United States District Court, Southern District of Indiana, Terre Haute Division
ENTRY GRANTING MOTION FOR SUMMARY JUDGMENT AND DIRECTING ENTRY OF FINAL JUDGMENT
Hon. Jane Magnus-Stinson, Judge United States District Court Southern District of Indiana
For the reasons explained in this Entry, the defendant's motion for summary judgment [dkt. 20] must be granted.
The plaintiff in this civil rights action is Christine Johnson ("Johnson"), a former inmate at the Rockville Correctional Facility ("Rockville"). The defendant, Dr. Vance Raham ("Dr. Raham"), was at all relevant times employed at Rockville.
Johnson alleges that when she was incarcerated, she had serious medical conditions including diabetes, pancreatitis, knee pain, and back pain, and that Dr. Raham refused to treat her in violation of the Eighth Amendment to the Constitution. She also brings a state law claim of medical malpractice.
Dr. Raham seeks resolution of Johnson's claims through the entry of summary judgment. Johnson has not opposed the motion for summary judgment.
II. Summary Judgment Standard
Summary judgment is appropriate if "the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed.R.Civ.P. 56(a). A dispute about a material fact is genuine only "if the evidence is such that a reasonable jury could return a verdict for the nonmoving party."
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). If no reasonable jury could find for the non-moving party, then there is no "genuine" dispute. Scott v. Harris, 127 S.Ct. 1769, 1776 (2007).
As noted, Johnson has not opposed the motion for summary judgment. The consequence of her failure to do so is that she has conceded the defendant's version of the facts. Smith v. Lamz, 321 F.3d 680, 683 (7th Cir. 2003) ("[F]ailure to respond by the nonmovant as mandated by the local rules results in an admission."); Waldridge v. American Hoechst Corp., 24 F.3d 918, 921-22 (7th Cir. 1994). This does not alter the standard for assessing a Rule 56(a) motion, but does "reduc[e] the pool" from which the facts and inferences relative to such a motion may be drawn. Smith v. Severn, 129 F.3d 419, 426 (7th Cir. 1997).
A. Undisputed Facts
On the basis of the pleadings and the portions of the expanded record that comply with the requirements of Rule 56(c)(1), construed in a manner most favorable to Johnson as the non-moving party, the following facts are undisputed for purposes of the motion for summary judgment:
At all times relevant to her complaint, Johnson was an inmate at Rockville. Dr. Raham was the Medical Director and treating physician at Rockville.
Johnson has a complicated and serious medical history. She has diabetes, hypertension, gastroesophageal reflux disease (GERD), asthma, Hepatitis C, chronic back pain, chronic knee pain, chronic hip pain, and chronic wide-spread pain. Prior to her incarceration, she had a left knee replacement, a lumbar fusion, and a partial pancreatectomy. Because she has had part of her pancreas removed, her diabetes is very difficult to control and she experiences extreme highs and lows in her blood sugar despite being on insulin. As a result of her previous pancreatectomy, she also suffers from chronic pancreatitis, which is inflammation of the pancreas. Because of her diabetes and her previous pancreatecomy, Johnson's kidneys are compromised and she is at risk for kidney failure. All medications are detoxified in the body through either the liver or the kidneys. Therefore, for a patient like Johnson who has chronic pancreatitis, diabetes, and compromised kidneys, her medication options are limited and she is at risk for kidney failure the more medications she takes. Johnson also has a history of deep venous thrombosis ("DVT"). Johnson took medication for her diabetes, her high blood pressure, her GERD, and for her DVT and water retention.
While incarcerated, Johnson's chronic conditions were managed in the Chronic Care Clinic. As a Chronic Care offender, she was seen every 12 weeks by either Dr. Raham or one of the nurse practitioners. For her diabetes management, in addition to being seen every 12 weeks, she received regular blood sugar checks and routine lab work including a hemoglobin Ale, which monitors the overall status of the patient's diabetes. She also received insulin and an American Diabetes Association diabetic diet. Johnson's insulin had to be regularly adjusted due to the large fluctuations in her blood sugars from her pancreas.
