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Deblasio v. Baldwin

United States District Court, S.D. Illinois

January 13, 2020



          Nancy J. Rosenstengel Chief U.S. District Judge.

         Pending before the Court is the Report and Recommendation of Magistrate Judge Gilbert C. Sison (Doc. 147), in which he recommends the undersigned grant the motions for summary judgment filed by Defendants Dr. John Coe and Wexford Health Sources, Inc. (“Wexford Defendants”) (Doc. 93) and Defendants John Baldwin, Steven Duncan, Lorie Cunningham, and Nicholas Lamb (“IDOC Defendants”) (Doc. 112). Plaintiff Brian DeBlasio timely filed an objection to the Report and Recommendation (Doc. 150). For the reasons set forth below, the Court adopts Judge Sison's recommendations and grants Defendants' motions.


         Plaintiff Brian DeBlasio filed this lawsuit under 42 U.S.C. § 1983 alleging Defendants violated his constitutional rights as an inmate in the Illinois Department of Corrections (IDOC) housed at Lawrence Correctional Center (Doc. 1). Specifically, DeBlasio claims Defendants were deliberately indifferent to his serious medical needs concerning his “chronic back and abdominal pain, chronic constipation, fractured vertebra and elevated blood pressure, ” in violation of the Eighth Amendment (Id.).

         DeBlasio's claims stem from medical treatment he sought beginning in 2015. In September 2015, DeBlasio saw a physician's assistant, Travis James, who noted that DeBlasio had right testicle pain, flank pain, and a small amount of blood in his urine (Id. at p. 9). James also noted tenderness on the right flank area (Id.). James suspected either epididymitis, which is inflammation of part of the testicle, or a kidney stone (Id.). On September 17, 2015, James saw DeBlasio for a follow-up exam and noted DeBlasio reported significant right flank pain and sharp pain in the inguinal area (Id. at p. 11). James ordered an x-ray of DeBlasio's abdomen and the pain medication Toradol (Id.).

         On September 21, 2015, James reviewed the results of the x-ray with DeBlasio and charted “noticed issue w/vertebrae.” (Id. at p. 16). DeBlasio testified that James looked at the x-ray for kidney stones, but did not see any. When James looked higher on the x-ray, DeBlasio testified, James told him to sit down and asked if he had been injured because there was a problem with his vertebrae (Doc. 113-2 at p. 9). DeBlasio could not recall any injuries to his back (Id.). James ordered Motrin 800 mg, a back support, a low bunk and low gallery permit, and a follow-up in two weeks (Id.; Doc. 119-1 at p. 56). DeBlasio alleges “on information and belief” that he may have a fracture in his back due to James's reaction to his x-ray (Doc. 113-2 at pp. 8-9). James is not an x-ray technician, however, and he did not diagnose DeBlasio with a fracture in his vertebrae (Doc. 113-2 at pp. 8-9; Doc. 113-3).

         On October 5, 2015, Dr. John Coe, the Medical Director at Lawrence, examined DeBlasio for his complaints of testicular and abdominal pain (Doc. 94-8 at p. 2). His blood pressure at this visit was 140/90 (Doc. 94-4 at p. 18). Dr. Coe examined DeBlasio's back and hips, noting that upon movement his right hip had some limitations and pain (Doc. 94-8 at p. 2). He also examined DeBlasio's testicles and noted that his prostate was tender and swollen. Dr. Coe diagnosed DeBlasio with epididymitis, or inflammation of part of the testicle, which can cause pain in the lower abdomen/pelvic region, pain and tenderness in the testicles, and issues with urination (Id.). Because it can be caused by an infection, Dr. Coe ordered 15 days of the antibiotic Cipro in addition to Tylenol and Bisacodyl, a laxative (Id.). He also ordered an x-ray of DeBlasio's right hip and lumbar spine, as well as a follow-up appointment after the x-ray (Id.).

         On October 14, 2015, Dr. Coe saw DeBlasio to follow up on the lumbar x-ray (Id.). The x-ray showed only mild degenerative disease (Id.; Doc. 94-4 at p. 19). Dr. Coe noted that DeBlasio moved well and was able to get up and down from the table without difficulty (Id.). Dr. Coe also performed neurological testing, which revealed no deficits (Id.). Dr. Coe further noted that DeBlasio was not wearing his back support (Id.). Because mild degeneration is not uncommon and does not require medical intervention, and based on the normal findings from the examination, Dr. Coe found that additional treatment was not required for DeBlasio's low back and hip complaints (Id.).

