Coleman v. Stolworthy et al
Filing
106
MEMORANDUM Opinion and Order signed by the Honorable Edmond E. Chang. For the reasons stated in the Opinion, Defendant's motion 82 for summary judgment is granted. The case is dismissed with prejudice. A separate AO-450 judgment shall be enter ed. Status hearing of 04/02/2020 is vacated. Civil case terminated. The Court expresses its deep gratitude to Plaintiff's recruited counsel, who all put substantial effort into representing an indigent client in the best traditions of the profession. Mailed notice (mw, )
UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION
MICHAEL COLEMAN,
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Plaintiff,
v.
ESTATE OF SALEH OBAISI,
Defendant.
No. 16-cv-04917
Judge Edmond E. Chang
MEMORANDUM OPINION AND ORDER
Michael Coleman brings this civil-rights lawsuit against Saleh Obaisi, the
former Medical Director at Stateville Correctional Center, for allegedly violating
Coleman’s right against cruel and unusual punishment under the Eighth
Amendment.1 R. 31, Am. Compl.2 According to Coleman, Dr. Obaisi was deliberately
indifferent toward Coleman’s chronic pain issues when Coleman was incarcerated at
Stateville.3 Obaisi has now moved for summary judgment. R. 82. For the reasons
explained below, the motion is granted.
I. Background
The facts narrated here are undisputed unless otherwise noted. Coleman has
been incarcerated at Stateville Correctional Center since 2003. R. 84, DSOF ¶ 1.4 In
Court has subject matter jurisdiction over the case under 28 U.S.C. § 1331.
2Citations to the record are noted as “R.” followed by the docket number.
3After Obaisi’s death in December 2017, the Court granted Coleman’s motion to
substitute Ghaliah Obaisi, Independent Executor of the Estate of Dr. Saleh Obaisi, in lieu of
Obaisi himself. R. 62. But for purposes of this motion, the Opinion will continue to refer to
the Defendant as Dr. Obaisi or Obaisi.
4Citations to the parties’ Local Rule 56.1 Statements of Fact are as follows: “DSOF”
for Obaisi’s Statement of Facts [R. 84], “Pl. Resp. DSOF” for Coleman’s response to Obaisi’s
1This
2011, shortly before the events of this case, Coleman fell down a set of stairs while he
was using a crutch.5 Id. ¶ 9. As a result of the fall, Coleman began experiencing pain
in his right knee. Id. With that knee injury, so began more than six years of pain and
near-countless medical appointments with both Dr. Obaisi as well as various
orthopedic specialists. A rough timeline of those visits follows.
The first time Coleman met Dr. Obaisi was in August 2012, shortly after Obaisi
had become the Medical Director at Stateville. DSOF ¶¶ 2, 9. During that initial visit,
Coleman complained about pain in his right knee stemming from the 2011 fall. Id. ¶
9. In response, Obaisi reviewed Coleman’s medical history, including a December
2011 MRI record of Coleman’s right knee, which showed that the fall had not resulted
in any ligament tear. Id. Obaisi also performed his own physical examination of
Coleman’s right knee. Id. At the end of the visit, Obaisi diagnosed Coleman with a
chronic knee sprain and prescribed him a non-steroidal anti-inflammatory drug
(often referred to as an “NSAID” in medical jargon) called Naprosyn to address the
pain. Id. Obaisi also renewed Coleman’s medical permits for a low bunk, low gallery,
crutch, and right knee brace. Id.
The next month, in September 2012, Coleman saw Dr. Obaisi again for a
follow-up visit. DSOF ¶ 11. This time, Coleman complained of pain in his lower back
as well as pain in his right knee. Id. After performing a physical examination, Obaisi
Statement of Facts [R. 93], “PSOF” for Coleman’s Statement of Additional Facts [R. 91], and
“Def. Resp. PSOF” for Obaisi’s response to Coleman’s Statement of Additional Facts [R. 95].
5Coleman was using a crutch because he had undergone knee surgery at the
University of Illinois at Chicago Medical Center in December 2010. DSOF ¶ 8. The procedure
involved a minor shaving of his cartilage, which is not meant to produce pain. Id. At the time
of the surgery and subsequent fall, Dr. Obaisi was not yet employed at Stateville.
2
diagnosed Coleman with chronic bursitis and lower back pain. Id. Obaisi also ordered
an x-ray to be performed on Coleman’s right knee and lumbar spine. Id. The x-ray
results came back showing a “bipartite patella in the left knee and minor
degenerative changes in Plaintiff’s lumbar spine.”6 Id. It is undisputed that a
“bipartite patella is a normal, painless anatomical variant” that “requires no
treatment.” Id. Degenerative changes in the lower back are also quite common. Id. At
this point, Obaisi offered Coleman a steroid injection for his right knee, but Coleman
refused. Id.
Coleman returned for a third visit with Dr. Obaisi in December 2012. DSOF
¶ 13; R. 92, Pl. Resp. DSOF ¶ 13. During this appointment, Obaisi diagnosed Coleman
with chronic right knee pain and advised him to follow-up on an as-needed basis.
