Santiesteban v. M. Delalamon, MLP et al
Filing
54
ORDER denying 45 Plaintiff's Motion for Summary Judgment; granting 49 Defendants' Cross-Motion for Summary Judgment; directions to the Clerk. Signed by Judge Timothy J. Corrigan on 9/1/2020. (JLD)
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UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
OCALA DIVISION
DARVIS SANTIESTEBAN,
Plaintiff,
v.
Case No. 5:18-cv-15-Oc-32PRL
MR. MONTALVO and
MR. M. OCASIO,
Defendants.
ORDER
I.
Status
Plaintiff is a federal prisoner proceeding on a Second Amended Complaint
(Doc. 32). He sues Mr. Montalvo, an Assistant Health Services Administrator;
and M. Ocasio, now-former Warden of Coleman Correctional Complex.1 Plaintiff
alleges that he was injured while playing softball on the recreation yard, and
Defendants were deliberately indifferent to his resulting serious medical needs.
He seeks monetary damages as relief, and requests that he receive no
“repercussions for filing this suit.”
The Court previously dismissed the claims against M. Delalamon and all
official capacity claims against Defendants Montalvo and Ocasio. See Order
(Doc. 37).
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Before the Court are the parties’ cross-motions for summary judgment
and respective responses. See Plaintiff’s Motion for Summary Judgment (Doc.
45); Defendants’ Opposition to Plaintiff’s Motion for Summary Judgment and
Cross-Motion for Summary Judgment (Doc. 49); Plaintiff’s Reply and Response
to Defendants’ Opposition and Cross-Motion for Summary Judgment (Doc. 52).2
The Motions are ripe for review.
II.
Standard of Review
“‘Summary judgment is appropriate where there is no genuine issue as to
any material fact and the moving party is entitled to judgment as a matter of
law.’” Hinkle v. Midland Credit Mgmt., Inc., 827 F.3d 1295, 1300 (11th Cir.
2016) (quoting Jurich v. Compass Marine, Inc., 764 F.3d 1302, 1304 (11th Cir.
2014)); see Fed. R. Civ. P. 56(a). “A genuine issue of material fact exists when
the evidence is such that a reasonable jury could return a verdict for the
nonmoving party.” Bowen v. Manheim Remarketing, Inc., 882 F.3d 1358, 1362
(11th Cir. 2018) (quotations and citation omitted); see Hornsby-Culpepper v.
Ware, 906 F.3d 1302, 1311 (11th Cir. 2018) (“Where the record taken as a whole
could not lead a rational trier of fact to find for the non-moving party, there is
no genuine issue for trial.” (quotations and citation omitted)). In considering a
summary judgment motion, the Court views “the evidence and all reasonable
The Court advised Plaintiff of the provisions of Federal Rule of Civil Procedure
56 and the consequences of granting such a motion. See Order (Doc. 20).
2
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inferences drawn from it in the light most favorable to the nonmoving party.”
Hornsby-Culpepper, 906 F.3d at 1311 (quotations and citation omitted).
“[W]hen the moving party has carried its burden under Rule 56(c), its
opponent must do more than simply show that there is some metaphysical
doubt as to the material facts.” Matsushita Elec. Indus. Co. v. Zenith Radio
Corp., 475 U.S. 574, 586 (1986) (footnote and citation omitted); see Winborn v.
Supreme Beverage Co. Inc., 572 F. App’x 672, 674 (11th Cir. 2014) (per curiam)
(“If the movant satisfies the burden of production showing that there is no
genuine issue of fact, ‘the nonmoving party must present evidence beyond the
pleadings showing that a reasonable jury could find in its favor.’” (quoting
Shiver v. Chertoff, 549 F.3d 1342, 1343 (11th Cir. 2008)). “‘A mere scintilla of
evidence supporting the opposing party’s position will not suffice; there must be
enough of a showing that the jury could reasonably find for that party.’” Loren
v. Sasser, 309 F.3d 1296, 1302 (11th Cir. 2002) (quoting Walker v. Darby, 911
F.2d 1573, 1577 (11th Cir. 1990) (internal quotations omitted)).
“The principles governing summary judgment do not change when the
parties file cross-motions for summary judgment. When faced with
cross-motions, the Court must determine whether either of the parties deserves
judgment as a matter of law on the undisputed facts.” T-Mobile S. LLC v. City
of Jacksonville, Fla., 564 F. Supp. 2d 1337, 1340 (M.D. Fla. 2008).
