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Jiggetts v. Spring Grove Hospital Center

United States District Court, D. Maryland

July 12, 2019

ALEXANDER JIGGETTS, Plaintiff,
v.
SPRING GROVE HOSPITAL CENTER, CEO DWAIN SHAW, DR. GAIL MISRA, [1] Defendants.

          MEMORANDUM OPINION

          Ellen L. Hollander, United States District Judge

         Self-represented plaintiff Alexander Jiggetts filed this civil rights complaint pursuant to 42 U.S.C. § 1983, in connection with his hospitalization at Spring Grove Hospital Center (“Spring Grove” or the “Hospital”) and the administration of risperidone to him during his stay. ECF 1. Defendants Spring Grove and Dwain Shaw moved to dismiss or for summary judgment. ECF 7. It is supported by a memorandum. ECF 7-1. In response, Jiggetts filed an “Omnibus Motion Reply Or Response And Motion To Amend Complaint.” ECF 10. He seeks, inter alia, to add Dr. Gail Misra as a defendant.

         Thereafter, defendants renewed their motion, joined by Dr. Misra. ECF 12. I shall refer to ECF 7, ECF 7-1, and ECF 12 collectively as the “Motion.” Jiggetts opposes the Motion (ECF 14) and has filed multiple motions to amend the complaint (ECF 10, 15, 18, 21, 22), together with supplemental complaints (ECF 11, 16, 19, 23) as well as a motion to appoint counsel. ECF 17. Defendants oppose Jiggetts' second motion to amend the complaint (ECF 20) and, presumably, all subsequent motions to amend.

         No hearing is necessary to resolve the pending matters. See Local Rule 106.5 (D. Md. 2018). For the reasons that follow, I shall grant plaintiff's motion to amend (ECF 10). And, I shall construe defendants' Motion as a motion to dismiss and grant it.

         I. Background

         A. Jiggetts' Allegations

         Jiggetts was hospitalized at Spring Grove from 2013 to 2016 and was required to take the drug risperidone[2] for treatment of his schizoaffective disorder. According to Jiggetts, the drug is used to treat schizophrenia and was inappropriately prescribed to him because he does not have that specific illness. He alleges that prescribing this medication to him, over his objection, was malpractice and constituted cruel and unusual punishment. ECF 1.[3]

         According to Jiggetts, the medication made him feel “sick.” ECF 1. He also experienced other side effects, such as gaining “excessive weight, ” breast growth, and fatigue. Id. Jiggetts claims the weight gain and breast growth appear to be permanent; he complains that he cannot lose weight “even when I starve myself.” Id. at 1, 3. Indeed, Jiggetts states that he is “so fat now” that “it's hard for [him] to exercise.” Id. at 1. He also describes an inability to “stop walking around” that has lingered since taking risperidone. Id. at 3. During his hospitalization Jiggetts periodically “stopped eating” because of the weight gain he was experiencing, and this resulted in his being punished by Hospital staff. Id.

         Plaintiff observes that Spring Grove staff do not discuss medication choices with the patients and gave him no say in what was prescribed to him. Id. at 1. He alleges that he was told that if he did not take the medication orally, he would receive it by injection. Id.

         Plaintiff seeks $500, 000 in damages, claiming that the drug he received was for schizophrenia, but he was hospitalized for schizoaffective disorder. Id. at 1. He asserts that the care he received constituted “malpractice and cruel and unusual punishment . . . .” Id.

         In plaintiff's first motion to amend the complaint, he seeks to include as a defendant Dr. Gail Misra, who was the first doctor he had at Spring Grove who prescribed risperidone. ECF 10. In the accompanying supplemental complaint Jiggetts expands on his claim against Dr. Misra, explaining: “[A]bout two months ago I found out that risperidone was not approved by the Food And Drug Administration [“FDA”] for Schizoaffective Disorder.” ECF 11 at 1. He states: “This is w[h]ere I sue for malpractice, false diagnosis, cruel and unusual punishment and deprival [sic] of life, property, and liberty.” Id. He claims Dr. Misra never explained the possible side effects of taking risperidone and states, “I am not suing because I was forcibly . . . medicated against my will I am suing because of the malpractice and false diagnosis in growing breast and weight gain. And the sickness I feel . . . .” Id.

