Prison Cells

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A federal judge has rebuffed an inmate's request to order prison officials to halt their alleged unofficial policy of denying dental crowns to detainees, believing the Federal Bureau of Prisons should be left to manage its own medical protocols.

Peter George Noe, who is incarcerated at the U.S. Penitentiary — Administrative Maximum facility in Florence, filed suit against the government and multiple medical personnel, claiming delayed and inadequate treatment of five of his teeth. He alleged a prison dentist acknowledged Noe needed crowns, but could not perform the procedure because it was too expensive.

As part of the lawsuit, Noe asked for a preliminary injunction that would order the Bureau of Prisons to provide crowns generally, and to specifically perform the needed dental work in his case.

But U.S. District Court Senior Judge Christine M. Arguello denied the motion, finding Noe had not shown he would suffer irreparable harm — specifically, losing his teeth — in the absence of a court order.

"Mr. Noe further contends that if he does not receive crowns, the dentist told him that he will lose his teeth," she wrote in a July 12 order. "However, Mr. Noe provides no additional information, medical records, or any evidence to support his conclusory allegations."

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Noe, who is representing himself from prison, described his struggles to receive dental treatment for three broken teeth and two other painful teeth beginning in November 2019. He saw a dentist, identified as "Dr. Burkley," who allegedly informed Noe he needed a crown and teeth fillings, but Burkley could only "do one procedure per inmate per visit."

"Burkley explained to plaintiff that plaintiff was going to lose all three of the teeth that needed crowns because under F.B.O.P. policy all of the dentists have been told they are not allowed to request crowns due to them costing too much money," Noe wrote.

Noe was placed on the waitlist for future dental care, during which time he was in substantial pain. He reported his last tooth was fixed in April 2021, allegedly "in response to this lawsuit."

The federal complaint against Burkley, a dental assistant, two nurses and the United States government included claims under the Eighth Amendment, which prohibits cruel and unusual punishment but also covers prison officials' deliberate indifference to the serious medical needs of inmates. 

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In November last year, Noe requested a preliminary injunction, asserting he would "lose three more teeth" and be left in pain. He also claimed the Bureau of Prisons had never performed crown work on high or maximum security inmates.

U.S. Magistrate Judge Scott T. Varholak analyzed the injunction request and issued a recommendation in May to deny Noe's motion. Because Noe was seeking to alter the status quo and mandate the prison change its practices, he needed to demonstrate a clear and imminent harm. 

"Plaintiff does not allege that any dentist has told him that tooth loss is imminent, nor has he submitted his medical records — or any other evidence — indicating that he requires crowns now, rather than at some unspecified time in the future," Varholak wrote, pointing to Noe's own admission that all of his teeth were fixed.

Varholak also cited the official Bureau of Prisons policy that does allow for inmates to have crowns, albeit upon the approval of the chief dental officer. Nixon Roberts, the chief dental officer for Florence, submitted a statement to the court that Noe had received adequate dental care and did not need crowns.

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Noe objected to the magistrate judge's recommendation, saying he was still in pain and also believed it unreasonable for the prison to wait so long between dental visits to fix his teeth. 

Arguello overruled those objections. Although Noe was challenging the "unofficial" prison policy of denying crowns, Arguello believed the official policy clearly permitted such dental work to take place, and it was simply not needed in Noe's case.

"Because Mr. Noe has not established that he needs crowns, the Court cannot find that his interest in receiving crowns outweighs BOP’s interest in providing dental care to each inmate according to its own policy," she wrote.

Earlier this week, the government moved to dismiss most of Noe's lawsuit, arguing the defendants had not acted with deliberate indifference toward Noe's serious medical needs. As such, they argued they are entitled to qualified immunity, which shields government employees from liability unless they violate a clearly-established constitutional right.

The government is not, however, seeking dismissal of the claim Noe made for one of his broken teeth that ultimately required extraction. Noe alleges Burkley was negligent in failing to address the broken tooth in a timely fashion, purportedly to save money.

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