Wakefield v. Saint Mary Hospital et al
Filing
48
DECISION AND ORDER signed by Judge Lynn Adelman on 7/18/14 granting 28 Motion for Summary Judgment; granting 34 Motion for Summary Judgment. Further ordering that defendant John Doe is DISMISSED and that this case is DISMISSED. (cc: all counsel, via USPS to plaintiff) (dm)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF WISCONSIN
DANIEL LEE WAKEFIELD,
Plaintiff,
v.
Case No. 12-CV-1193
WHEATON FRANCISCAN HEALTHCARE ALL SAINTS,
WARDEN JOHN PAQUIN, AAISHA SHAKOOR,
and JOHN DOE,
Defendants.
DECISION AND ORDER
Plaintiff, Daniel Lee Wakefield, a Wisconsin state prisoner, filed this pro se civil
rights action under 42 U.S.C. § 1983. He is proceeding in forma pauperis on Eighth
Amendment claims for failure to protect and deliberate indifference to a serious medical
need. His claims are based on allegations that he inadvertently consumed another
inmate’s blood on a meal tray and the subsequent medical care he received. Defendants
Warden John Paquin and Aaisha Shakoor1 have filed a motion for summary judgment.
Defendant Wheaton Franciscan Healthcare–All Saints, who is represented by separate
counsel, has also filed a motion for summary judgment. For the reasons set forth herein,
defendants’ motions will be granted and this case will be dismissed.2
1
Aaisha Shakoor is now known as Aaisha Flint. I will refer to her as Shakoor-Flint
in this Decision and Order.
2
Defendant John Doe will be dismissed because plaintiff has not identified him.
I. STANDARD OF REVIEW
“The court shall grant summary judgment if the movant shows that there is no
genuine dispute as to any material fact and the movant is entitled to judgment as a matter
of law.” Fed. R. Civ. P. 56(a); see also Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248
(1986); Celotex Corp. v. Catrett, 477 U.S. 317, 324 (1986); Ames v. Home Depot U.S.A.,
Inc., 629 F.3d 665, 668 (7th Cir. 2011). “Material facts” are those under the applicable
substantive law that “might affect the outcome of the suit.” See Anderson, 477 U.S. at 248.
A dispute over “material fact” is “genuine” if “the evidence is such that a reasonable jury
could return a verdict for the nonmoving party.” Id.
A party asserting that a fact cannot be or is genuinely disputed must support the
assertion by: “(A) citing to particular parts of materials in the record, including depositions,
documents, electronically stored information, affidavits or declarations, stipulations
(including those made for purposes of the motion only), admissions, interrogatory answers,
or other materials; or (B) showing that the materials cited do not establish the absence or
presence of a genuine dispute, or that an adverse party cannot produce admissible
evidence to support the fact.” Fed. R. Civ. P. 56(c)(1). “An affidavit or declaration used
to support or oppose a motion must be made on personal knowledge, set out facts that
would be admissible in evidence, and show that the affiant or declarant is competent to
testify on the matters stated.” Fed. R. Civ. P. 56(c)(4).
2
II. FACTS3
Plaintiff is an inmate at Racine Correctional Institution (RCI). At all times relevant,
defendant Paquin was the Warden at RCI. As Warden, he was responsible for the overall
administration and operation of the institution. Defendant Paquin is now employed by the
Wisconsin Department of Corrections (DOC) as an Assistant Administrator in the Division
of Adult Institutions.
Defendant Shakoor-Flint is employed by the DOC as a Nursing Supervisor at RCI.
In that capacity, she functions as the administrative supervisor of the Health Services Unit
(HSU) during the absence of the Health Services Director; assumes responsibility for
planning, implementing, and evaluating clinical programs to advance patient care and
nursing practices for RCI; plans, implements, and evaluates clinical programs to advance
patient care and nursing practices for RCI; plans and participates in learning opportunities
for nursing and ancillary staff; works with administration and practitioners to assure quality
patient care and promotes education; and collaborates with and receives clinical direction
from the Clinical Directors and Nursing Coordinators of the Bureau of Health Services
(BHS), RCI Physicians and Psychiatrists, and Dentists.
Amandy Moore (Nurse Moore) is employed by the DOC as a Nursing Clinician 2 at
RCI in the HSU. In that capacity, he provides skilled nursing care to incarcerated adults
in state correctional facilities, including both ambulatory and infirmary settings. Nurse
Moore’s duties include patient assessment and treatment, assisting the physician in
3
This section is taken from defendants Paquin and Shakoor-Flint’s Proposed
Findings of Fact, which defendant All Saints adopts in support of its summary judgment
motion. Facts are also taken from plaintiff’s Proposed Findings of Fact.
