Blackstock v. Corrections Corp. of America

• Decision Date: 16 September 2009
• Docket Number: Civil Action No. 08-1557.
• Citation: 660 F.Supp.2d 764
• Parties: Robert BLACKSTOCK v. CORRECTIONS CORP. OF AMERICA, et al.
• Court: U.S. District Court — Western District of Louisiana

660 F.Supp.2d 764

Robert BLACKSTOCK v. CORRECTIONS CORP. OF AMERICA, et al.

Civil Action No. 08-1557.

United States District Court, W.D. Louisiana, Alexandria Division.

September 16, 2009.

Robert Glenn Blackstock, Winnfield, LA, pro se.

Ronald E. Corkern, Jr., John Chris Guillet, Corkern & Crews, Natchitoches, LA, for Corrections Corp. of America, et al.

JUDGMENT

JAMES T. TRIMBLE, JR., District Judge.

Before the court is the report and recommendation¹ of the magistrate judge pertaining to plaintiffs two (2) motions for preliminary injunctive relief.² Also before the court are timely objections to the report and recommendation by defendants.³

The magistrate judge recommends that plaintiffs' motions for injunctive relief be granted, ordering that defendants provide plaintiff with the medications prescribed by Dr. McWilliams.⁴ Defendants do not object to such injunctive relief and assert that they have already agreed to begin dispensing such medications to plaintiff.⁵ Defendants do, however, object to those portions of the magistrate judge's report and recommendation which address the merits of plaintiffs claims of deliberate indifference, arguing that the magistrate judge's "findings" as to these issues are improper at this juncture and should be reserved for a trial on the merits in this case.⁶ The court disagrees.

After review of the record in this case, including the filings referenced above, it is clear to us that the magistrate judge was bound to address the issues of deliberate indifference and irreparable injury due to the requirement that plaintiff demonstrate a substantial likelihood of success on the merits in order to obtain preliminary injunctive relief under applicable law and jurisprudence.⁷ Therefore, we find no over-reaching in the magistrate judge's report and recommendations. Moreover, our review of the record before us leads us to share the exasperation evident in the work of the magistrate judge. The facts before us are simply astonishing, both in their volume and duration. It is deeply troubling that this great effort has been necessary to wedge common sense into the medical treatment offered to plaintiff. Therefore, it is hereby

ORDERED, ADJUDGED and DECREED that the report and recommendation of the magistrate judge, previously issued in the above captioned case, is ADOPTED in its entirety and, accordingly, plaintiffs motions for preliminary injunctive relief are GRANTED and, thereby, defendants are ORDERED to immediately comply with the written orders of Dr. McWilliams, hereafter dispensing all such medications as shall be prescribed for the treatment of plaintiffs medical condition at issue in this case.

REPORT AND RECOMMENDATION OF MAGISTRATE JUDGE

JAMES D. KIRK, United States Magistrate Judge.

Before the court is a motion by plaintiff for a preliminary injunction pursuant to FRCP 65 and a motion for medical attention which I construe as a motion for preliminary injunction [Doc. # 12 and 16]. Plaintiff asks the court to order the prison doctor to provide him with his medications.

In order for plaintiff to obtain a preliminary injunction, he must show: (1) a substantial likelihood that his cause will succeed on the merits, (2) a substantial threat of irreparable injury if the injunction is not granted, (3) that the threatened injury outweighs the threatened harm the injunction may do to the opposing party, and (4) that the court granting the injunction will not disserve the public interest. Piedmont Heights Civic Club, Inc. v. Moreland, 637 F.2d 430 (5th Cir.1981).

Plaintiff, now an inmate at Winn Correctional Center, alleges that in April 2002 he had a tumor removed from his spinal cord near his brain stem. Thereafter, he was diagnosed with neurological damage, reflex sympathetic dystrophy, abnormal reflex, involuntary movement and neuropathic pain and anxiety.

When he arrived at Winn in December 2007 from another prison, his prescribed medications were Neurontin¹, diazepam² and baclofen³ according to plaintiff. Defendants suggest that his medications were Neurontin, Naprosyn⁴, and Benadryl⁵. The medical records reflect that various medications were tried at Winn by the prison doctor, Dr. Pacheco. In March 2008 plaintiff was admitted to the LSU (charity) hospital with complaints of pain. When he was released, his prescribed medications were Neurontin, Senna⁶ and diazepam. He did not receive the Neurontin until April 7, 2008 and diazepam until April 24, 2008. However, Dr. Pacheco discontinued the Neurontin and diazepam on June 30, 2008. Pacheco testified that he discontinued the drugs because he looked in the Physicians Desk Reference (PDR) and concluded that Neurontin was not indicated for plaintiff's condition, that he had concerns whether plaintiff might be allergic to Neurontin⁷ and that it was suggested by his boss, Dr. Andre (ph), that he not use Neurontin because it was not on the corrections department's formulary.

