United States District Court, D. Arizona
David G. Campbell United States District Judge
Plaintiff Jonathan Michael Ploof, who is currently confined in Arizona State Prison Complex-Eyman, brought this civil rights case pursuant to 42 U.S.C. § 1983. (Doc. 61.) Defendants move for summary judgment, and Plaintiff opposes. (Docs. 241, 259.) The Court will grant the motion and dismiss this action.
On screening under 28 U.S.C. § 1915A(a), the Court determined that Plaintiff stated a claim and directed Defendants Ryan, Musson, and Pratt to answer. The Court dismissed the remaining claims and Defendants. (Doc. 76.)
II. Summary Judgment Standard
A court must grant summary judgment “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a); see also Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986). The movant bears the initial responsibility of presenting the basis for its motion and identifying those portions of the record, together with affidavits, if any, that it believes demonstrate the absence of a genuine issue of material fact. Celotex, 477 U.S. at 323. If the movant meets its initial responsibility, the burden shifts to the nonmovant to demonstrate the existence of a factual dispute and that the fact in contention is material (a fact that might affect the outcome of the suit under the governing law), and that the dispute is genuine (the evidence is such that a reasonable jury could return a verdict for the nonmovant). Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 250 (1986). The nonmovant need not establish a material issue of fact conclusively in its favor, First Nat’l Bank of Ariz. v. Cities Serv. Co., 391 U.S. 253, 288-89 (1968); but must “come forward with specific facts showing that there is a genuine issue for trial, ” Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986) (internal citation omitted).
At summary judgment, the judge’s function is not to weigh the evidence and determine the truth, but to determine whether there is a genuine issue for trial. Anderson, 477 U.S. at 249. The court must believe the nonmovant’s evidence and draw all inferences in the nonmovant’s favor. Id. at 255. The court need consider only the cited materials, but it may consider any other materials in the record. Fed.R.Civ.P. 56(c)(3).
III. Plaintiff’s Allegations
In his Second Amended Complaint, Plaintiff alleged that, while incarcerated at the Arizona State Prison Complex-Eyman, Charles Ryan, Director of the Arizona Department of Corrections (ADC), Richard Pratt, Division Director and Health Services Program Evaluation Administrator, and Matthew A. Musson, the Eyman Complex Health Administrator, were deliberately indifferent to Plaintiff’s heart condition because (1) healthcare providers in the prison have a practice of failing to provide timely medical care, which Defendants failed to correct; (2) Defendants have a policy of requiring unit healthcare providers to submit a referral for specialist care to a review board committee, which is not for medical reasons and takes months to process, and, thereafter, the referral requests are unreasonably denied by the committee; (3) Defendants have failed to create an effective tracking and scheduling system for healthcare appointments, there are lengthy delays in responding to health needs requests forms and providing necessary care, and there are no protocols or timeframes for when Plaintiff is to receive a face-to-face medical appointment; and (4) due to these policies, Plaintiff has suffered unreasonable delays and refusals, which cause current and future heart failure. (Doc. 61.)
IV. Plaintiffs Medical Condition Prior to Incarceration
In March 2003, Plaintiff had heart surgery and had a stent placed in the left anterior descending artery of his heart. (Doc. 242 ¶ 57.) On March 31, 2003, Plaintiff was seen by Dr. Kassel of Tri City Cardiology Consultants, who noted that Plaintiff was doing well despite a relatively extensive anterior wall myocardial infarction, and that he had a 60% ejection fraction. (Id. ¶ 58.) On April 20, 2003, Plaintiff had a Gated Stress/Rest Myocardial Perfusion Scan, which revealed a rest ejection fraction of 50% and a post exercise gated SPECT ejection fraction of 47%. (Id. ¶ 59.) Plaintiff entered the ADC on April 27, 2005. ( Id. ¶ 60.)
V. Plaintiffs Arguments and Evidence
On November 15, 2005,  Plaintiff received a “Communique” from Dr. McRill at ASPC-Eyman stating “In response to [the] HNR dated 11/4/05 requesting ‘Heartsmart’ diet: the only cardiac diet available here is the low fat, low salt diet that you have already tried. I will forward your HNR to the FHA’s office.” (Doc. 245-3 at 18.) On February 6, 2006, D.O. Strubeck noted that Plaintiff “wants a special diet” and noted that he discussed with Plaintiff that he would speak with Central Office about a special diet. (Doc. 245-3 at 20.)
