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Davis v. Singh

United States District Court, M.D. Louisiana

March 13, 2018




         Please take notice that the attached Magistrate Judge's Report has been filed with the Clerk of the United States District Court.

         In accordance with 28 U.S.C. § 636(b)(1), you have fourteen (14) days after being served with the attached Report to file written objections to the proposed findings of fact, conclusions of law and recommendations therein. Failure to file written objections to the proposed findings, conclusions, and recommendations within 14 days after being served will bar you, except upon grounds of plain error, from attacking on appeal the unobjected-to proposed factual findings and legal conclusions of the Magistrate Judge which have been accepted by the District Court.



         This matter comes before the Court on Defendants' Motion for Summary Judgment (R. Doc. 15). This Motion is opposed.[1]

         Pro se Plaintiff, an inmate confined at the Louisiana State Penitentiary (“LSP”), Angola, Louisiana, brought this action pursuant to 42 U.S.C. § 1983 against former DOC Medical Director Dr. Raman Singh, LSP Medical Director Dr. Randy Lavespere, Secretary James LeBlanc, Warden Darrell Vannoy and Ass't Warden Stephanie Lamartiniere, complaining that Defendants have violated his constitutional rights through deliberate indifference to his serious medical needs, specifically through a failure to provide adequate treatment or surgical intervention for his inguinal hernia(s) and hemorrhoids and through implementation of an alleged unconstitutional policy.

         Defendants move for summary judgment relying upon the pleadings, a Statement of Undisputed Facts, certified copies of Plaintiff's pertinent medical records and administrative proceedings (previously filed herein, see R. Doc. 12), a copy of the Louisiana Department of Corrections Referral Guidelines for Hernias, see R. Doc. 18-1, and the affidavits of Defendants Raman Singh and Randy Lavespere.

         Pursuant to well-established legal principles, summary judgment is appropriate where there is no genuine disputed issue as to any material fact, and the moving party is entitled to judgment as a matter of law. Rule 56, Federal Rules of Civil Procedure. Celotex Corp. v. Catrett, 477 U.S. 317 (1986); Anderson v. Liberty Lobby, Inc., 477 U.S. 242 (1986). A party moving for summary judgment must inform the Court of the basis for the motion and identify those portions of the pleadings, depositions, answers to interrogatories and admissions on file, together with affidavits, if any, that show that there is no such genuine issue of material fact. Celotex Corp. v. Catrett, supra, 477 U.S. at 323. If the moving party carries its burden of proof under Rule 56, the opposing party must direct the Court's attention to specific evidence in the record which demonstrates that the non-moving party can satisfy a reasonable jury that it is entitled to a verdict in its favor. Anderson v. Liberty Lobby, Inc., supra, 477 U.S. at 248. This burden is not satisfied by some metaphysical doubt as to alleged material facts, by unsworn and unsubstantiated assertions, by conclusory allegations, or by a mere scintilla of evidence. Little v. Liquid Air Corp., 37 F.3d 1069, 1075 (5th Cir. 1994). Rather, Rule 56 mandates that summary judgment be entered against a party who fails to make a showing sufficient to establish the existence of an element essential to that party's case and on which that party will bear the burden of proof at trial. Celotex Corp. v. Catrett, supra, 477 U.S. at 323. Summary judgment is appropriate in any case where the evidence is so weak or tenuous on essential facts that the evidence could not support a judgment in favor of the non-moving party. Little v. Liquid Air Corp., supra, 37 F.3d at 1075. In resolving a motion for summary judgment, the Court must review the facts and inferences in the light most favorable to the non-moving party, and the Court may not evaluate the credibility of witnesses, weigh the evidence, or resolve factual disputes. International Shortstop, Inc. v. Rally=s, Inc., 939 F.2d 1257, 1263 (5th Cir. 1991).

