United States Court of Appeals For the First Circuit
No. 22-1716
JERRY CINTRON,
Plaintiff, Appellee,
v.
PAUL BIBEAULT, in his official and individual capacity; RUI DINIZ, in his official and individual capacity; MATTHEW KETTLE, in his official and individual capacity; PATRICIA ANNE COYNE- FAGUE, in her individual capacity; WAYNE T. SALISBURY, JR., Director, in his official capacity; STEVEN CABRAL, Special Investigator, in his official and individual capacity; JEFFREY ACETO, in his official and individual capacity; LYNNE CORRY, in her official and individual capacity,
Defendants, Appellants,
LT. HAYES, in his official and individual capacity; LT. MOE, in his official and individual capacity; LT. BUSH, in his official and individual capacity; JENNIFER CHAPMAN, in her official and individual capacity; "COUNSELOR" FRANCO, in her official and individual capacity,
Defendants.
APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF RHODE ISLAND
[Hon. John J. McConnell, Jr., U.S. District Judge]
Before
Gelpí, Lipez, and Kayatta, Circuit Judges. Katherine Connolly Sadeck, Assistant Attorney General, for appellants. George Mills, with whom Natalia Friedlander, Jennifer L. Wood, Rhode Island Center for Justice, Daniel M. Greenfield, Kathrina Szymborski Wolfkot, Felipe Hernandez, Benjamin Gunning, and Roderick & Solange MacArthur Justice Center were on brief, for appellee. Marissa Lalli, Nina B. Garcia, Hannah E. Gelbort, and Wilmer Cutler Pickering Hale and Dorr LLP on brief for Terry Kupers, Craig Haney, Pablo Stewart, and Stuart Grassian, amici curiae. R. Stanton Jones, Andrew T. Tutt, Rebecca A. Caruso, and Arnold & Porter Kaye Scholer LLP on brief for Professor John F. Stinneford, amicus curiae. Daniel S. Ruzumna, Isaac Weingram, David Moosmann, Patterson Belknap Webb & Tyler LLP on brief for Rights Behind Bars, amicus curiae. Sonja L. Deyoe and Lynette Labinger on brief for American Civil Liberties Union of Rhode Island, Aaron Regunberg, and Leonela Felix, amici curiae. Jared A. Goldstein and Roger Williams University School of Law on brief for Incarcerated Persons Who Have Been Placed in Long- Term Solitary Confinement at Rhode Island's Adult Correctional Institutions, amici curiae. Melissa Giangrande, Tiara Brown, and Hogan Lovells US LLP on brief for Former Corrections Officials Dan Pacholke, Dick Morgan, Eldon Vail, and Steve J. Martin, amici curiae. John P. Bueker, Jessica Dormitzer, Emma Notis-McConarty, Jason P. Roskom, and Ropes & Gray LLP on brief for OpenDoors, amicus curiae. Alexandra D. Valenti, Anne Bayly Buck, Robert Frederickson, III, William E. Evans, and Goodwin Procter LLP on brief for Dr. Andrew Kolodny, amicus curiae. Nancy Gertner and Fick & Marx LLP on brief for Center for Law, Brain & Behavior, amicus curiae. Andrew S. Wainwright, Thornton Law Firm, LLP, Martin J. Siegel, and Appellate Civil Rights Clinic, University of Houston Law Center on brief for Dr. Jennifer G. Clarke, amicus curiae.
August 5, 2025 KAYATTA, Circuit Judge. In July 2019, Jerry Cintron
overdosed on a fentanyl-laced pill while in Rhode Island Department
of Corrections (RIDOC) custody. For his alleged role in acquiring,
possessing, and consuming the pill, RIDOC sanctioned Cintron with
450 days in solitary confinement. While so confined, Cintron
allegedly experienced severe mental and physical deterioration,
stemming from the conditions of confinement that characterized his
stint in solitary.
Relying on 42 U.S.C. § 1983, Cintron sued eight current
and former RIDOC officials ("defendants"), accusing them of
violating his Eighth Amendment "right to be free from cruel and
unusual punishment by deliberately and recklessly placing him at
substantial risk of serious harm." He alleges, among other things,
that defendants deliberately responded indifferently to his
suffering by continuing his punitive solitary confinement even as
his physical and mental deterioration went untreated. Defendants
moved for judgment on the pleadings, arguing, among other things,
that Cintron's claim failed on its merits and that defendants were
entitled to qualified immunity from his § 1983 claim for damages.
In a text order, the district court denied the motion in relevant
part, prompting defendants to appeal.
For the reasons we explain below, we affirm in part,
reverse in part, and vacate and remand in part.
- 3 - I.
Because this appeal concerns the adequacy of the
pleadings, we assume the truth of Cintron's factual allegations,
which we recite below. See Abraham v. Woods Hole Oceanographic
Inst., 553 F.3d 114, 115 (1st Cir. 2009).
A.
In February 2016, Cintron began serving a ten-year
sentence for possession of cocaine with intent to distribute, with
a good-time release date of September 2025. Cintron, who suffers
from opioid use disorder, successfully avoided drugs throughout
his first three-and-a-half years in RIDOC custody. During that
time, he sought enrollment in RIDOC's Medication Assisted
Treatment (MAT) program, a medication and therapy program that
RIDOC touts as "show[ing] great success" in "reduc[ing] opioid
overdose deaths in the state."1 RIDOC refused to enroll him.
