United States District Court, D. Connecticut
MEMORANDUM OF DECISION GRANTING IN PART AND DENYING
IN PART DEFENDANTS' MOTION FOR SUMMARY JUDGMENT [DKT. NO.
Vanessa L. Bryant, United States District Judge
Raudell Mercado brings this action pursuant to 42 U.S.C.
§ 1983, alleging violations of the First and Fourteenth
Amendments to the United States Constitution, and pursuant to
Title II of the Americans with Disabilities Act
(“ADA”), 42 U.S.C. § 12132. Now before the
Court is Defendants' Motion for Summary Judgment on all
claims. For the reasons that follow, Defendants' Motion
is GRANTED IN PART and DENIED IN PART.
December 20, 2013 through August 5, 2015, medical staff at
Manson Youth Institution (“Manson”) and other
Connecticut Department of Correction (“DOC”)
facilities at which Plaintiff was incarcerated, consistently
diagnosed him as having bipolar disorder and attention
deficit, hyperactivity disorder (“ADHD”). [Pl.
Exh. A ¶¶3-12]. Bipolar disorder is a serious and
chronic mental illness, which when left untreated, can leave
individuals profoundly depressed (including resorting to
suicide) or presenting with psychotic features, including
illusions of grandeur. [Def. Exh. 3 ¶ 15]. Throughout
this time period, Plaintiff was prescribed lithium and
traxadone. [Pl. Exh. A ¶¶ 6-7].
March 3, 2015, Raudell Mercado was admitted to the custody of
the DOC as a pre-trial detainee and placed at the New Haven
Correctional Center. [Def. Exh. 1]. Less than three weeks
later, the Plaintiff was transferred to Manson. He remained
at Manson until August 5, 2015, when he was transferred to
Cheshire Correctional Institution (“Cheshire”)
because he assaulted correctional staff. [Def. Exh. 1; Def.
Exh. 2 at 27; Def. Exh. 3 ¶ 10].
days later, he was transferred to Garner Correctional
Institution (“Garner”) for a mental health
evaluation to determine if he needed psychiatric care of the
type provided at Garner. [Def. Exh. 1; Def. Exh 3 ¶ 10].
Plaintiff remained at Garner from August 7, 2015 until August
28, 2015. Despite offering evidence regarding Garner's
standard practices for evaluating inmates, Defendants do not
offer any admissible evidence regarding Plaintiff's
psychiatric evaluation while at Garner.
is the Connecticut prison that provides psychiatric care for
inmates determined to be mentally ill and requiring special
management. [Def. Exh. 3 ¶ 10]. The phrase
“mentally ill” means that a person has a chronic
and severe Axis I mental illness. In the field of psychiatric
disorders, Axis I includes schizophrenia, bipolar disorder,
major depression, and thought disorders/psychosis. [Def. Exh.
4 at 48]. The Department of Correction has a standard
protocol for diagnosing inmate mental illness. At the first
step, a psychiatric treatment team completes a four-page
mental health evaluation, which reviews demographic
information, family history, legal history, psychiatric
history, medication history, physical history including head
injuries, surgeries, other injuries, and allergies.
Id. at 54-55. In general, if an inmate has a
psychiatric history, the psychiatric treatment assessment
team would examine his medication history, risk history,
current risk factors, substance abuse history, active
substance abuse, and any programs that he may have
participated in and the results of those programs.
Id. at 55. The evaluation would also examine the
inmate's prior incarceration and treatment history while
next stage of the evaluation process is a face to face
clinical interview with one or more doctors who would have
already reviewed not only the four page evaluation, but also
the inmate's medical and mental health records from the
DOC and outside health centers. Id. at 56. Upon
completion of the background and face to face evaluations,
the treatment team determines how the inmate presents
diagnostically to the doctors, and an actual diagnostic
category is chosen. Id. at 55. This diagnostic
recommendation is then forwarded to the Director of
Psychology or Psychiatry along with the four-page history and
face to face evaluation, whereupon the director reviews it
and makes a final determination as to whether the inmate is
mentally ill and should remain at Garner, or is not mentally
ill and may be transferred to another institution, such as
Northern Correctional Institution (“Northern”).
Id. at 56. If an inmate who is to be transferred to
Northern due to violent conduct is in fact mentally ill, the
inmate will not be transferred to Northern, unless his
behavior is too dangerous to house him at Garner.
Id. at 60.
those rare cases when an inmate is mentally ill but too
dangerous to be at Garner, he will be sent to Northern, but
managed safely in a clinical manner. Id. at 75. If
an inmate is not found to be mentally ill and is therefore
cleared for transfer to Northern, he will be provided with
another mental health screening by a nurse or social worker
within 24 hours of arrival at Northern, and will have monthly
follow-up appointments with a social worker, psychologist
Defendant Dr. Mark A. Frayne, and psychiatrist Defendant Dr.
