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Pierre v. Tawanna

United States District Court, D. Connecticut

August 27, 2018

JON A. ST. PIERRE, Plaintiff,
v.
TAWANNA et al., Defendants.

          RULING AND ORDER ON DEFENDANTS' MOTION FOR SUMMARY JUDGMENT

          VICTOR A. BOLDEN UNITED STATES DISTRICT JUDGE.

         Jon A. St. Pierre (“Plaintiff”), incarcerated at Osborn Correctional Institute in Somers, Connecticut, has sued current and former employees of Correctional Managed Health Care (“CMHC”) and the University of Connecticut Managed Health Care Center (“UConn Health”) under 42 U.S.C. § 1983. Specifically, Mr. St. Pierre alleges violations of rights guaranteed to him under the First and Eight Amendments to the U.S. Constitution and asserts claims of medical malpractice under Connecticut State law.[1]

         The incidents at issue allegedly took place while Mr. St. Pierre was incarcerated at Corrigan-Radgowski Correctional Center (“Corrigan”) and MacDougall-Walker Correctional Institute (“MacDougall”). He seeks declaratory and injunctive relief and money damages.

         Defendants have moved for summary judgment.

         For the following reasons, the motion is GRANTED.

         I. FACTUAL AND PROCEDURAL BACKGROUND

         Mr. St. Pierre alleges that Samuel Berkowitz, DPM, and Vinayak Sathe, MD, who were been affiliated with UConn Health, deprived him of adequate medical treatment resulting in cruel and unusual punishment in violation of the Eighth Amendment. He also asserts that Kym Martin, RN, Heidi Greene, RN, and Tawanna Furtick, RN, [2] who are or once were affiliated with CMHC, similarly deprived him of adequate medical treatment as well as retaliated against him for filing grievances against medical staff at UConn Health and CMHC.

         A. Factual Allegations

         The initial injury allegedly occurred in March 2012, while Mr. St. Pierre was incarcerated at Garner Correctional Institution (“Garner”). Sec. Am. Compl. ¶ 12. Inmates at Garner are allegedly required to keep their property in foot lockers. Id. ¶ 13. The foot lockers, allegedly made of heavy steel, are opened by pulling the steel door down towards the floor. Id. ¶ 14. While Mr. St. Pierre was retrieving a bag of coffee from the foot locker, the cover allegedly came down on his left foot, injuring his foot and toes. Id. ¶ 13. Specifically, the foot locker door allegedly clamped down and “blew his toenail off and crushed his toe.” Id. ¶ 16.

         1. Samuel Berkowitz, DPM

         Mr. Berkowitz, a doctor of podiatric medicine, is currently an Assistant Professor in the Department of Orthopedic Surgery at the University of Connecticut Medical School. Pl.'s SMF ¶ 1.

         On March 21, 2012, Mr. Berkowitz treated Mr. St. Pierre, because Mr. St. Pierre had allegedly injured his right foot.[3] Id. ¶ 4. He testified that, after examining Mr. St. Pierre's right foot, he diagnosed Mr. St. Pierre with a contusion and a possible fractured toe. Id. ¶ 4. Dr. Berkowitz ordered an x-ray of Mr. St. Pierre's toes. Id. Dr. Berkowitz testified that Mr. St. Pierre's toes were dressed with Band-Aids and antibiotic ointment to be re-applied daily for five days, and Dr. Berkowitz ordered a shower shoe for Mr. St. Pierre. Id. Mr. St. Pierre contends, however, that he sought treatment for an injury to his left foot. Id.

         According to Dr. Berkowitz, a radiologist interpreted the x-ray he ordered, id. ¶ 5, and found “[n]o acute bony or join space injury” in Mr. St. Pierre's “[r]right great toe.” Castro Report, Def.'s SMF, Ex. 6 at 4, ECF No. 105. In light of this finding, Dr. Berkowitz thought no further care was necessary. Defs.' SMF ¶ 5.

