United States District Court, E.D. Missouri, Eastern Division
MEMORANDUM AND ORDER
G. FLEISSIG, UNITED STATES DISTRICT JUDGE
matter comes before the Court on Defendant Jeffrey
Carson's (“Carson”) Motion for Summary
Judgment (ECF No. 44). The matter is fully briefed and ready
for disposition. For the reasons set forth below,
Carson's motion will be granted.
Lemont Butler (“Butler”) brings this action pro
se under 42 U.S.C. § 1983 alleging violations of his
Eighth Amendment constitutional rights, made applicable to
him by the Fourteenth Amendment, during his incarceration as
a pre-trial detainee at the St. Louis City Justice Center
(“SLCJC”). See Estelle v. Gamble, 429
U.S. 97, 101 (1976). Butler's complaint, as amended,
names as Defendants Corizon Health, Inc.
(“Corizon”), the healthcare services provider for
SLCJC, and Carson, Superintendent of SLCJC. Corizon has since
been dismissed, leaving Carson, who is sued in his individual
capacity only, as the remaining Defendant.
construing Butler's amended complaint, Butler alleges
that Carson was deliberately indifferent to his painful
dental condition, for which Butler allegedly did not receive
adequate treatment for nine months. The basis of his claims
against Carson stem primarily from Carson's role as the
superintendent of SLCJC. Carson now moves for summary judgment,
arguing that he is entitled to qualified immunity, that
Butler cannot establish that Carson was personally involved
in or responsible for the alleged denial of adequate dental
care, and that Butler cannot establish that Carson knew of
and disregarded an excessive risk to Butler's health due
to inadequate dental staffing and equipment during the
relevant period of time.
record establishes the following. Corizon provides healthcare
services for inmates at SLCJC pursuant to a contract between
the City of St. Louis and Corizon, and Corizon hires
healthcare professionals to provide those services. In
October 2015, the dentist who had been permanently assigned
to SLCJC ended his employment with Corizon. Between October
2015 and March 2016, Corizon retained a dentist on a
temporary basis to provide dental services to SLCJC inmates.
The temporary dentist ensured that inmates received their
yearly dental evaluations, while Dr. Fe Fuentes, the
physician assigned to SLCJC, was charged with identifying
circumstances that required an immediate referral to an
outside dentist for further treatment. Corizon hired Carla
Daugherty, DDM, as the permanent SLCJC dentist in March 2016.
Carson Aff., ECF No. 45-2; Fuentes Decl., ECF No.
following facts regarding Butler's treatment are
undisputed, except where otherwise specified. Butler was
incarcerated at SLCJC from October 10, 2015, until August 23,
2016. Upon his arrival at SLCJC, Butler underwent an initial
medical examination, at which time he did not report any
dental issues or pain. Carson's Undisputed Material Facts
(“Carson UMF”), ECF No. 45, at ¶¶ 1-5.
November 11, 2015, Butler filed a health services request
seeking dental treatment for the first time because a tooth
had broken off. He claimed the tooth caused him pain
“every so often, ” and he requested that his
teeth be cleaned. On November 23, 2015, Butler was seen by a
nurse, and Butler reported that his pain was 10 out of 10 and
that the pain interfered with his chewing. The nurse did not
note any signs or symptoms of infection, and she started
Butler on over-the-counter analgesics to address the pain.
She advised Butler to contact medical if the symptoms
worsened and referred Butler to dental for future evaluation.
Corizon's Statement of Uncontroverted Material Facts
(“Corizon UMF”), ECF No. 55.
December 14, 2015, Butler submitted a health services request
reporting that his teeth bled when he brushed them and that
he had pain and swelling in the broken tooth. Butler was seen
by a nurse on December 18, 2015, and he reported that nothing
improved the pain. The nurse did not note any signs or
symptoms of infection or swelling. She prescribed 400 mg of
ibuprofen twice a day, but did not refer Butler to dental or
a physician. Id.
January 30, 2016, Butler filed a health services request
complaining of tooth pain and bleeding gums, indicating that
this was his third request to be seen by a dentist. On
February 3, 2016, a nurse evaluated Butler, and she referred
him to a dentist. On February 11, 2016, Butler reported
significant tooth pain and bleeding gums and requested to be
seen by a dentist and prescribed medication. Butler was seen
by a nurse on February 17, 2016, who evaluated him and
contacted Dr. Fuentes. Dr. Fuentes prescribed Butler
antiseptic mouthwash and 400 mg of ibuprofen for seven days.
February 25, 2016, Butler requested a follow-up with a
dentist. After an appointment with a nurse, Butler was seen
by Dr. Fuentes on February 29, 2016. Dr. Fuentes noted
cavities in Butler's right upper and left lower molars,
but observed no symptoms of infection. Dr. Fuentes restarted
Butler on antiseptic mouthwash and prescribed 250 mg of
naproxen, three at a time, for 30 days, and referred Butler
to a dentist. Id.
March 28, 2016, Butler filed a health services request
reporting that the medication was not helping and that he was
not able to sleep. He was triaged and referred to nurse sick
call. On March 29, 2016, Butler filed a grievance concerning
his dental care. On March 30, 2017, Butler allegedly refused
antiseptic mouthwash, which Butler disputes. Id.
March 31, 2016, Butler submitted another health services
request asking to be seen by a dentist, claiming that he had
been cut off of his pain medication, and requesting a refill
of his prescription. He was seen by a nurse the same day, and
Butler reported for the first time that he had developed a
second tooth ache. The nurse referred his prescription refill
request to the physician. Id.
an April 4, 2016 visit, Dr. Fuentes observed that Butler had
cavities in his upper right molar and left lower molar. She
again prescribed Butler naproxen, this time 500 mg for 30
days. On April 12, 2016, Butler was seen by Dr. Daugherty for
a dental evaluation. Butler reported that his tooth had been
“messed up” since December and that he had
experienced dental issues “for years.” Dr.
Daugherty diagnosed bleeding gingiva and cavities in three
teeth. She determined that the teeth were
“unrestorable” and needed to be extracted, and
she prescribed Butler antiseptic mouthwash and antibiotics.
5, 2016, at Butler's request, Dr. Fuentes refilled his
Naproxen prescription for seven days. On May 15, 2016,
Plaintiff requested dental work and another refill of his
prescription. On May 17, 2016, a nurse saw Butler and
evaluated him for a medication renewal. Id.
21, Butler requested a follow up to obtain a new prescription
for his tooth pain. Dr. Fuentes again prescribed naproxen 500
mg tablets for a period of 30 days, starting on May 24, 2015.
On June 1, 2016, Dr. Daugherty advised Butler that he would
be referred out for the extraction of his teeth, and she
completed the consultation request that day. On June 19,
2016, Butler requested renewal of his antiseptic mouthwash,
which Dr. Daugherty refilled on June 22, 2016. Id.
2016, Butler made several requests to have his teeth pulled,
reported slight swelling in his mouth, and sought renewal of
his pain medication. On July 29, 2016, Dr. Daugherty noted
that Butler had been referred to an oral surgeon, which had
been approved. She planned to provide analgesic medication
until that appointment and started Butler on Naproxen 500 mg
tablets, three times a day. Dr. Fuentes also saw Butler that
day because he was requesting pain medication for his
toothache. She renewed Butler's antiseptic mouthwash
prescription, and, on August 11, 2016, Dr. Daugherty renewed
his naproxen prescription, ...