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STATE OF MINNESOTA
IN SUPREME COURT
A20-1481

Court of Appeals Thissen, J.
Dissenting, Gildea, C.J.
Christopher Welters,

Respondent,

vs. Filed: December 14, 2022
Office of Appellate Courts
Minnesota Department of Corrections, et al. ,

Appellants.
________________________

Zorislav R. Leyderman , The Law Office of Zorislav R. Leyderman, Minneapolis,
Minnesota, for respondent.

Keith Ellison, Attorney General, Michael Goodwin, Assistant Attorney General, Saint
Paul, Minnesota, for appellants.

Vicki A. Hruby, Jardine, Logan & O’Brien, P .L.L.P., Lake Elmo, Minnesota, for amicus
curiae Association of Minnesota Counties.

John J. Choi, Ramsey County Attorney, Rebecca Krystosek, Assistant County Attorney,
Saint Paul, Minnesota, for amicus curiae Minnesota County Attorneys Associa tion.

Richard D. Hodsdon, Minnesota Sheriffs’ Association, Saint Paul, Minnesota, for amicus
curiae Minnesota Sheriffs’ Association.
________________________
S Y L L A B U S
1. When no specific, immediate threat to order or institutional security exists ,
the deliberate indifference standard applies to Eighth Amendment claims seeking relief
under 42 U.S.C. § 1983 for injuries resulting from corrections officers overly tightening

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and unsafely applying mechanical restraints while transporting an inmate to a medical
procedure, while the inmate is waiting in a medical holding cell, and while the inmate is
undergoing a medical procedure .
2. The inmate’s claim under 42 U.S.C. § 1983 cannot be dismissed on summary
judgment based on the corrections officers’ qual ified immunity defense because a
reasonable factfinder could conclude that the facts alleged show an objective and
substantial risk of harm that the corrections officers subjectively recognized and
nevertheless disregarded, and because the constitutional o bligation to prevent the
substantial risk of harm posed by the improper use of restraints in non-emergency situations
was clearly established on the date the restraints were used.
Affirmed.
O P I N I O N
THISSEN, Justice.
The Eighth Amendment to the United States Constitution prohibits inflicting “cruel
and unusual punishments .” U.S. Const. amend. VIII; see also Wilson v. Seiter , 501 U.S.
294, 296–97 (1991). Respondent Christopher Welters is incarcerated in the Stillwater
correctional facility. On July 31, 2017, he was transported from the Stillwater correctional
facility to the Oak Park Heights correctional facility for an endoscopy. Welters alleges that
Appellants Cornelius Emily and Ernest Rhoney, Minnesota Department of Corrections
officers, subjected him to cruel and unusual punishment when they improperly applied
handcuffs in a manner that caused him injury and refused to loosen the handcuffs when he
complained that the handcuffs were too tight and causing numbness. Welters remained in

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the overtightened handcuffs for 3½ hours, including while under general anesthesia for the
endoscopy. Welters suffered serious injury in both wrists that required surgery and left
him with permanent nerve damage that continues to cause pain and decreased function. He
sued Officers Rhoney and Emily under 42 U.S.C. § 1983, seeking damages to compensate
him for his injuries.
We are asked to answer two questions in this case. First, we must determine whether
Welters’s Eighth Amendment claim should be assessed under the deliberate indifference
standard (applicable to conditions of confinement and medical care) or under the malicious
and sadistic standard ( applicable in Eighth Amendment excessive use of force cases ).
Eighth Am endment claims arising from conditions of confinement and medical care are
subject to the deliberate indifference standard , which asks whether officers knowingly
disregarded an objective risk of serious harm. Wilson, 501 U.S. at 303. In contrast, when
officers take security measures to “resolve a disturbance” that “indisputably poses
significant risks to the safety of inmates and prison staff,” the applicable Eighth
Amendment standard is “whether force was applied in a good faith effort to maintain or
restore discipline or maliciously and sadistically for the very purpose of causing harm.”
Whitley v. Albers, 475 U.S. 312, 320–21 (1986) (citation omitted) (internal quotation marks
omitted). We conclude that the deliberate indifference standard applies in this case.
Second, we must determine whether qualified immunity bars Welters’ s deliberate
indifference claim. This analysis has two parts. As an initial matter , because this case
comes to us from a district court decision granting summary judgment in favor of Officers
Rhoney and Emily, we must assess whether a jury, viewing the facts and inferences drawn

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from those facts in the light most favorable to Welters, reasonably could find that the
corrections officers acted with deliberate indifference. We conclude that a jury could do
so.
Next, we must decide whether, on July 31, 2017, a reasonable corrections officer
would have known that improperly applying handcuffs for routine medical transportation
in a manner that caused serious injury and refusing to loosen the overtightened handcuffs
when Welters complained that the y were too tight and causing him numbness , violated
Welters’s Eighth Amendment rights. We conclud e that a reasonable corrections officer
would have understood that such conduct violated the Eighth Amendment ’s prohibition on
cruel and unusual punishment. Accordingly, the right was clearly established such that
Officers Rhoney and Emily are not entitled to qualified immunity.
Accordingly, we hold that Welter s’s section 1983 claim survives summary
judgment. We affirm the decision of the court of appeals , which reversed the district
court’s decision to grant summary judgment in favor of Officers Rhoney and Emily, and
we remand for further proceedings in accordance with this opinion.
FACTS
We are reviewing the district court’s decision to grant summary judgment in favor
of Officers Rhoney and Emily. Accordingly, we recite the facts in the light most favorable
to Welters as the nonmoving party. Mumm v. Mornson, 708 N.W.2d 475, 481 (Minn.
2006). These facts are, of course, subject to proof at trial.
On July 31, 2017, Officers Rhoney and Emily were tasked with transporting inmates
from the Minnesota Correctional Facility–Stillwater to their appointments scheduled at the

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outpatient medical clinic housed at the Minnesota Correctional Facility–Oak Park Heights.
Welters was an inmate at Stillwater and was scheduled for a routine endoscopy under
general anesthesia that day at O ak Park Heights. He had been incarcerated for nearly 30
years and testified that , during that time, he had no altercations with officers, no assaults
on other inmates, and no escape attempts. Officers Rhoney and Emily both testified that
they did not have any spec ific safety or security concerns about Welters, and Officer
Rhoney testified that this was just a “routine” transportation for medical treatment .
Minnesota Department of Corrections (DOC) policy requires that all offenders be
transported in full restraints, regardless of the individual offender’s security classification.
Minn. Dep’t of Corr., Policy Manual 301.096(C)(1) (Nov. 5, 2019).1 Full restraints include
handcuffs, a waist chain, a black box (applied over the chain and lock area of handcuffs to
form a rigid link between the two wristlets), and leg irons. Id. at 301.096. DOC Policy
also requires handcuffs and leg irons to be “double locked”—a safety measure that prevents
the cuffs from continuing to tighten. Id.
When Officer Rhoney appl ied Welters’s restraints in preparation for transport,
Welters testified that he noticed right away that the handcuffs were “tighter than usual,”
but he did not mention it to Officer Rhoney at that time because he “didn’t think it w as
important.” About 15 to 20 minutes later, however, Welters began feeling symptoms . H e
testified that prior to getting into the transport vehicle, he told Officer Rhoney that the cuffs

1 This opinion cites the most recent Minnesota Department of Corrections Policy
Manual, which is available at https://policy.doc.mn.gov/DOCPolicy/. There have been no
substantive changes in the cited policies since the time of the incident.

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were “pretty tight .” Welters testified that Officer Rhoney responded, “Oh, it’s only a 15-
minute drive, it’ll be all right.”
When they were getting into the van, Welters felt his handcuffs click tighte n,
indicating that they were not double locked in violation of DOC policy. When Welters
mentioned this to Officer Rhoney and asked him to “fix this before we leave,” Officer
Rhoney pushed on the cuff, clicked it even tighter, told Welters he “was right,” but then
did nothing to correct the situation, repeating that they would be there in only 15 minutes.
During the drive to Oak Park Heights, Officer Rhoney sat in the back of the vehicle
with Welters and one other inmate, and Officer Emily rode in the front with a third officer.
Upon arrival at O ak Park Heights, neither Officer Rhoney nor Officer Emily did anything
to tend to Welters’ s overtightened handcuffs. Rather, Welters and the other Stillwater
inmate were placed in medical holding cells and left alone, still in full restraints. Welters
noticed that none of the other eight inmates in the other medical holding cells had any
restraints on. The third officer and Officer Rhoney then left to go back to Stillwater,
leaving Officer Emily at O ak Park Heights . Welters estimates that he and the other
Stillwater inmate were left alone for at least half an hour, during which time his hands were
becoming increasingly cold and numb. Welters testified that, in his decades of
incarceration, he had been transported “many, many, many times” and that this was the
first time handcuffs had been put on too tight. Welters asked an O ak Park Heights officer
about getting his restraints removed and that officer responded that a Stillwater officer
would need to attend to that.

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Welters testified that w hen Officer Emily came back about 45 minutes later and
opened the door to the cell, Welters told him that his hands were numb and asked Officer
Emily to “loosen them, please loosen them.” Officer Emily did nothing to fix Welters’ s
handcuffs. S tating that he needed to go find the other Stillwater officers , Officer Emily
closed the door of the holding cell and left. According to Welters, that was the last time
he saw Officer Emily until after he was recovering from anesthesia and the procedure.
When an Oak Park Heights officer came to take him back for his procedure, Welters
asked tha t officer to loosen his restraints and the officer responded that he would have to
get a Stillwater officer to do that. Welters testified that the nurse then asked that officer
“Why is he still in his restraints?” and the O ak Park Heights officer replied that he was
looking for Stillwater officers. According to Welters, t he nurse then asked Welters why
he was still in restraints, expressed that it was not normal for inmates to remain in restraints
during the procedure, and stated to another officer, “Why are these offender’s restraints
still on? I said I wanted them removed.” Welters testified that he could “barely sign” the
pre-procedure paperwork because his hands were “so numb,” although they were not yet
blue. When he told the nurse how numb his hands were, she reportedly stated that “the
officers should take them off soon.”
Once in the operating room and prior to the administration of anesthesia, Welters
testified that the medical staff again asked the O ak Park Heights officer who was present
why Welters was still in restraints and that officer replied that they were still “looking for
the Stillwater staff.” Welters was then placed on the gurney on his back, still in full
restraints. After medical personnel told him t o roll to his side so they could administer the

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anesthesia, Welters again asked if they were going to put him under and do the procedure
with his restraints still on and they told him that “they should be removing [the restraints]
soon.” Welters was then placed under anesthesia and the endoscopy was performed .
Welters was still in full restraints when he awoke from the procedure and reportedly
could not feel his hands “at all.” He testified that when he asked the nurse if they had been
on the whole time, she replied affirmatively and stated that she had “never seen a dangerous
procedure done on an offender in full restraints” in her 10 years of working at O ak Park
Heights. When Officer Emily came to get him, Welters contends that he again told Officer
Emily that he could not feel his hands and that he needed to go to the bathroom, but Officer
Emily again did not adjust his handcuffs. Welters tried to urinate but was unable to
maneuver to do so because he could not feel his hands, so he recalled that he “just didn’t
use the bathroom.” He was then returned to the medical holding cell, still in the
overtightened handcuffs and full restraints, to wait for transport back to Stillwater. Welters
observed that another Stillwater inmate already in the same holdin g cell awaiting transport
did not have any restraints on.
By the time Welters arrived back at Stillwater, his wrists had been in overtightened
handcuffs for 3½ hours, and he observed that his hands were “light bluish.” When the
cuffs were removed, he showed an officer the gouges left in his wrists and that officer told
him to “[b]ring it to medical.” The nurse at Stillwater noted that his blood pressure was
high and kept him there awhile to observe him because he was not feeling well . Welters

