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King v. Onwuanibe

United States District Court, D. Maryland

December 4, 2017

DR. ONWUANIBE[1] and DR. SCHRUMPF Defendants



         Plaintiff 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.

         I. Background

         A. Complaint Allegations

         Plaintiff 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.[2] (Id. at pp. 1 - 2).

         King 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.).

         King 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.[3] (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).

         King 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).

         B. Defendants' Response

         Defendants 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 Perkins.

         King's 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).

         On 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.).

         King 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.)

         After 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.).

         Because 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).

         While 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 ...

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