On September 19, 2006, Plaintiff was seen by Dr. Boulet at St. Mary’s Hospital in Tucson. (Doc. 231 at 19-20.) The assessment noted by Dr. Boulet was that Plaintiff had coronary artery disease with intracoronary stenting of his LAD with a negative angiogram performed nine months prior to September 19, 2006; hyperlipidemia with significant hypertriglyceridemia; chronic palpitations; and chronic chest pain. (Id.) Dr. Boulet recommended a calcium channel blocker, fish oil, an increase in Lipitor, and a follow-up in 6-12 months. (Id.) Plaintiff asserts he was not seen for this follow-up. Plaintiff also asserts that he was not prescribed lipids as recommended by the doctor.
On September 12, 2011, Plaintiff saw PA Salyer and advised him that he was feeling a lot better since starting Imdur and asked to see a cardiologist. (Doc. 242 ¶ 94.) On October 22, 2011, Salyer submitted an outside consult request for a cardiology appointment for a cardiac catheterization evaluation. (Id. ¶ 95.) On October 26, 2011, Salyer saw Plaintiff for a cardiac chronic care appointment and noted his stent was stable, but noted crescendo angina and requested an urgent emergency room evaluation. (Id. ¶ 96.) On October 26, 2011, Plaintiff was seen by Nurse Practitioner Mcelmeel at Tempe St. Luke’s Hospital. (Doc. 231 at 23.) NP Mcelmeel noted that Plaintiff was being seen after his routine visit with his physician at the ADC regarding ongoing angina and that Plaintiff reported that he had angina on and off for two years, which was managed medically with good relief with titration of his medications. (Id.) NP Mcelmeel noted that Plaintiff stated that he wanted to go back to the ADC and not get his current workup or angiogram at Tempe St. Luke’s because he was expecting a visit from his son on Saturday and would not get the opportunity to see him for another year, and that Plaintiff reported that his chest pain is no different than it ever is. (Id.) NP Mcelmeel recommended that Plaintiff follow-up with outpatient cardiology for an angiogram, continue all the same medications, and continue cessation of tobacco. (Id. at 25.) Plaintiff asserts that Mcelmeel’s medical record explains “in detail ADC’s failures and delays.” (Doc. 259 at 12). Mcelmeel noted that the DOC physician was frustrated with the slow process in coordinating an outpatient workup for Plaintiff and sent him to an inpatient setting to expedite a cardiology referral. (Doc. 231 at 23.) Plaintiff appears to assert that he was not provided follow-up treatment as recommended by NP Mcelmeel. (Doc. 259 at 12-13.)
On October 27, 2011, Salyer noted that Plaintiff had returned from Tempe St. Lukes and submitted a consult for a cardiology catheterization lab evaluation. (Doc. 242 ¶ 98.)
On November 18, 2011, Plaintiff was seen by Dr. Candipan at Phoenix Heart Center. (Doc. 231-1 at 47.) Dr. Candipan noted that Plaintiff had a history of coronary artery disease, and for the past few months was having symptoms of chest discomfort. (Id.) Dr. Candipan recommended that Plaintiff have a stress test and that his verapamil prescription be increased or that an ACE inhibitor be added. (Id. at 48.) Plaintiff asserts that Dr. Candipan’s orders were not followed. (Doc. 259 at 13.) Plaintiff asserts, without citation to evidence, that if a stress test had been performed, it would have shown an 87% blockage to the left side of his heart. (Id.)
On January 26, 2012, Plaintiff was seen by Dr. Kumar at Advanced Cardiac Specialists. (Doc. 231-2 at 1-3.) Plaintiff told Dr. Kumar that his chest pain was increasing and he wanted an angiogram and that he had previously told physicians that he could not do any kind of stress test because of a meniscal tear. (Id.) Dr. Kumar recommended that a coronary angiogram be done and that Plaintiff stop Verapamil, add Norvasc, and continue Atenolol. (Id.) Plaintiff asserts that he did not receive Norvasc for over a year and points to an HNR and response from prison staff to establish that he did not receive the Norvasc. (Doc. 245-3 at 38.) The response indicates that the prescription was filled on March 5, 2013. (Id.)
