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DeAngelis v. Farinella

United States District Court, D. Connecticut

October 18, 2017

MONICA FARINELLA, et al., Defendants.



         The plaintiff, Jeffery DeAngelis, commenced this civil rights action against correctional officials and medical staff at several correctional facilities. He contends that the defendants were deliberately indifferent to his serious medical needs. The defendants move for summary judgment. For the reasons that follow, the defendants' motion is GRANTED in part and DENIED in part.

         I. Standard of Review

         A motion for summary judgment may be granted only where there is no genuine dispute as to any material fact and the moving party is entitled to judgment as a matter of law. Rule 56(a), Fed. R. Civ. P.; In re Dana Corp., 574 F.3d 129, 151 (2d Cir. 2009). The moving party may satisfy his burden “by showing-that is pointing out to the district court-that there is an absence of evidence to support the nonmoving party's case.” PepsiCo, Inc. v. Coca-Cola Co., 315 F.3d 101, 105 (2d Cir. 2002) (per curiam) (internal quotation marks and citations omitted). Once the moving party meets this burden, the nonmoving party must set forth specific facts showing that there is a genuine issue for trial. Wright v. Goord, 554 F.3d 255, 266 (2d Cir. 2009). He must present such evidence as would allow a jury to find in his favor to defeat the motion for summary judgment. Graham v. Long Island R.R., 230 F.3d 34, 38 (2d Cir. 2000). The nonmoving party “must offer some hard evidence showing that its version is not wholly fanciful.” D'Amico v. City of New York, 132 F.3d 145, 149 (2d Cir. 1998).

         II. Facts[1]

         A. Medical Treatment at Corrigan-Radgowski Correctional Center (2010-2012)

         The plaintiff was admitted to the custody of the Connecticut Department of Correction in January 2010. On September 1, 2010, at Corrigan-Radgowski Correctional Center, Defendant Dr. Monica Farinella examined the plaintiff in response to claims of a herniated disc. She had him perform various movements to assess his strength, ability to flex, and muscle atrophy. According to her assessment, the plaintiff was able to function well. He had no neurological deficits or loss of strength. The medical notes refer to a June 2001 MRI which showed a mild disc bulge or small subligamentous central herniation[2] which did not significantly affect the dural sac, nerve roots, or neural foramina. Dr. Farinella found no need for a repeat MRI, but ordered an x-ray of the plaintiff's spine. The x-ray showed no fractures and normal vertebral alignment. The disc spaces were preserved and the paravertebral soft tissue was unremarkable. The x-ray did show a minimal posterior osteophyte formation, or bone spur. Dr. Farinella renewed the plaintiff's prescription for Naprosyn, to be taken twice a day, and instructed the plaintiff to perform back exercises.

         Dr. Farinella saw the plaintiff again on October 18, 2010. The plaintiff requested surgery because the bulging disc caused severe intermittent pain down his left leg. Dr. Farinella told the plaintiff that he was not a surgical candidate. He was able to ambulate without difficulty, had good strength, and showed no neurological deficits. Dr. Farinella reviewed the plaintiff's medical records including the recent x-ray results. She told him to continue the back exercises and the Naprosyn.

         In January 2011, per the plaintiff's request, Dr. Farinella renewed the Naprosyn prescription for three months. In February 2011, however, the plaintiff complained to medical staff that the Naprosyn was not providing relief. His chart was referred to Dr. Farinella. In March 2011, Dr. Farinella discontinued the Naprosyn and prescribed Motrin for pain relief. Dr. Farinella again saw the plaintiff in June 2011. Medical notes indicate that the plaintiff reported that the Motrin had relieved his sciatica pain. Dr. Farinella renewed the Motrin prescription for six months. The plaintiff now states that he received no pain relief from any prescribed medication.

         On September 2, 2011, the plaintiff attended sick call complaining of upper back and neck pain. He was placed on the list to see Dr. Farinella. The plaintiff saw the doctor on September 8, 2011, and requested a special air mattress. After examining the plaintiff, Dr. Farinella concluded that there was no need for a special air mattress.

         The plaintiff again complained of back pain to medical staff on September 24, 2011. Staff noted that the plaintiff was ambulating without difficulty, climbing up and down stairs without difficulty, standing with full weight bearing, and walking with a steady gait. He was referred to Dr. Farinella. On September 27, 2011, Dr. Farinella renewed the plaintiff's Motrin prescription for six months.

