[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FILED
FOR THE ELEVENTH CIRCUIT U.S. COURT OF APPEALS
________________________ ELEVENTH CIRCUIT
MARCH 6, 2008
THOMAS K. KAHN
No. 07-13936
CLERK
Non-Argument Calendar
________________________
D. C. Docket No. 06-00018-CV-JTC-3
TONY WEBB,
Plaintiff-Appellant,
versus
TERRY LANGLY,
DAVID JORDAN,
CARROLL COUNTY, GA,
Defendants,
WALTER SMITH, M.D.,
GEORGIA CORRECTIONAL HEALTH, L.L.C.,
Defendants-Appellees.
________________________
Appeal from the United States District Court
for the Northern District of Georgia
_________________________
(March 6, 2008)
Before CARNES, BARKETT, and HILL, Circuit Judges.
PER CURIAM:
Plaintiff, during the time period relevant to this action an inmate in the
Carroll County jail, brought this action under 42 U.S.C. § 1983 against various
defendants alleging a deprivation of his constitutional right to be free from cruel
and unusual punishment under the Eighth Amendment. Plaintiff alleges that the
various defendants did not afford him the proper medical care for a broken nose he
suffered during an attack by another inmate. The district court granted summary
judgment for all defendants. We review this decision de novo. Cockrell v. Sparks,
510 F. 3d 1307, 1310-11 (11 th Cir. 2007).
While incarcerated at the Carroll County Jail, plaintiff was attacked by
another inmate. Plaintiff was taken to the jail’s medical department and treated by
a physician’s assistant. The physician’s assistant sutured plaintiff’s lip and
referred him to the emergency room, noting that plaintiff had a swollen left eye and
a displaced nose. Plaintiff was transported to the emergency room where he was
treated by an emergency medicine physician. The emergency room physician
suspected that plaintiff had a left orbital fracture and ordered an x-ray of that area
of the face. The emergency room physician did not diagnose plaintiff with a nasal
fracture. After consulting with an ophthalmologist, the emergency room doctor
gave plaintiff antibiotics, Tylenol for pain, instructed him to use a cool compress
2
and not to blow his nose and discharged him to the jail.
Plaintiff received follow-up care from a specialist at the Carrollton Eye
Clinic for the orbital fracture. This doctor referred plaintiff to a facial cosmetic
surgeon who specializes in repairs to the eye area.
One week later, plaintiff requested additional medical treatment from a
particular doctor who had previously performed nasal surgery on him. That same
day, the physician’s assistant at the jail wrote an order for a consultation with this
doctor. Shortly thereafter, defendants scheduled an appointment with the doctor,
who examined plaintiff and referred him to another doctor for a possible
rhinoplasty on his nose. Subsequently, plaintiff was diagnosed with a nasal
fracture and underwent corrective surgery.
Plaintiff’s claim is that the various prison officials and medical personnel
failed to provide him with adequate care for his broken nose by virtue of the fact
that he was not afforded the requisite surgery on the nose until well after the
optimum two-to-three week period after the fracture occurred. The district court
concluded that this claim did not satisfy the threshold requirement under Section
1983 for a “serious medical need” because, during the two-to-three week period
following the attack, no doctor had diagnosed plaintiff’s nose as requiring surgery
and a lay person would not easily recognize the necessity for the surgery. A
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serious medical need is “one that has been diagnosed by a physician as mandating
treatment or one that is so obvious that even a lay person would easily recognize
the necessity for a doctor’s attention.” Farrow v. West, 320 F.3d 1235, 1243 (11 th
Cir. 2003). Moreover, the district court concluded, plaintiff’s fractured nose did
not pose a substantial risk of serious harm to him if left unattended.
Furthermore, the district court held that even if the delay in the requisite
surgery posed a serious medical need, no defendant acted with the requisite
deliberate indifference to establish a constitutional violation. Farmer v. Brennan,
511 U.S. 825, 837 (1994). Plaintiff failed to establish that any defendant had
actual knowledge of a risk of serious harm to plaintiff during the time period
before he was diagnosed with the nasal fracture. The jail defendants certainly did
not have such knowledge, and the district court held that the medical defendants
were all tending to plaintiff’s more serious injury – the orbital fracture.1 In the
absence of such knowledge, it cannot be said that the defendants deliberately
disregarded plaintiff’s need for nasal surgery.
Our review of the record in this case and the district court’s careful analysis
of plaintiff’s claim in the context of the treatment that he received demonstrate that
there is no error in the district court’s conclusion that no constitutional violation
1
The district court dismissed plaintiff’s claims against the county for failure to show any
official policy or custom that led to the injury or the failure to treat it.
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occurred in this case.2
Accordingly, the judgments of the district court are due to be AFFIRMED.
2
We note only that there is a difference between medical malpractice and a constitutional
injury.
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