Estien v. Showalter et al
Filing
142
MEMORANDUM re Mtns for Summary Judgment 107 , 113 , 122 (Order to follow as separate docket entry)Signed by Honorable Sylvia H. Rambo on 9/28/17. (ma)
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
EDWIN ESTIEN, JR.,
Plaintiff,
v.
MARY LOU SHOWALTER, et al.,
Defendants
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Civil No. 1:13-CV-02474
(Judge Sylvia H. Rambo)
MEMORANDUM
On September 30, 2013, Plaintiff Edwin Estien, an inmate currently
incarcerated at the State Correctional Institution at Smithfield in Huntingdon,
Pennsylvania (“SCI-Smithfield”), commenced this civil rights action with a
complaint filed pursuant to the provisions of 42 U.S.C. § 1983. (Doc. 1.) In the
complaint, Plaintiff alleges that Defendants, past and present employees
(“Corrections Defendants”) of his former place of incarceration, the State
Correctional Institution in Huntingdon, Pennsylvania (“SCI-Huntingdon”), as well
as medical staff employed at SCI-Huntingdon (“Medical Defendants”),1 were
deliberately indifferent to his serious medical needs with respect to care for injuries
to his left hand and thumb. Plaintiff also raises allegations of retaliation,
conspiracy, and related state law claims.
1
The remaining Corrections Defendants are former Corrections Health Care Administrator
(“CHCA”) Showalter, and RHU Lieutenant Dunkle. The remaining Medical Defendant is
Clinical Coordinator Tracey Parkes.
Presently before the court are two motions for summary judgment, filed
by both sets of Defendants, (Docs. 107 & 113), as well as a motion for cross
summary judgment filed by Plaintiff, (Doc. 122). For the reasons set forth below,
the motions for summary judgment filed by Defendants will be granted and
Plaintiff’s motion for cross summary judgment will be denied.
I.
Background
A. Facts
The following facts are related to Plaintiff’s claims. The court notes any
factual disputes between the parties by presenting all parties’ contentions.2
1. Facts Regarding Defendants
Plaintiff was incarcerated at SCI-Huntingdon from October 18, 2012
through September 25, 2012. (Doc. 115 ¶ 1; Doc. 125 ¶ 1.) The claims in
Plaintiff's complaint arise from an April 17, 2012 altercation he had with another
inmate that resulted in a broken left thumb and deep cut from a razor blade. (Doc.
1 ¶ 1.) At all times relevant, Corrections Defendants Showalter and Dunkle were
employed by the Pennsylvania Department of Corrections (“DOC”) at SCI-
2
In support, Plaintiff has submitted a declaration (Doc. 125-1) and other supporting documents.
In addition, Corrections Defendants have submitted the deposition transcript of Plaintiff, dated
August 12, 2015, and supporting exhibits (Doc. 116), as well as declarations of Defendants
Dunkle and Showalter, Amanda West, a DOC grievance review officer (Doc. 117), and Paula
Price, SCI-Huntingdon's current CHCA (Doc. 118). Defendant Parkes has submitted a
declaration and supporting documents also. (Doc. 108.)
2
Huntingdon. (Doc. 115 ¶ 2.) Medical Defendant Parkes worked at SCIHuntingdon, but was employed by Corizon Health Care, Inc. (Id.)
Defendant Dunkle serves as a Corrections Officer 3 or Lieutenant at SCIHuntingdon, a position he has held since 2011. (Id. ¶ 46.) At the relevant time,
Defendant Dunkle worked in the RHU, or “G” Unit. (Id. ¶ 47.) The RHU houses
inmates who are in disciplinary or administrative custody, and these inmates have
limited privileges and activities outside their cells. (Id.) Defendant Dunkle was
the RHU Relief Lieutenant from January 2011 through December 2011, and the
Lieutenant from January 2012 through December 2012. (Id.) As the RHU
Lieutenant, Defendant Dunkle was responsible for the supervision of the
Corrections Officers in the RHU as well as the inmates in the Unit. (Id.) The
RHU Sergeants reported to Defendant Dunkle, and he, in turn, reported to the Shift
Commander. (Id. ¶ 48.)
Generally, when an inmate is sent to the RHU, he is initially strip
searched by staff in a metal enclosure. (Id. ¶ 50.) The strip search is videotaped.
(Id.) An incoming inmate is asked a series of questions from the Suicide Risk
Indicators Checklist, which is completed by the RHU staff person. (Id.) A nurse is
also present and examines the inmate. (Id.) In addition, the nurse also completes
the Suicide Risk Indicators Checklist. (Id.)
3
When an injured inmate enters the RHU, he is seen by medical staff. (Id.
¶ 49.) If the injury is the result of an altercation and security staff had intervened
to separate the inmates, medical staff takes photographs of the inmate and any
injuries. (Id.) However, if security staff is not involved in separating inmates
involved in an altercation, RHU security staff takes the photographs of the inmate
and any injuries. (Id.) In his role as RHU Lieutenant, Defendant Dunkle does not
provide medical care to inmates in the RHU, nor is he responsible for what medical
care and treatment an inmate is to receive and when they are to receive it. (Id.)
Rather, the nurses and other medical staff make daily rounds in the RHU, or
inmates may fill out sick call request slips, if necessary. (Id.)
Turning to Defendant Showalter, at the relevant time, she was serving as
SCI-Huntingdon’s Corrections Health Care Administrator (“CHCA”). (Id. ¶ 2.)
Prior to her promotion to CHCA, Defendant Showalter held the positions of
Registered Nurse (“RN”) and RN Supervisor at SCI-Huntingdon. (Id. ¶ 30.) As an
RN, Defendant Showalter cannot prescribe medication, including painkillers. (Id.
¶ 31.)
As the CHCA at SCI-Huntingdon, Defendant Showalter’s duties included
the following: planning, organizing, directing and managing the health care
services program, the coordination of a professional medical staff in cooperation
with a contracted medical vendor, and compliance monitoring and supervision of
4
contracted medical services. (Id. ¶ 32.) She reported to the Deputy Superintendent
for Centralized Services. (Id.)
In addition, Defendant Showalter answered inmate grievances and
request slips from inmates regarding their medical treatment. (Id. ¶ 33.) The
Superintendent’s Assistant at SCI-Huntingdon would assign an inmate grievance to
her. (Id.) In order to respond to an inmate grievance or request slip, Defendant
Showalter normally would review the inmate’s medical records. (Id.) If an inmate
grievance or request slip concerned a consultation with an outside doctor,
Defendant Showalter would also normally contact the contracted medical vendor,
who, at the relevant time, was Corizon Health Care, Inc. (Id.)
After an inmate was taken to a local Emergency Room, any instructions
from the ER doctor would have been sent to Corizon, and not to Defendant
Showalter. (Id. ¶ 34.) If Corizon initiated or scheduled a consultation, Defendant
Showalter would monitor such consultations. (Id.) However, she would not have
been aware of any consultations not initiated or scheduled by Corizon. (Id.)
Under SCI-Huntingdon’s contract with Corizon, the medical vendor had
thirty (30) days to complete an inside consultation and sixty (60) days to complete
an outside consultation. (Id. ¶ 35.) However, if surgery was necessary, normally it
would be scheduled earlier than thirty (30) or sixty (60) days. (Id.) At the relevant
time, the Site Administrator for Corizon was Defendant Parkes. (Id.) Her duties
5
included scheduling outside consultations and surgeries. (Id.) Defendant
Showalter did not order outside consultations or surgeries. (Id.) Further, as the
CHCA, she could not override decisions of medical doctors, such as what
medications to prescribe or whether to order outside consultations or physical
therapy. (Id. ¶ 36.)
As to medical treatment of an inmate in the RHU, Defendant Showalter
provided that, if an inmate was issued a health care item such as a brace or splint,
the RHU staff would sometimes deny the item to the inmate for security reasons.
(Id. ¶ 37.) Further, nurses and other medical staff made daily rounds in the RHU.
(Id.) If an inmate had complaints about his health or treatment, he could complain
to the nurses and other medical staff monitoring the RHU, or he could submit a
sick call slip. (Id.)
Turning to Medical Defendant Parkes, she currently holds the position of
Health Services Administrator at SCI-Huntingdon, but formerly held the position
of clinical coordinator from April 2012 through May 2012. (Doc. 108 ¶1.) In her
position as clinical coordinator, Defendant Parkes did not provide medical care to
inmates, and indeed, had no personal contact with Plaintiff for the provision of
medical services. (Id. ¶¶ 2, 3.) Rather, her duties included scheduling
appointments with outside medical professionals when directed to do so by a
health care professional at the prison. (Id. ¶ 5.) To that end, it is the prison’s
6
medical personnel who determine the reason for an inmate to be transferred to an
outside medical provider. (Id. ¶ 12.)
Further, Defendant Parkes had no control over when an inmate will be
seen by a medical provider outside the prison facility. (Id. ¶ 4.) The date of an
appointment is determined by the outside medical provider based upon availability.
(Id. ¶ 6.) Once an appointment date is secured, prison officials are notified through
the distribution of a “trip sheet” so that arrangements can be made to transport the
inmate to the location of the outside medical provider. (Id. ¶ 7.) Defendant Parkes
did not control the availability of prison officials to transport an inmate to a
scheduled appointment. (Id. ¶ 9.)
As to the duties of both Defendants Showalter and Parkes, Plaintiff
counters that, as clinical coordinators, both Defendants had knowledge of
Plaintiff’s injuries after the April 17, 2012 altercation, yet “did nothing” to have
him immediately seen by a nurse, doctor, or physician’s assistant, nor did they
make arrangements to take him to a hospital. (Doc. 125, Part II, ¶ 1.)3 In addition,
he asserts that, after a second appointment with an outside doctor was made for
April 23, 2012, both Defendants knew of this appointment and “did nothing” to
have Plaintiff returned to the hospital on that day for “emergency surgery.” (Id.,
Part I, ¶ 10.) More specifically, Plaintiff asserts that “it was [Defendant Parkes’]
3
Plaintiff has submitted a two-part counter statement of material facts. (See Doc. 125.) As both
parts are docketed under Document 125, the court will differentiate by noting Part I or Part II.
7
job duty to arrange an escort team” to have Plaintiff taken to that appointment.
(Id., Part I, ¶ 11.) Defendant Parkes denies that this was her job duty. (Doc. 129 ¶
11.) Notably, however, at his deposition Plaintiff admits that the April 23, 2012
appointment was not, in fact, with a surgeon but, rather, with Dr. Stauff, who
would not conduct surgery on Plaintiff’s hand. (Doc. 116 at 79-80.) And finally,
Plaintiff asserts that both of these Defendants knew of the razor blade in his left
thumb and the need for a second surgery to remove the blade, but “did nothing” to
have him taken back to an outside doctor to be seen. (Doc. 125, Part II, ¶¶ 6, 7.)
2. Facts Regarding Plaintiff’s Injuries and Subsequent Requests for
Care
On April 17, 2012, Plaintiff and an inmate Jones were involved in a fight
in the yard of “C” Unit. (Doc. 115 ¶ 52.) Plaintiff contends that Jones instigated
the fight, claiming that Jones came up behind him and tried to cut him with a razor
blade. (Id. ¶ 5.) Plaintiff punched Jones in return, causing the break to his left
thumb and wrist. (Id.) In addition, Plaintiff, who is left-handed, was cut on his left
thumb with the razor blade. (Id.) Although his hand was bleeding, after the fight
Plaintiff returned to the field in the yard to watch a ballgame. (Id.) Corrections
Officers thereafter approached him on the bleachers and took him directly to the
RHU. (Id.) None of the Defendants were present for the fight. (See Docs. 108,
115, 125.)