In July 2019, while incarcerated in a medium-security
facility at RIDOC's Adult Correctional Institutions (ACI), Cintron
relapsed. He obtained and overdosed on half of a fentanyl-laced
pill, which he had thought was Percocet, a prescription drug
comprising a semisynthetic opioid (oxycodone) and acetaminophen.
1 Medication Assisted Treatment at the RI Department of Corrections, R.I. Dep't of Behav. Healthcare, Developmental Disabilities & Hosps. (Jan. 25, 2024), https://perma.cc/8R8A-3HRQ.
- 4 - He was taken to a hospital, where he was revived with multiple
doses of Narcan (a brand of the opioid antagonist naloxone).
Defendant RIDOC Investigator Paul Bibeault visited
Cintron at the hospital to question him about the pill's origins.
Bibeault and Cintron had some history -- Bibeault had served as a
correctional officer in Cintron's old cell block and reportedly
forced Cintron out of that block because Bibeault disliked Cintron.
While Cintron admitted to consuming a half pill, his condition
prevented him from otherwise answering Bibeault's questions.
The next day, the hospital discharged Cintron. He
returned to the ACI, where Bibeault once more questioned him
concerning the pill's origins. Bibeault threatened to send Cintron
to ACI's high-security unit if he did not cooperate, and Cintron
did in fact refuse to cooperate.
The following week, prison authorities issued Cintron a
disciplinary booking for being under the influence of the
unauthorized pill. He was adjudicated guilty two days later and
received twenty-five days in solitary confinement as punishment.2
2 The parties variably refer to Cintron spending time in "disciplinary segregation," "administrative segregation," and "restrictive housing." While the three phrases carry different technical meanings, we use the more well-known catch-all "solitary confinement" (or "solitary" for short) for clarity and consistency. See Natasha A. Frost & Carlos E. Monteiro, Administrative Segregation in U.S. Prisons, in Nat'l Inst. of Just., Dep't of Just., Restrictive Housing in the U.S. 1, 3–4 (Marie Garcia ed., 2016), https://perma.cc/TYJ6-JB8C (adopting a
- 5 - A week later, Bibeault issued Cintron a second booking for the
same incident, charging Cintron with possessing the intoxicant
that he had consumed. Adjudicated guilty four days later, Cintron
received another thirty days in solitary.
During Cintron's fifty-five days in solitary
confinement, Bibeault interrogated him at least twice about the
pill's origins. In one of those meetings, Bibeault called Cintron
a "piece of shit" and threatened him with state criminal charges.
In another meeting, Bibeault and Defendant RIDOC Investigator
Steve Cabral threatened to put Cintron in solitary confinement for
a year if he did not cooperate. When Cintron refused to divulge
the pill's origins, Bibeault (in Cabral's presence) said, "We'll
see if you're still normal when you get out of [solitary], kid.
You're fucking buried alive. I'm going to bury you alive."
Accusing Cintron of helping import the pill into the ACI, Bibeault
told Cintron (in Cabral's presence) that he would book Cintron for
trafficking because Cintron was "being a hard-ass."
Attempting to raise an alarm about Bibeault's threat,
Cintron informed Defendant Rui Diniz, the medium-security warden,
about his conversation with Bibeault and Cabral. Diniz responded
that he did not care and that he would personally make sure that
similar approach when discussing empirical research); see also Perry v. Spencer, 94 F.4th 136, 158–59 (1st Cir. 2024) (similar).
- 6 - Cintron received 365 days in solitary confinement -- the maximum
sanction for narcotics trafficking.
On August 8, after around three weeks in solitary,
Cintron had a hearing before RIDOC's classification board. At the
meeting, the board reclassified Cintron from medium security to
high security, prompting a transfer to RIDOC's high-security unit.
Shortly thereafter, Cintron wrote to Defendant Matthew Kettle,
RIDOC's assistant director of institutions and operations, asking
to remain in medium security. Cintron received a response two
weeks later from Defendant RIDOC Director Patricia Anne Coyne-
Fague,3 who informed Cintron that she had delegated review of
classification decisions to Kettle, who had approved Cintron's
reclassification to high security.
That same day, August 22, Bibeault booked Cintron for
trafficking the pill. RIDOC adjudicated Cintron guilty and
sanctioned him with a year of solitary confinement. During that
hearing, RIDOC also adjudicated Cintron guilty of circumventing
phone security procedures in connection with his alleged
trafficking, tacking on another thirty days of solitary. Thus,
over the course of about one month, RIDOC cumulatively sanctioned
3 Defendant Wayne T. Salisbury, Jr., took over RIDOC's directorship from Coyne-Fague in January 2023. Consequently, Cintron seeks relief against Salisbury only in his official capacity and against Coyne-Fague only in her individual capacity. He seeks recovery against the other six defendants in their official and individual capacities.
- 7 - Cintron with 450 days in solitary as punishment for his alleged
misconduct in connection with the pill. Kettle denied all of
Cintron's disciplinary appeals.
B.
Prior to entering solitary confinement, Cintron lived a
relatively normal prison life. He received ten hours of out-of-
cell time each day, visited with and called family members, took
advantage of educational and programming opportunities,
participated in a "Daddy Daycare" program with his children, and
did not take any mental health medication.