         Dr. Coe also examined DeBlasio's testicles and found that the epididymis was no longer swollen (Id. at p. 3). He did note, however, a tender, three-millimeter knot on DeBlasio's testicles, as well as tenderness near an old appendectomy scar (Id.). Dr. Coe ordered that DeBlasio remain on the same medication and be scheduled for a follow-up appointment (Id.).

         On October 23, 2015, DeBlasio went to nurse sick call with complaints of abdominal, back, and testicular pain (Doc. 94-4 at pp. 20-22). His blood pressure was 168/98 (Id.). Dr. Coe was contacted and ordered that DeBlasio receive Toradol, a pain and anti-inflammatory medication (Id.).

         Dr. Coe examined DeBlasio on October 26, 2015, noting that bowel sounds were present but not very active and that his abdomen was tender near his gallbladder (Doc. 94-8 at p. 3). DeBlasio's blood pressure on this date was 133/100 (Doc. 94-4 at p. 22). Dr. Coe suspected possible gallstones and requested a gallbladder ultrasound through the Collegial Review process (Doc. 94-8 at p. 3). Collegial Review is a Wexford process by which a case is presented to other physicians to determine what an appropriate treatment plan is for the patient, including whether imagining, specialty evaluation, or testing should be performed (Id.). The gallbladder ultrasound was approved and performed on October 28, 2015 (Id.). The results were normal (Id.).

         Dr. Coe next saw DeBlasio on November 12, 2015 (Id. at p. 4). In addition to discussing the normal ultrasound results, Dr. Coe examined DeBlasio and noted a weakened area near his old appendectomy scar, as well as a weakened internal right inguinal ring that was tender and bulged when DeBlasio coughed (Id.). Dr. Coe attested that he thought DeBlasio may have early signs of a hernia. He also considered whether DeBlasio may have internal scar tissue from his previous appendectomy that could be causing abdominal discomfort (Id.). Because either condition can cause discomfort with constipation, Dr. Coe ordered Fiberlax, Colace (a stool softener), and Milk of Magnesia (a laxative and antacid) (Id.). He also ordered a urinalysis test (Id.). DeBlasio's blood pressure was 146/90 at this visit (Doc. 94-4 at p. 28).

         The urinalysis came back positive for blood, so Dr. Coe ordered another urinalysis that could be sent away for additional testing (Id.). Dr. Coe saw DeBlasio on November 20, 2015, and again noted pain and tenderness near the inguinal area and appendectomy scar (Id. at p. 32). His blood pressure was 155/101 (Id.). Dr. Coe submitted his case to Collegial Review to determine an appropriate treatment plan, and on November 24, 2015, DeBlasio was approved to see an outside urologist (Id. at p. 36).

         Before he could see the urologist, on November 30, 2015, DeBlasio reported to the Healthcare Unit with dizziness, lightheadedness, and a small amount of blood in his spit (Id. at p. 5; Doc. 113-3 at p. 41). DeBlasio was sent to Lawrence County Memorial Hospital for evaluation, but a chest and abdomen x-ray came back unremarkable (Id.). DeBlasio received an IV infusion of Vasotec, a medication that can be used to lower blood pressure (Doc. 113-2 at p. 19).[1] Dr. Andrew West at Lawrence Hospital diagnosed DeBlasio with Irritable Bowel Syndrome (IBS), history of blood in vomit, and right inguinal pain, but he ruled out a right inguinal hernia (Doc. 113-3 at p. 40; Doc. 119-1 at p. 39). Dr. West wrote a prescription for Alosetron, which can be used to treat IBS, [2] and Librium, an anti-anxiety medication (Doc 1-1 at p. 7; Doc. 94-8 at p. 10). Dr. Coe attested that IBS is not a serious medical condition and can be controlled with an appropriate diet, exercise, stress management, sleep, and medication (Doc. 94-8 at p. 5).

