United States District Court, N.D. Indiana, South Bend Division
OPINION AND ORDER
P. SIMON JUDGE
Marshall, a prisoner without a lawyer, proceeds on an Eighth
Amendment claim of deliberate indifference to his serious
medical needs against Margaret Dawson. He alleges that Dawson
was aware of his mental condition and deprived him of
psychiatric medication beginning on August 22, 2016, which
resulted in his attempted suicide one month later. Dawson
filed a motion for summary judgment, arguing that she did not
act with deliberate indifference but relied on her medical
also provided Marshall with the summary judgment notice
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. ECF 40. The
notice informed Marshall of the importance of filing a
response. It advised that, unless he disputed the facts
presented by Dawson, the court could accept those facts as
true. See Fed. R. Civ. P. 56(e). It further advised
that a lack of response could result in the dismissal of his
case. See Fed. R. Civ. P. 56(a). Nevertheless,
Marshall did not file a response.
Dawson works as a psychiatric nurse practitioner at the Miami
Correctional Facility. ECF 39-2 at 1. Dawson submitted an
affidavit (ECF 39-2) and the relevant medical records for
Marshall's time in the custody of the Department of
Corrections (ECF 39-3), which revealed the following. On
January 9, 2015, Marshall underwent an initial psychiatric
evaluation at the Reception Diagnostic Center. Id.
at 31-34. He reported hearing voices and a two-week
hospitalization in Kentucky for hallucinations. Id.
He also reported a history of getting into fights and
substance abuse. He received diagnoses of paranoid
schizophrenia and polysubstance dependence and was prescribed
Risperdal, an antipsychotic. Id.
March 5, 2015, following his transfer to the Miami
Correctional Facility, Dawson saw Marshall for the first time
for medication management. Id. at 28-30. She renewed
his Risperdal prescription based on his report that it
effectively reduced auditory hallucinations. Id.
September 3, 2015, Marshall reported that he was expelled
from the GED program due to an altercation and did not have a
job. Id. at 17-19. Dawson began to question the
schizophrenia diagnosis as well as Marshall's need for
Risperdal. Id. She observed that his presentation
was not consistent with severe mental illness and saw no
impairment with his ability to function. Id. She
also noted that he received conduct reports even when
receiving Risperdal. Id. When she raised these
concerns, Marshall became defensive, and continued to argue
until a correctional officer instructed him to leave the
building. Id. Dawson suspected that Marshall might
have been attempting to manipulate her for secondary gain.
Id. She diagnosed Marshall with antisocial
personality disorder and discontinued Risperdal. Id.
to Dawson's expertise, the symptoms of paranoid
schizophrenia include anxiety, delusions, hallucinations,
disorganized thinking or speech, abnormal motor behavior, and
lack of an ability to function normally, including lack of
eye contact and flat affect. ECF 39-2 at 2-3. Other symptoms
include reluctance to acknowledge one's diagnosis and an
unwillingness to take antipsychotic medication. Id.
The symptoms of antisocial personality disorder include the
tendency to manipulate and treat others harshly or with
callous indifference, aggressive or violent behavior, lying,
impulsive behavior, inability to sustain consistent work
behavior, and substance abuse. Id. No medication
specifically treats antisocial personality disorder, but
medication may be prescribed for depression or anxiety.
Id. Psychotherapy, including anger management
training, is also used to treat the disorder. Id.
September 24, 2015, Marshall complained of aggravation and
not wanting to be around people. ECF 39-3 at 11-13. Dawson
reviewed Marshall's medical history, noting that, though
he persistently requested medication, he did not present with
symptoms consistent with paranoid schizophrenia. Id.
Marshall was offered additional therapy sessions but was
denied medication. Id. Marshall continued to argue,
leaving only the office after being asked several times.
Id. Dawson determined that there was no clinical
indication for medication, no impairment in his ability to
function, and that Marshall was seeking drugs for himself or
for secondary gain. Id.
thereafter, Marshall transferred to a different correctional
facility. ECF 39-2 at 7. At that facility, Marshall requested
Risperdal from a physician and complained of anxiety and
paranoia. ECF 39-3 at 8-10. The physician resumed the
prescription for Risperdal. Id. On June 21, 2016,
Marshall returned to the Miami Correctional Facility and was
placed in the restrictive housing unit. Id. at
19, 2016, Dawson saw Marshall for medication management, and
she renewed his prescription for Risperdal. Id. at
142-45. He indicated that he was first diagnosed with
schizophrenia about one year ago upon his entry into the
correctional system and that he had had no job since age
sixteen. Id. Dawson observed Marshall in the waiting
area conversing and laughing with another inmate.
Id. She requested that he sign an authorization for
her to obtain medical records from his mental health-related
hospital stay in Kentucky, and he agreed. Id. She
reasoned that she needed to verify Marshall's reported
medical history. Id. According to her expertise,
mental health patients may not be forthcoming or aware of
their diagnoses and may also try to manipulate medical
treatment through self-reporting. ECF 39-2 at 9-10.
August 12, 2016, a nurse observed that, when she gave
Marshall two Excedrin pills and one Risperdal pill, he moved
the Risperdal pill to the other hand as he approached the
water fountain, which suggested an attempt to divert
Risperdal. ECF 39-3 at 138. When the nurse asked to see the
pills in Marshall's hands, he said that he had
accidentally dropped the Risperdal pill. Id.
August 23, 2016, Dawson discontinued Marshall's
prescription of Risperdal based on his refusal to sign a
medical records authorization form, his attempt to divert his
medication, and her previous doubts regarding the paranoid
schizophrenia diagnosis. Id. at 130-32. She
concluded that his symptoms were more consistent with
antisocial personality disorder and that discontinuation
would not result in significant withdrawal symptoms.
Id. She planned to follow up with Marshall in one
month and to discuss his treatment plan at the weekly mental
health meeting. Id.
August 26, 2016, during an individual psychotherapy session
with Barbara Gibbs, Marshall again refused to sign the
medical records authorization and requested medication.
Id. at 126-29. He also denied suicidal ideation.
Id. Gibbs observed alert, pleasant, cooperative
behavior and no evidence of significant impairment or
distress. Id. She noted that Marshall was actively
and appropriately participating in anger management classes
and that he had no disciplinary issues since his arrival at
the Miami Correctional Facility. Id. She discussed
cognitive behavioral therapy skills to manage anger and
depression and gave him a self-help packet for him to
complete. Id. She also consulted with the ...