         In a pleading entitled “Motion to Withdraw Facts that are Incorrect and Make the Record Clear and Motion to Amend Complaint” Jiggetts appears to withdraw his claim against Dr. Misra. ECF 15. He “corrects” the record to state that he was given risperidone for schizophrenia, not schizoaffective disorder. Id. He states that all other claims “should be taken as truth.” Id.

         In another motion to amend complaint, Jiggetts moves to add as a defendant Dr. Gray of Spring Grove because “he gave me medicine that knocked me out and I didn't know where I was at, ” and he seeks to add information about Dr. Ekoh and Dr. Misra. ECF 18. The additional information, filed in a separate pleading that was docketed as a supplemental complaint, indicates that Dr. Gray, Dr. Misra, and Dr. Ekoh prescribed multiple medications for Jiggetts that he believes “can be dangerous to a person.” ECF 19 at 1. He expresses his belief that there was nothing wrong with him and that his treating psychiatrists “added thing wrong with me with the schizophrenia.” Id. Because he “can't do things the same, ” Jiggetts asserts that the medications he received caused him to develop mental disabilities. Id. He suspects that each of his treating psychiatrists diagnosed him with different conditions and believes this should be investigated. Id. He further reiterates his position that he is not suing for the forced medication issue; rather, he is “challenging the medications given, diagnosis, and side effects.” Id.

         In two motions, each titled “Motion to Let Amended Complaint Go Through And To Clarify To The Court My Pleadings, ” Jiggetts indicates that he is filing a “clean copy” of the amended complaint. ECF 21, ECF 22. In what was docketed as a supplemental complaint, Jiggetts provides the described amended complaint. ECF 23; ECF 23-1. He alleges that Drs. Gray, Misra, and Ekoh gave him medicine that made him feel drunk, caused him to pass out, and to feel as though he was in another world. ECF 23-1 at 1. Further, Jiggetts alleges that these doctors gave him three or four different medications “which can be dangerous to a person.” Id.

         Plaintiff questions the validity of his schizophrenia diagnosis in light of the medications he was prescribed, and asserts that these doctors simply “made up things wrong with [him]” when in reality nothing was wrong with him. Id. In Jiggetts' view, the medications he received (haloperidol, lorazepam, diphenhydramine, and risperidone) created mental disabilities. Id. He reiterates that he is not raising a claim regarding forced medication. Rather, he is “challenging the medications given, diagnosis, and side effects.” Id.

         B. Defendants' Response

         Relying on this court's decision in Jiggetts v. Ekoh, Civil Action JFM-15-3270 (D. Md. 2015), defendants assert that Jiggetts's claim regarding forced medication is subject to dismissal under the principals of res judicata. ECF 7. Additionally, defendants assert that Jiggetts' claims are barred by the Eleventh Amendment because he has named both a Maryland State agency and its director in his official capacity. ECF 7. Jiggetts filed a response to the Motion and included a motion to amend complaint in his response. ECF 10. He asserts that summary judgment is inappropriate because the FDA has not approved the use of risperidone for treatment of schizoaffective disorder, and his complaint is not limited to the issue of involuntary medication but includes claims of medical malpractice (lack of informed consent) and cruel and unusual punishment. Id. at 1-2.

         C. Prior Litigation

         In a Memorandum of March 28, 2016, Judge Motz summarized Jiggetts' claims in the case of Jiggetts v. Ekoh, Civil Action JFM-15-3270 (D. Md. 2015), as follows:

