Opinion
1:22-CV-00183-SPB
05-28-2024
HAFEES ALSTON, Plaintiff v. GEORGE LITTLE, P.A. SECRETARY OF CORRECTIONS; DERRICK B. OBERLANDER, SUPERINTENDENT; N.P. SUTHERLAND; N.P. LESLIE; K. M. SMITH, MEDICAL MANAGER; JANA SMITH; T. BEIL; KERI MOORE; D. VARNER; AND LISA LAMOREAUX, Defendants
SUSAN PARADISE BAXTER, United States District Judge
REPORT AND RECOMMENDATION ON DEFENDANTS' MOTION FOR SUMMARY JUDGMENT ORDER ECF NO. 63
RICHARD A. LANZILLO, CHIEF UNITED STATES MAGISTRATE JUDGE
I. RECOMMENDATION
It is respectfully recommended that Defendants' motion for summary judgment (ECF No. 63) be GRANTED.
IL REPORT
A. Introduction and Procedural History
Plaintiff Hafees Alston, an individual currently in the custody of the State Correctional Institution at Frackville, commenced this pro se civil rights action against ten individuals who are current or former employees of the Pennsylvania Department of Corrections (“DOC”) at the State Correctional Institution at Forest (“SCI-Forest”) or medical personnel who provided medical services at SCI-Forest. Alston's verified Complaint alleges that certain Defendants provided medical care for his knee injury that was so deficient as to constitute deliberate indifference to his serious medical needs in violation of the Eighth Amendment to the United States Constitution and medical malpractice under Pennsylvania state law, and that the conditions of his confinement constituted cruel and unusual punishment under the Eighth Amendment and false imprisonment under state law.
The DOC-employed Defendants are former Secretary George Little, SCI-Forest Superintendent Derrick Oberlander, Chief Healthcare Administrator K.M. Smith, Registered Nurse Jana Smith, Chief Grievance Coordinator D. Varner, Grievance Officer T. Biel, and Grievance Officer Keri Moore (“DOC Defendants”). The independent medical service provider Defendants are Certified Registered Nurse Practitioner (“CRNP”) Leslie, CRNP Sutherland, and Health Services Administrator Lamoreaux (“Medical Defendants”). Both the Medical Defendants and DOC Defendants responded to the Complaint with a motion to dismiss Alston's claims pursuant to Fed.R.Civ.P. 12(b)(6). ECF No. 13 (Medical Defendants' motion); ECF No. 23 (DOC Defendants' motion). The Court granted the DOC Defendants' motion to dismiss the claims against them and granted in part and denied in part the Medical Defendants' motion to dismiss. ECF No. 44. See also ECF No. 41 (Report and Recommendation). The only remaining claim in this case is an Eighth Amendment deliberate indifference to serious medical needs claim against CRNP Leslie and CRNP Sutherland based on their alleged delay in ordering a bottom bunk and cell tier assignment for Alston.
The Court dismissed Alston's Eighth Amendment conditions of confinement claim without prejudice and granted him leave to amend his Complaint. See ECF No. 44. When Alston failed to file an amended complaint by the deadline, the Court dismissed this claim with prejudice and terminated the DOC Defendants from this case. See ECF No. 46. The Court also dismissed the claims against Medical Defendant Lamoreaux with prejudice except for the state law medical malpractice claim, which the Court dismissed without prejudice based on Alston's failure to file a Certificate of Merit pursuant to 231 Pa. Code Rule 1042.3(a). See id:, ECF No. 41.
Leslie and Sutherland (collectively, “Defendants”) have filed a motion for summary judgment pursuant to Fed.R.Civ.P. 56 on Alston's remaining deliberate indifference claim. ECF No. 63. In accordance with Local Rule 56(B), Defendants accompanied their motion with a brief (ECF No. 64), concise statement of material facts (ECF No. 68), and a sealed exhibit (ECF No. 69). See ECF No. 67 (Order granting Defendants' motion for leave to file documents under seal). Thereafter, Alston filed a brief in opposition to the motion (ECF No. 72), a responsive concise statement of material facts (ECF No. 74) and Exhibits A-N (ECF Nos. 73-1-73-14), in accordance with LCvR 56(C).
