Facts
- The Court instructed Plaintiff Mary L. Harris to indicate if she requests pro bono counsel's services [lines="13-14"].
- The Plaintiff indicated a request for pro bono representation, leading the Clerk of Court to seek such counsel [lines="18-20"].
- The Court previously permitted the Plaintiff to proceed in forma pauperis, establishing her indigency [lines="80-81"].
- Plaintiff's claims are deemed "likely to be of substance," supported by the Court's prior opinions [lines="85-87"].
- The case may involve complex legal issues and credibility determinations, influencing the requirement for counsel [lines="100-101"], [lines="108-109"].
Issues
- Whether the Court should grant the request for pro bono counsel based on the Plaintiff's indigency and the substance of her claims [lines="22-23"].
- Whether the complexity of the legal issues and the nature of the claims warrant the appointment of pro bono counsel [lines="100-101"].
Holdings
- The Court requests pro bono counsel for the Plaintiff due to her indigency and significant claims [lines="116-117"].
- The decision is based on the potential complexity of the legal issues and the credibility factors involved in the claims [lines="90-94"], [lines="108-109"].
OPINION
ROBERT DANIELS, Plаintiff, v. PRITI MANDALAYWALA, Defendant.
9:23-cv-983 (BKS/TWD)
UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF NEW YORK
July 29, 2024
Hon. Brenda K. Sannes, Chief United States District Judge
For Plaintiff:
Amy Jane Agnew
Joshua L. Morrison
Law Office of Amy Jane Agnew, P.C.
24 Fifth Avenue, Suite 1701
New York, New York 10011
For Defendant:
Oriana L. Kiley
Gabriella R. Levine
Whiteman Osterman & Hanna LLP
One Commerce Plaza
Albany, New York 12260
Hon. Brenda K. Sannes, Chief United States District Judge:
MEMORANDUM-DECISION AND ORDER
I. INTRODUCTION
On August 12, 2023, Plaintiff Robert Daniels initiated this action pursuant to
Presently before the Court is Defendant Mandalaywala‘s motion to dismiss pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure. (Dkt. No. 26.) The motion is fully briefed. (Dkt. Nos. 28-29, 31.) For the following reasons, Defendant‘s motion to dismiss is denied.
II. FACTS2
A. Medications With Abuse Potential Policy
Plaintiff, who was held in the custody of the New York State Department of Corrections and Cоmmunity Supervision (“DOCCS“) from 2019 to 2022, alleges that Defendant Mandalaywala‘s continued refusal to represcribe Gabapentin and Tylenol #3 to treat Plaintiff‘s chronic pain, due to DOCCS policies and customs, constitutes deliberate indifference. (Dkt. No. 12, at 53, ¶¶ 334-39.) DOCCS’ “policy on Medications With Abuse Potential” (“MWAP“) was promulgated on June 2, 2017. (Id. ¶¶ 11, 143-44.)3 On its MWAP list, “DOCCS included a group of ... ubiquitous medications, including” medications at issue here: Neurontin (also known as Gabapentin), “an anticonvulsant generally taken to control seizures” and “often
Under the MWAP policy, a provider must “submit an MWAP Request Form” to a Regional Medical Director (“RMD“). (Id. ¶¶ 156-157.) The MWAP Request Form “asked for relevant health information regarding the patient, the justification for use of the medication and a list of any alternatives tried to treat the medical issue.” (Id. ¶ 158.) The MWAP Request Form “also asked if there is any recent evidence of drug diversion or abuse by the patient.” (Id. ¶ 159.) “Based on the MWAP Request Form contents-the RMD and not the patient‘s medical provider-determined whether a patient will receive an MWAP.” (Id. ¶ 162.) The treating physicians and mid-level clinical physicians “had to discontinue an MWAP prescription if it was not approved by the RMD“; “[p]harmacies would not fill a prescription for an MWAP without RMD approval“; and the providers “had no ability to provide the medication once an RMD refused to approve the prescription.” (Id. ¶ 167.)
