McCray v. Corizon Health Care
Filing
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OPINION, MEMORANDUM AND ORDER - IT IS HEREBY ORDERED that Defendants Motion for Summary Judgment, [Doc. No. 25 ], is GRANTED.A separate judgment in accordance with this Opinion, Memorandum andOrder is entered this same date.. Signed by District Judge Henry Edward Autrey on 08/13/2019. (AAS)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MISSOURI
EASTERN DIVISION
REGINALD PATRICK MCCRAY,
Plaintiff,
vs.
IVOR GARLICK, et al.,
Defendants.
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Case No.: 4:17CV2558 HEA
OPINION, MEMORANDUM AND ORDER
This matter is before the Court on Defendants’ Motion for Summary
Judgment, [Doc. No. 25]. The Motion is unopposed. For the reasons set forth
below, Defendants’ Motion is granted.
Facts and Background
Plaintiff alleges that Defendants violated his Eighth Amendment rights
through deliberate indifference to his serious medical needs while he was an
inmate at the St. Louis City Justice Center (“SLCJC”).
Defendants have, in accordance with the Court’s Local Rules, submitted a
Statement of Uncontroverted Material Facts. Plaintiff failed to respond to
Defendants’ facts. Pursuant to Rule 56 of the Federal Rules of Civil Procedure and
Rule 7-401(E) of this Court’s Local Rules, Defendants’ facts are deemed admitted.
Local Rule 7-401(E) provides:
Rule 7 - 4.01 Motions and Memoranda.
(E) A memorandum in support of a motion for summary judgment shall
have attached a statement of uncontroverted material facts, set forth in a
separately numbered paragraph for each fact, indicating whether each fact is
established by the record, and, if so, the appropriate citations. Every
memorandum in opposition shall include a statement of material facts as to
which the party contends a genuine issue exists. Those matters in dispute
shall be set forth with specific references to portions of the record, where
available, upon which the opposing party relies. The opposing party also
shall note for all disputed facts the paragraph number from movant’s listing
of facts. All matters set forth in the statement of the movant shall be deemed
admitted for purposes of summary judgment unless specifically controverted
by the opposing party.
The undisputed facts are as follows:
Plaintiff was previously an inmate at the SLCJC and was released in early
August 2018.
Dr. Fe Fuentes is the Medical Director at the SLCJC.
Dr. Ivor Garlick was the Regional Medical Director for Corizon. As
Regional Medical Director, Dr. Garlick did not provide medical treatment to
patients. Rather, he reviewed consultation requests for specialized services for
medical necessity. Where there was an alternative treatment or diagnostic plan to
the specialized services requested and the alternative would provide the equivalent
therapeutic or diagnostic result, Dr. Garlick may have suggested the alternative.
On April 6, 2017, Plaintiff injured his left knee and was sent to the St. Louis
University Hospital emergency room for evaluation, where he was diagnosed with
a patellar dislocation. A patellar dislocation occurs when the patella (or kneecap)
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slips out of its normal position. The initial treatment for patellar dislocation is
relocation of the kneecap back into its normal position and immobilization,
followed by slow rehabilitation. Conservative treatment for a patellar dislocation
involves immobilization of the knee joint, physical therapy to increase strength and
flexibility, and pain medications. If a patient does not respond well to conservative
treatment, surgery may be required to repair significant bone or ligament damage.
Dr. Fuentes saw Plaintiff upon his return to the SLCJC and ordered
ibuprofen, a bottom bunk, and a bottom tier for his knee dislocation. On April 7,
2017, Dr. Fuentes also requested an orthopedic evaluation for Plaintiff and noted
that he had a knee brace. She also prescribed Tylenol #4, a narcotic pain
medication, for Plaintiff. Plaintiff also had an x-ray which showed degenerative
changes but no acute fracture or dislocation. On April 11, 2017, Dr. Garlick
approved Dr. Fuentes’ request.
On April 25, 2017, Plaintiff was seen at the SLUH orthopedic clinic in
follow-up and was issued a short knee brace. The orthopedist recommended
physical therapy and a follow-up appointment. Dr. Fuentes requested physical
therapy and a follow-up orthopedic evaluation for Plaintiff. Dr. Garlick approved
the request.
