Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Cashner v. Widup

United States District Court, N.D. Indiana, South Bend Division

December 21, 2016

FREDERICK C. CASHNER, Plaintiff,
v.
JOHN J. WIDUP, et al., Defendants.

          OPINION AND ORDER

          RUDY LOZANO, Judge

         This matter is before the Court on: (1) Defendant John Widup's Motion for Summary Judgment (DE #64); and (2) Defendants Dr. Al-Shami and Kimberly White's Motion for Summary Judgment (DE #66), both filed on March 28, 2016. For these reasons the Court:

(1) GRANTS the defendants' motions for summary judgment (DE ##64, 66);
(2) DISMISSES with prejudice Plaintiff's federal claims;
(3) DISMISSES without prejudice Plaintiff's state law claims; and
(4) ORDERS the clerk to enter judgment in favor of the defendants consistent with this order and close this case.

         BACKGROUND

         Frederick C. Cashner, a pro se prisoner, is proceeding in this case against Dr. Nadir Al-Shami, Nurse Kimberly White, and Warden John J. Widup[1] for denying him proper medical treatment for chronic headaches while he was a pretrial detainee at the Porter County Jail between March 2011 to February 2013. He concedes that he received treatment for chronic headaches, but complains that the treatment provided was not effective.

         In his motion for summary judgment, Warden Widup argues that he had no personal involvement in Cashner's medical care and, therefore, the claims against him must be dismissed. In the medical defendants' motion for summary judgment, Dr. Al-Shami and Nurse White argue that the medical care rendered to Cashner was adequate and within the applicable standard of care. Cashner was provided with a “Notice of Summary Judgment Motion” as required by N.D. Ind. L.R. 56-1 and a copy of both Federal Rule of Civil Procedure 56 and Local Rule 56-1. (DE ##63, 69.) That notice clearly informed him that unless he disputed the facts presented by the defendant, the court could accept those facts as true. Fed.R.Civ.P. 56(e) (“If a party . . . fails to properly address another party's assertion of fact . . . the court may . . . consider the fact undisputed for purposes of the motion.”). It also told him that unless he submitted evidence creating a factual dispute, he could lose this case. Fed.R.Civ.P. 56(a) (“The court shall grant summary judgment 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.”). Cashner has filed his response.

         DISCUSSION

         Summary Judgment Standard

         Summary judgment must be granted when “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 genuine dispute of material fact exists when “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). Not every dispute between the parties makes summary judgment inappropriate; “[o]nly disputes over facts that might affect the outcome of the suit under the governing law will properly preclude the entry of summary judgment.” Id. In determining whether summary judgment is appropriate, the deciding court must construe all facts in the light most favorable to the non-moving party and draw all reasonable inferences in that party's favor. Ogden v. Atterholt, 606 F.3d 355, 358 (7th Cir. 2010). “However, our favor toward the nonmoving party does not extend to drawing inferences that are supported by only speculation or conjecture.” Fitzgerald v. Santoro, 707 F.3d 725, 730 (7th Cir. 2013) (citing Harper v. C.R. Eng., Inc., 687 F.3d 297, 306 (7th Cir. 2012)). Facts On April 25, 2011, Cashner was booked into the Porter County Jail. (DE #68-2 at 3.) At this time, Advance Correctional Healthcare (“ACH”) provided inmate medical services at the jail. (DE #65-1.) Between April 2011 and December 31, 2012, Registered Nurse Kimberly White and several other nurses were assigned to work at the jail. (DE #65-2 ¶ 4; DE #68-1 ¶ 2.) In addition, Dr. Nadir Al-Shami and two other physicians were assigned to work there. (Id.) During his incarceration, John Widup was the Warden of the Porter County Jail. (DE #65-2 ¶ 3.) He was charged with overseeing general day-to-day operations. (Id.) He typically deferred to the jail's medical staff for all inmate medical matters. (Id. at ¶ 6.)

         Cashner's medical history at the jail is lengthy, well-documented and largely undisputed. On August 13, 2011, Cashner submitted a Medical Request Form, complaining that he had been having headaches every day. (DE #68-4 at 174.) Cashner reported that the headaches began after he was taken off his blood pressure medication and that Ibuprofen was not relieving the headaches. (Id.) Dr. John Collier examined Cashner on August 16, 2011, and diagnosed him with headaches with hypertension and prescribed Tylenol. (DE #68-2 at 17.) Dr. Collier also ordered medical staff to monitor Cashner's blood pressure and headache patterns. (Id.) On August 23, 2011, Dr. Wes Harmston examined Cashner. (Ex. #68-2 at 18.) Cashner reported migraines that occurred first thing in the morning. (Id.) Dr. Harmston continued the Tylenol prescription and ordered Cashner to avoid caffeine and carefully observe his head position. (Id.)