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testified that the nurse explained that his elevated blood pressure was an indication that he
was in pain and advised him to “call a lawyer.”2
Welters testified that his hands remained “very numb” until the next morning, when
they “became alive with pain.” He saw a doctor that day who diagnosed “probabl[e] nerve
decompression” and prescribed steroids. When the steroids did not help, Welters was put
into wrist braces. He described the pain as “intense” in the palms of his hands, with
bruising on his wrists that lasted “at least a week.”
On August 1, 2017, t he day after Officers Rhoney and Emily transported him for
his procedure at O ak Park Heights , Welters submitted an Offender Kite Form (kite) ,3
reporting the overtightened handcuff incident. Welters reported: “It was horrific, painful

2 In deposition testimony, Officers Rhoney and Emily told a very different story from
Welters. Most notably, they both contended that Welters never asked them to loosen or
remove his restraints at any point on July 31, 2017. Officer Rhoney testified that he
checked Welters’s cuffs for tightness and that he would have double locked them, “[a]s per
policy.” He testified that he did not know anything about Welters’s wrist complaints until
“weeks later.” Officer Emily testified that Welters “never” complained of pain or
discomfort either before or after his procedure and that no medical personnel requested that
the restraints be removed. Contrary to Welters’ s account, Officer Emily testified that he
brought Welters back for his medical procedure , and he asked the nurse if restraints were
needed. Officer Emily contended that W elters “piped up” and volunteered to stay in
restraints, stating that when he was incarcerated in California, they did procedures with
restraints on “all the time.” Officer Emily also testified that he asked Welters, “Are you
good?” to which Welter’s replied, “Yes, I’m good.” Based on the procedural posture of
the case, we are required to assume Welter s’s testimony is true and to disregard any
contradictory testimony by Officers Rhoney and Emily. We note that a jury would be
under no such obligation and would be free to credit the testimony of Officers Rhoney and
Emily if it found that testimony more persuasive.

3 The “kite” is a printed form issued by the DOC and operates as the mechanism for
offenders to communicate with staff “in an effort to promptly resolve concerns/iss ues.”
Minn. Dep’t of Corr., Policy Manual 303.101 (June 16, 2020).

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and humiliating. It is a clear violation of policy and procedure. It violated my rights as a
human being. It was cruel and unusual punishment for no reason at all. Deliberate
indifference and a true violation of my constitutional rights.” In response, Captain Byron
Matthews interviewed the staff about the incident and issued a kite response memorandum
on August 24, 2017. The memorandum stated that the corrections officers denied that
Welters or the nurse requested that his restra ints be removed during the procedure. The
memorandum further said that the nurse “knew it wasn’t normal protocol for offenders to
be restrained during medical procedures.” The kite response memorandum concluded:
“The staff . . . should have removed your restraints upon placement into the OPH holding
cell. All involved officers have been reminded to always remove offender restraints upon
admittance unless there is a safety concern which would prevent the restrain t removal.”
Following the handcuffing incident, W elters continued to lose function in his hands
to the point that he struggled to hold his toothbrush. Welters suffered from worsening pain,
was placed on medical leave from prison work, and eventually requi red carpal tunnel
surgery in both wrists. According to Welters, the surgeries relieved his “intense pain,” but
his wrists persistently “ache” and “don’t work the same as they once did.”
4
Welters filed a section 1983 complaint in Washington County district court, alleging
that Off icers Rhoney and Emily acted with deliberate indifference towards his health,

4 On March 29, 2019, Dr. Meletiou (an orthopedic specialist and expert) authored an
expert report opining that “continuous compression resulting from being handcuffed during
anesthesia” was “the primary mechanism of injury” and the “substantial contributing
factor” to Welters’s bilateral carpal tunnel syndrome. Dr. Meletiou noted that Welters had
no previous risk factors and that nerve compression injuries from overtightened handcuffs
is “well documented in the literature.”

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safety, and substantial risk of serious harm in violation of the Eighth Amendment. Officers
Rhoney and Emily moved for summary judgment . They a rgued that to prove that they
violated his Eighth Amendment rights , Welters had to establish that they acted with
malicious or sadistic intent for the purpose of causing harm when they refused to double -
lock and to loosen Welters ’s handcuffs after they kne w the handcuffs were not double
locked and were overtightened so much that they were restricting Welters’s circulation and
causing numbness in his hands . They asserted that Welters failed to prove the requisite
intent under the malicious and sadistic standard. Instead, the officers argued that use of
restraints during medical procedures falls within officer discretion .
In the alternative, the corrections officers argued that they are shielded from suit by
qualified immunity . Framing Welters ’s claim as whether “the use of handcuffs for a
medical transport and medical procedure at another correctional facility” violates the
Eighth Amendment, the officers argued that no such right was clearly established on
July 31, 2017.
The district court granted summary judgment on the ground that the facts did not
show that the officers acted maliciously and sadistically and, accordingly, Welters did not
prove a violation of the Eighth Amendment. The district court did not reach the issue of
qualified immunity.
The court of appeals reversed . It held that the district court applied the wrong
standard when assessing Welters ’s Eighth Amendment claim. Welters v. Minn. Dep’t of
Corr., 968 N.W.2d 569, 583–84 (Minn. App. 2021). The court of appeals concluded that
the deliberate indifference standard applied and not the malicious and sadistic standard. Id.

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And the court determined that Welters had sufficiently alleged his deliberate indifference
claim, stating:
[A] reasonable factfinder could deter mine from the record in this case that
Officers Rhoney and Emily, like the officials in Hope, were not facing an
emergency situation but nevertheless ‘subjected [Welters] to a substantial
risk of physical harm, to unnecessary pain caused by the [ shackles] and the
restricted position of confinement . . . [and] created a risk of particular
discomfort and humiliation.’ ”
Id. (alteration in original) (emphasis added) ( quoting Hope v. Pelzer , 536 U.S. 730, 738
(2002)). The court of appeals also concluded that clearly established law barred qualified
immunity, stating: “The Supreme Court and the lower federal courts have concluded that
the Eighth Amendment bar on cruel and unusual punishments forbids the inhumane use of
restraints that cause injury to prisoners.” Id. at 582. We granted review.
ANALYSIS
Officers Rhoney and Emily ask us to reverse the court of appeals and reinstate the
district court’s grant of summary judgment in their favor. We review summary judgment
rulings de novo. Schroeder v. St. Louis Cnty., 708 N.W.2d 497, 503 (Minn. 2006). When
reviewing an appeal from a summary judgment decision, we must determine whether the
district court erred in applying the law and whether genuine issues of material fact exist.
Mumm, 708 N.W.2d at 481. “A genuine issue of material fact arises when th ere is
sufficient evidence regarding ‘an essential element . . . to permit reasonable persons to
draw different conclusions.’ ” Kelly for Washburn v. Kraemer Constr., Inc., 896 N.W.2d
504, 508 (Minn. 2017) (alteration in original) (quoting DLH, Inc. v. Russ, 566 N.W.2d 60,
71 (Minn. 1997)). In such cases, summary judgment “should not be granted.” Staub v.

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Myrtle Lake Resort, LLC. , 964 N.W.2d 613, 620 (Minn. 2021). We view the evidence in
the light most favorable to the nonmoving party and resolve all doubts and factual
inferences against the moving party. Id. In doing so, we do not “weigh facts or determine
the credibility of affidavits and other evidence.” Montemayor v. Sebright Prod., Inc.,
898 N.W.2d 623, 628 (Minn. 2017) (quoting Stringer v. Minn. Vikings Football Club, LLC,
705 N.W.2d 746, 754 (Minn. 2005) ).
I.
We turn first to the threshold issue in this case: Does the “malicious and sadistic ”
standard or the “deliberate indifference” standard apply?
The Eighth Amendment prohibits state officials from inflicting cruel and unusual
punishment on persons convicted of crimes. U .S. Const. amend. VIII. This prohibition
extends to “the treatment a prisoner receives in prison and the conditions under which he
is confined . . . .” Helling v. Mc Kinney, 509 U.S. 25, 31 (1993). As the United States
Supreme Court has explained:
[W]hen the State takes a person into its custody and holds him there against
his will, the Constitution imposes upon it a corresponding duty to assume
some responsibility for his safety and general well being . . . . The rationale
for this principle is simple enough: when the State by the affirmative exercise
of its power so restrains an individual’s liberty that it renders him unable to
care for himself, and at the same time fails to provide for his basic human
needs—e.g., food, clothing, shelter, medical care, and reasonable safety —it
transgresses the substantive limits on state action set by the Eighth
Amendment.

Id. at 32 (quoting DeShaney v. Winnebago Cnty. Dep’t Soc. Servs., 489 U.S. 189, 199–200
(1989)).

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In the prison context, the Eighth Amendment does not prohibit routine discomfort.
Hudson v. McMillan, 503 U.S. 1, 9 (1992). But for nearly half a century, the Supreme
Court of the United States has recognized that the unnecessary and wanton infliction of
pain on prisoners is unconstitutional because it serves no penological purpose and is
inconsistent with contemporary standards of decency. Estelle v Gamble, 429 U.S. 97, 102–
04 (1976); see also Hope, 536 U.S. at 737; Rhodes v. Chapman, 452 U.S. 337, 347 (1981).
To prove that an official acted wantonly when inflicting pain or injury, the offender
must show “more than ordinary lack of due care for the prisoner’s interest s or safety.”
Whitley, 475 U.S. at 319. But what that something more is depends on the type of violation
alleged. See, e.g., Stark v. Lee Cnty ., IA , 993 F.3d 622, 625 (8th Cir. 2021) ( quoting
Howard v. Barnett , 21 F.3d 868, 871 (8th Cir. 1994) ). Courts have stated that close
attention should be paid to the factual context whe n assessing the appropriate substant ive
standard to apply in passive restraint cases. See, e.g., Jackson v. Gutzmer, 866 F.3d 969,
976 n.3 (8th Cir. 2017). The focus on cont ext in which the official’s decision is being
made, as opposed to a focus on the particular type of act in which an officer engages (for
instance, applying force) , is important and is the primary distinction between our analysis
on the question of which st andard applies and that of the dissent. 5

5 Courts sometimes refer to the malicious and sadistic standard as the “excessive
force” standard. Like many shorthand catchphrases, “e xcessive force” does not capture
the essential distinction between the context when the malicious and sadistic culpability is
required and circumstances when a deliberate indifference level of culpability is required
to establish Eighth Amendment liability. See, e.g., Farmer v. Brennan, 511 U.S. 825, 840
(1994) (stating that “Eighth Amendment liability . . . is thus based on the Constitution and
our cases, not merely on a parsing of the phrase ‘deliberate indifference’ ”). (Footnote
continued on next page)

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The question of whether an official’s act “can be characterized as ‘wanton’ depends
upon the constraints facing the official.” Wilson, 501 U.S. at 303. Specifically, the United
States Supreme Court has recognized that, in addition to the “ ‘duty to assume some
responsibility for [the] safety and general well-being’ ” of offenders in their custody,
Helling, 509 U.S. at 32 (quoting DeShaney, 489 U.S. at 200) , prison officials also must
maintain order and institutional security in the facility , Hudson, 503 U.S. at 6. When
corrections officers are reacting to urgent circumstances that force them to balance their
obligations to maintain order and institutional security and to protect the well -being of
inmates, courts will be more deferential to the decisions of those officers. Wilson, 501 U.S
at 302. In other words, w hen corrections officers face a threat of unrest that requires the
use of force to restore order and discipline, that clash of obligations is most clearly present
and greater deference is afforded because the officers’ actions are taken with haste and
under pressure . Hudson, 503 U.S. at 6; Whitley, 475 U.S. at 320–22 (defining the
malicious and sadistic standard, clarifying that it applies when a disturbance “indisputably
poses significant risks to the safety of inmates and prison staff,” and determining that

As discussed below, the “malicious and sadistic” standard applies in circumstances
when the question is whether officers used excessive force to restore order and discipline
when faced with a threat of unrest, especially when the officials are making decisions in
haste and under pressure. The deliberate indifference standard applies in cases when those
conditions do not exist. Accordingly, the mere fact that the mechanism by which an officer
inflicted pain or injury involved the use of force (overtightening handcuffs, for example)
is not dispositive or necessarily relevant to which standard of culpability applies. For that
reason, we refer to the “malicious and sadistic” and “deliberate indifference” standards
henceforth since those formulations refer to the level of officer culpabil ity, which is the
focus of the Eighth Amendment test.

