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Rice v. Ashrah

United States District Court, D. Maryland

April 4, 2019

JAMAHL RICE, Plaintiff .
DR. ASHRAH, et al. Defendants



         Self-represented plaintiff Jamahl Rice filed the above-captioned civil rights action alleging that Defendants have been deliberately indifferent to his medical needs. ECF No. 1. Three of the four Defendants[1] have filed a Motion to Dismiss or, in the Alternative, Motion for Summary Judgment, and Plaintiff has responded. ECF Nos. 16, 25. Defendants have also filed a Supplemental Motion to Dismiss. ECF No. 32.

         The matter is now ripe for review. The Court finds a hearing in these matters unnecessary. See Local Rule 105.6. For the reasons that follow, Defendants' dispositive Motion, construed as a Motion for Summary Judgment, is GRANTED. Defendants' Supplemental Motion for Summary Judgment is terminated as moot.


         A. Plaintiffs Complaint

         Plaintiff, an inmate housed at North Branch Correctional Institution, filed this action on February 19, 2018. ECF No. 1 at 4; see also Houston v. Lack, 487 U.S. 266, 270-72 (1988) . (discussing prison mailbox rule). He alleges that he dislocated his left shoulder on January 15, 2018. Id. The following day, he saw Defendant Doctor Ashraf, who ordered that Plaintiff undergo an x-ray. Id. Plaintiff states that he "was not given any results" following the x-ray procedure. On January 19, 2018, Plaintiff was informed that the x-ray revealed "no change" when compared with a previously-taken x-ray and thus Plaintiff had was not "sent to the hospital yet or given any pain medication." Id.[2] Plaintiff reports that the refusal to send him to the hospital or provide him with pain medication remained ongoing as of his filing of this instant Complaint on February 19, 2018. Id. Plaintiff also asserts that Defendants have failed to comply with the instructions of an emergency room doctor "to follow up with an orthopedic surgeon," though he does not provide details about this instruction (such as when it was issued, the identity of the doctor, the time frame for follow-up, etc.). Id. at 5

         Plaintiff, who reports that he has "had 5 surger[ies] to correct this problem [of shoulder dislocations]" complains that medical providers are refusing to treat him because they claim he is deliberately dislocating his shoulders. Id. at 4-5. In particular, he states that Defendant Doctor Joubert-Curtis told other prison medical staff "to never see [Plaintiff] for this problem" because the problem is self-inflicted, and that Defendant Nurse Pierce "told [him] to live with it" and that medical providers "were not going to keep sending [him] out" to the hospital to address his recurring shoulder dislocations. Id.

         Plaintiff complains that the untreated dislocation is causing him pain that is preventing him from being able to sleep. Id. at 5. He also states that he is depressed because he feels he is being treated unfairly by the medical staff. Id.

         In addition to the issue of his shoulder dislocation, Plaintiff states that he suffers from Hepatitis C and is receiving inadequate treatment for this condition. Id. Specifically, he claims

The state knew about this [diagnosis of Hepatitis C] for 5 months now[.] I have high levels with a swollen liver[;] not once has a doctor check on me to see if my liver is still swollen [or] if my levels got higher. ... I have been having hot cold sweats, fever, fatigue, nose bleeds and my organs ache at night.


         B. Defendants' Exhibits

         (1) Shoulder Injury

         In support of their dispositive Motion, Defendants have submitted Plaintiffs medical records, dating back to September 2017. ECF No. 16-3. Defendants have also included an entry in Plaintiffs medical history dated June 16, 2017, that summarizes Plaintiffs history of "recurrent bilateral shoulder dislocations" including eight dislocations between November 2016 and June 2017. Id. at 3. It was also noted that, during his two prior terms in prison collectively totaling 23 months' imprisonment, Plaintiff suffered 12 dislocations and underwent 3 "ORIF" or open reduction surgical procedures.[3] Id. at 3.

         The June 16, 2017 entry further stated

Pt admitted on 6/12/17 to being caught cheeking opioid pain medications in DOC around 2009. As per previous visit by ortho on-site, pt has a chronic sublaxation[4] which is manipulated by the patient for secondary gain, (i.e., to go to hospital or to get a narcotic). Per note from 9/13/11, patient was caught self-applying tourniquet to cause edema/loss of circulation to left arm s/p left shoulder surgery. In note from 11/7/11, Dr. Hassan was contacted about further surgery. The patient told a provider that he could dislocate his shoulders at-will. Dr. Hassan, in note from 11/7/11, recommended no further surgery as surgery cannot prevent voluntary shoulder dislocations... . Pt seen by nursing, custody previously not wearing sling as advised.

Id. (emphasis omitted).

         On September 1, 2017, Plaintiff was transferred from the Department of Corrections' Metropolitan Transition Center (MTC) infirmary to the University of Maryland Medical Center (UMMC) for a treatment of a left shoulder dislocation, which Plaintiff had been suffering from for several weeks. Id. at 6-8. At UMMC, Plaintiffs "shoulder was reduced under sedation." Id. at 10.

         Plaintiff was discharged from UMMC the same day. Id. Prison health providers reported that Plaintiffs discharge note from the hospital stated that "patient [l]igaments are not strong enough to keep the shoulder in joint. Patient is to keep his shoulder in the sling and to avoid exercise." Id. Plaintiff was monitored in the infirmary for a day following his discharge but voiced no concerns. Id. at 12.

         Later the same month, Plaintiff was in the MTC infirmary with a left shoulder dislocation and repeatedly demanded that he be prescribed oxycodone for his pain. Id. at 15-18. Medical providers told him that his condition did not warrant oxycodone, and that his existing prescriptions for Tylenol-codeine and Ultram[5] were adequate to address his pain. Id.

