Spruill v. Gillis

Opinions of the United 2004 Decisions States Court of Appeals for the Third Circuit

6-18-2004

Spruill v. Gillis Precedential or Non-Precedential: Precedential

Docket No. 02-2659 Follow this and additional works at: http://digitalcommons.law.villanova.edu/thirdcircuit_2004

Recommended Citation "Spruill v. Gillis" (2004). 2004 Decisions. Paper 547. http://digitalcommons.law.villanova.edu/thirdcircuit_2004/547

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PRECEDENTIAL MICHAEL A. FARNAN (Argued) Department of Corrections UNITED STATES COURT OF Office of Chief Counsel APPEALS P.O. Box 598 FOR THE THIRD CIRCUIT Camp Hill, PA 17011

Attorney for Appellees Gillis and Goolier No. 02-2659 ALAN S. GOLD (Argued) Sean Robins ROBERT SPRUILL, Gold, Butkovitz & Robins 7837 Old York Road Appellant Elkins Park, PA 19027

v. Attorney for Appellees McGlaughlin and Brown FRANK GILLIS; GOOLIER, C.O.; MCGLAUGHLIN, M.D.; BROWN, P.A. ______________________

_________________ OPINION ______________________ On Appeal From The United States District Court For The Middle District Of Pennsylvania BECKER, Circuit Judge. (D.C. No. 3:01-CV-1625) This appeal raises important questions District Judge: Honorable Thomas I. of construction of the Prison Litigation Vanaskie, Chief Judge Reform Act of 1995 (PLRA), Pub. L. No. _________________ 104-134, 110 Stat. 1321 at 66 (1996). Plaintiff Robert Spruill is an inmate in the Argued January 13, 2004 custody of the Pennsylvania Department of Corrections. Spruill filed a civil rights Before: ALITO, CHERTOFF, and complaint under 42 U.S.C. § 1983 against BECKER Circuit Judges. four defendants at the State Correctional I n s t i t u t io n a t C o a l T o w n s h i p , (Filed: June 18, 2004) Pennsylvania: two prison officials (Frank Gillis and Stephen Gooler1 ); a prison ERIC R. SONNENSCHEIN (Argued) doctor (Dr. Shawn McGlaughlin); and a Covington & Burling 1201 Pennsylvania Avenue, N.W. Washington, DC 20004 1 Spruill in his complaint spells the name “Goolier,” but we will use the Attorney for Appellant correct spelling, “Gooler.”

prison physician’s assistant (Brian Brown). exhaustion requirement, and we have not In his complaint, Spruill alleges that, as a had occasion to pass on whether the result of the deliberate indifference of the exhaustion requirement is merely a defendants, his serious back condition was termination requirement or also includes a left untreated, or was inadequately treated, procedural default component—that is, resulting in excruciating pain and whether a prisoner may bring a § 1983 suit susceptibility to other injuries. Pursuant to so long as no grievance process remains Pennsylvania’s Inmate Grievance System open to him, or whether a prisoner must Policy (the “Grievance System Policy”), properly (i.e., on pain of procedural Spruill filed a series of three inmate default) exhaust administrative remedies grievances, and he ultimately received as a prerequisite to a suit in federal court. some measure of medical care. In his This case requires us to confront that issue, grievances, Spruill did not seek money and we hold that § 1997e(a) includes a damages, but in the instant suit under 42 procedural default component. We further U.S.C. § 1983, he does seek money hold that the determination whether a damages for the alleged violation of his prisoner has “properly” exhausted a claim rights under the Eighth Amendment to the (for procedural default purposes) is made United States Constitution. by evaluating the prisoner’s compliance with the prison’s a dm inistrativ e 42 U.S.C. § 1997e(a), enacted as part regulations governing inmate grievances, of the PLRA, provides that a prisoner may and the waiver, if any, of such regulations not bring a § 1983 suit with respect to by prison officials. prison cond itions “u ntil such administrative remedies as are available Applying this framework to Spruill’s are exhausted.” Because Spruill had failed grievances under the Grievance System to seek money damages in his grievances, Policy, we hold that (1) Spruill was not the District Court concluded that he had required to seek money damages in his failed to meet the exhaustion requirement grievances, and therefore has not of § 1997e(a), and therefore dismissed procedurally defaulted his claim for money Spruill’s suit in its entirety. The District damages; (2) Spruill was required to name Court also held in the alternative that Brown in his grievances, but that the Spruill’s failure to name Brown in his officials handling Spruill’s grievances grievances constituted a failure to exhaust waived his default on this requirement; his claims against Brown. Spruill appeals a n d ( 3 ) S p r u il l e x h au s t e d t h e the dismissal of his claims against Gooler, administrative remedies under the Dr. McGlaughlin, and Brown. He does Grievance System Policy. not appeal the dismissal of his suit against Finally, turning to the merits-based Gillis. arguments that the defendants advance as Courts have only recently begun to alternate grounds for affirmance of the define the contours of the PLRA’s District Court, we conclude that Spruill

does not state a claim for deliberate Bureau of Prisons, 355 F.3d 1204, 1212 indifference against Gooler, but that his (10th Cir. 2003) (quoting GFF Corp. v. allegations against Dr. McGlaughlin and Associated Wholesale Grocers, Inc., 130 Brown are sufficient to withstand a motion F.3d 1381, 1384 (10th Cir. 1997) (noting to dismiss. We will therefore affirm in that “a defendant may submit an part, reverse in part, and remand for indisputably authentic [document] to the f u r t h e r p r o c e e d in g s a g a in s t D r. court to be considered on a motion to McGlaughlin and Brown. dismiss”)). We now chronicle the facts as set forth in Spruill’s complaint. A. Spruill’s Complaint I. Facts and Procedural History Spruill is currently incarcerated at the As this case comes to us on the District State Correctional Institution at Chester, Court’s grant of a motion to dismiss, we Pennsylvania (“SCI-Chester”), but he has must accept as true the facts as pled in been housed in at least two other facilities. Spruill’s complaint. E.g., Bd. of Trs. of His complaint alleges that, shortly after he Teamsters Local 863 Pension Fund v. was transferred to the State Correctional Foodtown, Inc., 296 F.3d 164, 168 (3d Cir. Institution at Coal Township, Pennsylvania 2002). Given that the exhaustion issue (“SCI-Coal”) in May 2001, the defendants turns on the indisputably authentic were deliberately indifferent to his medical documents related to Spruill’s grievances, needs and subjected him to unnecessarily we hold that we may also consider these painful medical treatment. Named as without converting it to a motion for defendants in the complaint are Frank summary judgment.2 See Steele v. Fed. Gillis, the Superintendent at SCI-Coal; Lieutenant Steven Gooler, the Unit 2 Manager of the Restricted Housing Unit Strictly speaking, the motion acted on (RHU) at SCI-Coal, where Spruill was by the District Court should not have housed during the events at issue; Dr. been captioned as a Fed. R. Civ. P. Shawn McGlaughlin, a prison physician; 12(b)(6) motion to dismiss, but rather as and Brian Brown, a physician’s assistant. a Fed. R. Civ. P. 12(c) motion for judgment on the pleadings, because we On May 2, 2001, Spruill was have held that failure to exhaust transferred from the State Correctional administrative remedies under § 1997e(a) Institution at Rockview (SCI-Rockview), is an affirmative defense. See Ray v. Pennsylvania to SCI-Coal, where he was Kertes, 285 F.3d 287, 295 (3d Cir. 2002). housed in the RHU. Upon his arrival, There is no material difference in the Spruill immediately requested to see a applicable legal standards, so for the sake medical staff member about severe pain he of familiarity, we shall use the “motion was experiencing in his lower back area to dismiss” formulation of Fed. R. Civ. and his right leg. “Several hours later,” he P. 12(b).

