NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-2376-01T1
GEORGE SEEWARD,
Plaintiff-Appellant,
v.
INTEGRITY, INC., (improperly
identified as P.O.R.T. House);
CORRECTIONAL MEDICAL SERVICES;
DR. PARKS; DR. DESAI; MISS
ROBINSON, R.N.; ADRIENNE BORST;
CAROL HOLT; DR. ROBINSON;
DR. JAMES NEAL; JOSEPH SWEENEY,See footnote 11
Defendants-Respondents.
and
NEW JERSEY STATE DEPARTMENT
OF CORRECTIONS; SCOTT FAUNCE,
WARDEN OF BAYSIDE PRISON;
TERRANCE MOORE, WARDEN OF EAST
JERSEY STATE PRISON; ROY
HENDRICKS, WARDEN NEW JERSEY
STATE PRISON; and DR. CARLINO,
Defendants.
______________________________
Submitted January 7, 2003 - Decided
February 18, 2003
Before Judges Skillman, Cuff and Winkelstein.
On appeal from the Superior Court of New
Jersey, Law Division, Middlesex County, L-
9785-99.
Clifford N. Kuhn, Jr., attorney for appellant.
Fitzpatrick, Reilly, Supple & Gaul, attorneys
for respondents Integrity, Inc., improperly
identified as P.O.R.T. House and Joseph
Sweeney (Richard Wischusen, of counsel; Ronald
Citrenbaum, on the brief).
Holtzman & McClain, attorneys for respondents
Correctional Medical Services, Inc., Dr.
Parks, Adrienne Borst, Carol Holt, Dr.
Robinson, Dr. James Neal and Dr. Desai
(Stephen D. Holtzman, of counsel; Jeffrey S.
McClain, on the brief).
The opinion of the court was delivered by
WINKELSTEIN, J.A.D.
In this appeal plaintiff George Seeward challenges multiple
summary judgment orders dismissing his complaint as to all
defendants. Seeward was injured in October 1997 while serving a
state prison term. At the time, he was assigned to a halfway
house, operated by defendant Integrity, Inc., which trades as
P.O.R.T. House.See footnote 22 Seeward claimed the Integrity defendants, the New
Jersey State Department of Corrections (DOC), wardens of various
correctional institutions, Correctional Medical Services, Inc.
(CMS), which provides medical services for prisoners on behalf of
the State, and the medical care providers who attended to Seeward,
were either negligent or violated plaintiff's constitutional rights
by failing and refusing to properly treat his injuries.
The Law Division dismissed plaintiff's negligence claim
against the Integrity defendants based on the Charitable Immunity
Act, N.J.S.A. 2A:53-7; and dismissed plaintiff's constitutional
claims against those defendants on the grounds that plaintiff
failed to demonstrate defendants' "deliberate indifference" to his
medical problems. The Law Division also dismissed plaintiff's
claim of constitutional violations against CMS and its medical
providers (the CMS defendants) based on plaintiff's failure to
supply an affidavit of merit.See footnote 33
We affirm the dismissal of the negligence and constitutional
claims against the Integrity defendants. The Integrity defendants
are immunized against the negligence claims under the Charitable
Immunity Act; and plaintiff failed to prove a prima facie case of
deliberate indifference to his medical needs to support his
constitutional claim against those defendants. However, we reverse
summary judgment dismissing plaintiff's constitutional claims
against the CMS defendants based on plaintiff's failure to supply
an affidavit of merit.See footnote 44 We hold that an affidavit of merit is not
required to establish a cause of action to vindicate a federal
constitutional right, even if that right arises out of medical
treatment furnished to an inmate by licensed medical providers.
I
After plaintiff was convicted of manslaughter for causing a
fatal accident while driving under the influence in 1994, the court
sentenced him to a term of eight years with a four-year period of
parole ineligibility. On February 21, 1997, plaintiff was assigned
to P.O.R.T. House, a halfway house in Newark. P.O.R.T. House is a
"therapeutic community which teaches its residents a way to live,
interact and function in society." The P.O.R.T. program "treats
and educates pre-released prisoners . . . as a halfway stop between
prison and release into society." As part of the P.O.R.T. program,
"pre-released prisoners are selected for various crews to perform
tasks on site."
