United States District Court, D. Maryland
RICHARD D. BENNETT, UNITED STATES DISTRICT JUDGE
response to this civil rights complaint, Defendants Wexford
Health Sources, Inc. and Ruth Pinkney move to dismiss or for
summary judgment in their favor. ECF 37 & 43.
Self-represented Plaintiff Melvin Wayne Murray also filed a
motion for summary judgment, which is best construed as an
opposition to Defendants' motion. ECF 39. Defendants have
replied. ECF 49. No. hearing is necessary for the disposition
of the matters pending before the Court. See Local
Rule 105.6 (D. Md. 2018). For the reasons that follow,
Defendants' motion, construed as one for summary
judgment, is GRANTED and Plaintiffs motion DENIED.
time he filed this Complaint, Murray was an inmate at the
Eastern Correctional Institution (ECI). He claims that
during his chronic care clinic visits he complained to the
Physician's Assistant (PA) (presumably Defendant Pinkney)
about the symptoms of his conditions, which included chronic
obstructive pulmonary disease (COPD), a hernia, and tardive
dyskinesia (TD). ECF 1 at p. 3. The PA refused to refer him
to a physician or to send him to an outside hospital for
additional diagnostic testing. Id. at
Murray complains that the only treatment rendered for his
COPD was to prescribe him two inhalers. ECF 1 at 4. He claims
that Pinkney has refused to allow him to be seen by a
physician and that his COPD has worsened. Id. at 4,
also claims that Pinkney is aware of his TD which he
describes as a chronic eye nerve condition caused by an
overdose of Risperdal. Id. at 5. He claims
that on two occasions he suffered serious side effects that
left his eye blurry and caused constant blinking.
Id. He states that the disease cannot be cured but
can be treated. Id. He alleges that Defendants have
failed to treat this condition or have delayed treatment for
his vision, and he seeks referral to a neurologist and to be
provided a Botox injection. Id. at 6. He also
indicates that surgery could be performed to correct his
condition. Id. Murray claims that Defendants'
refusal to provide him access to a physician is improperly
based on security and cost saving concerns, and that the
medication he requires is on a restricted list. Id.
at pp. 6-7.
Murray claims that he suffers from recurrent hernia issues
which cause bowel problems. ECF 1 at p. 7. He states that he
underwent surgery in 2010 but the Defendants refuse him
additional treatment. Id. He claims that they have
not prescribed medication to treat his hernia symptoms, nor
will they refer him to a doctor or outside hospital for
testing because they do not believe that the hernia is
serious. Id. Murray reports that when he coughs he
"balls up in pain” Id. Murray has been
provided a "belt" to treat the hernia, which he
indicates worsens the pain and causes irritation.
Id. Murray seeks referral to an outside hospital for
additional diagnostic testing or treatment. Id.
submit exhibits, including the affidavits of Jason Clem, M.D.
and relevant portions of Murray's medical records from
February 5, 2015 through October 17, 2018, when Murray
attended a tele-med evaluation performed by Dr. Herjit S.
Bajaj, a neurologist with Bon Secours Hospital. ECF 37-5
(Clem Affidavit); ECF 43-2 (Clem Affidavit II); ECF 37-4
(medical records 2/5/15-5/3/18); ECF 43-1 (medical record
state that Murray has a history significant for an abscess,
hypertension, COPD, asthma, seasonal allergies, eczema,
chronic left should pain, glaucoma, abdominal and inguinal
hernias. They indicate he also suffers from an eye condition
that is either blepharospasm (an abnormal, involuntary
blinking or spasm of the eyelids) or TD (a side effect that
may occur with certain medication used to treat mental
illness that may appear as repetitive, jerking movements in
the face, neck, and tongue). Dr. Clem avers that Murray has
received appropriate medical care for his conditions. ECF
37-5, ¶¶ 6, 7, 8; ECF 43-2, ¶ 4.
Clem explains that TD is a disorder that results in
involuntary jerking movement of the tongue, lips, face,
trunk, and extremities. ECF 37-5, ¶ 5. It can be caused
by long-term treatment with dopamine antagonists such as
Risperdal. Murray, who presents with blinking of the eyes,
admitted he suffered from involuntary movements prior to
taking Risperdal. Id. Dr. Clem explains that it is
unusual for TD to occur in the absence of neuroleptic
medication. Given that Murray's symptoms predated his use
of Risperdal, Clem opines that it could indicate that his
symptoms were not caused by TD but rather were blepharospasm
or psychogenic in nature. Id.
medical records demonstrate that he was seen by an
ophthalmologist, Dr. Summerfield, on February 5, 2015. Dr.