Solitary confinement changed all of that. Cintron lost
access to virtually all interpersonal interaction. Prison
authorities confined him to his cell nearly constantly -- at most,
he could spend five hours outside his cell per week. He received
a maximum of one ten-minute phone call each month and could not
see his family members in person. "All meals [we]re taken alone
in [his] cell instead of in a common eating area." Wilkinson v.
Austin, 545 U.S. 209, 214 (2005). In short, these conditions
deprived Cintron "of almost all human contact." Id.
In addition to curtailing Cintron's ability to interact
with others, RIDOC denied him access to radio, television, an MP3
player, a desk, education, and programming. For roughly eight
months, Cintron also lacked access to newspapers and a mirror.
Thus "deprived of almost any environmental or sensory stimuli,"
- 8 - id., Cintron spent his days with no more than "a bed and a toilet"
to keep him company.
RIDOC also made it difficult for Cintron to sleep: "The
lights glared overhead 24 hours a day," and "there was a loud
bang -- a door locking -- every thirty minutes, even at night."
Cintron's sleep deprivation led him to begin "taking sleep
medication (for the first time in his life)."
As Bibeault foresaw, Cintron deteriorated physically and
mentally while in solitary. He lost seventy pounds, exhibited
self-injurious behavior (including punching his cell walls and
pulling out his hair), and suffered intrusive thoughts and severe
anxiety. In addition to taking his newly prescribed sleep
medication, Cintron began taking antidepressants for the second
time in his life (the first time was during a prior stint in
solitary) and abusing his prescription pain medication. RIDOC
responded to these relapses not with treatment, but by booking him
for additional infractions, thus extending his isolation.4
4 The parties seem to agree that Cintron spent 450 consecutive days in solitary stemming from his four disciplinary sentences in July and August 2019. In a February 2022 filing, Cintron alleged that he "has spent 950 days in High Security or in [solitary confinement] at Maximum Security," without specifying what portion of those 950 days (if any) he spent in nonsolitary high-security confinement. Additionally, Cintron's July 2023 opening brief states that he "spent two and a half years" in solitary and that RIDOC "continue[s] to cycle [him] in and out of solitary confinement." The precise length of Cintron's time in solitary -- whether 450 days or longer -- does not impact our resolution of this appeal.
- 9 - C.
While in solitary confinement, Cintron repeatedly asked
for relief, but his pleas largely fell on deaf ears. He renewed
his request for MAT enrollment to no avail. The limited treatment
he did receive -- antidepressants and time with a social
worker -- did little to improve his health.
After around four months in solitary confinement,
Cintron beseeched Diniz, as warden of medium security, to suspend
the remainder of his time in solitary. Diniz refused. Cintron
wrote multiple letters to Defendant Jeffrey Aceto, the warden of
high security, telling him about his psychiatric breakdowns and
requesting that Aceto suspend his remaining time in solitary
confinement. Aceto refused. Cintron's social worker likewise
spoke with Aceto and Defendant Lynne Corry (then a deputy warden)
about his deteriorating condition and asked that they suspend the
remainder of his time in solitary. Both refused.
When Corry became the new warden of high security,
Cintron wrote to her with a similar request. She responded in May
2020:
I understand that you are going through things at this time however the way to suspend your discipline time is as easy as stop being disciplined. [The COVID-19 pandemic] is a difficult time for all, and sacrifices must be made for the greater health of all around us. Occupy your time by writing letters, journal things and share with [your social worker] are a few suggestions to occupy your time. Your
- 10 - actions and behavior are what is holding you back from a discipline time suspension.
II.
Cintron filed the operative second amended complaint
(the "complaint"), with counsel, in February 2021, attempting to
state § 1983 claims for violations of the First, Fifth, and Eighth
Amendments, as well as state tort law claims.5
Defendants moved for judgment on the pleadings under
Federal Rule of Civil Procedure 12(c), arguing, among other
things, that Cintron's claims failed on their merits and that
defendants were entitled to qualified immunity for his § 1983
individual-capacity monetary claims. In an August 2022 text order,
the district court denied the motion as to four of Cintron's claims
(including his Eighth Amendment claim), while granting it with
Cintron's consent as to three claims. After defendants appealed,
the parties agreed to dismiss all but Cintron's Eighth Amendment
claim against all defendants.6
5 Cintron filed an initial pro se complaint in September 2019. 6 The parties' briefs feature one additional claim: a state tort abuse-of-process claim. However, the parties agreed to dismiss that claim prior to oral argument.
- 11 - III.
Because Cintron's Eighth Amendment claim remains alive
in the district court, this appeal is interlocutory. We enjoy
jurisdiction over interlocutory appeals of qualified immunity
denials and the related issues of law at bar. See Asociación de
Subscripción Conjunta del Seguro de Responsabilidad Obligatorio v.
Flores Galarza, 484 F.3d 1, 13, 20, 23–25 (1st Cir. 2007)
(exercising interlocutory jurisdiction over arguments concerning
the denial of qualified immunity and related issues involving
standing and § 1983 official-capacity claims).