Plaintiff is a carpenter. While a resident at P.O.R.T. House,
he participated in various remodeling and renovating projects. He
stored his tools and lumber in a shed in the P.O.R.T. House
backyard. On October 5, 1997, while sliding a plywood panel needed
to complete an on-site project out of the shed, plaintiff's heel
hit a lip on the door threshold and he fell. With complaints of
serious back pain, one-half hour later he was taken by ambulance to
St. Michael's Hospital, and later transferred to the hospital ward
at East Jersey State Prison.
While hospitalized at St. Michael's, an x-ray of his low back
was normal, but a CAT scan found a "focal, lateral disc herniation
present at L3-4 on the right." An MRI of the lumbar spine revealed
"degenerative [disc] disease at the L4-5 level with narrowing of
the intervertebral disc . . . [,]" but did not disclose a "focal
disc herniation." The doctor who performed the MRI opined that
plaintiff had degenerative disc disease at L4-5, but no disc
herniation.
Staff at St. Michael's and East Jersey State Prison treated
plaintiff with pain and anti-inflammatory medication. While at St.
Michael's, plaintiff was given a prescription for Voltaren, a pain
reliever, and Flexeril, a muscle relaxant. The prescription was
not, however, filled at St. Michael's or East Jersey State Prison.
Upon discharge from East Jersey State Prison on October 20,
1997, plaintiff returned to P.O.R.T. House at approximately 1:15
p.m. Approximately one-half hour later, at 1:45 p.m., he signed
out of P.O.R.T. House, indicating that he was going to work.
However, instead of going to work he went to St. Michael's to pick
up his medical records. The following day, he again signed out on
the premise that he was going to work, but instead he went to
Edison Imaging to obtain a second opinion as to his medical
condition, which confirmed a disc herniation at L4-5.
According to plaintiff, he was in "a lot of pain" when he
returned to P.O.R.T. House and constantly requested medical
treatment which was not provided. When asked if he complained to
anyone about his medical condition before signing out for work on
the day he returned to P.O.R.T. House, plaintiff said he complained
to "[w]hoever was there." He also stated, however, that on both
the first and second days back in P.O.R.T. House, he chose not to
tell the P.O.R.T. House staff that he wanted medical treatment,
because "they knew I needed medical treatment." He also said he
failed to disclose his need for medical treatment because he was
concerned about being transferred back to prison. He said: "When
a guy gets locked up for needing medical treatment, he ain't [sic]
going to tell the people that he wants the medical treatment now
because he's just going to end up back in prison."
Defendant knew that to receive medical attention while at
P.O.R.T. House, he needed to "drop a medical slip" to let staff
know of his need. He admitted that he failed to do so, because he
"always spoke to people verbally" about his pain.
Sometime after his return to P.O.R.T. House, plaintiff
explained to Sweeney and another staff member that no action had
been taken to fill the prescription he received from St. Michael's.
As a result, pursuant to DOC procedures, the P.O.R.T. House staff
attempted to have his prescription filled through the DOC on two
dates, October 22 and October 24, 1997. However, the DOC failed to
respond to the P.O.R.T. House staff's requests.
On October 27, 1997, plaintiff claimed his "legs gave out" and
he was unable to walk. The P.O.R.T. House staff called an
ambulance and had him taken to the hospital. He was subsequently
taken to Rahway State Prison and then to the DOC Central Reception
and Assignment Facility in Trenton, where he received medication.
Plaintiff never returned to P.O.R.T. House and was released from
the custody of the DOC on April 1, 1999.
After his release, plaintiff returned to work as a carpenter
with no restrictions. On July 9, 1999, while picking up roofing
material at work, he experienced pain, was diagnosed with a
herniated disc, and subsequently underwent surgery.
II
First, we turn to plaintiff's appeal of the order dismissing
his negligence claims against the Integrity defendants based upon
the Charitable Immunity Act. Plaintiff's challenge to that
decision on the grounds that he was a volunteer and not a
beneficiary of P.O.R.T. House's charitable services completely
disregards the undisputed evidence that plaintiff, a prisoner at
the time, was injured while engaged in a P.O.R.T. House education
and treatment program. Plaintiff's arguments on this issue are
without sufficient merit to warrant discussion in a written
opinion.
