Rhinehart v. Scutt, 062818 FED6, 17-2166

Opinion JudgeJOHN K. BUSH, Circuit Judge.
Party NameLewis Rhinehart and David L. Rhinehart, Joint Personal Representatives for the Estate of Kenneth A. Rhinehart, Plaintiffs-Appellants, v. Debra L. Scutt, Warden, Defendant, Adam Edelman, M.D.; Vernon Stevenson, M.D., Defendants-Appellees.
AttorneyPaul J. Zalewski, THE ZALEWSKI LAW FIRM, Warren, Michigan, for Appellant. Kevin A. McQuillan, CHAPMAN LAW GROUP, Troy, Michigan, for Appellees. Paul J. Zalewski, THE ZALEWSKI LAW FIRM, Warren, Michigan, for Appellant. Kevin A. McQuillan, Ronald W. Chapman, Carly Van Thomme, CHAPMAN LAW GROUP, Tro...
Judge PanelBefore: MOORE, THAPAR, and BUSH, Circuit Judges. KAREN NELSON MOORE, Circuit Judge
Case DateJune 28, 2018
CourtUnited States Courts of Appeals, U.S. Court of Appeals — Sixth Circuit

Lewis Rhinehart and David L. Rhinehart, Joint Personal Representatives for the Estate of Kenneth A. Rhinehart, Plaintiffs-Appellants,

v.

Debra L. Scutt, Warden, Defendant, Adam Edelman, M.D.; Vernon Stevenson, M.D., Defendants-Appellees.

No. 17-2166

United States Court of Appeals, Sixth Circuit

June 28, 2018

Argued: May 4, 2018

Appeal from the United States District Court for the Eastern District of Michigan at Detroit. No. 2:11-cv-11254-Stephen J. Murphy, III, District Judge.

ARGUED:

Paul J. Zalewski, THE ZALEWSKI LAW FIRM, Warren, Michigan, for Appellant.

Kevin A. McQuillan, CHAPMAN LAW GROUP, Troy, Michigan, for Appellees.

ON BRIEF:

Paul J. Zalewski, THE ZALEWSKI LAW FIRM, Warren, Michigan, for Appellant.

Kevin A. McQuillan, Ronald W. Chapman, Carly Van Thomme, CHAPMAN LAW GROUP, Troy, Michigan, for Appellees.

Before: MOORE, THAPAR, and BUSH, Circuit Judges.

OPINION

JOHN K. BUSH, Circuit Judge.

The Eighth Amendment bars the "inflict[ion]" of "cruel and unusual punishments." U.S. Const. amend. VIII. This case addresses how that constitutional provision applies to the medical treatment rendered by two prison doctors to an inmate who suffered from end-stage liver disease ("ESLD").

Kenneth Rhinehart ("Rhinehart"), then a prisoner, filed this action under 42 U.S.C. § 1983, alleging that medical providers associated with the Michigan Department of Corrections ("MDOC") denied him necessary treatment for his ESLD. When he died, his brothers, Lewis and David Rhinehart (the "Rhineharts"), filed an amended complaint on behalf of his estate. After defendants filed motions to dismiss and motions for summary judgment, only the Rhineharts' Eighth Amendment claims against Dr. Adam Edelman and Dr. Vernon Stevenson (the "Defendant Doctors") remained. The district court granted summary judgment to the Defendant Doctors, and the Rhineharts appealed. For the reasons below, we AFFIRM the judgment of the district court.

I.

In the summer of 2009, Rhinehart was an inmate at Alger Maximum Correctional Facility ("Alger") in Munising, Michigan. He was 58 years old but in poor health. He had been suffering from many medical conditions, including liver disease, and for the past four years, he had been experiencing general malaise, weight loss, and poor appetite. In August 2009, his prison doctor, Aster Berhane, ordered a CAT ("CT") scan of his abdominal area, which revealed a suspicion of bile duct cancer. The parties agree that Rhinehart did not in fact have cancer then or at any other time before his death.

But that was unknown in the fall of 2009, so Dr. Berhane arranged to transfer Rhinehart downstate for further investigation of this potential cancer. She contacted defendant Dr. Edelman about transferring Rhinehart to Cotton Correctional Center ("Cotton"). Dr. Edelman was the medical director for utilization management at Corizon Health Inc. ("Corizon"), 1 a company responsible for on-site medical services for all state inmates. He studied internal medicine, but his experience was mainly administrative. His job was to review requests for outside treatment, which other medical providers generally submitted on a form called a 407. Such requests were necessary for a prisoner to be referred to a specialist within Corizon's referral network.

Dr. Berhane arranged an expedited, doctor-to-doctor transfer from Alger to Cotton.2 She also submitted a 407 request to refer Rhinehart to an oncologist (cancer specialist) or hepatologist (liver specialist) for a biopsy of the potential cancer. Dr. Edelman approved the referral request.

Around that same time, Dr. Berhane also contacted defendant Dr. Stevenson-a general internist doctor, Corizon employee, and the senior doctor on staff at Cotton-to inform him about Rhinehart's medical issues. During his deposition, Dr. Stevenson testified that he understood that Rhinehart had "very urgent issues" and needed to be seen by a specialist for abnormal liver findings. R.263-3, Stevenson Dep., Page ID# 5025-26.