The MWAP policy “had the immediate impact of abruptly discontinuing the effective treatment of hundreds of inmates on MWAPs.” (Id. ¶ 173.) “As implemented, the MWAP Policy was an almost wholesale restriction on the prescription of MWAPs, except in cases of acute need
In February 2021, “as a direct result of class action litigation, DOCCS . . . rescinded the MWAP Policy and promulgated a new policy[,] 1.24A,” entitled “Prescribing for Chronic Pain.” (Id. ¶ 285.) “The new policy demanded ‘Pain management medication should only be discontinued after a provider has met with the patient, discussed the issues regarding the use of
B. Plaintiff‘s Medical Issues
Plaintiff is a 49-year-old man who suffers from “obesity, Type II diabetes[,] diabetic neuropathy,” and cervical spine syndrome, which result in a “chronic pain condition,” and throughout the relevant period, Plaintiff experienced, inter alia, chronic neuropathic pain. (Id. ¶¶ 313, 319-20, 328, 332, 335, 337-38, 340-42, 346-47.) Plaintiff‘s “chronic pain symptoms are well documented, obvious, and confirmed” and “require[] effective pain mаnagement and medication to control.” (Id. ¶ 313.)
Prior to Plaintiff‘s incarceration with DOCCS, he was a pretrial detainee at “New York City jail on Rikers Island.” (Id. ¶ 314.) While at Rikers, Plaintiff was “continually prescribed and represcribed Gabapentin and Tylenol #3 to treat and manage his chronic pain,” and Plaintiff‘s medical records from Rikers “note that he suffers from a lot of medical problems and he is in a lot of pain and needs medication to help manage his pain.” (Id. ¶¶ 315-16.) “The medication of Gabapentin and Tylenol #3 was effective in managing [Plaintiff‘s] pain.” (Id. ¶ 317.)
In October 2019, Plaintiff was transferred to the custody of DOCCS at Downstate Correctional Facility. (Id. ¶ 318.) “When a patient is first ‘drafted in’ to DOCCS he/she generally resides at a reception facility until staff conducts a medical assessment . . . .” (Id. ¶ 68.) The medical staff at a reception facility maintain a patient on all the medications and prescriptions they were taking before being “drafted in” to ensure continuity оf care. (Id. ¶ 69.) “The medical staff at the reception facility conduct a thorough individualized assessment of the patient‘s health issues for use by practitioners in receiving facilities, and their findings related to major disease or mobility issues are entered into the patient‘s Medical Problem List.” (Id. ¶ 70.) Upon transfer to a facility for housing, “a nurse is supposed to conduct an ‘assessment[]’ of the patient,” and if a
Upon arrival at Downstate, Plaintiff “had a broken right wrist and was in a cast,” his “Health Transfer Information Form reported numerous medical problems, including a crushing injury to his right forearm, polyneuropathy, lower back pain and ankle pain,” and his “medication on arrival was listed as Gabapentin and Tylenol Codeine #3.” (Id. ¶¶ 319-20.) “DOCCS medical providers at Downstate coded [Plaintiff‘s] medical problems as pain, neuropathy, cеrvical spine syndrome and back pain with radiating symptoms.” (Id. ¶ 320.) When Plaintiff arrived at Downstate, a doctor who performed a physical exam on Plaintiff “indicated that [Plaintiff] was morbidly obese, had an abnormal spine, extremities, abdomen, and skin.” (Id. ¶ 321.) At Downstate, Plaintiff‘s Gabapentin prescription was continued, he was assigned to the infirmary, and the doctor ordered that Plaintiff be prescribed Tylenol #3 as needed for his pain management needs.” (Id. ¶¶ 322-23.) “While in the Downstate infirmary, when [Plaintiff] complained of increased pain and requested Tylenol #3 it was provided to him.” (Id. ¶ 323.) Plaintiff‘s “medical records indicate that his pain medication regime provided him ‘good results’ with ‘reported relief.‘” (Id.)
