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Faysom v. Aguinaldo

December 8, 2008


The opinion of the court was delivered by: Magistrate Judge Susan E. Cox


In this civil rights suit, plaintiff David L. Faysom ("Faysom") brings an action under 42 U.S.C. § 1983 against defendants, Andrew Tilden, M.D., Evarista Aguinaldo, M.D., Kevin Smith, M.D., Parthasarathi Ghosh, M.D., and Paulette Timm, R.N. ("Timm"), a nurse at Stateville Correctional Center ("Stateville"). Faysom, a prisoner residing at Stateville, specifically alleges that each defendant violated the Eighth Amendment in acting with deliberate indifference when they failed to immediately act on a diagnosis of symptoms that are often linked to cancerous tumors and refused to administer available therapy and medications after he underwent brain tumor surgery. Currently before the court is the defendants' motion for summary judgment pursuant to Federal Rule of Civil Procedure 56(b). For the reasons stated herein, the motion is granted with respect to defendants Dr. Ghosh and Timm, and denied as to Drs. Tilden, Aguinaldo and Smith [dkt 215].


Unless otherwise noted, the following facts are undisputed and taken from the Plaintiff's Response to Defendants' Local Rule 56.1 Statement of Facts.*fn1 While many of the defendants' facts involve medical diagnoses and observations in Faysom's records, Faysom was unable to verify some of his prior physical complaints due to the illegibility of certain doctors' entries.

A. Dr. Aguinaldo, Dr. Tilden and Dr. Smith

Faysom is an inmate currently residing within the Illinois Department of Corrections and all of his claims arise from his incarceration at Stateville.*fn2 Beginning in February 2001, Faysom began experiencing blurred vision, headaches, memory loss and balance problems.*fn3 These problems persisted and on July 3, 2002, Dr. Aguinaldo, a staff physician at Stateville, examined Faysom after he complained of headaches and blurred vision.*fn4 He referred Faysom to an optometrist based on a potential abnormality found in his eye examination.*fn5 On July 16, 2002, Dr. Aguinaldo again examined Faysom and confirmed his referral to the optometry clinic.*fn6

The next day, Stateville's staff optometrist, Thomas Bialecke, O.D., examined Faysom. He found blurred and raised disc margins, and disc hemorrhages.*fn7 Dr. Bialecke noted that these symptoms could be indicative of papilledema or papillitis.*fn8 Papilledema is defined as both edema and inflammation of the optic nerve at its point of entrance into the retina.*fn9 It is a sign of increased intracranial pressure on the optic nerve, often a result of expanding brain tumors, and may result in rapid blindness if not relieved.*fn10 Papillitis is similar to papilledema but is only a sign of inflammation of the optic nerve.*fn11 Due to this finding, Dr. Bialecke then referred Faysom to the staff ophthalmologist, Dr. JamesBizzell, M.D.*fn12 On July 31, 2002, prior to meeting with Dr. Bizzell, Dr. Aguinaldo again examined Faysom.*fn13 Dr. Aguinaldo may have ordered a lab test after finding abnormal urinalysis results but this action is disputed since the legibility of Faysom's records are poor.*fn14

One month later, on August 30, 2002, Faysom eventually met with Dr. Bizzell and underwent a funduscopic examination of his eyes.*fn15 A funduscopy allows physicians to observe the "progression or resolution of certain local, systemic, and neurologic diseases."*fn16 "The optic nerve, blood vessels, and retina are inspected" in such an exam and may reveal "papilledema, optic atrophy, vascular disease, retinitis, and other disorders."*fn17 Dr. Bizzell only saw Dr. Bialecke's referral but not his actual report identifying the possibility of papilledema.*fn18 When asked if he had made any efforts to find the results of Dr. Bialecke's examination, Dr. Bizzell testified that he probably asked his nurse to request the report from the medical records department and that she would have told him that it was unavailable, as was the case with many medical records at Stateville.*fn19 Dr. Bizzell's notes from his examination revealed none of the abnormalities that Dr. Bialecke identified one month earlier.*fn20 Dr. Bizzell diagnosed Faysom with migraine headaches and prescribed a regimen of decreased caffeine intake.*fn21 Faysom and Dr. Bizzell met again on October 23, 2002, at which time Dr. Bizzell found the reduction in caffeine helpful and noted "fundis O.K."*fn22 Since migraine drugs may react adversely with other medications, Dr. Bizzell wanted a staff physician to see Faysom and prescribe the correct migraine medication.*fn23 He proceeded to make a copy of his notes from that day and personally hand it to Dr. Tilden, an internal medicine physician at Stateville, who was seeing patients in the emergency room that day.*fn24 Dr. Bizelle was unsure whether Dr. Tilden actually saw Faysom that day or prescribed any medication.*fn25