We treat a Rule 12(c) motion for judgment on the
pleadings much like a Rule 12(b)(6) motion to dismiss for failure
to state a claim upon which relief can be granted. Pérez-Acevedo
v. Rivero-Cubano, 520 F.3d 26, 29 (1st Cir. 2008). We review the
district court's judgment de novo, "accept[ing] all of the non-
moving party's well-pleaded facts as true and draw[ing] all
reasonable inferences in his favor." Rezende v. Ocwen Loan
Servicing, LLC, 869 F.3d 40, 42 (1st Cir. 2017). We do not vary
our approach even where, as here, the district court did not
explain its reasoning. Cf. Camilo-Robles v. Hoyos, 151 F.3d 1, 8
(1st Cir. 1998) ("When the district court's order is
unilluminating, the appellate court must fend for itself.").
- 12 - Under Rule 12(c), a movant can secure judgment on the
pleadings only when "it appears beyond a doubt that the nonmoving
party can prove no set of facts in support of [his] claim [that]
would entitle [him] to relief." Feliciano v. Rhode Island, 160
F.3d 780, 788 (1st Cir. 1998). To defeat a Rule 12(c) motion, a
§ 1983 plaintiff need not show probable victory, but he must plead
"more than a sheer possibility that a defendant has acted
unlawfully." Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009).
C.
Before proceeding to our analysis, we briefly delineate
the scope of relief available to Cintron. First, as to Cintron's
§ 1983 damages claim, he can only seek such relief from defendants
in their individual capacities. See Will v. Mich. Dep't of State
Police, 491 U.S. 58, 66, 70 (1989). Cintron conceded as much
below. Thus, Cintron cannot assert a § 1983 damages claim against
defendants in their official capacities, and we reverse the
district court to the extent it held otherwise.7 See Nieves-
Márquez v. Puerto Rico, 353 F.3d 108, 124 (1st Cir. 2003).
Second, defendants suggest that Cintron's complaint does
not seek declaratory relief because its "Relief Requested" section
omits declaratory relief. But the complaint's "Claims for Relief"
7 This means that Cintron's damages claim against Salisbury, whom Cintron sues only in his official capacity, falls away completely.
- 13 - section expressly requests "declaratory relief" for Cintron's
Eighth Amendment claim. And defendants advance no argument
concerning why we should elevate the "Relief Requested" section's
silence over the "Claims for Relief" section's clarity.
Third, defendants argue that Cintron lacks standing to
seek injunctive or declaratory relief, or that his claims to such
relief are moot. Cintron clearly has standing to press the
individual-capacity compensatory-damages claim that triggered the
assertion of a qualified immunity defense. As to his other claims,
though, we are sensitive to the fact that Cintron's carceral status
may have changed since oral argument, and we thus consider
ourselves ill-equipped to adjudicate his standing to pursue
declaratory and injunctive relief, or the mootness of his claims
thereto. We therefore leave it to the district court to determine,
on remand and with the benefit of up-to-date submissions, whether
it can properly entertain Cintron's declaratory and injunctive
claims. Cf. Welch v. Shultz, 482 F.2d 780, 783 (D.C. Cir. 1973)
(per curiam) (remanding to the district court where potential
mootness issues necessitated "definition and examination afresh on
an up-to-date factual record").
IV.
Defendants argue that they enjoy qualified immunity from
Cintron's Eighth Amendment individual-capacity monetary claim.
Qualified immunity shields state officials "from liability for
- 14 - civil damages insofar as their conduct [did] not violate clearly
established statutory or constitutional rights of which a
reasonable person would have known." Harlow v. Fitzgerald, 457
U.S. 800, 818 (1982). To defeat qualified immunity, Cintron must
show both "(1) that [a defendant] violated a statutory or
constitutional right, and (2) that the right was 'clearly
established' at the time of the challenged conduct." Ashcroft v.
al-Kidd, 563 U.S. 731, 735 (2011) (quoting Harlow, 457 U.S. at
818). Thus, in the context of this appeal predicated on a
qualified immunity defense to Cintron's complaint, we focus, in
order, on two questions: Does Cintron's complaint allege facts
that make out a violation of his Eighth Amendment rights? And, if
so, were those Eighth Amendment rights clearly established at the
relevant time?
We consider first whether Cintron alleges an Eighth
Amendment violation. "[A] prison official violates the Eighth
Amendment only when two requirements are met." Farmer v. Brennan,
511 U.S. 825, 834 (1994). First, under the "objective"
requirement, "the deprivation alleged must be, objectively,
sufficiently serious; a prison official's act or omission must
result in the denial of the minimal civilized measure of life's
necessities" such that the plaintiff "is incarcerated under
conditions posing a substantial risk of serious harm." Id.
- 15 - (quotation marks and citations omitted). Second, under the
"subjective" requirement, "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, a standard the parties agree governs the
claim in this case." Id. (quotation marks and citations omitted).
In conducting the objective and subjective inquiries, we
keep in mind Cintron's framing of his claim: Cintron does not
argue that solitary confinement is per se unconstitutional.
Rather, he claims that defendants violated the Eighth Amendment by
continuing to confine him under conditions that they knew were
causing him serious harm. In the words of his brief, "[t]ime and
again, Cintron told [defendants] that solitary was harming him,
yet they did nothing."
1.
