Ricky J. Johnson v. Dr. Kevin Marler

Court of Appeals for the Eleventh Circuit·Decided July 31, 2026·No. 24-11060·Unpublished

Opinion

USCA11 Case: 24-11060 Document: 57-1 Date Filed: 07/31/2026 Page: 1 of 31

NOT FOR PUBLICATION

In the United States Court of Appeals For the Eleventh Circuit ____________________ No. 24-11060 ____________________

RICKY J. JOHNSON, Plaintiff-Appellant, versus

DR SHARON LEWIS, Medical Director of GDC, et al., Defendants, DR KEVIN MARLER, Defendant-Appellee. ____________________ Appeal from the United States District Court for the Middle District of Georgia D.C. Docket No. 5:16-cv-00453-TES-MSH ____________________ USCA11 Case: 24-11060 Document: 57-1 Date Filed: 07/31/2026 Page: 2 of 31

2 Opinion of the Court 24-11060

Before BRANCH, LUCK, Circuit Judges, and MORENO,* District Judge. MORENO, District Judge: Ricky Johnson is an inmate in the custody and care of the Georgia Department of Corrections. Johnson was diagnosed with Hepatitis C in 2009, but did not receive medication for it until nine years later. By then, Johnson's Hepatitis C had progressed to stage F4 cirrhosis with indications of severe liver inflammation. Johnson sued numerous prison doctors alleging that they were deliberately indifferent to his serious medical needs in violation of the Eighth Amendment. The district court granted summary judgment in fa- vor of the doctors and dismissed all claims against them. Johnson appealed both the district court’s grant of summary judgment and its denial of his motion to amend the complaint. This Court re- versed the district court’s grant of summary judgment and re- manded for trial. 1 The case proceeded to trial against the other de- fendant medical doctors and resulted in a jury verdict in Johnson’s favor.2 However, prior to trial, the district court granted judgment on the pleadings in favor of Dr. Marler and dismissed him from the case on the basis that Johnson failed to exhaust his administrative

* The Honorable Federico A. Moreno, United States District Judge for the

Southern District of Florida, sitting by designation. 1 Johnson v. Lewis, 83 F.4th 1319 (11th Cir. 2023).

2 Jury Verdict, Johnson v. Lewis, 16-00453 (M.D. Ga. Mar. 6, 2024). USCA11 Case: 24-11060 Document: 57-1 Date Filed: 07/31/2026 Page: 3 of 31

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remedies under the Prison Litigation Reform Act. This appeal fol- lowed. We find that the district court did not abuse its discretion in permitting Dr. Marler to file a motion for judgment on the plead- ings, and we affirm the district court’s holding that Johnson failed to exhaust his administrative remedies. I. BACKGROUND A. Factual History The underlying lawsuit was previously appealed to this Court. Johnson v. Lewis, 83 F.4th 1319 (11th Cir. 2023), provides a thorough review of the many factual disputes in this case. We bor- row from that opinion any overlapping material. First, we provide some background on Hepatitis C (“HCV”) and the Georgia Depart- ment of Corrections (“GDC”) policy for treating it. Hepatitis C is a bloodborne virus that affects one’s liver. It can cause liver scarring and “fibrosis.” The most extreme form of liver damage from Hepatitis C is called “cirrhosis” and it can have fatal effects. Hepatitis C may take a long time to progress but irre- spective of the rate, it can only be cured with medication. The GDC has a policy for treating patients with HCV, which has and continues to evolve as new treatments and medicines become available. Because the relevant time period in this case spans from 2012-2018, two GDC policies are at issue: the 2012 policy and the 2016 policy. The 2012 policy provided for the admin- istration of a triple-drug treatment when patients met USCA11 Case: 24-11060 Document: 57-1 Date Filed: 07/31/2026 Page: 4 of 31

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certain criteria, including a liver biopsy showing stage 2 fibrosis and grade 2 inflammation. The policy also provided for exceptions, stating that it was

not intended to be a substitute for pro- fessional judgment by the managing physician, [gastrointestinal], or [infec- tious disease] consultant. Treatment is always to be individualized base[d] on any unique patient factors.

In other words, patients who did not meet the testing criteria could still qualify for treatment if approved by the managing physician or other professionals over- seeing the patient's care.

In August 2016, the GDC updated its policy to ac- count for the availability of newer, more effective treatments than the triple-drug regimen. The 2016 policy differed from the 2012 policy in a few relevant ways. First, it recognized a new class of HCV antiviral drugs. Second, it required the administration of a Fi- broSure test instead of a liver biopsy as part of a pa- tient's treatment eligibility determination. Finally, it created three priority levels for treatment, with med- ication generally reserved for Priority 1 patients as de- termined by their FibroSure results.

Johnson v. Lewis, 83 F.4th 1319, 1329 (11th Cir. 2023). Appellant Ricky Johnson is an inmate in the custody and care of the Georgia Department of Corrections. He was diagnosed with USCA11 Case: 24-11060 Document: 57-1 Date Filed: 07/31/2026 Page: 5 of 31

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Hepatitis C in 2009. On November 1, 2012, Dr. Chaudhary—who is not a party to this appeal—prescribed the triple-drug therapy as treatment for his Hepatitis C. He recommended that same treat- ment for Johnson on April 25, 2013. At that time, Johnson and Dr. Chaudhary agreed that Johnson would not begin treatment until Johnson returned to Ware State Prison after a temporary reloca- tion. Johnson returned in August 2013, but no treatment followed. On May 9, 2014, while incarcerated at Ware State Prison, a state-run prison within the GDC, Johnson filed a grievance stating: I was approved for medical treatment for Hepatitis C. Medical staff refuses to begin treatment . . . . I submit that medical staff is being deliberately indifferent to a serious medical need in violation of my 8th Amend- ment right against cruel & unusual punishment. I would like my treatment to begin immediately.

Ricky Johnson Grievance No. 173073, Ware State Prison, J.A. 1-1. But, on July 31, 2014, Dr. Chaudhary withdrew the prescription for triple-drug therapy and recommended continued monitoring, as well as a repeat liver biopsy to take place in July 2015. The Ware State Prison grievance was denied and Johnson appealed to the Of- fice of Health Services Management in the GDC. The Department denied the appeal on October 6, 2014. On May 21, 2015, Johnson was transferred to Jenkins Cor- rectional Facility, a private prison within the GDC. Appellee, Dr. Kevin Marler, was the medical director and physician at Jenkins USCA11 Case: 24-11060 Document: 57-1 Date Filed: 07/31/2026 Page: 6 of 31

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Correctional Facility. Johnson saw Dr. Marler for the first time in July 2015. At that time, Dr. Marler reviewed lab work and records for Johnson, and conducted a physical exam. Dr. Marler notified John- son that he would be placed in the chronic clinic, but would not receive drug therapy. According to Johnson, Dr. Marler told him he would consult with GDC doctors about the treatment, but John- son never heard back. Johnson never received the liver biopsy that Dr. Chaudhary recommended to take place by July 2015. Johnson did have blood work done in July 2016, which Dr. Marler noted “did not indicate a level of liver involvement then requiring treat- ment.” In April 2017, Dr. Lewis—who is not a party to this appeal— reminded Dr. Marler that the GDC had updated its policy, in Au- gust 2016, to require a FibroSure test as protocol for Hepatitis C. In June 2017, Dr. Marler administered the test which indicated that Johnson had liver cirrhosis and severe inflammation. On July 16, Dr.

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