United States District Court, D. Maryland
MEMORANDUM TO PARTIES
before the Court are: (1) Defendants Wexford Health Sources,
Inc. (“Wexford”), Robustianno Barrera, MD, Kim
Martin, RN, Janet Gilmore, PA, Peggy Mahler, PA, Mahboob
Ashraf, MD, and Ava Joubert, MD's (collectively, the
“Medical Defendants”) Motion to Dismiss or, in
the Alternative, Motion for Summary Judgment (ECF No. 42);
and (2) Defendant Richard Graham, Jr.'s (together with
the Medical Defendants, “Defendants”) Motion to
Dismiss or, in the Alternative, Motion for Summary Judgment
(ECF No. 55). The Motions are 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
Curtis Williamson is an inmate housed at Western Correctional
Institution (“WCI”) in Cumberland, Maryland.
(Compl. at 1, ECF No. 1). He is wheel-chair dependent and suffers
from chronic pain related to a back condition. (Id.
at 3; Joubert Aff. ¶ 3, ECF No. 42-5). On July 7, 2017,
Williamson filed a four-Count Complaint against Defendants,
alleging: (1) the discontinuation of his Oxycodone medication
caused him to suffer pain and experience withdrawal symptoms
(Count I); (2) Mahler authorized or allowed a pharmacist to
discontinue his Ultram medication, again causing him
withdrawal symptoms (Count II); (3) Wexford's medical
department and staff “are denying” him a
post-surgery appointment (Count III); and (4) medical
providers' response to his urinary incontinence forced
him to live in “inhumane, unsanitary, degrading and
humiliating conditions” (Count IV). (ECF Nos. 1, 30).
Williamson seeks compensatory and punitive damages and
injunctive relief. (Compl. at 3).
January 24, 2018, the Medical Defendants filed a Motion to
Dismiss or, in the Alternative, Motion for Summary Judgment.
(ECF No. 42). On February 8, 2018, Williamson filed an
Opposition, (ECF No. 50), to which the Medical Defendants
filed a Reply on February 22, 2018, (ECF No. 54). On March 8,
2018, Graham filed a Motion to Dismiss or, in the
Alternative, Motion for Summary Judgment. (ECF No. 55).
Williamson filed an Opposition to Graham's Motion on
March 22, 2018. (ECF No. 57). To date, the Court has no
record that Graham filed a Reply.
style their Motions as motions to dismiss under Rule 12(b)(6)
or, in the alternative, for summary judgment under Rule 56. A
motion styled in this manner implicates the Court's
discretion under Rule 12(d). See Kensington Volunteer
Fire Dep't, Inc. v. Montgomery Cty., 788 F.Supp.2d
431, 436-37 (D.Md. 2011), aff'd, 684 F.3d 462
(4th Cir. 2012). This Rule provides that when “matters
outside the pleadings are presented to and not excluded by
the court, the [Rule 12(b)(6)] motion must be treated as one
for summary judgment under Rule 56.” Fed.R.Civ.P.
United States Court of Appeals for the Fourth Circuit has
articulated two requirements for proper conversion of a Rule
12(b)(6) motion to a Rule 56 motion: notice and a reasonable
opportunity for discovery. See Greater Balt. Ctr. for
Pregnancy Concerns, Inc. v. Mayor of Balt., 721 F.3d
264, 281 (4th Cir. 2013). When the movant expressly captions
its motion “in the alternative” as one for
summary judgment and submits matters outside the pleadings
for the court's consideration, the parties are deemed to
be on notice that conversion under Rule 12(d) may occur.
See Moret v. Harvey, 381 F.Supp.2d 458, 464 (D.Md.
2005). The Court “does not have an obligation to notify
parties of the obvious.” Laughlin v. Metro. Wash.
Airports Auth., 149 F.3d 253, 261 (4th Cir. 1998).
summary judgment is inappropriate when “the parties
have not had an opportunity for reasonable discovery.”
