1:07-cv-00147 | D. Del. | Dec 16, 2008
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lN THE UN|TED STATES DlSTRlCT COURT
FOR THE D|STR|CT OF DELAWARE
ANTHONY PORTERF|ELD,
P|aintiff,
v. Civ. No. 07-147-SLR
DR. JOHN DURST, DR. DALE
RODGERS and CORRECT|ONAL
|V|ED|CAL SERV|CES,
Defendants.
N|ichae| Pi|eggi, Esquire, Phi|ade|phia, Pennsy|vania and Edward J. Fornias, Esquire of
Roeberg, |\/|oore & Friedman, P.A., Wi|mington, De|aware. Counse| for P|aintiff.
Kevin J. Connors, Esquire, of |V|arsha||, Dennehey, Warner, Co|eman & Goggin,
Wilmington, De|aware. Counse| for Defendants.
MEMORANDUM OP|N|ON
Dated: December16, 2008
Wi|mington, De|aware
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R lN ON, istrictJudge
l. lNTRODUCTlON
ln |\/larch 2007, plaintiff Anthony Porterfield (an incarcerated individual
proceeding pro se) filed suit for damages under 42 U.S.C. § 1983 against multiple
defendants, alleging denial of medical care, inadequate medical care, failure to
diagnose, deliberate indifference and cruel and unusual punishment, all in violation of
the Eighth Amendment of the United States Constitution. (D.l. 2) ln June 2007, plaintiff
(now represented by counsel) filed an amended complaint alleging denial of medical
treatment, pursuant to 42 U.S.C. § 1983. (D.l. 14) At the close ofdiscovery, the
remaining medical defendants - Correctional l\/ledical Services, lnc. (“CMS"), Dr. Dale
Rodgers and Dr. John Durst - filed a motion for summaryjudgment. (D.l. 48) The
motion is ripe for review.1
The court has jurisdiction over these matters pursuant to 28 U.S.C. § 1331.
ll. FACTS2
On July 7, 2005, plaintiff’s left index finger was injured when the tray slot door to
his cell was slammed shut by a correctional officer. Plaintiff thereafter submitted
1'l'he court notes in this regard that defendants did not file a brief in support of
their motion, pursuant to D. Del. LR 7.1.3(c), but chose instead to file a paper captioned
“memorandum of points and authorities” as an attachment to their motion. (D.l. 48) ln
violation of D. Del. LR 7.1.3(b), defendants’ paper is 23 un-numbered pages long and
includes an extensive recitation of the facts and legal argument. ln the future, any such
similar filings shall be disregarded by the court, consistent with D. Del. LR 5.1.2.
2'l'he court notes in this regard that neither party submitted plaintiff’s complete
medical record; the court resorted to collating both of the submitted appendices (D.l.
49, exs. A-L, O-P; D.|. 51, exs. 1-37) in order to fashion a time line of the relevant
events. Therefore, the court will not recite specifically to the parties’ submissions, but
will simply recite the facts.
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several requests for medical services and was seen by medical personnel on August
21, 2005. On September 1, 2005, plaintiff submitted a grievance report concerning his
“broken" finger whereby the remedy requested was “[t]o receive necessary medical
treatment.” On September 16, 2005, plaintiff’s finger was examined, with a diagnosis of
“disp|aced avulsion fracture at the base of distal pha|anx and sub|uxation of
corresponding interphalangeal joint with some overlying soft tissue swelling." A “memo"
sent to plaintiff from Ci\/|S on September 29, 2005 read: “Just wanted to let you know
that your x-ray results [c]ame back normal findings.”
Plaintiff's finger continued to be painful. On November 3, 2005, he was
prescribed “l\/lotrin" to relieve the pain. Plaintiff filed a medical grievance on November
16, 2005, and was referred for a consultation with a specialist in December 2005, who
confirmed the diagnosis and recommended surgery in a report dated December 2,
2005. Plaintiff’s prescription for l\/lotrin was refilled on December 8, 2005,
ln January and February 2006, plaintiff wrote letters to the Warden and Deputy
Warden requesting their assistance in getting medical treatment On February 17,
2006, plaintiff saw Dr. Richard DuShuttle who also reported that surgery was required.