8
Upon Plaintiff’s arrival at the RHU, Defendant Dunkle processed his
entry into the unit.4 (Doc. 115 ¶¶ 6, 52.) Defendant Dunkle noted the injuries to
Plaintiff’s left thumb, and took photographs of his hand. (Id. ¶¶ 6, 52.) He also
informed Plaintiff that medical staff would examine him in the RHU. (Id. ¶ 52.)
Plaintiff counters that Defendant Dunkle told him that he would not get him
medical assistance, and that he should “sit in [his] cell and think about what [he]
did because the inmate that [he] was fighting was one of his informants and the
pain [he’s] in should teach [him] a lesson.” (Doc. 1 at 3.) Defendant Dunkle
denies making these assertions. (Doc. 115 ¶¶ 55, 56.)
Also present in the RHU on April 17, 2012 was LPN Melanie Wagman.
(Id. ¶ 53.) Nurse Wagman examined Plaintiff and completed the bottom part of the
Suicide Risk Indicators Checklist, signing it at 8:30 p.m. (Id.; Doc. 117 at 66.)
Defendant Dunkle completed the top part of the Checklist. (Doc. 115 ¶ 53; Doc.
117 at 66.) In addition, Nurse Wagman entered a note in Plaintiff’s medical record
stating, “No injuries noted or voiced. [Plaintiff] stated, ‘I’m ok.’ P[rescribe]: sick
call as needed.” (Doc. 115 ¶61; Doc. 118 at 61.) In addition, Plaintiff’s medical
chart from the intake was reviewed by an RN Grassmyer. (Doc. 115 ¶ 61; Doc.
118 at 61.) Plaintiff denies that Nurse Wagman was present for the intake itself,
4
As a result of the fight, Plaintiff was issued a misconduct for which he pleaded guilty and
received forty-five (45) days in the RHU. (Doc. 115 ¶ 6.) Defendant Dunkle denies telling
Plaintiff that he was not leaving the RHU and ordering Corrections Officers to issue misconducts
to him in order to keep him in the RHU. (Id. ¶ 55.)
9
countering that only Defendant Dunkle and two other Corrections Officers were
there. (Doc. 125, Part II, ¶ 3.)
Two days later, on April 19, 2012, Plaintiff was seen in the RHU during
sick call by a Dr. Dayan. (Doc. 115 ¶ 62.) Dr. Dayan ordered x-rays of Plaintiff’s
left thumb and prescribed Tylenol. (Id.; Doc. 118 at 79.) Plaintiff denies that he
was seen on April 19, 2012. (Doc. 125, Part II, ¶ 3.) Rather, Plaintiff claims that
he was not seen by medical personnel until April 20, 2012. (Id.)
On April 20, 2012, Dr. Dayan noted that the x-ray revealed a fracture of
the first metacarpal bone at the base of Plaintiff’s left thumb, and ordered Plaintiff
be transported to the Altoona Regional Medical Center Emergency Room for an
orthopedic consult. (Doc. 115 ¶ 62; Doc. 118 at 78.) That same day, April 20,
2012, Plaintiff was transported to the Emergency Room and had his left thumb xrayed. (Doc. 115 ¶ 63; Doc. 118 at 83-88.) The x-ray revealed a fracture at the
base of the left first metacarpal bone and “a metallic radiopaque soft tissue foreign
body which is identified in the soft tissues at the level of the distal phalanx of the
left thumb. This has the shape of an arrow.” 5 (Doc. 115 ¶ 63; Doc. 118 at 86.)
The Altoona Regional Emergency Record set forth in the record notes the
following medical providers from that visit: ED Attending Jessica Shepherd,
5
The radiology consultation report originally noted on April 20, 2012, “Normal appearing left
thumb. No evidence for radiopaque soft tissue foreign body,” (Doc. 118 at 87), but was
corrected by way of addendum on April 22, 2012, (id. at 86).
10
Primary RN Shirley Huber, and Ordering Doctor Christopher Holland. (Doc. 118
at 83-88.) In addition, the Radiology Consultation was electronically signed by a
Dr. Richard A Wertz. (Id. at 87-88.)
Plaintiff was returned to SCI-Huntingdon the same day with a splint
secured with two ace wraps and stitches in his left thumb. (Doc. 115 ¶ 63.) He
was approved to have the splint and ace wraps in the RHU. (Id.)
The next day, April 21, 2012, Plaintiff saw a physician’s assistant (“PA”)
in the RHU and told him that his hand hurts. (Id. ¶ 64.) An orthopedic
consultation was submitted. (Id.) On April 24, 2012, Plaintiff complained to a
nurse in the RHU that his left hand was painful and he was having difficulty
sleeping due to the pain. (Id.) The nurse noted that his partial cast and ace wraps
were intact, but would ask the doctor about pain medication. (Id.) On that same
day, during the RHU pill line, Dr. Dayan saw Plaintiff and prescribed Tylenol #3
(Tylenol with codeine) for his pain. (Id.) The next day, April 25, 2012, Plaintiff
was not seen, but a Dr. Agra noted in his chart an “abnormal x-ray report” and
recommended a follow-up by a doctor or PA the next week. (Id.)
On April 29, 2012, Plaintiff was seen by a nurse in the RHU and had his
left hand checked. (Id. ¶ 65.) The nurse noted that Plaintiff’s splint was in place
and that his fingers were warm and dry. (Id.) On April 30, 2012, Dr. Araneda saw
Plaintiff, who had complaints of swelling and pain in his left thumb. (Id.) The
11
doctor noted pain on manipulation of the left thumb and a puncture wound on the
distal phalanx of the left thumb. (Id.; Doc. 118 at 57.) He also noted that Plaintiff
had an orthopedic appointment scheduled. (Doc. 115 ¶ 65.) Dr. Araneda made a
note on May 1, 2012 that Plaintiff was scheduled for “MD line,” and seen on April
30, 2012. (Id.)
On May 3, 2012, in Plaintiff’s chart Dr. Araneda added a late entry as an
addendum to an April 22, 2012 note making reference to Plaintiff’s x-ray report.
(Id. ¶ 66.) On the same day, May 3, 2012, a Nurse Hoffmaster saw Plaintiff in the
RHU and he complained that “it feels like that piece of metal in my thumb is
coming out. I can feel it jagging.” (Id.) The nurse noted that the ace wraps were
still in place, and movement to Plaintiff’s fingers and thumb was stationary due to
the half cast. (Doc. 118 at 57.) She also placed Plaintiff on the “MD line” for
follow-up on the foreign body in his left thumb on May 4, 2012 in the medical
department. (Doc. 115 ¶ 66; Doc. 118 at 57.) On May 4, 2012, Dr. Araneda
evaluated Plaintiff, noting that he was scheduled for removal of the foreign body
from his left thumb, and that he had a full splint on the thumb that looked clean.
(Doc. 115 ¶ 66.) Plaintiff complained of pain. (Id.) He was prescribed Tylenol-3
for three (3) days. (Doc. 118 at 77.)
On May 9, 2012, Plaintiff was seen in the RHU by a PA, who noted that
Plaintiff complained of continued pain in his left thumb. (Doc. 115 ¶ 67.) The PA
12
also noted that an orthopedic consultation was pending. (Id.) Further, Plaintiff
was prescribed Tylenol-3 for five (5) days. (Doc. 118 at 77.)
On May 10, 2012, Plaintiff was taken to an outside appointment with a
Michael Stauff, M.D., of the University Orthopedics Center in State College.
(Doc. 115 ¶ 67.) In his report, Dr. Stauff noted the following specifics regarding
Plaintiff’s left thumb injury:
The pain is aching and sharp. . . . The pain is aggravated by bending
and movement. The pain is relieved by brace/splint and rest.
Associated symptoms include decreased mobility, swelling and
tingling in the arms. Pertinent negatives include bruising, crepitus,
difficulty going to sleep, instability, limping, locking, night pain,
night-time awakening, numbness, popping, spasms, tingling in the
legs, tenderness or weakness. Additional information: [Plaintiff] here
for left thumb injury. [Plaintiff] is an inmate and was not taken to the
ER until 4 days later.
***
This is his first [appointment] since his ER visit. He has pain, but it is
improved. He is left handed. Xrays of the [left] hand show a
[displaced] Bennett fracture.
(Doc. 118 at 107.) Dr. Stauff also noted that he would refer Plaintiff to a hand
surgeon that same day. (Id. at 108.)
In Plaintiff’s counter statement of material facts, he asserts that he first
saw Dr. Stauff at the Altoona Regional Hospital on April 20, 2012. (Doc. 125,
Part I, ¶ 9; see also Doc. 116 at 29.) He also asserts that Dr. Stauff wrote a note to
Defendant Parkes that day directing her to make arrangements for him to return to
13
the hospital the following Monday, April 23, 2012, for “emergency surgery.”
(Doc. 125 ¶ 9.) He asserts that neither Defendant Parkes nor Defendant Showalter
followed through with those arrangements. (Id. ¶ 10.)
As stated above, however, the record reflects that Plaintiff initially saw
Dr. Stauff at the University Orthopedics Center in State College on May 10, 2012.
Plaintiff was evaluated by a hand surgeon, a Christopher J. Lincoski, M.D., that
afternoon, May 10, 2012. (Doc. 115 ¶ 67.) Dr. Lincoski noted that Plaintiff’s left
thumb required surgery, specifically an “open reduction and internal fixation given
that this fracture is a few weeks old.” (Doc. 118 at 109.) He scheduled the surgery
for the following day. (Id.) Further, the medical paperwork from the evaluations
was forwarded to Corizon. (Doc. 115 ¶ 67; Doc. 118 at 55.)
On May 11, 2012, Dr. Lincoski performed surgery on Plaintiff’s left
thumb at the University Orthopedic Center. (Doc. 115 ¶ 67; Doc. 118 at 110-12.)
The preoperative and postoperative diagnoses were “left Rolando fracture.” (Doc.
115 ¶ 67; Doc. 118 at 110.) Dr. Lincoski proceeded with an open reduction in
order to repair the thumb using the Wagner approach, a method that uses screws
and wires to secure the repaired fracture. (Doc. 118 at 110-12.) After the surgery,
Plaintiff’s thumb was placed in a splint and he was sent to recovery. (Id. at 111.)
Upon his discharge, Plaintiff was prescribed Percocet. (Id. at 144.) Rather than
14
being returned to SCI-Huntingdon, Plaintiff was placed in a medical observation
cell at SCI-Smithfield. (Doc. 115 ¶ 67.)
Also on May 11, 2012, Plaintiff complained of pain, and was prescribed
Vicodin. (Id. ¶ 68; Doc. 118 at 50.) A nurse noted that the bandage to his left
hand and arm was intact. (Doc. 115 ¶ 68; Doc. 118 at 50.) On May 12, 2012,
Plaintiff demanded more pain medication, but the nurse denied the request because
it was not yet time for distribution of more pain medication. (Doc. 115 ¶ 68; Doc.