Gerard G. Gagne. Id. at 76. There are three nurses
on two of the three shifts at Northern, and one additional
nurse who works the night shift. Id. at 80. Dr.
Frayne is the only psychologist on staff at Northern and he
works the first shift. Id. Dr. Gagne visits Northern
twice per week to serve whatever psychiatric needs exist in
the inmate population. [Id. at 80-81; Def. Exh. 5
Northern mental health screening is an abbreviated version of
the four-page mental health assessment conducted at Garner,
and covers the inmate's psychiatric history, risk
history, injury history, and substance history, as well as
containing a diagnostic section and formulation. [Def. Exh. 4
at 77]. The inmate's entire DOC medical and mental health
files are transported with the inmate and reviewed by intake
personnel when the inmate is transferred to Northern.
Id. at 81. In Plaintiff's case, these files
would have included mental health records from
Plaintiff's prior stints in DOC custody, including those
indicating that Plaintiff suffered from bipolar disorder and
ADHD. [Pl. Exh. B at 87].
inmate is on medication, the prescriptions are transferred
electronically at the time of transfer, and the nurse
clinician who manages medications will schedule an
appointment with Dr. Gagne to review the medications and
determine if the prescriptions are appropriate, should be
changed, or should be tapered down and eventually stopped.
[Def. Exh. 4 at 82]. Dr. Gagne consults with Dr. Frayne
regarding medications, but ultimately the decision regarding
whether or not medication is appropriate belongs to Dr.
Gagne. Id. at 83. When making his determination, Dr.
Gagne meets with the inmate for a session, shares his
impression, and discusses the risks and benefits of the
medication at issue, including short and long term side
effects. Id. Sometimes Dr. Frayne will be present
during the session along with Dr. Gagne, and often a nurse
clinician and social worker will also be present.
Id. at 84.
after Plaintiff's August 28, 2015 arrival at Northern,
Dr. Gagne met with him. [Id. at 89; Def. Exh. 5
¶ 3; Def. Exh. 6 at 19]. Dr. Gagne interviewed Plaintiff
a number of times after his intake both in standard sessions
and as the result of safety interventions. [Def. Exh. 4 at
89; Def. Exh. 5 ¶ 3; Def. Exh. 6 ¶ 19]. Dr. Frayne
also met with plaintiff shortly after his arrival at Northern
and after reviewing the Garner Psychiatric Treatment
Assessment Team's treatment notes. [Def. Exh. 3 ¶
13; Def. Exh. 4 at 92]. However, these treatment notes were
not submitted into evidence with Defendants' motion for
nor Plaintiff's opposition to summary judgment. When Dr.
Frayne met with him, Plaintiff insisted that he was seriously
mentally ill, that he had bipolar disorder, and that he
should be treated accordingly. [Def. Exh. 3 ¶ 13; Def.
Exh. 4 at 91]. Plaintiff also told Drs. Frayne and Gagne that
he should be provided with medications for bipolar disorder
and ADHD, specifically including lithium and trazadone. [Def.
Exh. 3 ¶ 17; Def. Exh. 4 at 123; Pl. Exh. A ¶ 15].
upon Plaintiff's past history, his trajectory through
youth residential programs, hospital placements, and his
impulsive, aggressive, moody, and angry manners, Defendants
opined that it would not have been unusual for him to been
diagnosed with a conduct disorder. [Def. Exh. 4 at 90, 92-95;
Def. Exh. 6 ¶¶ 11-12]. People with antisocial
personality disorder typically have no regard for right and
wrong, resulting in frequent trouble or conflict. They may
lie, be deceitful, repeatedly violate the rights of others,
intimidate others, be aggressive or violent, lack remorse, be
impulsive and easily become agitated. [Def. Exh. 3 ¶ 26;
Def. Exh. 4 at 105; Def. Exh. 5 ¶¶ 5-6; Def. Exh. 6
¶ 28]. People with narcissistic personality disorder
lack empathy. They have a sense of entitlement and
superiority, which if questioned, or if their desire for
something is denied, they will react with rage and will make
efforts to devalue, belittle or destroy the person they see
as blocking them from what they want or holding them
accountable for their actions, out of revenge. [Def. Exh. 4
at 106-07; Def. Exh. 5 ¶¶ 5-6; Def. Exh. 6
¶¶ 28-29]. Defendants diagnosed Plaintiff as having
antisocial personality disorder and narcissistic personality
disorder rather than bipolar disorder or ADHD. [Def. Exh. 3
¶¶ 17, 26-27, 29; Def. Exh 5 ¶ 4; Def. Exh. 6
¶¶ 16-17; Dkt. No. 124-1 ¶ 37]. Having
diagnosed Plaintiff with antisocial disorder, Defendants
discontinued Plaintiff's bipolar and ADHD medications.
