Holt et al v. Campbell County, Kentucky et al

Filing 248

MEMORANDUM OPINION & ORDER: The motion of the Campbell County defendants for partial summary judgment as to plaintiff, Anthony Holt 133 is GRANTED; (2) the motion of Southern Health Partners for summary judgment asto plaintiff, Anthony Holt 163 is GRANTED AS TO PLAINTIFFS FEDERAL CLAIM; and (3) Plaintiff Anthony Holts state law claims be, and are hereby,DISMISSED WITHOUT PREJUDICE. Signed by Judge William O. Bertelsman on 7/19/2013.(LMB)cc: COR

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF KENTUCKY
NORTHERN DIVISION
AT COVINGTON

CIVIL ACTION NO. 2009-082 (WOB-JGW)
ANTHONY HOLT, ET AL.
VS.

PLAINTIFFS

MEMORANDUM OPINION AND ORDER

CAMPBELL COUNTY, KENTUCKY,
ET AL.

DEFENDANTS

This is an action by former detainees at the Campbell
County Detention Center (CCDC) against the County and
Southern Health Partners (SHP) alleging cruel and unusual
punishment in violation of the 8th and 14th Amendments and
plaintiffs= civil rights under 42 U.S.C. ' 1983.

Plaintiffs

also allege state law claims.
This matter is currently before the Court on the
motion of the Campbell County defendants for partial
summary judgment as to plaintiff, Anthony Holt (Doc. 133),
and the motion of Southern Health Partners for summary
judgment as to plaintiff, Anthony Holt (Doc. 163).
Having reviewed this matter, the Court concludes that
oral argument is unnecessary to the resolution of these
motions.

The Court therefore issues the following

Memorandum Opinion and Order.

Factual and Procedural Background
A.

Facts Common to All Claims

Since February 1, 2007, the CCDC has had a contract
with SHP pursuant to which SHP provides “all professional
medical, mental health, dental and related health care and
administrative services” for CCDC inmates, including sick
call, nursing care, regular and emergency physician care.
(Doc. 132-1).

SHP, in turn, contracts with a physician

and employs nurses to staff the CCDC.

These arrangements

were in place at all times relevant to this action.
Plaintiffs filed this case on June 17, 2009, as a
proposed class action.

(Doc. 1).

On June 1, 2010,

plaintiff filed a Second Amended Class Action Complaint,
which is the operative complaint herein.

(Doc. 38).

Plaintiffs allege that they were denied medical attention
for their serious medical needs in violation of their 8th
and 14th Amendment rights.

(Doc. 38 ¶¶ 331-32).

Plaintiffs

also allege negligent or intentional infliction of
emotional distress, negligence, loss of consortium, and
wrongful death.
On July 9, 2010, this Court denied plaintiffs’ motion
for class certification.

(Doc. 48).

Discovery ensued and,

after numerous extensions, the pending motions for summary
judgment were filed and briefed.
2

B.

Plaintiff Anthony Holt

Plaintiff Anthony Holt (“Holt”) was incarcerated at
the CCDC from April 29, 2008 to February 5, 2009.
Depo. 102).

(Holt

He was forty-three years old at the time he

began this incarceration.

(Doc. 133 Exh. 3).

Holt told the booking officer when admitted to the
CCDC that he had been taking pain medication – Vicodin –
for back pain and might experience withdrawal symptoms.
(Doc. 133 Exh. 2).
blood pressure.

He also indicated that he had high

(Id.).

The next day, SHP nurse Tracy Evans performed a
medical intake screening on Holt.

(Doc. 163 Exh. 2).

Holt

told Evans that he had been taking Vicodin, Zanaflex, and
Flexaril every day for the past two to three years for back
pain.

(Id.).

He also stated that he was currently taking

Lisinopril for hypertension.

(Id.).

The same day, Holt began experiencing vomiting and
diarrhea, and he told CCDC deputies Cummins and Woods and
SHP nurse Amanda Pangallo (“Pangallo”) that he was
experiencing withdrawal.

The record contains a medical

chart that shows that the medical staff immediately began
monitoring Holt’s vital signs and prescribed him three
doses of Vistaril (one each on May 3, 4, and 5) and one
dose of Clonidine (on May 4) to treat his withdrawal
3

symptoms.

