Robert Downey v. Pennsylvania Department of Cor ( 2020 )


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  •                                      PRECEDENTIAL
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    _____________
    No. 19-2248
    ______________
    ROBERT DOWNEY,
    Appellant
    v.
    PENNSYLVANIA DEPARTMENT OF CORRECTIONS;
    SUPERINTENDENT WAYMART SCI;
    PAUL DELROSSO, Deputy Superintendent for Centralized
    Services;
    DO DAVID TOMAZIC, Medical Director;
    PA-C JESSICA ASHBY; OD KATHLEEN GAYNOR;
    PA-C JENNIFER VILLIANO; PA-C TOM LYONS;
    PA-C JANAN LOOMIS; WEXFORD HEALTH SOURCES
    INC; CORRECT CARE SOLUTIONS
    _____________
    Appeal from the United States District Court
    for the Middle District of Pennsylvania
    (D.C. No. 1-17-cv-00143)
    Magistrate Judge: Honorable Karoline Mehalchick
    ______________
    Argued on March 25, 2020
    ______________
    Before: JORDAN, RESTREPO, and FUENTES, Circuit
    Judges.
    (Opinion Filed: August 03, 2020)
    Clifford A. Rieders
    Corey J. Mowrey [Argued]
    Rieders, Travis, Humphrey, Waters & Dohrmann
    161 West Third Street
    Williamsport, PA 17701
    Counsel for Appellant
    Josh Shapiro
    Sean A. Kirkpatrick [Argued]
    Office of Attorney General of Pennsylvania
    Strawberry Square, 15th Floor
    Harrisburg, PA 17120
    Counsel for Appellees Pennsylvania Department of
    Corrections, Superintendent Waymart SCI, and Paul
    DelRosso
    Caitlin J. Goodrich
    Kenneth D. Powell, Jr. [Argued]
    Weber Gallagher
    2000 Market Street, 13th Floor
    Philadelphia, PA 19103
    Counsel for Appellees Correct Care Solutions, David
    Tomazic, DO, Jessica Ashby, PA-C, Jennifer Villiano,
    PA-C, and Janan Loomis, PA-C
    2
    ______________
    OPINION OF THE COURT
    ______________
    RESTREPO, Circuit Judge.
    Robert Downey has long struggled with glaucoma,
    which can lead to blindness if left uncontrolled. His condition
    worsened while he was imprisoned. As a result, doctors
    recommended that Downey have surgery expeditiously to save
    his eyesight. But nothing happened for almost a year—even
    though he repeatedly reached out to staff at the prison.
    Ultimately, surgery came too late and Downey is now blind.
    Downey sued various defendants for monetary
    damages, among other relief. The District Court granted
    summary judgment against Downey, concluding that he failed
    to exhaust available administrative remedies as required by the
    Prison Litigation Reform Act (“PLRA”). We disagree and hold
    that his claims for monetary relief are not procedurally
    defaulted. However, we will affirm dismissal of Downey’s
    claims against the Pennsylvania Department of Corrections
    and its officials on state sovereign immunity grounds, even
    though that defense was not raised before the District Court.
    Accordingly, we will reverse the District Court’s order in part,
    affirm in part, and remand for further proceedings.
    I.
    Downey was incarcerated from September 24, 2013 to
    January 26, 2017. He served most of his prison term at the State
    Correctional Institution at Waymart, Pennsylvania (“SCI
    3
    Waymart”). When he first entered prison, he used eyedrops to
    treat glaucoma. On December 22, 2014, Dr. Richard Roth, an
    ophthalmologist at Eye Care Specialists, evaluated Downey.
    He thought Downey “may need surgical intervention” due to
    elevated eye pressure. App. 1113.
    The following day, SCI Waymart’s medical director,
    Dr. David Tomazic, evaluated Downey’s condition. He
    concluded that Downey’s severe glaucoma required urgent
    care and approved Dr. Roth’s request for a follow-up
    consultation. The consultation took place on January 26, 2015.
