Precedents Cited

Eighth Amendment framework and its tightening around “subjective knowledge”

• Farmer v. Brennan: The opinion uses Farmer for two foundational propositions: (i) the Eighth Amendment governs prison conditions and treatment, and (ii) prison officials must ensure basic necessities including medical care and adequate food. The case anchors the opinion’s insistence that duty alone is not liability—liability turns on a culpable mental state.
• Estelle v. Gamble: Cited for the classic rule that deliberate indifference to serious medical needs is “unnecessary and wanton infliction of pain.” The panel treats Estelle as the doctrinal gateway but then relies on more modern Eleventh Circuit authority to specify the elements.
• Wade v. McDade (en banc): This is the opinion’s operational test. The court repeatedly returns to Wade to require: (1) an objectively serious deprivation, and (2) subjective recklessness—the defendant must be actually, subjectively aware that his own conduct caused a substantial risk of serious harm, plus the safe harbor that reasonable responses defeat liability. The case is used both at summary judgment (Espino) and at the pleading stage (Robinson; Burgin/Johnson/Lim-Kim).
• Hamm v. DeKalb Cty.: Controls the diet sub-issue. The panel relies on Hamm to reject O’Connor’s attempt to constitutionalize USDA guidelines and calorie targets, reiterating that the Constitution requires only a “well-balanced meal” with sufficient nutritional value to preserve health.
• Hoffer v. Sec'y, Fla. Dep't of Corr.: Deployed to draw the line between negligence or disagreements in medical judgment and constitutional deliberate indifference. The opinion quotes Hoffer to emphasize that deliberate indifference is not “constitutionalized negligence” and that a difference in medical opinion about treatment generally does not establish cruel and unusual punishment.

Standards of review and procedural doctrines driving outcome

• Stanley v. City of Sanford: Provides the de novo standard for summary judgment and the “no genuine dispute of material fact” framework.
• Sconiers v. Lockhart: Important pro se protection: a sworn complaint’s specific facts must be credited at summary judgment. Notably, even with this benefit, O’Connor’s evidence was deemed insufficient to show subjective knowledge or retaliatory motive.
• Henley v. Payne and Newbauer v. Carnival Corp.: Supply the Rule 12(b)(6)/§ 1915(e)(2)(B)(ii) plausibility lens used to affirm dismissals.
• Young v. City of Palm Bay: Supports broad district-court discretion to refuse untimely filings in docket management, absent clear error of judgment.
• Sapuppo v. Allstate Floridian Ins. Co., Calderon v. Sixt Rent a Car, LLC, and Access Now, Inc. v. Sw. Airlines Co.: These cases collectively enforce appellate waiver/abandonment rules. The panel used Sapuppo to affirm the RLUIPA dismissal against Espino because O’Connor failed to challenge the district court’s stated ground (redundancy).
• Bank v. Pitt (as limited by Wagner v. Daewoo Heavy Indus. Am. Corp.): Used to justify dismissal with prejudice based on futility—O’Connor already amended once and could not plausibly cure the defects.

First Amendment and RLUIPA standards

• Watts v. Fla. Int'l Univ.: Cited for the free-exercise requirement that a defendant must impermissibly burden a sincerely held religious belief. The opinion turns this into a “scope-of-authority plus actual burden” inquiry as applied to prison medical staff.
• Holt v. Hobbs: Provides the RLUIPA structure: substantial burden on religious exercise permitted only if the government meets compelling interest and least restrictive means. The court applies Holt at the pleading stage by emphasizing that a plaintiff must connect an identified policy to a substantial burden.
• Smart v. England, Williams v. Radford, Harris v. Ostrout, and O'Bryant v. Finch: These cases supply the retaliation elements, the subjective-motivation causation test, the need for evidence beyond conclusory allegations, and the “same action anyway” defense.

Supervisory liability

• Ingram v. Kubik: The controlling supervisory-liability standard: no vicarious § 1983 liability; plaintiffs must allege the supervisor, through his own actions, violated the Constitution, including via an improper custom/policy causing deliberate indifference—provided there is an underlying constitutional violation to connect to.

Legal Reasoning

1) Deliberate indifference: the opinion’s core move is “no subjective awareness”

Across defendants and procedural postures, the panel treated Wade v. McDade’s subjective-recklessness prong as decisive. For Dr. Espino, the record contained a sworn declaration that (a) he found no GI condition necessitating the demanded medications and (b) he provided care he believed medically necessary. O’Connor’s counter—characterizing Espino’s decisions as “BAD JUDGEMENT”—did not create a triable issue of actual subjective awareness that his conduct posed a substantial risk of serious harm.

The diet claim followed the same logic: even assuming diet changes could be “serious,” O’Connor did not produce evidence that Espino knew terminating the therapeutic diet would likely cause serious harm. Moreover, the court treated the request for a “hybrid” therapeutic/religious diet as outside a prison physician’s authority, framing Espino’s decision as medical judgment rather than constitutional misconduct.