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providing medical services, management of medications, provisions of emergency care,
and maintenance of medical records. In addition, he participates in educational programs
for staff and inmates and participates in activities to maintain his nursing skill level.
On July 23, 2012, while eating supper, plaintiff was informed by other inmates that
the food trays had blood on them. Later that day, plaintiff went to the HSU and stated that
he had eaten blood drops on his meal tray. He complained of stomach cramping and
nausea. Plaintiff alleges, “I noticed red spots on the tray but paid no attention thinking they
were just apple shavings from the apple given to us.” (Complaint at 4.) Nurse Moore was
working in HSU at that time.
In response to plaintiff’s assertion that he ingested another inmate’s blood, the DOC
policy regarding blood exposure was reviewed.4 Plaintiff was assessed, his vaccination
4
The DOC Health Services Policy/Procedure 300:36 governs the procedures
regarding Significant Exposures Management. According to the policy, the definition of a
significant exposure is:
Defined § 252.15(1)(em) as sustained contact which carries a potential for
transmission of HIV, by one or more of the following: a) by transmission into
a body orifice or onto mucous membrane, b) exchange during the accidental
or intentional infliction of a penetrating wound, c) exchange into an eye, an
open wound, an oozing lesion or where a significant breakdown in the
epidermal barrier has occurred of blood; semen; vaginal secretion;
cerebrospinal, synovial, pleural, peritoneal, pericardial, or amniotic fluid; or
other body fluid that is visible contaminated with blood.
(Shakoor-Flint Aff. ¶ 7, Exh. 101 at 3.) As soon as HIV is exposed to air, the virus starts
to die, particularly if there is only a small quantity of a bodily fluid. The response to
managing exposures is to:
a) Give immediate first aid at the nearest sink;
b) Notify the appropriate facility staff of the incident;
c) Do a medical evaluation in order to determine if the exposure is significant;
d) Complete a DOC-98A; and
e) Testing.
4
record was reviewed, and he received education regarding possible risks associated with
exposure to blood/blood borne pathogens. His lab work was drawn the following day and
he was scheduled for a follow-up appointment with RCI nursing staff.
Prior to speaking with the inmates on July 23, 2012, Nurse Moore was informed that
defendant All Saints was contacted regarding the potential blood exposure and that
hospital staff would not treat the inmates because the amount of blood they ingested was
small and stomach acids would minimize the exposure. Nurse Moore then explained to
the inmates who claimed to have ingested the blood that they would not be going to the
Emergency Room. Nurse Moore vaguely remembers discussions he had with plaintiff on
July 23, 2012. He believes that he repeated to plaintiff exactly what was related to him,
which was that the hospital was called and informed of the incident but that staff at the
hospital declined to triage/assess the inmates who had ingested the blood because
anything that would be done at the hospital for blood exposure could be done at RCI.
On July 23, 2012, Nurse Hawkins informed defendant Shakoor-Flint that defendant
All Saints was contacted regarding the potential blood exposure and that hospital staff
would not treat the inmates who ingested food that had drops of blood on it because the
amount of blood that was ingested was small and that stomach acids would minimize the
exposure. Defendant All Saints does not have a medical record that confirms such a call
took place because plaintiff was not admitted to the hospital.
The decision not to send plaintiff to the hospital was based on the nurse’s
assessment and the Emergency Room personnel. Based on the assessment of the
(Shakoor-Flint Aff. ¶ 9, Exh. 101 at 3.)
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inmates that ingested the drops of blood, it was determined that they had not ingested
enough blood to warrant transfer to the Emergency Room. As protocol dictates, labs for
HIV tests were drawn by DOC staff.
On July 23, 2012, the day of the incident, a nurse in HSU saw plaintiff. His vitals
were taken and within normal limits with the exception of an elevated blood pressure of
135/90 and pulse of 89. Plaintiff wanted to be tested for HIV in the Emergency Room, but
it was not recommended by hospital staff. The nurse recommended that plaintiff rest,
increase his water intake, and to notify the HSU if the symptoms did not improve.
