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Williamson v. Massey

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

April 10, 2019

MINA MASSEY, Defendant.



         Plaintiff, pro se, is a prisoner incarcerated in the Missouri Department of Corrections. He brought this 42 U.S.C. § 1983 lawsuit alleging violations of his constitutional rights related to the treatment of an alleged tumor in his nostril. Defendant Dr. Mina Massey has moved for summary judgment.

         I. Factual Background

         Plaintiff claims that defendant Dr. Massey failed to properly treat a “tumor” that was growing in his nose. The first time plaintiff reported any issues regarding his nose was February 9, 2014. He told a nurse that his nose would become dry and bleed. Plaintiff saw defendant for the first time on February 23, 2014, for multiple complaints, including nosebleeds. He did not mention any lump in his nose. Defendant ordered nasal saline spray for 180 days to moisten plaintiff's nasal passages and eliminate the nosebleeds.

         On April 7, plaintiff submitted a Medical Services Request (“MSR”) form complaining of a lump in his nasal passage that smelled bad, was draining, and was bleeding. Defendant saw plaintiff on April 10 to follow up on plaintiff's earlier ear complaints. At that visit, plaintiff told defendant about the bump inside his right nare. Plaintiff reported that three months earlier, he bit a staple in half, stuck it on an ink pen, and used it to remove the lump. Plaintiff said he thought it was a booger. But he also stated it was like a piece of flesh. Since that time, plaintiff reported that he had nasal congestion and drainage from his right nare.

         Defendant examined plaintiff's right nare and noted mild erythema, swelling, and yellow purulent discharge, but no masses. Plaintiff's left nare and throat were normal. Defendant diagnosed rhinosinusitis, which is an inflammation of the nasal passages and sinus cavities, usually caused by allergy or infection. She prescribed an antibiotic for 10 days and told plaintiff to submit an MSR if he did not improve.

         Plaintiff submitted MSRs on April 22, April 27, and May 3. He complained he had a lump in his nasal passage and could barely breathe at times. A nurse examined plaintiff on May 7 and noted he had no drainage or lump. On May 25, plaintiff declared a medical emergency for a nosebleed and was sent to the emergency room at Missouri Delta Medical Center. Plaintiff admitted to the ER doctor that he picked his nose to induce bleeding. The ER doctor wrote a prescription for an antibiotic, and, as an alternative treatment plan, suggested that plaintiff follow up with an otolaryngologist, which is an ear, nose, and throat specialist (“ENT”). Notably, the ER staff did not document that there was any nasal mass, tumor, or cancer. After reviewing the records, defendant did not believe an ENT visit was necessary. She believed that plaintiff's nosebleeds were caused by his picking his nose to induce bleeding, and no appointment was made with an ENT.

         On June 3, plaintiff saw nonparty Dr. Garcia to follow up on his trip to the ER. Plaintiff reported he had a problem with chronic nosebleeds and admitted he had a problem with picking his nose in order to cause bleeding. Dr. Garcia noted that nothing was found in ER and that “if the issue continues will need to see ENT.” On June 11, plaintiff saw a nurse for complaints of a nosebleed and was sent to the ER again. Nonparty ER doctor Mansell performed an anterior nasal packing/cauterization of the right nare and applied a nasal tampon and rhino rocket. He was discharged several hours after arriving. Plaintiff claims he “coughed up” a “tumor” during placement of the rhino rocket and gave it to a nurse, but there is no record of such an occurrence.

         Dr. Mansell prescribed narcotic pain medicine, Norco, for plaintiff and provided him with four tablets on discharge. Plaintiff also received Zofran to prevent nausea and morphine in the ER. Narcotics are generally not prescribed in the prison setting. Dr. Massey determined that, based on the cauterizations she has performed on patients, that Tylenol was sufficient to control pain post-procedure. Dr. Massey states that most pain occurs during the procedure. Had plaintiff still had pain, she would have prescribed Tramadol, a narcotic pain reliever, but she wanted plaintiff to try the Tylenol first.

         Plaintiff was placed in the prison infirmary after he returned from the ER. Approximately 12 hours after his discharge from the ER, defendant Massey saw plaintiff for followup. Plaintiff was agitated, as he wanted the Norco tabs and other followup care he thought he needed. Plaintiff would not stop yelling to allow defendant to explain her treatment plan. Defendant believed it was unsafe for her to enter his room at that time, so she walked away. Plaintiff became more agitated and pulled the nasal tampon out of his nose, inducing bleeding. Defendant instructed nurses to re-pack the nostril and apply and ice pack after plaintiff regained control of himself. Plaintiff refused treatment. Plaintiff was kept under observation until bleeding resolved on its own the next day, and he was returned to his cell.

         Defendant again saw plaintiff on June 17, four days after being discharged from the infirmary, and she was again unable to examine plaintiff due to his belligerence. She noted, however, that plaintiff had no active bleeding and his blood counts were normal.

         Plaintiff again self-declared an emergency for a nosebleed on August 3. No. active bleeding was observed, but the nurse packed the nostril and provided an ice pack. The nurse instructed plaintiff to refrain from taking ibuprofen and to start taking his blood pressure medicine.

         On August 20, defendant saw plaintiff after mental health referred him to medical for nosebleeds. A psychiatrist had apparently looked in plaintiff's nose and saw an ulceration and believed defendant should examine him. Defendant observed a small amount of dried mucus but no ulceration or source of bleeding. Plaintiff insisted on an ENT referral as recommended earlier by the ER doctor. Defendant attempted to explain that the ER recommendation was not a referral, but plaintiff would not listen. That was the last visit defendant had with plaintiff about nosebleeds, though she did see plaintiff again in September and October 2014 for scabies.

         Plaintiff alleges that in summer 2015, a nurse found a dime-sized hole in his right nostril, but no such encounter exists in the medical records. The medical records show he told other providers about the “tumor” ...

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