United States District Court, N.D. Alabama, Southern Division
MEMORANDUM OPINION 
H. ENGLAND, III UNITED STATES MAGISTRATE JUDGE.
15, 2015, Plaintiff James Edward Barber, Jr.
(“Barber”), a prisoner proceeding pro
se, initiated this action against Defendants Corizon
Health, Dr. Hugh Hood, Cheryl Price, and Dr. Roy Roddam,
asserting claims under 42 U.S.C. § 1983 that they had
refused to treat his medical needs and had denied him access
to outdoor recreation. (Doc. 1). On October 26, 2015, counsel
appeared for Barber, (docs. 12 & 14), and on November 5,
2015, Barber amended his complaint, (doc. 18). The amended
complaint reframed the original § 1983 claims and added
as defendants James Butler, Cedric Specks, Angela Miree,
Jefferson Dunn. (Id.). Specifically, the amended
complaint asserts an Eighth Amendment denial of medical care
claim against Corizon, Dr. Hood, Dr. Roddam, Butler, Price,
and Dunn; a conspiracy claim against Corizon, Dr. Hood, Dr.
Roddam, Butler, and Price; an Eighth Amendment failure to
intervene claim against Corizon, Dr. Hood, Dr. Roddam,
Butler, Price, and Dunn; an Eighth Amendment conditions of
confinement claim against Price, Specks, Miree, and Dunn; and
a medical malpractice claim against Corizon, Roddam, Hood,
and Butler. (Id.). The defendants generally fall
into two groups: the defendants involved with Barber's
medical care (Corizon, Dr. Roddam, Dr. Hood, and Butler - the
“Corizon Defendants”) and the defendants employed
by or overseeing the Alabama Department of Corrections
(Price, Specks, Miree, and Dunn - the “ADOC
Defendants”). Separately, the Corizon Defendants and
the ADOC Defendants now move for summary judgment. (Docs. 71
& 72). The motions are fully briefed and ripe for review.
(Docs. 79, 80 & 81). For the reasons stated below, each
motion is GRANTED IN PART and DENIED
Standard of Review
Rule 56(a) of the Federal Rules of Civil Procedure, summary
judgment is proper if the pleadings, the discovery, and
disclosure materials on file, and any affidavits “show
that there is no genuine issue as to any material fact and
that the movant is entitled to judgment as a matter of
law.” “Rule 56 mandates the entry of summary
judgment, after adequate time for discovery and upon motion,
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 Corp. v.
Catrett, 447 U.S. 317, 322 (1986). The moving party
bears the initial burden of proving the absence of a genuine
issue of material fact. Id. at 323. The burden then
shifts to the nonmoving party, who is required to “go
beyond the pleadings” to establish there is a
“genuine issue for trial.” Id. at 324.
(citation and internal quotation marks omitted). A dispute
about a material fact is genuine “if the evidence is
such that a reasonable jury could return a verdict for the
nonmoving party.” Anderson v. Liberty Lobby,
Inc., 477 U.S. 242, 248 (1986).
Court must construe the evidence and all reasonable
inferences arising from it in the light most favorable to the
non-moving party. Adickes v. S.H. Kress & Co.,
398 U.S. 144, 157, (1970); see also Anderson, 477
U.S. at 255 (all justifiable inferences must be drawn in the
non-moving party's favor). Any factual disputes will be
resolved in Plaintiffs favor when sufficient competent
evidence supports Plaintiffs version of the disputed facts.
See Pace v. Capobianco, 283 F.3d 1275, 1276-78 (11th
Cir. 2002) (a Court is not required to resolve disputes in
the non-moving party's favor when that party's
version of the events is supported by insufficient evidence).
However, “mere conclusions and unsupported factual
allegations are legally insufficient to defeat a summary
judgment motion.” Ellis v. England, 432 F.3d
1321, 1326 (11th Cir. 2005) (per curiam) (citing Bald
Mtn. Park, Ltd. v. Oliver, 836 F.2d 1560, 1563 (11th
Cir. 1989)). Moreover, “[a] mere ‘scintilla'
of evidence supporting the opposing party's position will
not suffice; there must be enough of a showing that the jury
could reasonably find for that party.” Walker v.
Darby, 911 F.2d 1573, 1577 (11th Cir. 1990) (citing
Anderson, 477 U.S. at 252).