On July 24, 2012, plaintiff was seen in the HSU by a nurse in sick call. He stated,
“I still feel sick about it. My eyes are red, tearing, and I am worried about HIV.” Plaintiff’s
vitals were taken and within normal limits with the exception of a slightly elevated blood
pressure of 132/80. The nurse noted an order for an HIV blood test and eye drops to apply
as directed. The nurse scheduled a follow-up appointment for the following week. Plaintiff
also signed a consent for the HIV antibody test.
On July 25, 2012, the HIV antibody test was administered with negative results.
Plaintiff also submitted a Health Service Request (HSR) stating, “My eyes were bloodshot
red after taking the medication, my stomach still in pain and it’s starting to affect my sleep.
All due to me consuming someone else’s blood. I need outside attention.” (Shakoor-Flint
Aff. ¶ 16, Exh. 100, Bates No. 00014, 000016.)
In response to the July 25, 2012 HSR, plaintiff was seen in HSU for sick call on July
26, 2012. His vitals were taken and within normal limits with the exception of an elevated
blood pressure of 131/73. The nurse noted that plaintiff’s chief complaint was eye redness
and stomach ache. Upon examination, the nurse noted that plaintiff’s eyes were red with
6
zero drainage, his ears and throat were clear, and his nasal passage was slightly red.
Plaintiff denied having allergies. He expressed feeling stressed about the blood exposure
and the nurse educated plaintiff regarding blood exposure and relaxation techniques to
relieve stress. The doctor ordered eye drops for plaintiff and the nurse directed him to
report any signs/symptoms and if there was no improvement in his condition to contact
HSU. The nurse also referred plaintiff’s case to the doctor.
On July 30, 2012, plaintiff submitted an HSR stating, “I need proper medical
treatment. I’m requesting outside attention. I am still very sick, with bloodshot eyes,
stomach pains, headaches, loss of sleep and appetite. There is something wrong. Please
get me proper help.” (Shakoor-Flint Aff. ¶ 18, Exh. 100, Bates No. 00015.) In response,
plaintiff was seen by the nurse in sick call the next day. His chief complaint remained
unchanged. He stated, “I just feel like something is wrong since I ate that blood.” Plaintiff’s
vitals were taken and within normal limits with the exception of an elevated blood pressure
of 138/84. The nurse directed plaintiff to report any signs/symptoms if there was no
improvement in his condition, and to continue using the eye drops as directed. (ShakoorFlint Aff. ¶ 19, Exh. 100, Bates No. 00006-00007, 00013.)
On August 1, 2012, at staff’s request, plaintiff was seen in HSU by nursing staff for
a follow-up appointment regarding his eye redness. He stated that his eyes were doing
better. Plaintiff’s vitals were taken and with the exception of an elevated blood pressure
of 131/75, unremarkable. Although his eyes were still pink, they showed improvement. The
nurse educated plaintiff again regarding eye care and advised him to report any signs or
symptoms. His medications were refilled.
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Defendant Shakoor-Flint has never seen or assessed plaintiff. She was not the staff
member who called defendant All Saints on July 23, 2012.
Defendant Paquin was not at the institution on July 23, 2012. He was verbally told
about the incident, but does not recall when or how. Paquin is not a health care provider
and does not possess professional expertise in any area of health care. He does not
attempt to set health care policies to be followed within the Bureau of Correctional Health
Services but relies on the health care professionals within the Bureau to set such policies.
As Warden, Paquin did not serve meal trays to inmates but rather relied on correctional
staff to hire inmates to serve food. The hiring authority is given to the Unit Manager via the
Housing Unit Sergeants. Paquin was not aware of any hygiene problems with the inmate
whose blood was on the food trays prior to the incident on July 24, 2012.
III. ANALYSIS
A.
Defendants Paquin and Shakoor-Flint’s Motion for Summary Judgment
Defendants Paquin and Shakoor-Flint contend that plaintiff’s medical-care claim
should be dismissed because he did not have a serious medical need and because
Shakoor-Flint was not deliberately indifferent. They also contend that plaintiff’s failure-toprotect claim is subject to dismissal because Paquin was not personally involved in the
claim. Plaintiff contends that genuine issues of material fact preclude summary judgment
on this claim. He claims that defendant Shakoor-Flint was deliberately indifferent to his
medical care and that defendant Paquin knowingly put him in a dangerous situation.
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1.
Medical-Care Claim
“The Eighth Amendment safeguards the prisoner against a lack of medical care that
‘may result in pain and suffering which no one suggests would serve any penological
purpose.’” Arnett v. Webster, 658 F.3d 742, 750 (7th Cir. 2011) (quoting Rodriguez v.