E.I. du Pont de Nemours & Co. v. Kolon Indus.,
Inc., 637 F.3d 435, 448 (4th Cir. 2011). Yet, “the
party opposing summary judgment ‘cannot complain that
summary judgment was granted without discovery unless that
party had made an attempt to oppose the motion on the grounds
that more time was needed for discovery.'”
Harrods Ltd. v. Sixty Internet Domain Names, 302
F.3d 214, 244 (4th Cir. 2002) (quoting Evans v. Techs.
Applications & Serv. Co., 80 F.3d 954, 961 (4th Cir.
1996)). To raise sufficiently the issue that more discovery
is needed, the non-movant must typically file an affidavit or
declaration under Rule 56(d), explaining the “specified
reasons” why “it cannot present facts essential
to justify its opposition.” Fed.R.Civ.P. 56(d). A Rule
56(d) affidavit is inadequate if it simply demands
“discovery for the sake of discovery.”
Hamilton v. Mayor of Balt., 807 F.Supp.2d 331, 342
(D.Md. 2011) (citation omitted). A Rule 56(d) request for
discovery is properly denied when “the additional
evidence sought for discovery would not have by itself
created a genuine issue of material fact sufficient to defeat
summary judgment.” Ingle ex rel. Estate of Ingle v.
Yelton, 439 F.3d 191, 195 (4th Cir. 2006) (quoting
Strag v. Bd. of Trs., Craven Cmty. Coll., 55 F.3d
943, 953 (4th Cir. 1995)).
the parties were on notice that the Court might resolve
Defendants' Motions under Rule 56 because both Graham and
the Medical Defendants styled their Motions in the
alternative for summary judgment and presented extra-pleading
material for the Court's consideration. See
Moret, 381 F.Supp.2d at 464. Accordingly, the Court
treats Defendants' Motions as motions for summary
reviewing a motion for summary judgment, the Court views the
facts in a light most favorable to the nonmovant, drawing all
justifiable inferences in that party's favor. Ricci
v. DeStefano, 557 U.S. 557, 586 (2009); Anderson v.
Liberty Lobby, Inc., 477 U.S. 242, 255 (1986) (citing
Adickes v. S.H. Kress & Co., 398 U.S. 144,
158-59 (1970)). Summary judgment is proper when the movant
demonstrates, through “particular parts of materials in
the record, including depositions, documents, electronically
stored information, affidavits or declarations, stipulations
. . . admissions, interrogatory answers, or other materials,
” that “there is no genuine dispute as to any
material fact and the movant is entitled to judgment as a
matter of law.” Fed.R.Civ.P. 56(a), (c)(1)(A).
Significantly, a party must be able to present the materials
it cites in “a form that would be admissible in
evidence, ” Fed.R.Civ.P. 56(c)(2), and supporting
affidavits and declarations “must be made on personal
knowledge” and “set out facts that would be
admissible in evidence, ” Fed.R.Civ.P. 56(c)(4).
motion for summary judgment is properly made and supported,
the burden shifts to the nonmovant to identify evidence
showing there is a genuine dispute of material fact. See
Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475
U.S. 574, 586-87 (1986). The nonmovant cannot create a
genuine dispute of material fact “through mere
speculation or the building of one inference upon
another.” Beale v. Hardy, 769 F.2d 213, 214
(4th Cir. 1985) (citation omitted).
“material fact” is one that might affect the
outcome of a party's case. Anderson, 477 U.S. at
248; see also JKC Holding Co. v. Wash. Sports Ventures,
Inc., 264 F.3d 459, 465 (4th Cir. 2001) (citing
Hooven-Lewis v. Caldera, 249 F.3d 259, 265 (4th Cir.
2001)). Whether a fact is considered to be
“material” is determined by the substantive law,
and “[o]nly disputes over facts that might affect the
outcome of the suit under the governing law will properly
preclude the entry of summary judgment.”
