Safar v. Corizon, Inc.

          MEMORANDUM OPINION

          GEORGE J. HAZEL UNITED STATES DISTRICT JUDGE.

         Plaintiff Fadwa Safar alleges that her federal and state constitutional rights were violated by Defendants Corizon Health, Inc. and Nurse Mojisola Adeyemi when she suffered severe pain and distress because she was not given a breastpump to relieve engorged breasts during a three-day detention at the Prince George's County Detention Center. Currently pending before the Court is Defendants' Motion for Summary Judgment, ECF No. 70, which Plaintiff opposed, ECF No. 71. No. hearing is necessary. See Loc. R. 105.6 (D. Md. 2016). For the following reasons, Defendants' Motion for Summary Judgment is granted in part and denied in part.

         I. BACKGROUND^[1]

         A. Plaintiff Fadwa Safar's Experience

         Plaintiff Fadwa Safar came to the United States from Iraq in 2008 to escape religious persecution. ECF No. 71-3 ¶ 1. In May 2013, she gave birth to her third and youngest child. Id. ¶ 2. To complete her naturalization application, Safar had sought a letter of good standing from local police departments. Id. ¶ 5. However, after she went to the Prince George's County Police Department on December 23, 2016, six months after giving birth, she was arrested pursuant to a mistaken arrest warrant and, early in the morning on December 24, 2016, was taken to Prince George's County's Adult Detention Center (ADC). Id. ¶¶ 5-6, 9. The arrest warrant stemmed from a mistake made a year earlier when a retailer misread its sales data and alleged that Safar had engaged in credit card fraud. Id. ¶ 6. Although the retailer withdrew its allegation against Safar hours after making it, no steps were taken to cancel the related arrest warrant. Id. Safar remained incarcerated for three days until she was able to appear before a judge after Christmas, at which point the case against her was dismissed. Id. ¶¶ 6, 10. She was still breast-feeding her youngest child at the time of this arrest. Id. ¶ 6.

         Safar was confused and scared, and given that she is a refugee who had previously escaped a “tyrannical regime, ” she acutely felt the stress of being arrested without cause. Id. ¶ 8. By the time she was taken to ADC, she had not expressed milk in almost 24 hours, which caused her breasts to painfully engorge because she was lactating. Id. ¶ 12. Engorgement results from unrelieved normal breast fullness. ECF No. 71-5 at 6. As the milk volume increases within the milk producing tissues and is not removed adequately, pressure builds, causing fluid and other milk components to leak into the surrounding tissues (“edema”). Id. As fluid shifts from the milk ducts into the tissues, the breasts become swollen, hardened, and red. Id.

         When her intake photo was taken, Safar's breasts were in pain, ECF No. 71-3 ¶ 15, and the photo shows her clutching them, ECF No. 71-6. She told the corrections officer taking her photo that her breasts hurt because she needed to express milk. ECF No. 71-3 ¶ 16. The officer responded, “this is not my job.” Id. The corrections officers and medical staff responsible for intake all work in the same room, ECF No. 71-4, and a sign hangs in the facility stating, “If you are ill notify an officer or a nurse, ” ECF No. 70-11 at 2, 7.

         Safar became increasingly stressed by the pain and used an ADC phone within earshot of the intake staff, ECF No. 71-4, to call her family for help, ECF Nos. 71-3 ¶ 17, 71-7 at 2-3. She spoke to her sister-in-law, Basma Zaiber. Id. Zaiber had lived in the United States longer than Safar and is naturally more assertive. Id. Zaiber told Safar not to worry because she would take care of getting her help expressing milk. ECF No. 71-7 at 3. While Safar continued to seek help from within ADC, she understood that her sister-in-law was also trying to get someone at ADC to help her relieve her pain. ECF No. 71-3 ¶ 18. She approached other corrections officers in the intake area-the same room where her photo was taken and where she used the phone-and told them she needed help “to take the milk out.” Id. ¶ 19. The officers responded that they could not do anything to help. Id.