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III.
Plaintiff’s Second Amended Complaint3
Plaintiff was playing softball on the recreation yard at Coleman Federal
Correctional Complex on August 30, 2015, when he fell and injured his right
knee and left upper arm. He was sent to the health clinic and seen by F. Dudas,
EMT. His injury was initially diagnosed as an upper arm contusion by
Delalamon. After multiple sick-call visits, “the correct diagnos[is] was
uncovered by another physician[’s] assistant.” Plaintiff claims that his “injury
initially required adequate medicine and a simple surgery.” He states that on
November 30, 2015, an “[o]rthopedic doctor informed [him] . . . that[] due to the
length of time that had passed since the injury, his injury had escalated from
‘normal’ to ‘chronic,’ and he would now need two surgeries to repair his injury
resulting with handicap, pain and discomfort.” On December 7, 2015,
“[P]laintiff was approved for the surgeries,” but “the surgeries were not done
until February 27, 2017. Due to the delay, [ P]laintiff had to endure excruciating
pain and discomfort.” Plaintiff claims that “[Defendant] Montalvo and
[Defendant] Ocasio both played a part in the deficient medical treatment
[P]laintiff received by failing to arrange and administrate surgery for [ P]laintiff
in a timely manner.”
The Court primarily focuses on the allegations against Defendants Ocasio and
Montalvo.
3
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Plaintiff claims that Defendants Montalvo and Ocasio “failed to take
reasonable measures to send [ P]laintiff to get the surgeries he needed after
they were approved . . . causing [ P]laintiff to endure prolong[ed] excruciating
pain and discomfort, which was also substantially harmful to [ P]laintiff’s
health.” He also “continues to experie[nc]e residual weakness in the strength of
his tricep[] tendon, numbness and lack of mobility as well.” Plaintiff alleges that
Defendants Montalvo and Ocasio “both sat on the committee that approves and
determine[s] ‘when’ and ‘where’ such treatments . . . are performed,” and that
“[t]hey were both made aware of the circumstances of the case in order to
approve the procedure[.]” He states that he “shared the complaint regarding the
medical treatment he was receiving with both[ Defendant] Montalvo and
[Defendant] Ocasio separately numerous times, and each time they would
spin[4] [P]laintiff.”
IV.
Parties’ Summary Judgment Positions
Plaintiff reiterates his factual allegations and argues that the record
shows he needed surgery, but he did not timely receive the surgery and thus
suffered severe pain for 417 days. See Doc. 45 at 1-3. During that time, he
asserts that he “communicated to Defendants Montalvo and Ocasio about his
severe pain and the delay in receiving his surgery,” but they failed to take any
Plaintiff defines “spin” as: “avo[i]ding issue, misdirecting, fail to address, or
fail to deal with.”
4
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action. Id. at 5. In support of his contention that he communicated his situation
to Defendants, he cites to two emails he sent. Id. at 6 (citing id. at 29-30). The
first email is dated January 3, 2016, and it was sent to “Health Services LOW.”
Id. at 29. Plaintiff addressed the email to Defendant Montalvo and stated:
I went to sick call because the medication I was taking
was not doing me any good because I was still in pain
because of my ruptured triceps. Medical staff changed
my medication from Naproxen to Meloxicam 15 mg
one a day and these medication is also not working for
the extreme pain I have in my arm. Please help me
with these issue[.] Sir I cant take these pain anymore.
I have been dealing with these issue seen [sic] my
accident acured [sic] in August 2015. Please help me.
Thank you.
Id. The second email, dated April 29, 2016,5 was sent to the Warden and states:
Sir I have a big issue and I don’t know who to go to
anymore. I have gone to everybody and nobody can
help me or nobody want to give me answers. I had an
accident here on the softball field August 30 2015. I
fell and after the MRI we realized I had ruptured my
tricep. Ok after time had passed by I had to file a BP8, 9, 10 and 11 because I was not being taken care of[]
and the situation worsened because of the time that
has passed by and the lack of medical attention. I now
am designated to a different institution for my
operation. Well I have been designated for 2 months
now and I am still here. I went today to medical to find
answers in why I am still here and not transferred yet.
