Reck v. Wexford Health Sources, Inc. et al

Filing 6

ORDER REFERRING CASE to Magistrate Judge Donald G. Wilkerson. Signed by Judge Nancy J. Rosenstengel on 2/23/2017. (tjk)

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ILLINOIS
MICHAEL RECK, # M-40413,
Plaintiff,
vs.
WEXFORD HEALTH SOURCES, INC.,
JOHN TROST,
KAREN KNIEPERT,
TONYA SMITH,
PRACTIONER WINTERS,
PRACTIONER SOUTH,
GAIL WALLS,
and UNKNOWN PARTY/JOHN DOE ONE
(Medical Director),
Defendants.

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Case No. 16-cv-1141-NJR

MEMORANDUM AND ORDER
ROSENSTENGEL, District Judge:
Plaintiff, an inmate currently incarcerated at Menard Correctional Center (“Menard”), has
brought this pro se civil rights action pursuant to 42 U.S.C. § 1983. Plaintiff claims that several
prison medical providers were deliberately indifferent to his serious medical condition. The
complaint is now before the Court for a preliminary review pursuant to 28 U.S.C. § 1915A.
Under § 1915A, the Court is required to screen prisoner complaints to filter out nonmeritorious claims. See 28 U.S.C. § 1915A(a). The Court must dismiss any portion of the complaint
that is legally frivolous, malicious, fails to state a claim upon which relief may be granted, or asks for
money damages from a defendant who by law is immune from such relief. 28 U.S.C. § 1915A(b).
An action or claim is frivolous if “it lacks an arguable basis either in law or in fact.” Neitzke
v. Williams, 490 U.S. 319, 325 (1989). Frivolousness is an objective standard that refers to a claim
that “no reasonable person could suppose to have any merit.” Lee v. Clinton, 209 F.3d 1025, 1026-27

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(7th Cir. 2000). An action fails to state a claim upon which relief can be granted if it does not plead
“enough facts to state a claim to relief that is plausible on its face.” Bell Atlantic Corp. v. Twombly,
550 U.S. 544, 570 (2007). The claim of entitlement to relief must cross “the line between possibility
and plausibility.” Id. at 557. Conversely, a complaint is plausible on its face “when the plaintiff
pleads factual content that allows the court to draw the reasonable inference that the defendant is
liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). Although the Court is
obligated to accept factual allegations as true, see Smith v. Peters, 631 F.3d 418, 419 (7th Cir. 2011),
some factual allegations may be so sketchy or implausible that they fail to provide sufficient notice
of a plaintiff’s claim. Brooks v. Ross, 578 F.3d 574, 581 (7th Cir. 2009). Additionally, Courts
“should not accept as adequate abstract recitations of the elements of a cause of action or conclusory
legal statements.” Id. At the same time, however, the factual allegations of a pro se complaint are to
be liberally construed. See Arnett v. Webster, 658 F.3d 742, 751 (7th Cir. 2011); Rodriguez v.
Plymouth Ambulance Serv., 577 F.3d 816, 821 (7th Cir. 2009).
Applying these standards, the Court finds that some of Plaintiff’s claims survive threshold
review under § 1915A.
The Complaint
Plaintiff suffers from Crohn’s disease, a chronic ailment that he states is well-documented in
his medical records. (Doc. 1, p. 23). This condition places him at higher than normal risk for
infections and other complications involving his digestive tract.
On July 10, 2015, Plaintiff submitted the first of many sick call requests seeking medical
attention for significant pain, tenderness, redness, and swelling that started in his scrotum. (Doc. 1, p.
6). On July 14, 2015, he was seen by Kniepert (medical technician) for labs that had been ordered as
part of his annual physical. Plaintiff told her about his painful condition, but she refused to give him
any treatment or pain medication for it.
Plaintiff’s symptoms worsened, to include deep tissue pain, redness, and swelling of his
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perineum, indicative of a cellulitis infection. (Doc. 1, p. 7). Plaintiff submitted two more sick call
requests, but got no response.
