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Scott v. Nwaobasi

United States District Court, E.D. Missouri, Eastern Division

March 26, 2018

JAMES M. SCOTT, Plaintiff,



         This 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.

         I. Background

         Plaintiff James Scott (“Plaintiff”), proceeding pro se, brings this action for monetary damages under 42 U.S.C. § 1983 against Samuel Nwaobasi, M.D. (“Defendant”).[1] 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.

         II. Legal Standard

         Summary 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).

         III. Facts [2]

         Plaintiff's medical history

         When 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)

         Between 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)

         In 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)

         A 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 ¶ 9)

         Plaintiff's treatment by Defendant

         In 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%[3], (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 ...

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