United States District Court, D. Maryland
JEAN B. GERMAIN, Plaintiff,
WARDEN FRANK BISHOP, JR., BRUCE A. LILLER, Chief of Psychology, WILLIAM BEEMAN, Assistant Director of Nursing, JANETTE CLARK, KRISTA BILAK, and WEXFORD HEALTH SOURCES, INC., Defendants.
THEODORE D. CHUANG, United States District Judge
Jean Germain, currently incarcerated at North Branch
Correctional Institution (“NBCI”) in Cumberland,
Maryland, has filed suit under 42 U.S.C. § 1983 against
Defendants Frank B. Bishop, Jr., Warden of NBCI; Bruce A.
Liller, the NBCI Mental Health Program Manager; William
Beeman, R.N., the NBCI Assistant Director of Nursing; Janette
Clark, a Nurse Practitioner (“N.P. Clark”) at
NBCI; Krista Bilak, a Registered Nurse Practitioner
(“R.N.P. Bilak”) at NBCI; and Wexford Health
Sources, Inc. (“Wexford”), NBCI's contracted
medical services provider. Germain alleges that Defendants:
(1) have exhibited deliberate indifference to both his
medical and psychological needs; (2) have implemented a
policy on handcuffing inmates that exacerbates his chronic
shoulder condition; (3) have imposed sanctions against him
without due process of law resulting in unconstitutional
conditions of confinement; and (4) have retaliated against
him for engaging in constitutionally protected activity by
denying him access to medical care and depriving him of free
multivitamins and skin lotion. Germain also alleges that he
was assaulted by Correctional Officer (“C.O.”)
Nicholas Soltas, who was not named as a defendant, and seeks
to amend the Complaint to add claims and join defendants
relating to that alleged assault.
pending before the Court are a Motion to Dismiss or, in the
Alternative, Motion for Summary Judgment filed by Defendants
Wexford, Beeman, Clark, and Bilak (collectively, “the
Medical Defendants”); a Motion to Dismiss, or, in the
Alternative, Motion for Summary Judgment filed by Defendants
Bishop and Liller (collectively, “the Correctional
Defendants”); a Motion for an Order Compelling
Discovery and Motion to Join Claims filed by Germain; the
Medical Defendants' Motion to Strike various filings by
Germain; and the Medical Defendants' Motions for
Sanctions under Federal Rule of Civil Procedure 11. No
hearing is necessary to resolve these motions. See
D. Md. Local R. 105.6.
reasons set forth below, the Medical Defendants' Motion
to Dismiss or for Summary Judgment will be granted in part
and denied in part; the Correctional Defendants' Motion
to Dismiss or for Summary Judgment will be granted;
Germain's Motion to Compel and to Join Claims will be
granted in part to the extent that Germain's proposed
amended complaint will be construed as a new complaint and
otherwise denied; the Medical Defendants' Motion to
Strike will be granted; and the Medical Defendants'
Motions for Sanctions will be denied.
Conditions of Confinement
March 3, 2015, Germain refused to accept a cellmate into his
cell and violated prison rules by placing his arm through the
security slot in his cell and refusing to remove it when told
to do so. The next day, March 4, 2015, Germain refused to be
handcuffed by correctional officers through the security
slot, grabbed the arm of one officer, and was then
pepper-sprayed by the guards. When he refused to submit to
handcuffing, correctional officers entered the cell and
handcuffed him. Germain also alleges that Soltas and other
correctional officers attacked him and pepper-sprayed his
rectal area, in violation of the Prison Rape Elimination Act.
March 10, 2015, Germain appeared at two formal prison
hearings relating to rule violations arising from the March 3
and March 4 incidents. After Germain testified in his own
defense before each panel, he was sentenced to 365 days of
disciplinary segregation and an indefinite loss of visitation
rights on the March 4, 2015 incident and 200 days of
segregation on the March 3, 2015 incident. After these
sentences were imposed, the NBCI Reduction in Violence
Committee recommended that Germain receive an additional 90
days of cell restriction, concurrent to the other sentences.
On April 2, 2015, the NBCI Chief of Security, on behalf of
the Warden, accepted the Committee's recommendation.
Germain filed an appeal, which was denied by the Chief of
Security, again on behalf of the Warden, on April 6, 2015.
The cell restriction began that same day.
to Germain, he was sentenced to 870 days of disciplinary
segregation at NBCI, during which he was limited to two
showers and five hours of exercise time per week. With the
cell restriction in place, Germain was limited to only one
hour of outdoor exercise per week.
Mental Health Care
to Germain, he is currently being treated by the NBCI
Psychology Department for post-traumatic stress disorder
(“PTSD”), chronic depression, and anxiety
disorder. Following the March 3, 2015 and March 4, 2015
incidents, Germain conducted a hunger strike. During medical
examinations on March 7, 2015 and March 11, 2015 in response
to his hunger strike, doctors referred Germain for a mental
health evaluation. Up to that point, Germain had been
receiving some form of psychiatric medication. On March 13,
2015, he met with Norma Holwager, a member of the Psychology
Department. Germain asserts that a correctional officer
interrupted the meeting, and that Holwager did not return the
following Monday as promised and did not respond to requests
and letters he sent to her.
on March 16, 2015, Germain submitted a series of sick call
requests in which he reported hearing voices, having anxiety
attacks, and nightmares. According to Germain, he has been
re-living the March 4, 2015 assault both while awake and in
nightmares, he has had anxiety attacks as a result of that
incident, and he “cannot quiet” voices he has
been hearing. Comp. Ex. 1 at 5, ECF No. 1-1. On April 19,
2015, Germain began another hunger strike. When he was seen
by Dr. Mahboob Ashraf on April 21, 2015 in response to the
second hunger strike, Dr. Ashraf told Germain that he would
request that Liller, the NBCI Mental Health Program Manager,
arrange for Germain to receive mental health services. The
following day, on April 22, 2015, Germain was seen by
Psychology Associate Laura Beitzel, but she did not follow up
with him after that visit. The record does not reflect that
Germain received any other mental health care or treatment
prior to the filing of his Complaint in this case in May
2015, other than preexisting orders for medication. By
November 2015, however, he had been prescribed various
psychiatric medications, including Doxepin, Vistaril, and
March and April 2015, Germain wrote to Liller to request that
his mental health needs be addressed and that he be
transferred to the Special Needs Unit (“SNU”).