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officers did not violate the Eighth Amendment when they shot a prisoner in the leg in
response to a prison riot).
Accordingly, depending on the circumstances facing prison officials, courts apply
one of two different tests to determine whether the official who inflicted pain acted
wantonly. When corrections officers are acting in the face of a threat that may reasonably
require the use of force to restore order and discipline, they violate the Eighth Amendment
only when they act “maliciously and sadistically to cause harm.” Hudson, 503 U.S. at 7–
9 (noting that the “context” determines whether the excessive force standard applies and
determining that when officers, in response to a disturbance, beat an inmate on the way to
lockdown, the context required an excessive force analysis). When officers act “in a good
faith effort to maintain or restore discipline,” the ir conduct does not violate the Eighth
Amendment. Id. at 6. On the other hand, when corrections officers face a situa tion that
does not implicate their duty to maintain order and institutional se curity in the face of a
threat (for example, when implementing routine security measures), then they act wantonly
if they are subjectively aware that a prisoner face d a substantial risk of serious harm and
yet disregarded the risk by failing to take reasonable efforts to abate it. Farmer v. Brennan, 511 U.S. 825, 835–47 (1994). In 2002, the Supreme Court applied the deliberate
indifference standard in determining that a prisoner, who was handcuffed to a hitching post
without food or water or bathroom breaks for 7 hours, stated a claim under the Eighth
Amendment. Hope, 536 U.S. at 737–38. Although Hope’s punishment was in response to
a “wrestling match with a guard,” in applying the deliberate indifference standard, the
Supreme Court observed that “[a]ny safety concerns had long since abated by the time the

17
petitioner was handcuffed to the hitching post because Hope had already been subdued,
handcuffed, placed in leg irons, and transported back to the prison.” Id. at 734, 737.6
We agree with the court of appeals that Officers Rhoney and Emily’s conduct in this
case should be assessed under the deliberate indifference standard. Indeed, that is how
Welters framed his section 1983 claim alleging that Officers Rhoney and Emily violated
the Eighth Amendment with their cumulative conduct: overtighteni ng of his handcuffs for
transport; failing to double -lock them to prevent further tightening in violation of
Department of Corrections policy; ignoring his reports of numbness; refusing his requests

6 The dissent places heavy but misplaced reliance on Hudson. Hudson was a case
where the corrections officers were responding to a specific threat of unrest that required
the temporary use of force to restore order and discipline. 503 U.S. at 4. The prisoner
alleged that the corrections officers beat him on the way to lockdown. Id. The incident
arose when the prisoner and a corrections officer argued. Id. In response to the
disturbance, two cor rections officers placed the prisoner in handcuffs and shackles, took
the prisoner out of his cell, and walked him toward the penitentiary’ s “administrative
lockdown” area. Id. On the way there, the corrections officer punched Hudson in the
mouth, eyes, chest, and stomach. Id. A supervisor on duty watched the beating but merely
told the officers “not to have too much fun.” Id. Hudson fits squarely within our distinction
between prison contexts where corrections officers face a threat of unrest that requires the
use of forc e to restore order and discipline , and contexts where corrections officers are
implementing routine security measures and not responding to a specific threat or
disturbance. And Hudson cannot be currently understood without reference to the Hope
Court’s subsequent decision.
In this case, there is not a whiff of any disturbance. The corrections officers point
to none, and one of them testified that he had no specific safety concerns during any of his
interactions with Welters or at any point during the transport, waiting, or medical procedure
that day. Moreover, there is no indication that the corrections officers inc orrectly applied
the handcuffs and applied them too tightly because they needed to do so to respond to some
kind of threat or disturbance. Finally, Welters does not accuse the corrections officers of
using excessive force; he accuses them of deliberately ignoring the risk of severe injury
from dangerously tight handcuffs.

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to loosen them , knowing that he was going into a medical procedure; and unnecessarily
subjecting him to overtightened handcuffs for 3½ hours.
There is no suggestion in the record that Officers Rhoney and Emily’s conduct was
taken in response to a threat that required the use of force to restore or maintain dis cipline.
Welters did not disobey the officers at any point on July 31, 2017, and he caused no
disturbance. Indeed, Officer Rhoney testified that this was a “routine” transport for a
“routine” medical procedure ,7 and Officer Emily testified that he had no specific safety
concerns during any of his interactions with Welters or at any point during the transport ,
waiting, or medical procedure that day. Further, Welters was held in a secure cell while
waiting for his medical procedure at Oak Park Heights—a maximum security facility with
other corrections officers around, and every offender in the other holding cells had their
restraints removed.
For safety and security reasons, Department of Corrections policy requires that
restraints, including handcuffs, are used during transportation to medical procedures . See
Minn. Dep’t of Corr., Policy Manual 301.096(C)(1). But We lters is not attacking that
general policy. He does not claim that the use of handcuffs during transport in compliance
with Department of Corrections policy is itself unconstitutional.
Rather, Welters contends that the handcuffs were unnecessarily and improperly
applied too tightly, subjecting him to a substantial risk of serious injury, and that Officers

7 The dissent objects to our characterization of the activities here as “routine.” Based
on the record, the characterization is appropriate —including the fact that the corrections
officers characterized the activities as routine.

19
Rhoney and Emily knew that. The Department of Corrections policy mandates
transportation in “full restraint s,” which specifically requires that handcuffs be “double
locked.” See Minn. Dep’t of Corr., Policy Manual 301.096. But Welters’s handcuffs were
not double locked, and there is no argument that either officer had to overtighten the
handcuffs or refuse to double-lock them in an effort to respond to a threat or to restore or
maintain order and discipline. And the re is nothing in the record to support a conclusion
that either officer lacked the time or opportunity to loosen Welters’s handcuffs because
they were faced with such a threat to order and discipline.
We reject Officers Rhoney and Emily’s argument that, under Whitley and Hudson,
deference must be afforded “anytime an officer inflicts pain in the course of any prison
security measure, whether or not faced with an emergency.” Supreme Court precedent is
clear that the malicious and sadistic standard applies when corrections office rs are faced
with a threat—whether it be from an individual inmate refusing to obey orders or a full -
blown riot—and use force to maintain order and discipline. Officers Rhoney and Emily’s
position that the malicious and sadistic standard applies to any act taken to maintain general
security would swallow even the day- to-day security measures taken as part of the
conditions of confinement of prison life.
We find persuasive that, in accordance with Supreme Court case law, and consistent
with our conclusion here, the Eighth Circuit has consistently applied the deliberate
indifference standard to the use of restraints during inmate transportation. See, e.g.,
Reynolds v. Dormire , 636 F.3d 976, 979 (8th Cir. 2011) (citing Davis v. Oregan Cnty.,
Mo., 607 F.3d 543, 548 (8th Cir. 2010) (quoting Nelson v. Corr. Med. Serv., 583 F.3d 522,

20
528 (8th Cir. 2009) (en banc))) (applying the deliberate indifference standard to analyze
whether the refusal by officers to remove restraints during an all -day transport to a nother
correctional facility violated the Eighth Amendment); Brown v. Fortner , 518 F.3d 552,
558–59 (8th Cir. 2008) (citing Farmer, 511 U.S. at 836) (applying the deliberate
indifference standard to a claim arising from the officer’s failure to apply seatb elts to
inmates in full restraints during transport). Even more specifically, the Eighth Circuit has
distinguished cases arising from restraints during medical procedures from “cases
involving prison riots, for example” and thus determined conclusively that the Whitley
malicious and sadistic standard does not apply to medical transport restraint injury cases.
Nelson, 583 F.3d at 528.8

8 The dissent offers three Eighth Circuit case s and several from other federal circuit
courts that it suggests are contrary to this conclusion. We disagree.
For instance, in Aldalpe v. Lambert, the jury found that a corrections officer violated
an inmate’s Eighth Amendment rights when he handcuffed the inmate from behind ,
contrary to medical orders that precluded such handcuffing because of the inmate’s pre -
existing shoulder injury. 34 F.3d 619, 623 (8th Cir. 1994) . Critical to our consideration
here, Aldalpe simply does not address whether the malicious and sadistic standard or the
deliberate indifference standard applies. That was not a question before the Aldalpe court.
Rather, in a ppealing his conviction, the officer argued among other things that the
prisoner’s injury was not significant enough to constitute an Eighth Amendment violation.
The court rejected that argument as contrary to Hudson. Id. at 624 (citing Hudson for the
proposition that an injury need not be significant to violate the Eighth Amendment). The
officer also argued that the instructions to the jury suggested that it should presume the
officer knew about the medical order precluding behind -the-back cuffing. The court
determined that the jury instructions required the jury to find as a fact that the officer knew
about the medical order . Id.
The same is true about Davidson v. Flynn, 32 F.3d 27 (2d Cir. 1994). There was no
dispute about what standard governed . T he only question was whether the standard the
district court used was properly applied. And, indeed, the Second Circuit ruled in favor of
the prisoner, finding his allegation that the corrections officers applied his handcuffs too
tightly stated a claim even under the more rigorous standard. Id. at 30. Similarly, in Pelfry
v. Chambers, 43 F.3d 1034 (6th Cir. 1995), the court did not address the question of what

