United States District Court, D. Maryland
L. Hollander United States District Judge.
James Robinson, a self-represented Maryland prisoner confined
at the State's North Branch Correctional Institution
(“NBCI”), filed this civil rights complaint
against several defendants, claiming that they acted with
deliberate indifference to his medical needs. ECF 1.
Subsequently, he filed an Amended Complaint, which is
substantially similar to the original Complaint. ECF
The suit is supported by plaintiff's Declaration. ECF
16-2. Robinson seeks compensatory and punitive damages, and
he includes other requests for relief.
Frank B. Bishop, Jr., defendant, has moved to dismiss or, in
the alternative, for summary judgment. ECF 28. The motion is
supported by a memorandum (ECF 28-1) (collectively, the
“Warden Motion”) and exhibits. Defendants Wexford
Health Sources, Inc. (“Wexford”); Krista Self,
N.P.; Stacie Mast, R.N.; Breauna Baker, R.N.; Holly Pierce,
N.P., and Mahboob Ashraf, M.D. (“Medical
Defendants”) have filed a similar motion. ECF 32. It is
supported by a memorandum (ECF 32-3) (collectively,
“Medical Motion”) and exhibits. Robinson was
notified of his right to respond to the motions (ECF 29, ECF
33) but has failed to do so.
hearing is needed to resolve these motions. See
Local Rule 105.6 (D. Md. 2018). For the reasons that follow,
I shall grant defendants' motions.
alleges that the health care providers at NBCI are not taking
reasonable measures to guarantee his health and safety. ECF
16 at 2. He asserts that the “screening procedures
[are] devastating most of the time they only spend an average
of 15 to 30 seconds with each prisoner making cryptic notes
of complaints.” Id. Robinson also complains
about delays in seeing a physician, scheduling follow up
appointments and diagnostic tests, and unidentified
individuals interfering with the medical appointments.
Id. at 3, 5.
plaintiff alleges that he has not been provided with adequate
medical treatment. He asserts:
Now I been putting sick calls in for over a whole year now
saying that I am having problems with something feeling like
it move[s] inside my head, my nerves twitching way more then
they suppose[d] to, migraines, my bones crack way more than
they suppose[d] to, I barely [am] able to hear, my eyes [are]
still swollen and bruised, I lost a lot of weight, my teeth
then wore down so much they [are] almost completely gone, my
gums [are] overlapping too much, my ears, nose & throat
[are] sucking in make me choke, hard to breath[e] and
swallow, my nuts in my balls [are] getting small and etc. but
what have they actually done about it?
ECF 16 at 3 (some capitalization altered).
to plaintiff, the Medical Defendants failed to follow up on
referrals and orders for diagnostic testing. ECF 16 at 4. He
asserts that if they believed that testing was necessary, as
evidenced by their ordering it, they should have followed up
to insure that he received it. Id. at 4, 5. He also
alleges that the medications prescribed did not work and he
needed medical treatment. Id. at 7.
plaintiff clams his food has been tampered with and that in
2016, “they got me to sign a life insurance
policy.” Id. at 3, 5. He claims that he should
have been transferred to another facility based upon the
“Intrasystem Transfer” summary paperwork from
February 24, July 13, and September 14 of 2017. Id.
claims that he saw Dr. Graves regarding his teeth wearing
down but Dr. Graves only smoothed his teeth and told him that
the issue with his teeth was due to plaintiff grinding his
teeth, which plaintiff disputed. ECF 16 at 6. Dr. Graves
advised plaintiff that he would refer him to an outside
specialist, but not until he had completed physical therapy
for his jaw. Id. When plaintiff objected, Dr. Graves
had plaintiff removed from the examination room without
providing him with any dental care. Id.
Medical Defendants' Response
Medical Defendants argue, inter alia, that they were
not deliberately indifferent to any serious medical needs of
Robinson. ECF 32-3 at 20. And, as to Wexford, they claim that
it cannot be liable based on respondeat superior.
Id. at 22. Defendants rely on their exhibits to
support these contentions.
18, 2016, plaintiff was involved in an altercation with
another inmate and suffered extensive facial and head trauma,
when he was 26 years of age. ECF 32-4 at 5, 7. Robinson was
initially taken to Western Maryland Regional Medical Center
(“WRMC”) for treatment. Id. at 7-18. The
CT scans of plaintiff's chest, abdomen, pelvis, and spine
were normal. Id. at 10, 11. However, the CT of
plaintiff's brain showed soft tissue injury. Id.
And, the CT of plaintiff's face showed a depressed
fracture of the left inferior orbital floor, with no evidence
of blood within the left maxillary sinus. It was noted as a
suspected chronic healing fracture. Id.
plaintiff was combative with staff. Id. He was
placed in high level care and provided analgesic medication.