was interviewed by a nurse. After Spruill described his pain, and stated that he “suffers from a chronic and debilitating well as severe pain up and down lower back disorder, spondylotic spinal the front and back sides of the stenosis with recurrent compression of L3 right leg. It was at that point this and/or L4 nerve root on right,” the nurse writer fell to the floor in a forceful said, “There is nothing I can do, you will manner, hitting the left side of my need to sign up for sick call.” face on the edge of the “metal” Spruill signed up for sick call on May toilet in the cell. This writer did 3, but the next morning, he fell due to a as well also jammed and/or severe pain in his leg and back, striking the injured his right thumb in the left side of his face on the metal toilet in same fall. This writer has reason his cell. Spruill believes he was knocked to believe that he may have passed unconscious and also injured his right out due to the forceful blow he thumb. That same day, May 4, he received to the left side of his face informed the nurse of his fall, his when he fell. This writer has additional injuries, and continuous back made repeated request, prior, to pain; the nurse said that she would inform see the doctor, only to be told that the doctor. Spruill also informed Gooler the doctor does not visit the RHU. about his fall, to which Gooler responded, To date, and even in light of this “so, what do you want me to do?” Spruill writer’s sick call request and most filed an official inmate grievance on May recent fall incident, this writer has 4 complaining about the fall and new yet to be examined by this injury. Gooler did not notify health care institution’s doctor and/or RHU providers once he was informed of security staff. This writer also Spruill’s injuries; at that point, Spruill had informed RHU Lt. Goolier, about yet to be examined by a medical doctor. 3 the aforementioned fall. His reply was: so, what do you want me to do. The writer finds Lt. Goolier 3 The grievance filed by Spruill dated said remarks to be highly May 4, 2001, reads as follows: unprofessional. He is required to notify medical respecting this On the above stated date at writer’s fall and blow to the head. approx. 5:35 a.m., this writer What must I do, die, before I can attempted to get up out of the bed. get medical attention? I took perhaps approximately 3 to 4 short steps, wherein, at that In response to the prompt on the juncture, this writer received grievance form to “[l]ist actions taken and/or experienced an extremely and staff you have contacted, before sharp pain in the lower back & as submitting this grievance,” Spruill wrote:

On May 5, Dr. McGlaughlin came to Spruill was seen by the physician’s Spruill’s cell regarding the sick call assistant, Brown, on May 7. At that request. Dr. McGlaughlin refused to encounter, Brown accused Spruill of examine Spruill and stated that Spruill faking his injuries and did not examine would never go to the infirmary. Spruill him. On May 9, Spruill complained to the filed a second grievance on May 6 nurse that the pain medication he was complaining that McGlaughlin had failed prescribed for his back5 “wasn’t working,” to conduct a physical examination of him.4 and later that morning Spruill experienced another “extremely sharp pain” in his

Submitted sick call request(s) about back pain, spoke to the the continued severe pain I am nurse(s) about my back pain and having. More pointedly, the seeing the doctor—they said that aforementioned doctor never once it was nothing they could do, and conducted a physical examination that the doctor will not come to in which to determine the full the RHU to see me. I spoke to Lt. extent of my pre-existing back Goolier about my situation, he condition or the injuries I demonstrated no “care” or sustained relative to my fall on 5- concern regarding my health 4-2001. In addition, said doctor’s and/or well being. visit to the RHU with me lasted approximately 30 seconds maybe 4 The grievance filed by Spruill dated less. To date, I am still May 6, 2001, reads as follows: experiencing a considerable amount of pain. This writer avers the following: I was seen on 5-5-2001, by a In response to the prompt on the member of the medical staff grievance form to “[l]ist actions taken whom identified himself as the and staff you have contacted, before institutional medical “doctor.” I submitting this grievance,” Spruill wrote: explained to the doctor that I suffer from a “chronic back Spoke to nurses and RHU staff disorder” and currently experience members who stated there’s severe pain around my lower back nothing they can do. I will need & right leg. And that I had fallen to submit a grievance. in the cell the day prior, “hitting 5 my face on the metal toilet & also It is not clear from Spruill’s hurting my right hand in said fall. complaint whether this medication was Moreover, I advised the doctor prescribed by an SCI-Coal physician, or that my fall was directly related to by a physician from SCI-Rockview, from my not being able to walk—due to which Spruill had just been transferred.

lower back and leg which caused him to On May 14, Dr. McGlaughlin had fall again. Spruill submitted another sick Spru ill brought into the medical call request, and was seen on May 10 by e x a m i n a t io n r o o m , w h e r e D r . Brown in response to that request. Spruill McGlaughlin deliberately bent and twisted told Brown that “the current medication Spruill’s legs “as if he was trying to shape was not working to reduce his pain,” but a pretzel.” Dr. McGlaughlin did not Brown did not take any actions to help examine Spruill’s face or thumb for him. Spruill submitted another sick call injuries sustained on the morning of May request on May 11, following which he 4. was seen by Dr. M cGlaughlin on May 12. The grievances were consolidated and Dr. McGlaughlin stated that he did not denied upon Initial Review, and Spruill believe there was anything wrong with filed administrative appeals. The first Spruill’s back, and accused Spruill of appeal was denied, and Spruill filed a final “playing games.” Spruill filed a third appeal, which was also denied. The stated grievance that day. 6

particular instance, since he has 6 The grievance filed by Spruill dated never conducted any physical May 12, 2001, reads as follows: examination on this writer.