(Doc. 133 Exh. 4).

In his deposition, however,

Holt testified that he received no medicine for his
withdrawal symptoms.

(Holt Depo. 123-27).

However,

plaintiff’s expert witness, Dr. Joseph Paris, notes in his
report concerning Holt that, “After intake, detoxification
of alcohol/opiates took place.”

(Doc. 133 Exh. 65 at 6).

In any event, Holt testified that his withdrawal
symptoms went away by May 6 or 7.

(Holt Depo. 118).

Holt testified that soon after he got to the CCDC,
still in April 2008, he fell on a floor that was slick from
being waxed and injured his hip.

(Holt Depo. 143).

On May 11, 2008, Holt submitted a medical request form
complaining of chronic lower back and hip pain due to
having had two discs removed and a sciatic nerve cut during
a surgery prior to his incarceration.

(Doc. 163 Exh. 4).

Holt also complained that he had not received any blood
pressure medicine.

(Id.).

On May 15, 2008, Pangallo saw Holt, who indicated that
his chronic back and hip pain had begun one and a half
years earlier after back surgery.

(Doc. 163 Exh. 5).

Pangallo prescribed Holt a fourteen-day course of
Percogesic for his pain, and she took his blood pressure,
which measured 125/86.

(Id.).

On May 19, May 25, and May 28, Holt again complained
4

about pain in his back and legs due to his past operation,
stating that the pain medicine he was taking was not
working.

(Doc. 163 Exhs. 6, 7, 8).

On June 3, Pangallo

again saw Holt and changed his medicine to a thirty-day
course of Naproxen to treat his pain.

(Doc. 163 Exh. 9).

She also took Holt’s blood pressure, which measured 123/89.
(Id.).
Holt next filed medical requests on July 3, 7, 8 and 9
complaining of back, hip and leg pain, again attributing
the pain to his prior back surgery.

(Doc. 163 Exh. 10).

Holt was examined by a SHP nurse on July 11, and she
prescribed him a thirty-day course of Percogesic for his
pain.

(Doc. 163 Exh. 11).

The nurse also took Holt’s

blood pressure, which measured 120/80.

(Id.).

On July 9, 2008, Holt signed a medical records release
so that SHP could obtain his pharmacy records from WalMart.

(Doc. 163 Exh. 33).

The records received, however,

did not show a prescription for blood pressure medicine,
only for muscle relaxers.

(Waldridge Depo. 105-06).

On July 15, 2008, Holt submitted another medical
request, requesting “something different for my pain
[because] what you are giving me is not helping.”
163 Exh. 12).

(Doc.

Two days later, SHP nurse Danielle Tucker

(“Tucker”) examined Holt.

She took his blood pressure,
5

which was 137/89, and she switched his medicine from
Percogesic to a thirty-day course of Naproxen.
For the remainder of July, Holt continued submitting
medical slips complaining of severe pain in his back and
leg.

(Doc. 163 Exh. 14).

On July 28, Nurse Pangallo

evaluated Holt and found his blood pressure to be 152/85,
so she put him on the list to see the doctor.
Exh. 15).

(Doc. 163

During this evaluation, Holt noted that his back

and hip pain dated back one year and were due to his
sciatic nerve having been cut during surgery.

(Id.).

Three days later, SHP physician Dr. Ronald Waldridge
(“Waldridge”) examined Holt.

Waldridge diagnosed Holt with

chronic back pain and prescribed him Fluoxetine, a generic
form of Prozac, to treat both the pain and Holt’s reported
anxiety.

(Waldridge Depo. 107) (Doc. 150); (Doc. 163 Exh.

16).1
Throughout August and September 2008, Holt filed more
than two dozen medical slips, many complaining of his leg
and hip pain, stating that he could hardly walk.
Exh. 17).

(Doc. 163

He also complained of side effects from the

Prozac.
Nurse Tucker examined Holt on August 16 and 18,
1

During this time, Holt also complained about a tooth
infection, for which he received treatment, but that
condition is not at issue herein.
6

continuing him on Naproxen and adding him to the doctor
list.

(Doc. 163 Exhs. 20, 21).

Two days later, Holt was

again evaluated by SHP, and his Prozac was discontinued and
he was prescribed Celexa.

