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Rhinehart v. Scutt

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

September 7, 2017

DAVID L. RHINEHART and LEWIS RHINEHART, Joint Personal Representatives of the Estate of KENNETH A. RHINEHART, Deceased, Plaintiffs,
DEBRA SCUTT, et al., Defendants.



         Before the Court is Defendant's second motion for summary judgment. The first was referred to the magistrate judge, who issued a report and recommendation ("Report") suggesting the Court deny the motion. ECF 273. The Court adopted the Report over Defendants' objections, ECF 284, and preparations for trial commenced. Extensive motion practice ensued and at least one additional deposition was taken. Also during that time, the Court of Appeals for the Sixth Circuit issued an opinion that addressed one of the central legal theories in this case. See Mattox v. Edelman, 851 F.3d 583 (6th Cir. 2017), reh'g denied (Apr. 6, 2017). Subsequent to the decision, Defendants filed a motion for leave to file a second motion for summary judgment in light of the appellate decision and new testimony. The Court granted leave and laid out the discrete issues that needed to be addressed. Both parties filed briefs and the Court held a hearing. The Court must grant Defendants' motion.


         Summary judgment is proper if 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). A fact is material for purposes of summary judgment if its resolution would establish or refute an "essential element[] of a cause of action or defense asserted by the parties[.]" Kendall v. Hoover Co., 751 F.2d 171, 174 (6th Cir. 1984).

         In considering a motion for summary judgment, the Court must view the facts and draw all inferences in the light most favorable to the non-moving party. Stiles ex rel. D.S. v. Grainger Cty., Tenn., 819 F.3d 834, 848 (6th Cir. 2016). The Court must then determine "whether the evidence presents a sufficient disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 251-52 (1986). And although the Court may not make credibility judgments or weigh the evidence, Moran v. Al Basit LLC, 788 F.3d 201, 204 (6th Cir. 2015), a mere "scintilla" of evidence is insufficient to survive summary judgment; "there must be evidence on which the jury could reasonably find for the plaintiff, " Anderson, 477 U.S. at 252.


         The facts of the case have been fully set forth several times. See, e.g., ECF 273. In very brief summary: Kenneth Rhinehart was an inmate at a state prison in Munising, Michigan when he was first diagnosed with End-Stage Liver Disease (ESLD). Prison medical personnel began treating him for the condition, but in September 2009, a CT scan revealed some abnormal liver findings that suggested Rhinehart might have cancer, so he was transferred to the JCF facility in Jackson, Michigan that October to be seen by a liver specialist or cancer specialist. The case concerns the treatments he did and did not receive from the time of his transfer until his death in February 2013 following hip surgery.


         I. The Standard for Deliberate Indifference Claims

         The Eighth Amendment to the United States Constitution prohibits cruel and unusual punishment and applies to the States through the Fourteenth Amendment. Estelle v. Gamble, 429 U.S. 97, 101-02 (1976). The Supreme Court has held that deliberate indifference to the serious medical needs of a prisoner constitutes "unnecessary and wanton infliction of pain" and therefore violates the Eighth Amendment. Id. at 104. Still, this does not transform medical malpractice claims into constitutional violations "merely because the victim is a prisoner." Id. at 106. Rather, "[i]n order to state a cognizable claim, a prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs." Id.

         To prevail on a claim of deliberate indifference, a plaintiff must satisfy objective and subjective components. Farmer v. Brennan, 511 U.S. 825, 834 (1994). The objective component requires the existence of a "sufficiently serious" medical need, while the subjective component requires that prison officials had "a sufficiently culpable state of mind in denying medical care." Blackmore v. Kalamazoo Cty., 390 F.3d 890, 895 (6th Cir. 2004).

         The Sixth Circuit "recognizes two theories under which a plaintiff can demonstrate the objective component of an Eighth Amendment deliberate indifference claim." Mattox, 851 F.3d at 598. One is to show that the medical need "has been diagnosed by a physician as mandating treatment." Id. When proceeding under that theory, a plaintiff must show that prison officials either entirely failed to treat the condition, or treated it inadequately. Blackmore, 390 F.3d at 898. In the latter case, a plaintiff must introduce "medical proof" that a delay in treatment caused a serious medical injury or that "the provided treatment was not an adequate medical treatment of his condition[.]" Santiago v. Ringle, 734 F.3d 585, 591 (6th Cir. 2013). The other route is to show that the claimed injury or illness was "so obvious that even a lay person would easily recognize the necessity for a doctor's attention[.]" Id. at 590. In those cases, the plaintiff must simply show that he "actually experienced the need for medical treatment, and that the need was not addressed within a reasonable time frame." Id.

