Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Dulcidio Quirindongo v. Warden Ricardo Martinez

July 18, 2012

DULCIDIO QUIRINDONGO, PLAINTIFF
v.
WARDEN RICARDO MARTINEZ, ET AL., DEFENDANTS



The opinion of the court was delivered by: Judge Rambo

MEMORANDUM

Plaintiff Dulcidio Quirindongo, an inmate currently incarcerated at the United States Penitentiary at Allenwood ("USP-Allenwood") in White Deer, Pennsylvania, filed this Bivens*fn1 -type action on August 19, 2010, as amended July 7, 2011, against several USP-Allenwood officials and two external medical providers.*fn2 (Doc. 32.) In the amended complaint, Plaintiff asserts that Defendants were deliberately indifferent to his serious medical needs following surgery related to his prostate cancer.

Before the court is a motion to dismiss and for summary judgment filed on behalf of Defendants. (Doc. 49.) For the reasons set forth below, the motion for summary judgment will be granted in favor of Defendants.

I. Background

In his amended complaint, Plaintiff alleges that on October 7, 2008, he underwent a "radical prostatectomy that required major surgery." (Doc. 32 at 1.) Following his surgery, he returned to USP-Allenwood. (See id.) In connection with his post-surgery care at USP-Allenwood, Plaintiff claims that "(1) [Defendants] failed to provide the proper standard of care; (2) [Defendants] willfully neglected to maintain a proper delivery of aftercare; (3) the onsite medical staff at USP-Allenwood was untrained to deal with the seriousness of the medical issues of the plaintiff; (4) plaintiff was not provided with the minimal standard of care for a human being; (5) and [Defendants] kept the plaintiff in a contaminated, unsanitary environment, post-operatorily, that caused the plaintiff a major infection." (Id. at 2.) Plaintiff further alleges that the lack of Spanish-speaking personnel at USP-Allenwood delayed his care because personnel could not understand his complaints. (Id. at 3.) As relief, Plaintiff seeks an order directing that medical staff be trained to speak Spanish at USP-Allenwood, monetary damages for pain and suffering, and an evidentiary hearing. (Id. at 5.)

A. Facts

In support of their motion for summary judgment, Defendants submitted a statement of material facts.*fn3 (Doc. 52.) Because Plaintiff has failed to file an opposing statement of material facts, the following facts submitted by Defendants are deemed admitted.*fn4

Defendant Physician's Assistant ("PA") Jennifer Holtzapple reviewed the medical records of Plaintiff relative to this action. (Doc. 52 ¶ 27.) Those records reveal that on August 7, 2008, Plaintiff was seen by the in-house urologist and it was determined that he had prostate cancer. (Id.) PA Holtzapple then submitted a consult to proceed with a radical prostatectomy as soon as possible. (Id. ¶ 28.) This medical encounter note was cosigned by Defendant Dr. Kevin Pigos. (Id. ¶ 29; Doc. 53-4 at 47.)

On September 16, 2008, PA Holtzapple reviewed a medical note written by Defendant Lisa Rey, USP-Allenwood's Medical Records Technician ("MRT"), requesting a physical examination, x-ray, and blood work for Plaintiff in preparation for his prostate surgery. (Doc. 52 ¶ 30.) On September 17, 2008, PA Holtzapple ordered the blood work and chest x-ray in preparation for Plaintiff's prostate surgery. (Id. ¶ 31.) Further, on October 2, 2008, PA Holtzapple conducted a physical examination of Plaintiff in preparation for the surgery, and the examination was noted as unremarkable. (Id. ¶ 32.) In addition, Plaintiff was counseled on a plan of care and he verbalized his understanding of the treatment plan. (Id. ¶ 33; Doc. 53-4 at 40.) This medical encounter was cosigned by Dr. Pigos on October 7, 2008. (Doc. 52 ¶ 34; Doc. 53-4 at 41.)

After the October 7, 2008 prostatectomy, on October 8, 2008, Dr. Pigos spoke with the outside physician who performed the surgery, and noted that Plaintiff was doing well post-surgery with no complications. (Doc. 53-4 at 38.) Further, it was noted that Plaintiff would return to USP-Allenwood in two days. (Id.)

