Chamberlain v. Mathena

JEREMIAH CHAMBERLAIN, Plaintiff, v. DR. T. MATHENA, et al., Defendants.

Civil Case No. 7:19-cv-00879

UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF VIRGINIA ROANOKE DIVISION

March 1, 2021

By: Elizabeth K. Dillon United States District Judge

MEMORANDUM OPINION

Jeremiah Chamberlain, a Virginia inmate proceeding pro se, brought this civil rights action naming three defendants: Dr. T. Mathena, Dr. Kevin Fox, and Dr. Mark Amonette. The claims in his amended complaint arise from allegations that he has been denied adequate medical treatment by defendants while incarcerated. His claims against Drs. Mathena and Fox focus on allegations that they either changed or refused to provide his preferred prescription medications for pain. His claims against Dr. Amonette stem from Dr. Amonette's alleged "refus[al] to intervene," despite his knowledge of Chamberlain's past medical history and his prior approval of Chamberlain's medications. He also points to Dr. Amonette's general role as a supervisory employee, which Chamberlain alleges makes him responsible for all medical services provided in VDOC facilities.

Pending before the court are two separate motions to dismiss. The first was brought by Drs. Mathena and Fox; the second by Dr. Amonette. The motions are fully briefed and ripe for disposition. For the reasons set forth in this opinion, the court will grant in part and deny in part the motion of Drs. Mathena and Fox and will grant the motion by Dr. Amonette.

I. BACKGROUND

A. Factual Background

Chamberlain identifies Dr. Fox as the regional health services supervisor and acting physician for Red Onion State Prison (Red Onion). He treated Chamberlain both at River North Correctional Center (River North) and at Red Onion. Dr. Mathena, also a physician, treated Chamberlain at River North. Dr. Amonette, the Director of health services for the Virginia Department of Corrections (VDOC), never treated Chamberlain, but Chamberlain alleges that he is "legally responsible for the overall operation of VDOC's health services," including services provided at River North and Red Onion. He also alleges that Dr. Amonette repeatedly "approved" prescriptions for years that were requested by Chamberlain's treating physicians and by outside specialists.

Chamberlain suffers from chronic pain as the result of suffering a gunshot wound to his right forearm in May 2011, which required various surgeries to "repair" it as best as possible. (Compl. ¶¶ 4, 10.) Chamberlain alleges that he continues to suffer from "constant and excruciating pain and suffering" that must be managed with medication. (Id. ¶ 10.) He explains that over the years, VDOC physicians tried several medications and treatments, but they either provided Chamberlain with no relief or he experienced serious adverse reactions to the medications. He alleges that he had received "multiple medical specialist consults and evaluations" by both a nerve specialist and a pain management specialist.

In 2015, Chamberlain alleges that his VDOC physician, Dr. Stevens, "began an effective treatment" that consisted of cyclobenzaprine (Flexeril) and, upon approval by Amonette, the prescription gabapentin (Neurontin) for pain, and later the prescription tramadol (Ultram) was added. (Id. ¶ 13.) Later, an outside nerve specialist also recommended the addition of pregabalin (Lyrica) to be taken with the other three medications.

On December 18, 2017, Chamberlain was treated by Dr. Fox to discuss the specialist's recommendation. Fox explained to Chamberlain "that there was no medical literature to supportthe prescription of both gabapentin and pregabalin, as they are virtually the same medication," and that Chamberlain could use one or the other. Chamberlain elected to try the Lyrica, and so Dr. Fox ordered that Chamberlain be weaned off the gabapentin and tramadol and to start Lyrica. This was not effective for Chamberlain, however, and he began to experience significant pain as a result of the stopping of the tramadol. Within weeks, Chamberlain was seen by Dr. Tarpley, who re-prescribed the original two medicines. At some unspecified point, however, Fox changed Chamberlain's medicine again, and the gabapentin was switched back to Lyrica. (Compl. ¶¶ 15-17.) In March 2018, Dr. Stevens returned Chamberlain to his original medications and added Flexeril, resulting in prescriptions for 1200 mg of gabapentin, twice a day, 100 mg of Tramadol twice a day, and 10 mg of Flexeril twice a day. Those prescriptions were approved by Amonette.

In November 2018, Chamberlain sought continued follow-up with the nerve and pain management specialists, noting other possibilities had been discussed, such as surgical relief options, using a "tens unit," and additional nerve block injections. He was told, however, that the pain management doctor "wasn't around anymore" and that River North was trying to find a new doctor or clinic. Dr. Stevens left VDOC in December 2018, but Chamberlain was told that a request had been submitted for him to be seen at the VCU medical center for further pain management evaluation.

