Spruill v. Gillis

Opinions of the United
2004 Decisions States Court of Appeals
for the Third Circuit

6-18-2004

Spruill v. Gillis
Precedential or Non-Precedential: Precedential

Docket No. 02-2659

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 PRECEDENTIAL MICHAEL A. FARNAN (Argued)
Department of Corrections
UNITED STATES COURT OF Office of Chief Counsel
APPEALS P.O. Box 598
FOR THE THIRD CIRCUIT Camp Hill, PA 17011

Attorney for Appellees Gillis and Goolier
No. 02-2659
ALAN S. GOLD (Argued)
Sean Robins
ROBERT SPRUILL, Gold, Butkovitz & Robins
7837 Old York Road
Appellant Elkins Park, PA 19027

v. Attorney for Appellees McGlaughlin and
Brown
FRANK GILLIS; GOOLIER, C.O.;
MCGLAUGHLIN, M.D.; BROWN, P.A. ______________________

_________________ OPINION
______________________
On Appeal From The United States
District Court For
The Middle District Of Pennsylvania BECKER, Circuit Judge.
(D.C. No. 3:01-CV-1625)
This appeal raises important questions
District Judge: Honorable Thomas I.
of construction of the Prison Litigation
Vanaskie, Chief Judge
Reform Act of 1995 (PLRA), Pub. L. No.
_________________
104-134, 110 Stat. 1321 at 66 (1996).
Plaintiff Robert Spruill is an inmate in the
Argued January 13, 2004
custody of the Pennsylvania Department of
Corrections. Spruill filed a civil rights
Before: ALITO, CHERTOFF, and
complaint under 42 U.S.C. § 1983 against
BECKER Circuit Judges.
four defendants at the State Correctional
I n s t i t u t io n a t C o a l T o w n s h i p ,
(Filed: June 18, 2004)
Pennsylvania: two prison officials (Frank
Gillis and Stephen Gooler1 ); a prison
ERIC R. SONNENSCHEIN (Argued)
doctor (Dr. Shawn McGlaughlin); and a
Covington & Burling
1201 Pennsylvania Avenue, N.W.
Washington, DC 20004 1
Spruill in his complaint spells the
name “Goolier,” but we will use the
Attorney for Appellant correct spelling, “Gooler.”
prison physician’s assistant (Brian Brown). exhaustion requirement, and we have not
In his complaint, Spruill alleges that, as a had occasion to pass on whether the
result of the deliberate indifference of the exhaustion requirement is merely a
defendants, his serious back condition was termination requirement or also includes a
left untreated, or was inadequately treated, procedural default component—that is,
resulting in excruciating pain and whether a prisoner may bring a § 1983 suit
susceptibility to other injuries. Pursuant to so long as no grievance process remains
Pennsylvania’s Inmate Grievance System open to him, or whether a prisoner must
Policy (the “Grievance System Policy”), properly (i.e., on pain of procedural
Spruill filed a series of three inmate default) exhaust administrative remedies
grievances, and he ultimately received as a prerequisite to a suit in federal court.
some measure of medical care. In his This case requires us to confront that issue,
grievances, Spruill did not seek money and we hold that § 1997e(a) includes a
damages, but in the instant suit under 42 procedural default component. We further
U.S.C. § 1983, he does seek money hold that the determination whether a
damages for the alleged violation of his prisoner has “properly” exhausted a claim
rights under the Eighth Amendment to the (for procedural default purposes) is made
United States Constitution. by evaluating the prisoner’s compliance
with the prison’s a dm inistrativ e
42 U.S.C. § 1997e(a), enacted as part
regulations governing inmate grievances,
of the PLRA, provides that a prisoner may
and the waiver, if any, of such regulations
not bring a § 1983 suit with respect to
by prison officials.
prison cond itions “u ntil such
administrative remedies as are available Applying this framework to Spruill’s
are exhausted.” Because Spruill had failed grievances under the Grievance System
to seek money damages in his grievances, Policy, we hold that (1) Spruill was not
the District Court concluded that he had required to seek money damages in his
failed to meet the exhaustion requirement grievances, and therefore has not
of § 1997e(a), and therefore dismissed procedurally defaulted his claim for money
Spruill’s suit in its entirety. The District damages; (2) Spruill was required to name
Court also held in the alternative that Brown in his grievances, but that the
Spruill’s failure to name Brown in his officials handling Spruill’s grievances
grievances constituted a failure to exhaust waived his default on this requirement;
his claims against Brown. Spruill appeals a n d ( 3 ) S p r u il l e x h au s t e d t h e
the dismissal of his claims against Gooler, administrative remedies under the
Dr. McGlaughlin, and Brown. He does Grievance System Policy.
not appeal the dismissal of his suit against
Finally, turning to the merits-based
Gillis.
arguments that the defendants advance as
Courts have only recently begun to alternate grounds for affirmance of the
define the contours of the PLRA’s District Court, we conclude that Spruill

2
does not state a claim for deliberate Bureau of Prisons, 355 F.3d 1204, 1212
indifference against Gooler, but that his (10th Cir. 2003) (quoting GFF Corp. v.
allegations against Dr. McGlaughlin and Associated Wholesale Grocers, Inc., 130
Brown are sufficient to withstand a motion F.3d 1381, 1384 (10th Cir. 1997) (noting
to dismiss. We will therefore affirm in that “a defendant may submit an
part, reverse in part, and remand for indisputably authentic [document] to the
f u r t h e r p r o c e e d in g s a g a in s t D r. court to be considered on a motion to
McGlaughlin and Brown. dismiss”)). We now chronicle the facts as
set forth in Spruill’s complaint.
A. Spruill’s Complaint
I. Facts and Procedural History
Spruill is currently incarcerated at the
As this case comes to us on the District
State Correctional Institution at Chester,
Court’s grant of a motion to dismiss, we
Pennsylvania (“SCI-Chester”), but he has
must accept as true the facts as pled in
been housed in at least two other facilities.
Spruill’s complaint. E.g., Bd. of Trs. of
His complaint alleges that, shortly after he
Teamsters Local 863 Pension Fund v.
was transferred to the State Correctional
Foodtown, Inc., 296 F.3d 164, 168 (3d Cir.
Institution at Coal Township, Pennsylvania
2002). Given that the exhaustion issue
(“SCI-Coal”) in May 2001, the defendants
turns on the indisputably authentic
were deliberately indifferent to his medical
documents related to Spruill’s grievances,
needs and subjected him to unnecessarily
we hold that we may also consider these
painful medical treatment. Named as
without converting it to a motion for
defendants in the complaint are Frank
summary judgment.2 See Steele v. Fed.
Gillis, the Superintendent at SCI-Coal;
Lieutenant Steven Gooler, the Unit
2 Manager of the Restricted Housing Unit
Strictly speaking, the motion acted on
(RHU) at SCI-Coal, where Spruill was
by the District Court should not have
housed during the events at issue; Dr.
been captioned as a Fed. R. Civ. P.
Shawn McGlaughlin, a prison physician;
12(b)(6) motion to dismiss, but rather as
and Brian Brown, a physician’s assistant.
a Fed. R. Civ. P. 12(c) motion for
judgment on the pleadings, because we On May 2, 2001, Spruill was
have held that failure to exhaust transferred from the State Correctional
administrative remedies under § 1997e(a) Institution at Rockview (SCI-Rockview),
is an affirmative defense. See Ray v. Pennsylvania to SCI-Coal, where he was
Kertes, 285 F.3d 287, 295 (3d Cir. 2002). housed in the RHU. Upon his arrival,
There is no material difference in the Spruill immediately requested to see a
applicable legal standards, so for the sake medical staff member about severe pain he
of familiarity, we shall use the “motion was experiencing in his lower back area
to dismiss” formulation of Fed. R. Civ. and his right leg. “Several hours later,” he
P. 12(b).