Anderson, 477 U.S. at 248; accord
Hooven-Lewis, 249 F.3d at 265. A “genuine”
dispute concerning a “material” fact arises when
the evidence is sufficient to allow a reasonable jury to
return a verdict in the nonmoving party's favor.
Anderson, 477 U.S. at 248. If the nonmovant has
failed to make a sufficient showing on an essential element
of her case where she has the burden of proof, “there
can be ‘no genuine [dispute] as to any material
fact,' since a complete failure of proof concerning an
essential element of the nonmoving party's case
necessarily renders all other facts immaterial.”
Celotex Corp. v. Catrett, 477 U.S. 317, 322-23
brings 42 U.S.C. § 1983 (2018) claims predicated on
allegations of improper medical care. “Deliberate
indifference by prison personnel to an inmate's serious
illness or injury is actionable under 42 U.S.C. § 1983
as constituting cruel and unusual punishment contravening the
[E]ighth [A]mendment.” Jones v. Granger, 935
F.Supp. 670, 673 (D.Md. 1996) (quoting Miltier v.
Beorn, 896 F.2d 848, 851 (4th Cir. 1990)). An inmate
asserting the constitutional violation must show that the
defendant “acted with ‘deliberate
indifference' (subjective) to the inmate's
‘serious medical needs' (objective).” Iko
v. Shreve, 535 F.3d 225, 241 (4th Cir. 2008) (citing
Estelle v. Gamble, 429 U.S. 97, 104 (1976)).
Deliberate indifference requires a showing that a prison
official “subjectively ‘knows of and disregards
an excessive risk to inmate health or safety.'”
Jackson v. Lightsey, 775 F.3d 170, 178 (4th Cir.
2014) (quoting Farmer v. Brennan, 511 U.S. 825, 837
(1994)). “Mere negligence or malpractice does not rise
to a constitutional level.” Justice v. Green,
No. JFM-11-266, 2012 WL 366875, at *8 (D.Md. Feb. 12, 2012).
Nor do disagreements between an inmate and his or her medical
provider “about the proper course of treatment”
establish an Eighth Amendment violation. Id.
as to Count I of the Complaint, the record does not show that
Defendants discontinuing Williamson's Oxycodone
medication amounts to deliberate indifference. Oxycodone is a
pain killer derived from opiates, which Williamson had used
since October 2015. (Med. Defs.' Mot. Dismiss Summ. J.
[“Defs.' Mot.”] Ex. 1 at 2, ECF No. 42-4).
According to Defendants' medical evidence, within four
days of Williamson submitting a sick call slip,
Barrera evaluated Williamson, substituted his Oxycodone order
with an Ultram (or Tramadol) prescription, and renewed his
prescription for Gabapentin (or Neurontin), an anti-seizure
medication used to treat neuropathic pain. (Id. at
2, 6-8; Joubert Aff. ¶ 4). Barrera also prescribed
Cymbalta, medication used in adults to treat chronic pain and
muscle or joint pain. (Joubert Aff. ¶ 4). Williamson,
however, declined it. (Id.). Against this evidence,
it is clear that medical providers attempted to treat
Williamson's condition by providing him with alternate
pain killers. To the extent Williamson is dissatisfied with
the type of pain killer prescribed, such a disagreement does
not provide a sufficient basis for finding a violation of the
Eighth Amendment. See Justice, 2012 WL 366875, at
Court similarly rejects Williamson's contention that he
should have been admitted to the infirmary upon arriving at
WCI “to be gradually weaned off of the Oxicodone
[sic].” (Compl. at 4). Williamson has failed to submit
any medical evidence supporting this contention. See
McKeown v. Pacheko, No. 1:10-1606-RMG, 2011 WL 5104621,
at *2 (D.S.C. Oct. 27, 2011) (“Although Plaintiff
contends that he should have been ‘weaned off'
Neurontin rather than switched to only Cymbalta, there is no
medical or psychiatric support for this contention.”).