GLEN E. CONRAD, Chief District Judge.
David Sprinkle, proceeding
Sprinkle sues Dr. Ali, the jail's physician; Head Nurse Buschor; and Captain Tuck, who oversees medical care for inmates at the jail. The doctor and nurse filed a motion to dismiss, Sprinkle responded, the defendants filed a reply and motion for summary judgment, and Sprinkle responded again. Capt. Tuck filed a motion to dismiss, supported with an affidavit and medical records, to which Sprinkle responded, making all defendants' motions ripe for disposition.
The following facts are presented in the light most favorable to the plaintiff.
Sprinkle suffers from polycystic kidney disease ("PKD"), an incurable genetic disorder in which non-cancerous, fluid-filled sacs, called cysts, form in the kidneys. Treatment of PKD patients is directed at managing complications associated with PKD, including back or abdominal pain; hypertension, also called high blood pressure; and hypertension-related headaches. Often pain associated with PKD can be managed with over-the-counter, non-narcotic pain medication.
Sprinkle arrived at the jail on December 27, 2012, as a pretrial detainee. During his medical intake interview, he told staff about his history of PKD, high blood pressure, and arthritis in his left ankle and other joints. Sprinkle reported that doctors in the past had prescribed Lortab and Percocet for his pain. The interviewer's notes indicate that Sprinkle did not report or appear to be in any pain at that time. Nurse Buschor advised Sprinkle that he would be placed on withdrawal from such opioid medications, because they were reserved for acute pain, while chronic pain was managed with non-opioid medications. Sprinkle stated that he did not want to undergo opioid withdrawal.
Medical staff monitored Sprinkle's blood pressure and prescribed medications designed to keep it under control, although Sprinkle did not always comply with the doctor's directions about medications. When Sprinkle complained of pain, staff provided him regularly with Tylenol. On January 3, 2013, Dr. Ali examined him and prescribed Tylenol and Mobic for pain. A few days later, on January 8, when Sprinkle complained about not receiving the pain medications he had requested, Nurse Buschor reviewed records from his treating physician and told him that he did not have a current prescription for narcotics.
Dr. Ali saw Sprinkle on January 10 and noted that he was sitting comfortably and in no distress. The doctor prescribed Neurontin and a higher dose of Tylenol at bedtime. When Sprinkle complained on January 16 about ankle pain, staff advised him to give the Neurontin a chance to take effect.
On January 18, Sprinkle complained of experiencing a "transient ischemic attach ("TIA") caused by his PKD and chronic pain. Staff noted that he walked to the medical department and climbed on the examination table without problems, was alert and oriented, and his speech, neurological, and strength exams were normal. His blood pressure was high and was treated with medication. Sprinkle began demanding his pain medication and asked the nurse to call his prior doctor. When she did so, she learned that at Sprinkle's last pre-incarceration appointment on November 12, 2012, his doctor had instructed Sprinkle to gradually reduce his use of his prescription medication for pain control. The doctor had also intended to help Sprinkle arrange for full time management of his care by a nephrologist. After this conversation, jail staff placed Sprinkle in "medical segregation" for observation
Dr. Ali examined Sprinkle again on January 24. Sprinkle told the doctor that he had stopped taking all of his medications because he did not know which one was causing his legs to swell. His blood pressure was high, and Dr. Ali changed his medication for that condition and released him into the general population.
Sprinkle saw a specialist, Dr. Ballenger, on January 29, 2013, for evaluation of his PKD. Dr. Ballenger recommended testing to rule out a brain aneurism, recommended a certain dose of Lortab every six hours as needed for pain, adjusted the blood pressure medication, and suggested a follow up exam in one month. Dr. Ali followed the specialist's plan and provided Sprinkle with the suggested narcotic pain medication, but at a smaller dose than the specialist recommended. The doctor told Sprinkle, "At no point since your arrival has medical seen you appear to be in any pain." (Compl. 4.) On March 4, 2013, Sprinkle filed a medical request for his Lortab to be reordered, but the medical staff advised him that he was "not approved to have [the medication] reordered."
The court construes Sprinkle's complaint as asserting the following claims under § 1983: (1) the defendants' policy of not treating chronic pain with narcotic medication deprived him of necessary treatment; (2) the defendants did not follow measures prescribed by plaintiff's prior treating doctors; (3) the defendants failed to request all relevant medical reports about plaintiff's prior treatment; (4) the defendants provided him with a different dose of narcotic pain medication than the kidney specialist recommended and then allowed the prescription to run out; (5) the defendants unfairly refused to treat plaintiff's chronic pain with narcotic pain medication, although other inmates at the jail did receive such drugs; (6) Capt. Tuck denied plaintiff access to the grievance procedure by ruling his requests for certain medication to be "nongrievable" and by refusing to provide him with grievance forms eight times; and (7) the defendants placed plaintiff in medical segregation as punishment for filing grievances. Sprinkle seeks monetary damages for these alleged violations of his constitutional rights.
A motion to dismiss tests the legal sufficiency of a complaint.
To prove a claim that prison officials have violated his rights under the Equal Protection Clause, an inmate "`must first demonstrate that he has been treated differently from others with whom he is similarly situated and that the unequal treatment was the result of intentional or purposeful discrimination.'"