(Doc. 163 Exh. 22).

On August 28, Nurse Tucker saw Holt, prescribed him
1000 mg of Tylenol, and added him to the doctor list.
(Doc. 163 Exh. 24).

On September 15, Tucker again

evaluated Holt and added him to the doctor list to see
about increasing his medication.

(Doc. 163 Exh. 27).

Tucker saw Holt again on September 25, placed him on the
doctor list, and prescribed him 1000 mg of APAP for his
pain.

(Doc. 163 Exh. 29).
Five days later, SHP discontinued the Fluoxetine and

placed Holt on Elavil.

(Doc. 163 Exh. 22).

On October 15, 2008, Tucker again examined Holt,
discontinued the Naproxen, and started Holt on Tramadol for
pain, which he received twice daily for the remainder of
his incarceration.

(Doc. 163 Exh. 30).

On November 19, 2008, SHP brought in a portable x-ray
service, which performed an x-ray of Holt’s back, hip, and
leg.

(Doc. 163 Exh. 31).

The Final X-Ray Report states:

“The alignment of the neurocanal is normal as are the bones
of the hips and pelvis visualized and also of the abdomen
and bony thorax.

Multiple views of the left femur show no
7

evidence of fracture, dislocation, or lytic or blastic
lesions.”

(Id.).

The report further stated that the

“bones of the hip and knee visualized are all normal.”
(Id.).
In late November, Holt sent a grievance to defendant
Jim Daley, then the Deputy Jailer:
I have talk[ed] to your medical staff about my chronic
pain two disc removed had bad surgery from Dr.
Ralfstein. I got permanent nerve damage hip and
leg[.] I have a class act law suit me and 89 others
try to shut him down . . . In medical try to help me
but they don’t have the wright [sic] care that I need
or medication I need. I sent a letter to them to try
to explain what I need. I need to be transferred to a
facility where I can be taken care of[.] These two
letters I sent I will need back from you please to
send to my lawyer . . .
(Doc. 133 Exh. 59).
Daley forwarded this grievance to SHP, and Nurse Amy
Autenrieb (“Autenrieb”) responded to Holt:
Inmate Holt you have been seen multiple times for your
complaint of back and leg pain. On 11-20-08 we had
American Portable complete an L-Spine X-ray which came
back negative and normal. You have been put on the
strongest anti-inflammatory and pain medication we
have in the medical department Tramadol. We have
given you crutches to assist with your needs and there
has been several times that the nurses have observed
you moving about fine without any complications. You
have stated that you were diagnosed through the
Mayfield Clinic with chronic back problems and if this
is the case then a MRI should have already been
performed. The medical department needs a release of
information for medical records from this facility.
Your chart has also been reviewed many times by the
nurse practitioner and the jail’s physician. At this
time I do not feel that a transfer is medically
8

necessary.
(Doc. 133 Exh. 60) (emphasis added).
Daley also responded to Holt:
Mr. Holt: I am in receipt of your follow-up grievance
on your medical issue related to your back. I did
speak with medical and understand that you have signed
the necessary release so that they can obtain medical
information. I have asked that the Medical Department
expedite obtaining the information and their review of
the same. Once this is [done] they are to contact my
office directly concerning their findings. Either my
office or the medical department will follow up with
you once the above has occurred.
(Doc. 133 Exh. 61).
After Autenrieb reviewed Holt’s medical records from
Mayfield Clinic, she sent Daley a memo summarizing the
treatment he had received there and the doctor’s findings.
(Doc. 133 Exh. 62).2

Autenrieb noted that the Mayfield

doctor stated that Holt’s follow up exams after his 1/16/07
surgery were normal; that the sciatic nerve was intact upon
closure of the surgical site; and that Mayfield had
prescribed Holt Tramadol, the same drug that Holt was then
taking at the CCDC.

(Id.).

In late 2008 and early 2009, Holt continued to
complain of pain but he refused treatment, telling the
nurses that the medical staff was “bull shit.”

(Doc. 163

Exh. 32).

2

By this time, Daley was no longer employed at the CCDC.
9

On January 20, 2009, Holt wrote a grievance to Daley’s
successor, Captain Jim Young (“Young”), reiterating his
complaints about his chronic pain and the medical staff,
and asking that he be transferred to a medical facility.
(Doc. 163 Exh. 63).

