Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-1_08-cv-00336/USCOURTS-almd-1_08-cv-00336-1/pdf.json

Nature of Suit Code: 555
Nature of Suit: Prisoner - Prison Condition
Cause of Action: 42:1983 Prisoner Civil Rights

---

IN THE DISTRICT COURT OF THE UNITED STATES

FOR THE MIDDLE DISTRICT OF ALABAMA

SOUTHERN DIVISION

RAYMOND MATHIS, )

AIS #140252, )

)

 Plaintiff, )

)

)

v. ) CIVIL ACTION NO.1:08-CV-336-WKW

 ) [WO]

)

SHERIFF ANDY R. HUGHES, et al., )

)

 Defendant. )

RECOMMENDATION OF THE MAGISTRATE JUDGE

I. INTRODUCTION

This cause of action is pending before the court on a 42 U.S.C. § 1983 complaint filed on

May 6, 2008 by Raymond Mathis [“Mathis”], an inmate currently incarcerated in the state prison

system and frequent litigant before this court. In the instant complaint, Mathis asserts the defendants

denied him adequate medical treatment for chronic back pain during his confinement in the Houston

County Jail. Mathis names Andy R. Hughes, the sheriff of Houston County, Alabama, Keith W.

Reed, commander of operations at the Houston County Jail, Sgt. Kim Turner, a correctional officer

for the jail, Jason Smoak, a certified physician’s assistant employed by the jail, and Dr. Sam Banner,

a physician for the jail, as defendants in this cause of action. Mathis seeks treatment by a free-world

physician and any other relief the court deems appropriate. Plaintiff’s Complaint - Court Doc. No.

1 at 4. 

Case 1:08-cv-00336-WKW-TFM Document 21 Filed 08/02/10 Page 1 of 23
Effective December 1, 2007, “[t]he language of Rule 56 [was] amended ... to make the rule[] more easily 1

understood and to make style and terminology consistent throughout the rules. These changes ... are stylistic only.”

Fed.R.Civ.P. 56 Advisory Committee Notes. Thus, although Rule 56 underwent stylistic changes, its substance

remains the same and, therefore, all cases citing the prior rule remain equally applicable to the current rule. 

2

The defendants filed a special report and supporting evidentiary materials addressing the

claim presented in the complaint. Pursuant to the orders entered herein, the court deems it

appropriate to treat the defendants’ report as a motion for summary judgment. Order of July 22,

2008 - Court Doc. No. 17. Thus, this case is now pending on the defendants’ motion for summary

judgment. Upon consideration of this motion, the evidentiary materials filed in support thereof and

the plaintiff’s response in opposition to the report/motion, the court concludes that the defendants’

motion for summary judgment is due to be granted.

II. STANDARD OF REVIEW

“Summary judgment is appropriate ‘if the pleadings, depositions, answersto interrogatories,

and admissions on file, together with the affidavits, if any, show there is no genuine issue as to any

material fact and that the moving party is entitled to judgment as a matter of law.’” Greenberg v.

BellSouth Telecomm., Inc., 498 F.3d 1258, 1263 (11 Cir. 2007) (per curiam) (citation to former th

rule omitted); Fed.R.Civ.P. Rule 56(c) (Summary judgment “should be rendered if the pleadings,

the discovery and disclosure materials on file, and any affidavits show that there is no genuine issue

as to any material fact and that the movant is entitled to judgment as a matter of law.”). The party

1

moving for summary judgment “always bears the initial responsibility of informing the district court

of the basis for its motion, and identifying those portions of the [record, including pleadings,

discovery materials and affidavits], which it believes demonstrate the absence of a genuine issue of

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3

material fact.” Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). The movant may meet this

burden by presenting evidence indicating there is no dispute of material fact or by showing that the

nonmoving party has failed to present evidence in support of some element of its case on which it

bears the ultimate burden of proof. Id. at 322-324. 

The defendants have met their evidentiary burden and demonstrated the absence of any

genuine issue of material fact. Thus, the burden shifts to the plaintiff to establish, with appropriate

evidence beyond the pleadings, that a genuine issue material to his case exists. Clark v. Coats &

Clark, Inc., 929 F.2d 604, 608 (11 Cir. 1991); Celotex, 477 U.S. at 324; Fed.R.Civ.P. 56(e)(2) th

(“When a motion for summary judgment is properly made and supported, an opposing party may not

rely merely on allegations or denials in its own pleading; rather, its response must ... set out specific

facts showing a genuine issue for trial.”). A genuine issue of material fact exists when the

nonmoving party produces evidence that would allow a reasonable fact-finder to return a verdict in

its favor. Greenberg, 498 F.3d at 1263. 

In civil actions filed by inmates, federal courts 

must distinguish between evidence of disputed facts and disputed matters of

professional judgment. In respect to the latter, our inferences must accord deference

to the views of prison authorities. Unless a prisoner can point to sufficient evidence

regarding such issues of judgment to allow him to prevail on the merits, he cannot

prevail at the summary judgment stage.

