Thomas v. Armstead et al

Filing 43

MEMORANDUM. Signed by Chief Judge Catherine C. Blake on 8/28/2017. (c/m 8/30/17 bas, Deputy Clerk)

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MARYLAND
TON JULIUS THOMAS

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Plaintiff

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v

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WARDEN ARMSTEAD, et al.

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Defendants

Civil Action No. CCB-16-2737

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***
MEMORANDUM

In response to a complaint filed by the plaintiff Ton Julius Thomas, the defendants
Warden Laura Armstead, Officer Muhammad Raja, and Director Randall Nero, Ph.D., (“state
defendants”), and Damon Fayall and Wexford Health Services, Inc., (“medical defendants”),
have moved for dismissal under Rule 12(b)(6) or, in the alternative, summary judgment. ECF 18
and 37. The plaintiff, for his part, filed a motion for summary judgment, ECF 27, asserting that
the defendants failed to properly investigate his administrative claims. The court finds a hearing
unnecessary. See Local Rule 105.6 (D. Md. 2016). For the reasons stated below, the defendants’
motions, construed as motions for summary judgment, 1 will be granted and the plaintiff’s motion
for summary judgment will be denied.
I.

Background
The plaintiff, Ton Julius Thomas, is an inmate confined at Patuxent Institution who

suffers from chronic epilepsy. ECF 18 at Ex. 1, p. 1. Plaintiff argues that the defendants violated
his Eighth Amendment protection from cruel and unusual punishment by failing to provide

1

Defendants’ dispositive submissions will be treated as motions for summary judgment under Federal Rule of Civil
Procedure 56 because materials outside the original pleadings have been considered. Fed. R. Civ. P. 12(d); See
Bosiger v. U.S. Airways, 510 F.3d 442, 450 (4th Cir. 2007).

adequate medical care. 2 Specifically, the plaintiff claims that he has a two year history of
overdoses on his anti-epilepsy medication, that prison medical staff has on occasion failed to
respond timely to his medical emergencies, and that Corrections Officer Raja failed to seek
medical help during one of the plaintiff’s seizures. The plaintiff also has filed a motion for
summary judgment arguing that the defendants failed to properly investigate his administrative
complaints. ECF 27.
A. Plaintiff’s Medical History
The plaintiff suffers from chronic epilepsy. ECF 18 at Ex. 1, p. 1. From February 2012
until March 2016, the plaintiff was prescribed phenytoin (dilantin), an anti-epileptic drug used to
treat epilepsy. Id. at 2–3. Dosages of phenytoin need to be carefully monitored through
phenytoin tests, examinations that determine how much phenytoin is in a patient’s blood stream,
to ensure that the drug remains at therapeutic levels. Id. at 3. The therapeutic range for phenytoin
is between 10 and 20 ug/ml, 3 toxic levels are greater than 30 ug/ml, and at 100 ug/ml or above
the drug becomes lethal. Id. at 3.
The plaintiff’s phenytoin levels have varied over time but repeatedly exceeded the
therapeutic range of the drug. ECF 23 at pp. 3–5. Although fluctuations in phenytoin levels can
be caused by latent medical conditions, improper dosing (either by the plaintiff’s failure to take
the medication or the plaintiff taking too much of the medication), or by other medications, none
of these explanations was identified as the cause of the plaintiff’s overdosing. ECF 18 at p. 4.
When the fluctuations were detected the high levels were treated by discontinuing administration
of phenytoin until the levels returned to a therapeutic range. Id. at p. 5.
2

“It is settled law that the allegations” in a prisoner’s complaint, “‘however inartfully pleaded’ are held ‘to less
stringent standards than formal pleadings drafted by lawyers.’” Hughes v. Rowe, 449 U.S. 5, 9–10 (1980) (quoting
Haines v. Kerner, 404 U.S. 519, 520 (1972)).
3
The abbreviation “ug/ml” stands for “microgram per milliliter” and is a measurement of concentration in the blood.
See http://medical-dictionary.thefreedictionary.com.

