Inmate States Claim for Heart Ailment

An inmate has alleged a plausible claim of deliberate indifference to his serious medical need –  congestive heart failure – against a physician at a correctional institution who allegedly failed to follow through on ordering additional tests, monitoring and a special diet after the inmate suffered a heart attack; the 4^th Circuit vacates dismissal of this claim under 42 U.S.C. § 1983 and remands for further proceedings.

Appellees first contend we are without jurisdiction to decide this case because plaintiff failed to name the 4^th Circuit as the court to which he intended to appeal an order of a federal district court within that circuit. Our approach to Fed. R. App. P. 3 is not so formalistic. We construe Rule 3 liberally and measure compliance by asking whether the litigant’s action is the functional equivalent of what the rule requires. We have no difficulty concluding that plaintiff’s failure to add the word “Fourth Circuit” to his notice of appeal did not bring him out of compliance with Rule 3. Where, as in this case, there is only one possible appellate forum, the filing of an otherwise proper notice of appeal may itself by the “functional equivalent” of naming that court under Rule 3(c)(1)(C). Appellees concede they received prompt notice of plaintiff’s appeal to the 4^th Circuit and suffered no prejudice as a result of the claimed deficiency in plaintiff’s notice. Under these circumstances, we hold plaintiff has complied with Rule 3(c)(1)(C), and we may proceed to consider his appeal.

However, this court’s jurisdiction does not extend to the 2012 order dismissing plaintiff’s claim against the staff, as plaintiff did not properly designate the 2012 order for appeal. There is no indication plaintiff intended to appeal the 2102 order when he filed his notice of appeal. Plaintiff named the 2013 order dismissing his claim against the prison doctors. Given plaintiff’s express designation of one particular order, the fairest inference is that plaintiff did not intend to appeal the order.

Also, there is a very substantial notice problem in this case. The staff was never notified of plaintiff’s appeal or asked to file an informal brief. The staff was not represented in this appeal, on briefs or at oral argument, and has had no opportunity to defend the 2012 order. Under Rule 3(c)(1)(B), we lack jurisdiction to review the 2012 order dismissing the staff as a party to this case.

Appellees do not dispute that plaintiff’s chronic heart condition qualifies as objectively serious. Where the parties differ is over the subjective component. We agree that plaintiff’s allegations against Dr. Joseph Lightsey, though describing behavior that might support a medical malpractice claim, do not make out a case of deliberate indifference. Plaintiff contends that during a screening appointment, Lightsey, who is not a heart specialist, diagnosed plaintiff with a heart arrhythmia, even though plaintiff had produced or offered to produce medical records showing that a cardiologist had diagnosed and treated him for a more serious condition. Lightsey also substantially modified the medication regimen prescribed by plaintiff’s cardiologist. Though hindsight suggests Lightsey’s treatment decisions may have been mistaken, even gravely so, we agree with the district court that plaintiff’s claim against Lightsey is essentially a disagreement between an inmate and a physician over the inmate’s proper medical care, and we consistently have found such disagreement to fall short of showing deliberate indifference.

Plaintiff’s case against Dr. Sher Guleria is of a different order. What plaintiff wanted was exactly the testing and treatment that Guleria prescribed. Plaintiff’s objection is that Guleria failed to enter the orders necessary to provide plaintiff with the promised care, which resulted in plaintiff going months without the testing and treatment for his serious heart condition that Guleria thought appropriate.

At the 12(b)(6) stage, it is fair to infer that when Guleria prescribed a set of tests and treatments for plaintiff’s unquestionably serious heart condition, he did so because he subjectively believed they were necessary, and therefore must have known that failing to provide them would pose an excessive risk to plaintiff’s health.

Plaintiff’s allegations state a plausible claim of deliberate indifferent as to Guleria. We vacate the district court’s dismissal of plaintiff’s claim against Guleria and remand for further proceedings.

Affirmed in part and vacated and remanded in part.

Jackson v. Lightsey (Harris) No. 13-7291, Dec. 18, 2014; USDC at Raleigh, N.C. (Fox) Daniel S. Harawa for appellant; Kelly S. Brown for appellees. VLW 014-2-208, 19 pp.