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Tilson v. Humphrey

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

December 18, 2019

JARED TILSON, Plaintiff,
ZOE HUMPHREY, et al.. Defendants.



         This matter comes before the court on defendants' motions to dismiss. Defendants have filed two separate motions-the first filed by defendants Brian Bosserman, Chrystal Boyers, Regina Chestnut, James Doyle, Jeffery Estes, Douglas Grimm, William Lee Hereford, "Officer Carter," Donna Reynolds, Nicholas Shires, Shawn Smals, and the Middle River Regional Jail Authority (MRRJA), ECF No. 9, and the second by defendants Bradford Barker, David Bauguess, Jr., Zoe Humphrey, Barry Munsey, and Stacy Stewart, ECF No. 12. Both sets of defendants argue correspondingly that all claims alleging ordinary negligence against them should be dismissed on the grounds that defendants are entitled to sovereign immunity, and that all claims brought against defendants William Lee Hereford, Regina Chestnut, Donna Reynolds, and Barry Munsey should be dismissed as speculative. See ECF Nos. 10 & 13. Plaintiff Jared Tilson responded in opposition on June 11, 2019. ECF No. 21. Each set of defendants filed a brief in reply-one filed June 14, 2019 by Bosserman, Boyers, Chestnut, Doyle, Estes, Grimm, Hereford, Carter, Reynolds, Shires, Smals, and MRRJA, ECF No. 22, and one filed on June 18, 2019 by Barker, Bauguess, Humphrey, Munsey, and Stewart, ECF No. 23.

         On November 19, 2019, Tilson filed a consent, motion for leave to file an amended complaint, dismiss defendants Bosserman, Carter, Estes, and Shires from this action, and dismiss Tilson's deliberate indifference claim against defendant Doyle. ECF No. 56. This motion was granted. Accordingly, Bosserman, Carter, Estes, and Shires were dismissed from this action, and Doyle was removed from Tilson's deliberate indifference claim.

         For the reasons stated below, the court GRANTS in part and DENIES in part defendants' motion to dismiss.


         Tilson was sentenced to two months incarceration for larceny of a milkshake and ice cream bar at Sheetz gas station. ECF No. 61, at 1. Before he began his sentence, Tilson informed medical staff at MRRJA that he held a prescription for a high dosage of Xanax, had held this prescription for years, and would likely have a seizure if he stopped taking his prescribed dosage suddenly. Id at 2. Tilson was told that MRRJA did not permit benzodiazepines and that Tilson would have to taper himself off his medication. Id. at 12. Tilson attempted to do so but was unable to completely taper himself off his medication before his sentence began. Id.

         Tilson entered MRRJA at approximately 4:30 pm on April 27, 2018. ECF No. 61, at 11. He again informed jail staff that he had been prescribed Xanax and that an abrupt halt in his medication would cause seizures. Id. Tilson's Booking Observation Report reported that he was taking medications and had medical problems, including anxiety, epilepsy, and/or seizures. Id. Tilson did not see a medical staff member to have his "Health History and Assessment" form filled out until April 30, 2018.

         Tilson first complained of symptoms of benzodiazepine withdrawal on April 28, 2018 to defendant Licensed Practical Nurse ("LPN") Stacy Stewart ("LPN Stewart"). ECF No. 61, at 12-13. Tilson complained of a migraine and explained he believed it was caused by the sudden halt in his Xanax dosage. Id. Tilson also mentioned his history of seizures. Id. LPN Stewart gave Tilson Ibuprofen and wrote on his medical chart: "IM c/o migraine has been tapering self off Xanax due to being incarcerated has Hx of seizures gave IM 800 mg Ibuprophen (sic) for headache S Stewart LPN 0235." Id. at 12. No. further action was taken by LPN Stewart. Id. Tilson did not see medical staff again until April 30, 2018.Id.

