United States District Court, D. Maryland
RICHARD D. BENNETT UNITED STATES DISTRICT JUDGE.
Joseph Gottleib is an inmate at the Baltimore County
Detention Center ("BCDC"). On January 7, 2016, he
filed this Complaint pursuant to 42 U.S.C. §1983 against
BCDC and "Medical Staff, " presenting claims arising
from the treatment he received for an infection in his
scrotum. (ECF 1). On January 28, 2016, Gottleib filed a
Supplement to the Complaint to name Deborah Richardson,
Thomas Fitzgerald, Robert Airey, Nurse Peal, Nurse Zeiders
and Dr. El- Bedawi as Defendants. (ECF 5). Gottleib seeks
damages of $5 million dollars and his immediate release from
are two separate Motions to Dismiss, or in the Alternative,
for Summary Judgment (ECF 16, 21). The first was filed by
counsel on behalf of Deborah Richardson, Director of BCDC,
Thomas Fitzgerald, Deputy Director of BCDC, and Captain
Robert Airey (collectively the "BCDC Defendants").
(ECF 16). The second Motion was filed by counsel on behalf of
Defendants Peal, Zeiders, and El-Bedawi (collectively the
"Medical Defendants").(ECF 21). Consonant with
Roseboro v. Garrison, 528 F.2d 309 (4th Cir. 1975),
the Clerk sent notice to Gottleib informing him of his right
to file Responses to Defendants' dispositive motions and
to file affidavits and exhibits in support. (ECF 17, 22).
Gottleib filed Opposition Responses to both dispositive
motions, although he filed no declarations. (ECF 18, 23). The
BCDC and Medical Defendants then filed separate Replies. (ECF
24, 25). Gottleib then filed an "addendum"
Response. (ECF 26). Also pending is Gottleib's Motion for
Appointment of Counsel. (ECF 19).
issues have been briefed, the matter is ripe for disposition
and no hearing is required, see Local Rule 105.6 (D.
Md, 2016). Gottleib has adequately presented his claims and
no extraordinary reasons are presented to warrant appointment
of counsel. For reasons explained below, this Court will
GRANT BOTH MOTIONS TO DISMISS (ECF 16, 21), and DISMISS WITH
PREJUDICE the claims against the BCDC Defendants and GRANT
summary judgment in favor of the Medical Defendants.
alleges that Defendants failed to respond adequately to his
medical complaints of a painful and swollen scrotum. Although
Gottleib does not specify what constitutional provision has
been abridged, Defendants assume he is alleging an Eighth
Amendment claim alleging deliberate indifference to a serious
medical need. (ECF 16-1 at 3; ECF 21-1). At the time Gottleib
alleges the violations occurred, he was a convicted prisoner,
serving a sixteen month sentence imposed on October 7, 2015.
following facts are not in dispute unless noted. On or about
November 20, 2015,  at 9:00 am, Gottleib noticed his scrotum
was painful and swollen "to the size of a
grapefruit." (ECF 1 at 4). He informed an unnamed BCDC
correctional officer that he needed to be seen by a medical
provider. Gottleib told the officer it was an emergency.
Id. Gottleib asked unidentified officers again at
11:30 am and 3:30 pm to see a medical provider. Gottleib
asserts when he asked at 11:30 am for a medical escort, the
officer commented that Gottleib did not "look so
good." (ECF 1 at 4). Meals were served and correctional
officers changed shifts during this time.
was escorted to the medical unit that evening, complaining of
scrotal swelling and tenderness, fever, and chills. Gottleib
informed the nurse that he had noticed a boil in his perineum
area the evening before and "popped it."
(Declarations of Bonita Cosgrove, BCDC Medical Liaison ECF
16-2.¶ 2; ECF 24-2 ¶3). Defendants indicate Gottleib
was treated by Nurse Practitioner Okoye for an indurated boil
and fever. ECF 16-2 ¶3; ECF 24-1 ¶3. She diagnosed
Gottleib with cellulitis, a common skin infection caused by
bacteria. She prescribed Tylenol 650 mg to reduce
the fever, an oral antibiotic (Bactrim) for ten days for the
infection, and warm compresses twice a day to open the boil.
She instructed Gottleib to return to the medical unit in
three days for further evaluation. (ECF 1 at 5, ECF 16-2
¶¶ 2, 3; ECF 24-1 ¶ 3). The parties dispute
the identity of the treating medical provider. The BCDC
Defendants assert Nurse Practitioner Okoye attended to
Gottleib. (ECF 24-1 ¶3). Gottleib claims Memmie Peal
examined and treated him. (ECF 23).
following day, November 21, 2015, Gottleib continued the
prescribed oral antibiotics, but his fever, chills, and
scrotal swelling persisted. ECF 1 at 6. At 3:00 pm, he asked
to be seen in the medical unit.
was seen by a nurse in the BCDC medical unit at 8 pm. She
noted the hardened boil and swelling of the penis and
scrotum. Because Gottleib has a history of
vasculitis and his medication regimen included
Prednisone for reducing inflammation, a determination was
made to send him on a non-emergency basis to St. Joseph's
Hospital Medical Center for evaluation. (ECF 16-2; ECF-21-2;
ECF-24 n. 1). There, Gottleib was treated with intravenous
antibiotics and hospitalized overnight. (ECF 1 at 7). A CT
scan showed extensive cellulitis but no necrosis. (ECF 21-2
November 22, 2015, Gottleib was admitted to the University of
Maryland Medical Center ("UMMC"). Id. at
7; ECF 16-3 at 1. Gottleib reported to 'UMMC medical
staff that "[f]ive days ago, he attempted to pop a boil
which had developed in his posterior perineum. Two days
later, his scrotum became enlarged, red, and tender with
tenderness and pain extending posterior along the
perineum." (ECF 21-2). Gottleib was diagnosed with a
left sided perineal Fournier Gangrene perineum or necrotizing
fasciitis of the scrotum. Id; see also ECF 16-3 at
3. The same day he underwent a surgical procedure to debride
his perineum and scrotal areas. (ECF 21 -2 at 7). Further, he
was treated with a broad spectrum of antibiotics.
