The opinion of the court was delivered by: Judge Munley
Before the court is Defendant Dr. Hassan Khalil's motion to dismiss plaintiff's amended complaint (Doc. 36). Having been fully briefed and argued, the matter is ripe for disposition.
This suit arises out of the death of Beth Ann Croasdale ("Deceased") at the Susquehanna County Correctional Facility ("SCCF") on April 2, 2004. Defendants in this case are prison officials, guards, and medical staff. In January 2004, Deceased was admitted to the SCCF on charges of operating a motor vehicle with a suspended or revoked license. (Amended Complaint (hereinafter "Cmplt") (Doc. 33) at ¶ 11). Deceased suffered from severe asthma and a respiratory problem, and brought with her to prison a nebulizer prescribed to her by a physician. (Id. at ¶ 14). Her physician ordered her to keep the nebulizer with her at all times. (Id.). In order for her nebulizer to function properly as asthma medication, Deceased needed to have "immediate access" to both the nebulizer and the medication that machine delivered. (Id. at ¶ 16).
Defendants, the complaint alleges, knew that Deceased suffered from severe asthma and a respiratory problem, but did not allow her to keep the nebulizer and medication with her at all times in her cell. (Id. at ¶¶ 18-19). Deceased requested treatment from her nebulizer at 4 a.m. on April 2, 2004; she would not have needed to make this request if she had the machine and the medication in her cell at all times. (Id. at ¶ 20). Eventually, guards called 911. (Id. at ¶ 23). An ambulance arrived and took Deceased to Endless Mountains Health Systems Hospital. (Id.). Under the treatment of Defendant Khalil, she died a short time later. (Id.).
Plaintiff argues that Dr. Khalil knew that Deceased required a nebulizer to treat her condition, and that he failed to review an available record documenting her use of medications. (Id. at ¶¶ 56-57). Such a review would have revealed that Deceased was not receiving her medication four times daily, despite doctor's orders to do so. (Id. at ¶ 57). Even though he knew the potential danger from plaintiff's lack of access to the nebulizer and medication, Dr. Khalil did nothing to ensure that these devices were readily available. (Id. at ¶ 58).
Dr. Khalil served as official jail doctor. (Id. at ¶ 59A). In that capacity, he visited the jail two times per week to see sick inmates who requested a doctor's visit. (Id.). Prison rules and regulations required that he oversee the administration of jail health care. (Id.). He did not make regular rounds of the prison. (Id. at ¶ 59B). Dr. Khalil also did not oversee orders for medication or make sure that patients recieved the medications prescribed for them. (Id. at ¶ 59C). Plaintiff also alleges that Dr. Khalil did not fulfill his obligation to ensure that proper medical procedures were in place at the facility. (Id. at ¶ 59D). Dr. Khalil also failed to provide proper training for non-medical personnel in recognizing and caring for life-threatening medical situations and allowed such ill-trained personnel to administer medications to inmates. (Id. at ¶¶ 59H-I). Though the prison had many environmental factors that exacerbated conditions like asthma, plaintiff alleges that Dr. Khalil failed to recognize those factors or to train non-medical personnel to recognize them. (Id. at ¶ 59L). Dr. Khalil also allegedly failed to develop procedures to deal with emergency medical situations and to train prison personnel in those procedures. (Id. at ¶ 59M). Plaintiff contends that "Dr. Khalil's actions, inactions and deliberate indifference violated [decedent's] constitutional rights." Id. at ¶ 61).
Plaintiff, Deceased's mother, filed this amended complaint on March 22, 2006, seeking relief for violation of decedent's constitutional rights under 42 U.S.C. ¶ 1983 and for negligence/gross negligence from prison officials and those who participated in decedent's care at the prison. On April 4, 2006, Defendant Khalil filed the instant motion to dismiss (Doc. 36). The issue was then briefed, bringing the case to its present posture.
When a 12(b)(6) motion is filed, the sufficiency of a complaint's allegations are tested. The issue is whether the facts alleged in the complaint, if true, support a claim upon which relief can be granted. In deciding a 12(b)(6) motion, the court must accept as true all factual allegations in the complaint and give the pleader the benefit of all reasonable inferences that can fairly be drawn therefrom, and view them in the light most favorable to the plaintiff. Morse v. Lower Merion Sch. Dist., 132 F.3d 902, 906 (3d Cir. 1997).*fn1
The Supreme Court has established that "deliberate indifference to serious medical needs of prisoners constitutes the 'unnecessary and wanton infliction of pain' proscribed by the Eighth Amendment." Estelle v. Gamble, 429 U.S. 97, 104 (1976) (quoting Gregg v. Georgia, 428 U.S. 153, 173 (1976)). Therefore, plaintiff must here allege facts that, if found true after trial, would lead to the conclusion that Defendant Khalil was "deliberately indifferent" to Decedent's "serious medical need." At oral argument, defendant conceded that decedent's asthma--which led to her death--constituted a serious medical need. We therefore have only to decide whether Dr. Khalil's behavior amounted to deliberate indifference to this need. In the medical context, courts have found this "deliberate indifference" in a number of ways, "including where the prison official (1) knows of a prisoner's need for medical treatment but intentionally refuses to provide it; (2) delays necessary medical treatment based on a non-medical reason; or (3) prevents a prisoner from receiving needed or recommended treatment." Rouse v. Plantier, 182 F.3d 192, 197 (3d Cir. 1999).
Plaintiff contends that "defendants were deliberately indifferent to the risk that the Deceased was an asthmatic and required a nebulizer to be with her at all times." (Cmplt. at ¶ 12). The complaint alleges that "[n]ot permitting the Deceased to have twenty-four hour access to her nebulizer and medication constituted deliberate indifference, and was a cause of the Deceased's death." (Id. at ¶ 21). Plaintiff clearly has met the pleading standard for an Eighth Amendment violation by Dr. Khalil. The prisoner died from her medical condition, and we therefore find that the condition was severe. See Spruill v. Gillis, 372 F.3d 218, 236 (3d Cir. 2004) (finding that a condition was "serious" because it caused great pain, required large and constant medication and the prisoner fell and collapsed twice). The parties do not dispute this finding. Plaintiff likewise has pled deliberate indifference on Dr. Khalil's part. See Rouse, 182 F.3d at 197. She alleges that Dr. Khalil was aware of the Deceased's medical condition and need for continual access to her medication and nebulizer, but he did nothing to provide those supplies. Since he was charged with setting up the system for delivery of medicine, Dr. Khalil could thus be seen to have intentionally denied Deceased access to her medication. Plaintiff's complaint could also be read to allege that Dr. Khalil, by not insisting that this necessary medication be constantly available, delayed treatment for a non-medical reason.
Defendant Khalil also argues that plaintiff has not made out a claim of negligence against him. His argument in this area centers on his contention that Dr. Khalil did not have a duty to the Deceased and therefore cannot be liable in negligence. Defendant concedes, however, that he treated the Deceased while she was in prison. He argues that Dr. Khalil's duties consisted only of visiting the prison twice a week and offering services as requested by the inmates, and that he had no particular duty to see that his orders in reference to the patients he saw were carried out. Defendant cites no case law to support this proposition that a doctor's duty to his (incarcerated) patient ends when he writes a prescription or offers a recommendation for treatment. Plaintiff argues that Dr. Khalil had access to plaintiff's medical records and should have been aware of her asthma and the danger that condition presented to a patient denied access to immediate treatment. In addition, as prison doctor, Dr. Khalil had an obligation to ensure that his orders for the Deceased ...