3
was interviewed by a nurse. After Spruill
described his pain, and stated that he
“suffers from a chronic and debilitating
well as severe pain up and down
lower back disorder, spondylotic spinal
the front and back sides of the
stenosis with recurrent compression of L3
right leg. It was at that point this
and/or L4 nerve root on right,” the nurse
writer fell to the floor in a forceful
said, “There is nothing I can do, you will
manner, hitting the left side of my
need to sign up for sick call.”
face on the edge of the “metal”
Spruill signed up for sick call on May toilet in the cell. This writer did
3, but the next morning, he fell due to a as well also jammed and/or
severe pain in his leg and back, striking the injured his right thumb in the
left side of his face on the metal toilet in same fall. This writer has reason
his cell. Spruill believes he was knocked to believe that he may have passed
unconscious and also injured his right out due to the forceful blow he
thumb. That same day, May 4, he received to the left side of his face
informed the nurse of his fall, his when he fell. This writer has
additional injuries, and continuous back made repeated request, prior, to
pain; the nurse said that she would inform see the doctor, only to be told that
the doctor. Spruill also informed Gooler the doctor does not visit the RHU.
about his fall, to which Gooler responded, To date, and even in light of this
“so, what do you want me to do?” Spruill writer’s sick call request and most
filed an official inmate grievance on May recent fall incident, this writer has
4 complaining about the fall and new yet to be examined by this
injury. Gooler did not notify health care institution’s doctor and/or RHU
providers once he was informed of security staff. This writer also
Spruill’s injuries; at that point, Spruill had informed RHU Lt. Goolier, about
yet to be examined by a medical doctor. 3 the aforementioned fall. His reply
was: so, what do you want me to
do. The writer finds Lt. Goolier
3
The grievance filed by Spruill dated said remarks to be highly
May 4, 2001, reads as follows: unprofessional. He is required to
notify medical respecting this
On the above stated date at writer’s fall and blow to the head.
approx. 5:35 a.m., this writer What must I do, die, before I can
attempted to get up out of the bed. get medical attention?
I took perhaps approximately 3 to
4 short steps, wherein, at that In response to the prompt on the
juncture, this writer received grievance form to “[l]ist actions taken
and/or experienced an extremely and staff you have contacted, before
sharp pain in the lower back & as submitting this grievance,” Spruill wrote:

4
 On May 5, Dr. McGlaughlin came to Spruill was seen by the physician’s
Spruill’s cell regarding the sick call assistant, Brown, on May 7. At that
request. Dr. McGlaughlin refused to encounter, Brown accused Spruill of
examine Spruill and stated that Spruill faking his injuries and did not examine
would never go to the infirmary. Spruill him. On May 9, Spruill complained to the
filed a second grievance on May 6 nurse that the pain medication he was
complaining that McGlaughlin had failed prescribed for his back5 “wasn’t working,”
to conduct a physical examination of him.4 and later that morning Spruill experienced
another “extremely sharp pain” in his

Submitted sick call request(s)
about back pain, spoke to the the continued severe pain I am
nurse(s) about my back pain and having. More pointedly, the
seeing the doctor—they said that aforementioned doctor never once
it was nothing they could do, and conducted a physical examination
that the doctor will not come to in which to determine the full
the RHU to see me. I spoke to Lt. extent of my pre-existing back
Goolier about my situation, he condition or the injuries I
demonstrated no “care” or sustained relative to my fall on 5-
concern regarding my health 4-2001. In addition, said doctor’s
and/or well being. visit to the RHU with me lasted
approximately 30 seconds maybe
4
The grievance filed by Spruill dated less. To date, I am still
May 6, 2001, reads as follows: experiencing a considerable
amount of pain.
This writer avers the following: I
was seen on 5-5-2001, by a In response to the prompt on the
member of the medical staff grievance form to “[l]ist actions taken
whom identified himself as the and staff you have contacted, before
institutional medical “doctor.” I submitting this grievance,” Spruill wrote:
explained to the doctor that I
suffer from a “chronic back Spoke to nurses and RHU staff
disorder” and currently experience members who stated there’s
severe pain around my lower back nothing they can do. I will need
& right leg. And that I had fallen to submit a grievance.
in the cell the day prior, “hitting
5
my face on the metal toilet & also It is not clear from Spruill’s
hurting my right hand in said fall. complaint whether this medication was
Moreover, I advised the doctor prescribed by an SCI-Coal physician, or
that my fall was directly related to by a physician from SCI-Rockview, from
my not being able to walk—due to which Spruill had just been transferred.

5
lower back and leg which caused him to On May 14, Dr. McGlaughlin had
fall again. Spruill submitted another sick Spru ill brought into the medical
call request, and was seen on May 10 by e x a m i n a t io n r o o m , w h e r e D r .
Brown in response to that request. Spruill McGlaughlin deliberately bent and twisted
told Brown that “the current medication Spruill’s legs “as if he was trying to shape
was not working to reduce his pain,” but a pretzel.” Dr. McGlaughlin did not
Brown did not take any actions to help examine Spruill’s face or thumb for
him. Spruill submitted another sick call injuries sustained on the morning of May
request on May 11, following which he 4.
was seen by Dr. M cGlaughlin on May 12.
The grievances were consolidated and
Dr. McGlaughlin stated that he did not
denied upon Initial Review, and Spruill
believe there was anything wrong with
filed administrative appeals. The first
Spruill’s back, and accused Spruill of
appeal was denied, and Spruill filed a final
“playing games.” Spruill filed a third
appeal, which was also denied. The stated
grievance that day. 6

particular instance, since he has
6
The grievance filed by Spruill dated never conducted any physical
May 12, 2001, reads as follows: examination on this writer.