2) Diet adequacy: constitutional baseline is health preservation, not external nutritional guidelines

Against the Secretary and Warden, O’Connor tried to define adequacy through USDA MyPlate and a 2,600-calorie target. The panel rejected this framing using Hamm v. DeKalb Cty.: the Eighth Amendment requires meals with sufficient nutritional value to preserve health—not compliance with USDA frameworks. This reasoning forecloses “guidelines-as-constitutional-floor” pleading unless tied to health deterioration or objectively inadequate nutrition.

3) Pleading burden for nurses and observation status: “authority” allegations are not “deliberate indifference”

For Nurse Robinson, the court assumed O’Connor’s factual allegations true but found them insufficient to infer the required mental state: giving a sick-call form, coupled with “nothing wrong” commentary, did not plausibly show she understood he faced an imminent serious risk. For Nurses Burgin and Johnson and Dr. Lim/Kim, even assuming they acted outside scope or without required examination, the pleadings did not plausibly allege they subjectively knew their actions created a substantial risk of serious harm—particularly where the conduct described was responsive to a hunger strike and perceived self-harm risk.

4) Supervisory and RLUIPA/free-exercise claims: conclusory “policy/practice/custom” assertions do not suffice

Applying Ingram v. Kubik, the court required O’Connor to identify a specific policy and a causal connection between that policy and a constitutional (or statutory) violation. For the medical/diet decisions, the panel reasoned that because Espino committed no Eighth Amendment violation, there was no predicate wrong to attribute to supervisors. Separately, O’Connor’s generalized claim that supervisors maintained a “widespread persistent policy” to deny a “Non-Standard Therapeutic Diet” was treated as conclusory and thus implausible under Newbauer v. Carnival Corp..

5) Free exercise vs. institutional role: no “burden” where defendant lacks authority and acts to remove obstacles

For free exercise, the opinion turned on whether Espino “impermissibly burdened” religious exercise under Watts v. Fla. Int'l Univ.. The panel accepted the district court’s view that therapeutic diets are “prescribed for medical reasons” (citing FDOC Rule 33-204.002 and FDOC Procedure No. 401.009), so Espino could not prescribe a diet to accommodate religion. It then recast Espino’s termination of the therapeutic diet as alleviating a burden—because prison rules rendered inmates on therapeutic diets ineligible for religious diets.

6) Retaliation: absence of non-conclusory evidence of animus, plus “same action anyway”

Under Smart v. England and Williams v. Radford, O’Connor had to show Espino was subjectively motivated by retaliatory animus. Under Harris v. Ostrout, conclusory allegations are not enough at summary judgment. The panel emphasized that Espino’s decision not to provide the demanded treatment preceded disclosure of the grievance and was supported by his medical judgment; thus, even taking O’Connor’s version of certain statements, Espino would have taken the same action absent protected conduct, invoking O'Bryant v. Finch.

7) Appellate abandonment: failure to challenge the actual basis for dismissal is fatal

The RLUIPA claim against Espino in his official capacity was dismissed as redundant of the claim against the Secretary. Because O’Connor did not address that ground in his opening brief, the panel affirmed on abandonment under Sapuppo v. Allstate Floridian Ins. Co., reinforced by Calderon v. Sixt Rent a Car, LLC and Access Now, Inc. v. Sw. Airlines Co.. This portion of the opinion functions as a warning that even potentially meritorious statutory arguments can be forfeited by defective appellate framing.

Impact

• Reinforces Wade’s subjective-knowledge barrier in practice: The decision illustrates how difficult it is for prisoners to survive dismissal or summary judgment without concrete facts (or evidence) showing a provider actually appreciated a substantial risk of serious harm and disregarded it—particularly when defendants produce sworn medical rationales.
• Constrains diet-based Eighth Amendment theories: By rejecting USDA MyPlate and calorie targets as constitutional baselines and returning to Hamm v. DeKalb Cty., the opinion discourages “nutritional guideline” litigation unless linked to health consequences or objectively inadequate nutrition.
• Clarifies role separation between medical and religious accommodations: The court’s reading of FDOC definitions narrows the free-exercise theory against medical staff when the requested diet is fundamentally religious. Future plaintiffs will likely need to direct such claims to officials who administer religious-diet programs, and plead a specific policy or denial mechanism.
• Elevates specificity demands for supervisory and RLUIPA pleadings: The opinion underscores that “policy/practice/custom” labels are not enough; plaintiffs must identify the policy, connect it to the defendant, and show causation.
• Procedural discipline matters: Through Young v. City of Palm Bay and the abandonment holdings under Sapuppo, the opinion demonstrates how missed deadlines and inadequate briefing can end a case independent of the underlying dispute.
• Note on precedential value: The opinion is “NOT FOR PUBLICATION,” which generally limits its precedential force, but it operationalizes binding standards (especially Wade v. McDade, Hamm, Ingram, and the retaliation line), making it practically influential as a template for how those standards are applied.