Civil Rights Lawsuit Filed By PLG Alleges Deliberate Indifference to Medical Needs of Prisoner Suffering from Cauda Equina Syndrome

Civil Rights Lawsuit Filed By PLG Alleges Deliberate Indifference to Medical Needs of Prisoner Suffering from Cauda Equina Syndrome

The California civil rights lawyers from the Piccuta Law Group have filed their latest civil rights lawsuit. The case involves a former prisoner who was being held at San Mateo County Jail. Specifically, the client was being housed at Maguire Correctional Facility in Redwood City, California. While there, the client began experiencing serious symptoms consistent with a condition called cauda equina syndrome. The lawsuit alleges that the medical personnel working for the jail ignored the client’s serious medical condition and were deliberately indifferent to his medical needs.

Deliberate Indifference to Medical Needs and the Failure to Diagnose and Treat Cauda Equina Syndrome

Cauda equina syndrome occurs due to dysfunction of the nerve roots at the bottom of the spine. This dysfunction is caused by the compression of the nerve roots. These nerve roots control the lower extremities and bladder. Cauda equina syndrome needs to be diagnosed quickly. Once the diagnosis is made, emergency surgery is typically the recommended course of treatment. If the condition is left untreated, it can result in permanent paralysis and incontinence.

According to the American Association of Neurological Surgeons, “red flag” symptoms include urinary retention problems, saddle anesthesia, weakness and numbness in lower extremities and pain in back and legs. Quick surgical treatment can alleviate the compressed nerve roots and allow the best chance at recovery. The failure to treat the condition may result in bladder dysfunction and permanent loss of motor skills in the legs.

The civil rights lawsuit that we filed claims that two doctors working for the County failed to diagnose and treat the condition. Specifically, the lawsuit alleges the doctors were deliberately indifferent to the client’s medical needs. The doctors who were named in the lawsuit are Robert Spencer, M.D. and Don McIntyre M.D. The lawsuit alleges that both doctors ignored the “red flag” symptoms the client was experiencing. The allegations state that a spinal MRI was taken that showed the cause of the condition but that the doctors simply ignored it and told the client to try yoga.

The Civil Rights Lawsuit Alleging Deliberate Indifference to Medical Needs in Violation of the 8^th and 14^th Amendments

The lawsuit our civil rights attorneys filed claims that both doctors were deliberately indifference to the serious condition caused by cauda equina syndrome. The lawsuit was filed in the United States District Court for the Northern District of California. The lawsuit is entitled Daniel Esser v. Robert Spencer, M.D. and Don McIntyre, M.D., Et Al. It is case number 21-CV-03440 and pending before Judge Jon S. Tigar. An initial case management conference is set for August 10, 2021 at 2:00 PM.

The client was both a pre-trial detainee and convicted inmate during the time he was held at San Mateo County Jail. A pre-trial detainee is the status given to an individual who has been arrested and is in custody, but has not been convicted of a crime. In other words, the individual is simply detained pending a disposition of his criminal charges. Whether or not that individual becomes a convicted criminal depends on the outcome of his or her criminal charges and case. Many pre-trial detainees are innocent and never convicted. Here, the client was awaiting a trial date when he decided to take a deal and plead guilty to one of the criminal charges alleged against him. At that point, his status changed to convicted inmate. He was deprived medical treatment both when he was a pre-trial detainee and convicted criminal.

The law applies two different standards for deliberate indifference to the medical needs of a person in custody. For someone who is a pre-trial detainee, the 14^th Amendment applies. Any deliberate indifference to medical needs claim, brought by a pre-trial detainee, is brought as a violation of the 14^th Amendment. On the other hand, a convicted prisoner must bring claims for deliberate indifference to medical needs under the 8^th Amendment.

It is Harder to Prove Deliberate Indifference to Medical Needs Under the 8^th Amendment than the 14^th Amendment

Proving a deliberate indifference to medical needs claim under the 8^th Amendment requires showing a subjective component of the intent of the individual. To prove a violation under the 14^th Amendment, on the other hand, only requires a showing that the individual accused did not act as a reasonable officer or medical provider would under the circumstances.

The Ninth Circuit’s Model Jury Instructions, for an Eighth Amendment violation alleging failure to provide medical care to a convicted prisoner, provide as follows:

Under the Eighth Amendment, a convicted prisoner has the right to be free from “cruel and unusual punishments.” This includes the right to adequate medical care while in custody. In order to prove a deprivation of this right, the inmate must prove the following elements by a preponderance of the evidence.

1. The inmate faced a serious medical need;
2. The defendant/doctor/government worker was deliberately indifferent to that medical need, that is, the defendant/doctor/government worker knew of it and disregarded it by failing to take reasonable measures to address it; and
3. The failure to by the defendant/doctor government worker caused harm to the plaintiff.

