United States District Court, S.D. Illinois
ORDER ADOPTING REPORT AND RECOMMENDATIONS
NANCY J. ROSENSTENGEL, District Judge.
This matter comes before the Court on several Report and Recommendations entered by United States Magistrate Judge Donald G. Wilkerson. Specifically, on December 19, 2013, Magistrate Judge Wilkerson entered a Report and Recommendation (Doc. 83) on three Motions for Temporary Restraining Order (Docs. 65, 68, 69) recommending that each Motion be denied. Magistrate Judge Wilkerson's Report and Recommendation entered on February 25, 2014 (Doc. 96) recommends that the Motion for Summary Judgment filed by Defendant Dr. Vipin Shah be granted and that this matter be dismissed as to Defendant Shah. On March 26, 2014, Magistrate Judge Wilkerson entered a third Report and Recommendation (Doc. 103) on Defendant Dr. Dina Paul's Motion for Summary Judgment (Doc. 55), recommending that the Motion for Summary Judgment be granted and that this matter be dismissed as to Defendant Dr. Paul. For the reasons set forth below, this Court adopts all three Report and Recommendations in their entirety.
Plaintiff, Dennis Sperow, an inmate incarcerated at Pinckneyville Correctional Center, brings this action for deprivation of his constitutional rights pursuant to 42 U.S.C. § 1893. Plaintiff claims that Defendants Shah and Paul, both physicians at Pinckneyville, were deliberately indifferent to his serious medical needs. More specifically, Plaintiff claims that he suffers from both Hepatitis C and an inguinal hernia, and Defendants failed to treat him despite his request. Plaintiff believes the hernia was caused by general weakening of his body due to the untreated Hepatitis C.
Hepatitis C Treatment
Plaintiff had type 1A Hepatitis C, the most common type, upon his arrival at Pinckneyville in January 2007 (Doc. 56-3, p. 7-22). On February 27, 2007, one month after his arrival, Plaintiff refused a liver biopsy ( Id. at 4). Between his arrival at Pinckneyville and the filing of this suit, Plaintiff's blood was tested on at least nineteen occasions (Doc. 56-3, p. 7-20; Doc. 56-4, p. 1-12). Dr. Paul first treated Plaintiff on January 5, 2011 (Doc. 56-1, p. 5). He reported that Plaintiff was not jaundiced, but had elevated liver enzymes and decreased blood platelet levels of 128 thousand - the normal range is 150-450 thousand ( Id. ). Dr. Paul testified that prior to pharmacological treatment, she needed to evaluate the cause of Plaintiff's low platelet levels ( Id. ). Pharmacological treatment is not provided to patients with unstable medical conditions or multiple other physical ailments, because the side effects of the medications involved can be life threatening ( Id. ). Dr. Paul decided that the proper treatment plan was to monitor Plaintiff by rechecking his liver enzymes, conducting other blood work, and providing vaccinations for Hepatitis A and B ( Id. ). Dr. Paul did not order another liver biopsy because, in her medical opinion, Plaintiff was not a candidate for further treatment ( Id. ). In July 2011, Dr. Shah examined Plaintiff and, like Dr. Paul, he decided that the appropriate plan was to continue to monitor Plaintiff's liver enzymes and blood work ( Id. at 6).
During Dr. Paul's next examination on January 11, 2012, Plaintiff complained of weakness, confusion, ear and eye pain, an upper respiratory infection, and nausea (Doc. 56-1, p. 6). Dr. Paul also found that Plaintiff's liver enzymes were elevated ( Id. ). Due to Plaintiff's various complaints, Dr. Paul again determined that Plaintiff was not a candidate for pharmacological treatment because he would be unlikely to tolerate the treatment or strictly adhere to the treatment regimen required to achieve success ( Id. ).
Plaintiff told Dr. Paul that he needed to see a mental health professional, but that he did not want to see one because they were "quacks" (Doc. 56-1, p. 6). Because confusion can be related to liver function, Dr. Paul ordered Plaintiff's levels drawn to determine the cause of his confusion ( Id. ). Dr. Paul found that Plaintiff's ammonia levels were elevated ( Id. ). Elevated ammonia levels in a patient with presumed cirrhosis and confusion are consistent with Hepatic Encephalopathy ( Id. ). Dr. Shah treated Plaintiff's condition with the prescription medication Lactulose ( Id. at 7).
On August 3, 2012, Dr. Paul examined Plaintiff because of his complaints of multiple physical ailments, as well as confusion ( Id. ). Plaintiff's liver enzymes and ammonia levels were elevated, and he again had low platelet levels ( Id. ). Again, Dr. Paul determined that Plaintiff was not a candidate for pharmacological treatment ( Id. ). She considered Plaintiff's lack of understanding of his diagnosis and multiple sick call refusals - he refused on eleven occasions between March 2007 and September 2012 - as an indication that he would not comply with a strict treatment regimen ( Id. ). In Dr. Paul's medical opinion, Plaintiff was not a candidate for pharmacological treatment of his Hepatitis C at any point during her treatment of him, but rather, that his best care was to monitor and provide support for his various other complaints ( Id. ).
Plaintiff's hernia developed on February 10, 2009. He was examined two days later, and it was determined that his hernia spontaneously reduced, without manipulation, when he laid down (Doc. 53-3, p. 2). On February 26, 2009, Plaintiff refused to be seen by a nurse ( Id. at 3).
Plaintiff was next seen on April 8, 2009, when he told the nurse he had "no pain at all" from the hernia when he laid down ( Id. ). Plaintiff received further examination by a physician on April 20, 2009, May 14, 2009, and May 20, 2009; at each examination it was determined that the hernia spontaneously reduced when Plaintiff laid down and that it was easily reducible in the upright position ( Id. at 5-6). During an examination on May 20, 2009, Plaintiff was given a low bunk and low gallery permit to help limit walking, and he was advised to follow up if he experienced any problems reducing the hernia, abdominal pain, or vomiting ( Id. ).
On July 16, 2009, and August 21, 2009, Plaintiff was again examined, and his hernia was deemed easily reducible. Plaintiff was scheduled for sick call on September 23, 2009, but failed to show up ( Id. at 9).
Plaintiff was examined by Dr. Jill Wahl on February 2, 2010, where, like previous examinations, it was determined that Plaintiff's hernia was easily reducible ( Id. at 12-13). Dr. Wahl ordered Plaintiff a slow walk or physically challenged line permit based on his complaint that this hernia prevented him from going to "chow" more than twice a day ( Id. ). On May 3, 2010, Dr. Wahl again found that Plaintiff's hernia was easily reducible and renewed his low bunk and low gallery permit ( Id. ). Plaintiff's physically challenged permit was discontinued on October 21, 2010, after Nurse Practitioner ...