Miller v. Wexford Health Services, Inc. et al

Filing 65

ORDER GRANTING Defendant John Coe's Motion for Summary Judgment (Doc. 52 ). The Clerk of Court is DIRECTED to enter judgment against Plaintiff Harley Miller and in favor of Defendant John Coe. Further, Defendant Coe's Motion to Continue Trial Date (Doc. 63 ) is DENIED as MOOT. Signed by Judge Staci M. Yandle on 5/22/2018. (mah)

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ILLINOIS

HARLEY T. MILLER,
Plaintiff,
vs.
JOHN COE,
Defendant.

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Case No. 16-CV-314-SMY-RJD

MEMORANDUM AND ORDER
YANDLE, District Judge:
Plaintiff Harley Miller, an inmate in the custody of the Illinois Department of Corrections
(“IDOC”), filed this lawsuit pursuant to 42 U.S.C. § 1983, alleging that he was provided
inadequate medical care when he was incarcerated at Lawrence Correctional Center
(“Lawrence”). He proceeds against Defendant Dr. John Coe on a deliberate indifference claim
for his alleged failure to properly diagnose and treat Miller’s complaints of abdominal pain and
rectal bleeding, and concerns regarding a mass on his testicle.
Now pending before the Court is Defendant’s Motion for Summary Judgment (Doc. 52).
Plaintiff filed a response (Doc. 59). 1

For the following reasons, Defendant’s Motion for

Summary Judgment is GRANTED. Insofar as Plaintiff moves to strike Defendant’s undisputed
material facts for non-compliance with Federal Rule of Civil Procedure 56, his request is
DENIED.

1

Defendant filed a reply that will not be considered by the Court due to his failure to comply with the undersigned’s
procedures for filing the same.

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Background
Plaintiff Harley Miller was incarcerated at Lawrence from August 2013 to May 2016
(Second Amended Complaint, Doc. 46, ¶ 13).

In June 2014, Miller began experiencing

abdominal pain and rectal bleeding (Deposition of Harley Miller, Doc. 53-4 at 3). He was seen
at nurse sick call for these complaints on June 17, 2014 (Doc. 53-1 at 1) and was referred to a
doctor or nurse practitioner (Id.).
Miller was examined by Nurse Practitioner Phillipe on June 19, 2014 and diagnosed with
epigastric pain (Deposition of Dr. Coe, Doc. 53-3 at 12-13; Doc. 53-1 at 2). Phillipe prescribed
Zantac and ordered a Complete Blood Count (CBC) and an H. Pylori test (Id.). The H. Pylori
test indicated a borderline infection and Miller was prescribed antibiotics to treat the same (Doc.
53-3 at 14; Doc. 53-1 at 3, 39-40, 43).
Dr. Coe first saw Miller for complaints of rectal bleeding on July 28, 2014 (Doc. 53-3 at
8; Doc. 53-1 at 4). He performed a physical examination and noted tenderness in Miller’s right
lower abdomen and anal canal (Doc. 53-3 at 8-9; Doc. 53-1 at 4). Miller’s stools were black and
his guaiac test (test for blood in the stool) was positive (Id.). Dr. Coe diagnosed Miller with an
upper gastrointestinal (“GI”) bleed and prescribed him Prilosec (Doc. 53-3 at 9; Doc. 53-1 at 4).
Dr. Coe ruled out diverticulitis, hemorrhoids, and rectal polyps as the cause of Miller’s rectal
bleeding due to the color of the blood in his stools (Doc. 53-3 at 10).
Following nurse sick call visits for complaints of abdominal pain and constipation on
August 1, 2014 and August 2, 2014, Miller was placed in the infirmary for observation on Dr.
Coe’s orders (Doc. 53-3 at 17-18; Doc. 53-1 at 5-7). Dr. Coe also gave verbal orders to issue
Milk of Magnesia (a laxative and antacid used to treat constipation), and Norco (an opioid
medication for moderate to severe pain) for Miller (Doc. 53-3 at 18; Doc. 53-1 at 7). Miller had

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a large bowel movement on August 3, 2014 and was released from the infirmary that day (Doc.
53-3 at 19; Doc. 53-1 at 7).
Miller next saw Dr. Coe on August 19, 2014, and again complained of rectal bleeding
and abdominal pain (Doc. 53-3 at 20; Doc. 53-1 at 8). Dr. Coe noted that Miller’s vital signs and
iron levels were normal and that his weight and blood count were stable (Id.). Miller had
minimal rectal pain during his exam and his guaiac was negative (Id.).

