Searching over 5,500,000 cases.

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Williams v. Schwarz

United States District Court, N.D. Illinois, Eastern Division

April 26, 2018




         Plaintiff 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 Defendant's actions.

         After 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.


         When 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).

         A. Treatment from April 2009 through November 2012

         Plaintiff 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.[2] (Doc. 130-1, at 5; Doc. 134 ¶ 7; Doc. 123-11, at 8, Molitch Dep., at 169).

         Since 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).

         B. Treatment in March 2013

         Plaintiff 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).

         During 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).

         Between 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 2013.

         C. Treatment in May 2013

         On May 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).

         A 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).

         D. Treatment from July through October 17, 2013

         Plaintiff 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 ¶ 20).

         There 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 35).

         E. Treatment from October 26, 2013 through 2015

         On 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 ¶ 24).

         On 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).

         In 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. ΒΆΒΆ 34, 35). A little more ...

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.