United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
FINNEGAN UNITED STATES MAGISTRATE JUDGE.
William Williams filed this lawsuit under 42 U.S.C. §
1983 alleging that Defendant Mary Diane Schwarz, P.A., was
deliberately indifferent to his type 2 diabetes mellitus
while he was a pretrial detainee at the Stateville Northern
Reception Classification Center (“NRC”).
Plaintiff also asserts state law claims for medical
malpractice, negligent infliction of emotional distress, and
intentional infliction of emotional distress. Currently
before the Court is Defendant's motion for summary
judgment on the deliberate indifference and infliction of
emotional distress claims. Defendant argues that Plaintiff
cannot establish that the treatment she provided him was
blatantly inappropriate given that her two retained medical
experts have both opined that she at all times complied with
the applicable standard of care. Defendant further contends
that Plaintiff cannot satisfy the elements of his infliction
of emotional distress claims, including that he actually
suffered severe emotional distress as a result of
careful review of the record, the Court concludes that when
the facts are construed in the light most favorable to
Plaintiff, a genuine issue of material fact exists that
forecloses summary judgment in Defendant's favor at this
stage of the case. Defendant's motion for summary
judgment is therefore denied.
considering Defendant's summary judgment motion, the
facts are viewed in a light most favorable to Plaintiff.
Continental Cas. Co. v. Nw. Nat. Ins. Co., 427 F.3d
1038, 1041 (7th Cir. 2005). Though the Court must assume the
truth of those facts for purposes of this motion, it does not
vouch for them. Arroyo v. Volvo Group N. Am., LLC,
805 F.3d 278, 281 (7th Cir. 2015).
Treatment from April 2009 through November 2012
has a history of type 2 diabetes dating back to 1993 and has
spent much of his adult life either incarcerated or homeless.
(Doc. 132 ¶ 9; Doc. 123-1, at 4-5, Williams Dep., at
15-18). He first encountered Defendant, a licensed
physician's assistant employed by Wexford Health Sources,
Inc. to provide medical care at the NRC, on April 3, 2009. At
that time, Defendant conducted an Offender Physical
Examination and, based on Plaintiff's average glucometer
reading of 280 (the target range is between 120 and 180),
switched him from the Metformin he had been taking to Novolin
70/30 insulin 28 units in the morning and 12 units in the
evening. (Doc. 130-1, at 5; Doc. 134 ¶ 7; Doc.
123-11, at 8, Molitch Dep., at 169).
the NRC serves as an intake for all the prison facilities in
northern Illinois, most inmates can expect to stay there for
30 days or less before being transferred to a longer stay
housing facility. (Doc. 132 ¶ 23). Consistent with that
usual protocol, Plaintiff was transferred to Shawnee
Correctional Center on April 14, 2009, where he continued to
be prescribed mixed insulin 70/30 and other diabetes care
through September 2011. There were, however, numerous
occasions when he refused treatment. (Doc. 130 ¶ 5; Doc.
134 ¶ 5; Doc. 130-2, at 2-66). Neither party has
provided medical records from September 2011 to March 2012 so
it is unclear what diabetes treatment Plaintiff was receiving
during that period, if any. When Plaintiff was released in
November 2012, his medication administration records showed
that he had been prescribed insulin 70/30 65 units in the
afternoon from March 8 to May 8, 2012, at which time the
dosage was increased to 75 units in the afternoon. (Doc.
130-1, at 11-24).
Treatment in March 2013
was living on the streets from November 2012 until March 2,
2013, when he entered the Cook County Jail. He told Dr.
Terrance Baker of Cermak Health Services that he had been
taking Metformin and 70/30 insulin 7 units in the morning and
15 units in the evening, and that his last insulin dose was
“yesterday morning.” (Doc. 130 ¶ 6; Doc. 132
¶ 16; Doc. 123-1, at 4, Williams Dep., at 15-16). Dr.
Baker was “not convinced” that Plaintiff needed
insulin and so ordered Metformin and twice-daily blood
glucose checks (“Accu-Cheks”) to assess his blood
sugar levels. (Doc. 132 ¶ 19; Doc. 134 ¶¶ 6,
8). He also prescribed tramadol and gabapentin for pain, and
enalapril for high blood pressure. (Doc. 130 ¶ 8; Doc.
