JOHN E. STEELE, District Judge.
This case is before the Court on the following:
The claims raised in the instant civil rights action stem from Defendant Cabreo-Muniz' alleged failure to promptly provide Plaintiff with surgery on a fractured finger on his right hand. As discussed below, the Court concludes that Defendant Cabreo-Muniz is entitled to judgment as a matter of law on each of Plaintiff's claims.
Plaintiff initiated this action by filing a civil rights complaint against Defendants Nicolas Cabreo-Muniz, D. Strodahl, J. Tate, and Kenneth Tucker on February 6, 2012 (Doc. 1). In the complaint, Plaintiff raised both constitutional claims and pendant state law negligence claims relating to the defendants' allegedly deficient treatment of a broken finger on Plaintiff's right hand.
On November 17, 2011, Plaintiff was injured after falling on a wet floor and sought medical attention (Doc. 1 at 3). That same day, Plaintiff was seen by a nurse and "was given a splint and a no use of right hand pass" effective November 17, 2011 through November 22, 2011.
On December 2, 2011, Plaintiff had x-rays taken and was sent to the "Hand Center of Florida in Charlotte County" where he was told his index finger was broken and would require surgery "immediately," which needed to be scheduled by the chief medical officer at his institution.
Based on the alleged actions of Defendant Cabreo-Miniz, Plaintiff states that he was denied adequate medical care in violation of the Eighth Amendment (Doc. 1 at 7). He asserts that as a result of the inadequate care he received, he has lost much use of his right hand, which has affected his everyday living.
As relief, Plaintiff seeks a declaratory judgment declaring Defendants' acts to be unconstitutional; various forms of injunctive relief, including an order directing Defendants to provide surgery for Plaintiff; and monetary damages (Doc. 1 at 7-9).
Plaintiff filed a motion for summary judgment in which he asserts that he is entitled to relief as a matter of law (Doc. 66). In support of his motion for summary judgment, Plaintiff filed numerous medical records and other documents relating to his medical care (Doc. 65-2 at 2-8; Doc. 65-3 at 2-6; Doc. 65-4 at 2-21; Doc. 65-6 at 2-5; Doc. 65-8 at 2-11); Grievances regarding his medical care (Doc. 65-5 at 2-7); Defendant Cabreo-Muniz' answers to Plaintiff's interrogatories (Doc. 65-7 at 2-8); Defendant Cabreo-Muniz' amended response to Plaintiff's request for admissions (Doc. 65-7 at 9-13); Defendant Cabreo-Muniz' response to Plaintiff's fourth request for production of documents (Doc. 65-7 at 14-23); Defendant Cabreo-Muniz' request for admissions to Plaintiff (Doc. 65-7 at 24-28); and documents regarding the Florida Department of Corrections' utilization management procedures and the job description of a prison's chief healthcare officer (Doc. 65-9 at 2-20).
In response to Plaintiff's motion for summary judgment, Defendant Cabreo-Muniz filed the Declaration of Administrative Assistant Gerri Carlucci; Declaration of Utilization Management Contract Manager Donna Graham; Plaintiff's Formal Grievance 1112-564-017; Plaintiff's Informal Grievance dated 1/20/2012; Plaintiff's Grievance Appeal 12-16-00443; excerpts from Plaintiff's deposition; Declaration of Department of Corrections Human Resources Analyst Vanessa Rodriguez; documents outlining procedures at Utilization Management; and Declaration of Defendant Cabreo-Muniz (Doc. 73-1 at 1-37).
Defendant Cabreo-Muniz filed a motion for summary judgment on February 27, 2014 in which he asserts that Plaintiff's claims are based solely upon his own opinion and dissatisfaction over his care rather than upon the Eighth Amendment (Doc. 85 at 2). He also asserts that he is entitled to qualified immunity on these claims because the facts in this case do not establish a constitutional violation.
In his response to Defendant Cabreo-Muniz' motion for summary judgment, Plaintiff filed the same documents he filed in support of his own motion for summary judgment as well as a Declaration of James Peacock (Doc. 91-2).
Summary judgment is appropriate only if it is shown "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). The Supreme Court has explained the summary judgment standard as follows:
If the party seeking summary judgment meets the initial burden of demonstrating the absence of a genuine issue of material fact, the burden then shifts to the nonmoving party to come forward with sufficient evidence to rebut this showing with affidavits or other relevant and admissible evidence.