         On September 2, 2011, Cashner submitted a Medical Request Form indicating that his headaches were continuing. (DE #68-4 at 173.) Cashner requested a re-examination of his headaches, which had worsened since his Tylenol had been reduced to once daily. (Id.) On September 6, 2011, Dr. Harmston reviewed Cashner's medical chart and prescribed Tylenol twice daily. (Id. at 141.) On September 7, 2011, Cashner submitted a Medical Request Form indicating that he would like to speak with Kimberly House about his ongoing medical problems. (Id. at 172; DE 68-1 ¶ 7.) On September 8, 2011, Nurse White responded that she would place Cashner on the list to see the doctor, and she also offered daily nursing services by the nurse on duty. (Id.) On September 13, 2011, Dr. Harmston examined Cashner, where he reported persistent headaches, unchanged on his prescribed regimen of Tylenol. (DE #68-2 at 19.) Dr. Harmston indicated that he would refer Cashner to a neurologist for his migraine headaches. (Id.) Dr. Harmston also prescribed a stronger dose of Tylenol as needed and Naprosyn as needed. (Id.) On September 14, 2011, Nurse White spoke with Dr. Harmston, and Dr. Harmston indicated that Cashner's neurology consultation would be discontinued and that Dr. Harmston would re-evaluate Cashner on September 20, 2011. (DE #68-1 ¶ 8.) On September 16, 2011, Nurse White spoke with Cashner and informed him of Dr. Harmston's decision to discontinue Cashner's neurology consult and to instead re-evaluate Cashner on September 20, 2011. (DE #68-3 at 140; DE #68-1 ¶ 9.) During this conversation, Cashner indicated that his new medication was helping with his headaches. (Id.) Cashner also indicated that he had experienced chronic headaches approximately 10 years prior due to a problem with his cervical spine. (Id.)

         On September 20, 2011, Dr. Harmston re-evaluated Cashner. (DE #68-2 at 20.) Cashner reported chronic headaches for the past month. (Id.) Cashner also reported a photophobia caused by a pain in his neck that radiated to the back of his head. (Id.) Dr. Harmston diagnosed migraine headaches versus tension-related headaches. (Id.) Dr. Harmston prescribed Fioricet as needed for 14 days and Flexeril 10 mg for 14 days. (Id.) On September 21, 2011, Nurse White spoke with Cashner to inform him that, because Dr. Harmston had prescribed certain medications (Flexeril and Fioricet), Warden John Widup wanted Cashner moved to medical isolation. (DE #68-3 at 139; DE #68-1 ¶ 10.) Cashner refused to be moved to medical isolation and stated, “I'm not going to move where there is no TV.” (Id.) Nurse White educated Cashner regarding his recurrent headaches and the need to take his medications as prescribed. (Id.) On September 25, 2011, Cashner submitted a Medical Request Form asking to speak to the doctor about his ongoing headaches and his treatments and prescriptions. (DE #68-4 at 171.) On September 27, 2011, Dr. Harmston examined Cashner, where he reported headaches, which had improved. (DE #68-2 at 21.) Cashner also indicated that he did not want to be confined to medical isolation, as he was claustrophobic. (Id.) Cashner inquired whether Imitrex would be allowed in general population. (Id.) On September 28, 2011, Nurse White responded that Imitrex would be allowed if Cashner moved to medical isolation for close observation, per Warden Widup. (DE #68-1 ¶ 11.)