118 at 51.) The physician’s notes indicate that, at that time, Plaintiff was
prescribed Tylenol-3, Percocet, Vicodin, and Motrin. (Doc. 118 at 75.) Later that
day, Plaintiff was discharged from the medical observation cell and returned to
SCI-Huntingdon. (Doc. 115 ¶ 68; Doc. 118 at 51.) Upon his return, Plaintiff’s
current pain medications (Percocet and Vicodin) were discontinued and Tylenol-3
was prescribed, as per Dr. Long. (Doc. 115 ¶ 68; Doc. 118 at 51, 75.)
On May 14, 2012, Dr. Dayan noted that “hand surgery follow-up consult
submitted in 10-14 days.” (Doc. 115 ¶ 69.) The next day, Dr. Dayan evaluated
Plaintiff at RHU sick call. (Id.) Plaintiff complained of pain in his left hand, and
Dr. Dayan prescribed Motrin. (Id.; Doc. 118 at 74.) On May 19, 2012, Plaintiff
complained to a nurse about left hand pain. (Doc. 115 ¶ 69.) The nurse instructed
him to continue the Motrin and to elevate his hand as directed. (Id.) On May 20,
15
2012, Plaintiff was seen again by a PA for complaints of pain in his left arm and
hand. (Id.) He was prescribed Motrin for thirty (30) days. (Doc. 118 at 74.)
On May 22 and 25, 2012, Dr. Dayan evaluated Plaintiff at the RHU sick
call for complaints relating to the placement of his cast. (Doc. 115 ¶ 69; Doc. 118
at 46.) Dr. Dayan did not note any problems, and continued the Motrin. (Doc. 118
at 46.)
On May 26, 2012, Plaintiff was seen twice by Nurse Hoffmaster. (Doc.
115 ¶ 69; Doc. 118 at 46-47.) During the first visit, Plaintiff complained of pain in
his left hand, a tingling sensation, and difficulty sleeping at times due to the pain.
(Doc. 115 ¶ 69.) The nurse instructed him to sign up for sick call regarding his
pain medication. (Id.) Later that same day, Nurse Hoffmaster saw Plaintiff after
he stated he fell off his bunk and landed on his right hand. (Id.; Doc. 118 at 47.)
He told her that the outside of his lower left arm also hit the bunk. (Doc. 118 at
47.) She checked his hand and fingers, and he told her that Motrin was not helping
with the pain. (Id.) The nurse placed Plaintiff on the urgent care list for the
following day and instructed him to continue taking the Motrin and keep his hand
elevated. (Id.) Plaintiff also complained about not yet having an appointment to
remove his cast. (Id.) The nurse explained to him that the consultation had been
written, but the scheduling of the appointment and transportation arrangements
take time. (Id.)
16
On May 27, 2012, Plaintiff was evaluated by a PA in the RHU. (Doc.
115 ¶ 70.) He told the PA he fell and hit his left arm and back. (Id.) He also
wanted to know when he was scheduled to return to the orthopedic surgeon to get
the cast off. (Id.) The PA noted: “No change in needs of treatment, await followup with ortho.” (Id.; Doc. 118 at 44.)
On May 29, 2012, Plaintiff was seen by Dr. Dayan at the RHU sick call,
where he complained of discomfort in his left hand. (Doc. 115 ¶ 71.) Dr. Dayan
checked his hand, discontinued Motrin and prescribed Tylenol 500 mg. (Id.) Later
that day, Plaintiff told a nurse that his arm was hurting and that no one had brought
him the Tylenol. (Id.) The nurse then gave Plaintiff the Tylenol as per the order,
and instructed him to alert nursing if the pain got worse or, in the alternative, go to
sick call. (Doc. 118 at 44.) The nurse noted that Plaintiff verified his
understanding. (Id.)
On May 31, 2012, Plaintiff had an outside consultation with Dr.
Lincoski, the hand surgeon. (Doc. 115 ¶ 71; Doc. 118 at 45, 136.) The doctor
noted that the fracture of the first metacarpal bone was healing well and that
follow-up within two (2) weeks was needed for pin removal. (Doc. 115 ¶ 71; Doc.
118 at 136.) When Plaintiff returned to SCI-Huntingdon that same day, his cast
was re-applied to his left hand/wrist area. (Doc. 115 ¶ 71; Doc. 118 at 45.) It was
inspected by security, who noted that nothing on the cast can be removed. (Doc.
17
115 ¶ 71; Doc. 118 at 45.) Plaintiff’s chart was forwarded to Corizon’s Medical
Director for review. (Doc. 115 ¶ 71; Doc. 118 at 45.)
On June 8, 2012, Plaintiff saw a nurse practitioner, complaining of hand
pain. (Doc. 115 ¶ 72.) She prescribed Tylenol 500 mg for fourteen (14) days.
(Id.; Doc. 118 at 73.) On June 11, 2012, Plaintiff was evaluated by Dr. Araneda
for complaints of pain in his left hand. (Doc. 115 ¶ 72; Doc. 118 at 42.) The
doctor noted that the skin of Plaintiff’s left hand and fingers looked normal, and
that there was no swelling or discoloration. (Doc. 115 ¶ 72.) He also noted that
Plaintiff was scheduled to have the cast on for another month. (Id.) He also
prescribed Motrin 400 mg. (Id.; Doc. 118 at 72.) On June 13, 2012, Plaintiff was
seen again at RHU sick call for continued pain in his left hand. (Doc. 115 ¶ 72;
Doc. 118 at 42.) He complained that his cold cell made the pain worse. (Doc. 118
at 42.) The PA advised Plaintiff to take the Motrin as ordered and to wrap his hand
in a blanket if his cell got cold. (Id.)
On June 15, 2012, Plaintiff was again seen by Dr. Araneda, who noted
that Plaintiff’s fingers had normal color, normal temperature, and normal motion.
(Doc. 115 ¶ 73.) The doctor noted: “In spite [of] his complaints [of] consistent
pain on left hand, his left hand and casting looks OK to me. Continue monitoring.”
(Doc. 118 at 43.) On June 20, 2012, Paul Noel, Corizon’s Medical Director,
18
ordered an orthopedic consultation within six (6) weeks. (Doc. 115 ¶ 73; Doc. 118
at 43, 72.)
On June 22, 2012, Plaintiff was evaluated again by Dr. Araneda. (Doc.
115 ¶ 73.) The doctor noted pain and swelling in Plaintiff’s left thumb and ordered
x-rays. (Id.; Doc. 118 at 40, 72.) Upon his review of the x-rays later that same
day, Dr. Araneda noted that the nail base of the left thumb was healing well. (Doc.
115 ¶ 73; Doc. 118 at 40.) The x-ray report also noted a “persistent 7 mm metallic
foreign body over left 1st distal phalanx.” (Doc. 118 at 160.) A splint was applied
and the doctor recommended continued monitoring. (Doc. 115 ¶ 73.)
On June 25, 2012, a nurse noted that Plaintiff had been issued Motrin on
June 11, 2012, so she would instruct him to “take all.” (Id.; Doc. 118 at 40.)
Plaintiff was also seen at sick call on June 26, 2012 for complaints of chest pain,
and was instructed to continue the Motrin. (Doc. 118 at 39, 40.)
In the evening of June 28, 2012, Plaintiff was seen by a nurse for
complaints that his tape and splint were causing a rash/itching throughout the
night. (Doc. 115 ¶ 74.) It was very uncomfortable for him. (Id.) The nurse noted
that he had a consult in four (4) weeks, but would have Dr. Araneda check on him
in the morning. (Id.) On the next day, June 29, 2012, Dr. Araneda evaluated
Plaintiff, noting that his thumb looked okay, but Plaintiff was not happy with the
splint. (Id.) The doctor noted the need for an orthopedic follow-up. (Id.)
19
On July 2, 2012, Plaintiff was evaluated by Dr. Araneda for complaints
of pain and swelling in his left thumb. (Id. ¶ 75.) The doctor noted that a followup consultation was pending. (Id.) On July 3, 2012, Dr. Araneda noted his review
of Plaintiff’s latest x-rays. (Id.)
On July 6, 2012, Dr. Araneda noted that Plaintiff was going to physical
therapy for his left hand, but that Plaintiff had no complaints that morning. (Id.)
On that same day, Plaintiff was seen at HealthSouth for occupational therapy. (Id.;
Doc. 118 at 129-31.) He presented with chief complaints of pain and lack of
strength in his left hand. (Doc. 118 at 131.) The therapist noted a slight edema on
his left thumb. (Id.) A brace/thumb split was ordered for six (6) months. (Doc.
115 ¶ 75; Doc. 118 at 94.) Plaintiff signed a health care item receipt for this splint.
(Doc. 118 at 94.) Three days later, on July 9, 2012, Dr. Araneda referred Plaintiff
again for physical therapy, noting that a consultation had been written. (Doc. 115 ¶
75; Doc. 118 at 71.)
On July 17, 2012, Plaintiff was evaluated by Dr. Araneda for complaints
of stiffness, pain, and muscle weakness in his left hand, especially in his left
thumb. (Doc. 115 ¶ 75; Doc. 118 at 35.) The doctor noted that the function in
Plaintiff’s left hand “seems to be OK to me.” (Doc. 118 at 35.) In addition, the
doctor noted that Plaintiff wanted to see an orthopedic doctor, but Dr. Araneda
responded, “I think he doesn’t need ortho, he might need PT.” (Id.)
20
On July 23 and 24, 2012, Plaintiff was not in his cell during sick call, so
did not see Dr. Araneda. (Doc. 115 ¶ 76.) On July 24, 2012, Dr. Araneda ordered
another x-ray of Plaintiff’s left hand. (Id.; Doc. 118 at 71.) On July 26, 2012,
Plaintiff had an outside follow-up consultation with Dr. Lincoski, who noted that
the fracture had healed. (Doc. 115 ¶ 76; Doc. 118 at 132.) He recommended
discontinuation of physical therapy and Plaintiff’s brace. (Doc. 118 at 132.) He
also advised activity as tolerated. (Id.) Plaintiff’s medical chart was sent to
Corizon on the same day for review. (Doc. 118 at 36.) Further, in a consultation
record signed by Dr. Araneda on July 31, 2012, it appears that, per the
recommendation of Dr. Lincoski, Dr. Araneda cancelled a physical therapy
consultation scheduled for July 30, 2012 at 9:00 a.m. (Id. at 128.)
On August 1, 2012, a Dr. Cole noted that an undated radiology report
indicated a “stable” fracture. (Doc. 115 ¶ 77; Doc. 118 at 33.) On August 2, 2012,
Plaintiff was seen in the RHU for complaints of continued pain in his left thumb.
(Doc. 115 ¶ 77; Doc. 118 at 33.) He told the PA that a piece of razor blade in his
left hand was “trying to get out.” (Doc. 118 at 33.) The PA noted that Plaintiff
could not be escorted to a treatment room that day, but ordered that he be taken to
one the following week for PA/MD line to evaluate his hand. (Doc. 118 at 33, 70.)
On August 8, 2012, Plaintiff was evaluated by another PA in the RHU.
(Doc. 115 ¶ 77; Doc. 118 at 33.) Plaintiff told the PA that he still has a razor blade
21
in his left thumb and that he was supposed to have a follow-up at Altoona Hospital
to remove the blade. (Doc. 118 at 33.) Upon examination, the PA did note the
presence of the razor blade in Plaintiff’s left thumb, and ordered that Plaintiff be
scheduled for the MD line to discuss the blade’s removal. (Id. at 33, 70.) Dr. Cole
saw Plaintiff on the following day, August 9, 2012, noted Plaintiff’s pain in his left
thumb, and referred him to a hand surgeon for further evaluation. (Doc. 118 at 34,
70.)
