United States District Court, D. Connecticut
JON A. ST. PIERRE, Plaintiff,
TAWANNA et al., Defendants.
RULING AND ORDER ON DEFENDANTS' MOTION FOR
A. BOLDEN UNITED STATES DISTRICT JUDGE.
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
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.
have moved for summary judgment.
following reasons, the motion is GRANTED.
FACTUAL AND PROCEDURAL BACKGROUND
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,  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.
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.
Samuel Berkowitz, DPM
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.
March 21, 2012, Mr. Berkowitz treated Mr. St. Pierre, because
Mr. St. Pierre had allegedly injured his right
foot. 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.
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.
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.
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,  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.
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.
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.
Vinayak Sathe, MD
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.
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.
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.” Id. ¶ 18.
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.
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.
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.
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.
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.
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
Kym Martin, RN
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.
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.
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.
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.
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.
Heidi Greene, RN
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.
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.
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.
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.
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.
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.
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.
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. ¶
Tawanna Furtick, RN
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.
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.
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. ...