Benjamin v. Pillai et al
Filing
31
ORDER GRANTING MOTION FOR SUMMARY JUDGMENT. Defendants' motion for summary judgment (Doc. # 18 ) is GRANTED. Because of the Court's grant of defendants' summary judgment motion, plaintiff's motion for a preliminary injunction (Doc. # 30 ) is DENIED as moot. The Clerk of Court shall close this case. It is so ordered.Signed by Judge Jeffrey A. Meyer on 2/5/2018. (Lombard, N.)
UNITED STATES DISTRICT COURT
DISTRICT OF CONNECTICUT
EZRA BENJAMIN,
Plaintiff,
No. 3:16-cv-01721 (JAM)
v.
OMPRAKASH PILLAI, et al.,
Defendants.
ORDER GRANTING MOTION FOR SUMMARY JUDGMENT
Plaintiff Ezra Benjamin is an inmate at MacDougall-Walker Correctional Institution.
Plaintiff brought this action under 42 U.S.C. § 1983 against certain members of the medical staff
at MacDougall-Walker, principally including Dr. Omprakash Pillai. Plaintiff alleges claims of
deliberate indifference to serious medical needs in violation of the Eighth Amendment against all
defendants as well as a First Amendment retaliation claim against Dr. Pillai. Defendants have
moved for summary judgment on all claims. After oral argument in this case, plaintiff moved for
a preliminary injunction. I will grant defendants’ motion for summary judgment and deny
plaintiff’s motion for a preliminary injunction.
BACKGROUND
The following facts are undisputed or viewed in the light most favorable to plaintiff as
the non-moving party. Plaintiff has suffered chronic sciatic nerve pain since roughly June 2015.
See Doc. #18-2 at 43. On June 2, 2016, plaintiff transferred from another correctional facility to
MacDougall-Walker, where he is currently housed. The medical transfer summary in plaintiff’s
medical file does not reflect any mention of lower back pain. Id. at 8-9. On June 13, plaintiff
submitted an inmate request form seeking treatment for his lower back pain. Doc. #21 at 38. On
June 17, plaintiff submitted another form addressing the same issue. The second request was
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stamped received on June 20, and a nurse documented on June 23 that plaintiff was put in for an
appointment. Doc. #18-4 at 2. On July 7, plaintiff filed a grievance detailing his medical
condition and seeking treatment and better communication. Doc. #21 at 34.
Dr. Pillai examined plaintiff on July 15. He recommended blood and urine tests, back
exercises, weight loss, naproxen as needed, and a lumbar x-ray. Doc. #18-3 at 3 (¶ 7); Doc. #182 at 65. Dr. Pillai allegedly called plaintiff a “pain in the ass” and threatened to withhold
treatment if plaintiff continued to write grievances. Doc. #21 at 30 (¶ 10). Plaintiff was also
denied a cane he requested. Id. (¶ 11).
On July 29, plaintiff filed another request form indicating that he had not received
naproxen and that he had not had his x-ray scheduled. The form was stamped received on August
4, and staff responded on August 10 by indicating that the pharmacy no longer fills naproxen
prescriptions “as needed,” and plaintiff’s chart was sent back to “MD” for a scheduled naproxen
order. Doc. #18-4 at 3; Doc. #21 at 30 (¶¶ 14-15).
On August 22, plaintiff filed another grievance in which he stated that he awoke the night
before in excruciating pain, reiterated his symptoms and complaints about lack of follow up, and
requested a cane. Doc. #21 at 35. On August 30, plaintiff filled out another request form
indicating that his right leg was numb and tingling and requesting someone to bring him to the
medical clinic. A corrections officer brought him to the medical clinic, and a nurse told plaintiff
that she would straighten out the naproxen order. Doc. #21 at 41; Doc. #18-2 at 36. Dr. Pillai was
advised of and corrected the issue with the naproxen prescription on September 1. Doc. #18-3 at
2 (¶ 10); Doc. #18-4 at 4; Doc. #18-2 at 63.