         On October 2, 2011, Cashner submitted a Medical Request Form asking to speak with the doctor about the change in his prescription for his headaches. (DE #68-4 at 170.) October 10, 2011, Dawn Martin, L.P.N. examined Cashner. (DE #68-3 at 138.) Cashner indicated that he was doing okay and had no complaints. (Id.) Dr. Harmston examined Cashner later that day, where he reported headaches, but indicated that his Imitrex prescription had been helping. (DE #68-2 at 22.) Dr. Harmston prescribed another round of the Butalbital and Flexeril regimen and discontinued Tylenol. (Id.) On October 11, 2011, Nurse Martin examined Cashner. (DE #68-3 at 138.) Cashner complained of not receiving his medications 4 times daily, and Nurse Martin explained the as-needed nature of his medications, i.e., if Cashner did not complain of or have a headache, he would not receive his medication. (Id.) On the morning of October 12, 2011, Cashner again expressed his frustration over not receiving his Fioricet every six 6 hours. (Id.) Nurse Walker informed Cashner that his as-needed medications were only to be administered for complaints of a significant headache. (Id.) Cashner continued to insist that he should receive his medications on a set schedule, and Nurse Walker again educated him on the parameters of his as-needed medications. (Id.) That night, Nurse Martin examined Cashner, where he complained of headaches that were constant and not relieved by his medications. (Id.) Nurse Martin administered Cashner's medications and discharged him to his housing unit. (Id.)

         On the morning of October 13, 2011, Cashner reported to nursing staff that his headache was worse than what it had been previously. (DE #68-3 at 137.) Nursing staff administered Cashner's medications as prescribed. (Id.) That evening, Cashner again reported to nursing staff that his headache had returned. (Id.) Cashner indicated that he took Motrin in addition to his prescription medications that morning. (Id.) Nurse Walker explained to Cashner that his prescription medications were to be administered on an as-needed basis and sent Cashner back to his housing unit. (Id.) On the morning of October 14, 2011, Cashner took his medications as prescribed, but indicated that his medications were not working to relieve his headaches. (Id.) Cashner requested to see a specialist and signed a Refusal Form for his Flexeril and Fioricet. (Id.; DE #68-2 at 23.) Cashner submitted a Medical Request Form indicating that the medication prescribed by Dr. Harmston was not working and that his headaches continued. (DE #68-4 at 169.) Cashner expressed that he would like testing or treatment to determine the cause of his headaches. (Id.) Nursing staff advised Cashner that he was scheduled to see Dr. Harmston and returned Cashner to general population. (DE #68-3 at 137.)

         On October 16, 2011, Cashner indicated to nursing staff that he would like to restart his Flexeril and Fioricet. (DE #68-3 at 136.) Dr. Harmston prescribed Flexeril and Fioricet. (Id.) Cashner later reported to nursing staff that he had a headache, and nursing staff administered his medications. (Id.) On October 17, 2011, Nurse White and Warden Widup met with Cashner to educate him on the meaning and purpose of his medications being prescribed “as needed, ” since he had previously complained that his medications were not delivered on a set schedule. (DE #68-1 ¶ 12; DE #65-2 ¶¶ 5, 9.) Cashner verbalized his understanding, and Nurse White informed Dr. Harmston of the conversation and education provided. (Id.) Dr. Harmston examined Cashner later that day, where he reported continued headaches and expressed concerns about his medications being administered as needed. (DE #68-2 at 24.) Cashner told Dr. Harmston that he thought that he needed his medications on a set schedule. (Id.) Dr. Harmston altered Cashner's medication regimen as follows: Butalbital twice daily (instead of as needed); and Flexeril once daily for one 1 week. (Id.) Dr. Harmston also prescribed Naprosyn twice daily as needed. (Id.) On October 18, 2011, Nurse Martin observed Cashner in his cell listening to music on his headphones very loudly. (DE #68-3 at 136.) Nurse Martin indicated that she could hear the music while checking on other inmates in medical isolation. (Id.) Cashner later reported to nursing staff that he had a headache. (Id.) After examination, Cashner indicated that his headache was much improved. (Id.) That same day, Dr. Harmston changed Cashner's Naprosyn prescription from 325 mg to 375 mg. (DE #68-3 at 134.) On October 19, 2011, Nurse Martin examined Cashner, where he complained of a headache, but that it was much better than before. (Id.) Nurse Martin administered Cashner's medications. (Id.) On October 20, 2011, Cashner told nursing staff that his medication was working to alleviate his headaches. Id. Cashner did express, however, that he wanted to discuss a change of his medications and that he wanted out of medical isolation. (Id.) On October 21, 2011, Nurse Martin examined Cashner, where he reported a headache, but that it was much better than before. (Id.)

