United States District Court, W.D. Virginia, Roanoke Division
Jeffrey Lyn Underwood, Pro Se Plaintiff; Ashlee A. Webster,
LeClairRyan, Roanoke, Virginia, for Defendant Santos; and
Angela Boice Axselle, Goodman Allen Donnelly, PLLC, Glen
Allen, Virginia, for Defendant Mehmood.
P. Jones, United States District Judge.
Lyn Underwood, a Virginia inmate proceeding pro se, filed
this civil rights action under 42 U.S.C. § 1983.
Liberally construed, Underwood's Complaint alleges that
in violation of his rights under the Eighth Amendment, prison
officials mishandled a guard dog that bit Underwood, causing
injuries for which the defendants, Chauncey Santos, M.D.
(“Dr. Santos”), and Khalid Mehmood, M.D. (Dr.
Mehmood), failed to provide adequate medical treatment. After
review of the record, I conclude that the motions to dismiss
filed by Dr. Santos and Dr. Mehmood must be
time of the alleged violations, Underwood was incarcerated at
Keen Mountain Correctional Center (“Keen
Mountain”). On October 7, 2014, in relation to an
altercation between Underwood and another inmate, a guard dog
bit Underwood's left forearm. Officials transported
Underwood to the emergency room at nearby Clinch Valley
Medical Center (“CVMC”), where medical staff
dressed his wounds and administered an oral antibiotic.
October 9, 2014, Underwood experienced swelling of his left
forearm. The prison doctor referred him to Dr. Santos, a
local orthopedic specialist, for further evaluation and
treatment. Dr. Santos examined Underwood and reported an
multiple puncture wounds especially over the extensor
compartment starting from the proximal third of the forearm
where a 1 centimeter laceration is noted with serous
drainage. There are multiple other lacerations which do not
look as deep. There is moderate swelling of the extensor
compartment. There is no swelling of the flexor compartments.
He has a seventy percent limitation in the range of motion of
the wrist and fingers. There is pain when attempting to
extend the fingers and the wrist. The pain is less intense
when he tries to make a fist although he cannot make a full
fist. He has strong radial pulse. He has good capillary
filling. There is slight redness around the wound area.
Ex. D, at 13, ECF No. 1-2.) Dr. Santos assessed a wound
infection. He noted that Underwood denied any past medical or
surgical history or past hospitalization and that he was
taking an oral antibiotic and Motrin. Dr. Santos reported
advising Underwood that he might have “compartment
syndrome” and that a fasciotomy was a possibility.
(Id.) Dr. Santos then admitted Underwood to CVMC for
IV antibiotics and close observation, and requested an MRI of
the injured arm.
CVMC, Dr. Mehmood supervised Underwood's care that
included administering the antibiotics Dr. Santos had
recommended: “[V]ancomycin and Zosyn.”
(Id. Ex. F, at 19, ECF No. 1-2.) Underwood alleges
that on two occasions, while in the hospital, he went into
what he refers to as “heart failure, ” when his
heart would race at a rate of 197 to 200 beats per minute.
(Compl., at 11, ECF No. 1.) Medical records that Underwood
submitted indicate that because of his episodes of racing
heartbeat, known as supraventricular tachycardia
(“SVT”), Dr. Mehmood transferred Underwood to the
hospital's intensive care unit, administered the drug
adenosine by IV to slow down his heart beat on two occasions,
ordered an echocardiogram, and consulted with a
cardiologist. (Id. Ex. F, at 19, ECF No. 1-2.)
Underwood alleges that Dr. Mehmood told him “something
had trigger[ed] his heart to start beating out of control.
[Underwood] said, “Yeah all that IV medicine bag after
bag is the cause of it!” (Compl., at 12, ECF No. 1.)
Dr. Mehmood said the SVT episodes “came from the
infection in [Underwood's] arm by the K-9 attack dog,
” but Underwood still blamed the IV medication.
(Id.) Underwood submits an untitled internet
description of the medication Vancomycin that indicates
cardiac arrest as a rare, possible side effect in
circumstances of “[r]apid bolus administration”
of the drug. (Id. Ex. B, at 2, ECF No. 57-1.)
submissions indicate that after the interventions Dr. Mehmood
ordered, Underwood's condition had stabilized and his
wound condition had improved by the time Dr. Mehmood
discharged him from CVMC. Underwood returned to the prison on
October 13, 2014, with ongoing oral medications.
following weeks, Underwood experienced similar episodes with
his heart beat racing. Ultimately, he underwent
“ablation of a concealed left lateral accessory pathway
for incessant paroxysmal AVRT” on January 5, 2015, a
“cardiac catheterization” on January 6, and a
second “ablation” surgery in June 2015. (Compl.
Ex. X, at 56, 83, ECF No. 1-2; Compl., at 1, ECF No. 1.)
§ 1983 Complaint, Underwood contends that the medical
care Dr. Santos and Dr. Mehmood provided to him in October
2015 was inappropriate, in violation his constitutional
rights. Specifically, he alleges that Dr. Santos,
when examining him on October 9, 2014, failed to test the
bacterial infection in his arm before prescribing IV
antibiotics. He asserts that the IV antibiotics that Dr.
Santos prescribed, and Dr. Mehmood administered, could have
been “non-active” against the infection in
Underwood's arm and “can cause heart failure if
giv[en] to[o] much.” (Compl., at 28, ECF No. 1.)
Underwood also contends that to continue these IV medications
after he suffered “heart failure” constituted
“deliberate indifference to [his] serious medical needs
in violation of the Eighth Amendment.” (Id.)
Underwood seeks compensatory and punitive damages. Dr. Santos
and Dr. Mehmood have filed separate motions to dismiss, and
Underwood has responded, making these matters ripe for
12(b)(6) motion to dismiss tests the legal sufficiency of a
complaint to determine whether the pleader has properly
stated a plausible claim for relief. See Edwards v. City
of Goldsboro, 178 F.3d 231, 243 (4th Cir. 1999). When
addressing such a motion, the court accepts as true all
well-pled facts and draws “all reasonable
factual inferences from those facts in the plaintiff's
favor.” Id. at 244. However, “[a]
pleading that offers ‘labels and conclusions' or
‘a formulaic recitation of the elements of a cause of
action will not do.' Nor does a complaint suffice if it
tenders ‘naked assertion[s]' devoid of
‘further factual enhancement.'” Ashcroft
v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell
Atl. Corp. v. Twombly, 550 U.S. 544, 555, 557 (2007)).
“A claim has facial ...