2

Despite the plaintiff’s phenytoin prescription and his assurances that he was taking his
medication, the plaintiff suffered occasional breakthrough seizures. ECF 18 at Ex. 2, pp. 2–3.
B.

Plaintiff’s Complaint

Against this medical background the plaintiff offers a history of past medical incidents, in
addition to describing his phenytoin overdoses, in support of his allegation that he has received
insufficient medical care.
The first medical incident plaintiff complains of occurred “sometime in March” 2014 in
which his phenytoin level was “way to[o] high” and he was transferred to the hospital at Jessup
Correctional Institution (JCI), where he was given an IV. ECF 23 at p. 3. Plaintiff remained
there for 30 days. Id.
A few months later, on May 7, 2014, the plaintiff had a seizure while sitting in the
Patuxent dining hall. ECF 1 at p. 7. According to the plaintiff, the medical unit’s attempt to treat
him failed and, as a result, he was sent to Howard County General Hospital for further treatment.
Id. The hospital performed a blood test which revealed that the plaintiff’s phenytoin level was
above the therapeutic range. Id. He was given an IV and prescribed new medication before
being sent back to Patuxent. Id.
The plaintiff would have little recovery time. Only two months after the May 7 incident,
the plaintiff reportedly felt sleepy. The medical unit took a blood test which found that the
plaintiff’s phenytoin level was too high “and he needed to stop taking” his medication to avoid
going into a seizure. Id. Over the course of about two years, medical staff examining the plaintiff
would repeatedly find that his phenytoin levels exceeded their therapeutic range. Id. at pp. 3–5.
The next major incident occurred on May 5, 2015, when Officer Raja, a corrections
officer at Patuxent, allegedly failed to seek medical help for the plaintiff. As the plaintiff tells it,

3

his cellmate, D. Washington, called out to Officer Raja informing him that the plaintiff was
having a seizure. ECF 1 at p. 2. Despite being told three times by Washington that the plaintiff’s
seizure was a medical emergency and he required immediate medical help, Officer Raja simply
told Washington to “stand by.” Id.
The plaintiff claims that Officer Raja never called for medical assistance and he only
received medical attention after a nurse called Officer Raja and told him that the plaintiff should
report back to the medical office because he left his pass there during an earlier visit. Id. The
plaintiff eventually made it to the medical unit. He informed the nurses that his “level is to[o]
high,” referring to his phenytoin level, and that he had a seizure but Officer Raja would not let
him out of his cell. Id. Plaintiff claims that the nurse tried to take him to see a Physician’s
Assistant (“PA”), but he kept falling down and required two nurses to assist him along the way.
The PA treated the plaintiff and sent him back to his cell. Id.
On May 6, 2015, the plaintiff filed an administrative remedy procedure complaint (ARP)
with the warden informing him of the events that occurred on May 5, 2015 and complaining
about Officer Raja’s alleged behavior. Plaintiff’s ARP was dismissed. Id.
On May 10, 2015, the plaintiff filed another ARP (PATX 0264-15), concerning the same
May 5th incident, this time including a request for relief. ECF 1 at p. 3. The plaintiff requested
that Officer Raja be suspended for two weeks without pay and that the plaintiff be awarded
$20,000 in damages. Id. The plaintiff filed a third ARP (PATX-0287-15) that asked for the
same relief. It was denied. Id.
On June 8, 2015, the warden responded to the plaintiff’s second filed ARP, PATX 026415. ECF 1 at p. 4. The warden stated that the plaintiff’s claim regarding Officer Raja’s failure to
secure medical assistance for him during his seizure was investigated and there was not enough

