Robinson v. Integrative Det. Health Servs., Inc.

MONICA ROBINSON, Plaintiff, v. INTEGRATIVE DETENTION HEALTH SERVICES, INC.,HART COUNTY, GEORGIA, SHERIFF MIKE CLEVELAND,BRUCE A. BAILEY, LPN, BRIAN EVANS, EMT,MIKE ADAMS, EMT, and ROBERT J. WILLIAMS, MD, Defendants.

No. 3:12-CV-20 (CAR)

UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF GEORGIA ATHENS DIVISION

SO ORDERED: March 28, 2014

ORDER ON DEFENDANTS' MOTIONS FOR SUMMARY JUDGMENT

Plaintiff Monica Robinson filed this civil rights action pursuant to 42 U.S.C. § 1983, alleging she received inadequate medical care while incarcerated at the Hart County Jail. Currently before the Court are the following Motions: (1) Defendants Hart County, Georgia and Sheriff Mike Cleveland's Motion for Summary Judgment [Doc. 47], (2) Defendant Robert J. Williams, M.D.'s Motion for Summary Judgment [Doc. 67], and (3) Plaintiff's Motion to Dismiss Sheriff Mike Cleveland as a party to this action without prejudice [Doc. 85]. Having considered the parties' arguments, the record, and the applicable law, the Court hereby GRANTS in part and DENIES in part Hart County and Sheriff Cleveland's Motion for Summary Judgment [Doc. 47] as more fullyexplained herein. Dr. Williams's Motion for Summary Judgment is DENIED. Plaintiff's Motion to Dismiss is GRANTED in part, and Sheriff Cleveland is hereby DISMISSED with prejudice as a party in this action.

LEGAL STANDARD

Summary judgment is proper if the movant "shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law."¹ The moving party "always bears the initial responsibility of informing the district court of the basis for its motion, and identifying those portions of the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, which it believes demonstrates the absence of a genuine issue of material fact" and that entitles it to a judgment as a matter of law.² If the moving party discharges this burden, the burden then shifts to the nonmoving party to go beyond the pleadings and present specific evidence showing that there is a genuine issue of material fact.³

The Court must view the facts, and any reasonable inferences drawn from those facts, in the light most favorable to the party opposing the motion.⁴ "The inferences, however, must be supported by the record, and a genuine dispute of material factrequires more than 'some metaphysical doubt as to the material facts.'"⁵ In cases where opposing parties tell different versions of the same events, and one is "blatantly contradicted by the record, so that no reasonable jury could believe it, a court should not adopt that version of the facts."⁶ A disputed fact will preclude summary judgment only "if the dispute might affect the outcome of the suit under the governing law."⁷ "The court may not resolve any material factual dispute, but must deny the motion and proceed to trial if it finds that such an issue exists."⁸

BACKGROUND

This civil rights action arises out of the medical treatment provided to Plaintiff while she was incarcerated in the Hart County Jail from July 21, 2010, to August 12, 2010. The facts viewed in the light most favorable to Plaintiff, the nonmovant, are as follows:

I. Contractual Relationship between Hart County and Integrative Detention Health Services, Inc.

At all relevant times herein, Sheriff Mike Cleveland was responsible for maintaining and operating the Hart County Jail (the "jail").⁹ Sheriff Cleveland did not,however, oversee the daily jail operations; rather, Captain Bobby Milford, the jail administrator, supervised jail operations.¹⁰ Hart County contracted with Integrative Detention Health Services, Inc. ("IDHS") to provide inmate medical care.¹¹ IDHS is a corporation, of which Bruce Bailey is the sole shareholder and operator.¹² Bailey is also employed by IDHS as a licensed practical nurse and paramedic.¹³ In addition, IDHS employs Robert J. Williams, MD, as the medical director and physician of record, as well as Mike Adams and Brian Evans, two critical care paramedics.¹⁴

Pursuant to the contract, IDHS agreed to "provide on a regular basis all professional medical and related health care and administrative services for the inmates/detainees, regularly scheduled sick call, nursing care, regular physician care, medical records management, administrative support services, and other services when deemed medically necessary."¹⁵ The bid proposal outlined services including "24 hour nursing consultation with onsite nursing visits when needed" and "2 on site clinic sessions per week, managed by a registered nurse under the supervision of [a] physician."¹⁶

To provide these services, Bailey, with the aid of Dr. Williams, promulgated the IDHS Policy and Procedure Manual (the "Manual"), detailing the manner in which medical services would be provided.¹⁷ According to the Manual, "health assessments by nurses are done within 24 hours of incarceration, and physical exam[s] by the contract physician or licensed nurse are done by the 14th day."¹⁸ In addition, the Manual outlines several supervisory responsibilities of the physician, Dr. Williams. For example, the Manual requires the "physician of record" to "make weekly visits or see inmates in his/her office[,]" and to perform "onsite monitoring of health services rendered by providers ... on a routine basis."¹⁹