This writer avers that at To date, this writer remains in approximately 8:34 a.m. on the constant sever[e] pain. And Dr. above indicated date, SCI-Coal McGlaughlin’s continued Chief M edical Director Dr. course of treatment that he knows McGlaughlin, came to my cell is painful & ineffective may soon regarding my sick call request. entail a substantial risk of me Dr. McGlaughlin stated to me: seriously harming myself in this that I had been evaluated back in cell “falling.” “February 2001,” by Dr. Osgood, who has said that I am pain-free, In response to the prompt on the and that there’s nothing wrong grievance form to “[l]ist actions taken with my back. and staff you have contacted, before submitting this grievance,” Spruill wrote: In addition: Coal’s Chief Medical Director stated to this writer that Spoke to officer Shay—“Pod this: “brings an end to your little officer” who indicated that it is back playing games.” This writer very little if anything at all he contends that Dr. McGlaughlin’s could do, the matter will need to remarks as stated herein above be addressed by medical or by were highly unprofessional in this way of the grievance system.

reasons behind the denials were that timely notice of appeal from the final order Spruill was, at the time, receiving dismissing the action and we have appropriate medical care. As our jurisdiction under 28 U.S.C. § 1291. We rescription of the grievances demonstrates, exercise plenary review over a district see supra notes 3, 4 & 6, Spruill did not court’s decision to grant a motion to seek monetary relief from the prison, nor dismiss. Broselow v. Fisher, 319 F.3d do the grievances identify Brown by name 605, 607 (3d Cir. 2003). To the extent that or by description. our review turns on the statutory construction of the exhaustion requirement B. Proceedings in the District Court in § 1997e(a), our review is also plenary. Spruill filed the present suit seeking Concepcion v. Morton, 306 F.3d 1347, monetary and injunctive relief. Because 1352 (3d Cir. 2002) (holding that “the Spruill had by then been transferred to scope of § 1997e(a)’s applicability, which SCI-Chester, the District Court held that is a question of law” is subject to plenary his claim for injunctive relief against review); see also Nyhuis v. Reno, 204 F.3d officials at SCI-Coal was moot under 65, 66 (3d Cir. 2000). Abdul-Akbar v. Watson, 4 F.3d 195, 206- The defendants advance several 07 (3d Cir. 1993). The District Court grounds on which to affirm the judgment granted all four defendants’ motions to of the District Court. First, they argue that dismiss on several grounds, holding, inter Spruill’s failure to seek money damages in alia, that (1) Spruill’s failure to seek his grievances precludes him from now money damages in his grievances seeking damages in federal court. Second, constituted a failure to exhaust Brown argues that Spruill’s failure to administrative remedies; (2) because name him in the grievances is a failure to Spru ill received adequate medical exhaust. Third, all defendants argue that treatment, he had stated no claim for a Spruill has not alleged facts sufficient to violation of his Eighth Amendment rights; establish a violation of his Eighth and (3) Spruill had failed to exhaust his Amendment rights.7 We will treat each of claim against Brown because the these arguments in turn. grievances did not name Brown. C. This Appeal II. Exhaustion Under the PLRA Spruill appeals the dismissals of Lt. Gooler, Dr. McGlaughlin, and Brown, but does not appeal the dismissal of 7 Gooler captions this issue as a Superintendent Gillis. The District Court qualified immunity defense, which it is had jurisdiction over this action pursuant not. The substance of his argument is to 28 U.S.C. § 1331 and § 1343, as a suit that Spruill’s complaint does not arising under a federal law securing civil establish that Gooler acted with a mental rights, 42 U.S.C. § 1983. Spruill filed a state of deliberate indifference.

A. The CRIPA discretionary continuance provision with a mandatory dismissal provision: In 1980, Congress enacted the Civil Rights of Institutionalized Persons Act No action shall be brought with (CRIPA), Pub. L. No. 96-247, 94 Stat. 349 respect to prison conditions under (1980). CRIPA § 7 (originally codified at section 1979 of the Revised 42 U.S.C. § 1997e) took several steps to Statutes of the United States (42 foster the development of administrative U.S.C. 1983), or any other Federal grievance systems in prisons: First, it law, by a prisoner confined in any directed the Attorney General to jail, prison, or other correctional promulgate, after consultation with others, facility until such administrative “minimum standards for the development remedies as are available are of a plain, speedy, and effective system for exhausted. the resolution of [inmate] grievances.” PLRA § 803(d) (codified at 42 U.S.C. § CRIPA § 7(b)(1). Second, it directed the 1997e(a) and amending CRIPA § 7(a)). Attorney General to set up a certification As the Supreme Court explained in Nussle: program for inmate grievance systems. CRIPA § 7(c). Third, it gave District [This] exhaustion provision differs Courts discretion to continue (i.e. stay) § markedly from its predecessor. 1983 cases brought by prisoners “in order Once within the discretion of the to require exhaustion of such plain, district court, exhaustion in cases speedy, and effective administrative covered by § 1997e(a) is now remedies as are available.” CRIPA § 7(a). mandatory. All “available” The Supreme Court “described this remedies must now be exhausted; provision as a ‘limited exhaustion those remedies need not meet requirement.’” Porter v. Nussle, 534 U.S. federal standards, nor must they be 516, 523-24 (2002) (quoting McCarthy v. “plain, speedy, and effective.” Madigan, 503 U.S. 140, 150-51 (1992)); Even when the prisoner seeks relief see also Concepcion, 306 F.3d at 1352. not a va ila ble in grievance proceedings, n o ta b ly m oney B. The PLRA damages, exhaustion is a This regime of discretionary prerequisite to suit. And unlike the continuance to exhaust administrative prev ious prov ision, w hich remedies lasted until the 1996 enactment encompassed only § 1983 suits, of the Prison Litigation Reform Act of exhaustion is now required for all 1995, Pub. L. No. 104-134, 110 Stat. 1321 “action [s] . . . brought with respect at 66 (1996). Section 803(d) of the PLRA to prison conditions,” whether amended CRIPA § 7 to, inter alia, remove under § 1983 or “any other Federal the standards-setting and certification roles law.” of the Attorney General, and replace the 534 U.S. at 524 (citing Booth v. Churner,

