Smith claims he did not receive adequate medical treatment at the Saline County jail while he was being detained pending trial on federal drug charges.1 He seeks to recover compensatory and punitive damages from ten named defendants,2 all of whom are sued in their individual and official capacities:
1. William W. Iverson ("Iverson")
Supervisory Deputy, U.S. Marshals Service
Metro Fugitive Task Force
2. Mark Long ("Long")
Deputy, U.S. Marshals Service
Metro Fugitive Task Force
3. Alan Moore ("Moore")
Saline County Sheriff
4. Jeff Mulberry ("Mulberry")
Saline County Jail captain
5. Adam Drake ("Drake")
Saline County Jail administrator
6. Dr. Troy Miller ("Miller")
Saline County Jail outside medical provider
7. Koreen Mullen ("Mullen")
Saline County Jail nurse
8. Tad Eickman ("Eickman")
Saline County Attorney
9. Marshall Lux ("Lux")
Nebraska State Ombudsman
10. Barb Brunkow ("Brunkow")
Assistant Ombudsman
(Filing 1, pp. 2-3, 16-18)
Smith alleges he was arrested by the Central Nebraska Safe Streets Drug Task Force on April 18, 2018, and turned over the United States Marshals Service two days later.3 On the evening of April 20, 2018, he was transported to the Saline County jail.
Smith alleges he first saw Nurse Mullen on April 23, 2018, at which time he told her that his right collarbone was broken. This injury had occurred almost six months earlier, on October 31, 2017, during a prior arrest. Smith alleges he also informed Mullen that he required daily prescription medication, including Flomax and Avodart for prostate problems, and Amlodipine for high blood pressure. Smith complains he did not receive the medicine until one week later, on April 30, 2018, and alleges that in the interim he was "housed in solitary confinement for complaining about headaches and dizziness, requesting my blood pressure be checked because it had been over a week since my last dose of medication, and for not receiving any medical treatment for said broken collarbone." (Filing 1, pp. 36-40)
Smith alleges he then began submitting inmate request forms to medical staff on a daily basis complaining about the lack of treatment for his broken collarbone. (Filing 1, p. 39) Inmate request forms attached to the complaint include the following:
• 5/4/18. Smith complains he is having a lot of pain and discomfort from his right collarbone which prevents him from sleeping at night, and states he was scheduled for surgery on 4/20/18. Nurse (Mullen?) responds: "Will fax for records for facility MD to review. (Filing 1-1, p. 1)
• 5/5/18. Smith complains he is experiencing extreme pain from his broken collarbone and cannot sleep. The nurse responds: "Avoid activity that causes pain/discomfort, Tylenol/Ibuprofen for pain." (Filing 1-1, p. 2)
• 5/6/18. Smith asks if the U.S. Marshal can be contacted about getting some type of treatment for the broken collarbone. The nurse responds as before. (Filing 1-1, p. 3)
• 5/8/18. Smith complains he is "starting to experience neck and chest pain from my right side of my upper torso around my right collarbone area. The nurse responds: "Will have MD review your records and proceed from there. Continue with Tylenol/Ibuprofen for pain. (Filing 1-1, p. 4)
• 5/8/18. Smith states he was seen by Dr. Choy, Dr. Frey, and Dr. Bowling before being scheduled for surgery on 4/20/18. The nurse responds: "have faxed for your records& request for surgery schedule you may have had. At this time it is MD expertise to give orders as he feels. (Filing 1-1, p. 5)
• 5/8/18. Smith says he does not appreciate "the lies and documentation about me playing basketball" and generally complains about the lack of adequate medical attention. The nurse responds: "You have been seen by MD. Awaiting your records of need for surgery. MD will then review. Documentation of you playing basketball was done when I was not here. You are receiving medical attention." (Filing 1-1, p. 6)
• 5/9/18. Smith complains he is experiencing sharp pain from the top of his right pectoral muscle toward the middle of his chest. The nurse responds: "Tylenol or Ibuprofen available off med cart for pain. Avoid activity that causes pain/discomfort." (Filing 1-1, p. 7)
• 5/10/18. Smith complains he is still experiencing extreme pain and discomfort despite taking ibuprofen, and demands surgery based on his doctors' recommendations. The nurse responds: "MD will review your records and will proceed from there. Tylenol or Ibuprofen for pain." (Filing 1-1, p. 8)
• 5/11/18. Smith complains he still has pain in his neck, chest and collarbone area, and is starting to feel numbness in the fingers of his right hand. He also inquires about MD's review of his medical records. The nurse responds: "Advised you of MD expertise opinion. Use Tylenol or Ibuprofen off cart for pain." (Filing 1-1, p. 10)