R. 2:11-3(e)(A) & (E).
III
We next address plaintiff's argument that the motion judge
erroneously dismissed his constitutional claims brought pursuant to
the Civil Rights Act,
42 U.S.C.A.
§1983, based upon his failure to
supply an affidavit of merit. The gravamen of plaintiff's claim
against the CMS defendants is that they subjected him to cruel and
unusual punishment by acting deliberately indifferent to his
complaints of pain. In other words, he alleges a violation of
rights secured by the Eighth Amendment.
See West v. Atkins,
487 U.S. 42, 48,
108 S. Ct. 2250, 2255,
101 L. Ed.2d 40, 49 (1988);
Estelle v. Gamble,
429 U.S. 97, 104,
97 S. Ct. 285, 291,
50 L. Ed.2d 251, 260 (1976).
Deliberate indifference to the serious medical needs of a
prisoner constitutes the "'unnecessary and wanton infliction of
pain,' which is proscribed by the Eighth Amendment."
Estelle,
supra, 429
U.S. at 104, 97
S. Ct. at 291, 50
L. Ed.
2d at 260
(quotation omitted). An inmate may prevail in an Eighth Amendment
claim by proving that a government actor _ in this case the
Integrity and CMS defendants acting on behalf of the State _
breached its obligation to the inmate by deliberately failing to
provide him with proper medical care.
Estelle,
supra, 429
U.S. at
103, 97
S. Ct. at 290, 50
L. Ed.
2d at 259. Plaintiff argues that
application of the affidavit of merit statute to this type of claim
raises an improper barrier to the vindication of his federal
constitutional rights.
The affidavit of merit statute says that
[i]n any action for personal injuries, . . .
resulting from an alleged act of malpractice
or negligence by a licensed person in his
profession or occupation, the plaintiff shall,
[within a specific time frame] provide each
defendant with an affidavit of an appropriate
licensed person that there exists a reasonable
probability that the care, skill or knowledge
exercised or exhibited in the treatment,
practice or work that is the subject of the
complaint, fell outside acceptable
professional or occupational standards or
treatment practices.
[
N.J.S.A. 2A:53A-27.]
The primary purpose of the statute "is 'to require plaintiffs
in malpractice cases to make a threshold showing that their claim
is meritorious, in order that meritless lawsuits readily be
identified at an early stage of litigation.'"
Cornblatt, P.A. v.
Barow,
153 N.J. 218, 242 (1998) (quoting
In re Petition of Hall,
147 N.J. 379, 391 (1997)). The failure to file an affidavit of
merit is a failure to state a cause of action.
N.J.S.A. 2A:53A-29.
Thus, the failure to comply with the affidavit of merit statute may
bar a state law claim for personal injuries for a doctor's
professional negligence. However, compliance with the affidavit of
merit statute is not a prerequisite for a federal civil rights
action against a doctor who is deliberately indifferent to his or
her patient's medical needs.
Section 1983, although not itself a source of substantive
rights, provides "a method for vindicating federal rights elsewhere
conferred."
Graham v. Connor,
490 U.S. 386, 393-94,
109 S. Ct. 1865, 1870,
104 L. Ed.2d 443, 454 (1989) (quoting
Baker v.
McCollan,
443 U.S. 137, 144 n. 3,
99 S. Ct. 2689, 2694 n. 3,
61 L.
Ed.2d 433, 442 n. 3 (1979)). Section 1983 provides an independent
cause of action to any person deprived of constitutional rights
under color of law. As a federal statute, section 1983 "is
entitled to the protection of the Supremacy Clause, Article VI, of
the United States Constitution, which precludes state laws that
thwart the purposes of federal legislation."
Fuchilla v. Layman,
109 N.J. 319, 331 (1988).
In
Fuchilla, the Court determined that the notice provisions
of the Tort Claims Act,
N.J.S.A. 59:8-8, 9, did not apply to causes
of action pursuant to section 1983.
Ibid. Justice Pollack,
speaking for the Court, said:
Barring a section 1983 claim for failure to
satisfy the notice provisions of the [Tort
Claims] Act would permit state legislation to
deny a federal right in violation of the
Supremacy Clause. Accordingly, we hold that
the notice provisions of the [Tort Claims] Act
do not apply to plaintiff's section 1983
claims. (citations omitted). [
Ibid.]
Under this same analysis, the affidavit of merit statute is
not applicable to plaintiff's section 1983 claim.