Summary Judgment Facts
is a death row inmate at Donaldson Correctional Facility in
Bessemer, Alabama. (Doc. 72-2 at 2-3 (4:1-8, 5:22-6:6)).
Barber began noticing problems with his left hip in January
2004, shortly after he became incarcerated at Donaldson.
(Id. at 6 (20:7-12)). On June 22, 2004, Dr. Sylvia
McQueen, then the medical director at Donaldson, diagnosed
Barber with osteoarthritisin his left hip. (Doc. 72-2 at 9-10
(32:8-33-6); doc. 79-1 at 8). Dr. McQueen prescribed an NSAID
and a muscle relaxant. (Doc. 72-2 at 10 (33:14-23); doc. 79-1
2004 to 2008, various prison physicians continued to treat
Barber's osteoarthritis with NSAIDs. (Doc. 72-2 at 11-12
(40:15-41:4)). X-rays taken during this period showed mild
arthritis, but Barber testified the pain was progressively
getting worse. (Doc. 72-2 at 11 (37:2-13, 38:9-39:4)).
Beginning in September 2004 and continuing through February
2006, Barber complained to prison physicians that the
medication was no longer working and that the pain affected
his mobility and prevented him from exercising and sleeping.
(Doc. 79-1 at 13-22).
March 2009, the narcotic Ultram was added to Barber's
prescription regimen. (Doc. 79-1 at 2, 86). Despite this new
medication, between 2009 and 2012, Barber continued to report
increased hip pain leading to loss of mobility and inability
to sleep or sit for long periods. (Id. at 9, 47-48,
51, 60, 103-04, 107, 112-14, 116-19, 122, 125). Barber also
requested increases in his medication's frequency or
dosage, as by his reports the medication was no longer
sufficient. (Id.). Barber was given a cane in
January 2011. (Id. at 126).
early 2013, Defendant Dr. Hugh Hood was serving as interim
medical director at Donaldson. (Doc. 79-2 at 55 (213:5-14)).
Dr. Hood saw Barber twice at Donaldson in early 2013.
Barber's first visit with Dr. Hood occurred on January
29, 2013, after Barber reported hip and back pain. (Doc. 79-1
at 32; doc. 79-2 at 52 (204:10-13)). Dr. Hood observed
Barber's osteoarthritis, noting increased pain on flexion
and rotation of the hip joint and reduced pain on extension
of the hip joint. (Doc. 79-1 at 32). Dr. Hood noted that the
pain was “probably more related to degenerative joint
disease of the left hip, ” but suspected Barber might
also be suffering from a herniated disc. (Id.; doc.
79-2 at 54 (209:20-210:15). To differentiate the source of
Barber's pain, Dr. Hood prescribed a tapered steroid
regimen, which would potentially rule out the herniated disc.
(Doc. 79-2 at 54 (210:6-211:3). Dr. Hood also prescribed
Norco, a narcotic, at 5/325 twice per day for thirty days.
(Doc. 79-1 at 27; doc. 79-2 at 58 (225:1-226:5).
Hood saw Barber approximately two weeks later for a follow-up
visit. (Doc. 79-1 at 31). Barber reported no improvement from
the steroid regimen, and Dr. Hood's notes reflect that
Barber's “[s]igns and symptoms worsen with internal
and external rotation of the left hip.” (Doc. 79-1 at
31; doc. 79-2 at 61 (240:4-10)). Dr. Hood testified his notes
reflect that Barber's hip was getting worse. (Doc. 79-2
at 61 (240:21-25)). Dr. Hood switched Barber from Norco to
the essentially identical narcotic Lortab at the same 5/325
dosage, but increased the frequency to three times per day
for thirty days. (Doc. 79-1 at 31; doc. 79-2 at 58
(226:24-227:13) & 61 (238:23-239:17)).
2013, Defendant Dr. Roy Roddam was hired by Corizon on a
part-time basis to see inmates at the prison. (Doc. 72-6 at 4
(11:10-12:14)). Dr. Hood was Dr. Roddam's medical
supervisor. (Id. at 4-5 (12:23-24)). Dr. Roddam saw
Barber on July 30, 2013, noting his pain was thought to be
caused by osteoarthritis (which had been confirmed by
X-rays). (Doc. 79-1 at 31; doc. 72- 6 at 13 (45:16-23)).
Barber saw Dr. Roddam again on October 8, 2013, reporting
pain in his left hip at a consistent severity of 6 out of 10.
