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Gills v. Coe

United States District Court, S.D. Illinois

February 21, 2017

JARYAN GILLS, Plaintiff,
v.
JOHN COE, M.D., WEXFORD HEALTH SOURCES, FE FUENTES, M.D., SAMUEL NWAOBASI, M.D., ROBERT SHEARING, M.D., JOHN SHEPHERD, M.D., and LOUIS SHICKER, M.D., Defendants.

          MEMORANDUM AND OPINION

          DONALD G. WILKERSON United States Magistrate Judge.

         Now pending before the Court is the Motion for Summary Judgment filed by Defendants John Shepherd, M.D., Robert Shearing, M.D., Samuel Nwaobasi, M.D., Fe Fuentes, M.D., John Coe, M.D., and Wexford Health Sources, Inc. on November 21, 2016 (Doc. 223). For the reasons set forth below, the Motion is GRANTED IN PART AND DENIED IN PART.

         Procedural Background

         Plaintiff Jaryan Gills, an inmate in the custody of the Illinois Department of Corrections (“IDOC”), initiated this lawsuit on August 5, 2013 pursuant to 42 U.S.C. §1983 alleging his constitutional rights were violated. Plaintiff's first two complaints (his original complaint and his first amended complaint), were dismissed without prejudice for their failure to state a viable claim against any named defendant (see Docs. 7 and 13). At the direction of the Court, Plaintiff filed a second amended complaint that was screened pursuant to 28 U.S.C. § 1915A. In his second amended complaint, Plaintiff alleges that officials at Stateville Correctional Center, Menard Correctional Center, and Lawrence Correctional Center failed to adequately address his complaints of pain related to his inguinal hernia and bullet fragments lodged in his body. Following the screening of Plaintiff's complaint, he was allowed to proceed on a claim of deliberate indifference against Defendants Arthur Funk, Nikki Malley, Warden Harrington, Warden Atchison, Dr. John Coe, Debbie Denning, Charles Fasano, Dr. Fuentes, S.A. Godinez, Pam Grubman, S. Nwaobasi, Jaclyn O'Day, Reynolds, N. Saneth, Dr. Robert Shearing, J. Shephard, and Louis Shicker (see Doc. 16). Plaintiff was also allowed to proceed against Defendant Wexford Health Sources for allegedly implementing policies and practices denying Plaintiff medical care (see id.).

         Subsequently, the Court sought to assign counsel to represent Plaintiff in this matter noting that discovery was more complex than anticipated due to the number of defendants and the fact that Plaintiff was transferred from an institution where at least some of the alleged actions took place. Accordingly, Attorney Robert H. Fredian was assigned as counsel for Plaintiff in this matter on January 8, 2016 (see Docs. 165 and 172). On January 28, 2016, Defendant Funk was dismissed without prejudice due to Plaintiff's failure to exhaust his administrative remedies as to his claim against this Defendant prior to filing his lawsuit (see Doc. 183). Recently, Defendants Atchison, Denning, Fasano, Godinez, Grubman, Harrington, Malley, O'Day, and Reynolds-Thompson were dismissed on motion by Plaintiff (see Docs. 234 and 245).

         Following the parties' consent to the Magistrate Judge, this matter was referred, in its entirety, to the undersigned on September 12, 2016 and a new schedule was entered. In accordance with the Amended Scheduling Order, Defendants Coe, Shearing, Fuentes, Nwaobasi, Shepherd, and Wexford filed a motion for summary judgment (Doc. 223) that is now before the Court. Plaintiff, through counsel, filed his timely response objecting to Defendants' motion on December 21, 2016 (Doc. 226). Defendants filed a reply that will be considered in accordance with the Court's January 30, 2017 Order (Doc. 239).

         Factual Background

         Plaintiff's claims in this matter relate to medical treatment, or alleged lack thereof, for his inguinal hernia and lodged bullet fragments while Plaintiff was incarcerated at Menard Correctional Center (“Menard”) and Lawrence Correctional Center (“Lawrence”).