         On April 30, Tilson met with medical staff and was asked a series of questions by defendant LPN Zoe Humphrey ("LPN Humphrey") regarding his medical history. ECF No. 61, at 12. Tilson told LPN Humphrey that he was prescribed Xanax, that he took between four and six milligrams per day, and that his doctor told him he would have seizures if he stopped taking Xanax. Id. He also told LPN Humphrey that he had been trying to taper himself off his dosage before his incarceration began in response to what an MRRJA medical staff member told him on the phone but had not completely stopped taking his prescribed Xanax before entering MRRJA. Id. Tilson also told LPN Humphrey that he had already had one migraine since entering MRRJA and "was worried about what would happen to him next." Id. at 12 -13.

         At the time of Tilson's incarceration, MRRJA had a Benzodiazepine Taper Protocol and Medical Guidelines for Acute Benzodiazepine Withdrawal. ECF No. 61, at 13. Tilson alleges that, for LPNs Humphrey and Stewart, these protocols and guidelines established medical procedures that were mandatory and "required no appreciable medical discretion." Id. The procedures are alleged as follows:

1. Performing a withdrawal assessment using a CIWA-AR form
2. Taking vital signs
3. Obtaining a urine screen to check for benzodiazepine use
4. Contacting outside primary care doctor, including records request
5. Requesting an appointment with the jail doctor or medical director
6. Requesting an appointment with the jail physician assistant
7. Requesting specialized housing to ensure patient safety
8. Review of policy to ensure quality of care

Id. According to the medical records, LPNs Humphrey and Stewart did not do any of the above tasks listed in the preceding paragraph, with the exception of the one meeting at which LPN Humphrey took Tilson's vital signs when filling out his "Health History and Assessment" form. Id. Tilson makes a number of allegations and alternative allegations regarding LPNs Humphrey and Stewart's conduct, including that they did not follow the above policies and did not report Tilson's self-reported Xanax use and cessation or his migraine, or alternatively, did report the Xanax use, Xanax cessation, and migraine, but proper action was not taken by those to whom LPNs Humphrey and Stewart reported. Id. at 14.

         Tilson also alleges that defendants Registered Nurse ("RN") Regina Chestnut ("RN Chestnut"), RN Donna Reynolds ("RN Reynolds"), Physician Assistant ("PA") Barry Munsey ('TA Munsey"), and Dr. William Hereford ("Dr. Hereford") were subject to procedures establishing mandatory tasks that required no appreciable medical discretion, triggered by Tilson's self-reported regular use of Xanax (prescribed or otherwise):

1. Reviewing, or referring the inmate to psychiatry to review, the medical records of inmates who are reported by LPNs/RNs to be on Xanax and not currently receiving Xanax.
2. Reviewing the medical records of inmates who are reported by LPNs/RNs to be complaining of migraine due to self-tapering off Xanax and not receiving Xanax while in jail.
3. Starting, or referring the inmate to psychiatry to start, the Benzodiazepine/Xanax tapering protocol which includes taking vital signs.
4. Seeing the inmate or referring the patient to Mental Health practitioners to see the inmate, within 72 hours of admission to jail.
5. Reviewing or performing a withdrawal assessment.

ECF No. 61, at 15-16. Tilson alleges that, according to medical records, RN Chestnut, RN Reynolds, PA Munsey, and Dr. Hereford did none of the things listed in the preceding paragraph, and that this failure was a violation of the standard of care. Id. at 16.

         On May 2, 2018, defendant Officer Gary Taylor ("Taylor") wrote in an incident report that Tilson approached him and told him he needed to be moved off the prison pod. ECF No. 61, at 16. Taylor also reported that Tilson was making "strange remarks that didn't make any sense." Id In response, Taylor moved Tilson to segregation and recorded that he needed to see a mental health professional. Id. at 18. Taylor signed his report, as did defendants Shift Supervisor Cp. David Bauguess, Jr. ("Bauguess") and Watch Commander Sergeant Bradford Barker ("Barker"). Standards of procedure required that an inmate entering segregation receive an evaluation of his physical condition from the medical staff. Id. at 16-17. This evaluation was not performed. Id at 17. Tilson alleges that defendants Bauguess, Barker, James Doyle ("Doyle") Chrystal Boyers ("Boyers"), and Douglas Grimm ("Grimm") all served a shift as Shift Supervisor between the time Tilson was moved to segregation and the time he had his seizure, and all failed to ensure Tilson received a medical screening. Id. at 17-18. As the mental health professional who visits MRBJA was ...

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