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Almond v. Wexford Health Source, Inc.

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

January 9, 2020

CHARLES ALMOND, Plaintiff,
v.
WEXFORD HEALTH SOURCE, INC., a Pennsylvania Corporation, JILL WAHL, M.D., BESSIE DOMINGUEZ, M.D. HECTOR GARCIA, M.D., DONALD ENLOE, and ASSISTANT WARDEN FASANO, Defendants.

          MEMORANDUM OPINION AND ORDER

          REBECCA R. PALLMEYER, UNITED STATES DISTRICT JUDGE

         Plaintiff Charles Almond, a prisoner in the custody of the Illinois Department of Corrections, suffered a serious knee injury in 2013, while Almond was incarcerated at the Dixon Correctional Center ("DCC"). The injury went undiagnosed for some time, and after nearly two years, Mr. Almond underwent surgery to repair his knee. On November 20, 2015, Almond filed this action against Wexford Health Services, a private firm that provides health care services to inmates at DCC, and against three physicians-Dr. Dominguez, Dr. Wahl, and Dr. Garcia- alleging that the 22-month delay in treatment violated his Eighth Amendment rights. He also asserts a state law claim of medical malpractice. Defendants move for summary judgment in their favor on all of Almond's claims. For the reasons stated here, the motion is granted in part and denied in part.

         BACKGROUND

         Although represented by counsel, Plaintiff did not comply fully with the Local Rules direction that he provide a concise response to the movant's statement of undisputed facts. N.D.Ill. R. 56.1(b)(3). Instead, Plaintiff submitted his own statement of facts, which contradicts that of Defendants in many respects. The parties' competing statements support the following account.

         The injury that gave rise to this suit occurred on May 16, 2013, when Mr. Almond tripped and fell while running in the prison yard. (DSUF ¶ 6; PSUF ¶ 2.) Mr. Almond walked back to his cell where he remained for the rest of the day. (DSUF ¶ 6-7; PSUF ¶ 2-3.) The next day, Mr. Almond reported to his job in the kitchen, but complained of knee pain and was sent to the healthcare unit, where he was seen by a nurse who gave him an ACE bandage, pain medication (Tylenol or Motrin), and crutches that, according to Plaintiff, lacked any cushions. (DSUF ¶ 8; PSUF ¶ 4.)

         On May 18, Mr. Almond returned to the healthcare unit, where a nurse gave him a "lay-in" order, allowing Almond to remain in his housing unit, and prescribed Motrin for his knee pain. (DSUF ¶ 10; PSUF ¶ 4.) On May 21, Mrs. Colgan-Valdez, a Physician's Assistant (P.A.) at DCC, examined Plaintiff's knee, performing Thrower and Lachman's tests to check for knee ligament damage[1]; she concluded that neither test revealed knee ligament damage. (DSUF ¶ 11.) Neither the Thrower nor Lachman exams test for a quadricep tendon injury. (Dominguez Dep. 45:1-46:19, Nov. 7, 2018, [149-3].) P.A. Valdez ordered Motrin, and an Ace bandage, but discontinued the authorization for the use of crutches. (DSUF ¶ 12.) An x-ray taken the following day showed that revealed only “mild osteoarthritis and mild effusion” in Almond's knee, similar to normal wear and tear on joints. (DSUF ¶ 13, 18; Dominguez Dep. 42:11-23.) On May 31, Almond returned to the healthcare unit and was again examined by P.A. Valdez. (DSUF ¶ 14; PSUF ¶ 6.) The parties disagree on whether there was any improvement in Almond's knee at this point, but P.A. Valdez prescribed Naproxen and Motrin. (DSUF ¶ 14; PSUF ¶ 6.)

