Oxendine v. Wexford Health Source Inc. et al
MEMORANDUM OPINION. Signed by Judge Theodore D. Chuang on 8/14/2017. (c/m 8/14/2017 tds, Deputy Clerk)
UNITED STATES DISTRICT COURT
DISTRICT OF MARYLAND
SHAUN P. OXENDINE,
Civil Action No. TDC-16-3168
WEXFORD HEALTH SOURCES, INC. and
YONAS SISA Y, M.D.,
Shaun P. Oxendine, currently confined at Eastern Correctional Institution in Westover,
Maryland, alleges that Defendants failed to provide him with adequate medical care, in violation
of the Eighth Amendment to the United States Constitution.
Pending before the Court is the
Motion to Dismiss, or in the Alternative, Motion for Summary Judgment filed by Wexford
Health Sources, Inc. ("Wexford") and Yonas Sisay, M.D ("Dr. Sisay,,).l
For the reasons set
forth below, the Motion, construed as a Motion for Summary Judgment, shall be granted.
On February 3, 2014, Oxendine, who had been assigned to Baltimore County Detention
Center, underwent intake medical screening at the Maryland Reception and Diagnostic and
Classification Center ("MRDCC").
At the time, Oxendine had a medical history of constipation,
During the screening,
Oxendine did not complain of either abdominal or hernia-related pain.
The following day,
The Clerk shall be directed to amend the docket to reflect the correct names of Defendants.
during a health assessment by Grace Emasea1u, a nurse practitioner, he reported a history of
gastrointestinal reflux, chronic constipation, and a right inguinal hernia. The nurse practitioner
recommended that he continue to receive medication for esophageal reflux and Metamuci1 for
constipation and that he increase his intake of fluids and the amount of fiber in his diet. During a
chronic care visit on February 11, 2014 with Dr. Virenda Chhunchha, Oxendine did not report
any nausea or vomiting, but told the doctor that Metamuci1 and Co1ace were ineffective to treat
his chronic constipation.
Du1co1ax and magnesi,um citrate were then added to his medication
regimen. On February 25,2014, Oxendine was transferred from MRDCC to Jessup Correctional
gastrointestinal issues until Apri116, 2014, when he was evaluated by Dr. Sisay during a chronic
care clinic. In response to his request for medication to treat constipation, Dr. Sisay prescribed
Lactu10se and Metamucil.
Then, on June 12, 2014, during a visit with Danielle Jones, R.N.,
Oxendine reported, "I think I have a stomach virus" and revealed that he had diarrhea, stomach
cramps, and vomiting. Mot. Summ. J. Ex. 1, at 17, ECF No. 15. The nurse directed him to take
Phenergan and Tylenol.
Later that day, Lum Maximuangu,
a nurse practitioner, examined
Oxendine and found that he had abdominal pain, diarrhea, nausea, and vomiting but could not
recall a trigger for the discomfort.
The nurse practitioner diagnosed Oxendine as suffering from
prescribed Tylenol and Promethazine,
and advised Oxendine to refrain
from work and heavy lifting and to take only clear liquids until the morning.
The next month, on July 4, 2014, Oxendine submitted a sick call request in which he
reported hernia-related pain, among other issues. On July 11,2014, during a visit with Dr. Sisay,
Oxendine did not shown signs of bowel and bladder incontinence or abdominal tenderness.
Likewise, during a chronic care visit on August 18,2014 with Dr. Bolaji Onabajo, Oxendine did
not complain of any abdominal pain or issues other than constipation,
for which he was
continuing to take Du1colax.
There are no further medical records reflecting complaints about abdominal issues until
October 2014. On October 5, 2014, four days after he had submitted another sick call request
Oxendine saw Nurse Maximuangu and complained of constipation and hernia-related pain. He
reported that the Du1colax did not help his constipation and requested milk of magnesia, which
he was provided. Oxendine also complained of abdominal tenderness. Although the nurse could
not palpate the hernia, a hernia belt was recommended.
