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Carter v. Smith

September 22, 2009


The opinion of the court was delivered by: O'neill, J.


On March 16, 2009, plaintiff Noah Carter filed an amended complaint against Donald T. Vaughn and David DiGuglielmo*fn1 alleging that they had violated his Eighth Amendment right to adequate medical treatment while incarcerated. Presently at issue is defendants' motion to dismiss.*fn2 I have before me the pleadings, defendants' motion to dismiss and plaintiff's memorandum in opposition thereof. For the following reasons, I will deny defendants' motion to dismiss.



Plaintiff Noah Carter is an inmate at the State Correctional Institution at Graterford (SCI Graterford). On January 22, 2008, plaintiff filed a pro se complaint against the Pennsylvania Department of Corrections (DOC), the Pennsylvania Department of General Services, Governor Edward Rendell, Prison Health Services (PHS), Julie Knauer, Dr. Ralph Smith, Dr. Dennis Iaccarino, Dr. Felipe Arias and John Does alleging that adequate medical treatment for his serious medical needs was denied and delayed. On December 17, 2008, I dismissed plaintiff's claims against all defendants except PHS, Knauer and Dr. Smith. I subsequently appointed counsel to represent plaintiff and granted him leave to amend his complaint. On March 16, 2009, plaintiff timely*fn4 filed an amended complaint alleging that defendants Donald T. Vaughn and David DiGuglielmo deprived plaintiff of his Eighth Amendment right to adequate treatment of his serious medical needs. On May 18, 2009, Vaughn and DiGuglielmo timely filed an answer and a motion to dismiss the amended complaint.


Plaintiff is currently serving at SCI Graterford a sentence imposed by the Montgomery County Court of Common Pleas. Defendant Vaughn served as Superintendent of SCI Graterford until 2003 when defendant DiGuglielmo replaced him. PHS is an organization that has been hired by the DOC to provide medical care to inmates residing in institutions including SCI Graterford, SCI Fayette and SCI Smithfield. PHS faced a budget deficit during the time plaintiff was allegedly receiving inadequate medical care. To address its financial needs, PHS offered monetary incentives to employees who were successful in cutting the costs of prisoners' medical care. Specifically, PHS discouraged the use of off-site treatment for inmates.

Beginning in 1999 during his incarceration at SCI Graterford, plaintiff began to experience severe lower back, spine and hip pain. After being unable to secure treatment for his condition from SCI Graterford medical staff, he filed an initial grievance with prison grievance officers. In 2001, Dr. Iaccarino, a physician employed by PHS, began treating plaintiff's back ailments. He ordered CT scans of plaintiff's head and neck to determine the extent of the injury but those CT scans were denied by Dr. Smith, another PHS physician at SCI Graterford. In early December 2001, plaintiff was sent by Dr. Iaccarino to Temple University Hospital for a neurological consultation. The Temple neurologist ordered an MRI of plaintiff's head and neck but that MRI was also denied by Dr. Smith. Plaintiff again submitted multiple grievances and was thereafter transferred back to Temple University Hospital where he was examined by neurologist Dr. Ayeesha Kamal. Dr. Kamal again ordered an MRI which plaintiff underwent about one month later. After reviewing the MRI films, Dr. Kamal prescribed a three-phase treatment plan to remove the tumor and to prevent, if possible, any serious damage to plaintiff's spine. In late March 2003, plaintiff received one week of phase one steroid treatment. Despite the fact that the phase one treatment was unsuccessful, plaintiff was not treated with radiation and surgery as prescribed in phases two and three because defendant PHS refused to pay for the additional treatment.

In October 2003, plaintiff was again examined by an outside physician--Dr. Allen Webber. Dr. Webber recommended in writing regular neurological examinations and MRIs. Several days later, plaintiff was examined by Dr. Arias at SCI Graterford. Dr. Arias reviewed Dr. Webber's report and noted the plaintiff was scheduled for an MRI in June 2005. Plaintiff did not undergo that MRI until April 17, 2006.

From 2004 through 2006, plaintiff continued to submit requests for appropriate medical treatment. Those requests were denied by individuals other than the defendants at issue here. After his requests were denied, plaintiff submitted grievances to defendant DiGuglielmo among others. Those requests were "summarily denied without reasonable investigation." Am. Compl. ¶ 36.

The results of his April 17, 2006 MRI showed expansion of the tumor. Dr. Webber noted that the ailment was serious enough to warrant care at a University-based neurological group. Plaintiff was then examined by Dr. Carroll P. Osgood, a neurosurgeon with Allegheny Brain and Spine Surgeons. She recommended surgical removal of the tumor.

On December 13, 2006, plaintiff was transferred from SCI Graterford to SCI Fayette, located in western Pennsylvania. On February 6, 2007, he underwent surgery at the University of Pittsburgh Medical Center (UPMC) to remove the tumor. Dr. William C. Welch, plaintiff's surgeon, was only partially successful, however, because the tumor had expanded to the point that it had become embedded in his spine. Dr. Welch prescribed a course of treatment to include three weeks of in-house therapy at UPMC, radiation that was to begin six weeks later and follow-up surgery in six months. Despite Dr. Welch's recommendations that plaintiff be treated at UPMC, SCI Fayette staff informed plaintiff that he would receive treatment at the prison. According to plaintiff, this decision was made for financial reasons.

In April 2007, two months after the surgery, plaintiff had an initial meeting with a physical therapist at SCI Fayette. There, plaintiff was told that the physical therapist visited SCI Fayette once a month, and that plaintiff would begin his physical therapy in May 2007. Plaintiff received no physical therapy treatment before being transferred back to SCI Graterford in June 2007. His physical therapy at SCI Graterford began in October 2008, but he never received the prescribed radiation treatment. In the meantime, Dr. Welch informed plaintiff that further surgery was impossible because the tumor had grown too large to remove without seriously risking paralysis.

Plaintiff has not yet received adequate medical care. He continues to suffer severe back pain as well as weakness and numbness in his extremities. He has filed numerous grievances and appeals with defendants DiGuglielmo and Vaughn among others, and those grievances and appeals have been and continue to be denied without ...

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