United States District Court, D. Maryland
SHARON BOST, individually and as personal representative of the ESTATE OF FATIMA NEAL, Plaintiff,
WEXFORD HEALTH SOURCES, INC., et al. Defendants.
Lipton Hollander United States District Judge
action arises from the unfortunate death of Fatima Neal
(“Neal” or “Decedent”) in 2012, who
suffered a stroke while she was detained at the Baltimore
City Detention Center (“BCDC”).
First Amended Complaint (ECF 56) (“Amended
Complaint”), plaintiff Sharon Bost, individually as
Neal's mother and as the personal representative of the
Estate of Fatima Neal, filed suit against a host of
defendants: Wexford Health Sources, Inc.
(“Wexford”); the State of Maryland
(“State”); BCDC; medical staff employed by
Wexford, including Anike Ajayi, R.N.; Elizabeth Obadina,
R.N.; Ebre Ohaneje, R.N.; Najma Jamal, R.N.; Karen McNulty,
R.N.; Andrea Wiggins, P.A.; Getachew Afre, M.D.; Jocelyn
El-Sayed, M.D.; Obby Atta, C.R.N.P.; twenty-five unnamed
medical service providers; various BCDC employees, including
Shavella Miles, Carol McKnight, Valerie Alves, Cierra Ladson,
Gwendolyn Oliver, Carolyn Atkins, Rickey Foxwell, Carol
Harmon, and twenty-five unnamed “custody
officers” at BCDC. Id. ¶¶
40-48. I shall refer collectively to the
individual health care providers as the “Medical
Defendants.” And, I shall refer to the BCDC employees
collectively as the “Custody Defendants.”
Amended Complaint, Bost asserted several claims for relief.
The “First Claim for Relief, ” lodged against all
defendants, is brought under 42 U.S.C. § 1983 for the
denial of medical care, in violation of the Eighth and
Fourteenth Amendments. ECF 56, ¶¶ 153-68. The
Second Claim for Relief is brought only against Wexford under
42 U.S.C. § 1983, alleging an unconstitutional policy
and practice of denial of medical care (the
“Monell Claim”). Id.
¶¶ 169-86. The Third Claim for Relief, against all
defendants, alleged a claim under Article 24 of the Maryland
Declaration of Rights. Id. ¶¶ 187-206.
Further, in her fourth claim, Bost alleged a claim against
Wexford and the Medical Defendants for medical malpractice.
Id. ¶¶ 207-17. The fifth claim asserted
negligence against the State, BCDC, and the Custody
Defendants. Id. ¶¶ 218-25. In addition, as
to all defendants, Bost asserted a sixth claim for
intentional infliction of emotional distress (id.
¶¶ 226-37) and a seventh claim for wrongful death.
Id. ¶¶ 238-43.
and the Medical Defendants have filed a joint Motion to
Bifurcate and Stay Discovery as to the Monell Claim.
ECF 130. The motion is supported by a memorandum of law (ECF
130-1, collectively, “Medical Defendants'
Motion”) and seven exhibits. ECF 130-3 through ECF
130-9. Bost opposes the Motion (ECF 134,
“Opposition”), and Wexford and the Medical
Defendants have replied. ECF 149 (“Reply”).
pending is the Motion to Bifurcate and Stay Discovery as to
the Monell Claim, filed by the Custody Defendants.
ECF 135 (“Custody Defendants' Motion”). Bost
opposes the Custody Defendants' Motion (ECF 147) and the
Custody Defendants have replied. ECF 153.
motions are fully briefed and no hearing is necessary to
resolve them. See Local Rule 105.6. For the reasons
that follow, I shall grant the motions.
Factual Background 
relevant time, Neal was “a detainee at BCDC . . .
.” ECF 56, ¶ 20. She was scheduled to be released
on November 5, 2012. Id. ¶ 9.
morning of October 30, 2012, Neal awoke with “an
excruciatingly painful headache and blurred vision.”
Id. ¶ 51. She reported to her
“bunkmates” later that day that her headache was
getting worse and that it was becoming difficult for her to
see or to concentrate. Id. ¶ 52. “She
stayed in bed all day . . . .” Id. ¶ 51.
Bost alleges, on information and belief, that Neal's
headache, loss of vision, and other symptoms were the result
of a stroke. Id. ¶ 53.
