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Demetrius Johnson v. Dale A. Meisel

February 20, 2013

DEMETRIUS JOHNSON
PLAINTIFF,
v.
DALE A. MEISEL, ERIK VON KIEL, ,
DR. WILSON, MEGAN HUGHES, AND PRIMECARE MEDICAL, INC. DEFENDANTS.



The opinion of the court was delivered by: Jones, II, J.

MEMORANDUM

Demetrius Johnson, a prisoner in state custody at the Lehigh County Prison ("LCP"), brought this civil rights action pursuant to 42 U.S.C. § 1983 alleging that all Defendants were deliberately indifferent to his serious medical condition. Presently before the Court is a Motion for Summary Judgment filed by Defendants Erik Von Kiel, Dr. Wilson, Megan Hughes and PrimeCare Medical, Inc. ("the Medical Defendants") (Dkt. No. 34), along with a Statement of Undisputed Facts ("MD SUF") (Dkt. No. 35). Also before the Court is a similar Motion filed by Defendant Dale A. Meisel (Dkt. No. 37) and Statement of Undisputed Facts ("Meisel SUF") (Dkt. No. 38). Johnson has filed a Joint Response to the Motions (Dkt. No. 39), his own Statement of Undisputed Facts ("Pl. SUF") (Dkt. No. 40), and a Statement of Disputed Facts (Pl. SDF") (Dkt. No. 41). For the reasons set forth below the Defendants' Motions will be granted.

I. LEGAL STANDARD

Under Federal Rule of Civil Procedure 56(c), summary judgment is appropriate "if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." Fed. R. Civ. P. 56(c); Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986). To defeat a motion for summary judgment, disputes must be both (1) material, meaning concerning facts that will affect the outcome of the issue under substantive law; and (2) genuine, meaning the evidence must be "such that a reasonable jury could return a verdict for the nonmoving party." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). Summary judgment is mandated "against a party who fails to make a showing sufficient to establish the existence of an element essential to that party's case, and on which that party will bear the burden of proof at trial." Celotex, 477 U.S. at 322. An issue is genuine if the fact finder could reasonably return a verdict in favor of the nonmoving party with respect to that issue. Anderson, 477 U.S. at 249. In reviewing a motion for summary judgment, the court does not make credibility determinations and "must view facts and inferences in the light most favorable to the party opposing the motion." Siegel Transfer, Inc. v. Carrier Express, Inc., 54 F.3d 1125, 1127 (3d Cir. 1995).

II. FACTS

Plaintiff Johnson alleges that, after being incarcerated at the LCP in the spring of 2009, he began to experience severe abdominal pains and significant amounts of blood in his bowel movements. (Am. Compl. ¶¶ 13-14.) Over a period of one year, he experienced sharp and crippling abdominal pains, vomiting, spontaneous and persistent rectal bleeding, insomnia due to pain, and dramatic weight loss (including an alleged weight loss during an undisclosed period of two weeks). (Id. at ¶15.) Beginning in August of 2009, he repeatedly and regularly notified Dr. Von Kiel and Dr. Wilson, PA. Megan Hughes, and Warden Meisel of his symptoms and condition and requested medical treatment. (Id. at ¶ 17.) Johnson alleges that these requests for treatment were communicated via written sick call requests, written staff requests, inmate grievances, grievance appeals, and verbal requests. (Id. at ¶18.) He alleges that Drs. Von Kiel and Wilson and P.A. Hughes told him that there was "nothing wrong with him" and he had to "hope the bleeding stops." (Id. at ¶19.)