4

evidence to support the plaintiff’s claim. The warden noted that Officer Raja reported that he
never observed or heard an emergency on the tier, the area in the prison in which the plaintiff
resides, on the date of the plaintiff’s seizure and that no further action would be taken through
the ARP process. Id.
On June 16, 2015, the plaintiff appealed the dismissal of ARP PATX 0264-15 to the
Commissioner of Corrections. The Commissioner dismissed the appeal. His decision found that
an investigation into the incident revealed that the plaintiff was seen by medical staff on May 5,
2015, on an urgent basis, ECF 1 at p. 5, that the nurse reported giving the plaintiff medication,
that the plaintiff appeared to be drowsy and confused after receiving it, and that the nurse had the
plaintiff stay in the medical unit based on his history of epilepsy. The Commissioner noted that
the plaintiff had reported having a seizure on the tier but had failed to substantiate his claim that
he had informed either the day or the night shift of the seizure.

Most importantly, the

Commissioner also found that Officer Raja worked the day shift on May 5, 2015, but the plaintiff
had claimed that the night shift officer was the officer who failed to call for medical assistance.
Id.
The plaintiff then filed a complaint with the Inmate Grievance Office (IGO) appealing
the Commissioner’s dismissal of his ARP.

ECF 1 at pp. 5–6.

The IGO complaint was

administratively dismissed for failure to state a claim upon which administrative relief can and
should be granted. Id. at p. 6.
The final incident occurred on March 12, 2016. The plaintiff alleges that he went to the
Patuxent medical unit at approximately 4:45 a.m. Id. at p. 7. When he arrived, a nurse informed
the plaintiff that the doctor left orders not to give the plaintiff his medication because his
phenytoin levels, at 22 mg/ul, exceeded the therapeutic range of the drug. Id. The plaintiff

5

returned to his cell and, at approximately 11:10 a.m., had a seizure. The plaintiff’s cellmate, D.
Murry, called out to Officer D. Kommgum in order to get medical assistance for the plaintiff.
The plaintiff alleges that it took Kommgum 30 minutes to open his cell door and 45 minutes to
call for medical assistance. Id. When an officer 4 arrived, “about 20 min[utes]” after the call for
assistance, all of the other inmates on the tier were told to return to their cells. Medical staff
arrived and attempted to treat the plaintiff. The plaintiff alleges that one of the nurses put a
needle in his arm but he “did not come around.” Id. At that time, the plaintiff states that Captain
Parker yelled out for the officers to call 911 and the nurse asked the officers there to move the
plaintiff into the dayroom. Id.
When the EMTs arrived, the plaintiff was taken to Howard County General Hospital. Id.
After blood tests were performed, the plaintiff was told by the doctor that his phenytoin level
was at 45 mg/ul, 23 mg/ul above the level he was told by the prison medical unit and 25 mg/ul
above the therapeutic range of the drug. The plaintiff remained in the hospital for four days and
then was sent to the JCI hospital before returning to Patuxent. Id. Because of this incident, the
plaintiff was prescribed a new medication, Vimpat, however the plaintiff complains that it took
over a week for him to receive the drug. ECF 18 at Ex. 2, p. 6.
The plaintiff filed an ARP complaint concerning the March 12, 2016, incident but
received no response from the warden and no responses from the Commissioner of Corrections
or the IGO when he appealed the non-response. ECF 1 at pp. 8–9.
As relief, the plaintiff seeks monetary damages of thirty thousand dollars from each
defendant. Id. at p. 9.

4

Plaintiff does not provide a name for the officer who arrived in his cell.

6

C.

Defendants’ Response
The defendants Warden Laura Armstead, Director Randall Nero, Ph.D., and Officer

