Lovelace v. Clarke
| Decision Date | 21 September 2022 |
| Docket Number | Civil Action 2:19-cv-75 |
| Parties | OBIE L. LOVELACE, Plaintiff, v. HAROLD CLARKE, et al., Defendants. |
| Court | U.S. District Court — Eastern District of Virginia |
This case alleging constitutional claims under 42 U.S.C. § 1983 is before the court on Defendant Dr. Charles Campbell's (“Campbell” or “Defendant”) motion for summary judgment. (ECF No. 81). Plaintiff Obie Lovelace (“Lovelace” or “Plaintiff') opposes the motion. (ECF No. 96). Campbell was Lovelace's primary healthcare provider while Lovelace was incarcerated with the Virginia Department of Corrections (“VDOC”). Mem. Supp. Def's Mot Summ. J. (“Def.'s Mem.”) Ex. 1, Pl.'s Ans. Def.'s Interrog. (“Pl.'s Ans.”) (ECF No. 82-1, at 4-5). In this action, Lovelace alleges that Campbell failed to treat his chronic Hepatitis C (“HCV”) in violation of the Eighth Amendment. Compl. ¶¶ 55-57 (ECF No. 1, at 21-23). In support of his current motion, Campbell argues that the evidence is insufficient as a matter of law to permit a reasonable juror to conclude that he was deliberately indifferent to Lovelace's serious medical needs. Def.'s Mem. (ECF No. 82, at 8-23). Campbell also argues that Lovelace was not seriously injured because he received HCV treatment after his release and was eventually cured. Id. at 24-27. Finally, Campbell claims that he is entitled to qualified immunity. Id. at 27-30.
Both parties consented to proceed before a magistrate judge in accordance with 28 U.S.C. § 636(c) and Federal Rule of Civil Procedure 73. (ECF No. 31). After reviewing the parties' briefs and the exhibits in the summary judgment record, I conclude that Campbell has failed to meet his burden to show that there is no genuine dispute as to whether he was deliberately indifferent to Lovelace's medical needs. I also find that Campbell has failed to show that there is no genuine dispute as to whether Lovelace suffered a serious injury as a result of Campbell's inaction. Lastly, I find that Campbell has failed to show that there is no genuine dispute that he is entitled to qualified immunity. Accordingly, for the reasons explained in detail below, the court DENIES Defendant's motion for summary judgment.
In February 2019, Lovelace filed suit pursuant to 42 U.S.C. § 1983 alleging that Campbell was deliberately indifferent to his serious medical needs-specifically his untreated chronic HCV-in violation of the Eighth Amendment.[1] Compl. ¶¶ 55-57 (ECF No. 1, at 21-23). He argues that Campbell knew he had HCV but failed to treat him because of its cost, causing him serious injury. Id. In March 2019, Campbell moved to dismiss Lovelace's complaint, arguing that, as to him, Lovelace had failed to state a claim. (ECF No. 7). Specifically, Campbell argued that, while Lovelace disagreed with the amount and type of treatment he had received, Campbell had in fact provided treatment to Lovelace during the relevant timeframe. Mem. Supp. Def's Mot. Dismiss (ECF No. 8, at 10-15). Campbell also argued that Lovelace failed to plead a significant injury resulting from the alleged lack of care. Id. at 15-16. Chief Judge Mark S. Davis denied Campbell's motion to dismiss. (ECF No. 23, at 10-13). The parties later consented to magistrate judge jurisdiction, (ECF No. 31), and the case was reassigned.
On July 15, 2022, Campbell moved for summary judgment. (ECF No. 81). Campbell argues that he was not deliberately indifferent to Lovelace's medical needs because he relied on records indicating Lovelace's HCV was being treated by an infectious disease specialist and because Lovelace's HCV was not a serious medical need. Def's Mem. (ECF No. 82, at 15-23). Campbell also argues that Lovelace has not suffered a serious injury because he was eventually treated for HCV and was cured. Id. at 24-27. Lastly, Campbell asserts that he is entitled to qualified immunity. Id. at 27-30. On August 5, 2022, Lovelace opposed Campbell's motion, arguing that Campbell did act with deliberate indifference because the specialist he purportedly relied on was not treating Lovelace's HCV, that his HCV was a serious medical need, and that Campbell's failure to treat it caused a significant injury. Resp. Opp'n Def.'s Mot. Summ. J. (“Pl.'s Opp'n”) (ECF No. 96, 15-19). Lovelace also argues that Campbell is not entitled to qualified immunity. Id. at 19-22. On August 12, 2022, Campbell replied, Def.'s Reply, (ECF No. 97), and requested oral argument, (ECF No. 98). On September 14, 2022, both parties appeared virtually via Zoom for oral argument. Campbell's motion is ripe for decision.
