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Abraham v. Digugleilmo

May 25, 2010


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


Plaintiff, a former inmate in the Pennsylvania state prison system, filed a four count complaint alleging that his medical needs were mistreated while he was incarcerated. After more than four years of proceedings, defendants Jude Germaine, Felipe Arias and Prison Health Services filed a motion to dismiss. Defendant William E. Radle filed his own motion to dismiss. Presently before me are both motions and plaintiff's response to each. For the following reasons, I will grant in part and deny in part the motion filed by Germaine, Arias and PHS and I will grant the motion filed by Radle.


I. Factual Background*fn1

During the time period relevant to the allegations in this case, plaintiff was an inmate at the State Correctional Institution at Graterford. On the afternoon of Sunday, January 25, 2004, while confined in the restricted housing unit, plaintiff began experiencing pain and swelling in his left testicle. When defendant nurse Sally Wirth made her 6:00 P.M. rounds, plaintiff explained his symptoms to her and attempted to submit a "sick call slip," which is a formal request for medical assistance. Defendant Wirth informed plaintiff that sick call slips were not accepted on weekends but that he could re-submit the sick call slip on Monday, January 26. Later that evening, plaintiff complained to an unidentified corrections officer about the pain he was suffering and again requested assistance. The corrections officer told plaintiff that he did not have authority to accept a sick call slip.

Plaintiff submitted a sick call slip on the morning of January 26 but received no medical attention. During the next three days, plaintiff complained to various corrections officers, including defendant William Radle, about his pain. On each occasion, he was merely told to submit a sick call slip. Finally, on the morning of Thursday, January 29, plaintiff was visited for the first time by a doctor, defendant Germaine. The visit occurred outside plaintiff's cell and lasted approximately two minutes. Defendant Germaine listened to plaintiff's description of his symptoms but did not conduct a physical examination. Instead, she told plaintiff that she would return before breakfast to examine him further. Defendant Germaine did not return until the morning of Friday, January 30, at which time she brought plaintiff to an examination room. Plaintiff alleges that after a brief examination defendant Germaine "acknowledged that his pleas for help were warranted and apologized for not returning to examine him the previous day." Am. Compl. ¶ 31.

Plaintiff was admitted to the infirmary upon the recommendation of defendant Germaine. He alleges that while he was in the infirmary his pain was at its worst. His scrotum and testicle were swollen to three times their normal size and the pain rendered him unable to walk. After lunch on January 30, defendant nurse Mark Sokolski examined plaintiff and delivered to him antibiotics, which had been prescribed by defendant Arias. As of that time, defendant Arias had not personally examined plaintiff, so plaintiff informed defendant Sokolski that he did not wish to take medication without first being examined by a doctor. Plaintiff further informed defendant Sokolski that he had experienced similar symptoms in the past and knew that he needed to go to the hospital. Plaintiff alleges that "[d]efendant Sokolski did nothing to obtain further medical treatment for [plaintiff]." Am. Compl. ¶ 37.

On Sunday, February 1, plaintiff was examined at least three times. On each occasion, he was informed that the pain medication and antibiotics he had been taking were not working and that his condition had worsened. Defendant Arias diagnosed plaintiff as having an infection and informed plaintiff that he would prescribe stronger intravenous antibiotics. Later that evening, defendant Arias was again notified that plaintiff's condition had worsened and that the pain medication was ineffective. Defendant Arias ordered the infirmary to continue to monitor plaintiff's condition. At one point, out of frustration with his perceived lack of medical treatment, plaintiff "forcibly removed" the IV from his arm. Am. Compl. ¶ 43.

On Monday, February 2, defendant Arias informed plaintiff that he was being taken to the hospital. Defendant Arias admitted that "[he] did not know what was wrong with [plaintiff.]" Am. Compl. ¶ 44. Defendant Germaine referred plaintiff to obtain an ultrasound and marked that referral "urgent." Am. Compl. ¶ 45. The referral was approved by defendant Arias.

On Tuesday, February 3, plaintiff was admitted to Mercy Suburban Hospital in Norristown, Pennsylvania. In the emergency room, hospital staff performed a sonogram on plaintiff. The sonogram revealed that plaintiff was suffering from subacute stage testicular torsion of his left testicle. The same sonogram revealed evidence of chronic torsion of plaintiff's right testicle. Hospital personnel concluded that plaintiff should be admitted for in-patient treatment and kept overnight for further observation and care. Prison officials, however, did not permit plaintiff to remain at the hospital overnight. Instead, he was rushed to a consultation with a urologist who "immediately knew" that plaintiff was suffering from testicular torsion. Am. Compl. ¶ 52. The urologist explained to plaintiff that if his condition had been diagnosed and treated within twelve hours of onset detorsion surgery could have prevented long-term damage to his testicle. These medical conclusions were documented in a letter from the urologist to defendant Arias.

Following his visit with the urologist, plaintiff was returned to SCI-Graterford and given over-the-counter pain medication to treat his symptoms. He continued to experience pain for one and one half to two months but never received follow-up treatment by the urologist. As a result of this ordeal, plaintiff lost his left testicle and is now sterile.

