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Smith v. Municipality of Lycoming County

August 24, 2007


The opinion of the court was delivered by: Judge Conner


Presently before the court are cross-motions for summary judgment filed on behalf of plaintiff Steven Smith ("Smith") (Doc. 74) and defendants Lynch and Poorman (Doc. 76). For the reasons that follow, defendants' motion will be granted and plaintiff's motion will be denied.

I. Statement of Facts

Plaintiff Steven Smith ("Smith") was committed to the Lycoming County Prison on October 5, 2002, with a history of the following medical conditions: Hepatitis A, B, and C; Herpes Simplex 1 and 2; genital warts; positive test for Tuberculosis; compromised immune system from removal of spleen; and bowel problems resulting from a recent bowel obstruction surgery. (Doc. 1, p. 20). Within a month of his arrival, he complained about a number of ailments, but allegedly was ignored.

On December 12, 2002, he was transferred to the State Correctional Institution at Camp Hill, where he remained until February 25, 2003. Upon his return to Lycoming County Prison, he disagreed with the course of treatment prescribed by the intake physician. Over the next several months, he was seen in the medical department for a myriad of complaints. On June 5, 2003, he was transferred to the State Correctional Institution at Camp Hill (Doc. 1, p. 24), where he remained until September 15, 2003, when he was transferred to the State Correctional Institution at Albion ("SCI-Albion"). (Id.). He was transferred back to the Lycoming County Prison on September 24, 2003.*fn1 (Doc. 32-2, p. 21).

Smith alleges that he was denied adequate medical treatment while incarcerated at the Lycoming County Prison during the following time periods: October 5, 2002, to December 12, 2002; February 25, 2003, to June 5, 2003; and September 25, 2003, to May 11, 2004. The court has previously concluded that any claims arising prior to August 16, 2003, are barred by the statute of limitations. (See Doc. 55). Consequently, the statement of facts is limited to the time period of September 24, 2003, through May 11, 2004.

On September 24, 2003, Smith returned to Lycoming County Prison from SCI-Albion. He arrived with a September 19, 2003 prescription for a seven-day regimen of Keflex, inter alia. (Doc. 32-2, p. 17). According to the "Transfer Health Information" received from SCI-Albion, the Keflex was to be discontinued on September 26, 2003. (Id.; Doc. 60-2, p. 1). Defendant Lynch noted this fact in the Physician's Orders, and the notation was signed by a physician. (Doc. 32-2, p. 17). The medication was stopped on September 26, 2003. Smith concedes that the prescription was written on September 19, 2003, but argues that because he did not begin taking the prescription until several days later, stopping the medication on September 26, 2003, was premature. In support of his argument, Smith submits a "Medication Administration Record" that indicates that the medication was not started until September 22, 2003. (Doc. 90, p. 2).

Medical clinics, which are staffed by various local physicians, are held at the Lycoming County Prison twice a week. (Doc. 32-2, p. 29). The physicians do not select which prisoners they treat, "rather, the prison medical staff serves as a triage and creates patient lists based on inmate request slips." (Id.) During the relevant time period, each time Smith submitted an inmate request for treatment, he was placed on the clinic list and treated on the next clinic day. (Id. at pp. 4-6, 8-9, 12-15, 17-19, 21-26). There were also numerous occasions on which Smith was seen without having submitted an inmate request. (Id. at pp. 18, 22-25). In addition to the clinics, an "on-call" physician is available twenty-four hours a day, seven days a week, to handle emergencies. (Id.)

Smith's medical records reveal the following treatment. On October 6, 2003, Smith submitted a sick call request stating that he would like to resume taking the Keflex and complaining of skin lesions, headaches and dandruff. (Doc. 32-2, pp. 4, 30). A physician reviewed the request and noted that Smith had a history of frequent demands for inappropriate antibiotic use. (Doc. 32-2, p. 21). Nonetheless, he was placed on the list for the next clinic day, which was October 10, 2003. At that time, he complained that bumps on his scalp were returning because he was not on Keflex and "Acyclovir." He indicated to the examining physician that he needed antibiotics periodically to "stay healthy." (Id.) The examination revealed no sores or open areas on the scalp, but, due to "minimal flaking," he was prescribed dandruff shampoo. (Id.) The physician concluded that administration of antibiotics was not clinically necessary.

On October 28, 2003, Smith requested treatment for his genital herpes and was informed that he was on the list to see the doctor on October 30, 2003. (Doc. 32-3, p. 22, Doc. 44, p. 35). After discussing Smith's symptoms with a nurse, on October 30, 2003, a physician concluded that his complaints were valid and he prescribed Acyclovir, a medication that is used to treat herpes. (Doc. 32-2, pp. 17, 22, 30).

In early 2004, Smith was seen on numerous occasions in the medical department for genital warts, a skin rash, and complaints that his liver was "acting up" and his immune system was down. (Doc. 32-2, pp. 22-23). He was examined and treated, blood work was ordered, and he was referred to the liver clinic.

On February 23, 2004, he had complaints of bleeding from his penis, and a skin infection on his head and in his groin area. (Doc. 32-2, pp. 9-11, 24, 50). An examination of the genital area revealed no discharge from his penis or tenderness in the penis, scrotum or testicles. Smith declined to take a urinalysis to rule out renal stones. (Doc. 32-2, pp. 51). Upon examination of the skin areas, the examining physician surmised that Smith was suffering from folliculitis, a superficial skin infection, but he refused to allow the doctor to swab the skin areas to confirm the diagnosis. (Id.). Therefore, Smith was referred to a dermatologist for a second opinion. (Doc. 32-2, pp. 18, 24). The following day, prison staff scheduled an appointment with a dermatologist for the following week. Smith returned from the dermatologist with a diagnosis of folliculitis to be treated with Keflex. (Doc. 44, p. 33).

In March 2004, he complained of an outbreak of genital herpes and was provided with Acyclovir. The following month, pursuant to his request (Doc. 32-2, p. 14), he was scheduled to see the doctor. He chose to go to the gym instead. (Id. At p. 26).

In early May 2004, he requested that the Keflex be discontinued. (Doc. 32-2, p. 15). The examining physician declined the request because he felt that it was in Smith's best interest to continue on the medication. He gave Smith the option to refuse the Keflex if he felt it was appropriate. On May 11, 2004, the prison nurse informed the "on-call" physician that Smith was complaining of severe right lateral abdominal pain, soft bloody stool and other physical ailments. (Id. at pp. 26, 38-39). The prison nurse was ordered to arrange transportation to the emergency room at The Williamsport Hospital via the Lycoming County Sheriff. (Id. at pp. 19, 39). Based on May 12, 2004 notations made ...

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