         DeBlasio testified that on December 1, 2015, the day after his ER visit, he asked Dr. Coe about getting blood pressure medication, but his blood pressure was normal at that time (Doc. 113-2 at pp. 21-22). DeBlasio further testified that he asked Dr. Coe about his blood pressure numerous times after his ER visit, but he could not provide any specific dates (Doc. 113-2 at p. 22).

         DeBlasio was seen by the urologist, Dr. Gary Reagan, on December 24, 2015 (Id.). Dr. Reagan recommended a cystoscopy, which is a scope of the bladder through the urethra (Id.). Dr. Coe submitted the cystoscopy recommendation to Collegial Review; it was approved on January 5, 2016, and performed on February 9, 2016 (Id. at p. 6). The cystoscopy did not reveal any structures, tumors, lesions, or stones that could account for the blood in DeBlasio's urine (Id.; Doc. 94-5 at p. 38). Furthermore, although Dr. Reagan found DeBlasio had an enlarged external ring, there was no distinct hernia (Id.). Dr. Reagan suggested that DeBlasio only follow up as needed, as routine follow up was not necessary (Id.). Dr. Coe saw DeBlasio on February 11, 2016, as follow up after his procedure, and ordered additional Toradol and Motrin (Doc. 94-8 at p. 6). DeBlasio's blood pressure on this date was 150/104 (Doc. 94-4 at p. 55)

         On February 23, 2016, DeBlasio returned to Dr. Coe for reexamination at the request of the Warden. DeBlasio complained of pain in his right groin, right pelvis, and right scrotum, where he reported increased swelling (Id. at p. 56). Dr. Coe noted mild tenderness in DeBlasio's right testicle and near his appendectomy scar (Id.). He also noted that DeBlasio's right internal ring was tender with roughing and a bulge (Id.). Dr. Coe further examined DeBlasio's prostate and rectum, noting no lesions, no external hemorrhoids, no masses, and no stool present (Id.). He diagnosed DeBlasio with adhesion pain from his appendectomy, pre-hernia pain, mild and recurrent epididymitis, and a history suggestive of symptom magnification (Id. at p. 57). Dr. Coe ordered antibiotics and scheduled a follow up for 10 days (Id. at p. 56).

         On February 25, 2016, Dr. Coe noted that DeBlasio's blood pressure had been high since October 2015 (Id. at p. 58). Dr. Coe ordered that his blood pressure be checked at the next appointment, after the round of antibiotics was over, and to start him on a prescription medication if appropriate (Id.). Dr. Coe attested that one's blood pressure can fluctuate, and medication is not immediately required due to high readings (Doc. 94-8 at p. 5). He further attested that blood pressure should be monitored over time and non-medication approaches can be taken to lower high blood pressure (Id.).

         On March 4, 2016, Dr. Coe examined DeBlasio as a follow up to his February 25 visit. He noted that DeBlasio continued to have pain but did not have a hernia, his testicles were normal and symmetric, and his blood pressure was normal at 118/85 (Doc. 94-4 at p. 59).

         On March 23, 2016, DeBlasio reported to the Healthcare Unit for nausea and vomiting (Id. at p. 60). His abdominal examination was normal, he showed no signs of guarding, tenderness, or distention, and his blood pressure was normal at 128/82 (Id. at pp. 60-61). On April 1, 2016, Dr. Coe saw DeBlasio and examined his abdomen and groin, noting no abnormalities (Id. at p. 62). Dr. Coe ordered Pepcid, Tums, Colace, and Fiberlax to treat DeBlasio's abdominal discomfort (Id.).

         Dr. Coe again saw DeBlasio on April 21, 2016, to address DeBlasio's concern that he had a left side groin hernia (Id. at p. 63). Dr. Coe found no left-sided hernia, not even a bulge (Id.). Dr. Coe went over DeBlasio's prior x-ray and further educated DeBlasio on his right-side pre-hernia that only slightly bulged when he coughed (Id.).

         On May 24, 2016, DeBlasio saw Nurse James regarding an H Pylori (stomach bacteria that can cause abdominal discomfort) test that was negative (Id. at p. 64; Doc. 94-8 at p. 8). DeBlasio reported that he had abdominal pain that got worse when his stomach was full after eating (Id.). James noted that DeBlasio has had multiple tests done for his ...

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