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Johnson v. Estate of Obaisi

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

September 25, 2019

NORMAN JOHNSON, Plaintiff,
v.
THE ESTATE OF SALEH OBAISI and WEXFORD HELATH SOURCES, INC., Defendants.

          MEMORANDUM OPINION AND ORDER

          Honorable Edmond E. Chang, United States District Judge

         Plaintiff Norman Johnson, a prisoner at Stateville Correctional Center, brings this civil rights lawsuit, 42 U.S.C. § 1983, alleging a violation of his Eighth Amendment rights.[1] Defendants are Wexford Health Sources, Inc., a private corporation that provides medical services at Stateville, and Wexford doctor Saleh Obaisi, who was Stateville’s medical director.[2] The Defendants filed a motion for summary judgment on December 28, 2018. R. 140.[3] For the reasons explained below, the Defendants’ motion is granted in part and denied in part.

         I. Background

         This case arises out of the treatment of two medical conditions suffered by Norman Johnson: a varicocele on his left testicle and a lipoma on his head. R. 151, Pl.’s Resp. Br. at 6.[4] For clarity’s sake, this Opinion will address each medical condition separately, though the relevant events overlap chronologically. The facts narrated here are undisputed unless otherwise noted. At the summary judgment stage, the Court views the evidence in the light most favorable to Johnson, the non-moving party. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986).

         A. Varicocele

         In early August 2013, Johnson filled out a request asking the prison’s medical staff to treat a lump on his left testicle. R. 72, Third Am. Compl., Exh. 1 at 3. On January 23, 2014, Johnson complained specifically to Dr. Obaisi about the lump. R. 142, DSOF ¶ 37; DSOF, Exh. B, Obaisi Dep. Tr. at 116:6-17.[5] Dr. Obaisi prescribed 100mg of Minocycline (an antibiotic) twice a day for three weeks, and planned for a follow-up visit in four weeks. Obaisi Dep. Tr. at 119:10-14. Around four weeks later, on February 27, Dr. Obaisi saw Johnson again, DSOF ¶ 38, but the parties dispute whether Johnson complained of left-testicle pain at this visit. Obaisi testified that Johnson made no complaint of testicle or scrotal pain. Obaisi Dep. Tr. at 120:12-18. According to Johnson, though, “[e]very time [he] talk[s] to [Obaisi] [he] tell[s] him everything that’s going on with [him], he [Obaisi] just don’t write it down.” DSOF, Exh. A, Johnson Dep. Tr. at 86:20-24. Johnson also wrote, on an August 2014 grievance form, that he was given Cephalexin 500mg on February 25, 2014 for his testicle pain and that he was still in pain. Third Am. Compl., Exh. 1 at 7.

         In late March 2014, Dr. Obaisi saw Johnson again. This time, it is undisputed that Johnson complained of discomfort and testicular pain. DSOF ¶ 39; Obaisi Dep. Tr. at 135:6-13. Obaisi diagnosed Johnson with chronic epididymitis, [6] changed the antibiotic to Levaquin, and added Prednisone to make the Levaquin more potent. DSOF ¶ 39; Obaisi Dep. Tr. at 135:22-24. In his deposition, Obaisi confirmed that he elevated Johnson’s treatment to a more intense prescription regimen based on Johnson’s continued complaints. Obaisi Dep. Tr. at 136:3-7. In early April 2014, Obaisi ordered a urinalysis for Johnson to rule out a urinary tract infection as the source of the testicular pain; the urinalysis result was within normal range. DSOF ¶ 40; Obaisi Dep. Tr. at 136:8-19. A repeat urinalysis and a syphilis test performed in May 2014 were both negative. DSOF ¶ 41; Obaisi Dep. Tr. at 137:1-16.

         On May 4, 2014, Johnson filed another grievance, complaining again about a painful lump on his left testicle that had not been alleviated by his prescription, and about not receiving a biopsy for that lump, as promised by Dr. Obaisi. Third Am. Compl., Exh. 1 at 6. Although it is unclear from the record what response Johnson received after he filed his grievance, it appears that he appealed it. In January 2015, the Administrative Review Board responded to the May 2014 grievance and denied Johnson’s request on the merits, finding that the issue was appropriately addressed by the prison and adding that “the ordering of tests must be done by attending physician.” Third Am. Compl., Exh. 5. In the meantime, Johnson filed another grievance, this time on August 7, 2014, reporting pain and a growing “cyst” on his left testicle, as well as difficulty urinating. Third Am. Compl., Exh. 1 at 7.

