SPRY v. DOE et al

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF NORTH CAROLINA
NICHOLAS JAMES SPRY, )
)
Plaintiff, )
)
v. ) 1:23CV835
)
JON DOE, DIETITIAN AT )
SCOTLAND CORRECTIONAL, et al., )
)
Defendants. )
MEMORANDUM OPINION AND RECOMMENDATION
OF UNITED STATES MAGISTRATE JUDGE
The United States Constitution
protects inmates from cruel and
unusual punishment, in the form of
prison officials’ deliberate
indifference to a medical need. But
this protection does not extend to an
inmate’s mere disagreement with
medical staff. Nor does it extend to
ailments that do not constitute a
serious medical need. For these
reasons, as set forth in further detail
below, the Court should grant the
defendants’ motion for summary
judgment and dismiss all claims
against them.
When the plaintiff, Nicholas James
Spry, was housed at the Scotland
Correctional Institute (“SCI”) and
then at Columbus Correctional
Institute (“CCI”), he repeatedly
requested a medical diet to lose
1 Spry voluntarily dismissed all other
defendants and claims and chose to
proceed only against Koelsch and Ryan
weight, believing his doctor had
ordered one. But, after a nutrition
consultation, the clinical dietitian
recommended a Kosher diet. Spry
sued Ryan Koelsch, a clinical dietitian
for the North Carolina Department of
Adult Corrections (“NCDAC”), and
Kimmi Ann Ryan, a nurse at CCI, in
their individual and official capacities
for deliberate indifference to his
serious medical needs in violation of
the Eighth Amendment. See Docket
Entries 20-1, 33 (collectively
“Amended Complaint”).1
Koelsch and Ryan have moved for
summary judgment, arguing that
Spry cannot show that he had a
serious medical need or that either
defendant was deliberately indifferent
and that they are both entitled to
qualified immunity. See Mot. for
for the Eighth Amendment violation. See
Docket Entries 56, 67.
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Summ. J., Docket Entry 63; Br. in
Supp. of Mot. for Summ. J., Docket
Entries 64, 64-1 to 64-11.
In opposition to the motion, Spry
submitted a declaration and the
defendants’ discovery responses but
he has not shown a genuine dispute of
material fact. See Docket Entries 69,
69-1, 70. Therefore, the Court should
grant the defendants’ motion and find
that they are entitled to qualified
immunity.
I. FACTS
On September 20, 2022, Koelsch, a
Registered Dietitian who consults
with the NCDAC, received a nutrition
consultation order from Dr. Claude
Nuzum, a hepatology specialist, for
Spry. See Ryan Koelsch Decl. ¶ 27
(Oct. 23, 2024), Docket Entry 64-2;
Clinical Encounter (Sept. 20, 2022),
Docket Entry 64-3. Dr. Nuzum
ordered a “nutrition consult with goal
of weight <175 lbs in a year.” See id.
¶ 28. The request did not prescribe
Spry any specific diet. See id. ¶¶ 29-
30. The only parameter was that the
diet support weight loss. See id. ¶¶ 29-
30.
Koelsch completed Spry’s nutrition
assessment and noted that Spry had
chosen the Kosher diet option on
April 12, 2022. See id. ¶ 32. But Spry
requested removal from the Kosher
diet around August 2022 “due to the
aggressive and disrespectful nature of
staff and family” and the request was
granted. See Spry Decl. ¶ 3.
NCDAC staff avoid interfering with
the Kosher diet, a voluntary religious
menu accommodation, in deference
to the inmate’s First Amendment
rights. See Koelsch Decl. ¶ 33.
Therefore, Koelsch recommended
that Spry continue the Kosher diet
unless and until he opted for a
different plan. See id. ¶ 34.
Furthermore, Koelsch felt that the
Kosher menu, along with regular
exercise, would support Spry’s weight
loss goal because it is a lower calorie
and lower fat diet than the standard
diet. See id. ¶¶ 35-37. If Spry wanted
Koelsch to reevaluate his nutrition
assessment, Spry would submit a new
sick call request. See id. ¶ 39.
On March 10, 2023, Spry submitted a
grievance claiming that Koelsch
“denied” the doctor’s order that he “be
placed on a weight management diet.”
