United States District Court, D. Maryland
L. Hollander United States District Judge
Aurel,  the self represented plaintiff, is a State
inmate housed at the North Branch Correctional Institution
(“NBCI”). He is a frequent litigator in this
Court. On January 26, 2018, the Court dismissed his civil
rights complaint in Aurel v. The Staff of Wexford Health
Sources, et al., Civil Action No. ELH-17-1201 (D. Md.),
upon finding that defendants had provided Aurel with adequate
medical care under the Eighth Amendment. See id.,
ECF 23; ECF 24.
March 26, 2018, Aurel filed an Affidavit in that case (ECF
25), asserting that for years he has not received proper
medical care for his symptoms, and that health care staff
continue to lie to him about treatment and medications for
his symptoms related to lower back, abdominal, and throat
pain; infection of his tongue; thyroid, liver, prostate, and
colon cancers; gastrointestinal problems (constipation,
ulcer, and blood in stool); and positive test results for
Hepatitis A & B (HAV and HBV). On March 28, 2018, Aurel
filed a motion for a preliminary injunction and a temporary
restraining order. Id., ECF 26. Aurel complained
that he has been threatened by medical staff and denied
medication for symptoms and injuries. The pleading also
discusses injuries and medical conditions including, but not
limited to, Aurel's back pain caused by a 2016 fall from
a top bunk; pain in his throat, neck, ears, bladder, and
abdomen; infection to the tongue; swollen lymph nodes
(possible thyroid cancer); and HAV and HBV. Further, he
contends that his organs have started to fail due to the lack
of adequate medical treatment over the past four years.
the case (ELH-17-1201) was already closed, and Aurel is
subject to the bar of 28 U.S.C. § 1915(g), the court
directed defendants to file a court-ordered response.
Id.; ECF 27. They did so on April 23, 2018.
Id., ECF 28. In addition, defendants provided
authenticated medical records and the Affidavit of Asresahegn
Getachew, M.D. See ECF 28-2; ECF 28-3.
Order of April 30, 2018, I determined that it would be
appropriate to construe Aurel's submissions in
ELH-17-1201 as the original and supplemental complaint in an
entirely new case. See ELH-18-1251. Therefore,
Aurel's Affidavit is construed as the Complaint, docketed
at ECF 1. His motion for preliminary injunction is docketed
as ECF 2. Defendants' court-ordered response, supported
by an exhibit and an affidavit, appears at ECF 3; ECF 3-2;
ECF 3-3. It shall be construed as a motion for summary
was twice provided notice of the court's construction and
the opportunity to file an opposition. ECF 4; ECF 5. Aurel
filed an opposition (ECF 6), which he supplemented by
Affidavit of June 8, 2018. ECF 9. Defendants filed a reply
(ECF 7), with an exhibit. By Order of May 30, 2018 (ECF 8),
the Court directed defendants to file an addendum to their
Reply, so as to include documentation in support of their
assertions. The supplementation has been provided. ECF 10;
hearing is necessary to resolve the Motion. See
Local Rule 105.6 (D. Md. 2016). For the reasons that follow,
defendants' motion for summary judgment shall be granted.
alleges that he has been denied medical treatment for
symptoms related to lower back, neck, ear, abdominal,
bladder, and throat pain; infection to his tongue; thyroid,
liver, prostate, and colon cancers; gastrointestinal problems
(constipation, ulcer, and blood in stool); and positive test
results for HAV and HBV. He seeks treatment (medication and
operations) from a specialist for his avowed
response, defendants state that Aurel is a fifty-two year old
male incarcerated at NBCI. They have provided two affidavits
of Asresahegn Getachew, M.D. ECF 3-3; ECF 10-1. Dr. Getachew
is a licensed physician employed by Wexford Health Sources,
Inc. (“Wexford”) as the acting Medical Director
at NBCI. ECF 3-3, ¶ 1; ECF 10-1, ¶ 1.
Getachew avers that Aurel has a medical history for
hypothyroidism; asthma; constipation; hypertrophy of
prostate; cough; hyperlipidemia; an esophageal reflux
positive tuberculosis (“TB”) skin test without
active TB disease; positive HAV AND HBV surface antibody
tests in 2009; seasonal allergies; syncopal episodes with
implanted cardiac monitor, which was surgically removed in
2006; micro fractures of the right foot diagnosed in 2011,
with calcaneous deformity and chronic apophysitis; and a
surgically repaired left lateral ankle fracture with retained
hardware. ECF 3-3, ¶ 4; ECF 10-1, ¶ 3. Further,
Getachew maintains that Aurel has a mental health diagnosis
of hypochondria. ECF 3-3, ¶ 4.
to Getachew, Aurel's current medications include Zyrtec
for his allergies; Simvastatin for high cholesterol; Mobic
for pain; Prilosec for esophageal reflux; Synthroid
(levothyrotine sodium) for hypothyroidism; Miralax for constipation;
Capsaicin ointment for topical pain relief;
Terazosin to improve urination; Amitriptyline for
pain; and a Proair Hfa (albuterol) inhaler as needed, to
control asthma. ECF 3-3, ¶ 6. Getachew opines that, to a
reasonable degree of medical probability, these medications
are appropriate for Aurel's medical conditions.
indicates that Aurel is not scheduled for surgery.
