Goodvine v. Monese et al
Filing
62
DECISION AND ORDER signed by Judge Lynn Adelman on 3/25/15 granting 30 Motion for Summary Judgment. The Clerk of Court shall enter final judgment. (cc: all counsel, via USPS to plaintiff) (dm)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF WISCONSIN
CHRISTOPHER GOODVINE,
Plaintiff,
v.
Case No. 13-CV-1057
DR. GEORGE MONESE
Defendant,
DECISION AND ORDER
Christopher Goodvine, a Wisconsin inmate, alleges that Dr. George Monese, a
psychiatrist at the Wisconsin Resource Center (WRC), provided him with inadequate
medical care while he was confined at that institution. Before me now is the defendant’s
motion for summary judgment. Summary judgment is required where “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). When considering a motion for summary judgment, I take the
evidence in the light most favorable to the non-moving party and may grant the motion only
if no reasonable juror could find for that party. Anderson v. Liberty Lobby, Inc., 477 U.S.
242, 248, 255 (1986).
I. BACKGROUND
The Wisconsin Resource Center is a specialized mental health facility established
as a prison under Wisconsin Statute § 46.056. The facility operates as a secure-treatment
center and is managed by the Wisconsin Department of Health Services, Division of
Mental Health and Substance Abuse. Inmates within the Wisconsin prison system are
referred to the WRC for treatment of behavioral and mental health issues. The goal of
treatment at the WRC is to modify an inmate’s behavior and enable him to be returned to
the general prison population.
Goodvine was admitted to the WRC on August 29, 2012. Prior to that date, he was
confined in ordinary Wisconsin prisons and had a history of engaging in various forms of
misbehavior, including self-harm. The misbehavior was attributed to “maladjustment within
the prison environment,” and he had been diagnosed with mood disorder and antisocial
personality disorder. Def. Prop. Findings of Fact (“PFOF”) ¶ 19. Goodvine was referred
to WRC to participate in a “coping skills” program, which was designed to help him with
these issues.
On August 30, 2012, Dr. Monese conducted an initial examination of Goodvine.
This was not Monese’s first encounter with Goodvine, as Goodvine was referred to the
WRC in 2010 and received treatment from Monese at that time. During the exam, Monese
determined that after Goodvine was discharged from the WRC in 2010, he did relatively
well in the general prison population, but only for a short time. Goodvine reported that he
had a tendency to self-injure, got angry a lot, and was disappointed with his life. He also
reported that he had a history of engaging in hunger strikes. At the time of his admission
to the WRC, however, Goodvine weighed 270 pounds and was seriously overweight.
Goodvine also informed Monese that he sometimes thinks of committing suicide. The
WRC referral report indicated that Goodvine had recently engaged in self-harm by
overdosing on 56 pills of Tylenol and cutting his arms. The report stated that Goodvine will
engage in self-injurious behavior when he does not get his way. After the examination, Dr.
Monese concluded that Goodvine’s behavior was largely attributable to his personality
2
disorder, although he noted that Goodvine might also have a legitimate mood disorder like
depression.
At the time of his admission to the WRC, Goodvine had been taking Seroquel, an
antipsychotic medication. Monese decided to continue that medication, and he also
prescribed Wellbutrin, an antidepressant.
To promote weight loss, Monese placed
Goodvine on a lower-calorie diet. Monese informed Goodvine that because of his history
of self-harm, the WRC would classify him as having a “high” risk of suicide. See Goodvine
Decl. ¶ 18, ECF No. 47.
About one month after his admission to WRC, Goodvine began to refuse his meals.
When nursing staff asked Goodvine about this, he replied that he “fasts sometimes.” Def.
PFOF ¶ 47. Staff at the WRC interpreted Goodvine’s refusing meals as the initiation of a
hunger strike, and they placed Goodvine on the institution’s hunger-strike protocol.
Goodvine started declining his meals on about September 25, 2012. From that date until
October 1, 2012, he generally declined his meals but intermittently drank juices and Ensure
and ate crackers and soup.