On October 28, 2019, one day before Plaintiff was transferred from Downstate to Franklin Correctional Facility, a nurse at Downstate “noted that she called Franklin medical department and gave a report on [Plaintiff], including going over his medication prescriptions.” (Id. ¶ 324.) On October 29, 2019, DOCCS transferred Plaintiff to Franklin. (Id. ¶ 325.) Plaintiff‘s “indraft documents from Downstate listed his chronic ailments and his current prescriptions of Gabapentin and Tylenol #3.” (Id. ¶ 326.) “However, immediately on his arrival at Franklin, and without first seeing his medical provider for an assessment, [Plaintiff‘s] Gabapentin and Tylenol
Plaintiff was immediately placed in the Franklin infirmary when he arrived, and Plaintiff complained to the nurse of “bilateral leg pain and weakness and radiating pain at a scale of 10 of 10.” (Id. ¶ 328.) The nurse provided Plaintiff with ibuprofen for his pain. (Id. ¶ 329.) Plaintiff “immediately informed [her] that ibuprofen was not effective in treating his pain and asked [her] to provide him with his Tylenol #3 and Gabapentin prescriptions that had been effectively managing his chronic pain for years.” (Id. ¶ 330.) The nurse, “despite already marking that those mеdications as discontinued, informed [Plaintiff] that those prescriptions would need to be ordered by a doctor in the morning.” (Id. ¶ 331.)
On October 30, 2019, “without his effective medication, and his increased pain complaints concerning his diabetic neuropathy, a wheelchair was ordered for [Plaintiff] by his medical provider Defendant Priti Mandalaywala, MD.” (Id. ¶ 332.) Defendant “was aware that [Plaintiff] had been treated with Gabapentin and Tylenol #3 to manage his pain, knew that they were discontinued when he arrived at Franklin, knew that Gabapentin and Tylenol #3 were effective[] treatments for [Plaintiff] for years, and knew that [Plaintiff] was obviously suffering uncontrolled pain from the discontinuation of those prescription medications,” but Defendant “ignored [Plaintiff‘s] suffering and refused to represcribe him his effective medication.” (Id. ¶ 333.) Instead, Defendant prescribed Plaintiff “ineffective medications such as ibuprofen and Lamictal for his neuropathic and chronic pain cоndition, despite the fact she knew that Gabapentin and Tylenol #3 were effective treatment.” (Id. ¶ 334.)
In November 2019, Plaintiff “continued to complain to medical staff of chronic pain and requested an appointment with his doctor.” (Id. ¶ 335.) On December 4, 2019, “still experiencing pain in his wrist, an x-ray was performed that found a marked widening of the scapholunate interval indicating injury to the scapholunate ligament” and “[a]n x-ray of [Plaintiff‘s] right knee showed degenerative joint disease.” (Id. ¶ 336.) Despite these findings, Defendant “provided no effective adjustments to [Plaintiff‘s] pain medication,” and Plaintiff “continued to suffer as a result.” (Id.) On December 5, 2019, Plaintiff “fell out of his wheelchair and was seen for pain and swelling in his right hand, left leg, left ankle, and left foot pain and swelling.” (Id. ¶ 337.) Plaintiff “continued to report uncontrolled neuropathic pain in his feet.” (Id.) “However, despite his suffering and requests for Gabapentin, Defendant [] refused to represcribe him the knowingly effective medicаtion.” (Id.)
In “late December of 2019,” Plaintiff “continued to attend physical therapy sessions to evaluate his need for a wheelchair as a result of the uncontrolled diabetic neuropathic pain in his feet,” and Plaintiff “fell numerous times due to his uncontrolled pain conditions in his feet.” (Id. ¶ 338.) Plaintiff‘s physical therapist recommended his continued use of a wheelchair. (Id.) On December 27, 2019, Plaintiff “was seen by an orthopedic hand specialist . . . to evaluate his hand,” and “[f]ollowing [the doctor‘s] assessment and evaluation of [Plaintiff], she noted that he was in much more pain than expected to be in four months after his wrist injury.” (Id. ¶ 339.) The doctor found that Plaintiff “had been suffering the whole time from a complete tear of a right wrist ligament and recommended complete reconstruction of his scapholunate ligament to prevent an advanced collapse of the ligament down the road.” (Id.) “Throughout this time, [Plaintiff] continued to suffer from his diabetic neuropathy and severe pain in his feet,” he “continued to inform [Defendant] and other staff of uncontrolled neuropathic pain[,] and he
In September 2020, Plaintiff “again reported to medical staff that both his feet were swelling, and he had pins and needles sensation when he walked and he requested to see his medical provider as soon as possible.” (Id. ¶ 341.) In response to his complaints of increased diabetic neuropathic pain, Plaintiff “was told to continue taking the ineffective over-the-counter medication and to elevate his legs.” (Id.) By “the end of September of 2020,” Plaintiff “had been trying to see his medical provider for months through the sick call process, but an appointment was never scheduled.” (Id. ¶ 342.) “As a result of the failure to provide any treatment or necessary care to [Plaintiff], his neuropathic pain in his feet had become so intolerable that he could not attend an EMG test study because of his pain.” (Id.)
