United States District Court, E.D. Missouri, Eastern Division
MEMORANDUM AND ORDER
E. JACKSON, UNITED STATES DISTRICT JUDGE.
matter is before the Court on the joint motion of defendants
William McKinney, M.D., and Corizon, LLC for summary judgment
pursuant to Federal Rule of Civil Procedure 56. Plaintiff has
responded in opposition and the issues are fully briefed.
William Maybin brings this action under 42 U.S.C. §
1983, claiming that defendants were deliberately indifferent
to his serious medical needs, in violation of the Eighth
Amendment. At all relevant times, plaintiff was an inmate in
the Missouri Department of Corrections (MDOC). He has been
confined at the Potosi Correctional Center (PCC) since his
transfer there in November 2014. William McKinney, M.D., is
the sole acting physician at PCC. Corizon, LLC provides
medical care to prison inmates.
for Respiratory Conditions
November 2013 plaintiff reported blood in his sputum. In
response, MDOC medical personnel conducted several tests in
December 2013, including (1) a chest x-ray, (2) a
tuberculosis skin test, and (3) an AFB smear of
plaintiff's sputum (screening for tuberculosis or other
mycobacteria). All of the tests yielded normal results.
next received an exam from a MDOC physician in March 2014
after reporting a cough. He also relayed that he first
developed respiratory symptoms following an influenza
vaccination in October 2013. The physician ordered albuterol
nebulization treatment, chest and sinus x-rays, and sputum
testing. Those x-rays revealed no chest
abnormalities, but did show potential allergic rhinitis and
sinusitis. Later that same month, an MDOC physician diagnosed
plaintiff with allergic rhinitis and sinusitis; plaintiff
received prescriptions for Cipro, Claritin, and saline
spray. During that visit, the MDOC physician
noted that plaintiff's “respiration was even and
unlabored, and his lungs were clear.” [Doc. #43-1 at
April 2014, the bloody sputum issue resurfaced, and an MDOC
physician subsequently renewed plaintiff's Cipro
prescription to treat his recurrent sinus infection.
Moreover, April 2014 records link pinkish mucous to
plaintiff's unresolved sinusitis. Notes also state that
“throat and nose regions are currently neg[ative] for
traces of mucous or pink drainage, ” but that pink
drainage might “eventually wind up in his airway and
will need to be coughed out.” [Doc. #43-2 at 76].
physicians took additional sinus x-rays in early July 2014.
They noted several abnormalities. Later that month, plaintiff
complained of “continuous pain in the chest, troubled
breathing, ” and “coughing up blood.” [Doc.
#54 at 10]. A physician opined that plaintiff might have
microcytic hypochromic anemia; records also reflect that
plaintiff had hilar granulomas on a previous chest x-ray from
March. The physician considered that plaintiff might have
sarcoidosis or hypersensitivity pneumonitis. Following this
assessment, plaintiff received a prescription for Cetirizine
(an antihistamine) and an albuterol nebulizer treatment for
shortness of breath, in addition to further lab work and
spirometry testing. An August 2014 chest x-ray produced normal
results. No pulmonary infiltrates were observed, though
granulomas remained. Plaintiff then had a spirometry test in
August 2014; McKinney contends that the spirometry test did
not produce results because plaintiff talked through the
attempted procedure. Plaintiff, for his part claims he was
simply responding to the nurse. Plaintiff continued to report
shortness of breath and blood in his sputum in late August
2014; upon examination a nurse observed no signs of
Treatment after Transfer to PCC
reported respiratory symptoms to nurses in November 2014 and
December 2014. Specifically, he complained of burning in his
chest, congestion when coughing up dark red sputum, and
shortness of breath. The nurse administered a nebulizer
treatment for plaintiff's wheezing in November 2014.
Plaintiff returned in late December 2014 and a nurse provided
a nebulizer treatment due to diminished sounds in one lung.
Plaintiff also produced a sputum sample for testing in
January and February 2015 plaintiff persisted in reporting
chest pain, burning, and numbness on multiple occasions.
McKinney evaluated plaintiff's respiratory conditions on
February 4, 2015. Noting plaintiff's history of negative
evaluations and lack of symptomology, McKinney ordered a
spirometry test. Plaintiff reported doing pushups and other
exercises three to four times each week. MDOC medical
personnel conducted the aforementioned spirometry exams on
February 20 and 23, 2015. Plaintiff “reported he did
not have enough air to do the test, ” and “did
not follow directions well.” [Doc. #43-1 at 17].
saw plaintiff again on March 11, 2015. During that visit
plaintiff reiterated that his respiratory symptoms originated
from an influenza vaccination. Medical records indicate that
plaintiff reported less coughing. Plaintiff further averred
that his symptoms generally included fatigue, weakness, chest
pain, drainage of pink to red colored sputum, and shortness
of breath. McKinney observed (1) good breath sounds, (2) no
cough, (3) a normal diagnostic history including chest
x-rays, labs, and an AFB smear, and (4) no indication of
disease. McKinney also ordered additional lab work.