This writer avers that at To date, this writer remains in
approximately 8:34 a.m. on the constant sever[e] pain. And Dr.
above indicated date, SCI-Coal McGlaughlin’s continued
Chief M edical Director Dr. course of treatment that he knows
McGlaughlin, came to my cell is painful & ineffective may soon
regarding my sick call request. entail a substantial risk of me
Dr. McGlaughlin stated to me: seriously harming myself in this
that I had been evaluated back in cell “falling.”
“February 2001,” by Dr. Osgood,
who has said that I am pain-free, In response to the prompt on the
and that there’s nothing wrong grievance form to “[l]ist actions taken
with my back. and staff you have contacted, before
submitting this grievance,” Spruill wrote:
In addition: Coal’s Chief Medical
Director stated to this writer that Spoke to officer Shay—“Pod
this: “brings an end to your little officer” who indicated that it is
back playing games.” This writer very little if anything at all he
contends that Dr. McGlaughlin’s could do, the matter will need to
remarks as stated herein above be addressed by medical or by
were highly unprofessional in this way of the grievance system.

6
reasons behind the denials were that timely notice of appeal from the final order
Spruill was, at the time, receiving dismissing the action and we have
appropriate medical care. As our jurisdiction under 28 U.S.C. § 1291. We
rescription of the grievances demonstrates, exercise plenary review over a district
see supra notes 3, 4 & 6, Spruill did not court’s decision to grant a motion to
seek monetary relief from the prison, nor dismiss. Broselow v. Fisher, 319 F.3d
do the grievances identify Brown by name 605, 607 (3d Cir. 2003). To the extent that
or by description. our review turns on the statutory
construction of the exhaustion requirement
B. Proceedings in the District Court
in § 1997e(a), our review is also plenary.
Spruill filed the present suit seeking Concepcion v. Morton, 306 F.3d 1347,
monetary and injunctive relief. Because 1352 (3d Cir. 2002) (holding that “the
Spruill had by then been transferred to scope of § 1997e(a)’s applicability, which
SCI-Chester, the District Court held that is a question of law” is subject to plenary
his claim for injunctive relief against review); see also Nyhuis v. Reno, 204 F.3d
officials at SCI-Coal was moot under 65, 66 (3d Cir. 2000).
Abdul-Akbar v. Watson, 4 F.3d 195, 206-
The defendants advance several
07 (3d Cir. 1993). The District Court
grounds on which to affirm the judgment
granted all four defendants’ motions to
of the District Court. First, they argue that
dismiss on several grounds, holding, inter
Spruill’s failure to seek money damages in
alia, that (1) Spruill’s failure to seek
his grievances precludes him from now
money damages in his grievances
seeking damages in federal court. Second,
constituted a failure to exhaust
Brown argues that Spruill’s failure to
administrative remedies; (2) because
name him in the grievances is a failure to
Spru ill received adequate medical
exhaust. Third, all defendants argue that
treatment, he had stated no claim for a
Spruill has not alleged facts sufficient to
violation of his Eighth Amendment rights;
establish a violation of his Eighth
and (3) Spruill had failed to exhaust his
Amendment rights.7 We will treat each of
claim against Brown because the
these arguments in turn.
grievances did not name Brown.
C. This Appeal
II. Exhaustion Under the PLRA
Spruill appeals the dismissals of Lt.
Gooler, Dr. McGlaughlin, and Brown, but
does not appeal the dismissal of 7
Gooler captions this issue as a
Superintendent Gillis. The District Court
qualified immunity defense, which it is
had jurisdiction over this action pursuant
not. The substance of his argument is
to 28 U.S.C. § 1331 and § 1343, as a suit
that Spruill’s complaint does not
arising under a federal law securing civil
establish that Gooler acted with a mental
rights, 42 U.S.C. § 1983. Spruill filed a
state of deliberate indifference.

7
 A. The CRIPA discretionary continuance provision with a
mandatory dismissal provision:
In 1980, Congress enacted the Civil
Rights of Institutionalized Persons Act No action shall be brought with
(CRIPA), Pub. L. No. 96-247, 94 Stat. 349 respect to prison conditions under
(1980). CRIPA § 7 (originally codified at section 1979 of the Revised
42 U.S.C. § 1997e) took several steps to Statutes of the United States (42
foster the development of administrative U.S.C. 1983), or any other Federal
grievance systems in prisons: First, it law, by a prisoner confined in any
directed the Attorney General to jail, prison, or other correctional
promulgate, after consultation with others, facility until such administrative
“minimum standards for the development remedies as are available are
of a plain, speedy, and effective system for exhausted.
the resolution of [inmate] grievances.”
PLRA § 803(d) (codified at 42 U.S.C. §
CRIPA § 7(b)(1). Second, it directed the
1997e(a) and amending CRIPA § 7(a)).
Attorney General to set up a certification
As the Supreme Court explained in Nussle:
program for inmate grievance systems.
CRIPA § 7(c). Third, it gave District [This] exhaustion provision differs
Courts discretion to continue (i.e. stay) § markedly from its predecessor.
1983 cases brought by prisoners “in order Once within the discretion of the
to require exhaustion of such plain, district court, exhaustion in cases
speedy, and effective administrative covered by § 1997e(a) is now
remedies as are available.” CRIPA § 7(a). mandatory. All “available”
The Supreme Court “described this remedies must now be exhausted;
provision as a ‘limited exhaustion those remedies need not meet
requirement.’” Porter v. Nussle, 534 U.S. federal standards, nor must they be
516, 523-24 (2002) (quoting McCarthy v. “plain, speedy, and effective.”
Madigan, 503 U.S. 140, 150-51 (1992)); Even when the prisoner seeks relief
see also Concepcion, 306 F.3d at 1352. not a va ila ble in grievance
proceedings, n o ta b ly m oney
B. The PLRA
damages, exhaustion is a
This regime of discretionary prerequisite to suit. And unlike the
continuance to exhaust administrative prev ious prov ision, w hich
remedies lasted until the 1996 enactment encompassed only § 1983 suits,
of the Prison Litigation Reform Act of exhaustion is now required for all
1995, Pub. L. No. 104-134, 110 Stat. 1321 “action [s] . . . brought with respect
at 66 (1996). Section 803(d) of the PLRA to prison conditions,” whether
amended CRIPA § 7 to, inter alia, remove under § 1983 or “any other Federal
the standards-setting and certification roles law.”
of the Attorney General, and replace the
534 U.S. at 524 (citing Booth v. Churner,

