Robinson v. Pytlewsi

ARLINA ROBINSON, et al., Plaintiffs, v. DAVID PYTLEWSI, et al. Defendants.

Civil Action No. 8:19-cv-01025-PX

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND

February 7, 2020

MEMORANDUM OPINION

Pending before the Court are two motions to dismiss, one filed by Defendants Dr. Howard Pinn and the State of Maryland on behalf of the State Department of Corrections ("DOC") and the other filed by Defendants MHM Services, Inc. and Dr. David Pytlewski. ECF Nos. 16, 26. The motions are fully briefed, and no hearing is necessary. See Loc. R. 105.6. For the reasons discussed below, both motions are granted in part and denied in part.

I. Background¹

This case centers on the tragic death of James Robinson who committed suicide while an inmate with the Maryland Department of Corrections. Robinson was diagnosed with bipolar disorder in 2007, and since that time was prescribed psychotropic medication to treat his severe symptoms. ECF No. 8 ¶ 16. Robinson had previously attempted to commit suicide on several occasions, including during prior terms of incarceration while in the custody of DOC. Id.

On October 2, 2015, Robinson received a sentence of one year and one day imprisonment to be served in DOC custody. Id. ¶ 14. While Robinson was pending designation, he was on suicide watch at the Howard County Detention Center. Id. ¶¶ 13-14.

On October 5, 2015, Robinson was transferred into DOC custody, and was specifically placed at Jessup Correctional Institution ("JCI") to begin serving his sentence. Id. ¶ 15. DOC records document Robinson's longstanding medical and psychiatric conditions—including prior suicide attempts—in his DOC medical and base files, and thus DOC and related personnel knew of Robinson's severe mental health condition. Id. ¶ 16.

Upon his arrival at JCI, Robinson was evaluated and diagnosed with psychotic disorder, schizoaffective disorder, and personality disorder; he was also "placed under close observation for self-injurious behavior." Id. ¶¶ 15, 17. As of October 25, 2015, progress notes in Robinson's medical file reflect that Robinson was complaining of suicidal ideations and was not taking his prescribed medication. Id. ¶ 18.

On recommendation from the staff psychiatrist at JCI, Robinson was transferred to the Patuxent Institution to receive additional psychiatric care. Id. ¶¶ 18-19. On January 8, 2016 Patuxent staff found Robinson alive but with a bedsheet around his neck in an apparent suicide attempt. Id. ¶ 20. In response, Patuxent Medical staff ordered Robinson to be placed in "administrative segregation," or suicide watch, to address the risk of Robinson's future self-harm. Id.

On February 2, 2016, Robinson was transferred to the Eastern Correctional Facility ("ECI"). Id. ¶ 21. Upon his arrival at ECI, Robinson did not receive a formal suicide screening as is required by the Maryland Department of Public Safety and Correctional Services ("DPSCS") policy. Nor did any medical staff examine Robinson for the next seven days. Id. ¶¶ 22-24. On February 9, 2016, Dr. Pinn, a medical doctor employed by the State of Maryland, recommended that Robinson be placed among the general population as long as DOC staff monitored Robinson's medications, even though Dr. Pinn knew of Robinson's lengthy history ofsuicide attempts. Id. ¶ 24.

The next day, Dr. Pytlewski conducted a psychiatric evaluation of Robinson during which Pytlewski learned of Robinson's history of suicide attempts and serious mental illness. Id. ¶ 25. Medical care at ECI is provided in part through a private corporation, MHM. Dr. Pytlewski is a medical doctor employed by MHM. Id. ¶¶ 3, 5. Robinson reported to Dr. Pytlewski at that time that he was taking his medication, that his hallucinations and disorganized thinking were minimal, and that he had no suicide plan or other suicidal ideation. Id. Dr. Pytlewski diagnosed Robinson with schizoaffective disorder, renewed his prescribed medication, and recommended a follow-up visit in 12 weeks. Id. Dr. Pytlewski did not take steps to verify or monitor Robinson's medication levels, and again in contravention of DPSCS Policy, did not complete a suicide screening or the mandatory suicide screening form. Id. ¶¶ 25-26.

Over the next few days, Robinson visited ECI's medical department several times complaining of chest pains. Id. ¶ 27. Each time he "appeared to the medical staff as disorganized, speaking tangentially, inappropriate, and very unclear." Id. The medical staff, concerned about Robinson's mental health, contacted Defendant Dr. Pinn and "asked him to intervene." Id.

Dr. Pinn consulted with Dr. Pytlewski and neither doctor examined Robinson. Id. ¶¶ 27-28. The two doctors agreed that Robinson likely had "intellectual deficits" that contributed to his erratic behavior, but that Robinson would remain psychologically stable if he took his medication. Id. ¶ 28. The doctors told the medical staff that Robinson should be "more closely guarded" on his visits to medical. Id.

