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Carter v. Ayala

United States District Court, W.D. Michigan, Southern Division

March 8, 2017


          Hon. Robert J. Jonker Judge


          RAY KENT United States Magistrate Judge

         This is a pro se civil rights action brought by a state prisoner at a Michigan Department of Corrections (MDOC) facility pursuant to 42 U.S.C. § 1983. This matter is now before the Court on defendant Dr. Jamie Ayala's motion for summary judgment (docket no. 94), defendant Robert Davis' motion for summary judgment (docket no. 109), and plaintiff's “Supplemental Motion for summary judgement and response to defendants Davis and Ayala's motion for summary judgment” (docket no. 122).

         I. Plaintiff's complaint

         Plaintiff's complaint is directed at two defendants, psychiatrist Dr. Jamie Ayala (“Dr. Ayala”) and social worker Mr. Robert Davis (“Mr. Davis”), both of whom worked at the Ionia Correctional Facility (ICF). Compl. (docket no. 1 at PageID.2-3).[1] Plaintiff suffers from multiple sclerosis. Id. at PageID.3. In 2009, while housed at the Marquette Branch Prison (MBP), he was diagnosed with “Psychosis disorder due to medical condition.” Id. Upon plaintiff's transfer to ICF, his assigned case manager, Mr. Davis, notified plaintiff that due to his major mental disorder, plaintiff could not be subjected to long-term segregation “and that [p]laintiff would be ‘appealed' back into the ‘Secure Status Outpatient Treatment Program, ' (‘SSOTP') for mental health treatment.” Id. at ¶ 11.

         By way of background, the MDOC Policy Directives regarding mentally disabled prisoners in segregation provide that:

Prisoners with a mental disability ordinarily should not be housed in segregation if the disability may preclude adequate adjustment in segregation. The Department has more appropriate mental health care settings which are designed for the therapeutic management and care of these prisoners; for example, inpatient psychiatric hospitalization, Residential Treatment Programs (RTPs) including the Adaptive Skills Residential Program (ASRP), and the Secure Status Outpatient Treatment Program (SSOTP). Some prisoners with mental disabilities, however, cannot be managed outside of a segregation unit without presenting a serious threat to their own safety or the safety of staff or other prisoners. While in segregation, such prisoners must be closely followed by the institution Outpatient Mental Health Team (OPMHT) or a QMHP to ensure their mental health needs are continuing to be met.

MDOC Policy Directive 04.06.182 ¶ D. The MDOC has summarized outpatient treatment programs, such as SSOTP as follows:

The Outpatient Mental Health Program (OPMHT) provides mental health treatment to prisoners with a mental disability and/or behavioral disorder that reside in general population. This includes services through a Secure Status Outpatient Treatment Program (SSOTP) which provides a safe and secure alternative treatment option to prisoners with a serious mental disability who, because of behavioral issues which present a risk to the custody and security of the facility, would otherwise be in Administrative Segregation.

See (Frequently Asked Questions) (“Health Care - The Rights of Prisoners to Physical and Mental Health Care”).[2]

         Plaintiff was admitted into the mental health program at ICF, but refused treatment. Id. at PageID.4. According to plaintiff, he feared the officers who worked with the mentally ill prisoners in the SSOTP unit. Id. Later, plaintiff was asked to enter SSOTP on two more occasions, but refused to participate. Id. Plaintiff's claims are based on incidents which occurred in July and September 2010.

         On July 27, 2010, Mr. Davis went to plaintiff's cell and told plaintiff that if he was not going to consent to participate in SSOTP, then “I'll be sure that you see the doctor.” Id. When plaintiff stated that he had “a constitutional right to refuse treatment, ” Mr. Davis left plaintiff's cell and Dr. Ayala came over stating that Davis “referred me to re-evaluate you.” Id. Plaintiff's meeting with Dr. Ayala “lasted less than three minutes.” Id. After the meeting, Dr. Ayala changed plaintiff's diagnosis to an anxiety disorder “with no explanation of why he was discontinuing Plaintiff's prescribed treatment and therapy for his Psychosis Disorder.” Id. According to plaintiff, by changing his diagnosis, Dr. Ayala “made [p]laintiff ineligible for mental health therapy, and subjected [p]laintiff to punitive detention and administrative segregation.” Id.

