Livermore v. Tonhofer

District Court, E.D. Washington·Decided October 22, 2020·No. 4:18-cv-05075·Unknown

Opinion

FILED IN THE U.S. DISTRICT COURT EASTERN DISTRICT OF WASHINGTON Oct 22, 2020

SEAN F. MCAVOY, CLERK

EASTERN DISTRICT OF WASHINGTON

NO: 4:18-CV-5075-RMP Plaintiff, ORDER GRANTING DEFENDANTS’ v. SUMMARY JUDGMENT MOTION

DEBORAH TONHOFER, MD; JOHN SMITH, MD; STEVEN HAMMOND, DOC Chief Medical Officer; RUSTY SMITH, Head of Medical at AHCC; DERRY, Correctional Officer at WSP; BRENT CARNEY, DOC Dietary Services Program Manager; JOHN BOUCHARD; JOHN DOES 1-2, transporting officers, C/O HOMELEIN, Correctional Officer at WSP, Defendants. BEFORE THE COURT is a Motion for Summary Judgment by Defendants Deborah Tonhofer, MD, et al.1 ECF No. 94. Also before the Court is Defendants’ 1 The caption in this matter shall be amended to reflect that Dr. Tonhofer spells her first name “Deborah,” rather than “Debra.” ECF No. 101 at 1 n.1. Motion to Strike Plaintiff’s unauthorized sur-reply from the docket. ECF No. 116. The Court has reviewed Defendants’ Motion for Summary Judgment, ECF No. 94,

and the supporting declarations and exhibits, ECF Nos. 96, 99, 100, 101, and 102; Plaintiff’s Response and supporting declaration and exhibits, ECF No. 109; Defendants’ Reply and Reply Statement of Facts, ECF Nos. 110 and 111; Plaintiff’s

Sur-Reply and Sur-Reply Statement of Facts, ECF Nos. 113 and 114; Defendants’ Motion to Strike Sur-Reply and Sur-Reply Statement of Facts, ECF No. 116; Plaintiff’s Response, ECF No. 117; the remaining record; the relevant law; and is fully informed.

Plaintiff seeks liability against Defendants under 42 U.S.C. § 1983, alleging that Defendants were deliberately indifferent to his medical conditions, including

back injury, chronic pain, and Type II diabetes; and under the Americans with Disabilities Act, 42 U.S.C. §12101 et seq., alleging that Defendants failed to provide reasonable accommodation for Plaintiff’s diabetic dietary needs and in transporting him in vehicles that were not wheelchair accessible. ECF No. 11. The following

underlying facts are undisputed, unless otherwise noted. Mr. Livermore has experienced back, shoulder, and neck pain going at least as far back as 1980, when he was severely injured while working as a longshoreman

and endured a lengthy process of learning to walk again through physical therapy. ECF Nos. 96 at 4; 109-2 at 3. Mr. Livermore went on disability after he reinjured his shoulder and back in approximately 1990. ECF No. 96 at 4. Mr. Livermore also reports a history of substance abuse disorder. See ECF No. 96 at 4.

Once Mr. Livermore was in the custody of the Washington Department of Corrections (“DOC”), his chronic back pain continued and he reinjured himself while lifting trash bags in 2007. ECF No. 96 at 4. Medical records and a declaration

from the DOC’s Chief Medical Officer, Frank Longano, M.D., who is not a Defendant in this action, reflect that Mr. Livermore has a long history of evaluation and treatment as an inmate. ECF Nos. 99 at 2−3; 96-2. His evaluations and treatment have involved numerous and frequent visits with physicians, physicians

assistants (PAs), nurses, and physical therapists at the DOC as well as with specialists. The DOC’s Offender Health Plan (“OHP”) sets forth the health services that

are available to inmates. See ECF No. 96-1 at 6. The OHP authorizes individual practitioners to administer “Level 1: Medically Necessary Care,” for intervention that is for a life threating emergency, onsite urgent care, or outpatient care that is listed in the DOC’s Levels of Care Directory. Id. at 13−15. The OHP categorizes