(Doc. 79-1 at 30). Barber's hip flexion was 20 degrees
with 0 degrees of abduction, contrasted with a normal
hip's 150 degrees of flexion and 45-50 degrees of
abduction. (Doc. 79-1 at 30; Doc. 72-6 at 15 (54:17-55:3);
doc. 72-8 at 6 (19:16-20:11)).
Barber's subjective reports of pain were inconsistent
with the x-rays showing mild or minimal osteoarthritis, Dr.
Roddam ordered another X-ray. (Doc. 79-1 at 30; doc. 72-6 at
15 (54:6-16, 56:13-17)). Dr. Roddam also planned to have
Barber undergo an orthopedic consultation with Dr. Thomas
Powell to determine why Barber's subjective complaints
were more severe than the minimal condition indicated by the
objective evidence. (Doc. 79-1 at 30; doc. 72-6 at 15-16
(56:10-20)). Pursuant to Corizon policy, on October 8, 2013,
Dr. Roddam submitted a request to Dr. Hood requesting a
consultation with Dr. Powell. (Doc. 79-5 at 2-3; doc. 79-6 at
2). Dr. Hood denied that request on November 8, 2013. (Doc.
79-6 at 3). Although Dr. Hood was required by Corizon policy
to document the reason for the denial, he did not do so;
instead, Dr. Hood directed Dr. Roddam to “[m]anage on
site.” (Doc. 79-5 at 2-3; doc. 79-6 at 3).
saw Dr. Roddam again on November 26, 2013, stating his pain
had worsened progressively over the past six years. (Doc.
79-1 at 29). Between visits, Barber had undergone another
X-ray showing modest osteoarthritis with spurring.
(Id. at 29, 64). Dr. Roddam tested Barber's hip
and found flexion to 40 degrees, causing significant pain,
and painful internal and external rotation. (Id. at
29; doc. 72-6 at 16 (58:1-8)). Dr. Roddam again noted
Barber's subjective reports were “out of
proportion” to the X-ray findings and again indicated
he planned to seek an orthopedic consultation with Dr.
Powell. (Doc. 79-1 at 29; doc. 72-6 at 16 (60:9-16) & 17
(61:7-18)). The same day, Dr. Roddam submitted a second
request for an orthopedic consultation to Dr. Hood, which Dr.
Hood approved. (Doc. 79-6 at 4; doc. 72-6 at 36 (140:21-24)).
January 23, 2014, Barber saw Dr. Powell at Brookwood Medical
Center in Birmingham Alabama. (Doc. 79-7 at 3-4). Dr.
Powell's progress notes from the visit state:
Mr. Barber presents complaining of left hip pain. He is Death
Row inmate from Donaldson who complains of left hip pain that
point where he has difficulty moving, bending, walking etc.
He is here for further evaluation and treatment. He denies
any specific injury to his left hip.
His left hip has about 100° of flexion but only 4/5
strength. He has about 15° of external rotation, but no
internal rotation and abduction is limited to maybe 15°
with pain. Neurologically appears intact and there is no
(Doc. 79-7 at 3). Dr. Powell testified that 4/5 strength was
near normal, but that the ranges of motion were less than
normal-fifty degrees fewer in flexion, thirty-five to forty
degrees fewer in internal rotation, forty-five to fifty
degrees fewer in external rotation, and thirty to forty-five
degrees fewer in abduction. (Doc. 72-8 at 6 (19:3-20:11)).
X-rays taken at the visit showed “end-stage arthritis
of the left hip without evidence of fracture, ” which
Dr. Powell testified was indicated by “bone spurs,
joint space loss, irregularity of the femoral head.”
(Id. at 7 (23:6-9); doc. 79-7 at 3). As treatment
for Barber's hip pain, Dr. Powell stated: “Today,
we discussed [Barber's] options and I think it would be
reasonable to at least try an intra-articular steroid
injection, and he agrees. Otherwise, or if he fails that, the
only treatment option would be total hip replacement.”
(Doc. 79-7 at 3). Dr. Roddam testified the X-rays taken at
Dr. Powell's office supported the pain Barber had
complained of, as they “showed a degree of
osteoarthritis that was different than the X-ray film that
had been taken at Donaldson, ” and that the reading of
the X-rays resolved his confusion. (Doc. 72-6 at 24 (89:6-20)
& 37-38 (144:25-145:16)). Dr. Roddam agreed with Dr.
