United States District Court, W.D. Virginia, Harrisonburg Division
Michael F. Urbanski, Chief United States District Judge.
Carey Hixson ("Hixson"), an insulin-dependent
diabetic, alleges he was denied insulin while incarcerated at
the Harrisonburg-Rockingham Regional Jail ("HRRJ"),
giving rise to a violation of his Eighth Amendment rights and
a state-law claim of gross negligence. Hixson's Second
Amended Complaint for Monetary Damages, ECF No. 125, raises
these claims against Defendant Dr. Michael Moran ("Dr.
Moran"), the doctor at HRRJ during Hixson's
incarceration. This matter comes before the court on Dr.
Moran's Motion for Summary Judgment. ECF No. 189. For the
reasons given below, the court GRANTS the
was first diagnosed with type 2 diabetes in April 2015 during
a hospitalization at Rockingham Memorial Hospital
("RMH"). ECF No. 199-5, at 49. During the same
hospital stay, he was also diagnosed with
methamphetamine-induced psychosis, polysubstance abuse, and
alcohol abuse. Id. A consultation note by a
physician on April 26, 2015 recorded that Hixson had a
history of intermittent blurry vision and paresthesias of the
hand and feet. Id.
Moran was the medical doctor for inmates at HRRJ during
Hixson's incarceration. ECF No. 199-3, at 5. He was
employed by Rockingham County to provide medical care to the
inmates. Id. at 6. Hixson entered HRRJ on August 23,
2016 and was released on January 29, 2017. ECF No. 199-2, at
31. Upon entry, Hixson was seen by a non party intake nurse.
ECF No. 199-3, at 7-8. He informed her that he had type 1,
insulin-dependent diabetes, but the intake nurse was unable
to confirm the diagnosis, despite faxing a record request to
Hixson's medical provider. Id. Dr. Moran
testified that the medical team at HRRJ was unable to obtain
Hixson's medical history because "when [Hixson]
signed his release form, he wrote do not release mental
health information," and Hixson's diagnosis of
diabetes was made during his stay in the psychiatric unit of
RMH. ECF No. 199-2, at 8. Policy dictated that a nurse repeat
the record request if a health provider failed to respond
within 24 hours. ECF No. 199-4, at 10. If the provider still
did not respond within 24 hours of the second request, policy
required that the nurse call the physician for orders and
document that no records were ever received. Id.
While the original record request to Hixson's provider
was made, no evidence has been elicited showing a repeat
request was made or that Dr. Moran was contacted regarding
the failure to secure records. Id.
Moran reviewed the information taken by the intake nurse and
placed Hixson on a diabetic diet. ECF No. 199-2, at 8. He
also ordered Hixson's blood sugar levels be tested every
day. Id. For the first four months of his
incarceration, Hixson's blood sugar readings were
variable, with some normal and some elevated
scores. See ECF No. 113-12, at 18-22. Hixson's
September readings ranged from a low of 94 mg/dL on September
24, 2016 to a high of 157 mg/dL on September 22, 2016.
Id. Likewise, in October, his low reading was 118
mg/dL on October 3, 2016 and his high reading was 169 mg/dL
on October 5, 2016. Id. November's readings
creeped up, but remained variable, from a low of 137 mg/dL on
November 25, 2016 to a high of 239 mg/dL on November 3, 2016.
Id. December's readings, while higher, still
fluctuated from 118 mg/dL on December 24, 2016 to 277 mg/dL
on December 7, 2016. Id. Hixson's blood sugar
values retained this variability in January 2017.
Id. On three days that month, January 21, 24, and
28, Hixson's twice daily readings were more than 100
points apart. Id.
also began occasionally refusing testing, claiming
apprehension in interacting with Nurse Katherine Raynes after
a confrontation with her over insulin. ECF No. 199-2, at
34. Dr. Moran reviewed the blood sugar readings on a weekly
basis, as indicated by his initials in Hixson's medical
record. ECF No. 199-4, at 13. In response to the higher
readings, Dr. Moran ordered that the blood sugar tests be
performed twice daily in January 2017, but at no point did
Dr. Moran prescribe Hixson any type of oral diabetes
medication or insulin injections. ECF No. 199-2, at 23. While
Hixson claims he repeatedly asked nursing staff for insulin,
nothing in the record indicates that Hixson reported any
symptoms of elevated blood sugar to either a nurse or Dr.
Moran. Indeed, Hixson was seen by Dr. Moran on September 29,
2016 and did not relate any symptoms of or discuss diabetes.
ECF No. 199-2, at 35. Nor did Hixson file an official
grievance or complaint asking for insulin or any other form
of diabetes treatment. Id.
filed his original lawsuit on March 31, 2017 against Dr.