On July 28, 2015, Plaintiff saw Kniepert again for additional labs unrelated to his new
symptoms. Again, Kniepert refused to examine Plaintiff or provide any treatment for his painful
condition, and he refused to refer him to the doctor. (Doc. 1, p. 8). Plaintiff’s symptoms continued to
worsen; he submitted two more sick call requests in August. These described inflammation and
severe pain that had spread to his anal area and left buttock, and then the development of a peri-anal
fistula with abscess. (Doc. 1, p. 8). Plaintiff wrote to his counselor about the lack of action on his sick
call requests, but got no response. He next asked his mental health counselor to intervene to get him a
medical appointment, but nothing happened despite her promise to help. (Doc. 1, p. 9).
On September 1, 2015, Plaintiff was bleeding from his anal area. He was brought to see Dr.
Trost, who confirmed that Plaintiff had a fistula. Plaintiff explained that he had a “prolonged past
history” with fistulas and that only surgery would correct the condition because the fistula would not
heal on its own. (Doc. 1, pp. 9-10). Dr. Trost told Plaintiff that he would refer him to a GI specialist
for a colonoscopy, and he would prescribe Humira and antibiotics. Plaintiff received the antibiotics
but not the Humira.
On September 2, 2015, Plaintiff’s fistula burst open, causing extreme pain and profuse
bleeding. He was taken to see Nurse Smith. She gave him gauze and promised she would inform Dr.
Trost and set an appointment, but refused to give Plaintiff any pain medication. (Doc. 1, p. 10).
On September 12, 2015, the fistula burst again, and Plaintiff passed out from the pain. He
submitted a request to see the doctor because the fistula had not responded to the antibiotics.
On September 17, 2015, Plaintiff saw Nurse Smith. She provided gauze but no pain
medication. (Doc. 1, p. 11). Plaintiff’s pain continued, and he developed symptoms of scrotal
tenderness and swelling, as well as multiple abscess eruptions and inflammation on his buttocks
indicative of cellulitis. (Doc. 1, p. 12). The extreme pain made it very hard for Plaintiff to sit or
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move.
On September 23, 2015, Plaintiff spoke to Nurse Winters during medication distribution to
say he feared he had a MRSA infection. Winters told Plaintiff to submit a sick call request. Plaintiff
responded that he had done so multiple times, but only two had been answered. Winters refused to
put in a pass for Plaintiff. The next day (September 24), an officer brought Plaintiff to sick call for
the possible MRSA infection. Nurse South examined Plaintiff. South treated Plaintiff rudely and
made several unprofessional comments. In response to Plaintiff’s complaints of ongoing severe pain,
South told him to “buck up,” and refused to give him any pain medication. (Doc. 1, p. 12).
On October 1, 2015, Plaintiff was awakened by pain and found he was bleeding from his anal
area. On October 2, he saw Dr. Trost and informed him of the past month of ongoing complications
and pain. Dr. Trost prescribed pain medication and antibiotics, and repeated his promise to schedule
Plaintiff for a colonoscopy and GI consultation. (Doc. 1, p. 13).
On October 14, 2015, the fistula burst again. He saw Nurse Smith on October 19, and was
given gauze and topical medications. The fistula burst again on October 23, and Plaintiff noticed a
second fistula forming to the right side of his anus. (Doc. 1, p. 14).
On October 31, both fistulas burst with extensive bleeding. A nurse was summoned, but
Plaintiff got no medical attention. Plaintiff submitted a sick call request. The bleeding continued into
the next day. Plaintiff was told in response to his inquiry that a nurse had deemed his condition “not
an emergency.” (Doc. 1, p. 14).
On November 2, Plaintiff was called to see a nurse (Smith), who said she would ask Dr. Trost
about the status of the colonoscopy and GI specialist referral. Smith refused to examine Plaintiff
despite his complaint of continued bleeding, and she denied pain medication. (Doc. 1, p. 15).
On November 4, 2015, Plaintiff’s bleeding and pain worsened, and he was brought to the
First Aid Unit. He saw Dr. Trost, who told him the colonoscopy and Humira were approved, and he
should “hang in there.” Id. Dr. Trost again prescribed antibiotics and pain medication. The
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colonoscopy was performed on November 6.
On November 13, Plaintiff’s fistula burst again. He submitted a sick call request the next day.
He was not seen in response until November 24, at which time nurse McGlorn (who is not a
defendant) told him not to submit any more sick call requests “unless he experiences blood clots ‘the
size of softballs.’” (Doc. 1, p. 16). She did not treat him or give him any pain medications.