    Dr. Roth ordered a surgical consultation with Dr. Robert
    Szulborski, another ophthalmologist at Eye Care Specialists,
    because the pressure in Downey’s eyes remained extremely
    elevated. One day later, Dr. Tomazic approved the order for a
    surgical consultation because Downey’s “severe bilateral
    glaucoma” required “urgent care.” App. 1334.
    It took nearly two months for the surgical consultation
    to take place. Dr. Szulborski saw Downey on March 18, 2015,
    concluding that Downey’s right eye required an emergency
    procedure in one to two weeks to save his vision. Dr. Tomazic
    quickly approved the procedure. Despite Downey’s well-
    documented rapidly deteriorating vision, however, no progress
    was made towards scheduling his surgery for the next nine
    months.
    During an emergency consultation on December 2,
    2015, Dr. Daniel Lutz, an ophthalmologist at Eye Care
    Specialists, recommended “surgical intervention to preserve
    remaining vision.” App. 1091–95. Dr. Lutz explained at a
    deposition that Downey needed surgery “[a]s soon as humanly
    possible . . . [w]ithin a week or two.” App. 1355. Downey
    4
    finally had surgery on his left eye on December 16, 2015 and
    his right eye on February 2, 2016. But the surgeries occurred
    too late to save his vision.
    Surgery was delayed for nearly one year through no
    fault of Downey’s. He attended numerous sick calls between
    April 15 and October 28, 2015 and filed inmate staff request
    forms on July 9 and November 29, 2015 to check on the status
    of the surgery and reiterate the symptoms he was experiencing.
    Downey may have also submitted additional request forms in
    May 2015 and on October 28, 2015.
    Approximately one year later, Downey sought legal
    redress for the long delay. He did not undergo the formal
    grievance procedure specified in the Pennsylvania Department
    of Corrections’ Inmate Handbook. Instead, he filed a complaint
    against the Pennsylvania Department of Corrections; Jack
    Sommers, the Superintendent of SCI Waymart; and Paul
    DelRosso, the Deputy Superintendent for Centralized Services
    at SCI Waymart (collectively, “DOC Defendants”). He also
    named certain medical personnel in the complaint, including
    Dr. Tomazic; PA-C Jessica Ashby; PA-C Jennifer Villiano;
    PA-C Janan Loomis; and Correct Care Solutions, which
    provides medical services at SCI Waymart (collectively,
    “Medical Defendants”).1
    One day later, which happens to be the day he was
    released from prison, Downey filed a first amended complaint
    (“FAC”). On June 1, 2017, he filed a second amended
    1
    Over the course of the litigation, three Medical
    Defendants were dismissed by stipulation: Wexford Health
    Sources, Inc., OD Kathleen Gaynor, and PA-C Tom Lyons.
    5
    complaint (“SAC”). Downey claims that Medical Defendants
    and DOC Defendants (collectively, “Defendants”) violated his
    Eighth Amendment rights pursuant to 42 U.S.C. §§ 1983 and
    1988. He also claims violations of his rights under
    Pennsylvania state law.2
    Medical Defendants filed a motion for summary
    judgment on December 27, 2018 and DOC Defendants did the
    same on January 28, 2019. The District Court granted
    Defendants’ motions for summary judgment and declined to
    exercise supplemental jurisdiction over Downey’s state law
    claims, holding that he failed to exhaust his administrative
    remedies because he did not satisfy the prison’s grievance
    requirements.3 Downey v. Pa. Dep’t of Corr., No. 1:17-CV-
    143, 
    2019 WL 2161692
    , at *6–7 (M.D. Pa. May 17, 2019). The
    Court noted that “[t]he exhaustion requirements of the PLRA
    continue to apply even if a plaintiff files an amended complaint
    after being released from prison.”
    Id. at *4.
    In dicta, the District
    Court rejected the notion that Downey’s condition was so
    2
    Upon consent of the parties, this case was reassigned
    from Judge William W. Caldwell to Magistrate Judge Karoline
    Mehalchick pursuant to 28 U.S.C. § 636(c). We refer to the
    Magistrate Judge as the District Court throughout this opinion.
