United States District Court, S.D. Illinois
MEMORANDUM AND ORDER
J. ROSENSTENGEL United States District Judge
matter is before the Court on Defendant Dr. Eric
Johnson's motion for summary judgment (Doc. 284),
Defendant Dr. Christine Lochhead's motion for summary
judgment (Doc. 285), and Defendants Wexford Health Sources,
Inc., Dr. Robert Shearing, and Dr. Mark Baker's motion
for summary judgment (Doc. 286). For the reasons set forth
below, Defendant Dr. Johnson's motion is denied,
Defendant Dr. Lochhead's motion is granted, and
Defendants Dr. Baker, Dr. Shearing, and Wexford's motion
Ronald Barrow, an inmate in the custody of the Illinois
Department of Corrections (“IDOC”), filed this
lawsuit pro se pursuant to 42 U.S.C. § 1983
alleging his constitutional rights were violated while he was
incarcerated at Menard Correctional Center. Barrow's
allegations relate to ongoing medical treatment, or lack
thereof, to address various eye conditions that have impaired
his vision since 2012. Following the filing of an amended
complaint and an order on motions for summary judgment on the
issue of exhaustion of administrative remedies, Barrow is
proceeding on a claim of deliberate indifference against
Defendants Wexford Health Sources, Inc.
(“Wexford”), Dr. Eric Johnson, Dr. Christine
Lochhead, Dr. Robert Shearing, and Dr. Mark Baker. The Warden
of Menard is named as a defendant only in an official
capacity for purposes of securing injunctive relief, if
necessary (see Docs. 1, 113, and 192).
timely responded to Defendants' motions for summary
judgment (after requesting, and being granted, an extension
of time to do so) (see Docs. 299, 300, 305, and
310-311). The Court, having carefully considered the briefs
and all of the evidence submitted by the parties, finds as
claims in this matter relate to the medical care he received
for various eye conditions from 2012 onward, causing him to
lose vision in one or both eyes. Barrow's first eye
examination relevant to this case occurred on January 10,
2012, when he saw Dr. Johnson, the onsite optometrist at
Menard (Barrow's Deposition, Doc. 285-1, p. 4; Doc.
284-1, p. 85). Barrow contends that he began losing vision in
his right eye in January 2012, and he told Dr. Johnson at his
exam that he was seeing floaters in his right eye (Doc.
285-1, p. 4). Dr. Johnson checked Barrow's visual acuity,
noting it was 20/20 with correction in both eyes, and
submitted an order for new eyeglasses for Barrow (Doc. 284-1,
p. 85). Barrow asserts Dr. Johnson did not address his
complaint of floaters at this examination (Doc. 299-1, p. 2,
¶ 4). Dr. Johnson contends there is no record that
Barrow ever complained of floaters on this date. In support
of this position, Dr. Johnson points to two letters written
by Barrow, dated February 2 and February 21, 2012, which
reference his examination on January 10, 2012, and complain
about recent loss of eye sight in his right eye, but fail to
include any reference to right eye floaters (although Dr.
Johnson asserts he never received the letters, a fact that
Barrow disputes) (Doc. 284-1, pp. 97-98). Barrow disputes
that these letters support an inference that he failed to
complain to Dr. Johnson about floaters. In any event, it is
undisputed that floaters can signal a detachment, tear, or
other problem involving the retina (Doc. 299-3, p. 4; Doc.
285-2, p. 16).
after this examination, Barrow lost all vision in his right
eye. He was seen on February 23, 2012, by Defendant Dr.
Lochhead, another onsite optometrist at Menard (Doc. 285-1,
p. 5). Based upon her examination, Dr. Lochhead referred
Barrow for evaluation on an emergent basis by an outside
physician for a possible right eye retinal
detachment (Affidavit of Dr. Christine Lochhead, Doc.
285-3, p. 2, ¶ 6; see Id. at p. 10). The
referral was approved, and Barrow was seen by Dr. Ahmad, an
ophthalmologist at Marion Eye Center, on February 24, 2012
(Doc. 285-1, p. 6; Doc. 285-3, p. 2, ¶ 7). Dr. Ahmad
determined Barrow had a detached retina in his right eye and
performed surgery for a right eye retinal detachment on
February 27, 2012 (Id.). Barrow saw Dr. Ahmed for a
follow-up exam on March 17, 2012; at that time, Dr. Ahmad
explained that Barrow would need two additional procedures on
his right eye: one to remove a cataract and one to remove
scar tissue that had formed following surgery (Doc. 285-1, p.
