United States District Court, D. Maryland, Southern Division
J. HAZEL UNITED STATES DISTRICT JUDGE
Richard Howard Beall, Jr. is involuntarily committed for
treatment to the Department of Health and Mental Hygiene (the
“Department”). Beall is a patient at Clifton T.
Perkins Hospital Center (“Perkins”), a state
psychiatric hospital. He claims that Defendant Macauley
Ujoatuonu, R.N., a nurse employed at Perkins, forcibly
administered medication to him. ECF Nos. 4-5. Defendant has
filed an Amended Motion to Dismiss or, in the Alternative for
Summary Judgment. ECF No. 14. No. hearing is necessary.
See Loc. R. 105.6. For the following reasons,
Defendant's Motion for Summary Judgment, ECF No. 14, is
mental health diagnoses include schizoaffective disorder
(bipolar type) and antisocial personality disorder. ECF No.
14-4 ¶ 6 (Affidavit of Sameer Patel, M.D.). Beall's
symptoms of mental illness include grandiosity,
hyper-spirituality, delusions about having superpower, and
paranoia. Id. ¶ 7. Beall exhibits poor insight
into his mental illness. Id.
also exhibits aggressive and assaultive behavior. ECF No.
14-4 ¶ 10; see also ECF No. 10-3 at 4-5. Beall
has been involuntarily medicated periodically pursuant to
determinations made by a clinical review panel
(“CRP”). ECF Nos. 14-4 ¶ 8, 14-5 at
Due to Beall's inconsistent compliance with medication
prescribed for him and increased aggression, the treatment
team pursued a medication order through a CRP pursuant to Md.
Code Ann. Health-Gen., § 10-708. ECF Nos. 10-5 at 2,
14-4 ¶ 11, 14-5 at 3.
13, 2016, Beall was provided a notice of the clinical review
panel meeting. ECF No. 14-8. On May 17, 2016, when the CRP
met to discuss Beall's medication and whether to
recommend administration of medication for Beall, it
considered medical compliance and incidents of aggression.
See ECF No. 14-4 ¶¶ 9, 10; ECF No. 14-5 at
2-6. Beall, Sonny Miranda, M.D., and Eseigboria Ogunbor,
Rights Advisor, were present at the meeting. ECF No. 14-5 at
1. The CRP was composed of Inna Taller, M.D., David Chandran,
M.D., and Valorie Grimes, LCSW-C. Id. During this
CRP, the following incidents were documented. In November
2015, Beall threatened to harm staff. Id. at 3. In
December 2015, Beall was verbally aggressive towards a
registered nurse and required the use of restraints to
control his aggression. Id. On March 19, 2016, Beall
had an altercation with a peer about the television.
Id. On March 21, 2016, he threatened to kill staff
by “spraying them with AK47 bullets.”
Id. He also threatened to harm his psychiatrist.
CRP meeting, Dr. Miranda explained that Beall's
aggression is psychotically driven and dissipates when he
adheres to his medication regimen. Id. Dr. Miranda
indicated that Beall's adherence to his medication
regimen had been “short-lived.” Id. When
Beall misses his medication, he clinically decompensates and
becomes violent. Id. Miranda told the CRP that Beall
has poor insight into his illness and need for treatment, and
would not take his medications without CRP oversight.
Id. The CRP record shows that during the meeting
Beall was irritable, agitated, and made paranoid and
delusional comments. ECF No. 14-4 ¶ 11; ECF No. 14-5 at
3. Beall told CPR members that Satan was talking in his ear
and commanding that angels were to be sprayed with bullets
from AK47 weapons. ECF No. 14-5 at 3.
determined Beall posed a danger to himself or others without
his medication. Id. at 4. The CRP recommended a
combination of the following medications for Beall:
Quetiapine by mouth, Fluphenazine by mouth, Fluphenazine
decanoate by intramuscular injection, Olanzapine or
Olanzapine Zydis by mouth, Divalproex Sodium or Valproic Acid
by mouth, Fluphenazine by intramuscular injection, Olanzapine
by intramuscular injection, Lorazepam by intramuscular
injection, and Diphenhydramine by intramuscular injection.