By letter dated l\/larch 14, 2006, Cl\/lS approved the surgery. On April 19, 2008, some
nine months after the initial injury, plaintiff undenNent a “fusion of his left index finger
with pinning and synthetic bone graft.”
Post-surgery, plaintiff was seen by Cl\/lS medical personnel on multiple
occasions during the month of l\/lay. On l\/lay 11, 2006, no problems were noted in a
follow-up visit with Dr. DuShuttle. By l\/lay 15, 2008, however, the pins had to be
removed early because of an obvious infection at the pin site. Dr. DuShuttle opined
3
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that the early removal of the pins meant that plaintiff’s results would not be as good as
othen/vise expected. Dr. DuShuttle applied a ve|cro finger splint and ordered “lV
antibiotics, Keflex 1 gram 08 hrs.”3 By May 22, 2006, a consultation report reflected
that plaintiff’s finger was showing signs of improvement; he was to continue “lV
antibiotics, Kef|ex 1 gram 08 hrs.” A follow-up was recommended in one-week’s time.
Plaintiff saw Dr. DuShuttle again on June 6, 2006.4 An x-ray of plaintiff’s finger
was taken in the office. “Bone deterioration of distal phalanges” was noted and a bone
scan was recommended to rule out osteomyelitis.5 Plaintiff continued to be seen by
Cl\/lS personnel on a regular basis through the month of .lune.
On July 6, 2006, a l\/lRl of plaintiff’s left index finger was taken. The findings
thereof were deemed “consistent with osteomyelitis of the distal and middle phalanges
of the index finger given the suspicion of infection.” Plaintiff was examined by Dr.
DuShuttle on Ju|y 18, 2006. For the first time, amputation of plaintiff’s finger was
mentioned. Plaintiff continued to be monitored by CMS medical personnel through the
months of July and August.
3Plaintiff alleges that Dr. Durst administered Ancef rather than Kef|ex.
4in connection with this office visit, the record includes a note that plaintiff
“admits to not being in the most sterile environment We had to give him a new Velcro
finger splint today because of how dirty his previous one was.”
5“[A]n infectious usually painful inflammatory disease of bone often of bacterial
origin that may result in the death of bone tissue.” Merriam-Webster Online Dictionary.
2008. l\/ierriam-Webster Online. 16 December 2008.
4
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By the end of August 2006, it had been determined that plaintiff’s finger had to
be amputated, which surgery was conducted in October 2006. Plaintiff continued to be
monitored by Cl\/lS medical personnel through the month of October.
lll. STANDARD OF REVIEW
A. Summary Judgment
A court shall grant summary judgment only if “the pleadings, depositions,
answers to interrogatories, and admissions on file, together with the affidavits, if any,
show that there is no genuine issue as to any material fact and that the moving party is
entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(c). The moving party bears
the burden of proving that no genuine issue of material fact exists. See Matsushita
Elec. /ndus. Co. v. Zenith Rad/`o Corp., 475 U.S. 574" date_filed="1986-03-26" court="SCOTUS" case_name="Matsushita Electric Industrial Co., Ltd. v. Zenith Radio Corporation">475 U.S. 574, 586 n.10 (1986). When
determining whether a genuine issue of material fact exists, the court must view the
evidence in the light most favorable to the nonmoving party and draw all reasonable
inferences in that party’s favor. W/'shk/'n v. Potter, 476 F.3d 180" date_filed="2007-02-07" court="3rd Cir." case_name="Richard M. Wishkin v. John E. Potter, Postmaster General">476 F.3d 180, 184 (3d Cir. 2007).
