United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
Tharp, Jr., United States District Judge
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. 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.
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.
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. Plaintiff's
Statement of Facts (“PSOF”) ¶ 8.
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.
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.
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.
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. ¶
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. ¶¶
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.
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.
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. 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
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. ¶ 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