21

standard applied. Instead, the court was asked whether an assault on an inmate constituted
punishment. Pelfry, 43 F.3d at 1037. And, as in Aldalpe and Davidson, the Pelfry Court
found in favor of the inmate and held that he state d a claim even under the more rigorous
standard. Id. The same is true of Wilkins v. Moore, 40 F.3d 954 (8th Cir. 1994), in which
a prisoner alleged Eighth Amendment violations when he was assaulted, denied clothing,
and denied medical care. Once again, there was not discussion in the case about what
standard applied. Further, the case is quite different from the one before us, arising when
a corrections officer confronted the plaintiff prisoner for wearing gang colors. Id. at 955.
Other inmates got involved and an altercation among officers and prisoners broke out. Id.
After the altercation, the prisoner was taken to a room where he was told to sign a statement
exonerating the officers. Id. When the prisoner refused, he was beaten, abused, and placed
in detention without clothes. Id . And, like all the other cases, the Eighth Circuit ruled in
favor of the prisoner, concluding that he sufficiently alleged an Eighth Amendment
violation. Id. at 958. Finally, in McReynolds v. Alabama Department of Youth Services,
an unpublished case, the Eleventh Circuit applied the sadistic and malicious standard in a
case where, after the juvenile detainee refused to cooperate with the corrections officers ,
the officers beat him. 204 F. App’ x. 819, 820–21 (2006). Once again, there was no
discussion of what standard applied. And like the other cases, the court held for the juvenile
detainee. Id. at 821–22.
Notably, all these cases aside from McReynolds were decided in the mid -1990s
before the decision in Hope v. Peltzer, 536 U.S. 730 (2002). As earlier noted, in Hope the
Supreme Court concluded that a prisoner who was handcuffed to a hitching post without
food, water, or bathroom breaks for 7 hours as punishment for an earlier disturbance stated
an Eighth Amendment claim. Id. at 737–38. In reaching its conclusion, the Court applied
a deliberate indifference standard, citing Hudson for support. Id. The fact that the Hope
court cited Hudson (a sadistic and malicious case) suggests that the distinction between the
standards was on the court’s mind.
In Walker v. Bowersox, unlike here, the officers were using non-routine restraints in
response to a disturbance: the inmate had slipped out of his handcuffs and refused to submit
to handcuffs while also refusing to cooperate with the addition of a cellmate. 526 F.3d
1186, 1188 (8th Cir. 2008) . Likewise, the cases cited by the dissent from other circuits
apply the malicious and sadistic standard in non- routine contexts where offi cers were
responding to a specific disturbance or acute safety concern. See, e.g., Lunsford v. Bennet,
17 F.3d 1574 (7th Cir. 1994) (flood response); Campbell v. Sikes, 169 F.3d 1353 (11th Cir.
1999) (self-injurious inmate); Jackson v. Gut zmer, 866 F.3d 969 (8th Cir. 2017) (same);
Stevenson v. Cordova, 733 F. App’ x. 939 (10th Cir. 2018) (inmate’s refusal to submit to
handcuffs and physical altercation with officers) .

22
Further, we are not convinced by Officer Emily’s contention that the malicious and
sadistic standard should apply becau se he was generally concerned for his own safety. 9
First, the facts in the record do not support his concerns. Welters and the other inmate were
transported from Stillwater directly to a secure holding cell at Oak Park Heights—a Level
5 maximum-security prison. Welters remained in that cell when he told Officer Emily that
his hands were numbing because the handcuffs were too tight and requested relief. And
further, Officers Rhoney and Emily do not dispute that there were O ak Park Heights
corrections officers present and assisting wit h the management of offenders attending
medical appointments. Moreover, hundreds of prisoners at Stillwater leave their cells and
move through the facility every day without handcuffs and other restraints . Finally,
Officers Rhoney and Emily do not identify any safety concern that would have been
implicated by simply loosening Welter s’s handcuffs while he was confined to a holding
cell to restore feeling to his hands and ensuring that the handcuffs were double locked.
We therefore conclude that the district court erred when it applied the malicious and
sadistic standard to Welters’s restraint injury claim.
II.
We turn now to the question of whether qualified immunity bars Welters’ s
deliberate indifferenc e claim against Officers Rhoney and Emily. Welters brought his

9 These generalized concerns flow from the contention that Officer Emily was n ot
accompanied by another Stillwater corrections officer when Welters requested that his
handcuffs be loosened while Welters was in the medical holding cell. Officer Emily stated
that he “[doesn’t] trust these guys if I’m by myself,” and he stated that he perceived Welters
without any handcuffs as a safety issue.

23
Eighth Amendment claim under 42 U.S.C. § 1983, which provides an enforcement remedy
for violations of constitutional rights by public officials. Qualified immunity is a judicially
created affirmative defense that allows public officials to avoid liability to citizens harmed
by public officials’ unconstitutional actions, leaving the individuals to bear the costs and
burdens of their injuries themselves. Elwood v. Rice Cnty., 423 N.W.2d 671, 674 ( Minn.
1988); Harlow v. Fitzgerald, 457 U.S. 800, 815 (1982). Qualified immunity is designed
to balance two important interests. On the one hand, when a citizen claims that a public
official violated his constitutional rights, “an action for damage s may offer the only
realistic avenue for vindication of constitutional guarantees.” Harlow, 457 U.S. at 814.
Constitutional guarantees do not mean as much if they cannot be enforced . On the other
hand:
[I]t cannot be disputed seriously that claims frequently run against the
innocent as well as the guilty—at a cost not only to the defendant officials,
but [also] to society as a whole. These social costs include the expenses of
litigation, the diversion of official energy from pressing public issues, and
the deterrence of able citizens from acceptance of public office. Finally,
there is the danger that fear of being sued will “dampen the ardor of all but
the most resolute, or the most irresponsible [public officials], in the
unflinching discharge of their duties. ”
Id. (footnote omitted) (quoting Gregoire v. Biddle, 177 F.2d 579, 581 (2d Cir. 1949) ). In
assessing the application of qualified immunity, we must remain cognizant of both of these
interests. See Harlow, 457 U.S. at 814. Importantly, the public officials seeking to invoke
a qualified immunity defense have the burden to prove it. Crawford-El v. Britton, 523 U.S.
574, 586–87 (1998).

24
This case arises from a grant of summary judgment to Officers Rhoney and Emily .
When considering whether qualified immunity bars a section 1983 suit from proceeding,
we consider two questions. First, we determine whether the plaintiff alleges facts showing
the violation of a federal constitutional right . Second, we ask whether th e constitutional
right was clearly established at the time of the alleged violations, such that reasonable
officials would have known that their actions were unlawful. See Pearson v. Callahan ,
555 U.S. 223, 232 (2009). “Qualified immunity is appropriate only if no reasonable
factfinder could answer yes to both of these questions.” Nelson, 583 F.3d at 528. When
there are contradictory facts relevant to the issue of qualified immunity, “summary
judgment is prohibited.” Id. at 531.
A.
In the preceding section, we concluded that Welters ’s Eighth Amendment claim
should be assessed under a deliberate indifference standard. Applying that standard here
means that a constitutional violation is shown with evidence that (1) an objective and
substantial risk to his health or safety existed; and (2) Officers Rhoney and Emily had
subjective knowledge of the risk and nevertheless disregarded it. See Farmer, 511 U.S. at
842; Nelson, 583 F.3d at 528–29. The second prong of this analysis requires proof of “a
state of mind more blameworthy than negligence,” but it is “satisfied by something less
than acts or omissions for the very purpose of causing harm or with knowledge that harm
will result.” Farmer, 511 U.S. at 835. Under the deliberate indifference standard, the
evidence need not show that the public official had knowledge that harm would actually
occur; the evidence must show that the public official had knowledge of a substantial risk

25
that serious harm would occur. Id. at 842. Further, when a risk of harm was “obvious”
such that a “reasonable prison official would have noticed it,” the prisoner has no burden
to prove knowledge; the requisite knowledge is imputed to prison officials. Id.
We conclude that at t his stage of the proceedings, Welters has shown that the
overtightened and improperly applied handcuffs posed a substantial risk to his health or
safety. Welters alleges several undisputed facts that demonstrate that the manner in which
Officers Rhoney and Emily handcuffed him posed an objective risk of serious harm: (1) his
handcuffs were overly tight; (2) his handcuffs were not double locked as required by
Department of Corrections policy to avoid over tightening, and thus were subject to
increased tightening; (3) as a result, his handcuffs continued to tighten; (4) he complained
about the tightness; and (5) his hands became numb. Welter s’s resulting serious wrist
injury also demonstrates that an objective risk of harm from overly tight handcuffs
existed.10 Indeed, Officers Rhoney and Emily do not dispute that an objective substantial
risk of harm from overly tight handcuffs existed for purposes of this appeal.
Officers Rhoney and Emily do contend , however, that the evidence in the summary
judgment record is insufficient to prove that the two officers had subjective knowledge that
the unsafely applied and overtightened handcuffs posed a substantial risk of harm to
Welters. We disagree.

10 Dr. Meletiou’s expert re port opined that the overtightened handcuffs caused
Welters’s wrist injury and pointed to the “well documented” risk of handcuffs during
anesthesia, further demonstrating the existence of an objective and serious risk. See
Nelson, 583 F.3d at 529 (determining that expert testimony that shackling during labor is
“inherently dangerous” satisfied the objective prong of the deliberate indifference inquiry).

26
Whether officers had subjective knowledge of a substantial risk that an inmate will
suffer harm is a “question of fact subject to demonstration in the usual ways, including
inference from circumstantial evidence.” Id. Among other things , a “factfinder may
conclude that a prison official knew of a substantial risk from the very fact that the risk
was obvious.” Id.11 When a risk is obvious, a reasonable jury may find that an officer had
knowledge of the risk even if the officer did not have medical training, the inmate did not
expressly state their level of pain or discomfort, and medical personnel did not expressly
forbid the use of restraints. Nelson, 583 F.3d at 529; see also Lenz v. Wade, 490 F.3d 991,
995 (8th Cir. 2007) (“An obvious risk of a harm justifies an inference [that] a prison official
subjectively disregarded a substantial risk of serious harm to the inmates.”). Department
of Corrections policies regarding mechanical restraints recognize the obvious risks of
overtightened and improperly applied handcuffs.
12 Moreover, it is common knowledge

11 Of course, the corrections officers may prove at trial that they were unaware of even
an obvious risk to inmate health and safety. Farmer, 511 U.S. at 844 (“That a trier of fact
may infer knowledge from the obvious, in other words, does not mean that it must do so.”).
But on the record before us at the summary judgment stage, we can conclude that a
reasonable trier of fact may infer that Officers Rhoney and Emily knew that the
overtightened handcuffs posed a substantial risk of harm to Welters.

12 Department of Corrections policies require safety measures that are specifically
aimed at protecting against the obvious risk of harm from overtightened handcuffs. The
mechanical restraint policies mandate the following:

(d) Mechanical restraints must not be used:
(1) Longer than necessary;
(2) As punishment; . . .
(4) To cause undue discomfort;
(5) To inflict physical pain; or
(6) To restrict blood circulation or breathing.

27
that constriction that causes numbness is dangerous and should not be ignored. See Fourte
v. Faulkner Cnty., Ark., 746 F.3d 384, 388 (8th Cir. 2014) (recognizing the principle that
some inmate needs are “so obvious that even a layperson would easily recognize” them
(citation omitted) (internal quotation marks omitted) ).
Moreover, evidence that officers ignored a request from an inmate to address a risk
of harm is evidence that suggests knowledge and supports a finding of deliberate
indifference. See, e.g., Brown, 518 F.3d at 559–60 (determining that officers had
knowledge of risk of harm to an inmate when they ignored the inmate’s request for a
seatbelt and to slow down during transport while the inmate was shackled in a way that
prevented him from applying his own seatbelt). Further, an officer’s “self -serving
contention that they did not have the requisite knowledge does not provide an automatic
bar to liability in light of the objective evidence to the contrary.” Vaughn v. Gray, 557 F.3d
904, 909 (8th Cir. 2009); see also Reynolds, 636 F.3d at 980 (determining that the officers
had knowledge when they had been previousl y warned of the type of accident at issue by
another officer and when other inmates had fallen the same way).