Plaintiff’s fistula(s) burst again on November 26 and December 15, 2015, causing significant
bleeding and pain.
On December 24, 2015, Plaintiff was taken to a GI specialist, who confirmed peri-anal
Crohn’s disease and fistulas. This doctor ordered Humira and colo-rectal surgery for Plaintiff.
Plaintiff again experienced bursting of the fistulas, bleeding, and possible infection into January
2016. (Doc. 1, p. 17).
On January 24, 2016, Plaintiff saw Dr. Butalid (who is not a defendant). This doctor renewed
Plaintiff’s pain medication and confirmed the approval of the Humira and GI surgery. Plaintiff had
still never received Humira despite the fact that Dr. Trost had first prescribed it on September 1,
2015. (Doc. 1, p. 18). Plaintiff started treatment on January 29, 2016, with Cimzia, a medication
similar to Humira.
On February 9, 2016, Plaintiff underwent surgery for the fistula at an outside hospital, where
the abscess was removed. (Doc. 1, pp. 18, 26). After returning to Menard, he was treated with
antibiotics by Dr. Trost on February 15, 2016, when the incision area became infected. Plaintiff was
given daily dressing changes of the surgical site until April 11, 2016, when Menard staff determined
the area had healed. (Doc. 1, pp. 18-19).
Based on these facts, Plaintiff asserts several claims of deliberate indifference for the delays
in providing adequate treatment, failure to timely refer him to a specialist, inadequate staffing and
procedures, and persisting with ineffective treatment. (Doc. 1, pp. 23-30). He seeks injunctive and
declaratory relief, as well as compensatory and punitive damages. (Doc. 1, pp. 32-33).
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Merits Review Pursuant to 28 U.S.C. § 1915A
Based on the allegations of the Complaint, the Court finds it convenient to divide the pro se
action into the four counts set forth below. The parties and the Court will use these designations in all
future pleadings and orders, unless otherwise directed by a judicial officer of this Court. The
designation of these counts does not constitute an opinion as to their merit. Any other claim that is
mentioned in the Complaint but not addressed in this Order should be considered dismissed without
prejudice.
Count 1: Eighth Amendment deliberate indifference claim against Kniepert, Smith,
Winters, and South for refusing to examine or treat Plaintiff’s symptoms, including
his severe pain;
Count 2: Eighth Amendment deliberate indifference claim against Dr. Trost for
delaying his referral of Plaintiff to a GI specialist despite having diagnosed the need
for such referral on September 1, 2015;
Count 3: Eighth Amendment deliberate indifference claim against Wexford Health
Sources, Inc., South, Walls, and John Doe One (Medical Director) for maintaining
deficient staffing, procedures, and a sick call system which caused delays and denials
of treatment for Plaintiff’s serious condition;
Count 4: Eighth Amendment deliberate indifference claim against Dr. Trost, for
continuing to treat Plaintiff with antibiotics for three months, while knowing that
such treatment was ineffective against Plaintiff’s condition.
As explained below, Counts 1, 2, and 3 shall proceed for further review against some of the
defendants. Count 4 shall be dismissed for failure to state a claim upon which relief may be granted.
Deliberate Indifference to a Serious Medical Condition
In order to state a claim for deliberate indifference to a serious medical need, an inmate must
show (1) that he suffered from an objectively serious medical condition; and (2) that the defendant
was deliberately indifferent to a risk of serious harm from that condition. “Deliberate indifference is
proven by demonstrating that a prison official knows of a substantial risk of harm to an inmate and
either acts or fails to act in disregard of that risk. Delaying treatment may constitute deliberate
indifference if such delay exacerbated the injury or unnecessarily prolonged an inmate’s pain.”
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Gomez v. Randle, 680 F.3d 859, 865 (7th Cir. 2012) (internal citations and quotations omitted). See
also Farmer v. Brennan, 511 U.S. 825, 842 (1994); Perez v. Fenoglio, 792 F.3d 768, 777-78 (7th Cir.
2015). The Eighth Amendment does not give prisoners entitlement to “demand specific care” or “the
best care possible,” but only requires “reasonable measures to meet a substantial risk of serious
harm.” Forbes v. Edgar, 112 F.3d 262, 267 (7th Cir. 1997). Further, a defendant’s inadvertent error,
negligence or even ordinary malpractice is insufficient to rise to the level of an Eighth Amendment
constitutional violation. See Duckworth v. Ahmad, 532 F.3d 675, 679 (7th Cir. 2008).