Young responded to Holt two day later,

stating:
I am in receipt of your request for transfer to
another facility. I have been in contact with
Population Coor. Volski about your request. You will
be contacted as soon as a decision has been made.
(Doc. 163 Exh. 64).
On February 2, 2009, Holt was called in to medical to
discuss a grievance he filed.

He told Nurse Evans that he

had a broken hip, and she explained that his x-ray had been
normal.

(Doc. 163 Exh. 22).

Holt was transferred to the Roderer Correctional
Complex four days later, on February 6, 2009.

He alleges

in an affidavit that he received a medical evaluation at
this facility and learned he had an untreated fractured
hip.

(Holt Aff. ¶ 10) (Doc. 159-1).

However, the medical

record of Holt’s x-ray at Roderer states: “Results show
moderate Osteoarthritis in left hip but otherwise
unremarkable.”

(Doc. 195-1).

After his release from jail,

Holt had a hip replacement.

10

Analysis
A.

Legal Standards

Section 1983 prohibits any “person who, under color of
any statute, ordinance, regulation, custom, or usage, of
any State” from depriving any U.S. citizen “of any rights,
privileges, or immunities secured by the constitution and
laws.”

Plaintiff argues that his Eighth Amendment rights

to be free from cruel and unusual punishment were violated.
“As applied to prisoners, this constitutional
guarantee encompasses a right to medical care for serious
medical needs.”

Perez v. Oakland County, 466 F.3d 416, 423

(6th Cir. 2006) (citing Estelle v. Gamble, 429 U.S. 97,
103-04 (1976)).

However, because the Eighth Amendment

prohibits mistreatment only if it is tantamount to
“punishment,” courts have imposed liability upon prison
officials only where they are “so deliberately indifferent
to the serious medical needs of prisoners as to
unnecessarily and wantonly inflict pain.”

Perez, 466 F.3d

at 423 (internal quotations and citation omitted).
“Negligence or medical malpractice alone cannot
sustain an Eighth Amendment claim, absent a showing of
deliberate indifference.”

Id. (citing Estelle, 429 U.S. at

105-06).
“Deliberate indifference” has both an objective and a
11

subjective component.

Id. (citing Comstock v. McCrary, 273

F.3d 693, 702 (6th Cir. 2001)).

With respect to medical

needs, the need “must be objectively, ‘sufficiently
serious.’”

Id. at 423-24 (quoting Farmer v. Brennan, 511

U.S. 825, 834 (1994)).
“In considering the subjective component, this circuit
has emphasized that a plaintiff must produce evidence
showing that the official being sued subjectively perceived
facts from which to infer substantial risk to the prisoner,
that he did in fact draw the inference, and that he then
disregarded that risk.”
and citation omitted).

Id. at 424 (internal quotations
“[A]n official’s failure to

alleviate a significant risk that he should have perceived
but did not, while no cause for commendation, cannot under
our cases be condemned as the infliction of punishment.”
Farmer v. Brennan, 511 U.S. 825, 838 (1994).

See also id.

at 842 (official must act or fail to act “despite his
knowledge of a substantial risk of serious harm”).
The subjective component “prevents medical-malpractice
claims from being transformed into constitutional claims.”
Quigley v. Thai, 707 F.3d 675, 681 (6th Cir. 2013)
(citation omitted).

12

B.

Qualified Immunity

Assuming a plaintiff raises a triable issue as to
whether a constitutional violation occurred, a public
official sued in his or her individual capacity may still
be shielded from suit under the doctrine of qualified
immunity.

All defendants here assert this defense.

“The doctrine of qualified immunity protects
government officials ‘from liability for civil damages
insofar as their conduct does not violate clearly
established statutory or constitutional rights of which a
reasonable person would have known.’” Pearson v. Callahan,
129 S. Ct. 808, 815 (2009) (quoting Harlow v. Fitzgerald,
457 U.S. 800, 818 (1982)).

“The protection of qualified

immunity applies regardless of whether the government
official’s error is ‘a mistake of law, a mistake of fact,
or a mistake based on mixed questions of law and fact.’”
Id. (quoting Groh v. Ramirez, 540 U.S. 551, 567 (2004)
(Kennedy, J., dissenting)).
C.