On October 1, 2012, Monese met with Goodvine at his cell. By this time, Goodvine
had completed the coping-skills program and was informed that he was ready to be
returned to prison. Goodvine told Monese that he felt depressed about this and expressed
a desire to remain at the WRC to participate in other programs, including a program known
as “DBT.”1 Monese then had a discussion with one of the staff members who had been
1
Although I have been unable to find anything in the record that identifies what DBT
stands for, it likely stands for dialectical behavior therapy, which is designed to help
individuals prone to self-harm and suicidal thinking. See http://en.wikipedia.org/wiki/
Dialectical_behavior_therapy (last viewed March 24, 2015).
3
working with Goodvine. That staff member told Monese that Goodvine had completed the
coping-skills program and that he was not a candidate for DBT. Monese also spoke with
Goodvine about his not eating, and Goodvine told Monese that he had lost his appetite.
Monese decided to prescribe Goodvine cyproheptadine, a medication that could help
improve his appetite. The medication was also prescribed to treat Goodvine’s complaints
of nightmares. During this meeting, Goodvine told Monese that he would kill himself before
he returned to the general prison population. Goodvine also told Monese that although he
would not eat, he would continue to drink Ensure. After the exam, Monese wrote in his
report that he would discuss with others at the WRC whether Goodvine could participate
in the DBT program. However, Monese concluded that Goodvine’s propensity to self-harm
was likely more volitional than impulsive, and that therefore DBT was likely not an
appropriate treatment.
On October 4, 2012, staff at the WRC examined plaintiff and found that he weighed
244 pounds, a loss of 26 pounds since his admission to the WRC. Around this time,
Goodvine’s feelings of depression and self-harm continued to worsen, and he began to
hoard his medications in preparation for a suicide attempt. Pl. PFOF ¶ 50. However, on
October 9, 2012, Goodvine received letters from his family that lifted his spirits. On
October 10, 2012, Goodvine voluntarily notified WRC staff that he had been hoarding his
medications. Staff members found Goodvine in possession of a large quantity of Tylenol
and Seroquel pills. One staff member noted on Goodvine’s chart that he was found with
30–40 pills in total. Monese Decl. Ex. 1 at 11. When staff informed Monese of what they
had found, Monese decided to discontinue Goodvine’s prescription for Seroquel and
ordered that his remaining medications (except for Wellbutrin) be crushed. (Crushing the
4
medications before giving them to an inmate is apparently a technique to prevent
hoarding.)
On October 10, 2012, upon learning that Monese had discontinued his Seroquel,
Goodvine wrote to Monese and asked him to continue that prescription. Monese replied
that he was aware of the situation and would address it with Goodvine at their next clinical
encounter.
On October 14, 2012, Goodvine submitted a written notice to WRC staff in which
he requested a “do not resuscitate” order and indicated that he did not want to be
resuscitated on October 16, 2012 or October 17, 2012. He also prepared a will. As soon
as WRC staff members received these papers, they referred Goodvine to Dr. Monese.
On October 15, 2012, Dr. Monese met with Goodvine in the dayroom of the
segregation unit. Goodvine told Monese that he was very depressed, had been having
thoughts of self-harm, and wanted to resume taking Seroquel, as that was the only
medication that helped him. Monese explained that because Goodvine had been hoarding
Seroquel, he could not continue that medication. Monese also noted that because of
Goodvine’s continuing lack of appetite, Wellbutrin was probably not an appropriate
medication for him, as appetite loss is one of its side effects. After discussing possible
medications with Goodvine, Monese decided to prescribe him Loxitane, an antipsychotic
that replaced the Seroquel, and Prozac, an antidepressant that replaced the Wellbutrin.
In his notes from the visit, Monese indicated that he confronted Goodvine about his
“writings and behaviors”—presumably the will, request for a do-not-resuscitate order, and
hoarding of medications, and wrote that Goodvine reported “fleeting thoughts of self-harm,
but no immediate intention to do so right now.” Monese Decl. Ex. 1 at 31. Goodvine
5
disputes this characterization of their conversation and contends that he “unequivocally”
told Monese that he was “imminently suicidal” and that he believed he would immediately
harm himself if he was returned to his cell. Goodvine Decl. ¶ 60.
At the conclusion of the exam, Goodvine was returned to his cell. Shortly thereafter,
he covered his cell window, placed a tourniquet on his left arm to make his artery more
visible, then seriously and deeply lacerated his right arm in the area of his elbow.
