United States District Court, D. Connecticut
RULING ON DEFENDANTS' MOTION FOR SUMMARY
MICHAEL P. SHEA, UNITED STATES DISTRICT JUDGE.
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.
Standard of Review
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).
Medical Treatment at Corrigan-Radgowski Correctional
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 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.
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.
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
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.
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.
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.
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
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.
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.
Medical Treatment at Cheshire Correctional
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.
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.
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
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.
Medical Treatment at Garner Correctional Institution
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.
Medical Treatment at Corrigan-Radgowski Correctional
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
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.
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.
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.
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
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.
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.
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.
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
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 ...