State
legislation may not impede an individual's right to allege a
federal constitutional violation. Through his section 1983 action,
plaintiff claims the CMS defendants, acting on behalf of the State,
were deliberately indifferent to his medical needs. Applying the
affidavit of merit statute to this claim would place a state-
constructed barrier between plaintiff and his federal rights.
The Supremacy Clause of the United States Constitution imposes
upon state courts a constitutional duty "to proceed in such manner
that all the substantial rights of the parties under controlling
federal law [are] protected."
Garrett v. Moore-McCormack, Co.,
317 U.S. 239, 245,
63 S. Ct. 246, 251,
87 L. Ed. 239, 244 (1942). "A
state law that conditions [a] right of recovery [under a federal
civil rights action] upon compliance with a rule designed to
minimize governmental liability, . . . is inconsistent in both
purpose and effect with the remedial objectives of the federal
civil rights law."
Felder v. Casey,
487 U.S. 131, 153,
108 S. Ct. 2302, 2314,
101 L. Ed.2d 123, 147 (1988). "Principles of
federalism, as well as the Supremacy Clause, dictate that such a
state law must give way to vindication of the federal right when
that right is asserted in state court."
Ibid.
Failure to file an affidavit of merit is a failure to state a
cause of action. Plaintiff's unfettered right to seek relief for
an alleged Eighth Amendment violation may not be conditioned on
compliance with the statute. Compliance with the affidavit of
merit statute would defeat, on the basis of state law, his
entitlement to pursue a federal claim. Therefore, we reverse the
motion judge's order dismissing plaintiff's complaint against the
CMS defendants based upon his failure to supply an affidavit of
merit, and remand to the Law Division to address plaintiff's
deliberate indifference claim against these defendants which
remains unresolved.
IV
We next determine whether plaintiff established a prima facie
showing of deliberate indifference so as to withstand the Integrity
defendants' summary judgment motion to dismiss plaintiff's
constitutional claims. The motion judge concluded that plaintiff
failed to do so. We agree.
The government has an obligation to provide medical care for
prisoners.
Estelle,
supra, 429
U.S. at 103, 97
S. Ct. at 290, 50
L. Ed.
2d at 259. To establish a deprivation of his constitutional
rights based on defendants' failure to treat his injuries,
plaintiff must demonstrate that defendants showed a "deliberate
indifference to [his] serious medical needs."
Id., 429
U.S. at
104, 97
S. Ct. at 291, 50
L. Ed.
2d at 260. A serious medical need
has been defined as "'one that has been diagnosed by a physician as
requiring treatment or one that is so obvious that a lay person
would easily recognize the necessity for a doctor's attention.'"
Monmouth County Corr. Institutional Inmates v. Lanzaro,
834 F.2d 326, 347 (3rd Cir. 1987) (quoting
Pace v. Fauver,
479 F. Supp. 456,
458 (D.N.J. 1979),
aff'd,
649 F.2d 860 (3d Cir. 1981)),
cert.
denied,
486 U.S. 1006,
108 S. Ct. 1731,
100 L. Ed.2d 195 (1988).
Although mere allegations of malpractice do not raise issues of
constitutional dimension,
Estelle,
supra, 429
U.S. at 106 n. 14, 97
S. Ct. at 292 n. 14, 50
L. Ed.
2d at 261 n. 14, if knowledge of the
need for medical care is accompanied by an intentional refusal to
provide that care, or medical treatment is delayed for nonmedical
reasons, deliberate indifference has been established.
Lanzaro,
supra, 834
F.
2d at 346.
Prison authorities "are accorded considerable latitude in the
diagnosis and treatment of prisoners,"
Durmer v. O'Carroll,
991 F.2d 64, 67 (3rd Cir. 1993), but if denying particular treatment
results in an unnecessary and wanton infliction of pain, the
medical need is sufficiently serious for Eighth Amendment
protection.
Estelle,
supra, 429
U.S. at 103, 97
S. Ct. at 290, 50
L. Ed.
2d at 259;
Lanzaro,
supra, 834
F.
2d at 347. Generally,
however, a court will not find deliberate indifference if the
inmate has been offered some level of medical care.
Christy v.
Robinson,
216 F. Supp.2d 398, 413 (D.N.J. 2002).
Here, plaintiff has not made a prima facie showing of
deliberate indifference by the Integrity defendants. His
constitutional claim against these defendants is for his lack of
treatment during his seven-day period of confinement at P.O.R.T.