Beard v. Banks, 548 U.S. 521, 530, 126 S.Ct. 2572, 2578, 165 L.Ed.2d 697 (2006) (internal citation

omitted). Consequently, to survive the defendants’ properly supported motion for summary

judgment, Mathis is required to produce “sufficient [favorable] evidence” which would be

admissible at trial supporting his claims of constitutional violations. Anderson v. Liberty Lobby,

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Inc., 477 U.S. 242, 249 (1986); Rule 56(e)(1), Federal Rules of Civil Procedure. “If the evidence

[on which the nonmoving party relies] is merely colorable ... or is not significantly probative ...

summary judgment may be granted.” Id. at 249-250. “A mere ‘scintilla’ of evidence supporting the

opposing party’s position will not suffice; there must be enough of a showing that the [trier of fact]

could reasonably find for that party. Anderson v. Liberty Lobby, 477 U.S. 242, 106 S.Ct. 2505, 2512,

91 L.Ed.2d 202 (1986).” Walker v. Darby, 911 F.2d 1573, 1576-1577 (11 Cir. 1990). Conclusory th

allegations based on subjective beliefs are likewise insufficient to create a genuine issue of material

fact and, therefore, do not suffice to oppose a motion for summary judgment. Waddell v. Valley

Forge Dental Associates, Inc., 276 F.3d 1275, 1279 (11 Cir. 2001); Holifield v. Reno, 115 F.3d th

1555, 1564 n.6 (11 Cir. 1997) (plaintiff’s “conclusory assertions ..., in the absence of [admissible] th

supporting evidence, are insufficient to withstand summary judgment.”); Harris v. Ostrout, 65 F.3d

912, 916 (11 Cir. 1995) (grant of summary judgment appropriate where inmate produces nothing th

beyond “his own conclusory allegations” challenging actions of the defendants); Fullman v.

Graddick, 739 F.2d 553, 557 (11 Cir. 1984) (“mere verification of party’s own conclusory th

allegations is not sufficient to oppose summary judgment....”). Hence, when a plaintiff fails to set

forth specific facts supported by requisite evidence sufficient to establish the existence of an element

essential to his case and on which the plaintiff will bear the burden of proof at trial, summary

judgment is due to be granted in favor of the moving party. Celotex, 477 U.S. at 322 (“[F]ailure of

proof concerning an essential element of the nonmoving party’s case necessarily renders all other

facts immaterial.”); Barnes v. Southwest Forest Industries, Inc., 814 F.2d 607, 609 (11 Cir. 1987) th

(if on any part of the prima facie case the plaintiff presents insufficient evidence to require

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submission of the case to the trier of fact, granting of summary judgment is appropriate).

For summary judgment purposes, only disputes involving material facts are relevant. United

States v. One Piece of Real Property Located at 5800 SW 74 Avenue, Miami, Florida, 363 F.3d th

1099, 1101 (11 Cir. 2004). What is material is determined by the substantive law applicable to the th

case. Anderson, 477 U.S. at 248; Lofton v. Secretary of the Department of Children and Family

Services, 358 F.3d 804, 809 (11 Cir. 2004) (“Only factual disputes that are material under the th

substantive law governing the case will preclude entry of summary judgment.”). “The mere

existence of some factual dispute will not defeat summary judgment unless that factual dispute is

material to an issue affecting the outcome of the case.” McCormick v. City of Fort Lauderdale, 333

F.3d 1234, 1243 (11 Cir. 2003) (citation omitted). To demonstrate a genuine issue of material fact, th

the party opposing summary judgment “must do more than simply show that there is some

metaphysical doubt as to the material facts.... Where the record taken as a whole could not lead a

rational trier of fact to find for the nonmoving party, there is no ‘genuine issue for trial.’” Matsushita

Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986). In cases where the evidence

before the court which is admissible on its face or which can be reduced to admissible form indicates

that there is no genuine issue of material fact and that the party moving for summary judgment is

entitled to it as a matter of law, summary judgment is proper. Celotex, 477 U.S. at 323-324

(summary judgment appropriate where pleadings, evidentiary materials and affidavits before the

court show there is no genuine issue as to a requisite material fact); Waddell, 276 F.3d at 1279 (to

establish a genuine issue of material fact, the nonmoving party must produce evidence such that a

reasonable trier of fact could return a verdict in his favor).

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Under all facets of Alabama law, a county sheriff, his jailers and medical staff act as state officers “when

2

supervising inmates and otherwise operating the county jails.” Turquitt v. Jefferson County, Alabama, 137 F.3d 1285,

1289 (11 Cir. 1998); see Ala. Const. Art. V, § 112 (designates sheriff and, by extension, his staff as members of th

State’s executive department); see also Parker v. Amerson, 519 So.2d 442 (Ala. 1987) (county sheriff is executive

officer of the State). 

6

Although factual inferences must be viewed in a light most favorable to the nonmoving party

and pro se complaints are entitled to liberal interpretation by the courts, a pro se litigant does not

escape the burden of establishing by sufficient evidence a genuine issue of material fact. Beard, 548

U.S. at 525, 126 S.Ct. at 2576; Brown v. Crawford, 906 F.2d 667, 670 (11 Cir. 1990). Thus, the th

plaintiff’s pro se status alone does not mandate this court’s disregard of elementary principles of

production and proof in a civil case. In this case, Mathis fails to demonstrate a requisite genuine

issue of material fact in order to preclude summary judgment. Matsushita, supra. 

III. DISCUSSION

A. Suit Against Defendants in Their Official Capacities - Absolute Immunity

To the extent Mathis sues the defendants in their official capacities, they are immune from

monetary damages. Official capacity lawsuits are “in all respects other than name, ... treated as a 2

suit against the entity.” Kentucky v. Graham, 473 U. S. 159, 166 (1985). “A state official may not

be sued in his official capacity unless the state has waived its Eleventh Amendment immunity, see

Pennhurst State School & Hospital v. Halderman, 465 U.S. 89, 100, 104 S.Ct. 900, 908, 79 L.Ed.2d

67 (1984), or Congress has abrogated the state’s immunity,see Seminole Tribe v. Florida, [517 U.S.