On May 9, 2017, Dr. Fuentes ordered Tramadol, a narcotic-like pain
medication, for Plaintiff.
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On June 6, 2017, Physical Therapist Colleen Long saw Plaintiff. She
recommended an orthopedic follow-up for surgical stabilization. On June 13,
2017, an orthopedist advised ordering an MRI and CT scan of Plaintiff’s left
knee. Dr. Fuentes requested an MRI and CT scan of Plaintiff’s left knee, stating
that Plaintiff had dislocated his left knee, which was unstable. Dr. Fuentes also
noted that he had undergone physical therapy, had a left knee brace, and was
treated with Naprosyn. Dr. Fuentes further noted that Plaintiff was able to perform
his activities of daily living (“ADLs”).
On June 23, 2017, Dr. Garlick noted that he believed that conservative
treatment was appropriate for Plaintiff’s patella because he was able to perform his
ADLs and was not in severe pain. He approved an orthopedic consultation to
determine whether conservative treatment was the correct approach for this patient.
Dr. Garlick was not aware that the orthopedist had recommended the MRI and CT
scan; if he had been made aware of the recommendation, he would have approved
the request.
On July 27, 2017, Dr. Fuentes saw Plaintiff for complaints of continued knee
pain. Dr. Fuentes ordered Tylenol #4 for his knee and an x-ray. The x-ray showed
mild degenerative changes but no fracture or dislocation.
On August 1, 2017, Dr. Chris Kim, an orthopedist, saw Plaintiff, and
recommended a CT scan and an MRI. Dr. Fuentes noted that she would direct a
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nurse to send a copy of the orthopedist’s notes to Dr. Garlick to approve the MRI.
Dr. Fuentes believed that the records would be transmitted to Dr. Garlick upon
receipt. She is not aware of whether the nurse sent the records to Dr. Garlick. Dr.
Garlick does not recall receiving or reviewing these notes, and Plaintiff’s medical
records do not reflect that a consultation request for an MRI or CT scan was
submitted in or around August 2017. If Dr. Garlick had been made aware of Dr.
Kim’s recommendations, he would have approved an MRI or CT scan.
Dr. Fuentes renewed Plaintiff’s Tylenol #4 prescription on August 29, 2017,
and prescribed ibuprofen on September 21, 2017. On September 29, 2017, Dr.
Fuentes saw Plaintiff for complaints of left knee pain. She ordered Tylenol #4 and
an x-ray. The x-ray, taken on October 4, 2017, showed no fracture or dislocation
and no significant changes from Plaintiff’s prior x-ray. On October 10, 2017, Dr.
Fuentes discussed Plaintiff’s x-ray results with him and renewed Tylenol #4. On
November 2 and November 10, 2017, Dr. Fuentes renewed Tylenol #4. On
November 22, 2017, Dr. Fuentes ordered Naproxen.
On December 21, 2017, Dr. Fuentes saw Plaintiff for complaints of
persistent knee pain. (Id. ¶ 21). She noted that his patella appeared to be dislocated
but could be positioned in place. Dr. Fuentes noted that she would request
authorization for an MRI of Plaintiff’s left knee. She provided an ACE bandage
and advised Plaintiff to use the bandage and brace. Due to an inadvertent oversight,
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a consultation request for an MRI was not submitted in or around December 21,
2017.
Plaintiff’s Tylenol #4 prescription was renewed on January 22, 2018,
January 25, 2018, and February 7, 2018. Dr. Fuentes ordered Naproxen for
Plaintiff on February 20, 2018. When Plaintiff complained that it caused blood in
his stool, Dr. Fuentes ordered Tylenol #4. Dr. Fuentes renewed it on March 5,
2018.
On March 19, 2018, Dr. Fuentes renewed Tylenol #4 and submitted a
request for an MRI of Plaintiff’s left knee. The request was approved by Dr.
Glenda Newell-Harris, the acting RMD. On April 2, 2018, Dr. Fuentes renewed
Tylenol #4.