DSOF ¶ 13. A few months later, in April 2013, Coleman saw Obaisi again, and
Coleman again complained of right knee pain and low back pain. Id. ¶ 14. This time,
Obaisi gave Coleman a prescription for Motrin (another NSAID) for his low back pain.
Id. Obaisi also told Coleman that he would be referred for an orthopedic evaluation
for his right knee pain. Id.
Then, in July 2013, Coleman met with a different physician at Stateville
named Dr. Ann Davis. DSOF ¶ 15. Coleman presented the same complaints about
back pain, so Davis administered him an injection of Toradol (an NSAID) and also
“left” knee appears to be a typo by the parties. Coleman’s patient chart clearly
states that the x-ray was taken of the “R Knee,” meaning right knee, and also shows that the
bipartite patella was in the right knee. Coleman Medical Records at 8.
6The
3
prescribed Prednisone (a steroid used to reduce pain and inflammation) and
Naproxen (another NSAID). Id.
A few days after the visit with Dr. Davis, Coleman had an offsite orthopedic
consultation with Dr. Samuel Chmell at the University of Illinois at Chicago Medical
Center. DSOF ¶¶ 8, 16. At the consultation, Chmell reviewed Coleman’s latest MRI
results (that Obaisi also had reviewed in August 2012), “which revealed no new
abnormalities.” Id. ¶ 16. Chmell also performed a physical examination of Coleman’s
right knee and noted “no instability or decrease in range of motion.” Id. Chmell then
administered a steroid injection into Coleman’s right knee and recommended that a
repeat MRI be conducted. Id. In addition, Chmell recommended a follow-up visit in
four to six weeks. PSOF ¶ 16. Specifically, Chmell made a note in Coleman’s patient
chart that “we will follow up with him in about 4-6 weeks’ time after he has obtained
all his imaging.” R. 84-4, DSOF, Exh. 4, Coleman Medical Records at 13-14. In the
meantime, Chmell advised Coleman to “remain on crutches, and to use a knee sleeve,
which is a supportive garment.” DSOF ¶ 16.
A few days after Coleman’s orthopedic consultation with Dr. Chmell, Dr. Obaisi
renewed Coleman’s medical permit for a low gallery, two crutches, and a right knee
brace. DSOF ¶ 17. Obaisi also obtained approval for an MRI of Coleman’s right knee,
as well as approval for a follow-up appointment with Chmell. Id. In addition, Obaisi
prescribed Coleman Mobic (another NSAID) as well as a muscle relaxer called
Robaxin. Id.
4
Coleman eventually underwent the MRI of his right knee in October 2013 at
Presence St. Joseph’s Medical Center. DSOF ¶ 18. It is undisputed that the MRI
revealed “minor post-meniscectomy changes,7 as well as … no unstable fragments.
These types of changes are common, and would have been expected to produce either
minimal, or no knee pain.” Id. Obaisi went over these MRI results with Coleman the
following month, in November 2013. Id. ¶ 19. At that point, Obaisi recommended an
abdominal binder to Coleman for additional support. Id.
Over the next several months, Coleman continued to receive the medications
he had previously been prescribed and was additionally given Meloxicam (yet another
NSAID), Prednisone, and Vicodin (an opioid) for a period of four days. DSOF ¶ 20. In
April 2014, Coleman went to Dr. Obaisi again with the same complaints of knee and
back pain. Id. 22. Obaisi ordered a second abdominal binder for him and also told
Coleman he would refer him for another orthopedic evaluation. Id. That orthopedic
consultation with Chmell was approved in May 2014. Id. ¶ 23.
In June 2014, Coleman again saw Obaisi, but this time he complained of pain
in his right upper thigh and groin area. DSOF ¶ 24. Obaisi performed a physical
examination and diagnosed Coleman with tendonitis of the right groin area. Id. To
reduce pain, Obaisi administered a steroid injection to Coleman’s left thigh.8 Id.
When Coleman returned for a follow-up visit the next month, in July 2014, Obaisi
administered a second steroid injection to Coleman’s right thigh. Id. ¶ 25.
December 2010, Coleman underwent a right knee arthroscopy with a partial
medial meniscectomy. See Coleman Medical Records at 12.
8It is not clear if the parties meant to write “right thigh.” Coleman’s medical records
are not legible on this point, but the DSOF says “left thigh.” DSOF ¶ 24.
7In
5
Coleman saw Dr. Obaisi again a month later, in August 2014. DSOF ¶ 26.
During this visit, Coleman again complained of tenderness in his right groin area. Id.
Obaisi performed a physical examination that revealed “no acute findings.” Id. But
Obaisi still prescribed Coleman another medication, Indocin (an NSAID). Id.
Coleman’s groin pain continued. DSOF ¶ 27. In October 2014, Dr. Obaisi
performed another physical examination of Coleman and diagnosed him with
“tendonitis due to overuse of crutches and body twists.” Id. As a result, Obaisi decided
to discontinue Coleman’s permit for crutches. Id. Obaisi also prescribed Coleman
Tylenol #3, an opioid, for the pain. Id.