         Plaintiff was transferred to Menard on June 11, 2011 and, soon after his arrival, it was noted that Plaintiff suffered from a left inguinal, reducible hernia (Plaintiff's Medical Records, Doc. 224-2, p. 2). Defendant Dr. Nwaobasi first examined Plaintiff's hernia on August 3, 2011, noting Plaintiff complained of pain related to his hernia (Deposition of Dr. Samuel Nwaobasi, Doc. 226-2, p. 17; see Doc. 224-2, p. 3). Following a physical examination of Plaintiff in the cell house, Defendant Nwaobasi assessed his hernia as being “partially reducible, ” meaning that although his hernia could be pushed in, it would come out again (Doc. 226-2, pp. 17, 19; see Doc. 224-2, p. 3). Defendant Nwaobasi did not address Plaintiff's pain issue during his examination, which, he admits, he should have done (Doc. 226-2, p. 18). Plaintiff was seen again by Defendant Nwaobasi on August 4, 2011 so that he could be examined in the healthcare unit (id. at p. 19). At this examination, Plaintiff indicated that his hernia was causing him pain in his groin down to his scrotum (Doc. 226-2, p. 20; Doc. 224-2, p. 4). Defendant Nwaobasi diagnosed Plaintiff with a reducible, left direct[1] inguinal hernia and advised Plaintiff to avoid strenuous exercises and activities (id.). Defendant Nwaobasi also prescribed Motrin for Plaintiff to take as needed and indicated he should be reassessed in six months (Doc. 226-2, p. 21; Doc. 224-2, p. 4).

         Plaintiff was next seen for complaints of his hernia on November 3, 2011 by Dr. Krieg (who is not a defendant in this lawsuit) (Deposition of Dr. John Shepherd, Doc. 226-3, p. 15; see also Doc. 224-2, p. 5). Dr. Krieg noted Plaintiff had been complaining of his left inguinal hernia since 2009 (id.). Dr. Krieg assessed Plaintiff with a left inguinal hernia and indicated that his plan was to refer Plaintiff to a surgeon (Doc. 226-3, p. 16; Doc. 224-2, p. 5). In accordance with Dr. Krieg's plan, Defendant Dr. Shepherd presented Dr. Krieg's request for surgery in Collegial Review on November 10, 2011 (Doc. 226-3, p. 16; see Doc. 224-2, p. 7). During the Collegial Review (which is also synonymous with Utilization Management), Dr. Baker and Defendant Shepherd discussed Dr. Krieg's examination and it was determined that Plaintiff's hernia would be managed conservatively with activity restrictions and NSAIDs, and Defendant Shepherd would reassess Plaintiff in a “few months” and re-present his case if needed (Doc. 226-3, p. 16; Doc. 224-2, p. 7). Defendant Shepherd then examined Plaintiff on November 21, 2011, making an objective finding that the hernia was small and “easily reducible” (Doc. 226-3, p. 17; see Doc. 224-2, p. 8). Defendant Shepherd recommended Plaintiff take Motrin as needed and indicated Plaintiff should be reassessed in two months (id.).

         Plaintiff was again examined by Defendant Shepherd on January 19, 2012 wherein it was noted that Plaintiff had a history of left inguinal hernia for three years (Doc. 226-3, p. 18; see Doc. 224-2, p. 9). After examining Plaintiff, Defendant Shepherd described Plaintiff's hernia as “nonscrotal” with “no incarceration, no strangulation” and recommended that Plaintiff not engage in any heavy lifting, weightlifting or excessive sports (id.). Defendant Shepherd prescribed Plaintiff 400 milligrams of Motrin to take as needed for pain; however, Defendant Shepherd testified that Plaintiff did not specifically complain about any pain or discomfort he was experiencing and Defendant Shepherd did not ask if Plaintiff was experiencing pain (id.). Plaintiff was not examined by Defendant Shepherd after January 19, 2012.