         Plaintiff continued to complain about his knee and request to see a doctor. On June 21, Almond was seen for the first time by Dr. Bessie Dominguez, a physician employed by Wexford Health Services, Inc.[2] (Wexford) and working at the DCC. (DSUF ¶ 3, 15-18; PSUF ¶ 8.) Dr. Dominguez noted swelling and a decreased range of motion in Plaintiff's knee, but she did not find any knots or hollowness above the knee (the typical signs of a quadricep tendon rupture). (DSUF ¶ 17.) She again prescribed Naproxen and Motrin and gave Almond a low bunk permit. (DSUF ¶ 15-18; PSUF ¶ 8; Dominguez Dep. 110:21-111:3.) Still experiencing pain in his right knee, Mr. Almond returned to the healthcare unit on July 15 and again saw Dr. Dominguez. (DSUF ¶ 20-22; PSUF ¶ 9-11.) Almond did not appear to be limping, and Dr. Dominguez again did not find knots or hollowness about the knee, but she noted that the knee was still swollen, and prescribed Prednisone and Motrin. (DSUF ¶ 20, 22.)

         One month later, on August 15, Almond saw Dr. Dominguez for a third time, still complaining of pain in his knee. (DSUF ¶ 23-27; PSUF ¶ 12.) Dr. Dominguez was concerned about the continued swelling of the knee but did not suspect a tear in his quadricep tendon; rather, based on the prior x-ray and the chronic condition of the injury, she diagnosed Almond as suffering from right knee osteoarthritis with mild effusion. She prescribed Naprosyn and extended Mr. Almond's low bunk permit for an additional six months. (DSUF ¶ 24-26.)

         Dr. Dominguez next saw Mr. Almond on August 28, when Plaintiff reported to the healthcare clinic after he discovered a "knot" or "lump" above his right knee. (DSUF ¶ 28-30; PSUF ¶ 13.) Dr. Dominguez examined the knee, and for the first time noted a "hollow area" above Plaintiff's right knee, leading the doctor to suspect, for the first time, that Mr. Almond may have ruptured his tendon. (DSUF ¶ 29; PSUF ¶ 13.) Wexford Health Sources, Inc. has a policy that, for non-emergency situations, a physician seeking to refer a prisoner for treatment off-site must first request a “collegial review, ” in which the Wexford utilization review management doctor confers with the local medical director at the prison (in this case, Dr. Jill Wahl) to assess whether an off-site referral is warranted. (DSUF ¶ 39; PSUF ¶ 14.) Consistent with that policy, Dr. Dominguez requested a collegial review of her proposal that Plaintiff receive an off-site MRI and examination by an orthopedic specialist at the University of Illinois Chicago (“UIC”) Hospital. (DSUF ¶ 30; PSUF ¶ 13.) Dr. Dominguez also ordered another x-ray of the knee and instructed Mr. Almond to apply an Ace bandage. (DSUF ¶ 30.)

         On September 6, Dr. Dominguez saw Mr. Almond for a follow-up on his x-ray. (DSUF ¶ 31-33.) Dr. Dominguez noted in Mr. Almond's medical file that the mass above his knee appeared "much improved." (DSUF ¶ 32). She prescribed additional anti-inflammatory medication and a muscle relaxant and advised Mr. Almond that the request for an off-site visit had been submitted. (DSUF ¶ 33.) In response to Dr. Dominguez's request for a collegial review, on September 12, Dr. Wahl, the local medical director at DCC, examined Mr. Almond. (DSUF ¶ 34-37; PSUF ¶ 14.) Dr. Wahl observed an indentation, or a dip, above Plaintiff's right knee and suspected a torn quadricep tendon. (DSUF ¶ 36-37; PSUF ¶ 14.) Two weeks later, on September 25, Dr. Wahl held a collegial review with Dr. Garcia, a doctor from Wexford's utilization review management department. (DSUF ¶ 40-41; PSUF ¶ 15-16.) Both parties agree that on September 25, Dr. Garcia had not personally examined Mr. Almond and was not informed of the suspected quadricep tear. (DSUF ¶ 38, 40; PSUF ¶ 15-16.) Dr. Garcia denied the request for an MRI and orthopedic exam, choosing instead to focus on treatment that was available on-site. (DSUF ¶ 40-41; PSUF ¶ 15.)