I was told [b]y the medical staff today that a hold was
put on me and it was by mistake but these mistake has
delayed the time for my operation. Please sir I need for
Plaintiff states in the Motion that he sent the email on May 9, 2016. Doc. 45
at 3. However, the exhibit shows that Plaintiff sent the email on April 29, 2016,
and he received the response on May 9, 2016.
5
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you to take action on these situation because this is
to[o] much. If I hadn’t gone today to sick call 4-29-2016
I would have never none [sic] why I am not being
transfer[r]ed and taken care of[]. The medical staff
told me that the person who takes care of my issue is
not here exc. On my BP-10 I was told by Regions that
if the issue wasn’t taken care of[], to appeal to you the
Warden of the institution. But before I take those
measures I write to you to see if you can resolve the
problem. Thank you for your time.
Id. at 30 (some internal formatting modified). As a result, Plaintiff asserts that
he now has “permanent loss of range of motion and quality of life[] and recurring
pain.” Id. at 5. Plaintiff requests summary judgment in his favor and an award
of $300,000 along with costs in the amount of $500. Id. at 7.
Defendants
counter
Plaintiff’s
assertions,
arguing
that
“the
comprehensive medical records, the submitted pleadings, and supporting
affidavits clearly establish that neither Defendant is a medical professional and
neither Defendant was directly involved in Plaintiff’s medical care.” Doc. 49 at
10.6 Defendants further assert that their duties were unrelated to medical care
Defendants also argue that they are entitled to judgment as a matter of law
because Plaintiff asserts claims against them in their official capacities only.
Doc. 49 at 14-15. Defendants’ request in this regard is denied as moot, because
the Court already dismissed those claims. See Order (Doc. 37). Although
Plaintiff only checked “official capacity” on the complaint form, considering his
pro se status and his allegations, it is clear he intended to sue Defendants in
their individual capacities. See Doc. 52 at 5, 11-12; see also Young Apartments,
Inc. v. Town of Jupiter, FL, 529 F.3d 1027, 1047 (11th Cir. 2008) (explaining
that “[w]hen it is not clear in which capacity the defendants are sued, the course
of proceedings typically indicates the nature of the liability sought to be
imposed,” and in considering the “course of proceedings,” courts look to “the
6
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and treatment of inmates. Id. at 11. Defendant Ocasio avers that he did not
participate in or have any authority over the Utilization Review Committee;
Defendant Montalvo avers that he “does not recall being involved in any
Utilization Review Committee decisions regarding Plaintiff’s care, but the final
authority of the committee rests with the Clinical Director and Defendant
Montalvo could not have overruled any such decision.” Id. at 11-12. In support,
each Defendant submitted a declaration. They also submitted a declaration by
Hector Lopez, M.D., and a declaration by Captain Damien Avery, DPT, OCS,
both of which include medical records from before and after Plaintiff’s surgery.
In his Declaration, Defendant Ocasio states that, as the Warden of
Coleman FCC, his “responsibilities included administrative and organization
control of the institution.” Doc. 49-1 at 2. He avers that his “job consisted of
supervisory and managerial related responsibilities of personnel in order to
maintain the safety and security of the institution, staff, and the inmates,” but
he did “not have any input or decision making power when it c[a]me[] to patient
care and other medical decisions.” Id. Rather, such decisions were “left to the
Clinical Director and other medical personnel.” Id. He further asserts that he
did “not participate in the Utilization Review Committee,” and the Clinical
nature of plaintiff’s claims, requests for compensatory or punitive damages, and
the nature of any defenses raised in response to the complaint, particularly
claims of qualified immunity which serve as an indicator that the defendant
had actual knowledge of the potential for individual liability”).
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Director has “final authority for all URC decisions,” which Defendant Ocasio
could not overrule. Id. Defendant Ocasio avers that “[w]hen and how the Inmate
receives the care from outside consults that have been approved[] is also
handled by the medical professionals” and that he did “not participate in the
medical care of an inmate.” Id. at 3. He asserts that if he were contacted by an
inmate or their families regarding the inmate’s medical care, he would “inform
them that [he is] not a medical professional, and that they should address this
concern with the medical personnel or their primary care physician as soon as
possible.” Id. He additionally would “forward their requests to the appropriate
medical staff, but [he could not] control how an inmate is triaged, or how and
what type of medical treatment they receive, as [he is] not a medical
professional.” Id. He states that he “do[es] not recall speaking with [Plaintiff]
in person about his medical treatment,” but even if he did, he “would have
referred him to the appropriate medical staff.” Id. Finally, Defendant Ocasio
affirms that the response to Plaintiff’s administrative remedy, in which
Plaintiff advised that he was experiencing pain and raised a concern about a
delay in receiving surgery, was not signed by him but by another warden in his
absence. Id. (referring to Doc. 49-1 at 5).