         On October 22, 2011, Cashner denied any headaches and told nursing staff that his headache medications were working. (DE #68-3 at 134.) On the morning of October 23, 2011, Cashner denied any headaches and again indicated that his headaches had dissipated since Dr. Harmston prescribed his most recent regimen of medications. (Id.) Later that day, however, Cashner reported to nursing staff that he had a headache and had taken Motrin to try to ease his pain. (DE #68-3 at 133.) Cashner indicated that the Motrin helped and that his headache went away. (Id.) Nurse Walker observed Cashner listening to his headphones loudly. (Id.) On October 24, 2011, Dr. Harmston examined Cashner. (DE #68-2 at 25.) Cashner indicated that he would like to take NSAIDs for his headaches. (Id.) Dr. Harmston ordered continuous monitoring of Cashner's blood pressure and prescribed Naprosyn 875 mg twice daily for 14 days. (Id.) Dr. Harmston discontinued Cashner's Ibuprofen and Flexeril and instructed Cashner to follow up in 2 weeks. (Id.) On October 31, 2011, Dr. Harmston again examined Cashner and prescribed Propranolol and ordered Cashner's Naprosyn continued. (Id. at 26.) Dr. Harmston also ordered continuous monitoring of Cashner's blood pressure and instructed him to return if his symptoms worsened. (Id.)

         On November 14, 2011, Dr. Harmston examined Cashner. (Id. at 27.) Dr. Harmston found Cashner to have elevated blood pressure and headaches. (Id.) Dr. Harmston also noted that Cashner had been tolerating his Propranolol well. (Id.) Dr. Harmston increased Cashner's Propranolol to 80 mg twice daily to lower his blood pressure. (Id.) Dr. Harmston also ordered Cashner's Naprosyn continued and that nursing staff monitor Cashner's blood pressure daily for 14 days. (Id.)

         On December 1, 2011, Cashner submitted a Medical Request Form requesting follow up regarding the recent change in his blood pressure medication and to discuss his headaches that had returned. (DE #68-4 at 168.) On December 5, 2011, Dr. Harmston examined Cashner, where he complained of adverse side-effects to his Propranolol. (DE #68-2 at 28.) Dr. Harmston prescribed Metoprolol and discontinued Propranolol. (Id.) Dr. Harmston also ordered that nursing staff monitor Cashner's blood pressure daily for 2 weeks. (Id.) On December 10, 2011, Cashner submitted a Medical Request Form indicating that he was experiencing headaches and other adverse side-effects to his Metoprolol and requesting to speak with the doctor about changing his blood pressure medication. (DE #68-4 at 167.) On December 19, 2011, Dr. Harmston examined Cashner and noted that Cashner attributed his headaches to his beta blocker blood pressure medication. (DE #68-2 at 29.) Dr. Harmston discontinued Cashner's Metoprolol and prescribed Norvasc. (Id.)

         On February 7, 2012, Cashner signed a Refusal Form for his Norvasc. (Id. at 30.) On February 14, 2012, Cashner submitted a Medical Request Form asking that the doctor extend his Naprosyn prescription for his headaches. (DE #68-4 at 166.) Cashner indicated that the Naprosyn had been working to relieve his headaches. (Id.) Nurse Walker responded to Cashner's request the next day and indicated that the doctor would renew his Naprosyn prescription. (Id.)

         On May 6, 2012, Cashner submitted a Medical Request Form asking to speak with the doctor about further testing or treatment related to his headaches. (Id. at 164.) Cashner indicated that his Naprosyn, which he had been taking for 7 months, was providing at least some relief, but that he still experienced headaches. (Id.) On May 8, 2012, Nurse Martin examined Cashner. (DE #68-3 at 133.) Nurse Martin noted that Cashner was doing well on his medications, and Dr. Harmston submitted a telephone order to continue them. (Id.) On May 14, 2012, Dr. Harmston examined Mr. Cashner, where he reported elevated blood pressure and off-and-on headaches. (DE #68-2 at 33.) Cashner also indicated that he was taking his Naprosyn as prescribed for his headaches. (Id.) Cashner told Dr. Harmston that he had been headache-free on Naprosyn, but that he recently had been experiencing headaches more frequently. (Id.) Dr. Harmston ordered that nursing staff monitor Cashner's blood pressure weekly and prescribed Fioricet, but Cashner declined this medication. (Id.) Dr. Harmston alternatively ordered that Cashner continue on his Naprosyn and also referred him for an outside consultation for a neurology evaluation.[2] (Id.) Pursuant to Dr. Harmston's orders, Nurse Kim White scheduled Cashner for a neurology consultation with Dr. Vyas. (DE #68-1 ¶ 13.)