On the other hand, to prove a 14^th Amendment violation for the failure to provide medical care to a pre-trial detainee, one must show:

1. The defendant/doctor/government worker made and intentional decision to deny the needed medical care;
2. The denial of needed medical care put the pre-trial detainee at substantial risk of suffering serious harm;
3. The defendant/doctor/government worker did not take reasonable available measures to abate or reduce the risk of serious harm, even though a reasonable defendant/doctor/government worker under the circumstances would have understood the high degree of risk involved—making the consequences of the defendant/doctor/government worker’s conduct obvious; and
4. By not taking such measures the defendant/doctor/government worker caused the pre-trial detainee’s injuries.

In sum, proving a deliberate indifference to medical needs claim under the 8^th Amendment is harder because it must be proven that the individual responsible knew of the condition, not simply that a reasonable person under in his situation would have.

The Factual Allegations From The Civil Rights Lawsuit Alleging Deliberate Indifference to Medical Needs

The actual allegations from the civil rights lawsuit the Piccuta Law Group filed are provided word for word below. They appear here just as they do in the civil rights action we filed that is now pending in federal court.

Plaintiff, Daniel Esser, by counsel, alleges as follows:

INTRODUCTION

This action arises from months of deliberate indifference to the medical needs of then-42-year-old Daniel Esser. As a result, Esser will never be able to walk again unaided and will require adult diapers for the remainder of his life. Shortly after he was booked into Maguire Correctional Facility on July 22, 2019, Esser began reporting a multitude of symptoms consistent with Cauda Equina Syndrome. From July 2019 until January 2020, Esser reported directly to Drs. Spencer and McIntyre and to other CHS personnel that he had lost feeling in his feet, genitals and buttocks; that he had begun losing his balance and falling down; that he was constantly experiencing severe low back pain shooting down into his legs; and that he was having difficulty urinating and emptying his bowels. Esser’s condition was so severe that he was issued special shoes because his slippers would fall off without his knowledge while walking due to the lack of sensation in his feet.

Defendants knowingly allowed Esser to suffer for months. It took over three months for Esser to receive a lumbar MRI that Dr. Spencer had indicated was urgent. The MRI results showed the obvious seriousness of Esser’s condition. Nevertheless, Dr. McIntyre completely ignored these results and, instead, prescribed Sunday yoga. When Esser was finally permitted to see an outside physician on January 15, 2020, the doctor immediately diagnosed Esser with Cauda Equina Syndrome. Esser’s condition was so dire that he was in surgery the next day. Unfortunately, the damage had already been done. After months of post-surgical therapy and slow and painful improvement, Esser is left with the realization that at 43-years old, he will now require the use of a cane, ankle foot orthosis device and require adult diapers for the rest of his life.  Esser now brings this action for damages against Defendants for constitutional violations arising out their deliberate indifference, resulting in a lifetime of needless suffering.

JURISDICTION AND VENUE

1. This action arises under 42 U.S.C. § 1983, conferring jurisdiction upon this Court under 28 U.S.C. §§ 1331 and 1343.
2. A substantial part of the events or omissions giving rise to Plaintiff’s claims occurred in the County of San Mateo, California. As a result, 28 U.S.C. § 1391(b) confers venue upon this Court.

PARTIES

3. Plaintiff Daniel Esser is, and at all relevant times was, a natural person and a citizen of California.
4. Defendant Robert Spencer, M.D., is, and at all relevant times was, a natural person and citizen of California. At all relevant times, Dr. Spencer was acting under color of state law and within the scope of his employment, providing healthcare services for San Mateo County at Maguire Correctional Facility in Redwood City, California.
5. Defendant Don McIntyre, M.D., is, and at all relevant times was, a natural person and citizen of California. At all relevant times, Dr. McIntyre was acting under color of state law and within the scope of his employment, providing healthcare services for San Mateo County at Maguire Correctional Facility in Redwood City, California.
6. Plaintiff is ignorant of the true names and capacities of the Doe defendants. However, Plaintiff is informed and believes that each Doe defendant, at all relevant times, was acting under color of state law and within the scope of employment, providing healthcare and/or correctional services on behalf of San Mateo County.  The reasons these names are not yet known or ascertainable are that initial disclosures have not yet been exchanged, and Plaintiff has not yet had an opportunity to engage in other formal discovery.  Upon ascertaining the true identity of any Doe defendant, Plaintiff will file an amended pleading or seek leave to do so as required by law.