B. Standard of Review
Rule 56(a) requires the district court to enter summary judgment “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). Under this standard “the mere existence of some alleged factual dispute between the parties will not defeat an otherwise properly supported motion for summary judgment; the requirement is that there be no genuine issue of material fact.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48 (1986). A disputed fact is “material” if proof of its existence or nonexistence would affect the outcome under applicable substantive law. Anderson, 477 U.S. at 248; Gray v. York Newspapers, Inc., 957 F.2d 1070, 1078 (3d Cir. 1992). An issue of material fact is “genuine” if the evidence is such that a reasonable jury could return a verdict for the nonmoving party. Anderson, 477 U.S. at 257; Brenner v. Local 514, United Bhd. of Carpenters and Joiners of Am., 927 F.2d 1283, 1287-88 (3d Cir. 1991).
When determining whether a genuine issue of material fact remains for trial, the court must view the record and all reasonable inferences to be drawn therefrom in favor of the nonmoving party. Moore v. Tartier, 986 F.2d 682, 685 (3d Cir. 1993); Clement v. Consol. Rail Corp., 963 F.2d 599, 600 (3d Cir. 1992); White v. Westinghouse Elec. Co., 862 F.2d 56, 59 (3d Cir. 1988). To avoid summary judgment, however, the nonmoving party may not rest on the unsubstantiated allegations of his or her pleadings. Instead, once the movant satisfies its burden of identifying evidence that demonstrates the absence of a genuine issue of material fact, the nonmoving party must go beyond his pleadings with affidavits, depositions, answers to interrogatories or other record evidence to demonstrate specific material facts that give rise to a genuine issue. Celotex Corp. v. Catrett, 477 U.S. 317, 324 (1986).
“In examining the record, and in consideration of [Alston's pro se] status, the factual allegations set forth in his verified Complaint will be considered as evidence to the extent they are based on his personal knowledge.” Gillmore, 2022 WL 801938, at *7 (citing Jackson v. Armel, 2020 WL 2104748, at *5 (W.D. Pa. May 1, 2020) (citing Reese v. Sparks, 760 F.2d 64, 67 (3d Cir. 1985) (treating verified complaint as an affidavit on summary judgment motion))). See also Brooks v. Kyler, 204 F.3d 102, 108 n.7 (3d Cir. 2000) (noting that an affidavit is “about the best that can be expected from [a pro se prisoner] at the summary judgment phase of the proceedings”).
The Court construes a pro se litigant's submissions liberally, but “a pro se plaintiff is not relieved of his obligation under [Federal Rule of Civil Procedure] 56 to point to competent evidence in the record that is capable of refuting a defendant's motion ...” Dawson v. Cook, 238 F.Supp.3d 712, 717 (E.D. Pa. 2017) (citation omitted). Put another way, pro se status does not relieve the non-moving party of his “obligation under Rule 56(c) to produce evidence that raises a genuine issue of material fact.” Id. (quoting Boykins v. Lucent Techs., Inc., 78 F.Supp.2d 402, 408 (E.D. Pa. 2000)).
C. Material Facts
In late December 2019, Alston sustained a knee injury while playing sports at SCI-Forest. On January 17, 2020, Defendant CRNP Leslie evaluated Alston and observed moderate swelling in his right knee. ECF No. 68, ¶ 4. Leslie also performed an Anterior Drawer Test (“ADT”) to assess the possibility of an anterior cruciate ligament (“ACL”) tear, which yielded negative results. Id. ¶¶ 3, 4. Although Alston denies that Leslie conducted an ADT, see ECF No. 74, ¶ 4, the test and its negative result are documented in the contemporaneous medical record, see ECF No. 73-2. Based upon his examination of Alston's knee, Leslie assessed Alston's injury as insignificant and prescribed him Motrin. See ECF No. 68, ¶ 5. Alston has produced no medical evidence to contradict this assessment. Leslie prescribed Alston five days of pain medication. See id. ¶ 5; ECF No. 73-2.
On January 30, 2020, Alston submitted a “sick call” request to the medical department in which he stated that his leg “didn't feel like it was getting better” and that “maybe something was not healing right.” ECF No. 73-3. Alston requested that the medical department recheck his knee or order an x-ray. See id. On February 9, 2020, Health Services Administrator Lisa Lamoreaux responded to Alston's request and noted that his knee had been medically assessed at his prior visit and that he had been prescribed medication that he had failed to pick-up. She further advised Alston that if his knee was “not better please submit a sick call to be seen again.” Id.
