4 STATE OF MAINE SUPERJOR COURT CUMBERLAND, ss. CIVIL ACTION DOCKET NO. CV-21-0346
) MARK GRAHAM ) ) Plaintiff ) ) V. ) ORDER ) JOHN COSTELLO, KEVIN JOYCE, DOCTOR ) "EDDY" AND ARMOR CORRECTIONAL ) HEALTH SERVICES 1 ) ) Defendants ) )
Before the Court are a number of pending motions: (I) Plaintiff Mark Graham's
("Graham") Motion for a Preliminary Injunction; (II) Defendants John Costello and Kevin Joyce's
(individually "Costello" and "Joyce" collectively "Cumberland County Sheriffs Office (CCSO)
Defendants") Motion for Leave to Amend their Answer; (III) Defendant Armor Health
Correctional Services, Inc.' s ("Armor") Motion to Dismiss. For the reasons set forth herein,
Graham's Motion for a Preliminary Injunction is DENIED, Cumberland County Defendant's
Motion for Leave to Amend their Answer is GRANTED, and Annor's Motion to Dismiss is
GRANTED IN PART and DENIED IN PART
FACTUAL BACKGROUND
1 The exact identities ofthe Defendants are not easily discerned from the various pleadings filed with this Court, so
the Defendants named in the case caption are those which have filed an answer, actively participating in this litigation. The following factual background is derived from the numerous pleadings filed in this
matter so far and is largely reflective of the allegations contained in the complaint, consistent
with M.R. Civ. P. 12(b)(6), which is implicated by Armor's motion for dismissal.
Prior to his current residence at the Riverview Psychiatric Center in Augusta, Maine,
Graham was an inmate who had a semi-regular presence at Cumberland County Jail in Portland,
Maine. 2 He has been discharged from and reentered that facility on multiple occasions.
Defendant Armor, and Defendant "Eddy" are medical providers at Cumberland County
Jail. Armor is a third party healthcare provider that Cumberland County Jail has contracted with
to provide medical services for residents, and Doctor "Eddy" is presumably Armor's employee.
Defendants Costello and Joyce are employees of the Cumberland County Sheriffs Office, the
law enforcement agency which operates the Cumberland County Jail. Costello is a Captain and
Joyce is the Sheriff.
Graham's complaint raises professional negligence claims against jail medical personnel
and seeks relief, pursuant to 42 U.S.C. § 1983 (2021), or multiple issues Graham claims he's had
with Cumberland County Jail and Armor personnel. Inter alia, Graham's complaint alleges that
he was intentionally placed in a segregated housing unit as punishment for seeking mental health
treatment, that medical personnel at the facility intentionally placed drugs in Graham's food and
water and ignored Graham's medical complaints, negligently treated/diagnosed Graham's
ailments, and treated Graham's medical needs with "deliberate indifference."
This last allegation, that medical staff and other personnel at Cumberland County Jail
acted with "deliberate indifference" towards Graham and his medical needs is grounded in the
Supreme Court's Eighth Amendment jurisprudence. In Estelle v. Gamble, the Court extended
2 Prior to Riverview, Graham was a resident at Maine State Prison in Warren, Maine, for a brief time.
2 Eighth Amendment protections against cruel and unusual punishment to the delivery of medical
care to incarcerated individuals. 429 U.S. 97, 104-105 (1976).
Mark Graham filed his complaint in this case on September 16th, 2021. As part of that
filing he included a Motion for a Preliminary Injunction. After a November 15th, 2021 order by
this Court (McKeon, J.) granting Graham's motion for service by alternative means and denying
his motion which sought to add additional defendants, Armor timely filed a Motion to Dismiss
Graham's complaint on December 7, 2021. Seven days later, on December 14th, CCSO
Defendants and Armor both properly filed answers. On January 10th, 2022, CCSO Defendants
moved to amend their answer. Graham filed an opposition to Armor's Motion to Dismiss on
December 29th, 2021 and Armor filed a reply memorandum on January 10th, 2022.