Plaintiff's Eighth Amendment claims against Defendant Cabreo-Muniz appear to be predicated upon three theories: (1) Defendant Cabreo-Muniz' failure to provide Plaintiff with effective pain medication; (2) Defendant Cabreo-Muniz' failure to ensure that Plaintiff received a "no work" pass instead of a "no use of right hand" pass after his injury; and (3) the delay between Plaintiff's injury and his surgery (Doc. 1; Doc. 66).
Prison officials violate the Eighth Amendment when they act with deliberate indifference to a plaintiff's health or safety.
The Supreme Court has cautioned that not every allegation of inadequate medical treatment states a constitutional violation.
"[A] serious medical need is considered one that has been diagnosed by a physician as mandating treatment or one that is so obvious that even a lay person would easily recognize the necessity for a doctor's attention."
Although evidence of recent traumatic injury has generally been sufficient to demonstrate a serious medical need, a broken bone does not per se constitute a serious medical need.
To demonstrate subjective deliberate indifference, the prisoner must show that the defendant: (1) knew of the risk of serious harm; (2) disregarded that risk; and (3) acted with more than just mere negligence.
In his complaint, Plaintiff asserts that Defendant Cabreo-Muniz had not provided him with "any pain killers." (Doc. 1 at 6). In his motion for summary judgment, Plaintiff modified this claim by asserting that Defendant failed to provide him with "effective" prescription pain medication (Doc. 66 at 4).
The Eleventh Circuit has recognized that prison officials may violate the Eighth Amendment by failing to treat an inmate's pain.
Defendant Cabreo-Muniz argues that Plaintiff cannot demonstrate deliberate indifference on the issue of pain medication because he
The evidence filed by both Plaintiff and Defendant Cabreo-Muniz indicates that Plaintiff was given ibuprofen for treatment of his pain (Doc 65-7 at 4). Plaintiff was also given a splint to immobilize his fractured finger and a medical pass exempting him from using his right hand (Doc. 1 at 3-4). Defendant Cabreo-Muniz attests that ibuprofen would be the appropriate pain medication to prescribe to an inmate in an institutional setting to address the pain of a fractured finger (Doc. 85-1 at 4).
Defendant Cabreo-Muniz has presented evidence in his sworn affidavit and other supporting documents that Plaintiff received ibuprofen, a splint, and a work exemption to address his pain.
Plaintiff also argues that he did not receive "effective" pain medication (Doc. 66 at 4). Plaintiff filed a grievance on December 9, 2011 in which he expressed concern that his no-work pass was expiring and that he was "made to go to work 5 days a week in pain." (Doc. 85-1 at 11). However, the grievance made no reference to ibuprofen and did not ask for "more effective" pain medication.
The record reveals no genuine dispute as to any material fact regarding Plaintiff's requests for pain medication, and the evidence could not enable a reasonable jury to conclude that Defendant Cabreo-Muniz subjectively knew of an obvious need for stronger pain medication and disregarded that need by conduct that was more than gross negligence. Accordingly, Plaintiff is not entitled to summary judgment on his claim that Defendant Cabreo-Muniz exhibited deliberate indifference by failing to prescribe a stronger pain medication. For the same reason, Defendant Cabreo-Muniz is entitled to summary judgment on this issue.
Plaintiff asserts that Defendant Cabreo-Muniz was deliberately indifferent to his serious medical needs because he failed to issue Plaintiff a "no work" pass instead of a "no use of right hand" pass during the period between his injury and his surgery (Doc. 1 at 5). Defendant Cabreo-Muniz attests that he issued the "no use of right hand pass" pursuant to Department of Corrections Technical Instruction No. 15.02.16 which provides that a "no work" pass should be issued "only where the inmate cannot perform any work activity either on the facility grounds or off the correctional facility property." (Doc. 85-1 at 44).
Defendant has presented evidence showing that Plaintiff was capable of performing some work, so that a "no work" pass would not have been in compliance with department regulations. Plaintiff has not offered any evidence in response. This is not a situation where Plaintiff's request for accommodation was ignored. Rather, Plaintiff was issued a pass exempting him from using his right hand. That Plaintiff may have preferred a no work pass to the pass he received does not show that his injury was not given appropriate medical treatment or that he was subjected to unnecessary pain and suffering. A "difference in medical opinion between the prison's medical staff and the inmate as to the latter's diagnosis or course of treatment [cannot] support a claim of cruel and unusual punishment."
As Plaintiff has not come forward with evidence to show that Defendant was deliberately indifferent to his medical needs for failing to issue a "no work" pass instead of a "no use of right hand" pass, summary judgment is granted in Defendant Cabreo-Muniz' favor. Likewise, Plaintiff is not entitled to summary judgment on this issue.