Id. ¶ 7. Further, Aurel utilizes a back brace
against medical advice, as his medical conditions do not
indicate a current need for any assistive device.
Id. ¶ 8. In addition, Aurel has a
well-documented history of incorrectly self-diagnosing
himself with bone, prostate, thyroid, throat, and colon
cancer, none of which have been medically diagnosed or
supported by clinical data; infections of various organs and
body parts, which have not been diagnosed by
“gross” examination or lab work-up; and
subjective claims of acute pain, “neither corroborated
by observation nor physical abilities which show normal
movements and no impairment in ability to complete normal
daily activities.” ECF 3-3, ¶ 9.
Getachew avers that Aurel “engages in obsessive
behavior frequently fixating on certain symptoms” of a
disease or condition, and has a “tendency to amplify
these symptoms in presentation and they form the basis of his
misdiagnosis.” Id. ¶ 10. The doctor also
asserts that Aurel is “a poor historian” who
“frequently confuses symptoms he has reported, and
treatments and medications received.” Id.
According to Dr. Getachew, Aurel “refuses to accept
clinical evidence, particularly when that evidence
contradicts his own diagnoses, ” and he often contends
that “lab results have been fabricated.”
claims that Aurel has been diagnosed by psychiatry as
hypochondriacal and, because of this condition and his
“habitual conduct of accessing health care,
[Aurel's] plan of care until December 2017 included a
biweekly evaluation by a mid-level provider.”
Id. ¶ 11. In December 2017 the plan of care was
changed to monthly evaluations. Id.; see
ECF 3-2 at 32-33, 40-41, 52, & 62-63.
to Getachew, Aurel has been “non-compliant with his
medications” ECF 3-3, ¶ 12, and the pharmacy has
been instructed to require him “to sign for his keep on
person medications, ” and Aurel is to be directly
observed when taking his chronic care medications.
Id. Getachew maintains that Aurel does not have
thyroid, prostate, colon, or eye cancer, and his lab results
were and are normal. Id. ¶ 13. Moreover, Aurel
had an unremarkable colonoscopy in 2016. His guaiac stool
tests are normal. Id. Aurel's evaluation by the
optometry department in February 2018 was unremarkable, aside
from his need for corrective lenses. Id. His lymph
nodes are not enlarged. Aurel's gums, throat, and tongue
have been evaluated by both medical and dental providers and
were found to be unremarkable. Id. Aurel has not
demonstrated fatigue, rectal bleeding, or night sweats.
Although Aurel has been educated as to these findings, he
“refuses to believe” the medical providers'
assessments. Id.; see ECF 3-2 at 2-3,
23-28, 35-36, 43, 47-50, & 53.
noted, Aurel does have certain chronic conditions, including
hypothyroidism, asthma, and hyperlipidemia, but they are
monitored with chronic medical care. ECF 3-3, ¶ 14. But,
the conditions are controlled with medications,
i.e., Synthroid, albuterol inhaler, Simvastatin, and
fiber supplements. Id. Further, Aurel has been
advised to increase his activity level and to follow an
exercise plan in light of his medical conditions and obesity.
Id.; see ECF 3-2 at 2, 20-22, & 40-42.
Dr. Getachew states that Aurel will “continue to be
regularly seen at chronic care and to have access to medical
staff at all times via the sick call process.” ECF 3-3,
avers that Aurel frequently complains of low back and hip
pain radiating down his right leg to his foot. ECF 3-3,
¶ 15. According to Getachew, Aurel has no anatomical
disorder and an x-ray of his “LS spine” was
normal, as was that of his right hip. Id. Aurel has
been examined by an orthopedist, Roy Carls, M.D., who has
only recommended conservative treatment with stretching
exercises. Id. Aurel completed a course of physical
therapy in 2017, with improvement to his antalgic gait. ECF
3-3, ¶ 15. Aurel has indicated he no longer wants any
physical therapy. Id. Previously, Aurel was treated
with Neurontin, Baclofen, Cymbalta, Mobic, and Robaxin, but
he has consistently requested to be placed on Vicodin and
Tramadol. He is being scheduled for an MRI of the back for a
further determination of his complaints of pain.
Id.; see ECF 3-2 at 4-8, 9-25, 27-30,
35-36, & 47-51.
asserts that Aurel often complains of abdominal pain and his
frequent constipation is being treated with Miralax. An
ultrasound of the abdomen, taken in January of 2018, was
unremarkable, except for indications of “hepatic
steatosis (fatty liver).” ECF 3-3, ¶ 16. But,
Aurel's liver function tests are normal. Id.
Getachew also states that Aurel has an 11 mm. benign cyst on
his liver. Id. Aurel has discontinued a
cardiovascular diet, but remains on a 2400 ...