         Plaintiffs medical records indicate that in late September and early October 2017 prison medical providers were having difficulty getting outside orthopedic specialists to treat Plaintiff due to his history with multiple providers and the risk of serious complications based on Plaintiffs numerous past procedures. Id. at 19-22, 25. For example, on September 28, 2017, Plaintiff had a scheduled appointment with an orthopedic specialist at Johns Hopkins Hospital (JHH) regarding his dislocation; however, the provider did not treat Plaintiff and instead advised that Plaintiff be returned to UMMC, where his recent reduction had been performed. Id. Notes from September 28 stated that Plaintiff continued to cause problems to his shoulders by ignoring post-surgical instructions regarding movement and exercise, and that he was frequently observed without his arm sling. Id. at 19, 21, 34.

         On October 16, 2017, an x-ray was taken of Plaintiff s left shoulder at Towson Orthopedic Associates; the evaluating doctor indicated that it was impossible to tell what caused the serious instability in Plaintiffs arm and opined that an open reduction would likely be necessary "to get his should back in[to]" place. Id. at 36-37.

         On October 22, 2017, while attempting to take a shower, Plaintiff called for help and was discovered on the bathroom floor. Plaintiff reported that he had fallen. Id. at 42-43. Someone called 911 and Plaintiff was taken to JHH. Id. at 43-45. At JHH, Plaintiff underwent a closed reduction on his right shoulder before his right arm and shoulder were "placed into a sling & swath which the patient should maintain at all times." Id. at 46-47. It was noted that the left shoulder was "not amenable to closed reduction" and recommended that Plaintiff follow up with UMMS about surgical options. Id. at 46. Doctors at JHH performed CT scans and x-rays on Plaintiffs shoulders and surrounding areas (e.g., spine, humerus bones, etc.). Id. at 48-53. Both shoulders were noted to be subluxed, but the images were reported to be substantially similar to images from earlier years. Mat 50-53.

         Once Plaintiff returned to the MTC infirmary, providers noted Plaintiffs bilateral shoulder subluxation "with degenerative changes & chronic Hill-Sachs deformity," observed that Plaintiff was wearing an arm sling, and planned to resume the same treatment plan as before Plaintiffs October 22 fall. Id. at 54-56. On October 26, 2018, it was noted that Dr. Craig Mathew of St. Joseph Hospital was willing to perform a procedure on Plaintiffs left shoulder provided that Plaintiff undergo an MRI; a consultation request for that MRI was placed. Id. at 58. However, Plaintiffs medical records also reported that multiple other orthopedic surgeons were unwilling to perform the procedure because they believed he should see the surgeon who performed surgery "on the same joint, in 2009." Id.

         On October 27, 2017, Plaintiff reported that a correctional officer pulled his right arm and dislocated it, but an x-ray was performed on the arm a few days later and revealed no change from the x-ray taken at JHH on October 23, 2017. Id. at 60, 63, 66.

         Between November 2 and November 15, 2017, Plaintiff was housed at the infirmary at Eastern Correctional Institution (ECI). Id. at 89. During his time there, Plaintiff "admitted to [a] provider that in the past he would intentionally dislocate his shoulder but stopped d[o]ing that after his surgeries and due to the chronic pain and restrictive movement." Id. at 66. Despite the results of the x-ray indicating that Plaintiffs right shoulder was unchanged compared with the October 27 incident, Plaintiff continued to insist that his right shoulder had been dislocated by the correctional officer and requested that the shoulder be reduced. Id. at 68, 74, 83, 85. He was informed that "on[-]site reduction is not medically indicated due to [his] excessive history of dislocation and repair." Id. at 68, 74.

         During the roughly two weeks that he was at the ECI infirmary, Plaintiff was observed on several occasions without his sling(s). Id. at 72, 79. On several occasions, Plaintiff attempted to reduce the shoulder himself (by banging his shoulder against the wall) despite being instructed not to do so. Id. at 72, 74, 76, 83. Although he was already prescribed pain medication including Tylenol-codeine, he repeatedly demanded specific pain medication such as oxycodone and, on some occasions, refused the medication that he was offered. Id. at 69, 79, 85. He was frequently reported as being belligerent to staff and refused to be evaluated on multiple occasions. Id. at 72, 74, 76, 80.

         On November 16, 2017, an MRI was performed on Plaintiffs left shoulder, as requested by Dr. Mathew. Id. at 91-92. Notes from the MRI report that Plaintiff appeared to have a "mild inferior subluxation of the humeral head" and characterized this inferior subluxation as "chronic." Id. at 92. Defendants have omitted Plaintiffs medical records from November 17, 2017 through December 21, 2017, and it is unclear if Dr. Mathew performed surgery on Plaintiffs left shoulder.

         On December 21, 2017, Plaintiff was housed at Jessup Correctional Institution. He fell in the shower, causing his left shoulder to be displaced. Id. at 93. Plaintiff was taken to Bon Secours Hospital (BSH) where he underwent an unsuccessful closed reduction on his left shoulder, was prescribed Percocet for pain, and was instructed to follow-up with an orthopedic surgeon in a week with a pending order for an open reduction of the left shoulder. Id. at 93, 98-100, 108. Plaintiff was returned to Jessup Correctional Institution/Jessup Regional Hospital (JRH) for observation, where the medical notes made repeated reference to his history of recurrent shoulder dislocations, with providers noting that they suspected the problems were self-induced and for the purposes of getting narcotics or other secondary gain. Id. at 95, 100, 106, 110. Notes in ...

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