532 U.S. 731, 739-41 & n.5). interpreting § 1997e(a)’s exhaustion requirement. Several courts have recounted the legislative history of the PLRA, and we C. Exhaustion and Procedural Default need not do so once again. See, e.g., We have previously addressed the Johnson v. Daley, 339 F.3d 582, 598-99 applicability of § 1997e(a) to actions by (7th Cir. 2003) (Ripple, J., concurring in prisoners who have filed suit in federal the judgment); Nussle v. Willette, 224 F.3d court before pursuing all avenues of relief 95, 106 (2d Cir. 2000), rev’d sub nom. available to them within their prison’s Porter v. Nussle, 534 U.S. 516 (2002); inmate grievance system. In Nyhuis, 204 Alexander v. Hawk, 159 F.3d 1321, 1324- F.3d 65, we held that an inmate seeking 25 (11th Cir. 1998). The Supreme Court relief that the prison’s administrative summarized the objectives of the grievance system cannot provide (in exhaustion requirement of the PLRA in Nyhuis, it was money damages) must Nussle: nonetheless pursue the grievance process Beyond doubt, Congress enacted § to its end before coming to federal court. 1997e(a) to reduce the quantity and We concluded that the PLRA “make[s] improve the quality of prisoner exhaustion of all administrative remedies suits; to this purpose, Congress mandatory.” Id. at 67 (emphasis added). afforded corrections officials time The question we now consider is whether and opportunity to address “all administrative re medies” are com plaints internally before exhausted whenever there is no further allowing the initiation of a federal process available to the inmate within the case. In some instances, corrective grievance system (which would happen if, action taken in response to an say, an inmate fails to file an inmate’s grievance might improve administrative appeal), or whether it is prison administration and satisfy necessary that the inmate reach this the inmate, thereby obviating the endpoint having availed himself of every need for litigation. In other process at every turn (which would require instances, the internal review might all appeals to be timely pursued, etc.). Put “filter out some frivolous claims.” another way, we ask whether the PLRA And for cases ultimately brought to requires simple exhaustion or something court, adjudication could be more— “proper” exhaustion, as it were. facilitated by an administrative To borrow terms from other areas of the record that clarifies the contours of law that recognize an exh austion the controversy. requirement, we consider whether the PLRA’s exhaustion requirement is merely 534 U.S. at 524-25 (quoting and citing a termination requirement, or also includes Booth, 532 U.S. at 737). With this a procedural default component. background to guide us, we turn next to

We recognize that there is an emerging failed to me et the State’s split among the circuits on whether the procedura l requirements for PLRA includes a procedural default presenting his federal claims has component. Compare Ross v. County of deprived the state courts of an Bernalillo, 365 F.3d 1181,1186 (10th Cir. opportunity to address those claims 2004) (“[T]he PLRA, like 28 U.S.C. § in the first instance. A habeas 2254, contains a procedural default petitioner who has defaulted his c o n c e p t w i t h in i t s e x h a u s t i o n federal claims in state court meets requirement.”), and Pozo v. McCaughtry, the technical requirements for 286 F.3d 1022 (7th Cir.) (same), cert. exhaustion; there are no state denied 537 U.S. 949 (2002), with Thomas remedies any longer “available” to v. Woolum, 337 F.3d 720, 723 (6th Cir. him. In the absence of the 2003) (“[W]e hold that so long as an independent and adequate state inmate presents his or her grievance to ground doctrine in federal habeas, prison officials and appeals through the habeas petitioners would be able to available procedures, the inmate has avoid the exhaustion requirement exhausted his or her administrative by defaulting their federal claims in remedies, and a prison’s decision not to state court. address the grievance because it was Coleman v. Thompson, 501 U.S. 722, 732 untimely under prison rules shall not bar (1991) (citing 28 U.S.C. § 2254(b); Engle the federal suit.”). v. Isaac, 456 U.S. 107, 125-26, n.28 1. The Procedural Default Component of (1982)). the PLRA The value of a procedural default rule The Supreme Court has observed in the for enforcing an exhaustion requirement is federal habeas corpus context that an obvious. For example, both state criminal exhaustion requirement with out a processes and prison administrative procedural default component is quite grievance systems normally include time toothless. To “protect the integrity of the bars; without the backstop of a procedural federal exhaustion rule, [federal habeas default rule, an aggrieved prisoner could courts] ask not only whether a prisoner has evade § 1997e(a)’s exhaustion requirement exhausted his state remedies, but also by simply letting the time to present his whether he has properly exhausted those grievance expire, and a habeas petitioner remedies, i.e., whether he has fairly could likewise evade 28 U.S.C. § presented his claims to the state courts.” 2254(b)’s exhaustion requirement by not O’Sullivan v. Boerckel, 526 U.S. 838, 848 timely appealing within the state court (1999) (quotation marks and citations system. There are many other points at omitted) (emphasis in original). which an aggrieved prisoner or a habeas petitioner could similarly deprive the [A] habeas petitioner who has prison grievance system or state court

system, respectively, of the opportunity to fairly consider his claim. The analogy is far from perfect, have been commenced [before the State though. For one thing, the Supreme Court authority].” In Oscar Mayer & Co. v. has consistently located the procedural Evans, 441 U.S. 750 (1979), the Supreme default component of federal habeas law in Court concluded that this provision the “independent and adequate state (which is parallel to § 706(c) of Title ground” doctrine, see, e.g., Lee v. Kemna, VII, see Oscar Mayer, 441 U.S. at 755- 534 U.S. 362, 375 (2002); Coleman, 501 56) makes “resort to administrative U.S. at 729, a doctrine that, in the habeas remedies in deferral States by individual context at least, “is grounded in concerns claimants . . . mandatory, not optional.” of comity and federalism,” id. at 730; see Id. at 758. In substance, then, section also Edwards v. Carpenter, 529 U.S. 446, 14(b) implies a sort of exhaustion 453 (2000); Lambrix v. Singletary, 520 requirement, because aggrieved parties in U.S. 518, 523 (1997). It is at least possible deferral states must at least commence that the comity-and-federalism rationale the available state administrative (and hence the “independent and adequate proceedings. The Oscar Mayer Court state ground” rule) applies with greater went on, however, to also hold that force to defaults in state judicial section 14(b) does not authorize the proceedings than it does to defaults in state denial of federal relief in the face of a administrative proceedings. Another state procedural default. 441 U.S. at problem with uncritically importing 758-65. Thus, section 14(b) does not bar principles from federal habeas doctrine a suit by an ADEA plaintiff in a deferral into this context is that in other federal state who does not avail himself of the statutory schemes—most prominently, available state administrative process, or employment discrimination claims under only seeks to invoke that process after a the Age Discrimination in Employment state time limit for doing so has expired. Act (ADEA)—the Supreme Court has not In short, the Court explained, “state interpreted an exhaustion-like requirement procedural defaults cannot foreclose to imply a procedural default component. 8 federal relief.” Id. at 762. Thus, the ADEA has an exhaustion requirement but no procedural default component. 8 Section 14(b) of the ADEA, 29 But like the federal habeas corpus U.S.C. § 633(b), provides that, in states analogy, the Oscar Mayer analogy is that have a “State authority” authorized imperfect. Oscar Mayer emphasizes that to enforce state laws against age relief before a state agency is based on discrimination (known as “deferral state law, and “independent [of] federal states”), an ADEA private plaintiff may relief.” 441 U.S. at 761. Thus, ADEA not bring a federal lawsuit “before the relief operates substantively in parallel expiration of sixty days after proceedings with state relief, even though section