Moran and various other defendants who have since been
dismissed. ECF No. 1. Hixson alleges the following
causes of action against Dr. Moran: (1) Dr. Moran violated
Hixson's "right to be free from deliberate
indifference to his known serious medical need for diabetic
medication (prescription or otherwise) to treat his known,
medically diagnosed condition of diabetes," ECF No. 125,
at 38; and (2) Dr. Moran committed medical malpractice, a
state law claim which has been dismissed to the extent it
sounds in negligence, rather than gross negligence. ECF No.
125, at 38; ECF No. 167. Hixson also seeks punitive damages
and attorneys' fees, premised on the liability under 42
U.S.C. § 1983 against Dr. Moran, ECF No. 125,
to Federal Rule of Civil Procedure 56(a), the court must
"grant summary judgment 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); Celotex Corp. v. Catrett, 477
U.S. 317, 322 (1986); Glynn v. EDO Corp.. 710 F.3d
209, 213 (4th Cir. 2013). When making this determination, the
court should consider "the pleadings, depositions,
answers to interrogatories, and admissions on file, together
with... [any] affidavits" filed by the parties.
Celotex. 477 U.S. at 322. Whether a fact is material
depends on the relevant substantive law. Anderson v.
Liberty Lobby. Inc., 477 U.S. 242, 248 (1986).
"Only disputes over facts that might affect the outcome
of the suit under the governing law will properly preclude
the entry of summary judgment. Factual disputes that are
irrelevant or unnecessary will not be counted."
Id. (citation omitted). The moving party bears the
initial burden of demonstrating the absence of a genuine
issue of material fact and may prevail by showing "an
absence of evidence to support" an essential element of
the nonmoving party's case. Celotex, 477 U.S. at
323. If that burden has been met, the nonmoving party must
then come forward with specific material facts that prove
there is a genuine dispute for trial. Matsushita Elec.
Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586-87
determining whether a genuine issue of material fact exists,
the court views the facts and draws all reasonable inferences
in the light most favorable to the nonmoving party.
Glynn. 710 F.3d at 213 (citing Bonds v.
Leavitt, 629 F.3d 369, 380 (4th Cir. 2011)). Although
"the evidence of the nonmovant is to be believed, and
all justifiable inferences are to be drawn in his favor,
"' McAirlaids, Inc. v. Kimberly-Clark
Corp., No. 13-2044, 2014 WL 2871492, at *1 (4th Cir.
2014) (internal alteration omitted) (citing Tolan v.
Cotton, 134 S.Ct. 1861, 1863 (2014) (per curiam)),
"[t]he mere existence of a scintilla of evidence in
support of the [nonmovant's] position will be
insufficient" to overcome summary judgment.
Anderson, 477 U.S. at 252. Rather, a genuine issue
of material fact exists only "if there is sufficient
evidence favoring the nonmoving party for a jury to return a
verdict for that party." Res. Bankshares Corp. v.
St. Paul Mercury Ins. Co., 407 F.3d 631, 635 (4th Cir.
2005) (quoting Anderson, 477 U.S. at 249). "In
other words, to grant summary judgment the [c]ourt must
determine that no reasonable jury could find for the
nonmoving party on the evidence before it." Moss v.
Parks Corp., 985 F.2d 736, 738 (4th Cir. 1993) (citing
Perini Corp. v. Perini Const, Inc., 915 F.2d 121,
124 (4th Cir. 1990)).
alleges a violation of Hixson's Eighth Amendment Rights
pursuant to 42 U.S.C. § 1983. To state a claim under
§ 1983, a plaintiff must allege the violation of a right
secured by the Constitution or laws of the United States and
must show that the deprivation of that right was committed by
a person acting under color of state law. Crosby v. City
of Gastonia, 635 F.3d 634, 639 (4th Cir. 2011) (citing
West v. Atkins, 487 U.S. 42, 48 (1988)). To prove an
Eighth Amendment violation, Hixson must show that he suffered
a sufficiently serious deprivation and that Dr. Moran acted
with "deliberate indifference" to his health or
safety. Farmer v. Brennan, 511 U.S. 825, 834 (1994)
(citations omitted). This is a two prong test, with the
first, "objective" prong requiring a demonstration
of the seriousness of the deprivation and the second,
"subjective" prong requiring a showing of the
defendant's "sufficiently culpable" state of
mind. Farmer, 511 U.S. at 834.
starting point, Hixson must meet the objective prong of the
Farmer test by raising a genuine question of
material fact that "the deprivation alleged [was],
objectively, 'sufficiently serious.'"
Farmer, 511 U.S. at 834 (quoting Wilson v.
Seiter,501 U.S. 294, 298, (1991)). Ultimately, the
deprivation must be "extreme"-meaning it must pose
"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 hand, the
Farmer test requires plaintiffs demonstrate
officials' deliberate indifference to a
"serious" medical need that has either "been
diagnosed by a physician as ...