According to Defendant Montalvo, he served “as an Assistant Health
Services Administrator (AHSA) at FCC Coleman, Low from approximately
June 2012 to October 31, 2017,” and was responsible for “overseeing the day-to9
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day operations of the Health Services Department, which involved managing
and directing the activities of a multi-disciplinary team of health care
professionals responsible for medical, dental, and allied health services to the
inmate population, in collaboration with the Assistant Health Administrator
and the Clinical Director.” Doc. 49-2 at 2. He asserts that his “responsibilities
were primarily administrative in nature” and he “did not participate in inmate
medical care” or “have input as to the type and timing of treatment inmates
received.” Id. “These decision[s] are the sole responsibility of the medical
providers, to include Nurses, Emergency Medical Technicians (EMT), MidLevel Practitioners (MLP), and Physicians. Each of these medical personnel
were directly supervised by the Clinical Director.” Id. If an inmate asked him
“about their non-emergency medical care, [his] custom and practice was to
explain to them that [he is] not a medical provider and that they should follow
up during sick call or with their primary care physician as soon as possible.” Id.
He states that “[t]he URC is chaired by the Clinical Director, and the Clinical
Director is the final authority for all URC decisions,” which “cannot be
overturned by the Warden, Associate Warden, HSA, AHSA, or primary care
physician.” Id. at 3. Defendant Montalvo “do[es] not recall being involved in a
URC decision regarding the medical treatment of [Plaintiff],” but regardless, he
“would not have any power to make a clinical decision as to [Plaintiff’s] medical
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care and/or actual treatment.” Id. As to Plaintiff’s January 3, 2016, email
addressed to Defendant Montalvo, he states:
I have reviewed the January 3, 2016, email Inmate
Santiesteban attached to his Motion for Summary
Judgment as Exhibit 14. It appears he sent this email
to the general inmate to staff Health Service email box
and addressed this to Health Services LOW as a
Request to Staff. He added my name to the body of the
email expressing concern about a change of his pain
medication. At that time inmates did not have direct
access to individual staff members via email. I did not
manage this general email account. My recollection is
that emails sent to this address were checked by
administrative staff, who would forward the emails to
health services or the individual for possible
resolution.
I do not remember receiving the January 3, 2016
email. In the email he is seeking a change in
medication. In instances such as this, I would refer the
inmate to his primary care physician, as well as
referring them to sick call so that they could speak
with a health care provider. I did this in these
instances because I did not provide or participate in
medical care or medical decisions, and the prescribing
of medication is a health care decision. Reviewing his
medical records, he saw a medical provider several
times after this email. There were many opportunities
for him to have requested a change in medication from
qualified personnel.
Id. Finally, Defendant Montalvo avers that he “was not personally involved in
the medical care of [Plaintiff],” nor did he “direct medical staff regarding
[Plaintiff’s] medical treatment.” Id.
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Dr. Lopez, who served as the Clinical Director at FCC Coleman from 2014
to 2016 submitted the following Declaration:
1. I am currently employed by the Federal Bureau of
Prisons as the Southeast Regional Physician and
have been since August 2016. My duties and
responsibilities include providing medical care to
inmates at institutions in the Southeast Region
that may need additional medical assistance. In
addition, I frequently review the treatment
provided by other medical staff within the region
and also in some cases review requests for certain
procedures to be performed. From 2014 to 2016, I
served as Clinical Director at the Coleman Federal
Correctional Complex (FCC Coleman). I have been
employed by the Federal Bureau of Prisons for
approximately 14 years.
2. As part of my duties, I provide medical care to the
inmate population at various institutions within
the Southeast Region. I have access to documents
and electronic data created and/or maintained by
the Federal Bureau of Prisons (“Bureau” or “BOP”).
These records are made at or near the time of the
occurrence of the matters set forth by, or from
information transmitted by, a person with
knowledge of the relevant matters.