Then, in November 2014, three weeks after Dr. Obaisi ordered the
discontinuation of the crutches, Coleman fell down the stairs again. PSOF ¶ 22. It is
undisputed that on the day of the fall, Coleman was not using crutches. Pl. Resp.
DSOF ¶ 29. It appears that somewhere at or near the top of the stairs, Coleman’s
right knee “went out,” he lost his footing, and then he fell down the stairs. Id. As he
was falling, Coleman tried to reach for a stair railing—but it was not there. Id. The
parties dispute what exactly caused the fall—Coleman argues that the lack of
crutches caused him to lose his balance and fall, while Obaisi maintains that it was
the missing railing that caused him to fall. DSOF ¶ 29; Pl. Resp. DSOF ¶ 29.
After the fall, Coleman was transported via stretcher to the internal infirmary
at Stateville, where Obaisi examined him. DSOF ¶ 30. To address Coleman’s back
pain, Obaisi administered an injection of Toradol (an NSAID) and renewed Coleman’s
Tylenol #3 prescription. Id. Obaisi also admitted Coleman to stay in the infirmary for
6
23 hours of observation. Id. The next day, Coleman was discharged from the
infirmary. Id. ¶ 31. According to a nurse’s note in Coleman’s medical records,
Coleman initiated the discharge when he stated that his back felt better, and he really
wanted to go back to his cell, but Coleman denies making such a statement. Id.; Pl.
Resp. DSOF ¶ 31.
Then, in January 2015, Coleman saw Dr. Chmell again, when he went to UIC
Medical Center for an orthopedic evaluation of his right knee, low back, right groin,
and right hip. DSOF ¶ 32. During this consultation, Chmell diagnosed Coleman with
chronic right knee, right hip, and right groin pain. Id. Chmell then recommended an
MRI as well as x-rays of Coleman’s right knee and hip. Id. There is a dispute about
whether the x-rays were ever taken. Obaisi asserts that the x-rays came back
“negative” for hip abnormalities, and the only knee indication was a “bipartite
patella,” which, as explained above, is a normal, painless condition that requires no
treatment. Id. But the record citations provided by Obaisi do not show any x-ray
results. Indeed, Coleman, maintains that x-rays were never taken, although he too
fails to provide any record cites. Pl. Resp. DSOF ¶ 32.
In any event, a few days after the orthopedic consultation, Coleman saw Dr.
Obaisi again. DSOF ¶ 33. Obaisi noted during this visit that Coleman was no longer
experiencing pain in his right groin area. Id. Obaisi also renewed Coleman’s Indocin
prescription and scheduled him for another steroid injection, which took place two
days after the appointment. Id.
7
In May 2015, Coleman returned to UIC to undergo an MRI of his right hip and
right knee. The parties again dispute when exactly the MRI was taken; again, both
parties failed to provide correct record citations. But it looks like Coleman did receive
an MRI in May 2015. Coleman Medical Records at 37. The MRI of the right hip
revealed “a muscular strain involving distal gluteal insertion that was suspected to
be a ‘tear.’” DSOF ¶ 34. The MRI of the right knee showed a “mid-grade chrondral
malacia in the medial compartment.” Id. ¶ 36.
That same month, Coleman had an initial physical therapy evaluation with a
physical therapist named Jose Becerra. Becerra examined Coleman and noted that
Coleman’s complaints of pain were “suspect.” DSOF ¶ 38. Nonetheless, Becerra
recommended that Coleman undergo one or two physical therapy sessions per week
for a period of four to six weeks. Id. It appears that Coleman attended additional
physical therapy sessions on May 20 and May 25, Pl. Resp. DSOF ¶ 39, but then
Coleman missed the next five appointments on May 28, June 2, June 11, June 18,
and June 25, DSOF ¶ 39. Coleman contends that he missed at least one of those
appointments due to a lockdown at the prison. Pl. Resp. DSOF ¶ 39. But in any event,
Becerra chose to discontinue Coleman from physical therapy due to “lack of
attendance.” DSOF ¶ 39.
But Coleman did show up for an appointment with Obaisi in June 2015 to go
over his May 2015 MRI results. DSOF ¶ 40. During that visit, Obaisi prescribed
Indocin (the NSAID) and advised Coleman that he would be referred for another
orthopedic follow-up evaluation. Id.
8
The orthopedic follow-up happened two months later, in August 2015, when
Coleman met with Dr. Chmell again. DSOF ¶ 41. Chmell reviewed Coleman’s most
recent MRIs and performed a physical examination. For Coleman’s knee pain, Chmell
prescribed him Flexiril (a muscle relaxer) and Ibuprofen (an NSAID) and noted that
he should be given the use of a bottom bunk. Id. For the hip pain, however, Chmell
recommended that Coleman see a different orthopedic specialist “to further evaluate
the suspected gluteus medius tear” in the right hip. Id.
Coleman then met with Dr. Obaisi in September 2015 to go over Dr. Chmell’s
evaluation. DSOF ¶ 42. Obaisi prescribed Coleman another muscle relaxer, as well
as Ibuprofen again. Id. Coleman continued to receive medications on at least two
occasions over the next several months. Pl. Resp. DSOF ¶ 42.