INTRADISTRICT ASSIGNMENT

7. Pursuant to Civil L.R. 3-2(c) and 3-5(b), this action shall be assigned to the San Francisco Division or Oakland Division under the Court’s Assignment Plan

STATEMENT OF FACTS

8. On, or about, July 22, 2019, Daniel Esser (“Esser”) was arrested and booked into Maguire Correctional Facility (“MCF”) in San Mateo County.
9. Shortly after, in July 2019, Esser was seen at MCF by a San Mateo County Health’s Correctional Health Services (“CHS”) nurse. Esser complained to the nurse of symptoms, including constant numbness of the left-foot toes, loss of feeling in the left foot, severe lower back pain and sharp radiating pain down the left leg.
10. The CHS nurse who saw Esser in July 2019 determined that Esser needed to be seen by a medical doctor, and an appointment was made.
11. On, or about, August 23, 2019, Esser was seen at MCF by Defendant Robert Spencer, M.D. (“Dr. Spencer”). Esser reported numbness in his entire left foot and the onset of numbness in his right-foot toes.  Esser also informed Dr. Spencer of episodes of balance-loss and an increase in the level of pain shooting down through his buttocks and into his left leg.  Spencer prescribed Gabapentin and ordered an urgent priority MRI.
12. In September 2019, Esser was seen at MCF by Defendant Don McIntyre, M.D. (“Dr. McIntyre”). Esser reported numbness of the feet and lower left leg, severe low back pain and pain shooting down both legs. He also complained of a loss of feeling in his genitals and buttocks. Further, Esser informed Dr. McIntyre that he had been falling down and having difficulty urinating. Dr. McIntyre responded by prescribing Diclofenac.
13. On, or about, October 3, 2019, Esser informed CHS staff that his balance had worsened and that he had begun falling more often due to weakness, numbness and absence of sensation in his lower extremities. Esser also explained that because he could not feel his feet and that his jail-issued footwear would fall off while he was walking, without his knowledge. CHS responded by allowing Esser “medical compliant shoes.”
14. Esser submitted a CHS Request Form on October 14, 2019, expressing concern and seeking an update on the status of the urgent MRI ordered by Dr. Spencer nearly two months prior. CHS instructed Esser to be patient.
15. On November 18, 2019, Esser was convicted by plea for the crime for which he had been arrested and booked on July 22, 2019.
16. By November 25, 2019, Esser could no longer feel either of his feet, and numbness of the genitals and rectum had more fully set in. Further, Esser had suffered muscle atrophy of the left calf and could not walk more than ten steps unaided.
17. On November 25, 2019, Esser was transported to San Mateo Medical Center for an MRI of the lumbar spine. The imaging revealed loss of intervertebral disc height, disc desiccation, dorsal bulging, severe canal stenosis and severe foraminal narrowing, all of which were documented in the Final Report.
18. On, or about, November 29, 2019, Dr. Spencer reviewed the Final Report of Esser’s lumbar MRI. Dr. Spencer then ordered a January 14, 2020 routine neurosurgery consult for Esser’s “severe” condition.
19. On, or about, December 16, 2019, Esser met with Dr. McIntyre to discuss the results of Esser’s November 25, 2019 MRI. Dr. McIntyre was again informed by Esser about his pain and numbness issues. Esser explained that he was having trouble standing upright and that his falls were more frequent. Further, Esser reported difficulty evacuating his bladder and bowels. Dr. McIntyre informed Esser that it was only a bulging disc and recommended Sunday yoga.
20. The next month, per CHS memoranda dated January 9 and January 14, 2020, Esser was allowed a cane.
21. On January 14, 2020, Esser was seen at San Mateo Medical Center by neurosurgeon Ronald Greenwald, M.D. (“Dr. Greenwald”). By this time, among his other symptoms, Esser was suffering from a complete loss of bladder and bowel control and muscle atrophy to both calves. Dr. Greenwald diagnosed Esser with Cauda Equina Syndrome secondary to L4-L5 spinal stenosis. Esser’s condition was so severe that Dr. Greenwald put in a “STAT” order for surgery to be performed the next day.
22. On January 15, 2020, Dr. Greenwald performed a bilateral L4-L5 hemilaminotomy, partial facetectomy, nerve root decompression and cauda equina decompression.
23. Esser is now permanently disabled and struggles with most activities of daily living, including walking and going to the bathroom. This now-43-year-old will require adult diapers, the use of a cane and an ankle foot orthosis device for the rest of his life.
24. Defendants, without penological justification, knowingly allowed Esser to suffer for months before he was seen by Dr. Greenwald who immediately confirmed the obvious nature of Esser’s serious medical condition. The conduct of Defendants was intended to cause injury to Esser. Their actions and inactions were also despicable and carried out with a willful and conscious disregard for Esser’s rights. Further, Defendants subjected Esser to cruel and unjust hardship in conscious disregard of those rights.

