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De'wayne German Thomas v. Dr. andrew Nangalama

March 26, 2013



Plaintiff is a state prisoner proceeding without counsel in an action brought under 42 U.S.C. § 1983. Defendants move for summary judgment. Dckt. No. 50. For the reasons explained below, it is recommended that the motion granted in part and denied in part.

I. The Complaint

This action proceeds on the verified complaint filed May 25, 2010. Dckt. No. 1. Plaintiff asserts therein that defendants denied him adequate medical care by withholding and then delaying a necessary urology consultation and by refusing to provide needed pain medication. Id. at 1.*fn1 Specifically, plaintiff alleges that he started experiencing discharge from his penis in early March 2009. Id. at 3. Defendant Nangalama, a medical doctor, evaluated plaintiff in the prison medical clinic in mid-March. Id. Defendant Nangalama ordered a urine test and a follow-up appointment in 7-10 days, but provided no further treatment. Id. By the end of March, plaintiff began experiencing severe pains in his stomach, lower back, and scrotum. Id. A nurse, Jill Walker, evaluated plaintiff on March 30 and told him that his urine test revealed an abnormal amount of white blood cells but that his follow-up appointment with defendant Nangalama had not been scheduled. Id. Walker told plaintiff that his appointment would occur on April 2, but it did not, so plaintiff filed a medical grievance. Id. at 3-4. Plaintiff was summoned to the medical clinic on April 8. Id. at 4. Defendant Nangalama prescribed antibiotics to plaintiff but no pain medication. Id. Plaintiff asked why nothing was being done for his pain, and defendant Nangalama responded, "You don't look to be in any pain at this time." Id.

The course of antibiotics prescribed by defendant Nangalama seemed to resolve plaintiff's penile discharge, but not the associated pain. Id. Plaintiff submitted a request for health care services on May 12 and was evaluated by Nurse R. Singh on May 13 for his complaint of ongoing and now excruciating pain. Id. During the appointment, Singh phoned defendant Nangalama and arranged a same-day appointment for plaintiff. Id. Plaintiff told defendant Nangalama that although the discharge was gone, the pain in his penis and testicles had gotten worse and was occurring as they spoke. Id. Defendant simply responded that plaintiff "looked clinically stable" and excused him without prescribing any pain medication. Id. at 5.

On May 21, plaintiff had a routine appointment with defendant Nangalama for his asthma. Id. During the appointment, plaintiff brought up "his chronic penile pain issues," but defendant Nangalama told plaintiff that he looked fine and again excused plaintiff without providing pain medication. Id. The following day, plaintiff's scrotum became inflamed and swollen, his pain increased, and the discharge from his penis returned. Id. Nurse Singh told plaintiff he would try to get him an appointment as soon as possible, but plaintiff still had not been seen by May 29, so he returned to the nursing station. Id. Nurse Walker told plaintiff she would call defendant Nangalama to see what he wanted to do. Id. Later in the day, Walker told plaintiff that defendant Nangalama had asked for another urine sample and had written another antibiotics prescription, but had not addressed plaintiff's complaints of pain. Id. at 6.

During a June 2 appointment with defendant Nangalama, plaintiff told him that he had "started pissing out long white strips and that his urine smelled like strong ammonia." Id. Plaintiff complained again of pain in his penis, scrotum, and testicles, and told defendant Nangalama that the pain had been recurring frequently, with off-and-on swelling. Id. Defendant Nangalama examined plaintiff and noted that his scrotum and testicles felt tender. Id. Defendant Nangalama told plaintiff he could have prostatitis, which could cause some pain and discharge. Id. at 7. However, defendant Nangalama did not provide pain medication or a referral for plaintiff to see a urologist. Id.

On June 17, plaintiff had a medical appointment with regard to a different medical issue. Id. Plaintiff was evaluated by Nurse Practitioner C. Bakewell. Id. After reviewing plaintiff's records and examining plaintiff, Bakewell concluded that plaintiff should be seen by a urologist and completed a request for a referral. Id.

On July 1, plaintiff's testicles again became swollen, and plaintiff experienced severe, throbbing pain and discharge. Id. He submitted a request for medical care indicating that his pain was a "six" on the 1-10 pain scale. Id. The next day a prison nurse evaluated plaintiff and arranged for a medical appointment. Id. at 7-8. At the appointment on July 9, plaintiff asked defendant Nangalama why nothing was being done to address his pain. Id. at 8. Defendant Nangalama responded that plaintiff had been referred to a urologist and should be seen by one soon. Id. He then excused plaintiff without providing pain medication. Id.

On July 10, plaintiff received a response to a medical appeal he had filed complaining about the treatment, or perceived lack thereof, he had received for his genital condition. Id.

Although plaintiff had complained in the appeal about not receiving any treatment for his pain, defendant Bal, who reviewed the appeal, did not respond to that complaint. Id.

Defendant Nangalama ordered another urine test and a blood test in mid-July. Id. at 8-9. Nurse Walker told plaintiff that the request for a urology referral had been denied around July 8 "because it had been decided that plaintiff continue taking the antibiotics a little longer." Id. at 9. Plaintiff ascribed responsibility for the denial of the request for a urology referral to defendants Nangalama and Bal. Id.

On July 23, plaintiff wrote a letter to Nangalama. Id. Plaintiff complained to Nangalama that the antibiotics had not been effective and that the urine and blood tests had thus far not led to a definitive diagnosis. Id. Plaintiff said, "I have been listing, describing, complaining, and informing you of the presence and existence of chronic and substantial pain on both sides of my lower scrotum sacks, my lower mid-section." Id. Plaintiff complained that Nangalama had not given him any pain medication or referred him for a urology appointment despite not being able to treat plaintiff effectively. Id. When plaintiff told Nurse Practitioner Bakewell about the letter, she copied it and put it into plaintiff's medical file. Id. Bakewell told plaintiff she would have liked to give him something for the pain but could not because plaintiff was going to have surgery soon for an unrelated condition. Id. at 9-10.

Plaintiff received the unrelated surgery on July 29 and was given Tylenol with Codeine ("Tylenol #3") for resulting pain. Id. at 10. On August 4, plaintiff told defendant Nangalama that the Tylenol #3 was also effective at relieving the pain in his penis and testicles. Id. He asked if Nangalama would continue the prescription once it expired. Id. Nangalama responded that plaintiff should just keep taking the antibiotics and that Nangalama had tried to do what he could for plaintiff, but that his "hands were tied." Id.

By August 21, plaintiff's pain had progressed, and plaintiff felt sharp pains while urinating. Id. Plaintiff's Tylenol #3 prescription from the surgery had expired. Id. Plaintiff submitted a request for medical ...

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