United States District Court, S.D. Illinois
TYRIN N. SMITH, B78535, Plaintiff,
RICHARD HARRINGTON, GAIL WALLS, ANGELA CRAIN, DR. FE FUENTES, DR. S. NWAOBASI and WEXFORD HEALTH SOURCES, INC., Defendants.
MEMORANDUM AND ORDER
M. YANDLE United States District Judge.
Tyrin Smith is an inmate at Menard Correctional Center
(“Menard”), a maximum security prison in the
Illinois Department of Corrections (“IDOC”).
Smith claims that prison officials at Menard provided him
inadequate medical treatment for his severe hemorrhoids. From
2010 through 2014, Smith was examined on multiple occasions
at the Menard Health Care Unit (“HCU”) for his
hemorrhoid related issues. He was finally taken to an outside
hospital for surgery in March 2014. Smith asserts that he
should have undergone surgery sooner, and that the delay
unnecessarily prolonged his pain.
filed suit on October 23, 2014 (Doc. 1). The Complaint was
screened pursuant to 28 U.S.C. § 1915A (Doc. 7). In the
screening order, Judge Gilbert found that Smith articulated a
colorable Eighth Amendment deliberate indifference to serious
medical needs claim against Dr. Fe Fuentes (Menard
Physician), Dr. S. Nwaobasi (Menard Physician), Gail Walls
(Menard Nursing Supervisor), Angela Crain (Menard Health Care
Unit Administrator) and Richard Harrington (Menard Warden).
Smith subsequently filed an Amended Complaint (Doc. 92) which
adds a Monell claim against Wexford Health Sources,
Inc. (“Wexford”), a private contractor that
provides healthcare services to IDOC inmates. Wexford, Dr.
Fuentes and Dr. Nwaobasi now seek summary judgment (Doc.
125). The motion is opposed (Docs. 147, 148, 149). For the
following reasons, the motion is GRANTED in part and DENIED
Tyrin Smith entered IDOC custody in December 2006 and was
transferred to Menard in June 2010 (Smith Deposition, Doc.
148-2, p. 2). Smith first began to experience hemorrhoid
problems in late 2009/mid 2010. Id. at p. 3. On July
26, 2010, Smith was examined by a Corrections Medical
Technician (“CMT”) with hemorrhoid related
complaints (Doc. 148-7, p. 15). The CMT prescribed Colace, a
stool softener, and recommended that Smith apply warm
compresses and Dibucaine ointment to the affected area.
Id. The CMT also counseled Smith on hemorrhoid
management (i.e., clean rectal area properly, increase fluid
and fiber intake, keep physically active to prevent
constipation). Id. Smith testified at his deposition
that neither the stool softeners nor the Dibucaine ointment
provided any relief (Doc. 148-2, p. 3).
medical records indicate that he was next examined on the
gallery (at his cell house as opposed to the health care
unit) on December 21, 2010 for continued complaints of
hemorrhoids (Doc. 148-7, p. 17). The records note,
“inmate states Colace and Dibucaine not work
December 29, 2010, Smith was examined by Dr. Fahim in the HCU
(Doc. 148-7, p. 18). Dr. Fahim's notes state,
“Rectal exam[, ] good tone[, ] no ext[ernal]
hemorrhoid, int[ernal] hemorrhoid at 12:00 o'clock,
prostate feels firm[, ] one nodule large on left side, guaiac
[positive] [.]” Id. Dr. Fahim prescribed
Preparation H, Colace and arranged for a follow up prostate
ultrasound examination. Id.
hemorrhoid condition was not improving and on February 12,
2011, Smith was examined by a nurse practitioner in the HCU
who prescribed an Anusol suppository (Doc. 148-2, p. 5). On
March 2, 2011, Smith was examined by Dr. Fuentes who noted
that the prostate ultrasound exam was normal, but that Smith
was still having problems with hemorrhoids and external
hemorrhoids were present (Doc. 148-7, p. 19). Smith was
scheduled for another examination on March 22, 2011, but the
examination was terminated because he declined to provide the
next day, Smith was examined by Dr. Nwaobasi at the asthma
“Chronic Clinic” (Doc. 148-1, p. 9). Dr. Nwaobasi
treated Smith's asthma, but the two also discussed the
hemorrhoid problems (Doc. 148-9). According to Smith, he
asked Dr. Nwaobasi if surgery was an option to treat his
hemorrhoids and Dr. Nwaobasi told him that he would not be
approved for surgery due to security and monetary reasons.
Id. However, at his deposition, Dr. Nwaobasi denied
that this conversation took place. Id.
several examinations for unrelated medical issues a CMT's
notes from June 14, 2011 state that Smith needed a renewal of
his prescriptions for suppositories, Colace and Dibucaine
(Doc. 126-3, p. 18). Dr. Nwaobasi examined Smith on June 18,
2011 and renewed the hemorrhoid medications (Doc. 126-3, p.
19). Dr. Nwaobasi noted, “[History] of external
prolapsed hemorrhoids. Needs the medications for his
25, 2011, Dr. Fahim examined Smith for his hemorrhoid related
complaints and issued prescriptions for Preparation H and
Colace (Doc. 126-3, p. 20). Smith was examined by a CMT for a
renewal of his prescriptions on October 17, 2011 (Doc. 126-3,
returned to the HCU for an examination by Dr. Fuentes on
November 2, 2011 (Doc. 126-3, p. 27). Dr. Fuentes states in
her notes that Smith was “complaining of hemorrhoids
for 1 ½ years, noticed prolapsing of hemorrhoids
[illegible] [with] occ. bleeding.” Id. She
performed a rectal examination and diagnosed Smith as having
external hemorrhoids. Id. At the conclusion of the
examination, Dr. Fuentes prescribed hot sitz baths, Anusol
suppositories and Colace. Id. She also directed
Smith to exercise more and to increase his water and fiber
November 16, 2011, Smith was again examined by Dr. Fuentes
for hemorrhoid issues (Doc. 126-3, p. 28). Smith complained
that he could feel the hemorrhoids when he strained in the
bathroom. Id. Dr. Fuentes did not observe any
external hemorrhoids, but prescribed Anusol suppositories and
Colace. Id. Smith returned to the HCU for another
examination with Dr. Fuentes on December 14, 2011 (Doc.
126-3, p. 30). Dr. Fuentes performed a rectal examination and
observed an external hemorrhoid. Id. Smith told Dr.
Fuentes that he would like to have surgery to correct the
problem, but she told him that his hemorrhoids could be
treated with suppositories. Id.
prison security issues, Smith was unable to be seen for a
follow up examination until January 24, 2012 (Doc. 126-3, pp.
31-32). On that date, Smith was examined by Nurse
Practitioner Pollion (Doc. 126-3, pp. 32). He told Nurse
Pollion that he was still experiencing some bleeding and that
the hemorrhoids protruded during bowel movements.
Id. Nurse Pollion directed Smith to “continue
Colace” and arranged for ...