A week later, Dr. Tilden performed an initial chart review of Faysom's medical records.*fn26 The record fails to elaborate on exactly which records or charts Dr. Tilden reviewed. Dr. Tilden saw Faysom two days later for complaints of severe headaches and performed a limited examination of his eyes, not a funduscopic exam.*fn27 He ordered several tests unrelated to Faysom's headaches, prescribed Motrin and multi-vitamins, and referred Faysom back to Dr. Bialecke.*fn28 The record fails to reflect whether Faysom was actually sent to the optometry clinic. On January 16, 2003, Faysom was again examined by Dr. Aguinaldo after he complained of pressure behind his eyes, blurred vision, and temporary blindness that morning.*fn29 The record is unclear whether Dr. Aguinaldo consulted any of Faysom's medical records other than the medical technician's note alerting him of Faysom's complaints from the morning.*fn30 While it appears that Dr. Aguinaldo referred Faysom for a psychological examination on that day, the plaintiff disputes this because the copies of his medical records lack sufficient clarity to unequivocally confirm the referral.*fn31 Faysom again saw Dr. Tilden on January 19, 2003,*fn32 and Dr. Tilden found Faysom's pupils to be equal, round and reactive to light.*fn33 He did not perform a funduscopic exam.*fn34 Dr. Tilden noted the possibility of hypoglycemia, ordered tests for the condition and referred Faysom to the optometry clinic again.*fn35 On January 27, 2003, Faysom was admitted to an emergency room after passing out and experiencing total blackouts in vision.*fn36 Dr. Tilden happened to be the emergency room doctor at the time and examined plaintiff, referring him to the ophthalmology clinic for the fourth time.*fn37

The Stateville medical director at the time, Dr. Smith, was the next physician to examine Faysom. Although Dr. Smith reviewed Faysom's medical records and twice signed off on consult forms from Dr. Bizzell,*fn38 January 31, 2003 was the first day that he personally examined Faysom.*fn39 Faysom had complained of nearly twelve episodes of blindness per day and headaches lasting nearly half an hour.*fn40 Dr. Bizzell had examined Faysom earlier that same day*fn41 and recommended that Dr. Smith personally see Faysom and arrange for an MRI to evaluate the risk of papilledema, since the results of his funduscopic exam were unusual.*fn42 Dr. Smith's funduscopic examination of Faysom revealed no changes consistent with papilledema.*fn43 The record fails to identify what records Dr. Smith consulted before examining Faysom and Dr. Smith was unsure whether he ordered the diagnostic tests after this initial examination or at some later date.*fn44 Though there are no entries in the record of visits with Dr. Smith on February 4, 6, 7, and 10, Dr. Smith contends that he again saw Faysom on these dates for similar complaints of headaches and vision problems.*fn45 On February 14, 2003, Faysom was transferred to the University of Illinois at Chicago Hospital ("UIC") to have an MRI to identify the cause of his potential papilledema.*fn46 The MRI revealed a large midline shift tumor, measuring three to four inches in diameter.*fn47 Dr. Bizzell explained that there are numerous causes of papilledema but Faysom's tumor was probably the underlying cause of his papilledema.*fn48

Faysom remained at UIC while he underwent craniotomies to remove his brain tumor on March 20 and April 4, 2003.*fn49 A craniotomy is an incision through the cranium to gain access to the brain during neurosurgical procedures.*fn50 The first craniotomy, on March 20, was performed to address the tumor that had been discovered a month earlier.*fn51 Faysom underwent his second craniotomy to relieve an infected abscess and remove a partially absorbed hemostatic agent.*fn52

B. Dr. Ghosh and Nurse Timm

Upon Faysom's return to Stateville's infirmary, the new medical director, Dr. Ghosh, examined Faysom on seven occasions from May 15 to June 3, 2003.*fn53 On June 3, Faysom showed signs of swelling on the side of his head with some tenderness. Concerned that an abscess may have formed at the site of his craniotomy, Dr. Ghosh sent Faysom to UIC Hospital's Department of Neurosurgery.*fn54 Surgeons inserted a shunt to drain the excess fluid from Faysom's skull.*fn55 After several days, Faysom returned to Stateville's infirmary where Dr. Ghosh examined Faysom seventeen times over the next ten days.*fn56

Dr. Ghosh monitored Faysom throughout the summer of 2003, occasionally sending him to UIC for additional procedures. On a visit to UIC in December 2003, Troy Close, M.D., recommended low vision rehabilitative therapy and a new eyeglasses prescription.*fn57 Dr. Ghosh elected not to send Faysom to the UIC ophthalmology clinic since Faysom's visual pathways were irreparably damaged and Stateville's own ophthalmologist continued to care for Faysom.*fn58 Timm ...

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