October 31, 2012, Neal continued to complain to custody
officers and other detainees of disorientation and a
headache. Id. ¶ 54. However, the BCDC employees
“did not alert any medical personnel . . . .”
early morning hours of November 1, 2012, Neal's bunkmate
“awoke to find Neal stumbling around the room . . .
.” Id. ¶ 55. At that time, Neal
complained that her headache had worsened and that “she
could not see at all.” Id. Neal asked her
bunkmate to call for help. Id. ¶ 56. Before
help arrived, Neal collapsed and broke into a cold sweat.
Id. ¶ 57. “Nurse Rachel” arrived
and saw Neal “sprawled out on the floor . . . .”
Id. ¶ 59. Neal's bunkmate informed Nurse
Rachel that Neal had spent most of the prior 24 hours in bed
due to a severe headache. Id. ¶ 58. The nurse
pulled Neal up and walked her to the infirmary, but did not
call for other medical assistance. Id. ¶ 60;
see also Id. ¶ 61.
medical staff members saw Neal in the infirmary during the
morning of November 1, 2012. Id. ¶¶ 63-78.
Nurse Ajayi, who first saw Neal, recorded that Neal was
“‘ambulatory but weak.'” Id.
¶ 64. She also noted that Neal had a
“‘pounding'” headache and “felt
‘cold.'” However, Ajayi did not contact an
emergency medical provider. Id. ¶ 65.
was then seen by Nurse Obadina, who recorded that Neal had
“‘walked to the infirmary'” and that
she was “‘a bit weak.'” Id.
¶¶ 67-69. Obadina also recorded that Neal
“refused to have her vital signs read.”
Id. ¶ 69. But, plaintiff asserts, on
information and belief, that Neal had not refused to have her
vital signs read. Id. ¶ 70. Rather, Obadina
“simply did not take them.” Id.
was then seen by Physician's Assistant Wiggins.
Id. ¶ 72. However, Wiggins “took no
action to contact emergency medical services . . . .”
approximately 9:53 a.m. on November 1, 2012, Neal was seen by
Dr. Afre, who prescribed Acetaminophen. Id.
¶ 76. Neal remained in the infirmary on November 1,
2012, complaining of a severe headache. Id. ¶
80. But, according to Bost, Neal's condition went
untreated. Id. ¶¶ 76, 78. Neal's
bunkmate in the infirmary twice inquired about Neal's
condition, but her inquiries were “ignored.”
Amended Complaint asserts, on information and belief, that
Neal suffered a second stroke between the night of November
1, 2012 and the morning of November 2, 2012. Id.
¶ 81. Nurse Ohaneje saw Neal in the early morning of
November 2, 2012, and recorded that Neal's condition was
“‘stable.'” Id. ¶ 82.
That observation was allegedly false. Id. ¶ 83.
Obadina also visited Neal in the early morning of November 2,
2012. Id. ¶ 85. She recorded that Neal had
“‘no complaints.'” Id. That
assertion was also allegedly false. Id. ¶ 86.
morning of November 2, 2012, “medical personnel,
custody officers and detainees in the BCDC infirmary began
noticing that Fatima's entire right side of her body
began to slump and that she was dragging her right leg while
walking.” Id. ¶ 88. Fellow inmates
expressed concern about Neal but were told that
“‘nothing was wrong'” with her.
Id. ¶ 89. And, despite requests from inmates,
Obadina and Ohaneje refused to check Neal's vital signs.
Id. ¶ 90.
Afre “visited” Neal on the morning of November 2,
2012, and recorded that she still complained of a severe
headache. Id. ¶ 92. Dr. Afre prescribed Tylenol
with codeine. Id. Neal spent the rest of the day in
bed. Id. ¶ 95.
Jamal visited Neal during the evening of November 2, 2012,
and recorded that Neal was in “‘stable'
condition.” Id. ¶ 96. Nurse Jamal made a
second visit in the early morning hours of November 3, 2012,
and recorded that there was no change in Neal's
condition. Id. ¶ 98. Around that time,
Neal's bunkmates “began to notice that her ribs
were protruding from her chest.” Id. ¶
101. Neal's bunkmates were “particularly troubled
by the fact that Fatima had stopped responding to their
the morning of November 3, 2012, Dr. El-Sayed
“visited” Neal and gave her a dose of Tylenol
with codeine. Id. ¶ 103. Dr. El-Sayed
“took no other actions to provide Fatima relief from
her intense pain.” Id. In the eight hours
following Dr. El-Sayed's visit, Neal received no
additional medical attention. Id. ¶ 110.
experienced severe pain in her head, lapsed in and out of
consciousness, was unable to walk, had involuntary bowel
movements, “and was left to lay in her own
feces.” Id. ¶ 104. According to
plaintiff, Neal was experiencing “multiple
intra-cerebral hemorrhages . . . .” Id.