DISCUSSION
As noted above, the pending motions in this case are (I) Graham's Motion for a
Preliminary Injunction; (II) CCSO Defendants' Motion for Leave to Amend their Answer; (Ill)
Armor's Motion to Dismiss. Each of these pending motions are addressed in turn:
I. Motion for Preliminary Injunction
Along with Graham's complaint, filed pro se on September 16th, 2021, Graham also filed
a Motion for a Preliminary Injunction. Graham's handwritten motion requests that this Court
enjoin certain Cumberland County Jail officials "from making decisions and having control over
Mark Graham's program, classification and security placement levels," It also seeks to prevent
them from interacting with him at all and asks for mandatory injunctions requiring CCSO to
place Captain Goulet in charge of his care and requiring the jail to remove him from the facility's
segregated housing unit.
3 A party seeking a preliminary injunction generally has the burden of demonstrating that
the following four criteria are met: ( 1) the plaintiff will suffer hTeparable injury if the injunction
is not granted; (2) such injury outweighs any harm which granting the injunctive relief would
inflict on the defendant; (3) the plaintiff has exhibited a likelihood of success on the merits (at
most, a probability; at least, a substantial possibility); and (4) the public interest will not be
adversely affected by granting the injunction. Department ofEnvironmental Protection v.
Emerson, 563 A.2d 762, 768 (Me. 1989). "Failure to demonstrate that any one of these criteria
are met requires that injunctive relief be denied." Bangor Historic Track, Inc. v. Dep 't of
Agric., Food & Rural Res., 2003 ME 140, if 10, 837 A.2d 129.
As is mentioned in the factual background section of this Order, Graham is now a
resident of Riverview Psychiatric Center, in Augusta, where he is engaged in that facility's
intensive mental health treatment program. Graham's residence in Augusta renders his request
for a preliminary injunction moot as he is no longer experiencing the complained of harm that he
seeks to enjoin. The entirety of Graham's allegations is set in the Cumberland County Jail, not
Riverview Psychiatric Center. Accordingly, issuing an injunction in Graham's favor would have
little practical effect. 3 See Ten citizens ofthe Town ofBiddeford v. Town ofBiddeford, 2003 ME
59, ,r 5, 822 A.2d 1196 ("[A] determination of mootness [is made] by examining the record to
determine "whether there remain sufficient practical effects flowing from the resolution of the
litigation to justify the application of limited judicial resources."). Additionally, Graham has not
alleged any facts which help his motion evade application of the mootness doctrine. See Clark v.
Hancock County Comm 'rs, 2014 ME 33 if 13, 87 A.3d 712 (recognizing three exceptions to the
3Even ifmootness did not serve as a sufficient basis for denial of Graham's Motion, the Court notes that his Motion does not set forth facts which constitute irreparable iajury, see Bar Harbor Banking & Trust Co. v. Alexander, 411 A.2d 74, 79 (Me. 1980) (""Irreparable injury" is defined as "injury for which there is no adequate remedy at law.""), or as discussed below, exhibit a likelihood of the success of the merits ofhis professional negligence claims.
4 Mootness doctrine: (1) sufficient collateral consequences will result from the determination of
the questions presented so as to justify relief; (2) the appeal contains questions of great public
concern that, in the interest of providing future guidance to the bar and public, the court may
address; or (3) the issues are capable of repetition but evade review because of their fleeting or
determinate nature). Plaintiffs Motion for a Preliminary Injunction is denied.
II. CCSO Defendants' Motion for Leave to Amend Answer
After filing their answer to Graham's complaint, Defendants Costello and Joyce moved
this Court for leave to amend their answer. Specifically, they noticed that the complaint named
Captain David Costello and determined that this was an error - nobody named David Costello
is employed at CCSO. There is, however, a John Costello, also with the rank of Captain. Because
Graham had filed an "objection" to the Defendant's answer, Costello and Joyce sought leave of
Court to amend their answer so it could accurately reflect the names of the parties. See M.R. Civ.