         On January 3, 2012, the plaintiff attended sick call to request a renewal of his Motrin prescription. As the plaintiff was no longer indigent, he was instructed to purchase Motrin at the commissary. On January 17, 2012, the plaintiff returned to sick call complaining that Motrin was not effective and was hurting his stomach. He requested a prescription for Naprosyn. On January 26, 2012, Dr. Farinella noted the plaintiff's complaints and told him to purchase Ibuprofen and Tylenol at the commissary.

         On February 5, 2012, and March 14, 2012, the plaintiff complained to medical staff that Motrin was causing stomach pain. He stated that he wanted Naprosyn but agreed to a trial of Tylenol given pursuant to a nursing protocol. On April 27, 2012, Dr. Farinella prescribed Naprosyn for six months. She also prescribed other medications for issues unrelated to this action.

         On May 4, 2012, Dr. Farinella examined the plaintiff for his complaints of back pain. Medical notes indicate that he wanted her to order an MRI for use in a state habeas case. Dr. Farinella noted that the plaintiff was not in acute distress and ambulated without difficulty. She observed that the plaintiff was able to transfer from sitting, supine, and standing positions without difficulty. Dr. Farinella observed no signs of functional or neurological deficits and concluded that an MRI was not medically warranted. She did order another x-ray of the lumbar spine.

         The x-ray showed no evidence of fracture or spondylolisthesis. There was normal vertebral body alignment. The vertebral body heights and intervertebral disc spaces were normally maintained. The posterior elements and both S1 joints were unremarkable. In short, the x-ray showed no abnormality.

         B. Medical Treatment at Cheshire Correctional Institution

         On May 30, 2012, the plaintiff was transferred to Cheshire Correctional Institution, where he remained until April 8, 2013. The plaintiff was seen in the medical department on July 13, 2012 for complaints of back pain. He reported mild pain and stated that his pain medication was not helping much. The plaintiff was instructed on stretching exercises.

         On October 23, 2012, the plaintiff saw a registered nurse for complaints of back pain. He requested an egg crate mattress, Naproxen, and a bottom bunk pass. The following day, Dr. Ruiz prescribed Naprosyn, a brand of Naproxen, for six months. Naprosyn is an anti-inflammatory medication used to treat pain and inflammation.

         Dr. Ruiz examined the plaintiff on October 29, 2012. The plaintiff told Dr. Ruiz that he had a herniated disc at L5-S1 and sciatica on the left side from his back to his ankle. Dr. Ruiz noted that plaintiff was able to sit, stand, and walk normally and exhibited no evidence of muscle atrophy. He scored 4-5 out of 5 on tests for motor strength on extension/flexion of his ankle. Any limitation was the result of pain, not weakness. Dr. Ruiz opined that the plaintiff was not making a good effort during the tests. He also questioned the plaintiff's statements that he had a herniated disc at L5-S1 but sciatica from the nerve roots at L3-L4. Dr. Ruiz also stated that he reviewed an MRI of the plaintiff's back from 2009. Dr. Ruiz prescribed Elavil, an anti-depressant also used to treat pain, for 90 days, ordered a bottom-bunk pass for 90 days, and directed the plaintiff to return for a follow-up examination in 90 days. Dr. Ruiz attempted to teach the plaintiff stretching exercises but the plaintiff refused, stating that stretching made his back worse.

         On November 6, 2012, Dr. Ruiz discontinued Elavil at the plaintiff's request. He wanted to substitute Neurontin. Because Neurontin is a nonformulary medication, meaning that it had to be approved and specially ordered for the plaintiff, Dr. Ruiz had to seek permission to prescribe it. The request for Neurontin was approved and, on November 29, 2012, Dr. Ruiz prescribed Neurontin for one year. On February 15, 2013, Dr. Ruiz renewed the bottom bunk pass for one year.

         C. Medical Treatment at Garner Correctional Institution

         On April 8, 2013, the plaintiff was transferred to Garner Correctional Institution. In August 2013, he underwent an MRI of the lumbar spine. The MRI showed normal alignment of the lumbar vertebrae. There was a mild circumferential disc bulge without significant stenosis at L1-L2. There was no significant disc bulge or stenosis at L2-L3 or L3-L4. There was, however, some early mild degeneration or arthritis at L3-L4. Although L4-L5 showed mild circumferential disc bulge and facet arthropathy as well as mild foraminal narrowing, there was no significant canal stenosis. At L5-S1, the MRI showed degenerative disc disease with a left disc protrusion which was adjacent to and slightly displacing the left S1 nerve root within the lateral recess.

