United States District Court, D. Connecticut
RULING ON DEFENDANTS' MOTION FOR SUMMARY
HAIGHT, SENIOR DISTRICT JUDGE:
Courtney Green ("Plaintiff"), currently
incarcerated at Osborn Correctional Institution and
previously incarcerated at Corrigan Correctional Center
(“Corrigan”), filed this Complaint pro
se pursuant to 42 U.S.C. § 1983 on June 2, 2017. On
August 17, 2017, this Court issued an Initial Review Order,
permitting Plaintiff's claims that he was denied adequate
medical care in violation of the Eighth Amendment to proceed
against two Registered Nurses at Corrigan, Nurses Shaw and
Brennan (the "Defendants"), in their
individual capacities. That Order, 2017 WL 3568666 (D. Conn.
Aug. 17, 2017), familiarity with which is assumed, also
dismissed Plaintiff's Amended Complaint to the extent it
sought to plead § 1983 claims for violations of his due
process rights or based on the Equal Protection Clause.
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.
Fed.R.Civ.P. 56(a); see also Redd v. New York Div. of
Parole, 678 F.3d 166, 173-74 (2d Cir. 2012). A
“genuine issue” exists “if the evidence is
such that a reasonable jury could return a verdict for the
non-moving party.” Anderson v. Liberty Lobby,
Inc., 477 U.S. 242, 248 (1986). A fact is
“material” if it “might affect the outcome
of the suit under governing law.” Id.
moving party bears the initial burden of demonstrating the
absence of a disputed issue of material fact. Celotex v.
Catrett, 477 U.S. 317, 323 (1986). If the initial burden
is satisfied, the burden then shifts to the non-moving party
to present “specific evidence demonstrating the
existence of a genuine dispute of material fact.”
Robinson v. Concentra Health Servs., 781 F.3d 42, 34
(2d Cir. 2015) (internal quotation marks and citation
omitted). While the Court must view the record in the light
most favorable to the nonmoving party, and resolve all
ambiguities and draw all reasonable inferences in favor of
the party against whom summary judgment is sought,
Anderson, 477 U.S. at 255, the non-moving party
nevertheless “must do more than simply show that there
is some metaphysical doubt as to the material facts.”
Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio
Corp., 475 U.S. 574, 586 (1986). Instead, the non-movant
must support any assertion disputing the veracity of a fact
or existence of an alleged dispute with specific citation to
the record materials. Fed.R.Civ.P. 56(c)(1).
Plaintiff is proceeding pro se, the Court must read his
submissions “liberally” and interpret them
“to raise the strongest arguments” that they
suggest. Chavis v. Chappius, 618 F.3d 162, 170 (2d
Cir. 2010). Nonetheless, “[p]roceeding pro se does not
otherwise relieve a litigant of the usual requirements of
summary judgment, and a pro se party's bald assertions
unsupported by evidence, are insufficient to overcome a
motion for summary judgment.” Rodriguez v.
Hahn, 209 F.Supp.2d 344, 348 (S.D.N.Y. 2002) (internal
quotation marks omitted).
about June 23, 2015, Green began experiencing pain and
bleeding from his rectum after a bowel movement, which
occurred after he had been playing basketball and while he
was fasting for Ramadan. Plaintiff's Local Rule 56(a)(2)
Statement, Doc. 29, at 18 ¶ 5. The next day, he wrote to
the medical unit of Corrigan stating that he was "having
pain in [his] rectum during bowel movement."
Id. ¶ 6. His request was returned on or about
June 26, 2015 with a notation that he had been placed on the
sick call list. Id. About a week later on July 1,
2015, he wrote the medical unit after experiencing severe
discomfort and because he still had not been seen by a
medical professional. Id. ¶ 7. He stated:
"I have a serious problem. Pain and bleeding from the
rectum and I need to see the Dr. urgently." Id.
He also reminded medical staff that he had sent a previous
written request regarding his symptoms. Id.
3, 2015, Green was seen by Defendant Shaw at sick call.