(e) If the mechanism contains a safety lock [double lock], mechanical
restraints must be safely locked once it is possible for the officer to do
so.
(f) It is the responsibility of all officers to ensure that, once an
incarcerated person is placed in restraints, visual and physical control
of the incarcerated person is maintained at all times.
(g) First aid must be provided whenever restraints are used. . . .

Minn. Dep’t of Corr., Policy Manual 301.081(B)(2)(d)–(g) (Nov. 22, 2021) ; see also id. at
301.096 (requiring handcuffs and leg irons to be “double locked”). DOC policy also
requires that mechanical restraints be “used on a selective basis.” Id. at 301.081(B)(2)(b).

28
Accordingly, on summary judgment , Officers Rhoney and Emily can prevail in
showing no constitutional right was violated only if no reasonable fa ctfinder could infer
from the evidence that Officers Rhoney and Emily: (1) knew that Welters’s handcuffs were
unsafely applied such that the required protections against overtightening were not in place,
or knew that the handcuffs were too tight; (2) that, as a result, Officers Rhoney and Emily
knew there was a substantial risk that Welters could suffer harm; and (3) that Officers
Rhoney and Emily nonetheless took no steps to loosen the handcuffs and engage the safety
mechanism.
We start our analysis with Department of Corrections policy, which supports an
inference of the obvious risk of harm from improperly applied and overtightened
handcuffs. The policy directs that handcuffs and other restraints be double locked. Minn.
Dep’t of Corr., Policy Manual 301.081(B)(2)(e); see also id. at 301.096 ( requiring that
handcuffs and leg irons be “double locked” during medical transportation). The purpose
of double locking is to prevent the handcuffs from further tightening after putting them on
an o ffender. 13 In other words, these sa fety requirements are specifically aimed at
protecting against the obvious risk of harm from overtightened handcuffs. This conclusion
is further reinforced by the fact that the mechanical restraint policies mandate that
handcuffs are not to be used longer than necessary; to cause undue discomfort or inflict
physical pain; or to restrict blood circulation or breathing. Id. at 301.081(B)(2)(d). The

13 See Titus v. Unger , No. 8:12CV261, 2013 WL 5937328, at *3 (D. Neb. Nov. 4,
2013) (“The function of double locking is to prevent the handcuffs from tightening on the
wrists if a suspect rotates or maneuvers in the cuff.”).

29
policy also directs that first aid be provided as necessary when restraints are used. Id. at
301.081(B)(2)(g). A reasonable juror could readily infer from the Department of
Corrections policy provisions that trained corrections officers would understand that the
reason handcuffs are to be double locked and not overtightened is that a substantial risk of
harm exists when those precautions and policies are not followed.
Further, Welters’s testimony supports an inference that Officers Rhoney and Emily
knew that his handcuffs were dangerously tight . In the transport van, Welters told Officer
Rhoney that his handcuffs were tight and not double locked. Officer Rhoney checked the
handcuffs by pressing on them and in the process clicked them even tighter (something that
would not happen had they been properly double locked). Officer Rhoney acknowledged
that the handcuffs were not double locked, but he did not loosen them or double lock them.
Instead, he told Welters that “it ’s only a 15- minute drive, it’ll be all right.” Officer
Rhoney’s statement seemed to suggest to Welters that he would adjust the handcuffs when
they arrived at Stillwater , which is relevant because it demonstrates Officer Rhoney’s
knowledge that he had an obligation to do so. A reasonable juror could certainly infer from
his statement that Officer Rhoney knew that the handcuffs should be double locked to avoid
the substantial risk of harm that flow s from overtightened handcuffs and that Welters’s
handcuffs should have been loosened and safely locked . Yet, once they arrived at Oak
Park Heights after the 15-minute drive, Officer Rhoney neither adjusted nor double locked
Welters’s handcuffs before he left him there and returned to Stillwater, running the risk of
injury. We conclude that these facts are sufficient to allow a reasonable jur y to conclude
an Eighth Amendment violation occurred.

30
After the van arrived at Oak Park Heights, Welters was taken to a medical holding
cell in the prison. At that point, Welters specifically told Officer Emily that the handcuffs
were too tight , causing numbness in his hands. 14 Officer Emily did not adjust or loosen
Welters’s handcuffs and subsequently disappeared. Moreover, Captain Matthews stated in
the kite response memorandum that , after the incident, he “reminded” the officers that
restraints shoul d be removed upon admittance to Oak Park Heights. This statement
supports the conclusion that Officers Rhoney and Emily had been previously informed of
this policy and thus knew at that time that by keeping the improperly applied and overtight
handcuffs on Welters, they were acting in knowing violation of safety policy and practice
intended to prevent harm.
The reason for Welters’s visit to Oak Park Heights also bears on our analysis. It is
undisputed that Officer Emily knew that Welters was at Oak Park Heights for a medical
procedure. Department of Corrections policy makes it clear that the use of re straints,
including overtight handcuffs, may carry additional risks of harm during medical
procedures. For instance, DOC policy states :
If medical st aff request the offender’s restraints be either partially or fully
removed for a medical procedure or treatment, officers must remove only
those restraints that would interfere with the examination or
treatment. . . . Officers are authorized to leave the o ffender in full restraint s

14 Officers Rhoney and Emily acknowledge that Welters “complained of numbness.”
They argue that Welters’s complaint is insufficient because he did not expressly say that
he was in “pain.” They imply without citation that the Eighth Amendment requires
knowledge of a risk that the offender will suffer “substantial pain.” The corrections officers
are wrong. The Eighth Amendment standard requires knowledge of a substantial risk of
harm; not a substantial risk of pain. Further, a reasonable jur y could conclude that
overtight handcuffs causing numbness due to lack of circulation could result in injury and
harm to the offender.

31
if, in their best judgment, control of the offender would be jeopardized even
with additional security staff.

Minn. Dep’t of Corr., Policy Manual 301.096(H)(5); see also Nelson, 583 F.3d at 534
(finding an Eighth Amendment violation when a corrections officer kept an inmate in
restraints during a serious medical procedure). And Department of Corrections policy has
additional requirements when an offender is going under anesthesia: “If the offender needs
surgery requiring complete anesthesia [as Welters’s surgery did], at least one officer must
be present and maintain visual contact of the offender.” Minn. Dep’t of Corr., Policy
Manual 301.096(H)(5). Accordingly, in order to comply with Department of Corrections
policy, the corrections officer must have some knowledge of the nature of the medical
procedure—at the very least, whether the medical procedure requires complete
anesthesia—and should be in communication with medical personnel .
Finally, viewing the facts in the light most favorable to Welters, Stillwater officers
(and not Oak Park Heights officers) had exclusive responsibility for ensuring that Welters
was secure. Accordingly, on these facts, a reasonable juror could infer that Officer Emily
had notice that Welters was having a serious medical procedure under anesthesia. The fact
that Officer Emily disappeared and was unreachable immediately before and during
Welters’s endoscopy meant that no one could authorize the removal of Welters’s restraints,
including the overtight ened and improperly applied handcuffs, during the medical
procedure.15

15 On several occasions, medical personnel expressed surprise that Welters remained
in restraints as he was going into surgery and requested that Oak Park Heights officers

32
In short, these facts would allow a reasonable jury to infer that Officer Rhoney knew
that the handcuffs on Welters were too tight and not properly double locked. A reasonable
jury could further conclude that Officer Rooney knew that overtight ened and unsafely
locked handcuffs posed a substantial risk of precisely the harm that Welters suffered in this
case, and yet he took no steps to adjust the handcuffs.
These facts would also allow a reasonable jury to infer that Officer Emily was aware
that Welters’s handcuffs were too tight and causing numbness in his hands. The facts
would further allow a reasonable jur y to conclude that Officer Emily understood that a
substantial risk existed that Welters would suffer harm and injury as a result of the
overtightened handcuffs, especially since Welters was scheduled to undergo a serious
medical procedure. Finally, the facts support the conclusion that Officer Emily disregarded
that risk and failed to loosen the handcuffs. Accordingly, a reasonable jur y presented with
these facts and the reasonable inferences to be drawn from these facts could readily
conclude that Officer s Rhoney and Emily subjectively knew of a substantial risk of harm
to Welters and did nothing. We therefore conclude that Welters has adduced sufficient
facts to support his claim that Officers Rhoney and Emily violated the Eighth Amendment.
We acknowledge in reaching this conclusion that Officers Rhoney and Emily may
still put Welters to his proof at trial. See Farmer, 511 U.S. at 844 (explaining that officer s
have an opportunity at trial to “prove” that they were “unaware even of an obvious risk to
inmate health or safety”). A reasonable jury may not believe Welters ’s allegations. A

remove the restraints. The Oak Park Heights officers told the medical personnel that o nly
a Stillwater corrections officer could authorize removal of the restraints.

33
reasonable jury could also conclude that the corrections officers’ conduct does not rise to
the level of deliberate indifference but was merely negligent . At this stage of the
proceedings, however, where all facts and inferences from those facts must be construed
in Welters’s favor, we cannot agree that the only conclusion a reasonable jury could reach
is that Welters is lying or that Officers Rhoney and Emily’s conduct was merely negligent.
B.
The second prong of the federal qualified immunity standard asks whether Welters’s
Eighth Amendment rights were clearly established at the time the conduct occurred .
Whether the constitutional right was “clearly established” is a question of law reviewed de
novo. Elder v. Holloway, 510 U.S. 510, 516 (1994) .
A constitutional right is clearly established when its contours are “sufficiently clear
that a reasonable offi cial would understand that what he is doing violates that right.”
Anderson v. Creighton, 483 U.S. 635, 640 (1987). “This is not to say that an official action
is protected by qualified immunity unless the very action in question has previously been
held unlawful; but it is to say that in the light of pre -existing law the unlawfulness must be
apparent.” Hope, 536 U.S. at 741 (quoting Anderson, 483 U.S. at 640 (citing Mitchell v.
Forsyth, 472 U.S. 511, 535 n.12 (1985)) ); see also Morris v. Zefferi, 601 F.3d 805, 812
(8th Cir. 2010) (“The lack of a factually identical case is not dispositive.”).
In other words, the “salient question” that must be asked is whether the “state of the
law” at the time of the alleged offenses gave officials “fair warning” that their alleged
actions were unconstitutional. Hope, 536 U.S. at 741. Reasoning in a binding case can
provide notice to officials within that court’s jurisdiction, even when the holding does not.