respiratory symptoms were again reviewed by a nurse in April
2015, when he complained of shortness of breath. The nurse
noted no shortness of breath, cough, or distress; plaintiff
had 99 percent oxygen saturation level. Plaintiff gave a
nurse a sample of his bloody sputum on May 18, 2015, which
was preserved and then “showed” to McKinney in
the morning. [Doc. #43-3 at 41]. The nurse also examined
plaintiff's respiratory status on that date, and found
that plaintiff had “easy and regular respirations,
” clear lungs, and oxygen saturation at 98 percent.
[Doc. #43-1 at 20]. On May 21, 2015, plaintiff returned to a
nurse to inquire about the testing of his sputum sample. He
was informed at that time that the sample was
“inconsistent with any chronic illness.” [Doc.
#43-3 at 41].
August 26, 2015, plaintiff reported “subtle fatigue and
a burning sensation in his chest and abdomen.” [Doc.
#43-1 at 24]. The parties disagree as to plaintiff's last
episode of bloody sputum. McKinney noted that plaintiff had
good breath sounds.
appointment with McKinney on October 5, 2015, plaintiff's
lungs demonstrated good air movement and clarity. Spirometry
testing showed normal results. Plaintiff's declaration
reflects visits to complain of bloody sputum and provide
further samples in October and November 2016.
for Podiatry Complaints
saw a physician at Truman Medical Center in 2006, while
incarcerated in the Jackson County Jail. He does not provide
records of this visit but states that a podiatrist instructed
him to wear “soft sole orthopedic shoes.” [Doc.
#54 at 3]. An MDOC doctor noted that plaintiff had
“significant bunion deformit[ies]” on both feet
in January 2012; the physician did not observe any tenderness
or tissue breakdown. [Doc. #43-2 at 13]. Notes indicate that
plaintiff had not been approved for shoes in the past, but
that he had bunion splints. Records also indicate the
potential for “amputation of foot deformity” as
part of a treatment plan. [Doc. #57 at 1].
filed numerous treatment requests for bunion-related pain
from April 2012, to January 2013. Notes from an MDOC
physician in May 2012 state that plaintiff had
“difficulty getting wider shoes from custody to
accommodate his bunion deformity, ” and that his
bunions were “impressive.” [Doc. #57 at 3].
Because plaintiff was in administrative segregation, the
physician stated that accommodation was “a moot
point.” Id. During a November 11, 2012,
appointment an MDOC physician recommended that plaintiff
avoid running, conduct x-rays of both feet, and use bilateral
bunion splints. And the November 12, 2012, x-ray of
plaintiff's right foot revealed “subtle bony
sclerosis” in the first metatarsophalangeal
articulations; the impression was “hallux valgus with
subtle periarticular soft tissue swelling” and mild
degenerative changes of the first metatarsophalangeal
articulation. [Doc. #43-2 at 33-34].
multiple visits in February 2013, doctors emphasized the
prominence of plaintiff's bunions. Records from a
February 4, 2013, doctor encounter state that “the
bunion deformity is not viewed as an indication for special
shoes, but [his] feet have impressive degree of
bunion.” [Doc. #57 at 7]. The shoe committee determined
that medical shoes should be prescribed upon plaintiff's
release to the general population. He instead received bunion
splints in April 2013. Plaintiff then requested surgery for
his foot issues in September 2013, during a nursing
received his medical shoes in October 2013. And he had an
evaluation of his feet in May 2014; that visit resulted in
diagnoses of bunions and mild degenerative joint disease.
Treatment after Transfer to PCC
November 2014, plaintiff submitted a request for new medical
shoes. He did not receive them. McKinney examined
plaintiff's feet in January 2015. McKinney noted a normal
gait, no limping, obvious bilateral flat feet with pronation,
and bilateral bunions. But he did not observe any
“abrasions or changes to [p]laintiff's feet which
would indicate that [plaintiff's] shower shoes were
rubbing.” [Doc. #43 at 11]. McKinney recommended that
plaintiff use arch support once released from administrative
segregation. He also recommended wider shoes to accommodate
plaintiff's bunions. He did not believe that medical
shoes were merited.
10, 2015, plaintiff saw McKinney and requested surgery for
his bunions. McKinney did not observe redness, soft tissue
swelling, or open areas; he had superficial callouses on his
right foot, as well as a “fluid gait with no
limp.” [Doc. #43-1 at 21]. Plaintiff stepped down from
the examination table without discomfort. McKinney determined
that surgery was not medically indicated, and that shoes of
the appropriate width would be the prudent treatment.
