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Mayes v. Aguilera

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

September 16, 2019

TAYLOR MAYES, Plaintiff,



         Plaintiff Taylor Mayes ("Plaintiff'), proceeding pro se, brings this action for monetary damages and injunctive relief pursuant to 42 U.S.C. § 1983 against Trinidad Aguilera, M.D. ("Defendant").[1] Plaintiff alleges Defendant was deliberately indifferent to his serious medical needs in violation of the Eighth Amendment. Specifically, Plaintiff alleges he was provided inadequate treatment for his infected and ingrown toenail. Defendant moves for summary judgment on the grounds that there is no genuine issue as to any material fact and that he is entitled to judgment as a matter of law. (Doc. No. 17). The motion is fully briefed and ready for disposition. For the following reasons, the motion will be granted.

         I. Background [2]

         On February 14, 2017, Plaintiff submitted a Health Services Request complaining of an infected toe. (SOF at ¶ 11). He was seen by Nurse Ashlee Skaggs who noted redness at the nail bed and a slightly swollen right great toe. (SOF at ¶ 12). On February 15, 2017, Dr. Alan Weaver ordered a ten-day prescription of the antibiotic Keflex for Plaintiff. (Id.). Plaintiff made no complaints concerning his toe at appointments with Nurse Kerri Stoner on February 22, 2017, or with Dr. Weaver on March 3, 2017. (SOF at ¶ 14).

         Plaintiff complained of ongoing toe symptoms to Nurse Skaggs on March 9, 2017. (SOF at ¶ 15). On March 13, 2017, Plaintiff saw Nurse Jobea Parker in sick call for complaints of an infected toe. (SOF at ¶ 16). Nurse Parker noted a large portion of skin growing over Plaintiffs toenail on the inside of the nail, macerated red or purplish skin, and swelling. She consulted with Defendant, who ordered another round of Keflex, a follow-up appointment, and details for no work, no recreation, shower shoes, and dressing changes once per week. (Id.).

         On March 17, 2017, Plaintiff saw Dr. Weaver for complaints of an infected toe which had not resolved after one round of antibiotics. (SOF at ¶ 17). Dr. Weaver noted that Plaintiff had developed a granuloma, which he reported was painful and bled easily with pressure. A granuloma is a result of the body attempting to contain an infection by walling it off from the rest of the body. Dr. Weaver observed no purulence (pus). Dr. Weaver assessed Plaintiff with an ingrown toenail and prescribed another antibiotic, Neomycin, to supplement Plaintiffs Keflex prescription. Dr. Weaver then removed one-third of the nail on Plaintiffs right great toe without complications and noted that, if the granuloma did not resolve naturally, a surgical removal could be considered. If an infection is progressing, it is appropriate to remove part of the ingrown toenail so that the area can drain and reduce the infection. This helps reduce swelling and inflammation. (Id.). On March 18, 2017, Plaintiff refused his dressing change. (SOF at ¶ 18).

         On April 11, 2017, Plaintiff saw Nurse Audrey Ford for complaints of a big toe infection which caused discomfort and showed no improvement. (SOF at ¶ 19). Upon examination, Nurse Ford noted a slightly swollen right great toe with redness around the left side of the toenail. She referred Plaintiff to a physician for reassessment. (Id.).

         On April 26, 2017, Plaintiff saw Nurse Tina Neer for complaints of an infected toe. (SOF at ¶ 20). Nurse Neer noted a red and swollen right great toe nail with serosanguinous (containing blood) drainage. She obtained a verbal order for Betadine foot soaks for ten days from Dr. Weaver and instructed Plaintiff to report any changes to the medical staff. Dr. Weaver ordered Keflex 500mg for 14 days and foot soaks for 10 days. (Id.).

         On April 27, 2017, Plaintiff saw Nurse Rhonda Burge for a Betadine foot soak. (SOF at ¶ 21). Nurse Burge noted that Plaintiffs right great toe was red and swollen. On April 28, 2017, Plaintiff saw Nurse Burge for a Betadine foot soak. Nurse Burge noted some improvement. Plaintiff was scheduled for an appointment with Defendant, but he complained about waiting, left, and did not want to reschedule. (Id.). On April 29 and 30, 2017, Plaintiff did not report for his Keflex or foot soaks. (SOF at ¶ 22). On May 1 and 2, 2017, Plaintiff reported for his foot soaks, but not for his Keflex. (Id.).