         The next time Plaintiff's hernia was assessed was on June 2, 2012 by Defendant Nwaobasi (Doc. 226-2, p. 22; see Doc. 224-2, p. 10). Defendant Nwaobasi noted that Plaintiff's hernia was “reducible but tender” and issued Plaintiff a low bunk permit and reissued Plaintiff's prescription for Motrin (Doc. 226-2, p. 23; see Doc. 224-2, p. 10). Defendant Nwaobasi never recommended Plaintiff for surgery as he only recommends surgery for patients whose hernia is incarcerated or strangulated (Doc. 226-2, pp. 23-24). On August 27, 2012, Plaintiff was examined by a nurse practitioner for a follow-up appointment for his hernia (see Doc. 224-2, p. 11). At this appointment, the nurse practitioner noted that Plaintiff's hernia was “small” and mildly tender with palpation (id.). Plaintiff's Motrin was reordered and he was reeducated on the plan for conservative treatment (id.). Plaintiff was seen by a physician, Defendant Dr. Fuentes, on October 19, 2012 at which time Plaintiff presented with a history of left hernia pain for the past four years (Deposition of Dr. Fe Fuentes, Doc. 226-4, p. 10; see Doc. 224-2, p. 12). Defendant Fuentes examined Plaintiff, noting an objective finding of a reducible, left inguinal hernia (id.). Defendant Fuentes issued Plaintiff a prescription for 400 milligrams of Motrin three times a day as needed and indicated he should be reexamined in four months (id.). Defendant Fuentes testified that she would not have prescribed Motrin “as needed” if Plaintiff described his pain as severe (Doc. 226-4, p. 10). Defendant Fuentes did not review any of Plaintiff's medical records prior to examining him on October 19, 2012 (id. at p. 11). Plaintiff saw Defendant Fuentes on one more occasion on January 15, 2013, at which time Defendant Fuentes again noted Plaintiff's subjective complaint of left inguinal hernia for four years with pain (Doc. 226-4, p. 11; see Doc. 224-2, p. 13). Defendant Fuentes conducted a physical examination and diagnosed Plaintiff with a “reducible left inguinal hernia, ” renewed Plaintiff's prescription for Motrin, and indicated he was to return as necessary (id.). Defendant Fuentes testified that Plaintiff's hernia did not increase in size in the time between his October, 2012 and January, 2013 appointments; however, Defendant Fuentes never measured Plaintiff's hernia (Doc. 226-4, p. 13).

         Plaintiff was not seen for complaints related to his hernia by any medical personnel at Menard between his appointment with Defendant Fuentes on January 15, 2013 and his transfer to Lawrence on April 24, 2013 (Deposition of Dr. John Coe, Doc. 226-5, p. 12; see, generally, Doc. 224-2). However, prior to his transfer to Lawrence, Plaintiff wrote two letters to the Medical Director at Menard, Defendant Dr. Shearing, complaining about the medical treatment for his hernia and lodged bullet fragments (see Docs. 226-10 and 226-11). Defendant Shearing only recalls receiving one letter written by Plaintiff dated February 20, 2013 (Deposition of Dr. Robert Shearing, Doc. 226-6, p. 8). In his February 20, 2013 letter, Plaintiff recites what he perceives as failures in the medical treatment he received at Menard for treatment of his inguinal hernia. Plaintiff specifically addresses the fact that he did not have a support belt and was only being provided Ibuprofen, which, he asserts, was not effective in treating his severe, constant pain (Doc. 226-11, p. 3). Plaintiff further explains that the staff was “fully aware of [his] condition and constant severe pain, ” but he could not get surgery because the State does not have any money (id. at p. 4). Plaintiff asks Defendant Shearing to use his authority and seek approval of surgery to treat his hernia (id.). Defendant Shearing responded to Plaintiff's letter on March 13, 2013 indicating that he reviewed Plaintiff's medical records and, with respect to Plaintiff's medical treatment for his inguinal hernia, Defendant Shearing writes that “[Plaintiff] ha[s] been examined many times and the hernia has always been reducible” and “[i]n the event the hernia becomes non-reducible in the future, surgery may be indicated. However, for now there is no medical necessity for surgery” (Doc. 226-12, p. 2).

         It is undisputed that while at Menard Plaintiff received the following prescription orders for Motrin: August 4, 2011, Motrin 400 mg three times a day for two months, ordered by Defendant Dr. Nwaobasi; November 10, 2011, Motrin 400 mg three times a day for two months, as needed, ordered by Dr. Shepherd; January 19, 2012, Motrin 400 mg twice a day for two months, as needed, ordered by Dr. Shepherd; March 31, 2012, Motrin 400 mg four times a day for three months, as needed, ordered by a nurse practitioner; June 2, 2012, Motrin 400 mg three times a day for two months, ordered by Defendant Dr. Nwaobasi; August 27, 2012, Motrin 400 mg three times a day for two months, as needed, ordered by a nurse practitioner; October 19, 2012, Motrin 400 mg three times a day for four months, ordered by Defendant Dr. Fuentes; January 15, 2013, Motrin 400 mg three times a day for one month, ordered by Defendant Dr. Fuentes (see Affidavit of Robert Shearing, M.D., Doc. 224-8, pp. 1-2). It is further undisputed that Plaintiff was issued 400 mg tablets of Motrin, based on his requests for refills of his prescription, on the following dates in the following amounts: August 6, 2011 - 90 tablets; November 18, 2011 - 30 tablets; December 15, 2011 - 30 tablets; January 22, 2012 - 30 tablets; April 3, 2012 - 30 tablets; June 5, 2012 - 90 tablets; July 24, 2012 - 33 tablets; August 29, 2012 - 30 tablets; October 22, 2012 - 90 tablets; January 17, 2013 - 90 tablets (see Id. at pp. 2-3).