On April 3, 2018, Dr. Fuentes saw Plaintiff and noted that an MRI had been
approved and that he would be scheduled for the procedure. Dr. Fuentes also
ordered an extra mattress for Plaintiff. On April 30, 2018, Dr. Fuentes requested
an orthopedics consultation in follow-up to Plaintiff’s MRI. Dr. Garlick approved
the request.
Plaintiff’s Tylenol #4 prescription was renewed on April 18, 2018, May 8,
2018, and May 21, 2018. On May 31, 2018, Dr. Fuentes saw Plaintiff, who had
seen an orthopedist on May 29, 2018. The orthopedist recommended a CT scan of
Plaintiff’s left knee. Dr. Fuentes submitted a request for an urgent CT scan of
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Plaintiff’s knee and a follow-up appointment with the orthopedist. Dr. Garlick
approved the request.
On June 13, 2018, Dr. Fuentes saw Plaintiff and noted that a CT scan and
orthopedist appointment were scheduled. On June 8 and June 19, 2018, Dr.
Fuentes renewed Tylenol #4.
On June 26, 2018, Plaintiff returned from an evaluation with an orthopedist
and reported that the orthopedist advised surgery. Dr. Fuentes requested an
arthroscopy of Plaintiff’s left knee on June 28, 2018, which Dr. Garlick approved.
Plaintiff underwent left knee arthroscopy in late July 2018, and was released
in early August 2018.
Plaintiff was provided medically appropriate treatment for his left knee
injury. The care he received was within the standard of care exercised by like
providers in similar circumstances. The care Plaintiff was provided also did not
cause him any injury or harm.
Plaintiff was not harmed by any perceived delay in receiving an MRI or left
knee surgery. In particular, the course of Plaintiff’s treatment, including his left
knee surgery or recovery from that surgery, was not affected by any perceived
delay. Further, Plaintiff exhibited no significant left knee deterioration between the
date of his injury and the date of his surgery.
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Dr. Garlick’s recommendations pertaining to the treatment of Plaintiff’s left
knee were not based on cost. Neither Dr. Fuentes nor Dr. Garlick denied Plaintiff
necessary medical treatment for any medical concerns or symptoms, nor did they
disregard or otherwise ignore any of his medical needs. There is no evidence that
Dr. Fuentes or Dr. Garlick communicated with the Missouri Protection Advocacy
regarding Plaintiff.
Summary Judgment Standard
The Eighth Circuit has articulated the appropriate standard for consideration
of motions for summary judgment, as follows:
Summary judgment is proper if the pleadings, the discovery and disclosure
materials on file, and any affidavits show that there is no genuine issue as to
any material fact and that the movant is entitled to judgment as a matter of
law. The movant bears the initial responsibility of informing the district
court of the basis for its motion, and must identify those portions of the
record which it believes demonstrate the absence of a genuine issue of
material fact. If the movant does so, the nonmovant must respond by
submitting evidentiary materials that set out specific facts showing that there
is a genuine issue for trial. On a motion for summary judgment, facts must
be viewed in the light most favorable to the nonmoving party only if there is
a genuine dispute as to those facts. Credibility determinations, the weighing
of the evidence and the drawing of legitimate inferences from the facts are
jury functions, not those of a judge. The nonmovant must do more than
simply show that there is some metaphysical doubt as to the material facts,
and must come forward with specific facts showing that there is a genuine
issue for trial. Where the record taken as a whole could not lead a rational
trier of fact to find for the nonmoving party, there is no genuine issue for
trial.
Torgerson v. City of Rochester, 643 F.3d 1031, 1043 (8th Cir. 2011) (en banc)
(internal citations and quotation marks omitted). “Although the burden of
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demonstrating the absence of any genuine issue of material fact rests on the
movant, a nonmovant may not rest upon mere denials or allegations, but must
instead set forth specific facts sufficient to raise a genuine issue for trial.” Wingate
v. Gage Cnty. Sch. Dist., No. 34, 528 F.3d 1074, 1078–79 (8th Cir. 2008) (cited
case omitted). With this standard in mind, the Court accepts the above listed facts
as true for purposes of resolving the parties' motions for summary judgment.