Lovelace was an inmate with VDOC from 2010 until approximately December 6, 2017.[2]Pl.'s Ans. (ECF No. 82-1, at 4); Compl. ¶¶ 13, 41 (ECF No. 1, at 9, 18). From 2012 until his release in 2017, Lovelace was housed at St. Bride's Correctional Center (“St. Bride's”). Pl.'s Ans. (ECF No. 82-1, at 4). Campbell became the Medical Director at St. Bride's in July 2013, shortly after Lovelace arrived at the facility. Id.; Def.'s Mem. SOF ¶¶ 2-3 (ECF No. 82, at 2).[3] As Medical Director, Campbell was Lovelace's primary care physician throughout his incarceration. See Pl.'s Ans. (ECF No. 82-1, at 4-5). Brief discussions of the available HCV treatment options at that time, as well as the VDOC guidelines under which Campbell was operating, are necessary to understand the analysis that follows.
HCV is a virus that affects the liver. Gordon v. Schilling, 937 F.3d 348, 351 (4th Cir. 2019). “[F]or up to 85% of HCV-infected persons, the disease progresses into a chronic condition.” Gordon, 937 F.3d at 351. Lovelace's medical expert, Paul J. Gaglio, M.D.,[4] will testify that HCV is considered chronic when it lasts longer than six months. Pl.'s Opp'n Ex. D, Gaglio Report (“Gaglio Rpt.”) ¶ 3(a) (ECF No. 96-4, at 2). As the Fourth Circuit recently noted:
Many of those afflicted with chronic HCV will experience liver damage, including scarring of the liver tissue, which is known as progressive fibrosis. And about 20% of those with chronic HCV will develop cirrhosis of the liver, that is, long-term liver damage. Cirrhosis can lead to liver failure, and those with cirrhosis also face a significant risk of developing liver cancer. Liver failure and liver cancer frequently develop in HCV-infected individuals up to twenty or thirty years after initial infection.
Gordon, 937 F.3d at 351 (cleaned up). According to Dr. Gaglio, patients who are coinfected with both HCV and human immunodeficiency virus (“HIV”) are at “increased risk” of developing these complications, with liver decompensation “accelerat[ing] at a rate of 3.9 to 7.5% every year” in patients who have developed HCV-induced cirrhosis. Gaglio Rpt. ¶¶ 4(b), 5 (ECF No. 96-4, at 4, 5).
Initial HCV therapies, which were often interferon-based, first became available around 1998. Id. ¶ 5 (ECF No. 96-4, at 4). These initial therapies, however, “produced inconsistent results and severe side effects.” Cunningham v. Sessions, No. 9:16-CV-1292-RMG, 2017 WL 2377838, at * 1 ; see Gaglio Rpt. ¶¶ 4(b) (ECF No. 96-4, at 3). In the 2010s, the Food and Drug Administration began approving direct-acting antiviral drugs (“DAAs”), “which have proven to be highly effective in the treatment and cure of Hepatitis C with minimal side effects.”[5]Cunningham, 2017 WL 2377838, at *1; see Pfaller v. Clarke, 630 B.R. 197,200 (E.D. Va. 2021), appeal docketed sub nom. Pfaller v. Amonette, No. 21-1555 (4th Cir. May 10, 2021).[6] By 2015, medical societies concerned with liver and infectious disease were recommending DAA therapy for HCV-HIV coinfected patients. Gaglio Rpt. ¶ 5 (ECF No. 96-4, at 4).[7] Today, DAAs produce “cure rates in greater than 95% of patients” coinfected with both HCV and HIV. Id.,. DAA treatment can be relatively costly.[8] Cf. Atkins v. Parker, 972 F.3d 734, 736 (6th Cir. 2020) (), cert, denied sub nom. Atkins v. Williams, 141 S.Ct. 2512 (2021). However, for patients who receive DAA treatment and are cured of their HCV, there are “dramatic decreases in complications of HCV including hepatic decompensation, portal hypertension, liver cancer, liver-related mortality, and requirement for liver transplantation.” Gaglio Rpt. ¶ 5 (ECF No. 96-4, at 5). Additionally, liver cirrhosis can “improve or resolve.” Id.
In October 2015, Mark Amonette, M.D., Chief Physician and Medical Director of VDOC, developed an Interim Guideline for Chronic Hepatitis C Infection Management (“VDOC Guidelines”).[9] Pl.'s Opp'n Ex. E, VDOC Guidelines (“VDOC Guidelines”) (ECF No. 96-5, at 35-45).
The VDOC Guidelines stated that all VDOC inmates who were eligible for HCV treatment would be referred for treatment at the Virginia Commonwealth University (“VCU”) Hepatology Clinic. Id. (ECF No. 96-5, at 35) (reciting that VDOC “has an [memorandum of understanding] with the VCU Medical Center Hepatology group to care for offenders with Hepatitis C and to provide medications for treatment”). Hepatology is a branch of medicine specializing in liver diseases. Hepatology Stedman's Medical Dictionary (27th ed. 2000). No other medical treatment providers besides the VCU Hepatology Clinic were authorized to treat VDOC inmates for HCV. See VDOC Guidelines (ECF No. 96-5, at 35-45); see also Pl.'s Opp'n Ex. B, Campbell Dep. (“Campbell Dep.”) 20:25-21:2 (ECF No. 96-2) ( that the physicians at the VCU Hepatology Clinic treated VDOC's HCV patients).
Under the VDOC Guidelines, the...
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