Thomass v. Wexford Health Sources, Inc.

          ORDER

          HON. REONA J. DALY UNITED STATES MAGISTRATE JUDGE.

         Plaintiff Bishara Thomas, an inmate in the custody of the Illinois Department of Corrections (“IDOC”), brings this action under 42 U.S.C. §1983 alleging his constitutional rights were violated while he was incarcerated at Menard Correctional Center. In particular, Plaintiff alleges he has been denied adequate medical treatment for his hiatal hernia, causing him to suffer severe abdominal pain and bloating. Plaintiff is proceeding on an Eighth Amendment deliberate indifference claim against Dr. John Trost, Dr. Steve Ritz, and Wexford Health Sources, Inc. (“Wexford”). Defendant Jeff Hutchinson, the current warden at Menard, is named in his official capacity to carry out any injunctive relief, if necessary.

         This matter is now before the Court on the Motion for Summary Judgment filed by Defendants Dr. Trost, Dr. Ritz, and Wexford (Doc. 129), and the Motion for Summary Judgment filed by Defendant Hutchinson^[1] (Doc. 131). For the reasons set forth below, the Motion filed by Dr. Trost, Dr. Ritz, and Wexford is GRANTED IN PART AND DENIED IN PART, and the Motion filed by Hutchinson is DENIED.

         Factual Background ^[2]

         Bishara Thomas has been incarcerated at Menard Correctional Center since 2005 (Deposition of Bishara Thomas, Doc. 130-5, p. 2). Since 2009, Thomas has suffered chronic, severe pain, which he describes as tightness or pressure in the upper area of his stomach, as well as pain and constipation in his lower abdomen (Id. at 3, 21). By 2013 or 2014, the pain intensified, rising to about a ten on a ten-point scale (Id. at 3).

         Thomas first reported complaints of stomach pain and constipation on November 4, 2009 during a visit to Nurse Sick Call (Deposition of Dr. Trost, Doc. 136-2, p. 17; see Plaintiff Thomas' Medical Records, Doc. 130-1, pp. 1-2). The nurse did not refer Thomas to a physician, but provided him with Metamucil and Maalox and ordered that he be on a twenty-four hour liquid diet (Id.). Throughout the remainder of 2009 and 2010 Thomas was regularly evaluated for complaints of abdominal pain (Doc. 136-2 at 18-20; see Doc. 130-1 at 3-14). Thomas underwent laboratory testing and x-rays of his chest and abdomen, and received prescriptions for Bentyl, a medication used to treat bowel problems, Milk of Magnesia, a laxative and antacid, and Colace, a stool softener used to treat constipation (Id.). There is no evidence demonstrating any treatment or evaluation of Thomas' complaints in 2011.

         Thomas was seen on May 27, 2012 for complaints of abdominal pain during Nurse Sick Call (Doc. 136-2 at 20; see Doc. 130-1 at 15). Thomas was seen for similar complaints of pain throughout 2013, for which he received a prescription for Zantac, a medication used to block the release of acid into the stomach, Milk of Magnesia, Fibercon, a laxative used to treat constipation, and Protonix, a protein pump inhibitor used to treat Gastroesophageal reflux disease (“GERD”) (Doc. 136-2 at 20-24; see Doc. 130-1 at 16-38).

         Defendant Dr. Trost, the Medical Director at Menard, first saw Thomas on December 30, 2013, wherein Thomas complained of epigastric pain (Affidavit of John Trost, M.D., Doc. 130-2, ¶¶ 2, 5; see Doc. 130-1 at 39). Dr. Trost conducted a physical examination and found Thomas' abdomen was flat, soft, and non-tender; however, he referred Thomas for an ultrasound of his gallbladder for further evaluation (Doc. 130-2 at ¶ 5; see Doc. 130-1 at 39). The ultrasound referral was approved and it was completed on February 6, 2014 (see Doc. 130-1 at 40-42). The ultrasound findings were normal and there was no evidence of cholelithiasis or cholecystitis (Doc. 130-2 at ¶ 6; see Doc. 130-1 at 42).

         Thomas was again evaluated for complaints of abdominal pain or pressure on March 12 and March 15, 2014 (Doc. 130-2 at ¶¶ 7-8; see Doc. 130-1 at 43-45). On March 15, 2014, a non-party physician conducted a physical examination that was unremarkable and issued Thomas a prescription for Reglan, a medication used to treat complaints of heartburn, nausea and vomiting, and Zantac (Doc. 130-2 at ¶ 8; see Doc. 130-1 at 45). After Thomas followed-up again with a nurse on April 17, 2014, he was referred to Dr. Trost for another evaluation (Doc. 136-2 at 25).