objectives will be served by interpreting § 1997e(a)’s exhaustion requirement to The competing analogies of federal include a procedural default component. habeas corpus and federal civil rights law Based on our earlier discussion of the are developed in greater detail in the PLRA’s legislative history, see supra Part majority and dissenting opinions in the III.B, Congress seems to have had three Court of Appeals for the Sixth Circuit’s interrelated objectives relevant to our opinion on the same exhaustion question inquiry here: (1) to return control of the we consider here. See Thomas, 337 F.3d inmate grievance process to prison 720 (Moore, J.); id. at 737 (Rosen, J., administra tors; (2) to encou rage dissenting in part and concurring in the development of an administrative record, judgment). Suffice it to say that we find and perhaps settlements, within the inmate neither position entirely satisfactory. But grievance process; and (3) to reduce the the foregoing discussion at least suggests burden on the federal courts by erecting that an exhaustion rule can (though need barriers to frivolous prisoner lawsuits. not) be fairly read to include a procedural Each of these goals is better served by default component. Therefore, the best interpreting § 1997e(a)’s exhaustion course, we think, is to examine Congress’s language to include a procedural default policy objectives in enacting § 1997e(a), component than by interpreting it merely and to evaluate whether those are better to require termination of all administrative served by a procedural default rule, or the grievance proceedings. absence of one. All three goals are obviously served by We believe that Congress’s policy a procedural default rule because such a rule prevents an end-run around the exhaustion requirement, and thereby 14(b) encourages that, procedurally, they creates an overwhelming incentive for a be pursued consecutively. In contrast, § prisoner to pursue his claims to the fullest 1997e(a) is addressed only to “[§ 1983 within the administrative grievance and] any other Federal law.” While system. There are subtler benefits too: A relief is to be pursued consecutively procedural default rule enhances the under § 1997e(a) (first in the prison integrity of prison administration because grievance system, and then in federal it ensures prisoner compliance with the court), the substantive rights are specific requirements of the grievance exclusively federal in character. If the system. A procedural default rule ensures PLRA charged state prison authorities that an administrative record will be with remedying only state law, we might developed in the best fashion (i.e., under a find the parallel to the ADEA more grievance system designed to create just persuasive; but in the PLRA regime state such a record), and that the possibility of prison authorities are called upon to settlement will be explored within a remedy violations of federal law.

framework where prison administrators identify a specific person does not will be receptive to settlement. Finally, prevent a later suit against that Congress wanted to erect any barrier it person. Brown v. Sikes, 212 F.3d could to suits by prisoners in federal court, 1205, 1208 (11th Cir. 2000). and a procedural default rule surely Presumably the sixth circuit reduces caseloads (even though it may be likewise would require legal claims a blunt instrument for doing so). to be identified, while the eleventh would not. Yet both of these 2. Measuring Procedural Default decisions skip over a vital question: Having concluded that, as a matter of what body of law governs the statutory construction, § 1997e(a) includes specificity inquiry? a procedural default component, we must Id. identify the source of the rules that a prisoner must follow to avoid procedurally We agree that this is a critical question: defaulting his claim. Judge Easterbrook Is procedural default under § 1997e(a) has aptly referred to this question as “the governed by express federal law, federal choice of law issue.” Strong v. David, 297 common law, or by the “law” of the state F.3d 646, 649 (7th Cir. 2002). He prison grievance system (as stated in this elaborates: case in the Grievance System Policy)? By “federal common law” we refer to some Very few courts have addressed putative set of rules, or at least general what things an administrative standards, for assessing whether a grievance must contain, and none grievance was timely, included a has attended to the choice-of-law sufficiently detailed factual account, issue. Courts—and presumably requested appropriate relief, etc. At all litigants too—have assumed that events, we agree with Judge Easterbrook’s the general objectives that inspired conclusion that prison grievance § 1997e(a) also determine how a procedures supply the yardstick for prisoner must go about exhausting measuring procedural default. Accord state remedies. The sixth circuit, Pozo, 286 F.3d at 1025. This result is for example, demands that the more in harmony with Congressional administrative grievance name each policy than creating ad hoc federal person who ultimately becomes a common law, and it is also fairer to defendant. Curry v. Scott, 249 F.3d inmates. 493, 504-05 (6th Cir. 2001). In contrast, the eleventh circuit To begin with, there simply is no requires only that a prisoner include express federal law describing the in a grievance all the information procedural requirements with which the prisoner reasonably can be prisoners must comply in satisfying § expected to know; failing to 1997e(a)’s exhaustion requirement. See

Strong, 297 F.3d at 649. As between into their grievance systems. crafting judge-made law on this subject We also believe that, from a notice and and looking to state prison grievance due process point of view, it is fairer to procedures, the latter will far better serve hold inmates to a single, consistent set of the policy interests of the PLRA. We have procedural rules in pursuing their repeatedly noted above that the legislative grievances. If we were to create our own history is clear that the PLRA was common law on the subject, we would in intended to return control of prisons to effect be asking prisoners to both comply wardens; one aspect of this was a with prison grievance procedures (to comprehensive program of returning ensure that the prison will hear their control of the grievance process. grievances), while keeping an eye on a Mandatory exhaustion (with a procedural separate set of federal requirements (to default component) ensures that inmate ensure that they will preserve a remedy in grievances will be addressed first within federal court if it comes to it). The better the prison’s own system— in this respect, approach is to have federal courts the PLRA is thus appropriately recognize prisoners’ procedural defaults defederalizing. Moreover, Congress within the applicable prison grievance repealed the portions of CRIPA that system.10 established federal standards-setting and certification for prison grievance systems. It would be anomalous, to say the least, to 10 To be sure, we have previously refuse to give effect to the very rules that suggested that in enacting the PLRA, the PLRA encourages state prison “Congress intended to save courts from authorities to enact.9 Indeed, the spending countless hours, educating unintended result of making federal themselves in every case, as to the common law on this subject might even be vagaries of prison administrative that prisons would acquiesce in that processes, state or federal.” Nyhuis, 204 federal common law by incorporating it F.3d at 74. This arose, however, in a discussion of the reasons that § 1997e(a) does not include a futility exception 9 Simply because the rules are (which would require federal courts to procedural does not somehow lessen the make predictive inquiries about what importance to the prison authority of grievances might or might not be futile). having federal courts honor them. Cf. We are comfortable that evaluating a Coleman, 501 U.S. at 730 (explaining procedural default in the course of an that when a federal habeas court ignores existing and fully developed grievance a state procedural ground for rejecting a will be an order of magnitude less federal claim, “the habeas court ignores complex and less fact-intensive than the State’s legitimate reasons for holding ascertaining whether a prisoner’s the prisoner”). undeveloped grievance would be futile.