8
532 U.S. 731, 739-41 & n.5). interpreting § 1997e(a)’s exhaustion
requirement.
Several courts have recounted the
legislative history of the PLRA, and we C. Exhaustion and Procedural Default
need not do so once again. See, e.g.,
We have previously addressed the
Johnson v. Daley, 339 F.3d 582, 598-99
applicability of § 1997e(a) to actions by
(7th Cir. 2003) (Ripple, J., concurring in
prisoners who have filed suit in federal
the judgment); Nussle v. Willette, 224 F.3d
court before pursuing all avenues of relief
95, 106 (2d Cir. 2000), rev’d sub nom.
available to them within their prison’s
Porter v. Nussle, 534 U.S. 516 (2002);
inmate grievance system. In Nyhuis, 204
Alexander v. Hawk, 159 F.3d 1321, 1324-
F.3d 65, we held that an inmate seeking
25 (11th Cir. 1998). The Supreme Court
relief that the prison’s administrative
summarized the objectives of the
grievance system cannot provide (in
exhaustion requirement of the PLRA in
Nyhuis, it was money damages) must
Nussle:
nonetheless pursue the grievance process
Beyond doubt, Congress enacted § to its end before coming to federal court.
1997e(a) to reduce the quantity and We concluded that the PLRA “make[s]
improve the quality of prisoner exhaustion of all administrative remedies
suits; to this purpose, Congress mandatory.” Id. at 67 (emphasis added).
afforded corrections officials time The question we now consider is whether
and opportunity to address “all administrative re medies” are
com plaints internally before exhausted whenever there is no further
allowing the initiation of a federal process available to the inmate within the
case. In some instances, corrective grievance system (which would happen if,
action taken in response to an say, an inmate fails to file an
inmate’s grievance might improve administrative appeal), or whether it is
prison administration and satisfy necessary that the inmate reach this
the inmate, thereby obviating the endpoint having availed himself of every
need for litigation. In other process at every turn (which would require
instances, the internal review might all appeals to be timely pursued, etc.). Put
“filter out some frivolous claims.” another way, we ask whether the PLRA
And for cases ultimately brought to requires simple exhaustion or something
court, adjudication could be more— “proper” exhaustion, as it were.
facilitated by an administrative To borrow terms from other areas of the
record that clarifies the contours of law that recognize an exh austion
the controversy. requirement, we consider whether the
PLRA’s exhaustion requirement is merely
534 U.S. at 524-25 (quoting and citing
a termination requirement, or also includes
Booth, 532 U.S. at 737). With this
a procedural default component.
background to guide us, we turn next to

9
 We recognize that there is an emerging failed to me et the State’s
split among the circuits on whether the procedura l requirements for
PLRA includes a procedural default presenting his federal claims has
component. Compare Ross v. County of deprived the state courts of an
Bernalillo, 365 F.3d 1181,1186 (10th Cir. opportunity to address those claims
2004) (“[T]he PLRA, like 28 U.S.C. § in the first instance. A habeas
2254, contains a procedural default petitioner who has defaulted his
c o n c e p t w i t h in i t s e x h a u s t i o n federal claims in state court meets
requirement.”), and Pozo v. McCaughtry, the technical requirements for
286 F.3d 1022 (7th Cir.) (same), cert. exhaustion; there are no state
denied 537 U.S. 949 (2002), with Thomas remedies any longer “available” to
v. Woolum, 337 F.3d 720, 723 (6th Cir. him. In the absence of the
2003) (“[W]e hold that so long as an independent and adequate state
inmate presents his or her grievance to ground doctrine in federal habeas,
prison officials and appeals through the habeas petitioners would be able to
available procedures, the inmate has avoid the exhaustion requirement
exhausted his or her administrative by defaulting their federal claims in
remedies, and a prison’s decision not to state court.
address the grievance because it was
Coleman v. Thompson, 501 U.S. 722, 732
untimely under prison rules shall not bar
(1991) (citing 28 U.S.C. § 2254(b); Engle
the federal suit.”).
v. Isaac, 456 U.S. 107, 125-26, n.28
1. The Procedural Default Component of (1982)).
the PLRA
The value of a procedural default rule
The Supreme Court has observed in the for enforcing an exhaustion requirement is
federal habeas corpus context that an obvious. For example, both state criminal
exhaustion requirement with out a processes and prison administrative
procedural default component is quite grievance systems normally include time
toothless. To “protect the integrity of the bars; without the backstop of a procedural
federal exhaustion rule, [federal habeas default rule, an aggrieved prisoner could
courts] ask not only whether a prisoner has evade § 1997e(a)’s exhaustion requirement
exhausted his state remedies, but also by simply letting the time to present his
whether he has properly exhausted those grievance expire, and a habeas petitioner
remedies, i.e., whether he has fairly could likewise evade 28 U.S.C. §
presented his claims to the state courts.” 2254(b)’s exhaustion requirement by not
O’Sullivan v. Boerckel, 526 U.S. 838, 848 timely appealing within the state court
(1999) (quotation marks and citations system. There are many other points at
omitted) (emphasis in original). which an aggrieved prisoner or a habeas
petitioner could similarly deprive the
[A] habeas petitioner who has
prison grievance system or state court

10
system, respectively, of the opportunity to
fairly consider his claim.
The analogy is far from perfect, have been commenced [before the State
though. For one thing, the Supreme Court authority].” In Oscar Mayer & Co. v.
has consistently located the procedural Evans, 441 U.S. 750 (1979), the Supreme
default component of federal habeas law in Court concluded that this provision
the “independent and adequate state (which is parallel to § 706(c) of Title
ground” doctrine, see, e.g., Lee v. Kemna, VII, see Oscar Mayer, 441 U.S. at 755-
534 U.S. 362, 375 (2002); Coleman, 501 56) makes “resort to administrative
U.S. at 729, a doctrine that, in the habeas remedies in deferral States by individual
context at least, “is grounded in concerns claimants . . . mandatory, not optional.”
of comity and federalism,” id. at 730; see Id. at 758. In substance, then, section
also Edwards v. Carpenter, 529 U.S. 446, 14(b) implies a sort of exhaustion
453 (2000); Lambrix v. Singletary, 520 requirement, because aggrieved parties in
U.S. 518, 523 (1997). It is at least possible deferral states must at least commence
that the comity-and-federalism rationale the available state administrative
(and hence the “independent and adequate proceedings. The Oscar Mayer Court
state ground” rule) applies with greater went on, however, to also hold that
force to defaults in state judicial section 14(b) does not authorize the
proceedings than it does to defaults in state denial of federal relief in the face of a
administrative proceedings. Another state procedural default. 441 U.S. at
problem with uncritically importing 758-65. Thus, section 14(b) does not bar
principles from federal habeas doctrine a suit by an ADEA plaintiff in a deferral
into this context is that in other federal state who does not avail himself of the
statutory schemes—most prominently, available state administrative process, or
employment discrimination claims under only seeks to invoke that process after a
the Age Discrimination in Employment state time limit for doing so has expired.
Act (ADEA)—the Supreme Court has not In short, the Court explained, “state
interpreted an exhaustion-like requirement procedural defaults cannot foreclose
to imply a procedural default component. 8 federal relief.” Id. at 762. Thus, the
ADEA has an exhaustion requirement
but no procedural default component.
8
Section 14(b) of the ADEA, 29 But like the federal habeas corpus
U.S.C. § 633(b), provides that, in states analogy, the Oscar Mayer analogy is
that have a “State authority” authorized imperfect. Oscar Mayer emphasizes that
to enforce state laws against age relief before a state agency is based on
discrimination (known as “deferral state law, and “independent [of] federal
states”), an ADEA private plaintiff may relief.” 441 U.S. at 761. Thus, ADEA
not bring a federal lawsuit “before the relief operates substantively in parallel
expiration of sixty days after proceedings with state relief, even though section