Plaintiff returned to USP-Allenwood on October 10, 2008. (Doc. 53-4 at 37.) He voiced a complaint of pain of 6 on a 1-10 scale. (Id.) A catheter was in place, draining blood-tinged urine. (Id.) Plaintiff was prescribed several medications for pain management, given instructions on use of the catheter, and told of the need to change his dressing daily. (Id.) Also, he was told to follow up at the next urology clinic. (Id.) This clinical encounter/administrative note was cosigned by Dr. Pigos on October 14, 2008. (Id.)

On October 11, 2008, a staff nurse examined Plaintiff, gave him sterile gauze and tape for incision care, and gave him Tylenol #3 (with codeine) as prescribed. (Id. at 36.) The medical encounter, cosigned by Dr. Pigos on October 14, 2008, also noted that Plaintiff was ambulating about his cell with no problems, had a catheter in place and urine was clearing up, but was voicing complaints about some pain. (Id.) As a result, the note indicated that Plaintiff would continue to be monitored and given medication as provided. (Id.)

On October 13, 2008, PA Holtzapple saw Plaintiff while doing rounds and gave him Tylenol #3 for pain, despite him telling her that he does not have much pain, only constipation. (Doc. 52 ¶ 35; Doc. 53-4 at 35.) PA Holtzapple explained to Plaintiff that the Tylenol #3 could cause constipation, and Plaintiff responded that he would only take the medication if he was having pain. (Doc. 52 ¶ 36; Doc. 53-4 at 35.) She then gave Plaintiff sterile gauze for a dressing change and medication for his constipation. (Doc. 52 ¶ 37; Doc. 53-4 at 35.) She also told Plaintiff to inform medical staff if any problems with his care arose and to drink a lot of water, both instructions of which he stated he understood. (Doc. 52 ¶ 39; Doc. 53-4 at 35.) Finally, she scheduled a consult with the in-house urologist for the next urology clinic. (Doc. 52 ¶ 38; Doc. 53-4 at 35.) This medical encounter was cosigned by Dr. Pigos on October 14, 2008. (Doc. 52 ¶ 40; Doc. 53-4 at 35.)

PA Holtzapple examined Plaintiff again on October 13, 2008, after he complained of being cold and having trouble breathing due to his pre-existing asthma. (Doc. 52 ¶ 41; Doc. 53-4 at 33.) Plaintiff's vital signs were within normal limits, but a rectal examination revealed hemorrhoids. (Doc. 52 ¶ 42; Doc. 53-4 at 34.) He was prescribed a nebulizer, an additional jumpsuit to wear in his cell, and an extra blanket. (Doc. 52 ¶ 43; Doc. 53-4 at 34.) He was also encouraged to drink a lot of water and avoiding straining during bowel movements. (Doc. 52 ¶ 43; Doc. 53-4 at 34.) Plaintiff stated that he felt better after receiving the nebulizer, and understood the plan of care explained to him. (Doc. 52 ¶ 44; Doc. 53-4 at 34.) This clinical encounter was cosigned by Dr. Pigos on October 14, 2008. (Doc. 52 ¶ 45; Doc. 53-4 at 34.)

On October 14, 2008, through Dr. Pigos, PA Holtzapple prescribed Plaintiff a stool softener (docusate sodium capsule) and an oxybutynin tablet to assist with a urinary problem. (Doc. 52 ¶ 46; Doc. 53-4 at 32.) Later that day, Defendant EMT Conlin examined Plaintiff, who stated that he was out of Motrin and continued to have moderate abdominal pain at the surgery site. (Doc. 53-4 at 31.) EMT Conlin gave Plaintiff twelve tablets of Motrin from the night stock immediately and instructed him to get additional refills at sick-call. (Id.)

On October 15, 2008, after speaking with Defendant Dr. Chopra from Bloomsburg Hospital, PA Holtzapple directed Plaintiff to report to Health Services to have his staples removed. (Doc. 52 ¶ 47; Doc. 53-4 at 30.) Once the staples were removed, it was noted that the incision site had healed well with no signs of infection. (Doc. 52 ¶ 48; Doc. 53-4 at 30.) He was given a "leg bag" (a small bag that straps to your leg and is used in conjunction with a catheter) to use during the day and a wheelchair. (Doc. 52 ¶ 49; Doc. 53-4 at 30.) Plaintiff requested pain medication, and was prescribed Naproxen. (Doc. 52 ¶ 50; Doc. 53-4 at 30.)