P. 15(a). Plaintiff Mark Graham filed no objection to this request for leave.
Consistent with M.R. Civ. P. 15(a)'s and the Law Court's instruction that "leave to
amend shall be freely granted," the CCSO Defendants Motion is granted. Barkley v. Goodwill
Home Assocs., 495 A.2d 1238, 1240 (Me. 1985).
III. Armor's Motion to Dismiss
On December 7th, 2021, Defendant Armor filed a Motion to Dismiss Graham's claims
against them pursuant to M.R. Civ. P. 12(b)(6). In their Motion, Armor asserts that Graham's
failure to comply with the Maine Health Security Act's requirement that any prospective medical
malpractice plaintiff first file a Notice of Claim with a prelitigation screening panel, forecloses
his claims. See 24 M.R.S. § 2903 (2021 ). The Court agrees that any claims alleging professional
5 negligence by Graham are subject to dismissal, but also finds that he has sufficiently plead
claims against Armor alleging a violation of his Eighth Amendment rights.
A. Motion to Dismiss Standard
"A motion to dismiss pursuant to M.R. Civ. P. 12(b)(6) tests the legal sufficiency of the
claim." Seacoast Hangar Condo. II Ass'n v. Martel, 2001 ME 112, 'if 16, 775 A.2d 1166 (quoting
New Orleans Tanker Corp, v. Dep 1t ofTransp., 1999 ME 67, 'if 3, 728 A.2d 673). \Vhen the court
reviews a motion to dismiss, "the claim is examined 'in the light most favorable to the plaintiff to
determine whether it sets forth elements of a cause of action or alleges facts that would entitle
the plaintiff to relief pursuant to some legal theory.rn Lalonde v. Cent. Me. Med. Ctr., 2017 ME
22, 'if 11, 155 A.3d 426. Allegations in the complaint are deemed true for the purposes of
deciding a motion to dismiss. Id. "A dismissal should only occur when it appears beyond doubt
that a plaintiff is entitled to no relief under any set of facts that he might prove in support of his
claim." Moody v. State Liquor & Lottery Comm'n, 2004 ME 20, 'i[ 7,843 A.2d 43 (quoting
McAfee v. Cole, 637 A.2d 463,465 (Me. 1994)) (internal quotations omitted).
B. Analysis
There are two considerations for this Court in deciding the instant Motion. First, as
challenged by Armor, whether Graham's claims are best characterized as claims for professional
negligence and thus subject to the prelitigation panel screening process under the Maine Health
Security Act. Second, whether Graham's allegations set forth a cognizable Section 1983 claim
against Armor for violation of the Eighth Amendment's prohibition against cruel and unusual
punishment.
1. Maine Health Security Act
6 Armor's grounds for dismissal premised on the Maine Health Security Act requires this
Court to consider two issues: (1) whether Graham's claims are subject to coverage under the Act;
and (2) if they are covered, whether Graham complied with the Act's procedures for bringing
claims of professional negligence against healthcare providers. In this case there is no allegation
by Graham that he compiled with the Maine Health Security Act's procedures. Thus, the
essential inquiry is whether his claims are covered by the statute.
The Maine Health Security Act, and the prelitigation panel screening process that it
establishes, is intended to promote the early identification of claims for professional negligence
and encourage their resolution. See 24 M.R.S. § 2851 (2021). The Act establishes a screening
process intended to evaluate the merits of a plaintiff's potential claims before they are brought to
court. See 24 M.R. S. § 285 5 (2021 ). If, before the screening panel, the plaintiff establishes that
the health care provider's negligence was the cause of the plaintiff's injury by a preponderance
of the evidence, then the plaintiff and the provider must enter settlement negotiations regarding
damages and liability. See generally 24 M.R.S. § 2858 (2021). If no agreement is reached, a
medical malpractice action may then be brought in the Superior Court. See 24 M.R.S. § 2903
(2021).
Claims subject to the Maine Health Security Act's requirements are those which fit the
statutory definition of"an action for professional negligence.'' See 24 M.R.S. § 2502(6) (2021).
An action for professional negligence is defined as:
any action for damages for injury or death against any health care provider, its agents or employees, or health care practitioner or the healthcare practitioner's agents or employees, whether based upon tort or breach of contract or otherwise, arising out of the provision or failure to provide health care services.