“Facts that could alter the outcome are ‘materia|,’ and disputes are ‘genuine’ if evidence
exists from which a rational person could conclude that the position of the person with
the burden of proof on the disputed issue is correct." Horowitz v. Federa/ Kemper Life
Assurance Co., 57 F.3d 300" date_filed="1995-06-07" court="3rd Cir." case_name="Horowitz v. Federal Kemper Life Assurance Co.">57 F.3d 300, 302 n.1 (3d Cir. 1995) (internal citations omitted).
lf the moving party has demonstrated an absence of material fact, the
nonmoving party then “must come forward with ‘specific facts showing that there is a
genuine issue for trial.”’ Matsushita E/ec. /ndus. Co. v. Zenith Radio Corp., 475 U.S. at
587 (quoting Fed. R. Civ. P. 56(e)). However, a party opposing summaryjudgment
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“must present more than just ‘bare assertions, conclusory allegations or suspicions’ to
show the existence of a genuine issue.” Podobnik v. U.S. Posta/ Serv., 409 F.3d 584" date_filed="2005-05-05" court="3rd Cir." case_name="Philip J. Podobnik v. United States Postal Service National Rural Letter Carriers Association John E. Potter, Postmaster General of the United States">409 F.3d 584,
594 (3d Cir. 2005) (quoting Celotex Corp. v. Catrett, 477 U.S. 317" date_filed="1986-06-25" court="SCOTUS" case_name="Celotex Corp. v. Catrett, Administratrix of the Estate of Catrett">477 U.S. 317, 325 (1986)). To
survive a motion for summary judgment, plaintiff cannot rely merely on the unsupported
allegations of the complaint, and must present more than the “mere existence of a
scintilla of evidence” in his favor. Anderson v. Liben‘y Lobby, /nc., 477 U.S. 242" date_filed="1986-06-25" court="SCOTUS" case_name="Anderson v. Liberty Lobby, Inc.">477 U.S. 242, 252
(1986). lf the nonmoving party fails to make a sufficient showing on an essential
element of its case with respect to which it has the burden of proof, the moving party is
entitled to judgment as a matter of law. See Ce/otex Corp. v. Catrett, 477 U.S. 317" date_filed="1986-06-25" court="SCOTUS" case_name="Celotex Corp. v. Catrett, Administratrix of the Estate of Catrett">477 U.S. 317,
322 (1986).
B. Eighth Amendment Violations
ln the context of medical care, an act of a prison official only becomes a
constitutional violation when it results from the “deliberate indifference to a prisoner’s
serious illness or injury." Este//e v. Gamble, 429 U.S. 97" date_filed="1976-11-30" court="SCOTUS" case_name="Estelle v. Gamble">429 U.S. 97, 105 (1976). Therefore, in
order to set forth a cognizable claim under the Eighth Amendment, an inmate must
prove (1) a serious medical need and (2) acts or omissions by prison officials that
indicate deliberate indifference to that need. /d. at 104; Rouse v. P/antier, 182 F.3d
192, 107 (3d Cir. 1999). As further explained by the Supreme Court in Este//e, because
an inadvertent failure to provide adequate medical care cannot be said
to constitute “an unnecessary and wanton infliction of pain” or to be
“repugnant to the conscience of mankind” . . . , a complaint that a
physician has been negligent in diagnosing or treating a medical condition
does not state a valid claim of medical mistreatment under the Eighth
Amendment Medical malpractice does not become a constitutional
violation merely because the victim is a prisoner.
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Id. at 105-106. Consequently, a mere difference of opinion concerning the treatment
received by an inmate is not actionable under the Eighth Amendment and § 1983. See
Inmates of Allegheny County Jai/ v. Pierce, 612 F.2d 754" date_filed="1979-12-28" court="3rd Cir." case_name="Inmates of The Allegheny County Jail v. Robert Pierce">612 F.2d 754, 762 (3d Cir. 1979).
The “deliberate indifference” prong of the Este//e test is satisfied only when the
inmate demonstrates that the medical provider acted to deny the inmate’s reasonable
request for medical treatment (thus subjecting the inmate to undue suffering) or if
medical treatment is delayed for non-medical reasons. Monmouth County Correctional
lnst. lnmates v. Lanzaro, 834 F.3d 326, 346-47 (3d Cir. 1987). To put the point
different|y, a prison official’s conduct does not constitute a “deliberate indifference”
unless it is alleged to occur in conjunction with the requisite mental state. ln this regard,
a prison official is deliberately indifferent if he knows that an inmate faces a substantial
risk of serious harm and fails to take reasonable steps to avoid the harm. Farmer v.
