Appeal from the United States District Court for the Eastern District of Arkansas.
The opinion of the court was delivered by: Colloton, Circuit Judge.
Submitted: September 22, 2011
Before RILEY, Chief Judge, COLLOTON, and GRUENDER, Circuit Judges.
Jose Luis Gonzalez filed suit under the Federal Tort Claims Act, 28 U.S.C. §§ 2671-2680, alleging that employees of the United States negligently caused significant delay in the proper treatment of leg injuries that he suffered while an inmate at the Federal Correctional Institution in Forrest City, Arkansas. After a twoday bench trial, the district court found the government liable and awarded*fn1 compensatory damages of $813,000. On appeal, the government argues that the amount of damages is excessive. Under the deferential standard of review that applies to an award of damages in a bench trial, we affirm.
On July 28, 2004, Gonzalez suffered an injury to his left leg and ankle in a prison-sanctioned softball game when another player slid into second base and struck Gonzalez. The next morning, Gonzalez self-reported to the prison's Health Services Department for medical treatment of his ankle and leg. Nurse G. Toliver told Gonzalez that "walk-ins" were not allowed and instructed him to return the next day. When Gonzalez returned on the morning of July 30, Nurse Toliver told him that he could not be treated and that he must make an appointment for August 2, 2004.
Gonzalez returned to the Health Services Department on August 3, 2004, and Physician's Assistant Yvette Toro examined him. According to Toro's notes, Gonzalez complained of pain in his left ankle "due to [a] sports injury" and assessed his pain level at a "6," noting that the pain is "worse at night." Toro requested x-rays of Gonzalez's left knee and ankle and gave him Motrin or Ibuprofen. Gonzalez requested crutches or a wheelchair, but the department did not provide them. Gonzalez also saw Dr. J. Edna Prince, the department's Clinical Director. While Gonzalez and Dr. Prince offered differing accounts of this meeting, Dr. Prince did not give Gonzalez a wheelchair or crutches or additional pain medication.
On August 17, 2004, Gonzalez returned to the Health Services Department for x-rays. A technician, however, attempted to perform an x-ray of Gonzalez's chest, because Toro's treatment order mistook Gonzalez for a similarly-named former inmate with a malady of the chest. Upon discovering the error, the technician told Gonzalez that he would have to reschedule the x-ray of his leg.
On August 26, 2004, the Health Services Department performed an x-ray of Gonzalez's leg, which revealed fractures of his fibula and ankle. After discovering the seriousness of Gonzalez's injury, Dr. Prince sent him to a local hospital where he was fitted with a supportive walking boot.
The next morning, Dr. Prince ordered Gonzalez to a hospital in Memphis, Tennessee, where a doctor performed surgery on Gonzalez's left leg and ankle. The operation-an "open reduction and internal fixation of medial malleolar fracture with closed treatment of proximal fibular fracture"-required the placement of two screws in Gonzalez's left ankle. With his ankle in a cast, Gonzalez returned to the prison that night. Upon his return, prison officials placed Gonzalez in a Special Holding Unit. Gonzalez referred to this unit as the "hole" or "punishment cell," and claimed that he suffered serious pain without adequate medical care. Dr. Prince, however, stated that the SHU was the appropriate place for Gonzalez until he was mobile.
After three to four weeks in a cast, and another four in a walking boot, Gonzalez was able to place weight on his ankle. The Bureau of Prisons later transferred Gonzalez to another institution and released him from custody on November 14, 2008. Gonzalez was then repatriated to Mexico.
Gonzalez filed suit under the Federal Tort Claims Act, alleging that the Health Services Department and its staff breached duties of care owed to Gonzalez by refusing medical treatment and causing unreasonable delay in the diagnosis and repair of his injury. Gonzalez alleged that the delay in treatment caused him "undue and unnecessary pain and suffering." He demanded $3,000,000 in compensatory damages. The demand for damages sought "at least $10,000 per day" for pain experienced from July 28 through August 3, 2004, and "at least $5,000 per day" for pain suffered from August 3 through August 26, 2004. For August 27 through August 30, 2004, the period immediately after surgery, Gonzalez demanded $20,000 per day. He sought $2000 per month for the rest of his lifetime, due to permanent disability and arthritic pain. Gonzalez also demanded $2,170,000 to compensate for "mental anguish" suffered between August 2, 2004, and the trial in 2010, a larger proportion of which presumably occurred during the span in August 2004 when Gonzalez was denied treatment and "despaired of ever being treated." Pl.'s Demand for Damages under the Federal Tort Claims Act, at 6.
At a bench trial, the district court heard testimony from Gonzalez's expert witness, Dr. James Keever, a licensed orthopedic surgeon. Dr. Keever gave his opinion, based on a reasonable medical probability, that Gonzalez has developed permanent post-traumatic arthritis of the ankle. According to Dr. Keever, this condition was caused by the delay in treatment and will worsen with time.
The district court found that the government breached its duty of care by failing to treat Gonzalez's ankle in the four weeks prior to the taking of x-rays. The court,*fn2 relying on Dr. Keever's testimony, also found that Gonzalez "suffered a continuing injury following his surgery on August 27, 2004 that was proximately caused by the ...