On September 30, 2020, Defendant “prescribed Elavil to attempt to treat [Plaintiff‘s] neuropathic pain.” (Id. ¶ 343.) “A few days later, [Plaintiff] experienced significant side effects from the prescription and it was discontinued.” (Id.) Defendant “did not prescribe alternative medication; she only placed [Plaintiff] back on acetaminophen.” (Id. ¶ 344.) “At this time, Defendant [] remained aware that [Plaintiff‘s] neuropathic pain had been controlled with Gabapentin for years before she discontinued it“; however, Defendant “continued to refuse a prescription of the medication.” (Id. ¶ 345.) As a result, Plaintiff “remained in such severe uncontrolled neuropathic pain that he could not go to his outside specialist appointments.” (Id. ¶ 346.) Defendant “continued to ignored [Plaintiff‘s] obvious condition and left him to suffer.” (Id.)
On October 23, 2020, Plaintiff “was seen for sick call” and “[t]he nurse noted in his chart that he needed pain medication for wrist and feet. Elavil did not work and different pain medication was needed.” (Id. ¶ 347.) On October 24, 2020, Defendant “completed a MWAP and Chronic Pain Patient Reassessment form on [Plaintiff‘s] condition as a result of the Allen litigation.” (Id. ¶ 348.)5 “Despite discontinuing and refusing to represcribe Gabapentin to [Plaintiff] since he entered Franklin in October of 2019, Defendant [] noted on the form that Gabapentin was an effective medication that was stopped,” and Defendant “further noted that she believed [Plaintiff] should be trialed on Gabapentin again.” (Dkt. No. 12, ¶ 348.) “Despite Defendant[‘s] [] knowledge that Gabapentin was effective in treating [Plaintiff‘s] neuropathic pain, for approximately one year she never submitted an MWAP request form to even attempt to prescribe the medication to him“; “[i]nstead, she decided to watch [Plaintiff] deteriorate and needlessly suffer in pain without effective treatment.” (Id. ¶ 349.)
On October 27, 2020, Defendant was informed that MWAP approvals for Gabapentin were being handled by the Chief Medical Officer (“CMO“) of DOCCS “due to the Allen litigation.” (Id. ¶ 350.) The CMO subsequently approved Defendant‘s MWAP request for Gabapentin. (Id.)
In June 2021, “an MRI of [Plaintiff‘s] right wrist showed damage including severe enlargement of the median nerve and probably median neuritis related to carpal tunnel syndrome.” (Id. ¶ 351.) Defendant subsequently “prescribed [Plaintiff] Percocet in addition to Gabapentin to manage his pain.” (Id. ¶ 352.) In July 2021, Plaintiff “underwent an MRI of his lumbar spine which showed he was suffering from degenerative lumbar spondylosis, including
In December 2022, Plaintiff “was released” and “has been consistently and effectively treated since his release by outside providers.” (Id. ¶ 356.)
Plaintiff alleges that he “was a victim of [a] grand plan” that involved certain DOCCS medical administrators determining “to remove certain medications from DOCCS[] facilities-not based on patients’ needs or efficacy-but the perceived ‘abuse potential’ of the medication.” (Id. at 53, ¶¶ 335, 337.) Plaintiff alleges that “DOCCS’ Central Office started marking each facility‘s ability to get their patients off the medications” and that “[d]iscontinuations were done without medical justification or individualized assessments.” (Id. at 53, ¶ 336.) “Despite having his medical records for review, Defendant . . . continuously refused to represcribe [Plaintiff‘s] effective treatment due to thesе policies and customs.” (Id. at 53, ¶ 338.) Plaintiff “repeatedly and consistently reported his pain and suffering to no avail,” and Plaintiff “suffered severely due to Defendant[‘s] adherence to the[se] customs, policies and practices.” (Id. at 53, ¶¶ 338-39.)