         On May 23, 2012, Cashner submitted a Medical Request Form indicating that his headaches were still frequently occurring. (DE #68-4 at 163; DE #68-1 ¶ 14.) Cashner inquired as to whether he was scheduled to see a specialist for further treatment of his headaches. (Id.) Nurse White responded that Cashner had been scheduled for a neurology evaluation. (Id.) Nurse White also inquired as to whether Cashner wanted to reconsider his having declined Fioricet at his May 14, 2012 visit with Dr. Harmston. (Id.)

         On June 14, 2012, Cashner submitted a Medical Request Form indicating that his headaches were occurring more frequently and more painfully than previous headaches. (DE #68-4 at 162; DE #68-1 ¶ 15.) Cashner expressed interest in interim treatment until he could consult with a specialist. (Id.) Nurse White responded and informed Cashner that medical staff had scheduled an appointment with a specialist and that Cashner had declined Fioricet, which Dr. Harmston had attempted to prescribe on May 14, 2012. (Id.) Nurse White again offered Cashner Fiorcet. (Id.) Nurse Martin examined Cashner later that day. (DE #68-3 at 132.) Nurse Martin noted that Cashner was doing well on his medications and that he was not experiencing any adverse side-effects. (Id.) Dr. Collier submitted a telephone order for Diltiazem and Naprosyn. (Id.) On June 18, 2012, Cashner submitted a Medical Request Form denying that he ever declined Fioricet and that he instead declined to be placed in medical isolation in order to take Fioricet. (DE #68-4 at 161; DE #68-1 ¶ 16.) Cashner requested Flexeril and Naprosyn until he could be seen by a specialist. (Id.) Nurse White responded the following day that Cashner had been offered appropriate medical treatment, but that he had refused and denied himself such treatment. (Id.) Nurse White also indicated that the medical provider dictates treatment options. (Id.) On June 20, 2012, Cashner submitted a Medical Request Form asking for an explanation as to the appropriate medical treatment that he had refused. (DE #68-4 at 160; DE #68-1 ¶ 17.) Cashner again asserted that he had not refused to take Fioricet, but had refused to be placed in medical isolation to take Fioricet. (Id.) Nurse White responded that Cashner had refused Fioricet and also indicated that medical staff had scheduled Cashner for an outside neurology evaluation. (Id.) On June 25, 2012, Cashner submitted a Medical Request Form asking to speak to “a different doctor” than whom Cashner had seen previously and whom “may have some knowledge” that “the other doctor doesn't.” (DE #68-4 at 159.) Nurse Walker responded the following day that every doctor at the Porter County Jail follows the same protocols and procedures and that Cashner would be able to discuss his headaches with the neurologist in several days. (Id.) Cashner had an appointment to see Dr. Vyas, the neurologist, on June 28, 2012. (DE #68-1 ¶ 32.) However, officers were not able to transport him to that appointment due to a staff shortage and an emergency in the jail that day. (Id.; DE #65-2 ¶ 13) Nurse Kim White was not responsible for transporting Cashner to this appointment. (Id.) Cashner's appointment with Dr. Vyas was re-scheduled for the next available date. (DE #65-2 ¶ 13.)

         On July 1, 2012, Cashner submitted a Medical Request Form asking to see the doctor. (DE #68-4 at 158.) Nurse White responded the following day that she had referred Cashner's request to the doctor. (Id.) On July 2, 2012, after being gone from the jail for several days, Nurse White was advised that Porter County Jail security staff could not transport Cashner to his outside neurologist consultation on June 28, 2012 due to an emergency in the jail. (DE #68-3 at 132; DE #68-1 ¶¶ 18, 32.) As soon as she was made aware of this, Nurse White rescheduled Cashner's appointment with Dr. Vyas for August 30, 2012 and informed security staff of the scheduling change. (Id.) On July 3, 2012, Dr. Collier examined Cashner, where Cashner reported headaches and issues with his blood pressure. (DE #68-2 at 33.) Dr. Collier discontinued Cashner's Naprosyn and prescribed Meloxicam. (Id.) On July 6, 2012, Cashner reported to nursing staff that Meloxicam was not ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.