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Fields v. Connections (LLC)

United States District Court, D. Delaware

November 28, 2018


          Isaiah Jamaal Fields, Pro Se

          Plaintiff Dana Spring Monzo, Lindsey E. Imbrogno, White and Williams LLP, Wilmington, DE -Attorneys for Defendants



         Plaintiff Isaiah Fields ("Plaintiff or "Mr. Fields") filed this action pro se against defendants Connections, Inc. ("Connections"), the medical provider within the Delaware prison system, and Louise Ryan ("Nurse Practitioner Ryan") (collectively "Defendants"), one of the nurse practitioners who provided care to Mr. Fields.[1] The Complaint, filed pursuant to 42 U.S.C. § 1983, alleges violations of the Eighth Amendment for failure to provide adequate medical treatment for injuries Mr. Fields sustained while playing basketball at Sussex Correctional Institution ("SCI"). (D.I. 1).

         Pending before the Court are (1) a motion for summary judgment (D.I. 52) filed by Defendants and (2) a motion for summary judgment filed by Mr. Fields. (D.I. 62).[2] The Court has reviewed the motions for summary judgment, the supporting papers, and the responses. (D.I. 52, 53, 55, 60, 62, 64). It has also reviewed the allegations in the Complaint, the discovery responses submitted, and the significant medical record pertaining to Mr. Field's allegations. (D.I. 53 at Exhs. B, C; D.I. 61, D.I. 63). For the reasons discussed below, the Court will grant Defendants' motion for summary judgment (D.I. 52) and deny Plaintiffs motion (D.I. 62).


         On February 1, 2016, Mr. Fields injured his left ankle while playing basketball at SCI. (D.I. 1 at 6). He was apparently able to walk to the infirmary where he was seen by the nursing staff. (D.I. 53-4 at 119). He was given an ice pack and 400 mg of ibuprofen and instructed to report any increase in pain or immobility. (D.I. 53-4 at 119, 221). Nurse Practitioner Ryan examined Mr. Fields a few days later. (D.I. 53-4 at 119). She noted that he complained of pain in his ankle, but that he had a full range of motion in all four of his extremities. (D.I. 53-3 at 35; D.I. 53-4 at 119). She ordered an x-ray and instructed him to file a "sick call" if his symptoms did not improve. (D.I. 53-4 at 118). The x-ray showed "a normal left ankle." (Id.). Based on the record before the Court, this was the only interaction between Mr. Fields and Nurse Practitioner Ryan in connection with the allegations in the Complaint.

         Thereafter, Mr. Fields continued to experience pain and to seek treatment for his injury. On February 9, 2016, Mr. Fields filed a "sick call," complaining of ankle pain, and saying he had not been examined, despite his prior visit to the infirmary and his examination by Nurse Practitioner Ryan. (D.I. 53-4 at 219). On that same day, Mr. Fields saw a nurse, who noted mild to moderate swelling in his ankle, a bruise on his heel, and limited flexion and extension of the ankle. (D.I. 53-4 at 118). The nurse educated Mr. Fields "on resting, icing and elevating" his leg. (D.I. 53-4 at 118-119). Mr. Fields again saw nurses on February 12, 19 and 24, 2016. (D.I. 53-4 at 118). The notes of these visit indicate mild swelling and a normal x-ray. (Id.).

         Mr. Fields requested an MRI and filed grievances within the prison system to make his wishes known. (Id.). He was seen for two Level 1 grievances on February 24, 2016 and was informed that he could request to see a medical provider to come up with a new treatment plan. At that time, Mr. Fields said he would rather proceed with the grievance process instead. (Id.). He continued to make "sick calls" for ankle pain and each time was seen by a nurse in response. (D.I. 53-4 at 89-118). Mr. Fields saw a nurse practitioner for his ankle pain again on May 20, 2016. (D.I. 53-4 at 113). At the time his gait was "normal" and he was given an ankle brace and ibuprofen. (Id.).

         On August 4, 2016, a physician reviewed Mr. Fields's records. (D.I. 53-4 at 111). That physician pointed out in his note that it appeared that "the pain and physical changes are out of proportion to the complaints," but noted that they would "continue to address" the issue. (Id.). The physician saw Mr. Fields on August 17, 2016. (D.I. 53-4 at 110-111). He noted that Mr. Fields had not followed the medical advice to ice and rest his ankle when the initial sprain occurred and now the pain was worse. (Id.). Mr. Fields was given insoles for his shoes and crutches and instructed to take ibuprofen. (Id.). He continued to file "sick calls" and continued to be seen by the nurses in response. (D.I. 53-4 at 89-111, 150-221). Follow-up x-rays were taken and again found to be normal. (D.I. 53-4 at 109). The physician saw Mr. Fields for follow up on September 29, 2016, again noting Mr. Fields's failure to comply with treatment recommendations. (D.I. 53-4 at 109). He was diagnosed with a grade HI ankle sprain and an e-consult was placed to orthopedics. (Id.). Thereafter, he filed more "sick calls," had more nurse evaluations, and was found to have normal range of motion. (D.I. 53-4 at 89-111, 150-221).

         Another physician saw Mr. Fields on December 21, 2016. (D.I. 53-4 at 107-108). He noted that Mr. Fields had swelling, but a normal range of motion. (Id.). The physician ordered an ultrasound of his ankle to rule out blood clots. The ultrasound results were normal, and Mr. Fields was referred to physical therapy. (Id.). Mr. Fields attended multiple physical therapy sessions. (D.I. 53-4 100-107). Mr. Fields said he still had pain following physical therapy, and the physical therapist recommended that Mr. Fields be seen by "provider/MD for further evaluation and other recommendations." (D.I. 53-4 at 100). Mr. Fields was seen by a physician on February 15 and February 22, 2017, and the physician placed a consult request for Mr. Fields to be seen by an outside physician as well as a request for an MRI. (Id. at 100-101).

         Mr. Fields continued to be seen by the nurses. (D.I. 53-4 at 89-100; D.I. 63). He saw an outside orthopedist on August 7, 2017. (D.I. 53-4 at 91). The orthopedist diagnosed a chronic ankle sprain and prescribed a brace. (Id.). The orthopedist also gave Mr. Fields a steroid injection in his knee for a medial meniscal tear. (Id.). An MRI on his knee was ordered on September 27, 2017. (D.I. 53-4 at 89-91). Additional physical therapy was ordered, and a podiatry consult was requested. (Id.). An MRI of Mr. Field's left ankle occurred on January 9, 2018, and reportedly was normal. (D.I. 60 at 4; D.I. 61). Mr. Fields has continued to receive therapy for his injury. (D.I. 55 at 1; D.I. 63 at 5).


         A. ...

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