III. LEGAL STANDARD
To survive a motion to dismiss under
IV. DISCUSSION
A. Statute of Limitations
Defendant argues that Plaintiff‘s claim is time-barred and must therefore be dismissed. (Dkt. No. 26-3, at 20-22.) Plaintiff argues that he is entitled to (1) tolling under the continuing violation doctrine; (2) tolling pursuant to COVID-related executive orders; and (3) equitable tolling during the period in which Plaintiff was exhausting administrative remedies. (Dkt. No. 29, at 21-28.) Defendant argues (1) Plaintiff has not alleged acts within the relevant statutory period that are traceable to policy of deliberate indifference that would render the continuing violation policy applicable; (2) even applying tolling pursuant to COVID-related executive orders, Plaintiff‘s claim is still untimely; and (3) Plaintiff has not sufficiently pleaded facts demonstrating that he is entitled to equitable tolling arising from the administrative-exhaustion process. (Dkt. No. 31, at 9-12.)
“The statute of limitations for
“Although the statute of limitations is ordinarily an affirmative defense that must be raised in the answer, a statute of limitations defense may be decided on a Rule 12(b)(6) motion if
Here, Plaintiff alleges that on October 30, 2019, Defendant “was aware that [Plaintiff] had been treated with Gabapentin and Tylenol #3 to manage his pain, knew that they were discontinued when he arrived at Franklin, knew that Gabapentin and Tylenol #3 were effective[] treatments for [Plaintiff] for years, and knew that [Plaintiff] was obviously suffering uncontrolled pain from the discontinuation of those prescription medications,” but Defendant “ignored [Plaintiff‘s] suffering and refused to represcribe him his effective medication,” instead prescribing “ineffective medications such as ibuprofen and Lamictal for his neuropathic and chronic pain condition, despite the fact she knew that Gabapentin and Tylenol #3 were effective treatment.” (Dkt. No. 12, ¶¶ 325, 332-334.)
The amended complaint also contains the following allegations involving Defendant: “Despite Defendant Mandalaywala‘s knowledge that Gabapentin was effective in treating [Plaintiff‘s] neuropathic pain, for approximately one year she never submitted an MWAP request form to even attempt to prescribe the medication to him. Instead, she decided to watch [Plaintiff] deteriorate and needlessly suffer in pain without effective treatment.” (Id. ¶ 349.) Specifically, in November 2019, Plaintiff “continued to complain to medical staff of chronic pain and requested an appointment with his doctor,” and on December 4, 2019, despite x-rays demonstrating
Plaintiff also alleges that “in approximately 2015, [certain] members of DOCCS medical administration determined to remove certаin medications from DOCCS’ facilities-not based on patients’ needs or efficacy-but the perceived ‘abuse potential’ of the medication.” (Id. at 53, ¶ 335.) Plaintiff further alleges that “DOCCS’ Central Office started marking each facility‘s ability to get their patients off the medications,” and “[d]iscontinuations were done without medical justification or individualized assessments.” (Id. at 53, ¶ 336.) Plaintiff alleges that “[d]espite having his medical records for review, Defendant . . . continuously refused to represcribe [Plaintiff‘s] effective treatment due to these policies and customs,” and Plaintiff “suffered severely due to Defendant[‘s] adherence to the[se] customs, policies and practices.” (Id. at 53, ¶¶ 338-39.)
