United States District Court, D. Maryland
L. Hollander, United States District Judge
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.
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.
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.
was hospitalized at Spring Grove from 2013 to 2016 and was
required to take the drug risperidone 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.
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.
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.
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.
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.
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
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.
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.”
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.
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.
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
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.
Id., ECF 6 at 1-2.
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.
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.
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.
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
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
Based on the undisputed record evidence, defendant Ekoh is
entitled to summary judgment in his favor.
Appointment of Counsel
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).
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).
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 ...