44, 59], 116 S.Ct. 1114, 1125, 134 L.Ed.2d 252 (1996). Alabama has not waived its Eleventh

Amendment immunity, see Carr v. City of Florence, 916 F.2d 1521, 1525 (11 Cir. 1990) (citations th

omitted), and Congress has not abrogated Alabama’s immunity. Therefore, Alabama state officials

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Mathis alleges the denial of treatment occurred for several months prior to his filing this cause of action. 3

The pleadings therefore indicate that the alleged denial of medical treatment which forms the basis of the instant

complaint may have occurred both prior to and after Mathis’ incarceration pursuant to a sentence of confinement

imposed by the Circuit Court of Houston County, Alabama arising from a criminal offense. Thus, the complaint

relates to medical treatment provided during Mathis’ status as a pretrial detainee and convicted felon.

Nevertheless, regardless of Mathis’ status in the jail, the applicable standard of review remains the same. Bell v.

Wolfish, 441 U.S. 520, 99 S.Ct. 1861 (1979); Lancaster v. Monroe County, Ala., 116 F.3d 1419, 1425 n.6 (11th

Cir. 1997); Cottrell v. Caldwell, 85 F.3d 1480, 1490 (11 Cir. 1996) (citations omitted) (“Claims involving the th

mistreatment of arrestees or pretrial detainees in custody are governed by the Fourteenth Amendment’s Due

Process Clause instead of the Eighth Amendment’s Cruel and Unusual Punishment Clause, which applies to such

claims by convicted prisoners.... However, the applicable standard is the same, so decisional law involving prison

inmates applies equally to cases involving arrestees or pretrial detainees.”); Hamm v. DeKalb County, 774 F.2d

1567, 1574 (11 Cir. 1985), cert. denied, 475 U.S. 1096, 106 S.Ct. 1492 (1986) (For analytical purposes, there th

is no meaningful difference between the analysis required by the Fourteenth Amendment and that required by the

Eighth Amendment.); Tittle v. Jefferson County Commission, 10 F.3d 1535, 1539 (11 Cir. 1994) (observing that th

“[w]hether the alleged violation is reviewed under the Eighth or Fourteenth Amendment is immaterial.”). 

The records of this court in the numerous cases filed by Mathis establish his criminal history. This court 4

takes judicial notice of its own records. 

7

are immune from claims brought against them in their official capacities.” Lancaster v. Monroe

County, 116 F.3d 1419, 1429 (11 Cir. 1997). th

In light of the foregoing, it is clear that the defendants are state actors entitled to sovereign

immunity under the Eleventh Amendment for claimsseeking monetary damages from them in their

official capacities. Lancaster, 116 F.3d at 1429; Jackson v. Georgia Department of Transportation,

16 F.3d 1573, 1575 (11 Cir. 1994). Thus, the defendants are entitled to absolute immunity from th

any claims for monetary relief presented against them in their official capacities. Parker v. Williams,

862 F.2d 1471 (11 Cir. 1989). th

B. Medical Treatment for Back Pain - Deliberate Indifference3

Mathis possesses an extensive criminal history including voluminous convictions before the

state courts of Houston County, Alabama beginning in the 1980’s and continuing until the filing of

this case. In 2005, Mathis entered the Houston County Jail on a charge of third degree burglary and 4

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The trial court did not delineate this sentence as a concurrent sentence, and, therefore, under applicable state 5

law, the sentence at the time of imposition is a consecutive sentence to any other imposed term of incarceration. Ala.

Code § 14-3-38(a) (“When a convict is sentenced to imprisonment in the penitentiary on two or more convictions,

unless it is specifically ordered in the judgment entry that such sentences be served concurrently, such sentences shall

be cumulative and shall be served consecutively ... beginning on the expiration of the preceding term.”). Thus, the

sentence for receiving stolen ran consecutive to all prior sentences imposed upon Mathis.

8

on an offense for first degree receiving stolen property for which an indictment had issued against

Mathis on December 3, 2004. See Mathis v. Glover, et al., Civil Action No. 1:05-CV-1084-MHTTFM (M.D. Ala. 2008), Defendants’ Exhibit D - Court Doc. No. 18-15 at 1- 4. A grand jury returned

an indictment against Mathis for the burglary offense on June 10, 2005. Id. at 2. This previous

record further demonstrates that Mathis entered a guilty plea to third degree burglary on March 29,

2006 and the trial court imposed a sentence of four (4) years imprisonment for this conviction. The

records before the court in yet another civil rights action filed by Mathis, Mathis v. Hughes, et al.,

Civil Action No. 1:08-CV-277-MEF-TFM, likewise establish Mathis entered a guilty plea to the

receiving stolen property charge on November 16, 2005 and received a sentence of three (3) years

imprisonment for this offense. Mathis v. Hughes, et al., Civil Action No. 1:08-CV-277-MEF-TFM,

Defendants’ Exhibit J - Court doc. No. 38-2 at 1. The state court awarded Mathis 228 days of jail 5

credit for time served in the county jail on this offense, ordered the sentence split with Mathis to

serve 15 months imprisonment with the “balance of [s]aid sentence suspended on the condition of

good behavior and payment of fines, costs and restitution for a period of 24 months at $50 per month

[to] begin Jan. 15, 2006.” Mathis v. Hughes, et al., Civil Action No. 1:08-CV-277-MEF-TFM,

Defendants’ Exhibit K - Court Doc. No. 38-3 at 15 and Plaintiff’s Exhibit B to Response - Court

Doc. No 40-2. Mathis subsequently secured his release from confinement on these charges. 