    3
    The District Court also concluded that Downey’s
    claims for injunctive and declaratory relief are moot because
    he is no longer incarcerated. Downey does not raise these
    claims in his briefs and thus waived challenging the District
    Court’s ruling. Kost v. Kozakiewicz, 
    1 F.3d 176
    , 182 (3d Cir.
    1993) (stating that an appellant’s failure to raise and brief an
    issue results in “abandon[ment] and waiv[er] [of] that issue on
    appeal and it need not be addressed”).
    6
    urgent that the grievance procedures were inapplicable to his
    claims.
    Id. at *6
    n.2. Downey timely filed a notice of appeal.
    II.
    The District Court had jurisdiction pursuant to 28
    U.S.C. §§ 1331 and 1343. This Court has jurisdiction under 28
    U.S.C. § 1291.
    Federal Rule of Civil Procedure 56(a) empowers district
    courts to grant summary judgment “if the movant shows that
    there is no genuine dispute as to any material fact and the
    movant is entitled to judgment as a matter of law.” We review
    the grant of summary judgment de novo and “draw all
    reasonable inferences in favor of the nonmoving party.” Hardy
    v. Shaikh, 
    959 F.3d 578
    , 581 n.1 (3d Cir. 2020). We apply the
    same standard of review to the District Court’s “determination
    of a failure to exhaust, and we accept the [District Court’s]
    factual conclusions unless clearly erroneous.”
    Id. at 584–85
    (alteration in original) (internal quotation marks and citation
    omitted).
    III.
    Downey challenges the District Court’s dismissal of his
    claims for monetary damages. He argues that the District Court
    erred when it held that he failed to exhaust his administrative
    remedies under the PLRA. Alternatively, he posits that he was
    not required to exhaust because he was no longer incarcerated
    when he filed the SAC. Defendants dispute these points, and in
    addition, DOC Defendants raise state sovereign immunity as a
    defense for the first time.
    7
    We agree that the District Court erroneously concluded
    that Downey procedurally defaulted his monetary damages
    claims. But we also agree that state sovereign immunity
    prohibits Downey’s suit as to DOC Defendants. Therefore, we
    will affirm in part, reverse in part, and remand to the District
    Court for further proceedings.
    A.
    Prisoners seeking to challenge the conditions of their
    confinement are subject to the PLRA, which mandates
    exhaustion of all available administrative remedies before
    bringing a lawsuit. 42 U.S.C. § 1997e(a). Exhaustion is a
    threshold requirement that district courts must consider.
    Woodford v. Ngo, 
    548 U.S. 81
    , 88 (2006); Rinaldi v. United
    States, 
    904 F.3d 257
    , 265 (3d Cir. 2018). Failure to exhaust is
    an affirmative defense that the defendant must plead and prove.
    Jones v. Bock, 
    549 U.S. 199
    , 216 (2007); 
    Rinaldi, 904 F.3d at 268
    .
    The PLRA requires proper exhaustion, meaning
    “complet[ing] the administrative review process in accordance
    with the applicable procedural rules.” 
    Woodford, 548 U.S. at 88
    . These procedural rules are supplied by the individual
    prisons. 
    Jones, 549 U.S. at 218
    (“[I]t is the prison’s
    requirements, and not the PLRA, that define the boundaries of
    proper exhaustion.”); Spruill v. Gillis, 
    372 F.3d 218
    , 222 (3d
    Cir. 2004) (determining whether “a prisoner has ‘properly’
    exhausted a claim . . . is made by evaluating the prisoner’s
    compliance with the prison’s administrative regulations
    governing inmate grievances”).