3. I have reviewed the Complaint filed by Inmate
Darvis Santiesteban, Register Number 34129-379,
as well as his medical records. The medical records
indicate that since he transferred to FCC Coleman,
the inmate was seen by on-site medical staff for
evaluation of a pre-existing pain in his elbows as
well as a torn left triceps.
4. In addition to the treatment of symptoms and pain
management, Inmate Santiesteban’s left elbow was
imaged on multiple occasions, to include an x-ray
on September 4, 2015, revealing no acute injury,
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and another on September 25, 2015 following a fall
on his left elbow that day. The Utilization Review
Committee (URC) approved an MRI, which
occurred on approximately October 10, 2015, that
revealed a rupture of the distal triceps.
5. In September 2015, the URC approved a request for
an orthopedic consult. After examining Inmate
Santiesteban on November 30, 2015, the consulting
specialist declined to perform the recommended
surgery as outside her area of expertise and
suggested the inmate see a shoulder/elbow subspecialist. In December 2015, the URC referred the
request for Inmate Santiesteban’s consult with a
sub-specialist to Region Review. When the
requested consult had not been approved, I referred
Plaintiff to a BOP orthopedic surgeon and physical
therapist for consult in February 2016. In May
2016, a second specialist declined to perform the
recommended surgery as outside her scope of
expertise.
6. During this time, medical staff submitted requests
to have Inmate Santiesteban transferred to Federal
Medical Center Butner (FMC Butner) to address
his medical needs. The transfer was approved on
March 2, 2016. Inmate Santiesteban’s surgical
classification was designated as a routine-urgent,
meaning inmates with more serious concerns would
be given bed space before him.
7. On June 10, 2016, a clinical note indicates bed
space is available at FMC Butner, and the inmate
transfer was approved.
8. Inmate Santiesteban’s medical records reveal that
his triceps injury was properly evaluated and he
received medically appropriate care. The records
also indicate Inmate Santiesteban received
diagnostic imaging when necessary and his injury
was appropriately diagnosed. As well, he was
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appropriately sent to two outside specialists for
evaluation; although, as previously stated, the
specialists were unable to perform the surgery.
9. In addition to the medical treatment he received,
Inmate Santiesteban’s subjective complaints of
pain were appropriately managed. He was
primarily given Naproxen for his pain
management, but when he let staff know the
Naproxen was not effective, he was provided a
different medication to alleviate his pain.
10. Although the surgery did not occur as quickly as
Inmate Santiesteban wanted, a successful surgical
intervention was performed. There is no
documented medical evidence indicating that
medical staff ignored his medical needs or that they
intentionally or unnecessarily delayed his surgery.
The medical records indicate that Inmate
Santiesteban made a full recovery following
surgery to repair his left triceps and follow-up
physical therapy.
11. The URC is chaired by the Clinical Director and all
final medical decisions are approved by the Clinical
Director. In this instance, the URC approved
Inmate Santiesteban’s visits to the outside
specialists and requested his transfer to FMC
Butner. Each of these actions were done in
accordance with approved policies and procedures.
Doc. 49-3 at 1-3.
The final Declaration submitted by Defendants is the Declaration of
Captain Damien Avery, DPT, OCS. He avers as follows:
1. I am currently employed by the United States
Government, Federal Bureau of Prisons, as a
Physical Therapist Orthopedic Specialist at the
Federal Medical Center (FMC) Butner, in Butner,
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North Carolina. As a Physical Therapist
Orthopedic Specialist, my responsibilities include
assisting the orthopedic surgeon in managing case
load, providing patient care, and acting as liaison
between rehabilitation & orthopedics. I have been
employed by BOP since 1998 as a physical
therapist, with the exception of 2003-2005, when I
attended seminary school. I worked at FMC
Carswell, Texas from 1998-2003, FMC Butner for
almost the remainder of my current employment
with BOP; from March 2007 to September 2008, I
left FMC Butner briefly to open a physical therapy
clinic at the Federal Correctional Center- Tucson.
2. I have a master’s and a doctorate from the US
Army-Baylor University Program for Physical
Therapy, awarded in 1998 & 2007 respectively. I
am board certified in orthopedic physical therapy
since 2002.
3. As part of my duties, I have access to documents
and electronic data created and/or maintained by
the Federal Bureau of Prisons. These records are
made at or near the time of the occurrence of the
matters set forth by, or from information
transmitted by, a person with knowledge of the
relevant matters.