On October 31, 2007, the trial court issued an alias warrant of arrest for Mathis in his

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receiving stolen property case. Mathis v. Hughes, et al., Civil Action No. 1:08-CV-277-MEF-TFM

Defendants’ Exhibit K - Court Doc. No. 38-3 at 5. On November 1, 2007, law enforcement officials

arrested Mathis on several charges of third degree burglary and returned him to the Houston County

Jail. On November 7, 2007, Mathis was arrested on the alias warrant while incarcerated at the

Houston County Jail. Id. at 7. On February 20, 2008, the court determined Mathis had “willfully

failed and refused to pay his fines and costs” with respect to the condition pertaining to suspension

of his receiving stolen property sentence and therefore ordered Mathis to “serve his fines and costs

associated” with this conviction in the Houston County Jail. Id. It is therefore clear that as of

February 20, 2008 Mathis’ confinement in the jail related, at least in part, to the sentence imposed

for his conviction for receiving stolen property. This sentence had not yet expired as the trial court

suspended the sentence pending payment of costs and fines. In addition, the four-year sentence

imposed on March 26, 2006 for third degree burglary remained in effect. 

Mathis complains the defendants failed to provide him adequate medical treatment for chonic

back pain. Plaintiff’s Complaint - Court Doc. No. 1 at 3. The defendants deny they acted with

deliberate indifference to Mathis’ back pain and, instead, maintain they provided Mathis with

appropriate treatment for his condition. 

To prevail on a constitutional claim concerning an alleged denial of adequate medical

treatment, an inmate must, at a minimum, show that those responsible for providing the treatment

acted with deliberate indifference to his serious medical needs. Estelle v. Gamble, 429 U.S. 97

(1976); Taylor v. Adams, 221 F.3d 1254 (11 Cir. 2000); McElligott v. Foley, 182 F.3d 1248 (11 th th

Cir. 1999); Waldrop v. Evans, 871 F.2d 1030, 1033 (11 Cir. 1989); Rogers v. Evans, 792 F.2d 1052, th

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1058 (11 Cir.1986). Specifically, jail medical personnel may not subject inmates to “acts or th

omissions sufficiently harmful to evidence deliberate indifference to serious medical needs.” Estelle,

429 U.S. at 106, 97 S.Ct. at 292; Mandel v. Doe, 888 F.2d 783, 787 (11 Cir.1989). When seeking th

relief based on deliberate indifference of responsible officials, an inmate is required to establish “an

objectively serious need, an objectively insufficient response to that need, subjective awareness of

facts signaling the need and an actual inference of required action from those facts.” Taylor, 221

F.3d at 1258; McElligott, 182 F.3d at 1255 (for liability to attach, the official must know of and then

disregard an excessive risk to the prisoner). Thus, deliberate indifference occurs only when a

defendant “knows of and disregards an excessive risk to inmate health or safety; the [defendant]

must both be aware of facts from which the inference could be drawn that a substantial risk of

serious harm exists and he must also draw the inference.” Farmer v. Brennan, 511 U.S. 825, 837

(1994); Johnson v. Quinones, 145 F.3d 164, 168 (4 Cir. 1998) (defendant must have actual th

knowledge of a serious condition, not just knowledge of symptoms, and ignore known risk to serious

condition to warrant finding of deliberate indifference). Furthermore, “an official’s failure to

alleviate a significant risk that he should have perceived but did not, while no cause for

commendation, cannot under our cases be condemned as the infliction of punishment.” Farmer, 511

U.S. at 838. 

 In articulating the scope of inmates’ right to be free from deliberate indifference,

... the Supreme Court has ... emphasized that not ‘every claim by a prisoner that he

has not received adequate medical treatment states a violation of the Eighth

Amendment.’ Estelle, 429 U.S. at 105, 97 S.Ct. at 291; Mandel, 888 F.2d at 787.

Medical treatment violates the eighth amendment only when it is ‘so grossly

incompetent, inadequate, or excessive as to shock the conscience or to be intolerable

to fundamental fairness.’ Rogers, 792 F.2d at 1058 (citation omitted). Mere

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incidents of negligence or malpractice do not rise to the level of constitutional

violations. See Estelle, 429 U.S. at 106, 97 S.Ct. at 292 (‘Medical malpractice does

not become a constitutional violation merely because the victim is a prisoner.’);

Mandel, 888 F.2d at 787-88 (mere negligence or medical malpractice ‘not sufficient’

to constitute deliberate indifference); Waldrop, 871 F.2d at 1033 (mere medical

malpractice does not constitute deliberate indifference). Nor does a simple difference

in medical opinion between the prison’s medical staff and the inmate as to the latter’s

diagnosis or course of treatment support a claim of cruel and unusual punishment.

See Waldrop, 871 F.2d at 1033 (citing Bowring v. Godwin, 551 F.2d 44, 48 (4

th

Cir.1977)). 