    8
    There is one exception to the mandatory exhaustion
    requirement: administrative remedies must be available to the
    prisoner. Ross v. Blake, 
    136 S. Ct. 1850
    , 1858 (2016) (“An
    inmate . . . must exhaust available remedies, but need not
    exhaust unavailable ones.”). An administrative remedy is
    unavailable when it “operates as a simple dead end[,] . . . is so
    opaque that it becomes, practically speaking, incapable of use,
    or when prison administrators thwart inmates from taking
    advantage of a grievance process through machination,
    misrepresentation, or intimidation.” Shifflett v. Korszniak, 
    934 F.3d 356
    , 365 (3d Cir. 2019) (internal quotation marks
    omitted). Both the Supreme Court and this Court have rejected
    judge-made exceptions to the PLRA. See, e.g., 
    Ross, 136 S. Ct. at 1856
    –58 (rejecting a “special circumstances” exception);
    Nyhuis v. Reno, 
    204 F.3d 65
    , 71 (3d Cir. 2000) (noting that the
    PLRA “completely precludes a futility exception”).
    The PLRA is intended to reduce the number of meritless
    inmate lawsuits challenging prison conditions. See 
    Woodford, 548 U.S. at 93
    –94. Its stringent requirements aim to
    accomplish this by returning “control of the inmate grievance
    process to prison administrators,” encouraging the
    “development of an administrative record, and perhaps
    settlements, within the inmate grievance process,” and
    reducing “the burden on the federal courts by erecting barriers
    to frivolous prisoner lawsuits.” 
    Spruill, 372 F.3d at 230
    . Just as
    inmates must properly exhaust administrative remedies per the
    prison’s grievance procedures, prison officials must strictly
    comply with their own policies. 
    Shifflett, 934 F.3d at 367
    (“[W]e hold that [the PLRA] requires strict compliance by
    prison officials with their own policies.”). But “[w]hen an
    administrative process is susceptible [to] multiple reasonable
    9
    interpretations, . . . the inmate should err on the side of
    exhaustion.” 
    Ross, 136 S. Ct. at 1859
    .
    B.
    We now turn to the “policies of the prison in question”
    during Downey’s incarceration. 
    Shifflett, 934 F.3d at 364
    . The
    Pennsylvania Department of Corrections’ 2013 Inmate
    Handbook sets forth the relevant procedures for inmates to file
    a grievance. Inmates are required to file a form, describing the
    incident, within fifteen working days to the Facility Grievance
    Coordinator, who generally must respond in fifteen working
    days.4 If the prisoner receives an unfavorable response, he or
    she must then file an appeal to the Facility Manager within
    fifteen working days. If the grievance is again denied, the
    inmate has fifteen working days from the date of the Facility
    Manager’s decision to appeal to the Secretary’s Office of
    Inmate Grievances and Appeals for final review. The
    Secretary’s Office must respond within thirty working days. In
    its entirety, the grievance process can take upwards of five
    months.
    These general grievance procedures do not apply to
    every situation. Rather than going through the formal
    grievance process, the Inmate Handbook clarifies that inmates
    “should speak to the nearest staff person as soon as possible”
    when facing emergency situations. App. 337. The DC-ADM
    804 policy effective May 1, 2015 adds that:
    4
    Per the DC-ADM 804 Inmate Grievance System
    Policy effective May 1, 2015, working days are equivalent to
    business days and exclude state holidays.
    10
    The Inmate Grievance System is intended to deal
    with a wide range of issues, procedures, or events
    that may be of concern to an inmate. It is not
    meant to address incidents of an urgent or
    emergency nature including allegations of sexual
    abuse. . . . When faced with an incident of an
    urgent or emergency nature, the inmate shall
    contact the nearest staff member for immediate
    assistance.5
    App. 280. In other words, a prisoner dealing with an
    emergency, or an urgent situation, is not bound by the ordinary
    procedures specified in the grievance policy. Instead, he or she
    only needs to alert the closest staff person.
    As we recognized in Spruill, our analysis of a prison’s
    grievance policy is “essentially a matter of statutory
    
    construction.” 372 F.3d at 232
    . We start with the policy’s plain
    language and ordinary meaning. See Idahoan Fresh v.
    Advantage Produce, Inc., 
    157 F.3d 197
    , 202 (3d Cir. 1998)
    (“[E]very exercise of statutory interpretation begins with [the]
    plain language. . . . Where the statutory language is plain and
    unambiguous, further inquiry is not required . . . .”). “We look
    to dictionary definitions to determine the ordinary meaning of
    a word.” United States v. Husmann, 
    765 F.3d 169
    , 173 (3d Cir.
