Diaz-Cruz v. Symons, Civil No. 1:11-CV-1302
| Decision Date | 26 October 2016 |
| Docket Number | Civil No. 1:11-CV-1302 |
| Parties | KRISTAN DIAZ-CRUZ, Plaintiff v. DR. SYMONS, et al., Defendants |
| Court | U.S. District Court — Middle District of Pennsylvania |
(Magistrate Judge Carlson)
We now are called upon to write the penultimate chapter in this long-standing lawsuit. The plaintiff, Kristan Diaz-Cruz, an inmate in the custody of the Pennsylvania Department of Corrections housed at SCI-Rockview, commenced this action pro se on July 13, 2011. In its current form, the lawsuit is reduced to three defendants and three legal claims. Presently, Diaz -Cruz is suing Dr. John Symons and Ted Williams, alleging that these defendants violated his rights under the Eighth Amendment to the United States Constitution through their deliberate indifference to his serious medical needs resulting from glaucoma, and negligently failed to provide the plaintiff with adequate vision care. In addition, Diaz-Cruz has alleged that a third defendant, Sergeant Thomas Rogers, retaliated against him for filing grievances and complaints by denying him access to medication on two occasions and by transferring him to another cell within the prison.
Throughout the protracted history of this case, we have endeavored in numerous ways over the past several years to accommodate the plaintiff's claims, by twice appointing pro bono counsel for the plaintiff, and by granting numerous extensions of time for discovery to the plaintiff. These efforts have often been unavailing, as the plaintiff has accepted assistance of pro bono counsel but then encountered irreconcilable conflicts with his counsel. Thus, in February of 2016, the plaintiff discharged his second pro bono counsel, following a colloquy with the Court in which we warned the plaintiff that he would be compelled to try the case in accordance with the schedule previously set by the Court if no other pro bono counsel could be obtained. (Docs. 187, 188.) The plaintiff indicated at that time that he understood that he must be prepared to pursue this case in a timely manner. (Id.)
The precipitating event which led to this conflict with counsel is now apparent, and forms part of the basis for the pending motions for summary judgment filed by the defendants. In January of 2016, the plaintiff's own medical expert unequivocally stated based upon a review of all of the plaintiff's medical records, that "Diaz-Cruz did in fact receive adequate and appropriate ophthalmology follow-up after his transfer to the Rockview State, Correctional Facility [and] that the Rockview StateCorrectional Facility and Dr. John Symons, M.D., did use such care as reasonably prudent healthcare providers practicing in the same field in the same or similar locality would, have provided under similar circumstances." (Doc. 192, p. 10.) Thus, Diaz-Cruz is proceeding forward on these medical claims in the face of a declaration from his own medical expert that he received adequate and appropriate ophthalmological care.
On these facts, we find that Diaz-Cruz's medical claims now fail and that defendants Symons and Williams are entitled to summary judgment in their favor on those claims. As for Diaz-Cruz's retaliation claim, this claim is still bound and defined by factual disputes which are not amenable to a summary judgment resolution. Therefore, the summary judgment motion of defendant Rogers will be denied.
This case involves an inmate's complaints regarding the medical treatment which he received for pre-existing medical conditions, conditions which had effected Diaz-Cruz long before he was incarcerated in the state prison system. According to the well-pleaded facts in Diaz-Cruz's second amended complaint, he has experienced a chronic medical condition, diabetes, since 2000. (Doc. 101, ¶31.) Diaz-Cruz hasalso experienced vision problems since 2007, beginning with the loss of vision in his right eye and a decline in visual acuity in his left eye. (Id., ¶¶35,36.)
On June 8, 2009, Diaz-Cruz was incarcerated at the Berks County Prison. (Id., ¶39.) He remained housed at that facility until February 9, 2010, when he was transferred to state custody. (Id., ¶67.) According to Diaz-Cruz when he was first incarcerated at the Berks County Prison, he was held in the prison's medical unit. (Id., ¶42.) Diaz Cruz also avers that by September 29, 2009, while housed at this county jail, he was diagnosed with a central retinal vein occlusion, the principal medical complaint which he now alleges in his second amended complaint. (Id.,¶ 64.)
Diaz-Cruz was then transferred to state custody on February 9, 2010, and was housed at the State Correctional Institution (SCI) Rockview. (Id., ¶¶67-68.) Upon his arrival at SCI Rockview Diaz-Cruz was medically assessed by a physician assistant. (Doc.191, ¶ 12.) That assessment observed that Diaz-Cruz was diabetic, asthmatic, and suffered from hypertension. This initial assessment also determined that Diaz-Cruz suffered from vision problems, and he was referred to the glaucoma clinic. (Id., ¶13.)