         On October 15, Dr. Wahl saw Mr. Almond and advised him that the request for an MRI and off-site visit was denied but that she planned to appeal that decision and also to request an ultrasound. (DSUF ¶ 42; PSUF ¶ 17.) Dr. Wahl also directed that Plaintiff undergo physical therapy. (DSUF ¶ 43.) The next day, October 16, Dr. Wahl and Dr. Garcia conducted another collegial review, this time a phone conference to review Dr. Wahl's request for an MRI or ultrasound of the knee. (DSUF ¶ 44; PSUF ¶ 17.) Dr. Garcia agreed that further testing was appropriate, and approved the request for an ultrasound, which could be done on-site. (DSUF ¶ 44; PSUF ¶ 17.) A month later, on November 13, Mr. Almond underwent an on-site ultrasound, which showed a possible tendon tear of Almond's right quadricep. (DSUF ¶ 46; PSUF ¶ 18.) Based on this test, on November 27, Dr. Wahl appealed the September 25 denial of the request for an off-site MRI and orthopedic examination. (DSUF ¶ 48; PSUF ¶ 18.) Dr. Neil Fisher, a Wexford physician, reviewed the appeal and approved the request for an off-site MRI and orthopedic consult at UIC. (DSUF ¶ 48; PSUF ¶ 18.) Once an off-site referral is granted, the off-site facility handles scheduling; Defendants assert, and Plaintiff does not challenge, that Wexford employees have no control over the off-site MRI scheduling. (DSUF ¶ 50-51.)

         On March 7, 2014, nearly five months after the request was approved, Dr. Amir El Shami, an orthopedic specialist at UIC, examined Mr. Almond's knee. (DSUF ¶ 52-55; PSUF ¶ 19-20.) Dr. El Shami diagnosed a chronic right quadricep tendon rupture, recommended an MRI and surgery by an orthopedic surgeon, and ordered a different knee brace for Mr. Almond. (DSUF ¶ 55; PSUF ¶ 19-20.) Back at the DCC, on March 20, Dr. Wahl saw Mr. Almond for a follow-up after his off-site examination. (DSUF ¶ 56.) Dr. Wahl noted Dr. El Shami's recommendation for an MRI and an orthopedic surgeon consultation, and filed a request for another collegial review to approve that recommendation. (DSUF ¶ 56.) Dr. Fisher approved the request on March 26. (DSUF ¶ 57). After some scheduling delays occasioned by UIC, staff there performed an MRI on May 20; the MRI confirmed Dr. El Shami's assessment of a chronic partial rupture of his right quadricep tendon. (DSUF ¶¶ 58, 60; PSUF ¶ 21.)

         Almond nevertheless received no further treatment until October 7, when he was again taken to UIC to see Dr. El Shami, “by mistake, ” according to the doctor's notes. (DSUF ¶ 62; PSUF ¶ 22.) Dr. El Shami confirmed his initial assessment and again referred Mr. Almond to a surgeon. (DSUF ¶ 62; PSUF ¶ 22.) Finally, on January 22, 2015, Dr. Samuel Chmell, an orthopedic surgeon at UIC, examined Plaintiff's right knee and confirmed the need for reconstructive surgery. (DSUF ¶ 63; PSUF ¶ 24.) On March 3, approximately twenty-two months after the May 16, 2013 injury, Dr. Chmell successfully operated on Plaintiff's right knee and set it in a cast. (DSUF ¶ 64; PSUF ¶ 24.) Almond saw Dr. Chmell for a post operation evaluation on March 9 and then again in June and October. (DSUF ¶ 65-68; PSUF ¶ 25-27.) At some point prior to the October appointment, the cast was removed and Plaintiff began physical therapy. (DSUF ¶ 67.)

         On November 20, 2015, he filed this complaint, alleging that Wexford violated 42 U.S.C. § 1983 by maintaining a policy of deliberate indifference to serious injuries, and that Wexford's physician employees exhibited deliberate indifference towards Plaintiff's knee injury.[3] Plaintiff also brought a claim for medical negligence based on the treatment he received for his knee injury. Defendants Dr. Garcia, Dr. Dominguez, Dr. Wahl, and Wexford now move for summary judgment.

         DISCUSSION

         I. ...


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