Ferola v. Moran, Civ. A. No. 81-0041P.

• Decision Date: 22 November 1985
• Docket Number: Civ. A. No. 81-0041P.
• Citation: 622 F. Supp. 814
• Parties: Michael J. FEROLA v. John MORAN, et al.
• Court: U.S. District Court — District of Rhode Island

622 F. Supp. 814

Michael J. FEROLA v. John MORAN, et al.

Civ. A. No. 81-0041P.

United States District Court, D. Rhode Island.

November 22, 1985.

Ernest Barone, North Providence, R.I., for plaintiff.

Stephen Robinson, Dept. of Corrections, State of R.I., Cranston, R.I., for defendants.

OPINION AND ORDER

PETTINE, Senior District Judge.

The plaintiff, Michael J. Ferola, has brought this civil rights action, 42 U.S.C. § 1983 against John J. Moran, Director, Department of Corrections; Matthew Gill, Assistant Director; Stafford Quick, Associate Director; Paul LaRochelle and Captain House, guard officers; and certain medical personnel of the Adult Correctional Institutions, namely, Chuck Dawson, a psychologist; Dr. Bernard Duval, a psychiatrist; Dr. Karoly Kun, a physician; and nurses Audrey Heon, Louise Donnelly and Joanne McNamara. Ferola asserts that while incarcerated as an inmate at the ACI, he was physically abused and denied psychiatric care, in violation of the rights guaranteed to him by the Eighth Amendment to the United States Constitution; he seeks damages and equitable relief. For reasons hereinafter stated, judgment is rendered in part for the defendants and in part for the plaintiff.

This case was tried to the Court and by agreement of the parties, hearsay evidence, letters, documents, and the like were accepted as though properly admitted. The evidence developed the following facts.

I. FACTS

1. Psychiatric care:

The plaintiff is a 25 year old inmate currently serving a ten year term for robbery and rape. The sentence was imposed in October of 1978. From the commencement of his term to at least 1981, his incarceration has involved a bizarre sequence of aberrant behavior. He candidly testified that within a week of his imprisonment he intentionally injured himself, and thereafter, over a period of approximately three years, periodically did so on sixty different occasions. Most of these incidents required the plaintiff to be hospitalized for approximately a week or more; he described these episodes as "cutting myself," "smashing my hand into the wall," and "setting cell on fire." He was placed under the care of Dr. Bernard Duval, the prison psychiatrist, who saw him "at least once a week" from 1978 to November of 1980. When asked to give reasons for his behavior, he replied, "one was places that I didn't want to be, fear of being same place, refusing to move me. I felt that as my means of getting out. Other times it was depression. I was young I didn't want to do time. Other times was out of hostility because of the way I was being treated."

Ferola's deviant behavior manifested itself prior to his present imprisonment. As a youth, he was examined or treated at four different medical facilities and placed in special schools and group homes. At age 14, he was sent to a special school for severely anti-social youths where he was diagnosed as having a severe character disorder. There is no doubt, as evidenced by the medical records introduced in this case, the plaintiff had a long standing, deeply rooted antisocial personality disorder when he started serving his current sentence.

A general survey of his prison disciplinary record commencing in 1979, reveals approximately eighty-five infractions; thirty-two went before a disciplinary board; as a result he was deprived of parole time. Throughout his imprisonment he has received medical attention from Dr. Duval, the prison psychiatrist. Dr. Bauermeister of the State's Department of Mental Health, who was called by the defendants as an expert, analyzed Ferola's condition and the treatment he received. He told the Court that there are no effective methods for treating a person who has an anti-social personality and that Dr. Duval, who is a psychiatrist as well as a physician, utilized both his medical and psychiatric skills in caring for Ferola. Dr. Bauermeister stated that "psychiatrists with M.D. degrees are a scarce commodity and in general they are used exclusively to prescribe medication. From reading the notes carefully I have had the feeling that Dr. Duval extended himself way beyond the limited definition of his task and did attempt counselling with Mr. Ferola;" he pointed out that in 1979, Dr. Duval saw Ferola 20 times and in 1980, 39 times. In addition to providing counselling, Dr. Duval, from time to time, placed Ferola in a "lock-up-feed-in" status, and prescribed drugs to control his behavior.