Plaintiff asserts that Defendant Cabreo-Muniz acted with deliberate indifference when he did not schedule the recommended surgery on his hand "ASAP" as was written on the order from Nurse Practitioner Hoffman from the Florida Hand Center in Charlotte County (Doc. 66 at 7).
A delay in medical treatment can, depending on the circumstances and length of the delay, constitute deliberate indifference.
Plaintiff points to Hoffman's December 2, 2011 consultation report in support of his claim that his surgery was unconstitutionally delayed:
(Doc. 65-4 at 5) (emphasis in original). Plaintiff argues that although Hoffman made the recommendation that Plaintiff be scheduled for surgery "asap" on December 2, 2011, Defendant Cabreo-Muniz did not actually request authorization for the surgery from utilization management until December 8, 2011, after "Plaintiff brought to the attention of medical staff that Plaintiff have [sic] not had the `immediate' surgery recommend by Hand Specialist's ARNP[.]" (Doc. 66 at 7).
Defendant Cabreo-Muniz attests that he did not become involved in Plaintiff's medical issue involving his fractured finger until December 2, 2014 (Doc. 85-1 at 42). Upon reviewing an x-ray of the fracture on that date, Defendant referred Plaintiff to an outside hand specialist for consultation.
Defendant Cabreo-Muniz filed the affidavit of Gerri Carlucci, an administrative assistant at the Florida Department of Corrections, who attests that on December 9, 2011, she uploaded to utilization management the documentation requesting Plaintiff's surgery that was signed by Defendant Cabreo-Muniz on December 8, 2011 (Doc. 85-1 at 3-4). She attests that she checked the utilization management database every other day for updates on requests, and scheduled Plaintiff's surgery on January 11, 2012.
Defendant Cabreo-Muniz filed the affidavit of Donna Graham, a utilization management contract monitor for the Florida Department of Corrections (Doc. 85-1 at 6). Graham attests that utilization management approval must be obtained before outside surgeries can be scheduled unless the condition is designated as an emergency (Doc. 85-1 at 7). Graham attests that even when a consultant recommends a surgery date, as was done in Plaintiff's situation, utilization management approval is required before a surgery may be scheduled.
Plaintiff has not filed any evidence to rebut Defendant Cabreo-Muniz' declaration that he requested utilization management authorization for Plaintiff's surgery on the same day that he became aware that surgery was required. Plaintiff attests that "the Hand Center gave the officers that transported me on 12-2-11 my medical chart, x-rays, and recommendations to be taken to medical department on return to institution." (Doc. 91-2 at 10). Plaintiff argues that Defendant Cabreo-Muniz
Defendant Cabreo-Muniz is entitled to summary judgment on Plaintiff's claim that he did not request utilization management approval of Plaintiff's surgery in a timely manner. Likewise, summary judgment is denied on Plaintiff's claim that Defendant Cabreo-Muniz was deliberately indifferent for failing to timely request utilization management approval for Plaintiff's surgery.
Although Plaintiff has presented no evidence that Defendant Cabreo-Muniz had the authority to bypass utilization management requirements and schedule his surgery prior to getting their approval, he argues that Defendant Cabreo-Muniz was deliberately indifferent to his serious medical needs because he classified Plaintiff's broken finger as "urgent" instead of "emergent." (Doc. 66 at 16). Plaintiff asserts that, had Defendant Cabreo-Muniz classified Plaintiff's broken finger as an emergency, he would have received surgery sooner.
Defendant Cabreo-Muniz has filed evidence showing that an emergency is defined by utilization management as conditions "which are life or function threatening and/or which may cause the person to deteriorate rapidly." (Doc. 85-1 at 7, 43; Doc. 85-1 at 49 (Technical Instruction No. 15.09.04, Utilization Management Procedures)). Urgent conditions are those that do not require immediate resolutions, "but must be treated within several days to several weeks or the condition will deteriorate and possibly become an emergency condition." (Doc. 85-1 at 43; Doc. 85-1 at 49). Defendant Cabreo-Muniz attests that Plaintiff's broken finger was not an emergency because it was not life threatening and would not cause him to deteriorate rapidly (Doc. 85-1 at 44).