On August 14, 2012, Plaintiff was evaluated by a PA in the RHU for his
continued pain in his left thumb. (Doc. 115 ¶ 78; Doc. 118 at 34.) The PA noted a
stable proximal metacarpal fracture in his thumb, as well as the presence of a
foreign body. (Doc. 118 at 34.) She noted that a referral for a hand surgeon had
already been placed and prescribed Motrin. (Id.)
Plaintiff was in the yard for sick call on August 21, 2012, but a PA did
evaluate him in the RHU on August 22, 2012. (Doc. 118 at 31.) Plaintiff
complained of continued pain in his left thumb and told the PA that the “screws are
coming out.” (Doc. 115 ¶ 78; Doc. 118 at 31.) The PA continued the Motrin and
Tylenol for Plaintiff’s pain and noted that a hand surgeon consultation was
pending. (Doc. 115 ¶ 78; Doc. 118 at 31.)
On August 23, 2012, Plaintiff had an outside consultation with Dr.
Lincoski, the hand surgeon. (Doc. 115 ¶ 78; Doc. 118 at 127.) Dr. Lincoski noted
22
the foreign body in Plaintiff’s left thumb tip and recorded that he would remove it
via surgery. (Doc. 118 at 127.) Plaintiff was returned to SCI-Huntingdon that
same day, and his medical chart was forwarded to Corizon for review. (Id. at 31.)
On August 24, 2012, Dr. Cole noted Dr. Lincoski’s consultation record from the
last appointment and placed a new consultation. (Id. at 31, 69.)
On August 28, 2012, Plaintiff was seen at sick call in the RHU for
complaints of continued pain in his left thumb. (Doc. 115 ¶ 78; Doc. 118 at 32.)
The PA noted the foreign body in Plaintiff’s left thumb, discontinued the Motrin,
and prescribed Relefen. (Doc. 115 ¶ 78; Doc. 118 at 32.) She also noted that a
surgery consultation had been submitted. (Doc. 118 at 32; see also Doc. 118 at
69.)
On September 1, 2012, Plaintiff was directed to cease taking Motrin, any
NSAIDs, or blood thinners, until further notice. (Doc. 118 at 32.) The medical
note indicates that Plaintiff agreed. (Id.) There is no explanation in the record for
this directive.
On September 7, 2012, Plaintiff underwent hand surgery at the
University Orthopedic Center for removal of the foreign body from his left thumb.
(Doc. 115 ¶ 79; Doc. 118 at 121-26.) Dr. Lincoksi, the surgeon, noted in the
consultation record: “Left thumb foreign body removed. May remove dressing in
48 hours. Apply band-aid. Follow-up 10-14 days.” (Doc. 118 at 121.) Plaintiff
23
returned to SCI-Huntingdon that same day and was seen by a PA. (Doc. 115 ¶ 79;
Doc. 118 at 32.) The PA noted no complaints from Plaintiff, and observed the
dressing was dry and no drainage from the surgical site. (Doc. 118 at 32.) Also on
that date, Dr. Araneda ordered an antibiotic, Tylenol-3, and Motrin. (Doc. 118 at
68.) He directed that the dressing be removed in 48 hours and then use band-aids
on the site. (Id.) He also directed follow-up and suture removal in 10-14 days.
(Id.)
On September 12, 2012, a nurse removed the dressing from Plaintiff’s
left thumb. (Doc. 115 ¶ 79.) Plaintiff had no complaints, and there was no
drainage, swelling, or redness on the site. (Id.; Doc. 118 at 32.) She noted that the
sutures were intact, and covered them with band-aids. (Doc. 115 ¶ 79; Doc. 118 at
32.)
On September 17, 2012, Plaintiff had a follow-up appointment with Dr.
Lincoski, who noted, “[Foreign body] removed. May benefit from a short course
of PT for hand strengthening and ROM [range of motion]. [Follow-up].” (Doc.
115 ¶ 80; Doc. 118 at 120.) On September 20, 2012, Plaintiff was evaluated by a
PA for continued pain in his left thumb. (Doc. 115 ¶ 80; Doc. 118 at 119.) The
PA wrote a consultation for physical therapy. (Doc. 115 ¶ 80; Doc. 118 at 68,
119.)
24
On September 25, 2012, Plaintiff was transferred to SCI-Fayette. (Doc.
115 ¶ 80.) He continued to receive medical care at that facility. (Id.; see generally
Doc. 118.)
Turning to Plaintiff’s grievances relating to his injuries, the record
reflects the following. On April 30, 2012, Plaintiff wrote a request slip to
Defendant Showalter, asking her why he had not yet been taken to an outside
specialist for his thumb injury. (Doc. 115 ¶ 9; Doc. 116 at 97.) In her response
dated the same day, Defendant Showalter stated, “I cannot give you the date but
you are scheduled to see [an] orthopedic specialist.” (Doc. 116 at 97.)
On May 9, 2012, Plaintiff sent another request slip to Defendant
Showalter, complaining about the pain in his hand, asking why he did not have a
follow-up appointment with a surgeon, and informing her that his pain medication
had been cut. (Doc. 115 ¶ 9; Doc. 116 at 98.) Defendant Showalter’s response,
dated May 10, 2012, stated only, “You saw the surgeon today.” (Doc. 116 at 98.)
On May 16, 2012, Plaintiff sent another request slip to Defendant
Showalter, complaining about the pain in his hand after his May 11, 2012 surgery.
(Doc. 115 ¶ 11; Doc. 116 at 99.) He stated that, although he was given Tylenol-3
for three (3) days before switching to Motrin on the fourth day, he remained in
pain and in need of more pain medication. (Doc. 116 at 99.) Defendant Showalter
did not respond to this inmate request slip. (See id.)
25
On May 20, 2012, Plaintiff sent an inmate request slip to Defendant
Showalter, asking how long he needed to keep the screws in, and cast on, his hand.
(Doc. 117 at 26.) Defendant Parkes responded on May 21, 2012, stating, “I am
currently working on your follow-up appointment. You can ask the doctor any
questions you may have at that appointment.” (Id.)
On June 6, 2012, Plaintiff submitted Grievance No. 415418, complaining
that Defendant Dunkle had unnecessarily extended his time in the RHU and had
denied him medical assistance in the RHU. (Doc. 115 ¶ 13; Doc. 116 at 101-02.)
On June 11, 2012, Facility Grievance Coordinator Connie Green rejected the
grievance, noting that Plaintiff’s complaints had already been addressed through
SCI-Huntingdon’s inmate discipline/misconduct procedures. (Id. at 100.) There is
nothing in the record indicating whether Plaintiff appealed this rejection. (See
Doc. 117 at 35.)
On June 15, 2012, Plaintiff filed Grievance No. 416313, complaining
about the treatment he was receiving for his left hand injury. (Doc. 117 at 57.)
Specifically, Plaintiff stated that, on June 14, 2012, he jammed his cast in his cell
door’s food slot, further injuring his hand. (Id.) He acknowledged that Dr.
Araneda examined him on June 15, 2012, but only looked at his cast and said
nothing was wrong with him. (Id.) Grievance Coordinator Green noted receipt of
26
the grievance on June 18, 2012. (Id.) On June 19, 2012, Defendant Showalter
denied the grievance, stating,
Review of your medical record and discussion with Dr. Araneda
reveals that after he saw you, he discussed this with Corizon Clinical
Coordinator.
You were already scheduled for a follow up
appointment with the orthopedic specialist on 6/18/12. For security
reasons you could not be told the day of your off site appointment.
You were also already receiving Motrin for pain. You have since
seen the specialist and your cast and pin were removed. This
grievance is without merit and is denied. You have received
appropriate medical care.
(Id. at 58.) Plaintiff appealed this decision to the Superintendent on June 21, 2012,
noting that “every medical staff is aware of my medical situation and I have appeal
this matter in particular to Ms. Showalter.” (Id. at 105.) The Superintendent
denied the appeal on July 5, 2012, stating,
In reviewing your grievance and appeal, I note that your concern with
your healthcare was appropriately addressed by Ms. Showalter. In
your appeal, you repeat your claims from your initial grievance, and
you state Dr. Araneda is incompetent. As Ms. Showalter explains in
her response to your initial grievance, you were already receiving
Motrin for the pain, the decision was made to wait for the orthopedic
specialist to check your hand and cast. The incident you describe
happened on 6-15-12, a Friday, and you were already scheduled to see
the specialist on 6-18-12, the Monday after the weekend. I find the
healthcare provided by Dr. Araneda was reasonable and appropriate.
In closing, I can only reiterate that I uphold the response provided by
the grievance officer. Your grievance is found to be without merit.
(Id. at 11.) Plaintiff appealed this decision to the DOC Secretary’s Office of
Inmate Grievances & Appeals (“SOIGA”) on July 23, 2012. (Id. at 9.) In his
appeal, Plaintiff again complained that Dr. Araneda was not providing him with
27
proper medical care for his left hand and thumb injuries. (Id.) On August 10,
2012, SOIGA dismissed the appeal on the basis that Plaintiff did not provide the
required documentation for proper review. (Id. at 8.)
On June 25, 2012, Plaintiff submitted an inmate request to Defendant
Showalter, inquiring into the delay in his physical therapy for his left hand and
complaining about treatment from Dr. Araneda.6 (Doc. 117 at 32.) Defendant
Showalter responded on June 25, 2012, stating, “Dr. Araneda did not have your
consult information because it was being reviewed. You have been referred to
physical therapy and when scheduled you will be taken out. The consult was
written and approved.” (Id.)
On June 28, 2012, Plaintiff filed Grievance No. 418059, complaining
about the denial of a brace for his hand and making general complaints about the
medical care he was receiving from medical staff, specifically Dr. Araneda. (Doc.
116 at 115-16.) Grievance Coordinator Green received the grievance on July 2,
2012, and directed a Captain Walters to respond to it by July 24, 2012. (Id. at 115,
117.) Captain Walters denied the grievance on July 11, 2012, stating, “you have
the proper splint on for your injury and I have found no merit to your complaint.”
6
It is not immediately clear whether this inmate request relates to any subsequently submitted
grievances, as there is no discernable order to the grievance paperwork filed on the record by
Defendants.
28
(Id. at 118.) Plaintiff appealed this decision to SOIGA on July 13, 2012, asserting,
inter alia,
I am filing this grievance, as well as the others that has been filed,
[for] fail[ure] to proper medicare [sic] and cruel and unusual. In
which Dr. Luis O. Araneda and the medical staff along with Capt.
Harris of Security here at SCI-Huntingdon has violated my Eighth
Amendment rights and the PLRA. . . . In which SCI-Huntingdon
medical staff denied me surgery for three weeks on my broken left
thumb. Because of the length and time wasted the orthopedic
specialist had to rebrake my left [wrist] and put two permanent screws
in my hand. I was being denied a brace for my hand after the removal
of my cast 6-18-12. A brace was sent here at SCI-Huntingdon and
Capt. Harris denied the brace. . . . I am now being denied therapy.
What was a temporary injury is now a permanent injury in which I
have two permanent screws in my left hand. I now have to suffer with
arthritis for the rest of my life because of the nefarious and atrocity of
the staff here at SCI-Huntingdon. Also this situation has brought a
high amount of stress mentally and [physically] because of the
reduction of my livelihood [failure] of the proper medical treatment
here at SCI-Huntingdon. . . . I was giv[en] a brace on 7-6-12 which I
was told by Nurse Price that I will get the proper brace upon my
release from the RHU.