Harris v. Thigpen, 941 F.2d 1495, 1505 (11 Cir. 1991). Moreover, “whether government actors th

should have employed additional diagnostic techniques or forms of treatment ‘is a classic example

of a matter for medical judgment’ and therefore not an appropriate basis for liability under the Eighth

Amendment.” Adams v. Poag, 61 F.3d 1537, 1545 (11 Cir. 1995); Hamm v. DeKalb County, 774 th

F.2d 1567, 1575 (11 Cir. 1985) (mere fact that prison inmate desires a different mode of medical th

treatment does not amount to deliberate indifference violative of the Constitution); Garvin v.

Armstrong, 236 F.3d 896, 898 (7 Cir. 2001) (“A difference of opinion as to how a condition should th

be treated does not give rise to a constitutional violation.”); Franklin v. Oregon, 662 F.2d 1337, 1344

(9 Cir. 1981)(prison medical personnel do not violate the Eighth Amendment simply because their th

opinions concerning medical treatment conflict with that of the inmate-patient). 

 To be deliberately indifferent, Defendants must have been “subjectively aware of

the substantial risk of serious harm in order to have had a ‘“sufficiently culpable state

of mind.”’” Farmer, 511 U.S. at 834-38, 114 S.Ct. at 1977-80; Wilson v. Seiter, 501

U.S. 294, 299, 111 S.Ct. 2321, 2324-25, 115 L.Ed.2d 271 (1991).... Even assuming

the existence of a serious risk of harm and causation, the prison official must be

aware ofspecific facts from which an inference could be drawn that a substantial risk

of serious harm exists--and the prison official must also “draw that inference.”

Farmer, 511 U.S. at 837, 114 S.Ct. at 1979. 

Carter v. Galloway, 352 F.3d 1346, 1349 (11 Cir. 2001). Thus, for Mathis to survive summary th

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judgment on his deliberate indifference claim against the defendants, he is “required to produce

sufficient evidence of (1) a substantial risk of serious harm; (2) the defendants’ deliberate

indifference to that risk; and (3) causation.” Hale v. Tallapoosa County, 50 F.3d 1579, 1582 (11th

Cir. 1995). 

The medical records filed herein demonstrate that during Mathis’ confinement in the Houston

County Jail medical personnel consistently provided treatment to Mathis for his back pain in

accordance with their assessment of his condition. Defendant’s Exhibit A to the Affidavit of Jason

Smoak (Houston County Jail Medical File of Raymond Mathis) - Court Doc. No. 16-4 thru Court

Doc. No. 16-6. The undisputed evidentiary materials before the court further demonstrate that the

jail’s medical staff routinely examined Mathis, thoroughly evaluated his complaints, ordered

necessary tests, prescribed various medications and provided treatment for his back in accordance

with their professional judgment. Id.; Defendant’s Exhibit 2 (July 21, 2008 Affidavit of Jason

Smoak) - Court Doc. No. 16-3 at 2-15.

The affidavit filed by defendant Smoak addresses the claim before this court, in pertinent

part, as follows: 

In addition to funding three full time nurse positions; one Certified Medical

Assistant [“CMA”]; one full time Certified Physician’s Assistant; a doctor contracted

as the Clinic Medical Director and staff doctor; and, a registered supervising

pharmacist for the provision of medical care to inmates such as the plaintiff, the

[Houston] County Jail provides a general medical clinic for medical problems that

may arise in the jail. The medical clinic is held daily, Monday through Friday. The

jail also has a nurse or CMA on duty on Saturdays and Sundays. The clinic is staffed

by the staff physician and/or myself as the Certified Physician’s Assistant under the

supervision of the physician. The nurses or CMA are in the Pods each day passing

out inmate medications as well. Thus, inmates are given daily access to either the

doctor or [physician’s assistant] and nursing or CMA services, hospital emergency

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room services, if necessary, and the general medical clinic. Either I or the doctor are

“on call” to the jail on a 24 hour a day, seven days a week, basis. 

It is the policy of the Houston County Jail that all requests for medical

treatment are forwarded to the jail’s medical staff with the expectation that

appropriate and necessary medical treatment will be provided to or obtained for the

inmate. 

The jail medical staff is committed to providing needed medical treatment to

every inmate. Based on my treatment to the plaintiff and my review of the plaintiff’s

jail medical file, the plaintiff was, during the period of time made the basis of

Plaintiff’s complaint, provided all necessary medical testing, treatment and care

while in the Houston County Jail. At all times alleged in Plaintiff’s Complaint, he

has been given and provided adequate and necessary medical treatment and has at all

times relevant thereto been provided with all medically necessary medications.

Inmate Mathis has presented with numerous subjective complaints many of which

could not be objectively verified. 

Inmate Mathis’ most recent incarceration in the Houston County Jail began

November 1, 2007. From November 1, 2007, through July 8, 2008, Mr. Mathis has

been seen for treatment byMedical Clinic personnel at least 34 times. All reasonable

and necessary medical treatment has at all times been provided to inmate Mathis. A

summary of the medical treatment provided to the plaintiff [relevant to the claim

presented in the instant complaint] is provided as follows: 

Nov. 5, 2007: Inmate Mathis came into the jail from the emergency

room of the Southeast Alabama Medical Center

(SAMC). Orders from SAMC were reviewed and

followed [including provision of blood pressure,

hemorrhoid and anti-infection medications]....

Nov. 7, 2007: Inmate Mathis was allowed to call home for his

medications (i.e. blood pressure, allergy and pain

medication). No medications were obtained from his

home so he was put on a Cold Pack twice a day for

five days for his cold symptoms. 