Plaintiff Alexander Jiggetts (“Jiggetts”) is a patient at Spring Grove Hospital where he is involuntarily committed following a finding that he was not competent to stand trial on criminal charges pending in both Baltimore City and Baltimore County. See ECF 1 at p. 3; ECF 4-1 at p. 2. Jiggetts alleges in his complaint that Dr. Chiyene Ekoh, a psychiatrist at Spring Grove and the only named defendant in this case, violated his rights by improperly medicating him over his objection. Jiggetts states that either Ekoh or another member of the staff have told other patients to fight Jiggetts so that a reason to force medicate Jiggetts will be established. As an example, Jiggetts states that “on October 12, 2015, [Ekoh] or staff pumped up a patient to fight me whom I didn't know” resulting in a 72 hour emergency medication order. ECF 1 at p. 1. While Jiggetts was forced to take medication, he claims the other patient who assaulted him suffered no consequence for his actions. Jiggetts further claims that the applicable Maryland state statute does not permit 72 hour emergency medication. ECF 1 at p. 1.
Jiggetts further alleges that Ekoh said Jiggetts was a danger and a threat to society for simply defending himself and because he will not consent to taking medication. He states that Ekoh told him that if he does not take his medication Jiggetts will never be released. Jiggetts claims that when he takes the medication prescribed for him his thoughts get disorganized, he hallucinates, feels dizzy and weak, his body slows down, and he experiences excessive sleepiness. Jiggetts asserts that Ekoh never discussed the side-effects of the medications with him. ECF 1 at p. 1.
Jiggetts states that when the fight occurred he was trying to “get the one guy off me who attacked me” when another man came over and held Jiggetts down, allowing his original assailant to continue hitting Jiggetts. ECF 1 at p. 1. Jiggetts states that “everyone” claimed that Jiggetts started the fight. Id. at p. 2. Ekoh told Jiggetts months before the fight that if he stayed out of trouble he would not have to take medication. Jiggetts alleges, however, that Ekoh kept telling him he had lice and accusing him of not bathing. He also claims that Ekoh mentioned Jiggetts' appeals of staff decisions to the court, but does not mention appeals filed by other patients. Additionally, Jiggetts takes issue with Ekoh allowing someone to press charges against Jiggetts. ECF 1 at p. 2.
Jiggetts also asserts that Ekoh took issue with the fact that Jiggetts was fasting and forced medicated Jiggetts in an effort to force him to start eating again. He claims that medicating him when he has not eaten is Ekoh's attempt to kill him and violates his constitutional rights. ECF 1 at p. 2. As relief, Jiggetts seeks to enjoin Ekoh from ordering medication over Jiggetts' objection. Id. at p. 3.

Id., ECF 6 at 1-2.

         The defendant in that case, Dr. Chinenye Ekoh, was a psychiatrist at Spring Grove at the time Jiggetts was a patient there. In response to the complaint filed against him, Dr. Ekoh provided evidence establishing that, during Jiggetts' hospitalization, which began on December 3, 2013, Jiggetts had only occasionally agreed to take prescribed medication on an emergency basis. See id. at ECF 4-3, ¶¶ 6 and 8. There were several instances when Jiggetts displayed aggressive and inappropriate behavior, including throwing his roommate's belongings around the room; attempting to convince a staff member to assist in his escape; telephoning 911 repeatedly to report that Dr. Ekoh was attempting to brainwash him through witchcraft and voodoo; chasing another patient from the bathroom with his fists raised and threatening staff who tried to intervene; violently banging on the nurses' station window and accusing staff of conspiring against him; harassment of other patients in an effort to provoke a fight; and declining to engage in personal hygiene. Id. ¶¶ 9-11, 13, 15, 20. Following one of these instances, Dr. Ekoh issued a 72-hour emergency medication order, as permitted by Md. Code, Health Gen. §10-708(b)(1) as well as Hospital policy. Id. ¶¶ 18 and 19.

         Subsequently, a clinical review panel was convened pursuant to Md. Code, Health Gen. §10-708, and the panel approved a plan to medicate Jiggetts involuntarily, in order to control his delusions and demonstrated aggression. Id. ¶ 22. Jiggetts appealed the decision of the panel, which was considered by an Administrative Law Judge. In the interim, however, Jiggetts violently attacked another patient, requiring him to be escorted by a staff member at all times. Id. ¶¶ 22, 23.