         D. Medical Treatment at Corrigan-Radgowski Correctional Center (2015-2016)

         The plaintiff returned to Corrigan-Radgowski Correctional Center (“Corrigan”) on May 29, 2015. On June 1, 2015, he was examined by an APRN for complaints of lower back pain and leg pain. The APRN noted that the plaintiff's gait was steady and he had no restrictions on raising and lowering his legs. His reflexes appeared normal. The plaintiff told the APRN that he performed sit-ups and push-ups every day. The APRN renewed the plaintiff's prescription for NSAIDS/Lyrica.

         On August 12, 2015, the plaintiff was seen at sick call complaining of lower back pain. Dr. Figura reviewed his chart and examined the plaintiff the same day. The plaintiff told Dr. Figura that he had foot drop and lower back pain. Dr. Figura's physical examination of the plaintiff showed moderate weakness in plantar flexion and iliopsoas on the affected side, but no evidence of foot drop. She opined that, if the plaintiff had foot drop, he would have been unable to perform the movements he did perform.[3]

         On August 19, 2015, Dr. Figura requested an MRI of the plaintiff's spine. The request was in response to the plaintiff's complaint of L5-S1 radicular pain and foot drop that had interfered with his activities of daily living since 2013. Since 2013, the plaintiff had three epidural steroid injections, the last in 2014. He stated that the injections provided no relief.

         On September 8, 2015, the plaintiff refused his appointment for an MRI at the University of Connecticut Health Center (“Health Center”). The defendants state that the plaintiff refused the appointment because he already had had an MRI. The plaintiff states that he refused the appointment because he would be required to pack and carry his property, and travel to New Haven Correctional Center to stay for the duration of his treatment. He also states that he would not be permitted to take his prescribed medication for sciatica and nerve pain while at New Haven Correctional Center.

         On September 25, 2015, the plaintiff told Dr. Figura that he would agree to the MRI only if he was directly transported to the Health Center. She expressed agreement with the plaintiff's objections to Correctional Transportation Unit (“CTU”) transport, which would route him through the New Haven Correctional Center, and noted her intent to seek Utilization Review Committee approval for a direct trip. Dr. Figura also noted an impression of left foot drop.

         Upon examination of the plaintiff in September 2015, Dr. Figura noted that he scored 3 out of 5 on the plantar flexion test. The plaintiff was able to perform a downward movement of his left foot in which his foot or toes flex downward toward the sole of his foot with a fair number of repetitions. She also noted that the plaintiff scored a 3 out of 5 on the iliopsoas flexion test of his left thigh. The iliopsoas muscle is one of the major hip flexors. The plaintiff was able to perform the exercise of this muscle with a fair number of repetitions. The plaintiff also complained of neuropathic pain and weakness in the fingers of his right hand and decreasing strength. The plaintiff attributed this condition to being handcuffed. Dr. Figura's examination of the plaintiff's hand was consistent with ulnar nerve compression. As a result, Dr. Figura submitted a request to the Utilization Review Committee to have a nerve conduction study performed on the plaintiff.

         On October 1, 2015, the plaintiff stated that he would speak to his counselor about a transfer to a correctional facility that provided direct transportation to the Health Center. Dr. Figura learned that same day that the plaintiff was denied a transfer because of profiles. The plaintiff refused to go to his appointment at the Health Center because he claimed to be unable to carry his property.

         Also on October 1, 2015, the plaintiff requested a double mattress. Dr. Figura told the plaintiff that she could not order a double mattress because Captain Shabenas had told her that double mattresses are not permitted.

         On October 5, 2015, the Utilization Review Committee approved the request for a nerve conduction study for the plaintiff's wrist. On November 4, 2015, the plaintiff again refused his appointment for an MRI claiming he was unable to pick up his property and carry it down two flights of stairs.

         On March 16, 2016, Dr. Figura examined the plaintiff at sick call. The plaintiff complained of foot drop. He denied all other extremity weakness and did not complain of pain. Dr. Figura reviewed the plaintiff's medical records. Dr. Figura noted discrepancies between her examination and the plaintiff's complaints. Her impression was that he did not have clinically proven MRI evidence of radicular disease or foot drop. Although she did not think the results would be different from the MRI in 2013, Dr. Figura sought ...

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