The Rhineharts presented evidence that the Cotton facility assigned inmates to doctors based on their prison number, and that generally, an assigned doctor was responsible for developing an inmate's treatment plan and examining that inmate (unless the doctor was unavailable to do so). Rhinehart's prison number revealed that he was assigned to Dr. Stevenson.3

Rhinehart was transferred to Cotton on October 26, 2009, but saw no doctor until about two months later. This delay is attributable to a failure by the nursing staff at Cotton in processing Rhinehart's intake and scheduling him for a medical-provider visit.4 During the time that Rhinehart had not seen a doctor, he filed complaints and grievances expressing concern about not being referred for a biopsy of his liver to determine his cancer risk. He also asked to see a doctor because of increasing pain in his liver and abdominal area and consequent difficulty in performing his porter job.

Dr. Stevenson testified that he did not receive notifications of inmate complaints or copies of grievances. But he recalled that in mid-December 2009, Cotton's Health Unit Manager, Beth Gardon, told him that Rhinehart had been at Cotton for six weeks and had not been seen for an intake. Upon hearing this, Dr. Stevenson directed Gardon to bring Rhinehart in for an appointment. The Cotton staff scheduled Rhinehart to see Dr. Stevenson three weeks later. When it came time for Rhinehart's appointment, however, Dr. Stevenson was too busy, so he arranged for another doctor, Dr. Padmaja Vemuri, to examine Rhinehart.5

From early January until the end of February 2010, Rhinehart had several appointments with prison medical providers but none with Dr. Stevenson. Dr. Vemuri first examined Rhinehart on January 4, 2010; he complained about weight loss and discomfort in his liver area.6 Dr. Vemuri noted that a request for Rhinehart to be referred to an oncologist had already been approved, and she set forth a plan to have the oncology appointment made, to have laboratory testing conducted, and for Rhinehart to have an appointment with the gastrointestinal clinic.7After this appointment, Rhinehart attended several more doctor appointments in January 2010 with Dr. Vemuri and another prison doctor, Dr. Zivit Cohen.8 On February 3, 2010, Dr. Cohen obtained approval for an ultrasound of Rhinehart's liver, which was completed about a week later.

Rhinehart was not satisfied with the care that he had received. He filed a grievance related to his first appointment with Dr. Vemuri in which he stated that he was experiencing severe pain and she failed to prescribe him pain medication. After that, he sent letters of complaints to medical and legal officials and filed a pro se lawsuit raising his concerns about his risk for cancer and the lack of care he was receiving.

Rhinehart's grievance for lack of pain medication was upheld on January 22, 2010. A little less than a month later, Dr. Cohen saw him for his complaints of abdominal discomfort and prescribed him pain medication.

Shortly after that appointment, a Jackson, Michigan newspaper ran an article reporting that Rhinehart probably had cancer and was in pain but had not been given a referral to a specialist, a liver biopsy, a treatment plan, pain pills, or an explanation for the delay. The article was followed by a call from the ACLU to the Michigan Attorney General's Office. This call resulted in a few internal emails among prison medical staff that showed some confusion about whether Rhinehart's cancer risk had been ruled out.

Three days after this exchange of emails, on February 25, 2010, Dr. Stevenson and Dr. Eddie Jenkins (the Regional Medical Director) examined Rhinehart. Rhinehart complained of abdominal pain, nausea, bilateral back and flank pain, blood in his urine, and a decreased urine stream. Dr. Stevenson "reassured" Rhinehart that he had no mass or cancer, ordered urine and laboratory tests, and scheduled a follow-up appointment in three weeks.

After that, Dr. Cohen monitored Rhinehart. She regularly examined him, ordered laboratory tests, and treated his pain. On March 8, Dr. Cohen saw Rhinehart for his ESLD. Dr. Cohen conducted a physical exam and noted improvements, including that he presented with an "okay" appetite, stable weight, and a reduction in his pain under the prescribed pain medication. In April, Rhinehart had additional follow-up appointments. Dr. Cohen conducted another full examination, prescribed Ensure, ordered lab work, and scheduled a one-month follow-up appointment. Then in May, Dr. Cohen gave Rhinehart a detail for a "light duty" work assignment to accommodate his pain. And when Rhinehart reported increased pain, Dr. Cohen prescribed methadone for him, which, during his May follow-up appointment, Rhinehart reported was working well.

But that summer, Rhinehart's condition took a turn for the worse. On June 20, 2010, about eight months after his transfer to Cotton, the Cotton medical staff transferred Rhinehart to the emergency room of Allegiance Hospital. The Cotton staff sent him there because he had been complaining of bloating, increased pain in his spleen/liver, general malaise, and fatigue. At the hospital, he presented with constipation, hallucinating, and abdominal pain. He was admitted and treated until his discharge on June 30, 2010.

A brief review of the Rhineharts' medical literature and expert testimony is necessary here. Liver disease can lead to cirrhosis of the liver-the deterioration of the liver when scar tissue replaces healthy liver tissue. Cirrhosis causes increased pressure in the veins that carry blood to and from the liver. This increased blood pressure can cause the formation of dilated veins in the esophagus, esophageal varices....

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