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Knox v. Powers

United States District Court, S.D. Illinois

August 18, 2014



MICHAEL J. REAGAN, District Judge.

A. Introduction

Before the Court are two summary judgments filed by Defendants. Defendant Nigel Vinyard has filed a summary judgment arguing that he was not deliberately indifferent to Plaintiff's serious medical needs (Docs. 141 and 142). Defendants Marvin Powers, Camille Adams, Carol George, Laura Qualls, Rhonna Medlin, Julie Klein, Kathy Butler, Gracy Hart, Delores Humelle, Heather Meade, Claudia Leslie, Marilyn Melton, Lakesha Hamby, Shelby Dunn, and Kristy Watson[1] have also filed a motion for summary judgment (Docs. 134 and 135) arguing that they were not deliberately indifferent to Plaintiff's serious medical needs, as Plaintiff alleges.

B. Background

Plaintiff alleges in his Complaint that Dr. Marvin Powers, Nigel Vinyard, and various nurses at Tamms Correctional Center ("Tamms") were deliberately indifferent to his serious medical condition as he self-mutilated by inserting a foreign object in his urethra. Plaintiff argues that the Defendants did not treat him for this injury. He further alleges that the Defendants were deliberately indifferent, insofar as they failed to document his medical condition and falsified medical records. Plaintiff alleges that, as a result, he had swelling in the bladder and groin area, difficulty urinating and urinating blood, and severe pain and suffering.

Plaintiff was housed at Tamms when on November 9, 2010 he reported to a nurse that he had self-mutilated himself by sticking a foreign object in his urethra (Doc 3-2 at 26; Doc. 135-1 at 2). In his complaint, he Plaintiff notes that he has an underlying mental health condition that causes him to self-mutilate (Doc. 3-2 at 26). While the nurse did not note any self-mutilating behavior, she notified mental health and noted that Plaintiff would be seen later that day (Doc. 135-1 at 2). At the time, Plaintiff did not complain of pain and the nurse noted that Plaintiff ambulated to the cell door with a steady gait and showed no signs of distress ( Id. at 2-3). Plaintiff was seen again by a nurse at 8:35 a.m. the same date and notified mental health to monitor ( Id. at 4). The nurse also noted that Plaintiff should have a urinalysis ( Id. ). At 2:55 p.m. that same day, Defendant Powers gave a verbal order that a urinalysis be done ( Id. at 5; Doc. 135-4 at ¶ 2). At 4:30 p.m. a urine specimen was collected and sent out for lab (Doc. 135-1 at 5).

The results of the urinalysis were received by the healthcare unit at Tamms at 11:30 a.m. the following day, November 10, 2010 ( Id. at 6; Doc. 135-4 at ¶ 3). No blood was present in the sample and only a trace of protein was present, which Powers noted was not indicative of a foreign object in the urethra ( Id. ). Plaintiff was seen by Defendant Powers on November 12, 2010 (Doc. 135-1 at 7; Doc. 135-4 at ¶ 4). At that time, Plaintiff informed Powers that he had inserted the ink cartridge of an ink pen into his urethra and that it was deeper in his body than the penis (Doc. 135-1 at 7). Powers palpitated Plaintiff and was unable to locate a foreign object ( Id.; Doc. 135-4 at ¶ 4). Although Plaintiff insisted that there was an ink pen in his urethra, Powers noted in his chart that his claim was not corroborated by Powers' examination of Plaintiff ( Id. ).

On November 19, 2010, Plaintiff was seen again by a nurse. She noted that a urinalysis dipstick was done and that it was negative for blood or signs of infection (Doc. 135-1 at 8). She noted that Plaintiff had not complained to security since his last exam but complained to the nurse about the ink pen still being in his urethra ( Id. ). The nurse scheduled Plaintiff for a follow-up with the doctor. Plaintiff saw Powers again on November 23, 2010, and again Powers found no sign of an object in his urethra ( Id. ).

On December 13, 2010, Plaintiff again complained to the nurse that he had a foreign object in his urethra and that he had difficulty urinating with blood in his urine. The nurse took a urine sample, which was not witnessed, and she returned 10-15 minutes later for the specimen (Doc. 135-1 at 9). The nurse noted that Plaintiff's urine was cranberry colored and that the dip test results showed blood in the urine ( Id. ). Plaintiff was placed in a doctor call line for the following day, December 14, 2010 ( Id. ). Plaintiff saw Defendant Powers the following day and he found no object upon palpation ( Id. at 10; Doc. 135-4 at ¶ 8). Powers also noted that Plaintiff was not in distress and noted no tenderness ( Id. ). Powers found that Plaintiff's alleged condition was not corroborated by the evidence before him and noted that he would monitor Plaintiff (Doc. 135-1 at 10).

Another urine sample was taken on December 30, 2010, which also tested positive for blood (Doc. 135-1 at 11). The urine collection was also unwitnessed (Doc. 135-4 at ¶ 9). As before, the Plaintiff was put in the doctor call line (Doc. 135-1 at 11). Powers again saw Plaintiff on January 3, 2011 and was unable to palpate an object in his urethra ( Id. at 12). Powers ordered that another urine sample be collected and that this one be witnessed; Plaintiff had also complained about bleeding gums during this time and a urinalysis cannot distinguish the origin of the blood (Doc. 135-4 at ¶¶ 10, 12; Doc. 135-1 at 14). Powers found the two tests which tested positive for blood to be unreliable as a result (Doc. 135-4 at ¶ 12). Plaintiff refused to give another urine sample (Doc. 135-1 at 13; Doc. 135-2 at 4). Plaintiff did submit to a urine sample on January 26, 2011, and no blood was found in his urine (Doc. 135-1 at 16). Powers saw Plaintiff again on January 27, 2011, but Plaintiff refused to allow Powers to palpate his genital area and told the doctor he was "straight" or okay ( Id.; Doc. 135-4 at ¶ 14).