On February 14, 2012, Plaintiff had a left heart catheterization and PTCA stent placement. (Doc. 231-2 at 4-7.) Plaintiff asserts, without citation, that any damage found during the catheterization was the effect of “delayed treatment.” (Doc. 259 at 15.) The impression from the catheterization was “long tubular in-stent narrowing in the proximal left anterior descending artery of approximately 70-80%, ” presence of an eccentric lesion prior to the stent of approximately 20-30% in the left anterior descending artery, and severe global hypokinesis of the left ventricle. (Doc. 231-2 at 5-6.) After the stent was placed, the resulting luminal narrowing was 0%. (Id. at 6.) Dr. Kumar recommended that Plaintiff be placed on Ecotrin and Plavix indefinitely and that Lipitor and Verpamil could continue, but Imdur “may not” be necessary anymore. (Id.)
On February 15, 2002, PA Salyer noted that Plaintiff returned from the cardiac catheterization procedure and referred Plaintiff for a post-surgical follow-up appointment and completed an Outside Consultation Request form for a cardiology follow-up for a cardiac stent placement. (Doc. 242 ¶ 102.) On February 16, 2002, Salyer saw Plaintiff for a cardiac chronic care appointment. Plaintiff had no complaints of chest pain, shortness of breath, or palpitations and was provided educations on nutrition, exercise, smoking, and medication management. (Id. ¶ 103.) Salyer requested a consult for a bilateral carotid artery ultrasound. (Id.)
On March 22, 2012, Plaintiff was again seen by Dr. Kumar. (Doc. 231-2 at 8.) In his assessment and plan, Dr. Kumar noted that Plaintiff was doing extremely well with no more chest pain after a post percutaneous transluminal coronary angioplasty and stent placement in the left anterior descending artery in February 2012, and that Plaintiff had a decreased ejection fraction of approximately 33%. (Id.) Dr. Kumar stated that Plaintiff “would like to have his carotid arteries check” and, although no evidence of carotoid bruit was noted on examination, “since the patient is insisting, he will be scheduled for carotoid Doppler ultrasound studies.” (Id.) Finally, Dr. Kumar stated: “The patient also wants us to recommend a cardiac diet. The patient was recommended a 2-gram sodium, low-cholesterol cardiac diet. However, I am not sure this is available in the prison system.” (Id.) Finally, Dr. Kumar stated that Plaintiff “needs a cardiac followup in six months’ time, ” and, at that time, an “echocardiogram may be necessary to reassess the ejection fraction.” (Id.)
On March 26, 2012, PA Salyer submitted an Outside Consult Request for a cardiology follow-up appointment for Plaintiff in six months. (Doc. 242 ¶ 105.)
On March 29, 2012, Plaintiff was set to be transported for a cardio-evaluation, but Plaintiff refused transport due to safety concerns. (Doc. 245-2 at 35.) On April 16, 2012, Plaintiff signed a refusal to follow-up with cardiology due to “abuse at Central Unit.” (Doc. 242 ¶ 107.) A follow-up appointment with the health care provider was scheduled for April 26, 2012. (Id.) On May 2, 2012, it was noted that Plaintiff’s blood pressure checks were normal. (Id. ¶ 108.) On June 13, 2012, FNP Linde reviewed Plaintiff’s chart and noted the March 22, 2012 recommendation that Plaintiff be provided a low cholesterol, low sodium diet. FNP noted that because the standard ADC diet is designed to be low in sodium and cholesterol, no further action was needed. (Id. ¶ 109.)
On June 13, 2012, Defendant Musson responded to a grievance Plaintiff filed stating that he had not received a renal or low fat/salt diet. In his response, Musson stated that a “low cholesterol and low sodium diet was ordered by the Medical specialist on 3/22/12, ” that the general population diet is “heart healthy” and “meets Plaintiff’s needs, ” and that the Medical specialist did not ...