Based on his

examination, Dr. Coe suspected Miller had irritable bowel syndrome (“IBS”) and prescribed
Bentyl, 10 milligrams, four times per day for one month (Id.). Dr. Coe did not address Miller’s
complaints of rectal bleeding in light of his negative guaiac test (Id.).
Miller saw Dr. Coe for a follow-up exam on September 19, 2014 (Doc. 53-3 at 21; Doc.
53-1 at 10). Dr. Coe noted that Miller was mistrustful of his medical care (Id.). Miller indicated
that the Bentyl was effective at addressing his pain, but still complained of rectal bleeding (Id.).
Dr. Coe found that he had a palpable mass in his left abdomen that was tender (Id.). He ordered
a CBC, an iron profile, and Complete Metabolic Panel (“CMP”) to determine if there was a drop
in Miller’s blood count or iron level, which would indicate blood loss (Id., Doc. 53-3 at 22). He
also prescribed Bentyl, 10 milligrams, four times per day for six months, and Fiberlax (Doc. 53-3
at 21; Doc. 53-1 at 10).
Miller saw Dr. Coe again on October 15, 2014 for complaints of pain in his left lower
abdomen (Doc. 53-3 at 23; Doc. 53-1 at 11). He reported that his bowel movements were
normal and that the Bentyl was working, but he needed to take more than the prescribed amount
to get relief (Doc. 53-3 at 23; Doc. 53-1 at 11). Dr. Coe noted that the labs ordered the previous
month had not been completed, so he reordered them (Id.). He also increased Miller’s Bentyl to
20 milligrams, three times per day for six months, and ordered an x-ray of Miller’s abdomen
(Id.).

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Dr. Coe followed up with Miller on October 23, 2014 (Doc. 53-3 at 25; Doc. 53-1 at 12).
Miller was experiencing continued pain in his abdomen despite reporting that the Bentyl was
working. Dr. Coe noted a palpable left elongated structure in his lower left quadrant that was
mildly tender when pressed (Id.). He determined that the elongated structure was stool in
Miller’s colon after a review of his abdominal x-ray, and prescribed Enulose (a laxative) to treat
his constipation (Doc. 53-3 at 25; Doc. 53-1 at 14).

Miller’s lab results, including his

hemoglobin level and iron levels, were stable (Doc. 53-3 at 25; Doc. 53-1 at 13).

Dr. Coe again

concluded that Miller suffered from IBS with constipation (Id.).
During a subsequent exam with Dr. Coe on December 16, 2014, Miller requested a
consultation with a GI specialist (Doc. 53-3 at 29; Doc. 53-1 at 17). He was complaining of mild
right abdominal pain with loose stools (Id.). Dr. Coe conducted a physical examination and
again determined that Miller suffered from IBS (Id.). Miller was scheduled to be seen in a
chronic care clinic in February 2015 for a blood draw, and Dr. Coe ordered that he undergo an H.
Pylori, “sed rate”, and iron level test, and a CBC during that visit (Id.).
On February 18, 2015, Miller was seen at nurse sick call for complaints of scrotal pain
(Doc. 53-1 at 18). He indicated that the pain had been present for the last 12 days (Id.). The
nurse noted that Miller’s left testicle was tender and referred him to a doctor (Id.). Per the
nurse’s referral, Miller was seen by Dr. Coe on February 20, 2015 (Doc. 53-3 at 29; Doc. 53-1 at
19). Miller told Dr. Coe that he had suffered testicular pain since October 2014 and “put in
multiple complaints” concerning the same (Id.). Dr. Coe reviewed Miller’s chart and found no
notation of any such complaints, but upon examination, noted that his left epididymis was
slightly swollen and tender (Id.). He diagnosed Miller with epididymitis and prescribed Cipro
(an antibiotic) to be taken for two weeks (Id.).

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During a follow-up visit on February 24, 2015, Dr. Coe performed a genitourinary exam
and observed that there was no more swelling (Doc. 53-3 at 30; Doc. 53-1 at 20). Based on his
exam, Dr. Coe determined that Miller’s epididymitis infection was improving (Id.). He also
reviewed Miller’s recent lab work, the results of which were normal (Id.). Miller alleges that he
still had a testicular mass during this exam (Doc. 53-4 at 16).
Miller continued to complain of testicular pain during follow-up visits with Dr. Coe on
March 5, 2015 and March 12, 2015 (Doc. 53-3 at 30-31; Doc. 53-1 at 21-22).