Id. The infection proved persistent and another
surgical procedure was performed on November 26, 2015.
Id. at 9. Gottleib was hospitalized at UMMC for ten
days and, according to Gottleib, he underwent three surgical
procedures. ECF 1 at 7. The record, however, shows two
procedures were performed. (ECF 21-2).
claims that had he been taken for medical treatment
immediately after his initial request at and his situation
been "taken seriously" at BCDC he would
"probably still have my scrotum." Id. at
10. He states he lost approximately one-third of his scrotum
as a result of the surgeries and his scrotum is numb and
disfigured. (ECF 1 at 7, 10). He also claims his penis is
numb. He expresses concern that "[t]his is going to have
a negative effect on my sex life for the remainder of my
life." Id. at 10.
returned to BCDC on December 1, 2015, where he was placed in
the medical isolation unit. UMMC medical staff prescribed
antibiotics and pain medications for Gottleib. He also had a
Jackson-Pratt (JP) drain in place at the surgery site which
needed to be emptied every eight hours. A silver dressing
covering the affected area needed to be kept in place for
seven days unless it became soiled, (ECF 16-2 ¶ 7; ECF
21-2 at 2, 3; ECF 24-1 ¶ 11). Gottleib was monitored by
BCDC medical staff who noted his condition continued
improving; he had no infection and his pain was lessening,
(ECF 16-2 ¶ 8). BCDC nursing staff on every shift noted
that Gottleib's drain was checked and drainage amounts,
if any, were recorded. The dressing was reported dry. On
December 3, 2015, reinforcement tape was applied. (ECF 24-1
¶ 11). On December 6, 2015, a clean dressing was
applied. The medical note read: "[D]ressings were
soiled, so they were changed. There was not fluid to empty
from the JP drain. Drain was intact and squeezed to promote
suction." Id. The dressings were changed again
on December 7 and December 8, 2015, after medical providers
examined the wound site for healing and sutures. Id.
Gottleib complains the isolation unit was an unsanitary
environment for a post-surgical patient with a drain and
stitches. He describes the unit as "filthy' and
without a working toilet. Gottleib had to use a toilet down
the hall. Id. at 8.
December 9, 2015, Gottleib was returned to UMMC for
follow-up. UMMC medical staff removed the JP drain and his
external stitches. (ECF 24-3; ECF 1 at 8). Gottleib's
UMMC medical record reports the left and right scrotal
closures healed well. (ECF 24-3 at 1). No further follow-up
was required. Id. at 2.
December 11, 2015, Gottleib was assigned to a BCDC medical
ward. (ECF-1 at 8). Gottleib also describes the medical ward
as unsanitary but provides no supporting factual allegations.
December 22, 2015, Nurse Practitioner Zeiders examined
Gottleib after he submitted a sick call request complaining
of drainage at the surgical area. (ECF 24-1 ¶ 6).
Zeiders observed a small amount of yellow drainage and no
swelling around the wound. He concluded the site was healing
and was not infected. Zeiders was unable to see, but felt a
suture in the left scrotum. Zeiders cleansed the wound in the
left pubis area with saline, covered the wound with a band
aid, prescribed Tylenol 650 mg. for five days, and referred
Gottleib to Dr. El Bedawi for removal of the suture. (ECF
24-1 ¶ 7). The stitches removed at BCDC were absorbable
internal stitches because Gottleib's external stitches
had already been removed at UMMC. Id.
December 24, 2015, Gottleib reported his scrotum was sore and
there was leakage at the surgical site. (ECF 1 at 9). The
BCDC Defendants indicate Gottleib filed a sick call slip
early in the morning on December 25, 2015. He was called to
the medical unit on December 26, 2015 at 6:35 am. (ECF 24-1
¶ 8). He refused to be seen or to sign a refusal of
treatment form. Id.
December 27, 2015, Gottleib went to the BCDC medical unit and
Nurse Practitioner Levy-Still removed several stitches that
were irritating his skin. Levy-Still prescribed an antibiotic
(amoxicillin) and an anti-inflammatory medication for
Gottleib. ECF 16-2 ¶ 11; ECF 24-1 ¶ 9. The medical
notes from that visit read:
Inmate came to medical with c/o drainage and blood from
scrotum and possibly stitches left in groin from surgery
secondary to Fournier Gangrene. Upon further examination, I
noted three deep stitches that were probably supposed to be
absorbable stitches but were very hard and rigid to touch.
Inmate had purulent drainage from the sutured site and a
macular, popular rash in the groin and scrotum area. Because
the site was healing nicely, I clipped the 3 very tight
sutures because they were actually digging into his skin and
24-1 ¶ 9.
complains received all three doses of antibiotic medication
within a six to eight hour period instead of the ...