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Johnson v. Iliff

United States District Court, S.D. Alabama, Southern Division

February 1, 2018

TIMOTHY ILIFF, et al., Defendants.



         Plaintiff Marcus Johnson (“Plaintiff”), a prison inmate proceeding pro se and in forma pauperis, filed a complaint under 42 U.S.C. § 1983.[1] (Doc. 8). This action was referred to the undersigned pursuant to 28 U.S.C. § 636(b)(1)(B) and Local Rule 72(a)(2)(R), and is now before the undersigned on Defendants' Motion for Summary Judgment. After careful review of the pleadings, and for the reasons set out below, it is ordered that Defendants' Motion for Summary Judgment be granted in favor of all Defendants and that the claims asserted against Defendants be dismissed with prejudice.

         I. Summary of Action.

         Plaintiff filed this suit on January 18, 2016, against Dr. Timothy Iliff, Dr. Calvin Johnson, Certified Registered Nurse Practitioner Shawn Geohagan, Warden Cynthia Stewart, and Corizon Services CEO Jay Cowan. (Doc. 8 at 5- 7). Plaintiff alleges that he suffers from an extremely painful softball-sized ventral hernia which Defendants refuse to treat properly with surgical repair and instead have opted to treat by prescribing a hernia belt and pain medication. (Doc. 8-1 at 4-5). Specifically, Plaintiff alleges Defendants Iliff and Geohagan failed to provide him with adequate medical care for his hernia and that Defendants Johnson and Stewart, as supervisors, [2] are legally responsible for the deficient medical treatment . (Doc. 8 at 5-7). Plaintiff requests that the Court order the defendants to provide surgical repair of his ventral hernia and to pay monetary damages. (Id. at 8; Doc. 8-1 at 6).

         Defendants, Dr. Timothy Iliff, Dr. Calvin Johnson, Shawn Geohagan, and Cynthia Stewart, have answered the suit and filed a Special Report, which the Court has converted in to a Motion for Summary Judgment. (See Docs. 42-43, 46). And, Plaintiff has subsequently filed a Response to the motion. (Doc. 53). After a thorough review of the record, it is determined that this motion is ripe for consideration.

         II. Factual Background.

         Defendants have presented the Court with sworn declarations summarizing Plaintiff's medical condition and the history of his treatment while imprisoned at Fountain Correctional Facility (See Docs. 43-1 - 43-5), as well as copies of Plaintiff's medical records dating from 2014 through December of 2016, with the exception of the records from Atmore Community Hospital where Plaintiff underwent a CT scan followed by hernia repair surgery on December 9, 2016. (See Doc. 43-6). Plaintiff has provided additional evidence in the form of approximately five sick call requests dating from 2004 through 2011. [3]

         In 1996, Plaintiff suffered an abdominal gunshot wound and received surgery for it; thereafter, in May 1997, he was convicted, sentenced, and imprisoned within the Alabama Department of Corrections for burglary and murder. (Id. at 227; Doc. 8 at 7). While incarcerated, Plaintiff developed a ventral hernia[4] at the previous surgical site and on January 16, 2003 was provided surgical repair of the hernia. (Doc. 43-5 at 2; Doc. 43-6 at 307). As early as June of 2004, Plaintiff again developed a ventral hernia and began receiving treatment for the symptoms within the prison's health care unit. (Doc. 8-1 at 10). On May 15, 2006, Plaintiff received his second hernia repair surgery while incarcerated. (Doc. 43-5 at 2; Doc. 43-6 at 287-303).

         It is unclear exactly when Plaintiff developed the third ventral hernia, subject of this suit, but according to the record, on May 28, 2011, Plaintiff reported abdominal pain when he stood or moved and complained that the pain had been progressively worsening for two months. (Doc. 8-1 at 12). The nursing staff instructed him to take Tylenol for the pain and wear his provided hernia binder. (Id.). By fall of 2014, Plaintiff's complaints of abdominal pain, consistent with a hernia, were frequent.

         On September 8, 2014, Certified Registered Nurse Practitioner Shawn Geohagan (“Geohagan”) examined Plaintiff for complaints of stomach pain and having blood in his stool for four days. (Doc. 43-6 at 176). Geohagan ordered a hemmocult card to test for the presence of blood in Plaintiff's stool, but the results were negative for the specimens taken on September 8 and September 12, 2014. (Doc. 43-6 at 147; Doc. 43-4 at 2-3).