Finally, we note that just as procedural available. default in the federal habeas corpus We turn, then, to the procedural default context must be predicated on an adequate component. Unlike federal habeas corpus (and independent) state ground, see Ford procedural default inquiries under 28 v. Georgia, 498 U.S. 411, 423-24 (1991), U.S.C. § 2254(b) and Coleman, where the so too must a prison grievance system’s federal court typically will have the benefit procedural requirements not be imposed in of a state-court ruling on whether a a way that offends the Federal Constitution petitioner has procedurally defaulted his or the federal policy embodied in § federal claim under state procedural law, a 1997e(a). We made the same observation court reviewing a prisoner’s § 1983 claim (albeit in somewhat different terms) in for compliance with § 1997e(a) will have, Nyhuis, 204 F.3d at 77-78, where we at best, a ruling from a prison grievance explained that the policy of § 1997e(a) is appellate body on whether the prisoner that “compliance with the administrative complied with the prison grievance remedy scheme will be satisfactory if it is system’s procedural rules.11 At worst, the substantial.” As the next Part makes clear, state administrative body will not have though, we have no occasion in this case to passed at all on the prisoner’s procedural further elaborate on this aspect of compliance vel non, and the federal court §1997e(a). must undertake an independent procedural D. Exhaustion of Spruill’s Claims default inquiry. This is what we must do here, for no ruling from the prison The first “exhaustion” question is administrators addresses the procedural whether Spruill has exhausted his implications of Spruill’s failure to administrative remedies in the literal specifically ask for money damages or his sense—whether further avenues of relief failure to name Brown in his grievances. are available to him within the prison’s inmate grievance process. None are. DC- Because this exercise is essentially a ADM-804 Part VI provides for three matter of statutory construction—it turns stages of review within Pennsylvania’s Grievance System: Initial Review (DC- ADM -804 Part VI.B), which addresses the 11 Aside from our comments above inmate’s filed grievance; the first appeal about the need for administrative from the Initial Review, known as Appeal grievance systems to comport with the to Facility Manager (DC-ADM-804 Part Federal Constitution and the federal VI.C); and a second and final appeal, the policy of § 1997e(a) to be given effect, Appeal to Secretary’s Office of Inmate we express no view as to whether, or Grievances and Appeals (DC-ADM-804 under what standard, any such state Part VI.D). Spruill’s grievances went administrative determinations of through all stages and were denied. He procedural default would be reviewable has no further administrative process by a federal court.

on the interpretation of the Grievance the claim. The text of the System Policy— it is a question of law over grievance shall be leg ible, which we have plenary review. See Stokes presented in a courteous manner, v. Dist. Attorney, 247 F.3d 539, 540-41 (3d and the statement of facts shall Cir. 2001). It is therefore appropriate for not exceed tw o (2) pages. The this Court to undertake the inquiry in the inmate should identify any persons first instance. See Hudson United Bank v. who may have information that LiTenda Mortgage Corp., 142 F.3d 151, could be helpful in resolving the 159 (3d Cir. 1998) (“When a district court grievance. The inmate should also has failed to reach a question below that include information on attempts to becomes critical when reviewed on appeal, resolve the matter informally. The an appellate court may sometimes resolve inmate may also specifically state the issue on appeal rather than remand to any claims he/she wishes to make the district court. This procedure is conc ernin g v i o l a ti o n s o f generally appropriate when the factual Department directives, regulations, record is developed and the issues provide court orders, or other law. The purely legal questions, upon which an inmate may include a request for appellate court exercises plenary review.” compensation or other legal relief (citations omitted)). normally available from a court. 1. Spruill’s Failure to Ask for Money DC-ADM 804, Part VI.A.1.d (emphasis in Damages original). We have reproduced in full the texts of The verbs in this paragraph establish Spruill’s three grievances. See supra notes three tiers of grievance components: items 3, 4 & 6. None requests money that are mandatory (“shall”); items that are damages—or any other specific relief for required to the extent practicable that matter. As noted above, the (“should”); and items that are optional defendants assert that Spruill cannot now (“may”). A request for money damages in federal court seek money damages. As falls in the third category. Since an we concluded in the discussion above, we optional procedural provision cannot give must look to the rules governing the rise to a procedural default, it appears that prison’s grievance system to ascertain Spruill is not now precluded from seeking whether Spruill has procedurally defaulted money damages. his claim for monetary relief. The portion There is, however, a possible of the Grievance System Policy that details alternative reading: The sentence at issue what “shall,” “should,” and “may” be may be addressed not to the written included in a grievance reads: contents of a grievance, but rather to the The inmate shall include a scope of relief available within the statement of the facts relevant to grievance system. This is not an

unreasonable matter for a prison grievance reads, “If the inmate desires compensation system policy to address; indeed, it was the or other legal relief normally available absence of a mechanism to recover from a court, the inmate shall request the monetary relief—in a prior version of the relief with specificity in his/her initial very grievance system here at issue—that grievance.” generated the controversy in Booth, 532 In sum, Spruill cannot be said to have U.S. 731 (holding that the unavailability of failed to follow the regulations—and thus monetary relief through a prison grievance procedurally defaulted— in this respect. system does not excuse a prisoner seeking Nothing in the Grievance System Policy only money damages from the PLRA’s would have put Spruill on notice that he exhaustion requirement). See also id. at had to ask for money damages—or any 734 & n.1 (noting that Pennsylvania’s particular form of relief at all. Therefore grievance system did not provide for we conclude that he has satisfied § recovery of money damages at the time of 1997e(a), and we cannot affirm the District Booth’s grievance, but that it had since Court’s dismissal on this failure-to-exhaust been modified to permit such recovery). ground. Interpreting the provision above as establishing the scope of available 2. Spruill’s Failure to Name Brown in relief—and implicitly requiring that the His Grievances p r i s o n er i d e n ti f y t h e r e l ie f h e The passage quoted above regarding seeks— would lead to the conclusion that the contents of the grievance is also the Spruill did procedurally default his claim only section of the Grievance System for monetary relief. Policy requiring that the grievance identify We reject this scope-of-available-relief specific persons. On this matter, the text is reading for several reasons. First, mandatory, or nearly so: “The inmate shall grammatically the regulation reads “may include a statement of the facts relevant to include a request for” and not “may the claim. . . . The inmate should identify request.” Second, the sentence appears as any persons who may have information part of a regulation directing the contents that could be helpful in resolving the of the written grievance, not one that grievance. The inmate should also include otherwise sets the scope of permissible information on attempts to resolve the relief. Third, the form itself on which matter informally.” DC-ADM 804, Part grievances are filed does not include any VI.A.1.d. To the extent that Brown’s prompt for stating the relief sought. identity is a “fact[] relevant to the Furthermore, the regulation does not read claim”—and it is—it was mandatory for like a regulation that could give rise to a Spruill to include it. To the extent that procedural default for failure to plead Brown was a “person[] who may have properly for relief. The regulation quoted information” or someone with whom above is far cry from, say, a regulation that Spruill made “attempts to resolve the

