Today’s blog entry is a published decision from the Third Circuit, Montanez v. Price, here decided on October 8, 2025 (which was my birthday). It discusses a series of issues, including: the Eighth Amendment; what is a program, service, and/or activity; and nondelegable duty. More specifically, the blog entry is divided into the following  categories and they are: facts; Eighth Amendment overview/conclusions; who can be sued for the disability law claims; programs, services, and activities were involved; ADA/504 are nondelegable duties; and thoughts/takeaways. Of course, the reader is free to focus on any or all of the categories.

 

Facts (Taken Directly from the Opinion)

 

On August 28, 2021, Jose Montanez stood up in his cell at SCI-Huntingdon and suddenly collapsed, his body numb from the chest down. Lying on the cell floor, Montanez alerted a nearby guard to his condition, and the guard soon returned with another prison officer. Montanez was then forced to “drag his body over to the cell door” before he was eventually taken to the medical unit in a wheelchair by Appellee Nurse Melanie Wagman.

 

Once in the medical unit, Nurse Wagman took Montanez’s vitals and felt around his legs. She then phoned Appellee Dr. Rajinder Mahli, who instructed her to move Montanez from his third-floor cell to a cell on the first floor and said he would evaluate Montanez the next day. When Montanez—still paralyzed from the waist down—learned that he would not be evaluated or treated until the next day, he 1 Evidence adduced in discovery may not support or may affirmatively disprove the allegations in Montanez’s complaint. In reviewing the dismissal of a complaint, however, we must accept the allegations as true. Stringer v. Cnty. of Bucks, 141 F.4th 76, 84, 90 (3d Cir. 2025). We therefore recount the facts below as set forth in the complaint, drawing all reasonable inferences in Montanez’s favor, as required at this stage. Id. 5 asked to be taken to the hospital, but Nurse Wagman responded, “you’re not going to the hospital,” and laughed at the request. App. 38. Nurse Wagman then wheeled Montanez to the door of his new cell, where she ordered him to “get out of the wheelchair,” offering him no assistance, forcing him to drag his limp body “across [his] cell to the bed,” and leaving him “exhausted and in so much pain.”

 

The next day, Dr. Mahli came to examine Montanez, but he, too, did not enter the cell, and ordered Montanez to “walk for him.” App. 38. Montanez was still unable to stand, let alone walk, so he again dragged his paralyzed body across the cell floor as Dr. Mahli watched. And when Montanez informed Dr. Mahli that he was also involuntarily urinating on himself, Dr. Mahli simply “nodded” and “walked off,” doing nothing to help Montanez with his sudden paralysis or incontinence.

 

Montanez was then left alone in his cell in this condition—paralyzed from his chest to his feet and uncontrollably urinating on himself—for another three days before receiving medical attention. At that point, Montanez was finally given an MRI that revealed spinal cord stenosis and spinal cord edema, requiring expedited back surgery in September 2021. Following surgery, Montanez was transferred to a private rehabilitation facility.

 

A mere two weeks into rehabilitation and still unable to stand, Montanez was returned to detention, this time to the infirmary of a different Pennsylvania state prison, SCI-Rockview. There, he continued his recovery until he took a serious fall that caused him intense pain in his spine. Nonetheless, the doctor on staff, Appellee Dr. Vernon Preston, refused to give him adequate pain medication. An x-ray revealed that Montanez had herniated a disc in his back in the fall, but SCI-Rockview’s Healthcare Administrator, Appellee Richard Ellers, “lied” to his doctor “about the results of the x-ray” to delay his treatment.

 

Two months later, Montanez was transferred back to SCI-Huntingdon, where he continued to suffer mobility issues and intense discomfort from his recent spinal surgery and subsequent spinal injury. So he requested certain accommodations, including a double mattress to control his back pain while sleeping, a cane or crutches to facilitate walking, stronger medication for pain management, and access to physical therapy. Those requests were repeatedly denied by prison personnel.

