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Carter v. Rysh

United States District Court, D. Minnesota

April 25, 2019

Ernest Carter, Plaintiff,
Jan Rysh, Darin Haugland, Dr. Craane, Katie Rueckert, Timothy Hiesterman, and Minnesota Department of Corrections, Defendants.



         This case is before the Court on a Motion for Summary Judgment (Dkt. No. 98) (“Motion”) brought by Defendants Jan Rysh (“Rysh”), [1] Darin Haugland (“Haugland”), and Dr. Stephen Craane (“Dr. Craane”) (collectively, the “Medical Defendants”).[2] The case has been referred to the undersigned United States Magistrate Judge for a report and recommendation pursuant to 28 U.S.C. § 636 and Local Rule 72.1. Plaintiff Ernest Carter (“Carter”) is an inmate of the Minnesota Department of Corrections (“DOC”) who brings this Section 1983 civil rights action against DOC personnel and medical providers for issues related to a fractured femur. (Dkt. No. 81.) Defendants Rysh (physical therapist), Haugland (physical therapist), and Dr. Craane seek summary judgment on the ground that they did not exhibit deliberate indifference towards Carter's medical needs.

         Carter responded to the motion (Dkt. No. 114) and the Medical Defendants replied (Dkt. No. 120). For the reasons stated below, the Court recommends the Motion be granted.

         I. BACKGROUND

         A. Procedural Background

         In his original Complaint filed on April 5, 2017, Carter alleges that on June 21, 2016, around 5:30 p.m., he fractured his femur during an incident at the Minnesota Correctional Facility (“MCF”)-St. Cloud. (Dkt. No. 1 at 7.) Carter alleges that he tripped, hit his head on a railing, and immediately experienced excruciating pain in his right leg. (Id. at 7-8.) Carter further alleges that he waited for an ambulance for over an hour, which ultimately took him to St. Cloud Hospital. (Id. at 8.) At the hospital, Carter underwent surgery and spent a few days recovering. (Id.) Thereafter, he was transferred to MCF-Oak Park for initial recovery and physical therapy (“PT”). (Id.) Carter was discharged from MCF-Oak Park to Rush City, where he alleges he underwent a great deal of pain and suffering. (Id.) Throughout the Complaint, he alleges he did not receive timely or adequate treatment or therapy to manage his pain. (Id. at 7-9.) He alleges that he will suffer ongoing consequences and he seeks damages for the same. (Id. at 9.) The three-page document does not associate facts with named defendants. (See generally id.) Carter appended fourteen pages of medical records to the Complaint. (Dkt. No. 1-1.)

         The Court directed Carter to correct or supplement information for his in forma pauperis (“IFP”) application. (Dkt. No. 3.) The Court also provided Carter with an opportunity to amend his Complaint to “allege[] how any particular defendant has acted in a way that is deliberately indifferent to his medical needs.” (Id. at 3.) This opportunity to amend was intended to close the gap between the three-page handwritten document and the individuals named on the Court's fill-in-the-blank Section 1983 form Carter submitted with his complaint (See id.; Dkt. No. 1 at 1-6). Carter complied on May 30, 2017 by filing an Amended Complaint. (Dkt. No. 7.)

         In his Amended Complaint, Carter indicated that Rysh was a physical therapist who gave him an assistive range of motion machine and leg exercises to perform on his own. (Dkt. No. 7 at 5.) Carter alleges that he told Rysh he needed assistance but was ignored by her. (Id.) Similarly, Carter claimed that physical therapist Haugland ignored his pleas for assistance with therapy or outside therapy-instead telling him he needed to progress on his own. (Id.) As to Dr. Craane, Carter alleges that Dr. Craane took him off pain medication. (Id. at 5.) He also mentions that physician assistant Brian Lee (“PA Lee”) gave him a prescription, but it was ripped up upon return to MCF-Oak Park. (Id. at 5-6.) Carter alleges that he was in constant pain, but only received Ibuprofen after the prescription was torn up. (Id. at 6.) He mentions that Defendants Katie Rueckert (“Rueckert”) and Dr. Timothy Hiesterman (“Dr. Hiesterman”) were on duty at St. Cloud the day he was injured. (Id.) On the night of his injury, he alleges he was rendered unconscious for as many as nine minutes, and then lay on the floor in extreme pain for 45 minutes to an hour before medical transport occurred. (Id.) He alleges that either the on-duty personnel or others reflected in records are the people responsible for the care he received. (Id.)

