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Stewart v. Corizon Medical LLC

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

July 16, 2018

CORIZON MEDICAL, LLC, et al., Defendants.



         Plaintiff Glennis Stewart, currently incarcerated within the Missouri Department of Corrections (MDOC), was diagnosed with breast cancer in early 2013. She had a double mastectomy, multiple breast reconstruction surgeries, and four rounds of chemotherapy while in state custody. Over the following years, Stewart was in and out of prison, eventually being re-incarcerated in July 2015 for her current sentence. In November 2016, Stewart filed this pro se action under 42 U.S.C. § 1983, alleging civil rights violations from defendants' deliberate indifference to her serious medical needs. Defendants are the MDOC medical services provider, a medical director, and a nurse. Defendants were previously granted partial summary judgment on Stewart's unexhausted claims. Now they seek summary judgment on Stewart's remaining claims concerning a delay in receiving adequate cancer care and medications.

         Stewart alleges that the delayed medical care that she has received from the MDOC defendants has increased her risk of cancer recurrence and has caused her pain. Defendants argue that the undisputed evidence demonstrates no deliberate indifference to Stewart's serious medical needs. There is no doubt that Stewart's receipt of certain medications has been delayed; however, Stewart has demonstrated no detrimental effect to her health from any delay in medical treatment or medication. In addition, there is no evidence of intentional denial or delay in treatment by defendants. Summary judgment will be granted to defendants.


         Plaintiff Glennis Stewart is currently incarcerated within the Missouri Department of Corrections at the Chillicothe Correctional Center. Her § 1983 complaint alleges violations of her civil rights during her imprisonment at the Women's Eastern Reception, Diagnostic, and Correctional Center (WERDCC) in Vandalia, Missouri. She contends that defendants Corizon Medical, LLC (the contracted medical provider for MDOC inmates), Dr. Justin Jones (Medical Director at WERDCC), and Danielle Halterman (Nurse at WERDCC) delayed in providing her necessary treatment and medications, given her history and past treatment for cancer.

         Defendants submitted the extensive medical records for Stewart, dating back to a January 2013 routine mammogram that revealed abnormalities. Because further medical testing confirmed an aggressive type of breast cancer, Stewart had a double mastectomy and concurrent breast reconstruction. Almost immediately following the surgery, Stewart suffered complications from the breast reconstruction. The left breast implant ruptured, requiring replacement with a silicone implant. Soon after replacement, Stewart had an open wound on her left breast with a cellulitis infection and exposure of her implant. She started antibiotics for the infection but eventually she had the implant surgically removed and the wound closed. Three months later, Stewart had another surgery to insert new silicone implants in both breasts. Following the double mastectomy, Stewart received four rounds of chemotherapy and started medication for the treatment and prevention of further breast cancer and for hot flashes.

         In November 2013, two days after receiving her new silicone implants, Stewart was released from MDOC custody. While out of custody, she received medical treatment at the Chub O'Reilly Cancer Center in Springfield, Missouri. In April 2014, the Chubb doctor noted that Stewart was bleeding vaginally and is “now not post menopausal.” ECF No. 46-8 at 117. As a result, Stewart started Lupron[1] injections on April 17, 2014, which were to be given every three months. ECF No. 46-8 at 125, 46-7 at 140. She received additional injections at Chubb on July 25, 2014, and October 27, 2014. ECF No. 46-8 at 2, 13.

         Stewart was incarcerated again from February 19 to March 25, 2015. Upon re-incarceration in February 2015, Stewart informed a nurse at intake that she was currently on “Lupron shot to keep in menopause.” ECF No. 46-5 at 22, 24. After being released from custody in March 2015, Stewart received another Lupron injection at Chubb Cancer Center on May 11, 2015.[2]

         Stewart returned to WERDCC, about four months later, on July 31, 2015. The records from her medical intake exam in July 2015 contain no mention of her history of Lupron injections. ECF No. 46-4 at 99-107. However, according to Stewart, she told the intake nurse about the Lupron “but the nurse didn't know what Lupron was and therefore ignored [her].” ECF No. 38 at 3. Stewart did report being on Lupron in her mental health intake evaluation on September 17, 2015. ECF No. 46-1 at 134.

