United States District Court, D. Maryland
L. HOLLANDER, UNITED STATES DISTRICT JUDGE
Mouzone, a self-represented Maryland prisoner, filed a civil
rights suit against Robustiano Barrera, M.D. and Mahboob
Ashraf, M.D. He alleges the denial of constitutionally
adequate medical care. ECF 1.
have filed a motion to dismiss or, in the alternative, for
summary judgment (ECF 11), supported by a memorandum (ECF
11-1) and many exhibits (collectively, the
“Motion”). Plaintiff has filed an opposition (ECF
15) as well as a memorandum (ECF 15-1). Defendants replied
(ECF 16) and filed another exhibit.
hearing is necessary to resolve the motion. See
Local Rule 105.6 (D. Md. 2016). For the reasons that follow,
I shall construe the Motion as one for summary judgment and I
shall grant it.
alleges that after undergoing shoulder surgery in 2017 he was
denied pain medication, a front cuffing order, and bandages.
ECF 1 at 8. In support of his claim, he explains that from
2015 to 2017 he complained of back, neck, and shoulder pain.
Eventually, on an unspecified date, after x-rays and
medication did not resolve the issues, he was referred to Ray
Carls, M.D., an orthopedic specialist. ECF 1 at 3.
of 2017, plaintiff was prescribed pain medication by Krista
Swann to treat the chronic pain in his left shoulder and
neck. The prescription expired on July 16, 2017. On July 18,
2017, plaintiff was transported to Western Maryland Medical
Center for surgery. Plaintiff states that he was advised that
he would undergo a procedure on his left shoulder rotator
but, when he awoke from surgery, he was advised by custody
staff that the procedure was done on his collar bone and his
surgical scar crosses his collar bone. Id.
was returned to the Western Correctional Institution
(“WCI”) infirmary for post-surgical observation.
On July 19, 2017, at approximately 10:00 p.m. he was given an
injection for pain relief and was told that he would receive
a shot every 8-12 hours until his prescription arrived.
Id. at 3. The following morning, he was examined by
“Dr. Barrera and given another shot.”
Id. at 4. Barrera approved his discharge from the
infirmary and return to the North Branch Correctional
Institution (“NBCI”), which occurred that
states that he received no pain medication until the
afternoon of July 22, 2017, when custody staff called the
medical office on his behalf. The officers explained the
urgency of plaintiff's situation and he was escorted to
the main building, where he was seen by medical staff and
provided a shot of pain medication. Id. When
plaintiff explained the situation to Nurse Travis, Travis
allegedly responded: “How we suppose to give you a shot
every 8-12 hrs. and we don't even have the staff for
reports that he was again escorted to the same building for
another shot during the 11 p.m. to 7 a.m. shift. According to
plaintiff, he advised unidentified medical personnel that the
injection was not working. Id. at 4.
Mouzone claims that on July 23, 2017, he received an
injection in the morning. But, he did not receive another
shot until the night of July 26, 2017. At that time, the
nurse advised plaintiff that his Ultram had not arrived, but
she was directed to give him two pills of Tylenol with
Codeine. Id. at 5. On July 27, 2017, plaintiff again
did not receive any pain medication. From July 28 to August
1, 2017 he received morning and nighttime doses of Ultram.
Thereafter, no pain medication was provided. Id.
this time, plaintiff filed sick call slips in an effort to
receive adequate pain medication and in order to receive
“front cuff paper work.” Id. On August
12, 2017, in response to his girlfriend calling and speaking
with Dr. Hassan and Bill Beeman, plaintiff was seen by a
nurse. However, the nurse could not prescribe pain medication
or provide paperwork regarding the cuffing and referred
plaintiff to Dr. Ashraf. Id. On August 16, 2017,
“defendant [presumably Dr. Ashraf] refused to provide
[plaintiff] pain meds or front cuff paperwork. Instead the
defendant opted to provide [plaintiff] a low grade muscle
relaxer called Baclofphin.” Id.
explanation for plaintiff's desire for a front cuffing
order, he states that when he returned to NBCI from his
surgery he was placed in Housing Unit 1, the Special Needs
Unit (“SNU”). When an inmate in the SNU is
removed from his cell, he must be placed in restraints.
Id. at 5-6. Despite the lack of a medical order to
be front cuffed, the officers cuffed plaintiff in front
because it was obvious that he just had surgery. Id.
at 6. This continued until August 31, 2017, when Sgt. Gamel
advised plaintiff that “medical specifically told him,
‘not to front cuff me no more.'” Id.