See Admin. Remedy Procedure,
Docket Entry 64-4. The Step One –
Unit Response grievance examiner
responded that Koelsch had
recommended that Spry continue the
Kosher diet because it supported his
weight loss goal. See Wakenda Greene
Decl. ¶¶ 28-29 (undated), Docket
Entry 64-6. The examiner told Spry
that if he wanted to change his diet, he
could request another nutrition
assessment through the sick call
process. See Grievance Resp., Docket
Entry 64-11.
Unsatisfied, Spry appealed to the Step
Two – Area/Complex/Institution
Response, and that examiner made
the same determination, reminding
Spry that the Step One examiner
instructed him how to request a
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different diet. See Greene Decl. ¶¶ 31-
33; Grievance Resp.
Spry then appealed to Step Three –
Administrative Remedy review where
the examiner concurred that
Koelsch’s recommendation supported
Spry’s weight loss goal. See id. ¶¶ 22-
27, 34-37.
Despite “follow[ing] all directives to
receive needed medical diet outlined
by Defendants through grievance
responses and policy,” Spry did not
receive the requested medical diet or
new nutritional consultation. See Spry
Decl. ¶ 4.
By April 25, 2023, Spry had
transferred from SCI to CCI. See CCI
Health Orientation, Docket Entry 64-
1.
On June 18, 2023, at CCI, Ryan saw
Spry for a sick call to address his
complaints of vision problems,
replacement insoles, and diet
consultation. See Kimmi Ann Ryan
Decl. ¶ 25 (undated), Docket Entry
64-7; Clinical Encounter, Docket
Entry 64-5. During this visit, Spry
requested a diet for weight loss. See
Clinical Encounter. Ryan reviewed
Koelsch’s nutrition assessment in
which he “charted that ‘Kosher menu
is overall low in fat and provides fewer
Kcals than regular menu. Will
recommend regular diet to allow
Kosher diet to be handled through
food service staff.’” See id. (all-caps
font removed); Ryan Decl. ¶¶ 27-29.
According to Ryan, she told Spry that
medical staff cannot change religious
diets. See Ryan Decl. ¶ 30. Spry avers
that Ryan “never told [him] anything
about [his] diet other than she would
put it in for the doctor.” See Spry Decl.
¶ 5. “She especially did not mention
adding or removing [him] from
Kosher diet.” See id.
II. STANDARD OF REVIEW
A court “shall grant summary
judgment if the movant shows that
there is no genuine dispute as to any
material fact and the movant is
entitled to judgment as a matter of
law.” Fed. R. Civ. P. 56(a). A genuine
dispute of material fact exists “if the
evidence is such that a reasonable jury
could return a verdict for the
nonmoving party.” Anderson v.
Liberty Lobby, Inc., 477 U.S. 242, 248
(1986). In analyzing a summary
judgment motion, courts
“must construe all facts and
reasonable inferences in the light
most favorable to the nonmoving
party.” Bandy v. City of Salem, 59
F.4th 705, 709 (4th Cir. 2023).
The moving party bears the burden of
establishing the absence of a genuine
dispute of material fact by
“identifying those portions of ‘the
pleadings, depositions, answers to
interrogatories, and admissions on
file, together with the affidavits, if any’
which it believes demonstrate the
absence of a genuine issue of material
fact.” Celotex Corp. v. Catrett, 477
U.S. 317, 323 (1986) (quoting Rule
56).
“Where, as here, the nonmoving party
bears the ultimate burden of proof at
trial, the moving party may discharge
its initial burden at summary
judgment by ‘showing – that is,
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pointing out to the . . . court – that
there is an absence of evidence to
support the nonmoving party’s case.’”
Anderson v. Diamondback Inv. Grp.,
LLC, 117 F.4th 165, 174 (4th Cir. 2024)
(quoting Celotex Corp., 477 U.S. at
325). “If the moving party carries this
initial burden, the burden then shifts
to the nonmoving party, who must ‘go
beyond the pleadings and by [his]
own affidavits, or by the depositions,
answers to interrogatories, and
admissions on file, designate specific
facts showing that there is a genuine
issue for trial.’” Id. (quoting Celotex
Corp., 477 U.S. at 324).
III. DISCUSSION
Title 42, United States Code, Section
1983 “is a federal statutory remedy
available to those deprived of rights
secured to them by the Constitution
and, in a more sharply limited way,
the statutory laws of the United
States” by persons acting under color
of state law. Philips v. Pitt Cnty.
Mem’l Hosp., 572 F.3d 176, 180 (4th
Cir. 2009). A Section 1983 claimant
must show that a person acting under
color of state law violated a
Constitutional or other federal legal
right. West v. Atkins, 487 U.S. 42, 48
(1988).