Muhammad Raja (“state defendants”) state that the plaintiff was not observed having a seizure
on May 5, 2015, nor was Officer Raja advised of a medical emergency by anyone else during his
shift. ECF 37 at Ex. 2. Rather, the plaintiff reported being drowsy at 1:46 p.m. and his medical
chart was updated to indicate that his phenytoin level was elevated. Id. at Ex. 5, pp. 19–20. The
Physician’s Assistant on call was notified, a notation to follow-up in the morning was made, and
for the incoming nurse to be informed of the plaintiff’s condition so that she could follow-up
with him and continue monitoring his condition. Id. at p. 20. On May 20, 2015, when the
plaintiff was seen he reported no problems since his last encounter with medical staff. Id. at pp.
16–18.
Further, ARP (PATX-0264-15), alleging that Officer Raja did not respond appropriately
when notified the plaintiff was having a seizure, was investigated and dismissed. ECF 37 at Ex.
6, pp. 13–14. The investigation included an interview of Officer Raja who reported that he was
never notified of the plaintiff’s seizure or even that the plaintiff required emergency medical
attention during his shift on May 5, 2015. In addition, the logbook from the tier where the
plaintiff was housed was reviewed and there was no indication that a medical emergency
occurred that day. Id. at pp. 22–26. The logs reflected that Officer Raja returned to his post after
a meal break at 12:10 p.m. and wrote his last log book entry at that time. He was relieved of his
post by Officer P. Morris at 4:10 p.m.

Id. Thus, the plaintiff’s ARP was dismissed as

unsubstantiated.
On appeal to the Commissioner of Correction, the plaintiff’s ARP (PATX-0264-15) was
dismissed on September 17, 2015.

ECF 37 at Ex. 6, p. 1.

7

The response noted that an

investigation revealed that the plaintiff was seen on May 5, 2015, by medical staff for an urgent
visit and that when the plaintiff received his medication he appeared to be drowsy and confused.
Id. at pp. 1, 17–21. The nurse had the plaintiff stay in the medical unit for evaluation; there was
no indication in the medical record that the plaintiff had a seizure or that anyone had called out to
the officer on the tier saying he was having a seizure. Id. Because the plaintiff had failed to
substantiate his claim regarding Officer Raja’s alleged failure to act and neither the day nor the
night shift officers indicated that the plaintiff experienced a medical emergency on May 5, 2015,
the ARP appeal was dismissed. Id. at pp. 1, 22–26.
Correctional defendants further explain that the IGO appeal of ARP (PATX-0264-15)
was dismissed on November 5, 2015, for failure to state a claim. ECF 37 at Ex. 8. Further, the
plaintiff’s appeal of that dismissal to the Circuit Court for Howard County was dismissed on
October 12, 2016. In the Matter of Ton Julius Thomas, Case No. 13C15105986 (Howard Co.
Cir. Ct.), http://casesearch.courts.state.md.us/inquiry.

A subsequent appeal to the Maryland

Court of Special Appeals was dismissed on March 16, 2017. Id. at docket 34 & 35.
An additional ARP (PATX-0291-16) was appealed to the IGO by the plaintiff, but was
dismissed for his failure to provide supporting paperwork to indicate that the matter had been
submitted to the Warden and appealed to the Commissioner of Corrections as required by
regulations governing the ARP process. ECF 37 at Ex. 8, p. 2. Although the documents
submitted by the plaintiff on October 24, 2016, indicate a complaint regarding his seizures, the
precise nature of his claim could not be discerned from the papers submitted. Id. There is no
record of the plaintiff appealing the November 28, 2016 dismissal of this IGO appeal. Id.
The defendants also dispute the plaintiff’s characterization of his medical history at
Patuxent. Defendants Wexford Health Sources, Inc. and Damon Fayall (“medical defendants”)