IDHS did not require Sheriff Cleveland's signature to enforce IDHS policies and procedures at the jail.²⁰ Indeed, both Sheriff Cleveland and Captain Milford deferred to IDHS to make all policies and procedures regarding the provision of inmate medical care.²¹ Apart from the Manual, the jail does not maintain separate protocols dealing with inmate medical services.²²

In practice, IDHS developed a three-tiered system to provide medical care to inmates. First, the paramedics, either Adams or Evans, covered the two weekly clinicalsessions and assessed each patient at the jail.²³ Next, the paramedics would call and report their assessments to Bailey.²⁴ Finally, Bailey would seek input from Dr. Williams.²⁵ It is undisputed that Adams and Evans were the only onsite medical personnel during the period of Plaintiff's incarceration, and neither Bailey nor Dr. Williams personally examined her.²⁶ In fact, Dr. Williams has never visited the jail in the ten years he has served as medical director, nor has he monitored the paramedics in-person.²⁷ Dr. Williams does not even know the names of the IDHS paramedics on staff.²⁸ The paramedics are entirely supervised by Bailey.²⁹ Bailey, however, has not been to the jail in approximately three to four years.³⁰

II. Plaintiff Medical History and Incarceration

Prior to her confinement at the jail, Plaintiff was admitted to the Hart County Hospital in April 2010, after presenting with a skin rash and pain in her right arm.³¹ She was diagnosed with an MRSA infection and treated with IV and oral antibiotics.³² Following discharge from the hospital, she had no recurring symptoms until July whenshe began feeling pain along the right side of her back.³³ To combat the pain, Plaintiff resorted to self-medicating with methamphetamine and Tylenol.³⁴ Eventually, the pain became so intense, nothing worked to dull it.³⁵

Between the late evening of July 21 and early morning of July 22, 2010, Plaintiff was arrested for failing to comply with the terms of her probation and booked into the jail.³⁶ As part of the booking process, a jailer asked Plaintiff a series of questions in order to identify any existing medical needs and obtain a brief medical history, and he recorded her responses on a medical questionnaire.³⁷ The questionnaire indicated that Plaintiff had recently been hospitalized and was currently experiencing severe back pain.³⁸ Under the "Special Notes" portion of the questionnaire, the jailer further noted Plaintiff stated she had a recent history of staph infection, which she did not believe was completely gone.³⁹

On the same day, Plaintiff filled out a sick call form, requesting to see medical staff regarding her back and side pain.⁴⁰ Jail staff responded by calling Bailey to informhim of her complaint.⁴¹ Bailey instructed the jail staff to give her Motrin and Benadryl and to ensure Adams examined her during clinic hours the following day.⁴²

In the early afternoon of July 23, 2010, Adams reviewed the intake medical questionnaire, examined Plaintiff, and took a brief medical history.⁴³ At the time, Plaintiff complained of back, right side, and right shoulder pain.⁴⁴ Plaintiff informed Adams about a previous physical altercation and her prior history of drug use.⁴⁵ She also stated she believed her shoulder pain was related to a staph infection and wanted to go to the emergency room.⁴⁶ Adams called the emergency room at the Hart County Hospital to inquire whether Plaintiff had been a patient in the past week and half to two weeks, but received a negative response.⁴⁷

Adams called Bailey to discuss his assessment and to determine the proper course of treatment.⁴⁸ They agreed to treat her pain with Tylenol and to continue to monitor her condition.⁴⁹ Despite her repeated concerns, they did not send Plaintiff tothe emergency room for further diagnosis.⁵⁰ Bailey later relayed this information to Dr. Williams.⁵¹

At the request of Plaintiff's mother, Adams returned to check on Plaintiff the next day.⁵² Before examining her, Plaintiff's mother spoke with Adams and expressed her concern that Plaintiff was suffering from a recurring staph infection.⁵³ After briefly examining Plaintiff, Adams found no change in her condition.⁵⁴ Adams relayed his assessment to Bailey, and Bailey in turn spoke with Dr. Williams.⁵⁵ Because Plaintiff complained the Tylenol alone was not alleviating her pain, Dr. Williams prescribed another pain killer in addition to the Tylenol.⁵⁶

After briefly examining Plaintiff, Adams told Plaintiff's mother there was nothing wrong with her except "she was coming down off the drugs."⁵⁷ Adams conferred with Bailey and told...