We begin with the objective requirement. The Supreme
Court long ago recognized that refusing an inmate "direct
intercourse with or sight of any human being, . . . employment[,]
or instruction" can force that inmate, "after even a short
confinement, into a semi-fatuous condition, from which it [i]s
next to impossible to arouse [him]," and may even push him to
"violent[] insan[ity]" or "suicide." In re Medley, 134 U.S. 160,
168 (1890). Modern research substantiates this pronouncement.
See, e.g., Craig Haney, The Psychological Effects of Solitary
- 16 - Confinement: A Systematic Critique, 47 Crime & Just. 365, 370–78
(2018) (discussing this phenomenon and surveying on-point
studies); Palakovic v. Wetzel, 854 F.3d 209, 225 (3d Cir. 2017)
(acknowledging "the robust body of legal and scientific authority
recognizing the devastating mental health consequences caused by
long-term isolation"). Summarizing such research, the Third
Circuit concluded, "in the absence of interaction with others, an
individual's very identity is at risk of disintegration." Williams
v. Sec'y Pa. Dep't of Corr., 848 F.3d 549, 566 (3d Cir. 2017).
The type of sensory deprivation that allegedly typified
Cintron's solitary confinement only exacerbates these risks. As
the Third Circuit has explained:
Based on an examination of a representative sample of sensory deprivation studies, the researchers found that virtually everyone exposed to such conditions is affected in some way. They further explained that "there is not a single study of solitary confinement wherein non-voluntary confinement that lasted for longer than 10 days failed to result in negative psychological effects." And as another researcher elaborated, "all individuals subjected to solitary confinement will experience a degree of stupor, difficulties with thinking and concentration, obsessional thinking, agitation, irritability, and difficulty tolerating external stimuli."
Id. (cleaned up). Similarly, the Fourth Circuit has labeled
conditions that "deprive[] inmates of the basic human need for
meaningful social interaction and positive environmental
- 17 - stimulation" as "pos[ing] a substantial risk of serious
psychological and emotional harm." Porter v. Clarke, 923 F.3d
348, 368 (4th Cir. 2019) (quotation marks and citation omitted).
Cintron's complaint also alleges that his conditions of
confinement deprived him of the ability to sleep. "[S]leep is
critical to human existence . . . ." Walker v. Schult, 717 F.3d
119, 126 (2d Cir. 2013). "It has been known since 1500 at least
that deprivation of sleep is the most effective torture." Ashcraft
v. Tennessee, 322 U.S. 143, 150 n.6 (1944) (citation omitted).
Amicus Center for Law, Brain & Behavior at Massachusetts General
Hospital cites over a dozen academic studies documenting the
harmful effects of sleep deprivation.8 As one writer succinctly
summarizes, "[t]he brain starts to eat itself after chronic sleep
deprivation."9 Indeed, several of our sister circuits have allowed
Eighth Amendment claims to proceed where the plaintiffs alleged
sleep-deprivation tactics akin to those allegedly deployed against
Cintron. See, e.g., Walker, 717 F.3d at 122, 126–27 (recognizing
that "sleep is critical to human existence" and allowing an Eighth
8 See, e.g., Christian Benedict et al., Acute Sleep Deprivation Increases Serum Levels of Neuron-Specific Enolase (NSE) and S100 Calcium Binding Protein B (S-100B) in Healthy Young Men, 37 Sleep 195 (2014); Vinod Venkatraman et al., Sleep Deprivation Elevates Expectation of Gains and Attenuates Response to Losses Following Risky Decisions, 30 Sleep 603 (2007). 9 Andy Coghlan, The Brain Starts to Eat Itself After Chronic Sleep Deprivation, NewScientist (May 23, 2017), https://perma.cc/K2ZZ-KPBE.
- 18 - Amendment claim to proceed where the plaintiff alleged that he
"got almost no sleep . . . because the noise inside the cell was
constant and loud" (cleaned up)); Allah v. Bartkowski, 574 F. App'x
135, 138–39 (3d Cir. 2014) (allowing an Eighth Amendment claim to
proceed where the plaintiff alleged that loud noises
"contribut[ed] to his sleep deprivation . . . 'for a lengthy or
consistent period of time'"); Antonelli v. Sheahan, 81 F.3d 1422,
1433 (7th Cir. 1996) (allowing a due process or Eighth Amendment
claim to proceed where the plaintiff alleged that "noise occurred
every night, often all night, interrupting or preventing his
sleep"); Keenan v. Hall, 83 F.3d 1083, 1090 (9th Cir. 1996) ("There
is no legitimate penological justification for requiring inmates
to suffer physical and psychological harm by living in constant
illumination. This practice is unconstitutional." (cleaned up));
see also Garrett v. Thaler, 560 F. App'x 375, 378–80 (5th Cir.
2014) ("[C]onditions designed to prevent sleep may violate the
Eighth Amendment.").10
Thus, the harm that Cintron alleges -- the mental and
physical deterioration from long-term social, sensory, and sleep
deprivation -- closely aligns with the types of injuries that other
10 All five currently incarcerated amici echo Cintron's narrative of sleep deprivation, describing how "very few people sleep much in [solitary confinement]," in large part because of the "banging from doors opening and closing" and the fact that the "night light [is] kept on all night long."
