Case: 20-11257 Document: 00515928784 Page: 1 Date Filed: 07/07/2021
United States Court of Appeals
for the Fifth Circuit United States Court of Appeals
Fifth Circuit
FILED
July 7, 2021
No. 20-11257
Lyle W. Cayce
Clerk
Justin Schrader,
Plaintiff—Appellant,
versus
Julie Ruggles,
Defendant—Appellee.
Appeal from the United States District Court
for the Northern District of Texas
USDC No. 4:20-CV-160
Before King, Dennis, and Ho, Circuit Judges.
Per Curiam:*
Justin Schrader arrived at the Erath County Jail with a broken ankle.
After he was released, he sued various jail administrators and medical staff,
as well as Erath County, alleging deliberate indifference for their failure to
adequately treat his injury. The district court granted the defendants’
motion for summary judgment and dismissed Schrader’s suit. Schrader
*
Pursuant to 5th Circuit Rule 47.5, the court has determined that this
opinion should not be published and is not precedent except under the limited
circumstances set forth in 5th Circuit Rule 47.5.4.
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No. 20-11257
appeals the district court’s grant of summary judgment for only one
defendant—a nurse named Julie Ruggles. Because Schrader fails to establish
a sufficiently serious deprivation, we affirm.
I.
Justin Schrader was pulled over for street racing and evading arrest.
After the officer who initiated the stop handcuffed Schrader, he performed a
leg sweep, causing Schrader to fall to the ground and break his ankle.
Schrader then was taken to a hospital, where he was seen immediately and
treated. The doctor that treated him gave him a splint, advised him to keep
his left ankle elevated and not to put any weight on it, gave him some crutches
to use, instructed him to ice his ankle for twenty minutes every two hours for
the next forty-eight hours, and prescribed “Tramadol 100mg every 6 [hours]
as needed for pain.” At the hospital, he was given a dose of Tramadol, which
is an opioid-based painkiller. The doctor provided all this information to the
officer accompanying Schrader in the form of an Inmate Clearance Report,
which cleared Schrader for incarceration. In addition, the officer was
provided with an After Visit Summary, which included instructions for care
and instructed that “Tylenol, [A]dvil, or [T]ramadol” be used “as needed
for pain.”
After his hospital visit, Schrader was taken to Erath County Jail where
he was booked at 2:10 a.m. on January 30, 2018. At the jail, he was put in a
holding cell, where he was housed, by himself, for two days. He was given
ice for his ankle, although he does not recall how frequently. He was not
allowed to use crutches in the holding cell. The jail staff explained to him
that this was because the cell was small enough that he did not need to move
far and also because the floor was slick, creating a risk that he could slip and
exacerbate his injuries. Instead, multiple jail employees stated that Schrader
was given a walker with a seat on it. In an affidavit submitted after those
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employees’ depositions, Schrader contends that he was never provided a
walker. Additionally, jail employees recalled that he used a wheelchair at
some point. Schrader does not remember whether he used a wheelchair or
not.
On each of the two days he was in the holding cell—January 30th and
31st—Schrader was given two doses of Tramadol: one in the morning and
one in the evening.
The jail had a medical staff. Appellee Julie Ruggles was a nurse who
worked at the jail about thirty hours a week. Ruggles was supervised by
Laurie Srubar, the jail’s nurse practitioner and primary care provider. While
Ruggles was in charge of dispensing medication, she had no authority to
prescribe medications—that was Srubar’s job.
Records indicate that Ruggles worked from 7:30 a.m. to 1:15 p.m. on
January 30th, which means she started her shift a few hours after Schrader
was booked. Ruggles never examined or spoke with Schrader on January 30th
and did not work on the 31st.
On February 1st, two days after he arrived at the jail, Schrader was
moved to a medical cell. He was given crutches to walk there, but they were
taken away once he got to his cell. In that cell, he recalls being given
Tramadol “one or two more times,” as well as ice for his ankle (though he
does not remember how often). There was also an intercom that he could
use without having to walk. He says that the jailers answered the intercom
the majority of the time.
Ruggles worked from 8:00 a.m. to 1:30 p.m. on February 1st. At some
point on that day, Srubar made the decision to switch Schrader from
Tramadol to ibuprofen. Because Tramadol was no longer approved for
Schrader, neither Ruggles nor any of the other nurses that treated him were
allowed to dispense Tramadol. So when he asked for Tramadol, he did not
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receive it. He recalls asking for pain medication four or five times a day and
that he received ibuprofen as a result. He does not remember how many
times he received it.
Also on that day, Ruggles attempted to examine Schrader. She says
that it was her understanding that he refused to come to the medical unit.
One of the other medical staff recalled asking Schrader “Are you sure you
don’t want to see the nurse?” to which he replied, “She’s not going to give
me the [T]ramadol anyway, so no.” Schrader contends that he did not refuse
to come to the medical unit. During his entire time in jail, he never asked to
go to the emergency room, see a doctor or a nurse, and did not file any
grievances.