         Dr. Trost conducted a physical examination of Thomas on April 23, 2014 (Doc. 130-2 at ¶ 9; see Doc. 130-1 at 46). His assessment was that of peptic ulcer disease or gastritis (Doc. 136-2 at 25; see Doc. 130-1 at 46). Dr. Trost ordered a stool check for the Helicobacter pylori (“H. Pylori”) antigen, and prescribed Thomas Protonix (Doc. 130-2 at ¶ 9; see Doc. 130-1 at 46). Thomas was to return in two weeks (Id.).

         Thomas agreed to provide a stool sample for the H. Pylori screen on May 28, 2014 (Doc. 130-2 at ¶ 11; see Doc. 130-1 at 48). The results of the screening were negative (Doc. 130-2 at ¶ 11; see Doc. 130-1 at 49).

         Thomas was not seen again for complaints of abdominal pain and related symptoms until July 23, 2014, although he was regularly seen in the interim for other conditions (Doc. 130-2 at ¶¶ 12-21; see Doc. 130-1 at 50-65). After performing an unremarkable physical examination on July 23, 2014, the nurse issued Thomas a prescription for Prilosec (Doc. 130-2 at ¶ 21; see Doc. 130-1 at 65). Thomas saw the same nurse again on September 3, 2014, complaining of epigastric distress and heartburn (Doc. 130-2 at ¶ 5; see Doc. 130-1 at 65). The nurse ordered an x-ray of Thomas' abdomen, an updated H. Pylori screening, and prescribed him Milk of Magnesium and Fibercon (Doc. 130-2 at ¶ 23; see Doc. 130-1 at 65). The abdominal x-ray revealed a mild degree of stool in the colon and non-specific distention in the loops of the small bowel, which could indicate early ileus, or intestinal obstruction (Doc. 130-2 at ¶ 24; see Doc. 130-1 at 67). During his follow-up visit on September 5, 2014, the nurse ordered a comprehensive metabolic panel (“CMP”), complete blood count (“CBC”), and an updated H. Pylori screening (Doc. 130-2 at ¶ 25; see Doc. 130-1 at 68). The blood testing produced unremarkable results, including a negative screening for H. Pylori (Doc. 130-2 at ¶ 25; see Doc. 130-1 at 69-70).

         Thomas saw Dr. Trost again on September 17, 2014, to address his complaints of epigastric pain (Doc. 130-2 at ¶ 26; see Doc. 130-1 at 71). Dr. Trost conducted a physical examination and diagnosed Thomas with non-specific abdominal pain (Id.). Dr. Trost issued Thomas a prescription for Prilosec and Colace and requested that he return for re-examination in six weeks (Id.). During his follow-up exam with Dr. Trost on October 29, 2014, Thomas continued to complain of epigastric pain with some nausea, and reported the Prilosec was ineffective (Doc. 130-2 at ¶ 29; see Doc. 130-1 at 74). Dr. Trost again assessed Thomas as suffering from non-specific abdominal pain and issued Thomas a prescription for Lactulose, a laxative used to treat constipation (Id.). Dr. Trost referred Thomas to collegial for referral to receive a CT scan of his abdomen and for examination by a gastrointestinal specialist (Id.).

         Dr. Trost presented Thomas' case in collegial on October 30, 2014 to Dr. Ritz, Wexford's Corporate Utilization Management Director (Doc. 130-2 at ¶ 30; see Doc. 130-1 at 75). Dr. Ritz did not authorize the referrals, indicating that more information was needed before an outside consultation could be considered (Doc. 130-2 at ¶ 30; see Doc. 130-1 at 75-76). Dr. Trost's proposed referrals were again discussed with Dr. Ritz during collegial on November 6, 2014 (Doc. 130-2 at ¶ 31; see Doc. 130-1 at 77-78). During collegial, Thomas' recent bloodwork and weight were discussed (Id.). Dr. Ritz did not approve the request for a CT scan or evaluation with a gastrointestinal specialist; rather, he recommended that Thomas continue to receive conservative treatment onsite (Id.). An x-ray of Thomas' abdomen was taken on November 7, 2014, which revealed a moderate degree of stool in the colon (Doc. 130-2 at ¶ 32; see Doc. ...