Johnson entered the Indiana Department of Correction on November 10, 2008. She reported having diabetes, high blood pressure, arthritis, pain, stomach troubles, back problems, low back pain, leg pain, and pancreatitis. On November 11, 2008, Johnson submitted a Request for Healthcare stating that she had severe nerve damage in her lower back and legs and she needed her Neurontin. She also said she needed her stomach pills for her pancreas and that the back part of her pancreas was absent and she was afraid of having a pancreas attack. In response to this Request, medical staff instructed Johnson to obtain her prior medical records because she did not arrive at the prison on any medications for pancreatitis. Johnson had her intake physical exam with the nurse practitioner on November 13, 2008. Johnson was given a new diagnosis of Hepatitis C on November 20, 2008.
On November 23, 2008, Johnson presented to the diabetic medicine line very confused and dizzy. Nursing staff took her blood sugar, which was 621. Johnson was sent to the infirmary and nursing staff contacted Dr. Raham, who ordered a pulse check and 20 units of regular insulin, and a recheck of the pulse and blood sugar in one hour. An hour later, Johnson's blood sugar was 69 and her pulse was 104. Dr. Raham called to check on Johnson and was given her new numbers. He ordered staff to observe her for 2 hours and recheck her blood sugar and pulse, then call him back. Johnson then ate something and her blood sugar was 106. A few hours later, a nurse called Dr. Raham to report a blood sugar of 48 and a pulse of 120. Dr. Raham ordered D50, sodium chloride at 150cc per hour for 2 hours, then turn back to 125 cc per hour for the rest of the night. He ordered that Johnson be placed on 23-hour observation in the infirmary until Dr. Raham could check her in the morning. Dr. Raham also ordered the staff to call him if she had a blood sugar less than 50 or greater than 200. A few hours later, nursing staff called Dr. Raham to report a blood sugar of 38 and pulse of 128. Dr. Raham ordered food and to continue to monitor her. Several hours later, Johnson's blood sugar was 125. Dr. Raham was contacted again by nursing staff early in the morning on November 24, 2008, and he ordered that Johnson be given half of her dose of insulin and a change in her IV. On November 24, 2008, in the early afternoon, Dr. Raham examined Johnson. He noted that her blood sugar was now normal but she was still nauseous. He stopped her IV fluids and gave her Phenergan for the nausea. He ordered continued infirmary observation.
On December 15, 2008, the nurse practitioner noted that Johnson had complaints of constant back and knee pain and that she was on Neurontin prior to her incarceration. She also noted that Johnson had a history of 5 back surgeries, 4 knee surgeries, and shoulder surgery. The nurse practitioner prescribed Neurontin for Johnson's chronic pain. The nurse practitioner examined Ms. Johnson on December 30, 2008, for back pain. Johnson reported increased back pain and weight gain. The nurse practitioner ordered a weight check every other day for 2 weeks and encouraged Johnson to exercise and use ice to decrease swelling.
On January 5, 2009, the nurse practitioner ordered that Johnson's blood sugar be checked twice a day for 2 months. On January 5, 2009, Johnson submitted a Request for Healthcare regarding severe hip and lower back pain. She said the hip pain was new and that Tylenol and Ibuprofen did not help. In response to this Request, Johnson was seen in sick call.
The nurse practitioner met with Johnson on January 20, 2009, to discuss the importance of her obtaining her prior medical records to assist with treating all of her pain complaints. The nurse practitioner instructed Johnson to purchase pain medication off the commissary. On January 25, 2009, Johnson had an episode of low blood sugar. Her blood sugar was 24 and nursing staff administered one tube of glucose gel and after 10 minutes, her blood sugar was 70. Her blood sugar then improved to 144 and she was returned to her dorm.
Dr. Raham examined Johnson on January 28, 2009. He noted that she had recently had several episodes of hypoglycemia, so he decreased her insulin dosage. Dr. Raham renewed all of Johnson's medications on February 10, 2009. Dr. Raham examined Johnson in the Chronic Care Clinic on February 17, 2009. He found her diabetes to be stable and her hemoglobin Ale was 9.4. He also reviewed the ...