Liller did not respond to Germain. Liller oversees
psychological and psychiatric treatment for inmates,
including the provision of psychiatric medications. Inmates
with serious mental illnesses are housed in the SNU.
According to the SNU Program Manual, inmates referred and
admitted to the SNU have a “severe” mental health
diagnosis pursuant to the Diagnostic and Statistical Manual
of Mental Disorders IV (“DSM IV”), such that
their “ability to function is so impaired” that
they “cannot be placed in General Population without
special consideration.” SNU Manual at 7, Correctional
Defs.' Mot. Dismiss Ex. 4, ECF No. 70-5. The manual
further provides that:
to functioning in General Population includes but is not
limited to the following criteria:
(a) Inability to understand a direct order;
(b) Responding to internal stimulation (hallucinations).
These hallucinations either distract the inmate from
following orders or are commanding the inmate to do something
contrary to security procedures;
(c) Inability to maintain personal hygiene and or clean his
(d) Vulnerable by nature of their mental illness;
(e) Disruptive behavior (banging door, yelling, etc.);
(f) Any aggressive behavior as a response to the mental
(g) Disrespectful for threatening verbalizations; (h) Severe
vulnerability to other inmates; and
(i) Diminished capacity through cognitive deficit or
misinterpretation of stimuli.
Id., According to Liller, Germain does not exhibit
any of the above symptoms and therefore has not been referred
to the SNU.
has suffered from a variety of physical ailments, including
athlete's foot, dry skin, and vitamin deficiency
associated with his periodic hunger strikes. As early as
January 2014, Germain received “Lubri-skin”
lotion as part of his medical treatment for dry skin. Med.
Records at 6, Med. Defs.' Mot. Dismiss Ex. 1, ECF No.
35-4. He also began receiving multivitamins on March 9, 2015
following a hunger strike in protest of the March 3 and 4,
2015 incidents in his cell. However, N.P. Clark discontinued
these prescriptions on April 8, 2015 when she determined that
they were no longer necessary.
also suffers from chronic shoulder pain caused by
degenerative spondylosis that affects his cervical spine.
Germain has received pain medication for this condition
including, at various times, Mobic, Neurontin, and Tramadol.
On October 19, 2016, Dr. Ashraf prescribed to Germain a
90-day supply of Tramadol for his shoulder pain. This
prescription was renewed on December 14, 2016 by R.N.P.
Bilak, who extended the prescription to April 14, 2017. At
the same time, Dr. Ashraf entered a duplicate prescription to
expire on February 14, 2017. Then, on February 13, 2017,
Germain was given a four-day Tramadol prescription to
accommodate him during a temporary transfer to another
institution for a medical consultation. When he returned, his
long term prescription was inadvertently superseded by the
four-day prescription, such that his prescription stopped as
of February 18, 2017. According to Germain, he began to
experience symptoms consistent with opiate withdrawal. After
submitting sick call requests, Germain was seen by a nurse on
February 28, 2017, who observed that Germain had “no
real issues at time of sick call” but referred him for
pain management. Med. Records at 113. On March 8, 2017, a
pharmacist reviewed his case and recommended that his
Tramadol prescription be re-started. Germain refused to
attend medical visits on March 8, 2017 and April 22, 2017, at
which the renewal could have taken place.
Germain's medical records show that he was seen by
medical personnel over 50 times from August 10, 2013 to March
8, 2017. These visits have included receiving pain
medication, undergoing diagnostic scans, and traveling to
another facility for examination by a neurosurgeon.
to Germain, because of his chronic shoulder pain, he received
an order from NBCI medical staff requiring that he “be
cuffed using a special pair of handcuffs with a longer chain
to alleviate his shoulder pain.” Compl. ¶ 10, ECF
No. 1. No copy of this order is in the record, and it is not
clear when it was issued. In Fall 2013, the Warden of NBCI
issued an order that gave authority to determine handcuffing
procedures to correctional officers, not medical staff. No
copy of this policy is in the record.
to Germain, he was originally granted “front cuffing
status” by medical personnel, which was later modified,
at the request of NBCI correctional officers, to handcuffing
behind his back using a longer-than-usual chain. Mot. Amend.
¶¶ 3-4, ECF No. 20. This order was subsequently
rescinded “at the request of custody staffs claiming
security reasons, ” but without providing a specific
security justification. Id. ¶¶ 5-6. Soon
after, Germain began to experience significant pain
throughout his body, beginning in his neck but spreading
throughout his body. Germain was examined by NBCI medical
personnel and eventually underwent a magnetic resonance
imaging (“MRI”) and consultation with a
neurosurgeon, who recommended that Germain continue to
receive physical therapy and pain medication.
26, 2015, Germain told the correctional officers assigned to
escort him to another facility, Officers Dorcon and Gilpin,
that he had a medical order stating that he had
“doublecuff only status.” Supp. Compl.¶ 3 at
4, ECF No. 7. The officers ignored his claim and sought to
handcuff him behind the back using a standard length chain.
One of the officers cursed at Germain.