Plaintiff alleges that Dr. Fuentes failed to follow the recommendations of the
bone specialist. He alleges Dr. Fuentes told him that Dr. Garlick would not
approve an MRI due to cost, and because it would lead to surgery. Essentially,
Plaintiff’s claim is that Defendants were deliberately indifferent to plaintiff's
serious medical needs. Defendant also claims that Drs. Fuentes and Garlick
“falsified [his] medical records to the Missouri Protection Advocacy.”
The Eighth Amendment prohibition on cruel and unusual punishment
extends to protect prisoners from “deliberate indifference to serious medical
needs.” Gregoire v. Class, 236 F.3d 413, 417 (8th Cir. 2000).
In a deprivation of medical care case, the inmate must show (1) an
objectively serious medical need; and (2) the defendants actually knew of the
medical need but were deliberately indifferent to it. See Grayson v. Ross, 454 F.3d
802, 808–09 (8th Cir. 2006). “An objectively serious medical need is one that
either has been diagnosed by a physician as requiring treatment, or is so obvious
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that even a ‘layperson would easily recognize the necessity for a doctor's
attention.’” Jones v. Minnesota Dep't of Corrs., 512 F.3d 478, 483 (8th Cir. 2008).
See also Coleman v. Rahija, 114 F.3d 778, 784 (8th Cir. 1997). “‘To establish a
constitutional violation, it is not enough that a reasonable official should have
known of the risk.’ Rather, a plaintiff must demonstrate the official actually knew
of the risk and deliberately disregarded it.’” Vaughn v. Greene Cnty., Ark., 438
F.3d 845, 850 (8th Cir. 2006) (quoting Farmer v. Brennan, 511 U.S. 825, 837
(1994)). The determination that prison officials had actual knowledge of a serious
medical need may be inferred from circumstantial evidence or from the very fact
that the risk was obvious. See Farmer, 511 U.S. at 842; Jones, 512 F.3d at 483. If
prison officials have actual knowledge of a serious medical need, and fail to take
reasonable measures to address it, they may be held liable for deliberate
indifference. See Farmer 511 U.S. at 847. That said, “[a] showing of deliberate
indifference is greater than gross negligence and requires more than mere
disagreement with treatment decisions.” Pietrafeso v. Lawrence Cnty., S.D., 452
F.3d 978, 983 (8th Cir. 2006) (quoting Gibson v. Weber, 433 F.3d 642, 646 (8th
Cir. 2006)).
When an inmate alleges that a delay in medical treatment rises to the level of
an Eighth Amendment violation, “the objective seriousness of the deprivation
should also be measured ‘by reference to the effect of delay in treatment.’”
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Beyerbach v. Sears, 49 F.3d 1324, 1326 (8th Cir. 1995), abrogation on other
grounds recognized by Reece v. Groose, 60 F.3d 487, 492 (8th Cir. 1995) (quoting
Hill v. Dekalb Regional Youth Det. Ctr., 40 F.3d 1176, 1188 (11th Cir. 1994)).
Therefore, the inmate “must place verifying medical evidence in the record to
establish the detrimental effect of delay in medical treatment.” Crowley v.
Hedgepeth, 109 F.3d 500, 502 (8th Cir.1997) (quoting Hill, 40 F.3d at 1188). To
prevail on a claim that a delay in medical care constituted cruel and unusual
punishment, an inmate must show both that: (1) the deprivation alleged was
objectively serious; and (2) the prison official was deliberately indifferent to the
inmate's health or safety. Id. When the inmate alleges that a delay in medical
treatment rises to the level of an Eighth Amendment violation, the “objective
seriousness of the deprivation should also be measured ‘by reference to the effect
of delay in treatment.’” Laughlin v. Schriro, 430 F.3d 927, 929 (8th Cir. 2005)
(affirming the district court's grant of defendants' motion for summary judgment
because plaintiff failed to offer evidence establishing any delay in treatment had a
detrimental effect).
Allegations of medical malpractice, inadvertent failure to provide adequate
medical care, or simple negligence do not amount to a constitutional violation.
Estelle v. Gamble, 429 U.S. 97, 106 (1976); Popoalii v. Correctional Med. Servs.,
512 F.3d 488, 499 (8th Cir. 2008); Smith v. Clarke, 458 F.3d 720, 724 (8th Cir.
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2006). Rather, the standard is met when the complainant establishes that the
official “intentionally den[ied] or delay[ed] access to medical care, or intentionally
interfer[ed] with treatment or medication that has been prescribed.” Vaughan v.
