Estelle v. Gamble

Following is the case brief for Estelle v. Gamble, 429 U.S. 97 (1976)

Case Summary of Estelle v. Gamble:

  • Respondent Gamble was seriously injured while doing prison work.
  • He was seen 17 times by prison medical personnel, but his injuries persisted.  Moreover, prison officials were not consistent in ensuring Gamble had his medications.  They even put Gamble in solitary confinement, despite his injuries, for not reporting to work.
  • Gamble instituted a civil rights action against the prison medical staff and officials, claiming that his treatment was cruel and unusual in violation of the Eighth Amendment.
  • The District Court dismissed his case, but the Fifth Circuit reversed, reinstating his complaint.
  • The U.S. Supreme Court granted certiorari, reversed part of the Fifth Circuit’s holding, and remanded the case back to the Fifth Circuit.  The Court held that deliberate indifference to a prisoner’s serious injury can violate the Eighth Amendment.  In this case, however, the Court found that the prison medical staff did not engage in deliberate indifference to Gamble’s condition, despite poor medical care.

Estelle v. Gamble Case Brief

Statement of the Facts:

Respondent Gamble, a prisoner, brought a civil rights action, under 42 U.S.C. § 1983 against the prison medical staff and other prison officials, alleging that he was subjected to cruel and unusual punishment in violation of the Eighth Amendment.  His allegations stem from the fact that he was doing prison work when a large bale of cotton fell on him.  Gamble tried to continue work, but soon realized his back injuries were serious.

Over the next few months, Gamble was treated multiple times by multiple medical personnel, yet his injuries persisted.  The treatment he received was largely comprised of pain killers and did not seem to get to the root of the problem.  Also, prison officials were inconsistent in ensuring that Gamble received his medications on time, or in allowing Gamble to follow his doctors’ instructions.  He was also placed in solitary confinement for a time for refusing to work because of his injuries.

Procedural History:

  • The District Court granted a motion to dismiss Gamble’s pro se application for § 1983 relief.
  • The Fifth Circuit Court of Appeals reversed, finding that the insufficiency of Gamble’s medical treatment required that the complaint be reinstated.
  • The U.S. Supreme Court granted certiorari.

Issue and Holding:

Can deliberate indifference by prison officials to a prisoner’s serious illness or injury constitute cruel and unusual punishment in violation of the Eighth Amendment?  Yes.


The decision of the Fifth Circuit is reversed and remanded for further proceedings.

Rule of Law or Legal Principle Applied:

Deliberate indifference by prison officials to a prisoner’s serious illness or injury can constitute cruel and unusual punishment in violation of the Eighth Amendment.


It is clear that deliberate indifference to the serious medical needs of a prisoner is the “unnecessary and wanton infliction of pain,” and thus can constitute cruel and unusual punishment in violation of the Eighth Amendment.  That does not mean, however, that every claim of inadequate medical treatment becomes an Eighth Amendment violation.  Further, medical malpractice does not become a constitutional violation simply because the victim is a prisoner.

In this case, Gamble’s claims against the prison medical staff are not sustainable.  The medical staff was not deliberately indifferent to Gamble’s injuries.  Gamble saw a member of the medical staff on 17 occasions.  Whether the treatment was adequate cannot be decided on the record available, and the Court is not equipped to determine whether the staff’s medical judgments were appropriate.  That said, the Court of Appeals focused only on the conduct of the medical staff.  The case is remanded to the Court of Appeals to determine whether other prison officials were deliberately indifferent.

Concurring and Dissenting Opinions:

Justice Blackmun concurred in the judgment of the Court.

Dissenting Opinion (Stevens):

There are three reasons to question the Court’s opinion.  First, the case should not have been dismissed against the medical personnel.  Gamble’s pleading was pro se.  He should be given the chance to develop facts to show how deficient the medical staff was in treating him.  Second, it is unclear why the Court granted certiorari, because it is unusual to hear a case when it has yet to be resolved based on the Court of Appeals’ decision to let the complaint go forward.  Third, the Court’s opinion relies heavily on the subjective motivation of those who treated Gamble.  The standard of care, not the treating physician’s motivation, should be the relevant inquiry for an Eighth Amendment analysis.


Estelle v. Gamble moved the Court’s Eighth Amendment jurisprudence forward by finding that deliberate indifference to a prisoner’s suffering can constitute cruel and unusual punishment.  In so doing, the Court also established the appropriate standard for § 1983 claims in the prison context.  The standard must be “deliberate indifference” so that ordinary medical malpractice is not found as a constitutional violation.

Student Resources:

Read the Full Court Opinion

Listen to the Oral Arguments