Powell's assessment of Barber's options.
(Id. at 37 (144:16-20)).
agreed to try the steroid injection. (Doc. 72-2 at 19
(69:1-12)). Dr. Hood verbally approved the procedure, and
another doctor at Brookwood Medical Center administered the
injection the same day. (Id. (69:11-12, 72:6-15);
doc. 79-6 at 6; doc. 79-7 at 2). However, the injection was
unsuccessful; Barber received only negligible relief from the
steroids. (Doc. 72-2 at 20 (73:1-2); doc. 72-6 at 18
(65:19-66:2) & 20 (73:12-19)).
Powell submitted a provider consultation report to Dr. Hood
the day of Barber's visit. (Doc. 79-6 at 5). In it, Dr.
Powell noted the X-ray revealed “endstage OA L
hip” and stated as his diagnosis and prescription
suggestions: “OA L hip. Try intraarticular steroid
injx. If fails - Total hip the only option.”
(Id.). Dr. Hood testified he understood Dr.
Powell's diagnosis to mean that Barber's
osteoarthritis was advanced (and not mild or moderate) and
his conclusion to mean that no intervention beyond total hip
replacement would be successful. (Doc. 79-2 at 68
(267:14-268:9)). After reviewing the report, Dr. Hood circled
“no further action” and commented only
“noted.” (Doc. 79-6 at 5). He testified he did so
because he “didn't feel like a total hip
replacement was medically necessary at this point, ”
but that it would be “when his physical impairment,
that is, his ambulation was such that he would no longer be
able to access healthcare without assistance. When the - when
pain relief was not adequate with reasonable pain medications
that impaired his ability to walk and get to the - to the
healthcare unit or around the - the prison, for requirements,
that would be a consideration, or if he had a job in the
prison where it was impairing his ability to perform his
work, that would be an indication.” (Doc. 79-2 at 68-69
(268:22-269:8)). Prior to Dr. Roddam's arrival at
Donaldson, Dr. Hood had had conversations with two officers
regarding Barber's ambulation, (id. at 48-50
(188:9-195:6)), but could not recall having any other
conversations about Barber's ambulation or whether he had
complaints of pain, including whether his pain or ambulation
had gotten worse. (Id. at 69 (269:9-270:8)). Dr.
Hood also testified use of a cane and/or a wheelchair would
constitute “assistance.” (Id.).
pain, Barber saw Dr. Roddam again on January 28, 2014. (Doc.
79-1 at 76). Dr. Roddam noted the pain continued despite the
steroid injection and “[Dr. Powell's] thinking is
[Barber] has end stage OA & total hip arthroplasty is
next option.” (Id.). As his treatment plan,
Dr. Roddam wrote: “Consult filled out. Whether approved
is another issue since [Barber] is on death row.”
(Id.). Dr. Roddam submitted a consultation request
to Dr. Hood on the same day, requesting a total hip
arthroplasty and noting in his objective findings that there
had been a “failed injection.” (Doc. 79-6 at 7).
On February 2, 2014, Dr. Hood requested Dr. Roddam
“please provide the disability associated with the
affected hip joint and conservative measures which have
failed.” (Id. at 8). Dr. Roddam directed Dr.
Hood to “See note by Dr. Powell” and re-requested
the hip replacement. (Id.; doc. 79-2 at 277:4-22)).
On February 27, 2014, Dr. Hood denied the request and offered
an alternative treatment plan: “Manage on site.”
(Doc. 79-6 at 9). Dr. Hood had no independent recollection of
the reason for this direction, although he testified it
implied Barber did not have a disability preventing him from
ambulating or accessing the healthcare unit without distress;
in any event, he did not indicate this in the denial. (Doc.
79-2 at 71 (278:21-280:14)). Dr. Hood could not recall
contacting Dr. Roddam about Barber's ambulation and did
not contact Dr. Roddam about Barber's level of pain or
treatment. (Id.). Dr. Roddam understood Dr.
