United States District Court, D. Maryland
L. Hollander United States District Judge.
Jabriel Chase, a self-represented inmate presently
incarcerated at Western Correctional Institution
(“WCI”) in Cumberland, Maryland, filed this civil
rights action under 42 U.S.C. § 1983. ECF 1. He
subsequently supplemented (ECF 3) and amended (ECF 6) his
Complaint, naming the following defendants: the Maryland
Department of Public Safety and Correctional Services
(“DPSCS”); Wexford Health Sources,
(“Wexford”); WCI Warden Richard Graham; WCI
Security Chief Bradley Butler; and Fatima Hussein, M.D. Chase
alleges that Wexford and Dr. Hussein failed to treat his
ankle injury properly and in a timely manner, resulting in
disfigurement, and that DPSCS, Graham, and Butler
(collectively, “Correctional Defendants”)
subjected him to discrimination. ECF 3 at 2, 4-5. He seeks $5
million in monetary damages from the correctional defendants
and $5 million from Wexford and Dr. Hussein. Id. at
filed a motion to dismiss or, alternatively, for summary
judgment, pursuant to Federal Rules of Civil Procedure 12(b)
and 56. ECF 23. It is supported by a memorandum (ECF 23-1)
(collectively, “Wexford Motion”) and several
exhibits. The Correctional Defendants also filed a
dispositive motion (ECF 25), supported by a memorandum (ECF
25-1) (collectively, Correctional Motion) and exhibits. And,
Dr. Hussein filed a dispositive motion (ECF 36), supported by
a memorandum (ECF 36-1) (collectively, “Hussein
Motion”) and an exhibit.
filed a response in opposition to defendants' motions
(ECF 38), which he supplemented (ECF 39), supported by a
Declaration. ECF 39-1. Defendants Wexford and Dr. Hussein
filed replies. ECF 40; ECF 41; ECF 42.
hearing is necessary to resolve the motions. Local Rule
105.6. For the reasons stated below, defendants'
dispositive motions shall be denied, without prejudice.
claims that on April 7, 2018, while he was incarcerated at
WCI, he sustained an ankle injury. ECF 3 at 2. He was seen by
Wexford's medical staff, who gave him crutches and
bandages. Id. Chase alleges that the following day,
he was taken for an x-ray and was seen by Dr. Hussein, who
informed him that his ankle was broken. Id. at 2, 4.
According to Chase, Dr. Hussein did not give him a cast,
boot, or brace, and she told him that he did not need to go
to a hospital. Id. at 4.
alleges that he was subsequently placed on segregation
pending adjustment, where he was housed on the top tier and
made to walk up some stairs. Id. Chase claims that
when he tried to refuse the housing assignment, he was
threatened with receiving an adjustment; therefore, he
remained in the top tier. Id.
was subsequently seen by Roy Carls, M.D., who said that he
would order a boot for Chase's ankle. Id.
However, Chase claims that he never received the boot.
Id. Approximately 10 weeks later, on June 23, 2018,
Chase returned for an x-ray and discovered that his ankle was
disfigured, as it did not heal properly as a result of not
receiving a cast, boot, or ankle brace. Id. The
following day, on June 24, 2018, Chase was seen by Janette
Clark, NP, who stated that she would order a brace.
Id. Chase claims that when he asked why he had not
received a boot yet, he was told that he was not permitted to
have one while being housed on segregation status.
Id. at 5. He states that he received an ankle
support on July 11, 2018. Id.
do not dispute that Chase suffered a left ankle injury on
April 7, 2018, following an altercation with other inmates.
Wexford Motion, ECF 23-1 at 3. After the incident, Chase was
brought to the medical department, where Asresahegn Getachew,
M.D. observed that Chase's ankle appeared swollen and
tender. Medical Records, ECF 23-3 at 3. Dr. Getachew wrapped
the ankle with an ace bandage for support, gave Chase
crutches, and provided Motrin for discomfort. Id.
next morning, on April 8, 2018, Chase was brought back to the
medical department, at which time Beverly McLaughlin, RNP
observed additional bruising, redness, and swelling of the
left ankle. Id. at 5. McLaughlin scheduled an x-ray
for the next day and splinted and wrapped Chase's ankle
for immobilization. Id.
April 10, 2018, Chase received an x-ray of the injured ankle.
ECF 23-4 at 2. The x-rays revealed an “acute fracture
involving lateral malleolus and distal fibula with minimal
displacement” and an “[a]cute avulsion fracture
involving the posterior malleolus of distal tibia.”
Id. There was “no evidence of joint
subluxation or dislocation.” Id. That same
day, Chase was seen by Dr. Hussein, who noted that the
swelling had improved but the ankle remained tender. ECF 23-3
at 7. Dr. Hussein replaced the splint and wrap, gave Chase
crutches, referred him for a consultation with an orthopedic
specialist, and recommended a wheelchair for long distances.
ECF 23-3 at 7-8.
April 20, 2018, Chase was seen by Dr. Carls, an orthopedic
specialist. Id. at 9. Chase alleges that he was seen
by Dr. Carls “only after [his] family called the
medical director.” ECF 39 at 7. Dr. Carls indicated
that Chase's ankle was mildly painful and no longer
splinted because plaintiff “was not allowed to get this
splint wet.” ECF 23-3 at 9. Dr. Carls also noted that
Chase would be able to bear weight on the ankle “as
long as he is in a boot such as a fracture boot.”
Id. Dr. Carls recommended a follow up a month later
with additional x-rays of the ankle. Id. There is
nothing in the record to indicate that a boot was ordered at
this time, however.