Plaintiff filed another request form on September 8 in which he acknowledged the
naproxen prescription was filled, but stated that Dr. Pillai had denied plaintiff’s request for a
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cane. Doc. #18-4 at 4. Plaintiff received an x-ray on September 9. Doc. #18-2 at 17. Staff
responded to plaintiff’s request on September 15 indicating that plaintiff was scheduled to see
Dr. Naqvi (who is not named as a defendant in this action) on September 18 to review his x-ray
results. Doc. #18-4 at 4. On September 19, plaintiff filed another request form complaining that
he missed his appointment with Dr. Naqvi because the corrections officer failed to timely release
him from his cell and that the naproxen was not working. Doc. #21 at 43.
On October 17, 2016, plaintiff filed the federal court complaint in this matter. Doc. #1.
The parties have subsequently submitted additional facts in their summary judgment papers. On
October 17, Dr. Pillai saw plaintiff again and noted unremarkable x-ray findings. Doc. #18-3
(¶ 11). Based on his exam, Dr. Pillai ordered an MRI. Id. (¶ 12). Dr. Pillai submitted the request
for the MRI to the Utilization Review Committee (URC) on October 18. Id. (¶ 13). This was
submitted as a priority-four request, meaning a decision would be made on the request within
two months. Id. (¶ 14). Plaintiff was informed on November 29 that his MRI was scheduled and
that he was authorized a prescription for a muscle relaxer. Id. (¶ 16). On December 12, plaintiff
submitted a “Request for Reasonable Accommodation” requesting a cane and back brace. Doc.
#21 at 48. This request was denied on December 16 by Dr. Pillai as not medically indicated. Ibid.
The MRI was administered on January 3, 2017. Doc. #18-2 at 15. It revealed a number of
diffuse disc bulges in the spine, some spinal stenosis, and a hemangioma. Ibid. Dr. Pillai
reviewed the MRI results on January 18 and made a request to the URC for steroid injections and
a neurosurgery consult. Doc. #18-3 at 5 (¶ 18). The URC approved the injections but did not
approve the surgery consult because the exam results were relatively normal. Id. (¶ 19).
On December 18, 2017, plaintiff filed a motion for a preliminary injunction seeking an
order that he be prescribed opiate pain relievers or THC pills, that the URC permit him to consult
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with a neurosurgeon, and that plaintiff be afforded additional recreation time in order to
rehabilitate and lose weight. Doc. #30 at 5. In his memorandum, plaintiff noted that all other
“first line” medications—i.e., Tylenol, naproxen, Gabapentin, baclofen, Flexeril, and Elavil—
have not relieved his pain. Id. at 3-4.
DISCUSSION
The principles governing the Court’s review of a motion for summary judgment are well
established. Summary judgment may be granted only if “the movant shows that there is no
genuine dispute as to any material fact and the movant is entitled to a judgment as a matter of
law.” Fed. R. Civ. P. 56(a). I must view the facts in the light most favorable to the party who
opposes the motion for summary judgment and then decide if those facts would be enough—if
eventually proved at trial—to allow a reasonable jury to decide the case in favor of the opposing
party. My role at summary judgment is not to judge the credibility of witnesses or to resolve
close contested issues but solely to decide if there are enough facts that remain in dispute to
warrant a trial. See generally Tolan v. Cotton, 134 S. Ct. 1861, 1866 (2014) (per curiam);
Pollard v. New York Methodist Hosp., 861 F.3d 374, 378 (2d Cir. 2017).
Deliberate Indifference to Serious Medical Needs
A prison official’s deliberate indifference to a prisoner’s serious medical needs
constitutes cruel and unusual punishment in violation of the Eighth Amendment. Estelle v.
Gamble, 429 U.S. 97, 104 (1976); Spavone v. New York State Dep’t of Corr. Servs., 719 F.3d
127, 138 (2d Cir. 2013). But a claim for deliberate indifference is not the same as a medical
malpractice claim, because mere medical negligence does not establish that a doctor was
deliberately indifferent to a prisoner’s medical needs. See Estelle, 429 U.S. at 106; Chance v.
Armstrong, 143 F.3d 698, 703 (2d Cir. 1998).