130-4, at 9). On the morning of March 4, 2013, Plaintiff did
not present for diabetic medication or an Accu-Chek. Later
that day he was transferred to the NRC, where he would remain
until November 2013. (Doc. 132 ¶¶ 21, 22).
a health screening evaluation at the NRC with C. Smith, R.N.,
Plaintiff again stated that he had been taking Metformin and
70/30 insulin 7 units in the morning and 15 units in the
evening. (Id. ¶¶ 22, 24). Defendant
examined Plaintiff at 4:00 p.m. and noted that according to
the Cook County Jail pharmacy sheet, he was not on insulin.
She documented that Plaintiff nonetheless “WANTS
INSULIN??, ” written in all-caps to indicate that he
was being aggressive in his demand. (Id.
¶¶ 26, 29). At the same time, Defendant recorded
that Plaintiff had a 20-year history of type 2 diabetes, and
she remembered having prescribed him insulin in April 2009
because he was on “major, major amounts” of oral
medication. (Doc. 130 ¶ 9; Doc. 134 ¶ 9). Plaintiff
did not raise any complaints regarding his eyes, feet,
fingers, or hands during that initial evaluation, and
Defendant decided not to order any of the medications listed
on the Cook County Jail pharmacy sheet. Instead, she ordered
twice-daily Accu-Cheks (with no stop date) and instructed
Plaintiff to follow up with her on March 5 or 6. (Doc. 132
¶¶ 25-27; Doc. 130 ¶ 9; Doc. 134 ¶ 9).
March 5 and 13, 2013, Plaintiff's blood sugar was checked
twice daily. His results were generally within the target
range, though one of his afternoon readings was slightly
elevated at 193. (Doc. 132 ¶ 34; Doc. 134 ¶ 10;
Doc. 130-1, at 65). When Plaintiff saw Defendant again on
March 8, 2013 for a follow-up on his type 2 diabetes, his
glucometer reading was 158 without medication and Defendant
again decided not to prescribe him insulin or any other
diabetes-related treatment. She did, however, prescribe a
fungal cream to treat a rash. (Doc. 134 ¶ 11; Doc. 132
¶¶ 32, 33; Doc. 123-2, at 139). The parties agree
that after March 13, 2013, Plaintiff stopped getting his
daily Accu-Cheks, though they dispute the reason for the
discontinuation. Defendant says that Plaintiff refused the
tests on the afternoon of March 13 and the morning of March
14, at which point the checks ceased. Plaintiff denies that
he refused any Accu-Cheks and claims he made repeated
requests for medical care that went unanswered. (Doc. 132
¶ 35; Doc. 130 ¶ 16). Regardless, it is undisputed
that Plaintiff did not receive further treatment until May
Treatment in May 2013
7, 2013, Plaintiff filed a grievance requesting medical
attention for his diabetes. He stated that he was
experiencing symptoms of hypoglycemia several nights a week,
and expressed concern that his life was in
“jeopardy.” (Doc. 130 ¶ 12; Doc. 130-1, at
27-28). Two days later, on May 9, 2013, Plaintiff started
experiencing back pain on his way to a court appearance.
Defendant examined Plaintiff, gave him a single dose of
tramadol, and asked him to follow up as necessary. (Doc. 132
¶¶ 38, 39). Plaintiff says he told Defendant he was
diabetic, explained that he had been at the NRC since March,
and asked about receiving insulin and Accu-Cheks. (Doc.
123-1, at 21-22, Williams Dep., at 84-85). Defendant claims
that Plaintiff never mentioned any concerns about diabetes or
hypoglycemia during that visit, but her treatment note states
“I didn't believe he was on insulin. I told him no
insulin [illegible] his records. His records confirm he was
never on insulin.” (Id. at 38; Doc. 134 ¶
14; Doc. 130-1, at 33).
prison official denied Plaintiff's grievance on May 23,
2013, and he filed a second one on June 8, 2013, again
seeking medical care for his diabetes and expressing concern
that his life was in “jeopardy.” (Doc. 130 ¶
15; Doc. 123-1, at 96-97; Doc. 130-1, at 27). Defendant
denies having any knowledge of either the May or June
grievances. (Doc. 134 ¶¶ 12, 15; Doc. 123-2, at 54,
Schwarz Dep., at 207).
