United States District Court, E.D. Missouri, Eastern Division
JAMES M. SCOTT, Plaintiff,
DR. SAMUEL NWAOBASI Defendant.
MEMORANDUM AND ORDER
A. ROSS UNITED STATES DISTRICT JUDGE.
matter is before the Court on Defendant's Motion for
Summary Judgment. (Doc. No. 40) On July 24, 2017, Plaintiff
filed a Response to Defendant's Motion, (Doc. No. 44), to
which Defendant submitted a Reply on July 31, 2017, (Doc. No.
45). Defendant's Motion for Summary Judgment is therefore
fully briefed and ready for disposition. For the following
reasons, the motion will be granted.
James Scott (“Plaintiff”), proceeding pro
se, brings this action for monetary damages under 42
U.S.C. § 1983 against Samuel Nwaobasi, M.D.
(“Defendant”). Plaintiff alleges Defendant was
deliberately indifferent to his serious medical needs while
he was a pre-trial detainee at the St. Louis City Criminal
Justice Center. Specifically, Plaintiff alleges that although
test results revealed he was diabetic, Defendant failed to
provide him with adequate treatment for his diabetes and
thereby caused him prolonged pain and suffering. (Amended
Complaint (“AC”), Doc. No. 7) Defendant now moves
for summary judgment pursuant to Fed.R.Civ.P. 56(c) on the
grounds that there is no genuine issue as to any material
fact and he is entitled to judgment as a matter of law.
judgment is appropriate when no genuine issue of material
fact exists in the case and the movant is entitled to
judgment as a matter of law. See Celotex Corp. v.
Catrett, 477 U.S. 317, 322-23 (1986). The initial burden
is placed on the moving party. City of Mt. Pleasant, Iowa
v. Associated Elec. Co-op., Inc., 838 F.2d 268, 273 (8th
Cir. 1988). If the record demonstrates that no genuine issue
of fact is in dispute, the burden then shifts to the
non-moving party, who must set forth affirmative evidence and
specific facts showing a genuine dispute on that issue.
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249
(1986). In determining whether summary judgment is
appropriate in a particular case, the evidence must be viewed
in the light most favorable to the nonmoving party.
Osborn v. E.F. Hutton & Co., Inc., 853 F.2d 616,
619 (8th Cir. 1988). Self-serving, conclusory statements
without support are not sufficient to defeat summary
judgment. Armour & Co., Inc. v. Inver Grove
Heights, 2 F.3d 276, 279 (8th Cir. 1993).
first incarcerated at the St. Louis City Criminal Justice
Center (“CJC”) in early 2014, Plaintiff had a
medical history of hypertension and chronic nerve pain
(neuralgia) resulting from a previous injury to his left arm.
(Defendant's Statement of Uncontroverted Facts
(“SOF”), Doc. No. 42 ¶ 20) Because his
hypertension was severe and difficult to control, (SOF ¶
22), Plaintiff was enrolled in chronic care to ensure regular
monitoring. (SOF ¶ 23) At this time, Plaintiff did not
report any symptoms commonly associated with diabetes, e.g.
frequent thirstiness, frequent urination, and blurred vision.
(SOF ¶ 24)
April 2014 and August 2014, Plaintiff was repeatedly
monitored and treated for hypertension. On April 7, 2014,
Plaintiff's blood pressure was reported as elevated at
152/100. (SOF ¶ 26) As of July 1, 2014, Plaintiff was
taking Lisinopril and ASA (aspirin) for hypertension and
Neurontin, an anticonvulsant used to treat neuralgia. (SOF
¶¶ 30, 31) On August 20, 2014, Plaintiff's
hypertension was again evaluated. (SOF ¶ 32) Plaintiff
was taking gabapentin for his neuralgia and had a highly
elevated blood pressure of 230/160 despite medication. (SOF
¶¶ 33, 34) The evaluator, Dr. Caldwell, ordered
additional hypertension medication and lab work. (SOF ¶
34) On August 22, 2014, test results indicated that
Plaintiff's fasting blood glucose level was 138, which,
although elevated, is not sufficient to diagnose a patient
with diabetes. (SOF ¶ 36)
September 2014, Plaintiff was treated again for hypertension.
(SOF ¶ 37) In a follow-up appointment on October 13,
2014, the treating doctor noted that Plaintiff's blood
pressure was elevated at 218/110 and increased
Plaintiff's hypertension medication. Plaintiff had
peripheral edema-a sign of hypertension-and chronic recurrent
headaches-a common symptom of hypertension-but no sensory or
motor defects that would have been relevant to a diagnosis of
diabetic neuropathy. (SOF ¶ 40) On October 15, 2014,
Plaintiff was again evaluated for high blood pressure and
constant headaches. (SOF ¶ 42) He reported that his
blood pressure increased whenever his headaches were severe.
(SOF ¶ 43) Dr. Mallard, the treating physician, ordered
blood work, which revealed that Plaintiff had an elevated
fasting blood glucose level of 156. (SOF ¶ 45) In
response to these results, Dr. Mallard ordered a Hemoglobin
A1c test to better measure Plaintiff's blood glucose
level. (SOF ¶ 45)
patient's fasting blood glucose level is an indicator of
the amount of glucose present in a patient's blood
stream. (SOF ¶ 4) While an elevated fasting blood
glucose level may indicate diabetes mellitus type II, (SOF
¶ 3), it might also indicate that the patient has failed
to adequately fast before the blood work (SOF ¶ 5). To
gain a more accurate measurement of a patient's blood
glucose level, it is common practice to conduct a Hemoglobin
A1c (“A1c”) test when a patient exhibits an
elevated blood glucose level. (SOF ¶¶ 5, 6) At 5.6%
or less, the A1c indicates the patient is non-diabetic;
between 5.6% and 6.4%, the patient is pre-diabetic; and over
6.5% the patient is diabetic. (SOF ¶ 7) The higher the
A1c, the higher the average blood glucose level. (SOF ¶
treatment by Defendant
October 2014, Defendant began work at CJC. (SOF ¶ 46) On
October 23, 2014, Defendant reviewed the A1c results that Dr.
Mallard had ordered-Plaintiff's A1c was
7.1%, (SOF ¶ 47), which indicated diabetes
(SOF ¶ 48). Standard treatment for diabetes takes one of
three forms: conservative treatment through diet, exercise,
and weight-loss; prescription of oral medication; or
prescription of insulin. (SOF ¶ 11) Because medications
carry side effects, Defendant prefers to treat an A1c of 7%
conservatively. (SOF ¶ 17) Therefore, rather than
prescribe oral medication or insulin, Defendant believed that
diet, exercise, and weight-loss ...