         As mentioned above, Plaintiff was transferred to Lawrence on April 24, 2013 (Doc. 226-5, p. 12; see Doc. 224-2, p. 17). Soon thereafter, on May 12, 2013, Plaintiff was seen by Dr. Butalid (who is not named as a defendant) regarding his left inguinal hernia and retained bullet fragments (Doc. 226-5, p. 14; Doc. 224-2, p. 18). Dr. Butalid described Plaintiff's hernia as reducible, advised Plaintiff to avoid lifting and straining, and ordered Tylenol as needed and a hernia belt for support (Doc. 226-5, p. 15; see Doc. 224-2, p. 18). Per Defendant Dr. Coe's orders, Plaintiff's hernia belt was ordered on May 14, 2013 (see Doc. 224-2, p. 19). Plaintiff was then examined by Defendant Coe the following day (see Id. at p. 20). Following an examination, Defendant Coe found that Plaintiff's left inguinal hernia was easily reducible, mildly tender, and came down to the external ring, indicating that the hernia was approximately three or four centimeters between the internal and external rings (Doc. 226-5, p. 16; see Doc. 224-2, p. 20). Defendant Coe prescribed Plaintiff stool softeners, but did not prescribe pain medication as Dr. Butalid had provided a prescription for pain medication a few days prior (Doc. 226-5, p. 16). Defendant Coe did not consider Plaintiff a surgical candidate on this date as his hernia was easily reducible and could be managed with a hernia belt (id.). On July 2, 2013, Plaintiff was issued a hernia belt (see Doc. 224-2, p. 21). Plaintiff's hernia was next evaluated on December 30, 2013 by Defendant Coe (Doc. 226-5, p. 17; see Doc. 224-2, p. 22). Defendant Coe noted that the hernia was reducible, but did not provide any additional directives concerning treatment or management for Plaintiff's hernia (id.).

         Plaintiff's hernia was not examined again until December 11, 2014 when he presented at nurse sick call (see Doc. 224-2, pp. 23-32). Plaintiff testified that during this time he attempted to see a physician and submitted requests for medical care, but “nobody was doing anything, ” which Plaintiff attributed to an issue he was having with a correctional officer at that time (Doc. 226-1, pp. 17-18). When Plaintiff was able to visit the healthcare unit on December 11, 2014 for an assessment of his hernia, he noted his pain was at an “8” on scale of one to ten (see Doc. 224-2, p. 32). Plaintiff also indicated that the hernia belt was not helping (id.). Plaintiff was not referred to see Defendant Dr. Coe (id.). On December 16, 2014, a nurse practitioner performed a routine chart review of Plaintiff's medical record and renewed his permit for a hernia belt, ordered medication for constipation, and declined to renew Plaintiff's permit for a low bunk (Doc. 226-5, p. 20; see Doc. 224-2, p. 33). Plaintiff's hernia was not examined again until he was transferred to Stateville on February 2, 2015 (Deposition of Dr. Saleh Obaisi, Doc. 226-7, p. 12). Dr. Obaisi, a physician at Stateville, examined Plaintiff on May 4, 2015 during which time Plaintiff complained of a left inguinal hernia that had been present since 2009 (id. at p. 13). Following a physical examination, Dr. Obaisi (who is not named as a defendant), diagnosed Plaintiff with an uncomplicated reducible left inguinal hernia and prescribed Plaintiff Motrin 400 milligrams twice a day for thirty days (id. at pp. 13-14). Despite his findings that the hernia was reducible and “uncomplicated, ” Dr. Obaisi ...


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