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Mercado v. Department of Corrections

United States District Court, D. Connecticut

May 25, 2018



          Hon. Vanessa L. Bryant, United States District Judge

         I. Introduction

         Plaintiff 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.

         II. Background

         From 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].

         On 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].

         Two 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.

         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 incarcerated. Id.

         The 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.

         In 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 ¶ 3].

         The 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].

         If the 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.

         Shortly 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].

         Based 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].

         After 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 ¶ 19].

         Dr. 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].

         Plaintiff 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].

         Plaintiff 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].

         Behavioral 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, last 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.

         Plaintiff 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].

         Plaintiff 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 ...

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