Here, Plaintiff describes a serious condition with complications that worsened over time, and
which required medical attention. The Complaint thus satisfies the objective component of an Eighth
Amendment claim. The remaining question is whether Plaintiff’s prison medical providers acted or
failed to act with deliberate indifference to a known risk of serious harm.
Count 1 – Kniepert, Smith, Winters, and South
Plaintiff saw Kniepert on two occasions in July 2015 for lab work, and he told her about his
pain and other symptoms. She refused to give him any pain medication or treatment, however, and
would not refer him to a doctor. Plaintiff describes five encounters with nurse Smith from September
to November 2015. She provided Plaintiff with first aid supplies but refused to give him any pain
medication despite his requests. While Nurse Winters was distributing medications on September 23,
Plaintiff asked Winters for help to get medical attention for his symptoms of a possible MRSA
infection, but Winters refused to take any action. Plaintiff was examined by Nurse South on
September 24, 2015. He told South about his ongoing pain, including the recent incident of having
passed out due to the severity of his pain. South refused to give Plaintiff any pain medication.
Plaintiff informed each of these defendants of his symptoms of pain, bleeding, and possible
infection. None of them provided Plaintiff with any treatment or assistance to address these serious
risks, however, with the exception of Smith, who gave Plaintiff gauze and ointment but failed to
address his severe pain. The provision of some medical care does not defeat an Eighth Amendment
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claim, if serious symptoms were ignored, or the prisoner’s pain was allowed to persist untreated. See
Gomez v. Randle, 680 F.3d 859, 865 (7th Cir. 2012); Edwards v. Snyder, 478 F.3d 827, 832 (7th Cir.
2007).
At this stage, the Complaint has articulated a deliberate indifference claim against Kniepert,
Smith, Winters, and South that survives threshold review under § 1915A. Count 1 shall proceed
against these defendants.
Count 2 – Delay in Referral to Specialist – Trost
Dr. Trost diagnosed Plaintiff’s fistula on September 1, 2015, and informed him that a
specialist consultation was needed. But Trost did not take action on the referral until a month later.
Plaintiff was not taken to see the GI specialist until December 24, 2015, nearly four months after
Trost told Plaintiff that he would be referred. The surgical consult did not take place until a month
later, and Plaintiff finally had surgery on February 9, 2016. During these months of delay, Plaintiff
continued to suffer pain, bleeding, and deterioration of his condition.
A deliberate indifference claim may be stated against a prison doctor who delays an inmate’s
referral for specialty care once the need for such care is diagnosed. See Perez v. Fenoglio, 792 F.3d
768, 778-79 (7th Cir. 2015) (Eighth Amendment claim was stated where prisoner’s injury was
serious and painful, and defendant’s delay in making referral to specialist prolonged his suffering);
McGowan v. Hulick, 612 F.3d 636, 640 (7th Cir. 2010). The Complaint indicates that Dr. Trost’s
inaction may have caused unconstitutional delay in Plaintiff’s treatment. Count 2 against Dr. Trost
also shall proceed for further review.
Count 3 – Deficiencies in Staffing, Procedures, and Policy
Defendant Wexford Health Sources, Inc. (“Wexford”) is a corporation that employs the
individual health care provider defendants including South, Walls, and the John Doe One Medical
Director. Wexford provides medical care at the prison, however, it cannot be held liable solely on
that basis. A corporation can be held liable for deliberate indifference only if it had a policy or
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practice that caused the alleged violation of a constitutional right. Woodward v. Corr. Med. Serv. of
Ill., Inc., 368 F.3d 917, 927 (7th Cir. 2004). See also Jackson v. Ill. Medi-Car, Inc., 300 F.3d 760,
766 n.6 (7th Cir. 2002) (private corporation is treated as though it were a municipal entity in a § 1983
action).