• 5/11/18. Smith states that "the medical assessment by the jail's MD is not acceptable." The nurse responds: "USM faxed for approval to see jail MD." (Filing 1-1, p. 12)
• 5/13/18. Smith states he is having complications from his broken collarbone and wants to be seen medically. The nurse responds as before. (Filing 1-1, p. 11)
• 5/14/18. Smith again states that "the medical assessment by the MD is not acceptable." The nurse responds: "You will be seen by facility MD when he is here next." (Filing 1-1, pp. 13, 15)• 5/14/18. Smith files a grievance stating that "the medical assessment by the MD is not acceptable." The response (signed by Jail Administrator Drake?) states: "You have seen our doctor twice. We trust and utilize his expertise." (Filing 1-1, pp. 14, 16)
Smith alleges he was seen by Dr. Miller on May 16, 2018, and was told that he would not receive surgery for his broken collarbone "anytime soon," and that "U.S.M.S. said you'll get your surgery when you get to where you're going," i.e., prison. Smith alleges Dr. Miller told him his shoulder was "fine without even examining the area." (Filing 1, pp. 41-42) The doctor's notes for that jail visit, which are attached to Smith's Complaint, read as follows:
Phillip is in here with his clavicle issue again. He wants surgery on it. We have been able to get most of the records from his orthopedic evaluations over the past year. Basically the story goes, he was running away from law enforcement, fell, fractured his clavicle. Evaluations revealed it to be stable. Basically sent him to jail with a sling. Subsequent to getting out of jail, went and saw Ortho, had a concern for a nonunion, was offered a surgery. He stated that he would wait until he had insurance and come back and have the surgery. Did schedule surgery and then failed to show. Then he showed back up with a different surgeon. Different surgeon said, "You know, it's probably not surgical at this point. Let's monitor it and see how you do," and that is where it was left at. Phillip is not happy with this answer. I have seen him previously. His range of motion is intact in that shoulder. I could not produce any tenderness either. I explained all of this to him, and also the fact that he has been witnessed using that arm normally without any difficulty or issues. He is going to file multiple complaints, sounds like the ACLU is involved. Sounds like he is going back on the initial arrest as far as who is responsible for all this. I told him at this point I would recommend continued range of motion therapy, Tylenol and ibuprofin. With further evaluation pending.
ASSESSMENT: History or right clavicle fracture.
PLAN: Reassurances given. Nonsurgical at this point. Further evaluation pending with Ortho at a date to be determined.
(Filing 1, p. 73)
Smith alleges he was complaining about pain on May 17, 2018, and was transported to the emergency room at the Crete Medical Center. The ER doctors allegedly "concured [sic] close displaced fracture of right clavicle with non-union 'surgery'." (Filing 1, p. 43)However, documentation of this encounter merely includes diagnoses of "chest wall pain" and "closed displaced fracture of right clavicle with nonunion, unspecified part of clavicle; subsequent encounter." No medication or treatment was prescribed; Smith was directed to follow-up with Dr. Miller. (Filing1-3, p. 3)
On May 20, 2018, Smith filed a grievance about not receiving approval for surgery to repair his broken collarbone. The response (signed by Drake?) was: "USMS have been contacted about this situation. We stand by our doctor's decision." (Filing 1-1, p. 19) On May 22, 2018, Smith submitted an identical complaint to medical staff. The nurse responded: "USM's have been made aware of your situation. It is the MD's knowledge and expertise on medical issues." (Filing 1-1, p. 20)
On May 24, 2018, at the request of the Saline County jail administrator, Deputy U.S. Marshal Long forwarded Smith's medical records to USMS headquarters for a second opinion as to whether clavicle surgery was needed at that time. (Filing 1, p. 61)
On May 25, 2018, Smith filed another grievance, stating: "MD hasn't did anything concerning my broken right cervical, he hasn't even examined or even looked at it. I was just told in a brief 2 min visit with him on the 15th [sic] May that I wouldn't be receiving surgery anytime soon. That was it." The response (signed by Sheriff Moore?) stated: "You have seen our doctor and your information has been...