Sprinkle fails to forecast evidence that would demonstrate that he was treated differently than other inmates similarly situated. Sprinkle merely alleges that other jail inmates received narcotic medication. He fails to allege facts that would tend to show that these inmates suffered from chronic pain like his, rather than a temporary condition, such as a painful toothache or pain during recovery from surgery. He also fails to identify circumstances demonstrating that other inmates received narcotic medications at the jail that had been prescribed to them before their incarceration by doctors outside the jail staff. Sprinkle does not allege facts that would support the assertions that the difference in treatment stemmed from intentional discrimination against him. Indeed, he complains that the medical staff's refusal to provide narcotics for chronic pain was a blanket policy, applicable to all inmates as a general rule. Moreover, Sprinkle's treatment history indicates that the jail's medical staff made an exception to their policy when circumstances required, as reflected by their willingness to refer Sprinkle to the specialist and order the narcotics the specialist recommended. Because Sprinkle's complaint fails to present the necessary elements of an equal protection claim, the court will grant defendants' motions to dismiss as to Claim (5).
Inmates do not have a constitutionally protected right to participate in a grievance procedure.
Similarly, the Fourth Circuit has held that a prisoner's use of grievance procedures is not a protected First Amendment right.
An award of summary judgment is appropriate "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." Fed. R. Civ. P. 56(a). In determining whether to grant a motion for summary judgment, the court must view the record in the light most favorable to the non-movant.
When a motion for summary judgment is made and properly supported by affidavits and other documentation, the non-moving party may not rest on the mere allegations or denials of the pleadings. Rule 56(e). Instead, the non-moving party must respond by affidavits and present specific facts from which a jury could reasonably find for either side.
The court has reviewed Sprinkle's claims about his course of medical treatment at the jail under the summary judgment standard of Rule 56, with reference to the medical records the defendants have submitted. Because Defendant Tuck's motion to dismiss Sprinkle's medical claims relies on records outside the plaintiffs pleadings, the court construes the motion as seeking summary judgment on those claims. Fed. R. Civ. P. 12(b)(6).
Punishments or prison conditions are "repugnant to the Eighth Amendment" if they .. . involve the unnecessary and wanton infliction of pain."
Inadvertent failure to provide treatment, negligent diagnosis problems, and even medical malpractice do not present constitutional deprivations.
The court will assume, for purposes of this opinion, that Sprinkle's medical conditions, including pain associated with his PKD and arthritis, presented serious medical needs. The record indicates, however, that Dr. Ali and Nurse Buschor provided him treatment for his medical conditions, including his chronic pain, as they deemed appropriate in their professional judgment, based on the symptoms they observed during his stay at the jail. Thus, the court finds no genuine dispute of material fact on which a fact finder could conclude that they were deliberately indifferent to Sprinkle's medical needs.
Sprinkle's claims all reflect his disagreement with various treatment decisions the defendants made: not treating chronic pain with narcotics, not treating his pain with the same medication previous doctors had prescribed, not immediately obtaining all his past medical records, not providing him the exact dose of medication recommended by the specialist, and not ensuring that the Lortab prescription would be refilled before it ran out. Sprinkle's complaint ignores or discounts the medical treatment Dr. Ali and Nurse Buschor provided during his brief stay at the jail: monitoring his blood pressure and treating it with medication; evaluating his symptoms of pain and providing non-narcotic pain medication; consulting his past medical records and treating physicians, placing him in the medical unit for closer observation after he claimed he had had a stroke, referring him to a kidney specialist, and providing the type of medication the specialist recommended. In the face of this treatment record, Sprinkle's allegation that the defendants did not treat his chronic pain cannot survive on summary judgment.
Moreover, Sprinkle offers no medical evidence to show that the defendants knew his condition necessitated different treatment than what they provided to him. Under § 1983, the court cannot second-guess Dr. Ali's medical judgment that Sprinkle's behavior at the jail was not consistent with a level of pain that required narcotic medications prescribed by his doctors in the past or, later, with the dosage of Lortab recommended by Dr. Ballinger. Indeed, Sprinkle's medical records from other facilities indicate that other treating physicians had questioned, as Dr. Ali did, whether Sprinkle's desire for narcotic pain medication might be drug-seeking behavior rather than a true medical need for such medication. The record establishes that Dr. Ali and Nurse Buschor, throughout the time Sprinkle was in their care, evaluated his medical needs and provided him with treatment as they deemed appropriate for his symptoms at that time. Sprinkle's self-diagnosed need for different treatment is nothing more than an allegation of negligent diagnosis, which is not actionable under § 1983.
Supervisory officials may generally rely on the opinion of the medical staff as to the proper course of treatment and cannot be vicariously liable for constitutional violations committed by officials under their supervision.
Sprinkle frames his medical claims against "the defendants," a group that includes Captain Tuck. Yet, Sprinkle offers no evidence to contradict Captain Tuck's evidence that as an a jail administrator, she has no role in making decisions about inmates' medical care.
For the reasons stated, the court grants summary judgment on behalf of the defendants as to plaintiff's medical claims and grants their motions to dismiss as to his remaining claims. An appropriate order will issue this day.
The Clerk is directed to send copies of this memorandum opinion and accompanying order to plaintiff.