Plymouth Ambulance Serv., 577 F.3d 816, 828 (7th Cir. 2009); see also Estelle v. Gamble,
429 U.S. 97, 103 (1976)). Prison officials violate the Constitution if they are deliberately
indifferent to prisoners’ serious medical needs. Arnett, 658 F.3d at 750 (citing Estelle, 429
U.S. at 104). Accordingly, a claim based on deficient medical care must demonstrate two
elements: 1) an objectively serious medical condition; and 2) an official’s deliberate
indifference to that condition. Arnett, 658 F.3d at 750 (citation omitted). “Deliberate
indifference to serious medical needs of a prisoner constitutes the unnecessary and
wanton infliction of pain forbidden by the Constitution.” Rodriguez, 577 F.3d at 828
(quoting Estelle, 429 U.S. at 103).
I will focus on the deliberate indifference prong of an Eighth Amendment claim. To
demonstrate deliberate indifference, a plaintiff must show that the defendant “acted with
a sufficiently culpable state of mind,” something akin to recklessness. A prison official acts
with a sufficiently culpable state of mind when he or she knows of a substantial risk of harm
to an inmate and either acts or fails to act in disregard of that risk. Roe v. Elyea, 631 F.3d
843, 857 (7th Cir. 2011). Deliberate indifference “is more than negligence and approaches
intentional wrongdoing.” Arnett, 658 F.3d at 759 (quoting Collignon v. Milwaukee Cnty.,
163 F.3d 982, 988 (7th Cir. 1998)). It is not medical malpractice; “the Eighth Amendment
does not codify common law torts.” Duckworth v. Ahmad, 532 F.3d 675, 679 (7th Cir.
2008).
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“A jury can infer deliberate indifference on the basis of a physician’s treatment
decision [when] the decision [is] so far afield of accepted professional standards as to raise
the inference that it was not actually based on a medical judgment.” Arnett, 658 F.3d at
759 (quoting Duckworth, 532 F.3d at 679). A plaintiff can show that the professional
disregarded the need only if the professional’s subjective response was so inadequate that
it demonstrated an absence of professional judgment, that is, that “no minimally competent
professional would have so responded under those circumstances.” Roe, 631 F.3d at 857
(quotation marks omitted). However, a prisoner “need not prove that the prison officials
intended, hoped for, or desired the harm that transpired.” Walker v. Benjamin, 293 F.3d
1030, 1037 (7th Cir. 2002). “Nor does a prisoner need to show that he was literally
ignored.” Arnett, 658 F.3d at 759 (citing Greeno v. Daley, 414 F.3d 645, 653 (7th Cir.
2005)). That the prisoner received some treatment does not foreclose his deliberate
indifference claim if the treatment received was “so blatantly inappropriate as to evidence
intentional mistreatment likely to seriously aggravate his condition.” Arnett, 658 F.3d at
759 (quoting Greeno, 414 F.3d at 653). However, deliberate indifference is a high
standard; it requires proof that the state officials actually knew of the inmate’s serious
medical need and that they disregarded it. Walker, 293 F.3d at 1037.
Here, plaintiff challenges the decision to not send him to the Emergency Room at
All Saints after he ingested another inmate’s blood on July 23, 2012. It is undisputed that
following the incident, an RCI staff member called defendant All Saints regarding the
potential blood exposure. The hospital advised that it would not treat the inmates because
the amount of blood ingested was small and stomach acids would minimize exposure. In
addition, anything that would be done at the hospital for blood exposure could be done at
10
RCI.
The decision not to send plaintiff to the hospital was based on the nurse’s
assessment and the recommendation of Emergency Room personnel. Plaintiff was seen
and assessed after he reported ingesting the blood. The next day, an HIV test was
ordered and plaintiff tested negative. In addition, plaintiff’s complaints about his red eyes
were addressed and HSU educated him on blood exposure and stress relief exercises
relative to his anxiety over the incident.
Courts defer to a medical professional’s treatment decisions “unless ‘no minimally
competent professional would have so responded under those circumstances.’” Sain v.
Wood, 512 F.3d 886, 894-95 (7th Cir. 2008) (quoting Collignon, 163 F.3d at 988; see
Jackson v. Kotter, 541 F.3d 688, 698 (7th Cir. 2008). Plaintiff would have preferred to
have been treated at defendant All Saints following the incident on July 23, 2012.
