from the United States District Court for the Eastern
District of North Carolina, at Raleigh. James C. Dever III,
Chief District Judge. (5:10-ct-03165-D)
Argued: September 23, 2016
H. Farra, COHEN MILSTEIN SELLERS & TOLL PLLC, Washington,
D.C., for Appellant.
J. Dodson, OFFICE OF THE UNITED STATES ATTORNEY, Raleigh,
North Carolina, for Appellees.
J. Zidlicky, SIDLEY AUSTIN LLP, Washington, D.C., for
Stuart Bruce, Acting United States Attorney, G. Norman Acker,
III, Assistant United States Attorney, OFFICE OF THE UNITED
STATES ATTORNEY, Raleigh, North Carolina, for Appellees.
NIEMEYER, MOTZ, and WYNN, Circuit Judges.
in part and reversed in part by published opinion. Judge Wynn
wrote the opinion, in which Judge Niemeyer and Judge Motz
Paul Scinto, Sr. ("Plaintiff"), a former federal
prisoner, sued several federal prison officials pursuant to
Bivens v. Six Unknown Named Agents of Federal Bureau of
Narcotics, 403 U.S. 388 (1971), alleging a number of
violations under the Fourth, Fifth, Eighth, and Fourteenth
Amendments. Defendants are Dr. Derick Phillip ("Dr.
Phillip"); Patricia Stansberry, former Federal Prison
Camp Butner Warden ("Warden Stansberry"); and Susan
McClintock, former Butner Camp Administrator
("Administrator McClintock"). Collectively, these
Defendants successfully moved for summary judgment on all of
appeal, Plaintiff limits his arguments to the district
court's dismissal of three claims that Defendants were
deliberately indifferent to his medical needs, in violation
of the Eighth Amendment. Plaintiff argues that, in dismissing
these claims, the district court made credibility
determinations and weighed the parties' evidence, thus
violating the summary judgment standard.
reasons that follow, we reverse the district court's
disposition of the two Eighth Amendment claims against Dr.
Phillip and Administrator McClintock but affirm its
resolution of the claim against Warden Stansberry.
Eighth Amendment prohibits the infliction of "cruel and
unusual punishments." U.S. Const. amend. VIII. This
prohibition "proscribes more than physically barbarous
punishments." Estelle v. Gamble, 429 U.S. 97,
102 (1976). It also encompasses "the treatment a
prisoner receives in prison and the conditions under which he
is confined." Helling v. McKinney, 509 U.S. 25,
31 (1993). In particular, the Eighth Amendment imposes a duty
on prison officials to "provide humane conditions of
confinement . . . [and] ensure that inmates receive adequate
food, clothing, shelter, and medical care." Farmer
v. Brennan, 511 U.S. 825, 832 (1994). To that end, a
prison official's "deliberate indifference to
serious medical needs of prisoners constitutes the
unnecessary and wanton infliction of pain proscribed by the
Eighth Amendment." Estelle, 429 U.S. at 104
(internal quotation marks and citation omitted). Prisoners
alleging that they have been subjected to unconstitutional
conditions of confinement must satisfy the Supreme
Court's two-pronged test set forth in Farmer v.
Brennan, 511 U.S. 825 (1994).
Farmer's "objective" prong requires
plaintiffs to demonstrate that "the deprivation alleged
[was], objectively, 'sufficiently serious.'"
Farmer, 511 U.S. at 834 (quoting Wilson v.
Seiter, 501 U.S. 294, 298 (1991)). To be
"sufficiently serious, " the deprivation must be
"extreme"--meaning that it poses "a serious or
significant physical or emotional injury resulting from the
challenged conditions, " or "a substantial risk of
such serious harm resulting from . . . exposure to the
challenged conditions." De'Lonta v.
Angelone, 330 F.3d 630, 634 (4th Cir. 2003) (internal
quotation marks and citation omitted). In medical needs
cases, like the case at bar, the Farmer test
requires plaintiffs to demonstrate officials' deliberate
indifference to a "serious" medical need that has
either "been diagnosed by a physician as mandating
treatment or . . . is so obvious that even a lay person would
easily recognize the necessity for a doctor's
attention." Iko v. Shreve, 535 F.3d 225, 241
(4th Cir. 2008).
under Farmer's "subjective" prong,
plaintiffs must show that prison officials acted with a
"sufficiently culpable state of mind."
Farmer, 511 U.S. at 834 (internal quotation marks
omitted) (quoting Wilson, 501 U.S. at 297). In
conditions of confinement cases, the requisite state of mind
is deliberate indifference. Id. To prove deliberate
indifference, plaintiffs must show that "the official
kn[ew] of and disregard[ed] an excessive risk to inmate
health or safety." Id. at 837. Put differently,
the plaintiff must show that the official was "aware of
facts from which the inference could be drawn that a
substantial risk of serious harm exist[ed], and . .
. dr[ew] th[at] inference." Id. (emphasis
added). Deliberate indifference is "more than mere
negligence, " but "less than acts or omissions
[done] for the very purpose of causing harm or with knowledge
that harm will result." Id. at 835. It
"lies somewhere between negligence and purpose or
knowledge: namely, recklessness of the subjective type used
in criminal law." Brice v. Va. Beach Corr.
