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Underwood v. Beavers

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

September 26, 2016

C. BEAVERS, ET AL., Defendants.

          Jeffrey Lyn Underwood, Pro Se Plaintiff; Mary Foil Russell, Russell Law Firm, Bristol, Virginia, for Defendant Stephanie Phillips.


          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 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.[1]


         At the 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.

         Dr. Phillips, a physician employed by the Virginia Department of Corrections (“VDOC”), examined and treated Underwood briefly at the prison medical unit.[2] 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.

         When 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.

         On 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. 1-2.)[3]

         Dr. 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.

         Dr. 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.

         The VCU 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.

         Underwood's 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.)

         On 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.

         Dr. 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 ...

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