8

state that the plaintiff has a significant medical history of epilepsy. The plaintiff is a chronic care
patient requiring regular visits to, and evaluations by, physicians. ECF 18 at Ex. 2, p. 2. In
addition, the plaintiff has access to medical staff between scheduled chronic care clinic
evaluations to address his medical complaints. Id. Damon Fayall is not a physician and has
never provided care to the plaintiff. Id.
In addition, none of the episodes where the plaintiff’s phenytoin levels were above the
therapeutic range approached the lethal level of 100. Id. at p. 5. The plaintiff’s seizures were
successfully controlled in both onset and severity without adverse side effects and there was no
indication that providing phenytoin at the prescribed dose contributed in any way to the elevated
levels of phenytoin. Id. Although the plaintiff reported to medical staff that he was having
seizures every four to five weeks, he did not report the seizures at the time they occurred and his
reports were often “contrary to the observations of medical providers and his medical records.”
Id. There were no visual confirmations of the plaintiff’s self-reported seizures, their severity, or
their duration. Id. The defendants argue that they have provided adequate health care to the
plaintiff. They offer the lead up to the plaintiff’s March 12, 2016 seizure as an example. On
March 9, 2016, the plaintiff was seen by medical staff for complaints of drowsiness. Id. at pp.
13–14. Medical staff suspected that the plaintiff’s phenytoin level was high, and on March 11,
2016 they were notified by the lab that the plaintiff’s level was critically high. Id. at pp. 12–13.
On March 12, 2016, the plaintiff was transported by ambulance to Howard County General
Hospital. Id. at p. 11.
With regard to the plaintiff’s epileptic seizure on March 12, 2016, medical records
prepared by Khadijat Adebayi, R.N., indicate that medical staff was notified of an emergency at
10:57 a.m., and that medical staff responded to the plaintiff’s cell at 11:03 a.m. ECF 18 at Ex. 2,

9

p. 2; Ex. 1, p. 77. Custody staff already had called for an ambulance, which arrived at 11:25
a.m., to take the plaintiff to Howard County General Hospital for emergency treatment. Id.
At the hospital the plaintiff’s phenytoin levels were measured at 32.7 mg/ul on March 13,
at 24.7 mg/ul on March 14, and at 25.3 mg/ul on March 15. ECF 18 at Ex. 2, p. 6. Hospital
medical providers suggested that the seizure the plaintiff experienced might have been a
consequence of phenytoin toxicity, which is a rare reaction, and recommended that the plaintiff’s
phenytoin prescription be discontinued and substituted with Vimpat. Id. This recommendation
was made because the plaintiff experienced a seizure despite having a phenytoin level above
therapeutic range. Id. Medical providers at Patuxent agreed with the recommendation to use
Lamictal and Vimpat 7 in place of Dilantin. Id. The plaintiff has been prescribed Vimpat since
his March 15, 2016 return to Patuxent, but it is a non-formulary drug, which means that the drug
had to be ordered and approved before it could be delivered, and was therefore not received until
March 24, 2016. Id.
Soon after receiving Vimpat, the plaintiff complained of side effects including poor
appetite, vomiting, and nausea and reported that he stopped taking the medication on March 26,
2016. ECF 18 at Ex. 2, p. 6. Given this reported non-compliance, an order was added that the
plaintiff must be observed taking his Lamictal medication, and the Vimpat prescription was
discontinued.

Id.

When the plaintiff’s Lamictal prescription was increased in dosage he

complained of gastrointestinal side effects, and his medical providers adjusted it to a lower
dosage. Id. at pp. 6–7. The plaintiff has continued to receive the lower dosage of Lamictal with
good results. Id. at p. 7.

7

Both Vimpat and Lamictal are anticonvulsant medications. Both indicate they can be used in conjunction with
other anticonvulsant medications to treat epilepsy.
See www.drugs.com/search.php?searchterm=Vimpat; and www.drugs.com/search.php?searchterm=lamictal.

10

II.

Standard of Review
A.