Summerfield who regularly treated Murray for glaucoma,
diagnosed Murray as suffering from blepharospasm in both
eyes, and indicated that Botox treatment should be considered
if Murray's condition became problematic. ECF 37-4 at 2.
did not complain of excessive blinking during his chronic
care visit on June 25, 2015, or during examinations on July
17 and 21, 2015. ECF 37-4 at pp. 4-8, pp. 11-13, 14-15. He
also did not complain of excessive blinking in August of
2015, when he was seen by medical staff after being exposed
to pepper spray. ECF 37-4 at p. 16.
was again evaluated by Dr. Summerfield on August 27, 2015.
ECF 37-4 at 18. His vision was 20/20 in one eye and 20/25 in
the other. Symptoms of either blepharospasm or TD were
observed; however, Dr. Summerfield noted that Murray was
doing well and would continue to be monitored. Id.
Dr. Summerfield did not recommend any additional treatment
for the blepharospasm. Id.
the next several months Murray was regularly seen by medical
staff but did not complain of excessive blinking during the
examinations, which occurred on September 3 and 22, 2015,
October 28, 2015, December 24, 2015, and January 22, 2016.
ECF 37-4 at 19-20, 21-23, 24-26, 27, 34-36.
again saw Dr. Summerfield on February 4, 2016. ECF 37-4 at
37. His vision was 20/25 in one eye and 20/30 in the other,
and the blepharospasm was assessed as stable. Id. On
February 26, 2016, during chart review, Sheila Kerpelman N.P.
noted that Dr. Summerfield had not renewed Murray's
prescription for Xalatan (a medication to treat
glaucoma) but the plan was to continue the
medication. Id. at 38-41. Murray was referred to
optometry for new glasses. Id.
the next several months Murray continued to be seen by
medical staff but did not offer any complaints regarding his
eyes. On May 17, 2016, Murray was seen by N.P. Kerpelman in
the chronic care clinic. ECF 37-4 at 42-48. Examination of
his eyes was unremarkable and he did not complain of
excessive blinking. Id. Murray was examined in the
chronic care clinic on August 17, 2016, November 16, 2016,
and February 27, 2017, but did not complain of excessive
blinking on any of these occasions. ECF 37-4 at 53-60, 61-63,
64-68. He was seen on March 20, 2017 by a nurse for a sick
call visit but did not complain of excessive blinking.
Id. at 69-70.
November 13, 2017, during a chronic care visit, Murray
complained that he had been blinking a lot and had excessive
tearing. ECF 37-4 at 78-83.
not offer any complaints regarding his eyes when he was seen
in sick call on January 2, 2018. ECF 37-4 at 84-86.
chronic care clinic on January 22, 2018, an optometry consult
was placed due to Murray's complaints of excessive
blinking. ECF 37-4 at 88-94. On February 5, 2018, P.A. Cyran
submitted a neurology consult to evaluate Murray's
excessive blinking. Id. at 95-101. Cyran noted
Murray's history of glaucoma and treatment by an
ophthalmologist. She also noted that she discussed
Murray's condition with a psychiatrist who recommended a
neurological work up. Id. Cyran documented
Murray's history of Risperdal use, including his report
that he suffered facial contractions prior to being
prescribed Risperdal in 2007, and that after he stopped
taking Risperdal his facial tics continued. Id.
February 5, 2018, the request for neurology consultation was
deferred and an alternative treatment plan to continue to
monitor Murray was recommended. ECF 37-4 at 102. It was noted
that the neurological complaint did not interfere with
Murray's activities of daily living and were likely
psychologically related. Id.
April 13, 2018, Murray was evaluated again by Cyran in the
chronic care clinic. ECF 37-4 at 106-112. He complained that
the movements of his eyes and mouth were bothersome and
interfering with his quality of life and that his medical
needs were not being met. His history of Risperdal use was
reviewed and his condition was discussed with psychiatry
staff who indicated that they did not believe the condition
was psychiatric in nature. Id. After discussing
Murray's condition with the Medical Director, a second
request for a neurological consult was placed. Id.
was examined by Dr. Summerfield on May 3, 2018. ECF 37-4 at
113. Dr. Summerfield noted the abnormal movements and
recommended that Murray be evaluated by a neurologist.
Id. He also ...