Robinson v. Wexford Health

          MEMORANDUM OPINION

          Ellen L. Hollander United States District Judge.

         Plaintiff 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 16.^[1] The suit is supported by plaintiff's Declaration. ECF 16-2. Robinson seeks compensatory and punitive damages, and he includes other requests for relief.^[2]

         Warden 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.

         No 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.

         I. Background

         A. Plaintiff's allegations

         Plaintiff 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.

         Specifically, 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).

         According 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.

         Additionally, 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. at 7.

         Plaintiff 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.

         B. Medical Defendants' Response

         The 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.

         On June 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.

         At WRMC 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.

         At 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.

         Plaintiff 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 34.

         The 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.^[3]

         On 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.

         Plaintiff 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.

         On 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.

         Plaintiff's Robaxin prescription was discontinued on October 25, 2016, after he was found to be hoarding the medication. ECF 32-4, p. 44.

         Nurse 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 provider. Id.

         Robinson 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.

         Nurse 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. Id.

         NP Self 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.

         On 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.

         On March 6, 2017, plaintiff's Thyroid Stimulating Hormone Test (“TSH”) results were elevated. ECF 32-4 at 58.^[4] 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.

         On 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. Id.

         Plaintiff 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.

         On 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.

         Plaintiff 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.

         Robinson 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.

         On 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.

         Nurse 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. Id.

         Plaintiff 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.

         Plaintiff 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.

         On 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 ...