November 23, 2015, plaintiff met with McKinney regarding his
bunions. McKinney noted that plaintiff was currently in
administrative segregation and that he “still wants
surgery.” [Doc. #43-3 at 69]. McKinney noted
plaintiff's smooth step off exam table. He determined
that “surgery is not currently medically
for Knee Instability and Pain
and August 2012, nurses evaluated plaintiff's knee pain.
Plaintiff requested a knee brace during those visits. In
particular he “reported he fell without a brace for his
right leg.” [Doc. #43-1 at 4]. However, medical
personnel did not observe swelling or popping sounds, and
plaintiff exhibited a full range of motion. Plaintiff and
McKinney disagree about whether plaintiff had been approved
for surgery at that time. Plaintiff did not report to
appointments regarding a potential operation. The parties
dispute whether plaintiff knew about the appointments and
intentionally missed them.
October and November 2012 plaintiff again complained of knee
pain and requested surgery. A nurse evaluated plaintiff's
knee on November 15, 2012. She found that he had full range
of motion in his knee. And he received a similar referral to
a physician for his knee pain in November 2012, but failed to
attend the appointment; plaintiff states that he was not
notified of the appointment.
September and October of 2013, plaintiff continued to report
knee pain and a need for surgery on his right knee to nurses.
On October 28, 2013, a physician noted plaintiff had “a
good gait with ambulation, ” but that he sat
“gingerly” and was “careful about bending
his knee.” [Doc. #43-2 at 48]. Although the MDOC
physician did not observe obvious swelling or gross
abnormalities, plaintiff demonstrated tenderness and slight
crepitus with palpation. The physician recommended Meloxicam
and a knee sleeve for the left knee pain and instability.
Plaintiff received a knee sleeve in December 2013.
evaluated plaintiff in January 2014 for bilateral knee pain,
knee “popping, ” as well as request for a bottom
bunk. [Doc. #43-1 at 8]. The nurse's review indicated
that he did not have any deformities, swelling, or
discoloration, although he wore a knee sleeve.
physician examined plaintiff's knees in May 2014,
pursuant to plaintiff's bottom bunk lay-in request. An
exam of plaintiff's knees revealed “tenderness
along the medial and lateral joint line of the right knee,
” and “trace swelling and some tenderness in the
right ankle, ” but no tears. [Doc. #42 at 4]. X-rays of
plaintiff's right knee in May 2014 showed no
abnormalities. Later that month, an MDOC physician diagnosed
chronic knee and ankle strains; he prescribed Indomethacin
(Indocin), analgesic balm, continued use of a right knee
sleeve, and the issuance of a right ankle sleeve. The
physician recommended steroid injections and imaging of the
right ankle if plaintiff's knee pain, ankle instability,
and sciatica did not improve. Subsequent x-rays of
plaintiff's ankle showed no abnormalities and plaintiff
received a prescription for arch supports.
August 2014 a nurse observed that plaintiff had a mild limp,
slightly more swelling of the right knee, and wincing on
palpation of the right knee. Plaintiff requested a knee
support on September 30, 2014; he told a nurse that MDOC
officials held it in impound.
Treatment after Transfer to PCC
evaluated plaintiff's knee pain (among other complaints)
on April 12, 2015. Plaintiff told McKinney that he suffered
right knee pain while jogging in place. McKinney prescribed
Indocin and continued plaintiff's Pamelor prescription to
treat plaintiff's general joint pain. In June 2015, a
nurse referred plaintiff to McKinney for “slight
swelling below” plaintiff's knee; plaintiff
continued to request a knee sleeve at that time. [Doc. #43-3
evaluated plaintiff on July 6, 2015. McKinney determined that
plaintiff did not require a neoprene sleeve; in particular he
noted plaintiff's prior normal x-ray. He did observe
increased movement in plaintiff's knees, which
demonstrated some instability; but he also stated that
plaintiff had no warmth, diffusion, palpable defect or any
other abnormality in his knees. Moreover, plaintiff did not
limp and easily climbed on and off the exam table without
discomfort. Therefore, McKinney prescribed quad and hamstring
reported knee pain to a nurse again several weeks later. He
requested a knee sleeve and reported swelling while doing
jumping jacks. On August 26, 2015, plaintiff also reported
right knee pain to McKinney. Plaintiff told McKinney that he
had done pushups, sit-ups and calisthenics, until custody
removed his tennis shoes. McKinney also noted plaintiff's
fluid gate and ability to climb on and off the exam table. On
September 19, 2014, plaintiff complained of bilateral knee
pain during a nurse encounter.
examined plaintiff on October 9, 2015, for knee pain.
Plaintiff expressed his desire to play basketball. During the
appointment, McKinney noted a fluid gait and normal heel
strike and stride. Plaintiff told McKinney that he
experienced pain when walking on his ...