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Chase v. DPSCS

United States District Court, D. Maryland

September 17, 2019

DPSCS, et al., Defendants.


          Ellen L. Hollander United States District Judge.

         Plaintiff 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, Inc.[1] (“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 3.

         Wexford 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.

         Chase 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.[2]

         No hearing is necessary to resolve the motions. Local Rule 105.6. For the reasons stated below, defendants' dispositive motions shall be denied, without prejudice.

         I. Factual Background

         Chase claims that on April 7, 2018, while he was incarcerated at WCI, he sustained an ankle injury. ECF 3 at 2.[3] 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.

         Chase 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.

         Chase 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.

         Defendants 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.

         The 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.

         On 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.

         On 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.

         On May 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.

         Chase 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.

         On June 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.

         On June 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.

         Chase 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.

         On July 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.

         On July 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.

         Chase 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 rescheduled. Id.

         Chase 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.

         After 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 ...

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