         After a hearing considering Jiggetts' appeal, the ALJ issued a decision affirming the panel's decision to involuntarily medicate Jiggetts. Id., ECF 4-9. Jiggetts' subsequent appeal to the Circuit Court for Baltimore County was also unsuccessful in overturning the panel's decision. Id., ECF 4-10. A second clinical review panel followed the same procedure. Id., ECF 4-13; ECF 4-14; ECF 4-15.

         In granting summary judgment in favor of the only named defendant, Dr. Ekoh, and finding that Jiggetts' Fourteenth Amendment right to due process was not violated, the court reasoned, id., ECF 6 at 8-9:

As an involuntarily committed patient in a State psychiatric facility, Jiggetts has a “‘significant constitutionally protected liberty interest in avoiding the unwarranted administration of antipsychotic drugs.'” Sell v. United States, 539 U.S. 166, 178 (2003), quoting Washington v. Harper, 494 U.S. 210, 221 (1990). “[W]hen the purpose or effect of forced drugging is to alter the will and the mind of the subject, it constitutes a deprivation of liberty in the most literal and fundamental sense.” United States v. Bush, 585 F.3d 806, 813 (4th Cir. 2009). “Involuntarily committed mental patients retain a liberty interest in conditions of reasonable care and safety and in reasonably nonrestrictive confinement conditions.” Youngberg v. Romeo, 457 U.S. 307, 324 (1982). The Fourteenth Amendment ensures that states will provide not only for the medical needs of those in penal settings, but for anyone restricted by a state from obtaining medical care on his own. See DeShaney v. Winnebago, 489 U.S. 189, 200 (1989); Youngberg, 457 U.S. at 324.
Jiggetts' allegations against Ekoh appear to be a product of his mental illness as there is no evidence to support a claim that Ekoh used involuntary medication to punish or retaliate against Jiggetts. There is ample evidence that his involuntary medication was necessitated by his aggressive and disruptive behavior. Against the backdrop of Jiggetts' assaultive behavior, his liberty interest in remaining free of unwanted medication was properly overridden. See Harper, 494 U.S. at 225.
Moreover, Jiggetts' [sic] received the procedural protections required before a protected liberty interest may be infringed. Jiggetts was provided notice, the right to be present at an adversarial hearing, and the right to present and cross-examine witnesses each time an order for his involuntary medication was issued. The process for review of the decisions to involuntarily medicate Jiggetts comports with procedural due process. See Harper, 494 U.S. at 235.
Based on the undisputed record evidence, defendant Ekoh is entitled to summary judgment in his favor.

         II. Non-Dispositive Motions

         A. Appointment of Counsel

         In plaintiff's motion to appoint counsel (ECF 17), Jiggetts cites his poverty as the basis for his request. A federal district court judge's power to appoint counsel under 28 U.S.C. § 1915(e)(1) is a discretionary one, and may be considered where an indigent claimant presents exceptional circumstances. See Cook v. Bounds, 518 F.2d 779, 780 (4th Cir. 1975); see also Branch v. Cole, 686 F.2d 264, 266 (5th Cir. 1982). There is no absolute right to appointment of counsel; an indigent claimant must present “exceptional circumstances.” See Miller v. Simmons, 814 F.2d 962, 966 (4th Cir. 1987).

         Exceptional circumstances exist where a “pro se litigant has a colorable claim but lacks the capacity to present it.” See Whisenant v. Yuam, 739 F.2d 160, 163 (4th Cir. 1984), abrogated on other grounds by Mallard v. U.S. Dist. Ct., 490 U.S. 296, 298 (1989) (holding that 28 U.S.C. § 1915 does not authorize compulsory appointment of counsel). Such circumstances also include a litigant who “is barely able to read or write, ” Whisenant at 162, or clearly “has a colorable claim but lacks the capacity to present it, ” Berry v. Gutierrez, 587 F.Supp.2d 717, 723 (E.D. Va. 2008).

         For reasons set forth more fully below, the claims asserted by Jiggetts are not colorable, a merits hearing is unnecessary, discovery will not take place, and therefore appointment ...


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