United States District Court, S.D. Illinois
REPORT AND RECOMMENDATIONS
A. BEATTY UNITED STATES MAGISTRATE JUDGE
Carlos Montanez, an inmate at Pontiac Correction Center
(“Pontiac”) in Pontiac, Illinois, brought this
action pursuant to 42 U.S.C. § 1983 for alleged
violations of his constitutional rights. More specifically,
he alleges that, while he was incarcerated at Menard
Correctional Center (“Menard”), Defendants were
deliberately indifferent to his serious medical needs when
they denied and/or delayed providing treatment for his
orbital bone fracture and diplopia.
matter has been referred to United States Magistrate Judge
Mark A. Beatty by United States District Judge Nancy J.
Rosenstengel pursuant to 28 U.S.C. § 636(b)(1)(B),
Federal Rule of Civil Procedure 72(b), and SDIL-LR 72.1(a)
for a Report and Recommendation on a motion for summary
judgment (Doc. 174). It is recommended the District Court
adopt the following findings of fact and conclusions of law,
and the motion for summary judgment (Doc. 174) be
GRANTED IN PART, DENIED IN PART.
Findings of Fact
the Court's threshold review of Plaintiff's complaint
pursuant to 28 U.S.C. § 1915A, Plaintiff was permitted
to proceed on an Eighth Amendment claim for deliberate
indifference against Defendants Trost, Walls, Brooks, and
Butler (Doc. 38). Defendants Ritz and Wexford filed a motion
for summary judgment on April 8, 2019 (Doc. 174). Plaintiff
filed a response in opposition to the motion (Doc. 189).
Defendants Ritz and Wexford then filed a reply to
Plaintiff's response in opposition (Doc. 198).
in the light most favorable to Plaintiff, the evidence and
the reasonable inferences that can be drawn from it establish
the following relevant facts for purposes of the instant
summary judgment motion.
October 7, 2015, while Plaintiff was incarcerated at Menard
when he was assaulted by a fellow inmate (Doc. 1) and then
taken to a local hospital until being transferred to
Barnes-Jewish Hospital (“Barnes”). While at
Barnes, medical personnel diagnosed Plaintiff with multiple
facial fractures to the right side (Doc. 145-5, p. 9).
Plaintiff was discharged from Barnes on October 8 with a
recommendation to consult Ophthalmology for “possible
blunt trauma to the globe.” (Doc. 140-1, p. 2). He also
received instructions to have a CT scan to diagnose further
injuries and make follow-up appointments to be seen by
Barnes's Ophthalmology Clinic within 2-3 weeks and by
Barnes's Plastic Surgery Clinic within one week. (Doc.
145-5, p. 15).
his discharge, Plaintiff was transferred to Menard's
Health Care Unit (“HCU”), where Dr. Trost assumed
responsibility of Plaintiff's medical care (Doc. 145-3,
p. 8). On October 14, Dr. Hager, a medical professional at
Menard, evaluated Plaintiff and agreed with Barnes's
recommendation that Plaintiff needs to follow-up as scheduled
(Id. at p. 15). Plaintiff also reported experiencing
blurry vision, pain, nausea, difficulty with eye movement and
double and quadruple vision (diplopia). (Docs. 140-2, 140-3,
140-5). Dr. Trost then recommended that Plaintiff be seen by
an ophthalmologist and Dr. Ritz, a physician working for
Wexford Health Sources, Inc. (“Wexford”) (the
private company that contracts with Illinois to provide
medical care to prisoners), approved the recommendation
(Docs. 140-2, 140-3, 140-4). Wexford's approval is
required whenever an inmate needs outside medical care. On
November 5, 2015, Menard personnel scheduled an appointment
for Plaintiff to been seen by Dr. Mark Nekola, an
ophthalmologist with Quantum Vision on November 24, 2015
(Doc. 140-2). Dr. Nekola evaluated Plaintiff on November 25
and provided the following assessment: “Mr. Montanez
gives conflicting symptoms but I do think he has an orbital
floor fracture on the left side. There is no restriction to
movement on exam. That said I would have an ENT take a look
at XRays/Scans to decide if needs repair.”
(Id. at p. 13).
November 25, in accordance with Dr. Nekola's
recommendation, Dr. Trost wrote a request to Dr. Ritz, which
he approved, for Plaintiff to been seen by an ENT (Doc.
140-2). However, the ENT declined to see Plaintiff and
recommended Plaintiff instead be seen by a plastic surgeon
(Doc. 140-3, 140-5). On December 7, Menard medical personnel
scheduled an appointment with Plastic Surgery Consultants for
Plaintiff to be evaluated on December 17. (Doc. 140-2). Dr.
Richard Hehmann, a plastic surgeon employed at Plastic
Surgery Consultants, evaluated Plaintiff and recommended that
Plaintiff be seen by an oculoplastic surgeon to determine if
Plaintiff's double vision would “benefit from
surgery.” (Doc. 140-7). Dr. Trost then requested a
referral for an outside specialist, which Dr. Ritz approved
on January 6, 2016. (Doc. 140-2). Menard's scheduling
office had difficulty scheduling the appointment because
outside providers refused to serve Plaintiff (Id.).
Dr. Trost again requested a referral for an outside
specialist which Dr. Ritz approved on January 15, and then
the Menard scheduling office made an appointment for
Plaintiff to be seen by an ophthalmologist (Id.).
February 1, an ophthalmologist evaluated Plaintiff, noted
that he was experiencing diplopia in all directions except
with his straight forward gaze, and suggested that he
“would not pursue surgical correction.”
(Id. at p. 29). In accordance with the
ophthalmologist's recommendation, Dr. Couch, an
oculoplastic surgeon, evaluated Plaintiff on March 17, 2016
and concluded, in part, that Plaintiff has “no
limitation in eye movement in eye movement in the medial and
lateral . . . I do not see signs or symptoms to suggest that
the diplopia has been caused by fracture.”
(Id. at p. 30). Dr. Couch then recommended a
“repeat of a CT scan of his orbits and return to
discuss this further in the future.” (Doc. 145-7, p.
April 2016, Plaintiff fell as he climbed down from his top
bunk and alleges that it was due to his double vision (Doc.
145-7). Because of his fall, Menard medical personnel
evaluated Plaintiff for his shoulder pain and provided him
with pain medication (Doc. 140-2). On May 26, 2016, Dr. Trost
evaluated Plaintiff and recommended physical therapy
(Id.). Dr. Ritz approved physical therapy for
Plaintiff and, in July 2016, medical personnel from Southern
Illinois Health Care Rehabilitation Institute of Chicago
treated Plaintiff (Id.). In August 2016, Plaintiff
began refusing physical therapy sessions because he believed
it was not benefiting his shoulder (Id.). On October
13, Plaintiff met with an optometrist to obtain new glasses
to help address his vision issues, but the optometrist noted
in his report that Plaintiff “refuses new gls
litigation @ menard . . .” (Doc. 140-8).