In the meanwhile, other medical arrangements were being made to address Diaz-Cruz's vision problems. Thus, Diaz-Cruz was identified by medical staff ashaving "a significant eye problem" and was referred to an outside medical group, Eye Consultants of Pennsylvania, for examination and treatment. (Id., ¶¶10-11.) Diaz-Cruz was also seen by a prison physician, the defendant, Dr. John Symons, on March 9, 2010. Dr. Symons, in turn, referred Diaz-Cruz's vision issues to two medical specialists, Dr. Marcovich, and opthalmologist, and Dr. Lanning, a retinal specialist. (Id., ¶14.) Both of these specialists examined and treated Diaz-Cruz over the ensuing months, prescribing medication for the plaintiff, and ultimately recommending that Diaz-Cruz receive surgery for his vision condition. (Id., ¶¶14-17.) That surgical procedure, a vitrectomy, was performed on Diaz-Cruz on April 12, 2012. (Id., ¶18.) Dr. Symons then retired in August of 2012 and played no further role in the care and treatment of Diaz-Cruz. (Id., ¶19.)
A review of prison medical records discloses the extensive nature of the care and treatment which Diaz-Cruz has received over the years for his vision problems. According to these records, between February 2010 and April 2012, Diaz Cruz received approximately 20 appointments with physicians and specialists dedicated to his vision issues. (Doc. 217.) At these appointments the plaintiff's eyes were examined; he received treatment and injections; and medical staff diagnosed his condition as one which resulted from a broken blood vessel which Diaz Cruz suffered in September of 2009, prior to his incarceration in state prison. (Id.) Moreover, whenDiaz-Cruz's condition declined significantly in March and April of 2012, he received prompt surgical care. (Id.) This level of care has continued to this day, with Diaz-Cruz receiving some 11 additional medical appointments for his vision between April 2012 and October 2016. (Id.)
It is against this factual backdrop that Diaz-Cruz brings two legal claims against Dr. Symons. First, according to Diaz-Cruz Dr. Symons displayed deliberate indifference to his serious medical needs in violation of the Eighth Amendment to the United States Constitution. Dias-Cruz further alleges a state tort of medical negligence, asserting that the care provided to him by Dr. Symons fell below generally acceptable standards of care in the medical profession. This latter claim was initially supported by a certificate of merit submitted in January of 2013 by Dr. Terrance Baker. Dr. Baker's certificate of merit was the legal lynchpin of this malpractice claim. However, as this litigation progressed, Dr. Baker reassessed his views and withdrew this certificate of merit in January of 2016. As Dr. Baker observed:
Discovery has been ongoing from January 2013 until today. Additional facts in evidence' include the deposition of John Symons, M.D. who was able to document, certify and provide medical records demonstrating that in fact the standards of care were met in providing glucose control during Mr. Diaz-Cruz's admission to the Rockview State Correctional Facility. Furthermore, Dr. Symons was able to demonstrate based upon personal knowledge and the review of the medical records that Mr.Diaz-Cruz did in fact receive adequate and appropriate ophthalmology follow-up after his transfer to the Rockview State, Correctional Facility on or around 2/9/10. Based upon a reasonable degree of medical certainty, it is my opinion that the Rockview State Correctional Facility and Dr. John Symons, M.D., did use such care as reasonably prudent healthcare providers practicing in the same field in the same or similar locality would, have provided under similar circumstances. It is my opinion that no breaches in care caused Mr. Diaz-Cruz to experience a worsening of his severe retinal vein occlusion with macular engorgement. On admission to Rockview State Correctional Facility, Mr. Diaz-Cruz had already experienced severe injury to his vision as documented by eye exams prior to his transfer to the Rockview State Correctional Facility and confirmed by additional examination scheduled for him by Dr. Symons in April 2010. No progression or significant worsening of Mr. Diaz-Cruz's diabetes or vision occurred during this period of review from 2/9/2010 until late April 2010.
Thus, as of January of 2016, the plaintiff's own medical expert had unequivocally stated based upon a review of all of the plaintiff's medical records, that "Diaz-Cruz did in fact receive adequate and appropriate ophthalmology follow-up after his transfer to the Rockview State, Correctional Facility [and] that the Rockview State Correctional Facility and Dr. John Symons, M.D., did use such care as reasonably prudent healthcare providers practicing in the same field in the same or similar locality would, have provided under...
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