 

Eventually, Montanez is look to the courts and filed a pro se complaint against the Commonwealth of Pennsylvania and Wellpath seeking compensatory and injunctive relief and alleged violations of the Eighth Amendment, Title II of the ADA, and §504 of the Rehabilitation Act. At the time, the middle District of Pennsylvania require pro se. Bringing civil rights claim to file their action using a specific complaint form. That form restricted any complaint to just 12 lines with no more than three extra sheets. Accordingly, the defendants moved to dismiss. Montanez responded with over 50 pages of new factual allegations, but the District Court wound up dismissing the complaint anyway. Montanez appealed

 

II

Eighth Amendment Overview/Conclusions

 

  1. An Eighth Amendment claim for inadequate medical care involves a prisoner showing a serious medical need and acts or omission by prison officials indicating deliberate indifference to that need.
  2. A medical need is sufficiently serious it is one that has been diagnosed by a physician as requiring treatment or one that is so obvious that a layperson would easily recognize the necessity for a Dr.’s attention.
  3. A prison official acts with deliberate indifference if the official knows of the serious medical need yet disregards it by failing to act reasonably. Such acts can be inferred from circumstantial evidence, including the obviousness of the serious health need.
  4. Deliberate indifference has been found in a variety of different situations, including where: 1) prison authorities deny reasonable requests for medical treatment; 2) knowledge of the need for medical care is accompanied by intentional refusal to provide it; 3) necessary medical treatment is delayed non-medical reasons; and 4) prison authorities prevent an inmate from receiving recommended treatment for serious medical needs.
  5. The spinal cord stenosis, edema, his sudden incontinence, and the herniated disc he suffered after falling at a facility, all easily qualify as serious medical needs.
  6. Montanez plausibly alleged that Dr. Mahli was deliberately indifferent to his health needs. In particular, the doctor despite knowing that Montanez was suddenly paralyzed and uncontrollably urinating on himself, provided no medical treatment and instead abandon him in this state for three days. So, this is a situation where knowledge of the need for medical care was accompanied by the intentional refusal to provide that care. It is also a situation where the defendant abandoned a prisoner in a condition unreasonably exposing him to the threat of tangible residual injury. Both constitute deliberate indifference.
  7. While certain defendants were dismissed from Eighth Amendment claims, the Eighth Amendment claims against Ellers and Wagman were plausibly alleged.
  8. Wellpath was properly dismissed for the §1983 claim because there were no allegations that their policies or customs were the cause of the constitutional violation.

 

 

II

Who Can be Sued for the Disability Law Claims

 

  1. Individual Commonwealth defendants and individual medical defendants are not subject to suit in their personal capacities because neither state employees nor contractors are public entities. Therefore, they cannot be sued under Title II of the ADA.
  2. The Commonwealth of Pennsylvania is a public entity that receives federal funds so it is a proper defendant under both Title II of the ADA and §504.
  3. While the allegations are not sufficient to transform Wellpath into a state actor, Wellpath indirectly through the prison facility and the Pennsylvania Department of Corrections receives federal funding. Therefore it is a proper defendant on the §504 claim. Further, the evidence is contradictory as to whether Wellpath directly receives federal funds.

 

 

III

Programs, Services, and Activities Are Involved

 

  1. No question exists that Montanez is a qualified person with a disability.
  2. The phrase “service, program, or activity,” under both Title II and §504 is extremely broad in scope and includes anything a public entity does.
  3. Healthcare is a service prison must provide to prisoners. The facts are such (see facts section above), that Montanez has made sufficient allegations to show that he was denied meaningful access to medical care because of his disabilities.
  4. Necessity for hygiene, including, showers, sinks, and toilets, are basic services that prison must provide. The allegations that Montanez was abandoned in his cell for at least three days, paralyzing urinating on himself, neither able to reach a toilet nor given an alternative way to relieve himself with dignity is a textbook example of a disabled prisoner being denied access to fundamental prison service.
  5. Given that all people need sleep, providing prisoners with accessible beds and appropriate and adequate bedding is are services of a prison.
  6. Construing the complaint liberally, Montanez adequately pleaded that he could not access the bed on the same basis as able-bodied inmates and was denied a reasonable accommodation necessary for him to sleep without significant pain just like able-bodied inmates could.
  7. Montanez argues persuasively that the Commonwealth of Pennsylvania and Wellpath had an obligation to reasonably accommodate his disabilities and that their repeated failure to do so was the reason he could not meaningfully access various prison services.
  8. The duty to accommodate is triggered when a disabled person’s need for an accommodation becomes known either because: 1) he requests an accommodation; or 2) his disability and need for the accommodation are open and apparent.
  9. Both the Commonwealth and Wellpath had an affirmative duty to accommodate Montanez, and their failure to do so was the same thing as denying him access to those prison services on the same basis as other inmates.
  10. Toilets, beds, and medical care are all services or programs under Title II and §504.

