United States District Court, S.D. Illinois
MEMORANDUM AND ORDER
J. ROSENSTENGEL UNITED STATES DISTRICT JUDGE.
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). 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.
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).
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.).
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 (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.).
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).
26, 2013, District Judge G. Patrick Murphy 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.
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
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. 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.
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.).
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.
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.
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 ...