7). Barrow saw Dr. Ahmad for another follow-up appointment on
April 10, 2012 (Doc. 285-1, p. 8; Doc. 284-1, p. 86). Dr.
Ahmad again recommended that Barrow undergo procedures to
remove the cataract and scar tissue that developed following
surgery on his right eye (Doc. 284-1, p. 92).
light of this recommendation, Barrow's case was submitted
by Dr. Johnson for collegial review with Defendants Dr. Baker
and Dr. Shepherd (Id. at pp. 86 and 93). The
cataract extraction was not approved because Barrow did
“not meet criteria for cat extraction”
(Id. at p. 93). There is no indication that Dr.
Ahmad's recommended membrane peel to remove the scar
tissue was brought forth by Dr. Johnson or considered by Dr.
Baker or Dr. Shepherd during this review (See id.).
Barrow was to see the onsite optometrist in two months and
have his case re-presented if needed (Id.). Dr.
Baker signed off on the decision as the “dedicated
utilization management physician” (Id.). Dr.
Baker attests that he and Dr. Shepherd came to their decision
after discussing Barrow's best corrected visual acuity of
20/400 in his right eye and 20/25 in his left eye, as well as
his ability to carry out his activities of daily living
within the prison environment (Doc. 287-7, pp. 2-3, ¶
parties do not dispute that Dr. Johnson examined Barrow again
on June 19, 2012; however, the parties dispute most of what
occurred at this appointment. Dr. Johnson asserts that he
referred Barrow to an offsite ophthalmologist for right eye
membrane stripping, but informed Barrow that Wexford would
not approve a right eye cataract removal. Barrow contends
that Dr. Johnson's documentation indicates the two
removal procedures had not been approved (See Doc.
284-1, p. 87). Accordingly, Barrow disputes that there was a
June 19, 2012 referral for evaluation of membrane stripping
and cataract removal. Barrow also claims there are no
documents concerning the collegial review of this purported
referral, and Barrow was not seen until August 1, 2012 by Dr.
Ahmad. Barrow's medical records, however, indicate that
Barrow's case was presented in collegial review on June
27, 2012 (Doc. 287-2, p. 34). Dr. Baker attests that during
this collegial review, it was determined that Barrow did not
meet the criteria for cataract extraction; however, Barrow
was approved for an outside examination by a retina
specialist regarding the scar tissue in his right eye (Doc.
287-7, p. 3, ¶ 12).
also asserts that he sent a letter to Dr. Johnson dated July
24, 2012, wherein he complained about left-eye floaters that
were impairing his ability to see (See Doc. 299-1,
p. 5, ¶ 21; Doc. 284-1, pp. 57-58; Doc. 285-1, p. 8).
Dr. Johnson denies ever receiving this letter (Doc. 284-1, p.
137). However, Barrow was seen by Dr. Ahmad on August 1, 2012
(Doc. 287-2, pp. 35-41). Dr. Ahmad diagnosed Barrow with a
retinal tear in his left eye that was repaired on the date of
his appointment (Id.; Doc. 285-1, p. 9). Dr. Ahmad
also advised Barrow again of the “macular
puckering” in his right eye and explained that the
longer the scar tissue remains on Barrow's eye, the less
his vision would improve if surgery was completed (Doc.
287-2, p. 40; Doc. 285-1, p. 9). Barrow's medical records
also indicate that Dr. Ahmad diagnosed Barrow with a
“severe NS and PSC cataract” in his right eye and
indicated he would have some vision improvement if the
cataract were removed (Doc. 287-2, p. 39).
his appointment with Dr. Ahmad, Barrow saw Dr. Johnson for a
follow-up exam (Doc. 285-1, p. 10; Doc. 284-1, p. 88). Barrow
asserts Dr. Johnson informed him Wexford policy did not allow
him to undergo the removal procedures recommended by Dr.
