Opinion
Case No. 1:19-cv-153
06-20-2019
JAMES T. KNEPP, Plaintiff v. NURSE PARAWAY, et al., Defendants
SUSAN PARADISE BAXTER UNITED STATES DISTRICT JUDGE REPORT AND RECOMMENDATION ON PLAINTIFF'S MOTION FOR TEMPORARY RESTRAINING ORDER
[ECF No. 5] I. Recommendation
It is respectfully recommended that Plaintiff James Knepp's Motion for a Temporary Restraining Order [ECF No. 5] be DENIED. II. Report
Pending before the Court is Plaintiff James Knepp's motion for a temporary restraining order. ECF No. 5. The Court held a hearing on the motion June 19, 2019. At the hearing and in his motion, Plaintiff asserts that he has a heart condition that required admission to UPMC Hamot on February 5, 2019, during which admission he underwent a heart catheterization procedure and several diagnostic tests. ECF No. 5, Ex: 1. He further alleges that he was scheduled for a follow-up appointment with a cardiologist at UPMC Hamot, but was prevented from attending the appointment by prison medical officials. Id. He claims that he is still experiencing the following symptoms emblematic of cardiac issues: chest pain, nausea, left arm and jaw numbness, and rapid heart rate. Id. By way of relief, he asks for an Order of Court directing prison officials to schedule him for an examination by a cardiologist, and for the Defendants to carry out the cardiologist's treatment plan. Id.
During narrative testimony at the hearing, Plaintiff stated that he has had approximately three "episodes" during the last week, but he also acknowledged that he has been seen by prison medical staff in relation to each episode. Plaintiff has not identified any instance when he reported cardiac symptoms that were ignored or went untreated.
The Court has been provided with Plaintiff's medical records which note that cardiology staff at UPMC Hamot performed the following tests on February 5-6, 2019: four EKGs, one chest X-Ray, one catheter lab study, and one echocardiogram with doppler. UPMC Hamot records report findings that include: "Patient has very mild coronary artery disease with normal [left ventricle]"; "EKG demonstrated normal sinus rhythm with possible prior inferior infarct and recent echocardiogram with normal LV ejection fraction and no evidence of wall motion abnormalities"; "Left heart catheterization was performed...and demonstrated no evidence of obstructive CAD [coronary artery disease] nor prior stenting"; and "At this time it is unlikely that the patient's presentation especially in light of the minimal improvement on nitroglycerin is secondary to coronary artery disease." Plaintiff was discharged form UPMC Hamot on February 7, 2019.
A temporary restraining order and/or a preliminary injunctive relief is extraordinary in nature, and is discretionary with the trial judge. Orson, Inc. v. Miramax Film Corp., 836 F. Supp. 309, 311 (E.D. Pa. 1993). In determining whether to grant a motion seeking preliminary injunctive relief, courts in the Third Circuit must consider the following four factors: (1) the likelihood that the applicant will prevail on the merits; (2) the extent to which the movant is being irreparably harmed by the conduct complained of; (3) the extent to which the non-moving party will suffer irreparable harm if the preliminary injunction is issued; and (4) whether granting preliminary injunctive relief will be in the public interest. Bimbo Bakeries USA, Inc. v. Botticella, 613 F.3d 102, 109 (3d Cir. 2010).
The burden of introducing evidence to support a temporary restraining order/preliminary injunction is on the moving party with respect to the first two factors. Acierno v. New Castle County, 40 F.3d 645, 653 (3d Cir. 1994) An absence of either of the first two factors warrants the denial of a request for preliminary injunctive relief. Id.; Adams v. Freedom Forge Corp., 204 F.3d 475, 484 (3d Cir. 2000).