34
Id. at 743 (pointing to reasoning in another case that cautioned against conduct similar to
the presently alleged conduct, even though the facts were different).
To determine whether the Eighth Amendment right that Welters claims Officers
Rhoney and Emily violated was clearly established, we must precisely define the right .
Welters claims that Officers Rhoney and Emily violated the Eighth Amendment conditions
of confinement prohibition against deliberate indifference to a substantial risk of serious
harm to an inmate.
In this case, the general conditions of confinement at issue were the routine
transportation for medical treatment from one correctional facility to another with
restraints, the continued use of restraints in a medical holding cell, and the continued use
of restraints during the procedure . The question, however, is not whether it was clearly
established that those general conditions violated the Eighth Amendment. Rather, the
question is whet her it was clearly established that the use of unsafely applied and
unnecessarily overtightened restraints during those conditions of confinement —when
Officers Rhoney and Emily were informed that the handcuffs were unsafely applied and
overtightened such that the inmate’s hands went numb and resulted in serious injuries —
violated the Eighth Amendment.
We conclude that a reasonable corrections officer would have understood and had
fair warning on July 31, 2017, that Welters had an Eighth Amendment right to routine
conditions of confinement when the officers were not facing a specific, immediate threat
to order and insti tutional security. And reasonable corrections officers on July 31, 2017,
would have understood that this right required that the corrections officers adjust handcuffs

35
once the y knew that the handcuffs were unsafely applied , such that a substantial risk of
harm from overtightening existed or that the handcuffs were dangerously tight and causing
numbness so as to pose a substantial risk of injury to a prisoner , or both.
Eighth Amendment conditions of confinement law had been clear for many years
before July 31, 2017: the Constitution prohibits conduct by prison officials that carries a
substantial risk of causing a prisoner harm or injury when that conduct is not necessary to
fulfill a penological purpose. See Hope, 536 U.S. at 737–38; see Farmer, 511 U.S. at 833.
That basic directive wa s sufficient to put Officers Rhoney and Emily on notice that their
refusal to adjust unnecessarily overtightened and unsafely applied handcuffs, when they
knew that the unsafely applied handcuffs were t oo tight and ran a substantial risk of harm
as a result and/or that the handcuffs were limiting circulation and therefore subjecting
Welters to substantial risk of injury, was unconstitutional. T he obligation to adjust the
handcuffs to prevent injury follows immediately from the constitutional prohibition against
the cruel and unusual punishment of routine conduct that causes penologically unnecessary
harm under circumstances where the officer is aware of a substantial risk that such harm
will result. See Mullenix v. Luna, 577 U.S. 7, 16 (2015). The constitutional obligation to
loosen and adjust the handcuffs under the circumstances of this case to prevent a substantial
risk of harm to Welters would be obvious to a reasonable corrections officer. See Farmer,
511 U.S. at 842. Critically, Officers Rhoney and Emily offer no justification for refusing
to adjust handcuffs that were dangerously tight and unsafely applied .
When an officer’s decision to take an unconstitutional action (imposing a condition
of confi nement that unnecessarily harms a pri soner) is not justified by a competing

36
government interest (the need to respond to a security threat ), less particularity is required
to provide fair warning of the unconstitutionality of the officer’s actions. 16 Consequently,
concern about holding an officer to a constitutional standard at too high a level of generality
is reduced. Cf. Mullenix, 577 U.S. at 12–19 (concluding that fact -specific case law was
required to clearly establish that an officer violated the Fourth Amendment when the officer
shot at a fleeing suspect during a high speed chase in response to reports that he was armed
and threatening to shoot officers ); Brosseau v. Haugen, 543 U.S. 194, 198–99 (2004)
(concluding that general constitutional t ests were insufficient to clearly establish that

16 Most of the qualified immunity cases decided by the Supreme Court involve alleged
violations of the Fourth Amendment. The Court has repeatedly noted the distinct
challenges presented to public officials in the Fourth Amendment context because “ [i]t is
sometimes difficult for an officer to determine how the relevant legal doctrine, here
excessive force, will apply to the factual situation the officer confronts.” Mullenix , 136 S.
Ct. at 308 (citation omitted) (internal quotation marks omitted).
The same may hold true for corrections officers responding to a threat that may
reasonably require the use of force to restore order and discipline in the prison. See, e.g.,
Hudson, 503 U.S. at 6 (“[O]fficials confronted with a prison disturbance must balance the
threat unrest poses to inmates, prison workers, administrators, and visitors against the harm
inmates may suffer if guards use force . . . .”). In those types of intense , rapidly-changing
situations, more fact -specific case law is required to provide fair warning to officers of the
contours of what actions the Constitution allows. See Anderson, 483 U.S. at 640.
But when a corrections officer is engaging in routine conduct that does not require
quick decision-making to evaluate and protect a competing government interest, there is
less nuance involved and thus less particularity is required to clearly establish what the
constitution requires. See Hope, 536 U.S. at 742 (cautioning against “the danger of a rigid,
overreliance on factual similarity” when determining whether the unnecessary infliction of
pain outside of an emergent situation clearly violates the Eighth Amendment).
There is little difficulty for a corrections officer to understand that a prohibition
against acting wi th deliberate indifference to the risk of injury means that corrections
officers should adjust handcuffs once they are on notice that the handcuffs are unsafely
applied such that a real risk of harmful overtightening exists or that the handcuffs are so
tight that they are causing numbness and thus pose a substantial risk of serious injury.

37
shooting a fleeing suspect to protect other officers violated the Constitution, requiring
instead law “particularized” to the specific context that the officer faced) .
This conclusion is consistent with the basic premise of section 1983 and the
qualified immunity doctrine: the need to balance the important interest in vindicating the
fundamental constitutional rights of American citizens (which often may be vindicated
only through an action for damages), with the important competing interest s of ensuring
that public officials are not unduly deterred from discharging their duties or burdened by
frivolous lawsuits. See Harlow, 457 U.S. at 814. How to properly strike that balance will
vary depending on the constitutional right at stake. Requiring corrections officers to avoid
knowingly inflicting unnecessary pain or subjecting prisoners to risk of serious injury when
engaging in routine conduct related to restraints will minimally impinge on the officers’
ability to discharge their duties .
Even though the nature of the constitutional violation at issue here means that less
particularity in governing law is required before the right is deemed “clearly established,”
there is no need for us in this case to pars e precisely where that line is to be drawn. That
is because here, factually analogous case law clearly establishes that officers violate the
Eighth Amendment when they act with deliberate indifference to the risk of injury from
mechanical restraints, incl uding handcuffs. First, the Hope Court held that corrections
officers acted unconstitutionally and with deliberate indifference in violation of the Eighth
Amendment because “ [d]espite the clear lack of an emergency situation,” they restrained
an inmate in a manner “that created a risk of particular discomfort and humiliation.”
536 U.S. at 737–38. The inmate in Hope was handcuffed to a hitching post for several

38
hours in the sun with no bathroom breaks after an altercation with a guard at a chain gang
worksite. Id. at 733–35. Certainly, the facts in Hope are more egregious than those in this
case. But the egregiousness of the officer’s acts goes to the question of whether a
constitutional violation occurred , and we have already determined that the evidence in the
record on summary judgment here sufficiently alleges a constitutional violation. Hope
clearly established the legal and constitutional principal that deliberate indifference to the
risk of harm from the use of restraints used outside of an emergency situation violates the
Eighth Amendment. Id. at 743.17
Indeed , Hope has been cited repeatedly across circuits for the rule that the use of
passive restraints in a way that causes unnecessary harm in the absence of a penological
purpose is unconstitutional. See, e.g., Young v. Martin, 801 F.3d 172, 177 (3rd Cir. 2015);
Mendiola-Martinez v. Arpaio, 836 F.3d 1239, 1248 (9th Cir. 2016). Cases further cite
Hope as clearly establishing such a right . See , e.g., Barker v. Goodrich, 649 F.3d 428,
434–37 (6th Cir. 2011) . see generally Stainback v. Dixon, 569 F.3d 767, 772 (7th Cir.
2009) (recognizing that by 2002 it was well established that “an officer may not knowingly

17 The Hope Court recognized that its reasoning was clearly establishing Eighth
Amendment rights in other contexts, stating: “Our opinion in Lanier thus makes clear that
officials can still be on notice that their conduct violates established law even in novel
factual circumstances.” 536 U.S. at 741 (affirming and applying the “clearly established”
standard from United States v. Lanier, 520 U.S. 259, 269 (1997)).
Addressing arguments attempting to distinguish case law based on specific details ,
such as the differences between hitching posts, shackling bars, fences, or bars of cells, the
Court warned against “the danger of a rigid, overreliance on factual similarity.” Id. at 742.
Accordingly, the Court specifically concluded that the Eleventh Circuit erred in its
“position that a violation is not clearly established unless it is the subject of a prior case of
liability on facts materially similar to those charged.” Id. at 746 (citation omitted) (internal
quotation marks omitted) .

39
use handcuffs in a way that will inflic t unnecessary pain or injury on an individual who
presents little or no risk of flight”).
Notably, the Seventh Circuit in Ajala v. Tom invoked the Hope standard as giving
rise to a clearly established right under the Eighth Amendment on nearly identical facts to
those Welters alleges. 658 F. App’x. 805 (7th Cir. 2016). The officers in Ajala refused to
loosen painfully tight handcuffs for 4½ hours during a transport, resulting in chronic injury
and pain. Id. at 806. Citing Hope, the Seventh C ircuit reversed the district court’s grant
of qualified immunity because it determined that, like Officers Rhoney and Emily here, the
officers “never even alleged a penological justification for refusing to loosen Ajala’s
handcuffs” and that “reasonable of ficers in their positions would have known that it was
unlawful for them to disregard Ajala’s pleas for help.” Id. at 806–07. Hope is thus binding
case law from the Supreme Court that is sufficiently specific to have given fair warning to
Officers Rhoney and Emily that their actions violated Welters’s Eighth Amendment rights,
as other courts have similarly held .
Moreover, even if the qualified immunity doctrine requires the existence of judicial
decisions that direct corrections officers to comply with De partment of Corrections policy
(requiring constitutionally mandated and common-sense conduct) before a court may even
entertain a lawsuit seeking damages for harm caused by the constitutional violation, that
case law also exists here. The Supreme Court in Hope determined that corrections officers’
noncompliance with prison regulations specifically aimed at avoiding cruel and unusual
punishment supported the conclusion that “they were fully aware of the wrongful character
of their conduc t” and thus “violated clearly established law .” Hope, 536 U.S. at 743–45.