matter informally”— and he was—Spruill insulting treatment by Brown— there was required to identify Brown if would be no constitutional violation there practicable. Spruill did not, and has anyway. Rather, the grievances and the offered no explanation for his failure to do suit are about a larger-scale denial of so. Any grievance against Brown would adequate medical care, in which prison now be time-barred. See DC-ADM 804, officials clearly knew Brown was alleged Part VI.A.1.e (“Grievances must be to be implicated. Thus we reject the submitted by the inmate . . . within fifteen District Court’s dismissal of Spruill’s suit (15) working days after the events on against Brown on these grounds. which the claims are based.”). Thus *** Spruill has procedurally defaulted a claim against Brown by failing to identify him. In closing this Part, we stress that under § 1997e(a), the warden is But the prison’s grievance process responsible for the grievance system. If excused this procedural default: The the warden (or whoever the appropriate grievance officer’s “Initial Review state official may be) is dissatisfied with Response” (the first-level determination the procedural default rulings in this Part, under the Grievance System Policy) he or she may alter the grievance system to identified Brown by name. Although the require more (or less) of inmates by way of response identified Brown only as exhaustion. Such measures, we reiterate, someone who had seen Spruill in the must be consistent with the Federal course of his medical visits, it is not to be Constitution and the federal policy expected that a response rejecting Spruill’s embodied in § 1997e(a) to be enforced as grievances on the merits would identify grounds for procedural default in a any malfeasance on Brown’s part. The subsequent federal lawsuit. As we purpose of the regulation here is to put the observed in Nyhuis, 204 F.3d at 77, “if in prison officials on notice of the persons the long run, something of a cooperative claimed to be guilty of wrongdoing. As ethos can be achieved between inmate and such, the prison can excuse an inmate’s jailer, the internal administrative process failure to do so by identifying the could prove a less hostile and adversarial unidentified persons and acknowledging forum than that of federal court.” We are that they were fairly within the compass of likewise hopeful that our holdings today the prisoner’s grievance. on procedural default and waiver will not The point is close, but we conclude that engender a prison grievance review culture the prison grievance officer’s recognition marked by technicalities, but will instead that Brown was involved in the events that foster the cooperative resolution of Spruill complained of excused any legitim ate gr ie va nce s by f u r th er procedural defects in Spruill’s initial encouraging prisoners to avail themselves grievances. Spruill’s grievances and suit of the forum usually best suited to redress are not about specific instances of those grievances.

III. Spruill’s Eighth Amendment Claims doctor is “intentionally inflicting pain on [a] prisoner[].” 897 F.2d at 109. In Because there is no exhaustion or MCCII, we identified several other procedural default bar to Spruill’s suit, we scenarios that satisfy Estelle. Most turn to the merits of his Constitutional relevant to this case are (1) “[w]here claims. We have on several occasions prison authorities deny reasonable requests discussed the conditions under which for medical treatment . . . and such denial deprivation of medical treatment violates exposes the inmate ‘to undue suffering or a prisoner’s Eighth Amendment right not the threat of tangible residual injury,’” to be subjected to cruel and unusual MCCII, 834 F.2d at 346 (quoting Westlake punishment. “Only ‘unnecessary and v. Lucas, 537 F.2d 857, 860 (6th Cir. wanton infliction of pain’ or ‘deliberate 1976)), and (2) “where ‘knowledge of the indifference to the serious medical needs’ need for medical care [is accompanied by of prisoners are sufficiently egregious to the] . . . intentional refusal to provide that rise to the level of a constitutional care,’” id. (quoting Ancata v. Prison violation.” White v. Napoleon, 897 F.2d Health Servs., 769 F.2d 700, 704 (11th 103, 108-09 (3d Cir. 1990) (quoting Cir. 1985)) (alterations in original). Estelle v. Gamble, 429 U.S. 97, 103 (1976) (quoting Gregg v. Georgia, 428 U.S. 153 The Estelle standard “‘requires (1976))). Allegations of medical deliberate indifference on the part of the malpractice are not sufficient to establish prison officials and it requires the a Constitutional violation. See id. (citing prisoner’s medical needs to be serious.’” Estelle, 429 U.S. at 106); Monmouth Id. (quoting West v. Keve, 571 F.2d 158, County Correctional Institutional Inmates 161 (3d Cir. 1978)). Spruill’s complaint v. Lanzaro, 834 F.2d 326, 346 (3d Cir. satisfies the second prong. First, his back 1987) (MCCII) (citing Estelle, 429 U.S. at condition itself has allegedly required 106 & n.14; Gittlemacker v. Prasse, 428 significant and continuous medication, and F.2d 1, 6 (3d Cir. 1970)); see also Daniels has caused him excruciating pain. Second, v. Williams, 474 U.S. 327, 332-34 (holding within the brief period described in his that negligence is not compensable as a complaint, Spruill claims to have fallen or Constitutional deprivation). “[M ]ere collapsed from the pain twice (first on disagreement as to the proper medical May 4, and again on May 9), exposing treatment” is also insufficient. MCCII, himself to further injury. The extreme 834 F.2d at 346 (citing Bowring v. pain and real possibility of permanent Godwin, 551 F.2d 44, 48 (4th Cir. 1977); injury could qualify Spruill’s condition as Massey v. Hutto, 545 F.2d 45, 46 (8th Cir. a serious medical need. Naturally, this 1976) (per curiam)). will need to be fleshed out with further evidence (e.g., expert medical testimony), As we explained in White, the Estelle but at the motion-to-dismiss stage, the “deliberate indifference to serious medical complaint is certainly adequate in this needs” standard is clearly met when a