         In his Complaint, Plaintiff alleges that he suffers with hemorrhoids and with two inguinal hernias (one right-sided and one left-sided) that have caused him “daily pain” and that allegedly require surgical intervention. He alleges that he was first diagnosed with a right inguinal hernia approximately seven or eight years prior to the filing of his Complaint (in August 2016) and that since that time, he has been denied medical treatment that is reasonably necessary for his condition. He asserts that this hernia is large and causes intense pain and that, although he has been told that it is reducible, meaning that it can be physically manipulated such that any protrusion can be pushed back into his body, he complains that it only remains reduced if he is lying down and otherwise comes out with “standing, walking, sneezing, coughing or toileting.” See R. Doc. 1 at p. 6. He alleges that the hernia causes loops of his intestines to descend into his scrotum which causes intense pain. He further asserts that when his intestines are pushed back into his stomach, they are often twisted or strangulated, such that he must endure substantial pain until gas or the passage of food causes the intestines to become untwisted. He further asserts that this is a dangerous practice and creates a dangerous situation that not only enlarges the hernia over time but can result in strangulation of the blood supply to the intestines such that an emergency life-threatening situation can develop very quickly. Relative to his second alleged inguinal hernia, Plaintiff alleges that this one is on the left side, is small, approximately “grape-sized, ” “has descended into his scrotum the last 7-8 years” and, although reducible, also causes pain and adverse symptomatology. Finally, he asserts that whereas he has been seen and evaluated by physicians at LSP on numerous occasions in connection with the right-sided hernia - and has now been provided with surgery therefor - prison officials delayed and refused to recommend surgery solely because the hernia was reducible, failed to refer him for a consultation with a surgeon to evaluate the need for surgical intervention, and have refused to even document the left-sided hernia.[2]

         Relative to Plaintiff's hemorrhoids, Plaintiff alleges that he suffers with multiple external hemorrhoids that cause him pain and interfere with his ability to defecate and to employ appropriate hygiene. He asserts that these hemorrhoids are constantly bleeding and smell horribly, causing him to experience conflict with co-inmates. He alleges that several hemorrhoid-like polyps were surgically removed approximately eight years prior to commencement of this proceeding. Plaintiff believes that the degree of discomfort warrants surgical intervention in connection with his hemorrhoids. Notwithstanding, he acknowledges that he has been informed by physicians at LSP that his hemorrhoids are characterized as being ‘mild to moderate” and are not large or severe enough to warrant surgery.

         In addition to the foregoing, Plaintiff asserts that there is a wrongful policy implemented by Defendant Raman Singh, the now-former DOC Medical Director, that addresses the care and treatment of inmates suffering with hernias and/or hemorrhoids who are confined at institutions governed by the Louisiana Department of Public Safety and Corrections. According to Plaintiff, this policy denies surgical intervention to all inmates with reducible hernias, obstructs even referrals for surgical evaluation for inmates, and delays treatment and surgical intervention until an inmate's condition has deteriorated and become emergent or life-threatening. Plaintiff asserts that obtaining a necessary surgical referral from an LSP staff physician is obstructed by the referenced policy because “[a] request for permission to send a surgical referral from LSP staff physicians to [Department] Headquarters must first be approved by LSP Medical Director (Defendant Randy Lavespere) who then sends the request for surgical referral to [Department] Headquarters where Defendant Raman Singh must then approve the request to submit a surgical referral to the outside facility.” See R. Doc. 1 at p. 9. According to Plaintiff, Defendants intentionally utilize this procedure to unreasonably delay authorizations for needed surgery consultations. In addition, Plaintiff asserts that Defendant Singh, the former DOC Medical Director, established generally four tiers of priority for all specialist, surgery and diagnostic consultation requests, i.e., Level 1 - low; Level 2 - routine; Level 3 - urgent; and Level 4 - emergent, and Plaintiff complains that Defendants utilize these priority levels to further delay the process of obtaining surgical consultations. Plaintiff further asserts that by assigning a low priority level to a request for a surgical consultation, Defendants inevitably create inordinate delays in the scheduling of consultations by the outside facility. Finally, Plaintiff complains that Defendant Singh implemented a written policy relative to hernias that provides that reducible hernias may generally be managed non-operatively by primary care physicians at LSP and that no urgent condition is presented if a hernia is found to be reducible and largely asymptomatic. According to Plaintiff, this policy additionally provides four indications for when a specialty care referral may be appropriate, specifically where:

Hernia is non reducible;
Hernia is very large in size failing medical ...

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