40
The Eighth Circuit —which Officers Rhoney and Emily concede is a source for clearly
established law —has held similarly. “Prison regulations governing the conduct of
correctional of ficers are [] relevant in determining whether an inmate’s right was clearly
established.” Treats v. Morgan, 308 F.3d 868, 875 (8th Cir. 2002) (concluding that an
inmate’s Eighth Amendment right was clearly established based on general principles of
law and on prison regulations that did not authorize the use of pepper spray in the way it
was used by the officers ); see also Nelson, 583 F.3d at 531, 533 (stating that a “review of
these sources” can lead to the conclusion that a constitutional right was clea rly established
and finding that the regulations in effect “reflected the constitutional protections
recognized in these judicial decisions”).
Officers Rhoney and Emily argue that Welters was restrained “pursuant to policy”
because DOC policy affords them “discretion in the use of mechanical restraints during
medical appointments.” This argument relies on the general medical transportation
provisions, Minn. Dep’t of Corr., Policy Manual 301.096, and it ignores the specific
requirements mandati ng safe mechanical restraint use , Minn. Dep’t of Corr., Policy
Manual 301.081.
When prison regulations “authorize” an action generally, but officials do not comply
with specific requirements guiding their implementation of that action, officials likely have
“fair warning” that their actions violate “clearly established law.” See Hope, 536 U.S. at
743–44 (concluding that although DOC regulations generally authorized using a hitching
post in certain circumstances, officials violated clearly established law w hen they did not
keep an activity log or offer bathroom breaks as those regulations required). As alleged,

41
Officers Rhoney and Emily did not comply with DOC policy forbidding the use of
handcuffs for longer than necessary, in ways that cause “undue discom fort” or pain, or in
ways that restrict circulation. See Minn. Dep’t of Corr., Policy Manual 301.081(B)(2)(d).
Officers Rhoney and Emily did not follow the policy directive that handcuffs be double
locked to prevent precisely the injury that Welters suff ered here. Id. at 301.096. And they
did not attend to Welters or provide first aid during their use of mechanical restraints . See
id. at 301.081(B)(2)(f), (g).
Finally, it is relevant that Welters was handcuffed and placed in other restraints
precisely because he was going to a medical treatment involving surgery under anesthesia.
Welters asserts that the Eighth Circuit’s decision in Nelson squarely controls thi s case
because it clearly established that corrections officers violate the Eighth Amendment when
they act with deliberate indifference to the substantial risk of severe injury from restraints
during medical procedures. See 583 F.3d at 524–34.
18 The Nelson court concluded that a
corrections officer acted with deliberate indifference in violation of the Eighth Amendment
when he kept an inmate restrained during labor in the absence of any acute security
concerns, when the officer was instructed not to shackle her, and because the restraints
caused “unnecessary suffering at a time when . . . [she] would have likely been physically

18 Welters also points to Key v. McKinney as clearly establishing what officers must
do to avoid Eighth Amendment violations in conditions of confinement restraint cases.
176 F.3d 1083, 1085 (8th Cir. 1999). In Key, officers placed an inmate in restraints for 24
hours for throwing water on a corrections officer, pursuant to policy. Id . at 1084–85. The
court determined that officers were not deliberately indifferent because they modified
restraints in response to the inmate’s need to take care of bodily functions, they regularly
checked on his conditions, they loosened his handcuffs , and they cons idered his medical
conditions. Id. at 1086.

42
unable to flee . . . .” Id. at 530. Like Welters, the inmate in Nelson suffered severe injuries
from the restraints, see id., and Welters was also physically unable to flee while he was
locked in a secure holding cell and while he was under general anesthesia. Officers Rhoney
and Emily flatly disregard Nelson, however, contending that it is “distinguishable on its
face,” presumably because it involved an inmate receiving medical care in labor and not
an inmate receiving medical care under general anesthesia. The officers in Morris similarly
attempted to distinguish Nelson on its facts. 601 F.3d at 809–10. The Morris Court
rejected those arguments, id. at 12, and we likewise reject them here. 19
The Eighth Circuit has cited Nelson several times when determining whether
officers acted with deliberate indifference to serious medical needs or risk of harm in
various contexts. Accordingly, the reasoning and holding in Nelson is not limited only to
factual contexts that include labor and childbirth. See, e.g., McCaster v. Clausen, 684 F.3d
740, 746 (8th Cir. 2012) (citing Nelson in determining that “it is well established” that
deliberate indifference to an inmate’s serious medical needs violates the Eighth
Amendment); Morris, 601 F.3d at 808–12 (affirming the denial of qualified immunit y
against Eighth Amendment claims arising from transporting a detainee in full restraints in
a dog kennel in a K -9 transportation vehicle, and stating, “We believe our decision in this
case is controlled by the reasoning of Nelson”).

19 Although Officers Rhoney and Emily argued that Nelson was distinguishable on its
facts, they conceded on the record in this case that “case law from the U.S. Supreme Court,
the Eighth Circuit, or this Court fi nding an Eighth Amendments violation under facts
similar to those alleged here” could give rise to clearly established law.

43
Because we conclude that Welters has sufficiently alleged violations of his clearly
established Eighth Amendment rights , Officers Rhoney and Emily are not entitled to
qualified immunity.
CONCLUSION
For the foregoing reasons, we affirm the court of appeals.
Affirmed.

D-1
D I S S E N T

GILDEA, Chief Justice (dissenting).
Christopher Welters is serving two life sentences in connection with a double
homicide. He is an inmate at Minnesota Correctional Facility –Stillwater, a high -level
security prison that houses violent offenders. Welters needed to be transported to the prison
at Oak Parks Heights, Minnesota’s only maximum-security prison and a prison that houses
high-risk offenders, for a medical procedure. He alleges that two Minnesota Department
of Corrections officers, Ernest Rhoney and Cornelius Emily, violated his Eighth
Amendment right to be free from cruel and unusual punishment during the transport and
his time at Oak Park Heights. Welters specifically asserts that Officer Rhoney
overtightened his handcuffs and that Officer Rhoney and Officer Emily failed to loosen the
handcuffs when he eventually told them that they were causing him discomfort. The
district court dismissed Welters’s section 1983 claim on summary judgment, concluding
that “[n]othing in the record indicates that either Officer Rhoney or Officer Emil y acted
with the intent to cause Plaintiff harm, let alone acted maliciously or sadistically.” The
court of appeals reversed, applying the deliberate indifference standard rather than the
malicious and sadistic standard. Welters v. Minn. Dep’t of Corr., 968 N.W.2d 569, 582–
87 (Minn. App. 2021).
The principal question raised by the parties is what legal standard should govern the
Eighth Amendment claim of an inmate who alleges that corrections officers overtightened
his handcuffs during a transfer to a ma ximum-security prison and failed to loosen those
handcuffs when he informed them of his discomfort. This question turns on whether the

D-2
inmate’s injury stems from the officer’s excessive use of force or whether the cause of
injury is better classified as a failure to attend to serious medical needs or arising from the
conditions of confinement. The majority concludes that, because the corrections officers’
handcuffing of the inmate was for “ ‘routine’ transport for a ‘routine’ medical procedure,”
the lower deliberate indifference standard should be applied. I disagree. I agree with the
district court and conclude that Welters’s injuries stem from the officers’ application of
allegedly excessive force via the overtightened handcuffs. I would therefore apply the
heightened malicious and sadistic standard and affirm the district court’s grant of summary
judgment to Officer Rhoney and Officer Emily. Accordingly, I dissent.
A.
The Eighth Amendment bars the infliction of “cruel and unusual punishments.”
U.S. Const. amend. VIII. But not all injuries suffered while incarcerated are punishment.
Instead, only “a deliberate act intended to chastise or deter” can be considered punishment.
Wilson v. Seiter, 501 U.S. 294, 300 (1991) (quoting Duckworth v. Franzen, 780 F.2d 645,
652 (7th Cir. 1985) (Posner, J.)). As a result, once a criminal sentence has been “formally
meted out . . . by the statute or the sentencing judge, some mental element must be
attributed to the inflicting officer” to qualify as punishment. Id. An “ordinary lack of due
care for the prisoner’s interests or safety” is not sufficient. Whitley v. Albers, 475 U.S. 312,
319 (1986); see also Estelle v. Gamble , 429 U.S. 97, 105 (1976) (explaining that “[a]n
accident, although it may produce added anguish, is not on that basis alone to be
characterized as” cruel and unusual punishment). Instead, once an individual is
incarcerated, there must be the “unnecessary and wanton infliction of pain” to violate the

D-3
prohibition against cruel and unusual punishment in the Eighth Amendment. Whitley,
475 U.S. at 319 (emphasis added) (quoting Ingraham v. Wright, 430 U.S. 651, 670 (1977)).
“Wanton” is not a static concept. Whether a given act rises to the level of “wanton
infliction of pain” requires us to appreciate the “differences in the kind of conduct against
which an Eighth Amendment objection is lodged.” Id. at 320. As a result, there are two
standards by which we judge whether an officer’s conduct was wanton.
The first category of conduct involves excessive use of physical force. In Hudson
v. McMillian, the United States Supreme Court “h[e]ld that whenever prison officials stand
accused of using excessive physical force . . . the core judicial inquiry is . . . whether force
was applied in a good -faith effort to maintain or restore discipline, or maliciously and
sadistically to cause harm.” 503 U.S. 1, 6–7 (1992) (emphasis added); see also Porter v.
Nussle, 534 U.S. 516, 528–29 (2002) (reaffirming Hudson). Hudson was clear that it was
“[e]xtending Whitley’s application of the ‘unnecessary and wanton infliction of pain’
standard to all allegations of exces sive force,” 503 U.S. at 7 (emphasis added), and that
this standard is no longer limited to “decisions involving the use of force to restore order
in the face of a prison disturbance,” see Whitley, 475 U.S. at 320. The highly deferential
malicious and sad istic standard “extends to . . . prophylactic or preventive measures
intended to reduce the incidence of [actual confrontations] or any other breaches of prison
discipline.” Id. at 322. Although “[m]ost excessive force cases involve beatings, physical
altercations, or use of force such as Tasers,” the use of passive restraints may involve
excessive force requiring the application of the malicious and sadistic standard. Jackson
v. Gutzmer, 866 F.3d 969, 976 n.3 (8th Cir. 2017) (applying the malicious and sadistic

D-4
standard to a prisoner’s claim that he was subjected to excessive force when he was placed
on a restraint board for 3½ hours). 1
The deferential malicious and sadistic standard is appropriate when examining
claims of excessive use of force becau se prison officials “must balance the need ‘to
maintain or restore discipline’ through force against the risk of injury to inmates.” Hudson,
503 U.S. at 6. And this standard serves to effectuate the principle that prison officials
“should be accorded wide-ranging deference in the adoption and execution of policies and
practices that in their judgment are needed to preserve internal order and discipline and to
maintain institutional security.” Id. (emphasis added) (quoting Whitley, 475 U.S. at 321–
22).
The second category of conduct involves claims of inadequate medical care and
conditions of confinement. When a prisoner challenges a condition of confinement or their
medical care, a finding of deliberate indifference will suffice to establish wantonness .
2

1 The majority argues that the Supreme Court’s decision in Hope v. Peltzer, 536 U.S.
730 (2002), implicitly narrowed the explicit holding in Hudson that the malicious and
sadistic standard should be applied “ whenever prison officials stand accused of using
excessive physical force,” 503 U.S. at 6–7 (emphasis added). But there was no dispute in
Hope about what standard should apply; the parties agreed that the deliberate indifference
standard should govern their claims. Hope, 536 U.S. at 738. As a result, there is no analysis
in Hope about when the malicious and sadistic standard should apply and when the
deliberate indifference standard should be used. See id. Instead, the Supreme Court only
addressed whether prison officials were deliberately indifferent to the prisoner’s health or
safety when they handcuffed him to a hitching post and left him in the Alabama sun. Id.

2 Deliberate indifference is a higher standard than mere negligence and equates to
“subjective recklessness as used in the criminal law.” Farmer v. Brennen , 511 U.S. 825,
839 (1994). Nevertheless, it is more lenient to the plaintiff than the highly deferential
malicious and sadistic standard that applies to excessive use of force claims . See Wilson,
501 U.S. at 305.

