United States District Court, D. Maryland
DEBORAH K. CHASANOW, UNITED STATES DISTRICT JUDGE.
December 27, 2017, the court received for filing a motion for
temporary restraining order from state inmate Danny Carroll
Hoskins, who is currently housed at the Western Correctional
Institution (“WCI”). The motion alleges that
Hoskins receives pain medication for a degenerative disease,
bulging and herniated discs with bone spurs, sciatica and
strokes, which have caused him major headaches, cramps,
spasticity, and ear ringing. He states that he is currently
confined to a wheelchair. ECF No. 1, pp. 1-2. Hoskins
contends that his pain medication (Tramadol and Baclofen) ran
out by December 2, 2017, and, in response to his complaints,
he was informed that the Baclofen was being discontinued
altogether and that he was being “weaned off”
another medication, Neurontin, due to inmate abuse and cost.
Hoskins stated that he has increased pain, cramps, and
headaches and has suffered the loss of proper mobility on his
right side. ECF No. 1, p. 3. As relief, he asks the court to
order Wexford immediately to continue his prescriptions for
Baclofen, Neurontin, Tramadol, and Tylenol at prescribed
dosages “until this matter can be deemed closed by this
motion was instituted as a new 42 U.S.C. § 1983 action
for injunctive relief and Defendant Wexford Health Sources,
Inc. (“Wexford”) was ordered to file a show cause
response. ECF No. 2. Hoskins, who informed the court that he
was preparing a § 1983 cause of action against Wexford
was granted additional time to file a formal complaint and
indigency motion. Id.
March 12, 2018, Wexford filed a show cause response,
indicating that prior to December, 2017, Hoskins was
receiving the medications Baclofen, Tramadol, Neurontin and
Tylenol. ECF No. 8-1. Wexford maintains that Hoskins has not had
his pain medications improperly discontinued and, as of the
filing date of its show cause response, he remains on a
Tylenol and Tramadol regimen, and recently had
Naproxen added to his pain treatment, but is no
longer receiving Neurontin and Baclofen “pursuant to
reasonable and appropriate medical judgment of his health
care providers and [Hoskins] continues to receive all
necessary pain medications.” Id.
medical record provided by Wexford shows that in August of
2017, Hoskins reported lower back pain, non-radiating from a
prior motor vehicle accident and right shoulder pain from a
football injury. His Neurontin, Tramadol, Baclofen and
Tylenol were renewed. ECF No. 8-1, pp. 3-6. Hoskins was seen
in the Chronic Care Clinic and for periodic examinations to
monitor his cardiovascular conditions and pain. His Baclofen
was discontinued because Hoskins had no muscle spasms and
Baclofen interacts with Ultram. ECF No. 8-1, pp. 9-11. On
November 29, 2017, a non-formulary drug request form was
submitted for Gabapentin (Neurontin) and Tramadol, and was
completed on December 7, 2017. ECF No. 8-3, pp. 2-4.
to Nurse Brenda Reese, the Director of Nursing at WCI, as of
November 29, 2017, Neurontin was no longer medically
necessary for Hoskins because “Neurontin does not treat
any of [Hoskins'] ongoing causes of chronic pain and
[Hoskins] did not have any ongoing muscle spasms
necessitating the use of Baclofen.” ECF No. 8-2, Reese
Aff., ¶ 3. Reese affirms that on December 29, 2017,
Hoskins was offered, but refused, 60 Tylenol pills. When half
that medication was offered to Hoskins for the month of
January 2018, they were accepted. Id., Aff., ¶
maintains that Hoskins has continued to receive Tramadol for
the months of December, 2017 and January, 2018, and in
February of 2018, Naproxen was added to Hoskins' pain
regimen. ECF No. 8-2, Reese Aff., ¶¶ 6 & 7.
to Medical Administration Records (“MAR) provided by
Wexford, in November, 2017, Hoskins received Neurontin,
Tylenol, Tramadol, Baclofen, along with other medications.
