Tenerelli v. United States of America

Background

Anthony Joseph Tenerelli was housed at the Federal Medical Center in Rochester and was treated by Dr. Lon Krieg. Tenerelli had complained for years about neck and back pain, numbness, tingling, and a chronic cough. From May 2015 through January 2016, he reported worsening chest and back pain, weakness, numbness, difficulty walking, and urinary problems. He was diagnosed with multiple myeloma in February 2016 after testing revealed a severe compression fracture of the T3 vertebra and a tumor.

Tenerelli brought two claims: one against the United States under the Federal Tort Claims Act and one against Krieg under the Eighth Amendment. The order concerns only Krieg’s motion for summary judgment on the Eighth Amendment claim. The parties did not dispute that Krieg was not liable under the Federal Tort Claims Act.

Legal standards

The court applied the summary-judgment standard, under which judgment is entered when the evidence shows no genuine dispute about a fact that could affect the outcome and the moving party is entitled to judgment as a matter of law.

Tenerelli’s claim against Krieg was brought under Bivens, a doctrine allowing certain constitutional claims against federal employees. The court also considered qualified immunity, which generally protects a government official unless the evidence shows both a constitutional violation and a violation of a clearly established right.

For an Eighth Amendment medical-care claim, a prisoner must show an objectively serious medical need and that the official actually knew about and deliberately disregarded a substantial risk of harm. Deliberate indifference requires more than negligence or gross negligence; it requires a mental state similar to criminal recklessness. A disagreement about medical judgment or the preferred course of treatment is generally not enough.

Court’s analysis

The court stated that Krieg did not dispute that Tenerelli had a serious medical need. The dispute concerned whether Krieg deliberately disregarded that need. Tenerelli argued that Krieg should have ordered an MRI, a computed tomography scan, or a neurology consultation sooner. Tenerelli did not appear to dispute that Krieg lacked actual knowledge, before the diagnosis, that Tenerelli had multiple myeloma.

The court rejected the claim. It found that Krieg and other medical providers made multiple efforts to identify the source of Tenerelli’s pain, including ordering imaging, laboratory testing, and specialist consultations. Providers considered and treated several possible causes, including reflux disease, costochondritis, esophagitis, degenerative back problems, and polymyalgia rheumatica. The court also noted that some treatments relieved Tenerelli’s pain and that Krieg followed recommendations from Mayo Clinic specialists.

The court further concluded that Krieg’s failure to act more quickly after Tenerelli reported tingling, numbness, and weakness did not establish deliberate indifference. Those symptoms were not entirely new, and providers sometimes found that objective observations did not match Tenerelli’s reported symptoms. In the court’s view, the evidence did not show conduct approaching criminal recklessness. The court therefore concluded that Tenerelli could not establish an Eighth Amendment violation and that Krieg was entitled to qualified immunity.

Disposition

The court granted Krieg’s motion for summary judgment, dismissed the claim against Krieg with prejudice, and dismissed Krieg from the suit. The order does not state a disposition of Tenerelli’s separate claim against the United States under the Federal Tort Claims Act.