He was placed on a high fiber diet and
directed to refrain from work and heavy lifting. On October 10, 2014, when Dr. Sisay evaluated
Oxendine, he did not complain of incontinence or show signs of abdominal tenderness, but Dr.
Sisay identified a small reducible hernia.
The following month, Oxendine's condition worsened. On November 2,2014, Oxendine
sought medical treatment after he reported nausea and vomiting that had begun overnight.
believed that his right upper abdominal quadrant was swollen and described his pain as a three
out of ten, with ten being the highest.
right upper abdomen.
An examination revealed no swelling or tenderness in
Oxendine agreed to eat breakfast but then vomited at the
clinic. The nurse provided him with acetaminophen, an ice pack, Pepto Bismol, and Phenergan.
However, his abdominal pain continued, and he vomited again. When Oxendine returned to the
medical clinic, he had sharp pain in his upper right abdomen that occurred randomly and was
aggravated by movement.
The physician's assistant who examined him consulted with a doctor
and sent Oxendine to the emergency room at Bon Secours Hospital ("BSH"). At BSH, Oxendine
was diagnosed with acute cholecystitis and underwent successful surgery to remove his gall
On November 6, 2014, he was discharged and advised to resume his normal diet and
medications, educated about surgical wound care, and advised to avoid strenuous activities.
Upon his return to JCI on November 7, 2014, he was evaluated by Nurse Maximuangu.
Oxendine had no difficulty eating, the surgical site was cleaned and dressed, and there was no
sign of infection.
Oxendine did, however, report abdominal tenderness, and he was prescribed
He was then returned to the general population, at his request. On November
17, 2014, Oxendine complained to Dr. Sisay about abdominal soreness, but there was no nausea
or vomiting, and his surgical incision had healed. Dr. Sisay refilled Oxendine's prescription for
Tylenol 3 and requested a consultation for a post-surgical follow up visit.
Oxendine had a post-surgical follow-up visit at BSH on December 11, 2014. The BSH
physician noted that the wound had healed well and that no follow up was required relating to
the surgery, but recommended follow up for his inguinal hernia. On January 5, 2015, Dr. Sisay
evaluated Oxendine and observed no abdominal tenderness, but he noted the reducible inguinal
hernia and placed an order for a hernia belt for Oxendine.
medication to address post-surgical issues.
Oxendine continued to receive pain
Since the January 5, 2015 visit, Oxendine has not
voiced any complaints to medical staff about abdominal or hernia-related pain, other than minor
pain at his surgical site. According to Dr. Sisay, where Oxendine has a small, reducible inguinal
hernia with minimal to no symptoms, surgery is not medically necessary.
On September 15, 2016, Oxendine filed this action pursuant to 42 U.S.C.
alleges that, beginning on or about February to March 2014, he submitted a number of sick call
of pain in his abdomen and stomach.
Oxendine asserts that he was
as having food poisoning, a stomach virus, and indigestion before he finally
underwent the surgery at BSH to remove his gall bladder.
According to Oxendine, the surgery
itself was delayed for 11.5 hours because Dr. Sisay had failed to answer a call from a nurse
seeking authorization for emergency surgery.
Oxendine also claims that, following the surgery, he "could not use the bathroom,
because [he] wasn't allowed the proper diet after surgery," and that nothing was done about his
diet until August 2015, despite h.is complaints that processed foods were complicating his
Compi. ~ 6, ECF NO.1.
According to Oxendine, Dr. Sisay did not schedule
a requested follow-up visit 60 days after the surgery at BSH to address continued bloating, pain,
and a hernia.
Moreover, he asserts that prison medical staff have not addressed his hernia or
ongoing abdominal pain and swelling and that he has "lost the use of muscles on my lower right
side." Id. ~ 7.
Defendants have filed a Motion to Dismiss or, in the Alternative, Motion for Summary
They attached to their Motion Oxendine's medical records and an affidavit by Dr.
Pursuant to Roseboro v. Garrison, 528 F.2d 309 (4th Cir. 1975), Oxendine was sent
correspondence notifying him that Defendants had filed a dispositive motion, the granting of
which could result in the dismissal of his action.