Ten days later, on February 19, 2020, Sutherland reexamined Alston's knee. In his progress note, Sutherland recorded that Alston had “Mild effusion of the R[ight] knee, the “Anterior drawer test is negative,” “No medial or lateral laxity,” the “Meniscal catch test is negative, but pain upon ROM [range of motion].” ECF No. 73-4. Sutherland ordered two steroid shots and an x-ray, placed Alston on a ninety-day sports restriction, and advised a “[r]echeck if continued problems.” Id. The x-ray was performed the following day, February 20, 2020. The x-ray revealed no structural damage or injury. See ECF Nos. 68, ¶ 9; 74, ¶ 9. The medical department reviewed the x-ray results with Alston in April. Id. Alston asserts that he “requested to be placed on housing restrictions” during this meeting. See ECF No. 74, ¶ 10 (citing ECF No. 73-1).
Defendants assert that Alston “only scheduled a sick call four times between February 19, 2020 and October 18, 2020 and at no point during those four instances expressed concerns regarding his knee.” ECF No. 68, ¶ 10 (citing ECF No. 7-17). Alston disputes this assertion, but he acknowledges that he sought medical attention for other issues on April 16, September 11, and September 12, and missed a scheduled sick call appointment on August 6, 2020. See ECF No. 74, ¶¶ 10-13.
On October 18, 2020, Alston reinjured his knee while exiting his top bunk in his cell. In the Medical Injury Report generated that day, medical provider Matthew Erickson reported that “Inmate jumped down off top bunk and heard a pop come from his right knee. Inmate stated he could not walk and was in significant pain . . . Inmate to follow up with practitioner in AM.” ECF No. 73-6. Erickson performed a medical and pain assessment and noted a “compensated gait,” “edema,” “inmate grimace[ed] due to exam,” “remaining assessment otherwise negative,” and pain “aggravated by . . . use straightening/pressure to foot” and “relieved by[] elevation/rest.” Id. Erickson “encouraged” Alston “to rest extremity” and “elevate extremity as much as possible,” and gave him Ibuprofen 600mg, two additional packs of Ibuprofen, an ice pack, and an ACE wrap for his right knee. Id.
Leslie examined Alston's knee the next day. In his progress note, Leslie recorded that Alston had reported that he “was running and his RIGHT knee ‘popped.'” ECF No. 73-7. Leslie observed “a marked limp .. . when walking” and “generalized swelling to the RIGHT knee with decreased ROM.” Id. Leslie changed Alston's “motrin to Celebrex 200mg PO BID” and noted that he “ha[d] an ACE wrap.” Id.
Subsequent examination by Leslie on October 27, 2020, for “R/o tibial plateau fx” revealed increased pain and swelling and decreased range of motion:
RIGHT knee continues to be very swollen and very painful with greatly decreased ROM patient had injured it years ago in sports and just “dealt with it” undergoing a few steroid injections, oral analgesia, etc. Approx. 2 weeks ago, he was running and twisted the knee, he felt a ‘pop' and his knee gave out. Since that time, flexion is extremely decreased, leg is almost in constant extension.ECF No. 73-8. Leslie could not perform “ValGUM and valGUS tests” and was “unable to adequately assess ADT” because of Alston's pain. Id. Leslie noted in his chart that he suspected he had tom his lateral collateral ligament (“LCL”) and ordered an MRI. Id.
An x-ray of Alston's knee was taken on October 29, 2020. The x-ray showed no significant findings. Although Alston disagrees with this conclusion, see ECF No. 74, ¶ 18, the x-ray report belies any significant radiographic findings. It “showed no evidence of an acute osseous fracture”; the knee joint was “maintained” and had “[n]o interarticular loose bodies”; “[n]o suprapatellar effusion”; “[n]o radiographic evidence of soft tissue swelling”; “[t]iny soft tissue calcifications anterior to the patellar tendon”; and “[n]o radiographic evidence of acute fracture.” ECF No. 73-9. The report recommended that “[i]f the patient has persistent pain or a radiographically occult fracture is clinically suspected, a follow-up radiographic evaluation in 10-14 days, MRI, or CT scan could be considered.” Id.