Johnson next alleges that the Medical Defendants did not perform diagnostic tests to assess his condition or refused to honor Johnson's request for further testing, leading to his filing of numerous grievances. (Id. at ¶ 20.) He alleges that instead of performing diagnostic tests, Drs. Von Kiel and Wilson prescribed inappropriate medications that were ineffective. (Id. at ¶ 21.) He alleges that in August 2010, after he expressed his intentions to file this lawsuit, he was sent to St. Luke's Hospital in Bethlehem for diagnosis and treatment, where he was seen by Dr. Daniel Bowers who ordered a colonoscopy and diagnosed Johnson with proctitis in his distal rectum and prescribed medication which resulted in the almost complete cessation of Johnson's symptoms. (Id. at ¶¶ 24-29.) Thereafter, he was taken for four (4) follow-up appointments relative to this outside consultation. (Id. at ¶ 30.) He alleges that this conduct constituted deliberate indifference by all Defendants to a severe medical condition in violation of 42 U.S.C. § 1983. (Id. at ¶¶ 6-7, 37-38.) He also alleges that PrimeCare failed to properly train and supervise its employees in providing adequate diagnostics and medical care, which constituted deliberate indifference. (Id. at ¶¶ 38-40.)*fn1 Johnson contends that Defendant Meisel, as warden of LCP, had the authority to decide inmate grievance appeals and take steps to address the denial of prisoner grievances, yet summarily denied his grievances without adequate investigation and without consideration to his serious medical needs, because he was under pressure to reduce costs associated with treating LCP inmates. (Id. at ¶¶ 23, 31.)

Defendant PrimeCare is the exclusive medical care provider to LCP inmates pursuant to a contract between PrimeCare and Lehigh County; it is the sole supplier and coordinator of all health care programs at LCP. (Meisel SUF, Ex. A at 1, I; Ex. A, App. A at 15, 1.2.2; Ex. B at 45-47; Ex. C at 19-20.) Pursuant to the contract, PrimeCare is a third party vendor to LCP, and as a vendor, PrimeCare's employees are not employees of Lehigh County or LCP. (Meisel SUF Ex. A; Ex. B at 18.) PrimeCare, not LCP or Defendant Meisel, makes all decisions relating to an inmate's medical treatment, including but not limited to whether or not an inmate needs to receive outside medical attention or whether he or she will need to go to a hospital. (Meisel SUF Ex. A; Ex. B at 46-47.) Nonetheless, "medical access" is an issue that may be raised by an inmate through the inmate grievance process. (Meisel SUF Ex. F at 2; Ex. G at 21.) Warden Meisel is the final arbiter of an inmate grievance. (Meisel SUF Ex. F at 4.)

When Johnson was booked at LCP on May 21, 2009, he received an Initial Medical Intake and Suicide Screening. (MD SUF Ex. A at 1-6.) Johnson disclosed that he was taking the medications Risperdal and Trazadone upon intake and the same was ordered for him in the Prison. (Id. at 2, 8-9.) No medical complaints were noted at intake. (Id. at 1-6.)

Johnson's first complaint of any gastrointestinal symptoms occurred on August 8, 2009, when he complained of nausea and indigestion. (Id. at 306.) He was seen by a nurse on August 11, 2009. (Id. at 69.) He was prescribed Prilosec by Dr. Von Kiel; this was later changed to Zantac on September 10, 2009, but changed back to Prilosec on September 14, 2009. (Id. at 11-12, 15.) On September 9, 2009, Johnson submitted a Sick Call Request indicating that he sometimes observes bleeding in the toilet with some bowel movements. (Id. at 302.) His medical chart notes "blood in stool.? GI bleed . . . I/m states he has blood in his stool. he was just seen 9/10/09. states the amount has gotten larger since then. . . Bright red blood. constipated and hard stools. . . . will add Metamucil will order labs and schedule f/u." (Id. at 371-72.) On September 10, 2009, Johnson was seen by PA. Hughes on a Sick Call Request for complaints of gastrointestinal upset including two trips to the medical department that week for complaints of chest pains after eating and blood in his stool. (Id. at 180.) He was placed on a bland diet by PA. Hughes after this appointment. (Id. at 74.) Johnson was also prescribed Colace stool softener and Simethicone to treat intestinal gas. (Id. at 13-14.) On September 14, 2009, he was prescribed Metamucil when it was noted that he was constipated with hard stools. An internal hemorrhoid was suspected. (Id. at 14-15, 180.) Diagnostic testing was also ordered for Johnson, including a hemoccult test to determine if there was blood in his stool, which was administered on September 16, 2009. (Id. at 77.)