The following year, in May 2016, Coleman met with a new orthopedic specialist
at UIC, Dr. Matthew Marcus, for another consultation for his hip and knee pain.
DSOF ¶ 44. During that consultation, Marcus reviewed Coleman’s MRI results,
performed his own physical examination, and concluded that Coleman was suffering
from a “small gluteus medius tear of the right hip.” Id. With regard to Coleman’s right
knee, Marcus noted that “there is some cartilage wear but no meniscal injury.” Id.
Marcus administered another round of steroid injections into Coleman’s right knee
and hip and prescribed him physical therapy. Marcus also recommended that
Coleman obtain x-rays of his right hip, pelvis, and knee and advised scheduling a
follow-up appointment in one year. Id.
9
A few days after this appointment with Dr. Marcus, Coleman met with Dr.
Obaisi to go over Dr. Marcus’s findings. DSOF ¶ 46. Based on Dr. Marcus’s
recommendations, Obaisi referred Coleman to physical therapy again. Id. Obaisi also
ordered x-rays of Coleman’s right knee and hip; those x-rays came back “negative” for
abnormalities in the knee and hip. Id. Coleman concedes that the knee and hip x-rays
were normal, but notes (without any record citation) that the L3, L4, and L5 vertebral
bodies were revealed to be abnormal. Pl. Resp. DSOF ¶ 46. See Coleman Medical
Records at 52.
In September 2016, Coleman returned for a physical therapy session with
Becerra. DSOF ¶ 47. It is undisputed that during this visit, Coleman refused physical
therapy. Id. But the reason for his refusal is disputed. Dr. Obaisi asserts that
Coleman wanted to defer physical therapy until his next orthopedic consultation at
UIC, while Coleman explains that he refused physical therapy because he was in
severe pain. DSOF ¶ 47; Pl. Resp. DSOF ¶ 47.
Finally, in May 2017, Coleman went back to UIC for a one-year-follow-up
evaluation with Dr. Marcus. DSOF ¶ 50. Marcus reviewed Coleman’s x-rays and
conducted a physical examination, then noted: “[W]e do not see anything surgical that
we could offer the patient at this time.” Id. It is undisputed that “minor abnormalities
of the gluteus medius virtually never require surgery,” and in this case, Coleman’s
“abnormality was quite minor on MRI.” Id. Coleman, however, claims that Marcus
did recommend him for nonoperative management of his pain with Dr. El Shami, but
that appointment was never scheduled. Pl. Resp. DSOF ¶ 50.
10
There is no dispute that over the course of these six or so years, Coleman filed
multiple grievances with the prison about lack of medical treatment. PSOF ¶ 12.
II. Summary Judgment Standard
Summary judgment must be granted “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.” Fed. R. Civ. P. 56(a). A genuine issue of material fact exists if “the
evidence is such that a reasonable jury could return a verdict for the nonmoving
party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). In evaluating
summary judgment motions, courts must view the facts and draw reasonable
inferences in the light most favorable to the non-moving party. Scott v. Harris, 550
U.S. 372, 378 (2007). The Court may not weigh conflicting evidence or make
credibility determinations, Omnicare, Inc. v. UnitedHealth Grp., Inc., 629 F.3d 697,
704 (7th Cir. 2011), and must consider only evidence that can “be presented in a form
that would be admissible in evidence.” Fed. R. Civ. P. 56(c)(2). The party seeking
summary judgment has the initial burden of showing that there is no genuine dispute
and that they are entitled to judgment as a matter of law. Carmichael v. Village of
Palatine, 605 F.3d 451, 460 (7th Cir. 2010); see also Celotex Corp. v. Catrett, 477 U.S.
317, 323 (1986); Wheeler v. Lawson, 539 F.3d 629, 634 (7th Cir. 2008). If this burden
is met, the adverse party must then “set forth specific facts showing that there is a
genuine issue for trial.” Anderson, 477 U.S. at 256.
11
III. Analysis
At the summary judgment stage, the Court views the evidence in the light most
favorable to Coleman, the non-moving party. Matsushita Elec. Indus. Co. v. Zenith
Radio Corp., 475 U.S. 574, 587 (1986). Coleman’s allegations can generally be divided
into two categories. First, Coleman argues that he “was subjected to delays that
unnecessarily prolonged and exacerbated his pain.” Pl. Resp. Br. at 4. Specifically,
Coleman points to four alleged delays by Dr. Obaisi that, according to him,
constituted deliberate indifference: (1) the April 2013 delay in securing an orthopedic
consultation for Coleman; (2) the July 2013 delay in securing a follow-up orthopedic
consultation for Coleman; (3) the January 2015 delay in conducting recommended
imaging of Coleman’s leg; and (4) the August 2015 failure to secure a recommended
surgical consultation for him.9 Second, Coleman also points to Dr. Obaisi’s October
2014 decision to take away Coleman’s crutches as another instance of deliberate
indifference. Because the claim about the crutches is not rooted in a theory of delay,
the Opinion will discuss the crutches in a separate section.
Prison doctors violate the Eighth Amendment when they act with “deliberate
indifference to [the] serious medical needs of prisoners.” Estelle v. Gamble, 429 U.S.
