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Aldridge v. Wexford Health Sources, Inc.

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

December 3, 2019

WEXFORD HEALTH SOURCES, INC., GHALIAH OBAISI, as Independent Administrator of the Estate of SALEH OBAISI, M.D., Deceased, and LATONYA WILLIAMS, Defendants.


          John Tharp, Jr., United States District Judge

         The plaintiff in this case, Charles Aldridge, is incarcerated at Stateville Correctional Center in Crest Hill, Illinois. He experienced severe pain in his hips for several years and was diagnosed with osteoarthritis, or degenerative joint disease. Mr. Aldridge brings this case under 42 U.S.C. § 1983, alleging deliberate indifference to his medical needs on the part of Physician's Assistant LaTonya Williams and Dr. Saleh Obaisi, and an unconstitutional policy, custom, or practice as to Wexford Health Sources, the vendor under contract to provide medical care for the Illinois Department of Corrections. The defendants have filed a motion for summary judgment.[1] Because the undisputed record shows that the defendants provided an appropriate course of treatment for Mr. Aldridge's osteoarthritis, culminating in hip replacement surgery, the defendants' motion for summary judgment is granted.


         Mr. Aldridge, who is now 56 years old, was convicted of murder and sentenced to life without parole in 1994. He has been incarcerated at Stateville since 2009. On November 28, 2012, Mr. Aldridge saw Physician's Assistant Williams and complained of pain in his hips and other joints. Defendants' Statement of Facts (“DSOF”) ¶ 17. P.A. Williams did not find any deformities, swelling, or other positive findings in examining Mr. Aldridge's hips. Id. ¶ 18. She prescribed Motrin, an analgesic balm, and x-rays of Mr. Aldridge's shoulders and lumbar spine. Id. ¶ 19. P.A. Williams referred Mr. Aldridge to Dr. Obaisi, the Medical Director at Stateville, and on January 31, 2013, Dr. Obaisi saw Mr. Aldridge and prescribed Mobic, a non-steroidal anti-inflammatory medication that “helps to alleviate inflammation and pain in a patient's joints.” Id. ¶ 21.

         Mr. Aldridge saw P.A. Williams a few weeks later, on February 26, 2013, after he injured his ankle while playing basketball. Id. ¶ 23. Mr. Aldridge saw P.A. Williams again on July 24, 2013, stating that he had pain in both hips that had been getting worse over the last six months. Id. ¶ 25. The Mobic that Dr. Obaisi prescribed “had helped him some, ” he said, but Tylenol and the analgesic balm had not. Id. P.A. Williams ordered a series of tests to try to rule out different types of arthritis and determine if Mr. Aldridge had osteoarthritis, including bilateral hip x-rays, and ordered Mobic for three more months. Id. The radiologist who examined the x-rays found that they indicated degenerative joint disease, or osteoarthritis of the hips. Id. ¶ 26. Mr. Aldridge alleges, and the defendants dispute, that the radiologist included a notation “? Candidate for hip replacement” on Mr. Aldridge's chart.[2] Plaintiff's Statement of Facts (“PSOF”) ¶ 8.

         P.A. Williams saw Mr. Aldridge for a follow-up appointment three weeks later, on August 14, 2013. DSOF ¶ 27. The Mobic appeared to be helping his pain, and P.A. Williams ordered physical therapy, educated Mr. Aldridge about his medical condition, and ordered a Vitamin D level blood test “to check for any issues with Plaintiff's bones”; that test returned a normal result. Id. ¶ 28. At this point, P.A. Williams believed “there was nothing more she could do as a provider” and referred Mr. Aldridge to Dr. Obaisi. Id. ¶ 29.

         Over the next few months, Mr. Aldridge had several appointments with Dr. Obaisi canceled due to prison lockdowns, and once because Dr. Obaisi was not present on-site. Id. ¶¶ 30-33. Mr. Aldridge saw Dr. Obaisi on February 4, 2014. Dr. Obaisi examined his hip and found that Mr. Aldridge had no acute symptoms. Id. ¶ 34. Dr. Obaisi ordered new x-rays, continued Mr. Aldridge's pain reliever Mobic, and referred him to an orthopedic specialist at UIC. Id. ¶ 35.

         On April 9, 2014, Mr. Aldridge was evaluated at UIC. The nurse noted that he “had a steady gait, meaning he was walking without difficulty or falling over.” Id. ¶ 37. Dr. Gonzalez, an orthopedic surgeon at UIC, examined Mr. Aldridge and found that his hip pain “had an insidious atraumatic onset, meaning there was no inciting event which caused it” and that Mr. Aldridge was in no acute distress, though he reported difficulty sitting for long periods of time, moving, jogging, or running. Id. ¶¶ 39-40. Dr. Gonzalez recommended physical therapy and continued use of Mobic, to be escalated to steroid hip injections and then to hip replacement if this conservative course of treatment proved unsuccessful. Id. ¶ 40.