         Five days later, on August 12, Johnson again complained to Dr. Obaisi of continuing pain in his left testicle. DSOF ¶ 42; Obaisi Dep. Tr. at 137:17-23. Obaisi assessed chronic pain in Johnson’s left testicle and requested approval for an ultrasound. Obaisi Dep. Tr. at 138:6-7, 16-21. The ultrasound was completed in early September 2014, and it showed a small left varicocele. Id. at 139:7-140:8. Obaisi did not examine Johnson again for more than a month, on October 29, when Johnson again reported pain in his left testicle. Id. at 140:17-23. Noting the results of the ultrasound, Obaisi diagnosed Johnson with a varicocele and put in a prescription order for a scrotal support device. Id. at 141:13-142:2. Johnson stated in his affidavit that he did not receive the scrotal support until December 23, nearly two months after it was prescribed. R. 151-1, Pl.’s Supp. Exh. G, Johnson’s Affidavit at ¶ 29. Neither party has offered any evidence to explain the delay.

         Fast forwarding to 2015, on September 23 of that year, Johnson again complained to Dr. Obaisi of left testicle pain. DSOF ¶ 46; Obaisi Dep. Tr. at 143:2-18. Obaisi requested a physician collegial review to discuss a potential urology consultation for Johnson’s varicocele and for his complaints of testicular pain.[7] DSOF ¶ 46; Obaisi Dep. Tr. at 144:8-23. The collegial-review discussion took place 12 days later, on October 5. R. 151-2, Pl.’s Resp. DSOF ¶ 45; Obaisi Dep. Tr. at 144:8-19. The urology consultation was not approved; instead, the physicians agreed on an alternative treatment plan, that is, to continue with the scrotal support device. Obaisi Dep. Tr. at 145:10-15. Dr. Obaisi agreed to re-consult the physician collegial review upon completion of the alternative plan, if indicated. Id. at 145:19-146:6.

         Around three months later, on January 25, 2016, Johnson had an appointment with Physician Assistant LaTanya Williams; he complained to her that his testicle pain was the same. DSOF, Exh. D, Williams Dep. Tr. at 62:6-12. Williams assessed Johnson as having chronic testicular pain and noted that she would refer Johnson to the medical director for “[c]hronic headaches/hydrocele/testicular pain chronic.” Id. at 62:22-63:15. She prescribed pain medication: Atenolol 100mg daily and Naproxen 500mg as needed or twice a day (although it is unclear whether this was meant to alleviate Johnson’s testicular pain or headaches or both). Id. at 63:1-15. In early February 2016, Johnson saw Dr. Obaisi. DSOF ¶ 49; Obaisi Dep. Tr. at 147:7-15. During this visit, Johnson reported that his left testicle pain had worsened during the last few days. Id. Obaisi’s assessment was tenderness epididymis with slight swelling. Obaisi Dep. Tr. at 147:16-18. Obaisi prescribed an injectable antibiotic for five days, in addition to scrotal support and follow-up in four weeks. Id. at 147:19-22. But Johnson asserts in his affidavit that he did not see Obaisi again until May 3, 2016, around three months later. Johnson’s Affidavit at ¶ 38. According to Johnson, Obaisi stated that the varicocele had progressed to a moderate size and prescribed Johnson 200mg of Tegretol twice daily, in addition to the scrotal support. Id. In June 2016, another collegial-review discussion was held, and Wexford approved Johnson for a urology evaluation at the University of Illinois-Chicago (which is commonly referred to as UIC). DSOF ¶ 50; Obaisi Dep. Tr. at 148:7-20.