Summary Judgment 10

Summary judgment is governed by Fed. R. Civ. P. 56(a) which provides that:
The court shall grant summary judgment 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.
The Supreme Court has clarified that this does not mean that any factual dispute will
defeat the motion:
By its very terms, this standard provides that the mere existence of
some alleged factual dispute between the parties will not defeat an
otherwise properly supported motion for summary judgment; the
requirement is that there be no genuine issue of material fact.
Anderson v. Liberty Lobby, Inc., 477 U. S. 242, 247–48 (1986) (emphasis in original).
“A party opposing a properly supported motion for summary judgment ‘may not rest
upon the mere allegations or denials of [her] pleadings,’ but rather must ‘set forth specific facts
showing that there is a genuine issue for trial.’” Bouchat v. Baltimore Ravens Football Club,
Inc., 346 F.3d 514, 522 (4th Cir. 2003) (quoting Fed. R. Civ. P. 56(e)). The court should “view
the evidence in the light most favorable to . . . the nonmovant, and draw all inferences in her
favor without weighing the evidence or assessing the witness[]’ credibility.” Dennis v. Columbia
Colleton Med. Ctr., Inc., 290 F.3d 639, 644–45 (4th Cir. 2002). The court must, however, also
abide by the “affirmative obligation of the trial judge to prevent factually unsupported claims and
defenses from proceeding to trial.” Bouchat, 346 F.3d at 526 (internal quotation marks omitted)

10

Under Rule 12(d), a motion to dismiss based on matters outside the pleadings, where those matters are not
excluded by the court, should be treated as a Rule 56 motion for summary judgment. Fed. R. Civ. P. 12(d). In this
case, the motions to dismiss included matters outside of the pleadings, and the plaintiff was on notice that the
motions might be treated as motions for summary judgment. Indeed, the plaintiff filed his own motion for summary
judgment.

11

(quoting Drewitt v. Pratt, 999 F.2d 774, 778–79 (4th Cir. 1993), and citing Celotex Corp. v.
Catrett, 477 U.S. 317, 323–24 (1986)).
II.

Analysis
The defendants argue, in two separate motions, 11 that summary judgment should be

granted in their favor because the plaintiff has failed to allege facts showing a deliberate denial
of medical care or, in the alternative, because respondeat superior liability is not available under
§ 1983, and, in any event, qualified immunity bars recovery. The plaintiff also has moved for
summary judgment, arguing that the defendants failed to properly investigate his administrative
complaints. Because the plaintiff has failed to allege facts sufficient to create a genuine dispute
as to whether the defendants deliberately withheld medical treatment or that the defendants failed
to properly investigate his administrative complaints, the defendants’ motions for summary
judgment will be granted and the plaintiff’s motion for summary judgment will be denied.
A.

The Plaintiff’s Medical Claims
“To state a claim under § 1983, a plaintiff must allege the violation of a right secured by

the Constitution and laws of the United States, and must show that the alleged deprivation was
committed by a person acting under color of state law.” West v. Atkins, 487 U.S. 42, 48 (1988). If
a court finds a § 1983 violation, a public official may defend by asserting qualified immunity.
The qualified immunity analysis has two prongs and this court may address the prongs in the
order best suited to “the circumstances of the particular case at hand.” Pearson v. Callahan, 555
U.S. 223, 236 (2009). The first is whether ““[t]aken in the light most favorable to the party
asserting the injury, . . . the facts alleged show [that] the officer’s conduct violated a
constitutional right[.]” Saucier v. Katz, 533 U.S. 194, 201 (2001). If the evidence establishes a
violation of a constitutional right, this court must assess whether the right was “clearly
11