(Doc. 117 at 36-37.) Grievance Officer Keri Moore responded to Plaintiff’s appeal
on July 17, 2012, stating that SOIGA could not take any further action on the
appeal because “You must await the initial review response prior to proceeding
with this grievance.” (Id. at 41.) On August 13, 2012, Grievance Officer Moore
further responded that final review of Plaintiff’s appeal would not be granted until
Plaintiff appeals the issue to the Facility Manager. (Doc. 116 at 119.) According
to the Automated Inmate Grievance Tracking System, there is no record that
29
Plaintiff appealed this grievance per SOIGA’s directives. (Doc. 115 ¶ 28; Doc.
117 at 35.)
On June 29, 2012, Plaintiff submitted two (2) inmate requests to Deputy
Superintendent Eckard and Superintendent Bickell, regarding denial of a brace for
his left hand.7 (Docs. 117 at 28, 29.) Superintendent Bickell responded to the first
request on July 2, 2012, stating, “There is an appt set up for you to go and get your
brace.” (Id. at 29.) Deputy Superintendent Eckard responded on July 5, 2012,
stating,
I subsequently checked into your noted concern with Medical
Department. You were referred to Physical Therapy to be evaluated
regarding a brace order, which my understanding is that you were to
be evaluated and not actually to be ordered a brace. Due to a
misunderstanding, a brace was attempted to be issued to you, which
was denied by Security due to security concerns in the make/material
of this brace. The Medical Department also advised me that you are
presently awaiting an evaluation by physical therapy to determine IF
you need a brace and if you do – what specific kind is needed.
(Id. at 27.)
On July 2, 2012, Plaintiff filed Grievance No. 418314, complaining that
Captain Harris from the RHU denied him a brace issued to him for use before and
during his physical therapy. (Doc. 117 at 30-31.) On July 3, 2012, Grievance
Coordinator Green rejected the grievance as duplicative of Grievance No. 418059.
(Id. at 16.) Plaintiff appealed on July 6, 2012, (Doc. 116 at 112-13), and
7
As with Plaintiff’s June 25, 2012, inmate request, see supra, note 6, at 28, it is not clear whether
these requests relate to any subsequently filed grievances.
30
Superintendent Bickell upheld the rejected grievance on July 13, 2012, as
duplicative of Grievance No. 418059, (Doc. 117 at 17). Plaintiff appealed the
Superintendent’s decision to SOIGA on July 13, 2012. (Id. at 23-24.) Grievance
Officer Moore of SOIGA initially responded on August 7, 2012, informing
Plaintiff that the action could not proceed to final review until he submitted the
initial review response/rejection by the Grievance Officer and a legible copy of his
appeal to the Facility Manager, signed and dated. (Id. at 22.) It appears that
Plaintiff attempted to obtain free photocopies of the appropriate paperwork at SCIHuntingdon, but his cash slip for those copies was denied, as he did not qualify as
indigent. (Id. at 22.) Plaintiff subsequently sought an extension of time to file his
appeal, (id. at 20), which was denied on September 20, 2012, (id. at 19). On
October 18, 2012, SOIGA dismissed Grievance No. 418314 as duplicative of
Grievance No. 418059. (Id. at 15.)
On July 18, 2012, Plaintiff filed Grievance No. 420612, complaining
about the medical care for his left thumb injury. (Doc. 116 at 120.) More
specifically, Plaintiff complained that Dr. Araneda rejected an outside specialist’s
orders for physical therapy and, instead, told Plaintiff to use a ball and squeeze it
or, in the alternative, use a washcloth for the same effect. (Id.) On July 24, 2012,
Defendant Showalter denied the grievance, stating,
31
Your grievance dated 7/18/12 has been received and investigated.
You complain that you are not receiving appropriate care (physical
therapy) for your thumb.
Review of your medical record indicates that you were seen on 7/6/12
by Occupational Therapy at Health South. On the written note
returned with your consult, she notes that you “will benefit from
therapy.” As per this note, Dr. Araneda did write for in house
physical therapy which was appropriate. Recommendations from a
specialist are just that, it is up to the practitioner at the site to order
what is needed. Dr. Araneda was following what the therapist wrote
on your consult. We received the packet from her 7/19/12 (which is
within the time frame allotted for reports from specialists) that gave us
the prescription for therapy. Your therapy is being scheduled.
On the 17th, Mr. Lynch was informing the doctor of options we have
available and using a washcloth to squeeze would give you same
effect as a ball. The consult for in house physical therapy had already
been written before this sick call visit.
This grievance is without merit and is denied. No monies will be
awarded via this grievance.
(Id. at 121.) Plaintiff appealed this denial on July 27, 2012. (Id. at 122.) On
August 7, 2012, Superintendent Bickell upheld the denial, reasoning,
In reviewing your grievance and appeal, I note that your concern with
physical therapy was appropriately addressed by Ms. Showalter. In
your appeal, you repeat the complaint that was presented in your
initial grievance. You go on to complain that you were told you
would be doing in-house therapy instead of traveling to HealthSouth
in State College for therapy. As Ms. Showalter explains in her
response to your initial grievance, physical therapy was
recommended, and as a result, Dr. Araneda wrote an order for inhouse physical therapy which was appropriate. Until your therapy
could begin, Mr. Lynch suggested squeezing a washcloth which
would give the same effect as squeezing a ball. I discussed this course
of treatment with Ms. Showalter and found that you were scheduled
for physical therapy; however, you were taken for a follow up visit
32
with the orthopedic specialist who discontinued the physical therapy
and discontinued your brace because he found your thumb had healed
properly. I find you have not been denied proper medical care for
your injured thumb.
In closing, I can only reiterate that I uphold the response provided by
the grievance officer. Your grievance is found to be without merit.
(Id. at 124.) There is no record of Plaintiff’s appealing this decision to SOIGA.
On July 19, 2012, Plaintiff filed Grievance No. 420876, complaining
about a delay in his physical therapy and denial of a brace for his left hand. (Id. at
125.) On July 23, 2012, Grievance Coordinator Green rejected the grievance as
duplicative of Grievance No. 420612. (Id. at 126.) On July 26, 2012, Plaintiff
appealed this decision to Superintendent Bickell, (id. at 127-28), who upheld the
rejection on August 7, 2012, (id. at 129). There is no record of Plaintiff appealing
this decision to SOIGA.
3. Procedural History
Plaintiff initiated this action with a complaint filed on September 30,
2013. (Doc. 1.) By order dated October 7, 2013, the court directed service of the
complaint on all Defendants named therein. (Doc. 7.) On December 9, 2013,
Corrections Defendants filed a motion to dismiss the complaint and supporting
brief. (Docs. 16 & 17.) On December 16, 2013, Medical Defendants also filed a
motion to dismiss the complaint and supporting brief. (Docs. 20 & 21.) After
those motions were ripe for disposition, on September 30, 2014, the court issued a
33
memorandum and order granting in part and denying in part both motions. (Docs.
52 & 53.) Specifically, the Eighth Amendment claim of deliberate indifference to
Plaintiff’s serious medical needs survived as to Defendants Dunkle, Showalter, and
Parkes. (See Doc. 53.) Further, Plaintiff’s retaliation claim against Defendant
Showalter survived. (Id.) The additional claims and Defendants were dismissed,
and the remaining Defendants were directed to answer Plaintiff's complaint. (Id.)
After both sets of Defendants answered the complaint, (see Doc. 57 &
58), Plaintiff filed a motion for the appointment of counsel. (Doc. 59.) On
November 19, 2014, the court granted Plaintiff’s motion, provided that a member
of the Pro Bono panel of the Middle District of Pennsylvania Chapter of the
Federal Bar Association agree to volunteer to represent Plaintiff. (Doc. 61.)
Plaintiff was also advised that, if the court was unable to locate counsel to
represent him, he would be required to proceed pro se. (Id.)
On June 23, 2015, the court informed Plaintiff that it had not received a
reply from the Pro Bono panel and, therefore, Plaintiff was granted leave to
proceed pro se. (Doc. 69; see also Doc. 71.) On August 3, 2015, the court issued
a scheduling order, setting deadlines for discovery and dispositive motions. (Doc.
72.) However, attempts to deliver these court orders to Plaintiff were unsuccessful.
(See Docs. 73-76.) As a result, pursuant to Rule 41(b) of the Federal Rules of Civil
Procedure, on September 23, 2015, the court issued an order dismissing Plaintiff’s
34
complaint for failure to prosecute, and directing the Clerk of Court to close the
case. (Doc. 77.) Notably, this court order sent to Plaintiff was also returned as
undeliverable. (Doc. 78.)
On November 18, 2015, Plaintiff filed a notice of change of address,
noting his new address at the Dauphin County Prison. (Doc. 79.) Subsequently,
the court directed the Clerk of Court to send the formerly undelivered court orders
to Plaintiff at his new address. (Doc. 80.) Thereafter, Plaintiff filed a response to
the order closing his case, explaining that he had been injured and unable to
communicate with the court. (Doc. 82.) On April 27, 2016, the court granted
Plaintiff leave to file a motion for reconsideration of the order dismissing his
complaint and closing the case. (Doc. 86.) Plaintiff filed a motion for
reconsideration on May 5, 2016, (Doc. 87), which was granted by order dated July
14, 2016, (Doc. 93). In the order granting reconsideration and reopening the case,
the court also set forth new scheduling deadlines. (Doc. 93.)
On September 29, 2016, Medical Defendant Parkes filed a motion for
summary judgment. (Doc. 107.) Corrections Defendants filed a motion for
summary judgment on October 6, 2016. (Doc. 113.) On October 19, 2016,
Plaintiff filed a motion for cross summary judgment. (Doc. 122.) All motions are
now ripe for disposition.
35
II.
Standard of Review
Federal Rule of Civil Procedure 56 sets forth the standard and procedures for
granting a motion for summary judgment. Rule 56(a) provides, “[t]he 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.” Fed.
R. Civ. P. 56(a); see also Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986). A
factual dispute is “material” if it might affect the outcome of the suit under the
applicable substantive law. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248
(1986). A factual dispute is “genuine” only if there is a sufficient evidentiary basis
that would allow a reasonable fact-finder to return a verdict for the non-moving
party. Id. When evaluating a motion for summary judgment, a court “must view
the facts in the light most favorable to the non-moving party,” and draw all
reasonable inferences in favor of the same. Hugh v. Butler Cnty. Family YMCA,
418 F.3d 265, 267 (3d Cir. 2005), cert. denied, 546 U.S. 1094 (2006).
The moving party bears the initial burden of demonstrating the absence of a
disputed issue of material fact. See Celotex, 477 U.S. at 324. “Once the moving
party points to evidence demonstrating no issue of material fact exists, the nonmoving party has the duty to set forth specific facts showing that a genuine issue of
material fact exists and that a reasonable factfinder could rule in its favor.” Azur v.
Chase Bank, USA, Nat’l Ass’n, 601 F.3d 212, 216 (3d Cir. 2010). The non-moving
36
party may not simply sit back and rest on the allegations in its complaint; instead,
it must “go beyond the pleadings and by [its] own affidavits, or by the depositions,
answers to interrogatories, and admissions on file, designate specific facts showing
that there is a genuine issue for trial.” Celotex, 477 U.S. at 324 (internal quotations
omitted); see also Saldana v. Kmart Corp., 260 F.3d 228, 232 (3d Cir. 2001).