         Dr. Obaisi saw Mr. Aldridge for a medical writ follow-up on April 14, 2014, noted that his objective condition had not changed, and gave him a permit for a double mattress. Id. ¶ 41. The next week, Dr. Obaisi conducted collegial review for Mr. Aldridge to return to UIC's orthopedic clinic for a follow-up visit that UIC had recommended, which was approved. Id. ¶ 42; Obaisi Dep. 136:6-11, ECF No. 59-3. At a nurse sick call on June 27, 2014, Mr. Aldridge was told that he had an upcoming appointment with an orthopedic surgeon at UIC. DSOF ¶ 43. At this appointment, Mr. Aldridge's “gait was steady, indicating that he was not falling over or limping.” Id. Mr. Aldridge's next appointment with Dr. Obaisi, in September, was canceled due to a prison lockdown and rescheduled for the following week. Id. ¶ 44.

         On September 29, 2014, Mr. Aldridge returned to UIC and additional x-rays were taken. Id. ¶ 45. At an appointment with P.A. Williams on November 10, 2014 for complaints regarding hearing loss, Mr. Aldridge said that he had not had a follow-up on his x-rays, and P.A. Williams referred him to Dr. Obaisi, whom he saw on November 17. Id. ¶¶ 46-47. Dr. Obaisi gave an order for Mr. Aldridge to undergo physical therapy, which he began in January 2015. Id. ¶¶ 48-49. While Mr. Aldridge initially reported some improvement in his hips with physical therapy, he still had some pain and ultimately the physical therapy was unsuccessful. Id. ¶¶ 49-50.

         Dr. Obaisi saw Mr. Aldridge again on March 10, 2015, again with no acute findings. Dr. Obaisi changed Mr. Aldridge's pain medication to Naproxen and planned to send him back to UIC. Id. ¶¶ 50-51. In light of the ineffectiveness of physical therapy, though Mr. Aldridge's hip condition had not changed from the prior UIC visit, on May 6, 2015 Dr. Gonzalez ordered that he receive steroid injections in his hips. These injections can relieve pain for six to eight months. Id. ¶¶ 51-52. Dr. Gonzalez expressed a preference for trying conservative treatment before hip replacement surgery, which can result in a variety of complications. Id. ¶ 53. Dr. Obaisi saw Mr.

         Aldridge for a medical writ follow-up on May 11, 2015 and noted that he had received an order for steroid injections at UIC. Id. ¶ 54. In May and June 2015, Mr. Aldridge submitted two grievances requesting that he be referred for hip replacement surgery. PSOF ¶¶ 10, 12 (“Relief Requested: THAT I BE SENT TO SPECIALIST TO HAVE HIP REPLACEMENT SURGERY.”) Mr. Aldridge based his grievances on what he terms the radiologist's “recommendation” that he receive hip replacement surgery. Id. ¶ 10. Both grievances were denied on the grounds that they were appropriately addressed by the facility administration, further noting that ordering treatment or medication must be done by the attending physician. Id. ¶¶ 11-12.

         Mr. Aldridge returned to UIC on September 2, 2015, to see Dr. Malik, an anesthesiologist and medical director of the pain management service at UIC. DSOF ¶ 56. Mr. Aldridge was ambulating without assistance and told Dr. Malik that the pain medication he was then taking, Indomethacin, was helping to control his hip pain. Dr. Malik diagnosed Mr. Aldridge as having osteoarthritis of the hips and ordered steroid injections; Dr. Obaisi held a collegial review and obtained approval on or about September 15. Id. ¶ 57. Mr. Aldridge saw P.A. Williams on September 22, 2015 to obtain a refill of his pain medications and to ask about whether his appointment at the pain clinic had been scheduled.[3] Id. ¶ 59. P.A. Williams noted at that appointment that he had already been approved to return to the pain clinic, and Mr. Aldridge had the steroid injections at UIC on October 7, 2015. Id. ¶¶ 60-61. Dr. Obaisi saw him for a follow-up on October 19, and the next day obtained approval to send him to an orthopedic surgeon at UIC for further follow-up with respect to the steroid injections. Id. ¶¶ 62-63. Dr. Obaisi saw Mr. Aldridge again, after his UIC appointment, on November 25, 2015, and adjusted his pain medication.

         Dr. Obaisi next saw Mr. Aldridge again on April 19, 2016. Mr. Aldridge's condition had not changed, but he was concerned about when he would return to UIC for additional steroid injections. Mr. Aldridge returned to UIC on April 28, 2016 and reported to Dr. Malik that he had good pain relief from the injections for a few months and wanted to repeat them. Id. ΒΆ 66. Dr. Obaisi saw Mr. Aldridge for a follow-up that same day and noted that he had been referred by the pain clinic to UIC's orthopedic clinic for ...

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