         Medical records for July through October 2015 indicate that medical staff (including defendant Dr. Jones) ordered medications regularly for Stewart including the cancer medication Arimidex, [3] but not Lupron injections. ECF No. 46-4 at 53, 61, 65-67, 72, 73, 81, 95. Stewart was seen by an OBGYN; was enrolled in the cancer chronic care clinic; had an EKG, x-rays, and lab work done; and was being seen by a MDOC psychiatrist. ECF Nos. 46-1 at 133-37, 46-4 at 55, 57, 58, 60, 92.

         WERDCC Complaint Number 15-404[4]

         On October 15, 2015, Stewart filed IRR complaint number WERDCC-15-404, alleging that she was not receiving adequate “cancer treatment and relevant medications, ” including Lupron injections and Gabapentin[5] as prescribed by her oncologist. ECF No. 36-5 at 36. She also requested to be seen by defendant Dr. Jones. Stewart met with defendant nurse Danielle Halterman on October 26 and informed her that she needed Lupron injections every three months. Halterman said she would discuss the Lupron with Dr. Jones. The MDOC written response to the IRR, dated October 26, 2015 and signed by defendant nurse Halterman, notes that Stewart had not made recent visits to nurse sick call, that she was enrolled in the chronic care clinic for her history of cancer, that her records would be reviewed at her scheduled appointment, and therefore, her current medical needs were being addressed. Id. at 35.

         Stewart filed a follow-up grievance 15-404 on November 16, 2015, reiterating that she felt her cancer treatment care was inadequate, especially the lack of Lupron as prescribed by her oncologist. Id. at 33-34. She argued that the medical records department already had the Lupron records from her outside oncologist yet she still was not receiving Lupron and had already missed two injections in July and October. Stewart stated that the “chemo pill” (Arimidex), that she takes every morning, only works when taken with the needed Lupron shot. She also requested acid reflux medication, Gabapentin for severe hot flashes, Biotene for dry mouth, and she complained of not being seen or evaluated by the cancer clinic since her arrival. Id. The grievance response, dated January 4, 2016, stated that “Medical records is obtaining your outside medical records, once they are all received you'll be scheduled for your chronic care visit.”[6] Id. at 32.

         In Stewart's appeal of 15-404, filed January 12, 2016, she stated that she had been to the medical records department and had her Lupron records pulled. Id. at 29. Defendant nurse Halterman then showed the records to defendant Dr. Jones. By January 14, 2016, Dr. Jones had seen the records because he noted in Stewart's medical chart: “suppose to be on Lupron shots every three months. last one may 2015.” ECF No. 46-4 at 24. Stewart also mentioned in her appeal that she had stopped taking her “chemo pill” because she had started bleeding vaginally due to not receiving Lupron.[7] ECF No. 36-5 at 29. The response to the appeal stated that Stewart had been seen by the community oncologist on February 5, 2016, and that she had been prescribed the recommended medications including Gabapentin, Prilosec, and Lupron. Id. at 28. Medical records for February 5, 2016, indicate that Stewart was approved for Gabapentin and for Lupron with priority status “Urgent, ” to be given “asap.” ECF No. 46-4 at 15-16, 11, 13. However, Stewart did not actually receive the Lupron injection for eleven more days - on February 16, 2016. ECF No. 46-3 at 147.

         WERDCC Complaint Number 16-225

         On June 21, 2016, Stewart filed IRR complaint number WERDCC-16-225, arguing that Dr. Jones should not have taken her off the medication Gabapentin, which had been prescribed by her oncologist for hot flashes and fibromyalgia. ECF No. 36-5 at 48-49. The MDOC classifies Gabapentin as a “watch take” medication, such that the offender is required to take the medication in the presence of medical staff. Id. at 47. On June 10, 2016, Stewart received a “Conduct Violation” after a Gabapentin pill was found wrapped in a piece of tissue in her locker. ECF No. 46-9 at 140-41. Stewart admits to having the pill. ECF Nos. 38 at 27, 40 at 8. As a result of the violation and the fact that Gabapentin is commonly abused within the correctional setting, Dr. Jones said she would be “weaned off” of Gabapentin. ECF Nos. 46-3 at 59, 36-6 ¶ 107. The MDOC response to ...

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