    2014). The key phrase of the DC-ADM 804 policy is:
    “incidents of an urgent or emergency nature.” App. 280. An
    emergency is “[a] sudden and serious event . . . that calls for
    5
    Another version of the DC-ADM 804 policy was in
    effect from May 1, 2014 to April 30, 2015, but that version
    contains identical language regarding urgent or emergency
    situations.
    11
    immediate action” and “[a]n urgent need for relief or help.”
    Emergency, Black’s Law Dictionary (11th ed. 2019). Urgent
    means “calling for or demanding immediate attention.”
    Urgent,               Merriam-Webster             Unabridged,
    https://unabridged.merriam-webster.com/unabridged/urgent
    (last visited July 3, 2020). An emergency or an urgent issue is
    one that requires immediate attention.
    The record is replete with documents and testimony
    making clear that Downey’s severe glaucoma was so urgent
    that it required immediate care to prevent permanent vision
    loss. Dr. Tomazic and Dr. Szulborski both characterized
    Downey’s condition as “urgent” during their depositions and
    the latter thought Downey needed surgery in one to two weeks
    at the March 18, 2015 visit. Notes prepared after the December
    2, 2015 consult emphasized that Downey needed an
    appointment “stat/now”6 for surgery “to prevent blindness.”
    App. 1587–89. Because surgery was not scheduled
    immediately as the doctors recommended, Downey is now
    blind in both eyes. In this urgent situation, all that the grievance
    system required Downey to do was to “contact the nearest staff
    member for immediate assistance,” App. 280, which is what he
    did repeatedly.
    Defendants raise several arguments in support of their
    position that the normal grievance procedures set forth in DC-
    ADM 804 still apply to Downey. They quibble with Downey’s
    contention that his condition was urgent. Medical Defendants
    6
    Janan Loomis, a physician assistant, explained during
    a deposition that the “stat/now” notation is used to trigger a
    “fast track way . . . if you’re very concerned or if you have
    concerns.” App. 2063.
    12
    go so far as limiting the exemption to individuals suffering
    conditions like a heart attack or stroke that demand immediate
    treatment. To bolster this argument, Defendants stress that this
    Court does not recognize a futility exception to the PLRA
    based on an emergency or an urgent circumstance.
    Defendants’ attempt to downplay the urgency of
    Downey’s condition is unavailing. They conflate the prison
    and providers’ obvious lack of urgency in providing medical
    treatment with a purported lack of urgency associated with
    Downey’s rapidly deteriorating condition. Further, nothing in
    the Inmate Handbook or the DC-ADM 804 policy instructed
    Downey to file a formal grievance once the harm was
    complete, i.e., once the urgency ceased because the delay in
    care already left him blind. To the contrary, according to the
    DC-ADM 804 policy, the typical grievance process does not
    apply to inmates faced with “incidents of an urgent or
    emergency nature.” App. 280 (instructing prisoners to contact
    the closest staff member because “[t]he Inmate Grievance
    System . . . is not meant to address” those situations); see also
    App. 337 (“For an emergency, you should speak to the nearest
    staff person as soon as possible.”). Though Defendants
    correctly assert that we do not recognize a futility exception to
    exhaustion, our analysis is drawn from the prison’s policies
    “rather than from any free-standing federal law.” 
    Shifflett, 934 F.3d at 364
    . The Inmate Handbook and DC-ADM 804 policy
    exempted inmates facing an urgent situation from the typical
    grievance procedures, and Downey’s condition clearly met that
    exemption.
    Next, Defendants posit that Downey was required to
    grieve his claims to pursue monetary damages even if his
    condition was urgent. They point to language in DC-ADM 804
    13
    providing that an inmate who “desires compensation or other
    legal relief normally available from a court . . . must request
    the specific relief sought in his/her initial grievance.” App.