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It is well established that a claim for deliberate indifference to serious medical needs has
two requirements. “The first requirement is objective: the alleged deprivation of adequate
medical care must be sufficiently serious. The second requirement is subjective: the charged
officials must be subjectively reckless in their denial of medical care.” Spavone, 719 F.3d at 138
(citations and quotation marks omitted). “The objective ‘medical need’ element measures the
severity of the alleged deprivation, while the subjective ‘deliberate indifference’ element ensures
that the defendant prison official acted with a sufficiently culpable state of mind.” Smith v.
Carpenter, 316 F.3d 178, 183–84 (2d Cir. 2003).
Defendants argue that there are no genuine fact issues as to the first element to support
plaintiff’s claim, i.e., that he was deprived of appropriate treatment for a serious medical need.
As an initial matter, I conclude there is at least a genuine fact issue to show that plaintiff’s
medical condition was a sufficiently serious medical need for purposes of sustaining an Eighth
Amendment claim. See, e.g., Faraday v. Lantz, 2005 WL 3465846, at *5 (D. Conn. 2005) (lower
back pain and sciatic nerve may be sufficiently serious). The closer question is whether there is a
genuine fact issue to suggest that plaintiff was actually deprived of appropriate treatment. As the
Second Circuit has made clear, there is an important distinction between cases involving a denial
of treatment and cases involving a delay in treatment. For cases involving a claimed delay in
treatment, “the seriousness inquiry is narrower,” and the analysis focuses “on the challenged
delay or interruption in treatment rather than the prisoner’s underlying medical condition alone.”
Salahuddin v. Goord, 467 F.3d 263, 280 (2d Cir. 2006) (internal quotations omitted).
The focus of plaintiff’s claims is the delay between his first appointment with Dr. Pillai
on July 15 and his later receipt of naproxen and an x-ray exam in early September.1 I will
1
Plaintiff states expressly in his briefing that his claims arise out of events occurring after he filed his
grievance on July 7, 2016. Doc. #21 at 7.
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consider the x-ray delay first. Dr. Pillai notes in his affidavit that the lapse of time between the
order for the x-ray and the actual x-ray exam—about eight weeks—is “a little longer . . . than is
typical.” Doc. # 18-3 at 2 (¶ 9). But this delay did not compromise plaintiff’s treatment in any
way. Ibid. The x-ray revealed unremarkable results, id. (¶ 9), and the delay cannot be said to
have contributed in any way to plaintiff’s pain. “Courts have found that a plaintiff’s allegations
fail to meet the objective prong where the alleged delay in providing medical attention is neither
the underlying cause of a plaintiff’s condition nor contributed to a worsening in the condition.”
Cuffee v. City of New York, 2017 WL 1232737, at *9 (S.D.N.Y.), report and recommendation
adopted, 2017 WL 1134768 (S.D.N.Y. 2017).2
Therefore, to the extent that plaintiff’s Eighth Amendment claim rests on the delay in
receiving an x-ray, plaintiff cannot show that this delay was sufficiently serious to be cognizable
for Eighth Amendment purposes. See Pierre v. Cty. of Broome, 2007 WL 625978, at *5–6
(N.D.N.Y. 2007) (insufficient evidence of specific effects that delay had on medical condition);
Farid v. Ellen, 2006 WL 59517, at *10–11 (S.D.N.Y. 2006) (“plaintiff has come forward with no
evidence of how this alleged delay exacerbated his condition or worsened his prognosis for
effective treatment,” and therefore “no reasonable jury could conclude that the alleged delay in
plaintiff’s medical treatment caused any harm to him that would be actionable under the Eighth
Amendment”), aff’d in part and vacated in part on other grounds, 593 F.3d 233 (2d Cir. 2010).
To the extent it could be argued that the delay in administering the x-ray caused a delay in the
2
By contrast, a far longer delay might well have sufficed to support an Eighth Amendment claim,
depending in part on the pain or disability experienced in the interim. See Rodriguez v. Manenti, 606 F. App’x 25,
26–27 (2d Cir. 2015) (more than one year delay for arranging knee surgery to address chronic pain and intermittent
disabling knee locking from gunshot injury to knee); Salahuddin, 467 F.3d at 281 (presuming that five-month delay
of liver biopsy was “objectively serious” where plaintiff put forth evidence that he suffered pain during that period);
Hathaway v. Coughlin, 841 F.2d 48, 50-51 (2d Cir. 1988) (more than two-year delay for surgery to correct broken
pins in hip).
