Turner v. United States of America and NAPHCARE Inc.

Background

Wilbert Kitson Andrew Turner, who was representing himself, was a pretrial detainee at the Metropolitan Correctional Center. He had been diagnosed with gastro-esophageal reflux disease and systemic sclerosis, also called scleroderma. Before detention, he received Prevacid, a prescription proton pump inhibitor used to treat acid-reflux symptoms. At the facility, Dr. Robert Beaudouin prescribed Prilosec, the generic drug omeprazole, for the same condition. The record stated that both medications are proton pump inhibitors and perform the same function without a notable distinction, and that Prevacid was unavailable because of medication-formulary restrictions.

Turner had also received Ensure as a nutritional supplement intended to prevent long-term weight loss associated with malnutrition from scleroderma. Facility medical staff temporarily stopped providing Ensure during two periods between February 22 and April 10, 2020, because Turner did not comply with pill-line rules. As of April 14, he was receiving Ensure again, although it could be stopped temporarily if he continued not to follow those rules.

Legal standard

Turner sought a preliminary injunction, an interim court order intended to prevent harm while a case continues. The court explained that such relief generally requires proof of likely irreparable harm and either a likely chance of success on the underlying claim or serious questions that warrant litigation with the balance of hardships strongly favoring the person seeking relief.

Because Turner was a pretrial detainee, the court considered his medical-care claim under the Due Process Clause of the Fourteenth Amendment. The court liberally interpreted his filing as alleging deliberate indifference to serious medical needs. That claim requires showing, objectively, that the medical deprivation was sufficiently serious and, subjectively, that officials knew or should have known that failing to provide the treatment would create a substantial health risk.

Court’s analysis

The court held that Turner had not shown a likelihood of success on a deliberate-indifference claim based on replacing Prevacid with Prilosec. It relied on the record’s statement that the two drugs are both proton pump inhibitors that treat acid-reflux disease without a notable distinction. It also concluded that the substitution was caused by a medication-formulary restriction beyond the federal defendants’ control.

The court separately considered the Ensure issue. Although Ensure was being provided when the order was issued and could be temporarily stopped again for rule violations, the court stated that neither the possible future stoppage nor the prior temporary stoppage established a sufficiently serious medical need. Dr. Beaudouin’s declaration stated that stopping Ensure for a few weeks did not create a serious health risk because the supplement was intended to prevent long-term weight loss. The court also noted that Turner had not alleged sufficiently serious medical harm from the temporary deprivation.

Ruling

The court denied Turner’s motion for a preliminary injunction. It separately ordered the federal defendants, by April 27, 2020, to email if possible and mail Turner a copy of the order and file proof of service, or file a letter explaining why they could not do so so that the court could make other arrangements.