    281. Again, this provision is inapplicable to Downey because
    he was not required to submit a grievance due to the urgency
    of his situation. Neither the Inmate Handbook nor DC-ADM
    804 suggests that a prisoner faced with an urgent situation must
    nonetheless file a grievance if seeking monetary damages. Cf.
    
    Spruill, 372 F.3d at 234
    (“Nothing in the Grievance System
    Policy would have put [the plaintiff] on notice that he had to
    ask for monetary damages—or any particular relief at all.”).
    The grievance procedures are clear. Individuals dealing
    with urgent situations are not required to file a grievance.
    Downey’s rapidly deteriorating vision as a result of severe
    glaucoma clearly constituted an urgent condition necessitating
    immediate care. We hold that, under the prison’s own
    grievance policies, Downey was exempt from the typical
    grievance steps.
    C.
    The District Court limited its consideration of the
    exemption to one footnote that is dicta. See Downey, 
    2019 WL 2161692
    , at *6 n.2 (stating that “it is not necessary to reach the
    issue of whether Downey’s situation was ‘urgent or
    emergent’”). Instead, the Court focused on Downey’s failure
    to file a grievance while imprisoned, concluding that it was
    immaterial that Downey filed an amended complaint after he
    was released. See
    id. at *4
    & n.1. Since then, our Court has
    addressed whether an amended or a supplemental complaint
    filed post-incarceration cures a former inmate’s failure to
    exhaust administrative remedies while imprisoned. In Garrett
    14
    v. Wexford Health, 
    938 F.3d 69
    (3d Cir. 2019), we answered in
    the affirmative, so long as the amended or supplemental
    complaint relates back to the initial complaint. Although
    Downey complied with his obligation under the prison’s
    grievance procedures, we will briefly discuss Garrett to
    provide guidance to district courts on amended and
    supplemental complaints filed post-incarceration.
    In Garrett, the plaintiff failed to exhaust available
    administrative remedies before filing a complaint.
    Id. at 76.
    After he was released from custody, he then filed an amended
    complaint.
    Id. 78–79.
    Although the initial complaint was
    defective because he did not satisfy the exhaustion
    requirement, we concluded that “[w]hen he filed the [third
    amended complaint], [he] was no longer a prisoner and
    therefore was not subject to the PLRA’s administrative
    exhaustion requirement.”
    Id. at 84.
    “[B]ecause it relates back
    to the original complaint, the [third amended complaint] cures
    the original filing defect.”7
    Id. We vacated the
    dismissal of the
    plaintiff’s claims for failure to exhaust and remanded to the
    district court.
    Id. at 96.
    Medical Defendants raise several arguments to limit the
    import of Garrett: (1) all of Downey’s claims arise from the
    same transaction or occurrence since he did not add any new
    claims, facts, or parties to his SAC; (2) none of Downey’s
    7
    Per Federal Rule of Civil Procedure 15(c)(1)(B), an
    amended complaint relates back when “the amendment asserts
    a claim or defense that arose out of the conduct, transaction, or
    occurrence set out—or attempted to be set out—in the original
    pleading.”
    15
    claims were dismissed by the District Court; and (3) Downey
    did not initiate the grievance process while Garrett simply did
    not complete it.8
    We consider each argument in turn. Medical
    Defendants’ first argument is based on a misreading of Garrett.
    In that case, the plaintiff filed a third amended complaint after
    he was released from prison. 
    Garrett, 938 F.3d at 78
    . This
    Court held that the PLRA’s exhaustion requirement did not
    apply because his third amended complaint arose from the
    same transaction or occurrence as his initial complaint.
    Id. at 83–84.
    Similarly, in this case, Downey’s SAC arises from the
    same transaction or occurrence as his initial complaint because
    8
    In addition, DOC Defendants urge us to stay applying
    Garrett because the defendants in the case filed a petition for
    certiorari. The Supreme Court has since denied certiorari.
    Wexford Health v. Garrett, 
    140 S. Ct. 1611
    (2020).