II. Procedural History

As a result of defendants' alleged misconduct with respect to treating plaintiff's condition, on January 6, 2008, plaintiff filed a motion for leave to proceed in forma paurperis. On January 19, 2006, that motion was denied without prejudice. After several procedural issues were resolved, plaintiff's request for in forma pauperis status was granted on March 15, 2006. That same day, plaintiff filed a complaint against a variety of defendants. On April 17, 2006, plaintiff requested that the Court appoint counsel to represent him in this lawsuit. On May 2, 2006, six of the defendants filed an answer. The next day, four other defendants filed a motion to dismiss. On June 12, 2006, plaintiff again requested that this Court appoint him counsel or, alternatively, place his case in civil suspense. The Court placed his case in civil suspense on July 11, 2006.*fn2

On September 13, 2006, the parties stipulated to the dismissal of several of plaintiff's claims unrelated to his allegedly deficient medical treatment. On December 18, 2006, plaintiff again requested that the Court either appoint counsel to represent him or continue the case in civil suspense. On January 12, 2007, the Court ordered that the case remain in civil suspense. On March 31, 2008, the Court granted plaintiff's motion for appointed counsel. It also ordered, however, that the case remain in civil suspense.*fn3 The case was finally removed from civil suspense on September 1, 2009. Later that month, the Court granted plaintiff's request for leave to file an amended complaint.

On October 19, 2009, with the assistance of Court-appointed counsel, plaintiff filed an amended complaint. The four-count*fn4 amended complaint alleged claims against DiGuglielmo, Prison Health Services, Germaine, Arias, Sokolski, Wirth and Radle. Defendant Wirth answered on October 28, 2009. Germaine, Arias and Prison Health Services filed a motion to dismiss on November 10, 2009. On November 16, 2009, Radle filed his own motion to dismiss. On November 30, 2009, plaintiff responded to Radle's motion to dismiss. On December 3, 2009 Sokolski filed an answer. The next day, DiGuglielmo did the same. Finally, on December 10, 2009, plaintiff responded to the motion to dismiss filed by Germaine, Arias and Prison Health Services.*fn5


Federal Rule of Civil Procedure 12(b)(6) permits a court to dismiss all or part of an action for "failure to state a claim upon which relief can be granted." Fed. R. Civ. P. 12(b)(6). Typically, "a complaint attacked by a Rule 12(b)(6) motion to dismiss does not need detailed factual allegations," though plaintiff's obligation to state the grounds of entitlement to relief "requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007). "Factual allegations must be enough to raise a right to relief above the speculative level on the assumption that all of the allegations in the complaint are true (even if doubtful in fact)." Id. (citations omitted). The complaint must state "'enough facts to raise a reasonable expectation that discovery will reveal evidence of' the necessary element." Wilkerson v. New Media Tech. Charter School Inc., 522 F.3d 315, 321 (3d Cir. 2008) (quoting Twombly, 550 U.S. at 556). The Court of Appeals has recently made clear that after Ashcroft v. Iqbal, --- U.S. ---, 129 S.Ct. 1937, 1955, 173 L.Ed. 2d 868 (2009), "conclusory or 'bare-bones' allegations will no longer survive a motion to dismiss: 'threadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice.' To prevent dismissal, all civil complaints must now set out 'sufficient factual matter' to show that the claim is facially plausible." Fowler v. UPMC Shadyside, 578 F.3d 203, 210 (3d Cir. 2009) (quoting Iqbal, 129 S.Ct. at 1949). The Court also set forth a two part-analysis for reviewing motions to dismiss in light of Twombly and Iqbal: "First, the factual and legal elements of a claim should be separated. The District Court must accept all of the complaint's well-pleaded facts as true, but may disregard any legal conclusions. Second, a District Court must then determine whether the facts alleged in the complaint are sufficient to show that the plaintiff has a 'plausible claim for relief.'" Id. at 210-11 (quoting Iqbal, 129 S.Ct. at 1950). The Court explained, "a complaint must do more than allege the plaintiff's entitlement to relief. A complaint has to 'show' such an entitlement with its facts." Id. (citing Phillips v. County of Allegheny, 515 F.3d 224, 234-35 (3d Cir. 2008)). "Where the well-pleaded facts do not permit the court to infer more than the mere possibility of misconduct, the complaint has alleged--but it has not 'show[n]'--'that the pleader is entitled to relief.'" Iqbal, 129 S.Ct. at 1949.


Defendants Germaine, Arias, PHS and Radle offer a variety of reasons why the claims against them should be dismissed. Plaintiff addresses each of the arguments offered by defendants and asks that I deny the motions to dismiss in their entirety. I will discuss each argument in turn.

I. Plaintiff Has Alleged Sufficient Facts To State a Section 1983 Claim Against PHS

A. Legal Standard

Section 1983 provides a civil right of action for violations by state actors of rights guaranteed by the United States Constitution or federal statutory law.*fn6 To state a valid claim under section 1983, "[a plaintiff] must demonstrate a violation of a right secured by the Constitution and the laws of the United States [and] that the alleged deprivation was committed by a person acting under color of state law."*fn7 Mark v. ...

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