Slopsema v. Spanenberg
| Decision Date | 13 April 2023 |
| Docket Number | 22A-CT-2336 |
| Parties | Joseph Slopsema, Appellant-Petitioner, v. William J. Spanenberg, M.D., Indiana Department of Correction, putnamville Correctional Facility, Wexford Health Sources, Inc., and Wexford of Indiana, LLC, Appellee-Respondent. |
| Court | Indiana Appellate Court |
Pursuant to Ind. Appellate Rule 65(D), this Memorandum Decision is not binding precedent for any court and may be cited only for persuasive value or to establish res judicata, collateral estoppel, or law of the case.
Appeal from the Marion Superior Court The Honorable Timothy W Oakes, Judge Trial Court Cause No. 49D02-2003-CT-12545
ATTORNEYS FOR APPELLANT Katherine A. Piscione Ann Marie Waldron Waldron Tate Bowen Spandau LLC Indianapolis, Indiana
ATTORNEY FOR APPELLEES - WILLIAM SPANENBERG, M.D. AND WEXFORD OF INDIANA Rachel D. Johnson Stoll Keenon Ogden PLLC Indianapolis, Indiana ATTORNEYS FOR APPELLEE - INDIANA DEPARTMENT OF CORRECTION Theodore E. Rokita Attorney General of Indiana Benjamin M.L. Jones Assistant Section Chief Criminal Appeals Indianapolis, Indiana
[¶1] Joseph Slopsema appeals the trial court's grant of summary judgment in favor of William J. Spanenberg, M.D., Wexford Health Sources, Inc., and Wexford of Indiana, Inc. (collectively, the "Wexford Defendants"), and the trial court's separate grant of summary judgment in favor of the Indiana Department of Correction ("DOC") and the Putnamville Correctional Facility ("Prison") (collectively, the ). Slopsema raised claims that the Wexford Defendants and the State Defendants violated his rights under 42 U.S.C. § 1983 ("Section 1983"). On appeal, Slopsema argues that both summary judgment orders were erroneous because genuine issues of material fact exist regarding whether the Wexford Defendants and the State Defendants exhibited deliberate indifference toward Slopsema's serious medical needs. We disagree with Slopsema's contentions, and accordingly, we affirm.
[¶2] Slopsema raises two issues, which we restate as:
[¶3] Slopsema was an inmate in the DOC from 2015 through September 2019. Wexford was awarded a contract to provide medical services to inmates at Indiana's correctional facilities including the Prison. Dr. Spanenberg was employed by Wexford and provided care at the Prison from 2016 through May 2018.
[¶4] On March 16, 2018, Slopsema had an appointment with Dr. Spanenberg. Slopsema informed Dr. Spanenberg that he was having bloating, constipation, and bloody bowel movements.[1] Dr. Spanenberg ordered laboratory testing and prescribed colace, a stool softener, and hemorrhoidal supplements.
[¶5] On March 17, Slopsema saw a nurse and reported that he was having frequent bloody diarrhea. The nurse notified Dr. Spanenberg, who saw Slopsema again on March 21. Slopsema reported sharp perianal pain that was aggravated by bowel movements and bloody bowel movements. Dr. Spanenberg diagnosed Slopsema with hemorrhoids, ordered sitz baths, and prescribed colace, suppositories, and naproxen.
[¶6] Dr. Spanenberg saw Slopsema again on March 23. Dr. Spanenberg noted a "marginal improvement" in Slopsema's symptoms. Appellant's App. Vol. IV p. 54. Dr. Spanenberg repeated laboratory testing and continued with the same prescriptions. At this appointment, Slopsema weighed 195 pounds.
[¶7] Between March 23 and March 30, Slopsema had nurse visits twice daily for sitz baths. On April 5, Slopsema saw Dr. Spanenberg, who noted that Slopsema's symptoms were "improving" and ordered that the sitz baths be restarted and continued with the prescribed medications. Id. at 35. At this appointment, Slopsema weighed 178 pounds. Slopsema continued with nurse visits and twice-daily sitz baths from April 6 through April 8. On April 8, Slopsema reported to the nurse that he was "having a bad day." Id. at 28. The nurse noted that Slopsema was "grey in pallor" and referred him to see Dr. Spanenberg. Id.
[¶8] Dr. Spanenberg saw Slopsema again on April 9 and again diagnosed Slopsema with hemorrhoids. Dr. Spanenberg ordered a recheck of Slopsema's labs, continued the sitz baths, and noted that Slopsema should see a general surgeon for "banding"[2] if the issue "persists" or he becomes "significantly anemic." Id. at 26. At an April 10th nurse visit, Slopsema reported significant pain. Slopsema saw Dr. Spanenberg again on April 11 because he was having ongoing bleeding six to eight times a day with bowel movements. Dr. Spanenberg referred Slopsema to see a specialist for treatment of the persistent internal hemorrhoidal bleeding. Dr. Spanenberg noted that Slopsema had "[f]ailed to respond to conservative treatment over the course of weeks." Appellant's App. Vol. III p. 244.