Accepting all facts in the amended complaint as true and drawing all reasonable inferences in Plaintiff‘s favor-as the Court must at this stage-Plaintiff has plausibly alleged that, as a result of adherence to a policies and customs of removing certain medications frоm DOCCS facilities, which were unrelated to patient needs or efficacy and done without medical justification or individualized assessments, Plaintiff was denied effective medical treatment by Defendant between October 30, 2019, and September 30, 2020. That is, Plaintiff has alleged an ongoing policy of deliberate indifference from October 30, 2019, to September 30, 2020, and acts by Defendant in furtherance of that policy throughout that span as late as September 30,
B. Eighth Amendment Deliberate Medical Indifference
Defendant argues that Plaintiff‘s allegations amount to mere disagreement with Defendant‘s chosen treatmеnts, which is insufficient to provide a basis for an Eighth Amendment claim, and that Plaintiff alleges no facts from which it can be reasonably inferred that Defendant knew of and disregarded an excessive risk of substantial harm to Defendant when she “treated Plaintiff with numerous medications in lieu of Gabapentin and/or Tylenol #3.” (Dkt. No. 26-3, at 16-19.)8 Plaintiff argues that he has not alleged “disagreement on a course of treatment” or that “there was a constitutional obligation to continue medications prescribed by others IF a medical provider conducted an individualized assessment of a patient‘s needs and medically determined a change was warranted” but rather that Defendant “knew the best course of treatment was to continue to prescribe Plaintiff‘s effective treatment, but, instead, she deliberately and blindly followed DOCCS’ policy and replaced Plaintiff‘s effective treatment with easier and knowingly
The Eighth Amendment, applicable to the states through the Fourteenth Amendment, see Robinson v. California, 370 U.S. 660, 666-67 (1962), prohibits the infliction of cruel and unusual punishment. See
“In order to establish an Eighth Amendment claim arising out of inadequate medical care, a prisoner must prove ‘deliberate indifference to [his] serious medical needs.‘” Chance v. Armstrong, 143 F.3d 698, 702 (2d Cir. 1998) (alteration in original) (quoting Estelle, 429 U.S. at 104). “The standard of deliberate indifference includes both subjective and objective components.” Id. “First, the alleged deprivation must be, in objective terms, ‘sufficiently serious.‘” Id. (quoting Hathaway v. Coughlin, 37 F.3d 63, 66 (2d Cir. 1994)). “Determining whether a deprivation is an objectively serious deprivation entails two inquiries“: (1) “whether the prisoner was аctually deprived of adequate medical care,” and (2) “whether the inadequacy in medical care is sufficiently serious.” Salahuddin v. Goord, 467 F.3d 263, 279-80 (2d Cir. 2006).
The first inquiry under the objective component requires examining “whether the prisoner was actually deprived of adequate medical care.” Id. at 279. Prison officials who act “reasonably” in response to an inmate‘s health risk will not be found liable because the official‘s duty is only to provide “reasonable care.” Id. at 279-80. The second inquiry under the objective component requires examining whether the purported inadequacy in the medical care is
As to the subjective component of a deliberate indifference claim, a plaintiff must show that the defendant “act[ed] with a sufficiently culpable state of mind.” Chance, 143 F.3d at 702 (quoting Hathaway, 37 F.3d at 66). The defendant‘s “state of mind need not reach the level of knowing and purposeful infliction of harm; it suffices if the plaintiff proves that the official acted with deliberate indifference to inmate health.” Salahuddin, 467 F.3d at 280. That is, the plaintiff must demonstrate that the defendant “kn[ew] of and disregard[ed] an excessive risk to inmate health or safety.” See Farmer v. Brennan, 511 U.S. 825, 837 (1994). An “inadvertent failure to provide adequate medical care” does not constitute “deliberate indifference.” Estelle, 429 U.S. at 105-06. Nor does the “mere disagreement over the proper treatment . . . create a constitutional claim[;] [s]o long as the treatment given is adequate, the fact that a prisoner might prefer a different treatment does not give rise to an Eighth Amendment violation.” Chance, 143 F.3d at 703.
Here, Plaintiff alleges that he suffers from “obesity, Type II diabetes[,] diabetic neuropathy,” and cervical spine syndrome, which result in a “chronic pain condition” and that, throughout the relevant period during which Defendant was treating Plaintiff, Plaintiff experienced, inter alia, uncontrolled chronic neuropathic pain. (Dkt. No. 12, ¶¶ 313, 319-20, 328, 332, 335, 337-38, 340-42, 346-47.) Plaintiff alleges that upon his transfer to Franklin, his pain was “at a scale of 10 out of 10.” (Id. ¶ 328.) Defendant does not argue that Plaintiff has failed to plead that this was, in objective terms, sufficiently serious. Rather, Defendant‘s motion is premised on the contention that Defendant did not know of and disregard an excessive risk of substantial harm to Defendant because Defendant provided medical treatment, and any allegations of the insufficiency of that treatment amount to mere disagreement between Plaintiff and Defendant. (Dkt. No. 26-3, at 16-19.)