11
 objectives will be served by interpreting §
1997e(a)’s exhaustion requirement to
The competing analogies of federal
include a procedural default component.
habeas corpus and federal civil rights law
Based on our earlier discussion of the
are developed in greater detail in the
PLRA’s legislative history, see supra Part
majority and dissenting opinions in the
III.B, Congress seems to have had three
Court of Appeals for the Sixth Circuit’s
interrelated objectives relevant to our
opinion on the same exhaustion question
inquiry here: (1) to return control of the
we consider here. See Thomas, 337 F.3d
inmate grievance process to prison
720 (Moore, J.); id. at 737 (Rosen, J.,
administra tors; (2) to encou rage
dissenting in part and concurring in the
development of an administrative record,
judgment). Suffice it to say that we find
and perhaps settlements, within the inmate
neither position entirely satisfactory. But
grievance process; and (3) to reduce the
the foregoing discussion at least suggests
burden on the federal courts by erecting
that an exhaustion rule can (though need
barriers to frivolous prisoner lawsuits.
not) be fairly read to include a procedural
Each of these goals is better served by
default component. Therefore, the best
interpreting § 1997e(a)’s exhaustion
course, we think, is to examine Congress’s
language to include a procedural default
policy objectives in enacting § 1997e(a),
component than by interpreting it merely
and to evaluate whether those are better
to require termination of all administrative
served by a procedural default rule, or the
grievance proceedings.
absence of one.
All three goals are obviously served by
We believe that Congress’s policy
a procedural default rule because such a
rule prevents an end-run around the
exhaustion requirement, and thereby
14(b) encourages that, procedurally, they creates an overwhelming incentive for a
be pursued consecutively. In contrast, § prisoner to pursue his claims to the fullest
1997e(a) is addressed only to “[§ 1983 within the administrative grievance
and] any other Federal law.” While system. There are subtler benefits too: A
relief is to be pursued consecutively procedural default rule enhances the
under § 1997e(a) (first in the prison integrity of prison administration because
grievance system, and then in federal it ensures prisoner compliance with the
court), the substantive rights are specific requirements of the grievance
exclusively federal in character. If the system. A procedural default rule ensures
PLRA charged state prison authorities that an administrative record will be
with remedying only state law, we might developed in the best fashion (i.e., under a
find the parallel to the ADEA more grievance system designed to create just
persuasive; but in the PLRA regime state such a record), and that the possibility of
prison authorities are called upon to settlement will be explored within a
remedy violations of federal law.

12
framework where prison administrators identify a specific person does not
will be receptive to settlement. Finally, prevent a later suit against that
Congress wanted to erect any barrier it person. Brown v. Sikes, 212 F.3d
could to suits by prisoners in federal court, 1205, 1208 (11th Cir. 2000).
and a procedural default rule surely Presumably the sixth circuit
reduces caseloads (even though it may be likewise would require legal claims
a blunt instrument for doing so). to be identified, while the eleventh
would not. Yet both of these
2. Measuring Procedural Default
decisions skip over a vital question:
Having concluded that, as a matter of what body of law governs the
statutory construction, § 1997e(a) includes specificity inquiry?
a procedural default component, we must
Id.
identify the source of the rules that a
prisoner must follow to avoid procedurally We agree that this is a critical question:
defaulting his claim. Judge Easterbrook Is procedural default under § 1997e(a)
has aptly referred to this question as “the governed by express federal law, federal
choice of law issue.” Strong v. David, 297 common law, or by the “law” of the state
F.3d 646, 649 (7th Cir. 2002). He prison grievance system (as stated in this
elaborates: case in the Grievance System Policy)? By
“federal common law” we refer to some
Very few courts have addressed
putative set of rules, or at least general
what things an administrative
standards, for assessing whether a
grievance must contain, and none
grievance was timely, included a
has attended to the choice-of-law
sufficiently detailed factual account,
issue. Courts—and presumably
requested appropriate relief, etc. At all
litigants too—have assumed that
events, we agree with Judge Easterbrook’s
the general objectives that inspired
conclusion that prison grievance
§ 1997e(a) also determine how a
procedures supply the yardstick for
prisoner must go about exhausting
measuring procedural default. Accord
state remedies. The sixth circuit,
Pozo, 286 F.3d at 1025. This result is
for example, demands that the
more in harmony with Congressional
administrative grievance name each
policy than creating ad hoc federal
person who ultimately becomes a
common law, and it is also fairer to
defendant. Curry v. Scott, 249 F.3d
inmates.
493, 504-05 (6th Cir. 2001). In
contrast, the eleventh circuit To begin with, there simply is no
requires only that a prisoner include express federal law describing the
in a grievance all the information procedural requirements with which
the prisoner reasonably can be prisoners must comply in satisfying §
expected to know; failing to 1997e(a)’s exhaustion requirement. See

13
Strong, 297 F.3d at 649. As between into their grievance systems.
crafting judge-made law on this subject
We also believe that, from a notice and
and looking to state prison grievance
due process point of view, it is fairer to
procedures, the latter will far better serve
hold inmates to a single, consistent set of
the policy interests of the PLRA. We have
procedural rules in pursuing their
repeatedly noted above that the legislative
grievances. If we were to create our own
history is clear that the PLRA was
common law on the subject, we would in
intended to return control of prisons to
effect be asking prisoners to both comply
wardens; one aspect of this was a
with prison grievance procedures (to
comprehensive program of returning
ensure that the prison will hear their
control of the grievance process.
grievances), while keeping an eye on a
Mandatory exhaustion (with a procedural
separate set of federal requirements (to
default component) ensures that inmate
ensure that they will preserve a remedy in
grievances will be addressed first within
federal court if it comes to it). The better
the prison’s own system— in this respect,
approach is to have federal courts
the PLRA is thus appropriately
recognize prisoners’ procedural defaults
defederalizing. Moreover, Congress
within the applicable prison grievance
repealed the portions of CRIPA that
system.10
established federal standards-setting and
certification for prison grievance systems.
It would be anomalous, to say the least, to 10
To be sure, we have previously
refuse to give effect to the very rules that
suggested that in enacting the PLRA,
the PLRA encourages state prison
“Congress intended to save courts from
authorities to enact.9 Indeed, the
spending countless hours, educating
unintended result of making federal
themselves in every case, as to the
common law on this subject might even be
vagaries of prison administrative
that prisons would acquiesce in that
processes, state or federal.” Nyhuis, 204
federal common law by incorporating it
F.3d at 74. This arose, however, in a
discussion of the reasons that § 1997e(a)
does not include a futility exception
9
Simply because the rules are (which would require federal courts to
procedural does not somehow lessen the make predictive inquiries about what
importance to the prison authority of grievances might or might not be futile).
having federal courts honor them. Cf. We are comfortable that evaluating a
Coleman, 501 U.S. at 730 (explaining procedural default in the course of an
that when a federal habeas court ignores existing and fully developed grievance
a state procedural ground for rejecting a will be an order of magnitude less
federal claim, “the habeas court ignores complex and less fact-intensive than
the State’s legitimate reasons for holding ascertaining whether a prisoner’s
the prisoner”). undeveloped grievance would be futile.