         On May 2, 2012, Dr. Berkowitz again saw Mr. St. Pierre. Pl.'s SMF ¶ 6. Mr. St. Pierre then complained of pain from the bunion on his left foot. Id. Dr. Berkowitz again advised him that he should wear shoes with a wider toe box, and counseled against surgery. Id.

         In early June 2012, a nurse treated Mr. St. Pierre's right big toe for an infection and provided him with warm compresses and antibiotics. Id. ¶ 7. Dr. Glassman, [4] a podiatrist, removed the medial edge of Mr. St. Pierre's right big toe nail to cure the infection which had not responded to antibiotics. Id. ¶ 8. Mr. St. Pierre's believed that some nail edge remained at the surgical sight of his right big toe, and saw Dr. Berkowitz on June 13, 2012. Id. ¶ 9. Dr. Berkowitz removed the remaining portion of the in-grown nail. Id.

         On July 31, 2012, Dr. Valletta saw Mr. St. Pierre due to complaints about an in-grown toenail of the right third toe. Id. ¶ 10. Dr. Valletta prescribed an antifungal cream and antibiotics to treat the infection. Id. The following day, Dr. Berkowitz removed the in-grown toenail. Id. ¶ 11.

         Dr. Berkowitz saw Mr. St. Pierre on October 3, 2012, and cut the nail edge of an ingrown nail on Mr. St. Pierre's left big toe. Id. ¶ 12. Dr. Berkowitz also saw Mr. St. Pierre on various other occasions during his incarceration and provided him with medical care, as did UCHC and CMHC medical professionals. Id. ¶ 13.

         2. Vinayak Sathe, MD

         Dr. Vinayak Sathe, a medical doctor, is currently an Assistant Professor in orthopedic surgery at the University of Connecticut Health Center and specializes in foot and ankle surgery. Pl.'s SMF ¶ 15.

         Dr. Sathe has performed several surgeries on Mr. St. Pierre at the Health Center, the first on September 5, 2013. Id. ¶¶ 16-17. This surgery was to correct a bunion on Mr. St. Pierre's left big toe that would alleviate pain Mr. St. Pierre had reported experiencing, correct the deformity, and correct a mild hammer toe on his left second toe, if necessary. Id. ¶ 17.

         In advance of the surgery, Dr. Sathe explained the procedure to Mr. St. Pierre, including its risks and benefits, and obtained his consent to perform “first metatarsal corrective osteotomy plus modified McBride release, osteotomy of the proximal phalanx plus any related procedures plus second hammertoe correction.”[5] Id. ¶ 18.

         Dr. Sathe testified that, during surgery, he operated according to medical standards for a surgery of its kind. Id. ¶ 19. Dr. Sathe opined that, after completing the procedures, he examined the left big and second toes and determined that Mr. St. Pierre would not require any additional procedures during the surgery, which would have included an osteotomy in the second bone of his left big toe and tendon release in his left second toe. Id. ¶ 20. Mr. St. Pierre, however, contends that Dr. Sathe removed the wrong side of his bone during surgery, exacerbating the condition and Mr. St. Pierre's pain. St. Pierre Aff. ¶¶ 29-31. The experience, Mr. St. Pierre testified, left him using crutches for several months. Id. ¶ 31.

         On May 1, 2014, Dr. Sathe performed a second surgery. Sathe Aff. ¶ 11. This surgery was due to a mild return of the bunion on Mr. St. Pierre's left big toe, a hammer toe of his left second toe, and pain Mr. St. Pierre attributed to the screw Dr. Sathe affixed in his big toe during the first surgery. Id. ¶ 11. Mr. St. Pierre maintains that Dr. Sathe informed Mr. St. Pierre that he would perform surgery to Mr. St. Pierre's left foot to correct for the first surgery. St. Pierre Aff. ¶ 39.

