United States District Court, E.D. Virginia, Alexandria Division
Calvin N. Bullock, Plaintiff,
Jeff Paul & Dr. Ohai, Defendants.
T. S. Ellis, III United States District Judge
Calvin N. Bullock filed this pro se civil rights action pursuant to 42 U.S.C. § 1983, alleging deliberate indifference to his serious medical needs at Meherrin River Regional Jail ("MRRJ"). The defendants have filed a Motion for Summary Judgment, as well as a memorandum of law and numerous supporting exhibits. Dkt. Nos. 30, 31. Plaintiff was given the Notice required by Local Rule 7(K) and the opportunity to file responsive materials pursuant to Roseboro v. Garrison. 528 F.2d 309 (4th Cir. 1975). Plaintiff has filed a response, and the matter is now ripe for disposition. Additionally, plaintiff has requested appointed counsel in this case. For the reasons that follow, plaintiffs request for appointed counsel must be denied, and defendants' Motion for Summary Judgment must be granted.
I. Undisputed Factual Background
Plaintiff was transferred to MRRJ on or about September 14, 2013. Dkt. No. 31, Ex. 1 ("Paul Dec") ¶ 5; Dkt. No. 31, Ex. A to Ex. 1 ("Med. Rec.") at 69, 73; Dkt. No. 31, Ex. 2 ("Ohai Dec") ¶3. At all times relevant to this lawsuit, Nurse Jeff Paul was the Director of Nursing at MRRJ, and Dr. Paul Ohai was a staff physician at MRRJ. Paul Dec ¶ 1; Ohai Dec. ¶ 1.
On September 18, 2013, Nurse Paul performed plaintiffs initial Patient Health Assessment, and aside from plaintiffs complaint of back pain due to a prior gunshot wound, the assessment was unremarkable. Paul Dec. ¶ 6; Med. Rec. at 74-77; Ohai Dec. ¶ 6. On Monday, October 7, 2013, plaintiff saw Nurse Practitioner Michael Henning regarding complaints that he had passed three kidney stones over the weekend and that he believed he was currently passing another. Paul Dec. ¶ 7; Med. Rec. at 67-68; Ohai Dec. ¶ 7. Plaintiff was prescribed Tylenol and Ibuprofen for the pain, and he was scheduled for a kidney, ureter, and bladder (KUB) x-ray the following day. Id. Nurse Henning instructed plaintiff to follow up with the Medical Unit after the x-ray was completed. Id.
Plaintiff underwent the KUB x-ray on October 8, 2013, and the x-ray results were normal, showing no kidney stones. Paul Dec. ¶8; Med. Rec. at 133; Ohai Dec. ¶ 8. On October 14, 2013, plaintiff was seen again at sick call regarding complaints of continued dysuria (painful urination). Paul Dec. ¶ 9; Med. Rec. at 67, 94; Ohai Dec. ¶ 9. Nurse Henning conducted a prostate specific antigen (PSA) test, which was normal. Id. On November 20, 2013, plaintiff had a follow-up appointment with Nurse Henning. Paul Dec. ¶ 10; Med. Rec. 67; Ohai Dec. ¶ 10. Because plaintiff was in no distress and his dysuria and pain had resolved, he was instructed to follow up with Medical as needed. Id.
On December 13, 2013, plaintiff submitted a sick call request indicating that he was again passing kidney stones. Paul Dec. ¶ 11; Med. Rec. at 6; Ohai Dec. ¶ 11. On December 17, 2013, Nurse Henning saw plaintiff regarding these complaints, and he continued plaintiff on pain medication and referred him to be seen by a facility physician later that week. Id. Then on December 21, 2013, plaintiff was seen by Dr. Edward Boakye, and Dr. Boakye noted that plaintiff believed he had passed his kidney stones and that plaintiff was no longer concerned about it. Paul Dec. ¶ 12; Med. Rec. at 66; Ohai Dec. ¶ 12. Dr. Boakye also noted that plaintiff had recurrent urolithiasis, and he directed plaintiff to increase his daily water intake and reduce the amount of vegetables in his diet that may cause kidney stones. Id.
On February 13, 2014, plaintiff was seen in Medical regarding complaints that he had recently passed another three kidney stones. Paul Dec. ¶ 13; Med. Rec. at 64-65; Ohai Dec. ¶ 13. Plaintiff told Nurse Henning that the stones had passed readily, but with significant pain. Id. Nurse Henning continued plaintiff on pain medication, and he also prescribed plaintiff hydrochlorothiazide, a diuretic that is effective in reducing calcium in urine and reducing kidney stones. Id.
On February 17, 2014, plaintiff was seen at sick call regarding complaints of nosebleeds and dizziness. Paul Dec. ¶ 14; Med. Rec. at 64; Ohai Dec. ¶ 14. Plaintiff also reported that he had recently passed three more small kidney stones, and he was directed to follow up in two weeks. Id. Approximately two weeks later, on March 3, 2014, plaintiff was against seen at sick call for complaints secondary to kidney stones. Paul Dec. ¶ 15; Med. Rec. at 64, 137; Ohai Dec. ¶ 15. Nurse Henning discontinued the hydrochlorothiazide and referred plaintiff for a renal ultrasound to rule out nephrolithiasis. Id. Then, on March 12, 2014, plaintiff underwent a renal sonogram that showed no kidney stones and was normal. Id.