7 Id. Acts which constitute "professional negligence" are acts or omissions which "constitute a
deviation from the applicable standard of care by the healthcare provider charged with that care .
. . that proximately cause[] the injury complained of." 24 M.R.S. § 2502(7) (2021).
Armor argues that all of Graham's claims are covered by the Maine Health Security Act
because many of his allegations "arise" out of alleged injury suffered as a result of Armor's
"provision or failure to provide health care" services. As a prose Plaintiff, Graham's specific
allegations are difficult to discern, but many of them do sound in professional negligence, as
defined by statute. Graham raises allegations which include the negligent placement of harmful
drugs in his food and water, the negligent provision of medical treatment, and the misdiagnosis
of various mental health disorders.
Thus, these specific allegations against Armor and their medical staff at Cumberland
County Jail fail to state a claim upon which relief may be granted. Before alleging his claims for
professional negligence, Graham did not comply with the statutorily required prelitigation
screening panel process. See Saunders v. Tisher, 2006 ME 94, ,r,r 15-16, 902 A.2d 830
(dismissing a complaint for failure to comply with the procedural provisions of the Maine Health
Security Act). As a result, Graham cannot now bring those claims before this Court. To the
extent that Graham raises any claims of professional negligence against Armor or Armor's
individual employees, they are dismissed.
2. 8th Amendment Claim
In addition to an allegation of professional negligence against Armor and the providers it
employs at Cumberland County Jail, Graham also makes allegations that their personnel violated
his Eighth Amendment right to be free from cruel and unusual punishment.
8 Claims brought under 42 U.S.C. § 1983 alleging a violation of a prisoner's 8th
amendment rights in the healthcare delivery context, are cognizable as long as they allege
"deliberate indifference to the serious medical needs of prisoners." Estelle, 429 U.S. 97, 104-105
( 1976). The indifference with which officials act towards a prisoner must be "deliberate," it
cannot be inadvertent or accidental. See id. at 106 ("In order to state a cognizable claim, a
prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to
serious medical needs. It is only such indifference that can offend 1'evolving standards of
decency 11 in violation of the Eighth Amendment.")
Here, viewing Graham's complaint in a light most favorable to him, he sets forth facts
alleging that Cumberland County Jail medical personnel "intentionally neglected and ignored"
his medical and mental health needs. He also claims that they treated his serious mental health
needs with deliberate indifference by placing him in a segregated housing unit as "treatment" and
"punishment" for those needs. He also alleges that personnel intentionally restricted his access to
needed medication.
Accepting these allegations as true for the purposes of this Motion, Graham does state
facts which constitute a cognizable claim under the Eighth Amendment. Accordingly, Graham's
claims that Armor and its employee's deliberate indifference towards Graham's serious medical
needs are not dismissed.
IV. Conclusion
Although Mr. Graham is a pro se, incarcerated, Plaintiff, he has sufficiently met the
pleading standards required ofrepresented parties. See Brown v. Thaler, 2005 ME 75, ,r 8, 880
A.2d 1113 ("self-represented parties are subject to the same standards as represented parties").
Mr. Graham has gone to great lengths to make his legal arguments, conduct research to support
9 those arguments, and hand write them, in a legible manner, on notebook paper.
Viewing Graham's complaint in a light most favorable to him, he raises two independent
causes of action against Armor. First, claims of professional negligence by Armor's employees,
and second, a section 1983 claim alleging violation of his Eighth Amendment rights. The Court
agrees that the former is dismissed for Graham's failure to comply with the Maine Health
Security Act. The latter however, survives Armor's Motion.
Plaintiffs Motion for a Preliminary Injunction is Denied.
CCSO Defendants Costello and Joyce's Motion for Leave to Amend their Answer is Granted.
Defendant Armor Correctional Health Services, Inc.'s Motion to Dismiss is Granted in Part and Denied in Part.
The clerk is directed to incorporate this Order into the docket by reference pursuant to M.R. Civ.
Dated: Johnr:.bf? Justice, Maine Superior Court