Goodvine punctured a major vein or artery, and blood began pouring from his arm and
covering the floor. While Goodvine was still conscious, a staff member discovered
Goodvine and alerted medical staff. See ECF No. 45-13. Dr. Monese was paged and
arrived at the scene along with nursing staff. Paramedics were also called, and after some
initial treatment at his cell, Goodvine was taken to the hospital emergency room, where the
laceration was sutured.
On October 16, 2012, Goodvine was returned to the WRC. Pl. PFOF ¶ 82. He
remained there for two days and was returned to prison on October 18, 2012.
II. DISCUSSION
In the present suit, Goodvine alleges that Monese was deliberately indifferent to his
serious medical needs, in violation of the Eighth Amendment. 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. E.g., Arnett v. Webster, 658
F.3d 742, 750 (7th Cir. 2011). 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. Id.
6
The burden is on the prisoner to demonstrate that prison officials violated the Eighth
Amendment, and that burden is a heavy one. Pyles v. Fahim, 771 F.3d 403, 408–09 (7th
Cir. 2014). Deliberate indifference is a subjective standard. Arnett, 658 F.3d at 751. To
demonstrate deliberate indifference, a plaintiff must show that the defendant acted with a
sufficiently culpable state of mind, something akin to recklessness. Id. A prison official
acts with a sufficiently culpable state of mind when he knows of a substantial risk of harm
to an inmate and either acts or fails to act in disregard of that risk. Id. Deliberate
indifference is more than negligence and approaches intentional wrongdoing. Id. In other
words, “[d]eliberate indifference is not medical malpractice; the Eighth Amendment does
not codify common law torts.” Duckworth v. Ahmad, 532 F.3d 675, 679 (7th Cir.2008). “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.” Id. (quotation marks omitted). 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.” Arnett, 658 F.3d at 751 (quotation marks omitted).
A prisoner, however, “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); see also Duckworth, 532 F.3d at 679 (“[A]lthough deliberate means more than
negligen[ce], it is something less than purposeful.”). Nor does a prisoner need to show that
he was literally ignored. 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
7
treatment received was “so blatantly inappropriate as to evidence intentional mistreatment
likely to seriously aggravate his condition.” Id. (quotation marks omitted).
In alleging that Monese acted with deliberate indifference in his treatment, Goodvine
focuses on three aspects of Monese’s care: (1) prescribing Wellbutrin; (2) discontinuing
the Seroquel prescription; and (3) failing to take adequate precautions in response to
Goodvine’s risk of suicide.
A.
Wellbutrin
First, Goodvine contends that Monese acted with deliberate indifference when he
prescribed Wellbutrin, which carries a risk of appetite loss, and then failed to discontinue
the medication once he learned that Goodvine was refusing his meals. However, there is
no evidence in the record from which a jury could reasonably conclude that Monese’s
actions in prescribing Wellbutrin and continuing the prescription for as long as he did were
so inappropriate that no minimally competent psychiatrist would have taken them. At the
time Monese prescribed the medication, Goodvine was seriously overweight and had not
been diagnosed with an eating disorder or other condition for which Wellbutrin was
contraindicated. On October 1, 2012, only a few days after Goodvine began refusing
meals, Monese saw Goodvine and spoke to him about his appetite loss. In response,
Monese prescribed cyproheptadine, a medication that was intended to stimulate his
appetite. Fifteen days later, when Monese examined Goodvine again and determined that
the cyproheptadine had not improved Goodvine’s appetite, Monese discontinued the
Wellbutrin prescription. I have no reason to think that these actions were not perfectly
appropriate responses to Goodvine’s complaints of appetite loss. Although Goodvine
thinks that Monese should have discontinued the Wellbutrin as soon as he learned about
8
Goodvine’s refusing meals, there is no evidence in the record suggesting that an
immediate discontinuation of the medication was the only responsible choice under those
circumstances. Accordingly, Monese is entitled to summary judgment on this issue.2
B.
Seroquel
Next, Goodvine contends that Monese acted with deliberate indifference when he
discontinued Goodvine’s Seroquel prescription after learning that he had been hoarding
pills.