14
 Finally, we note that just as procedural available.
default in the federal habeas corpus
We turn, then, to the procedural default
context must be predicated on an adequate
component. Unlike federal habeas corpus
(and independent) state ground, see Ford
procedural default inquiries under 28
v. Georgia, 498 U.S. 411, 423-24 (1991),
U.S.C. § 2254(b) and Coleman, where the
so too must a prison grievance system’s
federal court typically will have the benefit
procedural requirements not be imposed in
of a state-court ruling on whether a
a way that offends the Federal Constitution
petitioner has procedurally defaulted his
or the federal policy embodied in §
federal claim under state procedural law, a
1997e(a). We made the same observation
court reviewing a prisoner’s § 1983 claim
(albeit in somewhat different terms) in
for compliance with § 1997e(a) will have,
Nyhuis, 204 F.3d at 77-78, where we
at best, a ruling from a prison grievance
explained that the policy of § 1997e(a) is
appellate body on whether the prisoner
that “compliance with the administrative
complied with the prison grievance
remedy scheme will be satisfactory if it is
system’s procedural rules.11 At worst, the
substantial.” As the next Part makes clear,
state administrative body will not have
though, we have no occasion in this case to
passed at all on the prisoner’s procedural
further elaborate on this aspect of
compliance vel non, and the federal court
§1997e(a).
must undertake an independent procedural
D. Exhaustion of Spruill’s Claims default inquiry. This is what we must do
here, for no ruling from the prison
The first “exhaustion” question is
administrators addresses the procedural
whether Spruill has exhausted his
implications of Spruill’s failure to
administrative remedies in the literal
specifically ask for money damages or his
sense—whether further avenues of relief
failure to name Brown in his grievances.
are available to him within the prison’s
inmate grievance process. None are. DC- Because this exercise is essentially a
ADM-804 Part VI provides for three matter of statutory construction—it turns
stages of review within Pennsylvania’s
Grievance System: Initial Review (DC-
ADM -804 Part VI.B), which addresses the 11
Aside from our comments above
inmate’s filed grievance; the first appeal
about the need for administrative
from the Initial Review, known as Appeal
grievance systems to comport with the
to Facility Manager (DC-ADM-804 Part
Federal Constitution and the federal
VI.C); and a second and final appeal, the
policy of § 1997e(a) to be given effect,
Appeal to Secretary’s Office of Inmate
we express no view as to whether, or
Grievances and Appeals (DC-ADM-804
under what standard, any such state
Part VI.D). Spruill’s grievances went
administrative determinations of
through all stages and were denied. He
procedural default would be reviewable
has no further administrative process
by a federal court.

15
on the interpretation of the Grievance the claim. The text of the
System Policy— it is a question of law over grievance shall be leg ible,
which we have plenary review. See Stokes presented in a courteous manner,
v. Dist. Attorney, 247 F.3d 539, 540-41 (3d and the statement of facts shall
Cir. 2001). It is therefore appropriate for not exceed tw o (2) pages. The
this Court to undertake the inquiry in the inmate should identify any persons
first instance. See Hudson United Bank v. who may have information that
LiTenda Mortgage Corp., 142 F.3d 151, could be helpful in resolving the
159 (3d Cir. 1998) (“When a district court grievance. The inmate should also
has failed to reach a question below that include information on attempts to
becomes critical when reviewed on appeal, resolve the matter informally. The
an appellate court may sometimes resolve inmate may also specifically state
the issue on appeal rather than remand to any claims he/she wishes to make
the district court. This procedure is conc ernin g v i o l a ti o n s o f
generally appropriate when the factual Department directives, regulations,
record is developed and the issues provide court orders, or other law. The
purely legal questions, upon which an inmate may include a request for
appellate court exercises plenary review.” compensation or other legal relief
(citations omitted)). normally available from a court.
1. Spruill’s Failure to Ask for Money DC-ADM 804, Part VI.A.1.d (emphasis in
Damages original).
We have reproduced in full the texts of The verbs in this paragraph establish
Spruill’s three grievances. See supra notes three tiers of grievance components: items
3, 4 & 6. None requests money that are mandatory (“shall”); items that are
damages—or any other specific relief for required to the extent practicable
that matter. As noted above, the (“should”); and items that are optional
defendants assert that Spruill cannot now (“may”). A request for money damages
in federal court seek money damages. As falls in the third category. Since an
we concluded in the discussion above, we optional procedural provision cannot give
must look to the rules governing the rise to a procedural default, it appears that
prison’s grievance system to ascertain Spruill is not now precluded from seeking
whether Spruill has procedurally defaulted money damages.
his claim for monetary relief. The portion
There is, however, a possible
of the Grievance System Policy that details
alternative reading: The sentence at issue
what “shall,” “should,” and “may” be
may be addressed not to the written
included in a grievance reads:
contents of a grievance, but rather to the
The inmate shall include a scope of relief available within the
statement of the facts relevant to grievance system. This is not an

16
unreasonable matter for a prison grievance reads, “If the inmate desires compensation
system policy to address; indeed, it was the or other legal relief normally available
absence of a mechanism to recover from a court, the inmate shall request the
monetary relief—in a prior version of the relief with specificity in his/her initial
very grievance system here at issue—that grievance.”
generated the controversy in Booth, 532
In sum, Spruill cannot be said to have
U.S. 731 (holding that the unavailability of
failed to follow the regulations—and thus
monetary relief through a prison grievance
procedurally defaulted— in this respect.
system does not excuse a prisoner seeking
Nothing in the Grievance System Policy
only money damages from the PLRA’s
would have put Spruill on notice that he
exhaustion requirement). See also id. at
had to ask for money damages—or any
734 & n.1 (noting that Pennsylvania’s
particular form of relief at all. Therefore
grievance system did not provide for
we conclude that he has satisfied §
recovery of money damages at the time of
1997e(a), and we cannot affirm the District
Booth’s grievance, but that it had since
Court’s dismissal on this failure-to-exhaust
been modified to permit such recovery).
ground.
Interpreting the provision above as
establishing the scope of available 2. Spruill’s Failure to Name Brown in
relief—and implicitly requiring that the His Grievances
p r i s o n er i d e n ti f y t h e r e l ie f h e
The passage quoted above regarding
seeks— would lead to the conclusion that
the contents of the grievance is also the
Spruill did procedurally default his claim
only section of the Grievance System
for monetary relief.
Policy requiring that the grievance identify
We reject this scope-of-available-relief specific persons. On this matter, the text is
reading for several reasons. First, mandatory, or nearly so: “The inmate shall
grammatically the regulation reads “may include a statement of the facts relevant to
include a request for” and not “may the claim. . . . The inmate should identify
request.” Second, the sentence appears as any persons who may have information
part of a regulation directing the contents that could be helpful in resolving the
of the written grievance, not one that grievance. The inmate should also include
otherwise sets the scope of permissible information on attempts to resolve the
relief. Third, the form itself on which matter informally.” DC-ADM 804, Part
grievances are filed does not include any VI.A.1.d. To the extent that Brown’s
prompt for stating the relief sought. identity is a “fact[] relevant to the
Furthermore, the regulation does not read claim”—and it is—it was mandatory for
like a regulation that could give rise to a Spruill to include it. To the extent that
procedural default for failure to plead Brown was a “person[] who may have
properly for relief. The regulation quoted information” or someone with whom
above is far cry from, say, a regulation that Spruill made “attempts to resolve the