         At this point, more than one corrections officer had dismissed Safar's requests for help, leading her to feel helpless. ECF No. 71-3 ¶ 20. After these interactions with ADC staff, Safar met with Defendant Mojisola Adeyemi, a licensed practice nurse (LPN) who works for Defendant Corizon and is responsible for medical intake screenings of inmates. ECF No. 71-3 ¶ 22. While Adeyemi asked Safar standard intake questions, Safar interrupted to tell her that she had pain and a burning sensation in her breasts. ECF No. 71-3 ¶ 24. Adeyemi responded by directing her to take a pregnancy test. ECF No. 71-3 ¶ 25. Adeyemi asked Safar when her last menstrual period was; and Safar responded that she did not know because she gave birth in May 2013 and was breastfeeding. ECF No. 71- 3 ¶ 28. However, Adeyemi made a notation- inconsistent with Safar's recollection of this encounter-that Safar's last period was in May 2013. ECF No. 71-9 at 1. Adeyemi knows that breastfeeding inhibits menstrual periods, ECF No. 71-2 at 3, but assumed that a delay in an inmate's menstrual period is not cause for concern because she is aware of other situations where it is normal for a young woman to not have a regular period, including during use of certain forms of contraception, ECF No. 70-7 at 11-12. Adeyemi wrote “no” next to the intake form's question “Recent major surgical history or hospitalization within the past year?” ECF No. 71-9 at 1. When Adeyemi asked Safar if she was on any medications or had any allergies, Safar again interrupted to say that she had pain in her breast and needed help expressing breastmilk. ECF No. 71-3 ¶ 27. Although Safar was experiencing physical distress during the medical screening, see e.g., ECF No. 71-3 ¶ 23-24, there are no notations on her medical intake form regarding her pain or Adeyemi's observation of her physical condition.

         Adeyemi does not recall performing Safar's medical intake, ECF No. 71-2 at 4, but she denies that she would have ignored Safar's call for help, ECF No. ECF No. 70-7 at 19. In a similar instance, when a lactating woman advised Adeyemi that she was in pain and needed medical assistance, she reclassified the inmate to the medical unit for care. ECF No. 70-7 at 16. At the end of Safar's medical screening, Safar was in excruciating pain. ECF No. 71-3 ¶ 29. She signed a document, which she does not remember signing, acknowledging that she had provided information to Adeyemi. Id. Above the signature line on the form it says, “It has been told and shown to me in writing what to do if I get sick while I am in this facility.” ECF No. 70-4 at 2. Nonetheless, Safar claims that she never learned from ADC or Corizon staff about procedures for requesting medical assistance. ECF No. 71-3 ¶ 34.

         After Adeyemi finished screening other inmates, Safar tried again to request Adeyemi's help. ECF No. 71-3 ¶ 30. Safar told Adeyemi that she needed help and that, at the suggestion of another inmate, she had tried applying hot water to her breasts but that did not relieve her pain. ECF No. 71-3 ¶ 20, 30. Adeyemi responded that she did not have experience in that area. ECF No. 71-3 ¶ 30.

         After these fruitless attempts to get help, Safar was demoralized. ECF No. 71-3 ¶ 31. She was then transferred to a locked cell. ECF No. 71-3 ¶ 32. From that point on, she relied on her family to get her help. ECF No. 71-3 ¶ 35. Safar's sister-in-law, Basma Zaiber, came to the detention center with Safar's criminal defense attorney and spoke with a corrections officer sitting at the reception desk. ECF No. 71-7 at 5. They explained that Safar was in physical distress and needed a breastpump but were told that the facility did not have one and that Zaiber could not bring her one because a breastpump would not be allowed into the facility. Id. The corrections officer told Zaiber that she could contact the medical unit for further assistance. ECF No. 71-7 at 6. Zaiber then repeatedly called the medical unit on December 24 and 25. Id; ECF No. 71-13. The first time Zaiber called the medical unit, she explained that her sister-in-law was incarcerated, in pain, and needed a breastpump. ECF No. 71-7 at 7. Zaiber felt that the woman answering the phone was disinterested-she did not even ask for Safar's name-and that nothing would be done to resolve Safar's issue. Id. 7-8. The next time Zaiber called, she spoke with a different person who told her “I don't think I saw anyone complaining or crying” in response to Zaiber's plea that someone help relieve Safar's pain. ECF No. 71-7 at 8. No. one in the medical unit contacted Safar in response to Zaiber's calls. ECF No. 71-3 ¶ 36.

         On December 26, 2016, when Safar was released from custody around 4:30pm, her breasts had been engorged and causing her physical distress for approximately 56 hours. ECF No. 71-3 ¶ 37. As fluid accumulates in the breast, more pressure is placed on the milk producing tissue, making removal of breastmilk more difficult (“milk stasis”), and causing unrelieved pain. ECF No. 71-5 at 6. Because she could not express milk while incarcerated, Safar suffered milk stasis. Id. After her incarceration, Safar was able to nurse her baby for a brief period, but “a combination of reduced flow, nausea, and psychological blockage” led her to stop. Id. She had breastfed her other children until they were each two-years old without incident, and she planned to continue to breastfeed her youngest child until he turned two. ECF No. 71-3 ¶ 3. But after her incarceration she was unable to continue feeding her son as she had planned, which caused her great distress. ECF No. 71-3 ¶ 38.

         B. Defendant ...