         On September 22, 2014, Geohagan examined Plaintiff, following a sick call request for stomach pain, swelling, and a request for an x-ray scan. (Doc. 43-6 at 175; Doc. 43-4 at 3). Geohagan noted Plaintiff's chronic abdominal discomfort on the chart but indicated Plaintiff's “large abdomen [was] due to obesity state” (Plaintiff, who stands 5 feet 10 inches tall, is reported as weighing 290 pounds on the date of the exam) and did not order any diagnostic imaging at that time. (Doc. 43-6 at 177).

         On September 25, 2014, Plaintiff was seen by a nondefendant nurse in the Chronic Disease Clinic for routine care for his medical conditions, and the presence of an abdominal hernia was indicated on the chart, an abdominal binder was prescribed to hold the hernia in to place, and a notation was made to for the nurse to discuss with Dr. Iliff whether or not surgical repair of the hernia was advisable. (Doc. 43-6 at 151).

         On October 9, 2014, Dr. Iliff examined Plaintiff for complaints of hernia pain that had been present for “years, ” and noted a “large ventral hernia” on the right side of Plaintiff's abdominal surgical scar. (Doc. 43-6 at 12). Dr. Iliff prescribed Plaintiff Naprosyn for pain and performed an x-ray, which indicated a diffuse ileus, which the radiologist found to be “worse compared to [the x-ray images of] October 11, 2012.” (Doc. 43-6 at 45). Dr. Iliff, however, indicated that the hernia was not incarcerated at that time and did not recommend surgical intervention due to Plaintiff's weight and risk for increased complications. (Id. at 12).

         Plaintiff was subsequently seen in the Chronic Disease Clinic on October 23, 2014 and January 22, 2015, and although Plaintiff failed to voice any complaints of abdominal pain, his hernia was assessed and determined to be reducible at both visits. (Doc. 43-6 at 27-28).

         On April 15, 2015, Plaintiff was examined in the health care unit for complaints of hernia pain; the hernia was reducible, but the examining nurse noted she would discuss the possibility of surgical intervention with Dr. Iliff. (Id. at 10, 14).

         On April 23, 2015, Plaintiff was seen in the Chronic Disease Clinic with complaints of abdominal pain and swelling and was scheduled an appointment with Dr. Iliff. (Id. at 31). Dr. Iliff saw Plaintiff the next day and again confirmed by examination a “large ventral hernia” at the site of past surgeries and further noted that he would discuss Plaintiff's condition with the Regional Medical Director. (Id. at 10).

         On July 21, 2015, Plaintiff was again seen in the Chronic Disease Clinic and complained of abdominal pain persisting for approximately 12 years. (Id. at 30). A week later, Dr. Iliff examined Plaintiff on July 28, 2015, finding Plaintiff's weight had decreased to 264 pounds and estimated Plaintiff's hernia to be “softball” sized. (Id. at 46-47). Dr. Iliff notes that Plaintiff has “complained of pain regularly” and recommends a surgical evaluation. (Id.). However, Dr. Hood (who is not a party to this suit) denied Dr. Iliff's request for a surgical consult on July 29, 2015, and recommended managing Plaintiff's care on site. (Id. at 46).

         The nursing staff and Dr. Iliff again examined Plaintiff on November 2, 2015 for complaints of hernia pain. (Id. at 11). Dr. Iliff noted Plaintiff's obese state and chronic abdominal pain from ventral hernia. (Id.). Plaintiff confirmed he was using the provided abdominal binder, and Dr. Iliff assessed that the hernia was still reducible. (Id.). Dr. Iliff determined and discussed with Plaintiff that a conservative treatment plan of medication and binder use was appropriate given Plaintiff's obesity and surgical history. (Id.). Following this examination, Plaintiff submitted a formal grievance stating:

When I went to see the doctor he told me I had a hernia I have been going back and forth for several years trying to get my stomach fixed. My stomach is constantly swelling look like a tumor, constantly in pain. I asked the doctor was he going to do anything to fix my stomach. And his reply was, ‘It wouldn't do any good to have it fixed, the same thing would happen again.' He clearly stated that, ‘he wasn't going to do anything to have it fixed!'

(Id. at 74).

         On November 9, 2015, Nurse Practitioner Shawn Geohagan examined Plaintiff (weighing 246 pounds) and again discussed the conservative treatment plan for the hernia with him. (Id. at 55). Although Plaintiff disagreed with the plan, he confirmed his understanding of it. (Id.).