         On August 9, 2018, U.S. District Judge Donovan W. Frank adopted a Report and Recommendation (“R&R”) that recommended granting the DOC's Motion to Dismiss and dismissed any official capacity claim against Rueckert. (Dkt. No. 72.) The Court separately granted Carter leave to file a second amended complaint wherein he could specify any personal capacity claims against Defendants. (Dkt. No. 73.)

         Carter filed a Second Amended Complaint on August 31, 2018 (Dkt. No. 78).[3] In the Second Amended Complaint, Carter asks to remove his request for monetary damages, seeking instead to have weekly PT by external healthcare providers. (Id. at 2.) He also asks for general external medical care until release. (Id.) As to personal capacity claims-he claims that he will “leave that up to the court” but he also states that “I [sic] would be fair by suing Katie Rueckert all the defendants for personal & for the record official-capacity.” (Id. at 2-3.) He also adds that he filed a damage or “kite” claim at MCF-Oak Park in 2016 but got no response back. (Id. at 4.) The general tenor of the Second Amended Complaint is that Carter would like costs covered for outside medical care. In view of the case's posture and Carter's pro se status, the Court decided to consider the Amended Complaint and Second Amended Complaint together as the operative pleading and directed the Clerk's Office to create and docket a Third Amended Complaint by combining the two.[4] (Dkt. No. 80 at 3-4.) The Third Amended Complaint was docketed on September 10, 2018.[5] (Dkt. No. 81.)

         On October 3, 2018, the Medical Defendants moved for summary judgment. (Dkt. No. 98, 99.) After a thorough recitation of the facts, the Medical Defendants contend that Carter has not met the subjective component of deliberate indifference because there is no evidence in the medical records of deliberate indifference to his medical needs. (Dkt. No. 99 at 13.) The Medical Defendants indicate that Carter received ongoing care for his injury, even if it was not the type he desired. (Id. at 13-14.) They contend that Carter has not established a claim for deliberate indifference to his femur fracture because his disagreement with treatment does not equate to deliberate indifference. (Id. at 14-15.) In support of their motion for summary judgment, the Medical Defendants supplied medical records and other materials regarding Carter's condition. (Dkt. No. 102.)

         B. Medical History

         The medical records catalogue Carter's treatment and progress following his June 21, 2016 injury. (Dkt. No. 102.) The records provide varied explanations for the exact source of his injury-at one time he reported running, tripping on another inmate's laundry and hitting his leg on a rail (id. at 46); another time he reported running, tripping on an unknown object, and hitting his head on a railing (id. at 149-51). Following the injury, he was transported to St. Cloud Hospital where he underwent surgery to repair his fractured femur. (Id. at 89, 149-51.)

         Upon intake to the hospital, the medical records indicate that an x-ray showed Carter had a femur fracture. (Id. at 149-51.) Treatment options were discussed. (Id.) According to notes from June 23, 2016, Carter underwent a successful surgery. (Id. at 156-57.) Carter was directed to be non-weightbearing for six weeks and to follow-up in two weeks for imaging. (Id.) Carter was discharged to the DOC on June 24, 2016. (Id. at 171-73.)

         On June 24, 2016, Carter was transferred to MCF-Oak Park Heights to continue recovering from surgery. (Id. at 51.) Over the following days, he reported some discomfort and the charts note he was given pain medication. (Id. at 49-51.) As early as July 5, 2016, Carter reported that he wanted to return to activity as quickly as possible and that he decided to discontinue one of his pain medications because he believed it was causing constipation. (Id. at 49.) On July 11, 2016, he refused medications for constipation. (Id.)

