KENDALL J. NEWMAN, Magistrate Judge.
Plaintiff is a 38 year old state prisoner, proceeding pro se and in forma pauperis. Plaintiff seeks relief pursuant to 42 U.S.C. § 1983. Plaintiff consented to proceed before the undersigned for all purposes.
Plaintiff seeks preliminary injunctive relief in the form of an order requiring defendants to order him an MRI, and to refer him to a neurologist or an orthopedic specialist, ostensibly to diagnose the source of his alleged extreme back pain. Plaintiff contends that the balance of hardships tips in plaintiff's favor. He argues that defendants have an on-site MRI, which is about a three minute walk from plaintiff's housing unit. Thus, he contends that defendants will suffer little hardship in providing plaintiff with an MRI. By contrast, plaintiff argues that he continues to suffer unbearable, constant pain, which is worse than the pain he sustained when he suffered five gunshot wounds. (ECF No. 1 at 11.) Plaintiff argues that awarding him injunctive relief is in the public interest to prevent an Eighth Amendment violation.
In response, defendants provide the declaration of plaintiff's treating physician, Dr. Lotersztain, who has been working with plaintiff since June of 2013. (ECF No. 11-1.) Dr. Lotersztain confirms that plaintiff is consistent in complaining of severe low back pain, and demanding an MRI, as well as to be referred to corrective spine surgery. (ECF No. 11-1 at 2.) However, plaintiff also consistently admits to being able to exercise regularly. Indeed, the physical therapist who saw plaintiff on August 21, 2013, documented that plaintiff was in no distress, playing sports, and his physical exam showed no motor or neurologic deficits. (ECF No. 11-1 at 2.) Dr. Lotersztain has personally seen plaintiff run very fast down the stairs without showing any signs of difficulty, and claims plaintiff is "extremely well built with high muscular mass." (ECF No. 11-1 at 2.) Plaintiff's lower spine x-rays on December 10, 2012, showed mild degenerative disk disease, which Dr. Lotersztain states is "very common in young athletes." (
In reply, plaintiff submitted his own declaration, and a medical record reflecting results from lab tests performed in late May 2015. (ECF No. 12.) Plaintiff states that on December 4, 2012, he felt a pop in his lower back, accompanied by severe pain, and that by noon on December 5, he was unable to walk or even lift his legs. He was removed by wheelchair to the treatment facility where he received multiple injections. Upon discharge, plaintiff claims he was only able to take baby steps. In early 2013, Dr. Pfile ordered plaintiff physical therapy, and plaintiff was taught exercises to strengthen his core and instructed to perform the exercises daily and told "that if [plaintiff's] core became sufficiently strong it would resolve the problem with [his] lumbar spine." (ECF No. 12 at 2.) The physical therapist and Dr. Pfile told plaintiff it was "very important" to keep as active as possible, to master the exercises, performing them 4-5 times per week, warned plaintiff he might need to do them for the rest of his life, and that if he did, plaintiff would be able to do everything anyone else [his] age could do physically." (
Plaintiff states that on February 4, 2015, his back spasmed so severely that he could not move his legs. He was again transported to the medical facility by wheelchair where he again received a series of injections. Plaintiff claims that his mobility was further reduced for a least a month. Since the December 2012 injury, plaintiff estimates that he has recovered only 60% of his original mobility. (ECF No. 12 at 4.) Since filing this lawsuit, plaintiff states he has presented at clinic once a week, but that prison staff does nothing to address his symptoms, but simply checks his vitals and issues over the counter painkillers.
The party requesting preliminary injunctive relief must show that "he is likely to succeed on the merits, that he is likely to suffer irreparable harm in the absence of preliminary relief, that the balance of equities tips in his favor, and that an injunction is in the public interest."
Alternatively, under the so-called sliding scale approach, as long as the plaintiff demonstrates the requisite likelihood of irreparable harm and can show that an injunction is in the public interest, a preliminary injunction may issue so long as serious questions going to the merits of the case are raised and the balance of hardships tips sharply in plaintiff's favor.
The principal purpose of preliminary injunctive relief is to preserve the court's power to render a meaningful decision after a trial on the merits.
On the one hand, plaintiff continues to complain of severe lower back pain, and defendants refuse to order an MRI, perform other neurological testing, or refer plaintiff to a neurologist or an orthopedic specialist. On the other hand, Dr. M. Lotersztain, who has examined plaintiff on multiple occasions, notes that plaintiff's mild degenerative disk disease, common in young athletes, does not explain the symptoms of which plaintiff complains, and opined that following multiple careful examinations, she found no indications of any anatomic or physiologic disease to explain plaintiff's pain complaints. Rather, she opines that plaintiff may suffer from a psychological condition that may be exacerbated by the performance of other medical testing.
While the Eighth Amendment of the United States Constitution entitles plaintiff to medical care, the Eighth Amendment is violated only when a prison official acts with deliberate indifference to an inmate's serious medical needs.
Moreover, a difference of opinion as to the medically acceptable course of treatment does not establish deliberate indifference by prison officials.
It is unclear at this time whether plaintiff will prevail on the merits of his claim. At present, it appears that plaintiff has a difference of opinion as to the type of medical care he should be provided. The Office of the Attorney General has presented evidence that plaintiff is receiving medical treatment, albeit not the treatment that plaintiff wants or prefers, and that Dr. M. Lotersztain has a reasoned medical opinion as to why further tests are not appropriate at this time. Thus, at this stage of the proceedings, plaintiff has failed to demonstrate that defendants are being deliberately indifferent to his serious medical needs. Plaintiff may be able to demonstrate, through discovery or the provision of expert testimony, that some or all of the defendants were deliberately indifferent based on their failure to perform an MRI, a fairly routine diagnostic procedure, or to refer plaintiff to a medical specialist, once plaintiff presented with increasing and continued back pain. But the present record does not support an order for preliminary injunctive relief at this time.
In accordance with the above, IT IS HEREBY ORDERED that the Clerk of the Court is directed to assign a district judge to this case; and
IT IS RECOMMENDED that plaintiff's request for preliminary injunctive relief (ECF No. 1) be denied.
These findings and recommendations are submitted to the United States District Judge assigned to the case, pursuant to the provisions of 28 U.S.C. § 636(b)(l). Within fourteen days after being served with these findings and recommendations, any party may file written objections with the court and serve a copy on all parties. Such a document should be captioned "Objections to Magistrate Judge's Findings and Recommendations." Any response to the objections shall be filed and served within fourteen days after service of the objections. The parties are advised that failure to file objections within the specified time may waive the right to appeal the District Court's order.
(ECF No. 12 at 6.) However, plaintiff's motion did not include claims concerning alleged liver damage, and therefore defendants did not respond to such claim. Thus, such new claim is not addressed herein.