FIRST CLAIM FOR RELIEF 42 U.S.C. § 1983-Deliberate Indifference to Serious Medical Needs in Violation of the Fourteenth Amendment to the United States Constitution

25. Plaintiff incorporates by reference the allegations contained in paragraphs 1 through 24 as though fully set forth herein.
26. Defendants made intentional decisions regarding Esser’s medical care while Esser was a pretrial detainee at MCF. These decisions amounted to a delay and denial to Esser of necessary treatment for the serious medical condition from which he was suffering.
27. The delay and denial of needed medical care put Esser at a substantial risk of suffering serious harm due to Esser’s Cauda Equina Syndrome, severe spinal stenosis and severe foraminal narrowing.
28. Defendants did not take reasonable measures to reduce or abate the risk to Esser of serious harm. Because Esser reported his symptoms directly to Defendants and other CHS personnel, reasonable medical doctors under the circumstances would have understood and appreciated the high degree of risk involved. As a result, the consequences of Defendants’ conduct were obvious.
29. By not taking such reasonable measures, Defendants caused Esser’s injuries, including disability, loss of enjoyment of life, physical pain, mental suffering and emotional distress while incarcerated and for the rest of his life.

SECOND CLAIM FOR RELIEF 42 U.S.C. § 1983-Deliberate Indifference to Serious Medical Needs in Violation of the Eight Amendment to the United States Constitution

30. Plaintiff incorporates by reference the allegations contained in paragraphs 1 through 29 as though fully set forth herein.
31. After he was booked into MCF, Esser faced a serious medical need due to the condition of his spine, including his spinal nerve root disorder, Cauda Equina Syndrome.
32. In between July 2019 and January 2020, Esser complained directly to Dr. Spencer that his feet were numb, that he had been losing his balance and that pain had been shooting down from his lower back into his leg. In this same timeframe, Esser reported to Dr. McIntyre that he was experiencing numbness of the feet and lower left leg, severe low back pain and pain shooting down both legs. Esser also complained to Dr. McIntyre of a loss of feeling in his genitals and buttocks. Further, Esser informed him that he had been falling down and having difficulty urinating and emptying his bowels. Both Defendants also reviewed Esser’s November 25, 2019 MRI. Further, Defendants had access to Esser’s medical file. As a result, Defendants’ acts and failure to act amounted to deliberate indifference to Esser’s serious medical need. That is, Defendants knew of the need and disregarded it by failing to take reasonable steps to address it.
33. The acts and failure to act of Defendants caused harm to Esser, including disability, loss of enjoyment of life, physical pain, mental suffering and emotional distress while incarcerated and for the rest of his life.

Contact an Experienced California Civil Rights Lawyer If You or a Loved One Has Experienced a Violation of Your Constitutional Rights

If you or a loved one has experienced a violation of your civil rights, contact the Piccuta Law Group today. Our law firm specializes in civil rights cases. We have litigated civil rights cases in every district in California and Arizona. We have obtained civil rights jury verdicts in both state and federal court. We regularly advance claims involving police excessive force, police brutality, police misconduct, failure to protect prisoners, deliberate indifference to medical needs of inmates, among other claims. A consultation is free and we only earn a fee if we recover for you. An experienced civil rights lawyer is available now to discuss your case by phone. Call us today or send us an email.

About the author: The content on this page was written by California civil rights lawyer and Monterey personal injury attorney Charles “Tony” Piccuta. Piccuta graduated with honors from Indiana University-Maurer School of Law in Bloomington, Indiana (Ranked Top 35 US News & World Report 2018).  Piccuta took and passed the State bars of Arizona, California, Illinois and Nevada (all on the first try). He actively practices throughout California and Arizona. He is a winning trial attorney that regularly handles serious personal injury cases and civil rights lawsuits. He has obtained six and seven figure verdicts in both state and federal court. He has been recognized by Super Lawyers for six years straight. He is AV Rated by Martindale Hubble. He is a member of the Consumer Attorneys of California, American Association for Justice, National Police Accountability Project, Arizona Association of Justice, Maricopa County Bar Association and Scottsdale Bar Association, among other organizations.

Disclaimer: The information on this web site is attorney advertising and is for informational purposes only. It does not constitute legal advice. Reading and relying upon the content on this page does not create an attorney-client relationship. If you are seeking legal advice, you should contact our law firm for a free consultation and to discuss your specific case and issues.

References:

[1] https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Cauda-Equina-Syndrome

[2] https://www.ce9.uscourts.gov/jury-instructions/model-civil