Hood's direction to mean that Barber would not get a hip
replacement, and that the condition should be managed in
other ways (e.g., pain management). (Doc. 72-6 at 41
the denial of the request, Barber continued to complain of
“unbearable” pain, stating it interfered with his
sleep and ability to move. (Doc. 72-2 at 20 (74:23-75:5);
doc. 79-1 at 38-46). In July 2014, Barber twisted his right
leg when he caught it in a crack in the prison's concrete
floor. (Doc. 72-2 at 20 (75:20-76:6)). Barber saw Dr. Roddam
on July 29, 2014, reporting pain in his right knee and left
hip. (Doc. 79-1 at 75). Dr. Roddam again noted the steroid
injection had been ineffective and that Dr. Powell had
“suggested THR [total hip replacement] as only other
option, ” but that the procedure had been previously
denied. (Id.). Dr. Roddam's plan notes “UM
[utilization management] for hip arthroplasty previously not
had a follow-up visit on September 16, 2014, but saw Dr. Hood
rather than Dr. Roddam. (Doc. 72-2 at 21 (77:18-78:19; doc.
79-1 at 74). Dr. Hood's notes indicate that he and Barber
discussed the possibility of hip replacement; Barber
testified Dr. Hood told him “we don't do surgery
for mild arthritis” and stated Barber's X-rays
supported mild arthritis, but Barber insisted Dr. Powell had
recommended him for surgery. (Doc. 79-1 at 74; doc. 72-2 at
21 (79:5-11). Dr. Hood's notes indicate hip replacement
was not medically necessary at that point “considering
[Barber's] required level of activity.” (Doc. 79-1
at 74). Instead, Dr. Hood's treatment plan was to
“continue pain mgmt for knee & hip. Wheelchair
& cane. F/u pain med renewal.” (Doc. 79-1 at 74;
doc. 79-2 at 64 (251:19-252:15)).
Hood testified he believed the degree of pain Barber reported
seemed to be unsupported by medical findings and suspected
Barber had not been taking his narcotic medication
appropriately; therefore, he had the department of
corrections perform a drug test on Barber and the inmates on
either side of him. (Doc. 79-2 at 4-6 (11:21-13:16,
19:21-20:7)). The inmates in adjoining cells tested positive
for opiates, despite not having prescriptions for narcotic
medications. (Doc. 79-1 at 74; doc. 79-2 at 4 (21-24), 6
(19:21-20:7)). As a result, Dr. Hood discontinued
Barber's Norco. (Doc. 72-2 at 21 (79:3-80:12); doc. 79-1
at 74). Dr. Hood could not recall whether the test on Barber
had come back at the time he made his decision to discontinue
the narcotic, but testified he was sure he would have
indicated in the report had he known of the results. (Doc.
79-2 at 65 (254:2-255:9)). Barber ultimately tested negative
for opiates two weeks after his medication was discontinued,
but Dr. Hood testified he did not know how long it would have
taken for the medication to be eliminated from Barber's
system. (Doc. 79-1 at 37; doc. 79-2 at 65 (255:22-256:6)).
Barber testified he was compliant in taking medications,
including narcotics, as prescribed. (Doc. 72-2 at 22
(83:15-84:1) & 38 (150:16-151:1)). In any event, Dr. Hood
did not want to restart narcotics after the negative test,
“as there is no indication for them.” (Doc. 79-1
of narcotics, Barber received NSAIDs for approximately one
year. (Doc. 79-1 at 66-67). During this time period, Barber
complained repeatedly that his medication was inadequate and
that his hip pain was preventing him from walking, sleeping
well, and using the bathroom. (See doc. 79-1 at 34,
October 14, 2014, Barber saw Defendant James Dennis Butler, a
certified registered nurse practitioner
(“CRNP”) at Donaldson, on a complaint of hip pain.
(Doc. 79-1 at 73). Barber told Butler he did not believe Dr.
Hood understood the severity of his hip problem at the time
Dr. Hood denied the hip replacement. (Id.). Butler
reviewed Dr. Hood's note discontinuing Barber's
narcotic pain medication and increased Barber's Naprosyn
prescription. (Id.; doc. 72-7 at 30-31
(116:17-118:8)). Butler testified he would have been unable
to prescribe narcotics, even had he felt them to be
appropriate. (Doc. 72-7 at 119:22-120:5)). In a progress note
on the same date, Butler noted Barber had stated he
“did not want his wheelchair any more and left it in
the hallway.” (Doc. 79-1 at 73). Butler then observed
Barber walking with a limp and using his cane, but talking
with others and not struggling to keep up. (Id.).