Nov. 9, 2007: Inmate Mathis was seen in [the medical] clinic ... with

subjective complaints [including] ... muscle spasm

across right upper back for two weeks - hurts to lay on

right side. [Medical personnel prescribed] Flexeril 10

mg by mouth twice a day for 14 days [as treatment for

the back spasm]. 

***

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Nov. 20, 2007: Inmate Mathis was seen in [the medical] clinic for

complaints of sinus congestion. Inmate Mathis was

given a Cold Pack to be taken by mouth twice a day

for 5 days. Inmate Mathis also wanted an extra mat

but due to no objective signs indicating a need for

same, I denied his request for an extra mat at that

time. 

***

Dec. 10, 2007: Inmate Mathis was seen in [the medical] clinic ... with

multiple subjective complaints [including] ... Lower

and Upper Back Pain. Upon examination, I found that

he had mild subjective tenderness between his

shoulder blades but no significant muscle spasm was

found. As for his lower back, there was no boney

tenderness but muscularly he was subjectively tender

across his lower back. The following treatment [for

his back] was provided: ... [An] analgesic cream and

... a muscle relaxer Flexeril to be take[n] by mouth

two times a day. He was to return to clinic in two

weeks.

Dec. 19, 200[7]: Inmate Mathis was seen in [the medical] clinic ... for

complaints [including] ... back pain. Mathis said that

Flexeril had helped his back... Upon examination of

his back, I found no significant muscle spasm and

onlysubjective [claims of] diffuse tenderness to touch

was noted. Objectively, I could not find any signs or

symptoms of back pain or problems at that time....

For his subjective complaints of back pain, inmate

claimed that he had seen Dr. Banner for back pain in

the past. Upon contacting Dr. Banner’s office there

was no record of Dr. Banner evertreating [Mathis] for

back pain. Dr. Banner’s records revealed that he had

only done a physical on the plaintiff. 

Dec. 26, 2007: Inmate Mathis was seen in [the medical] clinic for

follow up for back pain complaints. Inmate claims

that [his] back is still hurting and request[s] to see Dr.

Banner. Inmate says his back was good while he was

on Flexeril. Objectively, Nurse Cameron notes that

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inmate [Mathis] is sitting on table moving from side

to side rocking and sitting with elbow on knee

showing no signs of pain or problems [with his back].

She spoke with me and I [prescribed] Naprosin 500

mg, twice a day for 21 days [which was provided to

Mathis as prescribed. Over the next three weeks,

Mathis reported various complaints to the health care

staff none of which related to back pain.] 

***

Jan. 24, 2008: Inmate Mathis to [the medical] clinic with complaints

of back pain. Inmate claimsto have torn nerves in his

back. Inmate was referred to see [defendant Smoak

the following] Monday to evaluate his present

complaints. In the mean time, the inmate was given

... Tylenol from Corrections Officers as needed [for

pain relief].

Jan. 29, 2008: Inmate [Mathis seen in the medical] clinic for

complaints of back pain. Inmate wants more

medication as his prescription ran out. Upon

examination I found only diffuse/unspecific subjective

lower back pain as inmate claimed to be tender to

touch no matter where I touched him on his back.

Objectively, I could find no indications to support the

inmates subjective complaint. In the interest of

caution and based on his subjective complaints of

pain; I prescribed Naproxyn 500 mg by mouth twice

a day for 7 days, Flexeril 10 mg by mouth twice a day

for 7 days. I also prescribed Trazodone 50 mg by

mouth at night to aid sleep.

***

Feb. 27, 2008: Inmate Mathis was seen in [the medical] clinic

pursuant to inmate request claiming back pain but

when inmate presented to clinic he only complained

about pain in his right shoulder. The treatment

provided was to put inmate on a Medrol Dose Pack [a

steroid regimen] to be taken with food, Naprosyn 500

Case 1:08-cv-00336-WKW-TFM Document 21 Filed 08/02/10 Page 15 of 23
16

mg twice a day for 21 days, and Flexeril 10 mg twice

a day for 14 days.

 Mar.10, 2008: Inmate Mathis to [the medical] clinic with complaint

of right should pain for past 5 days. Inmate is

requesting an injection in his shoulder for the pain. I

told the inmate that he was witnessed playing football

for one hour on Thursday March 6, 2008, throwing

make shift football across [recreation] yard. Asked

inmate about playing football, and inmate stated “he

was in too much pain that he had to play.” Inmate

states ... he is hurting and ... demands something for

pain or [immediate referral] to the hospital.

 Upon examination inmates shoulder was found not to

have any effusion or swelling, no subacromial

tenderness, some positive tenderness anterior deltoid,

full passive range of motion without pain, negative

neer, questionable positive hawkins sign, inmate

subjectively complained of pain in anterior deltoid

with forward flexion greater than 100 degrees.

Physical examination did not warrant an injection. I

tried to explain to inmate that an injection was not

necessary and was not indicated. 

Upon examination of his neck, no muscle spasm was

noted, his right trap was subjectively tender to

palpitation, but had full range of motion. Right upper

extremity was found to be unremarkable.

Treatment: For his right should pain, I told him to

rest, continue Flexeril and Naprosyn as ordered for 2

weeks.

Note: Inmate left clinic verbally upset, stating what

was going to happen (i.e. his filing of a lawsuit) was

nothing personal, but he was not going to sit up here

and hurt....