         The question now before the Court is whether any of the alleged shortcomings in Rhinehart's treatment satisfy the objective component under any theory. Plaintiffs have made clear that they are not arguing about delays in treatment, see ECF 349, PgID 8849, and Plaintiffs' counsel stated flatly at oral argument that they do not claim Rhinehart had an obvious medical need that any lay person would recognize. So Plaintiffs have one option: they must show that Rhinehart's needs were diagnosed by physicians as mandating treatment and that Defendants failed to treat him or so inadequately treated him that he suffered a verified medical injury.

         I. The Claims

         Plaintiffs' theories of liability have vacillated. But at the hearing, Plaintiffs clarified their eight theories of liability:

         1. Stevenson failed to make accommodations to receive Rhinehart.

         2. Stevenson failed to ensure that Rhinehart was seen by a specialist after he became aware of Rhinehart's arrival at JCF.

         3. Stevenson failed to create a meaningful plan of care for Rhinehart's ESLD, including portal hypertension, ascites, and EV.

         4. Stevenson failed to order monitoring by a gastroenterologist after his June 2010 EGD.

         5. Stevenson failed to request any specialist consultations after Rhinehart's June 30th discharge.

         6. Edelman failed to act after learning, in February 2010, that Rhinehart had not seen the recommended specialists.

         7. Edelman failed to approve a TIPS procedure.

         8. Edelman failed to approve Rhinehart's requests to be seen by a hepatologist for evaluation and treatment of his liver disease, including consideration for a possible liver transplant.

         Nowhere in their case is a claim based on a delay in cancer diagnosis or Rhinehart's fear of cancer. While the cancer claims were a central component of the magistrate judge's analysis on the initial summary judgment motion and in the Court's adoption of the Report, Plaintiffs have decided to no longer pursue them. The Court therefore considers the claims abandoned and will review Defendants' second motion in light of what Plaintiffs' case actually is.

         1. Stevenson failed to make accommodations to receive Rhinehart

         Plaintiffs argue that "Stevenson was the physician assigned as primary provider for Mr. Rhinehart" and was "responsible for developing the initial treatment plan" for Rhinehart after his transfer. ECF 349, PgID 8856-57. They also argue that Rhinehart was supposed to be seen right away, since he was transferred on an "expedited" basis. Accordingly, they fault Stevenson for failing to make arrangements for Rhinehart to see specialists shortly after his arrival. Defendants dispute that Stevenson was Rhinehart's assigned physician, and that there were "assigned physicians" at all. But even so, they argue that Plaintiffs' claim fails because Rhinehart was treated for his diagnosed conditions and suffered no harm from any delay or treatment choice.

         Although the Sixth Circuit has rejected "the notion that a prison doctor who delays treatment may escape liability simply because the treatment was recommended rather than prescribed, " Santiago, 734 F.3d at 590, the court has also emphasized that "where a prisoner has received some medical attention and the dispute is over the adequacy of the treatment, federal courts are generally reluctant to second guess medical judgments and to constitutionalize claims that sound in state tort law." Graham ex rel. Estate of Graham v. Cty. of Washtenaw, 358 F.3d 377, 385 (6th Cir. 2004) (quoting Westlake v. Lucas, 537 F.2d 857, 860 n.5 (6th Cir. 1976)). Thus, when a deliberate-indifference claim is "based on the prison's failure to treat a condition adequately . . . medical proof is necessary to assess whether the delay caused a serious medical injury." Blackmore, 390 F.3d at 898 (citing Napier v. Madison Cty., 238 F.3d 739, 742 (6th Cir. 2001)). When, therefore, medical personnel recommend a specialist referral in the ongoing treatment of a diagnosed condition, the verifying-medical-evidence requirement applies. To conclude otherwise would undermine the body of established case law permitting prison doctors to accept or reject recommendations in their medical judgment. See, e.g., Estelle, 429 U.S. at 107 (holding that the decision not to order "additional diagnostic techniques or forms of treatment . . . is a classic example of a matter for medical judgment.") and Howze v. Hickey, No. 10-CV-094-KKC, 2011 WL 673750, at *9-10 (E.D. Ky. Feb. 17, 2011) (finding no Eighth Amendment violation when treating doctor rejected the treatment recommendation of outside specialists).

         Rhinehart was being treated for longstanding ESLD and Hepatitis C before his transfer to JCF. A suspicion of cancer arose in the course of that treatment when a CT scan revealed "abnormal liver findings." See ECF 259-1, PgID 4601, 4606. Rhinehart was then transferred to JCF to allow for a further "work up" of the findings. Id. at 4606. The medical providers' suspicion of cancer, however, was not a new diagnosis, and their recommendations that Rhinehart see an oncologist or hepatologist were not "mandated treatments." Rhinehart in ...

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