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Mason v. Ryan

United States District Court, D. Arizona

May 8, 2018

Nathan Sterling Mason, Plaintiff,
Charles L. Ryan, et al., Defendants.


          David G. Campbell United States District Judge.

         Before the Court is Plaintiff Nathan Sterling Mason's Motion for Preliminary Injunction, which requests that the Court order Defendants-Corizon, LLC and Nurse Practitioner Andreas Thude-to provide specialist recommended treatment and medication. (Doc. 73.) On April 10, 2018, the Court issued an Order directing the parties to file supplemental briefing with documentary evidence indicating Plaintiff's current course of treatment and his present condition. (Doc. 156.) The Court will grant the Motion for Preliminary Injunction in part.

         I. Background Summary

         A detailed factual background is set forth in the Court's April 10, 2018 Order. (Doc. 156 at 4-8.) In brief, Plaintiff has suffered chronic neck pain since early 2016, and a December 2016 MRI showed severe narrowing of the spinal canal and likely early myelomalacia (softening of the spinal cord). (Id. at 4.) In January 2017, Plaintiff saw orthopedic specialist Dr. Waldrip, who diagnosed spinal stenosis and informed Plaintiff that he had to fail a full course of pain management therapy before Dr. Waldrip could perform surgery. (Id. at 4.) Dr. Waldrip's treatment plan was to schedule cervical epidural injections with a pain management specialist. (Id.) On March 2017, Plaintiff saw a pain management specialist, Dr. Brian Page, who noted severe neck, arm, and shoulder pain and cervical radiculopathy, and he diagnosed cervical disc bulge. (Id. at 5.)[1] Dr. Page recommended a series of three epidural steroid injections and prescribed Ultram (brand name for Tramadol) to be taken twice a day for pain. (Id.) Dr. Page performed the first steroid injection at the March 2017 appointment, and directed that the second injection should be given four weeks later. (Id.) Dr. Page informed Plaintiff that the efficacy of the steroid injections would not be known until after a course of three injections was completed. (Id. at 6.)

         Plaintiff did not receive the Ultram medication. Defendant Thude discontinued the prescription for Ultram and instead prescribed duloxetine (Cymbalta), which is a selective serotonin/norepinephrine reuptake inhibitor used to treat depression and mood disorders. (Id. at 6-7.) Thude submitted a consult request for the second epidural steroid injection, but this request was denied and Plaintiff did not receive any further steroid injections from Dr. Page. (Id. at 6.) In June 2017, Plaintiff saw Dr. Waldrip, who performed a corticosteroid injection. (Id. at 7.) Thereafter, Plaintiff refused to take any more antidepressant/psychiatric medications due to their ineffectiveness for pain and the side effects, and he filed numerous requests to receive the medication and treatment prescribed by Dr. Page, to no avail. (Id. at 7-8.) On December 1, 2017, Plaintiff filed his pending Motion for Preliminary Injunction seeking the specific treatment prescribed by Dr. Page. (Doc. 73.)

         II. Preliminary Injunction

         As set forth in its prior Order, to warrant a preliminary injunction, Plaintiff must show that (1) he is likely to succeed on the merits, (2) he is likely to suffer irreparable harm without an injunction, (3) the balance of equities tips in his favor, and (4) an injunction is in the public interest. Winter v. Natural Res. Def. Council, Inc., 555 U.S. 7, 20 (2008). If Plaintiff can show that there are “serious questions going to the merits, ” which is a lesser showing than likelihood of success on the merits, then a preliminary injunction may still issue if he can show that the balance of hardships tips sharply in his favor and he satisfies the two other Winter factors. Shell Offshore, Inc. v. Greenpeace, Inc., 709 F.3d 1281, 1291 (9th Cir. 2013) (quoting Alliance for the Wild Rockies v. Cottrell, 632 F.3d 1127, 1135 (9th Cir. 2011)).

         In its April 10, 2018 Order, the Court determined that Plaintiff had a serious medical need and showed serious questions whether Defendants' failure to provide the treatment and medication prescribed by the pain management specialist was medically unacceptable. (Doc. 156 at 13.) Thus, Plaintiff satisfied the first Winter factor. (Id.) But because Plaintiff's Motion for Preliminary Injunction was filed in December 2017, the Court was unable to determine whether, at the present time, there is an ongoing harm or threat of irreparable injury sufficient to support injunctive relief. (Id. at 14-15.) Nor was it clear what treatment Defendants are currently providing in response to Plaintiff's serious medical need. See Farmer v. Brennan, 511 U.S. 825, 845-46 (1994) (a defendant's current conduct determines whether injunctive relief is warranted). The Court directed the parties to file evidence of Plaintiff's current treatment and medication regimen and Plaintiff's current condition. (Doc. 156 at 15.) The parties have filed their supplemental briefing.

         III. Supplemental Facts

         Plaintiff avers that since December 2017, his condition and pain symptoms have dramatically worsened and he suffers pain every day. (Doc. 169, Pl. Decl. ¶ 2.) He states that he cannot lay on his left or right side or his back due to the extreme pain, and, consequently, he is in a constant state of sleep deprivation. (Id. ¶ 3.)

         Plaintiff believes that on January 31, 2018, he suffered a cardiac incident due to severe sleep deprivation and anxiety caused by extreme pain. (Id. ¶ 7.) Plaintiff blacked out, and officers initiated an Incident Command System for a medical emergency. (Id.) Plaintiff states that both his hands were completely numb, he was sweating, and his blood pressure was 190/120. (Id.) Plaintiff was diagnosed with hypertension and is now prescribed high-blood pressure medication. (Id.)

         On February 20, 2018, Plaintiff saw Dr. Itoro Elijah in the Buckley medical unit. (Doc. 168-1 at 2.) Plaintiff requested completion of the epidural steroid injections, and he stated that he found some relief from the first injection. (Id.) Dr. Elijah noted that Plaintiff had received just one injection in the past, so Dr. Elijah documented that she would request two additional injections for completion of the original series of three and she would re-order a consult. (Id.) But Dr. Elijah's request for a consult and additional epidural steroid injections was denied. (Doc. 168 at 1-2.) Plaintiff avers that Dr. Elijah resubmitted the request for epidural injections again, and it was denied again. (Doc. 169, Pl. Decl. ¶ 8.)

         On March 26, 2018, Plaintiff saw Dr. Elijah. (Doc. 168-1 at 7.) The medical note for this encounter documented that there is an Alternative Treatment Plan because “the patient did not receive any relief from previous injection it does not make sense to do this again.” (Id.) The note further stated that since Plaintiff's pain is getting worse, a CT scan with contrast was suggested. (Id.) The “Plan Notes” indicate that a CT scan will be ordered and there will be follow-up pending results of the CT scan. (Id. at 9.) Plaintiff avers that Dr. Elijah offered him two more psychiatric drugs for his pain, but he told her he would not take any more psychiatric medications. (Doc. 169, Pl. Decl. ¶ 8.) Plaintiff states that Dr. Elijah informed him she requested a CT scan. (Id.) On April 10, 2018, a nurse reordered Ibuprofen for Plaintiff. (Doc. 168-1 at 12-14.)

         IV. Discussion

         A. ...

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