ECF 18 and 37

12

established” at the time of the events at issue. Id. If the evidence does not establish a violation of
a constitutional right, however, “there is no necessity for further inquiries concerning qualified
immunity.” Id. In this case, there is no reason to inquire into qualified immunity, at least not its
second part, because the plaintiff fails to raise a genuine dispute that his rights under the Eighth
Amendment protection from cruel and unusual punishment were violated when the defendants
allegedly failed to provide him adequate medical treatment.
A plaintiff alleging inadequate medical treatment under the Eighth Amendment must
prove that the defendants acted with “deliberate indifference to serious medical needs.” Estelle v.
Gamble, 429 U.S. 97, 104–05 (1976). This standard applies as well to a prison doctor as it does a
prison guard who “intentionally den[ied] or delay[ed] access to medical care.” Id. Critical to the
Eighth Amendment analysis under § 1983 is deliberateness. “[A]n inadvertent failure to provide
adequate medical care” does not constitute cruel and unusual punishment and, therefore, “a
complaint that a physician has been negligent in diagnosing or treating a medical condition” is
not “a valid claim of medical mistreatment under the Eighth Amendment.” Id. at 105–06.
"Deliberate indifference may be demonstrated by either actual intent or reckless disregard."
Miltier v. Beorn, 896 F.2d 848, 851 (4th Cir. 1990) (citation omitted) (overruled in part on other
grounds by Farmer v. Brennan, 511 U.S. 825, 837 (1994); aff’d in pertinent part by Sharpe v.
S.C. Dep’t of Corr., 621 Fed.Appx. 732 (Mem), (4th Cir. 2015)
To prove deliberate indifference a plaintiff must meet two components. First, a plaintiff
must show that, objectively, he was suffering from a serious medical need. “In medical needs
cases, like the case at bar” plaintiffs are required “to demonstrate [an] official[’s] deliberate
indifference to a ‘serious’ medical need that has either ‘been diagnosed by a physician as
mandating treatment or . . . is so obvious that even a lay person would easily recognize the

13

necessity for a doctor's attention.’” Scinto v. Stansberry, 841 F.3d 219, 225 (4th Cir. 2016)
(quoting Iko v. Shreve, 535 F.3d 225, 241 (4th Cir. 2008))
Second, a plaintiff must show that, subjectively, the prison staff were aware of the need
for medical attention but failed to either provide it or ensure the needed care was available. See
Farmer v. Brennan, 511 U.S. 825, 837 (1994). The subjective component requires, at least,
“subjective recklessness” in the face of a serious medical condition. Farmer, 511 U.S. at 839–
40. “True subjective recklessness requires knowledge both of the general risk, and also that the
conduct is inappropriate in light of that risk.” Rich v. Bruce, 129 F.3d 336, 340 n.2 (4th Cir.
1997). “Actual knowledge or awareness on the part of the alleged inflictor . . . becomes essential
to proof of deliberate indifference ‘because prison officials who lacked knowledge of a risk
cannot be said to have inflicted punishment.’” Brice v. Va. Beach Corr. Center, 58 F.3d 101,
105 (4th Cir. 1995) (quoting Farmer, 511 U.S. at 844). If the requisite subjective knowledge is
established, an official may avoid liability “if [he] responded reasonably to the risk, even if the
harm was not ultimately averted.” See Farmer, 511 U.S. at 844.
The Fourth Circuit’s analysis in Scinto v. Stansberry helps ground the Estelle and Farmer
standard. In Scinto, the court found the plaintiff’s evidence showing that the defendant refused,
more than once, to administer insulin shots to treat the plaintiff’s diabetes sufficient to overcome
summary judgment. The court held that the defendant “was aware of facts—[the plaintiff’s]
diabetes and his blood sugar value at the time of request for insulin—giving rise to an inference
that failing to provide insulin could result, at least, in a substantial risk of serious harm.” Scinto,
841 F.3d at 229. The defendant in Scinto took an affirmative act, despite understanding its
serious medical consequences, to deprive the plaintiff of medical care.