Ahmad (Doc. 285-1, p. 10). Dr. Johnson asserts that he
referred Barrow for a right eye pars plana vitrectomy (a
procedure to remove vitreous gel from the eye) and a
three-month follow-up for the retinal tear in Barrow's
left eye (Doc. 284-1, p. 88). It is not clear why Dr. Johnson
did not refer Barrow for removal of his cataract and scar
tissue based on Dr. Ahmed's recommendations. Barrow did
not undergo any further examinations by Dr. Johnson relevant
to this lawsuit.
Johnson's referral for a pars plana vitrectomy
(“PPV”) was approved by Dr. Baker and Dr. Shah
(not a named defendant) during collegial review on August 13,
2012 (Doc. 287-2, p. 43; Doc. 287-7, p. 3, ¶ 13). Barrow
was referred to Dr. Ahmad on October 31, 2012 for another
examination (Doc. 285-1, p. 10). At this appointment, Dr.
Ahmad examined Barrow's left and right eye and again
recommended procedures for the removal of his right eye
cataract and scar tissue; however, he indicated that he had
not received approval to complete these procedures
same date, Dr. Lochhead submitted a referral for Barrow to
undergo removal procedures for his right eye cataract and
scar tissue (Doc. 285-1, p. 10; Doc. 285-2, p. 19;
see Doc. 287-2, p. 44). In her referral, Dr.
Lochhead indicates that the procedures might improve
Barrow's visual acuity in his right eye to 20/60, but
that the membrane peel alone would only improve his visual
acuity to 20/200 (this referral appears to have been handled
as an appeal of the April 18, 2012 denial of a referral for
extraction of Barrow's right eye cataract) (Doc. 285-3,
p. 3, ¶ 12; see Doc. 287-2, p. 44). On November
6, 2012, Dr. Lochhead's request for a referral was denied
by Dr. Baker, in consultation with Dr. Shepherd (Doc. 285-3,
p. 3, ¶ 13; Doc. 287-2, p. 46). This decision was made
after discussing Barrow's best correct visual acuity of
20/400 in his right eye and 20/20 in his left eye and his
ability to carry out his activities of daily living (Doc.
287-7, pp. 3-4, ¶ 14; Doc. 287-2, p. 46). According to
Dr. Baker, Wexford's policy for the management of
cataracts allows for approval of cataract surgery if the
inmate's best corrected visual acuity is 20/60 or worse
in the dominant eye, or if the cataract causes inflammation,
angle closure, or medically unmanageable open angle glaucoma
(Doc. 287-7, p. 4, ¶ 15). Defendant Baker asserts that
these conditions were not present in Barrow's case on
April 18, 2012 (though he fails to assert whether these
conditions were present on November 6, 2012) (Id.).
At her deposition, Dr. Lochhead testified that no test was
done to determine Barrow's dominant eye due to the
retinal detachment (Doc. 285-2, pp. 6, 19). In other words,
Dr. Lochhead explained that “[i]t would be impossible
to evaluate which of his eyes were dominant with one of them
so severely damaged” (Id. at p. 19).
Significantly, there is no documentation regarding the
disapproval of the scar tissue removal.
continued to see Dr. Lochhead for regular eye exams from
October 31, 2012, to December 26, 2013 (Doc. 285-3, pp. 3-4,
¶ ¶ 14-18; see Doc. 287-3, pp. 8-12).
Barrow testified at his deposition that he had no complaints
regarding the treatment provided by Dr. Lochhead during this
time, aside from the fact that she was bound to follow
Wexford's decision regarding the recommended removal
Barrow saw Dr. Lochhead for an examination on December 26,
2013 (Doc. 287-3, p. 11), he complained of worsening vision
in his left eye. After performing an examination, Dr.
Lochhead determined that Barrow's vision in his left eye
was 20/70. Based on this finding, Dr. Lochhead concluded that
Barrow met the criteria for cataract removal and submitted a
referral for Barrow to be seen for an evaluation for cataract
extraction (Doc. 285-2, p. 13; Doc. 285-3, p. 4, ¶ 18;
see Docs. 287-2, p. 47 and 287-3, p. 12). On January
13, 2014, Dr. Lochhead's referral was approved by Dr.
Garcia, and Barrow was sent to Dr. Unwin at Illinois Eye
Surgeons on March 5, 2014 (Doc. 287-2, pp. 48-52). Dr. Unwin
recommended Barrow see a retinal specialist after which he
would perform cataract surgery (Doc. 285-1, p. 12; Doc.
