Opinion
3:22-cv-135 Johnstown
01-14-2023
WARREN EASLEY, Plaintiff v. CRNP BLOOM, et al., Defendants
RICHARD A. LANZILLO, CHIEF UNITED STATES MAGISTRATE JUDGE
REPORT AND RECOMMENDATION ON PLAINTIFF'S MOTION FOR TEMPORARY RESTRAINING ORDER [ECF NO. 14]
SUSAN PARADISE BAXTER, UNITED STATES DISTRICT JUDGE
MAGISTRATE JUDGE'S REPORT AND RECOMMENDATION
I. Recommendation
It is respectfully recommended that Plaintiff Warren Easley's Motion for Temporary Restraining Order [ECF No. 14] be denied.
II. Report
Plaintiff Warren Easley is an inmate in the custody of the Pennsylvania Department of Corrections (DOC), currently incarcerated at the State Correctional Institution at Houtzdale (SCI-Houtzdale). Pending before the Court is Easley's Motion for Temporary Restraining Order. ECF No. 14. In his motion, Easley maintains that prison officials are denying him necessary mental health treatment in retaliation for his use of the inmate grievance system. ECF No. 14, pp. 1-2. Easley seeks an order directing the Defendants to provide him with “[an] appropriate mental health course of proper and just mental health treatment.” ECF No. 14, p. 1. For the reasons discussed below, it is respectfully recommended that the motion be denied.
III. Background
According to Easley, he attempted suicide with a razor on August 4, 2022, while incarcerated at SCI-Houtzdale. ECF No. 14-2 ¶ 5. He received stitches and a visit from Defendant Bloom, a psychiatric nurse practitioner, and Defendant Bresnahan, a licensed psychologist manager. Id. ¶¶ 6-7. Easley avers that Defendants were abrasive and confrontational, refused to place him in a psychiatric observation cell, and discontinued his psychiatric medications without a clinical evaluation in retaliation for “plaintiff having a mental health crisis.” Id. ¶¶ 8-10. Defendants later changed Easley's psychiatric designation from “c-code” to “b-code,” indicating that he had no mental health issues, allegedly to deprive him of mental health care in retaliation for his grievance activity. Id. ¶¶ 22-24. As a result, Easley has suffered insomnia, depression, anxiety, mood swings, impulse issues, and thoughts of self-harm. Id. ¶ 11.
IV. Standards of review
To obtain the “extraordinary remedy” of a temporary restraining order or preliminary injunction, the moving party must establish: “(1) a likelihood of success on the merits; (2) that [he] will suffer irreparable harm if the injunction is denied; (3) that granting preliminary relief will not result in even greater harm to the nonmoving party; and (4) that the public interest favors such relief.” Kos Pharm., Inc. v. Andrx Corp., 369 F.3d 700, 708 (3d Cir. 2004). The plaintiff's failure to demonstrate either a likelihood of success on the merits or irreparable harm precludes injunctive relief. Hohe v. Casey, 868 F.2d 69, 72 (3d Cir .1989). The irreparable harm alleged must be actual and imminent, not merely speculative. “[A] showing of irreparable harm is insufficient if the harm will occur only in the indefinite future. Rather, the moving party must make a clear showing of immediate irreparable harm.” Campbell Soup Co. v. ConAgra, Inc., 977 F.2d 86, 91 (3d Cir. 1992) (internal quotations omitted).
In the instant case, Easley's Eighth Amendment claim against prison medical professionals is based on alleged deliberate indifference to his mental health needs. To demonstrate a likelihood of success on the merits of this claim, Easley must adduce evidence to support the existence of: (1) a serious medical need, and (2) acts or omissions by prison officials that indicate deliberate indifference to that need. Rouse v. Plantier, 182 F.3d 192, 197 (3d Cir. 1999). Such indifference is manifested by an intentional refusal to provide care, delayed medical treatment for non-medical reasons, denial of prescribed medical treatment, a denial of reasonable requests for treatment that results in suffering or risk of injury, Durmer v. O'Carroll, 991 F.2d 64, 68 (3d Cir. 1993), or “persistent conduct in the face of resultant pain and risk of permanent injury.” White v. Napoleon, 897 F.2d 103, 109 (3d Cir. 1990).
