California Civil Jury Instructions (CACI)

3012. Violation of Prisoner's Federal Civil Rights (42 U.S.C. § 1983) - Eighth Amendment—Medical Care

[Name of plaintiff] claims that [name of defendant] provided [him/ her] with inadequate medical care in violation of [his/her] constitutional rights. To establish this claim, [name of plaintiff] must prove all of the following:

1. That [name of defendant] acted with deliberate indifference to a serious medical need of [name of plaintiff];

2. That [name of defendant] was acting or purporting to act in the performance of [his/her] official duties;

3. That [name of plaintiff] was harmed; and

4. That [name of defendant]'s deliberate indifference was a substantial factor in causing [name of plaintiff]'s harm.

A serious medical need exists if the failure to treat a prisoner's condition could result in further significant injury or the unnecessary and pointless infliction of pain.

To establish "deliberate indifference," [name of plaintiff] must prove that [name of defendant] knew [name of plaintiff] faced a substantial risk of serious harm and that [he/she] disregarded that risk by failing to take reasonable measures to correct it. Negligence is not enough to establish deliberate indifference.

Directions for Use

The "official duties" referred to in element 2 must be duties created pursuant to any state, county, or municipal law, ordinance, or regulation. This aspect of color of law most likely will not be an issue for the jury, so it has been omitted to shorten the wording of element 2.

De minimis harm is insufficient to satisfy the third element. (Hudson v. McMillian (1992) 503 U.S. 1, 10-11 [112 S.Ct. 995, 117 L.Ed.2d 156], internal citations omitted.) If there is conflicting evidence on the issue of harm, the court may need to instruct the jury on the severity of the harm that must be proved.

Sources and Authority

42 U.S.C. section 1983 provides, in part: "Every person who, under color of any statute, ordinance, regulation, custom, or usage, of any State . . . subjects, or causes to be subjected, any citizen of the United States or other person within the jurisdiction thereof to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws, shall be liable to the party injured in an action at law . . .."

"Section 1983 claims may be brought in either state or federal court." (Pitts v. County of Kern (1998) 17 Cal.4th 340, 348 [70 Cal.Rptr.2d 823, 949 P.2d 920].)

"[D]eliberate indifference to serious medical needs of prisoners constitutes the 'unnecessary and wanton infliction of pain,' proscribed by the Eighth Amendment. This is true whether the indifference is manifested by prison doctors in their response to the prisoner's needs or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with the treatment once prescribed. Regardless of how evidenced, deliberate indifference to a prisoner's serious illness or injury states a cause of action under section 1983." (Estelle v. Gamble (1976) 429 U.S. 97, 104-105 [97 S.Ct. 285, 50 L.Ed.2d 251], internal citation and footnotes omitted.)

"Our cases have held that a prison official violates the Eighth Amendment only when two requirements are met. First, the deprivation alleged must be, objectively, 'sufficiently serious.' For a claim . . . based on a failure to prevent harm, the inmate must show that he is incarcerated under conditions posing a substantial risk of serious harm. The second requirement follows from the principle that 'only the unnecessary and wanton infliction of pain implicates the Eighth Amendment.' To violate the Cruel and Unusual Punishments Clause, a prison official must have a 'sufficiently culpable state of mind.' In prison-conditions cases that state of mind is one of 'deliberate indifference' to inmate health or safety . . .." (Farmer v. Brennan (1994) 511 U.S. 825, 834 [114 S.Ct. 1970, 128 L.Ed.2d 811], internal citations omitted.)

"We hold . . . that a prison official cannot be found liable under the Eighth Amendment for denying an inmate humane conditions of confinement unless the official 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 he must also draw the inference." (Farmer, supra, 511 U.S. at p. 837.)

"Prison officials are deliberately indifferent to a prisoner's serious medical needs when they 'deny, delay or intentionally interfere with medical treatment.' . . ." (Wood v. Housewright (9th Cir. 1990) 900 F.2d 1332, 1334, internal citation omitted.)

"[A]llegations that a prison official has ignored the instructions of a prisoner's treating physician are sufficient to state a claim for deliberate indifference." (Wakefield v. Thompson (9th Cir. 1999) 177 F.3d 1160, 1165.)

"[A] complaint that a physician has been negligent in diagnosing or treating a medical condition does not state a valid claim of medical mistreatment under the Eighth Amendment. Medical malpractice does not become a constitutional violation merely because the victim is a prisoner. In order to state a cognizable claim, a prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs." (Estelle, supra, 429 U.S. at p. 106.)

"While poor medical treatment will at a certain point rise to the level of constitutional violation, mere malpractice, or even gross negligence, does not suffice. Although Wood's treatment was not as prompt or efficient as a free citizen might hope to receive, Wood was given medical care at the prison that addressed his needs." (Wood, supra, 900 F.2d at p. 1334.)

"It has been recognized . . . that inadequate medical treatment may, in some instances, constitute a violation of 42 United States Code section 1983. In Sturts v. City of Philadelphia, for example, the plaintiff alleged that defendants acted 'carelessly, recklessly and negligently' when they failed to remove sutures from his eye, neck and face. The court concluded that although plaintiff was alleging inadequate medical treatment, he had stated a cause of action under section 1983: '. . . where a prisoner has received some medical attention and the dispute is over the adequacy of the treatment, federal courts are generally reluctant to second guess medical judgments. In some cases, however, the medical attention rendered may be so woefully inadequate as to amount to no treatment at all, thereby rising to the level of a § 1983 claim. . . .' " (Ochoa v. Superior Court (1985) 39 Cal.3d 159, 176- 177 [216 Cal.Rptr. 661, 703 P.2d 1], internal citations omitted.)

"Because society does not expect that prisoners will have unqualified access to health care, deliberate indifference to medical needs amounts to an Eighth Amendment violation only if those needs are 'serious.' " (Hudson, supra, 503 U.S. at p. 9, internal citation omitted.)

"A 'serious' medical need exists if the failure to treat a prisoner's condition could result in further significant injury or the 'unnecessary and wanton infliction of pain.' The 'routine discomfort' that results from incarceration and which is 'part of the penalty that criminal offenders pay for their offenses against society' does not constitute a 'serious' medical need." (Doty v. County of Lassen (9th Cir. 1994) 37 F.3d 540, 546, internal citations and footnote omitted.)

"The Supreme Court has interpreted the phrase 'under "color" of law' to mean 'under "pretense" of law.' A police officer's actions are under pretense of law only if they are 'in some way "related to the performance of his official duties.' " By contrast, an officer who is ' "pursuing his own goals and is not in any way subject to control by [his public employer],' " does not act under color of law, unless he 'purports or pretends' to do so. Officers who engage in confrontations for personal reasons unrelated to law enforcement, and do not 'purport[] or pretend[]' to be officers, do not act under color of law." (Huffman v. County of Los Angeles (9th Cir. 1998) 147 F.3d 1054, 1058, internal citations omitted.)

Secondary Sources

3 Civil Rights Actions, Ch. 11, Deprivation of Rights Under Color of State Law—Prisons, ¶ 11.09 (Matthew Bender)

11 California Forms of Pleading and Practice, Ch. 114, Civil Rights: Prisoners' Rights, § 114.15 (Matthew Bender)

3 California Points and Authorities, Ch. 35, Civil Rights (Matthew Bender)

(New September 2003)