4. Inmate Darvis Santiesteban, Registration Number
34129-379, arrived at FMC Butner on August 2,
2016. As part of the orthopedic medical team, I
personally participated in Inmate Santiesteban’s
medical care and am familiar with the treatment
provided. I saw him on a regular basis prior to the
February 27, 2017 surgery of his left triceps and
followed him after the surgery to ensure he followed
medical recommendations and was progressing in
his recovery. I have also re-reviewed Inmate
Santiesteban’s medical records with specific regard
to the medical treatment provided with respect to
his left triceps at Butner FMC.
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5. The medical staff monitored Inmate Santiesteban’s
condition from the time of his arrival until the date
of his scheduled surgery. He was provided pain
medication when requested and medically
necessary.
6. FMC initially scheduled his left triceps surgery for
December 5, 2016. [Plaintiff] initially presented
with a complex picture not entirely consistent with
a simple tricep tendon rupture. Consequently,
repeat plain films, MRI, nerve conduction studies,
and a second opinion from a Hand Surgeon were
necessary before surgical scheduling could be
completed. The surgery then had to be postponed
when the Inmate was placed in the Special Housing
Unit after he was involved in an altercation with
another inmate on November 30, 2016.
7. His surgery was rescheduled for February 27, 2017,
and performed with no complications.
8. Inmate Santiesteban’s post operation care
consisted of regular follow-up appointments with
the orthopedic team (one physician, two physician
assistants & one physical therapist), and
physical/occupational therapy appointments in
order to improve the overall functionality and
strength of the left arm.
9. Medical records indicate Inmate Santiesteban
received timely and appropriate medical care to
include pain medication for pain management. His
records indicate that he was a participant in these
medical decisions as he specifically requested to
discontinue narcotics for pain management, and
instead was provided Tylenol to manage his pain.
10. His cast was removed on April 14, 2017, and his
physical/occupational therapy appointments were
scheduled.
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11. His recovery plan consisted of the initial casting,
then splinting of his surgically repaired arm. Once
the cast was removed he started his physical
therapy program. This program consisted of
progressive range of motion exercises (passive,
active and active assisted), strengthening exercises
(isometric and isotonic resistive), and stretching
with heat.
12. Inmate Santiesteban’s medical records reveal that
on May 26, 2017, during an orthopedic follow-up, he
reported to the orthopedic surgeon that he was not
feeling any pain and he was not experiencing any
problems.
13. Medical records indicate that approximately a
month later on June 30, 2017, he informed clinical
staff that he did not have any functional limitations
and demonstrated for staff that he had strength in
his arm by doing body weight exercises with no
pain. He asked staff if he could have stronger
therabands to continue to strengthen his arm.
14. Inmate Santiesteban successfully completed his
physical therapy for []his left triceps. He was able
to achieve, what can be best described as, a full
recovery. He has attained full function of his arm
with no deficits in his range of motion, no pain, no
lack of functionality; and no deficits in strength.
15. Any delay alleged in Inmate Santiesteban’s surgery
on his left triceps did not have an effect on the
result of the surgery and did not impair the
successful recovery of functionality and strength in
Inmate Santiesteban’s arm. Additionally, Inmate
Santiesteban has stated he was so pleased with the
surgery and recovery that he requested to have
surgery of his right elbow and right knee.
Doc. 49-4 at 2-4.
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In Plaintiff’s response, he asserts that he “communicated with both
Defendants Ocasio and Montalvo by email and in person, during mainline.” Doc.
52 at 2. He claims that “[a]ll electronic messages sent to Health Services go to
the AHSA,” which at the relevant time was Defendant Montalvo. Id. He further
states he “communicated with Defendant Ocasio on several occasions, by email
or in person, regarding his medically necessi[t]ated transfer and his severe
pain.” Id. He additionally asserts that “[t]he delay in receiving medically
necessi[t]ated surgery and the severe pain Plaintiff suffered caused him to
suffer severe depression and was seen by Psychology Services.” Id. at 3. He
argues that because he brought his concerns regarding the lack of adequate
medical treatment to Defendants’ attention, they were under a “duty to
investigate and/or ensure Plaintiff was receiving mandated adequate medical
care.” Id. at 9; see id. at 10-11.