respect. The closer question is whether experts (Dr. McGlaughlin and Brown in Spruill has alleged facts supporting the this case), a non-medical prison official inference that Gooler, Dr. McGlaughlin, will generally be justified in believing that and Brown were deliberately indifferent the prisoner is in capable hands. This (or intentionally malicious) with respect to follows naturally from the division of his condition. For reasons that will labor within a prison. Inmate health and become apparent, we treat Gooler first, safety is prom ote d by div iding and then Dr. McGlaughlin and Brown responsibility for various aspects of inmate together. life amo ng g uards, administrators, physicians, and so on. Holding a non- A. Claims Against Gooler medical prison official liable in a case Durmer v. O’Carroll, 991 F.2d 64 (3d where a prisoner was under a physician’s Cir. 1993), resembles the case at bar in care would strain this division of labor. that the plaintiff-prisoner (Durmer) sued Moreover, under such a regime, non- both medical and non-medical prison medical officials could even have a officials. With respect to the non-medical perverse incentive not to delegate prison officials, Barker and Fauver, we treatment responsibility to the very explained: physicians most likely to be able to help prisoners, for fear of vicarious liability. [W]e believe that summary judgment was proper with respect Accordingly, we conclude that, absent to defendants Barker and Fauver. a reason to believe (or actual knowledge) The only allegation against either that prison doctors or their assistants are of these two defendants was that mistreating (or not treating) a prisoner, a they failed to respond to letters non-medical prison official like Gooler Durmer sent to them explaining his will not be chargeable with the Eighth predicament. Neither of these Amendment scienter requirement of d e f e n d a n t s , how ever, i s a deliberate indifference. Thus dismissal of physician, and neither can be Spruill’s claims against Gooler after the considered deliberately indifferent point at which Spruill was first under simply because they failed to medical care is appropriate because Spruill respond directly to the medical bears the burden of proving (and hence complaints of a prisoner who was pleading) facts supporting the defendants’ already being treated by the prison mental states, see Singletary v. Pa. Dep’t doctor. of Corr., 266 F.3d 186, 192 n.2 (3d Cir. 2001), and he has failed to so plead with Id. at 69 (footnote omitted). Although respect to Gooler. 12 Durmer was decided at the summary judgment stage, its holding can be readily imported into the motion-to-dismiss stage: 12 We do not find our admonition in If a prisoner is under the care of medical Alston v. Parker, 363 F.3d 229, 233-34

With respect to Spruill’s claims against treatment . . . expos[ing] the inmate to Gooler in the period before he was under undue suffering” or “knowledge of the medical care— i.e., from his May 2 arrival need for medical care” coupled with an at SCI-Coal, through his fall and face “intentional refusal to provide that care.” injury on May 4, to Dr. McGlaughlin’s 834 F.2d at 346 (quotation marks and first visit to his cell on May 5—we also citations omitted). Therefore, Spruill has conclude that Spruill has not stated a claim not stated a claim against Gooler and we against Gooler. First, Spruill did sign up will affirm the judgment of the District for sick call on May 3, and he was seen by Court dismissing the suit against Gooler. an (unidentified) nurse on May 4; hence he B. Claims Against Dr. McGlaughlin and was receiving a minimal measure of Brown medical attention. Second, Spruill does not allege that his condition was so dire Though Spruill’s allegations about Dr. and obvious that Gooler’s failure to McGlaughlin’s and Brown’s course of summon immediate medical attention on treatment (or nontreatment) pale next to May 4 (and to instead let the sick call the allegations in such cases as White, 897 process run its course) amounted to F.2d 103, Spruill’s complaint nonetheless deliberate indifference. The facts as sufficiently attributes a mental state of Spruill himself describes them simply do deliberate indifference (or worse) to both not amount to the MCCII examples of Dr. McGlaughlin and Brown. Especially “deny[ing] reasonable requests for medical when read in light of Alston, 363 F.3d at 233-34 & n.6, several excerpts from Spruill’s complaint suffice to make the point: Spruill asserts that due to Dr. & n.6 (3d Cir. 2004), applicable to this McGlaughlin’s and Brown’s “lack of specific point. In Alston, we reaffirmed proper medical care, the plaintiff was that pro se complaints (especially from subjected to the possible risks of a civil rights plaintiffs) should be read permanent disability or an fatal or serious liberally, and noted that prisoners in injury.” We have held that “the threat of particular are often at an informational tangible residual injury” can establish disadvantage that may prevent them from deliberate indifference. MCCII, 834 F.2d pleading the full factual predicate for at 346 (quoting Westlake, 537 F.2d at their claims. Id. Spruill’s complaint is 860). Spruill further claims that Dr. lacking not because it fails to allege M cG laugh lin and B row n acte d specific facts to support Gooler’s mental “maliciously and sadistically,” and that state (which, at all events, would be those actions were “intended to inflict pain unnecessary under our notice pleading on the plaintiff without any medical standard, see id.), but rather because it justification.” If proven, intentional does not so much as suggest that Gooler conduct of this sort plainly makes out an was aware of the alleged inadequacies in Eighth Amendment violation. And finally, Spruill’s medical treatment.

according to Spruill, Brown and Dr. Amendment rights. We will therefore McGlaughlin refused to examine him on reverse the judgment of the District Court, multiple occasions and Dr. McGlaughlin and remand for further proceedings, with instead accused him of “playing games”; respect to Dr. McGlaughlin and Brown. when Dr. M cGlaughlin ultimately did examine him, he twisted Spruill’s legs “as if he was trying to shape a pretzel,” and Spruill “repeatedly told Defendant McGlaughlin that the examination was causing additional pain to his back and leg.” In sum, Spruill has connected his factual allegations to the alleged mental states of Dr. McGlaughlin and Brown. That he believes their actions were not only deliberately indifferent, but malicious and sadistic, reinforces the sufficiency of his complaint. Since at this stage we are making no judgment about what actually happened, but only about the sufficiency of the pleadings, we must take Spruill’s factual allegations, and the reasonable inferences therefrom, as true. We will therefore reverse the District Court’s dismissal of Spruill’s suit against Dr. McGlaughlin and Brown.

IV. Conclusion The judgment of the District Court with respect to Gooler will be affirmed on the ground that Spruill has failed to state a claim upon which relief can be granted for a violation of his Eighth Amendment rights by Gooler. With respect to Dr. McGlaughlin and Brown, we hold that Spruill has met the exhaustion requirement of § 1997e(a), and that he has stated a claim for violation of his Eighth