United States District Court, W.D. Virginia, Roanoke Division
Jeffrey Lyn Underwood, Pro Se Plaintiff; Mary Foil Russell,
Russell Law Firm, Bristol, Virginia, for Defendant Stephanie
OPINION AND ORDER
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
employees wrongfully attacked Underwood with a guard dog,
causing injuries for which the defendant, Stephanie Phillips,
D.O. (“Dr. Phillips”), and others failed to
provide adequate medical treatment. After review of the
record, I conclude that Dr. Phillips' Motion for Summary
Judgment must be granted.
time of the alleged violations, Underwood was incarcerated at
Keen Mountain Correctional Center (“Keen
Mountain”). On October 7, 2014, in relation to
Underwood's altercation with another inmate, a K-9
officer directed his dog to attack Underwood. From the
encounter with the dog, Underwood sustained multiple puncture
wounds and lacerations on his left forearm.
Phillips, a physician employed by the Virginia Department of
Corrections (“VDOC”), examined and treated
Underwood briefly at the prison medical unit. Then, officials
transported him to the nearby Clinch Valley Medical Center
(“CVMC”) emergency room, where medical staff
dressed his wounds and administered an oral antibiotic.
Underwood returned to Keen Mountain, Dr. Phillips
re-evaluated him and placed him in the medical unit for two
days for monitoring and observation of his wounds. His
continuing care plan included antibiotics, twice daily
dressing changes, and an urgent referral to an orthopedist.
October 9, 2014, Dr. Chauncey Santos, a local orthopedist,
evaluated Underwood's injured arm. A nurse in Dr.
Santos' practice notified Dr. Phillips later that day
that Dr. Santos was admitting Underwood to CVMC for IV
antibiotics, based on his concern about a high possibility of
compartment syndrome (a buildup of pressure in an enclosed
compartment of muscles in the body). While Underwood was
hospitalized at CVMC, he experienced two episodes when his
heart rate became elevated - a cardiac condition known as
supraventricular tachycardia (“SVT”). The
hospital doctor, Dr. Mehmood, placed Underwood in the
intensive care unit and successfully treated him
intravenously with a drug that slowed his heart beat to a
more normal rate. When Underwood's condition had
stabilized and his wound condition had improved, Dr. Mehmood
discharged him on October 13. In his discharge summary, Dr.
Mehmood recommended, among other things, “follow up
with electrophysiologist as outpatient” regarding
Underwood's SVT episodes. (Compl. Ex. F, at 20, ECF No.
Phillips re-evaluated Underwood on October 14, 2014, and
wrote orders for a non-emergency cardiology referral to
Virginia Commonwealth University (“VCU”) via
telemedicine (“telemed”) for evaluation of
Underwood's SVT issues. She also placed a quality medical
control (“QMC”) request for approval by VDOC
medical staff of the VCU telemed referral, per standard
protocol for any medical consultation for a VDOC prisoner
with a physician outside the prison. In addition, Dr.
Phillips also wrote orders for antibiotics, pain medication,
an extra pillow to elevate the injured arm, and a follow up
with the orthopedist. She scheduled a follow up appointment
with Underwood in two days to check his wounds and ordered
daily wound dressing along with other nursing care. At that
visit on October 16, Dr. Phillips noted that Underwood's
vital signs were stable, there was no sign of infection, and
he was doing well.
Phillips evaluated Underwood again on October 23, 2014. She
noted no complaints of palpitations or chest pain. His vital
signs were stable, and his wounds were healing well. Dr.
Phillips reviewed with Underwood reasons that he should alert
the medical department, and he indicated his understanding of
these instructions. Underwood also had follow up evaluations
with Dr. Santos. When he filed inmate request forms or
complaints in October and November, asking about his
appointment with the heart specialist, staff responded that
it was in the process of being scheduled.
telemed appointment with a cardiologist that Dr. Phillips had
requested for Underwood was approved and scheduled for
December 17, 2014. In the meantime, Dr. Phillips evaluated
Underwood on November 18 for complaints of occasional heart
fluttering. She found his pulse to be normal at that time,
but until he could be assessed by the cardiologist, she
adjusted Underwood's Metroprolol dosage. Metroprolol is a
common medication used with SVT patients to control the heart
rate. On December 7, in preparation for the upcoming
cardiology visit, Underwood underwent an electrocardiogram
(“EKG”). The test reflected that his pulse rate
was well controlled at 80 beats per minute.
VCU telemed appointment occurred as scheduled on December 17,
2014. Underwood alleges that he was told during the visit
that “the [E]KG heart test showe[d] [his] heart was
beating way to[o] fast and he would be scheduled to see the
heart specialist.” (Compl., at 20, ECF No. 1.) On
December 26, Dr. Phillips reviewed with Underwood the
cardiologist's notes from the telemed consultation.
Following standard procedure as Underwood's primary
physician, Dr. Phillips had transcribed the
cardiologist's notes into Underwood's chart and had
written orders as the cardiologist had requested, to be
carried out by the nursing and scheduling staff. As the
cardiologist had requested, Dr. Phillips placed orders for
Underwood to be assessed at the Medical College of Virginia
(“MCV”) electrophysiology clinic - for routine
outpatient follow up regarding his heart rhythm issue, rather
than for an emergency or urgent intervention. Dr. Phillips
also noted the cardiologist's diagnosis of
Underwood's condition as “AV nodal reentrant
tachycardia, ” a non-emergency condition. (Phillips
Decl. ¶ 22, ECF No. 59-1.)
December 30, 2014, Underwood presented to the Keen Mountain
medical unit with complaints of dizziness, severe chest pain,
and feeling like he was going to pass out. Dr. Phillips
assessed him and had someone immediately call for an
ambulance. Keen Mountain staff stabilized Underwood with
oxygen, administered aspirin 81 mg, and obtained an IV line
in preparation for ambulance transport. Underwood went first
to the CVMC emergency room for evaluation and was
hospitalized at CVMC until January 2, 2015, when he was
transported to MCV and admitted to the hospital there.
Phillips did not see Underwood again after preparing him for
ambulance transport on December 30, 2014, and was not
involved in his medical care after that point. She ...