On June 17 and 18, 2014, plaintiff submitted sick call requests complaining of kidney stones and pain, and he was subsequently referred to Dr. Ohai. Paul Dec. ¶ 16; Med. Rec. at 23-24; Ohai Dec. ¶ 16. On June 20, 2014, plaintiff was seen by Dr. Ohai, and Dr. Ohai determined that plaintiff suffered from hematuria (blood in urine) of questionable etiology, but that plaintiff was otherwise clinically stable. Id. Dr. Ohai ordered repeat lab tests, urinalysis, and blood work and directed plaintiff to follow up with medical within 1-2 weeks after the test results became available. Id.
On June 23, 2014, plaintiff submitted another sick call request complaining of blood in his urine and pain with urination. Paul Dec. ¶ 17; Med. Rec. at 25, 62; Ohai Dec. ¶ 17. He was seen that day by Nurse Henning, who noted that plaintiff had a history of nephrolithiasis, and he again scheduled plaintiff to be seen by Dr. Ohai. Id. On June 28, 2014, plaintiff was seen by Dr. Ohai, and this time, Dr. Ohai noted that plaintiff reported he had passed dark colored urine in the past and that he had history of kidney stones. Paul Dec. ¶ 18; Med. Rec. at 61; Ohai Dec. ¶ 18. Dr. Ohai also noted that plaintiff mentioned that he does up to 5, 000 push-ups daily. Id. Dr. Ohai diagnosed plaintiff with possible early rhabdomyolysis due to excessive exercise, and he placed plaintiff on gym restriction for 30 days. Id. Dr. Ohai also continued plaintiff on pain medication and directed that plaintiff be seen in the clinic for follow-up in 3-4 weeks. Id.
On July 7, 2014, plaintiff submitted another sick call request complaining of leg swelling. Paul Dec. ¶ 19; Med. Rec. at 31, 60-61; Ohai Dec. ¶ 19. On July 19, 2014, plaintiff was seen by Dr. Charles Campbell in Medical for evaluation of his swelling in both legs, but at that time plaintiff reported that the swelling had resolved. Id. Plaintiff also reported that he had not had any kidney stones in the last six days. Id. At that time, Dr. Campbell noted that plaintiffs rhabdomyolysis was resolving and his nephrolithiasis was improving. Id. Plaintiff was also counseled on complications of rhabdomyolysis and the importance of increased hydration regarding nephrolithiasis and rhabdomyolysis. Id. On August 23, 2014, plaintiff was seen in Medical by Dr. Ohai for complaints of hematuria and flank pain, as well as recurrent urinary tract infections. Paul Dec. ¶ 20; Med. Rec. at 49, 59; Ohai Dec. ¶ 20. Dr. Ohai prescribed an antibiotic to treat the urinary tract infection, and he ordered a repeat urine analysis in 10-14 days. Id. Dr. Ohai also referred plaintiff for a CT scan of the abdomen and pelvis to rule out recurrent nephrolithiasis versus renal neoplasm (cancer of the kidney). Id. On September 8, 2014, Nurse Paul saw plaintiff for his annual health assessment. Paul Dec. ¶ 21; Med. Rec. at 78-80. At that time, plaintiff had no medical complaints, but he dId. mention a medical history of indigestion, high blood pressure, and hematuria. Id. During this appointment, plaintiff asked Nurse Paul to check on his pending outside referral, and Nurse Paul confirmed with the appointment secretary that an outside appointment had been scheduled for plaintiff on September 10, 2014. Id. Then on September 10, 2014, Nurse Paul received and responded to an Inmate Grievance submitted by the plaintiff regarding his medical treatment for hematuria. Paul Dec. ¶ 22; Med. Rec. at 144-47. At that time, Nurse Paul reiterated the substance of his conversation with plaintiff on September 8, 2014, and explained to plaintiff that he had undergone multiple tests at MRRJ. Id. On the same day, plaintiff was sent offsite, and he underwent a CT scan of the abdomen and pelvis, which showed a small cortical cyst in the right kidney and several small kidney stones, but there were no other significant diagnostic findings. Paul Dec. ¶ 23; Med. Rec. at 138-40; Ohai Dec. ¶ 21.
On September 15, 2014, plaintiff submitted a sick call request indicating that he continued to have blood in his urine and that he wanted to know the results of his CT scan. Paul Dec. ¶ 24; Med. Rec. at 38, 58-59; Ohai Dec. ¶ 22. On September 19, 2014, plaintiff was seen by Dr. Ohai, who reviewed the CT scan and diagnosed plaintiff with chronic nephrolithiasis, right renal cyst, chronic constipation, and chronic back pain due to myositis from strenuous exercise, despite being counseled to stop exercising. Id. Dr. Ohai again strongly recommended that plaintiff stop exercising and increase his fluid intake, and he continued plaintiff on pain medication. Id.
On October 2, 2014, plaintiff submitted another sick call request indicating that he continued to have blood in his urine. Paul Dec. ¶ 25; Med. Rec. at 42, 56-57; Ohai Dec. ¶ 23. On October 13, 2014, he was seen by Nurse Rosla Johnson, and he was scheduled for a rectal exam. Id. On October 19, 2014, plaintiff was seen by Dr. Ohai, and plaintiff reported rectal bleeding for the prior 5-7 days. Id. At that time, plaintiff refused a rectal exam. Id. On October 25, 2014, plaintiff submitted another sick call request indicating that he was continuing to have blood in his urine, and on October 29, 2014, plaintiff was seen by Nurse Johnson. Paul Dec. ¶ 26; Med. Rec. at 44, 51, 55-56; Ohai Dec. ¶ 24. Nurse Johnson conducted a rectal exam, ...