On September 20, 2009, Johnson was weighed to compare his weight at intake, and it was discovered that he had suffered a 9 pound weight loss since May 2009. (Id. at 78.) It was also noted that Johnson had not had a bowel movement in three days and that he was still constipated despite Metamucil. (Id. at 180.) Johnson complained of a small amount of blood in his last stool. (Id.) On September 23, 2009, an x-ray was ordered for Johnson, (id.), and on September 24, 2009, radiologist Charles Woodruff, M.D., authored a report finding a normal gas pattern and no evidence of a bowel obstruction or kidney stones in the x-ray. (Id. at 299). Between October 2 and 14, 2009, Johnson intermittently refused doses of Metamucil. (Id. at 36-37.) On October 15, 2009, after his release from more than a week of disciplinary segregation, Johnson complained of more blood in his stool and stomach pain, and a 15-pound weight loss since intake was noted. LPN Dolores Lutzko noted that it was very difficult to get answers from Johnson and that he had not eaten in two to three days while in segregation confinement. (Id. at 84.) Johnson was scheduled to see P.A. Hughes the next day for the complaints of stomach pain and blood in stool. (Id. at 85.) The medication dispensary chart reveals that between October 12 to November 4, 2009, Johnson had repeatedly refused his medications or failed to present for medication rounds. (Id. at 38.) On November 4, 2009, Johnson again complained of rectal bleeding. When he was seen by P.A. Hughes, Johnson admitted he was not taking the Metamucil and refused a rectal exam. (Id. at 181.)

On November 13, 2009, Johnson was seen by Dr. Wilson who noted that Johnson denied any GI family history. (Id. at 92, 181.) Johnson stated he had been nauseated for two months and had a bitter taste in his mouth. (Id.) Johnson stated that he ate a lot, spending about $70 per week on commissary food. (Id.) He indicated that he had some constipation and strained when making a bowel movement. (Id.) A rectal exam was performed. (Id.) It was noted that Johnson was concerned about his weight loss and requested to see a male doctor related to his rectal bleeding after Dr. Wilson opined that Johnson's weight loss was normal for being in the prison environment. (Id.) She noted that Johnson was "instructed no more than 50 repetitions of any exercise a day. No other therapy needed." (Id. at 373.) Between November 20 and December 4, 2009, Johnson mostly refused medications or failed to appear for medication distribution rounds. (Id. at 41-42.)

On December 1, 2009, Johnson was seen by Dr. Von Kiel who ordered that a check of his GI status and a fasting complete blood count ("CBC"), urinalysis and hemoccult stool x 3 be performed. (Id. at 98.) These tests were performed the next day. (Id.) The results of all three hemoccult samples were negative. (Id. at 160.) On December 4, 2009, Dr. Wilson reviewed Johnson's lab results, and Johnson indicated that he had been moving his bowels better and requested to go off the bland diet. (Id. at 100, 182.) On December 23, 2009, Johnson's request to be placed back on Metamucil, which had been discontinued on December 4, 2009, after his continued refusals to take it, was granted. (Id. at 17, 42, 107.) Between December 25 and 27, 2009. Johnson refused all medications. (Id. at 42.)

On December 28, 2009, Johnson complained of vomiting and stomach pains and was seen by a nurse. Two days later Johnson was assessed by P.A. Hughes for these complaints and was prescribed Bentyl for his irritable bowel symptoms and Pepto-Bismol. (Id. at 18-19). On January 1, 2010, another fasting CBC was ordered and Johnson was provided with Ensure or equivalent with his meals. (Id. at 111.) Dr. Von Kiel noted that Johnson may be suffering from ulcers and placed him on a bland diet, noting a loss of nine pounds since intake in May 2009. (Id.) The fasting CBC was ...


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