In late December 2018, Chamberlain was scheduled to be seen by Dr. Stevens's replacement because his prescription for Flexeril had expired. On January 4, 2019, Chamberlain was seen by Dr. Mathena, who told him that the medications he was taking were not approved and were not allowed at other VDOC facilities. Dr. Mathena offered him different medications, but Chamberlain told Dr. Mathena they were not effective and refused to take the alternative medicines. Rather than ordering that Chamberlain be "weaned" or tapered off of his currentmedications, however, Dr. Mathena ordered that the medications he had been taking be stopped immediately. Chamberlain argues that he should have been weaned off of both the gabapentin and the tramadol and that, because he was not, he experienced significant withdrawal symptoms for approximately one week, including vomiting, constant diarrhea, muscle spasms, convulsions, cramps, insomnia, cold chills, and excruciating pain. He claims that Dr. Mathena also denied him "further access" to both the nerve specialist and his pain management specialist. (Id. ¶¶ 26-31, 36.)

At some unspecified point, Chamberlain was transferred to Red Onion where Dr. Fox became his treating physician. According to Chamberlain, Dr. Fox told him that he would not be given any of his previous medications and would not be seen by either a nerve or pain management specialist. (Id. ¶ 38.)

With regard to the "effective" treatment he received, Chamberlain alleges that Dr. Amonette repeatedly approved those medications. He does not allege that Dr. Amonette was aware of any later change in his medications or the denial of any outside treatment, but he simply states that Dr. Amonette "refuses to intervene in any way." (Id. ¶ 42.)

B. Chamberlain's Claims

In its introduction, Chamberlain's complaint asserts that he is bringing an Eighth Amendment claim under 42 U.S.C. § 1983. He also asks the court to exercise supplemental jurisdiction over claims brought pursuant to the Virginia Tort Claims Act ("VTCA") and Virginia Code §§ 8.01-195.1, and he refers to a medical malpractice claim. Lastly, he asserts a claim under the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12101 et seq. Later, in a section where he specifically lists his legal claims, he references the following claims: (1) an Eighth Amendment claim (presumably brought pursuant to § 1983); (2) medical malpractice; (3)intentional infliction of emotional distress; (4) an Equal Protection claim (also pursuant to § 1983); and (5) an ADA claim. Thus, the court construes his complaint as asserting those five claims against all three defendants.¹ His complaint states that it seeks preliminary and permanent injunctive relief, declaratory relief, and compensatory and punitive damages.

II. DISCUSSION

A. Legal Standard for Motion to Dismiss

A motion to dismiss under Rule 12(b)(6) tests the complaint's legal and factual sufficiency. See Ashcroft v. Iqbal, 556 U.S. 662, 677-80 (2009); Bell Atl. Corp. v. Twombly, 550 U.S. 544, 554-63 (2007); Giarratano v. Johnson, 521 F.3d 298, 302 (4th Cir. 2008). To withstand a Rule 12(b)(6) motion, a pleading must "contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face." Iqbal, 556 U.S. at 678. In considering the motion, the court must construe the facts and reasonable inferences "in the light most favorable to the nonmoving party." Massey v. Ojaniit, 759 F.3d 343, 347 (4th Cir. 2014). A court need not accept as true a complaint's legal conclusions, "unwarranted inferences, unreasonable conclusions, or arguments." Giarratano, 521 F.3d at 302. Pro se complaints are afforded a liberal construction. Laber v. Harvey, 438 F.3d 404, 413 n.3 (4th Cir. 2006).

Although filed in two different motions, all defendants argue that all claims against them should be dismissed, and their motions raise many of the same grounds. The court will therefore discuss the two motions jointly.

B. Eighth Amendment Claim

1. Applicable Law

"It is beyond debate that a prison official's deliberate indifference to an inmate's serious medical needs constitutes cruel and unusual punishment under the Eighth Amendment." Gordon v. Schilling, 937 F.3d 348, 356 (4th Cir. 2019). To demonstrate deliberate indifference, an inmate must show that (1) he has a medical condition that has been "diagnosed by a physician as mandating treatment or is so obvious that even a lay person would easily recognize the necessity for a doctor's attention" and (2) the defendant "had actual knowledge of the plaintiff's serious medical needs and the related risks, but nevertheless disregarded them." Id. at 356-57; Estelle v. Gamble, 429 U.S. 97, 105 (1976). The first component is an objective inquiry and the second is subjective. Heyer v. U.S. Bureau of Prisons, 849 F.3d 202, 209-10 (4th Cir. 2017). To establish deliberate indifference, a...