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Bentz v. Ghosh

United States District Court, S.D. Illinois

April 26, 2018




         This matter comes before the Court on the Report and Recommendation of Magistrate Judge Donald G. Wilkerson (Doc. 311), which recommends denying the Motion for Preliminary Injunction filed by Plaintiff David Robert Bentz (Doc. 276). The Report and Recommendation was entered on March 5, 2018. Bentz filed a timely objection on March 7, 2018 (Doc. 313).[1] For the following reasons, the Court modifies the Report and Recommendation and grants in part and denies in part Bentz's Motion for Preliminary Injunction.


         Bentz, an inmate at Menard Correctional Center, filed this lawsuit on June 17, 2013, alleging medical personnel at Stateville, Pontiac, and Menard correctional centers were deliberately indifferent to his serious dental needs. Specifically, Bentz claims he has sought dental treatment and relief for chronic tooth pain since 2010 (Doc. 1, pp. 5-7).

         According to Bentz's testimony, in December 2009, an intake dentist at Graham Correctional Center told Bentz he needed three teeth “fixed.” (Doc. 197-3, p. 7). The dental record accompanying this visit, however, only indicates that he needed a “routine exam.” (Doc. 299-1, p. 1). Shortly thereafter, Bentz was transferred to Stateville, where he asserts he asked Defendant Dr. Ghosh for pain medication and a dental referral (Doc. 197-3, p. 7). Dr. Ghosh denied Bentz pain medication, but referred him to a dentist (Id.). On November 5, 2010, a dentist took x-rays of Bentz's teeth and indicated he would be scheduled to receive fillings (Id., p. 8). Bentz was not given any medication for his chronic pain (Id.). He was scheduled for a referral exam on March 31, 2011, which was later rescheduled to May 6, 2011, then to August 17, 2011 (Id., pp. 11-12). Prior to his August 2011 appointment, however, Bentz was transferred to Pontiac Correctional Center (Doc. 1, p. 6). When Bentz saw the Medical Director at Pontiac in August 2011 for another medical issue, the Medical Director refused to do anything for Bentz's tooth pain or to put him in to see dental (Id., p. 6). Bentz alleges he never saw a dentist while at Pontiac before he was transferred to Menard in November 2011 (Id.).

         Upon arriving at Menard, Bentz told the intake nurse that he had dental issues but was simply told to put in a request slip for dental (Id., p. 7). Bentz claims he did not see a dentist until May 22, 2013, when he had his biannual exam (Id.). He asserts he told the dentist, Defendant Dr. Stelfox, that he had an abscessed tooth causing swelling down to his neck, but Dr. Stelfox informed him he only needed a cleaning and there was nothing wrong with his teeth[2] (Id.). Bentz alleged in his complaint that he was told he would have to wait until he was released to get his teeth fixed, but Bentz is serving a life sentence, making him ineligible for release (Id.).

         In June 2013, Bentz sought medical care to address his chronic pain and because he was having trouble swallowing and eating (Id., p. 8). When Bentz saw a nurse on June 10, 2013, the nurse did nothing for him despite his jaw being swollen and bruised (Id.). Bentz claims the denial of access to dental treatment has caused a risk of harm to his health because he is unable to eat normally, causing him to lose weight and suffer “other health issues.” At the time Bentz filed his complaint, he sought monetary damages and injunctive relief in the form of immediate treatment of his abscessed tooth and chronic tooth pain, as well as “other dental care” (Doc. 1, p. 28).

         On July 26, 2013, District Judge G. Patrick Murphy[3] denied Bentz's motion for preliminary injunction (Doc. 35). Judge Murphy concluded that Bentz's tooth pain, which “comes and goes on its own, ” combined with the fact that his pain and swelling was reduced with over-the-counter pain medication (although supplied by another inmate), supported the conclusion that his condition was not so dire as to warrant the extraordinary remedy of a preliminary injunction. Furthermore, while Bentz was concerned about the possibility of further tooth decay or extractions of his teeth, Judge Murphy found the possibility of irreparable harm is insufficient-rather, irreparable harm must be likely in the absence of an injunction.