Summary judgment should be granted where a party “fails to make a showing
sufficient to establish the existence of an element essential to that party’s case, and
on which that party will bear the burden of proof at trial.” Celotex, 477 U.S. at
322-23. “Such affirmative evidence – regardless of whether it is direct or
circumstantial – must amount to more than a scintilla, but may amount to less (in
the evaluation of the court) than a preponderance.” Saldana, 260 F.3d at 232
(quoting Williams v. Borough of W. Chester, 891 F.2d 458, 460-61 (3d Cir. 1989)).
III.
Discussion
A plaintiff, in order to state a viable § 1983 claim, must plead two essential
elements: 1) that the conduct complained of was committed by a person acting
under color of state law, and 2) that said conduct deprived the plaintiff of a right,
privilege, or immunity secured by the Constitution and laws of the United States.
West v. Atkins, 487 U.S. 42, 48 (1988). A defendant’s conduct must have a close
causal connection to plaintiff’s injury in order for § 1983 liability to attach.
37
Martinez v. California, 444 U.S. 277, 285 (1980).8 A prerequisite for a viable civil
rights claim is that a defendant directed, or knew of and acquiesced in, the
deprivation of a plaintiff’s constitutional rights. Rode v. Dellarciprete, 845 F.2d
1195, 1207-08 (3d Cir. 1988). On its face, § 1983 creates no exceptions to the
liability it imposes, nor does it speak of immunity for any individual who might
deprive another of civil rights. See Buckley v. Fitzsimmons, 509 U.S. 259, 268
(1993). Nevertheless, it is well-settled that certain government officials possess
immunity from § 1983 liability. Id.
As stated above, there are two motions for summary judgment and one
motion for cross summary judgment pending in the instant case. In the Corrections
Defendants’ motion, they argue that summary judgment should be granted in their
favor on the following grounds: (1) Plaintiff failed to exhaust his available
administrative remedies relating to his allegations of denial of medical care and/or
painkillers; (2) the record reflects that Defendants were not deliberately indifferent
to Plaintiff’s serious medical needs; and (3) the record shows that Defendant
Showalter did not retaliate against Plaintiff for submitting verbal and written
complaints about her. Medical Defendant Parkes argues that summary judgment
should be granted in her favor because there is no evidence to support Plaintiff’s
8
The Court in Martinez explained: “Although a § 1983 claim has been described as ‘a species of
tort liability,’ Imbler v. Pachtman, 424 U.S. 409, 417, 96 S. Ct. 984, 988, 47 L. Ed. 2d. 128
[(1976)], it is perfectly clear that not every injury in which a state official has played some part is
actionable under that statute.” Martinez, 444 U.S. at 285.
38
claim that she was deliberately indifferent to his serious medical needs. And
finally, Plaintiff argues in his motion for cross summary judgment that summary
judgment should be entered in his favor because: (1) all remaining Defendants
delayed and/or denied him proper medical treatment for his injuries; and (2)
Corrections Defendant Showalter retaliated against him for verbal and written
complaints he made about her. As exhaustion is a threshold issue, the court will
first address Corrections Defendants’ argument with respect to exhaustion of
available administrative remedies before addressing the remaining arguments.
A. Exhaustion of Administrative Remedies
DOC Defendants argue that Plaintiff’s claims related to medical
treatment for his injuries should be dismissed based on Plaintiff’s failure to exhaust
his administrative remedies, as required by the Prison Litigation Reform Act of
1995 (“PLRA”), Pub. L. No. 104-134, 110 Stat. 1321 (1996).
The PLRA requires a prisoner to present his claims through an
administrative grievance process before seeking redress in federal court. The act
specifically provides as follows:
No action shall be brought with respect to prison conditions under
section 1983 of this title, or any other Federal law, by a prisoner
confined in any jail, prison, or other correctional facility until such
administrative remedies as are available are exhausted.
42 U.S.C. § 1997e(a). This “exhaustion requirement applies to all inmate suits
about prison life, whether they involve general circumstances or particular
39
episodes, and whether they allege excessive force or some other wrong.” Porter v.
Nussle, 534 U.S. 516, 532 (2002). A prisoner must exhaust all available
administrative remedies before initiating a federal lawsuit. Booth v. Churner, 532
U.S. 731, 739 (2001). Failure to exhaust available administrative remedies is an
affirmative defense. Ray v. Kertes, 285 F.3d 287, 295 (3d Cir. 2002). As such, the
failure to exhaust available administrative remedies must be pleaded and proven by
the Defendants. Brown v. Croak, 312 F.3d 109, 111 (3d Cir. 2002).
The Pennsylvania DOC has an Inmate Grievance System which permits
any inmate to seek review of problems that may arise during the course of
confinement. 37 Pa. Code § 93.9(a); see also www.cor.state.pa.us, DOC Policies,
Policy No. DC-ADM 804, Inmate Grievance System. After an attempt to resolve
any problems informally, an inmate may submit a written grievance to the
facility’s Grievance Coordinator for initial review. An inmate may then appeal an
adverse decision of the Grievance Coordinator to the Superintendent of the
institution, and can finally appeal to the Secretary of the DOC Office of Inmate
Grievances and Appeals (“SOIGA”). See Booth v. Churner, 206 F.3d 289, 293 n.2
(3d Cir. 2000) (outlining Pennsylvania’s grievance review process).
Courts within the Third Circuit and the Middle District have consistently
imposed a procedural default component on the exhaustion requirement that
requires inmates to “fully satisfy the administrative requirements of the inmate
40
grievance process before proceeding into federal court.” McClintic v. Bickell, No.
1:14-CV-2005, 2015 WL 4207229, at *3 (M.D. Pa. July 10, 2015) (citing Spruill v.
Gillis, 372 F.3d 218 (3d Cir. 2004)). “Inmates who fail to fully, or timely,
complete the prison grievance process, or who fail to identify the named
defendants, are barred from subsequently litigating claims in federal court.” Id. at
*3 (citing Spruill, 372 F.3d 218). Indeed, an “untimely or otherwise procedurally
defective administrative grievance” fails to satisfy the exhaustion requirement of
the PLRA and the failure to properly “exhaust administrative remedies” is a bar to
“filing suit in federal court.” Woodward v. Ngo, 548 U.S. 81, 83-84, 92 (2006).
However, the particularity of the administrative complaint is judged only by the
prison grievance process itself, which will vary from system to system and claim to
claim. Jones v. Bock, 549 U.S. 199, 218 (2007); see also Moore v. Bennette, 517
F.3d 717, 726 (4th Cir. 2008) (vacating a lower court’s decision to dismiss a claim
for failing to “identify specific individuals in his grievances” where the grievance
policy did “not require identification of the persons responsible for the challenged
conduct.”). Because “early notice to those who might later be sued . . . has not
been thought to be one of the leading purposes of the exhaustion requirement,” the
named defendants in the administrative complaint have no bearing on the
sufficiency of the district court complaint, as long as the administrative complaint
was proper in its own right. Jones, 549 U.S. at 201.
41
In the present case, Corrections Defendants argue that summary
judgment should be entered in their favor as to the claims of denial of medical care
and/or painkillers because Plaintiff either did not properly and fully exhaust the
three (3) relevant available administrative remedies or he failed to name the
Defendants in those grievances. Medical Defendant Parkes makes no argument
with respect to exhaustion of available administrative remedies. The court will
discuss the grievances Corrections Defendants refer to separately.
1.
Grievance No. 416313
On June 15, 2012, Plaintiff filed Grievance No. 416313, complaining
about the treatment he was receiving for his left hand and thumb injuries.
Defendant Showalter denied the grievance on June 19, 2012. Plaintiff appealed,
and on August 10, 2012, the grievance was dismissed by SOIGA on final review
for Plaintiff’s failure to provide the required documentation for proper review.
Further, in this Grievance, Plaintiff does not mention either Defendant
Showalter or Dunkle. Rather, he only refers to Dr. Araneda and a “Nurse Holly.”
In fact, at his deposition, Plaintiff admitted that, in this grievance, he was not
complaining about anything that Defendant Showalter or Dunkle did. (Doc. 116 at
46-47.)
In a supplement to his counter statement of material facts and brief in
opposition, Plaintiff responds to Corrections Defendants’ argument with respect to
42
exhaustion of available administrative remedies. (Doc. 126.) However, Plaintiff
makes no argument to excuse exhaustion as to this Grievance. (See id. at 2.)
In light of the evidence on record in this case, as well as Plaintiff’s
admission that, in this Grievance No. 416313, he was not complaining about the
conduct of either Defendant Showalter or Dunkle, the court finds that Plaintiff did
not properly and fully exhaust his administrative remedies with respect to a denial
of medical care and/or painkillers, through this Grievance.
2.
Grievance Nos. 418059 / 418314
On June 28, 2012, Plaintiff filed Grievance No. 418059, complaining
about the denial of a brace for his hand and making general complaints about the
medical care he was receiving from medical staff. Captain Walters denied the
grievance on July 11, 2012. Plaintiff appealed, and on July 17, 2012, SOIGA
initially responded to Plaintiff that it could not take further action until the initial
review response process had concluded. On August 13, 2012, SOIGA further
responded that final review of Plaintiff’s appeal would not be granted until
Plaintiff appealed the issue to the Facility Manager. The record indicates that
Plaintiff did not complete the appeal process per SOIGA’s directives.
On July 2, 2012, Plaintiff filed Grievance No. 418314, complaining that
Captain Harris from the RHU denied him a brace for his left hand. On July 3,
2012, a Grievance Coordinator rejected the grievance as duplicative of Grievance
43
No. 418059. Plaintiff appealed, and on August 7, 2012, SOIGA initially responded
that the action could not proceed to final review until Plaintiff submitted the proper
documentation. Plaintiff sought an extension of time while he tried to obtain free
photocopies of the appropriate paperwork, but the extension was denied on
September 20, 2012. Further, SOIGA dismissed the grievance on October 18,
2012, as duplicative of Grievance No. 418059, and provided no substantive
decision on appeal.
In the supplement to his counter statement of material facts and brief in
opposition, Plaintiff seeks to excuse exhaustion of available administrative
remedies with respect to Grievance No. 418314 (and presumably Grievance No.
418059), by stating that, due to prison officials’ failure to recognize his indigence,
he was unable to provide SOIGA with the proper documentation needed for final
review. (Doc. 126 at 2.) He claims that he was unable to make photocopies or
obtain postage to send his appeal to SOIGA. (Id.) While he does not explicitly
connect this to an access to the courts claim, Plaintiff appears to be claiming that
because he could not file timely appeals, he would have failed to properly exhaust
under the PLRA, see Woodford, 548 U.S. at 93, and thus could not bring his
federal claims in court. However, the problem with such an argument is that
Plaintiff’s grievances were not rejected as untimely. First, it does not appear that
Plaintiff attempted to make photocopies for the appeal of Grievance No. 418059,
44
nor did he even file an appeal. Further, while Plaintiff did seek an extension of
time to file an appeal to the rejection of Grievance No. 418314, that extension was
denied and, later, the grievance was dismissed as duplicative of Grievance No.
418059. Thus, in neither case was an appeal dismissed as untimely. Notably, if
Plaintiff could show that prison authorities prevented him from timely filing, then
he would be able to proceed here based on Brown v. Croak, 312 F.3d 109 (3d Cir.
