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Williams v. Pierce

United States District Court, D. Maryland

June 5, 2019

HOLLY PIERCE, NP, Defendant.



         Defendant Holly Pierce, NP, filed a motion to dismiss or for summary judgment (ECF No. 15) in response to this civil rights complaint filed by Plaintiff James M. Williams, an inmate incarcerated at North Branch Correctional Institution in Cumberland, Maryland. Mr. Williams opposes the motion. ECF No. 17.[1] A hearing in this matter is deemed unnecessary. See Local Rule 105.6 (D. Md. 2018). For the reasons stated below, Defendant's motion, construed as one for summary judgment due to the court's reliance on outside materials, [2] will be granted.


         Mr. Williams suffers from diabetic neuropathy which causes burning and numbness in his feet and hands. ECF No. 1 at p. 2. To address the pain caused by his condition, Mr. Williams was prescribed Neurontin which he was taking for approximately three or more years. Id. On February 20, 2018, when Mr. Williams placed a sick call slip requesting renewal of his Neurontin prescription, he was informed that the prescription was cancelled by Defendant Holly Pierce, a Nurse Practitioner employed by the healthcare contractor providing services to inmates confined to the Maryland Division of Correction. Id. Mr. Williams claims that in place of his prescription medication, Defendant gave him fish oil pills for his pain. Id. When Mr. Williams could no longer take his prescription medication, the pain caused by his diabetic neuropathy returned. Id.

         Mr. Williams states that Defendant took other steps deliberately to cause him harm and explains that on June 15, 2018, Defendant altered the standing order for the administration of his insulin. Id. Mr. Williams was on a sliding scale for the administration of insulin whenever his “numbers are high.” Id. Defendant changed the order to administration of 10 ml of insulin at 4:00 a.m. and 4:00 p.m. Id. Mr. Williams states that he believes Defendant is “now out to hurt me because of these actions I am taking to get taken care of.” Id.

         As relief Mr. Williams asks for an Order requiring the medical care providers at NBCI to treat his diabetic neuropathy, return his prescription for Neurontin, and award compensatory damages of $5, 000 for his pain and suffering. ECF No. 1 at p. 3.

         Defendant admits that Mr. Williams suffers from type II diabetes, [3] but claims she did not terminate his prescription for Neurontin, nor did she write a prescription for 10 ml of insulin to be administered to him twice daily. ECF No. 15-5 (Affidavit of Holly Pierce, NP). Verified medical records submitted in support of Defendant's motion establish that Mr. Williams was seen by Dr. Mahboob Ashraf on November 16, 2017, in the “chronic care clinic” for the monitoring of his chronic health conditions, including diabetes. ECF No. 15-4 at pp. 2-5. At that time, a prescription for 800 mg of Neurontin administered twice daily was in place. Id. at p. 4 (list of medications showing start date of Neurontin as October 16, 2017 and expiration date of February 16, 2018).

         On that same date, Dr. Ashraf submitted a “non-formulary request” for Gabapentin, 800 mg twice daily, for treatment of “diabetic neuropathies.” Id. at p. 6. Gabapentin is the generic name for Neurontin.[4]

         According to Defendant's explanation, unnamed staff made an error in Mr. Williams' prescription when the February 2018 medication administration record was prepared and a prior order issued by Nurse Practitioner Self for a Neurontin prescription covering the period of October 25, 2017 through February 21, 2018 was recorded. ECF No. 15-5 at p. 2, ¶3. When Mr. Williams was again seen by Dr. Ashraf on February 15, 2018, his prescription was not renewed but he received Neurontin through the February 21, 2018 expiration date. Id., see also ECF No. 15-4 at pp. 9-12.

         Defendant states that the only time she encountered Mr. Williams was on January 26, 2018, when he reported suffering an injury to his knee. ECF No. 15-5 at p. 2, ¶4; ECF No. 15-4 at pp. 7-8. At that time, Mr. Williams had a current, unexpired prescription for Neurontin. ECF No. 15-4 at p. 8. Defendant had no further encounters with Mr. Williams until March 2, 2018, when she discussed his lab test results with him. ECF No. 15-4 at p. 13.

         On March 9, 2018, Mr. Williams was seen by Stacie Mast, RN, for complaints of pain in his feet and hands. ECF No. 15-4 at pp. 16-17. Mr. Williams told Ms. Mast that he needed his Neurontin returned to address the pain he was experiencing as a result of his diabetes. Id. at p. 16. Ms. Mast noted that Mr. Williams had been non-compliant with his medications and insulin schedule, resulting in several recent high blood sugar levels. Id. Mr. Williams was also not reporting to medical to have his blood sugar checked at 4:00 a.m. Id. She discussed the importance of having his blood sugar checked and watching his weight. He was not prescribed Neurontin but advised to continue taking the medications he was already prescribed. Id. The provider noted for this encounter is Defendant Holly Pierce, NP. Id. at p. 17. There is no explanation regarding why Mr. Williams's prescription for Neurontin was allowed to expire in any of the records submitted by Defendant. Rather, Tammy Buser, RN, states in a record dated June 29, 2018, that Mr. Williams was not interested in attempting other solutions for his pain and that she “[e]xplained that Neurontin was not a choice at this time.” Id. at p. 21.

         Defendant denies that she altered Mr. Williams' prescription for insulin. She explains that the alleged dosage prescribed (10 ml, twice per day) is lethal if given once per day and therefore would not have been written by any medical care provider. ECF No. 15-5 at p. 2, ¶6. In addition, she states that no order for insulin for Mr. Williams was entered in June of 2018. Id.

         Standard ...

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