The Eighth Amendment of the United
States Constitution prohibits
punishment that involves “the
unnecessary and wanton infliction of
pain.” Gregg v. Georgia, 428 U.S. 153,
173 (1976). “The Amendment also
provides protection with respect to
‘the treatment a prisoner receives in
prison and the conditions under
which he is confined.’” Shakka v.
Smith, 71 F.3d 162, 165–66 (4th Cir.
1995) (quoting Helling v. McKinney,
509 U.S. 25, 31 (1993)). “In order to
establish the imposition of cruel and
unusual punishment, a prisoner must
[allege] two elements—that the
deprivation of [a] basic human need
was objectively sufficiently serious,
and that subjectively the officials
act[ed] with a sufficiently culpable
state of mind.” See id. at 166 (internal
quotation and citations omitted)
(alterations in original).
Specifically, “a plaintiff must allege a
serious or significant physical or
emotional injury resulting from the
challenged conditions, or a
substantial risk of such serious harm
resulting from the prisoner’s
unwilling exposure to the challenged
conditions.” Hammock v. Watts, 146
F.4th 349, 360 (4th Cir. 2025)
(internal quotation and citation
omitted).
A claim that prison officials have
failed to provide inmates with
“reasonable medical treatment,” see
Bowring v. Godwin, 551 F.2d 44, 47
(4th Cir. 1977), “sound[s] in the
Eighth Amendment,” Iko v. Shreve,
535 F.3d 225, 241 (4th Cir. 2008).
Prisoners are entitled to
“‘nutritionally adequate food,
prepared and served under conditions
which do not present immediate
danger to the[ir] health and well-
being.’’ Hammock v. Watts, 146 F.4th
349, 361 (4th Cir. 2025) (quoting
Shrader v. White, 761 F.2d 975, 986
(4th Cir. 1985)). A constitutional
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violation arises when the inmate
suffers “‘serious medical . . .
deterioration attributable to’ the
challenged conditions.” Id. (citation
omitted). But “[a]bsent a
demonstration of a meal posing a
substantial risk of harm, many courts
have rejected arguments [even] from
diabetic inmates who believe that they
have a constitutional right to
[specific] diets . . . .” Lewis v. Hoke
Cnty., No. 1:17CV987, 2020 WL
5213929, at *12 (M.D.N.C. Sept. 1,
2020) (collecting cases), report and
recommendation adopted, 2022 WL
292928 (M.D.N.C. Feb. 1, 2022),
aff’d, 2022 WL 1641282 (4th Cir.
2022). In sum, “[o]nly an ‘extreme
deprivation’ is actionable under the
Eighth Amendment.” Scinto v.
Stansberry, 841 F.3d 219, 234 (4th
Cir. 2016); see also id. at 233
(recognizing that the right to “receive
special diets when medically
appropriate is not without limit”).
To succeed on an Eighth Amendment
claim related to medical treatment, a
plaintiff must show that the officer
“acted with ‘deliberate indifference’
(subjective) to the inmate’s ‘serious
medical needs’ (objective).” See Iko,
535 F.3d at 241 (quoting Estelle v.
Gamble, 429 U.S. 97, 104 (1976)).
A serious medical need is “‘one that
has been diagnosed by a physician as
mandating treatment or one that is so
obvious that even a lay person would
easily recognize the necessity for a
doctor’s attention.’” Id. (quoting
Henderson v. Sheahan, 196 F.3d 839,
846 (7th Cir. 1999)).
Furthermore, it is well-settled that
“not every claim by a prisoner
[alleging] that he has not received
adequate medical treatment states a
violation of the Eighth Amendment.
Rather, the treatment must be so
grossly incompetent, inadequate or
excessive as to shock the conscience
or to be intolerable to fundamental
fairness. Mere negligence,
malpractice, or incorrect diagnosis is
not actionable.” Boone v. Carvajal,
No. CV 6:21-3053-JD-KFM, 2024 WL
3052064, at *11 (D.S.C. Feb. 5, 2024),
report and recommendation
adopted, No. 6:21-CV-3053-JD-KFM,
2024 WL 3052046 (D.S.C. May 3,
2024), aff’d, No. 24-6588, 2025 WL
1098543 (4th Cir. Apr. 14, 2025)
(internal quotations and citations
omitted).