Butler testified he had made this note “because of what
it said about [Barber's] complaint of pain” earlier
that day; Butler was “flabbergasted” that Barber
had abandoned his wheelchair and did not seem to be in pain
as he was walking. (Doc. 72-7 at 37 (142:12-144:1)).
saw Dr. Roddam on December 23, 2014, complaining of
“real bad” hip pain. (Doc. 79-1 at 72). Dr.
Roddam's notes state “Dr. Powell noted end stage OA
& recommended THR. UM refused.” (Id.). Dr.
Roddam prescribed ibuprofen and Tylenol. (Id.).
next saw Dr. Roddam on February 10, 2015. (Doc. 79-1 at 71).
Dr. Roddam noted X-rays had showed only modest
osteoarthritis, and that it was “difficult to reconcile
[Barber's] degree of pain & his X-ray findings in
hip.” (Id.). The notes also reflect Dr. Roddam
planned to speak with Dr. Hood the next day regarding the
reasons for the denial of the hip replacement.
(Id.). Dr. Roddam also wrote “Do not fill out
UM” (i.e., the utilization management for the hip
replacement), indicating he saw no reason to fill out another
consultation request form without discussing the previous
denial with Dr. Hood. (Id.; doc. 72-6 at 23-24
(88:14-89:5)). Dr. Roddam discussed the procedure with Dr.
Hood at a provider meeting the next day. (Doc. 72-6 at 23
(86:12-87:1)). During that conversation, Dr. Hood stated the
UM was not indicated; Dr. Roddam noted this in an addendum to
his progress note. (Doc. 72-6 at 24 (90:19-91:3); doc. 79-1
at 71). Dr. Roddam recalled from the conversation that the UM
was disapproved because Barber could have treatments other
than arthroplasty: specifically, medical therapy in the form
of drugs for Barber's pain. (Doc. 72-6 at 24 (91:8-20)).
Dr. Roddam also testified Dr. Hood stated to him the UM would
not be approved because Barber had limited amounts of
activity; he did not have a job, play basketball, or
“traverse the prison.” (Id. at 24-25
saw Dr. Roddam again on August 4, 2015, complaining that he
could not use his hip any longer and that his medication did
not work. (Doc. 79-1 at 70). Dr. Roddam's notes state
“prior hip film shows mild OJD.” (Id.).
Dr. Roddam restarted Barber on narcotics and ordered another
X-ray. (Id.). This X-ray was taken by MobilexUSA at
Donaldson on August 5, 2015. (Doc. 72-6 at 41
(159:25-160:5)). According to the radiologist, the X-ray
showed arthritis in Barber's left hip and a possible
femoral fracture; the radiologist described the changes in
the hip as “minimally worse” since the October
20, 2013 X-ray and indicated an orthopedic consultation would
be required. (Id. (160:8-16); doc. 79-1 at 69). Dr.
Roddam noted his intention to confirm whether a fracture was
present through an MRI or CT scan and, if it was, order
another consultation with Dr. Powell; additionally, Dr.
Roddam planned to have Dr. Powell review the film. (Doc. 79-1
same day, Tomeka Sellers, a medical scheduler at Donaldson,
emailed Kathy Green, Dr. Powell's assistant, requesting
Dr. Powell review Barber's recent X-ray. (Doc. 72-8 at
18). Green replied: “Dr. Powell suggests that he get an
intraarticular steroid injection. This will have to be done
in radiology at Brookwood. He will probably eventually need a
total hip replacement but certainly don't want to have to
do that until much later on.” (Id. at 19). On
August 6, 2015, Sellers responded, inquiring if Dr. Powell
agreed with the MobilexUSA radiologist that the subcapital
femoral neck was fractured. (Id.). Green responded:
“Dr. Powell said that he has pretty significant
arthritis and doesn't think the fracture is significant
enough to do anything for at this point. He suggests keeping
him nonweightbearing for 2-3 weeks, then re-x-ray and send us
the films.” (Id.).
Roddam ordered a CT scan, which was taken on August 20, 2015.
(Doc. 72-6 at 38-39 (148:11-149:1)); doc. 72-8 at 26). The CT
scan did not show a fracture but did show severe degenerative
osteoarthritis of the left hip with complete loss of the
superior lateral joint space and large subchondral cystlike
change. Large marginal osteophytes are present. There is a
small hip effusion.” (Doc. 72-8 at 26). The impression
of the physician who read ...