On February 18, 2016, Dr. Pinn met with Robinson about the previous week's visits to the medical department. Id. ¶ 30. Dr. Pinn personally observed at this visit that Robinson"remained difficult to focus and very scattered." Id. When Robinson reported that he found it difficult to wake up for his medication, Dr. Pinn noted that Robinson's "lack of full medication maybe [sic] contributing to his very scattered, poorly focused and odd behavior." Id. Thereafter, aside from one visit to the medical department for more chest pain, Robinson had no contact with ECI medical staff until March 7, 2016. Id. ¶ 31.

On March 7, Robinson told medical staff that he felt "like taking a sheet and trying it around my neck and hanging it up" and that he had trouble waking up to take his medication. Id. ¶ 32. Drs. Pytlewski and Pinn were additionally aware that Robinson's long-term relationship with the mother of his children was likely coming to an end. Id. ¶¶ 32-33. In response, Dr. Pytlewski placed Robinson on administrative segregation, or suicide watch. Id. ¶¶ 32.

On March 8, Drs. Pytlewski and Pinn examined Robinson together. Both doctors observed that Robinson was "moderately/severely depressed,"—Robinson spent the examination lying on the floor in a "suicide blanket." Id. ¶ 34 & n.1. Robinson also admitted to the doctors that he was not taking his medications. Id. ¶ 34. Dr. Pytlewski ordered that Robinson remain on "Level 1 administrative segregation observation," and that he continue with his medication. Id. Based on information in Robinson's prison records, the doctors knew that Robinson had been cited for committing a "lewd act" which had the potential of extending Robinson's prison term by two months. Id. ¶¶ 35, 49.

The next day, March 9, Drs. Pytlewski and Pinn met with Robinson again. Robinson refused to speak to them and instead "la[id] on the floor of his cell wrapped in a suicide blanket." Id. ¶ 35. The doctors met with Robinson again the next day and noted "that [Robinson] had been compliant with his medication and that he denied suicidal ideations." Id. ¶ 37.² Based on thisencounter with a very ill Robinson—and despite his inability to communicate, his physical immobilization, and his previous medication noncompliance—the doctors cleared Robinson for transfer, within 24 hours, to a less restrictive housing tier. Id. ¶¶ 36-37.

The doctors conditioned Robinson's transfer on his being "double celled" so that another prisoner could alert staff if he attempted suicide and on his "compliance with his prescribed medication." Id. ¶ 37. If Robinson "was not compliant with his medication, medical staff was to be informed immediately." Id.

The doctors took no steps to ensure that these directives were communicated to prison staff. ECF No. 8 ¶¶ 40-41. Nor did Drs. Pytlewski and Pinn perform a suicide assessment on Robinson prior to transfer out of administrative segregation. The doctors also did not restrict Robinson's access to bed linens despite Robinson's prior attempt at Patuxent to kill himself using bedsheets and his more recent reference to tying a sheet around his neck and "hanging it up." Id. ¶¶ 39-40.

As it turns out, and contrary to the doctors' belief, Robinson had not taken his medication on March 10, and refused his medication in the days that followed. Id. ¶¶ 44-48. On March 12, Robinson also lost his cellmate. Id. ¶ 46. Yet, even though Robinson was now alone in his cell, unmedicated, and under no special observation, no staff, including Drs. Pytlewski and Pinn, did anything to assess Robinson's continued safety. See id. ¶¶ 43, 49.

Then, on the evening of March 14, 2016, Robinson was found unresponsive, sitting on his cell bunk with his sheet tied around his neck and secured to the bedframe. Id. ¶ 50. Robinson was pronounced dead at 11:19 p.m. Id. He was 33 years old. Id. ¶ 13.

The DOC conducted an internal investigation following Robinson's death. Drs. Pinn and Pytlewski represented to the investigators that Pinn had in his possession a "close observationform" that documented the doctors' March 10 release orders for Robinson. Id. ¶ 53. However, ECI staff reported never having received such orders. The form itself also did not direct DOC staff to ensure that Robinson is housed with another inmate at all times. Id.; ECF No. 8-1 at 10.

The investigation ultimately concluded that Dr. Pinn's statements regarding the close observation form were "patently false." ECF No. 8 ¶¶ 52-53. Dr. Pinn eventually conceded that he never memorialized his orders, and instead blamed his faulty memory for the misrepresentation. Id. ¶¶ 51, 53. Ultimately, Dr. Pinn adopted the position that Dr. Pytlewski verbally advised ECI correctional staff of the need to "double cell" Robinson. Id.

On February 6, 2019, Plaintiffs Arlinda Robinson (James Robinson's mother) and Diana Calderon (the mother of Robinson's two minor children) filed in Prince George's County Circuit Court a wrongful death and survivorship action against Dr. Pinn, Dr. Pytlewski, the State...