97, 104 (1976). In order to prevail on a deliberate indifference claim, a plaintiff must
prove that he suffered from “(1) an objectively serious medical condition to which (2)
To be clear, Coleman does not explicitly list these four instances as examples of
delayed treatment. Rather, his response brief provides general arguments and case citations
relating to deliberate indifference and delay, and then interspersed throughout the brief are
examples of actions by Dr. Obaisi that Coleman takes issue with. These are the four periods
of delay that the Court interpreted as supporting a delayed-treatment claim.
9
12
a state official was deliberately, that is subjectively, indifferent.” Whiting v. Wexford
Health Sources, Inc., 839 F.3d 658, 662 (7th Cir. 2016). In other words, there is both
an objective and subjective element to deliberate indifference claims—the specific
standard is whether the physician intentionally or recklessly disregarded a known,
objectively serious medical condition that poses an excessive risk to an inmate’s
health. Gonzalez v. Feinerman, 663 F.3d 311, 313-14 (7th Cir. 2011). Thus, deliberate
indifference requires more than mere negligence or medical malpractice. Duckworth
v. Ahmad, 532 F.3d 675, 679 (7th Cir. 2008). Even objective recklessness—failing to
act in the face of an unjustifiably high risk that is so obvious that it should be
known—is not enough. Petties v. Carter, 836 F.3d 722, 728 (7th Cir. 2016) (cleaned
up).10 Having said that, subjective recklessness can sometimes be based on an
inference arising from a physician’s treatment decision when the decision is so far
afield of accepted professional standards as to raise the inference that it was not
actually based on a medical judgment. Arnett v. Webster, 658 F.3d 742, 751 (7th Cir.
2011).
To be clear, Dr. Obaisi is not insulated from liability simply because he
provided some degree of treatment, no matter how cursory, to Coleman. So, for
instance, Obaisi does not automatically win on summary judgment simply because
he prescribed medication in response to Coleman’s complaints of pain. Rather, the
inquiry is whether the treatment provided was “adequate in light of the severity of
This Opinion uses (cleaned up) to indicate that internal quotation marks,
alterations, and citations have been omitted from quotations. See Jack Metzler, Cleaning Up
Quotations, 18 Journal of Appellate Practice and Process 143 (2017).
10
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the condition and professional norms.” Perez v. Fenoglio, 792 F.3d 768, 777 (7th Cir.
2015) (emphasis added). As the Seventh Circuit has explained, “deliberate
indifference may occur where a prison official, having knowledge of a significant risk
to inmate health or safety, administers blatantly inappropriate medical treatment,
acts in a manner contrary to the recommendation of specialists, or delays a prisoner's
treatment for non-medical reasons, thereby exacerbating his pain and suffering. Id.
at 777 (cleaned up). Whether the length of delay is “tolerable depends upon the
seriousness of the condition and the ease of providing treatment. [In some cases,]
[e]ven a few days’ delay in addressing a severely painful but readily treatable
condition suffices to state a claim of deliberate indifference.” Smith v. Knox Cty. Jail,
666 F.3d 1037, 1040 (7th Cir. 2012) (cleaned up).
With this framework in mind, the Court will now turn to Coleman’s specific
allegations of deliberate indifference on the part of Dr. Obaisi.
A. Treatment Delays
Coleman argues that he “was subjected to delays that unnecessarily prolonged
and exacerbated his pain.” Pl. Resp. Br. at 4. According to Coleman, his medical
records “are replete with prolonged delays in treatment and follow-up to independent
physician’s recommendations.” Id. at 6. These “delays in referrals coupled with the
prison medical staff’s apparent refusal to schedule follow up visits or consults,” argues
Coleman, “create multiple questions of fact appropriate for jury consideration.” Id.
Coleman’s briefing does not neatly identify the precise treatment delays that he is
challenging as Eighth Amendment violations. Accordingly, the Court will only
14
address the particular instances that Coleman specifically mentions in his briefing.
Based on the Court’s reading of the response brief, that comprises four incidents.
1. April 2013 Orthopedic Consultation
The earliest incident named by Coleman happened in 2013. Specifically,
Coleman notes that Dr. Obaisi recommended that he see an orthopedic specialist for
his knee pain in April 2013. Pl. Resp. Br. at 6 (citing DSOF ¶ 15). But Coleman was
not able to secure an appointment with Dr. Chmell at UIC until July 2013, which
amounted to a three-month delay. Pl. Resp. Br. at 6 (citing DSOF ¶ 16). This delay,
argues Coleman, constituted deliberate indifference to his knee pain by Dr. Obaisi.