Again, however, there is no evidence in the record from which a jury could
reasonably infer that every minimally competent psychiatrist would have continued the
medication under these circumstances. Discontinuing the medication might have been a
perfectly appropriate response to Goodvine’s having hoarded it in preparation for a suicide
attempt. Moreover, Monese did not discontinue the medication and then leave Goodvine
entirely unmedicated for an extended period. Five days after discontinuing Seroquel, he
prescribed Loxitane, which is a different antipsychotic. Finally, there is no evidence in the
record from which a jury could reasonably find that the lack of Seroquel for five days had
any adverse effect on Goodvine’s health. To the extent Goodvine believes that the lack
of Seroquel caused his suicide attempt on October 15, there is no evidence in the record
suggesting that discontinuing an antipsychotic medication such as Seroquel could have
such an effect in such a short period of time. Thus, the jury could not reasonably infer that
Monese’s discontinuing Seroquel for five days constituted deliberate indifference to
Goodvine’s serious medical needs.
2
Goodvine also seems to contend that Monese should not have prescribed
Wellbutrin to a person who is having thoughts of suicide. Again, however, there is no
evidence in the record indicating that Goodvine’s history of self-harm would have caused
every minimally competent psychiatrist to refrain from prescribing him Wellbutrin.
9
C.
Response to thoughts of suicide
Finally, Goodvine contends that despite Monese’s knowledge of a substantial risk
that Goodvine would seriously harm himself on October 15, 2012, he took no steps to
abate that risk, with the result that Goodvine attempted suicide later that day. Monese
does not dispute that he was aware that Goodvine was a suicide risk the entire time he
was in the care of the WRC. Indeed, one of the main reasons he was referred to the WRC
was because of his propensity towards self-harm. However, Monese does deny that
Goodvine stated unequivocally on the morning of October 15 that he intended to attempt
suicide immediately upon returning to his cell. But because at the summary-judgment
stage I must view the facts in the light most favorable to Goodvine, I will assume that
Goodvine told Monese that he was having thoughts of attempting suicide immediately.
Goodvine claims that Monese did nothing in response to his expressing thoughts
of attempting suicide immediately. However, Goodvine overlooks the fact that he was
already housed in an institution that was equipped to deal with suicidal behavior, and that
the WRC had already designated him as posing a high risk of suicide. No evidence in the
record supports the conclusion that every minimally competent psychiatrist would have
taken additional precautions in response to Goodvine’s having said that he feared a suicide
attempt was imminent. Goodvine contends that Monese could have taken precautions
such as sending him to an observation cell or having his cell searched. But despite
Goodvine’s claiming that he felt that a suicide attempt was imminent, Monese’s clinical
impression, as reflected in his notes of the visit, was that Goodvine was not an immediate
suicide risk. No evidence in the record suggests that once Goodvine said that he felt that
10
a suicide attempt was imminent, Monese was required to believe him and place him in the
most restrictive cell available at the WRC or take other drastic measures.
In any event, as noted, Goodvine was already being closely monitored by WRC
staff, and they discovered him only moments after he attempted suicide and were able to
provide him with immediate and effective treatment. Thus, it is not clear that placement
in an observation cell would have made a difference, as there is no evidence in the record
showing that placement in an observation cell results in uninterrupted monitoring or would
have deprived Goodvine of access to whatever he used to lacerate his arm. As for the
suggestion that Monese could have had Goodvine’s cell searched, it is not clear that this
would have prevented the suicide attempt, as WRC staff members searched Goodvine and
his cell after the suicide attempt and were unable to locate anything that Goodvine might
have used to cut himself. See ECF No. 45-4 at p. 17.
In short, Goodvine was already being closely monitored by WRC staff, and staff
members were aware that Goodvine posed a high risk of suicide at all times. Because of
this, a jury could not reasonably conclude that Monese acted with deliberate indifference
to Goodvine’s suicide risk when he failed to order additional precautions in response to
Goodvine’s most recent thoughts of suicide. Monese did not disregard Goodvine’s suicide
risk but concluded that existing precautions were adequate to manage the risk.
III. CONCLUSION
For the reasons stated, IT IS ORDERED that defendants’ motion for summary
judgment (Docket #30) is GRANTED. The Clerk of Court shall enter final judgment.
11
Dated at Milwaukee, Wisconsin, this 25th day of March, 2015.
s/ Lynn Adelman
_______________________
LYNN ADELMAN
District Judge
12
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?