Joaquin Ramos v. Alejandro Reyes, Warden, Mike Durfee State Prison, in individual and official capacity; Elizabeth Paul, Medical Provider (DNP), Mike Durfee State Prison, in individual and official capacity; and Dr. Aaron Haynes, Medical Director, All state facilities, in individual and official capacity

District Court, D. South Dakota·Decided August 27, 2026·No. 4:26-cv-04010·Unknown

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF SOUTH DAKOTA SOUTHERN DIVISION JOAQUIN RAMOS, 4:26-CV-04010-CCT Plaintiff, vs. OPINION AND ORDER TO DISMISS ON § 1915A SCREENING ALEJANDRO REYES, Warden, Mike Durfee State Prison, in individual and official capacity; ELIZABETH PAUL, Medical Provider (DNP), Mike Durfee State Prison, in individual and official capacity; and DR. AARON HAYNES, Medical Director, All state facilities, in individual and official capacity, Defendants. Plaintiff Joaquin Ramos, an inmate at Mike Durfee State Prison, filed a pro se civil rights lawsuit. Docket 1. This Court granted Ramos’s motion for leave to proceed in forma pauperis and ordered him to pay an initial partial filing fee, Docket 8, which he timely paid. But as this Court was preparing its screening order pursuant to 28 U.S.C. § 1915A, Ramos passed away.1 Before this Court addresses Ramos’s death, it screens his complaint pursuant to 28 U.S.C. § 1915A.

1 Rae Yost, DOC: 3rd inmate death in March, KELO (Mar. 23, 2026, at 3:54 CDT), https://www.keloland.com/news/local-news/doc-3rd-inmate-death-in-march/. I. 1915A Screening A. Factual Background as Alleged by Ramos Ramos’s complaint2 arises out of events occurring while he was

incarcerated at Mike Durfee State Prison (MDSP). See generally Docket 1. On September 6, 2023, Ramos first complained to medical that he was “having problems with breathing.” Id. at 4. After Ramos made a sick call request on September 6, 2023, he was seen by Rachel Kneifl, LPN, who placed Ramos on a list to see a provider and gave him “10 mg Loratadine3 and 200 mg of Ibuprofen without any diagnosis whatsoever.” Docket 2 ¶ 1; Docket 3 ¶ 1.4 See also Docket 2-1 at 29–31. On September 8, 2023, Ramos was seen by Elizabeth Paul, DNP, and informed her that he had been experiencing shortness of

2 Ramos also filed a “Motion to Substitute and Amend Pursuant to Rule § 15 & 25 of Fed R. Civ. P.” Docket 9. But this motion does not appear to be aimed toward “assert[ing] matters that were overlooked or were unknown at the time” Ramos filed his original complaint, as would an amended complaint. See generally Docket 9; 6 Wright & Miller’s Federal Practice & Procedure § 1473 (3d ed. 2026). Nor does the motion appear to be intended to “set[] forth transactions, occurrences, or events that have happened since the filing of the pleading to be supplemented, thereby bringing the case up to date[,]” as would a supplemental pleading. See generally Docket 9; 6A Wright & Miller’s Federal Practice & Procedure § 1504 (3d ed. 2026). Therefore, this Court declines to construe this filing as either an amended or supplemental pleading, and instead liberally construes this motion, Docket 9, as a motion to add a representative, which the Court will discuss below. Additionally, Ramos also seeks to correct the spelling of Defendant Aaron Haynes’s name, Docket 9 at 1, and his motion is granted to this extent.

3 Loratadine is an antihistamine commonly known as Alavert or Claritin. Loratadin, Drugs.com, https://www.drugs.com/loratadine.html (last visited Aug. 21, 2026).

4 Along with his complaint, Ramos filed an affidavit in support of his complaint, Docket 2, and a brief in support of his complaint, Docket 3. In considering whether Ramos has stated a claim upon which relief may be granted, the Court may look to “documents necessarily embraced by the complaint.” Zean v. Fairview Health Servs., 858 F.3d 520, 526 (8th Cir. 2017) (citing Enervations. Inc. v. Minn. Min. & Mfg. Co., 380 F.3d 1066, 1069 (8th Cir. 2004)). breath for at least two to three months. Docket 2 ¶ 3; Docket 3 ¶ 3. See also Docket 2-1 at 32–34. Ramos claims that Paul “is the ‘provider’ for the inmate population at MDSP and is only a ‘Nurse’ and not a qualified Doctor to make any diagnosis in any ‘serious’ medical need.”5 Docket 1 at 5. Ramos told Paul

