Opinion
Civil Action No. 99-3190 (JEI)
July 19, 2002
SCHNADER, HARRISON, SEGAL LEWIS, LLP, By: Louis R. Moffa, Jr., Esq., Cherry Hill, NJ, Attorney for Plaintiff.
MURPHY O'CONNOR, LLP, By: Timothy J. Galanaugh, Esq., Cherry Hill, NJ, Attorney for Defendants.
OPINION
Presently before the Court is the motion for summary judgment of Defendants Frank Mazzone, Marvin Roth, Carol Loller, and Diane North, in this action. Plaintiff Charles Green, an inmate formerly incarcerated at the Atlantic County Justice Facility in Mays Landing, New Jersey, asserts that several employees of the ACJF were deliberately indifferent to his serious medical needs, in violation of the Eight Amendment and 42 U.S.C. § 1983. For the reasons stated below, Defendants' motion will be granted.
I.
In 1996, Plaintiff was initially incarcerated at Ely State Prison in Nevada. On July 16, 1998, Plaintiff was diagnosed with "lateral subluxation of both patellas" and treated with cortisone injections. (Pl. Ex. W-1, Attached to Pl. Answer to Def. Mot. for Summary Judgment). Lateral subluxation of the patella is an incomplete or partial dislocation" of the knee cap. (Dorland's Medical Dictionary, 28th Edition). In January 1999, Plaintiff was released from Ely State Prison and traveled to New Jersey.
The statement of facts is drawn from the medical records presented by both Plaintiff and Defendant in relation to this summary judgment motion.
On January 24, 1999, Plaintiff was arrested on an outstanding bench warrant and incarcerated at the Atlantic County Justice Facility, in Mays Landing, New Jersey. The Plaintiff's intake physical examination report noted his statement concerning the arthritic condition in his knees. On February 10, 1999, Plaintiff was treated for complaints of a sore throat and tingling in his toes, feet, back, and head. On February 21, 1999, Plaintiff again received treatment for tingling in his extremities and head pain. On March 17, 1999, Plaintiff requested treatment for shoulder and knee pain. In response to this request, X-rays were performed on Plaintiff's shoulder and Motrin was prescribed to address the knee pain. (Pl. Ex. A-i). A few days later, in response to the Plaintiff's request, additional pain medication was prescribed for shoulder and knee pain.
On March 29, 1999, Plaintiff sought treatment for knee pain, at which time he specifically requested x-rays and expressed his willingness to pay for the procedure. (Pl. Answer to Def. Mot. for Summary Judgment). The request for x-rays was refused, and Dr. Roth, the treating physician at the facility, instead prescribed Motrin. (Pl. Ex. A-i). On April 4, 1999, Plaintiff received treatment from Dr. Roth for nasal congestion. On April 17, 1999, Plaintiff sought treatment for shoulder and knee pain, and received treatment a few days later. At that time, Dr. Roth again prescribed anti-inflammatory medication and requested the release of Plaintiff's medical records from the Nevada State Prison. (Pl. Ex. A-i).
On April 26, 1999 Plaintiff sent a complaint to Warden Mazzone, stating that Dr. Roth was denying him medical treatment for his knee pain. (Pl. Ex. T-1). Plaintiff contends that Warden Mazzone never responded to this complaint. (Pl. Answer to Def. Mot. for Summary Judgment). Throughout the last week in April 1999, Plaintiff received treatment from Dr. Roth for a facial abscess, but was not treated for knee pain.
On April 30, 1999, Plaintiff sent a complaint to Diane North stating that Dr. Roth was denying him treatment for his knee pain. (Pl. Ex. T-2). Plaintiff contends that North never responded to his complaint. After Plaintiff requested treatment for knee pain on at least two occasions at the beginning of May, Dr. Roth ordered x-rays on the Plaintiff's knees. (Pl. Ex. A-2). On May 19, 1999, Dr. Roth evaluated Plaintiff's x-rays and concluded that the x-rays showed no signs of arthritis. (Pl. Ex. I-i). Plaintiff contends that after he was informed of this diagnosis, he asked Dr. Roth about the possibility of performing further tests, to which Roth responded, "no, who is going to pay for it?" (Green Dep., at 23, Attached to Def. Mot.). Only a few days later, on May 25, 1999, Plaintiff filed a medical request seeking treatment for knee pain. From May 25 through June 1, 1999, Defendant Loller, a nurse at the facility, unsuccessfully attempted to obtain Plaintiff's medical records from the Nevada State Prison.