285-3, p. 4, ¶ 20; see Doc. 285-3, p. 25).
on April 4, 2014, Dr. Lochhead submitted a referral for
Barrow to see Dr. Tarigopula at Illinois Eye Surgeons for a
retinal consultation prior to cataract surgery (Doc. 285-3,
p. 5, ¶ 22). This referral was approved on April 21,
2014, and Barrow was seen by Dr. Tarigopula on May 16, 2014
(Doc. 287-2, pp. 53-56). Dr. Tarigopula was unable to
evaluate the scar tissue on Barrow's right eye due to the
thickness of his right eye cataract. Dr. Tarigopula
recommended that Barrow undergo a procedure to remove his
right eye cataract before having his scar tissue evaluated
(Doc. 285-1, p. 12).
Tarigopula also noted that Barrow had a cataract in his left
eye (Doc. 285-1, p. 12; see Doc. 287-2, p. 54).
9, 2014, Barrow was approved to undergo a removal procedure
for his right eye cataract by Drs. Fisher and Trost (Doc.
287-2, p. 57). Following some confusion regarding which eye
the cataract would be removed from (the left eye or the right
eye), Barrow's right eye cataract was removed on June 26,
2014 (Doc. 285-1, p. 13; see Doc. 287-2, pp. 23-24).
Barrow was seen by Dr. Lochhead for follow-up appointments on
June 27 and July 3, 2014 (Doc. 285-1, p. 13; see
Doc. 285-3, pp. 35, 37). By the July 3, 2014 examination,
some vision had returned in Barrow's right eye (Doc.
285-1, p. 13). Barrow was scheduled to be seen by site
optometry on July 17 and August 8, 2014, but the appointments
were cancelled because the facility was on deadlock (Doc.
285-3, p. 5, ¶ 27; see pp. 38-39). On August 8,
2014, Dr. Lochhead did, however, submit a referral for Barrow
to again see Dr. Tarigopula for a consultation for a membrane
peel on his right eye (Doc. 285-1, p. 14; Doc. 285-3, pp. 6,
40). Defendant's referral was purportedly approved on
August 14, 2014 (Doc. 285-1, p. 14).
was seen by Dr. Unwin on September 9, 2014, at Quantum Vision
Center (Doc. 287-3, pp. 15-19). At this appointment, Barrow
complained of blurred vision in both of his eyes, but
indicated that the vision in his right eye was improving
since his cataract extraction (Doc. 287-3, p. 16).
Barrow's visual acuity was documented as 20/40 in his
right eye and 20/50 in his left eye (Doc. 287-3, p. 17).
Barrow saw Dr. Tarigopula on September 19, 2014, during which
time she again confirmed the need for a membrane peel and
indicated she would recommend the procedure (Doc. 287-3, pp.
29-33). Based on Dr. Tarigopula's recommendation, Dr.
Lochhead submitted a referral for Barrow to undergo a right
eye pars plana vitrectomy and membrane peel (Doc. 285-3, p.
6, ¶ 31; see Doc. 287-3, p. 34). Barrow
underwent these procedures on October 14, 2014 (Doc. 285-1,
p. 15; Doc. 285-3, p. 6, ¶ 32; see Doc. 287-3,
saw Dr. Tarigopula for a follow-up examination on October 15,
2014 (Doc. 287-3, pp. 39-41). On October 21, 2014, Barrow saw
Dr. Lochhead complaining about pain in his right eye (Doc.
285-1, p. 16; see Doc. 285-3, p. 50). Defendant
Lochhead recommended that Barrow follow-up with a retinal
specialist in two days and return to site optometry the
following week (Doc. 285-3, p. 6, ¶ 32, see
Doc. 285-3, p. 50). In accordance with Dr. Lochhead's
recommendation, Barrow saw Dr. Tarigopula on October 23, 2014
(Doc. 285-1, p. 16; Doc. 285-3, p. 7, ¶ 33). According
to Barrow, Dr. Tarigopula was concerned about some bleeding
in his right eye, and she was surprised that Barrow had not
been supplied the eye drops she prescribed on October 18,
2014 (Doc. 285-1, p. 16). Dr. Tarigopula recommended that
Barrow come in for a follow-up exam in one month (Doc. 285-3,
p. 7, ¶ 33). Dr. Lochhead put in a referral based on
this recommendation that was apparently approved, as Barrow