I also wrote a note further documenting that inmate

wrote a request to be evaluated for right shoulder pain

on March 3, 2008. Thereafter, Inmate was witnessed

by multiple personnel playing football ... on March 6,

2008, inmate witnessed throwing, jaming/blocking

players off line, reaching over head to catch or knock

down passes. Inmate Mathis came to medical clinic

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asking for shoulder injection. Physical examination

did not warrant an inter-articular injection. I tried to

explain to Inmate Mathis that his shoulder was hurting

because he over used it and needs to rest. Inmate

became upset about not getting a shot and stated he

needed to go to hospital, that he was not going to sit

in here and hurt. Informed inmate that the plan for

him was to: 

1. Rest with stretching exercises.

2. Continue his Naprosyn.

3. Continue his Flexeril.

Inmate was noted to be verbally upset and left clinic.

***

Mar. 18, 2008: Inmate Mathis was seen in clinic for followup on

back. Inmate states that back pain is still the same, I

continued inmate on medications [previously] ordered

until April 2, 2008. Inmate also given Lamisil antifungal cream and a laxative for constipation.

***

April 2, 2008: Inmate Mathis was seen in clinic for multiple

complaints. Inmate’s chief complains were of back

pain, shoulder pain, constipation and hemorrhoids.

As treatment, inmate was given Preparation H

suppositories, Colace 100 mg by mouth twice a day

and Milk of Magnesia every morning for three days

for constipation. For his complaint of right shoulder

pain, inmate was given an analgesic muscle rub

cream.

April 14, 2008: Inmate Mathis was seen in clinic with multiple

complaints; right shoulder pain, neck pain, [etc.]....

Upon examination right shoulder found to have

subjectively positive subacromial tenderness with

increased pain with forward flexion of greater than 90

degrees. Examination of his lower back revealed

subjective diffuse nonspecific tenderness.

Examination of his neck revealed subjective right

Case 1:08-cv-00336-WKW-TFM Document 21 Filed 08/02/10 Page 17 of 23
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sided tenderness. 

Plan:

1. For right shoulder pain, put him back on Naprosyn

500 mg by mouth twice a day for 21 days. To return

to clinic in one week.

2. For neck pain, put him on Flexeril 10 mg by mouth

twice a day for 21 days....

April 15, 2008: At my request, Dr. Banner examined Inmate Mathis

and noted that the inmate states that he has chronic

back pain and has had injections in the past. Inmate

also states his right shoulder is hurting causing his

arm into hand to tingle and feel numb. After

examination, Dr. Banner informed inmate that playing

football and soccer is going to aggravate his shoulder

and back pain. Inmate Mathis started shouting and

wanted to know what playing football or soccer had to

do with his pain. Inmate repeatedly requested

injection for pain and asked for a second medical

opinion. 

Plan: Will do record search for past medical history in

an effort to find out if inmate actually has had past

injections for pain. Informed inmate not to play

sports, try to obtain medical records from Dr. Ghori

and medical records from clinic in Saginaw,

Michigan. We were unable to find the clinic in

Michigan.... [R]ecords [obtained] from Dr. Ghori

indicated that [Mathis’] tests were within normal

limits.

No objective evidence of disease (i.e. nerve damage)

with regard to inmate Mathis was found by Dr. Ghori.

May 5, 2008: Inmate Mathis was seen in clinic with subjective

complaints of back pain. I talked with the inmate

about our records search and that the telephone

number for the clinic in Michigan he provided was a

wrong number. I informed inmate [Mathis] that

people with chronic back pain do not get out and play

football and basketball like he has been witnessed

doing. Inmate stated that he was not here for his back

but only wanted a cold pack for sinus congestion.

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.... I continued the inmate’s Naprosyn 500 mg two

times a day as needed.; Flexeril 10 mg two times a

day for 21 days even though the inmate said he was

not here for back pain on this visit.... [No further

complaints of back pain received from Mathis for

several weeks.] 

***

July 9, 2008: Inmate Mathis was seen in Pod for complaint of upper

back pain. Inmate states that there is a knot under his

right shoulder blade. Asked inmate to locate area of

pain and he was unable to locate the painful area. It

took inmate several seconds and several tries for

inmate to locate painful area. Inmate unexplainedly

started rubbing back against door sill and then again

tried to show painful area to me. 

On physical examination, subjective tenderness noted

on the right rhomboid muscle. No masses noted. No

muscle spasms noted. No bruising or swelling noted.

Moves all extremities without difficulty or pain. 

Plan was for inmate to take Tylenol to be obtained

from the guards three times a day as needed.

Subjective complaints did not match [the objective

findings] and were inconsistent with physical

examination. Upon leaving inmates cell, inmate

became upset and started shouting that “he knew what

he needed and that was not Tylenol.” Inmate

specifically asked for Flexeril and was told no.

Inmate started shouting obscenities. I left cell and

went to check on another inmate in the same Pod. I

Came back by inmate Mathis’ cell. Inmate was still

shouting stating that “he will slap me in my damn

eye.” Note: During visit inmate repeated multiple

times that he was trying to work with me, and he

indicated that he would sue me if I did not work with

him and give him the drugs he wants. Informed

inmate [Mathis] that [his] physical examination did

not match his [subjective] complaints. Inmate became

agitated and started shouting that I was neglecting his

medical needs. I again told inmate that his

complaint[s] did not match his physical examination.

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[Mathis made no further complaints to medical

personnel regarding back pain until August 11, 2008.]

Defendants’ Exhibit 2 (July 21, 2008 Affidavit of Jason Smoak) - Court Doc. No. 16-3 at 2-15.