17
matter informally”— and he was—Spruill insulting treatment by Brown— there
was required to identify Brown if would be no constitutional violation there
practicable. Spruill did not, and has anyway. Rather, the grievances and the
offered no explanation for his failure to do suit are about a larger-scale denial of
so. Any grievance against Brown would adequate medical care, in which prison
now be time-barred. See DC-ADM 804, officials clearly knew Brown was alleged
Part VI.A.1.e (“Grievances must be to be implicated. Thus we reject the
submitted by the inmate . . . within fifteen District Court’s dismissal of Spruill’s suit
(15) working days after the events on against Brown on these grounds.
which the claims are based.”). Thus
***
Spruill has procedurally defaulted a claim
against Brown by failing to identify him. In closing this Part, we stress that
under § 1997e(a), the warden is
But the prison’s grievance process
responsible for the grievance system. If
excused this procedural default: The
the warden (or whoever the appropriate
grievance officer’s “Initial Review
state official may be) is dissatisfied with
Response” (the first-level determination
the procedural default rulings in this Part,
under the Grievance System Policy)
he or she may alter the grievance system to
identified Brown by name. Although the
require more (or less) of inmates by way of
response identified Brown only as
exhaustion. Such measures, we reiterate,
someone who had seen Spruill in the
must be consistent with the Federal
course of his medical visits, it is not to be
Constitution and the federal policy
expected that a response rejecting Spruill’s
embodied in § 1997e(a) to be enforced as
grievances on the merits would identify
grounds for procedural default in a
any malfeasance on Brown’s part. The
subsequent federal lawsuit. As we
purpose of the regulation here is to put the
observed in Nyhuis, 204 F.3d at 77, “if in
prison officials on notice of the persons
the long run, something of a cooperative
claimed to be guilty of wrongdoing. As
ethos can be achieved between inmate and
such, the prison can excuse an inmate’s
jailer, the internal administrative process
failure to do so by identifying the
could prove a less hostile and adversarial
unidentified persons and acknowledging
forum than that of federal court.” We are
that they were fairly within the compass of
likewise hopeful that our holdings today
the prisoner’s grievance.
on procedural default and waiver will not
The point is close, but we conclude that engender a prison grievance review culture
the prison grievance officer’s recognition marked by technicalities, but will instead
that Brown was involved in the events that foster the cooperative resolution of
Spruill complained of excused any legitim ate gr ie va nce s by f u r th er
procedural defects in Spruill’s initial encouraging prisoners to avail themselves
grievances. Spruill’s grievances and suit of the forum usually best suited to redress
are not about specific instances of those grievances.

18
III. Spruill’s Eighth Amendment Claims doctor is “intentionally inflicting pain on
[a] prisoner[].” 897 F.2d at 109. In
Because there is no exhaustion or
MCCII, we identified several other
procedural default bar to Spruill’s suit, we
scenarios that satisfy Estelle. Most
turn to the merits of his Constitutional
relevant to this case are (1) “[w]here
claims. We have on several occasions
prison authorities deny reasonable requests
discussed the conditions under which
for medical treatment . . . and such denial
deprivation of medical treatment violates
exposes the inmate ‘to undue suffering or
a prisoner’s Eighth Amendment right not
the threat of tangible residual injury,’”
to be subjected to cruel and unusual
MCCII, 834 F.2d at 346 (quoting Westlake
punishment. “Only ‘unnecessary and
v. Lucas, 537 F.2d 857, 860 (6th Cir.
wanton infliction of pain’ or ‘deliberate
1976)), and (2) “where ‘knowledge of the
indifference to the serious medical needs’
need for medical care [is accompanied by
of prisoners are sufficiently egregious to
the] . . . intentional refusal to provide that
rise to the level of a constitutional
care,’” id. (quoting Ancata v. Prison
violation.” White v. Napoleon, 897 F.2d
Health Servs., 769 F.2d 700, 704 (11th
103, 108-09 (3d Cir. 1990) (quoting
Cir. 1985)) (alterations in original).
Estelle v. Gamble, 429 U.S. 97, 103 (1976)
(quoting Gregg v. Georgia, 428 U.S. 153 The Estelle standard “‘requires
(1976))). Allegations of medical deliberate indifference on the part of the
malpractice are not sufficient to establish prison officials and it requires the
a Constitutional violation. See id. (citing prisoner’s medical needs to be serious.’”
Estelle, 429 U.S. at 106); Monmouth Id. (quoting West v. Keve, 571 F.2d 158,
County Correctional Institutional Inmates 161 (3d Cir. 1978)). Spruill’s complaint
v. Lanzaro, 834 F.2d 326, 346 (3d Cir. satisfies the second prong. First, his back
1987) (MCCII) (citing Estelle, 429 U.S. at condition itself has allegedly required
106 & n.14; Gittlemacker v. Prasse, 428 significant and continuous medication, and
F.2d 1, 6 (3d Cir. 1970)); see also Daniels has caused him excruciating pain. Second,
v. Williams, 474 U.S. 327, 332-34 (holding within the brief period described in his
that negligence is not compensable as a complaint, Spruill claims to have fallen or
Constitutional deprivation). “[M ]ere collapsed from the pain twice (first on
disagreement as to the proper medical May 4, and again on May 9), exposing
treatment” is also insufficient. MCCII, himself to further injury. The extreme
834 F.2d at 346 (citing Bowring v. pain and real possibility of permanent
Godwin, 551 F.2d 44, 48 (4th Cir. 1977); injury could qualify Spruill’s condition as
Massey v. Hutto, 545 F.2d 45, 46 (8th Cir. a serious medical need. Naturally, this
1976) (per curiam)). will need to be fleshed out with further
evidence (e.g., expert medical testimony),
As we explained in White, the Estelle
but at the motion-to-dismiss stage, the
“deliberate indifference to serious medical
complaint is certainly adequate in this
needs” standard is clearly met when a