The record does not clearly demonstrate North's involvement in the incident. The Plaintiffs hand-written medical complaint form addressed to North, refers to her as "Head of Correction Health Care, Inc.," however, this instance is the sole interaction between the Plaintiff and this Defendant.
On May 29, 1999, in response to Plaintiff's medical requests seeking treatment for knee pain, Nurse Loller informed Plaintiff that he would not receive treatment because Dr. Roth had not received the Nevada medical records. On June 1, 1999, Plaintiff filed a medical request seeking treatment for knee pain and was seen by Dr. Roth. On June 3, 1999, Plaintiff filed a medical request seeking treatment for pain in both knees but did not receive treatment. On June 7, 1999, Plaintiff was treated for a pulled neck muscle.
On June 12, 16, 17, 1999, Plaintiff received treatment from Dr. Roth for a nodule. On June 23, 1999, Plaintiff was treated by Dr. Roth and prescribed medication in response to complaints of arm swelling and pain. Beginning in late June and continuing through early July, Plaintiff received treatment from Dr. Roth for a facial abscess. On July 8, 1999, Plaintiff received treatment in response to persistent knee pain and Dr. Roth prescribed 800 mg of Motrin. (Def. Ex. D). On July 17, 1999, Plaintiff was seen by Nurse Loller in response to his request for treatment of a developing rash.
On July 22, 1999, in response to the Plaintiff's request for medical treatment for arm pain and a developing nodule, Plaintiff received treatment from Nurse Loller and was prescribed medication to address the pain and swelling. On July 28, 1999, Plaintiff filed a medical request seeking additional Motrin and vitamins, however, it is unclear whether he received these prescriptions. On August 5, 1999, Plaintiff received treatment in response to his complaints from the previous day of arm pain and a developing abscess. At this time, Dr. Roth prescribed 800 mg of Motrin and other medications. On August 7, 1999, Plaintiff received treatment for irritation and pain in his ear.
On August 17, 1999, Plaintiff was released from the Atlantic County Justice Facility. Plaintiff contends that Dr. Roth did not perform a physical examination of his knees at any point during his treatment, and refused to run further tests after he concluded that the x-rays showed no sign of arthritis. (Pl. Ans. to Def. Mot).
On January 13, 2000, Plaintiff was re-incarcerated at the Atlantic County Justice Facility. On June 24, 2000, Plaintiff was transferred to Bayside Prison. Soon after arriving at this facility, Plaintiff received a number of treatments for knee pain. On October 17, 2000, Plaintiff was referred to an orthopedist who reviewed the original x-rays taken during the Plaintiff's incarceration in Nevada. On November 29, 2000, the orthopedist, Dr. Okezie, examined Plaintiff and ordered x-rays. After reviewing the new x-rays, Dr. Okezie diagnosed the Plaintiff with an arthritic condition in his knees that caused his patella to conjugate with the femur. (Pl. Ex. M-8). Plaintiff was ordered to undergo physical therapy to alleviate pain and received two cortisone injections. (Pl. Ex. M-6, M-7, M-8).
II.
"Summary judgment is proper `if the pleadings, depositions, answers to interrogatories, and admissions on file, together with affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.'" Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986) (quoting Fed.R.Civ.P. 56 (c)).
In deciding a motion for summary judgment, because the role of the court is not "to weigh the evidence and determine the truth of the matter, but to determine whether there is a genuine issue for trial," Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986), the Court must construe the facts and inferences in the light most favorable to the non-moving party. Pollock v. American Tel. Tel. Long Lines, 794 F.2d 860, 864 (3d Cir. 1986). Further, "a party opposing a properly supported motion for summary judgment may not rest upon the mere allegations or denials of his pleadings, but . . . must set forth specific facts showing that there is a genuine issue for trial." Id. at 248 (citations omitted).
III. A.
Defendants contend that they are entitled to summary judgment based on the Plaintiff's failure to comply with the New Jersey "affidavit of merit" statute, N.J.S.A. 2A:53A-27 (2001), which requires a Plaintiff in a medical malpractice action to file an affidavit of a licensed physician asserting that the care provided was substandard. However, as the Plaintiff alleges a violation of the Eighth Amendment, and does not allege a medical malpractice claim, this statute does not apply.
