United States District Court, S.D. Indiana, Terre Haute Division
ENTRY GRANTING MOTION TO DISMISS OR IN THE ALTERNATIVE FOR SUMMARY
JUDGMENT AND DIRECTING ENTRY OF FINAL JUDGMENT
WILLIAM T. LAWRENCE, District Judge.
Plaintiff Robert Martin, an inmate of the Federal Correctional Institution in Butner, North Carolina, brings this action based on alleged inadequate medical care he received while he was confined at the Federal Correctional Complex in Terre Haute, Indiana ("FCC Terre Haute"). He alleges that the defendants failed to treat him properly for his heart and gastrointestinal conditions. He brings a Federal Tort Claims Act ("FTCA") claim against the United States and a claim under Bivens v. Six Unknown Named Agents, 403 U.S. 388 (1971) against William E. Wilson, J. Beighley, and A. Rupska (the "Individual Defendants"). The United States and the Individual Defendants move to dismiss and for summary judgment.
On the basis of the pleadings and the expanded record, the following facts are undisputed:
At all times relevant to this action, Mr. Martin was an inmate of the FCC Terre Haute. During his time at the FCC Terre Haute, he suffered from heart palpitations and H. Pylori stomach infection.
On February 2, 2010, Mr. Martin was sent to Union Hospital for an emergency cardiac consultation due to complaints of pain, recent EKG test results, and a history of myocardial infarction. An Implantable Cardioverter Defibrillator (ICD) was implanted to treat his condition on February 13, 2010, by Dr. Sameh Lamiy. The ICD was implanted appropriately and the management of it was within the standard of care. Mr. Martin saw Dr. Lamiy at least three times, including a follow-up appointment in July and a time in August when the defibrillator fired several times and he was sent to Union Hospital. Mr. Martin claims that the defibrillator was shocking him improperly, that the Individual Defendants did nothing to address these concerns, that he should have been referred to a specialist for these concerns, and that Dr. Lamiy was incorrect about the need for an ICD. Mr. Martin has no medical training of any sort, including medical school, nurses training, or parmedic training. No medical professional has told Mr. Martin that Dr. Lamiy's decisions about the ICD were inappropriate.
Mr. Martin also suffered from an H. pylori infection of his stomach. His heart symptoms were not due to this infection. An H. pylori infection is essentially confined to the stomach and is not associated with cardiovascular problems. Mr. Martin had some gastrointestinal symptoms and was evaluated by esophagogastroduodenoscopy (EGD) on October 6, 2010. This showed a small sliding hiatal hernia and redness in his stomach. These are very non-specific findings and do not establish any particular diagnosis. Biopsies were taken from the stomach and these showed chronic gastritis (inflammation of the stomach lining) and some H. pylori organisms. Mr. Martin was therefore diagnosed with an H. pylori infection which caused the gastritis. Many individuals are infected with H. pylori. Although this infection produces stomach inflammation, most people do not have any symptoms from the infection.
Following the diagnosis of H. pylori infection, Mr. Martin was prescribed a 14-day course of four different medicines which are all approved by the United States Food and Drug Administration as part of treatment combinations for H. pylori infection. The 14-day duration of treatment was appropriate and within the standard of care. H. pylori infection is difficult to treat and requires a minimum of three, and sometimes four, medicines. The combination of medicines that Mr. Martin received was appropriate and within the accepted standard of care.
On October 10, 2010, Mr. Martin had a barium swallow x-ray investigation to evaluate dysphagia-difficulty with swallowing. This showed the small sliding hiatal hernia that had already been documented and minimal gastroesophageal reflux (GER) as well as some mucosal irregularity in the distal esophagus. GER documented during this type of X-ray procedure is a common finding and does not establish a diagnosis of GERD. Whether or not Mr. Martin suffered from GERD, he was being appropriately treated with both ranitidine and omeprazole at different times for his symptoms.
Mr. Martin had a second EGD on February 27, 2012. No abnormality was found in the esophagus to explain Mr. Martin's complaint of dysphagia. In the stomach, there was again redness. Biopsies showed chronic gastritis, intestinal metaplasiaii, and H. pylori bacteria. This indicates that the initial treatment that Mr. Martin received had been unsuccessful in curing his H. pylori infection. However, this is not unusual. Treatments for H. pylori infection - including that given to Mr. Martin - are not always successful in curing the infection.
Around March of 2013, Mr. Martin was re-treated for H. pylori infection. This is not unusual in routine clinical practice. Treatment is successful in only around 70% of patients even with full compliance with medication. When the treatment is unsuccessful, it is appropriate to retreat the patient. However, in Mr. Martin's case, he was re-treated with the same combination of medicines that was used initially. This was inappropriate. When initial treatment for H. pylori infection fails, as it did in Mr. Martin, the patient should not be given the same combination of medicines that was used initially. In particular, the medicine clarithromycin should not be used a second time since initial failure with this medicine probably means that the patient's H. pylori infection is resistant to it. However, this is a relatively minor issue and does not fall outside of the accepted standard of care for primary care physicians. This was a common, minor, and non-lifethreatening error in overall management. This did not fall outside of the standard of care for primary care physicians.
The United States moves to dismiss Mr. Martin's FTCA claim based on actions by Dr. Lamiy and moves for summary judgment on Mr. Martin's medical malpractice claims brought pursuant to the FTCA. Finally, the Individual ...