Application to Holt’s Claims
1.

Objectively Serious Medical Need

“A plaintiff may establish the serious medical needs
requirement in one of two ways.

First a medical need is

sufficiently serious if it is ‘so obvious that even a lay
person would easily recognize the necessity for a doctor’s
13

attention.’”

Blosser v. Gilbert, 422 F. App’x 453, 460

(6th Cir. 2011) (quoting Blackmore v. Kalamazoo County, 390
F.3d 890, 897 (6th Cir. 2004)).
Second, “if the medical need is less obvious, its
seriousness is evaluated by the effect of delay in
treatment,” and plaintiff must “place verifying medical
evidence in the record to establish the detrimental effect
of the delay in medical treatment.”

Id.

Holt initially raised three medical conditions as the
basis for his § 1983 claim: treatment for drug withdrawal,
high blood pressure, and chronic back and hip pain.
As to Holt’s high blood pressure, it is undisputed
that his pressure was routinely monitored during his
incarceration, and only on one occasion did the reading
approach “high.”

(Waldridge Depo. 111-12).

Dr. Waldridge

testified that this reading in and of itself did not
indicate a need for medication, particularly because the
pain Holt was experiencing could have elevated his blood
pressure, and because there were more normal blood pressure
readings than abnormal ones over the course of his
incarceration.

(Id.).

Furthermore, when the CCDC obtained Holt’s pharmacy
records, there was no blood pressure medication listed.
Finally, plaintiff’s own expert, Dr. Parris, opined that
14

“Holt did not need chronic blood pressure medications.”
(Doc. 133 Exh. 65 at 3).
Holt thus cannot show as a matter of law that his
alleged high blood pressure constituted a serious medical
need.3
With respect to Holt’s withdrawal from his regular
intake of Vicodin, courts “have found withdrawal symptoms
to qualify as a serious medical need.”

French v. Daviess

County, Ky., 376 F. App’x 519, 522 (6th Cir. 2010)
(citations omitted).
The Court will thus assume that Holt’s withdrawal
symptoms, as well as his chronic back/leg/hip pain, were
serious medical needs for purposes of his § 1983 claim.
2.

Deliberate Indifference

Even assuming those two medical conditions were
serious medical needs, there is no evidence from which a
reasonable jury could conclude that any of the defendants
were deliberately indifferent to those needs.

3

The Court also notes that Holt effectively abandoned his
claim based on his blood pressure given that his response
to the CCDC defendants’ motion for summary judgment devotes
only one sentence to the issue (Doc. 159 at 6), and he does
not address it at all in his response to the SHP
defendants’ motion.
15

a.

CCDC Defendants4

Holt argues that defendants Buckler and Daley were
aware of facts from which they could, and did, draw an
inference that a substantial risk of serious harm existed
as to Holt’s health.

This argument fails as a matter of

law because there is no such evidence in the record.
First, there is no evidence that either Buckler or
Daley were aware of Holt’s withdrawal symptoms or that they
had any involvement with his treatment for those symptoms.
That aspect of his claim thus fails.5
Further, Holt concedes that Buckler, the former
Jailer, had no contact with him during his incarceration
(Holt Depo. 49-51), nor is there any evidence that Buckler
was involved in any of the medical decisions involving
Holt.

Because respondeat superior is not available as a

basis for liability under § 1983, Buckler is thus entitled

4

In his responsive memorandum, Holt concedes that CCDC
defendants Fickenscher and “Fisher” should be dismissed.
(Doc. 159 at 1). There is no defendant named Fisher; it
appears that plaintiff means defendant Lisa Fletcher.
5

The Court thus need not reach the CCDC defendants’
argument (asserted for the first time in their reply brief)
that Holt’s claim based on his withdrawal symptoms is timebarred because his § 1983 claim was filed more than a year
after the events related to his drug withdrawal.
16

to summary judgment.6
As to Daley, his only involvement with Holt was
handling the November 2009 grievance that Holt filed
complaining of his medical care.

That grievance makes no

mention of Holt’s alleged fall or his alleged fractured
hip.

To the extent that the grievance expressed

dissatisfaction with his medical care, Daley’s response
does not demonstrate deliberate indifference.
Daley forwarded the grievance to the medical staff,
who reviewed Holt’s medical file and reported the various
actions that had been taken to address Holt’s pain.