         At the end of November 2016, Johnson went to UIC and saw Dr. Simone Crivellaro, a urologist. DSOF, Exh. G, Crivellaro Dep. Tr. at 21:5-7. Neither party has explained why it took nearly six months to schedule Johnson for this consultation. In any event, during the appointment, Johnson described his pain as “sharp” and “intermittent, ” localized to the area of the testicle, and at a pain level of 6 out of 10. Id. at 23:2-6, 38:5-24; see also Pl.’s Supp. Exh. F at 32-33. The clinic note described a nontender and enlarged left testicle, normal epididymitis (meaning no inflammation), and a Grade Two spermatic cord left varicocele. Crivellaro Dep. Tr. at 22:10-24:18; see also Pl.’s Supp. Exh. F at 32-33. Dr. Crivellaro prescribed Johnson with Ibuprofen for pain management. Crivellaro Dep. Tr. at 27:17-28:5.

         In early August 2017, Johnson had a follow-up appointment with Dr. Crivellaro. DSOF ¶ 52; Crivellaro Dep. Tr. at 29:5-7. Johnson complained that the swelling had worsened, and the physician noted that the “pain is sharp in nature, localized, and does not radiate.” Pl.’s Resp. DSOF ¶ 51; Crivellaro Dep. Tr. at 29:17-23.[8] The varicocele was classified as a clinically nonsignificant Grade One, which Dr. Crivellaro testified means that surgical treatment is not indicated. DSOF ¶ 52; Crivellaro Dep. Tr. at 31:11-18, 32:6-19, 32:20-33:2. Crivellaro’s treatment plan consisted of pain control with Tramadol based on Johnson’s complaints of worsening pain, as well as scrotal support. Pl.’s Resp. DSOF ¶ 51; Crivellaro Dep. Tr. at 32:20-33:2, 46:20-47:2.

         A few months later, in mid-November 2017, Johnson asserts in his affidavit that Dr. Obaisi referred him for a scrotal sonogram. Johnson’s Affidavit at ¶ 45. Johnson also says that he was again prescribed a scrotal support a few days later by another doctor. Id. Johnson continues to experience testicular pain to this day. R. 151-2, PSOF ¶ 113; Johnson’s Affidavit at ¶ 60.

         B. Lipoma

         In mid-June 2011, Johnson filed his first grievance relating to a large lump on his head, as well as a headache. PSOF ¶ 89; Pl.’s Supp. Exh. B. In February 2012, Johnson complained to Physician Assistant Williams that he has had a lump on his head for the past 12 months and that he experienced pain when combing his hair. DSOF ¶ 53; Johnson Dep. Tr. at 79:11-19. Williams assessed Johnson with a mass on the forehead and planned to refer Johnson to urgent care for possible aspiration. Johnson Dep. Tr. at 79:11-19; Williams Dep. Tr. at 50:6-24. A few weeks later, on February 23, Williams re-evaluated Johnson and found him to be “within normal limits.” DSOF ¶ 54; Williams Dep. Tr. at 37:7-10. She noted that the bump on his head was small (1.5cm x 1.5cm), mobile, nontender to touch, well circumscribed, and solid. DSOF ¶ 54; Williams Dep. Tr. at 36:15-37:1. Williams diagnosed a “cyst forehead/hairline” and set a treatment plan for observation and follow-up in six months. Williams Dep. Tr. at 37:7-15. She also testified that she educated Johnson on things to look out for with respect to the mass. Id. at 37:16-19. In early April 2012, Williams learned that Johnson had filed a grievance, and she added a progress note- without seeing Johnson-assessing a lesion on the forehead and a plan to refer to “M.D. urgent care for second opinion.” Id. at 42:4-13.

         On May 1, 2012, Johnson filed another grievance, this time stating: “I was informed by Dr. Dubrick that I would need surgery to have it removed but also that I would inconvenience him to do so. He then stated that if Dr. Williams wanted to do it, she could. At that point he asked Dr. Williams if she would because he won’t do it and she also stated that she won’t do it because Stateville will not pay for it. This is the second time she has told me this-the tumor has become very painful … .” Pl.’s Supp. Exh. C; see also PSOF ¶ 90.