Plaintiff submitted numerous sick call requests seeking a
front cuff order but was not seen. Id.
addition, plaintiff alleges that after his surgery he did not
receive proper bandage changes. Id. He was
instructed not to remove his bandages for the first 48 hours
after surgery. He states that he went two weeks without a
shower due to his fear of contracting an infection from the
shower. Id. He explains that the SNU houses
segregation inmates as well as inmates with mental health
issues who, in various areas of the prison, including the
showers, regularly use bodily waste as weapons against other
inmates and staff and/or “just play in” the
waste. Id. at 6-7. The showers on the SNU are
cleaned once a day, after all of the inmates have utilized
them, by sanitation workers who do a poor job. Id.
indicates that using the showers posed a risk of harm to him
due to the possibility of there being life threatening
bacteria and given that the showers have black mold.
Id. at 7. He explains that he would have been forced
to use a shower with a fresh open wound after numerous
inmates used the shower, without the shower being properly
cleaned, and without his having access to anti-bacterial
cream or fresh gauze to properly clean and wrap his wound.
Id. Accordingly, plaintiff felt the best way to
protect himself was not to go into the
support of their Motion, Drs. Barrera and Ashraf submitted
various exhibits, including their own affidavits, relevant
portions of plaintiff's medical records, and the
commissary menu describing over the counter medications
available to plaintiff. ECF 11-2 (Discharge Instructions);
ECF 11-3, ECF 11-6, ECF 11-7, ECF 11-8; ECF 16-1 (Medical
Records 7/18/17-10/19/17); ECF 11-4 (Medical Diet Commissary
Menu); ECF 11-5 (Ashraf Affidavit); ECF 11-9 (Barrera
was admitted to the WCI Infirmary on the evening of July 18,
2017, in preparation for left shoulder surgery the following
day. ECF 11-6 at 2-4; ECF 11-3 at 6. Plaintiff underwent
arthroscopic surgery on his shoulder on July 19, 2017. ECF
11-5, ¶3; ECF 11-6 at 5, 8; ECF 11-9, ¶ 3. It was
performed by an outside physician, Roy Carls, M.D.
See, e.g., ECF 11-3 at 6; ECF 11-6 at 2.
discharge instructions, signed by plaintiff on July 19, 2017,
provided that plaintiff could shower in 24 hours, he was to
have ice and NSAIDs (non-steroidal anti-inflammatory drugs,
e.g., ibuprofen, acetaminophen), a sling, and to begin
occupational therapy exercises. ECF 11-2 at 2. He was to
follow up with Dr. Carls at the next orthopedic clinic at the
prison. Id. Dr. Barrera discharged plaintiff from
the WCI infirmary on July 20, 2017. ECF 11-5, ¶ 3; ECF
11-9, ¶ 3.
returned to the WCI infirmary the day of the surgery. ECF
11-6 at 5. At that time, Dr. Barrera gave verbal orders that
plaintiff be held in the infirmary for 23 hours, and that he
receive 600 mg of Motrin every 6 hours, as needed.
Id. The prescription for Motrin was valid from July
18, 2017 to July 26, 2017. ECF 11-3 at 3. That night,
plaintiff reported that his arm “really hurt, ”
and he asked if he could have anything for pain. ECF 11-6 at
7. Dr. Ashraf ordered an injection of Toradol immediately,
and then another shot in 12 hours, as needed, until the
arrival of plaintiff's prescription for Ultram.
Ashraf avers that, given plaintiff's discharge
instructions, and based on his medical training and
expertise, plaintiff did not require higher levels of pain
relievers, such as the narcotics plaintiff referenced in his
compliant. ECF 11-5 at 2, ¶ 4. Dr. Ashraf states that
although the higher level pain relievers were not medically
necessary, “as a matter of courtesy, ” plaintiff
was provided some narcotic pain medication for the first two
days after the surgery and an order was placed for narcotic
pain medication for the two weeks after the surgery. ECF 11-5
at 2-3, ¶ 6. Ashraf explains that he has no control
regarding whether a medication is provided to a patient by
the pharmacy. ECF 11-5 at 3 ¶ 7. Plaintiff was permitted
to purchase NSAID pain relievers through the prison
commissary. ECF 11-5 at 2, ¶ 5; ECF 11-4 at 2.
Barrera avers that his only interaction with plaintiff during
the time period at issue in the complaint was when he
discharged plaintiff from the infirmary on July 20, 2017. ECF
11-9 at 2, ¶ 4. At the time of discharge it was noted
that “pain medication is effective, ” plaintiff
was to be seen by Dr. Carls at the next orthopedic clinic,
and a request for physical therapy ...