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Barrow v. Wexford Health Sources, Inc.

United States District Court, S.D. Illinois

May 5, 2017



          NANCY J. ROSENSTENGEL United States District Judge

         This 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 is denied.


         Plaintiff 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).

         Barrow 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 follows.

         Factual Background [1]

         Barrow's 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).

         Soon 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[2] (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;[3] 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).

         In 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, ¶ 11).

         The 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).

         Barrow 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).

         After 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.

         Dr. 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 (Id.).

         On this 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.

         Barrow 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 procedures.

         When 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).

         Subsequently, 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).

         Dr. Tarigopula also noted that Barrow had a cataract in his left eye (Doc. 285-1, p. 12; see Doc. 287-2, p. 54).

         On June 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).

         Barrow 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, pp. 35-38).

         Barrow 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 saw ...

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