On December 16, 2020, Leslie saw Alston for a sick call. ECF No. 73-10. Leslie visited Alston at his cell due to COVID-19 restrictions. Id. Leslie noted that Alston “[r]eports continued RIGHT knee pain and ‘popping.' States that nothing is working and that he needs to go out for an MRI.” Id. Leslie “[o]ffered [him] Tylenol for pain and advised squats for quad/strengthening exercises,” and recorded in his note that “Patient became very argumentative that I didn't know what I was talking about.” Id. Leslie ended the “visit early due to visit becoming nonproductive.” Id.
Along with ordering the x-ray of Alston's knee on October 27, Leslie had also requested that an MRI be scheduled to assess his injury. See ECF No. 73-8. The MRI was conducted on January 6, 2021, and revealed that he had a tom ACL, “a probable bucket-handle tear of the medial meniscus with displacement of the fragment into the intercondylar notch,” and “bone contusion pattern of the femur and tibia.” ECF No. 73-12. On February 23, Alston received this MRI result, as well as a knee brace and housing restrictions. See ECF No. 68, ¶ 21; ECF No. 74, ¶ 21. Alston underwent surgery for his torn ACL on June 24, 2021. See ECF No. 68, ¶ 22; ECF No. 74, ¶ 22.
D. Discussion
Alston claims that Leslie and Sutherland acted with deliberate indifference to his serious medical needs in violation of his Eighth Amendment rights based on their failure to issue him a bottom bunk restriction until February 23, 2021, the same day they reviewed with Alston the results of the MRI scan that disclosed his tom ACL. Defendants seek judgment as a matter of law on this claim because Alston has not produced evidence sufficient to support a finding that Sutherland or Leslie acted with deliberate indifference to his serious medical needs. The undersigned agrees.
“[D]eliberate indifference to serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain proscribed by the Eighth Amendment.” See Estelle v. Gamble, 429 U.S. 97 (1976)) (internal quotation omitted). To establish a violation of his constitutional right to adequate medical care, a plaintiff must produce evidence that demonstrates: (1) he had a serious medical need, and (2) acts or omissions by prison officials that reflect deliberate indifference to that need. See Rouse v. Plantier, 182 F.3d 192, 197 (3d Cir. 1999). A serious medical need exists when a “failure to treat can be expected to lead to substantial and unnecessary suffering.” Colburn v. Upper Darby Twp., 946 F.2d 1017, 1023 (3d Cir. 1991). A prison official acts with deliberate indifference to a prisoner's medical needs only when he or she “knows of and disregards an excessive risk to inmate health or safety.” Farmer v. Brennan, 511 U.S. 825, 837 (1994). “That is the equivalent of recklessness.” Wall v. Bushman, 639 Fed.Appx. 92, 94 (3d Cir. 2015) (citing Farmer, at 836-37). The Third Circuit has found deliberate indifference manifested by an intentional refusal to provide care, delayed medical treatment for non-medical reasons, denial of prescribed medical treatment, a denial of reasonable requests for treatment that results in suffering or risk of injury, Durmer v. O'Carroll, 991 F.2d 64, 68 (3d Cir. 1993), or “persistent conduct in the face of resultant pain and risk of permanent injury,” White v. Napoleon, 897 F.2d 103, 109 (3d Cir. 1990).
The assessment of whether Alston's knee injury satisfies the “serious medical need” element of his Eighth Amendment claim varies depending on the point in time his knee condition is considered. Prior to October 18, 2020, the date Alston reinjured his knee while exiting his top bunk, physical examination had revealed only swelling of the knee, an ADT was negative for an anterior cruciate ligament tear, and x-ray results showed no structural injury. See ECF Nos. 732, 73-4. After the reinjury on October 18, 2020, Alston's right knee swelled and he experienced a decreased range of motion, which Leslie confirmed by examinations on October 19 and 27, 2020. See ECF Nos. 73-6, 73-7, 73-8. Leslie was unable to perform an ADT because of Alston's pain and noted in his chart that he suspected a tom LCL. See ECF No. 73-8. Although an x-ray of Alston's knee taken on October 29, 2020, revealed no significant findings, a subsequent MRI scan revealed that Alston had sustained a torn ACL. See ECF No. 73-9.