Although Powers saw Plaintiff for unrelated complaints through much of 2011, Plaintiff did not complain again about a foreign object in his urethra until December 1, 2011 (Docs. 135-1 at 17-20; Doc. 135-2 at 1-8). Plaintiff informed Powers that he had folded the pen into a "v" and entered it into his penis (Doc. 135-2 at 8; Doc. 135-4 at ¶ 15). Powers was unable to locate an object when he palpated Plaintiff ( Id. ). Powers saw Plaintiff again on January 5, 2012 (Doc. 135-2 at 10). Plaintiff complained of burning during urination but Powers found no palpable evidence of a pen in Plaintiff's urethra ( Id. ). Powers took a urine sample ( Id. ). Powers again saw Plaintiff on January 11, 2012, again about a foreign object in his urethra ( Id. at p. 11). Plaintiff claimed the object had been there for two years ( Id. ). Powers was unable to palpate a foreign object and the January 5, 2012 urinalysis was normal (Doc. 135-4 at ¶. 17). Powers also noted that Plaintiff was voiding adequately ( Id. ).

Although Plaintiff was seen by health care staff for various other issues he did not present with his complaints about a foreign object in his urethra again until June 6, 2012 (Doc. 135-2 at 12-17). Powers found no tenderness and did not find any object upon palpation ( Id. at 17; Doc. 135-4 at ¶. 18). Powers took a urinalysis (Doc. 135-2 at 17). Plaintiff was last seen by Powers on September 4, 2012, and Powers again was unable to locate an ink pen in Plaintiff's urethra ( Id. at 20).

Powers testified in his affidavit that it is his medical opinion that there was not a foreign object in Plaintiff's urethra from the time Plaintiff first reported his concerns on November 9, 2010, to the last time Powers saw Plaintiff on September 4, 2012 (Doc. 135-4 at ¶¶ 20-21). Powers testified that multiple palpations of the relevant area over two years never revealed a foreign object and given Plaintiff's claim that he folded an ink pen cartridge into a "v" and inserted it into his urethra, Powers believes that it would be palpable upon examination ( Id. at ¶ 20). Powers testified that his opinion is also supported by the fact that Plaintiff never showed any sign of infection, either urinary tract or other type, and by the fact that Plaintiff went multiple months without complaining about the object ( Id. at ¶¶ 21, 23). While Plaintiff now claims he needs an x-ray to identify the object, Powers testified that Plaintiff had eleven x-rays of his genital region in the past and absent some other concrete evidence, beside Plaintiff's own self-reporting that an object was in his urethra, Powers felt that the risks of exposure to additional radiation by another x-ray outweighed any possible benefit ( Id. at ¶ 25).

Although no party addresses the issue, additional facts regarding Plaintiff's treatment were presented to the Court in response to Plaintiff's two motions for preliminary injunction. The Court notes that in response to a Report and Recommendation on Plaintiff's motion for preliminary injunction requesting medical treatment, Plaintiff objected to the recommendation indicting that he had been transferred from Tamms to Pontiac Correctional Center, where he alleges he received proper treatment, including an x-ray which revealed that a foreign object was in his urethra (Doc. 71 at 4). Plaintiff informed the Court that the foreign body was removed by Pontiac Correctional Center medical staff ( Id. ). Thus, the Report and Recommendation on the preliminary injunction for medical care was deemed moot. On April 29, 2013, Plaintiff filed a motion for a temporary restraining order (Docs. 76 and 77), arguing that the foreign object from November 9, 2010, was still in his urethra (Doc. 107 at p. 2). At an evidentiary hearing on Plaintiff's motion, Dr. Andrew Tilden, medical director for Pontiac Correction Center, testified that he found a palpable foreign object in Plaintiff's urethra and ordered an x-ray which revealed a foreign body including a metallic object which resembled the tip of an ink pen (Doc. 107 at p. 4). The foreign object was removed on January 15, 2013 (three months prior to his statement that the object was still there and had been there since November 2010) ( Id.; Doc. 88 Ex. B; Doc. 87 Ex. B at ¶ 8). When removed, the ink pen cartridge was clear with no signs of infection ( Id.; Doc. 87 Ex. B at ¶ 9). Although Plaintiff believed the object had been in his body since 2010, Tilden testified that he believed the object had been in Plaintiff's body a short time as it was clean and showed no signs of infectious material (Doc. 107 at p. 5). He also noted no infection or urinary tract issues, which, if present, would indicate that the object had been in Plaintiff's body for a lengthy period of time ( Id. ). Plaintiff argued that Dr. Tilden never removed the object and pointed to an x-ray report from March 22, 2013, after the pen was removed, which indicated that the object appeared "stable since the prior examination" ( Id.; Doc. 102 Ex. C).

Plaintiff also alleges that Nigel Vinyard was deliberately indifferent to his medical condition. Defendant Vinyard was the Health Care Unit Administrator at Tamms from August 2009 to January 2013 (Doc. 142-1 at ¶¶ 1-2). Although she is a registered nurse, her duties are to oversee the Health Care Unit, address inmate grievances, and ensure medical services provided by Wexford meet contract requirements ( Id. at ¶ 3). She did not personally evaluate or treat Plaintiff but did review various letters and grievances from him regarding his medical treatment ( Id. at ¶¶ 5-6). In reviewing those grievances, she would check Plaintiff's medical file to make sure he was getting adequate medical care ( Id. at ¶7). She even referred Plaintiff to Dr. Powers on several occasions ( Id. at ¶. 9). She relied on Dr. Powers' findings and treatment in responding to Plaintiff's grievances and she ...

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