Heiden v. Boffeli

Decision Date09 March 2022
Docket NumberC18-3068-LTS
CourtU.S. District Court — Northern District of Iowa
PartiesROBERT D. HEIDEN, Plaintiff, v. LINDA BOFFELI, et al., Defendants.

Leonard T. Strand, Chief Judge.


This case is before me on a motion (Doc. 41) for summary judgment filed by Karen Anderson, Patricia Dettbarn, Linda Boffeli and Jana Hacker (defendants). Plaintiff Robert Heiden has filed a resistance (Doc. 49) and defendants have filed a reply (Doc 55). I find oral argument is unnecessary. See Local Rule 7(c).

Heiden initiated this action by filing a pro se complaint (Doc. 1) in the Southern District of Iowa on November 28, 2018, seeking relief pursuant to 42 U.S.C. § 1983 for alleged violations of his Eighth Amendment rights. The case was transferred to this district on December 7, 2018, (Doc. 5), and defendants filed their answer (Doc. 18) on August 13, 2019. I subsequently granted Heiden's motion (Doc. 3) to appoint counsel.


The following facts are undisputed except where otherwise noted:

Heiden has been committed to the custody of the Iowa Department of Corrections since May 11, 1990, to serve a life sentence. Doc. 42-2 at 1. While Heiden has been housed at several facilities in Iowa, the allegations in this case arise from his stay at the Anamosa State Penitentiary (ASP) in Anamosa, Iowa, and the Fort Dodge Correctional Facility (FDCF) in Fort Dodge, Iowa. Doc 42-2 at 2. Heiden spent time at the ASP from April 13, 2004, to July 7, 2016, and again from July 22, 2016, to January 26, 2017. Id. During the times relevant to this case, Boffeli was a registered nurse at the ASP and Dettbarn was the nursing director. Id. Since January 26, 2017, Heiden has been serving his sentence at the FDCF. Id. at 2. During the times relevant to this case, Anderson was a registered nurse and the nursing director at the FDCF and Hacker was a nurse practitioner at that facility. Id.

At both facilities, medical care is available to inmates 24 hours a day. Doc. 41-2 at 2. Upon request, an inmate is seen first by a member of the nursing staff. Id. The nurse will then decide, sometimes after consulting with other medical staff, whether the patient requires additional care, such as an appointment with a physician's assistant, dentist, nurse practitioner, psychiatrist, or doctor. Id. If an inmate requests a visit with an outside medical consultant, a prison medical provider (either a doctor, dentist, nurse practitioner, physician's assistant, or optometrist) assesses the issue and determines whether an outside consultation is medically necessary. Id. at 2-3.

Heiden has periodically reported right shoulder pain since he underwent rotator cuff surgery in 2013. From 2013 to 2018, he received the following care[1] before he discovered the permanent impairment he now alleges is the result of constitutionally deficient care:

. April 20, 2009: Heiden underwent an arthroscopy on his right shoulder, which was accompanied by rotator cuff repair. Doc. 49-3 at 13. The surgery took place at the University of Iowa Hospitals and Clinics (UIHC).
. October 4, 2013: Heiden met with Dettbarn to discuss his ongoing concerns for his right shoulder and requested an appointment at the UIHC. Dettbarn told him ASP was in the process of scheduling the appointment. Doc. 41-3 at 9.
. December 4, 2013: Heiden underwent a second arthroscopy on his right shoulder, again accompanied by rotator cuff repair, at the UIHC. Doc. 49-3 at 14. Over the next few days, Heiden received various post-operation treatments from healthcare providers. Doc. 42-1 at 163-86.
. March 17, 2014: Heiden met with a nurse to ask whether he had a follow-up appointment at the UIHC for his right shoulder. He indicated he had a limited range of motion and, based on his conversations with other inmates who had undergone the surgery, he was concerned something was wrong with the way his right shoulder was healing. The nurse requested an ASP doctor review Heiden's chart, though it appears no ASP doctor did. Doc. 42-1 at 189.
. March 20, 2014: Three days after complaining of right shoulder pain, Heiden met with Boffeli in a follow-up appointment at which she observed him crawling on his hands and knees. She did not notice any expressions of discomfort and she wrote in the encounter notes that he displayed a full range of motion. Boffeli requested a chart review by a doctor. Again, it does not appear an ASP doctor performed this review. Doc. 42-1 at 190.
. April 15, 2015: Heiden reported shoulder pain during a physical examination with an ASP doctor, who prescribed Meloxicam in response. Doc. 42-1 at 191-95.
. January 20, 2016: An ASP doctor reviewed Heiden's medical chart and previous providers' notes, though it is unclear what prompted his review. He recommended Heiden perform various low-impact shoulder exercises. Doc. 42-2 at 83.
. January 27, 2016: Heiden requested copies of the shoulder exercises he was prescribed in 2013, as he claimed they were never given to him and he had “done shoulder exercises on his own” after his second rotator cuff surgery. Doc. 42-2 at 86.
. February 1, 2016: Heiden filed his first grievance (Grievance No. 28383) with the ASP, alleging the medical staff had neglected him, as a medical chart review slated to be done in March 2014 was not completed until January 20, 2016. Doc. 41-3 at 52.
. March 17, 2016: Heiden saw an ASP doctor for right shoulder pain. Heiden reported that he was doing his range of motion and strengthening exercises regularly. The doctor gave Heiden a cortisone injection and Heiden noted relief with the injection. The doctor advised Heiden to continue his range of motion and strengthening exercises and to continue taking Naproxen. Doc. 42-2 at 101.
. June 14, 2016: Heiden requested a doctor's appointment for his right shoulder. Doc. 42-2 at 140.
. June 20, 2016: Heiden saw an ASP doctor for his right shoulder pain. Heiden felt that the right shoulder was weaker by 20-30 pounds than the left. The doctor diagnosed him with bursitis of the shoulder, though he noted Heiden had a full range of motion. The doctor advised Heiden to alternate between placing ice and heat on his shoulder, take Tylenol instead of NSAIDs and follow up as needed. Doc. 42-2 at 144.
. August 24, 2016: Heiden requested a follow-up on his right shoulder, claiming his shoulder pain had worsened over the previous few weeks. He noted that he had started weightlifting the day before. The nurse referred him to a doctor. Doc. 42-3 at 18.
. August 29, 2016: Heiden saw an ASP doctor for his right shoulder pain. The doctor diagnosed Heiden with arthritis and recommended band therapy and NSAIDs. Doc. 42-3 at 20.
. September 27, 2016: Heiden requested to extend his physical therapy for his right shoulder, as he believed it was helping his shoulder heal. Doc. 42-3 at 27.
. October 5, 2016: Heiden requested a doctor's appointment for his right shoulder because, while the physical therapy exercises had helped to some extent, he did not have strength in his arm and his shoulder was “numb and tingly.” Doc. 42-3 at 28.
. October 11, 2016: Heiden met with an ASP doctor for his right shoulder pain. The doctor attributed Heiden's pain to arthritis but also referred Heiden to the UIHC for a consultation with their orthopedics department. The doctor also told Heiden to continue resistance band therapy. Doc. 42-3 at 32.
. November 4, 2016: Heiden attended an appointment at the UIHC, where a doctor suggested Heiden could have a recurrent or new tear in his rotator cuff or that he suffered from early arthritis and inflammation. The doctor recommended diagnostic shoulder injections and suggested Heiden may require an additional MRI on his rotator cuff in the future. Doc. 42-3 at 43.
. November 16, 2016: An ASP doctor referred Heiden to the UIHC for a right shoulder injection. Doc. 49-3 at 10.
. December 20, 2016: A UIHC doctor performed two diagnostic shoulder injections on Heiden's right shoulder, which brought some reprieve. Doc. 42-3 at 58.
. January 4, 2017: Heiden saw an ASP doctor for right shoulder pain. Heiden had numbness and tingling in his right hand, and he had been using a hammer drill at work. The doctor recommended he rest the shoulder and use Naproxen as needed, as it was too soon for another steroid injection. Doc. 42-3 at 60-61.
. January 23, 2017: Heiden went to health services and asked whether a doctor had made another appointment at the UIHC, as his shoulder had worsened and he demonstrated a limited range of motion. Doc. 42-3 at 63.
. January 24, 2017: Heiden requested a copy of his medical files from Boffeli. Doc. 42-3 at 64.
. January 26, 2017: Heiden was transferred to the FDFC. Doc. 41-2 at 5.
. April 3, 2017: Hacker ordered various lab work before Heiden's prison-mandated physical. Doc. 42-3 at 68.
. April 20, 2017: Hacker administered Heiden's physical, during which he requested a follow-up for his shoulder at the UIHC. Doc. 42-3 at 73.
. July 25, 2017: Heiden requested an appointment with a doctor for his shoulder pain. He said he believed his shoulder was digressing and that he needed to go back to the UIHC “to see if something is really wrong with my shoulder and my knee both.” A nurse referred him to Hacker. Doc. 42-3 at 78-79.
. August 1, 2017: Heiden met with Hacker, complaining of right shoulder pain and a limited range of motion. Heiden alleged he had never been given access to stretch bands or any other type of therapy after his 2013 surgery. Hacker provided stretch bands and exercises for his shoulder. Doc. 42-3 at 81. . September 24, 2017: Heiden complained via the prison email system that his shoulder still hurt, he could not sleep on his

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