Moreover, Plaintiff attacks the authenticity and accuracy of some of the
documents submitted in support of Defendants’ position, and he claims that
Defendants may have violated his right to privacy by filing medical records that
are not relevant to the issues in this case. See Doc. 52 at 3, 4, 5-8.7 Plaintiff
One document Plaintiff takes issue with is a Utilization Consult Review Case
Review Decision dated December 7, 2015. One copy shows that his request for
an elbow and shoulder surgeon was approved (Doc. 52 at 25) while another copy
has a handwritten note saying “error” and “referred to Region. New letter
resent” (id. at 26). It appears that the first copy was sent in error, and the second
7
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requests entry of summary judgment in his favor, but also “renew[s] his request
for appointment of counsel.” Id. at 13.8
V.
Analysis
“To prevail on [a] § 1983 claim for inadequate medical treatment, [the
plaintiff] must show (1) a serious medical need; (2) the health care providers’
deliberate indifference to that need; and (3) causation between the health care
providers’ indifference and [the plaintiff’s] injury.” Nam Dang by & through
Vina Dang v. Sheriff, Seminole Cty. Fla., 871 F.3d 1272, 1279 (11th Cir. 2017)
(citation omitted).
A serious medical need is one that has been diagnosed
by a physician as mandating treatment or one that is
so obvious that even a lay person would easily
recognize the necessity for a doctor’s attention. In the
alternative, a serious medical need is determined by
whether a delay in treating the need worsens the
condition. In either case, the medical need must be one
that, if left unattended, poses a substantial risk of
serious harm.
Mann v. Taser Int’l, Inc., 588 F.3d 1291, 1307 (11th Cir. 2009) (quotations and
citation omitted).
copy marked “error” was resent to Plaintiff. Regardless, this does not make a
distinction in the Court’s analysis.
Plaintiff’s request for counsel is denied. See Order (Doc. 53) (denying Plaintiff’s
request for counsel for the same reasons previously stated in Docs. 22, 47).
8
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Deliberate indifference to a serious medical need requires “three
components: (1) subjective knowledge of a risk of serious harm; (2) disregard of
that risk; (3) by conduct that is more than mere negligence.” Farrow v. West,
320 F.3d 1235, 1245 (11th Cir. 2003) (citations omitted); see Patel v. Lanier Cty.
Georgia, No. 19-11253, 2020 WL 4591270, at *9 n.10 (11th Cir. Aug. 11, 2020)
(recognizing “a tension within [Eleventh Circuit] precedent regarding the
minimum standard for culpability under the deliberate-indifference standard,”
as some cases have used “more than gross negligence” while others have used
“more than mere negligence”; finding, however, that it may be “a distinction
without a difference” because “no matter how serious the negligence, conduct
that can’t fairly be characterized as reckless won’t meet the Supreme Court’s
standard” (citations omitted)). “Subjective knowledge of the risk requires that
the defendant be ‘aware of facts from which the inference could be drawn that
a substantial risk of serious harm exists, and he must also draw the inference.’”
Dang, 871 F.3d at 1280 (quoting Caldwell v. Warden, FCI Talladega, 784 F.3d
1090, 1099-1100 (11th Cir. 2014)).
An official disregards a serious risk by more than mere
negligence “when he [or she] knows that an inmate is
in serious need of medical care, but he [or she] fails or
refuses to obtain medical treatment for the inmate.”
Lancaster v. Monroe Cty., Ala., 116 F.3d 1419, 1425
(11th Cir. 1997), overruled on other grounds by
LeFrere v. Quezada, 588 F.3d 1317, 1318 (11th Cir.
2009). Even when medical care is ultimately provided,
a prison official may nonetheless act with deliberate
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indifference by delaying the treatment of serious
medical needs. See Harris v. Coweta Cty., 21 F.3d 388,
393-94 (11th Cir. 1994) (citing Brown v. Hughes, 894
F.2d 1533, 1537-39 (11th Cir. 1990)).[9] Further,
“medical care which is so cursory as to amount to no
treatment at all may amount to deliberate
indifference.” Mandel v. Doe, 888 F.2d 783, 789 (11th
Cir. 1989) (citations omitted). However, medical
treatment violates the Constitution only when it is “so
grossly incompetent, inadequate, or excessive as to
shock the conscience or to be intolerable to
fundamental fairness.” Rogers v. Evans, 792 F.2d
1052, 1058 (11th Cir. 1986) (citation omitted).