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MRI exam, that delay, too, does not appear to have contributed in any meaningful way to
plaintiff’s pain.
The same is true regarding the delay in the receipt of naproxen, which involved a delay of
nearly seven weeks. Plaintiff himself has admitted multiple times that naproxen was ineffective
in treating his sciatic nerve pain. See Doc. #21 at 43 (“The pain meds are not working
(Naproxen)”); id. at 44 (“[Discontinue] my order for naproxen because it does not work.”).
Indeed, plaintiff claims that none of the first line medications has been effective. Doc. #30 at 3-4.
Therefore, no reasonable jury could conclude that the delay in the provision of naproxen
amounted to a deprivation that was sufficiently serious to support a constitutional violation.
Plaintiff also claims that defendants’ refusal to provide him a cane or a back brace
constitutes deliberate indifference. This claim amounts to nothing more than a disagreement
about the appropriate treatment, which is insufficient to support a claim of deliberate
indifference. See Chance, 143 F.3d at 703. (“It is well-established that mere disagreement over
the proper treatment does not create a constitutional claim.). The Eighth Amendment does not
create a constitutional right for prisoners to receive canes or back braces, and plaintiff has not
shown on the particular facts here that Dr. Pillai was no less than deliberately indifferent when
deciding that a cane was not medically indicated. In short, notwithstanding plaintiff’s
experiencing of severe back pain, there is no genuine issue of fact to show that he was the victim
of deliberate indifference to his serious medical needs by Dr. Pillai or other prison medical staff.
Retaliation
“[T]o sustain a First Amendment retaliation claim, a prisoner must demonstrate the
following: (1) that the speech or conduct at issue was protected, (2) that the defendant took
adverse action against the plaintiff, and (3) that there was a causal connection between the
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protected speech and the adverse action.” Gill v. Pidlypchak, 389 F.3d 379, 380 (2d Cir. 2004)
(internal quotation marks omitted). “Only retaliatory conduct that would deter a similarly
situated individual of ordinary firmness from exercising his or her constitutional rights
constitutes an adverse action for a claim of retaliation.” Davis v. Goord, 320 F.3d 346, 353 (2d
Cir. 2003) (internal quotation marks omitted). Courts should “approach prisoner retaliation
claims with skepticism and particular care, because virtually any adverse action taken against a
prisoner by a prison official—even those otherwise not rising to the level of a constitutional
violation—can be characterized as a constitutionally proscribed retaliatory act.” Dolan v.
Connolly, 794 F.3d 290, 295 (2d Cir. 2015).
In its initial review order, the Court permitted plaintiff’s retaliation claim to proceed
against Dr. Pillai only. Doc. #7 at 7. There is little doubt that the grievances plaintiff filed
constitute protected activity. See Davis, 320 F.3d at 352–53. But no genuine fact issue remains to
suggest that Dr. Pillai’s subsequent conduct was motivated by any retaliatory intent. See Bilal v.
White, 494 F. App’x 143, 147 (2d Cir. 2012) (rejecting First Amendment retaliation claim
stemming from delay in receipt of prescription drugs “for substantially the same reasons” as the
Eight Amendment claim was rejected and noting that officials’ “alleged comments relating to
[prisoner’s] filing of grievances do not, on their own or in combination with the other alleged
acts, amount to actionable harm”). In fact, after the delay regarding the naproxen and the x-ray,
Dr. Pillai continued to pursue more advanced diagnostic tests and pain therapy, despite the fact
that plaintiff continued to write grievances. Accordingly, no reasonable jury could conclude that
Dr. Pillai retaliated against plaintiff because of his filing of a grievance. Therefore, I will grant
summary judgment in favor of defendants on plaintiff’s retaliation claim.
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CONCLUSION
Defendants’ motion for summary judgment (Doc. #18) is GRANTED. Because of the
Court’s grant of defendants’ summary judgment motion, plaintiff’s motion for a preliminary
injunction (Doc. #30) is DENIED as moot. The Clerk of Court shall close this case.
It is so ordered.
Dated at New Haven this 5th day of February 2018.
/s/ Jeffrey Alker Meyer
Jeffrey Alker Meyer
United States District Judge
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