Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-1_08-cv-00548/USCOURTS-almd-1_08-cv-00548-1/pdf.json

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

---

The documents filed by Mathis indicate that he is now incarcerated in the state prison system at the Bibb 1

County Correctional Facility.

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. 2:08-CV-548-MEF

 ) [WO]

)

JASON SMOAK, )

)

 Defendant. )

RECOMMENDATION OF THE MAGISTRATE JUDGE

This case is before the court on a 42 U.S.C. § 1983 complaint filed by Raymond Mathis

[“Mathis”], an indigent inmate and frequent litigant before this court. In this complaint, Mathis

asserts that Jason Smoak, a certified physician’s assistant, denied him adequate medical treatment

for chronic back pain during Mathis’ most recent confinement in the Houston County Jail. Mathis

seeks treatment by a free-world physician and monetary damages. Plaintiff’s Complaint - Court

Doc. No. 1 at 4. 

1

 The defendant filed a special report, answer and supporting evidentiary materials addressing

Mathis’ claim for relief. Pursuant to the orders entered herein, the court deems it appropriate to treat

this report as a motion for summary judgment. Order of October 14, 2008 - Court Doc. No. 18.

Thus, this case is now pending on the defendant’s motion for summary judgment. Upon

consideration of this motion and the evidentiary materials filed in support thereof, the court

Case 1:08-cv-00548-MEF-TFM Document 19 Filed 11/21/08 Page 1 of 20
Effective December 1, 2007, “[t]he language of Rule 56 [was] amended ... to make the rule[] more easily 2

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

concludes that the defendant’s motion for summary judgment is due to be granted.

I. STANDARD OF REVIEW

“Summary judgment is appropriate ‘if the pleadings, depositions, answers to 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

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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

2

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

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 defendant has met his 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

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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) (“When a motion th

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 

Beard v. Banks, 549 U.S. 521, 530, 126 S.Ct. 2572, 2578, 165 L.Ed.2d 697 (2006) (internal citation

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

judgment, Mathis is required to produce “sufficient evidence” which would be admissible at trial

supporting his claim of a constitutional violation. Anderson v. Liberty Lobby, 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 allegations based th

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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 1555, 1564 n.6 th

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

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 beyond “his th

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 allegations is not sufficient th

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) (if on any part of the prima th

facie case the plaintiff presents insufficient evidence to require 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

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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).

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

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

II. DISCUSSION

A. Suit Against Defendant in his Official Capacity

To the extent Mathis sues defendant Smoak in his official capacity, Smoak is immune from

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

against the entity.” Kentucky v. Graham, 473 U. S. 159, 166 (1985). Under all facets of Alabama

law, a county sheriff, his jailers and medical staff act as state officers “when 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

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

(county sheriff is executive officer of the State). “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 omitted), and Congress has

th

not abrogated Alabama’s immunity. Therefore, Alabama state officials 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 defendant is a state official entitled to Eleventh

Amendment immunity when sued in his official capacity. Thus, defendant Smaok is entitled to

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The pleadings indicate that the alleged denial of medical treatment which forms the basis of the instant 3

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

by the Circuit Court of Houston County, Alabama for a felony 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 (11 Cir. 1997); Cottrell v. th

Caldwell, 85 F.3d 1480, 1490 (11 Cir. 1996) (citations omitted) (“Claims involving the mistreatment of arrestees th

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 (11th

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

7

absolute immunity from the plaintiff’s claims for monetary damages asserted against him in his

official capacity.

B. Medical Treatment for Back Pain - Deliberate Indifference3

Mathis complains defendant Smoak failed to provide him “medical treatment [for] ... chronic

back pain” and prescribed onlyTylenol to alleviate his pain. Plaintiff’s Complaint - Court Doc. No.

1 at 3. Defendant Smoak denies he acted with deliberate indifference to Mathis’ back pain and,

instead, maintains he 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

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

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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

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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

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

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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

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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 basisfor 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 of specific 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

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

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sufficient evidence of (1) a substantial risk of serious harm; (2) the defendant[’s] 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, including the individual named as a defendant, 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. 17-3 thru Court Doc. No. 17-6. 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 1 (Affidavit of Jason Smoak) - Court Doc. No. 17-2 at 2-14.