The United States Court of Appeals for the Third Circuit has defined irreparable injury as "potential harm which cannot be redressed by a legal or equitable remedy following a trial." Instant Air Freight, 882 F.2d at 801. A court may not grant preliminary injunctive relief unless "[t]he preliminary injunction [is] the only way of protecting the plaintiff from harm." Id. The relevant inquiry is whether the party moving for the injunctive relief is in danger of suffering the irreparable harm at the time the preliminary injunction is to be issued. SI Handling Sys., Inc. v. Heisley, 753 F.2d 1244, 1264 (3d Cir. 1985).
Also, because the purpose of preliminary injunctive relief is to prevent irreparable injury pending the resolution of an underlying claims on the merits, the injury claimed in the motion for preliminary injunctive relief must relate to the conduct alleged and permanent relief sought in the plaintiff's complaint. The Court of Appeals for this Circuit has recognized that there must be a connection between the underlying complaint and the relief requested in the motion for a preliminary injunction. Ball v. Famiglio, 396 Fed. Appx. 836, 837 (3d Cir. 2010). "In sum, a federal district court lacks jurisdiction over claims raised in a motion for injunctive relief where those matters are unrelated to the underlying complaint." Stewart v. Verano, 2015 WL 1636124, at *2 (M.D. Pa. April 8. 2015).
Upon balancing the above-cited factors, the Court concludes that Plaintiff has not made a showing that he (1) has a substantial likelihood of success on the merits, or (2) will suffer irreparable harm unless the preliminary injunction is issued.
Regarding likelihood of success on the merits, it is a "well-established rule that mere disagreements over medical judgment do not state Eighth Amendment claims." White v. Napoleon, 897 F. 2d 103 (3d Cir. 1990). At this stage of the litigation, neither Plaintiff nor the Court may "substitute [their] desires and opinions for the professional judgments of prison officials[.]" Iseley v. Dragovich, 236 F.Supp 2d 472, 478 (E.D. Pa. 2002).
As stated above, Plaintiff has not identified a single instance during which he had an "episode" that went untreated or was ignored by prison medical staff. Indeed, Plaintiff testified that he has been evaluated and treated on a recurring basis since his February hospitalization. While Plaintiff identified aspects of his treatment plan that he believes may be questionable or inappropriate, this Court is not permitted to second-guess the medical determinations of trained prison medical staff absent evidence of deliberate indifference or compelling medical evidence. No such evidence has been presented. Accordingly, Plaintiff has not shown a likelihood of success on the merits.
Regarding whether Plaintiff will suffer irreparable harm unless the preliminary injunction is issued, the record does not support a finding that Defendants are neglecting his serious medical needs or that Plaintiff's current treatment plan threatens his health. Further, the Court notes that counsel for the medical defendants represented at the hearing that he would follow-up with medical staff at the prison to ensure that Plaintiff's medical needs are being met, and that any recommendations for further consultations or referrals are pursued. Finally, the records of UPMC Hamot reflect that Plaintiff underwent several tests to evaluate his cardiac condition and that he was discharged one day after those tests.
The record presently before the Court includes no documentary support for Plaintiff's assertion that UPMC Hamot personnel recommended a return visit or referral to a cardiologist. --------
Accordingly, I respectfully recommend that the Plaintiff's Motion for a Temporary Restraining Order [ECF No. 5] be denied. It is further recommended that this denial of injunctive relief be without prejudice to Plaintiff's right to seek such relief in the future if either Plaintiff's condition or the quality of Defendants' care deteriorate to the extent that the above-stated reasoning no longer applies.
The parties are hereby notified that pursuant to 28 U.S.C. § 636(b)(1) and Local Civil Rule 72(C)(2), they may file to these findings and recommendations. Such objections must be in writing and must be filed within fourteen days of this date. The failure to file timely objections may constitute a waiver of appellate rights. Angle v. Murin, 2013 WL 5888272, *1 (W.D. Pa. Oct. 31, 2013).
/s/ Richard A. Lanzillo
RICHARD A. LANZILLO
United States Magistrate Judge Dated: June 20, 2019