Coumadin dosage several times in December 2011.

On December 21, 2011, Heyd ordered follow-up INR testing within two weeks. While records show a blood draw the next day, Heyd contended the draw never occurred. He also said Murray missed two subsequent blood draws, which Murray denied.

From January 20-28, 2012, Murray reported to the prison’s medical department with symptoms including a headache and vomiting. He was given over-the-counter medications. When he saw Heyd on January 31 and reported fever and chills, Heyd gave him an injection and more standard medications. He noted Murray’s INR test was overdue but took no other action.

On February 3, 2012, Murray complained of feeling woozy, with pain in his legs. More over-the-counter medications were issued. He suffered a stroke on February 6, 2012, caused by a cerebral blood clot. That resulted in bilateral loss of vision, and he is now legally blind.

Murray filed suit pro se in federal court for the Southern District of Ohio, which granted summary judgment to state prison officials on claims against them on April 8, 2014; however, Murray’s claims against individual medical defendants — including Heyd — were preserved. See: Murray v. Ohio Dep’t of Corr., 2014 U.S. Dist. LEXIS 49449 (S.D. Ohio).

The case proceeded, with Murray picking up counsel from Cincinnati attorney Robert A. Klinger by the time Heyd eventually moved for summary judgement, which the district court denied on March 31, 2021. See: Murray v. Ohio Dep’t of Corr., 2021 U.S. Dist. LEXIS 62060 (S.D. Ohio).

The doctor then turned to the Sixth Circuit, claiming he was entitled to QI and therefore summary judgment. The Court disagreed.

“Under the subjective component of an Eighth Amendment claim,” the Court began, “the plaintiff is required to show that ‘the official knew of and disregarded an excessive risk to inmate health or safety,’” citing Richmond v. Huq, 885 F.3d 928 (6th Cir. 2018).

Moreover, the Court continued, still drawing on the same precedent, when “an official fails to ‘adhere to a … prescribed course of treatment,’ the official’s actions ‘may satisfy the subjective component of an Eighth Amendment violation.’”

A “simple mistake in medical judgment … does not amount to deliberate indifference,” the Court allowed, citing Rhinehart v. Scutt, 894 F.3d 721 (6th Cir. 2018). Rather, “the plaintiff must show that each defendant acted with a mental state ‘equivalent to criminal recklessness,’” the Court said, quoting Santiago v. Ringle, 734 F.3d 585 (6th Cir. 2013).

Heyd knew Murray’s INR needed regular monitoring, but he did not review the most recent test results and took no action when testing was overdue. Murray also presented expert testimony that his symptoms prior to the stroke indicated a cerebral edema.

In this case, the Court concluded, “there is sufficient evidence in the record for a jury to find (1) facts from which the inference … of a substantial risk of serious harm to Murray’s health could be drawn, and (2) that Dr. Heyd knew of and disregarded that substantial risk.”

As it was clearly established at the time “that interruptions of a prescribed plan of treatment could constitute a constitutional violation,” the Court said Murray had overcome Heyd’s claim of QI and the district court’s order was affirmed. See: Murray v. Ohio, 29 F.4th 779 (6th Cir. 2022).

The case has now returned to the district court, and PLN will report developments as they are available. See: Murray v. Ohio, USDC (S.D. Oh.), Case No. 1:14-cv-00168. 

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Related legal cases

Murray v. Ohio

Murray v. Ohio

Murray v. Ohio Dep’t of Corr.

Murray v. Ohio Dep’t of Corr.