14

The plaintiff’s case stands in sharp contrast to these facts. It is undisputed that the
plaintiff suffers from an objectively serious condition. He has a well-documented medical history
of epilepsy that requires constant attention and treatment. The defendants deny, and the plaintiff
fails to dispute, however, that they possessed the necessary subjective state of mind under
Farmer, that they “knew of and disregarded an excessive risk to inmate health or safety,” to
overcome summary judgment. Farmer, 511 U.S. at 834.
The plaintiff asserts, and the record supports, that he repeatedly suffered from phenytoin
overdoses over a two year period. But he never offers facts to dispute the defendants’ evidence
showing reasonable medical attention—the defendants carefully dosed the plaintiff’s medication,
phenytoin overdoses may result from causes outside of the defendants’ control, the defendants
promptly attended to the plaintiff’s overdoses, and, in any case, the plaintiff may never have
been injured by the overdoses. Far from the facts in Scinto, the overwhelming character of the
record before this court shows competent, if imperfect, medical attention—evidence too weak to
meet the Farmer standard. Farmer, 511 U.S. at 835–36 (negligence is insufficient to meet the
deliberate indifference standard).
The rest of the plaintiff’s claims follow in tow. Contrary to the plaintiff’s unsworn claim
that during a March 12 seizure it took 45 minutes for medical help to arrive, the record shows
instead that the prison medical staff responded six minutes after the call for help went out. The
record does show that despite being prescribed new medication on March 15, 2016, it took until
March 24, 2016 for the plaintiff to receive his first dose. But the delay was not a result of
indifference. The new medication was non-formulary and was not available until the date the
plaintiff received it. As for the plaintiff’s claim concerning Officer Raja’s alleged failure to seek
medical attention during one of the plaintiff’s seizures, the plaintiff alleges that the incident

15

occurred during the night shift. On the day of the incident, Officer Raja was working the day
shift.
Again, Scinto is instructive. That case also involved a claim against prison officials for
failure to promptly respond to the plaintiff’s medical emergency. The plaintiff there suffered
severe gastrointestinal distress, vomiting up blood. After responding to the plaintiff’s call for
help, the defendants merely looked at the plaintiff “in disgust” and walked away without
providing medical aid until at least two days after the incident. The Fourth Circuit again found
the Farmer standard satisfied. The court held that a genuine dispute of fact was raised on the
objective prong, “whether the denial of medical attention during this emergency resulted in
serious injury or a substantial risk of serious injury,” because of the severity of the medical issue
involved. Farmer, 841 F.3d at 232. The plaintiff also raised a genuine dispute, through
“sufficient circumstantial evidence,” that the subjective prong was satisfied. The court found that
there was sufficient evidence showing the defendants were aware that failing to treat the plaintiff
“created a substantial risk of serious injury.” Id.
By contrast, the plaintiff never supports, even with circumstantial evidence, his
allegations against Officer Raja. More than that, the defendants directly refute the plaintiff’s
unsworn claims proving that, at least as the plaintiff tells it, Officer Raja could not have possibly
been involved in the incident described. In short, there is no evidence that Officer Raja was
aware that failing to treat the plaintiff’s seizure “created a substantial risk of serious injury,”
Scinto, 841 F.3d at 232, because the unrebutted evidence shows he was not even there.
Because the plaintiff fails to provide anything more than unsworn testimony to support
his claims against the defendants, and because the defendants provide unrebutted evidence that

16

they never recklessly or intentionally withheld medical treatment, the defendants’ motions for
summary judgment will be granted.
B.

The Plaintiff’s Motion for Summary Judgment
The plaintiff, for his part, filed a motion for summary judgment arguing that the

defendants violated due process by improperly investigating his administrative complaints.
Prisoners are not afforded a free-floating constitutional right to grievance procedures. See Adams
v. Rice, 40 F.3d 72, 75 (4th Cir. 1994). Indeed, the liberty interests of prisoners protected by the
Due Process Clause “will be generally limited to freedom from restraint which . . . imposes
atypical and significant hardship on the inmate in relation to the ordinary incidents of prison
life.” Sandin v. Conner, 515 U.S. 472, 483 (1995).
The plaintiff’s ARP complaint was investigated and found to be without merit. The
failure to conduct extensive interviews of all those present during the alleged incident is not an
adequate basis for a claim that the plaintiff’s due process rights were infringed. Where, as here,
the plaintiff has failed to reference admissible evidence that supports his claim, supervisory
defendants cannot be held accountable for failing to prove the plaintiff’s claim for him. The
motion for summary judgment will be denied.
A separate order follows.

___8/28/2017____
Date

__________/s/__________
Catherine C. Blake
United States District Judge

17