10th Circuit emphasizes ‘deliberate indifference’ standard | Courts

A Denver-based federal appeals court agreed last week that a doctor did not violate the constitutional rights of an incarcerated man who later died, while rejecting an alleged attempt to “redefine the standard” for holding medical providers accountable.

A three-judge panel of the U.S. Court of Appeals for the 10th Circuit emphasized that constitutional violations, unlike medical negligence, cannot result solely from improper treatment.

Charles Anthony Hurtado died in December 2018 after being transferred from the Buena Vista Correctional Facility to Heart of the Rockies Regional Medical Center in Salida. Hurtado suffered from an abscess and one of the doctors treating him, Jerry A. Smith, prescribed oral antibiotics and pain medications after determining that he did not have a “liquefied cavity” requiring drainage.

Later that day, Hurtado returned to the emergency room in severe pain. At this point he underwent surgery to drain the abscess and was transferred to a hospital in Colorado Springs. He then died, and the coroner’s office determined the primary cause was an abscess.

Hurtado’s brother then filed a lawsuit against Smith. Instead of bringing a negligence claim, which was barred under Colorado law because of Smith’s status as a public employee, the lawsuit alleged that Smith was deliberately indifferent to Hurtado’s serious medical needs. Such a constitutional violation, consistent with the Eighth Amendment’s prohibition on cruel and unusual punishment, requires the defendant to know of, but ignore, a significant risk to a person’s health and safety.

In September 2023, U.S. District Court Judge Daniel D. Domenico decided the lawsuit in Smith’s favor, noting that the evidence showed that Smith may have been negligent in treating Hurtado, but his actions did not rise to the level of a constitutional violation.

In issuing his decision, Domenico noted that the plaintiff’s attorneys presented the testimony of an expert, surgeon Hobart W. Harris, who opined that Smith “demonstrated deliberate indifference on several occasions.” Harris defined deliberate indifference as the act of making a decision “where the (negative) consequences are foreseeable.” Domenico pointed out that Harris’ understanding was contrary to the law.

“As an expert witness, Dr. Harris can testify on industry standards for physicians and other factual issues,” he wrote, “but cannot opine on legal standards.”

On appeal, the plaintiff’s lawyers argued that the jury could have believed Smith was “lying” about his ignorance of the existence of an abscess requiring drainage. However, the 10th Circuit panel rejected during oral arguments the notion that Smith’s initial treatment of Hurtado was cruel and unusual.

“The doctor said that during the examination there was no indication of a liquefied oral cavity. “I think they were really trying to figure out what was going on with this person,” Senior Judge Paul J. Kelly Jr. said. “If this is supposed to be intentional indifference rather than a mistake or a failure to do enough, then what have we done with this profession?”

Although plaintiffs’ counsel argued that Smith must have known about the nature of Hurtado’s illness, Kelly… volunteer emergency medical technician in his home state of New Mexico – suggested that the dispute was actually about a medical misdiagnosis.

“You may be stupid, but you’re not deliberately indifferent,” he replied. “Strict liability – if you make a wrong diagnosis, you are deliberately indifferent – ​​this cannot be the rule. All my children are doctors. It would be a disaster.”

In the opinion of the panel on October 22Kelly emphasized Smith’s testimony that he was unaware of the existence of a liquefied cavity requiring drainage, meaning Smith was unaware of the serious risk to Hurtado’s life and disregarded it. Like Domenico, Kelly also criticized the plaintiff’s expert for characterizing Smith’s actions as willful indifference based on a lower constitutional violation threshold.

“Plaintiffs cannot attempt to redefine the willful indifference standard,” Kelly wrote. “Indeed, Dr. Harris’s standard of willful indifference ignores the reality that physicians are constantly dealing with probabilities and making medical decisions in the face of risk.”

Here’s the thing Estate of Hurtado v. Smith.