[¶9] Slopsema continued twice daily nurse visits and sitz baths from April 14 to April 21, and once daily nurse visits and sitz baths from April 22 to April 25. Slopsema saw the specialist, Dr. Francis Tapia, on April 26, who diagnosed Slopsema with hemorrhoids, ordered continued conservative treatments, and scheduled a colonoscopy.
[¶10] Slopsema continued with the daily nurse visits and sitz baths through May 8. At that time, Slopsema experienced more intense pain. Laboratory testing revealed that he had low hemoglobin levels. Dr. Spanenberg determined that they could not "further wait for the planned colonoscopy," and that Slopsema needed a "transfusion, CT scan and the colonoscopy in rapid sequence." Id. at 192. Dr. Spanenberg sent Slopsema to the emergency room of a local hospital, where a CT scan showed "diffused colitis." Appellant's App. Vol. II p. 99. In the emergency room, Slopsema was prescribed an antibiotic typically used for bacterial diarrhea and was returned to the Prison on the same day.
[¶11] Dr. Spanenberg disagreed with the diagnosis given in the emergency room and suspected that Slopsema had ulcerative colitis and possibly which is a "bacterial infection" that can cause diffused colitis and "a number of serious consequences." Id. at 100. People in nursing homes, prisons, and hospitals are at increased risk for contracting C. difficile. Dr. Spanenberg prescribed steroids for the ulcerative colitis and Flagyl, which is the "appropriate treatment" for C. difficile. Id. The colonoscopy was already scheduled for the following week.
[¶12] On May 10, Slopsema reported a "dramatic improvement in symptoms since the initiation of steroids." Appellant's App. Vol. III p. 184. On May 11, however, Slopsema's blood sample was hand delivered to the hospital so that Dr. Spanenberg could have immediate results. The laboratory testing of Slopsema's blood revealed a "critical [hemoglobin count] of 6.6." Id. at 178. Slopsema was then transported to Methodist Hospital in Indianapolis, where he was admitted. Slopsema tested positive for C. difficile, received medications, and received blood transfusions. When Slopsema was discharged from Methodist Hospital, he was sent to the Plainfield Correctional Facility. On June 8, Slopsema was again admitted to Methodist Hospital, where his colon was removed. He weighed 135 pounds when discharged from Methodist Hospital after his surgeries. Slopsema was then returned to the Plainfield Correctional Facility.
[¶13] On August 24, 2018, Slopsema filed a tort claim notice alleging that the twomonth delay in his diagnosis resulted in the removal of his colon. In March 2020, Slopsema filed a complaint against the Wexford Defendants and the State Defendants, which was amended in September 2020. The amended complaint alleged: (1) the medical care and treatment provided to Slopsema was "careless, negligent and failed to comply with appropriate standards of medical care and treatment required and/or expected of physicians and healthcare providers in the State of Indiana"; and (2) "[t]he actions of the Defendants violated Slopsema's rights under 42 U.S.C. § 1983 and constituted deliberate indifference." Appellees' App. Vol. II pp. 81-82.
[¶14] In May 2022, the Wexford Defendants filed a motion for summary judgment. The Wexford Defendants argued: (1) Slopsema's claim against the Wexford Defendants for medical malpractice failed because Slopsema had failed to present the necessary expert testimony; (2) Slopsema's claim against Dr. Spanenberg for deliberate indifference failed because Slopsema "failed to present evidence to even establish negligence, and therefore cannot even approach a claim under Section 1983 for deliberate indifference"; and (3) Slopsema's claim against Wexford under Section 1983 required Slopsema to demonstrate that Wexford had "an unconstitutional policy that was the 'direct cause' or the 'moving force' behind a constitutional injury," which Slopsema had failed to do. Appellant's App. Vol. II pp. 47-48. The Wexford Defendants designated Slopsema's deposition, Dr. Spanenberg's deposition, and the report of an expert witness, Dr. Bradford Bomba. Dr. Bomba opined:
[T]he focus of my review was specifically upon the care and treatment provided by Dr. Spanenberg and the medical staff during March, April, and May 2018. It is my professional medical opinion, to a reasonable degree of medical certainty, that care and treatment provided by Dr. Spanenberg and other medical staff at the Putnamville Correctional Facility was appropriate and within the applicable standard of care. Mr. Slopsema initially had reports of rectal bleeding which were treated appropriately with conservative measures. Mr. Slopsema reported some intermittent improvement. When his symptoms persisted, Dr. Spanenberg appropriately referred...
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