         Dr. Sathe testified that, in advance of the second surgery, he explained to Mr. St. Pierre the risks and benefits of undergoing the surgery. Defs.' SMF ¶ 24. By way of a written authorization form, Mr. St. Pierre allegedly consented to a “first metatarsal corrective osteotomy plus modified McBride release, plus akin's osteotomy plus second hammertoe corrective plus any related procedure.” Sathe Aff. ¶ 12. Mr. Sathe opined that the surgery proceeded as planned and was effective in correcting the deformities at issue. Defs.' SMF ¶ 27. Mr. St. Pierre asserts that his foot ailments persisted. Pl.'s SMF ¶ 27.

         Dr. Sathe performed a third surgery on November 13, 2014. Defs.' SMF ¶ 28. Dr. Sathe explained that Mr. St. Pierre's left, second toe was “cocked up” and required remedial surgery. Sathe Aff. ¶ 16. Before this surgery, Dr. Sathe explained to Mr. St. Pierre the risks and benefits of surgery, and Mr. St. Pierre, by written authorization, consented to the left foot second hammertoe correction plus second metatarsal osteotomy plus fusion of the toe plus any related procedure. Pl.'s SMF ¶ 29. Dr. Sathe testified that he explained to Mr. St. Pierre that this procedure on his left second toe had a higher likelihood of failure due to a congenital deformity of his left, second toe and due to scaring from the previous surgery. Defs.' SMF ¶ 30. Mr. St. Pierre, for his part, asserts that this third surgery was to correct for “damage done” during the first two surgeries that Dr. Sathe had performed. St. Pierre Aff. ¶ 41. He further claims that the third surgery was “problematic” because of the intervening time since the two earlier surgeries and a “deterioration” of his medical condition. St. Pierre Aff. ¶ 42.

         Dr. Sathe opined that the third surgery proceeded according to plan and was effective in correcting the targeted deformity in Mr. St. Pierre's left second toe. Defs.' SMP ¶ 32. Mr. St. Pierre maintains that it was during this surgery that he suffered nerve damage to his foot, “causing it to become deformed.” St. Pierre Aff. ¶¶ 42-43.

         Dr. Sathe testified that bunion surgery and hammertoe correction can be effective in alleviating pain, but there is always a likelihood of reoccurrence. Pl.'s SMF ¶ 34. Although Mr. St. Pierre experienced some reoccurrence of his deformity, Dr. Sathe opined that he was satisfied with each surgery and considered them to be effective. Defs.' SMF ¶ 36.

         3. Kym Martin, RN

         Kym Martin is a registered nurse. Pl.'s SMF ¶ 39. She previously worked for CMHC as a correctional nurse and was assigned to Corrigan-Radgowski Correctional Center from 2008 until 2015 to provide medical care to inmates. Id. ¶¶ 40-41.

         Nurse Martin saw Mr. St. Pierre on September 7, 2013, after he was admitted to the infirmary at Corrigan. Pl.'s SMF ¶ 41. After she entered his cell, the door closed, and Mr. St. Pierre, who was lying in bed at the time not near the door, yelled a profanity at Nurse Martin and accused her of hurting his foot. Id. Nurse Martin said she was confused given that the bed, and Mr. St. Pierre in it, were not positioned near the door. Id. She administered Tylenol No. 3 to him as he requested. Id.

         Nurse Martin testified that she saw Mr. St. Pierre on October 5, 2015, noting that he rested in bed, with his eyes closed, most of the night. Id. ¶ 42. She provided him with two tablets of Tylenol No. 3 at 5:45 a.m., and, after following up with him later, determined that the medication was effective. Id.