As discussed above, there is both an objective and a subjective element to
deliberate-indifference claims. Here, Coleman has failed to put forth any evidence
showing that Dr. Obaisi subjectively disregarded his pain. It is undisputed that,
during Coleman’s April 2013 visit with Obaisi, Coleman complained of both low back
pain and right knee pain. DSOF ¶ 14. During that appointment, Obaisi gave Coleman
a prescription for Motrin (an NSAID). Id. Obaisi also told Coleman that he would be
referred for an orthopedic evaluation to address his right knee pain. Id. But there is
no allegation that Obaisi was personally responsible for the later three-month delay
in securing the specialist consultation. Coleman’s patient chart for the April 2013
visit with Obaisi includes a note by Dr. Obaisi that “R knee [illegible] to be completed
at UIC.” Coleman Medical Records at 10. Coleman does not offer any evidence
showing that Obaisi then delayed putting in an actual request for an orthopedic
consultation. Compare to Jones v. Simek, 193 F.3d 485,491 (7th Cir. 1999) (prison
15
doctor identified nerve damage but did not personally arrange for nerve specialist
consultation until six months later).
From an objective standpoint, too, it is not clear that the three-month delay
exacerbated or prolonged Coleman’s pain (beyond the baseline level of pain associated
with a chronic knee injury). This is evidenced by the fact that, when Coleman actually
met with Dr. Chmell in July 2013, Chmell concluded that there were “no new
abnormalities” in Coleman’s MRI results and “no instability or decrease in range of
motion” based on a physical examination of Coleman’s knee. DSOF ¶ 16. It is
important, too, that Chmell then prescribed essentially the same course of treatment
that Obaisi had been prescribing, with the only exception being that Chmell gave
Coleman a steroid injection during the consultation. Id. This is not like other cases,
for instance, where a delay in treatment led to an exacerbation of an injury that could
have easily been avoided had the delay not happened. See Berry v. Peterman, 604
F.3d 435, 442 (7th Cir. 2010) (finding deliberate indifference where doctor refused to
send prisoner to dentist for tooth decay despite complaints of escalating pain over a
two-month period); Smith, 666 F.3d at 1040 (finding deliberate indifference where
prisoner “bled, vomited, sustained retinal or corneal damage, and endured dizziness
and severe pain for five days as guards merely looked on”); Edwards v. Snyder, 478
F.3d 827, 830 (7th Cir. 2007) (finding deliberate indifference where prison doctor’s
delay in treating dislocated finger due to doctor’s holiday plans caused permanent
disfigurement). The delay between April 2013 and July 2013 does not exhibit
deliberate indifference.
16
2. July 2013 Orthopedic Consultation
Coleman’s next argument is that when he was finally able to meet with Dr.
Chmell in July 2013, Chmell at that time recommended a follow-up visit in four to
six weeks. Pl. Resp. Br. at 6. But that follow-up visit did not occur until October 2013,
which was three months later than recommended.11 Id. Again, though, there is no
evidence that it was Dr. Obaisi who was responsible for the three-month delay in
securing a follow-up consultation. For instance, Coleman’s patient chart reflects that
it was Dr. Chmell who noted that “we will follow up with him in about 4-6 weeks’ time
after he has obtained all his imaging.” Coleman Medical Records at 13-14. Although
not conclusive, this note suggests that the onus might have been on UIC to follow up
with Coleman. In any event, it is undisputed that less than one week after Coleman’s
July 2013 visit with Chmell, Obaisi “obtained approval for the MRI of the right knee
and follow-up appointment with Dr. Chmell.” DSOF ¶ 17. At that time, Obaisi also
renewed Coleman’s medical permit for two crutches and a right knee brace, per
Chmell’s recommendations. Id. There is no explanation for why the specialist visit
took so long to happen after Obaisi “obtained approval” for the follow-up appointment
in July 2013. But in any event, these facts do not support an inference that Obaisi,
with deliberate indifference, delayed Coleman’s follow-up orthopedic consultation in
violation of the Eighth Amendment.
purposes of this discussion, the Court assumes that the October 2013 follow-up
visit refers to Coleman’s October 2013 visit to Presence St. Joseph’s Medical Center, where
he underwent an MRI of his right knee. DSOF ¶ 18.
11For
17
And from an objective standpoint, too, there is no evidence that the threemonth delay unnecessarily prolonged Coleman’s pain. That is, the record shows that
when Coleman actually underwent the MRI in October 2013, the results showed only
“minor post-meniscectomy changes,” which both parties agree “are common, and
would have been expected to produce either minimal, or no knee pain.” DSOF ¶ 18.
So even if Obaisi were somehow responsible for the delay in accomplishing the followup specialist visit, there is no evidence that the delay caused Coleman additional
pain. The July 2013 to October 2013 delay in holding the follow-up visit does not
amount to deliberate indifference.
3. January 2015 Imaging Delay
Moving forward two years, Coleman next notes that “in January 2015, Dr.
Chmell recommended various imaging” of Coleman’s leg, but “the prison staff did not
complete these imaging studies until May 2015. Pl. Resp. Br. at 7. Indeed, Coleman
appears to have filed at least four grievances between when he was told he needed
imaging and when he actually received imaging. PSOF ¶ 17.