Id. ¶ 8. He explained his symptoms and informed
Shaw that he was fasting for Ramadan. Id. Shaw
questioned the Plaintiff about his bowel movements, and
Plaintiff indicated that earlier in the day he had a hard
bowel movement. Defendants' Local Rule 56(a)(1)
Statement, Doc. 24-3 ¶ 22. Plaintiff did not disclose
black tarry stools, which would have indicated blood in the
stool. Id. ¶ 25. Shaw also auscultated to
determine if Plaintiff's bowels were stagnant and for
regular peristalsis, felt the plaintiff's abdominal area
for distention caused by stool buildup, and took
Plaintiff's vital signs. Doc. 29 at 18-19; Doc. 24-3
¶ 23. Shaw did not, however, conduct a rectal
examination. Doc. 29 at 18-19. Shaw diagnosed Plaintiff with
hemorrhoids due to constipation, and recommended that
Plaintiff increase his intake of water, consume more fiber,
and not strain while using the restroom. Doc. 24-3
¶¶ 16, 31, 33, 34. Green was also instructed to
follow up in three to four days if the problem persisted.
Id. ¶ 16. Green did not return within three to
four days, and Shaw did not see Green again.
August 20, 2015, Green again wrote to the Corrigan medical
unit stating "I'm having hemorrhoid trouble
problems." Doc. 29 at 38, Pl.'s Ex. 5. Soon after he
was called to medical for triage where Defendant Brennan met
with him at sick call. Doc. 24-3 ¶ 2. During this
consultation, Green informed Brennan that he had been using
hemorrhoid cream but it was not effective and his rectum was
still bleeding. Id. ¶ 7. Brennan explained that
hemorrhoids are chronic. Id. Brennan instructed
Green to push the hemorrhoids back into his rectum with his
fingers while in the shower. Id. Green requested
that Brennan put him on a list to see the doctor so that they
could begin a process to remove the hemorrhoids. Id.
Brennan told Green that there was no removal of hemorrhoids
and Green stated "Oh ok. I'm all set." Doc.
24-3 ¶ 47. Brennan did not place Green on the
wait list to see a doctor and did not examine Green's
rectum. Id. ¶¶ 50. Plaintiff does not
allege that he interacted with either Defendant after August
about March 31, 2016, Green was transferred from Corrigan to
Macdougall Walker Correctional Institution. Doc. 29 at 20
¶ 27. While housed there, his symptoms worsened and
eventually impeded his ability to have regular bowel
movements, to the point that his underwear would be soiled
with blood. Id. At that point, he also experienced
burning sensations from his rectum and he was in extreme
discomfort while walking, running and during bowel movements.
Id. In mid- to late-August 2016, Green wrote to the
medical unit via an inmate request form regarding his
symptoms. Id. at 21 ¶ 28. He was not seen and
two weeks later, on September 12, 2016, he wrote again
elaborating on the difficulties he was experiencing and
explaining that he had not been seen for sick call treatment
as required under Administrative Directives 8.1(6)A and
8.1(3)A. See Id. at 40, Pl.'s Ex. 6. On or about
October 4, 2016, Green received a notification that he was
scheduled to see a doctor five days later. Id.
¶ 29. Green was not seen by a doctor while at MacDougall
Walker, but was subsequently transferred to Osborn on October
21, 2016. Id. ¶ 30. Two days after his
transfer, Green wrote to medical via an inmate request form,
stating that his hemorrhoids were “causing a great deal
of burning, bleeding and restrict[ion] of my bowel
movements” and requesting to have his veins removed.
Id. ¶ 31; id. at 42, Pl.'s Ex. 7.
On October 31, 2016, his inmate request was returned stating
that he had been a no show at sick call. Id. ¶
32; id. at 42, Pl.'s Ex. 7. On November 7, 2016,
he filed an Inmate Administrative Remedy Form requesting a
Health Services Review, and stating that he had not attended
sick call because he had previously met with two nurses at
Corrigan who had told them there was nothing that could be
done about his condition. Id. at 45-46, Pl.'s
Ex. 8. On December 1, 2016, Green was called to medical where
Dr. Wright saw him. Id. ¶ 33. During his
consultation, Green explained in detail the symptoms that he
had been experienced over about 18 months. Id. at
21-22 ¶ 33. Dr. Wright then examined Green's rectum
and did not find any hemorrhoids but did observe blood.
