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Freeman v. Wells

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

July 18, 2019

D. WELLS, et al., Defendants.


          Robert S. Ballou United States Magistrate Judge.

         Plaintiff Joshua A. Freeman, a Virginia inmate proceeding pro se, filed a civil rights action pursuant to 42 U.S.C. § 1983, against Nurses Wells, Crawford, Parks, and Sellers, and Dr. Stevens, alleging that they denied him adequate and timely medical treatment for his ulcerative colitis while he was a prisoner at River North Correctional Center (River North).[1] Defendants' motion for summary judgment is ripe, and having considered the record and for the reasons stated, I grant Defendants' motion for summary judgment and dismiss this action.[2]

         I. BACKGROUND

         Freeman was diagnosed with ulcerative colitis[3] in 2013. In June 2016, Freeman suffered a “flare up” of his condition which was successfully treated with medication, including mesalamine, MyTab, Metamucil, and Prilosec. Freeman alleges that on December 14, 2016, he experienced symptoms of an ulcerative colitis flare up, and submitted a request for services to the medical department the following day asking to be seen as soon as possible “before the symptoms worsen.” Defendant Nurse Crawford responded the next day and indicated that Freeman was on a list to be seen by the doctor.

         On December 19, 2016, Freeman saw defendant Nurse Parks for a sick call evaluation and advised her that his symptoms were “persistent” and that he was experiencing increased rectal bleeding and mucus discharge, abdominal pains, and discomfort. Nurse Parks told Freeman that she would place him on a list to see the doctor and advised him to return to the medical department if his condition worsened. Freeman states that Nurse Parks refused to provide or request an order of pain medication to alleviate his severe abdominal pains. Freeman contends that Nurse Parks was “fully aware” of his rectal bleeding and mucus discharge, and that he asked her for pain medication “to alleviate some of the pains and discomfort that he was experiencing, but [she told him] that he had to see the doctor first.” Freeman claims that Nurse Parks “completely ignored [his] symptoms of pain and chose to let [him] suffer . . . .” Freeman further claims that nurses did not give offenders, including him, access to nurses during cell rounds, stating specifically that nurses “will not stop at an offender['s] door to conduct sick call, ” but instead will instruct the inmate to submit a sick call request. Freeman asserts that because he did not get treatment for his medical condition, despite submitting sick call requests, he had no access to medical care while waiting to see the doctor.

         Nurse Parks claims in her sworn declaration that she medically evaluated Freeman on December 19, 2016, and that he reported “persistent exacerbation of his pre-existing ulcerative colitis.” She states that Freeman “mentioned abdominal pain and discomfort but there were no reports of rectal bleeding.” Nurse Parks states that “[c]omplaints of abdominal pain and discomfort were consistent with [Freeman's] GERD and . . . colitis, ” so she placed Freeman on the list to see the doctor “during the next available time.” Nurse Parks avers that she “did not objectively observe [Freeman] to be in acute distress [or] in unbearable or considerable pain.” Nurse Parks maintains that after placing Freeman in line to see the doctor, he “still had access to medical care and to the nursing staff” during cell rounds, in the event his condition worsened.

         There is no evidence that Freeman submitted any grievances, made any emergency request for treatment or otherwise complained about his condition again until December 27, 2016. At that time, Freeman filed an emergency grievance for medical care claiming that he was “experiencing symptoms and had developed an unbearable pain in [his] lower left abdomen.” Defendant Nurse Wells responded that evening and determined that his grievance did not present an emergency situation. She advised Freeman that he was on the doctor's list.

         Nurse Wells served as the Director of Medical Services at River North during the period that Freeman complains that he did not receive adequate medical treatment for his condition. Nurse Wells responded to several of Freeman's grievances concerning medical treatment that he received for his condition. She states that Freeman's grievances were “reviewed, investigated appropriately, and timely addressed” and that Freeman had access to nurses during cell rounds. If a nurse or an officer “objectively observed” Freeman “to be in acute distress, considerable or unbearable pain, or to be experiencing a medical emergency, ” Freeman “would have been brought to medical for evaluation.” Freeman's reported symptoms of bleeding, abdominal pain, and mucus in his stool were consistent with and expected for someone with ulcerative colitis. Nurse Wells states that Freeman “received a variety of medications to try to relieve his symptoms, lessen his abdominal pain, and improve his overall comfort level.” Freeman contends that his condition was in fact an emergency requiring immediate medical treatment as reflected by his December 27, 2016 emergency grievance which informed the medical department that his pain had become “unbearable” and that he was “experiencing all of the symptoms of ulcerative colitis.” Freeman argues that the determination by Nurse Wells that his condition was not an emergency without examining him demonstrates that his grievances were not “investigated appropriately.” He also challenges Nurse Wells's assertion that nurses made cell rounds claiming that “[n]o nurses ever rounded on [him] while he was in his cell suffering for 25 days from severe abdominal pains and rectal bleeding.” Finally, Freeman disputes Nurse Wells' assertion that he received various medications. Instead, he contends that, during the twenty-five days that he suffered in pain from December 14, 2016 until he saw the doctor on January 10, 2017, he “received no medication other than Metamucil, ” which he did not receive until January 4, 2017, and which aggravated his symptoms.