2002) (holding that an administrative remedy is not “available” under the PLRA
where prison authorities thwart a prisoner’s efforts to exhaust administrative
remedies). Simply denying Plaintiff’s request for free photocopies because he is
not indigent does not qualify as obstruction by prison authorities. Thus, the court
finds that Plaintiff did not properly and fully exhaust his administrative remedies
with respect to a denial of medical care through these Grievances.
B. Deliberate Indifference Claims
In both their motions for summary judgment, Corrections Defendants and
Defendant Parkes argue that Plaintiff has failed to establish that they were
deliberately indifferent to Plaintiff’s serious medical needs with respect to
addressing Plaintiff’s left hand and thumb injuries. A Section 1983 claim based on
a violation of the Eighth Amendment’s prohibition of unnecessary and wanton
infliction of pain arises where prison officials or doctors exhibit deliberate
indifference to serious medical needs of prisoners. Estelle v. Gamble, 429 U.S. 97,
45
104 (1976). A deliberate indifference claim has two components: an objective
component under which the plaintiff must show that denial of care itself was
serious or that it had serious consequences; and a subjective component under
which the plaintiff must show that the defendant has a sufficiently culpable state of
mind. See Montgomery v. Pinchak, 294 F.3d 492, 499 (3d Cir. 2002). Further, a
serious medical need is “one that has been diagnosed by a physician as requiring
treatment or one that is so obvious that a lay person would easily recognize the
necessity for a doctor’s attention.” Mines v. Levi, 2009 WL 8390011, at *7 (E.D.
Pa. Mar. 26, 2009) (quoting Colburn v. Upper Darby Twp., 946 F.2d at 1017, 1023
(3d Cir. 1991)); Monmouth Cty. Corr. Inst. Inmates v. Lanzaro, 834 F.2d 326, 347
(3d Cir. 1987). “[I]f unnecessary and wanton infliction of pain results as a
consequence of denial or delay in the provision of adequate medical care, the
medical need is of the serious nature contemplated by the Eighth Amendment.”
Young v. Kazmerski, 226 F. App’x 191, 193 (3d Cir. 2008) (quoting Lanzaro, 834
F.2d at 347).
Deliberate indifference occurs where a defendant: (1) knows of a
prisoner’s need for medical treatment but intentionally refuses to provide it; (2)
delays necessary medical treatment based on a non-medical reason; (3) prevents a
prisoner from receiving needed or recommended medical treatment; or (4) persists
in a particular course of treatment “in the face of resultant pain and risk of
46
permanent injury.” Rouse v. Allen, 182 F.3d 192, 197 (3d Cir. 1999). However,
“claims of negligence or medical malpractice, without some more culpable state of
mind, do not constitute ‘deliberate indifference.’” Id. (citing Estelle, 429 U.S. at
105); see also Durmer v. O’Carroll, 991 F.2d 64, 69 (3d Cir. 1993) (finding that if
inadequate treatment results simply from an error in medical judgment, there is no
constitutional violation); Lanzaro, 834 F.2d at 346 (stating mere disagreement as to
the proper medical treatment does not support an Eighth Amendment claim). In
Estelle, the Supreme Court held the following:
[A]n inadvertent failure to provide adequate medical care cannot be
said to constitute “an unnecessary and wanton infliction of pain” or to
be “repugnant to the conscience of mankind.” Thus, 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. Medical malpractice does not become a
constitutional violation merely because the victim is a prisoner.
Estelle, 429 U.S. at 105-06.
It follows then that inconsistencies or differences in medical diagnoses,
short delays unaccompanied by arbitrary or unduly burdensome bureaucratic
procedures, and the refusal to summon the medical specialist of the inmate’s
choice, perform tests or procedures that the inmate desires, or to explain to the
inmate the reason for medical action or inaction does not amount to cruel and
unusual punishment. Runkle, 2013 WL 6485344, at * 8 (citing Maqbool v. Univ.
Hosp. of Medicine & Dentistry of New Jersey, Civ. No. 11-4592, 2012 WL
47
2374689, at * 9 (D. N.J. Jun. 13, 2012)). As such, allegations that the inmate was
provided with medical care, but the care was “inadequate,” fails to state a
cognizable claim. Runkle, 2013 WL 6485344, at *8 (citing Taylor v. Visinsky, 422
F. App’x 76, 78 (3d Cir.), cert. denied, 565 U.S. 947 (2011)). See also Jetter v.
Beard, 130 F. App’x 523, 526 (3d Cir. 2005) (noting that while the plaintiff would
have preferred a different course of treatment, his preference does not establish an
Eighth Amendment cause of action). Rather, “the decision whether to summon a
doctor, like the question of whether a certain diagnostic technique or form of
treatment should be prescribed, ‘is a classic example of a matter for medical
judgment.’” McNeil v. Redman, 21 F. Supp. 2d 884, 887 (C.D. Ill. 1998) (quoting
Estelle, 429 U.S. at 107). Accordingly, the deliberate indifference test “affords
considerable latitude to prison medical authorities in the diagnosis and treatment of
the medical problems of inmate patients. Courts will ‘disavow any attempt to
second guess the propriety or adequacy of a particular course of treatment . . .
which remains a question of sound professional judgment.’” Little v. Lycoming
County, 912 F. Supp. 809, 815 (M.D. Pa. 1996) (citing Inmates of Allegheny
County Jail v. Pierce, 612 F.2d 754, 762 (3d Cir. 1979), quoting Bowring v.
Godwin, 551 F.2d 44, 48 (4th Cir. 1977)).
Further, a non-medical prison official is not deliberately indifferent
simply because he or she failed to respond to a prisoner’s medical complaints when
48
a doctor was already treating the prisoner. Durmer, 991 F.2d at 69. “Absent a
reason to believe (or actual knowledge) that prison doctors or their assistants are
mistreating (or not treating) a prisoner, a non-medical [prison official] . . . will not
be chargeable with the Eighth Amendment scienter requirement of deliberate
indifference.” Spruill, 372 F.3d at 236. “[T]he same division of labor concerns
that underlie that rule apply when a nurse knows that a prisoner is under a
physician’s care and has no reason to believe that the doctor is mistreating the
prisoner.” Pearson v. Prison Health Serv., 850 F.3d 526, 540 n.4 (3d Cir. 2017).
“Given that it is the physician with the ultimate authority to diagnose and prescribe
treatment for the prisoner, a nurse who knows that the prisoner is under a
physician’s care is certainly ‘justified in believing that the prisoner is in capable
hands,’ id. so long as the nurse has no discernable basis to question the physician’s
medical judgment.” Id. (quoting Spruill, 372 F.3d at 236.).
In the instant case, Plaintiff claims that the remaining Defendants were
responsible for the delays in medical treatment for his left hand and thumb
injuries.9 The court will discuss the delays as they relate to the appropriate
Defendants as follows:
9
In the court’s September 30, 2014 memorandum and order addressing two motions to dismiss,
the court dismissed Plaintiff’s claims that he was denied physical therapy and a brace for his
injuries. (See Docs. 52 & 53.) Therefore, what remains here on summary judgment with respect
to inadequate medical care claims are Plaintiff’s claims of delays in his treatment.
49
1. Delay in Initial Medical Treatment
Plaintiff claims that Corrections Defendant Dunkle caused a three-day
delay in his initial medical treatment once he entered the RHU after the April 17,
2012 fight.10 Specifically, Plaintiff claims that Defendant Dunkle denied him
treatment because Plaintiff had engaged in a fight with one of Defendant Dunkle’s
informants. (Doc. 1 at 3.) This denial in treatment for non-medical reasons
resulted in Plaintiff remaining in unnecessary pain for his untreated injuries until
three days later, or April 20, 2012.
Based on the record before the court on summary judgment, the court
concludes that Plaintiff has failed to establish that Defendant Dunkle was
deliberately indifferent to his serious medical needs in this instance. The record
reflects that, upon Plaintiff’s arrival at the RHU, Defendant Dunkle followed
proper procedures in processing Plaintiff’s entry into the unit. He noted Plaintiff’s
injuries to his left hand and thumb, and took photographs of those injuries. In
addition, he completed in part the Suicide Risk Indicators Checklist for Plaintiff.
Because Defendant Dunkle is not a medical provider, he did not directly provide
medical care to Plaintiff. Rather, a Nurse Wagman entered a note in Plaintiff’s
medical record on April 17, 2012, stating, “No injuries noted or voiced. [Plaintiff]
stated, ‘I’m okay.’ P[resciption:] sick call as needed.” (Doc. 118 at 61.) That
10
No other Defendants are implicated in this claim. (See Doc. 52 at 23 n.5.)
50
medical chart from April 17, 2012 was reviewed by another nurse that night.11
Further, two days later, on April 19, 2012, Plaintiff was seen in the RHU during
sick call by Dr. Dayan. The doctor ordered x-rays and prescribed Tylenol. (Doc.
118 at 79.) While Plaintiff denies he was seen on April 19, 2012, he does not
dispute that he was seen and treated on April 20, 2012.
In short, even accepting Plaintiff’s assertion that the delay in initial
treatment was three (3) days, the court cannot say this delay was caused by
Defendant Dunkle or that such a delay rises to the level of deliberate indifference.
The record demonstrates that medical staff was aware of Plaintiff’s injuries once
he was processed into the RHU and that medical attention was paid to those
injuries. Given the medical staff’s awareness of Plaintiff’s injuries, the court fails
to see how Defendant Dunkle, himself not a medical provider, could have delayed
a treatment plan that was underway. There is nothing in the record to suggest that
Defendant Dunkle prevented medical personnel from entering the RHU, from
conducting sick call, or from evaluating Plaintiff during those initial three (3) days.
Even if Defendant Dunkle directed Plaintiff to sit in his cell in the RHU, an act
Plaintiff was required to do anyway by virtue of his intake into the unit, there is
nothing in the record indicating that Defendant Dunkle deliberately or intentionally
11
Again, Plaintiff denies that Nurse Wagman was present for his intake into the RHU, which
took place at a strip-search cell in the unit. While that may be the case, there is nothing in the
record to suggest that Nurse Wagman did not evaluate Plaintiff in the RHU that day following
Plaintiff’s intake conducted at the strip-search cell in the RHU.
51
prevented medical staff, who enter and treat inmates in the RHU, from evaluating
Plaintiff. Rather, this is clearly a case where Plaintiff has been given medical
attention and is dissatisfied with the course of treatment and subsequent results.
An inmate’s disagreement with medical treatment is insufficient to establish
deliberate indifference. Durmer, 991 F.2d at 69; Spruill, 372 F.3d at 235. Thus,
Plaintiff’s claim here will be denied and summary judgment will be granted in
favor of Defendant Dunkle.
2. Delay in Requesting and/or Scheduling Medical
Treatment
Plaintiff claims that Defendants Showalter and Parkes were deliberately
indifferent to his serious medical needs when they intentionally delayed requesting
and/or scheduling medical treatment on behalf of Plaintiff. In support of this
claim, Plaintiff asserts that, after his Friday, April 20, 2012 visit to Altoona
Regional Hospital’s ER, doctors there recommended immediate emergency
surgery to his left thumb for the following Monday, April 23, 2012. Plaintiff
claims that both Defendants Showalter and Parkes knew of the need to schedule
this April 23, 2012 appointment, but failed to do so. Plaintiff also asserts that he
continued to inform these Defendants of his pain and suffering in the following
weeks, but neither took any steps to schedule appropriate medical appointments.