Daley

also responded directly to Holt, noting that he had
instructed the medical staff to expedite obtaining Holt’s
records from Mayfield Clinic, and that appropriate followup would occur once those records were reviewed.

Daley

left his position at the CCDC shortly thereafter, and
Holt’s case was handled by Daley’s successor, Captain
Young.
Thus, no reasonable jury could conclude that Daley was
aware of any serious risk to Holt’s health due to his

6

Holt argues that Buckler was aware of general problems
with the medical contractor at the CCDC. That, however,
provides no basis for the claim against him in his
individual capacity where it is undisputed that Buckler
played no role in Holt’s care.
17

chronic pain and that he disregarded that risk.
With no underlying constitutional violation, Holt can
state no “municipal liability” claim as to Campbell County.
See Blackmore v. Kalamazoo County, 390 F.3d 890, 900 (6th
Cir. 2004) (“A municipality or county cannot be liable
under § 1983 absent an underlying constitutional violation
by its officers.”) (citation omitted).7
For these reasons, all the CCDC defendants are
entitled to summary judgment.8
b.

SHP Defendants9

With respect to the SHP defendants, the Court first
notes that Holt has abandoned his claim based on his
withdrawal symptoms because his responsive memorandum

7

Holt also has adduced no admissible evidence of a clear
and persistent pattern of deliberate indifference to inmate
medical needs. This Court has already held in another case
that the same affidavits submitted by plaintiff here
regarding allegedly poor care at the CCDC are: (1)
inadmissible for a variety of reasons, and (2) even if
admissible, inadequate as a matter of law to support a
municipal liability claim against Campbell County. Fryman
v. Campbell County, Covington Civil Action No. 09-114-WOBJGW, Docs. 25, 30.
8

The Court thus need not reach the issue of qualified
immunity, although the individual defendants would
obviously be entitled to that defense given the absence of
any constitutional violation.
9

Plaintiff concedes that SHP defendant Ernest should be
dismissed. (Doc. 183 at 1).
18

addresses only his chronic back/hip/leg pain.10
With respect to his chronic pain, Holt argues that the
medical staff failed to prescribe him medicine that
alleviated his pain, and that such failure constituted
deliberate indifference.

This argument fails for several

reasons.
First, Holt does not dispute that, within four days of
his first complaint of back and leg pain, the medical staff
evaluated him and began prescribing him medications to
address his pain, including anti-inflammatories and various
pain medications.

While Holt argues that the sheer volume

of the medical requests he submitted demonstrates that the
medical staff’s response to his pain was deliberately
indifferent, this ignores the undisputed evidence that the
SHP defendants regularly evaluated Holt and continued to

10

Even had plaintiff not abandoned this claim, it would
fail as a matter of law. The record contains undisputed
evidence that Holt received medication for his withdrawal
symptoms, and his own expert witness noted the same. The
fact that Holt denied in his deposition that he had
received treatment for his withdrawal symptoms thus creates
no triable issue. See Scott v. Harris, 550 U.S. 372, 380
(2007) (“When opposing parties tell two different stories,
one of which is blatantly contradicted by the record, so
that no reasonable jury could believe it, a court should
not adopt that version of the facts for purposes of ruling
on motion for summary judgment.”). See also Bruederle v.
Louisville Metro Gov’t, 687 F.3d 771, 779 (6th Cir. 2009)
(holding that plaintiff’s testimony as to identity of
booking officer raised no triable issue where it was
contradicted by record evidence).
19

adjust his medications to address his pain, ultimately
prescribing him the strongest pain medicine they had at the
facility, which was the same drug that had been prescribed
by his doctors at the Mayfield Clinic.
In this context, Holt’s numerous and often duplicative
medical requests do not demonstrate deliberate
indifference, nor does his disagreement with the course of
action taken by the medical staff.

See White v. Corr. Med.

Serv., Inc., 94 F. App’x 262, 264 (6th Cir. 2004)
(“Although White did not receive the care he wanted, the
conduct he alleged did not constitute a deliberate
indifference to his medical needs.”); Graham v. County of
Washtenaw, 358 F.3d 377, 385 (6th Cir. 2004) (noting that
where “a prisoner has received some medical attention and
the dispute is over the adequacy of the treatment, federal
courts are generally reluctant to second guess medical
judgments and to constitutionalize claims that sound in
state tort law.”) (citation omitted).
Further, when Holt continued to complain of the pain,
SHP arranged for a portable x-ray facility to come to the
CCDC and perform an x-ray on Holt.

