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Bristow v. Dulaney

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

June 28, 2017

DR. DULANEY, et al., Defendants.


          Hon. Robert S. Ballon, United States Magistrate Judge.

         Steven Bristow, a Virginia inmate proceeding pro se, commenced a civil rights action pursuant to 42 U.S.C. § 1983. The only remaining defendant is Dr. Dulaney, who is licensed to practice osteopathic medicine in the Commonwealth of Virginia and is a Board Certified Family Physician. Dr. Dulaney provided medical care to inmates at WRSP for two days per week between August 18, 2014, and February 9, 2016. Bristow alleges that Dr. Dulaney was deliberately indifferent to his serious medical condition as he suffered from hemorrhoids which caused bleeding and pain. Dr. Dulaney has filed a motion for summary judgment along and attached a copy of Bristow's relevant medical records relating to Dr. Dulaney's evaluation, diagnoses, and treatment of the hemorrhoid condition for several years. Bristow has responded to the motion, making this matter ripe for disposition. After reviewing the record, I grant Dr. Dulaney's motion for summary judgment because the extensive treatment records do not show that Dr. Dulaney acted with deliberate indifference to Bristow's serious medical need.[1]



         Hemorrhoids are swollen veins located around the anus or in the lower rectum and may cause itching, irritation and pain, fecal leakage, painful bowel movements, and blood on toilet tissue after a bowel movement. Some people also may experience anemia, weakness, and pale skin due to blood loss. A health care provider may diagnose hemorrhoids through both a visual and digital rectal exam.

         Hemorrhoids often go away without any treatment, but treatments are available. Initial treatment may include pain relief, topical treatments, and fiber supplements. If these methods are not successful, a rubber band ligation procedure may be performed, and if not successful, a hemorrhoidectomy may be performed. A rubber band ligation procedure involves cutting off the circulation to the hemorrhoid by placing a rubber band around it, causing it to shrink and fall off within two days. The rubber band is expected to fall off, too, which typically indicates that the procedure was effective.


         The record reflects that Bristow had a ten-plus year history of chronic, but infrequent, internal hemorrhoids before Dr. Dulaney became his physician in August 2014. Bristow's prison health record contains no hemorrhoid complaints between February 2009 and January 2014.

         In February 2014, Bristow complained of blood in his stools. A physician with Wellmont Medical Associates evaluated Bristol in March 2014. That examination was negative for a prolapsed hemorrhoid, nausea, vomiting, abdominal pain, abdominal distention, or external abnormalities. The Wellmont Medical physician diagnosed Bristol with internal hemorrhoids and planned to schedule a colonoscopy and possible rubber band ligation of the hemorrhoid. After the March 2014 examination, however, the Wellmont Medical physician announced his retirement scheduled for June 18, 2014, and recommended Dr. Ernspiker, another physician at Wellmont Medical to take over Bristow's care. A prison facility doctor, thereafter, referred Bristow to Dr. Ernspiker on August 15, 2014.

         In early August 2014, Bristow reported to the medical department at the prison facility that he had bleeding hemorrhoids. A facility doctor examined him, determined he was anemic, and ordered an iron supplement, a complete blood count, a colonoscopy, and rubber band ligation. Dr. Ernspiker performed the colonoscopy and the banding procedure, noting that Bristow tolerated the procedure well. Bristow returned to WRSP on August 26, 2014, and denied feeling any pain, but reported that a rubber band had fallen out.


         Dr. Dulaney first examined Bristow on August 27, 2014, after Bristow returned from the banding procedure. Bristow was alert, oriented, and in no apparent distress. Bristow reported that two more rubber bands came out but denied rectal bleeding. Dr. Dulaney confirmed with Dr. Ernspiker that rubber bands routinely fall out after a rubber band ligation procedure, and she informed Bristow of her conversation with Dr. Ernspiker. Dr. Dulaney also prescribed two tables of Tylenol, 500 mg twice per day for three days to treat pain. A nurse noted that Bristow walked without difficulty and with a steady gain as he left the medical department.

         Bristow complained at the September 4, 2014 sick call of his hemorrhoids and asked to see the doctor. The nurse's notes reflect that Bristow maintained a steady gait, and refused vital sign measurements. The nurse referred him to a doctor for further evaluation.

         Dr. Dulaney evaluated Bristow on September 15, 2014, in the housing pod. Bristow reported swelling, decreased bleeding, decreased pain, a protruding hemorrhoid, and difficulty walking. Bristow's vital signs were stable and he was in no apparent distress. Dr. Dulaney gave him a master pass to come to medical for a rectal examination.

         Dr. Dulaney performed a rectal examination two days later which revealed a three-centimeter prolapsed, non-thrombosed internal hemorrhoid. Initially, Dr. Dulaney ordered that Bristow apply Dibucaine ointment, twice per day, take Preparation-H suppositories, twice per day for thirty days, and use a stool softener, 100 milligrams daily for three ...

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