         Mr. St. Pierre testified that, the following day, Nurse Martin entered his cell to deliver breakfast. St. Pierre Aff. ¶ 57. Although she placed his cellmate's food tray on the table, she allegedly dropped his tray on the floor and said to him that, if he did not stop writing grievances, she was going to make his life “a living hell.” St. Pierre Aff. ¶ 57. He claims that Nurse Martin threatened to allege that Mr. St. Pierre “flashed” her as a way to rid her of him for alleged sexual harassment, as she allegedly had done to someone else. Id. ¶ 58. Mr. St. Pierre testified that these statements made him nervous and afraid that Nurse Martin may actually take action against him. Id. ¶ 59. Mr. St. Pierre filed a petition against Nurse Martin with the Connecticut Department of Public Health, which was ultimately dismissed. Pl.'s SMF ¶ 45. Mr. St. Pierre claims that Nurse Martin has a reputation for “setting up” inmates and fabricating disciplinary reports. St. Pierre Aff. ¶ 56.

         Records indicate that Nurse Martin saw Mr. St. Pierre on various other occasions to provide him with medication, including Tylenol No. 3 and Percocet, at his request. Pl.'s SMF ¶ 43. Nurse Martin denies that she ever threatened him, dropped his food tray, or withheld medical care from Mr. St. Pierre. Id. She claims to have acted professionally at all times and to have provided Mr. St. Pierre with adequate medical care and medications as ordered by the doctor. Martin Aff. ¶ 10.

         4. Heidi Greene, RN

         Heidi Greene is currently a nursing supervisor for CMHC and assigned to MacDougall. Greene Aff. ¶ 2, Defs.' SMF, Ex. 5, ECF No. 103-7. From October 2008 to March 2015, she was a correctional nurse assigned to MacDougall. Id. ¶ 3. Her duties principally included staffing, scheduling, supervising nurses, evaluating staff, and touring the facility. Pl.'s SMF ¶ 48.

         On May 1, 2014, Mr. St. Pierre returned to MacDougall from surgery. Id. ¶ 49. The on-call physician ordered five milligrams of Oxycodone every six hours, if needed, for three days and a bottle of Tylenol for pain management. Id. On May 4, 2014, Dr. Pillai ordered five milligrams of Oxycodone every eight hours for three days. Id. ¶ 50. Three days later, the on-call physician saw Mr. St. Pierre and ordered an immediate two-tablet dose of Oxycodone and five milligrams, three times daily, for four days and twice daily for two days to follow. Id. ¶ 51. Mr. St. Pierre's medical records indicate that he was administered Oxycodone from May 1, 2014, through May 9, 2014, as prescribed. Def.'s SMF ¶ 52. Mr. St. Pierre contends that he received pain medication as prescribed on two days only; on the other days, Nurse Greene allegedly administered Motrin. St. Pierre Aff. ¶ 71.

         Nurse Greene testified that, on May 9, 2014, at 4:30 p.m., she received a call from the CMHC pharmacy director to inform her that nurses were removing medication from the medication electronic storage dispenser without proper authorization. Pl.'s SMF ¶ 53. Nurse Greene explained that she spoke with the on-call physician, Dr. LaPlante, at approximately 4:50 p.m. that day, and he discontinued the oxycodone and prescribed Motrin to Mr. St. Pierre. Greene Aff. ¶ 13. According to Mr. St. Pierre's medical chart, Mr. St. Pierre's oxycodone prescription “[did] not meet CMHC policy and med should be changed.” May 9, 2014, Notation at 24, Def.'s SMF, Ex. 6, ECF No. 105. The note further details that Nurse Greene called “on call MD informed of above noted APAP sensitivity. N.O. obtained for Motrin. Pharmacy nurse notified.” Id. Nurse Greene explained that Mr. St. Pierre's Oxycodone prescription was prescribed without the requisite non-formulary authorization-a CMHC physician can only prescribe a non-formulary medication by submitting a non-formulary request to the CMHC medical director approval. Greene Aff. ¶ 11. Nurse Greene testified that Mr. St. Pierre refused the Motrin. Id.

