Coston v. Nangalama, No. 19-16450 (9th Cir. 2021)
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The Ninth Circuit reversed the district court's judgment following a jury trial in an action brought by plaintiff, a California state prisoner, under 42 U.S.C. 1983 against a prison doctor and nurse, alleging claims of deliberate indifference to his medical needs in violation of the Eighth Amendment. Plaintiff's claims stemmed from defendants' termination of his prescription for morphine pills without tapering, despite the risk of withdrawal.
The panel concluded that the district court's deference instruction, which instructed the jury to defer to defendants' asserted security justification, violated established law under the facts presented and was not harmless. In this case, plaintiff introduced substantial evidence that the prison did not act pursuant to a security-based policy and that the prison had several less drastic alternatives available, including Direct Observation Therapy. Accordingly, the panel remanded for a new trial.
Court Description: Prisoner Civil Rights The panel reversed the district court’s judgment following a jury trial, and remanded, in an action brought by a California state prisoner pursuant to 42 U.S.C. § 1983 against a prison doctor and nurse alleging deliberate indifference to medical needs, in violation of the Eighth Amendment. After a correctional officer found morphine pills in Plaintiff’s cell, Defendants terminated Plaintiff’s prescription for those pills without tapering, despite the risk of withdrawal. The district court instructed the jury to defer to Defendants’ asserted security justification. On appeal, Plaintiff argued, among other things, that the district court erred by giving the jury a “deference instruction.” The panel held that Defendants did not draw a plausible connection between a security-based policy or practice and the challenged decision to terminate Plaintiff’s morphine * The Honorable Michael H. Simon, United States District Judge for the District of Oregon, sitting by designation. COSTON V. NANGALAMA 3 prescription without tapering. The panel stated that although it is reasonable for a prison to want to prevent “pill hoarding” by prisoners, had Defendants simply followed the prison’s mandatory policy for narcotic medications, Plaintiff’s pill hoarding would not have occurred. This fact broke any plausible connection between a security-based policy or practice and the medical decision being challenged. Thus, because a deference instruction should not be routinely given in all medical care cases and the threshold requirement of a plausible connection for giving such an instruction was not present in this case, it was error to give that instruction. The panel further concluded that the instructional error was not harmless. Plaintiff introduced substantial evidence that the prison did not act pursuant to a security-based policy and that the prison had several less drastic alternatives available, including Direct Observation Therapy, under which a prisoner must be observed taking the medication by both the nurse who delivers it and the correctional officer who escorts the nurse.
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