The next day, February 2nd, Schrader was taken to a doctor’s
appointment, where a specialist told him that he needed surgery. He was
given crutches to move to and from this visit. Surgery was then scheduled
for February 9th. Jail administrators contacted the county judge and
petitioned for Schrader to be released on a personal recognizance bond so
that he could recuperate from surgery at home rather than at jail. The county
judge granted that request, and on February 8th Schrader was released. His
surgery went as scheduled and he experienced no complications.
Schrader then sued Erath County, various jail personnel and medical
staff, including Ruggles, alleging deliberate indifference under 42 U.S.C.
§ 1983. After discovery, the district court granted the defendants’ motion
for summary judgment. Schrader appeals only his claim against Ruggles.
II.
“We review a district court’s grant of summary judgment de novo,
applying the same standards as the district court.” Hagen v. Aetna Ins. Co.,
808 F.3d 1022, 1026 (5th Cir. 2015). “As a pretrial detainee contesting the
conditions of [his] confinement, [Schrader]’s § 1983 claim invokes the
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protections of the Fourteenth Amendment. The standard is the same as that
for a prisoner under the Eighth Amendment.” Cadena v. El Paso Cnty., 946
F.3d 717, 727 (5th Cir. 2020) (citations omitted).
Deliberate indifference has two elements. “First, the deprivation
alleged must be, objectively, sufficiently serious,” such that the official’s
actions “result[ed] in the denial of the minimal civilized measure of life’s
necessities.” Farmer v. Brennan, 511 U.S. 825, 834 (1994) (cleaned up).
Second, the “prison official must have a ‘sufficiently culpable state of
mind,’” i.e., she must act with “deliberate indifference” to inmate health
and safety. Id. (quoting Wilson v. Seiter, 501 U.S. 294, 297 (1991)). A prison
official acts with the requisite mental state when she “knows of and
disregards an excessive risk to inmate health or safety; the official must both
be aware of facts from which the inference could be drawn that a substantial
risk of serious harm exists, and [s]he must also draw the inference.” Id. at
837.
“Deliberate indifference is an extremely high standard to meet,”
Domino v. Texas Dep’t of Crim. Just., 239 F.3d 752, 756 (5th Cir. 2001), and
upon a thorough review of the record, we agree with the district court that
Schrader has failed to meet that standard here.
Schrader argues that Ruggles was deliberately indifferent to a serious
risk of harm because she “did literally nothing to assess him, assist him, care
for him, monitor him or even ensure that [the emergency room doctor’s]
instructions were followed.”
Schrader fails to establish a sufficiently serious deprivation. He does
not dispute that he was given ice, pain medication, his own cell, an intercom
to communicate with jail staff, and crutches to use when he moved cells and
when he traveled to his appointment. That Ruggles did not personally
provide this care—because she worked only five half-days out of the ten days
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that Schrader was incarcerated—does not somehow establish that Ruggles’s
“actions result[ed] in the denial of ‘the minimal civilized measure of life’s
necessities.’” Farmer, 511 U.S. at 834 (quoting Rhodes v. Chapman, 452 U.S.
337, 347 (1981)). And while Schrader might disagree with Srubar’s decision
to switch him from Tramadol to ibuprofen, that decision was entirely
consistent with the doctor’s instructions to take Tramadol “as needed.”
That Schrader disagrees with how much of that opioid-based drug was
needed does not establish a sufficiently serious deprivation—especially since
he was given ibuprofen as a substitute. See Gobert v. Caldwell, 463 F.3d 339,
346 (5th Cir. 2006) (holding that “a prisoner’s disagreement with his medical
treatment, absent exceptional circumstances” does not constitute deliberate
indifference). More importantly, Ruggles had no power to override her
supervisor’s decision.
Nor does Schrader explain how the fact that Ruggles did not evaluate
him on January 30th—just hours after he was treated by a doctor and cleared
for incarceration—caused him substantial harm. See Easter v. Powell, 467
F.3d 459, 463 (5th Cir. 2006) (“The mere delay of medical care can also
constitute an Eighth Amendment violation but only ‘if there has been
deliberate indifference [that] results in substantial harm.’”) (alteration in
original) (quoting Mendoza v. Lynaugh, 989 F.2d 191, 195 (5th Cir. 1993)).
Schrader saw a specialist on February 2nd and had surgery the next week,
which by all accounts went well.
Finally, Schrader does not put forth any evidence that Ruggles was
subjectively aware of a substantial risk of serious harm. Even if he did not
refuse to be seen by Ruggles on February 1st, Schrader does not dispute that
a jail administrator told Ruggles that Schrader did not want to be seen. Nor
does Schrader provide any evidence that Ruggles was aware of any
deficiencies in his care.
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Accordingly, we affirm the judgment of the district court.
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