Oxendine was also informed that he was
entitled to file materials in opposition to the Motion within 17 days from the date of that letter,
and that his failure to file a timely responsive brief to illustrate, through accompanying affidavits
or other evidence, a genuine dispute of material fact could result in the dismissal of his case or in
the entry of summary judgment without further notice of the Court.
Oxendine did not file a
Defendants seek dismissal of the Complaint or summary judgment in their favor on
several grounds, including that:
(1) Oxendine failed to state a plausible
1983 claim as to
Wexford, a private corporation; (2) Oxendine has failed to allege sufficient facts to support a
claim against Dr. Sisay for deliberate indifference to a serious illness or injury; and (3)
Defendants are entitled to summary judgment on the undisputed facts presented in medical
have submitted evidence for the Court's
reVIew, and because
Oxendine has not requested an opportunity for discovery, the Motion is construed as a motion for
See Fed. R. Civ. P. 12(d). Under Federal Rule of Civil Procedure 56(a), the
Court grants summary judgment if the moving party demonstrates there is no genuine issue as to
any material fact, and that the moving party 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). In assessing the Motion, the
Court views the facts in the light most favorable to the nonmoving party, with all justifiable
inferences drawn in its favor. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 255 (1986). The
Court may rely only on facts supported in the record, not simply assertions in the pleadings.
Bouchat v. Baltimore Ravens Football Club, Inc., 346 F.3d 514, 522 (4th Cir. 2003).
nonmoving party has the burden to show a genuine dispute on a material fact. Matsushita Elec.
Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586-87 (1986). A fact is "material" if it "might
affect the outcome ofthe suit under the governing law." Anderson, 477 U.S. at 248. A dispute of
material fact is only "genuine" if sufficient evidence favoring the nonmoving party exists for the
trier of fact to return a verdict for that party. Id. at 248-49.
At the outset, Oxendine's claims against Wexford must be dismissed because he has
neither alleged nor provided evidence to show that Wexford had a policy or custom that resulted
in a deprivation of his constitutional rights.
Section 1983 allows individuals to sue in federal
court any person who violates their federally protected rights while acting under the color of law.
1983 (2012). The United States Supreme Court, in Monell v. Department of Social
Services of the City of New York, 436 U.S. 658 (1978), concluded that local government entities
are considered "persons" for the purposes of
1983, but they cannot be held liable solely
because they employ an individual who committed an unlawful act. Id at 690-91.
governments can only be sued if the constitutional violation alleged results from a custom or
policy of the local government.
Id This standard also applies to private companies that employ
individuals acting under color of state law, such as special police 'officers or prison medical
personnel, who allegedly commit unlawful acts. See Austin v. Paramount Parks, Inc., 195 F.3d
715, 728 (4th Cir. 1999) (citations omitted). Such companies are liable under
S 1983 "only
an official policy or custom of the corporation causes the alleged deprivation of federal rights."
Id. Because Oxendine has neither alleged nor provided evidence to show that Wexford had a
policy or custom that caused the alleged deprivation of his constitutional rights, the claim against
Wexford is dismissed.
The Eighth Amendment prohibits cruel and unusual punishment.
U.S. Const. amend.
VIII. An inmate's Eighth Amendment rights are violated when there is "deliberate indifference
to [his] serious medical needs." Estelle v. Gamble, 429 U.S. 97, 104 (1976); Jackson v. Lightsey,
775 F.3d 170, 178 (4th Cir. 2014).
A deliberate indifference claim has both an objective
there objectively exists a serious medical condition and an excessive risk to the
inmate's health and safety-and
the condition and risk.
a subjective component-that
the official subjectively knew of
Farmer v. Brennan, 511 U.S. 825, 834, 837 (1978) (holding that an
official must have "knowledge" of a risk of harm, which must be an "objectively, sufficiently
To be objectively "serious," the condition must be "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."
Jackson, 775 F.3d at 178 (quoting Iko v.