- 19 - courts have recognized as satisfying the Eighth Amendment's
objective requirement. We therefore hold that Cintron has alleged
the requisite objective harm to make out an Eighth Amendment
claim -- that is, Cintron's complaint supportably asserts that
RIDOC officials denied him "the minimal civilized measure of life's
necessities" such that he was "incarcerated under conditions
posing a substantial risk of serious harm." Farmer, 511 U.S. at
834 (citation omitted); see also Porter, 923 F.3d at 368 (outlawing
conditions that "deprive[] inmates of the basic human need for
'meaningful social interaction and positive environmental
stimulation'" (citation omitted)). We turn next to examining
whether Cintron's complaint also alleges facts that satisfy the
subjective requirement of an Eighth Amendment claim.
2.
The Eighth Amendment's subjective requirement mandates
that a defendant "possessed a sufficiently culpable state of
mind . . . amount[ing] to deliberate indifference to the
claimant's health or safety." Zingg v. Groblewski, 907 F.3d 630,
635 (1st Cir. 2018). "Deliberate indifference is characterized by
'obduracy and wantonness, not inadvertence or error in good
faith.'" Leite v. Bergeron, 911 F.3d 47, 52 (1st Cir. 2018)
(quoting Whitley v. Albers, 475 U.S. 312, 319 (1986)). "To show
such a state of mind, [Cintron] must provide evidence that [a given
defendant] had actual knowledge of impending harm, easily
- 20 - preventable, and yet failed to take the steps that would have
easily prevented that harm." Zingg, 907 F.3d at 635 (quotation
marks and citation omitted).
The subjective requirement poses "a question of fact
subject to demonstration in the usual ways, including inference
from circumstantial evidence." Farmer, 511 U.S. at 842. "[A]
factfinder may conclude that a prison official knew of a
substantial risk from the very fact that the risk was obvious."
Id. This inquiry focuses on the conduct of each official to
determine whether any given official "acted or failed to act
despite his knowledge of a substantial risk of serious harm." Id.
We read Cintron's complaint to sufficiently allege only
that Aceto, Corry, and Kettle knew of his deterioration in solitary
and possessed the authority to end the conditions causing that
deterioration. Aceto, Corry, and Kettle held supervisory
positions at RIDOC and plausibly must have known, at least in
general terms, the nature of RIDOC's solitary confinement -- i.e.,
that it involved conditions, like severe social, sensory, and sleep
deprivation, that risk serious mental and physical harm. And
Cintron adequately alleges that these three officials knew that
such risk had become reality for Cintron. Specifically, Cintron
contends that he and his social worker both informed Aceto and
Corry about his deteriorating condition and requested early
release from solitary. And he alleges that he appealed his
- 21 - solitary confinement several times to Kettle, who has admitted
that in reviewing such appeals, he "talk[s] to the staff members
[to see] how [the inmate is] doing."
We therefore turn our attention to what Cintron alleges
that Aceto, Corry, and Kettle did or did not do after gaining the
requisite knowledge. Cintron contends that they each refused to
suspend the remainder of his time living under the conditions
causing his deterioration, and that Corry instructed him to
"[o]ccupy [his] time by writing letters, journal[ing] things[,]
and shar[ing] with [his social worker]." He further contends that
RIDOC, as an institution, provided only modest medical
treatment -- psychopharmacologic drugs and sessions with a social
worker -- otherwise leaving his conditions of confinement
unchanged. In fact, Cintron alleges that RIDOC extended his
solitary confinement in direct response to an untreated symptom of
his opioid use disorder -- his abuse of prescription pain
medication while in solitary.
Case law makes clear that prison officials may impose
certain harmful conditions on a prisoner if they have a "legitimate
penological justification" for so doing. Porter, 923 F.3d at 362–
63. "[S]ecurity and administration" concerns can constitute one
such justification. Kosilek v. Spencer, 774 F.3d 63, 83–84 (1st
Cir. 2014) (en banc) (citation omitted). Defendants argue that
such is the case with solitary confinement, which they say they
- 22 - employ to help fulfill their "duty to maintain prison order,
discipline inmates for serious offenses they commit, and combat
narcotics consumption and trafficking that risks inmates' lives."
See Porter, 923 F.3d at 362–63.
Cintron, though, does not argue that solitary
confinement in all its forms is per se unconstitutional. Rather,
he trains his attention more narrowly, pointing to the particular
conditions that allegedly typified his solitary confinement in
RIDOC's ACI -- long-term social, sensory, and sleep deprivation.
And even as to those conditions, he focuses not on the conditions
per se, but on defendants' alleged failure to ameliorate them even
when his deterioration became manifest.
Defendants respond by insisting that "[r]eturning
[Cintron] to the general population before the completion of his
disciplinary sentence after he trafficked fentanyl into the prison
and while he admittedly was continuing to abuse substances would
have created an obvious and immediate danger for both Cintron and
other inmates." While we acknowledge "the deference owed to prison
administrators" when they make disciplinary decisions, Kosilek,
774 F.3d at 93, Cintron's long-term solitary confinement self-
evidently caused rather than prevented an "obvious and immediate
danger" to Cintron himself. And while officials can justify
removing a prisoner from the general population to improve the
safety of other inmates, they cannot -- in the face of that
- 23 - prisoner's deterioration -- perpetuate the kind of social,
sensory, and sleep deprivation that Cintron alleges.
