In Stewart v. Aranas, published May 4, 2022, the 9th circuit affirmed the district court's denial of qualified immunity to prison officials in a prisoner's lawsuit under 42 U.S.C. section 1983. According to the summary of facts in the majority opinion, the prisoner complained to prison staff of severe pain when urinating and difficulties in urination. Staff examined him, gave him generic medication, and sent him on his way. Over the next three years, the prisoner's urethra, testicles, and abdominal areas grew inflamed. The prisoner continued to complain to prison staff. They did not change their treatment. The prisoner was transferred to another facility in an eight-hour ride. The staff at the new facility initiated emergency medical care. A catheterization drained fourteen pounds of fluid from the prisoner's bladder and unrinary system. He underwent prostate surgery. He claims long-term kidney disease, erectile dysfunction, urine build up, and pain. He sued the prison officials alleging deliberate indifference to serious medical needs. The officials appealed denial of qualified immunity on the second prong of the immunity--the law was clearly established.
The 9th Circuit agreed that the district court properly denied qualified immunity on the second prong. The prison officials claimed that no clearly established law barred their "wait and see" treatment plan for the prisoner's enlarged prostate. But case law establishes that denying, delaying, or intentionally interfering with medical treatment can violated the constitution. At some point, "wait and see" becomes deny and delay. The prisoner's condition sharply deteriorated, yet prison officials never deviated from their "wait and see" treatment plan. A delay in treatment can violated the constitution if it results in injury. Further, it is clearly established that prison officials violate the constitution when they persist in a treatment known to be ineffective.
A concurring judge agreed that a reasonable prison official with awareness of a factual predicate like the one set forth in the majority opinion would have violated clearly established rights by a treatment plan of "watchful waiting." But the judge opined the records showed a different factual predicate than the one set forth in the opinion. Since the defendants appealed only denial of qualified immunity on the second prong, the first prong--whether the plaintiff's constitutional rights were actually violated--was not an issue on appeal.
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