         On December 12 and 13, 2015, Plaintiff completed sick call request forms complaining of pain and swelling in his abdomen and blood in his stool and requested stronger medication for the pain.[5] (Id. at 16-17). The requests were received by the health care unit on December 14, 2015, and the nursing staff examined Plaintiff on December 15. 2015, noting pain in the right side of Plaintiff's stomach for 12 years that increased with movement and confirming normal vital signs, active bowel sounds, and that Plaintiff had had a bowel movement the previous day. (Id. at 15).

         On December 21, 2015, Geohagan saw Plaintiff for complaints of stomach pain after eating and diarrhea. (Id. at 55). Geohagan confirmed a soft, non-tender abdomen and diagnosed Plaintiff with gastroesophageal reflux disease and prescribed Zantac at 150 mg to be taken twice a day for 180 days. (Id.).

         Geohagan again saw Plaintiff in the Chronic Disease Clinic on February 1, 2016 and May 2, 2016, where Plaintiff did not mention complaints of abdominal pain or swelling, and Geohagan again confirmed a soft, non-tender abdomen. (Id. at 38-39).

         On May 10, 2016, Plaintiff submitted a sick call request form complaining of a “risen” formed on the right side of his stomach that had puss coming out of it. (Id. at 68). The nursing staff examined Plaintiff the same day for the complaint, and the nursing notes indicate the presence of a “hot, red, tender, odoriferous” 10 mm bump on the right side of Plaintiff's abdomen with slight yellow discharge draining from the site. (Id. at 66-67). Plaintiff was prescribed 375 mg of Naproxen to be taken twice a day for 30 days, Bactrim to be taken twice a day for 10 days, and a follow up appointment was scheduled for one week later. (Id. at 67).

         On July 19, 2016, Plaintiff presented to the health care unit with complaints of stomach pains and difficulty digesting his food. (Id. at 63, 65). Plaintiff reported to the nursing staff that for approximately four days to a week he not only suffered from abdominal cramping but also nausea, vomiting, and diarrhea. (Id. at 63). When examined on July 20, 2016 by Nurse Practitioner Geohagan, Plaintiff complained that for three weeks he had suffered from pain in his upper right abdominal area, that food was “souring on stomach, ” that he was vomiting, and had seen blood in his stool. (Id. at 55). Geohagan's examination revealed a soft abdomen with mild tenderness, and Geohagan prescribed Pepto-Bismol, Prilosec, and two antibiotics for a possible infection. (Id.; Doc. 43-4 at 4).

         On August 3, 2016, Plaintiff filed an Inmate Request Slip stating:

Dr. Stone, since 1997 I have been having serious problems from a gunshot wound to my stomach. . . my food does not properly digest, and I have blood in my bowel movements. The pain is getting worse, and I am bleeding more. I need help. GOEHAEN[sic] won't do anything to help.

(Doc. 43-6 at 61). Nurse Practitioner Geohagan followed up with Plaintiff that same day and noted Plaintiff's continued complaints of pain and dark stools. Geohagan charted active bowel sounds, a flat and erect abdomen, and scheduled Plaintiff an appointment with nondefendant Dr. Karen Stone. (Id. at 56; Doc. 43-3 at 1).

         Dr. Stone ordered an x-ray of Plaintiff's abdomen on August 11, 2016, which indicated “a slight, small bowel loop dilation consistent with mile ileus” but showed no significant bowel obstruction. (Doc. 43-6 at 44). Dr. Stone then examined Plaintiff on August 12, 2016 for his concerns of abdominal pain. (Id. at 56). Dr. Stone reviewed Plaintiff's history, and her examination confirmed a large ventral hernia which was reducible, revealed no blood in Plaintiff's stool, but Dr. Stone detected some bowel within the hernia. (Id.; Doc. 43-5 at 12). Dr. Stone scheduled a follow up for assessment for Plaintiff and noted the possibility of discussing Plaintiff's care with the Regional Medical Director, Dr. Hood, and obtaining a possible surgical consultation. (Doc. 43-6 at 55; Doc. 43-5 at 12).

         On September 10, 2016, Plaintiff was examined by the nursing staff for complaints of hernia pain, gas, and blood in stool. (Doc. 43-6 at 184). The chart notations indicate ...

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