Here, Plaintiff’s recitation of the facts indicates that the delays he experienced in obtaining
medical appointments in response to his sick call requests, and the delay in securing appropriate
treatment once he saw the initial provider (see Counts 1 and 2) resulted at least in part from the
official policies espoused by Defendant Wexford. He specifically points to Wexford’s sick call
procedures and its failure to maintain adequate staffing and/or properly trained staff. Plaintiff made
numerous attempts to obtain care through the sick call system and by personal request to medical
staff beginning on July 10, 2015, but no medical professional would examine him until nearly two
months later, when his condition worsened to the point that a fistula burst. Further delays ensued
while Plaintiff waited for Dr. Trost to initiate the process to seek a specialist referral, and then for
that referral to be approved. Taking these facts as true, Plaintiff’s claim against Defendant Wexford
in Count 3 cannot be dismissed at this stage.
Plaintiff’s inclusion in Count 3 of South, Walls, and the John Doe Medical Director,
however, is not warranted. Plaintiff alleges that he suffered humiliation because of South’s
unprofessional comments during his sick call visit. Such remarks do not constitute deliberate
indifference, and Plaintiff does not allege that South’s conduct was caused by a Wexford policy. To
the contrary, he claims that South violated a policy of Wexford’s. Accordingly, South’s offensive
remarks do not support a claim against South or Wexford, and this portion of the claim shall be
dismissed.
As for Walls (Health Care Administrator) and the John Doe Medical Director, Plaintiff does
not describe any personal involvement of these individuals in the failure to provide him with
treatment for his condition, the failure to respond to his sick call requests, or the delays in referring
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him to outside specialists. In order to be held liable in a civil rights action, a defendant must have
been “personally responsible for the deprivation of a constitutional right.” Sanville v. McCaughtry,
266 F.3d 724, 740 (7th Cir. 2001) (citations omitted). Likewise, the doctrine of respondeat superior
(supervisory liability) is not applicable to § 1983 actions. Id. Plaintiff rests his claims against Walls
and the Medical Director on the allegation that they were aware of deficiencies in the sick call system
and other “medical processes” at Menard, yet failed to correct those deficiencies. (Doc. 1, p. 28).
Even if this allegation is true, it does not state a claim of constitutional dimension against these
defendants; instead, it suggests possible negligence on their part. Negligence does not violate the
Constitution. See Estelle v. Gamble, 429 U.S. 97, 106 (1976); Sanville v. McCaughtry, 266 F.3d 724,
734 (7th Cir. 2001).
For these reasons, Plaintiff fails to state a claim upon which relief may be granted against
South, Walls, or the John Doe Medical Director in Count 3. Count 3 shall proceed only against
Wexford.
Dismissal of Count 4 – Continuing Ineffective Treatment – Trost
Finally, Plaintiff asserts a separate claim against Dr. Trost, based on Trost’s use of antibiotics
(Levaquin) to treat Plaintiff’s peri-anal abscess and fistula. Trost first prescribed a 14-day course of
this antibiotic on September 1, 2015. Trost prescribed a second course of the medication on October
1, 2015, and a third dose on November 4, 2015. During this time, Plaintiff’s condition not only failed
to improve, but became significantly worse. Plaintiff put Trost on notice of his deteriorating
symptoms through his sick call requests and visits. Nonetheless, Trost continued the ineffective
antibiotic treatment for three months. Plaintiff includes references to medical articles noting that anal
abscesses are not usually curable with antibiotics, and that most anal fistulas require surgical
treatment. Plaintiff ultimately had this surgery, but only after much delay (See Count 2).
The mere fact that Dr. Trost prescribed a treatment that proved ineffective does not state a
claim. See Duckworth v. Ahmad, 532 F.3d 675, 680 (7th Cir. 2008). A deliberate indifference claim
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may arise, however, if a doctor continues an ineffective treatment plan despite knowing that it is
ineffective. See Edwards v. Snyder, 478 F.3d 827, 832 (7th Cir. 2007) (treatment that was “‘so
blatantly inappropriate as to evidence intentional mistreatment likely to seriously aggravate’ a
medical condition” may support deliberate indifference claim); Greeno v. Daley, 414 F.3d 645, 655
(7th Cir. 2005) (doctor continued ineffective treatment and refused to order endoscopy or specialist
referral over a two-year period during which plaintiff suffered from ulcer); Kelley v. McGinnis, 899
F.2d 612, 616-17 (7th Cir. 1990) (inmate may prevail if he can prove that defendant “deliberately
gave him a certain kind of treatment knowing that it was ineffective” (citing Estelle v. Gamble, 429
U.S. 97, 104 n.10 (1976)). The decision to continue the allegedly ineffective treatment must be “so
significant a departure from accepted professional standards or practices that it calls into question
whether the doctor actually was exercising his professional judgment.” Pyles v. Fahim, 771 F.3d 403,
409 (7th Cir. 2014).
