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Montanezz v. Trost

United States District Court, S.D. Illinois

June 20, 2019

CARLOS A. MONTANEZ, Plaintiff,
v.
DR. JOHN TROST, WEXFORD HEALTH SOURCES, INC. and DR. STEPHEN RITZ, Defendants.

          MEMORANDUM AND ORDER

          ROSENSTENGEL, CHIEF JUDGE:

         This matter is before the Court on an Amended Report and Recommendation of United States Magistrate Judge Mark A. Beatty (Doc. 202), which recommends that the Motion for Summary Judgment filed by Defendants Dr. Stephen Ritz, and Wexford Health Sources, Inc. (Doc. 174) be granted in part and denied in part. The Amended Report and Recommendation was entered on May 22, 2019 (Doc. 202). On May 31, 2019, Montanez filed an objection (Doc. 206). On June 4, 2019, Dr. Ritz filed an objection (Doc. 215). That same day, Wexford filed a response to Montanez's objection (Doc. 216). For the reasons set forth below, the Court adopts the Report and Recommendation.

         Background

         Montanez, an inmate of the Illinois Department of Corrections, complains of conduct that took place while he was incarcerated at Menard Correctional Center. Montanez alleges that he was assaulted by an inmate at Menard and then taken to a local hospital until he was transferred to Barnes-Jewish Hospital in St. Louis, Missouri (“Barnes”) for treatment. While at Barnes, medical personnel diagnosed Montanez with multiple fractures on the right side of his face (Doc. 145-5, p. 9). On October 8, 2015, Montanez was discharged from Barnes with a recommendation to consult Ophthalmology for “possible blunt trauma to the globe.” (Doc. 140-1, p. 2). He was also discharged with instructions to have a CT scan to diagnose further injuries and make follow-up appointments to be seen by the Ophthalmology Clinic at Barnes within two to three weeks and the Plastic Surgery Clinic at Barnes within one week (Doc. 145-5, p. 15).

         Following his discharge on October 8th, Montanez was transferred to Menard's Health Care Unit (“HCU”), where Dr. Trost assumed responsibility for his care (Doc. 145-3, p. 8). On October 14, 2015, Dr. Hager, a medical professional at Menard, evaluated Montanez and agreed with the recommendation from Barnes that Montanez needed follow-up care (Id. at p. 15; Doc. 180-1). Montanez 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 Montanez be seen by an ophthalmologist and Dr. Ritz, a physician working for Wexford Health Sources, Inc. (“Wexford”), approved the recommendation (Docs. 140-2, 140-3, 140-4).

         On November 5, 2015, Menard personnel scheduled an appointment for Montanez to be seen by Dr. Mark Nekola, an ophthalmologist with Quantum Vision, on November 24, 2015 (Doc. 140-2). Dr. Nekola evaluated Montanez 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 x rays/scans to decide if it needs repair.” (Id. at p. 13).

         On November 25, 2015, in accordance with Dr. Nekola's recommendation, Dr. Trost wrote a request for Montanez to be seen by an ENT, and the request was approved by Dr. Ritz (Doc. 140-2). The ENT declined to see Montanez, however, and recommended that he be seen by a plastic surgeon instead (Doc. 140-3, p. 5; Doc. 140-5).

         On December 7, 2015, Menard medical personnel scheduled an appointment with Plastic Surgery Consultants for Montanez to be evaluated on December 17, 2015 (Doc. 140-2). Dr. Richard Hehmann, a plastic surgeon employed at Plastic Surgery Consultants, evaluated Montanez and recommended that he be seen by an oculoplastic surgeon to determine whether his 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 treat Montanez (Doc. 140-2, p. 16). Dr. Trost again requested a referral for an outside specialist, which Dr. Ritz approved on January 15; the Menard scheduling office then made an appointment for Montanez to be seen by an ophthalmologist (Id.).

         On February 1, an ophthalmologist evaluated Montanez, 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). On March 17, in accordance with that recommendation, Dr. Couch, an oculoplastic surgeon, evaluated Montanez and concluded that he has “no limitation in eye movement in the medial and lateral gaze . . . I do not see signs or symptoms to suggest that the diplopia has been caused by fracture.” (Id. at p. 31). Dr. Couch then recommended a “repeat of a CT scan of his orbits and return to discuss this further in the near future.” (Doc. 145-7, p. 3).

         In April 2016, Montanez fell when climbing down from the top bunk, and he alleges this was due to his double vision (Doc. 145-7). After the fall, Menard medical personnel evaluated Montanez for his shoulder pain and provided him with pain medication (Doc. 140-2). On May 26, Dr. Trost evaluated Montanez and recommended physical therapy (Id.). Dr. Ritz approved physical therapy and, in July 2016, medical personnel from the Southern Illinois Health Care Rehabilitation Institute of Chicago treated Montanez (Id.). In August, Montanez started to refuse physical therapy sessions because he believed that it was not helping his shoulder (Id.). On October 13, Montanez met with an optometrist to obtain new glasses to help address his vision issues, but the optometrist noted in his report that Montanez “refuses new gls litigation @ menard . . . .” (Doc. 140-8).

         The Report and Recommendation

         Judge Beatty recommends denying the motion for summary judgment as to Dr. Ritz because a reasonable jury could find that Dr. Ritz consciously disregarded the risks associated with delaying Montanez's follow-up with a plastic surgeon. Specifically, Judge Beatty found that there were issues of fact as to whether: (1) Dr. Ritz knew of Barnes's recommendation that Montanez see a plastic surgeon for follow-up within one week of his discharge; and (2) Dr. Ritz should have modified Dr. Trost's initial recommendation to include an off-site medical referral for Montanez to visit a plastic surgeon.

         Judge Beatty recommends granting the motion for summary judgment as to Wexford because Montanez fails to present evidence to support any type of causal link or connection between the alleged policy and claimed constitutional violation. As to Montanez's claim that Wexford maintained a practice of condoning employee misconduct despite knowing it delayed treatments, Judge Beatty found that this policy has no bearing on whether Dr. Trost's failure to follow Barnes's specific recommendation ultimately amounts to deliberate indifference. As to Montanez's claim that Wexford maintained a practice of hiring underqualified medical directors despite knowing it caused ...


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