         Mr. St. Pierre counters by stating that Nurse Greene refused to provide him with postoperative pain medication as prescribed. St. Pierre Aff. ¶ 65. Mr. St. Pierre alleges he informed a doctor of this, and the doctor confirmed the prescription and stated that he did not know why Nurse Greene was refusing him medication Id. ¶¶ 68-69. The doctor allegedly said he would speak with Nurse Greene. Id. ¶ 73. Mr. St. Pierre claims that he filed several grievances against Nurse Greene for refusing him medical treatment. Id. ¶¶ 72, 75.

         On May 11, 2014, Dr. Naqvi saw Mr. St. Pierre and prescribed Oxycodone. Pl.'s SMF ¶ 56. Mr. St. Pierre's medical records indicate that he received Oxycodone on May 11 and 12, 2014. Greene Aff. ¶ 15. Mr. St. Pierre claims that he was not administered medication on these dates.

         On May 12, 2014, at 7:00 p.m., the pharmacy director contacted Nurse Greene to notify her that Mr. St. Pierre's Oxycodone prescription was again written without a non-formulary request and was unauthorized. Pl.'s SMF ¶ 58. The pharmacy director instructed her to contact the on-call physician for instruction. Id. Nurse Green spoke with on-call physician Dr. Freston at 7:30 p.m. on May 12, 2014. Id.¶ 59. Dr. Freston discontinued the Oxycodone and prescribed sixty milligrams of Toradol. Id.

         Nurse Greene then spoke with Mr. St. Pierre to discuss his medication. Id. ¶ 60. She reviewed his previous sick calls and prescriptions, which included Tylenol, Motrin, Naproxen, and Toradol, which are all the same class of non-steroidal anti-inflammatory drugs. Greene Aff. ¶¶ 18, 20. Mr. St. Pierre alleges that Nurse Greene informed him that Toradol does not contain Motrin; he claims the Toradol Nurse Greene administered caused him to be sick and break out in a rash. St. Pierre Aff. ¶¶ 84-86. Nurse Greene, for her part, claims that Mr. St. Pierre informed her that he may be allergic to Motrin and said that he had small red spots on his neck and arm but he was taking Motrin and eating peanut butter and was not sure what had caused the spots. Greene Aff. ¶ 19. Nurse Green did not herself observe any spots on him. Id.

         Ms. Greene testified that Mr. St. Pierre informed her that he had an outstanding administrative remedy with respect to a surgery, a response to which he had to yet to receive. Greene Aff. ¶ 22. Ms. Greene claimed that she followed up with the administrative remedies coordinator and passed along Mr. St. Pierre's concerns. Id. She testified that Mr. St. Pierre never stated that any of the administrative remedies were with respect to her. Defs.' SMF ¶ 68. Mr. St. Pierre contends that he discussed with Nurse Greene his multiple grievances against her. St. Pierre Aff. ¶ 78.

         5. Tawanna Furtick, RN

         Tawanna Furtick is a registered nurse and currently a supervisor for CMHC and assigned to MacDougall. Pl.'s SMF ¶ 70. During the relevant time period, she worked at MacDougall. Id. ¶ 71.

         On July 15, 2014, Nurse Furtick saw Mr. St. Pierre to address complaints of pain in his right foot. Id. ¶ 73. She evaluated him, changed the dressing on his foot, and referred him to a medical doctor. Id. She saw him again the following day for a scheduled dressing change. Id. ¶ 74. Mr. St. Pierre asked her about an approval pending with the utilization review committee (“URC”). Id. She changed the dressing and referred him to the URC nurse. Id.

         On July 26, 2014, she saw Mr. St. Pierre again, after another nurse had inadvertently administered to him another inmate's medication. Id. ¶ 75. She contacted the on-call doctor for instructions on taking his vital signs. Id. ¶ 75. She again saw him on December 5, 2014, for swelling of his left foot. Id. ¶ 76. She changed the dressing on his foot and took his vital signs. Id. She administered medication to him-e.g. Oxycodone, Neuronton, Tylenol, Bactrim, and Keflex-on numerous occasions and claims not to have withheld medication from him. Id. ...


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