As a result, Plaintiff’s first surgery was delayed until May 11, 2012, and his second
surgery to remove the razor blade was delayed until September 7, 2012. Finally,
52
Plaintiff also claims that Defendant Showalter refused to provide him with pain
medication during all relevant times.
Based on the record before the court on summary judgment, the court
concludes that Plaintiff has failed to establish that Defendants Showalter and
Parkes were deliberately indifferent to his serious medical needs with respect to
any delay in his treatment. In analyzing Plaintiff’s claim, it is important to set
forth the duties of both Defendants Showalter and Parkes. As to Defendant
Showalter, it is noted that, as the CHCA, her duties ranged from overseeing the
health care services program to coordinating cooperation between prison medical
staff and Corizon, the contracted medical vendor. Even though Defendant
Showalter is a licensed RN, in her capacity as the CHCA, she could not prescribe
medication, including painkillers, to inmates.
Defendant Showalter also answered inmate grievances regarding their
medical treatment. In order to do so, she normally would review an inmate’s
medical records. If an inmate grievance or request slip concerned a consultation
with an outside doctor, Defendant Showalter would also normally contact the
contracted medical vendor, Corizon, about the inmate’s concerns.
If an inmate was taken to a local Emergency Room, any instructions from
the ER doctor would be sent to Corizon, and not to Defendant Showalter. If
Corizon initiated or scheduled a consultation, Defendant Showalter would monitor
53
such consultations, but she would not have been aware of any consultations not
initiated or scheduled by Corizon. Specifically, Defendant Showalter did not order
outside consultations or surgeries. Further, as the CHCA, she could not override
decisions of medical doctors, such as what medications to prescribe or whether to
order outside consultations or physical therapy.
Turning to Defendant Parkes, at the relevant time, she held the position
of clinical coordinator at SCI-Huntingdon, but was an employee of Corizon. In her
position as clinical coordinator, Defendant Parkes did not provide medical care to
inmates, and indeed, had no personal contact with Plaintiff for the provision of
medical services. Rather, her duties included scheduling appointments with
outside medical professionals when directed to do so by medical staff at the prison.
It is the prison’s medical personnel who determine the reason for an inmate to be
transferred to an outside medical provider.
Further, Defendant Parkes had no control over when an inmate will be
seen by a medical provider outside the prison. The date of an appointment is
determined by the outside medical provider based upon availability. Once an
appointment date is secured, prison officials are notified through the distribution of
a “trip sheet” so that arrangements can be made to transport the inmate to the
location of the outside medical provider. Defendant Parkes did not control the
54
availability of prison officials to transport an inmate to a scheduled outside
appointment.
In his complaint and subsequent filings relating to the instant motions,
Plaintiff displays a general misunderstanding of the duties of these Defendants. In
fact, Plaintiff assigns authority to both Defendants with respect to his medical
treatment that is misplaced. Notably, Plaintiff has provided no support,
documentary or otherwise, for his blanket statements regarding what these
Defendants were able to provide for him medically. Instead, from the record, it is
clear that the duties of these Defendants were purely administrative and neither had
the independent ability to direct or control the medical care provided to Plaintiff.
Importantly, this includes securing appointments for Plaintiff’s surgeries and other
treatment, most notably the April 23, 2012 appointment to which Plaintiff refers.12
12
Plaintiff claims that at the April 20, 2012 appointment with Dr. Stauff, the doctor
recommended that Plaintiff return on April 23, 2012 for surgery. (Doc. 125-1, Ex. 1, Pl. Decl.)
According to Plaintiff, the doctor asked the Corrections Officers escorting Plaintiff that day to
whom should he send the request, and a CO Duccassi responded: Traci Parkes, because she
handles “all” arrangements and appointments. (Id. at 3.) Dr. Stauff then wrote the
recommendation on a piece of purple note paper and attached it to the medical record. (Id. at 4.)
When Plaintiff saw CO Duccassi on Monday, April 23, the CO told him that he was not on the
list for transport to the hospital that day. (Id.) Plaintiff asked Defendant Showalter about the
appointment, and she responded that he would be seeing a doctor soon. (Id.)
There is nothing in Plaintiff’s medical records indicating that Dr. Stauff recommended an April
23, 2012, appointment. In fact, from the medical records submitted by both Plaintiff and
Corrections Defendants, it appears that Plaintiff first saw Dr. Stauff at the University
Orthopedics Center in State College on May 10, 2012. The medical records from Plaintiff’s
April 20, 2012 ER visit at the Altoona Regional Hospital do not indicate Dr. Stauff was present
and evaluated Plaintiff at that time. However, as neither set of Defendants dispute whether Dr.
Stauff conducted the April 20, 2012, evaluation, the court will not make a further issue of it here.
55
Patients, both inmates and non-inmates, generally have to obtain referrals
and appointments to see medical professionals, especially for treatments such as
surgery. In Plaintiff’s case, it was the outside medical providers who conveyed to
Corizon the need for treatment. From there, according to the record in this case, a
Corizon medical professional at the prison would have to authorize an
appointment. A coordinated effort between those providers and administrators, in
this case Defendant Parkes, was clearly made to schedule Plaintiff’s appointments.
As to Plaintiff’s first surgery, the record shows that an orthopedic
consultation was submitted on April 21, 2012, by a prison medical staff member.
(Doc. 115 ¶ 64.) He was seen by a nurse in the RHU on April 24, 2012, for
complaints of pain in his left hand, and later that day was prescribed pain
medication. (Id.) Further, another note in the record reflects that by April 29,
2012, an orthopedic appointment had been scheduled. (Id. ¶ 65.) Plaintiff was
also seen by prison medical staff, who evaluated him and prescribed pain
medications, on April 30, 2012 (id. ¶ 65), May 3, 2012 (id. ¶ 66), May 4, 2012
(id.), and May 9, 2012 (id. ¶ 67). And it was on May 10, 2012, that Plaintiff was
finally transported to an outside doctor for evaluation. (Id.) Dr. Lincoski
performed the first surgery the next day, May 11, 2012. (Id.)
As to Plaintiff’s second surgery, the record is not entirely clear why Dr.
Lincoski did not perform this surgery until September 7, 2012. Nevertheless, the
56
record is clear that, between Plaintiff’s two surgeries, he received extensive
medical care, by both prison medical providers and outsider providers. Dr. Dayan
and Dr. Araneda, along with several nurses and PAs, evaluated Plaintiff on
multiple occasions in the RHU. (See Doc. 115 ¶¶ 68-78.) Physical therapy and
pain medications were prescribed, monitored, and in some instances, cancelled.
(Id.) Plaintiff had outside consultations with Dr. Lincoski on July 26, 2012 (id. ¶
76), and August 23, 2012, (id. ¶ 78). But Plaintiff did not have his second surgery
until September 7, 2012. (Id. ¶ 79.)
Plaintiff takes issue with the timing of these surgeries. He may think that
he should have been referred to a surgeon for surgery sooner than he was, but
Plaintiff’s disagreement with the protocol taken does not rise to the level of
deliberate indifference. A prisoner administrator cannot be found deliberately
indifferent under the Eighth Amendment because he or she fails to respond to the
medical complaints of an inmate being treated by a prison physician or, because, as
a non-physician, he or she defers to the medical judgment of the inmate’s treating
physicians. Durmer, 991 F.2d at 69.
The court notes that if, however, non-medical prison personnel had “a
reason to believe (or actual knowledge) that prison doctors or their assistants are
mistreating (or not treating) a prisoner,” liability may be imposed. Spruill, 372
F.3d at 236. This is simply not the case here. The medical record, as summarized
57
above, shows that the prison medical staff responded quickly and thoroughly to
Plaintiff’s medical needs for his left hand and thumb injuries. He was taken to
several outside appointments to be seen by various medical professionals,
including ER doctors and orthopedic surgeons, and given appropriate treatment.
He was prescribed pain medications to alleviate his suffering. Unfortunately for
Plaintiff he remained in pain despite the efforts of his medical team. But, again,
Plaintiff’s disagreement with his treatment fails to establish deliberate indifference.
Absent a showing that the medical report is inaccurate and that the described
course of treatment did not occur, Plaintiff’s claims as to the delay in treatment and
a refusal to provide pain medication fail.
In sum, while Plaintiff is not in agreement with the medical decisions
made, the record before the court clearly demonstrates that Plaintiff was receiving
ongoing medical attention, both immediately after the fight and during the period
of time it took to repair his left hand and thumb through two (2) surgeries. Staff
treated and evaluated Plaintiff on sick call visits and scheduled appointments.
Defendants Showalter and Parkes followed the written directives provided by
outside providers to prison medical providers, relying on the professional judgment
of those providers in coordinating orthopedic consultations and appointments.
Accordingly, Plaintiff has failed to demonstrate that these Defendants possessed
the culpable mental state necessary for Eighth Amendment liability to attach. As a
58
result, the deliberate indifference claims against Defendants Showalter and Parkes
will be denied.
C. Retaliation Claim
Plaintiff alleges that Corrections Defendant Showalter delayed his
medical treatment in retaliation for his written and verbal complaints against her.
Upon review, the court will grant summary judgment in favor of Defendant
Showalter as to this claim.
In order to state a retaliation claim, a plaintiff must satisfy three elements.
First, a plaintiff must prove the he was engaged in a constitutionally protected
activity. Rauser v. Horn, 241 F.3d 330, 333 (3d Cir. 2001). Second, an inmate
plaintiff must demonstrate that he “suffered some ‘adverse action’ at the hands of
prison officials.” Id. (quoting Allah v. Seiverling, 228 F.3d 220, 225 (3d Cir.
2000)). This requirement is satisfied by showing adverse action “‘sufficient to
deter a person of ordinary firmness from exercising his First Amendment rights.’”
Id. at 333 (quoting Allah, 229 F.3d at 225). Third, a prisoner plaintiff must prove
that “his constitutionally protected conduct was a ‘substantial or motivating factor’
in the decision to discipline him.” Id. at 333 (quoting Mount Healthy Bd. of Educ.
v. Doyle, 429 U.S. 274, 287 (1977); Suppan v. Dadonna, 203 F.3d 228, 235 (3d
Cir. 2000).
Here, Plaintiff has not demonstrated that his filing of grievances was a
substantial or motivating factor for any delay in his medical treatment by
59
Defendant Showalter. This is particularly true where the record reveals that, as the
CHCA, Defendant Showalter did not order outside consultations or surgeries, nor
could she override decisions of medical doctors, such as what medications to
prescribe or whether to order outside consultations or physical therapy. While
Defendant Showalter could monitor consultations initiated or scheduled by prison
medical providers, she herself was not in charge of scheduling such consultations.
Thus, any delay in Plaintiff’s medical treatment simply cannot be attributed to
Defendant Showalter. Consequently, Plaintiff’s claim of retaliation against
Defendant Showalter fails and summary judgment will be entered in favor of the
Defendant.
IV. Conclusion
For the reasons set forth above, Corrections Defendants’ motion for
summary judgment (Doc. 113) will be granted. In addition, Medical Defendant
Parkes’ motion for summary judgment (Doc. 107) will be granted. Plaintiff’s
motion for cross summary judgment (Doc. 122) will be denied. Judgment will be
entered in favor of all Defendants and against Plaintiff.
An appropriate order will issue.
s/Sylvia H. Rambo
SYLVIA H. RAMBO
United States District Judge
Dated: September 28, 2017
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