United States District Court, D. Maryland
Catherine C. Blake United States District Judge
August 25, 2017, self-represented plaintiff Willie Dixon,
presently incarcerated at the Roxbury Correctional
Institution in Hagerstown, Maryland, filed this civil action
pursuant to 42 U.S.C. § 1983 against defendant Wexford
Health Sources, Inc. ("Wexford"), the prison
healthcare provider. ECF No. 1. Dixon claims that he has been
taking the drug Humira and therefore needs annual medical
checkups with Dr. Siaton, which Wexford allegedly denies.
Id. at 4-5. He seeks an order directing Wexford to
allow the yearly visits. Id. at 4.
December 22, 2017, Wexford filed a Motion to Dismiss or, in
the Alternative, Motion for Summary Judgment. ECF No. 12.
Pursuant to Roseboro v. Garrison, 528 F.2d 309 (4th
Cir. 1975), the court informed Dixon that the failure to file
a response in opposition to Wexford's Motion could result
in dismissal of the Complaint. ECF No. 13. Dixon did not
respond. After review of the record, exhibits, and applicable
law, the court deems a hearing unnecessary. See
Local Rule 105.6 (D. Md. 2016). Wexford's Motion shall be
construed as a Motion for Summary Judgment and shall be
is a 52-year old male inmate with a medical history
significant for Behcet's syndrome,  panuveitis,
cataracts. See ECF No. 12-4; ECF No. 12-5 at
¶4. He states that he has been taking the drug
Humira for almost three years and is, therefore,
required to have annual visits with Dr. Bernadette Siaton, an
off site rheumatologist who, he alleges, can best examine the
effects of the drug on his bones. ECF No. 1 at 4; ECF No.
1-1. Dixon claims that Wexford has failed to provide adequate
medical care by denying him the required visits. Id.
medical records reflect that on January 18, 2017, he was
denied a follow-up visit with an off site rheumatologist, and
the alternative treatment plan was to monitor his condition
on site. ECF No. 12-4 at 3. On January 22, 2017, Dixon saw a
nurse and inquired about the status of his rheumatologist
consult. Id. at 1. The nurse emailed the scheduler
and provider to research the status of the consult.
Id. On January 26, 2017, Dixon was referred to a
provider for a determination of the consult disposition.
Id. at 3.
February 3, 2017, Dixon was seen by Ava Joubert, M.D.
Id. at 4-5. Dixon complained of continued right
lower quadrant pain and discomfort, associated with
occasional nausea and dysuria,  and stated that he often had dark
urine and had lost about 20 lbs. in the past year.
Id. Dixon believed that his symptoms were possibly
related to taking Humira. Id. At that time, Dr.
Joubert noted that Dixon had persistent
neutropenia and a recent rise in the
February 14, 2017, Dixon had a follow-up visit with Dr.
Joubert, who requested an abdominal ultrasound. Id.
at 6-7. By that time, Dixon had been taking Bactrim for three
months without alleviating his prostatitis symptoms.
Id. During the visit, Dixon told Dr. Joubert the
rheumatologist had stated that the symptoms might be related
to his pancreas. Id. Dr. Joubert planned to complete
the ultrasound first, and then submit a request for a
follow-up with the rheumatologist. Id. She advised
Dixon to continue taking Humira. Id.
March 8, 2017, Dixon had the abdominal ultrasound.
Id. at 8. On March 17, 2017, Dixon was seen by
Mahboobeh Memarsadeghi, M.D. Id. at 9-11. Again,
Dixon was noted to have been on Humira for two years but
continued to have right lower quadrant pain and discomfort,
associated with occasional nausea and dysuria, no hematuria.
Id. Dixon's ultrasound was unremarkable except
for bilateral cysts in the kidneys, one measuring 19mm in the
right, and two, measuring 1.4cm and 2cm, in the left.
March 22, 2017, Dixon was denied a follow-up rheumatology
consult and a course of urine dip sticks with follow up in
three months was recommended as an alternative treatment
plan. See Id. at 12-13, 16.
April 19, 2017, Dixon saw Crystal Jamison, P..A. to review
his ultrasound results. Id. at 14. On May 16, 2017,
Dixon again saw. Jamison, who reviewed his urine dip stick
and urinalysis treatment plan. Id. at 16-17. At that
time, Dixon expressed dissatisfaction and felt that he should
see a rheumatologist. Id. Jamison informed Dixon he
could successfully be monitored onsite. Id. Dixon
refused to give a urine specimen or to have his vitals taken,
and stated that he was going to self-terminate taking Humira.
Id. Jamison advised Dixon to continue taking his
6, 2017, Dixon saw a nurse during a sick call to inquire
about the urinalysis. Id. at 18. He stated that he
had stopped taking all his medications due to the renal
cysts. Id. In response, the nurse educated Dixon on
cysts and advised him to comply with his medication orders.
Id. Dixon agreed to take his medications.
14, 2017, Dixon saw Dr. Memarsadeghi at chronic care.
Id. at 20-22. Dixon had no complaints but wanted to
know how much longer he needed to be on Humira. Id.
Again, he indicated a belief that the renal cysts were
related to Humira. Id. Dr. Memarsadeghi informed
Dixon that the conditions were separate and not caused by his
medication. Id. A urinalysis was ordered.
August 25, 2017, Dixon initiated this action. ECF No. 1. Soon
thereafter, on August 30, 2017, Dixon saw Dr. Memarsadeghi at
chronic care. ECF No. 12-4 at 23-25. At that time,
Dixon's Humira medication was on hold due to neutropenia
and fever. Id. Dixon also had diarrhea and nausea.
Id. He was started on an empirical course of
antibiotics, chest x-rays and lab work were ordered, and a
consult for rheumatology was submitted. Id.
September 6, 2017, the rheumatology consult was approved.
Id. at 35. On September 20, 2017, Dixon again saw
Dr. Memarsadeghi. Id. at 26-28. Dixon's lab work
was negative for invasive organisms, his white blood cell
count had returned to normal, and he was afebrile.
Id. Dixon ...