Shreve, 535 F.3d 225, 241 (4th Cir. 2008)). However, deliberate indifference "does not require
proof that the plaintiff suffered an actual injury." Heyer v. Us. Bureau of Prisons , 849 F.3d 202,
210 (4th Cir. 2017). Instead, it is enough that the defendant's actions exposed the plaintiff to a
'substantial risk of serious harm.'" Id. (quoting Farmer v. Brennan, 511 U.S. 825,837 (1994)).
As for the subjective component, "[a]n official is deliberately indifferent to an inmate's
serious medical needs only when he or she subjectively knows of and disregards an excessive
risk to inmate health or safety." Jackson, 775 F.3d at 178 (quoting Farmer v. Brennan, 511 U.S.
825, 837 (1994)) (internal quotation marks omitted).
"[I]t is not enough that an official should
have known of a risk; he or she must have had actual subjective knowledge of both the inmate's
serious medical condition and the excessive risk posed by the official's action or inaction."
(citations omitted). "[M]any acts or omissions that would constitute medical malpractice will not
rise to the level of deliberate indifference."
Id. Thus, "[d]eliberate indifference is "more than
mere negligence, but less than acts or omissions done for the very purpose of causing harm or
with knowledge that harm will result." Scinto v. Stansberry, 841 F.3d 219,225
(4th Cir. 2016)
(internal alterations omitted). Under this standard, a mere disagreement between an inmate and a
physician over the appropriate level of care does not establish an Eighth Amendment violation
absent exceptional circumstances.
The record in this case establishes that there has been no attempt by Dr. Sisay or other
members of the prison medical staff to ignore or recklessly disregard a serious medical need
suffered by Oxendine. To the contrary, the record demonstrates Dr. Sisay and the other medical
staff consistently responded to Oxendine's medical complaints dating back to February 2014,
provided medicine and dietary supplements for his chronic constipation, and prescribed pain
medication to ease his symptoms.
Moreover, they performed diagnostic testing before referring
him to outside specialists to treat his abdominal pain, ultimately resulting in surgery.
The right to treatment is "limited to that which may be provided upon a reasonable cost
and time basis and the essential test is one of medical necessity and not simply that which may be
considered merely desirable."
Bowring v. Godwin, 551 F.2d 44,47-48
(4th Cir. 1977). Here,
although it would have been preferable if Oxendine's cholecystitis had been diagnosed earlier
such that the surgery that relieved most of his symptoms could have occurred sooner, the record
of consistent medical attention to address Oxendine's symptoms establishes that prison medical
staff did not deliberately fail to provide treatment. Even if Oxendine could establish that some of
his complaints were left unaddressed, that his medical condition was initially misdiagnosed, or
that his surgery was temporarily delayed because of Dr. Sisay's failure to answer a phone call, an
does not amount
Estelle, 429 U.S. at 105-06 ("[A] complaint that a physician has been negligent in
diagnosing or treating a medical condition does not state a valid claim of medical mistreatment
under the Eighth Amendment.").
As for Oxendine's post-surgery treatment, Oxendine's claim that his diet was supposed to
be changed after surgery, but was not actually changed until August 2015, does not provide
sufficient facts to establish that Defendants, rather than prison officials, had control over the
meals provided to Oxendine, or that their conduct relating to the food provided to Oxendine
establishes deliberate indifference to a serious medical need.
hernia requires surgery and additional treatment.
Oxendine also asserts that his
Dr. Sisay, however, arranged for Oxendine to
be evaluated for possible hernia surgery, and he concluded both that it is not at the level of
severity to warrant surgery and that the level of post-surgical pain management provided is
appropriate. Thus, Oxendine's claim amounts to another disagreement between the inmate and
his physician over the appropriate level of care, which does not establish an Eighth Amendment
violation absent exceptional
let alone provided
Scinto, 841 F.3d at 225.
of, any exceptional
Oxendine has not
such that his
over the appropriate level of care rises to an Eighth Amendment
Accordingly, Defendants are entitled to summary judgment on all claims .
For the foregoing reasons, Defendants' Motion is GRANTED.
A separate Order shall
Date: August 14,2017
THEODORE D. CHUANG
United States District Judge
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