4, 2018, Chase was by NP Clark. Id. at 10. At that
time, Clark discussed the orthopedic visit, noting that Chase
had a “[n]on displaced left fibular fracture” and
that it had been recommended that he wear a boot.”
Id. In response to Dr. Carls' orders and her
clinical exam, Clark requested a follow up with orthopedics
and scheduled another x-ray of the ankle for May 21, 2018.
Id. at 12.
received a follow up x-ray of his ankle on May 21, 2018,
which again indicated an “[a]cute avulsion fracture
involving the dorsal aspect of the distal end of the
tibia.” ECF 23-4 at 3. Again, there was no evidence of
joint dislocation or subluxation. Id. Moreover, the
joint mortise was preserved, and the ankle maintained an
anatomical alignment. Id.
6, June 14, and June 19, 2018, Chase filed sick call requests
complaining of continued ankle pain. Sick Call Requests, ECF
23-6 at 2-4. Chase indicated that his ankle had not yet been
reset and that he had not received a boot. Id.
Thereafter, Chase was sent for another x-ray on June 22,
2018. ECF 23-4 at 5. That x-ray revealed that there was
“[s]ubluxation with increased distance between the
medial malleolus and the talus” and “no definite
visible acute fracture.” Id.
23, 2018, Chase was seen by RNP McLaughlin, who noted that
Chase was experiencing pain and that the orthopedist
“suggested” the use of a boot, but that the boot
had not been received. ECF 23-3 at 13. McLaughlin also noted
that Chase was “seen by another provider last month,
who placed ortho f/u/ consult, no decision in ephr for
review, so sent to offsite scheduler for answer from
collegial.” Id. McLaughlin stated that
“according to previous provider left boot was ordered
via nan-form, ” but she would also send an email.
Id. McLaughlin submitted a request for evaluation
and treatment by an outside provider. Id. at 13-14.
In the interim, McLaughlin requested the nursing department
to “assess [patient] on tier for needs of assistant
device to help him for now, ” and she prescribed 50 mg
of Tramadol. Id. at 13.
was brought back to the medical unit the following day, on
June 24, 2018, for a scheduled visit with NP Clark.
Id. at 15. Clark noted that Chase was seen by
orthopedics on April 20, 2018, who “[r]ecommended
wearing boot, ” but Chase “ha[d] not received
brace.” Id. Clark observed that there was
“[m]oderate swelling over medial aspect of left ankle
with obvious bony deformity. He is limping. Painful to
palpitation.” Id. Clark noted that his
“Referral to provider 1 wk review xray/track fx”
had been ordered. Id.
2, 2018, Chase submitted a request for administrative remedy
(“ARP”), complaining about the medical treatment
he received for the ankle injury. ECF 25-2 at 12-13. He
indicated that medical providers explained that his left
ankle healed improperly and needed to be reset. Id.
An investigation determined that his claim was meritorious
because medical providers failed to order medical supplies in
a timely manner. Id.
12, 2018, Chase was given a gel ankle support. ECF 23-3 at
18. Chase was seen again on July 21 and July 22, 2018, in
follow up to sick call requests. Id. at 19-21.
During the visit on July 22, RNP McLaughlin discussed the
latest x-ray results and offered to provide
“[wheelchair] and bottom bunk and bottom tier for 2
months.” Id. at 20. According to the
Correctional Defendants, however, “[n]o medical orders
provided for housing him on a bottom tier nor for the use of
a wheelchair other than for long distances.” ECF 25-1
at 3. McLaughlin advised Chase to keep the ankle
“elevated while laying down and take motrin with food
or milk for pain, ” and to “[follow up] if new or
worsening current conditions.” ECF 23-3 at 57. Chase
was advised that he would see the orthopedist at the end of
the month. Id.
was scheduled for an orthopedic consultation on August 8,
2018. However, Dr. Carls had an emergency and was not able to
see him. Id. at 22. Instead, RNP McLaughlin
reevaluated Chase and noted he was “doing better with
ambulation” but “does have swollen medial
malleolus.” Id. During that visit, Chase
informed McLaughlin that he did not receive a copy of the
request for bottom tier, bottom bunk, and wheelchair;
therefore, McLaughlin asked medical to resend it. McLaughlin
also advised Chase about his medication adjustment and
informed him that his visit with Dr. Carls would be
saw Dr. Carls on August 24, 2018. Id. at 24. After
reviewing Chase's x-rays of June 22, 2018, Dr. Carls
determined that Chase had a “chronic injury of the left
ankle that includes shortening of the fibula, a lateral shift
of the mortise, and, likely deltoid incompetency.”
Id. Dr. Carls and Chase discussed corrective surgery
and that, “at best, [surgery] will give him about a 50%
chance for a good functioning ankle.” Id. Dr.
Carls discussed the need to reconstruct the fibular,
lengthening it by using a bone graft. Id. Chase
indicated to Dr. Carls that he would like to attempt the
ankle surgery, despite the risks. Id.
two sick calls in early September regarding plaitniff's
pain medication, ECF 23-6 at 11-12, Chase was brought for a
follow up visit on September 10, 2018. ECF 23-3 at 25. Chase
complained that he was in constant pain and that
“[n]othing he does helps with pain.” ECF 23-3 at
25. According to the Consultation Notes, it was during this
visit that the pain medication for Chase's ankle was
considered to be failing and “[l]ocal outpatient ankle
repair w/ Dr. Carls” was requested. ECF ...