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Underwood v. Beavers

United States District Court, W.D. Virginia, Roanoke Division

September 23, 2016

C. BEAVERS, ET AL., Defendants.

          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.


          James P. Jones, United States District Judge.

         Jeffrey 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 granted.[1]


         At the time of the alleged violations, Underwood was incarcerated at Keen Mountain Correctional Center (“Keen Mountain”).[2] 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.

         On 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 observation of:

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.

         (Compl. Ex. D, at 13, ECF No. 1-2.)[3] 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.

         At 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.[4] (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.)

         Underwood's 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.

         In the 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.)

         In his § 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.[5] 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 disposition.


         A Rule 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 ...

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