Yet again, though, there is no evidence that this delay in securing imaging for
Coleman was caused by Dr. Obaisi, or that the delay exacerbated or prolonged
otherwise avoidable pain. When Coleman finally underwent an MRI in May 2015,
five months after Dr. Chmell’s recommendation, the MRI of the right hip revealed a
suspected muscular tear, while the MRI of the right knee revealed “a mid-grade
chrondral malacia in the medial compartment.” DSOF ¶¶ 34, 36. With regard to the
hip, the defense expert Dr. Prodromos opined that these types of muscular tears
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“virtually never require surgery” and that “certainly Mr. Coleman’s minor
abnormality would not.” R. 84-5, DSOF Exh. 5, Prodromos Report at 7. And with
regard to the knee, Dr. Prodromos noted that the MRI results showed only “ageappropriate wear and tear,” along with the “post-meniscectomy changes of the
meniscus” that had been noted previously. Id. But none of these MRI findings,
explained Dr. Prodromos, would have necessitated surgical intervention of Coleman’s
right knee. Id.
The takeaway here is that despite the five-month delay, the imaging ultimately
does not support an exacerbation or prolonging of Coleman’s pain. Imaging, after all,
is only a diagnostic tool meant to reveal hidden conditions that might require
treatment, so a delay in imaging can be harmful if it delays the ultimate treatment
of a hidden injury. But a delay in imaging for the sake of imaging does not necessarily
mean that an injury has been made worse. It might be a different matter, for instance,
if the MRIs revealed that Coleman had been nursing an extremely serious knee injury
that could have been discovered and treated had there not been a five-month-long
delay in obtaining the imaging. But that is not the case here. Rather, the MRIs merely
confirmed what Dr. Obaisi and Dr. Chmell had previously observed. Indeed, in
response to the May 2015 imaging results, Obaisi prescribed Coleman with Indocin
(an NSAID). DSOF ¶ 40. This is actually less intervention than the course of
treatment prescribed back in January 2015, when the imaging was first
recommended; at that point, Obaisi prescribed Indocin, as well as a steroid injection.
Id. ¶ 33. Of course, there is another important difference between the January
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treatment and the May treatment; in May, Coleman attended at least two physical
therapy sessions with Becerra. But there is no suggestion that the physical therapy
sessions would have been more helpful to Coleman if only he could have started
attending earlier. Coleman does not provide any evidence, for instance, that he would
have felt well enough to attend physical therapy in February or March 2015, as
opposed to in May 2015, when he felt “severe pain” during two of his appointments
and then missed the rest of the scheduled appointments. Pl. Resp. DSOF ¶ 39; DSOF
¶ 39. For these reasons, there was no deliberate indifference in the delay of the
medical imaging.
4. August 2015 Surgical Consultation
Finally, Coleman claims that Dr. Chmell recommended a surgical consultation
for him during his August 2015 visit to UIC. Pl. Resp. Br. at 6. This referral, according
to Coleman, never occurred. Id.
On review of the parties’ Statements of Facts, it appears that during the
August 2015 visit at issue, Dr. Chmell recommended that Coleman be referred for
another orthopedic consultation with a different specialist to further evaluate the
suspected gluteus medius tear in his right hip. DSOF ¶ 41. Indeed, Coleman’s medical
records for the August 2015 consultation with Chmell includes the note: “At this
point, we will refer him to Dr. Marcus for possible arthroscopic intervention.”
Coleman Medical Records at 46. But contrary to Coleman’s contention, the
consultation with Marcus did actually happen, albeit nine months after the initial
recommendation by Chmell. Specifically, Coleman finally met with Dr. Marcus in
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May 2016. At this visit, Marcus confirmed that Coleman had a “small gluteus medius
tear of the right hip.” DSOF ¶ 44. Marcus also noted that Coleman had “some
cartilage wear but no meniscal injury.” Id. In terms of treatment, Marcus
administered steroid injections into Coleman’s right knee and hip, prescribed him
physical therapy, and advised him to follow-up in one year. Id.
Once again, Coleman has not offered any evidence that Dr. Obaisi was
responsible for the nine-month delay in securing an orthopedic consultation with Dr.
Marcus. Indeed, Dr. Chmell’s note in Coleman’s chart says that “we will refer him to
Dr. Marcus.” Coleman Medical Records at 46 (emphasis added). So perhaps there was
an internal delay at UIC, where both Dr. Chmell and Dr. Marcus worked, as opposed
to an intentional or reckless decision to delay the appointment by Dr. Obaisi. In any
event, Coleman offers no evidence attributing the delay to Obaisi. And similarly,
Coleman has not offered any evidence that the delay exacerbated or unnecessarily
prolonged his preexisting pain. Importantly, Dr. Marcus did not immediately
recommend surgical intervention for Coleman when he finally saw him in May 2016.
Instead, Marcus prescribed physical therapy and administered two steroid injections,
which was largely the same course of treatment that Obaisi had previously
administered back in 2015. DSOF ¶¶ 33, 38. Finally, it is notable that Marcus did not
recommend that a follow-up was necessary until one year later, which suggests that
the orthopedic specialists at UIC considered Coleman’s pain as more of a long-term
condition, as opposed to an injury that needed frequent and immediate attention. For
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these reasons, Coleman has failed to provide evidence that Dr. Obaisi delayed his
surgical consultation with deliberate indifference toward Coleman’s pain.