Claimants alleging a constitutional violation in a medical context are not bound to satisfy the state statutory requirements for medical malpractice actions. Freeman v. Fairman, 916 F. Supp. 786, 791 (N.D.I.L. 1996). In Freeman, the District Court for the Northern District of Illinois held that because a constitutional violation is a federal cause of action, Illinois' statutory requirements for medical malpractice actions were inapplicable even though the alleged violation occurred in a medical setting. Id.
This Court has held that when a Plaintiff asserts both a medical malpractice claim and a constitutional violation, the "affidavit of merit" requirement applies only to the malpractice action. Taylor v. Plousis, 101 F. Supp.2d 255, 269 (D.N.J. 2000). In Taylor, this Court held that while the failure to comply with the "affidavit of merit" requirement barred the Plaintiff's medical malpractice claim, the Plaintiff was not precluded from alleging a constitutional violation. Id.
While the Plaintiff in this case alleges a constitutional violation in the context of medical treatment, he does not allege a medical malpractice claim. The Plaintiff's suit, filed pursuant to 42 U.S.C. § 1983, asserts jurisdiction on the basis of a federal question and in no way implicates the New Jersey statutory requirement for medical malpractice actions. Accordingly, because Plaintiff alleges a constitutional violation, Court concludes that he is not required to comply with the "affidavit of merit" statute simply because the alleged constitutional wrong occurred in the course of his medical treatment.
B.
The Plaintiff's suit, filed pursuant to 42 U.S.C. § 1983, alleges a violation his Eighth Amendment rights. Defendants contend that summary judgment is appropriate because the Plaintiff's claim does not demonstrate a constitutional violation.
As the Plaintiff is an incarcerated prisoner, the government is obliged to adequately address his medical needs. Estelle v. Gamble, 429 U.S. 97, 104 (1976). However, as prison officials are afforded significant latitude in the diagnosis and treatment of an inmate's medical requests, "mere" medical malpractice is not sufficient to demonstrate a violation of the Eighth Amendment. Parham v. Johnson, 126 F.3d 454, 458 n. 7 (3d Cir. 1997). Neither a prisoner's difference of opinion on a course of treatment, nor prison officials' inadvertent failure to provide adequate medical care, is sufficient to demonstrate a constitutional violation. White v. Napoleon, 897 F.2d 103, 109-10 (3d Cir. 1990).
On the contrary, "deliberate indifference to [a prisoner's] serious medical need constitutes the `unnecessary and wanton infliction of pain' proscribed by the Eighth Amendment." Estelle, 429 U.S. at 104 (quoting Gregg v. Georgia, 428 U.S. 153, 173 (1976)). Therefore, to prove a constitutional violation a prisoner must demonstrate not only serious medical needs, but also that the Defendants acted with "deliberate indifference" in addressing those needs. Inmates of Allegheny County Jail v. Pierce, 612 F.2d 754, 762 (3d Cir. 1979).
In applying this standard, the Supreme Court has found deliberate indifference when prison officials provided consistently ineffective treatment "in the face of resultant pain." Estelle, 429 U.S. at 110. Moreover, "prison officials may not, with deliberate indifference to the serious medical needs of the inmate, opt for "an easier and less efficacious treatment.'" Monmouth County Correctional Institutional Inmates v. Lanzaro, 834 F.2d 326, 347 (3d Cir. 1987) (quoting West v. Keve, 571 F.2d 158, 162 (3d Cir. 1978)).
Likewise, a prisoner's Eighth Amendment rights are violated when prison officials delay or prevent medical treatment because of a non-medical reason. Rouse v. Plantier, 182 F.3d 192, 197 (3d Cir. 1999). Among the non-medical reasons that may not motivate the prevention of treatment, prison officials may not condition necessary medical services on the "inmate's ability or willingness to pay." Lanzaro, 834 F.2d at 347.
For purposes of the Defendants' motion for summary judgment, and construing the facts in the light most favorable to the non-moving party, the Plaintiff has sufficiently established that the arthritic condition in his knees constitutes a serious medical need. As the Third Circuit has defined a serious medical need as a "[condition] that has been diagnosed by a physician requiring treatment," id., the Plaintiff's previous diagnosis and treatment for arthritis establish the requisite severity.