In an affidavit filed addressing a similar deliberate indifference claim presented in Mathis

v. Smoak, 1:08-CV-548-MEF-TFM (M.D. Ala. 2008), Smoak continues with the following

recitation of relevant treatment provided to Mathis for his complaints of back pain:

August 11, 2008: Inmate Mathis was seen in the clinic for blood

pressure check, back and leg pain, complaints of knot

on right eye, denies pain [in eye].... [Defendant

Smoak preformed a physical examination of Mathis,

prescribed treatment in accordance with his objective

findings and referred Mathis to a free-world

gastroenterologist for a second opinion related to

inmate’s hemorrhoids.] 

August 25, 2008: Inmate Mathis was seen in the clinic with complaints

of shoulder pain. Upon physical examination, I noted

that his left shoulder was essentially normal, inmate

had subjective complaints of tenderness to palpation,

radial pulse and capillary refill all normal, he had free

range of motion with no muscle spasm noted. 

I prescribed inmate Mathis with Biofreeze muscle rub

and Flexeril by mouth twice a day for seven days. 

August 30, 2008: I received a call from Dr. Banner about inmate Mathis

having given a large assembly of [Mathis’ prescribed]

medicine to another inmate ... who took at least six (6)

Claritin at one time. That inmate was brought to the

clinic and stated he had received that medicine from

inmate Mathis.... Inmate Mathis’ Claritin, Flexeril,

Trazadone, Naprosyn all were discontinued at that

time. Inmate Mathis [was] sent to administrative

segregation. 

August 31, 2008: I received a call from Sgt. Bonin stating that [another]

inmate ... took more than twenty (20) Tylenol at once

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which he received from inmate Mathis. [This other

inmate] reported that inmate Mathis had additional

Tylenol in his sock....

Sept. 3, 2008: Inmate Mathis was seen in the clinic regarding his

medications [and the discontinuation of the majority

of such medications based on his hoarding the

medications]. 

Mathis v. Smoak, 1:08-CV-548-MEF-TFM (M.D. Ala. 2008), Defendants’ Exhibit 1 (October 10,

2008 Affidavit of Jason Smoak) - Court Doc. No. 17-1 at 13-14. Smoak’s synopsis of the treatment

provided to Mathis is supported by the medical records filed in the cases before this court and there

is nothing before the court which undermines the validity of these records. 

Under the circumstances of this case, it is clear that the course of treatment undertaken by

the defendants was neither grossly incompetent nor inadequate. Although Mathis asserts he should

have been provided a different treatment regimen for pain relief, this assertion fails to establish

deliberate indifference. Garvin, 236 F.3d at 898 (difference of opinion regarding manner in which

condition should be treated fails to demonstrate a constitutional violation); Adams, 61 F.3d at 1545

(whether medical personnel “should have employed additional ... forms of treatment ‘is a classic

example of a matter for medical judgment’ and therefore not an appropriate basis for liability under

the Eighth Amendment.”); Hamm, 774 F.2d at 1505 (inmate’s desire for some other form of medical

treatment does not constitute deliberate indifference violative of the Constitution); Franklin, 662

F.2d at 1344 (simple divergence of opinions between medical personnel and inmate-patient do not

violate the Eighth Amendment). It is undisputed that Mathis received significant medical treatment

as dictated by objective evaluations of his condition. Based on well settled law cited herein, his mere

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desire for a different mode of medical treatment does not amount to deliberate indifference. Mathis

has failed to present any evidence which indicates the defendants knew the manner in which medical

personnel treated his back pain created a substantial risk to his health and that with this knowledge

consciously disregarded such risk. The record is devoid of evidence, significantly probative or

otherwise, showing that the defendants acted with deliberate indifference to Mathis’ complaints of

back pain. Consequently, summary judgment is due to be granted in favor of the defendants. Carter,

352 F.3d at 1350.

IV. CONCLUSION

Accordingly, it is the RECOMMENDATION of the Magistrate Judge that:

1. The defendants’ motion for summary judgment be GRANTED.

2. Judgment be GRANTED in favor of the defendants.

3. This case be dismissed with prejudice.

4. The costs of this proceeding be taxed against the plaintiff.

It is further 

ORDERED that on or before August 16, 2010 the parties may file objections to this

Recommendation. Any objections filed must clearly identify the findings in the Magistrate Judge’s

Recommendation to which the party is objecting. Frivolous, conclusive or general objections will

not be considered by the District Court. The parties are advised that this Recommendation is not a

final order of the court and, therefore, it is not appealable.

Failure to file written objectionsto the proposed findings and advisements in the Magistrate

Judge’s Recommendation shall bar the party from a de novo determination by the District Court of

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issues covered in the Recommendation and shall bar the party from attacking on appeal factual

findings in the Recommendation accepted or adopted by the District Court except upon grounds of

plain error or manifest injustice. Nettles v. Wainwright, 677 F.2d 404 (5th Cir. 1982). See Stein v.

Reynolds Securities, Inc., 667 F.2d 33 (11th Cir. 1982). See also Bonner v. City of Prichard, 661

F.2d 1206 (11th Cir. 1981, en banc), adopting as binding precedent all decisions of the former Fifth

Circuit handed down prior to the close of business on September 30, 1981.

Done this 1 day of August, 2010. st

/s/Terry F. Moorer 

TERRY F. MOORER

UNITED STATES MAGISTRATE JUDGE

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