Based on this record, Alston has failed to produce evidence sufficient to support a finding that he had a serious medical need prior to October 18, 2020. In his affidavit, Alston claims that he heard a popping sound when he sustained his initial injury on December 27, 2019, and experienced knee swelling, stiffness, and pain thereafter. ECF No. 73-1, p. 1. These conditions are insufficient to support a serious medical need when considered in conjunction with the various negative test results and assessments that followed his initial sports injury in December 2019. See Mines v. Levi, 2009 WL 839011, at *8 (E.D. Pa. Mar. 26, 2009) (citing, inter alia, Brander v. First Correctional, 167 Fed.Appx. 328, 329-30 (3d Cir. 2006) (dismissing inmate's complaint which alleged that prison officials failed to treat pain and swelling in inmate's knee because “[t]hese allegations do not rise to the level of deliberate indifference on the part of Appellees to [inmate's] serious medical needs.”)); Lee v. Abellos, 2014 WL 7271363, at *5 (E.D. Pa. Dec. 19, 2014) (“Plaintiffs left knee condition from the time he reported an injury” until he had an MRI several months later “ did not constitute a serious medical need” because the x-ray was negative for “fracture, dislocation, or intrinsic bone disease,” and his “Progress Notes reported that Plaintiff was ‘ambulatory' with ‘no limp,' was ‘negative' for ‘swelling,' and was ‘negative for pain upon palpation.'”); McKenzie v. Wetzel, 2016 WL 1068374, at *5 (W.D. Pa. Feb. 10, 2016), report and recommendation adopted, 2016 WL 1077904 (W.D. Pa. Mar. 17, 2016) (citating Royster v. Beard, 2013 WL 4786028, at *5 (W.D. Pa. Sept. 6, 2013)) (“knee pain caused by a recent injury that has lasted only a few days is not considered a serious medical condition.”). In contrast, the tom ACL and other injuries Alston sustained on October 18, 2020, clearly supports a serious medical need. See Romero v. Ahsan, 827 Fed.Appx. 222, 226 (3d Cir. 2020) (“it is clear that Romero's injury - involving a tom anterior cruciate ligament (ACL), meniscal tear, and other knee damage - constituted a serious medical condition”) (citation omitted); Lee, 2014 WL 7271363, at *5 (Plaintiffs knee injury constituted a serious medical need once MRI revealed “[c]omplex tear of the posterior horn and body segment of the medial meniscus and of the lateral meniscus,” “[a]nterior cruciate ligament tear which may be chronic,” and “[s]mall joint effusion.”). Although this injury was not diagnosed until February 23, 2021, when the MRI results were reviewed, this does not negate the serious nature of the injury.
Moreover, as discussed below, even if Alston's December 2019 injury was found to have resulted in a serious medical need before his reinjury on October 18, 2020, the record is insufficient to support a finding that Leslie or Sutherland acted with deliberate indifference to Alston's medical need during this period or after his reinjury.
Because Alston has failed to demonstrate a serious medical need prior to October 18, 2020, he has no viable Eighth Amendment claim based on Leslie and Sutherland's alleged refusal to order a bottom bunk restriction prior to that date. Accordingly, Alston can defeat Leslie and Sutherland's motion for summary judgment only if he has produced evidence sufficient to support a finding that Leslie and Sutherland's delay in ordering a bottom bunk restriction between October 18, 2020 and February 23, 2021, represented deliberate indifference to his tom ACL. The record is insufficient to support such a finding.
The record reflects that Leslie or Sutherland learned of Alston's torn ACL on or about February 23, 2021, when they reviewed the MRI results with him. They ordered his bottom bunk restriction on that same day. Furthermore, even if Leslie or Sutherland had learned of the ACL tear as early as January 6, 2021, the date the MRI was performed, the less than seven-week period between this date and February 23, when the MRI results were reviewed with Alston and the restriction granted, is too short to support a finding of deliberate indifference. Any finding of deliberate indifference is also belied by the tests and care the Defendants repeatedly provided to Alston both before and after his October 18, 2020 reinjury. Leslie examined Alston on October 27, 2020, and ordered a follow-up x-ray, which was taken two days later, and an MRI.