For an Eighth Amendment claim, an
officer must have acted with a
sufficiently culpable state of mind,
that is with deliberate indifference;
he must have had “actual knowledge
of the risk of harm to the inmate” and
also “‘recognized that his actions were
insufficient’ to mitigate the risk of
harm to the inmate arising from his
medical needs.” Iko, 535 F.3d at 241
(quoting Parrish ex rel. Lee v.
Cleveland, 372 F.3d 294, 303 (4th Cir.
2004) (emphasis in Iko); see also
De’lonta v. Johnson, 708 F.3d 520,
525 (4th Cir. 2013) (Acting with
deliberate indifference is “something
more than mere negligence but does
not require actual purposive intent. It
requires that a prison official actually
know of and disregard an objectively
serious condition, medical need, or
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risk of harm.”) (internal quotation
and citation omitted).
Prison officials may act with
deliberate indifference by
“intentionally denying or delaying
access to medical care . . . .” Estelle,
429 U.S. at 105. But “[m]ere delay is
not enough.” Moskos v. Hardee, 24
F.4th 289, 298 (4th Cir. 2022). “A
commonplace medical delay such as
that experienced in everyday life will
only rarely suffice to constitute an
Eighth Amendment violation, absent
unusual circumstances where the
delay itself places the prisoner at
‘substantial risk of serious harm,’ such
as where the prisoner’s condition
deteriorates markedly or the ailment
is of an urgent nature.” Id.
Additionally, an inmate’s
disagreement with medical staff about
his treatment is insufficient absent
exceptional circumstances. See
Hixson v. Moran, 1 F.4th 297, 302–
03 (4th Cir. 2021) (citing Wright v.
Collins, 766 F.2d 841, 849 (4th Cir.
1985) (citing Gittlemacker v. Prasse,
428 F.2d 1, 6 (3d Cir. 1970) (noting
that exceptional circumstances are
those in which medical care is “so
grossly incompetent, inadequate or
excessive as to shock the general
conscience or to be intolerable to
fundamental fairness”))); see also
Jackson v. Lightsey, 775 F.3d 170, 178
(4th Cir. 2014) (“[W]e consistently
have found such disagreements
[between an inmate and physician
about proper medical care] to fall
short of showing deliberate
indifference.”).
A. Spry’s official capacity
claims fail as a matter of law.
Spry asserts his § 1983 claim against
Koelsch and Ryan in their official
capacities. At all relevant times, they
were both employees of the State of
North Carolina. See Koelsch Decl. ¶ 2;
Ryan Decl. ¶¶ 1-2; see also Biggs v.
N.C. Dep’t of Pub. Safety, 953 F.3d
236, 241 (4th Cir. 2020) (recognizing
that the NCDAC “is a North Carolina
agency”).
“[A] suit against a state official in his
or her official capacity is not a suit
against the official but rather a suit
against the official’s office. As such, it
is no different from a suit against the
State itself.” Will v. Mich. Dep’t of
State Police, 491 U.S. 58, 71 (1989).
“State officials acting in their official
capacity are therefore not ‘persons’
for the purposes of § 1983 and are not
proper defendants to a § 1983
lawsuit.” Diggs v. Balogun, 2017 WL
4921690, at *4 (D. Md. Oct. 31, 2017)
(citing Will, 491 U.S. at 71). Even if
that were not the case, North Carolina
is immune from a § 1983 suit. See
Biggs, 953 at 241; Singh v. Univ. of
N.C. at Chapel Hill, 659 F. Supp. 3d
659, 669 (M.D.N.C. 2023).
Therefore, the Court should dismiss
the official capacity claims against
Koelsch and Ryan.
B. Spry’s deliberate
indifference claim fails as a
matter of law.
Spry’s claim that, in their individual
capacities, Koelsch and Ryan were
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deliberately indifferent to his serious
medical need fails at each element.
First, he did not have a serious
medical need. Dr. Nuzum’s clinical
assessment of Spry was possible fatty
liver. Dr. Nuzum did not mandate
treatment for the provisional
diagnosis, nor is a possible fatty liver
something a lay person would easily
recognize as necessitating medical
attention.
Next, even if a provisional diagnosis
of fatty liver was a serious medical
need, neither defendant acted with
deliberate indifference to that need.
When Koelsch assessed Spry’s
nutritional needs and goals, he saw
that Spry had earlier requested a
Kosher diet. By the time of the
nutritional assessment, Spry was no
longer on the Kosher diet at his
request – not due to a medical or
other health need, but because the
staff and his family were being rude
about it.