House after he returned from East Jersey State Prison on October
20, 1997. Although plaintiff stated he complained of his pain to
anyone who would listen, upon plaintiff's return to P.O.R.T. House,
he gave the P.O.R.T. House staff the impression he was well enough
to go to work. The record shows that within one-half hour of
plaintiff's return to P.O.R.T. House, he signed out indicating he
was going to work. On the second day after his return, he signed
out for the same reason. Although plaintiff was out obtaining his
medical records and a second medical opinion of his injuries
instead of working, plaintiff did not communicate the real reasons
for his signing out. In neither case did he explain to the
P.O.R.T. House staff that he was suffering from a serious medical
condition that needed attention.
Also, plaintiff never executed the appropriate medical forms
to obtain medical attention while at P.O.R.T. House. He was aware
of the procedure which required a written request for medical
attention, but he failed to comply with that procedure.
Additionally, and significantly, while he was at P.O.R.T.
House, the staff attempted to fill the prescription plaintiff
obtained at St. Michael's. Plaintiff testified that he was given
a prescription for pain medication and muscle relaxants while at
St. Michael's, which was not filled either there or while he was in
the hospital ward at East Jersey State Prison. Upon returning to
P.O.R.T. House, the staff, following DOC standard procedure, made
an effort to have the prescription filled. This attempt by the
P.O.R.T. House staff to obtain pain medication for plaintiff
effectively negates his claim that the P.O.R.T. House staff was
deliberately indifferent to his complaints of pain. Rather than
demonstrating the type of indifference necessary to establish a
violation of the Eighth Amendment, the staff's attempts to obtain
pain medication for plaintiff, though unsuccessful, evidence a
willingness to respond to his complaints. Moreover, once
plaintiff's condition progressed to the point where he claimed he
was unable to walk, the P.O.R.T. House staff immediately called an
ambulance and plaintiff was taken to the hospital. At the
hospital, no treatment was rendered to plaintiff aside from
providing him with pain medication, which was what the P.O.R.T.
House staff attempted to obtain for plaintiff before he was
hospitalized.
To determine whether there exists a genuine issue of fact so
as to defeat a motion for summary judgment, the court must decide
whether "the competent evidential materials presented, when viewed
in the light most favorable to the non-moving party, are sufficient
to permit a rational factfinder to resolve the alleged disputed
issue in favor of the non-moving party."
Brill v. Guardian Life
Ins. Co. of Am.,
142 N.J. 520, 540 (1995). We agree with the
motion judge that there exists no genuine issue of fact concerning
the question of deliberate indifference which requires submission
to a jury. Plaintiff's general complaints of pain notwithstanding,
the Integrity defendants attempted to obtain for plaintiff a
prescription for pain medication and muscle relaxants, and when
plaintiff's symptoms became severe, they sent him by ambulance to
the hospital. No reasonable fact-finder could conclude that the
Integrity defendants were deliberately indifferent to plaintiff's
medical care. The constitutional claims against the Integrity
defendants were therefore properly dismissed.
Affirmed in part and reversed and remanded in part.
Footnote: 1 1The names of defendants DeSai, Robinson, Borst and Neal are
spelled differently in various documents in the record. We have
used the spelling found in these defendants' answer filed in the
Law Division.
Footnote: 2 2 Defendant Joseph Sweeney is the director of P.O.R.T.
House. Both Integrity, Inc. and Joseph Sweeney shall be jointly
referred to in this opinion as the "Integrity defendants."
Footnote: 3 3All claims against the DOC and the wardens were dismissed
by stipulation. Plaintiff's claims against Dr. Carlino, who
filed his own answer, were dismissed by summary judgment.
Although plaintiff named Dr. Carlino as a respondent and served
his attorney with the Notice of Appeal and Case Information
Statement, plaintiff did not brief the issues concerning Dr.
Carlino, and accordingly, Dr. Carlino did not file a responsive
brief. Because they were not briefed, the claims against Dr.
Carlino are waived. See Soc'y Hill Condo. Ass'n v. Soc'y Hill
Assoc.,
347 N.J. Super. 163, 175-76 (App. Div. 2002); Pressler,
Current N.J. Court Rules, comment on R. 2:6-2 (2003).
Footnote: 4 4 The CMS defendants, having been dismissed by reason of
plaintiff's failure to file an affidavit of merit, never moved
before the Law Division on the deliberate indifference issue.