D-5
Wilson, 501 U.S. at 303 (extending the deli berate indifference standard to all condition -of-
confinement claims); Estelle, 429 U.S. at 104 (holding “that deliberate indifference to
serious medical needs of prisoners constitutes the unnecessary and want on infliction of
pain proscribed by the Eighth Amendment” (citation omitted) (internal quotation marks
omitted)). This more lenient standard is appropriate because providing medical care and
humane conditions of confinement “ordinarily does not conflict w ith competing
administrative concerns.” Hudson, 503 U.S. at 6.
When, like here, “the use of passive restraints is challenged, careful analysis of the
factual context may be needed to determine the appropriate substantive standard.”
Jackson, 866 F.3d at 976 n.3. After undertaking this careful analysis, I conclude that the
malicious and sadistic standar d is the appropriate standard to judge Welters’s claims
against Officer Rhoney and Officer Emily. I reach this conclusion because Welters’s
alleged injury ultimately stems from a use of force—the overtightening of his handcuffs —
and we must apply the malic ious and sadistic standard “ whenever prison officials stand
accused of using excessive physical force.” Hudson, 503 U.S. at 6–7 (emphasis added). 3
The majority acknowledges that “ Welters contends that the handcuffs were
unnecessarily and improperly applied too tightly.” One would expect that this would be
the end of the majority’s analysis given the clear binding instruction in Hudson that we are

3 The Second Circuit reached a similar conclusion in Davidson v. Flynn, 32 F.3d 27
(2d Cir. 1994). In Davidson, a prisoner alleged that his handcuffs were purposefully
overtightened during transport to a different correctional facility, cutting off his circulation.
Id. at 29. The Second Circuit applied the malicious and sadistic standard to his
overtightened handcuff claim. Id. at 29–30.

D-6
to apply the malicious and sadistic standard “ whenever prison officials stand accused of
using excessive physical force.” Hudson, 503 U.S. at 6–7 (emphasis added). But it is not.
Instead, the majority attempts to reason around Hudson by noting that this appli cation of
force occurred during “a ‘routine’ transport for a ‘routine’ medical procedure.” In the
majority’s analysis, because the application of excessive force occurred during transport
and persisted through a medical procedure, it is somehow transforme d into a condition of
confinement and medical care claim. I disagree.
Central to the majority’s analysis is the assumption that an active disturbance or
individualized safety concern is required for us to employ the malicious and sadistic
standard. This assumption is wrong. Instead, the Supreme Court is clear that the malicious
and sadistic standard should also be applied to “prophylactic or preventive measures
intended to reduce the incidence of [actual confrontations] or any other breaches of prison
discipline.” Whitley, 475 U.S. at 322. Although it is true that the need for quick and
decisive decision-making has been used as one justification for the malicious and sadistic
standard, it is not a prerequisite. Instead, Hudson noted that the situations in which the
malicious and sadistic standard should appropriately be applied “ may require prison
officials to act quickly and decisively,” not that they must. 503 U.S. at 6 (emphasis added).
Accordingly, the majority’s reliance on the absence of an emergency to justify its use of
the deliberate indifference standard is misplaced.
4

4 This conclusion is supported by decisions from other jurisdictions that regularly
apply the malicious and sadistic standard to excessive force claims even when the force is
not alleged to have been used in response to an active disturbance or individualized security
concern. See, e.g., Pelfrey v. Chambers , 43 F.3d 1034, 1035–37 (6th Cir. 1995)

D-7
Further, the use of handcuffs during the transport of Welters (a convicted violent
offender) to and from a high-security facility , and while he underwent a medical procedure
at Minnesota’s only maximum-security prison, is plainly the kind of prevent ive measure
intended to ensure the safety of the public, staff, medical personnel, and other prisoners. If
there could be any doubt on this score, the Minnesota Department of Corrections Policy
301.095 governing the transportation of inmates in full restraints explicitly provides that
its purpose is “[t]o ensure the safety of the public . . . while also providing for the safe,
secure, and humane treatment of offenders during transport.” Minn. Dep’t of Corr., Policy
Manual 301.095(C)(1) (Nov. 5, 2019). This balance between the use of force and others’
safety is precisely why the malicious and sadistic standard is necessary. Compare Hudson,
503 U.S. at 6 (explaining that one of t he primary concerns undergirding the malicious and
sadistic standard is that “corrections officers must balance the need ‘to maintain or restore
discipline’ through force against the risk of injury to inmates” (quoting Whitley, 758 U.S.
at 320–21) ), with W ilson, 501 U.S. at 302 ( explaining that the deliberate indifference
standard is appropriate in medical care and condition of confinement cases because the
State’s responsibility “does not ordinarily clash with other equally important governmental
responsibilities,” such as the safety of other inmates) (quoting Whitley, 475 U.S. at 320)).

(concluding that a spontaneous assault of a prisoner amount ed to “malicious and sadistic
use of force to cause harm”); Wilkins v. Moore, 40 F.3d 954 (8th Cir. 1994) (applying the
malicious and sadistic standard to a prisoner’s claims that he was physically and sexually
assaulted by prison officials when he refused to sign a statement exonerating those officials
of wrongdoing); McReynolds v. Ala. Dep’t of Youth Servs., 204 F. App’x 819, 820–22
(11th Cir. 2006) (per curiam) (applying the malicious and sadistic standard to a minor
prisoner’s claims that guards assaulted him with a nightstick after he requested a complaint
form).

D-8
This is not a situation where there are no “competing administrative concerns” that could
justify the use of the deliberate indifference standard. Hudson, 503 U.S. at 6. 5
Nor is it sufficient for the majority to justify its conclusion that the deliberate
indifference standard should apply because Welters “does not claim that the use of
handcuffs during transport . . . is itself unconstitutional” but rather “ contends tha t the
handcuffs were unnecessarily and improperly applied too tightly” in his specific case. An
explicit purpose of the malicious and sadistic standard is to give appropriate deference to
prison officials in the “execution of policies and practices that in their judgment are needed
to preserve internal order and discipline and to maintain institutional security.” Hudson,
503 U.S. at 6 (emphasis added) (quoting Whitley, 475 U.S. at 321–22). Officer Rhoney
and Officer Emily were executing just such a policy here —the DOC’s restraint policy —
when they applied Welters’s handcuffs and declined to remove or adjust them once Welters
complained. It is only proper that they receive the deferential review that the Supreme
Court has mandated for those in their circumstance.
6

5 For this reason, the combined transport and medical procedure case that the majority
cites—Nelson v. Correctional Medical Services , 583 F.3d 522 (8th Cir. 2009) (en banc)—
is inapposite. Nelson involved a female “nonviolent offender” in the late stages of labor
whose injuries arose from being shackled to a delivery bed and unable to move while in a
civilian hospital. Id. at 525–26. The Eighth Circuit specifically noted that “from the record
evidence in Nelson’s case there does not even appear to have been a competing penological
interest in shackling her.” Id. at 530. By contrast, there are competing penological interests
when handcuffing a violent offender like Welters for transport to and from a high- security
facility that houses only violent offenders.

6 Welters’s allegations about how the officers executed the policy are troubling to be
sure. But how the officers executed the policy, whether rightly or wrongly, goes to whether
the standard is met. It does not go to which standard to apply.

D-9
The Eighth Circuit cases that the majority cites to support its conclusi on that
Welters’s claims should be treated as a condition of confinement because he was
transported are also easily distinguished. None of the transport cases cited by the majority
involve physical injury from the restraints and, as a result, do not involve the application
of excessive force. See Reynolds v. Dormire , 636 F.3d 976, 979–80 (8th Cir. 2011)
(addressing a prisoner’s complaints that he was handcuffed during a day-long transport and
would have had difficulty relieving himself had he chosen to do so); Brown v. Fortner ,
518 F.3d 552, 558–59 (8th Cir. 2008) (addressing a prisoner’s complaints that officers
refused to fasten his seatbel t when he was in full restraints, resulting in his subsequent
injury when the vehicle was involved in an accident). 7
Finally, it is important to note that the majority overlooks cases from the Eighth
Circuit that do not support its conclusion. For inst ance, in Aldape v. Lambert , the Eighth
Circuit applied the malicious and sadistic standard to a prisoner’s claim that officers
handcuffed him behind his back to perform a strip search, that he had a medical order that
should have precluded handcuffing behind his back, and that the officers were aware of his
condition. 34 F.3d 619, 623–24 (8th Cir. 1994). And in Walker v. Bowersox, the Eighth
Circuit applied the malicious and sadistic standard to a prisoner’s claim that he was

7 It is also worth noting that the federal circuits do not agree about what standard to
apply to Eighth Amendment claims arising from transport. For instance, in Thompson v.
Commonwealth of Virginia , the Fourth Circuit held that, under similar facts as Brown, a
prisoner’s claims that he was injured in a transport van due to erratic driving while in full
restraints should be judged by the malicious and sadistic standard (rather than the deliberate
indifference standard) because the claim is “essentially . . . that [the officer] applied force
against him without any legitimate purpose . . . using the transport van’s momentum.”
878 F.3d 89, 99 (4th Cir. 2017).

D-10
restrained on a bench for 24 hours after initially expressing displeasure over a proposed
cell mate, even though his claim also involved conditions of confinement such as no access
to water, food, or bathroom facilities. 526 F.3d 1186, 1188 (8th Cir. 2008) (per curiam).
Recently, th e Eighth Circuit applied the malicious and sadistic standard in Jackson v.
Gutzmer when analyzing a prisoner’s claim that he was placed on a restraint board for
3½ hours. 866 F.3d at 976. Admittedly, the parties in Jackson agreed that the proper
standard was the malicious and sadistic standard, but the panel went out of its way to note
that the malicious and sadistic standard may be warranted in passive restraint cases
depending on the “factual context” in which they arrive. Id. at 976 n.3.8
I do not suggest that these Eighth Circuit cases definitively resolve the issue before
us today. Rather, the varied decisions from the Eighth Circuit (and elsewhere) reinforce
the need to look to the Supreme Court’s rulings on when to apply the malicious and sadistic
standard and when to apply the deliberate indifference standard. Because I believe that
binding Supreme Court precedent requires us to apply the malicious and sadistic standard

8 Other federal circuit courts have also applied the malicious and sadistic standard to
passive restraint cases. For example, in Lunsford v. Bennet , the Seventh Circuit applied
the malicious and sadistic standard to three prisoners’ complaints that they were subjected
to cruel and unusual punishment when prison officials shackled them to their cells for
3 hours in order to remove flood water. 17 F.3d 1574, 1581–82 (7th Cir. 1994). And in
Campbell v. Sikes, the Eleventh Circuit applied the malicious and sadistic standard to an
inmate’s claims that she was subjected to cruel and unusual punishment when prison
officers placed her in full restraints for extended periods of time when she posed a threat
to her own safety. 169 F.3d 1353, 1359–60, 1376–78 (11th Cir. 1999). Recently, the Tenth
Circuit applied the malicious and sadistic standard to a prisoner’s allegations that officers
overtightened his handcuffs, resulting in the loss of circulation. See Stevenson v. Cordova,
733 F. App’x 939, 945 (10th Cir. 2018).

D-11
“whenever prison officials stand accused of using excessive physical force,” Hudson,
503 U.S. at 6–7 (emphasis added), I would apply that standard to Welters’s claims.
B.
Having concluded that the appropriate standard to apply to Welters’s claim is the
malicious and sadistic standard, I turn to the application of tha t standard to the facts of the
case. As previously stated, the district court determined that “[n]othing in the record
indicates that either Officer Rhoney or Officer Emily acted with the intent to cause
[Welters] harm, let alone acted maliciously or sadi stically.” Welters does not challenge
the district court’s conclusion or argue that he should prevail if we apply the malicious and
sadistic standard. Accordingly, I would reverse the court of appeals and reinstate the grant
of summary judgment for Offic er Rhoney and Officer Emily.
I respectfully dissent.