Brennan, 511 U.S. 825" date_filed="1994-06-06" court="SCOTUS" case_name="Farmer v. Brennan">511 U.S. 825, 837 (1994). A prison official may manifest deliberate
indifference by “intentional|y denying or delaying access to medical care." Este//e, 429
U.S. at 104-105.
Finally, an inmate “has no right to choose a specific form of medical treatment,
so long as the treatment provided is reasonable." B/ackston v. Corr. Med. Servs., /nc.,
499 F. Supp. 2d 601" date_filed="2007-08-16" court="D. Del." case_name="Blackston v. Correctional Medical Services, Inc.">499 F. Supp. 2d 601, 605 (D. Del. 2007). Thus,
[a]n inmate’s claims against members of a prison medical department
are not viable under § 1983 where the inmate receives continuing care,
but believes that more should be done by way of diagnosis and treatment
and maintains that options available to medical personnel were not
pursued on the inmate’s behalf.
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ld. Accord Estelle, 429 U.S. 97" date_filed="1976-11-30" court="SCOTUS" case_name="Estelle v. Gamble">429 U.S. at 107 (“A medical decision not to order an X-ray, or like
measures, does not represent cruel and unusual punishment.”).
lV. ANALYS|S
The chronology of relevant events is not in dispute. Rather, the legal
consequences of such events is contested.
Plaintiff asserts that too little care was administered between the date of his
initial injury (..luly 2005) and the date of his initial surgery (April 2006); according to
plaintiff, this delay subjected him to undue suffering Plaintiff further asserts that the
care administered by defendants after the date of his initial surgery (April 2006) was so
deficient as to have caused the infection that required amputation of his finger in
October 2006.
Defendants argue that plaintiff was seen “by numerous Cl\/lS doctors, nurse
practitioners, physician’s assistants, and outside specialists” and that defendants
“properly coordinated plaintiff’s care with the outside healthcare provider, Dr.
DuShuttle.” According to defendants, because plaintiff has not produced any expert
who has opined that defendants are responsible in any way for causing plaintiff’s
osteomyelitis, summary judgment should be awarded to them.
With respect to the individual defendants, they are each mentioned in connection
with a single course of conduct Dr. Durst is alleged to have administered the antibiotic
Ancef rather than Keflec; Dr. Rodgers is alleged to have prescribed physical therapy
post-surgery. A|though plaintiff claims that the above described conduct contributed to
his injury, there is no evidence of such. lndeed, this conduct falls within the ambit of
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medical judgment and, therefore, defendants’ motion for summary judgment is granted
as to defendants Durst and Rodgers.
With respect to defendant CMSl there can be no doubt that plaintiff has proven a
serious medical need. `l'he question that remains is whether there are genuine issues
of material fact that relate to the second prong of the Estelle test, that is, whether CN|S
was “deliberater indifferent” to plaintiff’s serious medical need. Although ClVlS
personnel did see plaintiff, the court’s lingering discomfort with the record has to do with
the objective evidence that: (1) plaintiff was not given an honest report of the initial
diagnosis; (2) consultation with and surgery by a specialist took nine months to
accomplish; and (3) plaintiff’s finger was infected within a month of surgery, with the
outside consultant noting plaintiff’s dirty splint months before the infection led to
amputation of the finger. ln sum, the overall course of treatment administered to
plaintiff by Cl\/lS personnel between July 2005 and October 2006 raises concerns of a
constitutional dimension. The record, such as it is, is difficult to discern and the court is
not prepared to enterjudgment in favor of Cl\/lS when it is not clear what ClVlS
personnel did, or did not, do during this 15-month medical saga.6
V. CONCLUSION
For the reasons stated, defendants’ motion for summary judgment is granted in
part and denied in part. An appropriate order shall issue.
6The court is satisfied that plaintiff exhausted his administrative remedies
9