United States District Court, D. Maryland
DEBORAH K. CHASANOW, UNITED STATES DISTRICT JUDGE.
Robert King filed a motion for temporary restraining order
which was construed as a complaint filed pursuant to 42
U.S.C. § 1983. (ECF No. 1). Defendants were directed to
show cause why the injunctive relief sought should not be
granted. (ECF No. 3). Because Defendants' response (ECF
No. 4) refuted King's allegations and relied upon
materials outside of the original pleadings, this court
construed the response as a motion for summary judgment and
advised King of his right to file a response in opposition.
(ECF No. 6). King filed a response in opposition (ECF Nos. 8
& 9) and Defendants filed a reply (ECF No. 10). A hearing
is not necessary to determine the matters pending.
See Local Rule 105.6 (D. Md. 2016). For the reasons
that follow, King's request for injunctive relief will be
denied and the complaint dismissed.
Robert King is a patient involuntarily committed to the
custody of the Maryland Department of Health and currently
hospitalized at Clifton T. Perkins Hospital Center
(“Perkins”). He claims that on June 9, 2017, he
attended a meeting with Dr. Onwuanibe, a psychiatrist, and
Dr. Schrumpf, a psychologist. (ECF No. 1 at p. 1). King
states that during that meeting, Dr. Onwuanibe told him she
thought he was “getting ‘sick' and therefore
she was going to increase [his] Lurasidone (Latuda) dosage
from 20 mg to 40 mg.” (Id.). King relates that
he has had two Transient Ischemic Attacks (“TIA”)
during his hospitalization at Perkins and that Lurasidone is
known to cause strokes in elderly patients. (Id. at
pp. 1 - 2).
claims that he was given a 60 mg dose of Lurasidone by Dr.
Onwuanibe in 2016 and experienced left-sided facial
paralysis, which he claims is an indicator and symptom of a
stroke. (Id. at p. 2). On October 22, 2016, King
complained of the facial paralysis to his somatic doctor, Dr.
Shesadri, and expressed his concern regarding the use of
Lurasidone. (Id.). King states that he was
“eventually taken to the University of Maryland Medical
Center (“UMMC”) and given an MRI.”
(Id.). He claims that the MRI results revealed
“the existence of the past ischemic disorders.”
(Id.). King states that following his trip to the
UMMC, he returned to Perkins and discussed his Lurasidone
dosage with Dr. Onwuanibe. King agreed to take a lower dose
(20 mg) and claims the facial paralysis “subsided to a
tolerable level” as a result. (Id.).
claims that despite this history of TIAs and facial paralysis
experienced with the increased dose of Lurasidone, Dr.
Onwuanibe ordered an increase in his dose of Lurasidone from
20 mg to 40 mg for the purpose of “knowingly,
willfully, maliciously and deliberately” causing King
“to experience an exacerbation of facial paralysis
which may eventually lead to an episodic stroke, physically
incapacitating” him. (Id.). King asserts that
Dr. Onwuanibe's ulterior motive is to incapacitate him so
that he cannot “sufficiently and fully” prosecute
his lawsuit filed as Civil Action DKC-16-3804. (Id.).
He further claims that Lurasidone is “known to induce
strokes in those persons who are prone to such strokes”
and Dr. Onwuanibe is attempting to “physically and
mentally incapacitate” him. (Id. at p. 3).
alleges that Drs. Onwuanibe and Schrumpf “are
attempting to intimidate, coerce, prohibit, hamper, hinder,
prevent and punish the Plaintiff for his initiating his
lawsuit against them in Federal Court by prescribing
medications that would either physically and mentally induce
a stroke in the Plaintiff or to overmedicate and oversedate
(sic) the Plaintiff to such a degree as to render the
Plaintiff incapacitated and incapable to adequately,
sufficiently and fully prosecute Plaintiff's lawsuit in
[Civil Action DKC-16-3804] now pending before this Honorable
Court.” (Id.). King further avers that this
court has the authority to order the United States Marshals
Service to take custody of him, remove him along with all of
his property from Perkins, and take him to either a federal
detention center under the federal witness protection program
or to a local federal regional hospital. (Id. at p.
