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Jefferson v. Overton

United States District Court, W.D. Pennsylvania

September 7, 2017

MAXINE OVERTON, et al., Defendants.



         I. Introduction

         A. Relevant Procedural History

         Plaintiff Leonard C. Jefferson, a prisoner formerly incarcerated at the State Correctional Institution at Albion, Pennsylvania (“SCI-Albion”), [2] originally filed this pro se civil rights action in the Court of Common Pleas of Erie County, Pennsylvania. Defendants removed the case to this Court on July 19, 2013 [ECF No. 1], and Plaintiff filed an amended complaint. [ECF No. 9]. Named as Defendants in the operative amended complaint are Maxine Overton (“Overton”), a former Correctional Health Care Administrator at SCI-Albion; Christine Zirkle (“Zirkle”), Overton's successor as Health Care Administrator at SCI-Albion; and Jean Oakes (“Oakes”), Infection Control Nurse at SCI-Albion.

         Plaintiff's amended complaint sets forth claims pursuant to 42 U.S.C. § 1983 arising under the Eighth Amendment, the Fourteenth Amendment Equal Protection Clause, and the Americans with Disabilities Act (“ADA”). Plaintiff also alleges a pendant state law claim of medical negligence. Defendants previously filed a motion to dismiss Plaintiff's amended complaint pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure, for failure to state a claim upon which relief may be granted. Upon resolution of the motion, only Plaintiff's Eighth Amendment claim against each Defendant remains. [ECF No.23].

         On September 8, 2014, the Court granted Plaintiff's motion for the appointment of counsel and stayed the action pending acceptance of his case by a member of the bar. On January 20, 2015, counsel entered an appearance on Plaintiff's behalf, and the action was reopened on March 6, 2015. Discovery has been completed and Defendants have filed a motion for summary judgment. [ECF No. 62]. Plaintiff filed his response through counsel [ECF Nos. 68-70], and the motion is now ripe for consideration.

         B. Relevant Factual History

         The evidence adduced to date establishes that for all times relevant to this action, Plaintiff has been required to use a urethral catheter four to five times daily to empty his bladder. Since at least 2006, SCI-Albion medical staff provided Plaintiff seven catheters per week, requiring Plaintiff to reuse a catheter several times per day. Plaintiff contends that despite his adherence to DOC instructions to wash each catheter in his cell with soap and water before reusing, Plaintiff suffered at least nine urinary tract infections (“UTIs”) during the two years immediately preceding the filing of his complaint, and at least 19 UTIs since arriving at SCI-Albion. Plaintiff attributes his chronic infections to reusing an issued catheter several times each day, without sterile gloves and antiseptic cleansers.

         Plaintiff filed several grievances and requests for assistance challenging the required reuse of catheters and requesting antiseptic wipes and sterile gloves. (ECF No. 1-1, pp. 16-30). Plaintiff related his chronic UTI's to the lack of sterile procedures for in-cell catheterization. Plaintiff contends that despite his grievances and history of infection, each of the Defendants were deliberately indifferent to his condition and refused to authorize or supply additional catheters or sterile gloves. As an example, Plaintiff notes that on June 27, 2012, he addressed a request for assistance to Defendant Overton, in her capacity as SCI-Albion's Corrections Health Care Administrator (“CHCA”), indicating that during his recent incarceration at SCI-Somerset for shoulder surgery, he was supplied one catheter per day, two Povidone-Iodine Prep-pads[3] and two sterile gloves. Plaintiff stated his belief that the additional supplies provided a superior method of reducing the risk of infection over the DialTM soap provided at SCI-Albion. Plaintiff requested that he be supplied these items each week with his catheters to reduce the risk of infection. Defendant Zirkle responded on Defendant Overton's behalf, indicating that “[s]elf-cath procedure is a clean procedure not a sterile procedure; sterile gloves are not required.” (ECF No. 1-1, p. 16; ECF No. 70-3, p.5).