After

examination, Dr. Coe diagnosed subjective scrotal pain and, on March 12, 2015, placed Miller in
the general medicine clinic for IBS to monitor his condition (Id.).
On May 4, 2015, Miller saw Dr. Coe after he told prison personnel he was bleeding from
his rectum and was not being seen (Doc. 53-3 at 31; Doc. 53-1 at 23). Dr. Coe asked to complete
a rectal exam, but Miller refused (Id.). He ordered blood tests, including a CBC, “sed” rate, and
iron profile (Id.).
Dr. Coe saw Miller again on October 15, 2015 and December 1, 2015 and reiterated his
IBS diagnosis (Doc. 53-3 at 32-34; Doc. 53-1 at 26, 32). During an exam on April 8, 2016
during which Dr. Coe was addressing a self-inflicted wound of Miller’s hand, he continued to
complain of abdominal pain and bloody stools (Doc. 53-3 at 34; Doc. 53-1 at 37). Dr. Coe told
Miller that if he had blood in his stool, he needed to call a security officer so a guaiac test could
be performed (Id.). Dr. Coe again prescribed Enulose (Id.).
Miller was transferred to Pontiac Correctional Center (“Pontiac”) on April 21, 2016 (Doc.
53-1 at 38). After several encounters with medical personnel at Pontiac, Miller was scheduled
for an upper GI endoscopy that was performed on September 30, 2016 (Doc. 53-2 at 6-8). Dr.
Matter, the outside physician who performed the endoscopy, advised Dr. Tilden at Pontiac that
the test revealed mild gastritis, but opined it was not significant enough to explain multiple

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months of melena (blood in the stool) (Id. at 9). Dr. Matter suggested colonoscopy as the next
step to evaluate Miller’s left lower quadrant discomfort and melena (Id.).
Miller underwent a colonoscopy on October 28, 2016 (Doc. 53-3 at 38; Doc. 53-2 at 4-5).
The colonoscopy revealed that Miller suffered from diverticulosis in the rectum and sigmoid.
Dr. Matter recommended that Miller take a fiber supplement (Id.).
On February 7, 2017, Miller underwent a testicular ultrasound (Doc. 53-3 at 40; Doc. 531 at 41). The ultrasound revealed 8 mm cysts within the epididymis adjacent to the inferior poles
on the right and left testes (Id.). In his deposition, Dr. Coe testified that this was not a finding of
testicular cancer and such condition is not documented in Miller’s medical records (Doc. 53-3 at
40). However, Miller testified that Dr. Tilden told him he had testicular cancer on February 2,
2017, before the ultrasound, but did not record this diagnosis in his medical records (Doc. 53-4 at
2-3, 22).
Discussion
Summary judgment is appropriate only if the moving party can demonstrate “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); Celotex Corp. v. Catrett, 477 U.S. 317, 322(1986); see also RuffinThompkins v. Experian Information Solutions, Inc., 422 F.3d 603, 607 (7th Cir. 2005). The
moving party bears the initial burden of demonstrating the lack of any genuine issue of material
fact. Celotex, 477 U.S. at 323. Once a properly supported motion for summary judgment is
made, the adverse party “must set forth specific facts showing there is a genuine issue for trial.”
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 250 (1986). A genuine issue of material fact
exists when “the evidence is such that a reasonable jury could return a verdict for the nonmoving
party.” Estate of Simpson v. Gorbett, 863 F.3d 740, 745 (7th Cir. 2017) (quoting Anderson, 477
U.S. at 248). In considering a summary judgment motion, the district court views the facts in the

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light most favorable to, and draws all reasonable inferences in favor of, the nonmoving party.
Apex Digital, Inc. v. Sears, Roebuck & Co., 735 F.3d 962, 965 (7th Cir. 2013) (citation omitted).
The Eighth Amendment protects inmates from cruel and unusual punishment. U.S.
Const., amend. VIII; see also Berry v. Peterman, 604 F.3d 435 (7th Cir. 2010). As the Supreme
Court has recognized, “deliberate indifference to serious medical needs of prisoners” may
constitute cruel and unusual punishment under the Eighth Amendment. Estelle v. Gamble, 429
U.S. 97, 104 (1976). In order to prevail on such a claim, the plaintiff must first show that his
condition was “objectively, sufficiently serious” and second, that the “prison officials acted with
a sufficiently culpable state of mind.” Greeno v. Daley, 414 F.3d 645, 652-53 (7th Cir. 2005)
(citations and quotation marks omitted).
The following circumstances are indicative of an objectively serious medical condition:
“[t]he existence of an injury that a reasonable doctor or patient would find important and worthy
of comment or treatment; the presence of a medical condition that significantly affects an
individual’s daily activities; or the existence of chronic and substantial pain.” Hayes v. Snyder,
546 F.3d 516, 522-23 (7th Cir. 2008) (quoting Gutierrez v. Peters, 111 F.3d 1364, 1373 (7th Cir.
1997)); see also Foelker v. Outagamie Cnty., 394 F.3d 510, 512-13 (7th Cir. 2005) (“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.”).
An inmate must also show that prison officials acted with a sufficiently culpable state of
mind, namely, deliberate indifference. In other words, the plaintiff must demonstrate that the
officials were “aware of facts from which the inference could be drawn that a substantial risk of
serious harm exists” and that the officials actually drew that inference. Greeno, 414 F.3d at 653.
A plaintiff does not have to prove that his complaints were “literally ignored,” but only that “the
defendants’ responses were so plainly inappropriate as to permit the inference that the defendants