4). He states that he is a material witness in Civil Action
DKC-16-3804 and permitting Defendants to continue to medicate
him as described will render him unable to provide evidence
or prosecute his claims. (Id. at pp. 4 - 5).
explain that King was committed to the custody of the
Department of Health and admitted to Perkins on May 14, 1999,
after he was found Not Criminally Responsible on charges of
second degree assault and carrying a concealed weapon in the
Circuit Court for Prince George's County. (ECF No. 4 at
Ex. 2, p. 1). On March 15, 2007, during his hospitalization,
King was convicted of second-degree assault and sentenced to
serve three years in the Division of Correction after he
assaulted an employee at Perkins. (Id.) After
service of that three-year sentence, King returned to
psychiatric diagnoses are: schizoaffective disorder, bipolar
type; substance use disorder (full remission in a protected
controlled environment); and anti-social personality
disorder. (ECF No. 4 at Ex. 2, p. 3). Symptoms King has
experienced include: auditory hallucinations, grandiose and
paranoid delusions, rapid and pressured speech, irritability,
general mistrust of hospital staff, agitation, violence,
non-compliance with prescribed medication, and poor sleep and
increased goal-directed activity consistent with hypomania or
mania. (ECF No. 4-7 at p. 3, Affidavit of Inna Taller, M.D.,
Clinical Director at Perkins).
April 28, 2016, King was transferred to “2 South”
from a minimum security ward because of his “increasing
agitation, refusal to participate in treatment, and refusal
to take medications for his mental illness.” (ECF No.
4-1 at p. 2, Affidavit of Angela Onwuanibe, M.D.). After his
transfer, King told staff he did not intend to take any of
his medications and that he would not work with the treatment
team. (Id.). King was described as “loud,
agitated and verbally aggressive” during a meeting with
his treatment team, prompting his transfer to a maximum
security ward for approximately one month. (Id.).
returned to 2 South on June 3, 2016, and remained angry and
agitated for “the next several months, ”
complaining about the medications he was prescribed,
particularly Lurasidone. (Id.) King continued to
argue about what medication was appropriate and told his
treatment team that he “had no intention of taking more
than 5mg of Zyprexa.” (ECF No. 4-3 at p. 3). King was
reminded that acceptance of treatment was an important part
of being approved for housing on a medium security ward.
(Id.). During the November 29, 2016 meeting, King
complained about taking Lurasidone and maintained he had been
“faking his symptoms all along.” (Id.)
King began taking Lurasidone (60 mg), he complained of facial
paralysis and numbness. He attributed the symptoms to
Lurasidone. (ECF No. 4-1 at p. 2; ECF No. 4-7 at pp. 3 - 4).
When King made these complaints he was evaluated by his
somatic physician, Dr. Jagdish Shesadri, who could not
substantiate King's symptoms. (ECF No. 4-1 at p. 2).
Despite the lack of evidence of adverse side-effects caused
by the Lurasidone, Dr. Onwuanibe reduced the dosage of
Lurasidone prescribed from 60 mg to 40 mg. (Id.).
King also expressed concerns regarding the tremors he suffers
and his fear that Lurasidone was causing him to suffer
strokes, he was referred to UMMC for neuroimaging studies,
evaluated by a neurologist at University of Maryland
(February 2017), and provided with a consultation with a
clinical pharmacist. (Id.). An MRI of King's
brain, ordered when King expressed concern that Lurasidone
caused him to have a stroke, revealed no significant
intracranial abnormality, i.e., King had not
suffered a stroke. (Id.). The neurologist who
examined him noted that King had a tremor in his hands, but
that it did not appear to affect his daily life. She also
concluded that King appeared to be stable on his medication
regimen and did not recommend any changes. (ECF No. 4-5 at p.
3 Neurological Consultation Report, February 15, 2017, Dr.
Neil C. Porter).
King was compliant with the Lurasidone prescribed, his
demeanor and behavior improved. Between his Individual
Treatment Plan meeting (ITP) on January 24, 2017 and May 2,
2017, King was “elected president of the ward and did
an excellent job.” (ECF No. 4-1 at p. 3). King was