         Physician Assistant Williams saw Johnson again on September 30, 2013, and wrote in the progress note that the lump on Johnson’s forehead had not changed in size, and that it was palpable, soft, mobile, nontender, and well circumscribed. Williams Dep. Tr. at 56:15-57:5. She assessed a lipoma and ordered a follow-up at the clinic in six months for reevaluation. Id. at 57:7-13. One week later, Johnson filed another grievance about the lump on his head. Third Am. Compl., Exh. 1 at 4. He filed another one on November 5, asserting, “I’ve been having really bad headaches (lately). Sometimes it hurts so bad, I’m unable to sleep. I’ve also been having blurred vision in my left eye. I talk to ‘Physician Assistant Williams’ and was told that I have a ‘Tumor’ in my head, but Statesville wouldn’t pay for the surgery. I’m am [sic] asking to see an ‘outside specialist’ because my life may be in danger.” Id. at 5. Under “Relief Requested, ” Johnson wrote: “To be seen by outside specialist to remove the ‘Tumor.’ Because it is getting bigger.” Id.

         Almost three months later, on February 26, 2014, a nurse recorded that the lipoma now measured 3.5cm by 3cm. PSOF ¶ 95; Johnson Dep. Tr. at 85:5-22. Over five months later, in mid-August 2014, Dr. Obaisi saw Johnson, and noted Johnson’s complaints of “[h]eadache episodes over left eye with a blurred vision. Pounding headache. Episode several hours every few days.” Obaisi Dep. Tr. at 137:17-4. The clinic note does not show that Johnson received any medication for the symptoms on that day. See Id . at 137:17-138:11. Another month went by, and on October 29, 2014, Johnson complained again to Obaisi that he had blurred vision and pain in his left eye since 2012, and relayed that Dr. Dunn-a prison optometrist-had recommended an MRI. Id. at 121:18-122:2. Obaisi referred Johnson for an ophthalmology follow-up, an MRI, and an HVF study. PSOF ¶ 97; Johnson Dep. Tr. at 96:11-15. It is not clear from the record whether the MRI was ever performed.[9]

         Around one week later, on November 4, a collegial-review discussion between Dr. Obaisi and Dr. Ritz, Wexford’s Corporate Director for Utilization Management, resulted in approval of a CT scan of Johnson’s head. DSOF ¶ 61; Obaisi Dep. Tr. at 122:21-123:15. After the CT scan was performed at UIC in January 2015, Johnson was diagnosed with “a well encapsulated low attenuation lipoma” measuring 1.4cm by 3.7cm by 4.4cm. PSOF ¶ 98; Johnson Dep. Tr. at 99:1-22.

         Johnson saw Dr. Obaisi again in mid-March 2015, and Johnson reported eye pain, headache, and blurred vision. PSOF ¶ 99; Johnson Dep. Tr. at 101:15-102:4. Obaisi prescribed Atenolol, HCL cream, a follow-up in eight weeks, and a referral for an optometry consultation. R. 158, Defs.’ Resp. PSOF at ¶ 99; Johnson Dep. Tr. at 101:20-102:4. At the end of April 2015, an optometrist saw Johnson and prescribed him with warm compresses and artificial tears for dry eyes, as well as 500mg of acetaminophen for the headaches. PSOF ¶ 100; Johnson Dep. Tr. at 102:5-17.

         At this time, despite the prescribed treatment of Atenolol, HCL cream, and Tylenol, Johnson was still experiencing symptoms. PSOF ¶ 101; Johnson Dep. Tr. at 102:20-105:8. In May 2015, Johnson was approved for an ophthalmology appointment at UIC. Johnson Dep. Tr. at 105:9-18. On August 24, 2015, the UIC ophthalmologist found no ocular reason for Johnson’s headaches and recommended a neurology consultation, as well as a consultation with general surgery for a possible excision of Johnson’s lipoma. DSOF ¶ 64; Defs.’ Resp. PSOF ¶ 101; Johnson Dep. Tr. at 102:20-105:8. The next day, Obaisi submitted the general-surgery and neurology referral requests to Wexford collegial review, which consisted of a discussion between Dr. Ritz and Dr. Obaisi. Obaisi Dep. Tr. at 126:16-128:5. Neither request was approved. Instead, Ritz and Obaisi decided on an alternative treatment plan to re-evaluate Johnson onsite and ...


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