Id. at 22 ¶ 34. Dr. Wright prescribed to Green
a stool softener, suppositories and cortisone cream.
Id. Dr. Wright also submitted Green to a review
committee to be determined if he should be tested for colon
cancer. Id. ¶ 36.
about December 9, 2016, Green's Inmate Administrative
Remedy Form requesting his Health Services Review was
returned with the disposition "Change DX/TX.” Doc.
29 at 45-46, Pl.'s Ex. 8. Between December 1, 2016 and
February 6, 2017, Green was approved by the review committee
to have testing done with Dr. Giles at the UCONN Health
Center on February 7, 2017. Id. at 22 ¶ 36.
During the consultation it was determined that Green did not
have colon cancer, but that he, in addition to suffering from
moderate size hemorrhoids, had an anal fissure which had
healed with gradation tissue, and would not properly heal and
would continue bleeding without a resection procedure.
Id. ¶ 37. On or about March 15, 2017, Green was
transferred to UCONN Health Center for the resection
procedure. Id. ¶ 38. He also had the wall of an
internal hemorrhoid band ligated. Id. Sometime in
the middle of May 2017, Green again began experiencing sharp
pain from his rectum in addition to bleeding. Id.
¶ 39. Green met with a series of medical providers since
May 2017, but as of July 2018 he continues to suffer from
pain and bleeding from his rectum. Id. at 26 ¶
defendants move for summary judgment on three grounds: (1)
Green did not exhaust his administrative remedies before
filing this action, (2) the Defendants were not deliberately
indifferent to a serious medical need, and (3) the Defendants
are protected by qualified immunity.
Exhaustion of Administrative Remedies
first argue that Green has not exhausted his administrative
remedies. The Prison Litigation Reform Act requires prisoners
to exhaust administrative remedies before filing a federal
lawsuit relating to prison conditions. 42 U.S.C. §
1997e(a) (“No action shall be brought with respect to
prison conditions under section 1983 of this title, or any
other Federal law, by a prisoner confined in any jail,
prison, or other correctional facility until such
administrative remedies as are available are
exhausted.”). This exhaustion requirement applies to
all claims regarding “prison life, whether they involve
general circumstances or particular episodes.”
Porter v. Nussle, 534 U.S. 516, 524, 532 (2002).
of all available administrative remedies must occur
regardless of whether the administrative procedures provide
the relief that the inmate seeks. See Booth v.
Churner, 532 U.S. 731, 741 (2001). Furthermore,
prisoners must comply with all procedural rules regarding the
grievance process prior to commencing an action in federal
court. See Woodford v. Ngo, 548 U.S. 81, 90-91, 93
(2006) (proper exhaustion “means using all steps that
the agency holds out ... (so that the agency addresses the
issues on the merits) ... [and] demands compliance with
agency deadlines and other critical procedural rules”).
Special circumstances will not relieve an inmate of his
obligation to adhere to the exhaustion requirement. An
inmate's failure to exhaust administrative remedies is
only excusable if the remedies are in fact unavailable.
See Ross v. Blake, 136 S.Ct. 1850, 1858 (2016).
Administrative Review Procedure
Health Services Review procedure is the administrative remedy
for all medical issues. Department of Correction
Administrative Directive 8.9(1),
visited Dec. 11, 2018). An inmate, like Green, seeking review
of a diagnosis- or treatment-related issue (including the
decision to provide no treatment) is directed to seek an
informal resolution prior to filing a formal request for a
Health Services Review. Id. at 8.9(10). If the issue
is not satisfactorily resolved informally, the inmate is then
directed to file an Inmate Administrative Remedy Form seeking
a Health Services Review. Id. at 8.9(11). The Inmate
Administrative Remedy Form must designate that the inmate is
experiencing an issue related to
“Diagnosis/Treatment” by checking the appropriate
box, and provide a concise statement of what diagnostic or
treatment decision he believes is wrong and how he has been
affected. Id. The Health Services Review Coordinator
will then ...