There is simply no evidence that
Koelsch or Ryan had actual
knowledge that a recommended lower
fat and lower calorie Kosher diet
posed any risk to Spry, much less that
the recommendation was insufficient
to mitigate the risk. Koelsch reviewed
Dr. Nuzum’s clinical note – in which
Dr. Nuzum did not prescribe any type
of diet – and order for a nutrition
consultation. Koelsch recognized the
weight loss goal, saw Spry’s earlier
selection of a Kosher diet, and
determined that the Kosher diet
would both honor Spry’s exercise of
religion and, along with regular
exercise, contribute to weight loss.
Nothing about Koelsch’s assessment
of Spry’s nutritional needs and weight
loss goal or Ryan’s confirmation of
that recommendation shocks the
conscience or is fundamentally unfair.
And even Spry acknowledges that
Ryan told him that, after his June
2023 sick call visit, “she would put it
in for the doctor.”
There is also no evidence that Spry
developed fatty liver or any other
medical infirmity as a result of the
recommended Kosher diet.
The law is clear that mere
disagreement with medical treatment
decisions is insufficient for a
deliberate indifference claim, absent
exceptional circumstances that are
not present here. And, at its heart,
Spry’s claim is nothing more than
disagreement and frustration with
Koelsch’s recommended Kosher diet
and Ryan’s confirmation of the
recommendation.
C. Qualified immunity protects
Koelsch and Ryan.
“The doctrine of qualified immunity
‘balances two important interests,’
namely, the need to hold accountable
public officials who exercise power
irresponsibly, and the need to shield
officials who perform their duties
responsibly from ‘harassment,
distraction, and liability.’” Byers v.
Painter, 173 F.4th 155, 160 (4th Cir.
2026) (quoting Pearson v. Callahan,
555 U.S. 223, 231 (2009)).
“In resolving whether to award
qualified immunity at summary
judgment, courts are to engage in a
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‘two-pronged inquiry.’” Nazario v.
Gutierrez, 103 F.4th 213, 230 (4th Cir.
2024) (quoting Tolan v. Cotton, 572
U.S. 650, 655 (2014)). First, the court
determines whether “in a light most
favorable to the injured party – ‘the
officer’s conduct violated a
constitutional right.’” Id. (quoting
Saucier v. Katz, 533 U.S. 194, 201
(2001)). Next, the court asks
“whether the right at issue in the first
prong was ‘clearly established at the
time’ of the contested action.” Id.
(quoting Pearson, 555 U.S. at 227).
“Accordingly, a court may award
qualified immunity to an official if
either (1) there is no violation of a
constitutional right, or (2) the
constitutional right was not clearly
established.” Id. (citing Pearson, 555
U.S. at 227).
The court is required to define the
constitutional right at a “‘high level of
particularity’” because “[t]he way in
which an alleged right is described
matters.” Atkinson v. Godfrey, 100
F.4th 498, 505 (4th Cir. 2024)
(quoting Ewards v. City of
Goldsboro, 178 F.3d 231, 250-51 (4th
Cir. 1999)). “Although a case directly
on point is not required, existing
precedent ‘must have placed the
statutory or constitutional question
beyond debate.’” Id. at 505-06
(quoting Kisela v. Hughes, 584 U.S.
100, 104 (2018)).
“In the end, the key inquiry is whether
‘the law provided “fair warning” that
[the officer’s] conduct was
unconstitutional.’” Atkinson, 100
F.4th at 506. (quoting Booker v. S.C.
Dep’t of Corr., 855 F.3d 533, 538 (4th
Cir. 2017) (alteration in Booker)). To
answer that question, courts look to
precedent of the United States
Supreme Court and, in this district,
the Fourth Circuit Court of Appeals.
Id.
As previously discussed, it was well
established at the time of his
nutritional assessment and sick call
visit that Spry had the right to
reasonable medical treatment and
nutritionally adequate meals. But
neither Koelsch nor Ryan violated
that right. Accordingly, they are
entitled to qualified immunity.
IV. CONCLUSION
For the reasons stated herein, it is
hereby RECOMMENDED that the
Court grant the defendants’ Motion
for Summary Judgment and find that
they are entitled to qualified
immunity.
JoAnna Gibson McFadden
United States Magistrate Judge
September 9, 2026
Durham, North Carolina
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