Plaintiff does not disagree with utilization management's definitions of "urgent" or "emergency." Rather, he argues that Hoffman's recommendation that Plaintiff be scheduled for surgery "asap" mandated that Defendant Cabreo-Muniz classify his broken finger as an emergency and that his failure to recognize such constituted deliberate indifference (Doc. 66 at 16; Doc. 91-2 at 11). Plaintiff has filed Hoffman's consultation notes in support of his motion for summary judgment (Doc. 65-4 at 5). Upon review, the Court notes that Hoffman's consultation notes do not indicate that Plaintiff's condition was "life or function threatening" or would cause Plaintiff to "deteriorate rapidly." Rather, the consultation notes indicate only that Plaintiff's surgery should be arranged "asap." (Doc. 65-4 at 5).
Plaintiff's assertion that his condition necessitated "emergency" classification rather than "urgent" classification is merely a disagreement with Defendant Cabreo-Muniz' professional judgment. Disagreement about the course of one's treatment is "a classic example of a matter for medical judgment" that does not give rise to an actionable claim of deliberate indifference.
Because there is no medical evidence to support Plaintiff's claim that Defendant Cabreo-Muniz was deliberately indifferent when he failed to classify Plaintiff's broken finger as an emergency, Defendant Cabreo-Muniz is entitled to summary judgment on this claim. Likewise, Plaintiff's motion for summary judgment on this issue is denied.
In his complaint, Plaintiff seeks orders from the Court enjoining the Department of Corrections from providing legal representation to Defendant Cabreo-Muniz; ordering Defendant Cabreo-Muniz to immediately arrange surgery, physical therapy, and treatment for Plaintiff's hand; and enjoining Defendant Cabreo-Muniz from "retaliating" against him for filing the instant lawsuit (Doc. 1 at 7-8).
Plaintiff asks this Court to enter an injunction prohibiting the Department of Corrections, the Attorney General, or any other state agency from providing legal assistance to Defendant (Doc. 1 at 8).
Florida Statute § 111.07 authorizes any agency of the state to provide an attorney to defend a civil action against its employees.
Plaintiff's attempt to prevent the Attorney General from representing Defendant Cabre-Muniz is a challenge to an essentially discretionary decision.
Under Article III of the Constitution, federal courts may only hear "cases or controversies."
Evidence has been presented that Plaintiff received surgery on his right hand on January 26, 2012 and is currently undergoing physical therapy (Doc. 85-1 at 45; Doc. 65-7 at 5). There is no reasonable expectation that Plaintiff will be denied surgery on his hand in the future. Accordingly, Plaintiff's requests that he receive medical treatment for his broken finger are moot.
Plaintiff seeks injunctive relief prohibiting Defendant Cabreo-Muniz from retaliating against him for filing this action.
Plaintiff has not alleged any specific act of retaliation on the part of Defendant Cabreo-Muniz. Plaintiff's subjective belief that correctional officials may retaliate against him for his litigation activities is insufficient to demonstrate a constitutional violation.
Plaintiff likewise fails to demonstrate that he will suffer the requisite irreparable injury absent issuance of a preliminary injunction. His speculative allegations concerning the conduct of Defendant Cabreo-Muniz is not the type of irreparable harm justifying the issuance of an injunction. Any problems Plaintiff may encounter as a result of filing grievances, complaints, and/or lawsuits can be accomplished through the filing of a complaint in federal court.
Finally, with regard to the third and fourth factors, Plaintiff fails to show that the harm to Plaintiff outweighs the harm to the defendant, and the pleadings before the court are devoid of any evidence showing that issuance of an injunction would serve the public interest.
In light of the foregoing, the court finds that Plaintiff has failed to meet the requisite burden for injunctive relief. He has not demonstrated a likelihood of success on the merits. Additionally, Plaintiff has not demonstrated that any threatened injury he faces outweighs the potential harm caused to Defendant Cabreo-Muniz by injunctive relief. Finally, it would not serve the public interest to grant him injunctive relief. Defendant Cabreo-Muniz is granted summary judgment on all of Plaintiff's claims for injunctive relief.
Plaintiff has failed to show that there is a genuine issue of material fact regarding whether Defendant Cabreo-Muniz was deliberately indifferent to his serious medical condition. In addition, Plaintiff has not demonstrated that he is entitled to injunctive relief. Because all claims against Defendant Cabreo-Muniz are dismissed, this Court will not address his argument that he is entitled to qualified immunity.
Accordingly, it is hereby
1. Plaintiff's motion for summary judgment (Doc. 66) is
2. Defendant Cabreo-Muniz' motion for summary judgment (Doc. 85) is
3. With no remaining defendants or claims, the