[Pl. Exh. A ¶¶ 14-16; Pl. Exh. B at 90].
Plaintiff was admitted to Northern, Plaintiff received
regular mental health evaluations and treatment and was not
held in isolation. He was housed in a cell, but had access to
correctional staff that conducted tours and checked on each
cell every fifteen minutes, 24 hours per day. [Def. Exh. 3
¶ 34; Def. Exh. 4 at 79; Def. Exh. 5 ¶ 14]. He also
had access to mental health providers who tour to block one
per day, seven days per week, as well as nurses who tour the
block when medications are administered. [Def. Exh. 4 at 79;
Def. Exh. 5 ¶ 7; Def. Exh. 6 ¶¶ 20-22].
Plaintiff was also offered regular mental health treatment at
least once per month. [Def. Exh. 3 ¶ 34; Def. Exh 5
¶¶ 7-8; Def. Exh. 6 ¶¶ 17, 19, 20, 22].
Each time the Plaintiff is admitted to Northern or Cheshire,
he is evaluated by their respective Mental Health Staff and
offered regular mental health treatment at least once per
month. [Def. Exh. 5 ¶¶ 7, 10, 14; Def. Exh. 6
Frayne testified that from August 28, 2015 when
Plaintiff's arrived at Northern to the present,
Defendants classified Plaintiff's mental health score as
3. [Def. Exh 4 at 100-01]. As an inmate with a mental health
score 3, the Plaintiff's treatment plan consisted of a
focus on his behaviors. He was provided with the opportunity
for talk therapy in a group with two other inmates, in which
he participated most of the time. [Def. Exh. 3 ¶ 34;
Def. Exh. 4 at 101-02; Def. Exh. 5 ¶¶ 19-21].
is not disorganized or disheveled. He maintains a neat and
well-organized cell and his personal hygiene is very good.
[Def. Exh. 5 ¶ 25]. When Plaintiff has acted out with an
episode of self-injury, he has been placed on Behavior
Observation Status to ensure his personal safety. [Def. Exh.
3 ¶¶ 37-38; Def. Exh. 5 ¶ 26].
argues that after he filed a grievance against Dr. Frayne
complaining about the failure of Dr. Frayne and Northern to
provide him with care for bipolar disorder and ADHD, Dr.
Frayne retaliated by placing Plaintiff on behavioral
observation status. [Pl. Exh. A ¶ 18; Pl. Exh B at
118-19]. Plaintiff also asserts that because he was denied
appropriate treatment for bipolar disorder and ADHD, he
engaged in behavior consistent with these disorders, and was
then punished for those behaviors by placement in
administrative and punitive segregation and on behavioral
observation status. [Pl. Exh. A ¶ 17].
Observation Status is an “intervention, determined by a
qualified mental health professional, to extinguish
maladaptive behaviors while maintaining safety and security
of the inmate.” Department of Correction Administrative
Directive 9.4.3F, available at
visited May 24, 2018. The purpose of this status is to
“preserve the order, safety and security of
correctional facilities to comply with the law, and to manage
inmate behavior.” Department of Correction
Administrative Directive 9.4.1, id. “For
inmates who are using maladaptive behaviors, such as
threatening self harm without intent or destroying property
to avoid compliance with custody requirements such as housing
or disciplinary actions, Behavioral Observation Status shall
be initiated. Behavioral Observation Status shall be utilized
in areas other than an infirmary/hospital Unit but shall be
limited to housing areas in which custody staff routinely
conduct 15 minute tours.” Department of Correction
Administrative Directive 9.4.17D, id.
filed multiple grievances regarding Northern's failure to
provide him treatment for bipolar disorder and ADHD, but
these grievances were denied. [Pl. Exh. A ¶ 22].
graduated from the administrative segregation program on or
about February 29, 2016, at which time he was transferred to
Cheshire where he received similar treatment and care by the
complement of mental health providers at that facility. [Def.
Exh. 1; Def. Exh. 3 ¶¶ 37-38; Def. Exh. 5 ¶
11]. Plaintiff was and is being afforded steady contact with
mental health staff at Northern and Cheshire, and Plaintiff
is familiar with and has used these facilities' 24-hour
safety plans for mental health inmates. [Def. Exh. 5 ¶
14]. However, Plaintiff asserts that after his transfer to
Cheshire, and while he was on administrative segregation
there, Gagne ordered him to speak with him one on one, and
made sexually inappropriate comments about his physical
appearance. [Pl. Exh. A. ¶ 19]. Plaintiff alleges that
he reported this conduct, but no action was taken in
response. [Pl. Exh. A ¶ 19]. Northern's warden, Anne
Cournoyer, was ...