However, in order to satisfy the second prong of the Eighth Amendment standard, the Plaintiff must demonstrate that each individual Defendant acted with deliberate indifference to this serious medical need. Defendants must have "actual knowledge and acquiescence" or participation in the alleged wrong in order for liability to be proper in a civil rights action. Rode v. Dellarciprete, 845 F.2d 1195, 1207 (3d Cir. 1988). Each individual Defendant must be "personally involved in the alleged wrong." Sunkett v. Misci, 183 F. Supp.2d 691, 710 (D.N.J. 2002) (quoting Santiago v. City of Vineland, 107 F. Supp.2d 512, 540 (D.N.J. 2000)). Consequently, a claim asserted pursuant to § 1983 cannot be predicated solely on respondeat superior. Monell v. New York City Dep't of Social Servs., 436 U.S. 658, 691 (1978). However, while respondeat superior is not alone sufficient, the Third Circuit has "held that `actual knowledge and acquiescence' suffices for supervisory liability because it can be equated with `personal direction' and `direct discrimination by the supervisor.'" Robinson v. City of Pittsburgh, 120 F.3d 1286, 1294 (3d Cir. 1997) (quoting Rode, 845 F.2d at 1207).
Here, the Plaintiff has not demonstrated sufficient involvement of all the named Defendants in the alleged constitutional wrong. The record does not show sufficient involvement on the part of either Loller or North to justify the imposition of liability. At the very most, these Defendants followed Dr. Roth's and Warden Mazzone's directions, but neither was responsible for making decisions about the Plaintiff's medical treatment.
Since the Plaintiff in this case is proceeding in forma pauperis, pursuant to 28 U.S.C. § 1915(e)(2)(B)(i), this Court has discretion to dismiss those claims asserted by the Plaintiff that do not have merit. Therefore, as the Plaintiff has not demonstrated sufficient involvement of either Loller or North, summary judgment is appropriate for both of these Defendants.
In contrast, the record shows sufficient involvement of both Defendants Dr. Roth and Warden Mazzone in the alleged constitutional wrong. Dr. Roth was substantially involved in all of the decisions surrounding the Plaintiff's medical treatment. Furthermore, the Plaintiff's claim against Warden Wazzone is not predicated solely on respondeat superior. Assuming that Plaintiff has demonstrated "deliberate indifference" by Dr. Roth, Warden Mazzone's knowledge and acquiescence of the alleged denial of treatment, demonstrated by the Plaintiff's complaint filed with the Warden's office, (Pl. Ex. T-1), justify the potential imposition of liability.
However, even though Roth and Mazzone were sufficiently involved in the alleged denial of treatment, the record does not demonstrate that these Defendants acted with "deliberate indifference" to the Plaintiff's serious medical need. In response to the Plaintiff's consistent complaints of pain, Dr. Roth ordered x-rays on the Plaintiff's knees. (Pl. Ex. A-2). Dr. Roth then concluded that x-rays showed no signs of arthritis and prescribed anti-inflammatory medication. (Pl. Ex. I-1). While Dr. Roth denied the Plaintiff's subsequent requests for cortisone injections and a specialist referral, he appears to have done so because he believed that the Plaintiff's condition did not warrant such treatment. The record demonstrates that Dr. Roth attempted to address the Plaintiff's continued pain by prescribing additional medications. Even if it is assumed that Dr. Roth was negligent in his diagnosis or treatment of the Plaintiff's condition, this conduct does not rise to the level of a constitutional violation.
Despite the Plaintiff's assertion that Dr. Roth denied treatment due to the Plaintiff's inability to pay, (see Green Dep., at 23), the treatment record does not support that conclusion. Dr. Roth appropriately responded to the Plaintiff's complaints of knee pain by ordering x-rays, (Pl. Ex. A-2), and it was only after Dr. Roth concluded that the Plaintiff did not have arthritis that the Plaintiff's subsequent requests for additional treatment were denied. Furthermore, during the same period in which Plaintiff alleges that Dr. Roth acted with deliberate indifference to his arthritic condition, Roth suitably treated the Plaintiff's other ailments. The record demonstrates the consistency with which Dr. Roth remedied the Plaintiff's non-knee related complaints, without regard to cost. When the Plaintiff's allegations are viewed in the context of the overall treatment provided, Dr. Roth did not act with "deliberate indifference" to the Plaintiff's medical needs. Moreover, because Dr. Roth's conduct was constitutionally sufficient, there is no basis to hold Warden Mazzone liable for his knowledge of and acquiescence in Roth's conduct.
IV.
Because Plaintiff has not presented sufficient evidence of the involvement of either Defendants Loller or North to support the imposition of liability, the Court will enter summary judgment with respect to those Defendants. Furthermore, because Plaintiff has not presented sufficient evidence to demonstrate a violation of his constitutional rights, the Court will enter summary judgment with respect to the remaining Defendants as well. The Court will issue an appropriate order.