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Smith v. Harrington

United States District Court, S.D. Illinois

June 2, 2017

TYRIN N. SMITH, B78535, Plaintiff,


          STACI M. YANDLE United States District Judge.

         Plaintiff 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.

         Smith 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 in part.


         Plaintiff 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).

         Smith's 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 [sic]”. Id.

         On 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.

         The 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 co-pay.

         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.

         After 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 hemorrhoids.” Id.

         On July 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, p. 25).

         Smith 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 intake. Id.

         On 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.

         Due to 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 ...

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