         Defendants maintain that Freeman was placed on the doctor's list on December 19, 2016 and would have been seen by a doctor by January 2, 2017, but the facility went on security lockdown from December 27, 2016 through January 3, 2017. During lockdown, only inmates with urgent medical issues are seen by a doctor, and ulcerative colitis “is not considered an urgent medical issue requiring immediate evaluation.” The lockdown ended on January 3, 2017, and the facility rescheduled missed doctor's appointments based on urgency.

         On January 3, 2017, Freeman submitted another emergency grievance to the medical department complaining that he was experiencing “severe symptoms of ulcerative colitis, ” including abdominal pain, rectal bleeding, and mucus discharge for approximately nineteen days. Freeman stated that his bleeding was more frequent and heavy and that the symptoms were “far [] worse” than they had been. He also stated that he still had not seen or been treated by a doctor. Nurse Crawford responded that morning, indicating that Freeman's grievance was not an emergency, that Freeman had been placed on the list to be seen by the doctor, and advised him to submit a medication renewal request. Nurse Crawford states in her declaration that on January 3, 2017, she “reviewed a medicine renewal request” from Freeman for mesalamine enemas, that Dr. Stevens approved the request and that Freeman received the medication “he requested.”[4]Freeman maintains that he never submitted a medical renewal request, that he was not “on any medication for the treatment of ulcerative colitis to [be able] to request a renewal, ” and that he did not receive mesalamine enemas until January 10, 2017, the day on which he saw Dr. Stevens. Freeman suggests that Nurse Crawford “ignor[ed]” his “pleas for help, ” despite knowing that his symptoms had worsened and he continued to suffer in pain for nineteen days.

         Freeman also filed a request for services on January 3, 2017, indicating that he had been waiting nineteen days to see a doctor while he suffered a “constant aching pain, ” as well as blood and mucus in his stool. Nurse Sellers responded the next day by indicating that was on the list to see the doctor.

         On January 10, 2017, Dr. Stevens saw Freeman who described the severity of his abdominal pains and advised Dr. Stevens that he was still defecating blood. Dr. Stevens determined that Freeman should “continue” the psyllium fiber medication (Metamucil). Freeman states that he showed Dr. Stevens that he should not take that medication because it “shouldn't be provided to a person suffering from abdominal pains and rectal bleeding.” Freeman claims that he also informed Dr. Stevens that psyllium fiber “is not a medication to treat [u]lcerative [c]olitis.”

         According to Freeman, Dr. Stevens disregarded everything that Freeman told him and continued the psyllium fiber medication. When Freeman advised Dr. Stevens that he had not been provided pain medication for twenty-five days, Dr. Stevens told Freeman to utilize “sick call procedures and inform the nurses that you are in pain.” Freeman told Dr. Stevens that he filed two emergency grievances and that with both he was told the grievance was deemed not an emergency with responses which stated that he was on the doctor's list. Freeman explained that he also informed “multiple nurses” that he was in pain and he was told that he needed to see a doctor first. Freeman allegedly told Dr. Stevens that he was still having severe abdominal pains and would like to be prescribed a pain medication, but Dr. Stevens did not prescribe pain medication. Freeman also asked why he had not been prescribed an antibiotic to “fight off any infections that may have arisen due to the damaging inflammation and the daily bleeding, ” and Dr. Stevens said that he did not believe that Freeman had any infections in his body. Freeman asked him how he could know since no blood or stools were tested since June 2013. Dr. Stevens did not answer Freeman's question, but he said he would submit a referral for a gastroenterology consultation and order lab work. Freeman continued to suffer “severe abdominal pains and daily rectal bleeding” for nearly a month until February 7, 2017, when the symptoms “diminish[ed].”

         Dr. Stevens explains that there are “many appropriate ways to treat ulcerative colitis” and that he examined Freeman on January 10, 2017 which included taking a history, performing a physical examination and providing Freeman medications to treat his medical conditions. Dr. Stevens noted that Freeman had chronic symptoms of ulcerative colitis and that Freeman reported abdominal pain, mucus, and bleeding. Dr. Stevens did not “objectively observe” Freeman in acute distress or “in unbearable or considerable pain.” Dr. Stevens ordered that Freeman “continue to receive” mesalamine, Metamucil, and prilosec. Dr. Stevens also added MyTab to Freeman's medications and requested a gastroenterology consult for Freeman to be examined for potential colonic malignancies and ulcerations. Dr. Stevens stated that non-steroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen can “trigger or worsen” the symptoms of ulcerative colitis, that opioids can cause gastrointestinal side effects, and that acetaminophen has possible side effects of nausea, stomach pain, diarrhea, and loss of appetite. While Dr. Stevens avers that “[t]hese recognized side effects would be problematic ...

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