Defendant is correct that “[i]t is well-established that mere disagreement over the proper treatment does not create a constitutional claim.” Chance, 143 F.3d at 703. But this is so where there exists such disagreement and the medical treatment that is provided is adequate. See id. (“So long as the treatment given is adequate, the fact that a prisoner might prefer a different treatment does not give rise to an Eighth Amendment violation.“). The cases on which Defendant relies demonstrate this requirement. See Acosta v. Thomas, 837 F. App‘x 32, 35 (2d Cir. 2020) (summary order) (finding no Eighth Amendment deliberate indifference claim where there was disagreement as to proper care but “the medical records show that [the plaintiff] was monitored, that [a doctor] exercised his medical judgment to take [the plaintiff] off Neurontin, that Tylenol addressed [the plaintiff‘s] pain, and that his overall treatment was adequate“); Reyes v. Gardener, 93 F. App‘x 283, 285 (2d Cir. 2004) (summary order) (“[The plaintiff] has offered no evidence . . . showing that the prescribed medication regimen deviated from reasonable medical practice
Plaintiff has alleged that, upon entering Defendant‘s care at Franklin, Plaintiff experienced, inter alia, uncontrolled chronic neuropathic pain. (Dkt. No. 12, ¶¶ 313, 319-20, 328, 332, 335, 337-38, 340-42, 346-47.) Despite Defendant‘s various treatments, this condition persisted at least until the date on which Defendant submitted an MWAP form for Plaintiff. (Id. ¶¶ 332-337, 340, 344-47, 349.) Plaintiff further alleges that Gabapentin and Tylenol #3 were effective treatments, Defendant knew they were effective treatments but refused to represcribe them, and this resulted in continuing chronic pain of which Defendant was aware. (Dkt. No. 12, ¶¶ 317, 323, 330, 333-34, 336-37, 340, 343-46, 348.)
Defendant lists the treatments Plaintiff alleges Defendant provided. (Dkt. No. 26-3, at 16-17; see also Dkt. No. 31, at 6.) It is true that where a deliberate indifference claim is based on “delay or interruption” in treatment rather than “failure to provide any treatment,” the analysis of
Plaintiff has also alleged that he was a “victim of [a] grand plan” under which medications were removed from DOCCS facilities based on policies and customs related to the perceived abuse potential of the medicines, not based on patients’ needs or efficacy; that discontinuances were done “without medical justifications or individualized assessments“; that doctors, including Defendant, continued to refuse to represcribe Plaintiff‘s effective treatment “due to these policies and customs“; and that Plaintiff “suffered severely due to Defendant[‘]s adherence to these customs, policies and practices.” (Id. ¶¶ 335-39); see Brock v. Wright, 315 F.3d 158, 167 (2d Cir. 2003) (“[T]he policy [precluding use of certain medications], the jury may
Furthermore, Defendant‘s contention that Plaintiff “does not offer any specific facts to corroborate” his allegation that Defendant “knew that Gabapentin and Tylenol #3 were effective treatments for [Plaintiff] for years,” (Dkt. No. 26-3, at 18; see also Dkt. No. 31, at 7-8), is squarely contradicted by the amended complaint. Plaintiff alleges that as a pretrial detainee and at Downstate prior to his transfer to Franklin, he was prescribed Gabapentin and Tylenol #3 and that this “pain medication regime provided him ‘good results’ with ‘reported relief.‘” (Dkt. No. 12, ¶¶ 315, 317, 322-23.) Plaintiff also alleges that his medical records from his pre-DOCCS detention and his DOCCS medical records from Downstate listed these medications and indicated their effectiveness, (id. ¶¶ 316, 320, 323), and that his “indraft documents” for his transfer tо Franklin list these medications, (id. ¶ 326). From these allegations it is reasonable to infer that Defendant “was aware that [Plaintiff] had been treated with Gabapentin and Tylenol #3 to manage his pain, knew that they were discontinued when he arrived at Franklin, knew that Gabapentin and Tylenol #3 were effective[] treatments for [Plaintiff] for years, and knew that [Plaintiff] was obviously suffering uncontrolled pain from the discontinuation of those prescription medications.” (Id. ¶ 333; see also id. ¶ 345.) Moreover, Plaintiff alleges specifically that, when Defendant ultimately completed an MWAP form for Plaintiff, she “noted on the form that Gabapentin was an effective medication that was stopped” and that “that she believed [Plaintiff] should be trialed on Gabapentin again.” (Id. ¶ 348.) These allegations stand in stark contrast to the unsupported and conclusory allegations at issue in the cases Defendant cites. (Dkt.