Ctr., 58 F.3d 101, 105 (4th Cir. 1995) (citing
Farmer, 511 U.S. at 835). Under this standard, mere
"[d]isagreements between an inmate and a physician over
the inmate's proper medical care" are not actionable
absent exceptional circumstances. Wright v. Collins,
766 F.2d 841, 849 (4th Cir. 1985) (citing Gittlemacker v.
Prasse, 428 F.2d 1, 6 (3d Cir. 1970)).
deliberate indifference to medical needs cases,
Farmer's subjective prong requires proof of the
official's "actual subjective knowledge of both the
inmate's serious medical condition and the excessive risk
posed by [the official's] action or inaction."
Jackson v. Lightsey, 775 F.3d 170, 178 (4th Cir.
2014) (citing Farmer, 511 U.S. at 837-39). A
plaintiff can meet the subjective knowledge requirement
through direct evidence of a prison official's actual
knowledge or circumstantial evidence tending to establish
such knowledge, including evidence "that a prison
official knew of a substantial risk from the very fact that
the risk was obvious." Makdessi v.
Fields, 789 F.3d 126, 133 (4th Cir. 2015) (quoting
Farmer, 511 U.S. at 842).
plaintiff also makes out a prima facie case of deliberate
indifference when he demonstrates "that a substantial
risk of [serious harm] was longstanding, pervasive,
well-documented, or expressly noted by prison officials in
the past, and the circumstances suggest that the
defendant-official . . . had been exposed to information
concerning the risk and thus must have known about it . . .
." Parrish ex rel. Lee v. Cleveland, 372 F.3d
294, 303 (4th Cir. 2004) (first alteration in original)
(internal quotation marks omitted) (quoting Farmer,
511 U.S. at 842). Similarly, a prison official's
"[f]ailure to respond to an inmate's known medical
needs raises an inference [of] deliberate indifference to
those needs." Miltier v. Beorn, 896 F.2d 848,
853 (4th Cir. 1990), overruled in part on other grounds
by Farmer, 511 U.S. at 837. However, even officials who
acted with deliberate indifference may be "free from
liability if they responded reasonably to the risk."
Farmer, 511 U.S. at 844.
entered federal custody at Federal Prison Camp Seymour
Johnson in October 2002. At that time, he suffered from myriad
medical conditions, including hepatitis C, a knee infection,
insulin-dependent diabetes, and high blood pressure. In the
years that followed, Plaintiff was confined in various
federal prison facilities. In particular, from June 2005 to
March 2006, Plaintiff was incarcerated at Federal Prison Camp
Butner in Butner, North Carolina. During that time, several
incidents purportedly occurred and gave rise to a number of
constitutional claims. Following a circuitous journey through
the federal judicial system, the present appeal addresses
only a subset of these claims.
February 28, 2008, Plaintiff filed a Bivens action
pro se in the United States District Court for the District
of Columbia. Plaintiff's original complaint sought relief
for alleged violations of his rights under the Fourth, Fifth,
Eighth, and Fourteenth Amendments, naming as defendants
various federal officials, including the Bureau of Prisons,
then-Bureau Director Harley Lappin, Regional Director Kim
White, Warden Stansberry, Administrator McClintock, and
Butner Correctional Officer Richard Holt ("Officer
Holt"). After dismissing a number of these claims on
jurisdictional and sovereign immunity grounds, the district
court transferred Plaintiff's remaining claims against
Warden Stansberry, Administrator McClintock, and Officer Holt
to the United States District Court for the Eastern District
of North Carolina. Scinto v. Fed. Bureau of Prisons,
608 F.Supp.2d 4, 10 (D.D.C.), aff'd, 352
F.App'x 448 (D.C. Cir. 2009). Following a second appeal
in this Circuit, Plaintiff successfully amended his complaint
to include additional Eighth Amendment claims against
defendants Dr. Phillip and Butner Correctional Officer
Lawrence Coor ("Officer Coor"). Scinto v.
Stansberry, 507 F.App'x 311 (4th Cir. 2013) (per
curiam). Cross-motions for summary judgment followed and, on
September 9, 2014, the district court denied Plaintiff's
motion for summary judgment and granted summary judgment to
the defendants on each of Plaintiff's claims.
appeals only three of the claims dismissed on summary
judgment, each arising under the Eighth Amendment. These
include: (1) Plaintiff's claim against Dr. Phillip for
allegedly denying Plaintiff insulin to treat his diabetes;
(2) Plaintiff's claims against Dr. Phillip and
Administrator McClintock for allegedly failing to provide aid
in a medical emergency; and (3) Plaintiff's claim against
Warden Stansberry for her alleged failure to provide
Plaintiff with a diabetic diet during Plaintiff's
incarceration in administrative segregation (the
"Special Housing Unit"). We address the facts
relevant to each claim below.
review the district court's grant of summary judgment de
novo, viewing the facts and the reasonable inferences
therefrom in the light most favorable to the nonmoving
party." Bonds v. Leavitt, 629 F.3d 369, 380
(4th Cir. 2011). Summary judgment must be granted "if
the movant shows that there is no genuine dispute as to any
material fact and the movant is entitled to judgment as a
matter of law." Fed.R.Civ.P. 56(a). To survive summary
judgment, "there must be evidence on which the ...