Allegations of deliberate indifference must satisfy “a high threshold.” Anderson v. Bickell, 2018 WL 5778241, at *2 (3d Cir. Nov. 2, 2018). It is well-settled that “an inmate's dissatisfaction with a course of medical treatment, standing alone, does not give rise to a viable Eighth Amendment claim.” Tillery v. Noel, 2018 WL 3521212, at *5 (M.D. Pa. June 28, 2018) (collecting cases). Such complaints fail as constitutional claims because “the exercise by a doctor of his professional judgment is never deliberate indifference.” Gindraw v. Dendler, 967 F.Supp. 833, 836 (E.D. Pa. 1997) (citing Brown v. Borough of Chambersburg, 903 F.2d 274, 278 (3d Cir. 1990) (“[A]s long as a physician exercises professional judgment his behavior will not violate a prisoner's constitutional rights.”)). “Therefore, where a dispute in essence entails nothing more than a disagreement between an inmate and doctors over alternate treatment plans, the inmate's complaint will fail as a constitutional claim under § 1983.” Tillery, 2018 WL 3521212, at *5 (citing Gause v. Diguglielmo, 339 Fed.Appx. 132 (3d Cir. 2009) (characterizing a dispute over medication as the type of “disagreement over the exact contours of [plaintiff's] medical treatment” that does not violate the constitution)).
By the same token, “the mere misdiagnosis of a condition or medical need, or negligent treatment provided for a condition, is not actionable as an Eighth Amendment claim because medical malpractice standing alone is not a constitutional violation.” Tillery, 2018 WL 3521212, at *5 (quoting Estelle, 429 U.S. at 106). “Indeed, prison authorities are accorded considerable latitude in the diagnosis and treatment of prisoners.” Durmer, 991 F.2d at 67 (citations omitted). Thus, “courts have consistently rejected Eighth Amendment claims where an inmate has received some level of medical care.” Hensley v. Collins, 2018 WL 4233021, at *3 (W.D. Pa. Aug. 15, 2018) (quoting Clark v. Doe, 2000 WL 1522855, at *2 (E.D. Pa. Oct. 13, 2000)). See also Wisniewski v. Frommer, -- Fed.Appx. --, 2018 WL 4776165, at *3 (3d Cir. Oct. 3, 2018) (noting that “there is a critical distinction ‘between cases where the complaint alleges a complete denial of medical care and those alleging inadequate medical treatment.'”) (quoting Pearson v. Prison Health Serv., 850 F.3d 526, 535 (3d Cir. 2017)).
V. Analysis
The Court conducted a hearing by video on Easley's motion on November 29, 2022. In support of his motion, Easley testified that, during the twelve years prior to his arrival at SCI-Houtzdale, he had consistently received mental health medications and regular psychiatric care. Upon his transfer to SCI-Houtzdale, however, he was not initially given an opportunity to be seen by a psychiatric review team (“PRT”) to review his mental health treatment plan. After he filed a grievance to that effect, he asserts that Defendants continued to refuse to meet with him. Defendants eventually discontinued his medications without conducting a clinical evaluation. Easley maintains that the discontinuation of his medications represented an act of retaliation rather than an exercise of professional medical judgment.
In response, the Defendants have proffered Easley's medical records from the timeframe at issue. These records document that Easley was given a mental health assessment upon his initial reception at SCI-Houtzdale. Easley expressed frustration with his transfer to SCI-Houtzdale but denied any acute mental health issues. His notes indicate that he was taking four psychiatric medications at that time: Buspar, Remeron, Sinequan, and Tegretol. Easley reported that his medications were not as effective as they used to be and was advised to discuss his medication needs with psychiatry.