Defendant also argues that she had no constitutional duty to provide “continuity of care” based on the treatments Plaintiff had received before entering Franklin. (Dkt. No. 31, at 8; see also Dkt. No. 26-3, at 18.) Defendant is correct that “[t]he mere fact that DOCS physicians in other facilities may have previously provided [a] plaintiff with some of the treatments . . . he demanded . . . does not render the medical decisions of [a defendant] ‘deliberate indifference.‘” See Gillespie v. N.Y. State Dep‘t of Corr. Servs., No. 08-cv-1339, 2010 WL 1006634, at *6, 2010 U.S. Dist. LEXIS 26246, at *18 (N.D.N.Y. Feb. 22, 2010) (collecting cases), report and recommendation adopted, 2010 WL 1006643, 2010 U.S. Dist. LEXIS 26221 (N.D.N.Y. Mar. 19, 2010). But Defendant does not square this argument with Plaintiff‘s allegations that Defendant‘s
Finally, Defendant argues in reply that even if Defendant “acted in ‘reflexive’ compliance to prison policies without exercising medical judgment, that is still not enough to establish” Plaintiff‘s claim because “‘[f]ollowing a mandatory prison policy, without more, does not amount to a “conscious disregard of a substantial risk of harm.“‘” (Dkt. No. 31, at 6 (emphasis added) (quoting Hernandez v. Keane, 341 F.3d 137, 144 (2d Cir. 2003))). But, as with other cases cited by Defendant, Hernandez-in which the Second Circuit held that medical malpractice is not tantamount to deliberate indifference-involved undisputed exercises of medical judgment that result in mere disagreement in determining appropriate treatments. See 341 F.3d at 146-47 (“‘[The] decision to perform or not perform [a surgery] was “purely an issue of medical judgment.” This is precisely the sort of issue that cannot form the basis of a deliberate indifference claim.‘” (citation omitted)). Here, Plaintiff expressly alleges that Defendant refused to represcribe effective treatment for Plaintiff‘s debilitating pain due to DOCCS policies and customs that were not based on patients’ needs or efficacy. (Dkt. No. 12, ¶¶ 336-37.)
Moreover, Defendant misconstrues Plaintiff‘s argument related to Defendant‘s medical judgment. Plaintiff does not argue, as Defendant suggests, that the Court should deny Defendant‘s motion because there exist questions of fact as to whether Defendant exercised proper medical judgment. (Dkt. No. 31, at 5-6.) Rather, Plaintiff argues that he has pleaded a
In sum, Plaintiff has plausibly alleged a sufficiently serious deprivation in his medical care by Defendant and that Defendant knew of and disregarded an excessive risk to his health or safety by refusing to represcribe Plaintiff known effective treatments due to DOCCS policies and customs that were not based on patients’ needs or efficacy. See Brunache v. Annucci, No. 22-cv-196, 2023 WL 146850, at *11, 2023 U.S. Dist. LEXIS 4529, at *30-31 (W.D.N.Y. Jan. 9, 2023). Accordingly, Defendant‘s motion to dismiss is denied.
V. CONCLUSION
For these reasons, it is hereby
ORDERED that Defendant‘s motion to dismiss under Rule 12(b)(6), (Dkt. No. 26), is DENIED.
IT IS SO ORDERED.
Dated: July 29, 2024
Syracuse, New York
Brenda K. Sannes
Chief U.S. District Judge