Id. at 12. He was diagnosed as suffering from a
depressed fracture of the left inferior orbital floor, head
injury, cervical strain, and blunt chest/abdominal injury.
Id. He was transferred to the University of Maryland
Shock Trauma due to the lack of ophthalmology staff at WMRMC.
Id. at 6, 17, 18, 19-26.
Shock Trauma, Robinson was also diagnosed with “swan
neck deformity” of his right long finger, for which he
was provided a splint. Id. at 25. He was discharged
from Shock Trauma on June 20, 2017 (id. at 27-28)
and admitted to the Western Correctional Institution
infirmary for skilled care monitoring, where he remained
until June 22, 2016. On that date, he was discharged back to
the prison population. Id. at 29-32. When plaintiff
was discharged he was described as uncooperative, banging on
the door seeking discharge. Id. at 32. He offered no
complaints of pain. Id.
was seen by Dawn Hawk, R.N. on July 5, 2016, due to
plaintiff's complaint of a sore on his right foot, his
belief that his right middle finger was broken, and left ear
pain. ECF 32-4 at 33-34. Examination demonstrated that
plaintiff's left ear was slightly swollen, but the ear
canal was clear and no other abnormality was observed.
Id. at 33. He had a small sore on his left foot,
which was cleaned and treated. Id. Plaintiff's
right middle finger was red, with a slight malformation.
Id. He was able to move the finger and no swelling
was observed. He was referred to a provider. Id. at
following day, plaintiff was seen by N.P. Krista Self (f/n/a
Bilak). ECF 32-4 at 35-36. Plaintiff did not have any
swelling or residual bruising but did have clicking on his
left temporomandibular joint. Id. at 35. Plaintiff
denied difficulty chewing or any pain but was nevertheless
prescribed Robaxin. Id.
August 18, 2016, plaintiff was seen by Self for complaints of
hearing loss. ECF 32-4 at 37-38. Self submitted a
consultation request for an audiology evaluation.
Id. at 37. On October 13, 2016, Self discussed the
results of the audiology evaluation with plaintiff.
Id. at 40-41. The audiologist recommended a hearing
aid for plaintiff's left ear (id.), which was
issued by Self on December 12, 2016. Id. at 45.
was scheduled to see Dr. Ashraf on August 22, 2016, but
refused to go to the clinic. ECF 32-4 at 39. He was
rescheduled for one month. Id.
October 21, 2016, plaintiff was evaluated by Nurse Evans
after a use of force incident involving the administration of
pepper spray. ECF 32-4 at 42.
Robaxin prescription was discontinued on October 25, 2016,
after he was found to be hoarding the medication. ECF 32-4,
Evans saw Robinson on December 18, 2016, due to his
complaints of a swollen face and that the bones in his face
were “cracking.” ECF 32-4 at 46. He was not in
apparent distress. However, there was swelling on the left
side of plaintiff's face, and he was referred to a
was evaluated by Nurse Buser on December 22, 2016, after a
use of force episode involving pepper spray. ECF 32-4 at 48.
Robinson was seen by NP Self on January 17, 2017, due to his
complaint of “jumping” nerves and his stated need
for an MRI. ECF 32-4 at 49. Plaintiff explained only that his
“head [was] jumping around.” Id. His
examination was unremarkable, and he was assessed as having
no unusual anxiety or depression. Id.
Hawk examined plaintiff on January 22, 2017, in response to a
sick call slip he filed the previous day, stating that his
nerves “jumped” and his bones cracked. ECF 32-5
at 51-53. He was unable to identify which nerves or bones he
was referencing. Id. at 52. He complained that the
left side of his face was still swollen. However, on
examination, no swelling or markings were observed.
again evaluated plaintiff on February 15, 2017. ECF 32-4 at
54-55. Plaintiff complained that he was sick, his bones were
cracking, and his nerves were jumping, he was going brain
dead, and needed a brain scan. Id. at 54. He was
referred to Behavioral Health. Id.
February 22, 2017, plaintiff was evaluated by Lauren Beitzel,
LCPC. ECF 32-4 at 56-57. Plaintiff expressed “paranoia
regarding his food being poison[ed], as well as a fixation on
physical problems that do not exist.” Id. at
56. He reported that his “nerves jump” and that
his skin felt different although he could not explain how.
Id. He also indicated his face felt swollen and his
bones crack, and he complained that Beitzel was not acting
right because she would not give him candy or a telephone
call. Id. Correctional staff reported that plaintiff
had components of impaired intellectual functioning and had
been problematic before his assault by the other inmate and
had been unable to keep cellmates. Id. Beitzel
assessed plaintiff as “presenting with elements of a
fictitious, body preoccupation” presenting in a
manipulative nature. Id.
