SUE E. MYERSCOUGH, District Judge.
Plaintiff, proceeding pro se and presently incarcerated at Pontiac Correctional Center, filed a Motion for Temporary Restraining Order and Preliminary Injunction seeking injunctive relief in the form of an order requiring medical staff at the prison to refer him to a urologist. The matter was fully briefed by the parties, and the Court held an evidentiary hearing on Plaintiff's motion on June 30, 2015. The matter is now before the Court for ruling.
Plaintiff is currently incarcerated at Pontiac Correctional Center ("Pontiac"). Plaintiff filed the present lawsuit pursuant to 42 U.S.C. § 1983 alleging deliberate indifference to a serious medical need in violation of the Eighth Amendment. Plaintiff alleges he suffers from an untreated mental illness that manifests itself through self-mutilation (cutting) and other physical self-harm. In his Complaint and the motion now before the Court, Plaintiff alleges that prison officials have failed to remove a foreign object present in his urethra. Plaintiff alleges further that medical staff at Pontiac is not qualified to perform the removal procedure, and, therefore, Plaintiff seeks injunctive relief in the form of an order requiring Pontiac officials to send him to an outside specialist (urologist).
On June 30, 2015, the Court held an emergency evidentiary hearing on Plaintiff's motion for injunctive relief. At the hearing, the Court heard testimony from Plaintiff and Dr. Andrew Tilden, the physician primarily responsible for Plaintiff's medical care at Pontiac. Plaintiff testified that he is currently receiving proper medical care for his mental health issues, but that the foreign object (an ink cartridge from a pen) is still in his urethra and causing him great pain. Plaintiff objects to Dr. Tilden performing the removal procedure on the basis that Dr. Tilden is not a licensed urologist, despite the undisputed testimony that Dr. Tilden has removed foreign objects from Plaintiff's and other prisoners' urethras multiple times in the past. As a result, Plaintiff has refused further medical care at Pontiac.
Plaintiff's allegations stem from a medical examination that occurred in April 2015. Except as noted below, the Court finds the following facts are undisputed: On April 14, 2015, Plaintiff was examined by Dr. Tilden. An x-ray taken a week prior showed a foreign object, 1.5 centimeters in length, lodged in the external opening of Plaintiff's urethra. Upon physical examination, Dr. Tilden observed that no foreign object was palpable in Plaintiff's penis. When Dr. Tilden ordered an x-ray to confirm that no foreign body was present, Plaintiff went to the restroom and made loud noises as if he were in pain. When Plaintiff returned, and upon reexamination, Dr. Tilden observed that a foreign body was now palpable throughout the full length of Plaintiff's urethra. Dr. Tilden believed that Plaintiff had reinserted the foreign object while in the restroom. Nonetheless, Plaintiff refused further medical treatment, including an x-ray, and any attempts to remove the foreign object. Plaintiff became hostile, upset, used foul language, and left the examination room. According to Dr. Tilden, the necessity for an outside specialist depends upon the depth of the foreign object in Plaintiff's urethra. Thus, without an x-ray or further examination, Dr. Tilden could not, upon the discovery of the foreign object, ascertain the degree of medical treatment necessary to remove it. While Plaintiff claims x-rays were taken prior to his examination on April 14, 2015, and that his cries of pain while in the restroom were due to the foreign object's continuing presence in his urethra, and not its reinsertion, Plaintiff does not dispute that he refused further medical care. Nor do the parties dispute that Plaintiff has not since been examined for this alleged malady. Defendants maintain that medical care for this condition is, and has been, available to Plaintiff.
A preliminary injunction is "an extraordinary and drastic remedy, one that should not be granted unless the movant, by a clear showing, carries the burden of persuasion."
The Prisoner Litigation Reform Act (PLRA) limits the scope of the court's authority to enter an injunction in the corrections context.
The purpose of a temporary restraining order and ultimately a preliminary injunction is to preserve the status quo pending a final hearing on the merits of the case.
To succeed on a claim for inadequate medical care, the Plaintiff must show that the prison official acted with deliberate indifference to a serious medical need.
"A prison physician is not required to authorize a visit to a specialist in order to render constitutionally acceptable medical care. Like other medical decisions, the choice whether to refer a prisoner to a specialist involves the exercise of medical discretion, and so refusal to refer supports a claim of deliberate indifference only if that choice is "blatantly inappropriate."