United States District Court, D. Maryland
L. RUSSELL, III UNITED STATES DISTRICT JUDGE.
MATTER is before the Court on Defendant Wexford Health
Sources, Inc.'s (“Wexford”) Motion to Dismiss
or, in the Alternative, Motion for Summary Judgment (ECF No.
12). The Motion is ripe for disposition, and no hearing is
necessary. See Local Rule 105.6 (D.Md. 2016). For
the reasons outlined below, the Court will grant the
John William Britt, an inmate in the custody of the Maryland
Division of Correction and confined in Maryland Correctional
Institution Jessup (MCIJ), alleges he was denied needed
surgery for a severe neck injury causing him “years of
suffering.” (Compl., ECF No. 1). “Wexford Health
Sources, Inc. Review Board Members” denied him surgery
scheduled for July 19, 2016. (Id. at 4). The surgery
was meant to address his congenital narrowing of the central
spinal cord, borderline central canal stenosis at ¶
3-C4, and moderate left C-4 neural stenosis. (Id.).
Britt explains that these conditions reduced his motor skills
by 70%. (Id.). Britt seeks an injunction requiring
Wexford to provide the surgery needed and $250, 000.00 in
damages for “deliberate indifference.”
Yonas Sissay, a Wexford physician that provides medical care
to inmates in MCIJ, testifies that suffers from chronic neck
and back pain with limited movement of his neck. (Sissay Aff.
at 1, ECF No. 12-5). In July 2016, Dr. Charles Park, a
neurosurgeon at Mercy Medical Center, evaluated Britt.
(Id. at 2). Park noted that Britt experienced pain
and had limited movement of his neck, but did not note any
neurological deficits, nor did Britt have a loss of strength
in upper and lower extremity muscle groups. (Id.).
Based on that evaluation, Park “recommended an anterior
cervical discectomy and fusion with cage reconstruction and
internal fixation with plating from C3-C4 surgery as a
last resort, and explained to [Britt] the risks and
benefits of surgery.” (Id.) (emphasis in
original). Alternative treatments were noted to be physical
therapy, steroid injections, and pain management.
Sissay presented the specialty care requests to Wexford's
utilization management review, the recommendation was to
proceed with conservative treatment. (Id. at 3). The
recommendation was made in light of possible side-effects of
the surgery. Those risks included infection, bleeding, nerve
damage, numbness, burning sensation, paralysis, spinal fluid
leakage, difficulty swallowing, hoarseness of voice, hardware
related problems such as misposition, malposition, loosening
or breaking hardware; stroke, coma, pulmonary embolism, and
death. (Id. at 2). In addition, the recommendation
noted that pain relief from the surgical procedure would not
be 100%; 50% would be the goal and Britt's pain could
worsen after the surgery. (Id.).
Britt began physical therapy. Britt had gone through a
“limited prior session of physical therapy”
previously and reported that it did not help his condition.
(Id. at 3). Likewise, Britt reported the new session
of physical therapy was no exception as Britt reported it to
be “wholly ineffective.” (Id. at 3).
Upon receipt of that report, Britt was given a steroid
epidural injection which provided pain relief for about one
week but did not provide long-term relief, nor did it address
the limitation of movement in his neck. (Id.). Britt
also received pain medication including Neurontin,
Acetaminophen, Tylenol #3, Prednisone, Mobic, Naproxen, and
the conservative treatments failed to provide significant
pain relief, Britt was sent back to Dr. Park to be
re-evaluated in April of 2017. (Id.). Dr. Park
ordered a repeat x-ray and MRI which were reviewed in July of
2017. (Id.). Park recommended neck surgery and
Wexford utilization management approved the request for
surgery in August of 2017. Britt underwent the surgery on
September 20, 2017 at Mercy Medical Center. (Id.).
Standard of Review
Motion to Dismiss
purpose of a Rule 12(b)(6) motion is to test the sufficiency
of a complaint, ” not to “resolve contests
surrounding the facts, the merits of a claim, or the
applicability of defenses.” King v.
Rubenstein, 825 F.3d 206, 214 (4th Cir. 2016) (quoting
Edwards v. City of Goldsboro, 178 F.3d 231, 243-44
(4th Cir. 1999)). A complaint fails to state a claim if it
does not contain “a short and plain statement of the
claim showing that the pleader is entitled to relief, ”
Fed.R.Civ.P. 8(a)(2), or does not “state a claim to
relief that is plausible on its face, ” Ashcroft v.
Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl.
Corp. v. Twombly, 550 U.S. 544, 570 (2007)). A claim is
facially plausible “when the plaintiff pleads factual
content that allows the court to draw the reasonable
inference that the defendant is liable for the misconduct
alleged.” Id. (citing Twombly, 550
U.S. at 556). “Threadbare recitals of the elements of a
cause of action, supported by mere conclusory statements, do
not suffice.” Id. (citing Twombly,
550 U.S. at 555). Though the plaintiff is not required to
forecast evidence to prove the elements of the claim, the
complaint must allege sufficient facts to establish each
element. Goss v. Bank of Am., N.A., 917 F.Supp.2d
445, 449 (D.Md. 2013) (quoting Walters v. McMahen,
684 F.3d 435, 439 (4th Cir. 2012)), aff'd sub
nom., Goss v. Bank of Am., NA, 546 F.App'x
165 (4th Cir. 2013).
considering a Rule 12(b)(6) motion, a court must examine the
complaint as a whole, consider the factual allegations in the
complaint as true, and construe the factual allegations in
the light most favorable to the plaintiff. Albright v.
Oliver, 510 U.S. 266, 268 (1994); Lambeth v. Bd. of
Comm'rs of Davidson Cty., 407 F.3d 266, 268 (4th
Cir. 2005) (citing Scheuer v. Rhodes, 416 U.S. 232,
236 (1974)). But, the court need not accept unsupported or
conclusory factual allegations devoid of any reference to
actual events, United Black Firefighters v. Hirst,
604 F.2d 844, 847 (4th Cir. 1979), or legal conclusions
couched as factual allegations, Iqbal, 556 U.S. at
filed his Amended Complaint pro se. Pro se pleadings are
liberally construed and held to a less stringent standard
than pleadings drafted by lawyers. Erickson v.
Pardus, 551 U.S. 89, 94 (2007) (quoting Estelle v.
Gamble, 429 U.S. 97, 106 (1976)); accord Brown v.
N.C. Dep't of Corr., 612 F.3d 720, 722 (4th Cir.
2010). Pro se complaints are entitled to special care to
determine whether any possible set of facts would entitle the
plaintiff to relief. Hughes v. Rowe, 449 U.S. 5,
9-10 (1980). But even a pro se complaint must be dismissed if
it does not allege “a ...