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intentionally or recklessly disregarded his needs.” Hayes, 546 F.3d at 524 (quoting Sherrod v.
Lingle, 223 F.3d 605, 611 (7th Cir. 2000)). Negligence, gross negligence, or even recklessness
as that term is used in tort cases, is not enough. Id. at 653; Shockley v. Jones, 823, F.2d 1068,
1072 (7th Cir. 1987).
Dr. Coe first argues that Miller does not have testicular cancer and he was therefore not
deliberately indifferent in failing to diagnose and treat the same. Miller concedes that no medical
records show a diagnosis of testicular cancer, but maintains that Dr. Tilden told him he had
testicular cancer on February 2, 2017. Assuming Dr. Tilden made such a statement, it was made
before an ultrasound revealed that Miller suffered from epididymal cysts, which, according to
Dr. Coe’s sworn affidavit, are not cancerous. Miller has provided no evidence to rebut Dr. Coe’s
testimony and opinions.
Dr. Coe further argues that even if epididymal cysts constitute a serious medical
condition, he was not deliberately indifferent in treating the same; he diagnosed Miller with
epididymitis in February 2015, and prescribed antibiotics to treat the condition.

Dr. Coe

conducted follow-up examinations that revealed reduced swelling, and noted that Miller only had
subjective complaints of testicular pain.
It is not clear what, if any, treatment was recommended or provided for Miller’s
epididymal cysts at Pontiac. Moreover, it is not apparent from the record that epididymal cysts
qualify as a serious medical need, and Plaintiff makes no argument concerning this issue. On
this evidence, no reasonable jury could conclude that Dr. Coe was deliberately indifferent in
treating Miller’s complaints of testicular pain. Thus, he is entitled to summary judgment on this
issue.

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Miller also contends that Dr. Coe was deliberately indifferent in failing to diagnose his
diverticulosis 2.

In support of this argument, Miller points to Dr. Coe’s failure to order a

colonoscopy and to correctly diagnose his condition despite Miller making repeated complaints
of rectal bleeding and stomach pain for over two years. The record demonstrates that Dr. Coe
regularly examined Miller to address his complaints and ordered various tests, including blood
tests and an x-rays, to continually assess his condition. Based on his assessments, Dr. Coe
diagnosed Miller with IBS and treated him for this condition. Dr. Coe’s treatments included
dispensation of Bentyl for pain, as well as various laxatives and fiber supplements to address
constipation.
Summary judgment in Dr. Coe’s favor is warranted because there is no evidence that he
knew of and disregarded the risk of diverticulosis. Rather, the record supports a finding that Dr.
Coe thoroughly investigated Miller’s complaints and used his medical judgment in arriving at a
diagnosis of IBS.

Miller has not presented evidence from which a reasonable jury could

conclude that Dr. Coe’s treatment or conduct was “so far afield of accepted professional
standards as to raise the inference that it was not actually based on medical judgment.” Norfleet
v. Webster, 439 F.3d 392, 396 (7th Cir. 2006). Although Dr. Coe did not refer Miller to an
outside physician for a colonoscopy, the decision to forego such diagnostic testing is “a classic
example of a matter for medical judgment.” Estelle, 429 U.S. at 107. Finally, the colonoscopy
that was ultimately completed revealed only a diagnosis of diverticulosis, and led to a
recommendation for Miller to use fiber, which he had already been provided on various
occasions by Dr. Coe.

2

Miller incorrectly states that he was diagnosed with diverticulitis throughout his response brief. The record does
not support such diagnosis. Rather, Miller’s colonoscopy indicated “diverticulosis in the rectum and in the sigmoid
colon” (Doc. 53-2 at 4). Miller has not pointed to any evidence challenging this finding or supporting a finding that
he was diagnosed with diverticulitis. As Dr. Coe testified to at his deposition, diverticulosis occurs when an
individual develops pouches in their colon. If these pouches become infected or inflamed, the condition is known as
diverticulitis (Doc. 53-3 at 35).

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Because no reasonable jury could conclude that Dr. Coe’s actions were “blatantly
inappropriate,” he is entitled to summary judgment on Miller’s deliberate indifference claim.
Conclusion
For the reasons stated above, the Motion for Summary Judgment filed by Dr. Coe (Doc.
52) is GRANTED. The Clerk of Court is DIRECTED to enter judgment against Plaintiff
Harley Miller and in favor of Dr. John Coe.

IT IS SO ORDERED.
DATED: May 22, 2018
s/ Staci M. Yandle
STACI M. YANDLE
United States District Judge

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