    Alternatively, Medical Defendants suggest that we adopt the
    Tenth Circuit’s approach in May v. Segovia, 
    929 F.3d 1223
    (10th Cir. 2019). The Tenth Circuit concluded that the
    applicability of the PLRA’s exhaustion requirement is
    determined by referring to the plaintiff’s status as a prisoner at
    the time of the initial complaint. See
    id. at 1228–29
    (“The
    amended complaint, as the operative complaint, supersedes the
    original complaint’s allegations but not its timing.”) (emphasis
    in original). We decline to adopt the Tenth Circuit’s approach
    because we are bound by Garrett. See Reich v. D.M. Sabia Co.,
    
    90 F.3d 854
    , 858 (3d Cir. 1996) (noting that “a panel of this
    court is bound by, and lacks authority to overrule, a published
    decision of a prior panel”).
    16
    he sets forth identical facts and nearly the same claims. Garrett
    squarely fits the facts presented in this case.
    Next, neither Garrett nor Rule 15 requires that an
    amended complaint follow the dismissal of the previous
    complaint in order for the former to cure the latter’s defects.
    Instead, Garrett reflects the liberal approach we take when
    considering amended complaints intended to cure defects in
    initial pleadings—as Downey’s SAC was meant to do here. See
    id. at 82.
    Lastly, Medical Defendants attempt to distinguish the
    plaintiff’s failure to complete the grievance procedures in
    Garrett from Downey’s failure to begin the process. That is a
    distinction without a difference. Rather than being limited to
    situations where plaintiffs file a grievance but do not fully
    exhaust their administrative remedies, Garrett took a broader
    approach focusing on completion. See
    id. at 84
    (noting that the
    plaintiff’s initial complaint was defective because he failed to
    “complet[e] the prison grievance process then in effect”). The
    fact that Downey did not file an initial grievance is irrelevant.
    All that matters is that he was no longer incarcerated when he
    filed the SAC and that it relates back to his initial complaint.
    Both because he satisfies the urgency exemption and
    because he filed the SAC, which relates back to his original
    complaint, after he was released from custody, Downey was
    not subject to the Pennsylvania Department of Corrections’
    usual grievance procedures. Therefore, the District Court erred
    when it concluded that Downey’s claims for damages are
    17
    procedurally defaulted for failure to exhaust his administrative
    remedies.
    D.
    DOC Defendants raise an additional issue. They claim
    that Eleventh Amendment state sovereign immunity bars
    Downey’s claims against them. In response, Downey argues
    that sovereign immunity is not properly before this Court
    because DOC Defendants waived the defense. We agree with
    DOC Defendants and will affirm the District Court’s order to
    the extent that it dismissed Downey’s claims against them.9
    Although DOC Defendants did not claim sovereign
    immunity in their summary judgment motion, “it has been well
    settled . . . that the Eleventh Amendment defense sufficiently
    partakes of the nature of a jurisdictional bar so that it need not
    be raised in the trial court.” Edelman v. Jordan, 
    415 U.S. 651
    ,
    677–78 (1974). Further, we may affirm the judgment on any
    grounds supported by the record, including those not reached
    by the District Court. Oss Nokalva, Inc. v. Eur. Space Agency,
    
    617 F.3d 756
    , 761 (3d Cir. 2010).
    It is well established that lawsuits seeking retrospective
    relief by private persons against a state, state officials, and state
    entities are generally prohibited. See, e.g., Regents of the Univ.
    of Cal. v. Doe, 
    519 U.S. 425
    , 429 (1997) (stating that “[i]t has
    long been settled” that the Eleventh Amendment applies to
    “not only actions in which a State is actually named as the
    9
    As such, we need not address DOC Defendants’
    argument that they are entitled to summary judgment as to
    Downey’s Eighth Amendment claims.
    18
    defendant, but also certain actions against state agents and
    instrumentalities”); P.R. Aqueduct & Sewer Auth. v. Metcalf &
    Eddy, Inc., 
    506 U.S. 139
    , 146 (1993) (“[Eleventh Amendment
    immunity] does not permit judgments against state officers
    declaring that they violated federal law in the past . . . .”).