As to those deprivations, defendants defend as "not
necessary for a civilized life," Rahman X v. Morgan, 300 F.3d 970,
974 (8th Cir. 2002), some of the items of which they allegedly
deprived Cintron: a mirror, newspapers, a radio, a desk, a
television, and an MP3 player. But in ninety-seven pages of
appellate briefing, defendants point to no legitimate penological
need to interfere systematically with Cintron's sleep or to
maintain such a high degree of isolation and sensory deprivation.
In this manner, defendants waive -- at least for the purposes of
their motion for judgment on the pleadings -- any argument that
there exists a legitimate penological justification for subjecting
Cintron to these alleged conditions in the face of his
deterioration. See Gonzalez-Morales v. Hernandez-Arencibia, 221
F.3d 45, 51 n.7 (1st Cir. 2000) (providing that "arguments not
developed are waived").
We therefore conclude that Cintron plausibly alleges
facts that, if true, would establish that Aceto, Corry, and Kettle
violated his Eighth Amendment right against cruel and unusual
punishment. He has, however, not done so vis-à-vis any other
defendant under his theory of the case, so we reverse the district
court insofar as it allowed Cintron's individual-capacity monetary
- 24 - claim to proceed against Bibeault, Cabral, Coyne-Fague, and
Diniz.11
We must now determine whether, at the time Aceto, Corry,
and Kettle allegedly allowed Cintron to deteriorate from the
deprivations he claims he experienced in solitary, it was clearly
established that the Eighth Amendment bars such treatment.
Throughout our analysis above, we rely exclusively on authority
predating defendants' actions at issue. As we conclude below,
those authorities were sufficient to put Aceto, Corry, and Kettle
on notice both that solitary confinement of the type alleged by
Cintron can seriously harm prisoners and that prison officials may
not respond indifferently to such harm once it manifests.
For the purposes of qualified immunity, a right is
clearly established when it is "sufficiently clear that every
reasonable official would have understood that what he is doing
11 In so holding, we do not mean to imply any approval of Bibeault's, Cabral's, Coyne-Fague's, or Diniz's alleged conduct. Under different theories of the case, Cintron very well might be able to make out claims against some of these defendants -- especially Bibeault, whose alleged threats to Cintron's mental health strike us as particularly pernicious. But Cintron presses a claim grounded in defendants' alleged indifference to his ongoing deterioration, and he asserts facts showing only that Aceto, Corry, and Kettle knew of that deterioration and could have ended it. Notably, Cintron does not allege any facts showing that he or anyone else informed Diniz of his deterioration, nor does he allege facts showing that Bibeault had any role in (or knowledge of) the responses to Cintron's deterioration as it developed.
- 25 - violates that right." Mullenix v. Luna, 577 U.S. 7, 11 (2015)
(per curiam) (citation omitted). Although a plaintiff need not
point to "a case directly on point for a right to be clearly
established, existing precedent must have placed the statutory or
constitutional question beyond debate." White v. Pauly, 580 U.S.
73, 79 (2017) (per curiam) (quotation marks and citation omitted).
In adjudicating this requirement, we look mainly to Supreme Court
and First Circuit precedent, see Stamps v. Town of Framingham, 813
F.3d 27, 40 (1st Cir. 2016), while also considering cases from
other courts, see Wilson v. Layne, 526 U.S. 603, 616–17 (1999),
and certain non-case-law sources, like statutes, see Eves v.
LePage, 927 F.3d 575, 587 (1st Cir. 2019), prison regulations, see
Hope v. Pelzer, 536 U.S. 730, 743–44 (2002), and government studies
and reports, see id. at 744–45.
Importantly, "officials can still be on notice that
their conduct violates established law even in novel factual
circumstances." Id. at 741. "Although earlier cases involving
'fundamentally similar' facts can provide especially strong
support for a conclusion that the law is clearly established, they
are not necessary to such a finding. The same is true of cases
with 'materially similar' facts." Id. Thus, even without such
similarity, we may find evidence that "the state of the law in
[2019] gave [defendants] fair warning that their alleged treatment
of [Cintron] was unconstitutional." Id.
- 26 - Applying this framework, we hold that it was clearly
established, as of 2019, that Cintron's alleged conditions of
continued confinement violate the Eighth Amendment's objective
requirement. We reach this holding most easily as to Cintron's
allegations of prolonged sleep deprivation. As of 2019, at least
four courts of appeals had recognized the unlawfulness of the type
of sleep-deprivation tactics alleged by Cintron. See Walker, 717
F.3d at 122, 126–27; Allah, 574 F. App'x at 138–39; Antonelli, 81
F.3d at 1433; Keenan, 83 F.3d at 1090–91; see also Wilson, 526
U.S. at 617 (indicating that "a consensus of cases of persuasive
authority" can demonstrate "that a reasonable officer could not
have believed that his actions were lawful"). And the Supreme
Court itself had described such tactics as "the most effective
torture." Ashcraft, 322 U.S. at 150 n.6 (citation omitted).
As of 2019, several courts of appeals had also recognized
that prolonged social and sensory deprivation pose objectively
grave threats to inmates' health. See, e.g., Porter, 923 F.3d at
360–61; Williams, 848 F.3d at 566–67. These holdings followed
(and heavily relied on) a chorus of "studies and scholarly
articles . . . demonstrating that prolonged isolated confinement,
under conditions closely analogous to those [Cintron]
challenge[s], creates a substantial risk of psychological and
emotional harm." Porter, 923 F.3d at 360–61; Williams, 848 F.3d
at 566–69. As Cintron documents in his brief, leaders of Rhode
- 27 - Island -- and of RIDOC itself -- had acknowledged by 2019 the
dangers of social and sensory deprivation in solitary confinement.
