If you are a federal practitioner, the headline will prompt a double-take. For the rest of you, know this: Iqbal is a Supreme Court decision that makes it easier to dismiss lawsuits that do not allege plausible claims. And inmates rarely win their cases.
The case is Dotson v. Fischer, a summary order decided on June 2. Dotson said he was denied adequate medical treatment in state prison and retaliated against for complaining about it. He says that, in violation of the Eighth Amendment, prison medical authorities denied an urgent recommendation that he receive surgery to remove a cyst in his ear, prolonging his severe symptoms. One doctor did a lousy job with the surgery, and a jail official put Dotson in keeplock in retaliation for his grievances over the medical treatment. The district court dismissed the case. The Court of Appeals brings it back.
Iqbal requires detailed and plausible allegations against defendants. The Second Circuit (Parker, Sack and Carney) says the complaint "plausibly alleges a serious medical need. Dotson alleges that a CAT scan revealed a cyst in his left ear, and that Nurse Practitioner Jennifer Wrest recommended surgery and requested an “urgent” level of attention. Over the year following that 'urgent' recommendation, while the recommended surgery was delayed, Dotson complained on numerous occasions of 'vertigo, blinding headaches, extreme pain in his left ear, and increased hearing loss.' When the cyst was finally removed, one year later, it was of 'significant size.'" These allegations are enough to show plaintiff was in "extreme pain."
The complaint also establishes that the defendants acted with deliberate indifference to plaintiff's medical needs. "Dotson asserts that Drs. Dinisio and Koenigsmann reviewed Wrest’s evaluation and recommendation that his condition demanded 'urgent' care and rejected it, apparently without causing him to be examined again in person or taking any further step. ... Allegations of delayed medical care may support a finding of deliberate indifference to a serious medical need, and allegations that delayed treatment resulted in serious harm may bear on the reasonableness of an inference of a defendant’s knowledge of the risks to which he or she subjected the plaintiff. We believe Dotson’s allegations suffice at this early stage of the litigation."
Plaintiff also gets back his First Amendment claim. "Although Dotson’s pleadings on this matter are not a model of clarity, they suggest sufficient temporal proximity between Dotson’s complaints of inadequate medical care and Sticht’s decision placing Dotson in keeplock to support Dotson’s retaliation claim at this pleading stage."