However, there is no indication that the decision to treat him RCI was anything other than
a reasonable decision under the circumstances, especially considering that he received
the same treatment there that he would have received at All Saints. A course of treatment
violates the Eighth Amendment only when it departs so radically from the standards of the
profession that it falls outside the bounds of the defendant's professional judgment. See
King v. Kramer, 680 F.3d 1013, 1018-19 (7th Cir. 2012). The record shows that RCI
medical staff treated plaintiff following the incident and reasonably addressed his concerns
in the days after the incident. Therefore, plaintiff’s medical care claim against defendant
Shakoor-Flint fails.
2.
Failure-to-Protect Claim
The Constitution imposes on prison officials the duty to protect those in their charge
from harm from other prisoners. Dale v. Poston, 548 F.3d 563, 569 (7th Cir. 2008) (citing
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Mayoral v. Sheahan, 245 F.3d 934, 938 (7th Cir. 2001)). However, an inmate does not
have a claim “unless the official knows of and disregards an excessive risk to inmate health
or safety; the official must both be aware of facts from which the inference could be drawn
that a substantial risk of serious harm exists, and he must also draw the inference.”
Farmer v. Brennan, 511 U.S. 825, 837 (1994). The deliberate indifference test has both
objective and subjective prongs, the former requiring a grave risk and the latter requiring
actual knowledge of that risk. Dale, 547 F.3d at 569 (citing Greeno v. Daley, 414 F.3d 645,
653 (7th Cir. 2005)). Once prison officials know about a serious risk of harm, they have
an obligation “to take reasonable measures to abate it.” Borello v. Allison, 446 F.3d 742,
747 (7th Cir. 2006). An official’s response may be reasonable even if it fails to avert the
harm. Id.
Plaintiff alleges that defendant Paquin allowed the inmate who contaminated the
food tray with blood to keep his food service job despite his reputation for intentionally
contaminating food trays and for being unsanitary. However, defendant Paquin was not
aware of any hygiene problems with the inmate in question prior to the incident. Paquin
was not personally involved in serving meals or hiring inmates to work in food service.
Only a defendant who is personally responsible for depriving the plaintiff of a
constitutional right may be held liable under § 1983. Grieveson v. Anderson, 538 F.3d 763,
778 (7th Cir. 2008).
If someone else has committed the act that resulted in the
constitutional deprivation, then the defendant is personally responsible, and thus liable
under § 1983, only if he knows about the other person’s act, has a realistic opportunity to
prevent it, but deliberately or recklessly fails to do so. Lewis v. Downey, 581 F.3d 467, 472
12
(7th Cir. 2009). Because the the undisputed facts reveal that defendant Paquin was not
personally involved in plaintiff’s failure to protect claim, the claim will be dismissed.
B.
Defendant All Saints’ Motion for Summary Judgment
Defendant All Saints contends that it is entitled to summary judgment because, as
an off-site independent hospital, it had no duties to plaintiff under the Eighth Amendment.
It further contends that, even if it did, plaintiff did not have a serious medical need and All
Saints was not deliberately indifferent. Plaintiff’s response does not address All Saints’
arguments.
Private hospital liability to prisoners under the Eighth Amendment is not
unprecedented. See Rodriguez v. Plymouth Ambulance Serv., 577 F.3d 816, 823 (7th Cir.
2009). I will not therefore dismiss All Saints merely because it is an off-site independent
hospital. However, All Saints is subject to dismissal because there is no indication of
deliberate indifference on the part of the hospital.
Rather, someone at All Saints
recommended to not bring the prisoners to the Emergency Room because the blood
exposure was small and RCI could provide the same treatment that they would receive at
the hospital. As set forth herein, these facts do support an inference of deliberate
indifference. Therefore, I will grant defendant All Saints’ motion for summary judgment.
THEREFORE, IT IS ORDERED that defendants Paquin and Shakoor-Flint’s motion
for summary judgment (Docket # 28) is GRANTED.
IT IS FURTHER ORDERED that defendant All Saints’ motion for summary judgment
(Docket # 34) is GRANTED.
IT IS FURTHER ORDERED that defendant John Doe is DISMISSED.
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IT IS FURTHER ORDERED that this case is DISMISSED.
Dated at Milwaukee, Wisconsin, this 18th day of July, 2014.
s/ Lynn Adelman
_______________________
LYNN ADELMAN
District Judge
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