Shortly thereafter, Easley met with a medical professional to discuss his mental health care. Notes from that meeting indicate that the medical professional was skeptical as to the need for further medication:
Medications unlikely having much of an effect and presentations seen likely based on motivations and goals. May be prudent to come up with updated plan of action for managing acting out behaviors.
On July 12, 2022, Defendant Bloom responded to a request from Easley concerning his medications. Bloom noted the following impressions:
Mr. Easley does not present with any signs of objective signs of mental illness. Reviewing long history of violence and acting out, previous psychiatric records indicate Mr. Easley begins acting out when he does not get what he wants and is in control of his actions. This is inconsistent with intermittent explosive disorder so this diagnosis will be discontinued. History and presentation is consistent with antisocial personality traits. Will work with Mr. Easley in order to avoid acting out
actions on his part. No psychiatric indications for these medications otherwise. If Mr. Easley again begins acting out, would recommend considering d/c'ing medications at that time as there would no longer be an indication of preventing acting out behaviors on his part.
On August 4, 2022, Bloom entered the following note in response to Easley's threats of self-harm:
Mr. Easley is making conditional threats of suicide which are inconsistent with genuine suicidal ideation. History and presentation consistent with an individual who attempt to use anger and threats of violence to exert his will on others. Given history high likelihood of following through with these threats as well if given the opportunity. Presentation consistent with aspd and so IED dx will be removed as previously discussed. As there is no indication for psychiatric medication other than prevention of acting out and he is acting out anyways will discontinue his psychiatric medication at this time as the risks do not outweigh the benefits (as no benefits are being seen).
Based on these records, the Court concludes that Easley has failed, at this stage in the proceedings, to demonstrate a reasonable likelihood that he will succeed on the merits of his claim. Although Easley asserts that Defendants' decision to change his mental health code and deprive him of psychiatric medications stemmed from retaliatory animus rather than an exercise of medical judgment, his medical records belie this averment. Instead, a careful review of those records indicates that Bloom and the medical staff at SCI-Houtzdale discontinued Easley's medication because they believed it was ineffective and unnecessary. While Easley plainly disagrees with that diagnosis, “the exercise by a doctor of his professional judgment is never deliberate indifference.” Gindraw v. Dendler, 967 F.Supp. 833, 836 (E.D. Pa. 1997) (citing Brown v. Borough of Chambersburg, 903 F.2d 274, 278 (3d Cir. 1990) (“[A]s long as a physician exercises professional judgment his behavior will not violate a prisoner's constitutional rights.”)). “Therefore, where a dispute in essence entails nothing more than a disagreement between an inmate and doctors over alternate treatment plans, the inmate's complaint will fail as a constitutional claim under § 1983.” Tillery, 2018 WL 3521212, at *5 (citing Gause v. Diguglielmo, 339 Fed.Appx. 132 (3d Cir. 2009) (characterizing a dispute over pain medication as the type of “disagreement over the exact contours of [plaintiff's] medical treatment” that does not violate the constitution)). Such is the case here.
Given the nascent state of this litigation, the record is admittedly incomplete. Discovery may ultimately reveal evidence that Defendants' decision to discontinue Easley's medication stemmed from something other than an exercise of medical judgment; for example, that it was made in the absence of a clinical examination or thorough review of his records. Based on the record available, however, the Court concludes that Easley has failed to meet his burden of demonstrating a likelihood of success on the merits. Under such circumstances, his motion must be denied.
V. Conclusion
Because Easley has failed to demonstrate a reasonable likelihood of success on the merits if the injunction is not granted, it is respectfully recommended that his motion be DENIED.
VI. Notice
In accordance with the applicable provisions of the Magistrate Judges Act, 28 U.S.C. § 636(b)(1)(B) & (C), and Rule 72.D.2 of the Local Rules of Court, Plaintiff shall have fourteen (14) days from the date of the service of this Report and Recommendation to file written objections thereto. Plaintiff's failure to file timely objections will constitute a waiver of his appellate rights.