On October 24, 2008, Defendant Nurse Russell removed Plaintiff's catheter and noted no trauma. (Doc. 53-4 at 29.) Nurse Russell also examined a sore at the surgery incision site, now draining, and noted, "old tan [sic] discharge w/o odor and wound edges w/o erythema." (Id.) She cleaned the wound and covered it with dry dressing. (Id.) She advised Plaintiff through an interpreter to wash the area daily with soap and water and cover with dry dressing. (Id.) Nurse Russell sent Plaintiff off with dressing supplies and instructed him to follow up with medical staff the following week. (Id.) In the clinical encounter/administrative note, Nurse Russell also noted that Plaintiff stopped her in the hallway later to ask her about a swollen leg "since surgery," which was not painful. (Id.) She advised him to follow up through sick-call. (Id.)

On November 5, 2008, Nurse Russell examined Plaintiff for an open wound at the incision site in his lower abdomen, swelling in his legs, and blurred vision. (Doc. 53-4 at 25.) She noted that the abdominal wound was open, "but with good granulation tissue size." (Id. at 26.) She washed the wound and applied a dry dressing. (Id.) She also noted that Plaintiff's swollen leg was resolved after receiving the "leg bag." (Id. at 27.) She wrote a consult for the next optometry clinic, and documented Plaintiff's current medications. (Id.) Further, she noted that she would consult with PA Holtzapple for continued wound reassessment. (Id.) Finally, she noted that Plaintiff verbalized his understanding of the plan of care. (Id.)

On November 12, 2008, Defendant EMT Donlin dispensed to Plaintiff one pack of sixteen incontinence briefs. (Doc. 53-4 at 24.) On November 14, 2008, Defendant EMT Potope examined Plaintiff and noted that 3-4 weeks post-prostate surgery, Plaintiff was using sixteen incontinence briefs in two days. (Id. at 23.) EMT Potope stated that Plaintiff needs to be reevaluated by primary medical staff to determine if Plaintiff was making appropriate progress. (Id.) He also stated that he would continue to provide Plaintiff with briefs at the 3:30 p.m. pill line. (Id.) Later on that same day, EMT Conlin dispensed to Plaintiff one pack of sixteen incontinence briefs, and noted that Plaintiff would need refills every few days. (Id. at 22.) Plaintiff was provided with refills on November 19, 2008 and December 11, 2008. (Id. at 19, 17.)

On November 14, 2008, MRT Rey completed an administrative note documenting that Plaintiff was having a liver biopsy, and would need various preliminary tests taken during the week of December 15, 2008. (Id. at 21.) On November 18, 2008, PA Holtzapple ordered the appropriate blood work for the liver biopsy. (Doc. 52 ¶ 51; Doc. 53-4 at 20.)

On December 5, 2008, PA Holtzapple entered an administrative note in Plaintiff's medical record noting that Plaintiff had been seen by the in-house urologist on December 4, 2008. (Doc. 52 ¶ 52; Doc. 53-4 at 18.) A quarterly blood test related to his prostate condition was ordered, and a consult was written for a follow-up with the urologist in three months. (Doc. 52 ¶ 52; Doc. 53-4 at 18.)

This administrative note was cosigned by Dr. Pigos on December 18, 2008. (Doc. 52 ¶ 53; Doc. 53-4 at 18.)

On December 15, 2008, Plaintiff reported to Health Services claiming that he had an infection and pain at the site of his incision on his lower abdomen, and he had a fever over the weekend. (Doc. 52 ¶ 54; Doc. 53-4 at 15.) PA Holtzapple examined him, noting that he had no fever, but he did have redness, tenderness and warmth around the incision site. (Doc. 52 ¶ 55; Doc. 53-4 at 15.) She prescribed him with an antibiotic (Cephalexin) and pain medication (Acetaminophen), and instructed him to follow-up at sick call as needed, or return to Health Services immediately if his condition worsened, or come back within two to three days if there was no improvement. (Doc. 52 ¶ 56; Doc. 53-4 at 16.) PA Holtzapple counseled Plaintiff on the plan of care, and he verbalized his understanding. (Doc. 52 ¶ 57; Doc. 53-4 at 16.)