The affidavit filed by defendant Smoak delineates the relevant treatment provided to Mathis

as follows: 

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

Assistant (“CMA”); one full time Certified Physician’s Assistant (“P.A.”); 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, P.A., nurses or CMA services and the general medical

clinic as well as the hospital emergency room services, if necessary. Either I or the

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

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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 of 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 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. Inmate Mathis’ complaint in this case is dated July 9. 2008....

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

treatment by Medical 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 with

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 there being 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 ... with

subjective complaints [including] ... back pain.

Mathis said that Flexeril had helped his back... Upon

examination of his back,I found no significant muscle

spasm and only subjective claims of diffuse

tenderness to touch [a]s noted. Objectively, I could

not find any signs or symptoms of back pain or

problems at that time.... For hissubjective 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

ever treating [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

subjectively claims that his back is still hurting and

requests to see Dr. Banner. Inmate says his back was

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good while he was on Flexeril. Objectively, Nurse

Cameron noted that 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. [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 subjective

complaints of back pain. Inmate claims to have torn

nerves in his back. Inmate was referred to see

[defendant Smoak the following] Monday to evaluate

his subjective complaints. In the mean time, the

inmate was given ... Tylenol as needed [for pain

relief].

Jan. 29, 2008: Inmate Mathis to [the medical] clinic for subjective

complaints of back pain. Inmate wants more

medication as his prescription ran out. Upon

examination I found only diffuse/unspecified

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 objective signs and

symptoms 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

Trazadone 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

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(steroids) to be taken with food, Naprosyn 500 mg

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

day for 14 days.

 Mar.10, 2008: Inmate Mathis was brought to [the medical] clinic ...

with subjective complaint of right should pain for the

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 that he

was going to file a lawsuit against me, that it was

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

and hurt....

I noted further 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

Case 1:08-cv-00548-MEF-TFM Document 19 Filed 11/21/08 Page 14 of 20
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off line, reaching over head to catch or knock down

passes. Inmate Mathis came to medical clinic 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 ordered until April

2, 2008. Inmate also given Lamisil anti-fungal 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

Case 1:08-cv-00548-MEF-TFM Document 19 Filed 11/21/08 Page 15 of 20
16

subjective diffuse nonspecific tenderness.

Examination of his neck revealed subjective right

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. According to records received from Dr.

Ghori, Dr. Ghori indicated that inmate[] 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 the inmate that people

with chronic back pain do not get out and play

football and basketball like he has been witnessed

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17

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

but only wanted a cold pack for sinus congestion.

.... 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. I 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 was

reported 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 to check on him.

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. I

informed the inmate that his physical examination did

not match his subjective complaints. Inmate became

agitated and started shouting that I was neglecting his

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18

medical needs. I again told inmate that his subjective

complaints did not match my objective findings upon

my physical examination of him. [Mathis made no

further complaints to medical personnel regarding

back pain until August 11, 2008.] 

***

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

which he received from inmate Mathis. [This other

inmate] reported that inmate Mathis had additional

Tylenol in his sock....

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19

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]. 

Defendants’ Exhibit 1 (Affidavit of Jason Smoak) - Court Doc. No. 17-2 at 2-14.

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

defendant Smoak was neither grossly incompetent nor inadequate. Although Mathis asserts he

should have been provided a different treatment regimen for pain relief, this assertion, without more,

fails to establish deliberate indifference. Hamm, 774 F.2d at 1575; Garvin, 236 F.3d at 898;

Franklin, 662 F.2d at 1344. It is undisputed that Mathis received significant medical treatment as

dictated by objective evaluations of his condition. His mere desire for a different mode of medical

treatment does not amount to deliberate indifference. Harris, 941 F.2d at 1505. Mathis has failed

to present any evidence which indicates defendant Smoak knew the manner in which he treated

Mathis’ back pain created a substantial risk to Mathis’ health and that with this knowledge

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

otherwise, showing that defendant Smoak acted with deliberate indifference to Mathis’ complaints

of back pain. Summary judgment is therefore due to be granted in favor of the defendant.

III. CONCLUSION

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

1. The defendant’s motion for summary judgment be GRANTED.

2. Judgment be GRANTED in favor of defendant Smoak.

3. This case be dismissed with prejudice.

Case 1:08-cv-00548-MEF-TFM Document 19 Filed 11/21/08 Page 19 of 20
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4. The costs of this proceeding be taxed against the plaintiff.

It is further 

ORDERED that on or before December 5, 2008 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

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 21st day of November, 2008.

/s/Terry F. Moorer 

TERRY F. MOORER

UNITED STATES MAGISTRATE JUDGE

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