A 2017 report, commissioned by Rhode Island's legislature to study
and assess the use of solitary at the ACI, found:
[Community members] shared personal experiences of the lasting negative impact of their isolation, or that of a loved one, on their mental and physical health. In addition, many community members noted that those who are sentenced to solitary confinement often suffer from profound mental health issues even before their incarceration. In this regard, they testified that solitary confinement served to exacerbate those pre- existing issues rather than to serve any rehabilitative purpose, which they offered as counter to the goals of the greater community who will receive these very individuals in society upon their release from the ACI.
The commission also heard from experts in both medical and psychiatric fields regarding the physical and psychological impact of solitary confinement on a prisoner. Presenters offered testimony on recent research studies which showed that prolonged isolation causes higher rates of psychiatric hospitalization, sleeplessness, anxiety, depression and suicidal thoughts among prisoners. Additional research studies noted negative physiological effects on prisoners to include loss of appetite, lethargy and diminished impulse control.
Report of the Special Legislative Commission to Study and Assess
the Use of Solitary Confinement at the Rhode Island ACI 6 (June 29,
2017). Viewing the overall landscape as of 2019 -- in particular,
the legislative report addressing the deleterious effects of
solitary at the very facility at which Cintron was imprisoned -- we
- 28 - conclude that any reasonable officer would have known in 2019 that
prolonged social and sensory deprivation "pos[e] a substantial
risk of serious harm" to inmates. Farmer, 511 U.S. at 834.
We also conclude that it was clearly established, at the
time Aceto, Corry, and Kettle allegedly ignored Cintron's pleas
for help, that prison officials may not respond indifferently to
an inmate's deterioration under objectively harmful conditions of
confinement. The Supreme Court held as much over thirty years
ago. See id. (providing that the Eighth Amendment bars "deliberate
indifference" to an inmate's injuries accrued "under conditions
posing a substantial risk of serious harm" (citation omitted));
see also Estelle v. Gamble, 429 U.S. 97, 104 (1976) ("Deliberate
indifference to serious medical needs of prisoners constitutes the
unnecessary and wanton infliction of pain proscribed by the Eighth
Amendment." (cleaned up)).
Defendants do not argue that this rule of law was not
clearly established as of 2019. Instead, they contend that no
pre-2019 case law clearly established "that a prison official is
required to suspend an inmate's disciplinary sentence in
circumstances where that inmate committed multiple, serious
disciplinary offenses." True enough. But we do not here hold
that the Eighth Amendment required defendants to grant Cintron's
specific suspension requests. Instead, we hold simply that the
Eighth Amendment barred defendants from responding to those
- 29 - requests with complete indifference. Defendants had several
options short of suspension that may well have cured the alleged
objectively harmful conditions of confinement, but Cintron asserts
that they deliberately selected none of those options.
Finally, we note that defendants invoke several District
of Rhode Island decisions that they claim approved of solitary
confinement akin to that alleged by Cintron. But defendants
overread the case law. In Harris v. Perry, the court rejected an
Eighth Amendment claim challenging prolonged solitary, but in so
doing, the court opined simply on solitary confinement in the
broadest sense (i.e., disciplining a prisoner by separating him
from the general population). See No. 15-cv-00222, 2015 WL
4879042, at *5 (D.R.I. July 15, 2015). The plaintiff there made
no allegations evincing unconstitutionally harsh conditions or
deliberate indifference to any harm arising therefrom. See id. at
*3. In Rodriguez v. Cabral, the court rejected as insufficient to
support an Eighth Amendment claim the plaintiff's bare allegation
that "his period in [solitary] caused his mental health issues to
worsen." No. 16-cv-00203, 2018 WL 1449515, at *3 (D.R.I. Mar. 23,
2018). And in Paye v. Wall, the court rejected the plaintiff's
Eighth Amendment challenge, pointing out that the plaintiff did
"not demonstrate[], or even allege[], that he was subjected to
inhumane conditions during" his solitary confinement. No. 17-cv-
00193, 2018 WL 4639119, at *3 (D.R.I. Sept. 27, 2018). In none of
- 30 - those cases did the plaintiffs come remotely close to making out
Eighth Amendment claims predicated on the type of social, sensory,
and sleep deprivation that Cintron alleges. Defendants therefore
find no shelter in this case law.
Thus, we conclude that Aceto, Corry, and Kettle have not
demonstrated their entitlement to qualified immunity from
Cintron's Eighth Amendment claim.
For the foregoing reasons, we affirm the district
court's August 2022 text order in part, vacate and remand it in
part, and reverse it in part. We affirm the order insofar as it
allowed Cintron's Eighth Amendment monetary claim against Aceto,
Corry, and Kettle in their individual capacities to proceed. We
vacate it insofar as it allowed Cintron's Eighth Amendment
declaratory and injunctive claims against those three defendants
in their official capacities to proceed and remand those claims
for renewed standing/mootness analysis. And we otherwise reverse
the order in full. The parties shall bear their own costs.
- 31 -