Treatment from July through October 17, 2013
next received treatment on July 24, 2013, when Defendant
examined him and administered an Accu-Chek (the first one
documented since March 14, 2013). One reading showed his
blood glucose level was 426, and two subsequent readings
measured it at 300. (Doc. 134 ¶ 17; Doc. 132 ¶ 40).
Defendant indicated that Plaintiff had “no insulin on
streets secondary to homeless; lost to follow-up, no
complaints to anyone.” (Doc. 132 ¶ 40). She also
claimed that Plaintiff had been “vague about his
diabetic insulin” with no evidence of “weight
loss, polydipsia, glucose leakage, protein, etc.” (Doc.
134 ¶ 18; Doc. 130-1, at 33). Defendant administered
insulin and issued a prescription for an intermediate-acting
insulin (“NPH” insulin) that continued for the
next few months. Defendant claims she also planned to add 10
units of regular insulin and twice-daily Accu-Cheks if
needed, but it does not appear she documented that in her
notes. After receiving the first dose of insulin,
Plaintiff's blood glucose level dropped to 195. (Doc. 132
¶ 41; Doc. 130-1, at 33). Over the next three months,
Plaintiff's blood glucose levels ranged from 123 to 350
in the mornings (with the average being 223), and 114 to 216
in the evenings (with the average being 164). (Doc. 134
is no documentation showing that Plaintiff was referred back
to Defendant for diabetes concerns from July 24 to October 9,
2013. (Doc. 132 ¶ 43). On October 9, 2013, he saw
Defendant due to increasing glucometer scores noted by staff
members performing his Accu-Cheks. Defendant prescribed
Novolin 70/30 24 units in the morning and 12 units in the
afternoon. She also ordered an optometry exam. (Id.
¶ 44). The last treatment note from Defendant is dated
October 17, 2013 and states that Plaintiff is “insulin
dependent” with “stable” glucometer and
blood pressure readings. (Doc. 134 ¶ 22; Doc. 130-1, at
Treatment from October 26, 2013 through 2015
October 26, 2013, Plaintiff was taken to the health clinic
with a painful “golf ball sized” lump on the
right side of his neck and a swollen throat. He was treated
with pain medication. The next day, Plaintiff was having
trouble swallowing and there was a “foul odor”
coming out of his mouth. (Doc. 130 ¶¶ 23; Doc.
130-1, at 36-38). Plaintiff was ultimately admitted to the
infirmary on October 28, 2013, and had to remain there until
November 8, 2013. After being discharged, Plaintiff continued
to take oral antibiotics for another 10 days. (Doc. 130
November 25, 2013, Plaintiff was transferred to Dixon
Correctional Center. (Doc. 130 ¶ 25; Doc. 132 ¶ 47;
Doc. 123-1, at 173). He had a focused diabetes evaluation on
December 17, 2013, and reported “numbness/tingling pain
in his legs.” In addition to insulin therapy, the
doctor prescribed a low sugar and low fat diet. (Doc. 130
¶ 26). A few months later, on February 3, 2014,
Plaintiff asked to see an eye doctor because of issues he was
experiencing while reading and obscured vision in his right
eye. (Doc. 130 ¶ 27; Doc. 130-3, at 2). When Dr. David
T. Hicks examined Plaintiff on March 18, 2014, he noted
retinopathy and macular area changes in Plaintiff's right
eye. (Doc. 130 ¶ 28; Doc. 130-1, at 79).
November 2014, Plaintiff was transferred to East Moline
Correctional Center, and by the end of the year, he was
complaining that he “can't see” from his
right eye for the previous three months. (Doc. 130
¶¶ 31, 32). On February 26, 2015, Plaintiff had an
annual optometric exam conducted by Ned B. Hubbard, O.D.
Plaintiff reported decreased visual acuity in his right eye
since September 2014, and Dr. Hubbard referred him to a
retinal specialist due to a possible macular edema secondary
to his diabetes. (Doc. 130 ¶ 33; Doc. 130-1, at 86).
Plaintiff saw Dr. Min Han on March 27, 2015, and was
diagnosed with diabetic background retinopathy and diabetic
macular edema. Dr. Han recommended that Plaintiff return for
a fluorescein angiogram, which the doctor performed on May
11, 2015. (Id. ¶¶ 34, 35). A little more