19
respect. The closer question is whether experts (Dr. McGlaughlin and Brown in
Spruill has alleged facts supporting the this case), a non-medical prison official
inference that Gooler, Dr. McGlaughlin, will generally be justified in believing that
and Brown were deliberately indifferent the prisoner is in capable hands. This
(or intentionally malicious) with respect to follows naturally from the division of
his condition. For reasons that will labor within a prison. Inmate health and
become apparent, we treat Gooler first, safety is prom ote d by div iding
and then Dr. McGlaughlin and Brown responsibility for various aspects of inmate
together. life amo ng g uards, administrators,
physicians, and so on. Holding a non-
A. Claims Against Gooler
medical prison official liable in a case
Durmer v. O’Carroll, 991 F.2d 64 (3d where a prisoner was under a physician’s
Cir. 1993), resembles the case at bar in care would strain this division of labor.
that the plaintiff-prisoner (Durmer) sued Moreover, under such a regime, non-
both medical and non-medical prison medical officials could even have a
officials. With respect to the non-medical perverse incentive not to delegate
prison officials, Barker and Fauver, we treatment responsibility to the very
explained: physicians most likely to be able to help
prisoners, for fear of vicarious liability.
[W]e believe that summary
judgment was proper with respect Accordingly, we conclude that, absent
to defendants Barker and Fauver. a reason to believe (or actual knowledge)
The only allegation against either that prison doctors or their assistants are
of these two defendants was that mistreating (or not treating) a prisoner, a
they failed to respond to letters non-medical prison official like Gooler
Durmer sent to them explaining his will not be chargeable with the Eighth
predicament. Neither of these Amendment scienter requirement of
d e f e n d a n t s , how ever, i s a deliberate indifference. Thus dismissal of
physician, and neither can be Spruill’s claims against Gooler after the
considered deliberately indifferent point at which Spruill was first under
simply because they failed to medical care is appropriate because Spruill
respond directly to the medical bears the burden of proving (and hence
complaints of a prisoner who was pleading) facts supporting the defendants’
already being treated by the prison mental states, see Singletary v. Pa. Dep’t
doctor. of Corr., 266 F.3d 186, 192 n.2 (3d Cir.
2001), and he has failed to so plead with
Id. at 69 (footnote omitted). Although
respect to Gooler. 12
Durmer was decided at the summary
judgment stage, its holding can be readily
imported into the motion-to-dismiss stage: 12
We do not find our admonition in
If a prisoner is under the care of medical
Alston v. Parker, 363 F.3d 229, 233-34

20
 With respect to Spruill’s claims against treatment . . . expos[ing] the inmate to
Gooler in the period before he was under undue suffering” or “knowledge of the
medical care— i.e., from his May 2 arrival need for medical care” coupled with an
at SCI-Coal, through his fall and face “intentional refusal to provide that care.”
injury on May 4, to Dr. McGlaughlin’s 834 F.2d at 346 (quotation marks and
first visit to his cell on May 5—we also citations omitted). Therefore, Spruill has
conclude that Spruill has not stated a claim not stated a claim against Gooler and we
against Gooler. First, Spruill did sign up will affirm the judgment of the District
for sick call on May 3, and he was seen by Court dismissing the suit against Gooler.
an (unidentified) nurse on May 4; hence he
B. Claims Against Dr. McGlaughlin and
was receiving a minimal measure of
Brown
medical attention. Second, Spruill does
not allege that his condition was so dire Though Spruill’s allegations about Dr.
and obvious that Gooler’s failure to McGlaughlin’s and Brown’s course of
summon immediate medical attention on treatment (or nontreatment) pale next to
May 4 (and to instead let the sick call the allegations in such cases as White, 897
process run its course) amounted to F.2d 103, Spruill’s complaint nonetheless
deliberate indifference. The facts as sufficiently attributes a mental state of
Spruill himself describes them simply do deliberate indifference (or worse) to both
not amount to the MCCII examples of Dr. McGlaughlin and Brown. Especially
“deny[ing] reasonable requests for medical when read in light of Alston, 363 F.3d at
233-34 & n.6, several excerpts from
Spruill’s complaint suffice to make the
point: Spruill asserts that due to Dr.
& n.6 (3d Cir. 2004), applicable to this
McGlaughlin’s and Brown’s “lack of
specific point. In Alston, we reaffirmed
proper medical care, the plaintiff was
that pro se complaints (especially from
subjected to the possible risks of a
civil rights plaintiffs) should be read
permanent disability or an fatal or serious
liberally, and noted that prisoners in
injury.” We have held that “the threat of
particular are often at an informational
tangible residual injury” can establish
disadvantage that may prevent them from
deliberate indifference. MCCII, 834 F.2d
pleading the full factual predicate for
at 346 (quoting Westlake, 537 F.2d at
their claims. Id. Spruill’s complaint is
860). Spruill further claims that Dr.
lacking not because it fails to allege
M cG laugh lin and B row n acte d
specific facts to support Gooler’s mental
“maliciously and sadistically,” and that
state (which, at all events, would be
those actions were “intended to inflict pain
unnecessary under our notice pleading
on the plaintiff without any medical
standard, see id.), but rather because it
justification.” If proven, intentional
does not so much as suggest that Gooler
conduct of this sort plainly makes out an
was aware of the alleged inadequacies in
Eighth Amendment violation. And finally,
Spruill’s medical treatment.

21
according to Spruill, Brown and Dr. Amendment rights. We will therefore
McGlaughlin refused to examine him on reverse the judgment of the District Court,
multiple occasions and Dr. McGlaughlin and remand for further proceedings, with
instead accused him of “playing games”; respect to Dr. McGlaughlin and Brown.
when Dr. M cGlaughlin ultimately did
examine him, he twisted Spruill’s legs “as
if he was trying to shape a pretzel,” and
Spruill “repeatedly told Defendant
McGlaughlin that the examination was
causing additional pain to his back and
leg.”
In sum, Spruill has connected his
factual allegations to the alleged mental
states of Dr. McGlaughlin and Brown.
That he believes their actions were not
only deliberately indifferent, but malicious
and sadistic, reinforces the sufficiency of
his complaint. Since at this stage we are
making no judgment about what actually
happened, but only about the sufficiency
of the pleadings, we must take Spruill’s
factual allegations, and the reasonable
inferences therefrom, as true. We will
therefore reverse the District Court’s
dismissal of Spruill’s suit against Dr.
McGlaughlin and Brown.

IV. Conclusion
The judgment of the District Court
with respect to Gooler will be affirmed on
the ground that Spruill has failed to state a
claim upon which relief can be granted for
a violation of his Eighth Amendment
rights by Gooler. With respect to Dr.
McGlaughlin and Brown, we hold that
Spruill has met the exhaustion requirement
of § 1997e(a), and that he has stated a
claim for violation of his Eighth

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