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Eighth Circuit Holds Delaying Surgery for Reducible Hernia Not Deliberate Indifference to Missouri Prisoner’s Serious Medical Needs

by Matt Clarke

What happens if you develop a hernia while jailed? One Missouri prisoner found the answer when he was forced to wait 16 months for surgical relief. Then, on June 30, 2022, the U.S Court of Appeals for the Eighth Circuit said that’s okay – primarily because he presented no evidence to “establish a detrimental effect of the delay in treatment,” so he therefore had “not established a serious medical need.”

The prisoner, Michael Hancock, got the diagnosis while awaiting trial at Greene County Justice Center. Dr. Jason Wilkins — an employee of Advanced Correctional Healthcare (ACH), the jail’s privately contracted healthcare provider —determined that the hernia did not require immediate surgery; rather, he said, surgery to repair the hernia was “an elective procedure [that] may be delayed until release.” An outside surgeon made a similar determination. A nurse told Hancock he could make a $3,500 down payment to proceed with the elective surgery, the total cost of which would be $18,000. He could not afford that, so no surgery was performed.

Later, Hancock filed a federal civil rights lawsuit under 42 U.S.C. § 1983 in federal court for the Western District of Missouri against jail and ACH employees, alleging deliberate indifference to his serious medical needs, in violation of his Eighth Amendment guarantee of freedom from cruel and unusual punishment.

Because Wilkins testified that the “hernia required surgery to be resolved,” the district court granted Hancock a preliminary injunction ordering the jail to provide it without prepayment. But by then Hancock had already been transferred to the state Department of Corrections (DOC). Medical personnel there also determined that surgery was not medically necessary at that time. It was only after another 15 months passed, and his condition worsened, that Hancock finally received the hernia surgery.

Defendants then filed for summary judgment. Noting the corroborating diagnosis from DOC medical personnel, the district court granted the motion, concluding that Hancock had failed to establish a serious medical need while he was at the jail. Hancock appealed.

The Eighth Circuit upheld the district court’s decision. Noting that Defendants “delayed Hancock’s surgery; they did not deny it,” the Court also said the preliminary injunction was not a final determination and had been based on an incomplete record. Defendants since then had presented evidence of multiple medical experts agreeing that the surgery was not medically necessary while Hancock was at the jail.

Moreover, Hancock presented no contravening evidence or any evidence that Defendants disregarded a known risk to his health. Thus the district court’s judgment was affirmed. Hancock was represented by Kansas City attorneys with Shook & Hardy and Stueve & Siegel. See: Hancock v. Arnott, 39 F.4th 482 (8th Cir. 2022).

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