Balbin v. Concepcion

411 F.Supp.3d 1340

Manuel BALBIN, Plaintiff,

v.L. CONCEPCION, et al., Defendants.

Case No. 1:18-cv-20875-KMM

United States District Court, S.D. Florida.

Signed September 26, 2019

ORDER ON REPORT AND RECOMMENDATION

K. MICHAEL MOORE, UNITED STATES CHIEF DISTRICT JUDGE

THIS CAUSE came before the Court upon Defendants Dr. Luis Concepcion ("Dr. Concepcion"), Dr. Otis Egins ("Dr. Egins"), Jesus "Manny" Estrada ("Estrada"), Edith Wright ("Wright"), Dr. Carmelo Berrios ("Dr. Berrios"), Ramses "Randy" Perez ("Perez"), Daniel Junior ("Junior"), and Enrique Rodriguez's ("Rodriguez") Motion to Dismiss ("First Motion to Dismiss") (ECF No. 64)¹ and Defendants Dr. Loines Piña ("Dr. Piña") and Dr. Greta Barban-Rodriguez's ("Dr. Barban-Rodriguez") Motion to Dismiss ("Second Motion to Dismiss") (ECF No. 65) Plaintiff Michael Balbin's ("Plaintiff") Amended Complaint brought pursuant to 42 U.S.C. § 1983 ("Am. Compl.") (ECF No. 8). Plaintiff filed a response to the Motions to Dismiss (ECF Nos. 76, 77), and Defendants replied (ECF Nos. 78, 79). The Court referred the matter to the Honorable Lisette M. Reid, United States Magistrate Judge, who issued a Report and Recommendation recommending that the First Motion to Dismiss be GRANTED and the Second Motion to Dismiss be GRANTED IN PART AND DENIED IN PART. ("R&R") (ECF No. 95). Dr. Piña filed objections ("Piña Objections") (ECF No. 97), and Plaintiff filed objections ("Plaintiff's Objections") (ECF No. 98). Dr. Piña and Dr. Barban-Rodriguez filed a Response to Plaintiff's Objections ("Dentist Response") (ECF No. 99), and the County Defendants filed a Response to Plaintiff's Objections ("County Response") (ECF No. 100). The matter is now ripe for review. As set forth below, this Court ADOPTS IN PART the R&R except as replaced by the following supplemental analysis.²

The Court may accept, reject, or modify, in whole or in part, the findings or recommendations made by the magistrate judge. 28 U.S.C. § 636(b)(1) ; Fed. R. Civ. P. 72(b)(3). The Court "must determine de novo any part of the magistrate judge's disposition that has been properly objected to." Fed. R. Civ. P. 72(b)(3). A de novo review is therefore required if a party files "a proper, specific objection" to a factual finding contained in the report. Macort v. Prem, Inc. , 208 F. App'x 781, 784 (11th Cir. 2006). "It is critical that the objection be sufficiently specific and not a general objection to the report" to warrant de novo review. Id. Here, the Court conducts a de novo review of the R&R as more fully set forth below.³

I. BACKGROUND

Plaintiff, a pretrial detainee, alleges that (1) the County Defendants and Defendant Barban-Rodriguez were deliberately indifferent to his serious medical needs when they prevented him from receiving root canal treatments, which were recommended by three dentists and an oral surgeon, and (2) Dr. Concepcion and Dr. Piña were deliberately indifferent to his serious medical needs when Dr. Piña refused to fill a cavity in Plaintiff's upper wisdom tooth and Dr. Concepcion denied Plaintiff's grievance about Dr. Piña's refusal to fill the cavity. See Am. Compl. Plaintiff alleges that because the County Defendants and Dr. Barban-Rodriguez have denied him root canal treatment, he has suffered significant pain for over eighteen months, a gum infection, and dangerous weight loss because he is unable to chew food. Id. at 6. Plaintiff also alleges that he suffered thirty-four days of tooth pain after Dr. Piña refused to fill a cavity in his upper wisdom tooth. Id.

In the First Motion to Dismiss, the County Defendants argue that Plaintiff has failed to state a claim against the County Defendants sued in their individual capacities because (1) Plaintiff has not plausibly alleged that these County Defendants acted with deliberate indifference to Plaintiff's serious medical needs and (2) these County Defendants are entitled to qualified immunity. See First Mot. to Dismiss at 4–18. Further, the County Defendants argue that Plaintiff's claims against the County Defendants in their official capacities fail because (1) Plaintiff has not identified an unlawful official policy or unofficial custom or practice, and (2) Plaintiff has not alleged that any of the County Defendants are final policymakers. Id. at 18–20.