    There are several important aspects of state sovereign
    immunity relevant to this appeal. First, Eleventh Amendment
    immunity bars actions for retroactive relief against state
    officers acting in their official capacity. Kentucky v. Graham,
    
    473 U.S. 159
    , 169 (1985). To determine whether a plaintiff
    sued state officials in their official capacity, “we first look to
    the complaints and the course of proceedings.” Melo v. Hafer,
    
    912 F.2d 628
    , 635 (3d Cir. 1990), aff’d, 
    502 U.S. 21
    (1991)
    (internal quotation marks omitted). Second, a state may waive
    the defense by consenting to be sued. Koslow v. Pennsylvania,
    
    302 F.3d 161
    , 168 (3d Cir. 2002). Third, Congress may also
    abrogate state sovereign immunity pursuant to its power to
    enforce the Fourteenth Amendment.
    Id. Downey seeks monetary
    damages against the
    Pennsylvania Department of Corrections and two DOC
    officials, Superintendent Jack Sommers and Deputy
    Superintendent Paul DelRosso. The Pennsylvania Department
    of Corrections is undoubtedly a state instrumentality and its
    officials are state agents. See 71 Pa. Stat. and Cons. Stat. Ann.
    § 61. Moreover, Sommers and DelRosso were not directly
    involved or even aware of the long delay in surgery until
    immediately before it was scheduled. They were named in the
    19
    complaint because of their positions—and were thus sued in
    their official capacity.10
    The two exceptions to state sovereign immunity do not
    apply. Downey claims that the Commonwealth of
    Pennsylvania waived the defense pursuant to title 42, section
    8522(b)(2) of the Pennsylvania Statutes and Consolidated
    Statutes, which waives sovereign immunity for damages
    caused by medical professional liability. But Downey
    overlooks a separate provision in Pennsylvania law making
    clear that any waivers to sovereign immunity do not apply to
    lawsuits in federal court. 42 Pa. Stat. and Cons. Stat. Ann. §
    8521(b) (“Nothing contained in this subchapter shall be
    construed to waive the immunity of the Commonwealth from
    suit in Federal courts guaranteed by the Eleventh Amendment
    . . . . ”). Pennsylvania has not waived its sovereign immunity
    defense in federal court.
    Further, Congress did not abrogate Eleventh
    Amendment immunity via § 1983. Quern v. Jordan, 
    440 U.S. 332
    , 345 (1979) (concluding that the history and language of §
    1983 indicate that Congress did not intend to make states liable
    10
    At oral argument, Downey conceded that he is suing
    Sommers and DelRosso in their official capacity. He added
    that this is a Monell claim against DOC Defendants premised
    on the policies and procedures in place. That does not help
    Downey get around DOC Defendants’ Eleventh Amendment
    defense because liability under Monell is limited to
    municipalities. Monell v. Dep’t of Soc. Servs., 
    436 U.S. 658
    ,
    690 n.54 (1978) (“Our holding today is, of course, limited to
    local government units which are not considered part of the
    State for Eleventh Amendment purposes.”).
    20
    under the statute). Notably, the Supreme Court came to the
    opposite conclusion with respect to § 1988 in Hutto v. Finney,
    
    437 U.S. 678
    , 693–694 (1978), however, this claim still fails
    because the Eleventh Amendment bars the § 1983 action.
    
    Graham, 473 U.S. at 165
    (“[W]here a defendant has not been
    prevailed against, either because of legal immunity or on the
    merits, § 1988 does not authorize a fee award against that
    defendant.”). Thus, state sovereign immunity prohibits
    Downey’s claims against DOC Defendants.
    In sum, we conclude that Downey’s claims for
    monetary relief are not procedurally defaulted. We will reverse
    the District Court’s grant of Medical Defendants’ motion for
    summary judgment. But because DOC Defendants are immune
    from Downey’s claims for retrospective relief under the
    Eleventh Amendment, we will affirm summary judgment in
    their favor.
    IV.
    For the foregoing reasons, we will affirm in part and
    reverse in part the order of the District Court and remand the
    case for further proceedings consistent with this opinion.
    21