that he experienced “shortness of breath when [he] climbed stairs, walked long distances and [he] felt like [his] condition was getting worse by the day.” Docket 2 ¶ 3; Docket 3 ¶ 3. “Without a diagnosis from any specialist or qualified doctor, [Ramos] was given a[n] Albuterol Inhaler, informed [he] had X-rays scheduled, and was told to come back in a month for a follow up.” Docket 3 ¶ 3. Ramos claims he was told by Paul that “Asthma or COPD [chronic obstructive pulmonary disease] was suspected but instead of ordering tests

and a consult from a lung specialists [sic], [he] was given treatment for an assumption.” Id. X-rays were taken on September 13, 2023, and Ramos “received MDSP medical correspondence regarding [his] visit with the provider and the x-rays that were taken on September 13, 2025 which stated: ‘Some possible Infiltrates, maybe mild pneumonia, Z pack started.’” Docket 2 ¶ 6. On October 12, 2023, Ramos was called to medical to see Paul after he reported that his condition was getting worse and that he was not receiving adequate relief from the medication he had been provided. Id. ¶ 9; Docket 3

5 Ramos provides that Paul is a “DNP[,]” Docket 1 at 2, which this Court understands to be a Doctor of Nursing Practice. According to the South Dakota Board of Nursing, Paul is licensed as a Registered Nurse and Certified Nurse Practitioner. See Primary Source License Verification, S.D. Bd. of Nursing, https://sdbon.boardsofnursing.org/licenselookup/Home/Report?o=afdEhYB9k4aajih cucVzCg== (last visited Aug. 25, 2026). ¶ 5. See also Docket 2-1 at 35–37. In the affidavit he attaches in support of his complaint, Ramos alleges that Paul diagnosed him with COPD.6 Docket 2 ¶ 9. Paul provided Ramos with a COPD patient education packet and a Spiriva

Respimat spray inhaler and scheduled Ramos for a follow up in a month without referring Ramos to a “lung specialist[.]” Id.; Docket 3 ¶ 5. Ramos was seen by Paul again on November 17, 2023, December 5, 2023, and January 17, 2024, where he was given inhalers, glucose tabs, and told to follow hypoglycemia protocol.7 Docket 2 ¶¶ 10–12; Docket 2-1 at 38–43, 45–47. Ramos attaches a record from his December 5 visit noting that he “reports his symptoms vary from day to day but overall seem to be worse than 1 month ago.” Docket 2-1 at 41. At his January 14 visit, however, the report notes that

Ramos “states his [shortness of breath] is still slightly present with going up stairs and walking long distances, but is greatly improved since last month[,]” and the assessment states “COPD well controlled/stable[.]” Id. at 45, 46. The report also notes that Ramos was “educated on treatment plan and is agreeable to the plan.” Id. at 46. On May 29, 2024, Ramos was seen again by Paul, where he reported that he suffered from “continued shortness of breath and . . . additional triggers” which included changes in the weather, temperature, and humidity. Docket 2

6 Ramos attaches records from his October 12, 2023 visit with Paul, which provide: “recommend [pulmonary function tests] to appropriately diagnose COPD; however, patient declines at this time. Will start Spiriva 2 puffs once daily. Patient educated on causes, symptoms, risks, treatments, and goals of treatment related to COPD.” Docket 2-1 at 36.

7 The “[a]ssesment” for each of these visits noted “COPD[.]” Docket 2-1 at 39, 42, 46. ¶ 14; Docket 2-1 at 48–51. Ramos was given a “normal physical exam and told [his] lungs sounded a little congested.” Docket 2 ¶ 14; Docket 3 ¶ 7. Paul also referred Ramos to pulmonology and ordered labs for COPD. Id. On July 28,

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Joaquin Ramos v. Alejandro Reyes, Warden, Mike Durfee State Prison, in individual and official capacity; Elizabeth Paul, Medical Provider (DNP), Mike Durfee State Prison, in individual and official capacity; and Dr. Aaron Haynes, Medical Director, All state facilities, in individual and official capacity, (D.S.D. 2026).

Joaquin Ramos v. Alejandro Reyes, Warden, Mike Durfee State Prison, in individual and official capacity; Elizabeth Paul, Medical Provider (DNP), Mike Durfee State Prison, in individual and official capacity; and Dr. Aaron Haynes, Medical Director, All state facilities, in individual and official capacity (Joaquin Ramos v. Alejandro Reyes, Warden, Mike Durfee State Prison, in individual and official capacity; Elizabeth Paul, Medical Provider (DNP), Mike Durfee State Prison, in individual and official capacity; and Dr. Aaron Haynes, Medical Director, All state facilities, in individual and official capacity) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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