Jones v. Lam

Background

Antwion R. Jones, a prisoner at the Correctional Training Facility, filed this civil-rights action without a lawyer under 42 U.S.C. § 1983. He alleged that Dr. P. Lam, Dr. S. Posson, and Dr. T. Zewert were deliberately indifferent to serious medical needs involving his left middle finger, in violation of the Eighth Amendment’s prohibition on cruel and unusual punishment.

Jones injured his right index finger and left middle finger during a flag football game on October 30, 2016. The care of his right finger was not part of this case. Dr. Lam ordered x-rays of Jones’s left hand in December 2016 and June 2017 after complaints and decreased movement were noted. Dr. Lam was transferred to another facility in July 2017.

Dr. Zewert examined Jones in August 2017 and found a severe contracture—an abnormal tightening that prevented movement—of the left middle finger. He warned that surgery offered only a low chance of restoring some function and a minimal chance of restoring full function. Dr. Zewert performed surgery on September 19, 2017. Afterward, Jones was treated for a possible infection, tissue damage, and wound complications. Dr. Zewert drained a hematoma, monitored the finger, removed dead tissue, removed a stabilizing pin, prescribed or continued antibiotics, and later performed a skin graft. The graft healed successfully, but Jones continued to have limited movement.

Jones later requested physical therapy and a second medical opinion. Dr. Posson reviewed Jones’s medical records and an interview with Jones before responding to Jones’s prison appeal. The records indicated that Jones could perform daily activities and write legibly, that he had an upcoming appointment to discuss physical therapy, and that his primary care provider had discussed his case with other orthopedic surgeons. Dr. Posson concluded that Jones should continue with the existing treatment plan. Jones eventually received physical therapy on January 4, 2019.

Legal standard

The court explained that an Eighth Amendment medical-care claim requires proof of two elements: an objectively serious medical need and deliberate indifference by the defendant. Deliberate indifference means that the defendant knew of a substantial risk of serious harm and disregarded that risk by failing to take reasonable steps to address it. A disagreement between a patient and doctor about an acceptable course of treatment generally is not enough; the prisoner must show that the treatment was medically unacceptable and chosen with conscious disregard of an excessive risk.

The defendants did not dispute that the evidence could support finding Jones’s finger problems were a serious medical need. The dispute therefore centered on whether the evidence could show deliberate indifference.

Dr. Lam

The court held that no reasonable jury could find deliberate indifference by Dr. Lam. Dr. Lam promptly ordered x-rays after Jones’s requests and again after observing limited movement. The court found no evidence that physical therapy was medically necessary at the time, and Jones did not identify the dates when he allegedly asked Dr. Lam for physical therapy or a second opinion.

The court also noted that Dr. Lam stopped treating Jones before the left-finger surgery and that Jones provided no evidence showing Dr. Lam knew the later x-ray results or understood the underlying problems before his transfer. Even assuming Dr. Lam denied physical therapy and a second opinion, the court found that Jones had not shown the decisions were medically unacceptable or made with conscious disregard of an excessive health risk.

Dr. Posson

The court held that no reasonable jury could find deliberate indifference by Dr. Posson. Dr. Posson’s involvement was limited to reviewing Jones’s inmate appeal. He relied on Jones’s medical records and an interview with a nurse, including records showing that Jones could perform daily activities and write legibly, that he would discuss physical therapy with his primary care provider, and that other orthopedic surgeons had been consulted about the treatment plan.

Although Dr. Posson did not grant Jones’s requests for physical therapy and a second opinion, the court found no evidence that either service was medically necessary at that time. Jones also did not show that Dr. Posson’s decision was medically unacceptable or that he disregarded an excessive risk. The court noted that Jones continued receiving treatment for his finger.

Dr. Zewert

The court held that no reasonable jury could find deliberate indifference by Dr. Zewert. Jones claimed that Dr. Zewert ignored warnings about a possible infection on September 27, September 29, and October 7, 2017. The court accepted Jones’s version of events for purposes of summary judgment but found no evidence that any alleged failure to respond during that period caused harm. On two of those dates, other medical providers were treating Jones and he was taking antibiotics. On September 29, Dr. Zewert examined the finger, found no physical signs of infection, and nevertheless recommended continuing antibiotics because of the risk of infection.

The court also relied on evidence that Dr. Zewert continued monitoring and treating the finger, that he and an emergency-room doctor concluded on October 7 that there was no active, progressing infection requiring surgery or more aggressive antibiotics, and that he later cleaned the wound, removed dead tissue, and provided wound-care instructions. The court found that the presence of an infection did not itself establish deliberate indifference.

Jones argued that Dr. Zewert should have provided physical therapy. The court found no evidence that physical therapy would have been appropriate after surgery involving pins, significant tissue death, and a skin graft. The fact that Jones later received physical therapy did not establish that Dr. Zewert had acted improperly, particularly because the therapy did not restore movement in the finger.

Jones also argued that Dr. Zewert was not qualified to perform the surgery. The court rejected that argument, citing evidence of Dr. Zewert’s experience performing hand surgeries and an expert opinion that his care met the applicable standard. Jones did not raise a trial-worthy factual dispute on that issue.

Disposition

The court concluded that Jones had shown, at most, disagreements about the proper course of medical care. It ruled that no reasonable jury could find Drs. Lam, Posson, or Zewert deliberately indifferent to Jones’s left-finger medical needs. The defendants’ motions for summary judgment were GRANTED, and the court stated that the defendants were entitled to judgment as a matter of law. The clerk was directed to close the file.