Id. at 5. The use of an intramuscular injection of
Olanzapine and Fluphenazine was authorized if Beall refused
medications by mouth. ECF No. 14-4 ¶ 12. ECF No. 14-5 at
5. Dr. Sameer Patel, Beall's treating psychiatrist,
stated that these medications are standard practice for
treating schizoaffective disorder, and in his professional
opinion, is a reasonable exercise of professional judgment.
ECF No. 14-4 ¶¶ 5, 18.
appealed the CRP decision. On May 26, 2016, an Administrative
Law Judge held a hearing on the appeal, found that Beall met
the criteria for involuntary medication under the Maryland
Health-General Code § 10-708, and authorized the use of
medications approved by the CRP on May 17, 2016 for a
ninety-day period. ECF No. 14-6; ECF No. 14-4 ¶ 14.
May 26, 2016 through June 1, 2016, Beall received his
medication by injection after he refused to take his
medication orally. Id. ¶ 16; ECF No. 10-9. Dr.
Patel opines that it was a reasonable exercise of
professional judgment to administer the intramuscular
injections (Olanzapine and Fluphenazine) authorized by the
CRP to treat Beall's mental illness. ECF No. 14-4 ¶
31, 2016, Beall approached the nurse's station, where
Ujoatuonu offered him the medications authorized by the CRP.
ECF No. 10-6. Beall was told that he would receive an
intramuscular injection if he did not take the prescribed
dose of Olanzapine by mouth. ECF No. 10-6, ECF No. 14-4
¶ 15. Beall indicated he would not accept the
intramuscular medication backup that the clinical review
panel had approved. Beall refused redirection when asked to
leave the nurse's station so that other patients could
receive their medication. Id. Beall then reached
into the nurse's station and punched Ujoatuonu in the
face. Id. Beall remained combative. While staff
placed him into a restraint chair, Beall used his head to hit
Ujoatuonu in the lower abdomen. Id. Beall was then
administered CRP authorized injections of Olanzapine and
Fluphenazine. ECF 10-7; ECF No. 14-7.
October 13, 2016, Beall initiated this case against multiple
defendants alleging that he was subjected to excessive force
when he was placed in restraints. ECF No. 1. On October 24,
2016, Beall filed an Amended Complaint, which he supplemented
on November 2, 2016. ECF Nos. 4, 5. As supplemented, the
Complaint alleged that in May of 2016, Beall was placed in
cervical restraints, his head was pushed back, and he was
injected with medication. ECF No. 4 at 3; ECF No. 5 at
As relief, Beall sought damages, investigation, expungement
of his criminal history, and his release. Id.
February 2, 2017, the Court dismissed Beall's claims
against all Defendants except Macauley Ujoatuonu, the only
defendant alleged to be personally involved in the actions
underlying the Complaint. ECF No. 7. The Court also ordered
counsel for the Department to submit a report on Beall's
mental health status to assist in determining whether
appointment of a guardian ad litem was necessary. ECF No. 7.
On March 1, 2017, counsel filed the court ordered mental
health status report. ECF No. 9. Based on this information,
the Court determined appointment of a guardian ad litem was
not warranted. ECF No. 12 at 5-9.
March 28, 2017, Defendant Ujoatuonu filed a Motion to Dismiss
or, in the Alternative, for Summary Judgment. ECF No. 10. On
March 26, 2018, the Court granted Ujoatuonu's Motion for
Summary Judgment in part. ECF No. 13, ECF No. 12 at 11
(discussing use of restraint and use of force claim). On that
date, the Court provided Ujoatuonu twenty-eight days to
submit evidence addressing whether the decision to administer
medication forcibly to Beall complied with due process. ECF
No. 13. He filed no response, and on April 16, 2018, the
Court mailed a Rule 12/56 letter to Beall warning him of the