When plaintiff saw his neurologist, Dr. McWilliams at LSU on August 1, 2008, he was still not receiving his medications and his condition had already worsened. His only prescription at the prison was Motrin⁸. Dr. McWilliams prescribed Neurontin again and also Valium. Dr. McWilliams' M.D. resident, Dr. Kelley, wrote a note to the prison on the prescription script saying "Attention prison authoritiespt [patient] needs these meds".

Still, thereafter plaintiff did not receive those medications and only received Motrin from the prison.

Then, plaintiff saw Dr. McWilliams, the neurologist, again on October 24, 2008. The doctor noted again that the medications had been discontinued in June. She also noted that plaintiff said his physical therapy had been cancelled and he was not getting to use his splints. On October 30th Dr. McWilliams also took the time to write a letter to the prison warden, Wilkerson, explaining Blackstock's medical condition and advising the warden that the prison doctor, Pacheco, had cancelled his prescriptions. She explained that Blackstock had responded positively to the Neurontin and pointed out that a generic version is available. She pointed out that Pacheco's notation in the medical records that plaintiff was "faking" his symptoms was simply not true based on objectively verifiable physical neurological changes. Dr. McWilliams pointed out that plaintiffs condition was not repairable and was irreversible.

She explained that Blackstock was "already developing irreversible complications of his paralysis". She concluded:

"I find it incomprehensible that the prison physician is denying him Neurontin for pain management as it is not a drug of abuse and is not very expensive in the generic form."

* * * I am writing to you in hopes that you can correct the situation before it becomes a legal issue as I believe that the case record will speak for itself and he appears to have been willfully denied minimal medical care. It makes no sense to send him repeatedly to a specialty clinic for appropriate advice and then have a physician ignorant of the diagnosis and treatment of his problem decide that he should not be treated as indicated. We want to cooperate with you on getting the best care for Mr. Blackstock, but this is not possible when the prison doctor is cancelling all of our prescriptions for him as soon as he returns."

Dr. McWilliams, obviously frustrated with the actions of the prison, sent a copy of the letter to Louisiana Governor Bobby Jindal, among others. However, and unfortunately, the Governor apparently only forwarded the letter to Dr. Singh, the DOC's medical director. Instead of accepting the letter for what it was—a detailed recitation of the patient's medical condition and his lack of effective treatment at the hands of the prison—Singh considered it to be "accusations" and, instead of attacking the problem, decided he would attack the doctor, Dr. McWilliams. On March 11, 2009 Singh said in an email to the warden that he would contact the Vice Chancellor of LSU-S, Dr. Clay, about the doctor and suggested that she was going "overboard with this"⁹. This, despite the fact that Blackstock was not receiving effective treatment, and had already suffered irreversible complications of his paralysis probably due to the prison's lack of appropriate care.

Despite the doctor's letter to the warden, Blackstock still did not receive his medications and continued to be prescribed only Motrin, with Percogesic being added on January 2, 2009.

On February 12, 2009 (3½ months later), Nurse Thomas and Dr. Pacheco at Winn telephoned Dr. McWilliams to discuss his medications and treatment. Pacheco then memorialized the conversation in his notes saying that Dr. McWilliams had "recommended some alternatives to Neurontin such as Elavil, Baclofen or Tegretol . . ."

Dr. McWilliams confirmed the conversation in her letter of February 18, 2009 where she recommends Neurontin, Baclofen, or carbamazepine (Tegretol). However, she pointed out that carbamazepine is toxic to the liver and bone marrow and patients need to be closely monitored because of the potentially life-threatening side effects.

Dr. Pacheco chose carbamazepine (Tegretol), the only one of the three medications with potentially serious side effects.

This motion for injunction was then filed. By March 11th the prison medical notes reflected that Blackstock had shown no response to the Tegretol and it was discontinued. Incredibly, instead of starting Blackstock on one of the other two drugs recommended by Dr. McWilliams (including Neurontin which was known to work for him in the past), Pacheco again ignored the specialist's recommendations and chose another drug entirely, Elavil, which is ordinarily used to treat depression¹⁰ and sometimes chronic pain (as opposed to neuropathic pain).

So on the very same day that Dr. Singh was complaining about Dr. McWilliams instead of correcting the problem, Dr. Pacheco was once again ignoring Dr. McWilliams' advice—advice obtained at the...