         On May 3, 2017, Nurse Burge saw Plaintiff for a foot soak and noted some improvement. (SOF at ¶ 23). Nurse Neer observed signs of healing on May 4, 2017, and Plaintiff reported improved pain. (SOF at ¶ 24). On May 5, 2017, Plaintiff did not show for his foot soak. (SOF at ¶ 25). On May 6, 2017, Plaintiff saw Nurse Burge for a foot soak. At that time, Nurse Burge noted some swelling around Plaintiffs right great toe. (SOF at ¶ 26). On May 12, 2017, Plaintiff saw Nurse Kerri Stoner for continued toe complaints. (SOF at ¶ 27). She referred him to a doctor for further evaluation. (Id.).

         On May 16, 2017, Defendant first saw Plaintiff, who complained of an infected toenail to the right great toe. (SOF at ¶ 28). He stated he ripped an ingrown toenail out about three months ago. Defendant noted that Plaintiff had been treated with Betadine soaks and Keflex and exhibited good healing of the wound. Defendant also observed a hypertrophic scar on the medial, right great toe with moderate redness and induration at the proximal nail bed. Defendant assessed Plaintiff with an infected ingrown toenail right great toe that was healing well and prescribed ibuprofen for pain and inflammation, Clindamycin (an antibiotic), and continued foot soaks for ten days.

         On June 5, 2017, Plaintiff saw Nurse Parker for complaints of an infected toe. (SOF at ¶ 29). Nurse Parker noted Plaintiffs great right toe was red, swollen, some macerated skin (skin in contact with moisture for too long) around the edge of the toe. Nurse Parker also noted bloody drainage on the dressing around Plaintiffs toe. She advised Plaintiff to leave the wound open to air when he was not in his cell. Nurse Parker discussed Plaintiffs care with Defendant, who ordered twice-daily Betadine foot soaks for ten days and Clindamycin for ten days. (Id.).

         Plaintiff reported for foot soaks on June 6 and 8, 2017, but skipped one of the two foot soaks on June 7, 9, 10, 11, 12, 13, 14, and 15, 2017. (SOF at ¶ 30). On June 14, 2017, Plaintiff told the nurse he did not want to do them. (Id.). On June 16, 2017, Plaintiff had a foot soak at 8:30 a.m. (SOF at ¶ 31). He later saw Dr. Weaver to assess his toe. Dr. Weaver noted that the right first nail medial side had a granuloma formation on the nail and that the toe appeared red and purulent with tenderness. Dr. Weaver assessed Plaintiff with an ingrown toenail of the first toenail medially with infection. He again removed a portion of Plaintiffs toenail, prescribed Augmentin (an antibiotic), and ordered foot soaks once daily with Epsom salts and once daily with Betadine. Dr. Weaver noted that, if the ingrown toenail recurred, Plaintiff would need complete removal with nail growm plate ablation and removal of granulation tissue. Plaintiff was issued a soak pan and Epsom salts. (Id.).

         Plaintiff appeared for foot soaks between June 17, 2017, and June 25, 2017. (SOF at ¶ 32). On July 12, 2017, Nurse Parker saw Plaintiff and noted some improvement but continued issues such as swelling and macerated skin. (SOF at ¶ 29).

         On July 18, 2017, Plaintiff saw Nurse Practitioner ("NP") Laurel Davison for a follow up on his toe. (SOF at ¶ 34). Plaintiff reported the toenail had grown back in. Upon examination, NP Davison noted a mild ingrown toenail. She advised Plaintiff to use shower-soaks to stretch skin flap away from the ingrowing nail and educated him on nail trimming techniques. She determined there was no indication for complete nail removal and no overt infection and advised him to report to sick call as needed. (Id.).

         On August 3, 2017, Plaintiff saw Nurse Stoner and stated his big toe was infected again. (SOF at¶ 35). Nurse Stoner noted some serosanguinous (yellowish with small amounts of blood) drainage and redness. She discussed Plaintiffs condition with Defendant, who ordered a wound culture to determine the ...

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