care that is not medically necessary, and therefore, not authorized to be provided to inmates, as “Level 3.” Id. at 13. When a specialist consultation is necessary, or an intervention is not listed in the Levels of Care Directory, the decision regarding

whether care is allowed as Level 1 or disallowed as Level 3 must be made by the Care Review Committee (“CRC”). Id. at 13−15. The CRC determines by majority vote whether a proposed intervention is approved as medically necessary (Level 1) or not approved as not medically necessary. ECF No. 96-1 at 15.

The more than 300 pages of medical records before the Court on summary judgment contains numerous CRC Reports for interventions requested by Mr. Livermore himself or proposed by DOC medical staff. See ECF No. 96-2. In one

report dated February 8, 2012, the CRC authorized as Level 1 the administration of opioids to Mr. Livermore for up to six months for lower back pain relief. ECF No. 96-2 at 10. However, in July 2012, after Mr. Livermore violated his opioid contract on three separate occasions and “cheeked” his medications, the CRC denied Mr.

Livermore’s request to reinstate his opioid authorization. Id. at 26. In an August 27, 2014 report, the CRC rejected as Level 3 a request by Mr. Livermore to see a dermatologist. ECF No. 96-2 at 15.

Around mid-May 2015, while incarcerated at Airway Heights Correctional Facility (“Airway Heights”) in Airway Heights, Washington, Mr. Livermore reported an unwitnessed fall from standing. ECF No. 96-2 at 52. He was immediately transported to the Deaconess Hospital emergency room. Id. After Mr.

Livermore received a physical examination, a CT scan, and an x-ray, he received pain medications before being discharged to Airway Heights in stable condition with a recommendation to take Tylenol or ibuprofen as needed. ECF No. 96-2 at 52−53.

On June 17, 2015, the CRC denied as level 3 a neurosurgery consult and a wheelchair. ECF No. 96-2 at 35−36. Dr. Tonhofer is the Medical Director at Airway Heights. ECF No. 101 at 1.

In approximately September 2015, Mr. Livermore was transferred to the Washington State Penitentiary (“WSP”). ECF No. 96 at 8. During this time, DOC medical staff “tried many different non-opioid medications to decrease Mr.

Livermore’s pains, such as acetaminophen, etodolac, amitriptyline, dilaudid, MS Contin, Robaxin, Lisinopril, Tegretol, naproxen, gabapentin, and hydroxyzine, with some limited success.” ECF No. 96 at 5−6. DOC also provided physical exams, x- rays, physical therapy, and counseling on the benefits of weight loss and increased

mobility to address back pain. Id. at 6, 10. Around June 2017, Mr. Livermore filed a complaint with the Washington State Medical Quality Assurance Commission alleging inadequate care by Defendant Dr. Smith for Mr. Livermore’s chronic pain.

See ECF No. 98-2 at 24. In a letter dated August 15, 2017, the Commission informed Dr. Smith: “A Commissioner panel comprised of physician(s), physician assistant(s), and public member(s) considered the evidence and determined that [Dr. Smith’s] care was within the standard and closed the case.” Id. at 40.

Mr. Livermore began to present with hip ulcerations suggestive of prolonged immobility in 2017. ECF No. 99 at 4. Based on an examination of Mr. Livermore’s medical records, Dr. Longano notes: “When the CRC was presented with this

objective evidence [that Mr. Livermore’s condition was worsening], they appropriately approved a neurosurgical consult and intervention.” Id. Mr. Livermore received an MRI in June 2017 and, subsequently, saw several different providers throughout fall 2017 to be evaluated for surgery. See ECF No. 96 at 12.

On December 6, 2017, Mr. Livermore received lumbar fusion surgery and recovered in the WSP Infirmary. ECF No. 96-2 at 94. Mr. Livermore received opioid pain medication for approximately two weeks after the surgery while in the

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