Dang, 871 F.3d at 1280. “‘[I]mputed or collective knowledge cannot serve as the
basis for a claim of deliberate indifference. Each individual defendant must be
judged separately and on the basis of what that person kn[ew].’” Id. (quoting
Burnette v. Taylor, 533 F.3d 1325, 1331 (11th Cir. 2008)).
Upon review of the parties’ filings and consideration of the evidence
submitted, the Court finds that, viewing the evidence in the light most favorable
to Plaintiff, Defendants are entitled to entry of summary judgment in their
“Even where medical care is ultimately provided, a prison official may
nonetheless act with deliberate indifference by delaying the treatment of
serious medical needs, even for a period of hours, though the reason for the
delay and the nature of the medical need is relevant in determining what type
of delay is constitutionally intolerable.” McElligott v. Foley, 182 F.3d 1248, 1255
(11th Cir. 1999) (citation omitted). However, “[i]t is also true that when a prison
inmate has received medical care, courts hesitate to find an Eighth Amendment
violation.” Waldrop v. Evans, 871 F.2d 1030, 1035 (11th Cir. 1989) (citing
Hamm v. DeKalb Cty., 774 F.2d 1567, 1575 (11th Cir. 1985)); see Boone v.
Gaxiola, 665 F. App’x 772, 774 (11th Cir. 2016).
9
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favor. It is undisputed that Defendants are not medical professionals and were
not involved in Plaintiff’s medical care or treatment. Even if Plaintiff advised
these Defendants about his issues, they did not have the authority to provide or
govern the type of treatment he received and would have directed him to
medical and/or forwarded his complaints to medical personnel. Indeed, Plaintiff
received the following response to his April 29, 2016, email addressed to the
Warden: “See the Medical Representative at mainline.” Doc. 45 at 30. There is
no evidence suggesting that Defendants were deliberately indifferent.
Moreover, the medical records from Coleman FCC show that Plaintiff was
seen by several health care providers for his injury, his elbow was imaged on
multiple occasions, and he saw two outside specialists for consultations. Less
than two months after Plaintiff sent his April 29, 2016, email to the Warden,
his transfer to Butner FMC was approved.10 When a bed became available,
Plaintiff was transferred to Butner on about July 21, 2016. See Doc. 49-3 at
167.11 His surgery was initially scheduled for December 2016, but Plaintiff got
into an altercation with another inmate and was moved to the Special Housing
Dr. Lopez provides two different dates in his declaration for when Plaintiff’s
transfer was approved. He first states that it was approved on March 2, 2016,
and subsequently avers that bed space was available and Plaintiff’s transfer
was approved on June 10, 2016.
10
Plaintiff was seen at Butner for his “14-day physician evaluation after recent
arrival” from Coleman on August 5, 2016. See Doc. 49-4 at 38.
11
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Unit; thus, his surgery was postponed. See Doc. 49-4 at 7. Although Plaintiff
did not receive the surgery as timely as perhaps he should have, there is no
evidence to suggest that Defendants either personally or through a policy
denied or delayed any medical treatment to Plaintiff. Neither has Plaintiff
presented any “verifying medical evidence” showing that he suffered any
“detrimental effect” as result of the alleged delay. See Hill v. Dekalb Reg’l Youth
Det. Ctr., 40 F.3d 1176, 1188 (11th Cir. 1994), overruled on other grounds by
Hope v. Pelzer, 536 U.S. 730 (2002) (“An inmate who complains that delay in
medical treatment rose to a constitutional violation must place verifying
medical evidence in the record to establish the detrimental effect of delay in
medical treatment to succeed.”). And Defendants cannot be found liable simply
because they hold supervisory positions. Accordingly, it is
ORDERED:
1.
Plaintiff’s Motion for Summary Judgment (Doc. 45) is DENIED.
2.
Defendants’ Cross-Motion for Summary Judgment (Doc. 49) is
GRANTED.
3.
The Clerk shall enter judgment in favor of Defendants Montalvo
and Ocasio and against Plaintiff, terminate any pending motions, and close the
file.
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4.
As to Plaintiff’s concerns about his medical records, should he seek
to have any of the records filed under seal, he may file a motion in accordance
with this Court’s Local Rule 1.09.
DONE AND ORDERED in Jacksonville, Florida, this 1st day of
September, 2020.
TIMOTHY J. CORRIGAN
United States District Judge
JAX-3 8/31
c:
Darvis Santiesteban
Counsel of record
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