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Perez v. Wexford Health Sources, Inc.

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

November 6, 2019

ISAAC PEREZ, Plaintiff,
v.
WEXFORD HEALTH SOURCES, INC, THE ESTATE OF SALEH OBAISI, M.D., and TIMOTHY J. FAHY, M.D., Defendant.

          MEMORANDUM OPINION AND ORDER

          MARVIN E. ASPEN, DISTRICT JUDGE.

         Plaintiff Isaac Perez alleges that Dr. Timothy Fahy, Dr. Saleh Obaisi, [1] and Wexford Health Sources, Inc. ("Wexford") were deliberately indifferent to his eye and back conditions during his incarceration at Stateville Correctional Center ("Stateville"). (Amend. Comp. (Dkt. No. 10) ¶¶ 1-4, 26, 30-32, 34-36.) Before us is Defendants' motion for summary judgment. (Mot. (Dkt. No. 52).) For the reasons set forth below, we grant Defendants' motion.

         BACKGROUND

         The facts outlined hereafter are taken from the parties' Local Rule 56.1 statements and are undisputed unless otherwise noted.

         Perez is incarcerated and has been living at Stateville since 2013. (Defs.' Statement of Facts (“Defs.' Facts”) (Dkt. No. 53) ¶ 4.) Perez experienced recurring left eye and back problems while incarcerated that prompted him to seek medical treatment from the Illinois Department of Corrections ("IDOC"). IDOC provides care to inmates, in part, by contracting with Wexford. (Id. ¶ 5.) Wexford in turn hires physicians and other medical staff who provide direct care to Stateville's inmates. (Id. ¶ 5.) Drs. Obaisi and Fahy were employed by Wexford and provided medical care to Perez. (Id. ¶¶ 6-7, 22, 62.)

         I. PEREZ'S LEFT EYE

         Perez first started having eye problems while incarcerated in 2014. (Perez Decl. (Dkt. No. 62-1) ¶ 1; Perez Dep. (Dkt. No. 53-1) at 22.) Perez testified that blurry vision, watery eyes, and fluid discharge prompted him to request an appointment with an optometrist. (Perez Dep. at 22-23; Perez Decl. ¶¶ 1-2.)

         A. Perez's Initial Eye Appointments

         Perez's eyes were initially examined in November 2014. (Pl.'s Add. Statement of Undisputed Facts ("Pl.'s Facts") (Dkt. No. 59) ¶ 3; Dkt. No. 59-1 at 2.) The examining optometrist observed that Perez complained of blurry vision in his left eye and may have had a previous episode of Central Serous Retinopathy ("CSR").[2] (Dkt. No 59-1 at 2.) CSR occurs when fluid accumulates in retinal tissue and can manifest as blurry or distorted vision, or grayness in the central area of a patient's vision. (Fahy Dep. at 6-7, 19; Defs.' Facts ¶ 25.) It is unknown what causes CSR, but it is often temporary. (Defs.' Facts ¶ 25.) Perez's eyes were examined again about nine months later. (Pl.'s Facts ¶ 5; Dkt. No. 59-2 at 2.) The examining physician noted that there was "no change in [Perez's] Retina," and his left eye was "quiet." (Dkt. No. 59-2 at 2.)

         B. Perez's Appointments with Dr. Fahy

         Dr. Fahy first saw Perez on December 2, 2016 for a general eye checkup. (Defs.' Facts ¶ 22; Fahy Dep. at 13.) Dr. Fahy did not review Perez's medical records before the checkup. (Fahy Dep. at 11.) Dr. Fahy observed that Perez had irritated eyelids and mucus discharge from both eyes, and diagnosed him with "atopic conjunctivitis," for which he proscribed anti-inflammatory eyedrops. (Defs.' Facts ¶ 22; Perez's Med. Recs. (Dkt. No. 57) at 64.) Dr. Fahy also ordered Perez glasses and told him to follow up in a week. (Defs.' Facts ¶ 22.)

         At Perez's follow-up appointment on December 12, 2016, Dr. Fahy diagnosed Perez with CSR in his left eye and referred him to an ophthalmologist. (Defs.' Facts ¶¶ 23-24, 51; Med. Recs. at 62.) Dr. Fahy testified that as an optometrist, his only treatment option when presented with CSR is to refer the patient to a specialist. (Fahy Dep. at 22; Defs.' Facts ¶ 52.) He also testified that he has previously encountered two patients with CSR and that he referred them both to an ophthalmologist. (Fahy Dep. at 9.)

         Wexford utilizes a review process when patients are referred for offsite treatment or to a specialist. (Defs.' Facts ¶ 18-19.) Referrals are reviewed by the "Wexford Collegial Review Board" ("Review Board") that consists of physicians and nurses who determine whether recommended treatments should be approved. (Id.) In December 2016, the Review Board approved Dr. Fahy's referral to an ophthalmologist and Perez was eventually scheduled for an appointment at the University of Illinois at Chicago's ("UIC") Ophthalmology clinic. (Id. ¶ 26.)

         C. Perez's Ophthalmology Appointment and Dr. Fahy Follow Up

         Perez was seen at UIC on May 11, 2017, approximately five months after Perez's appointment was approved. (Id. ¶ 28.) It is unclear why there was such a long delay, but it is undisputed that Dr. Fahy does not have control over UIC's scheduling processes. (Pl.'s Resp. to Defs.' Facts (Dkt. No. 59) ¶ 53.) The ophthalmologist that examined Perez did not diagnose him with CSR. (Defs.' Facts ¶ 28; Med. Recs. at 62.) Rather, the UIC ophthalmologist diagnosed Perez with "myopia astigmatism" (nearsightedness), recommended that he wear his glasses full time, and instructed him to follow up in a year. (Defs.' Facts ¶¶ 28-29.)

         Dr. Fahy saw Perez less than a week later and observed that the fluid in Perez's eyes were receding and his vision was improving, but Perez still had CSR. (Id. ¶ 31.) Dr. Fahy instructed Perez to follow up in three months or as needed if his vision worsened. (Id.) Dr. Fahy saw Perez again four months later. (Id. ¶ 32.) At the appointment, Perez complained that the vision in his left eye was reduced and that he had lost contrast sensitivity. (Id.) Dr. Fahy thereafter referred Perez to another specialist, however, instead of referring Perez to an ophthalmologist, he referred him to a retina specialist. (Id. ¶¶ 32-33.) A retina specialist is a tertiary care eye physician that is more highly specialized than an ophthalmologist. (Id. ¶ 51.)

         D. Perez's Retina Specialist Appointment and Dr. Fahy Follow Up

         On March 6, 2018, Perez was seen by a retina specialist, Dr. William F. Mieler. (Id. ¶ 35.) Dr. Mieler diagnosed Perez with CSR and recommended he be treated with photodynamic therapy ("PDT"). (Id. ¶¶ 35-36.) But the Review Board did not approve Dr. Mieler's recommendation for Perez to receive PDT. (Id. ¶ 39; Med. Recs. at 43.) Rather, it determined that Perez's diagnosis should be confirmed and that it needed "written confirmation" from UIC's Retina Clinic that PDT was an "FDA approved treatment for CSR." (Med. Recs. at 43; Defs.' Facts ¶ 39.) While the Review Board waited for confirmation, Dr. Fahy saw Perez again and noted that Perez's vision was still blurry and he was experiencing light sensitivity for which Dr. Fahy ordered Perez tint for his glasses. (Defs.' Facts ¶ 40; Med. Recs. at 105.) Not long thereafter, a Wexford physician affirmed the Review Board's denial. (Defs.' Facts ¶ 42.) That Wexford ...


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