In the Second Motion to Dismiss, Dr. Barban-Rodriguez and Dr. Piña argue that Plaintiff has failed to state a claim against either Dr. Barban-Rodriguez or Dr. Piña in their individual capacities because (1) Plaintiff has not plausibly alleged that either dentist acted with deliberate indifference to Plaintiff's serious medical needs and (2) they are entitled to qualified immunity. See Second Mot. to Dismiss at 11–19. Further, Dr. Barban-Rodriguez and Dr. Piña argue that Plaintiff's claims against them in their official capacities fail because (1) Plaintiff is barred from obtaining monetary relief by the Eleventh Amendment and injunctive relief in light of Plaintiff's transfer from Metro West Detention Center ("MWDC"), (2) Plaintiff has not identified an unlawful official policy or unofficial custom or practice, and (3) Plaintiff has not alleged that Dr. Barban-Rodriguez or Dr. Piña are final policymakers.⁴ Id. at 6–11.

II. DISCUSSION

A. Individual Capacity Claims

Plaintiff brings claims against Estrada, Dr. Berrios, Perez, Junior, Rodriguez, Dr. Concepcion, and Dr. Barban-Rodriguez in their individual capacities, arguing that they were deliberately indifferent to his serious medical needs when they prevented him from receiving root canal treatments. See Am. Compl. Plaintiff also brings claims against Dr. Concepcion and Dr. Piña, arguing that they were deliberately indifferent to his serious medical needs when Dr. Piña did not fill a cavity in Plaintiff's upper wisdom tooth and Dr. Concepcion denied Plaintiff's grievance about the cavity filling. See id. at 19–23, 31–32. Each of the Defendants argue that they are entitled to qualified immunity as to all claims brought against them in their individual capacities. See First Mot. to Dismiss at 16–18; Second Mot. to Dismiss at 17–19.

Judge Reid recommends dismissal of the individual capacity claims brought against Estrada, Dr. Berrios, Perez, Junior, Rodriguez, Dr. Concepcion, and Dr. Barban-Rodriguez in their individual capacities because they are each entitled to qualified immunity. R&R at 12–17, 20–22. However, Judge Reid recommends denying the Second Motion to Dismiss as it pertains to Dr. Piña, finding that Dr. Piña is not entitled to qualified immunity and that Plaintiff has plausibly alleged a deliberate indifference claim against Dr. Piña. R&R at 23–28.

To be entitled to qualified immunity, a public official must first establish that he or she was engaged in a "discretionary duty." Mercado v. City of Orlando , 407 F.3d 1152, 1156 (11th Cir. 2005). Once it has been established that the official was engaged in a discretionary duty, the burden shifts to the plaintiff to establish "both [1] that the defendant committed a constitutional violation and [2] that the law governing the circumstances was already clearly established at the time of the violation." Youmans v. Gagnon , 626 F.3d 557, 562 (11th Cir. 2010).

i. Root Canal Treatment: County Defendants and Dr. Barban-Rodriguez

As set forth in the R&R, it is undisputed that the County Defendants were acting within their discretionary authority when they denied Plaintiff's requests for root canals, did not make root canals available to Plaintiff, reviewed his medical treatment, and denied grievances related to Plaintiff's requested root canals. See R&R at 11–12. Therefore, the burden is on Plaintiff to demonstrate that these defendants violated a constitutional right that was "clearly established" under existing law. Youmans , 626 F.3d at 562.

Judge Reid does not explicitly address whether the County Defendants or Dr. Barban-Rodriguez's conduct violated Plaintiff's constitutional rights. See Maddox v. Stephens , 727 F.3d 1109, 1121 (11th Cir. 2013) (noting that courts "are afforded the flexibility to determine that the right allegedly violated was not clearly established without deciding whether a constitutional violation occurred at all"). Rather, Judge Reid focuses her analysis on the second inquiry and finds that Plaintiff has not cited to any authority to demonstrate that there is "well-settled" case law finding an Eighth Amendment violation under circumstances like those here. R&R at 13–17. This Court agrees.

To be clearly established, a rule must "have a sufficiently clear foundation in then-existing precedent" such that it would be "clear to a reasonable [official] that his conduct was unlawful in the situation he confronted." D.C. v. Wesby , ––– U.S. ––––, 138 S. Ct. 577, 589–90, 199 L.Ed.2d 453 (2018). To demonstrate that a constitutional right is "clearly established," the party opposing qualified immunity must identify "a controlling case or robust consensus of cases" finding a constitutional violation "under similar circumstances." Id. at 591 (citation omitted). The ultimate inquiry is "whether the state of the law gave the defendants fair warning that their alleged conduct was unconstitutional." Vaughan v. Cox , 343 F.3d 1323, 1332 (11th Cir. 2003) (citation and internal quotation marks omitted). Here, Plaintiff alleges that Defendants were deliberately indifferent to his medical needs because they offered only extraction of his teeth, rather than a root canal. See Am. Compl. However, as set forth in the R&R, Plaintiff has not identified case law to support the proposition that denying an inmate a root canal violates an inmate's constitutional rights. R&R at 13–16.

To the contrary, the Eleventh Circuit has held that it is not unconstitutional to offer an inmate an extraction over other dental procedures so long as an extraction is a minimally adequate treatment option. Lynch v. Jackson , 478 F. App'x 613, 618 (11th Cir. 2012) (finding that the plaintiff's refusal to undergo an extraction...