         Upon receipt of Defendant Zirkle's response, Plaintiff submitted Grievance No. 418916, complaining that since 2005, he had suffered more than 19 urinary tract infections (“UTIs”), the most recent occurring one month earlier.[4] Plaintiff complained that medical personnel at SCI- Somerset were “appalled” to learn that SCI-Albion medical personnel did not provide him with gloves and antiseptic wipes to reduce the risk of infection. Plaintiff stated his belief that the practice constitutes deliberate indifference to his ongoing suffering and need for infection prevention, and falls below appropriate medical standards. (ECF No. 1-1, p. 17). The facility grievance coordinator reviewed Plaintiff's concerns with Defendant Overton, who contends that the procedures implemented at SCI-Albion comply with DOC policy and community health standards. (Id.; ECF No. 70-4, pp. 8-9). In addition, Defendant Overton reported that the additional procedures encountered by Plaintiff at SCI-Somerset were necessitated by the inpatient infirmary setting where Plaintiff was housed for a surgical procedure. Plaintiff appealed this response, again noting that he suffered repeated infections and that the policy, as applied to him, was not sufficient to prevent infection. (ECF No. 1-1, p. 20). Plaintiff's appeal to the Secretary's Office of Inmate Grievances & Appeals was referred to the DOC Bureau of Health Care Services.

         Plaintiff submitted a second grievance, No. 437538, on November 22, 2012, and complained that despite the dispensed catheters being labeled “single use only, ” Plaintiff was provided only one catheter per day, and was not provided sterile gloves or sanitizing wipes to prevent infection. Plaintiff indicated he was aware that the medical department was providing a Caucasian inmate with a sufficient number of catheters to permit single use, and Plaintiff questioned the difference in treatment afforded to him, an African American. (ECF No. 1-1, p. 24). Defendant Overton received a copy of the initial review response, which denied Plaintiff's grievance. The responding officer stated that the Medical Department determined treatment on an individualized basis, that he had been appropriately instructed in catheter care, and that he was issued anti-bacterial soap to clean his catheters between uses. (ECF No. 1-1, p. 29). Appeals of this grievance response were denied.

         Defendants have attached as an exhibit to their motion the Corrections Health Care Administrator job description, as relevant to both Defendants Overton and Zirkle. Among her duties, the incumbent CHCA: “manages health care services for inmates in the treatment of illnesses, diseases, and injuries in accordance with health care standards, guidelines and directives on a 24-hour daily basis, 7-days a week, including … medical and surgical treatment;” resolves grievances; prepares requisitions for supplies; and, “acts as staff adviser on matters of health and welfare of inmates.” (ECF No. 65-5, pp. 3-4). Relying on the scope of the CHCA position as exclusive of direct patient care, Defendants Overton and Zirkle indicate that all decisions related to the provision of catheters and supplies were relegated to Plaintiff's treating physician or physician assistant, and were not within their purview to change. (ECF Nos. 64, 65-4, pps.15-16, 33-34). However, both acknowledge receipt of Plaintiff's requests for assistance and grievances, and the fact that they did not intercede on Plaintiff's behalf. (ECF 65-1, pp. 6, 16-17; 65-2, p.5).

         Plaintiff identifies Defendant Oakes as an SCI-Albion infection control nurse. In December 2012, Defendant Oakes conducted a catheter use and care training session for Plaintiff and other catheter-dependent inmates. Defendant Oakes acknowledges that in the course of the training session, attendees, including Plaintiff, voiced concerns regarding the link between reusing single use catheters and suffering chronic UTIs. Defendant Oakes further acknowledges that she discussed Plaintiff's repeated UTIs with him and addressed his concerns related to catheter reuse with Defendants Zirkle and Overton, and with the SCI-Albion Medical Director. (ECF Nos. 65-4, pp. 41-48). In Defendants Oakes' experience, only doctors and physician's assistants determined and prescribed the number of catheters per inmate, and she did not participate in dispensing catheters to inmates. (ECF 65-3, p. 4).

         Defendants defend the practice of reusing catheters in an institutional setting contending that while each catheter is labeled by the manufacturer as “single use, ” such designation is meant to prevent sharing catheters between inmates, and is not a limit on the number of uses for each catheter. (ECF No. 65-1, p. 17, 65-4, p. 32 n. 19). In addition, Defendants argue that the self-catheterization procedure is a “clean” procedure, and sterile conditions are not required. (ECF No. 65-2, p. 8). Defendants Oakes and Zirkle state that it is ...

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