The record in this case simply cannot support a finding of deliberate indifference on the part of Leslie or Sutherland. While Alston asserts that they should have ordered a bottom bunk restriction sooner than they did, “an inmate's dissatisfaction with a course of medical treatment, standing alone, does not give rise to a viable Eighth Amendment claim.” Tillery v. Noel, 2018 WL 3521212, at *5 (M.D. Pa. June 28, 2018) (collecting cases). Such complaints fail as constitutional claims because “the exercise by a doctor of his professional judgment is never deliberate indifference.” Gindraw v. Dendler, 967 F.Supp. 833, 836 (E.D. Pa. 1997) (citing Brown v. Borough of Chambersburg, 903 F.2d 274, 278 (3d Cir. 1990) (“[A]s long as a physician exercises professional judgment his behavior will not violate a prisoner's constitutional rights.”)). “Therefore, where a dispute in essence entails nothing more than a disagreement between an inmate and doctors over alternate treatment plans, the inmate's complaint will fail as a constitutional claim under § 1983.” Tillery, 2018 WL 3521212, at *5 (citing Gause v. Diguglielmo, 339 Fed.Appx. 132 (3d Cir. 2009) (characterizing a dispute over pain medication as the type of “disagreement over the exact contours of [plaintiffs] medical treatment” that does not violate the constitution)). Leslie and Sutherland clearly exercised medical judgment regarding Alston's injury as evidenced by the care they provided in response to his complaints of pain and swelling. When examined in the context of the multitude of tests, medications, and treatments Leslie and Sutherland prescribed for Alston's knee injury, the failure to impose a bottom bunk restriction cannot be considered deliberate indifference to his medical needs.
Any claim based on an assertion that Leslie and Sutherland erred in their medical judgment by not ordering a bottom bunk restriction sooner than February 23,2021, also fails. “[T]he mere misdiagnosis of a condition or medical need, or negligent treatment provided for a condition, is not actionable as an Eighth Amendment claim because medical malpractice standing alone is not a constitutional violation.” Id. (quoting Estelle, 429 U.S. at 106). “Indeed, prison authorities are accorded considerable latitude in the diagnosis and treatment of prisoners.” Durmer, 991 F.2d at 67 (citations omitted). And the Third Circuit has made clear that “there is a critical distinction ‘between cases where the complaint alleges a complete denial of medical care and those alleging inadequate medical treatment.'” Wisniewski v. Frommer, 751 Fed.Appx. 192, 195-96 (3d Cir. Oct. 3, 2018) (quoting Pearson v. Prison Health Serv., 850 F.3d 526, 535 (3d Cir. 2017)). Thus, “courts have consistently rejected Eighth Amendment claims where an inmate has received some level of medical care.” Hensley v. Collins, 2018 WL 4233021, at *3 (W.D. Pa. Aug. 15, 2018) (quoting Clark v. Doe, 2000 WL 1522855, at *2 (E.D. Pa. Oct. 13, 2000)).
Even if Alston's knee condition between his sports injury in December of 2019 and his reinjury on October 18, 2020. is considered to represent a serious medical need, the record reflects that the Defendants did not respond with deliberate indifference to that need. They examined Alston, ordered tests and knee injections, and prescribed medication for Alston's knee condition following that injury. Although their medical response did not include a bottom bunk restriction, this omission supports nothing more than a difference in medical judgment or, at worst, medical negligence, neither of which supports an Eighth Amendment claim.
III. Conclusion
For the foregoing reasons, it is respectfully recommended that Leslie and Sutherland's motion for summary judgment (ECF No. 64) be GRANTED.
IV. Notice
In accordance with 28 U.S.C. § 636(b)(1) and Fed.R.Civ.P. 72, the parties may seek review by the district court by filing Objections to the Report and Recommendation within fourteen (14) days of the filing of this Report and Recommendation. Any party opposing the objections shall have fourteen (14) days from the date of service of objections to respond thereto. See Fed.R.Civ.P. 72(b)(2). Failure to file timely objections may waive appellate rights. See Brightwell v. Lehman, 637 F.3d 187, 194 n.7 (3d Cir. 2011); Nara v. Frank, 488 F.3d 187 (3d Cir. 2007).