This x-ray, as

discussed above, showed normal results for Holt’s hip,

20

back, and leg.11
Second, Holt’s allegation that he fell shortly after
booking into the CCDC and broke his hip raises no triable
issue.

Notably, Holt does not allege or testify that he

ever told anyone on the medical staff that he had fallen
and that he thought he had injured his hip as a result.
In fact, in his medical requests, Holt consistently
and repeatedly attributed his back/hip/leg pain to the
surgery he had undergone prior to his incarceration.
It was only on February 2, 2009, just before his
transfer out of the CCDC, that Holt told Nurse Evans that
he had a broken hip.

In response, Evans explained to Holt

that the results of his x-ray had been normal.

(Doc. 163

Exh. 22).
Further, the medical documentation from the facility
to which Holt was then transferred shows that an x-ray
performed at that facility on February 5, 2009 revealed
“moderate Osteoarthritis” in Holt’s left hip, which was
“otherwise unremarkable.”

(Doc. 195-1).

There is thus no verifying medical evidence that Holt
actually suffered any fracture of his hip while at the

11

Holt complained in his deposition that the x-ray taken
only imaged his back (Holt Depo. 147-149), but the
undisputed record evidence shows that he is simply
mistaken. (Doc. 163 Exh. 31).
21

CCDC.
The report of plaintiff’s expert, Dr. Paris, also
raises no genuine dispute of fact as to deliberate
indifference.

While Dr. Paris states that the “[w]orkup of

left hip chronic pain was slow,” (Doc. 133 Exh. 65 at 3),
this suggests, at most, negligence.

“Deliberate

indifference is characterized by obduracy or wantonness –
it cannot be predicated on negligence, inadvertence, or
good faith error.”

Bruederle, 687 F.3d at 777 (citation

omitted).
Moreover, Dr. Paris notes in his report that the
“treatment of chronic, non-malignant pain in jails is
controversial, especially when one considers that high
rates of abuse of narcotics and other drugs by the jail
population prior to incarceration.”
3).

(Doc. 133 Exh. 65 at

Dr. Paris does not opine that the medications

prescribed to Holt were so deficient as to constitute a
deliberate indifference to his pain.

His statement that

Holt’s care at the CCDC was “lacking” and “may have reached
the level of deliberate indifference” raises no triable
issue.
Specifically as to Holt’s hip, Dr. Paris makes no
mention of any alleged injury that Holt suffered to his hip
at the CCDC, and he discusses only generally the debate
22

over the optimal timing of hip replacements.

On that

issue, he declines to offer an opinion, deferring to
“another expert with experience in Orthopedics.”

(Doc. 133

Exh. 65 at 4).12
Finally, as to any “Incidental medical complication”
that Holt suffered as a result of the allegedly deficient
care at the CCDC, Dr. Paris states: “None.”

(Id.).

Holt thus cannot raise a triable issue as to whether
the medical staff perceived a serious risk to his health
and then ignored that risk.
All defendants are thus entitled to summary judgment
on Holt’s § 1983 claim.

Given this disposition, the Court

will decline to exercise its supplemental jurisdiction over
Weber’s state law claims.

See 28 U.S.C. § 1367(c).

Therefore, having reviewed this matter, and the Court
being otherwise sufficiently advised,
IT IS ORDERED that the motion of the Campbell County
defendants for partial summary judgment as to plaintiff,
Anthony Holt (Doc. 133) be, and is hereby, GRANTED; (2) the
motion of Southern Health Partners for summary judgment as
to plaintiff, Anthony Holt (Doc. 163) be, and is hereby,

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Of course, Holt does not allege that he ever requested a
hip replacement while incarcerated at the CCDC.
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GRANTED AS TO PLAINTIFF’S FEDERAL CLAIM; and (3) Plaintiff
Anthony Holt’s state law claims be, and are hereby,
DISMISSED WITHOUT PREJUDICE.

This 19th day of July, 2013.

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