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Ratcliffe v. Russell

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

March 26, 2018

BOBBY RUSSELL, ET AL., Defendants.

          Matthew Lee Ratcliffe, Pro Se Plaintiff;

          Christopher F. Quirk, Sands Anderson, PC, Richmond, Virginia, for Defendants.


          James P. Jones United States District Judge

         The plaintiff, Matthew Lee Ratcliffe, a Virginia inmate proceeding pro se, filed this civil rights action under 42 U.S.C. § 1983, alleging that he did not receive appropriate medical care for his vision problems while in jail. Upon review of Ratcliffe's Amended Complaint, his exhibits, and the parties' cross motions for summary judgment, I conclude that the defendants' motion must be granted, and that Ratcliffe's motion must be denied.


         A. Undisputed Evidence.

         Ratcliffe was incarcerated at the Western Virginia Regional Jail (“the jail”) in Salem, Virginia, from June 10, 2016, until February 28, 2017.[1] Dr. MacDonald was the jail's Medical Director. According to the jail's procedures, within his training and experience as a primary care physician, Dr. MacDonald evaluated inmates for medical complaints, including declining vision. If he determined that he could not properly treat an inmate's condition, he would order his staff of licensed practical nurses (“LPNs”) to arrange for examination of that inmate by an outside medical specialist.

         During an intake medical review on June 10, 2016, an LPN recorded Ratcliffe's visual acuity test results as 20/20, with no pre-existing vision problems. On July 18, Ratcliffe filed a request for free reading glasses, complaining that the fluorescent lighting was adversely affecting his vision. On August 9, 2016, defendant Deborah Quesenberry, LPN, (“Nurse Quesenberry”) informed Ratcliffe that he could order reading glasses from the commissary, but that she could not provide him with free reading glasses until he had remained indigent for a total of ninety days. After his records showed ninety days of indigency, the nurse provided him with reading glasses on September 27, 2016.

         Nurse Quesenberry performed a visual acuity test on November 4 at Ratcliffe's request. This test is “a subjective exam where the patient indicates his ability to see letters on a chart, which get progressively smaller as the test proceeds.” Mem. Supp. Mot. Summ. J. Ex. 2, Quesenberry Decl. ¶ 5, ECF No. 52-2. Ratcliffe's responses to his test indicated that he had 20/70 visual acuity. The nurse documented these results so the doctor could monitor Ratcliffe's condition and order outside care if he found it to be medically appropriate. As an LPN, Nurse Quesenberry was not licensed to diagnose Ratcliffe's condition herself or to decide whether it required evaluation by an outside specialist or any prescription treatment. Dr. MacDonald states that 20/70 “falls at the lower threshold for moderate low vision.” Id., Ex. 3, MacDonald Decl. ¶ 6, ECF No. 52-3. In the doctor's judgment, this test result did “not present a serious medical need” or warrant evaluation by outside specialist.

         On November 23, 2016, Superintendant Bobby Russell received Ratcliffe's Formal Inmate Grievance Form - Step II, asking for examination by an eye doctor because his visual acuity had tested as 20/70 on November 4. Before responding, Russell reviewed Ratcliffe's medical records. As is his normal practice, Russell deferred to the doctor's medical judgment and advised Ratcliffe, “This measurement does not meet an established level of vision requiring additional treatment. Therefore, you will not be sent to an outside eye specialist at this time.” V.S. Attach. 11, ECF No. 2.

         In January 2016, Ratcliffe filed medical requests complaining that his blurry vision was causing him headaches. Medical staff provided him Tylenol. Ratcliffe also asked for another visual acuity test, lab tests, and Excedrin, but staff refused these requests. They advised him that he could purchase different medication in the commissary. They also informed him that if he disagreed with the opinion of the jail's medical provider about his care, he could see an outside eye doctor if he prepaid the $200 cost. When Ratcliffe's mother brought him eye glasses, the jail would not let him use them at the jail without first seeing an eye doctor.

         On February 10, 2017, the medical staff performed another visual acuity test on Ratcliffe to compare with the test performed in November. This test indicated that his visual acuity was still 20/70. Shortly thereafter, Russell received a second letter from Ratcliffe, complaining about his vision problems. At this point, given Ratcliffe's many complaints about his vision, Russell decided that arranging for Ratcliffe to be evaluated by an outside specialist was “necessary for the orderly administration of medicine” at the jail. Mem. Supp. Mot. Summ. J. Ex. 1, Russell Decl. ¶ 2, ECF No. 52-1. Specifically, Russell thought this referral “could only benefit [Ratcliffe] and potentially reduce the stress that [he] would place on the administrative resources of [the jail] to respond to his myriad complaints.” Id. at ¶ 7. Russell states that in so doing, he “did not second-guess the medical judgment of [the jail's medical] providers regarding [Ratcliffe's] vision requests.” Id.

         After receiving Ratcliffe's February visual acuity test results, Dr. MacDonald evaluated the inmate again on February 17 and performed a fundus examination to check for retina problems, with negative results. Nevertheless, because of Ratcliffe's continued complaints, Dr. MacDonald ordered staff to make arrangements for the inmate to be evaluated by an ophthalmologist. Before an appointment could be secured, however, Ratcliffe was transferred to a state prison facility on February 28, 2017.

         Dr. MacDonald states that he did not “ha[ve] any objective clinical basis to believe that [Ratcliffe] had a serious medical condition that required outside care” while he was incarcerated at the jail. MacDonald Decl. ¶ 8, ECF No. 52-3. The doctor

testif[ies], to a reasonable degree [of] medical certainty, that [Ratcliffe] did not suffer any serious degradation in his vision because he did not see an ophthalmologist after his first eye exam on November 4, 2016 and before February 28, 2017. Any claim that such a delay caused a serious eye injury . . . [is] speculation and inconsistent with his presentation throughout that period.

Id. Dr. MacDonald, Nurse Quesenberry, and Russell state that, at no time, did they believe that Ratcliffe's vision problems required different medical treatment than ...

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