B. Crutches
Coleman also takes issue with Dr. Obaisi’s decision to remove him from
crutches in October 2014. According to Coleman, “Dr. Chmell recommended that Mr.
Coleman use two crutches when walking in the July 2013 appointment, yet Dr. Obaisi
took Mr. Coleman’s crutches away in October 2014.” Pl. Resp. Br. at 7. And then, even
though Coleman “filed an emergency grievance the next day,” Dr. Obaisi did not
return Coleman’s crutches. Id. at 7. Because he did not have crutches, Coleman
argues, he fell down the stairs. Id.
The precise sequence of events is as follows. In November 2014, three weeks
after Obaisi took away Coleman’s crutches, Coleman was heading from his cell (on
the second floor) to the showers (on the first floor) and came across a set of stairs.
DSOF ¶ 29. According to Coleman, he was “holding onto the bars all the way there,”
but when he “tried to scan the steps to go down, [his] right knee went out and [his]
back was in pain.” Pl. Resp. DSOF ¶ 29. He then fell down the steps. When he
attempted to reach for the stair railing, it was not there. Id.
Coleman cites the Seventh Circuit’s decision in McGowan for the proposition
that “[i]f it is true that the length of delay that is tolerable depends on the seriousness
of the condition and the ease of providing treatment, then a jury should be allowed to
decide how serious Mr. Coleman’s condition was and the ease with which the prison
staff could have provided treatment (e.g. failure to provide crutches following Mr.
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Coleman’s emergency grievance on October 23rd, 2014, three weeks before the second
fall).” Pl. Resp. Br. at 5 (referring to McGowan v. Hulick, 612 F.3d 636, 640 (7th Cir.
2010)). But that ignores the context surrounding Dr. Obaisi’s decision.
Under the governing deliberate-indifference standard, the question is not
simply whether crutches were an “easy” treatment, but rather whether Dr. Obaisi
subjectively knew that taking away Coleman’s crutches would cause his right knee to
give out (which then led to Coleman losing his balance and falling down the stairs).
On that question, there is no evidence from which a reasonable jury could find that
Obaisi was aware of any risk of Coleman’s knee giving out in the way that it did. The
record shows that Obaisi had mainly been treating Coleman for knee pain. And in
October 2014 in particular, it is undisputed that Coleman’s pain had extended beyond
just his knee; since July 2014, he had been feeling pain in his right groin area that
Obaisi diagnosed to be tendonitis caused by overuse of crutches. DSOF ¶¶ 24, 27. At
worst, Obaisi’s decision to take away Coleman’s crutches represented a calculated
decision to prioritize Coleman’s tendonitis over his chronic knee pain. And there is no
evidence that Obaisi entirely ignored Coleman’s knee pain; at the same appointment
during which Obaisi took away Coleman’s crutches (to address the right groin pain),
he also prescribed Coleman an opioid pain medication to specifically address the knee
pain. Id. ¶ 24. Ultimately, without a reason to think that Coleman’s knee would
buckle in the way that it did, the decision to take away the crutches does not amount
to deliberate indifference. See McGowan, 612 F.3d at 641 (“But in the end, this
23
dispute is over nothing but the choice of one routine medical procedure versus
another, and that is not enough to state an Eighth Amendment claim.”).
And for what it is worth, it is not clear that crutches objectively make stairs
safer. Dr. Prodromos, for instance, opined that “crutches on stairs are quite dangerous
and are associated with causing falls.” Prodromos Report at 5-6. Not only that, but
Dr. Prodromos doubts whether crutches were even necessary for “typical, age
appropriate, post-surgical knee degenerative changes.” Id. This expert opinion is
echoed in Coleman’s personal experiences. After all, when Coleman originally fell
down the stairs back in 2011, he had been using a crutch. DSOF ¶ 9. Thus, even
viewing the evidence in Coleman’s favor, Dr. Obaisi was not deliberately indifferent
to Coleman’s knee pain when he made the decision to take Coleman off crutches in
October 2014.
IV. Conclusion
The Court does not doubt Coleman’s subjective experiences of chronic pain. But
that is precisely one of the problems here—the pain was chronic. As a result, it is
difficult to pinpoint any individual action or delay by a physician as the precise cause
for the unnecessary and avoidable continuation of pain or the exacerbation of injury.
Indeed, Dr. Obaisi continued to monitor him, prescribe him pain medication, secure
imaging, and send him out for specialist referrals over the course of six years.12 Even
also argued that Coleman’s punitive damages claim should be dismissed.
Def. Br. at 10. Because Coleman did not address this argument in his response brief, the
claim is dismissed for that reason alone. But even if Coleman had addressed it, the punitive
damages claim would still need to be dismissed given that Coleman has failed to survive
summary judgment on the underlying deliberate-indifference claims.
12Defendant
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giving Coleman the benefit of reasonable inferences, a jury cannot find that Obaisi
was deliberately indifference to Coleman’s medical needs. Thus, the motion for
summary judgment is granted, and the Court will enter final judgment. The status
hearing of April 2, 2020 is vacated.
ENTERED:
s/Edmond E. Chang
Honorable Edmond E. Chang
United States District Judge
DATE: March 22, 2020
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