March 6, 2017, plaintiff's Thyroid Stimulating Hormone
Test (“TSH”) results were elevated. ECF 32-4 at
Additional laboratory tests were ordered to reevaluate.
Id. The results were received on June 16, 2017, and
showed that plaintiff's T4 was normal and his T3 was
slightly low. Id. at 72-73.
March 24, 2017, custody staff requested NP Self see plaintiff
due to his complaints of bones cracking, nerves jumping, and
his brain dying. ECF 32-4 at 59-60. She noted that plaintiff
had been evaluated on a number of occasions regarding these
complaints and no medical reason for his symptoms had been
identified. Id. at 59. His physical examination was
unremarkable, and he was again referred to psychology.
was seen by Nurse Mast on April 25, 2017, in response to his
complaints of his eye twitching and nerve pain. ECF 32-4 at
61-62. At the time of exam, he had no active complaint of
pain and no twitching was observed. Although plaintiff had
slight swelling of the left eye lid, there was no bruising or
drainage. Id. at 61. Plaintiff advised Mast that he
wanted to have left eye surgery, which he claimed he refused
when he was taken to Baltimore for his head trauma.
Id. He was referred to a provider. Id.
April 27, 2017, plaintiff was seen by NP Self. ECF 32-4 at
63-64. He continued to complain of muscle twitching.
Id. at 63. His lab results were reviewed, and the
physical exam was normal. Id.
was evaluated by Nurse Evans on April 29, 2017, as a result
of an altercation between plaintiff and custody staff. ECF
32-4 at 65-66. Plaintiff had superficial lacerations on his
lips and knees. Id. at 65. He was wearing a spit
mask and admitted that he spat on the officers. Id.
He refused to have his abrasions treated and threatened to
spit on nurses if they did not start taking care of his
medical issues. Id.
submitted a sick call slip on May 7, 2017, complaining of
cracking bones, jumping nerves, that his nose felt like it
was “sucking in”, his stomach growled, and his
brain was loose and moving. ECF 32-4 at 67. He was seen by
Nurse Baker on May 9, 2017. Id. at 68-69. He was
seen by NP Self on May 12, 2017, raising the same claims
regarding bones cracking and nerves jumping and also
complaining that his hair was falling out. Id. at
70. His examination demonstrated that he had full range of
motion, no crepitus in any joints, and no balding spots on
his scalp. Id. He was encouraged to discuss his
complaints with Behavioral Health. Id. He appeared
anxious and paranoid and reported that he was being poisoned.
NP Self assessed plaintiff as anxious, exhibiting compulsive
behavior, having obsessive thoughts, exhibiting poor insight
and judgment, and having poor attention span and
concentration. Id. He was referred to Behavioral
Health for anxiety and paranoia. Id. at 71.
August 14, 2017, plaintiff was seen by Nurse Shively in
response to his complaints of “headaches, dizziness,
fatigue, memory failure, weight loss and lack of focus, [and]
problems with his nerves.” ECF 32-4 at 74. He asked to
be admitted to the infirmary and refused to leave the medical
department. He also denied that he had previously refused
medical appointments. Id. He was escorted back to
his cell by custody staff. Id.
Self saw plaintiff again on August 18, 2017. ECF 32-4 at 76.
He complained that his teeth were decaying but reported no
pain. Id. NP Self referred plaintiff to dental.
also complained that he had a concussion but denied any
recent injuries and no bruising or injuries were observed.
Id. He complained that his head was “messed
up” and NP Self encouraged him to see Behavioral
Health. Id. He continued to complain that his nerves
were jumping and his bones were cracking. However, no
crepitus was observed. Robinson erroneously claimed that he
had a cauliflower ear. Id. In addition, he
complained of weight loss, but there was no significant
weight loss observed. Id. Ultimately, plaintiff
became loud and cursed and lunged at NP Self, necessitating
his removal by custody staff. Id.
was evaluated by Dr. Ashraf on August 28, 2017. ECF 32-4 at
78-79. He complained of nerve pain. Id. at 78.
Examination showed no symptoms of weakness, however plaintiff
was assessed as being positive for neck stiffness, back pain,
bone and joint symptoms, and rheumatologic manifestations.
Id. His examination was otherwise unremarkable.
Id. He was prescribed Robaxin and Ibuprofen.
Id. at 79.
September 7, 2017, plaintiff was seen by Nurse Hawk after a
use of force incident with custody staff. ECF 32-4 at 80.
Plaintiff reported a right foot injury, but refused to
elaborate. Id. No. injuries were observed on
plaintiff's foot. Id. There was no swelling,
redness, or malformation. Id. But, he had mild
swelling and redness to his left ...