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Britt v. Wexford Health Sources, Inc.

United States District Court, D. Maryland

March 30, 2018




         THIS 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 Motion.[1]

         I.BACKGROUND [2]

         Plaintiff 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.” (Id.).

         Dr. 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. (Id.).

         When 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.).

         Accordingly, 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 Ibuprofen. (Id.).

         When 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.).


         A. Standard of Review

         1. Motion to Dismiss

         “The 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).

         In 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 678.

         Britt 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 ...

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