Several hours later on that same day, December 15, 2008, Plaintiff returned to Health Services and noted that his incision had opened and puss was coming out of it. (Doc. 52 ¶ 58; Doc. 53-4 at 14.) PA Holtzapple noted a hole on the left side of his abdomen where the puss was draining. (Doc. 52 ¶ 59; Doc. 53-4 at 14.) She consulted with Dr. Pigos, who directed her to send Plaintiff to the local urologist, Dr. Chopra, at Bloomsburg Hospital that same day for evaluation. (Doc. 52 ¶ 60; Doc. 53-4 at 14.) She wrote the consult to send Plaintiff to Dr. Chopra and cleaned and bandaged the wound. (Doc. 52 ¶ 61; Doc. 53-4 at 14.)

Several administrative notes were made regarding Plaintiff's outside care at Bloomsburg Hospital and his return to USP-Allenwood in the days following Plaintiff's December 15, 2008 encounter at Health Services. On December 16, 2008, EMT Potope noted that Plaintiff was transported to Bloomsburg Hospital on December 15, 2008, for treatment of a possible infection at the incision site. (Doc. 53-4 at 13.) This administrative note was cosigned by Dr. Pigos on December 23, 2008. (Id.) Further, on December 16, 2008, EMT Potope noted that Dr. Chopra called with an update on Plaintiff's status. (Id. at 12.) Dr. Chopra found on Plaintiff a supra-pubic abscess near the rectal muscle, and was treating Plaintiff with IV antibiotics. (Id.) If Plaintiff continued to improve, he would switch to oral antibiotics and have the drain site re-packed daily to allow the area to heal over time. (Id.) It was also noted that the Plaintiff was stable. (Id.) This administrative note was cosigned by Dr. Pigos on December 23, 2008. (Id.) On December 17, 2008, EMT Potope noted that Plaintiff would remain at Bloomsburg Hospital to treat his abdominal infection until late in the week, and that Plaintiff was stable. (Id. at 11.) This administrative note was cosigned by Dr. Pigos on December 23, 2008. (Id.) On December 18, 2008, EMT Potope noted that Plaintiff was being released soon back to USP-Allenwood and would need his medication ready at that time. (Id. at 9.) EMT Potope was awaiting a verbal order for medication from Dr. Chopra. (Id.) This administrative note was cosigned by Dr. Pigos on December 29, 2008. (Id.) On December 19, 2008, EMT Potope noted that Plaintiff would return that day and that all of his ordered oral medication was ready except for the Tylenol #3. (Id. at 8.) He also noted that Plaintiff had pain at the drain site of 3 out of a 1-10 scale and that the drain site would be re-packed with dressing daily. (Id.) This administrative note was cosigned by a Dr. Jay Miller on December 19, 2008. (Id.)

After Plaintiff's return to USP-Allenwood, he was seen at Health Services for a dressing change. (See id. at 6, 7.) EMT Donlin noted that there was minimal drainage on the old dressings when he removed them. (Id. at 6.) The wounds looked moist and pink, and he redressed them with saline gauze and an abdominal pad. (Id.) Plaintiff was informed to follow-up at sick-call in the morning. (Id.) This administrative note was cosigned by Dr. Pigos on December 29, 2008. (Id.)

On December 22, 2008, PA Holtzapple changed Plaintiff's dressing without incident with gauze and sterile saline. (Doc. 52 ¶ 62; Doc. 53-4 at 5.) She instructed him to return the next day at the same time for a dressing change and renewed his urology medication (Doxazosin). (Doc. 52 ¶ 62, 63; Doc. 53-4 at 5.)