 

 

IV

ADA/504 Are a Nondelegable Duty

 

  1. Both the text and purposes of Title II and §504 confirm the Commonwealth’s obligation to ensure compliance with both laws even when it contracts out the operation of their programs, services, or activity to third parties.
  2. Congress wanted to give people with disabilities an affirmative right to access all (emphasis in opinion), covered programs and services no matter how or through whom (emphasis in opinion), the government or federally funded entity elects to deliver them. Regardless of the medium of delivery, those programs and services must be accessible to people with disabilities.
  3. Congress’s use of the passive voice (no qualified individual with a disability shall by reason of such disability, be excluded…), only reinforces that conclusion. That is, both statutes (ADA and the Rehabilitation Act), focus on an event constituting a type of prohibited disability discrimination without respect to a specific actor. Such a linguistic choice to pull the actor off the stage reflects Congress’s indifference as to who does the excluding or denial of benefits-be they government employees or government contractors.
  4. Title II of the ADA prohibits covered entities from directly or indirectly (through contractual or other arrangement), from utilizing criteria or methods of administration that have the effect of discriminating on the basis of disability.
  5. While it is true that States often contract with private companies to provide prison services and programs of many different kinds of varieties, Title II and §504 would become dead letter if States could evade their statutory duties merely by outsourcing the operation of such programs.
  6. Congress did not design the ADA or the Rehabilitation Act so that a public entity could forever prevent a qualified individual with a disability from utilizing a service, program, or activity.
  7. Whether or not a State uses contractors, States remain responsible for ensuring that prisoners with disabilities can accept their prisons services, programs, and activities on the same basis as nondisabled prisoners. As such, the Commonwealth of Pennsylvania was obligated to ensure that Wellpath and its employees-like all other state contractors-complied with federal laws prohibiting discrimination on the basis of disability.
  8. In a footnote, the court noted that 28 C.F.R. §35.152(a) says that Title II of the ADA applies to public entities that are responsible for the operation or management of correctional facilities either directly or through contractual, licensing, or other arrangements with public or private entities. That is, if a person is occupied by state prisoners and is inaccessible, the State is responsible under Title II of the ADA.

V

Thoughts/Takeaways

 

  1. The court also said that the court erred by not granting Montanez the ability to amend the complaint since he had stated several different claims that were plausible.
  2. With the exception of the 11th Circuit when it comes to an individual employed by a public entity engaged in retaliatory activities, here, the courts are unanimous that individual liability is not a thing under either the ADA or §504 of the Rehabilitation Act.
  3. Title II of the ADA and §504 of the Rehabilitation Act apply to everything that a public entity does.
  4. The legal standard for Title II and §504 is meaningful accessibility.
  5. The duty to accommodate is an affirmative duty.
  6. If the duty to accommodate is an affirmative duty that gets triggered when a disabled person’s need for an accommodation becomes known as the court says, a logical extension of that is that an interactive process is required to figure out how to accommodate that individual. Granted, you have to look far and wide to find, outside of higher education, cases holding that Title II of the ADA requires an interactive process (the cases can be found), the logic still remains. Also, an interactive process regardless of whether it is required or not is excellent preventive law. Finally, we discussed the do’s and don’ts of the interactive process in this blog entry.
  7. The court all but says that the ADA and §504 are nondelegable duties.
  8. An entity can be subject to §504 of the Rehabilitation Act if it indirectly take federal funds.
  9. Another example of why the ADA is a nondelegable duty for Title II entities can be found in 28 C.F.R. §35.130(b)(1)(v), which prohibits a public entity from providing significant assistance to an entity that discriminates on the basis of disability. I have also found that this particular section is often underutilized when a Title II entity contracts with another entity that discriminates on the basis of disability.