         From June 24 to September 6, 2016, Carter was seen 13 times by Dr. Craane at MCF-Oak Park. (Dkt. No. 102 at 47-51.) On July 21, 2016, Carter's pain medication was swapped for another at his own request. (Id. at 49.) By July 27, Carter reported improved range of motion and no negative complications. (Id.) On August 10, Carter agreed to begin weaning off pain medications during an appointment with Dr. Craane. (Id. at 48.) However, he subsequently sought more pain medications from an external care provider at a follow-up appointment on August 19, 2016-PA Lee authored a prescription for 40 pills. (Id.) Dr. Craane noted that upon seeing PA Lee's prescription he contacted PA Lee, discussed that Carter had already ingested many pain pills, and the two agreed to shred PA Lee's prescription. (Id.) PA Lee's notes corroborate that he discussed pain management with Carter, and with Dr. Craane, and concluded that further medication would be inappropriate based upon the amount of medication already administered by Dr. Craane. (Dkt. No. 102 at 137-38.)

         On August 22, 2016, Dr. Craane switched the over-the-counter medications from Tylenol and naproxen to Tylenol and Lodine to improve pain management for Carter. (Id. at 47.) On August 30, Dr. Craane did not record any new pain management complaints. (Id.) On September 2, 2016, Dr. Craane approved Carter for discharge from MCF-Oak Park with the recommendation that he continue PT and attend a follow-up appointment with his surgeon, Dr. Hiesterman. (Id. at 46.) Upon discharge, Dr. Craane noted that Carter ingested a total of 290 narcotic pain pills. (Id.)

         C. Nursing Notes

         Detailed nursing notes fill the gaps that Dr. Craane's notes do not address. On June 26 and 27, 2016, the nursing notes reflect that Carter appeared to be in pain, so he was given more medication and was put on Dr. Craane's list for follow-up care. (Id. at 84.) During the last few days of June into early July, Carter complained of constipation, was educated on the role of each medication, and was offered medications for his bowel symptoms. (Id. at 82-84.) From July 1 to 10, 2016, the notes reflect that Carter resisted some medications and demanded others; the care provider notes indicate that staff had thorough conversations with Carter about the purpose of various medications, his options on how to use them for best results, and the potential risks of preferences he expressed. (Id. at 75-83.) Subsequently, Carter began to negotiate with staff about the type and frequency of medications. (Id. at 72-74.) From July 11-21, 2016, Carter typically received pain medication when requested, although staff did not always comply with his request to switch medication from oxycodone and Tylenol to Percocet. (Id. at 70-74.) During that timeframe, Carter was frequently noted to be socializing in the unit with no apparent distress. (Id.)

         On July 23, 2016, Carter reported no medical concerns and was observed to be moving about the facility independently in a wheelchair. (Id. at 68.) On July 24, the morning notes indicate he was lying in bed and reporting 6/10 pain, but by the evening he was asking staff if he could use the exercise bike unsupervised. (Id.) Staff advised that he wait until PT clears him for such an activity. (Id.) From late July to mid-August, Carter participated in some PT and received pain medication upon request. (Id. at 64-66.) For the duration of August, whenever Carter noted pain, he received attention from nursing staff and medications. (Id.) He was often noted to be about socializing with no apparent signs of distress. (Id. at 63-64.) September was much the same, although Carter noted the advent of chest pain, which was responded to by nursing staff. (Id.) During the first week of September, Carter was transferred from MCF-Oak Park to MCF Rush City. (Id. at 61-62.)

         Carter was seen for follow-up appointments by the orthopedic surgery office on multiple occasions. On July 8, 2016, Dr. Hiesterman directed that he should be non-weight bearing, should be introduced to range-of-motion PT, and may continue pain medication. (Id. at 148.) On August 19, 2016, Carter was directed to return in approximately four weeks for a follow-up with x-rays. (Id. at 147.) At the August 19, 2016 appointment, Carter got the prescription for 40 additional pain pills that PA Lee and Dr. Craane ultimately agreed to shred. (Id. at 48.) On September 28, 2016, x-rays and a physical examination revealed “excellent bone growth” and intact hardware with no signs of loosening or failure. (Id. at 137-39.) Carter requested ongoing pain medication at the orthopedic consultation, but the consult notes indicate that after conferring with the correctional facility, the orthopedic office decided that more prescriptions were inappropriate. (Id.) Carter was directed to use ice, over-the-counter medications, and PT to improve his situation. (Id.) Notes from December 22, 2016, indicate that the x-rays were stable and there were zero complications for the healed right femur fracture. (Id. at 134.) Dr. Hiesterman recommended zero medications, and weekly PT for six-weeks to address range of motion and strengthening. (Id.)

         D. ...

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