Thereafter, the record contains administrative notes from December 23, 2008 through January 29, 2009, noting daily dressing changes. (Doc. 53-4 at 1-4; Doc. 53-3 at 57-59; Doc. 53-7 at 1-4; Doc. 53-6 at 38-60.) On December 26, 2008, Plaintiff noted no complaints and denied having pain. (Doc. 53-4 at 1.) On December 27, 2008, no drainage and no signs of infection were noted, and Plaintiff noted no pain. (Doc. 53-3 at 59.) On December 29, 2008, a moderate amount of greenish discharge was noted on Plaintiff's old dressing. (Id. at 58.) On December 31, 2008, no drainage was noted and the wound appeared to be healing well. (Id. at 57.) On January 4, 2009, it was noted that the wound looked much improved and there were no signs of infection. (Doc. 53-7 at 1.) On January 12, 2009, Plaintiff reported to Health Services to have his dressing changed, and it was noted that the wound was continuing to heal well and that there were no signs of infection. (Doc. 52 ¶ 64; Doc. 53-6 at 55.) On January 15, 2009, Plaintiff reported to Health Services to have his dressing changed, and it was noted that the wound was continuing to heal well and that there was no redness or drainage. (Doc. 52 ¶ 66; Doc. 53-6 at 52.) He was instructed to return the next day. (Doc. 52 ¶ 67; Doc. 53-6 at 52.)

On January 26, 2009, Plaintiff was examined during his quarterly chronic care clinic and it was noted that he was still waiting for a liver biopsy, which had been postponed due to his prostatectomy. (Doc. 52 ¶ 68; Doc. 53-6 at 41.) Plaintiff did not have any complaints and noted that his abdominal wound was healing well. (Doc. 52 ¶ 69; Doc. 53-6 at 41.) His vital signs showed a slight elevation in blood pressure, but otherwise the examination was unremarkable. (Doc. 52 ¶ 70; Doc. 53-6 at 41.) His medications for asthma, high cholesterol, high blood pressure, and urology symptoms were renewed; routine blood work was ordered; a new medication was added for the elevated blood pressure; and a follow-up chronic care clinic visit was scheduled. (Doc. 52 ¶¶ 71, 72; Doc. 53-6 at 41-43.) In addition, Plaintiff was counseled on the plan of care, and he verbalized his understanding. (Doc. 53-6 at 43.) This clinical encounter note was cosigned by Dr. Pigos on January 27, 2009. (Id.)

On January 29, 2009, EMT Conlin changed the dressings at Plaintiff's abdominal incision wound. (Doc. 53-6 at 38.) In his administrative note from this encounter, EMT Conlin noted that Dr. Pigos advised him that the daily dressing changes can now be every other day and packing the wound would no longer be needed. (Id.)

On February 2, 2009, Plaintiff reported to Health Services to have his dressing changed, and it was noted that the wound was almost completely healed, but had a foul smell to it since Plaintiff took the dressing off himself two days earlier. (Doc. 52 ¶ 74; Doc. 53-6 at 36.) PA Holtzapple cleaned the wound and applied a new dressing. (Doc. 52 ¶ 75; Doc. 53-6 at 36.) She then gave Plaintiff his own gauze and tape and instructed him that he could shower and wash the area with soap and water before his next dressing change. (Doc. 52 ¶ 76; Doc. 53-6 at 36.) His next dressing change occurred on February 5, 2009, and again on February 7, 2009. (Doc. 53-6 at 35, 33.)

On February 9, 2009, Plaintiff reported to Health Services to have his dressing changed, and it was noted that the wound was healed and there was no discharge on the gauze. (Doc. 52 ¶ 77; Doc. 53-6 at 32.) As a result, the dressing changes were discontinued and he was instructed to report to Health Services immediately if any problems arose. (Doc. 52 ¶ 78; Doc. 53-6 at 32.)

On March 3, 2009, Plaintiff went to Health Services with complaints that his abdominal wound that previously was closed was now leaking a clear fluid and the site was tender. (Doc. 53-6 at 29.) Upon examination, Nurse Russell noted that Plaintiff's abdominal incision wound appeared to be well healed except for a small two millimeter opening. (Id.) She also noted that she could not see any drainage from the opening, but the area was tender. (Id.) As a result, she issued Plaintiff dressings to contain any drainage, and referred him for a follow-up appointment. (Id.)

On March 5, 2009, PA Holtzapple noted that Plaintiff had been seen by an in-house urologist who had prescribed him with medication (Oxybutynin) to assist him with his urinary problem, and recommended quarterly prostate specific ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.