Hilton v. Wright
| Decision Date | 11 March 2013 |
| Docket Number | No. 9:05–CV–1038.,9:05–CV–1038. |
| Citation | 928 F.Supp.2d 530 |
| Parties | Robert HILTON and Louis Vasquez, on behalf of themselves and all others similarly situated, Plaintiffs, v. Lester N. WRIGHT, M.D., M.P.H., Associate Commissioner/Chief Medical Officer, for the New York State Department of Correctional Services; and New York State Department of Correctional Services, Defendants. |
| Court | U.S. District Court — Northern District of New York |
OPINION TEXT STARTS HERE
Koob & Magoolaghan, of Counsel: Elizabeth L. Koob, Esq., Joan Magoolaghan, Esq., Yonkers, NY, for Plaintiffs.
Eric T. Schneiderman, Attorney General for the State of New York, of Counsel: Belinda A. Wagner, Esq., James Seaman, Esq., Ass't. Attorneys General, Albany, NY, for Defendants.
I. INTRODUCTION
Plaintiff Robert Hilton (“Hilton” or “plaintiff”) 2 brought suit against defendant Lester N. Wright, M.D., M.P.H. (“Dr. Wright”) and the New York State Department of Correctional Services and Community Supervision (“DOCCS”) (collectively “defendants”) pursuant to the Civil Rights Act, 42 U.S.C. § 1983; Title II of the Americans with Disabilities Act (“ADA”), 42 U.S.C. § 12132 (“Title II”) 3; and Section 504 of the Rehabilitation Act, 29 U.S.C. § 794 (“Section 504”), alleging that Dr. Wright was deliberately indifferent to his serious medical needs in violation of the Eighth Amendment to the United States Constitution, and that both Dr. Wright and DOCCS discriminated against him in violation of Title II and Section 504 by failing to treat his chronic Hepatitis C (“HCV”). Currently under consideration is defendants' motion for summary judgment.
II. BACKGROUNDA. Factual History
Plaintiff is a 58 year old African–American male with HCV, genotype 1. He was first diagnosed with HCV in 1999 at Bellevue Hospital in New York City (“Bellevue”), where a liver biopsy revealed scarring and fibrosis and rated his liver disease as Stage 2 fibrosis, and Grade 2 inflammation.4 According to plaintiff, he received HCV treatment at Bellevue in 1999 for almost one year. The record is unclear whether he completed the full course of treatment.5
Plaintiff entered DOCCS' custody on April 14, 2003, and was released on April 29, 2004. He was incarcerated again from August 18, 2004, to May 1, 2007. 6 He alleges defendants denied him HCV treatment since 2003 on the basis that he failed to complete an alcohol and substance abuse treatment (“ASAT”) program. Plaintiff argues there is no medical basis for conditioning HCV treatment on enrollment in an ASAT program.
Dr. Wright is the Deputy Commissioner and Chief Medical Officer of DOCCS. As Chief Medical Officer, he is responsible for the development and implementation of medical policies and practices for inmates in DOCCS' custody. Dr. Wright must approve every request by a treating physician to have an inmate receive any medical treatment for HCV. Individual facility physicians do not have the authority to prescribe HCV treatment without Dr. Wright's approval.
HCV is a blood-borne virus which affects the liver. It attacks, and if not treated, commonly destroys the liver. Liver damage progresses through a series of stages beginning with fibrosis, or scarring, and often ending in cirrhosis, or pervasive scarring and inflammation. Cirrhosis often leads to liver cancer.
As of 2002, the standard clinical treatment for HCV patients with genotype 1 was a forty-eight week course of medication combining two antiviral agents, Pegylated Interferon and Ribavirin (“combination therapy”). Like many diseases, the treatment for HCV has side effects. It can cause further damage to the liver, harm the kidneys, and affect platelets and red and white blood cells.7 Other side effects of combination therapy include headaches, soreness of muscles, sore joints, fatigue, hair loss, skin rash, depression, and suicidal feelings.
When successful, combination therapy can effectively cure HCV. If a patient's viral levels remain undetectable six months after the completion of HCV therapy, they are considered to have achieved a “sustained viral response” and are considered cured. A patient who at first responds positively with HCV treatment, but upon completion of the treatment, the viral load returns to its previous levels is considered to be a “relapser.” Finally, a patient who never responds during treatment is considered to be “non-responder.”
DOCCS develops and regularly updates clinical practice guidelines for various diseases in an effort to maintain consistency of care throughout the correctional setting and to stay current with scientific advances and community standards of treatment. DOCCS houses a large number of inmates who are infected with HCV and accordingly developed guidelines relating to the primary care of inmates with HCV. The Hepatitis C Primary Care Practice Guideline was initially developed and approved on March 31, 1999, and was based upon information from many sources including national guidelines, consensus statements, and recommendations, along with peer-reviewed medical journals (the “Guidelines”). Specifically, Dr. Wright cites three governmental studies in support of the Guidelines: (1) the Centers for Disease Control and Prevention's (“CDC”) “Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV–Related Chronic Disease”; (2) the 1997 National Institutes of Health (“NIH”) consensus statement on management of HCV; and (3) the CDC Prevention and Control of Infections with Hepatitis Viruses in Correctional Settings, 52 MMWR 1, 25 (2003). Wright Decl., Apr. 16, 2009, ¶¶ 9–10. According to defendants, the Guidelines have been modified consistent with the evolution of care and treatment for HCV. Dr. Wright, as Chief Medical Officer, was responsible for the approval and implementation of the guidelines. Integral to this case are the Guidelines that were in effect at the time of plaintiff's two...
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