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Bost v. Wexford Health Sources, Inc.

United States District Court, D. Maryland

May 8, 2017

SHARON BOST, individually and as personal representative of the ESTATE OF FATIMA NEAL, Plaintiff,
v.
WEXFORD HEALTH SOURCES, INC., et al. Defendants.

          MEMORANDUM OPINION

          Ellen Lipton Hollander United States District Judge

         This 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”).[1]

         In the 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.[2] 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.”

         In the 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.[3] 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.

         Wexford 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”).

         Also 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.

         Both 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.[4]

         I. Factual Background [5]

         At the relevant time, Neal was “a detainee at BCDC . . . .” ECF 56, ¶ 20. She was scheduled to be released on November 5, 2012. Id. ¶ 9.[6]

         On the 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.

         On 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 . . . .” Id.

         In the 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.

         Several 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.

         Neal 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.

         Neal was then seen by Physician's Assistant Wiggins. Id. ¶ 72. However, Wiggins “took no action to contact emergency medical services . . . .” Id.

         At approximately 9:53 a.m. on November 1, 2012, Neal was seen by Dr. Afre, who prescribed Acetaminophen.[7] 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.” Id.

         The 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.

         Nurse 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.

         By the 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.

         Dr. 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.

         Nurse 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 questions.” Id.

         During 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.

         Neal 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.

         One of 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.

         Notably, 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.

         During 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. ¶ 115.

         Neal 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.

         At 2:25 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. ¶ 128.

         Officer 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.

         The 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.

         At 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.

         Neal 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 “‘cardiopulmonary arrest/arrhythmia.'” 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.

         On 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, ...


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