         Bentz appealed that decision to the Seventh Circuit Court of Appeals, arguing that he has suffered from painful tooth decay and has needed fillings since October 2010. He stated in his brief on appeal that his only request at the hearing on his motion for preliminary injunction was for Motrin to address his chronic pain. Because this request was denied, Bentz argued, he has continued to suffer despite his continued requests for pain medication and dental care. Therefore, he argued, he met the requirements “for a preliminary injunction for pain management and/or pain medication.”

         The Seventh Circuit Court of Appeals vacated the Court's order denying a preliminary injunction, finding that the Court rested on an incorrect conclusion that the prison staff's refusal to treat Bentz's intermittent tooth pain, which affected his ability to eat and swallow, was not evidence of irreparable harm.[4] Bentz v. Ghosh, No. 16-1697, 2017 WL 5564679, at *3 (7th Cir. Nov. 20, 2017). The Seventh Circuit noted that an official's refusal to treat pain that affects a prisoner's daily living may be irreparable harm even though it is episodic and treated without prescription medication. Id. Accordingly, the Court of Appeals remanded the case to the undersigned for further proceedings on Bentz's motion for preliminary injunction (Id.; Doc. 267). The Court of Appeals also directed the Court to reinstate the Warden of Menard to perfect any injunctive relief awarded.

         On January 22, 2018, Magistrate Judge Wilkerson ordered Bentz to file a notice indicating whether he was still at risk of imminent harm resulting from the denial of dental care. In his response to the Court, Bentz stated that he still suffers chronic pain, swelling, and bleeding, and that his condition has severely worsened as he has had no treatment to date (Doc. 283). Bentz also requested a wrap-around x-ray of all of his teeth to determine how the damaged has progressed since 2013, as well as a court-appointed dental expert to determine the extent of treatment needed (Id.).

         In response, Defendants argued first that Bentz is not entitled to injunctive relief, as he is unlikely to succeed on the merits of his claim regarding Defendants' deliberate indifference to his serious dental needs. Defendants pointed out that Bentz has been scheduled for a number of dental appointments since 2013. While he received treatment at some appointments, he either refused to pay the copay or did not report to dental for others. More recently, Bentz received an x-ray of his teeth on September 8, 2016, which resulted in a recommendation that tooth No. 19 be extracted because it was decayed (Doc. 299). Bentz refused the extraction. Bentz also was examined by a dentist on May 22, 2017, and voiced no complaints. Thus, Defendants argued, Bentz is unlikely to succeed on his claim that Defendants deliberately disregarded a serious dental issue.

         Defendants further argued that Bentz has an adequate remedy at law, as the Court can remedy the harm alleged in a final determination on the merits. Defendants assert that an Order directing them to x-ray Bentz's teeth would essentially substitute the Court's judgment for the medical judgment of Bentz's current treating dentist, who has evaluated Bentz, knows his treatment history, and has established a treatment plan. Moreover, Defendants stated, Bentz will not suffer irreparable harm absent an injunction, as demonstrated by Bentz's refusal to comply with the recommendation of his dentist to extract tooth No. 19. Finally, Defendants argued that the “balance of equities” is in their favor and that granting preliminary relief in this case is not in the public interest.

         Magistrate Judge Wilkerson held a hearing on Bentz's motion on March 2, 2018 (Docs. 312, 326). At the hearing, Bentz stated he “believe[s]” he has at least three teeth with cavities, one of which has been filled and one that needs to be extracted (tooth No. 19) (Doc. 326, p. 15). He also “believe[s]” he has other cavities that need to be filled (Id.). As for tooth pain, Bentz testified that eight out of ten times he experiences pain while eating, the level of which varies from a 3 to a 10 (Id., pp. 6-8). When his pain is at a level 10, his face and neck swells, he has headaches, and it affects his vision (Id., p. 8). Bentz also testified that while he did receive an x-ray on September 8, 2016, it was only a bitewing x-ray and not a wrap-around x-ray (Id., p. 11). While the x-ray revealed tooth No. 19 needed to be pulled, Bentz refused the extraction because he had been told by another dentist at Menard that he was “not at risk” for losing his tooth; rather, he only needed a filling to replace one that had ...

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