In short, Dr. Duval exhausted every available means of helping Ferola but was frustrated at every turn. He finally concluded that further treatment was of no avail; as he states in his notes, "I tried to treat Mr. Ferola though there is no known treatment for anti-social personality; it led to nothing so I will stop." Dr. Bauermeister felt that Dr. Duval was completely correct in his diagnosis and supported Dr. Duval's conclusion of the futility of further treatment, as demonstrated by the course of Ferola's behavior. He referred to the record, which shows that increased treatments did not lessen the number of infractions committed by Ferola; indeed, in the years in which there was no treatment, Ferola's infractions dropped.

A further elaboration of Ferola's psychiatric condition is not necessary. It is clear and uncontradicted that he is a manipulative individual who uses self-injurious behavior to improve his condition at the prison; there is no question he is the victim of an anti-social personality disorder for which there is no cure; however, in this case, Dr. Duval administered treatment to Ferola above and beyond the reasonable requirements and duties of a prison doctor.

The plaintiff's own evidence, a report from Dr. T.J. Chamberlain, a psychiatrist, is compatible with Dr. Duval's diagnosis, treatment and care. The plaintiff relies heavily on Dr. Chamberlain; however, I fail to see how his testimony gives any support to plaintiff's position. The language quoted to the Court is as follows:

His psychiatric history is not compatible with a psychotic process (e.g. schizophrenia or manic depressive illness), a psychoneurotic process (dysthymic disorder, compulsive disorder, etc.) or as an organic syndrome, (e.g. mental retardation, seizure disorder, etc.). His history is compatible with a personality disorder, i.e., anti-social personality disorder as defined in DMS III of the American Psychiatric Association. Although there are well defined treatment modalities for the psychotic, psychoneurotic and organic disorders, the treatment for personality disorders, and particularly the anti-social disorders is not well defined, and is controversial. He has been treated with some of the proposed therapeutic interventions, e.g., a group home with group and individual therapy without any detectable improvement. It should be noted that the anti-social personality is at best, very difficult to treat, and has a very poor prognosis. Optimal therapy within a confinement system would consist of a combination of group therapy and medication, if indicated. Lithium was utilized without any significant improvement even though the blood levels were well within therapeutic range. Lithium is not indicated for anti-social personalities, and Dr. Duval apparently ordered it on an empirical basis, and on the patient's request. Group therapy, if available may have proved beneficial, although his earlier inability to respond would indicate that his outcome with group therapy would not be significantly different.

Anti-social personalities, under the best of circumstances are very difficult to treat. The only aspect of his care that could be addressed is the global one of the prison having vocational rehabilitation facilities, and group psychotherapy. In terms of his psychiatric condition being exacerbated by the alleged lack of treatment, it should be noted that anti-social personalities are remarkably stable over time, that any change is usually short lived, and in reaction to environmental changes.

The foregoing statement is supportive of, and consistent with Dr. Duval's diagnosis. The only ingredient missing from Dr. Duval's prescribed treatment of Ferola is the group therapy. Even here, however, Dr. Chamberlain states that Ferola's "outcome" with group therapy would not have been significantly different. The plaintiff argues that even though an anti-social personality is difficult to treat, it should not be ignored. Ferola was not ignored however; in fact, there was almost solicitous concern for him.

2. Physical Abuse

On November 5, 1980, Mr. Ferola severely cut himself. As a result of this self-inflicted injury he was taken to the Rhode Island Hospital, a community based medical facility, where the wound was treated and sutured. At 5 p.m. of the same day he was returned to the prison in the charge of Lt. LaRochelle who testified that Ferola was very upset and stated that regardless of what was done for him he was going to injure himself again because he wanted to be confined in the prison hospital.

Dr. Duval was contacted. He gave instructions to the nurse, which were passed on to Lt. LaRochelle, that Ferola's cell was to be stripped bare and that he was to be shackled and handcuffed to prevent any further self inflicted injuries. At 5 P.M. these orders were executed; Ferola was shackled in a supine position. Each arm was extended over his head and handcuffed to the bed — his legs were spread and likewise shackled. The defendants claim each arm could be moved up or down by one to one and a half feet; the plaintiff disputes this claim and alleges that he was only able to move his arms 6 inches and his left arm not at all once the left cuff had slipped down the cot leg. The evidence supports the conclusion that for approximately 20 hours (5 P.M. Nov. 5 to 1 P.M. Nov. 6) he was shackled to his bed and that for approximately fourteen consecutive hours (5-5:30 P.M. to 7-7:30 A.M.) of the 20 hours he was restrained in spread eagle fashion as described.

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