         On September 22, 2010, Mr. Davis told plaintiff that, according to Dr. Ayala, plaintiff “was ineligible for the mental health program because he refused treatment, not because he [Dr. Ayala] downgraded Plaintiff's diagnosis.” Id. at PageID.4-5. Mr. Davis later stated that plaintiff was ineligible for both reasons “but more because you were admitted to the SSOTP and you refused to go several times.” Id. The next day, plaintiff asked Dr. Ayala if the doctor could change his diagnosis back to the original psychosis disorder. Id. at PageID.5. Plaintiff promised Dr. Ayala that he would be compliant with treatment and attend SSOTP therapy, because he needed to be provided with proper treatment for his psychosis and released from segregation.” Id. According to plaintiff,

Defendant AYALA then stated that, the reason he changed Plaintiff's diagnosis was because of Plaintiff's “previous non-compliance” with SSOTP therapy, and that “if your Case Manager agree [sic] to give you a second chance in the SSOTP, I'll be glad to re-consider a more favorable diagnosis.” Plaintiff replied “your [sic] the Psychiatrist, you make the diagnosis not my psychologist.” Defendant AYALA stated that Defendant DAVIS recommended re-evaluation and that Plaintiff should develope [sic] a better relationship with his psychologist if he want [sic] a favorable diagnosis that will make him eligible for the program.


         Plaintiff notified Mr. Davis “numerous times that he will be compliant with treatment and that he was ready to leave segregation because segregation exacerbated the symptoms of his mental illness” and Davis “repeatedly promised that he was going to speak to Dr. Ayala and have Plaintiff's diagnosis corrected.” Id. at PageID.5-6. However, neither Mr. Davis nor Dr. Ayala corrected “their unlawful actions.” Id.

         Plaintiff does not allege when he transferred from ICF. However, at his deposition, plaintiff testified that he was transferred to MBP in January 2011. Carter Dep. (docket no. 113-3, PageID.752). Approximately four months after his transfer, plaintiff experienced an exacerbation of his multiple sclerosis and severe symptoms of his psychosis. Compl. at PageID.6. On May 29, 2011, plaintiff attempted to commit suicide. Id. Dr. Thomas Henry, a psychiatrist, found that plaintiff's “clinical status was worsening” and that plaintiff “suffered from paranoia, delusions, and suicidal behavior, along with sleeping and eating problems.” Id. Dr. Henry diagnosed plaintiff with a psychosis disorder and recommended that he enter a residential treatment program “for intensive mental health treatment.” Id. On June 16, 2011, plaintiff was transferred to an inpatient mental health facility and released from segregation. Id.

         According to plaintiff, Dr. Ayala and Mr. Davis “intentionally downgraded” his diagnosis based on his refusal to enter a mental health program. Id. This “downgrade” caused him to be subjected to segregation for 11 months “solely because of Plaintiff's initial refusal to participate in the SSOTP.” Id. By being subjected to segregation, plaintiff suffered severe mental anguish and emotional pain, which “created a substantial risk of harm to his mental health.” Id. at PageID.6-7.

         Plaintiff's complaint contained two constitutional claims. In Count 1, plaintiff alleged that defendants retaliated against him:

At all times relevant, pursuant to the 1st Amendment of the United States Constitution, and clearly established law, Plaintiff had a right to engage in constitutionally protected conduct when refusing mental health treatment, and not be subjected to retaliation. Plaintiff suffered an adverse action when Defendants AYALA and DAVIS intentionally downgraded Plaintiff's diagnosis for the sole purpose [sic] to deny him prescribed treatment and subject him to segregation.

Id. at PageID.7-8.

         In Count 2, plaintiff alleged that defendants were deliberately indifferent to his serious medical needs:

At all times relevant, pursuant to the 8th Amendment of the United States Constitution, and clearly established law, Plaintiff had a right not to be subjected [sic] cruel and unusual punishment. Defendants AYALA and DAVIS acted with deliberate indifference when denying Plaintiff already prescribed treatment, when they intentionally switched Plaintiff's diagnosis. Defendants AYALA and DAVIS knew Plaintiff was suffering from a “Psychosis Disorder[”], knew they were intentionally misdiagnosing Plaintiff, and knew their treatment was otherwise grossly inadequate but proceeded with treatment anyway when treating Plaintiff for an “Anxiety Disorder.” Defendants AYALA and DAVIS knew that housing Plaintiff in segregation would increase his risk of relapse and/or exacerbate the symptoms of his mental illness.

Id. at PageID.8-9. Plaintiff seeks monetary damages and declaratory relief. Id. at PageID.9

         The Court dismissed plaintiff's First Amendment retaliation claim on the merits and allowed the case to proceed on plaintiff's Eighth Amendment claim. See Opinion and Order re Report and Recommendation (R&R) (docket no. 48). In denying motions for summary judgment filed by Mr. Davis and plaintiff, the Court noted that plaintiff's Eighth Amendment claim implicated a Fourteenth Amendment right to refuse medical treatment which the Court could not ignore, and allowed plaintiff to further develop this claim. See Opinion and Order re R&R (docket no. 60, PageID.361-362). Discovery has closed. The Court will now review the ...

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