Lacey, 49 F.3d 1344, 1346 (8th Cir.1995). Furthermore, “prison officials do not
violate the Eighth Amendment when, in the exercise of their professional
judgment, they refuse to implement a prisoner's requested course of treatment,”
since prisoners do not have a right to any particular course of medical care. Long
v. Nix, 86 F.3d 761, 765 (8th Cir.1996) (citing Kayser v. Caspari, 16 F.3d 280, 281
(8th Cir.1994)); Taylor v. Turner, 884 F.2d 1088, 1090 (8th Cir.1989). “[N]othing
in the Eighth Amendment prevents prison doctors from exercising their
independent professional judgment.” Long, 86 F.3d at 765. Accordingly, under
Eighth Circuit law, “mere disagreement with treatment decisions does not rise to
the level of a constitutional violation.” Popoalii, 512 F.3d at 499 (quoting Estate
of Rosenberg v. Crandell, 56 F.3d 35, 37 (8th Cir.1995)).
Discussion
For purposes of summary judgment, Defendants do not dispute that Plaintiff
had a serious medical need. What is at issue is whether Defendants were
deliberately indifferent to Plaintiff’s medical condition.
The undisputed facts in this case show that plaintiff was assessed and treated
on a regular basis for his left knee injury. Plaintiff was examined by Dr. Fuentes
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on a regular basis. Dr. Fuentes ordered evaluations with specialists, physical
therapy, pain medication, bottom bunk detail, an extra mattress, and diagnostic
testing, including x-rays, an MRI, and a CT scan. Although two requests for an
MRI from Dr. Fuentes were inadvertently not made or did not reach Dr. Garlick,
“simple negligence [does] not amount to a constitutional violation.” Estelle v.
Gamble, 429 U.S. at 106.
The undisputed facts show that Dr. Garlick did not deny any requests based
on cost. He did not deny an MRI, but, by some oversight he was not aware that the
orthopedist had recommended an MRI and CT scan. Although Dr. Garlick
believed that a conservative course of treatment was appropriate based on
Plaintiff’s ability to perform ADLs and lack of severe pain, he still approved
orthopedic evaluations to determine the best course of treatment. Plaintiff’s “mere
disagreement with treatment decisions does not rise to the level of a constitutional
violation.” Popoalii, 512 F.3d at 499.
Plaintiff has failed to provide any medical evidence of a detrimental effect
due to the delay in surgery. Additionally, he has provided no evidence that the
delay was intentional or the result of deliberate indifference. The delay therefore
cannot rise to the level of an Eighth Amendment violation.
Finally, Plaintiff’s allegation that Defendants falsified his medical records to
Missouri Protection and Advocacy services is unsupported by the undisputed facts,
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which state that there is no record of such communication between Defendants and
Missouri Protections and Advocacy. In addition, it is unclear what cause of action
is alleged or what kind relief Plaintiff is requesting with this statement.
Since he filed this suit, Plaintiff has undergone surgery on his left knee.
Surgery was performed while he was in the custody of SLCJC; he was released
shortly after. Plaintiff has not established that there is a triable issue as to whether
Defendants deliberately disregarded his serious medical needs. There is nothing in
the record to establish that Defendants violated Plaintiff's Eighth Amendment
rights. Summary judgment is, therefore, granted in favor of the defendants.
Conclusion
Based upon the foregoing analysis, Defendants are entitled to judgment as a
matter of law. The undisputed material facts establish that Defendants have not
been deliberately indifferent to Plaintiff’s serious medical needs. As such,
Defendants’ Motion for Summary Judgment will be granted.
Accordingly,
IT IS HEREBY ORDERED that Defendant’s Motion for Summary
Judgment, [Doc. No. 25], is GRANTED.
A separate judgment in accordance with this Opinion, Memorandum and
Order is entered this same date.
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Dated this 13th day of August, 2019.
________________________________
HENRY EDWARD AUTREY
UNITED STATES DISTRICT JUDGE
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