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Enow v. Reeves

United States District Court, D. Maryland

November 12, 2019

NDOKEY ENOW, Plaintiff



         Ndokey Enow's pro se Complaint alleges that Dr. Talmadge Reeves provided him inadequate medical care in violation of his rights under the Eighth Amendment.[1] ECF No. 1. Dr. Reeves previously filed a Motion to Dismiss or, in the Alternative, Motion for Summary Judgment (ECF No. 25), which I denied without prejudice to renewal.[2] ECF Nos. 38, 39. Dr. Reeves thereafter renewed his dispositive motion and filed the pending Supplemental Motion to Dismiss or, in the Alternative for Summary Judgment. ECF No. 41. Enow, a Maryland inmate in the custody of the Division of Correction, filed a verified Response in Opposition with a request for a settlement conference. ECF Nos. 48, 52. The matter is ripe for disposition, and no hearing is necessary. See Local Rule 105.6 (D. Md. 2018). For the reasons discussed below, Dr. Reeves' Supplemental Motion (ECF No. 41), will be treated as a Motion for Summary Judgment[3] and granted. Enow's claims are dismissed with prejudice.[4]


         Enow claims that on February 17, 2017, Dr. Reeves discontinued his medication for Zoloft, a psychotropic drug, without notice or due process, in violation of his rights under the Eighth Amendment. ECF No. 1 at 7, ¶ 8; ECF No. 48 (“Pl. Opp'n”) at 2, ¶ 3. Enow denies that he was hoarding this medication. Pl. Opp'n at 3, ¶ 8.

         The facts germane to this issue were summarized in my Memorandum Opinion dated February 16, 2018. ECF No. 38 at 20. On January 25, 2017, Dr. Reeves saw Enow for psychiatric treatment, at which time Dr. Reeves noted that Enow was being seen every 12 weeks to monitor the Zoloft he was prescribed for depression. Id. On February 13, 2017, Nurse Victoria Midgette reported that Enow was found hoarding 20 Zoloft pills. Id. The following day, Dr. Reeves discontinued the Zoloft prescription without seeing Enow due to concerns about hoarding. Id. On March 24 and 25, 2017, Enow submitted sick call slips stating that he was not receiving his anti- depressant medicine and, in the March 24, 2017 sick call slip, he complained of suffering heart palpitations, chest pain, pain attacks, and other symptoms. Id.

         On May 10, 2017, Dr. Reeves saw Enow for the “12 week” check-up, although more than 12 weeks had passed since the last visit on January 25, 2017. Enow told Dr. Reeves that he was “prescribed Zoloft 50 mg. and he was breaking it in two [be]cause it cause[s] his stomach to bubble.” Id. In response to the concern expressed by Enow, Dr. Reeves prescribed Zoloft 25 mg. Id. Dr. Reeves continued to see Enow after the medication was discontinued in February 2017 and decided to reorder the medication at half strength at his next appointment because Enow had been on the medication for many years. Decl. of Dr. Reeves, ECF No. 25-3 (“Dr. Reeves Decl. I”), at ¶ 5. Dr. Reeves advised Enow that in the future he needed to refuse the medication instead of pretending to take it or to hoard it. Id. Dr. Reeves states that it is standard prison policy to discontinue medication if an inmate is hoarding it. Id. at ¶ 7.

         Given these facts, I determined there remained a genuine dispute of material facts making summary judgment inappropriate. ECF No. 38 at 21. Specifically, at issue was (1) whether Enow was hoarding medication, and if he was not, whether Dr. Reeves was aware the report of hoarding was incorrect; (2) if Enow was hoarding his medication or Dr. Reeves was unaware the report was inaccurate, did the abrupt discontinuation of the medication without seeing the patient for more than twelve weeks, despite Enow's complaints about adverse effects from the discontinuance, violate acceptable medical standards; (3) whether the discontinuation of the medication caused the injuries alleged and, if so whether Dr. Reeves was aware or should have been aware of the possible adverse effects; and (4) whether Dr. Reeves knew or should have known about the sick call slips complaining of adverse effects. Id.


         Legal Standard

         In order to establish an Eighth Amendment claim, Enow must show that Dr. Reeves' actions amounted to deliberate indifference to a serious medical need. See Estelle v. Gamble, 429 U.S. 97, 106 (1976). There is no underlying distinction between the right to medical care for physical ills and its psychological and psychiatric counterpart. Bowring v. Godwin, 551 F.2d 44, 47 (4th Cir. 1977); see also DePaola v. Clarke, 884 F.3d 481, 486 (4th Cir. 2018) (“Courts treat an inmate's mental health claims just as seriously as any physical health claims.”).

         Deliberate indifference to a serious medical need requires proof that, objectively, a prisoner was suffering from a serious medical need and that, subjectively, the prison staff were aware of the need for medical attention but failed to either provide it or ensure it was available. See Farmer v. Brennan, 511 U.S. 825, 834-37 (1994); see also Heyer v. U.S. Bureau of Prisons, 849 F.3d 202, 209-10 (4th Cir. 2017); King v. Rubenstein, 825 F.3d 206, 218 (4th Cir. 2016); Iko v. Shreve, 535 F.3d 225, 241 (4th Cir. 2008). Objectively, the medical condition at issue must be serious. See Hudson v. McMillian, 503 U.S. 1, 9 (1992) (“Because society does not expect that prisoners will have unqualified access to health care, deliberate indifference to medical needs amounts to an Eighth Amendment violation only if those needs are ‘serious.'”); Jackson v. Lightsey, 775 F.3d 170, 178 (4th Cir. 2014). The subjective component requires “subjective recklessness” in the face of the serious medical condition. See Farmer, 511 U.S. at 839 (1994); see also Anderson v. Kingsley, 877 F.3d 539, 544 (4th Cir. 2017).

         “Deliberate indifference is a very high standard-a showing of mere negligence will not meet it. . . . [T]he Constitution is designed to deal with deprivations of rights, not errors in judgment, even though such errors may have unfortunate consequences.” Grayson v. Peed, 195 F.3d 692, 695-96 (4th Cir. 1999). “[A]ny negligence or malpractice on the part of . . . doctors in missing [a] diagnosis does not, by itself, support an inference of deliberate indifference.” Johnson v. Quinones, 145 F.3d 164, 166 (4th Cir. 1998). Further, “[a] prisoner's disagreement with medical providers about the proper course of treatment does not establish an Eighth Amendment violation absent exceptional circumstances.” Lopez v. Green, No. PJM-09-1942, 2012 WL 1999868, at *2- 3 (D.Md. June 4, 2012) (citing Wright v. Collins, 766 F.2d 841, 849 (4th Cir. 1985)).

         Dr. Reeves' Supplemental Response

         Dr. Reeves states that on February 13, 2017, a psychiatric nurse informed him that Enow was found hoarding his medications.[5] Declaration of Dr. Reeves, ECF No. 41-1 (“Dr. Reeves Decl. II”) at 1 ¶ 4. The nurse documented that she had discussed with Enow stopping his medication due to hoarding and “Enow was aware of same.” Id. Dr. Reeves explains psychiatric nurses are trained to provide mental health treatment and he relies on them as an “extra set of eyes and ears” to provide information including misuse of psychotropic medication. Id. at 1-2 ¶¶ 4, 5. Dr. Reeves states that had Enow disputed hoarding his medication, the psychiatric nurse would be expected to so indicate in her email and she did not. Dr. Reeves indicates Enow later admitted to him that he was hoarding medication. Id. at 1-2 ΒΆ4. Dr. Reeves maintains that it was reasonable for him to rely on the nurse's report about the ...

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