Neal's bunkmates sat with her for four hours on November
3. Id. ¶ 106. Neal continued to complain of a
severe headache and was unable to move. Id. That
bunkmate “attempted to convince medical staff on duty
that Fatima needed immediate and emergency medical
attention.” Id. A nurse told the fellow inmate
that Neal “was fine, and that she just needed to
eat.” Id. ¶107.
one of Neal's bunkmates “[s]pecifically informed
[a] particular nurse that she believed Fatima was having a
stroke.” Id. ¶ 108. Neal “told [a]
bunkmate that she was going to die if she did not receive
medical treatment.” Id. ¶ 109. During
this time, Neal “lay in her bed in a near vegetative
state, was unable to speak clearly, began making incoherent
and delusional statements and her skin began to feel cold and
clammy.” Id. ¶ 111.
the afternoon of November 3, 2012, Nurse McNulty checked Neal
and recorded that there was “‘no distress
present, '” yet Neal was “‘visually
impaired, '” “‘had trouble ambulating,
'” and complained of a headache with “a
degree of pain” registering ten out of ten.
Id. ¶¶ 112-113. McNulty also recorded that
Neal had a “‘decreased appetite, ' and
experienced ‘lethargy' and
‘weakness.'” Id. ¶ 114.
However, McNulty did not alert a physician. Id.
was next visited by Nurse Jamal during the evening of
November 3, 2012. Id. ¶ 119. Nurse Jamal
provided Neal with Tylenol with codeine and recorded that
Neal “experienced ‘no vision changes or
headaches.'” Id. ¶¶ 120-21. Neal
continued to complain of severe and intense pain.
Id. ¶ 123.
a.m. on November 4, 2012, Neal “violently awoke and
began involuntarily foaming at the mouth.” Id.
¶ 125. At this time, Neal was completely non-responsive.
Id. ¶ 126. Detainees in the infirmary attempted
to alert medical staff, but the nurse on duty, Nurse Obadina,
“was sleeping and could not be woken up . . . .”
Id. ¶ 127. The detainees were able to get the
attention of Officer Ladson, and informed him that Neal was
foaming at the mouth and struggling to breathe. Id.
Ladson contacted Nurse Obadina, who began assessing Neal at
approximately 3:30 a.m, more than one hour after Neal first
began foaming at the mouth. Id. ¶ 129. As a
result of Nurse Obadina's assessment, “a triage
nurse was rushed to Fatima's bedside.” Id.
¶ 130. But, there was no doctor available to respond.
Id. ¶ 131.
triage nurse attached an oxygen mask to Neal's mouth and
attempted to suction the foam out of Neal's mouth.
Id. ¶ 133. Wexford records indicate that, at
that time, Neal had no pulse. Id. ¶ 134.
Medical staff then called emergency services, reporting to
the 9-1-1 dispatcher that Neal was unresponsive. Id.
¶¶ 135, 136.
approximately 3:45 a.m., the medical staff on duty began to
perform CPR and gave an order for Neal to be transported to
the Johns Hopkins Hospital (“Hospital” or
“Johns Hopkins”). Id. ¶ 137-138.
Neal was transported to the Hospital at approximately 4:25
a.m, two hours after the report that she was foaming at the
mouth. Id. ¶ 139.
arrived at the Hospital at 4:31 a.m. on November 4, 2012.
Id. ¶ 143. Although Neal had “displayed
clear symptoms of a stroke” for several days
(id. ¶ 141), the BCDC medical staff on duty
reported that Neal was suffering from
Id. ¶ 140. Seven minutes later, Neal was
pronounced dead by Dr. Latoya Hendricks of Johns Hopkins.
Id. Plaintiff asserts in the Amended Complaint, on
information and belief, that Neal had died at BCDC.
Id. ¶ 144. Neal was scheduled to be released
from BCDC the next day. Id. ¶ 9.
November 4, 2012, Dr. Theodore King, Jr. of Johns Hopkins
conducted an autopsy on Neal. Id. ¶ 147. Dr.
King concluded that Neal had died as a result of an
“intracerebral hemorrhage, ...