Considering all the facts Plaintiff presents regarding Dr. Trost’s treatment plan and his
announced intention to refer Plaintiff to a specialist for care, the decision to give Plaintiff three
courses of antibiotics does not suggest that Trost failed to exercise professional judgment. Nor does
Trost’s use of antibiotics appear to be “blatantly inappropriate” in the context of his plan to send
Plaintiff to an outside specialist. The delay in that referral is the subject of Count 2 in this action and
shall be duly considered. But Plaintiff’s assertion of a separate constitutional violation based on the
ineffectiveness of the antibiotics prescribed by Trost over a 3-month period does not rise to the level
of deliberate indifference to a serious medical condition. Count 4 against Dr. Trost shall be
dismissed without prejudice.
Disposition
COUNT 4 is DISMISSED without prejudice for failure to state a claim upon which relief
may be granted. WALLS and UNKNOWN PARTY JOHN DOE ONE (Medical Director) are
DISMISSED from this action without prejudice for failure to state a claim against them upon which
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relief may be granted.
The Clerk of Court shall prepare for WEXFORD HEALTH SOURCES, INC., TROST,
KNIEPERT, SMITH, WINTERS, and SOUTH: (1) Form 5 (Notice of a Lawsuit and Request to
Waive Service of a Summons), and (2) Form 6 (Waiver of Service of Summons). The Clerk is
DIRECTED to mail these forms, a copy of the complaint, and this Memorandum and Order to each
defendant’s place of employment as identified by Plaintiff. If a defendant fails to sign and return the
Waiver of Service of Summons (Form 6) to the Clerk within 30 days from the date the forms were
sent, the Clerk shall take appropriate steps to effect formal service on that defendant, and the Court
will require that defendant to pay the full costs of formal service, to the extent authorized by the
Federal Rules of Civil Procedure.
With respect to a defendant who no longer can be found at the work address provided by
Plaintiff, the employer shall furnish the Clerk with the defendant’s current work address, or, if not
known, the defendant’s last-known address. This information shall be used only for sending the
forms as directed above or for formally effecting service. Any documentation of the address shall be
retained only by the Clerk. Address information shall not be maintained in the court file or disclosed
by the Clerk.
Plaintiff shall serve upon each defendant (or upon defense counsel once an appearance is
entered), a copy of every pleading or other document submitted for consideration by the Court.
Plaintiff shall include with the original paper to be filed a certificate stating the date on which a true
and correct copy of the document was served on defendants or counsel. Any paper received by a
district judge or magistrate judge that has not been filed with the Clerk or that fails to include a
certificate of service will be disregarded by the Court.
Defendants are ORDERED to timely file an appropriate responsive pleading to the
complaint and shall not waive filing a reply pursuant to 42 U.S.C. § 1997e(g).
Pursuant to Local Rule 72.1(a)(2), this action is REFERRED to United States Magistrate
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Judge Donald G. Wilkerson for further pre-trial proceedings.
Further, this entire matter shall be REFERRED to United States Magistrate Judge Wilkerson
for disposition, pursuant to Local Rule 72.2(b)(2) and 28 U.S.C. § 636(c), if all parties consent to
such a referral.
If judgment is rendered against Plaintiff, and the judgment includes the payment of costs
under § 1915, Plaintiff will be required to pay the full amount of the costs, notwithstanding that his
application to proceed in forma pauperis has been granted. See 28 U.S.C. § 1915(f)(2)(A).
Finally, Plaintiff is ADVISED that he is under a continuing obligation to keep the Clerk of
Court and each opposing party informed of any change in his address; the Court will not
independently investigate his whereabouts. This shall be done in writing and not later than 7 days
after a transfer or other change in address occurs. Failure to comply with this order will cause a delay
in the transmission of court documents and may result in dismissal of this action for want of
prosecution. See FED. R. CIV. P. 41(b).
IT IS SO ORDERED.
DATED: February 23, 2017

___________________________
NANCY J. ROSENSTENGEL
United States District Judge

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