ECF No. 8-4, pp. 2-3. In December, 2017, he was prescribed
Tramadol, Tylenol, and Neurontin. The Baclofen was
discontinued. ECF No. 8-4, pp. 4-9. In January, 2018, Hoskins
received Neurontin, Tylenol, and Tramadol. Id., pp.
filed an answer to the show cause response claiming that his
Tramadol medication was discontinued before the prescription
expired. ECF No. 13. He complains that he receives an
inadequate number of prescription tablets to complete the
prescription period, and he is forced to follow a burdensome
prescription process by submitting a sick-call slip to be
“seen and have a new order processed.” ECF No.
13. Hoskins disputes Wexford's response, stating that he
did not receive his medications for several days in December,
2017 and March, 2018, and his medications were discontinued
with his seeing a physician. He contends that he only has two
medications for pain, Tramadol and Tylenol, and although he
was informed he would be seen in late March, the appointment
did not occur. ECF No. 13, pp. 1-5. Wexford's counsel has
filed a reply contending that Hoskins' answer confirms
their statements regarding his current pain medication
regimen and his Naproxen has been discontinued due to
Hoskins' history of stroke. Wexford further argues that
the MAR submitted shows that Hoskins was receiving his
Tramadol in December, 2017. ECF No. 14.
preliminary injunction is an “extraordinary and drastic
remedy, ” Munaf v. Geren, 553 U.S. 674, 689-90
(2008), that requires a movant demonstrate: 1) that he is
likely to succeed on the merits; 2) that he is likely to
suffer irreparable harm in the absence of preliminary relief;
3) that the balance of equities tips in his favor; and 4)
that an injunction is in the public interest. See Winter
v. Nat. Resources Def. Council, Inc., 555 U.S.
7, 20 (2008); The Real Truth About Obama, Inc. v. Fed.
Election Comm'n, 575 F.3d 342, 346 (4th Cir. 2009),
vacated on other grounds, 559 U.S. 1089
(2010), reinstated in relevant part on remand, 607
F.3d 355 (4th Cir. 2010) (per curiam). “Issuing a
preliminary injunction based only on a possibility of
irreparable harm is inconsistent with [the Supreme
Court's] characterization of injunctive relief as an
extraordinary remedy that may only be awarded upon a clear
showing that the plaintiff is entitled to such relief.”
Winter, 555 U.S. at 22, citing Mazurek v.
Armstrong, 520 U.S. 968, 972 (1997) (per curiam). A
movant must show that the irreparable harm he faces in the
absence of relief is “neither remote nor speculative,
but actual and imminent.” Direx Israel, Ltd. v.
Breakthrough Medical Group, 952 F.2d 802, 812 (4th Cir.
1991) (citation omitted).
response supported with copies of Hoskins' medical
records and Brenda Reese's affidavit, Wexford denies that
Hoskins' pain medications were discontinued improperly.
The record shows that Hoskins continues to be treated for his
chronic pain, receives medication, and the medications that
were discontinued were deemed not medically necessary for
him. He cannot show he is likely to succeed on the merits or
suffer irreparable injury without the relief he seeks.
Hoskins' request to compel his receipt of medications
deemed by medical provider to be no longer medically
necessary for his treatment and potentially contraindicated,
does not serve the the public interest or tip the balance of
equities in Hoskins' favor. Consequently, the court will
deny Hoskins' request for preliminary injunctive relief.
March 12, 2018, the same day Wexford filed its show cause
response, Hoskins filed a supplemental complaint additionally
naming Licensed Practical Nurse Beverly
McLaughlin and WCI Warden Richard J. Graham as
defendants. ECF No. 9. Service has been accepted on behalf of
McLaughin. ECF No. 10. Service will proceed on Warden Graham.
alleges that when seen by McLaughlin in late 2015 to early
2016, she informed him that she was not going to renew his
fish oil, skin lotion, Tonaftate (antifungal treatment),
selenium sulfide lotion (treatment for dandruff and certain
scalp infections), and cholesterol-lowering medication
(Lovastatin) for cost-cutting reasons. ECF No. 9, p. 2 &
claims that he was first seen for a MERSA [sic] infection on
September 15, 2016, and again seen in October and November of
2016, and was prescribed Tonaftate and Gold Bond Powder. He
states that he was transferred to another prison for physical
therapy and a physician noted an “outbreak” on
his left ear. The area was swabbed and test results proved
positive for MRSA. Hoskins claims ...