Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-2_09-cv-00367/USCOURTS-almd-2_09-cv-00367-1/pdf.json

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

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IN THE DISTRICT COURT OF THE UNITED STATES

FOR THE MIDDLE DISTRICT OF ALABAMA

NORTHERN DIVISION

FRANK JONES, #118930, )

)

Plaintiff, )

)

v. ) CASE NO. 2:09-CV-367-WC

) [WO]

)

DR. CORBITT, et al., )

)

Defendants. )

MEMORANDUM OPINION

I. INTRODUCTION

This 42 U.S.C. § 1983 action is before the court on a complaint filed by Frank Jones

[“Jones”], a state inmate, in which he challengesthe medical treatment provided to him for

chronic constipation and related bowel discomfort during his confinement at the Elmore

Correctional Facility [“Elmore”]. Specifically, Jones alleges the defendants failed to

provide “the treatment necessary to eliminate” his constipation. Pl.’s Compl. (Doc. No. 1)

at 3. Jones names Dr. Corbitt, Dr. McAuther and Correctional Medical Services as

defendants in this cause of action. Jones seeks monetary damages and requests issuance

1

of an order requiring the defendants to provide him proper medical treatment for his

chronic constipation. Id. at 4.

The defendants indicate Dr. Corbitt’s true name is Dr. Paul Corbier and further advise Dr. 1

McAuther is actually Donald McArthur, a physician’s assistant. 

Case 2:09-cv-00367-WC Document 42 Filed 12/15/11 Page 1 of 20
The defendants filed a special report and relevant supporting evidentiary materials

addressing Jones’ claim for relief. Pursuant to the orders entered in this case, the court

deems it appropriate to construe this report as a motion for summary judgment. June 15,

2009 Order (Doc. No. 18). 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 to the 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, answers to

interrogatories, and admissions on file, together with the affidavits, if any, show there is

no genuine [dispute] 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 (11th Cir. 2007) (per curiam) (citation to former rule omitted); Fed. R. Civ. P. 56(a)

(“The court shall grant summary judgment if the movant shows that there is no genuine

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

2

The party moving for summary judgment “always bears the initial responsibility of

Effective December 1, 2010, Rule 56 was “revised to improve the procedures for presenting and 2

deciding summary-judgment motions.” Fed. R. Civ. P. 56 Advisory Committee Notes. Under this revision,

“[s]ubdivision (a) carries forward the summary-judgment standard expressed in former subdivision (c),

changing only one word – genuine ‘issue’ becomes genuine ‘dispute.’ ‘Dispute’ better reflects the focus of

a summary-judgment determination.” Id. “‘Shall’ is also restored to express the direction to grant summary

judgment.” Id. Thus, although Rule 56 underwent stylistic changes, its substance remains the same and,

therefore, all cases citing the prior versions of the rule remain equally applicable to the current rule. 

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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 [ – now dispute – ] 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 322-24.

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

any genuine dispute of material fact. Thus, the burden shifts to the plaintiff to establish,

with appropriate evidence beyond the pleadings, that a genuine dispute material to his case

exists. Clark v. Coats &Clark, Inc., 929 F.2d 604, 608 (11th Cir. 1991); Celotex, 477 U.S.

at 324; Fed. R. Civ. P. 56(e)(3) (“If a party fails to properly support an assertion of fact or

fails to properly address another party’s assertion of fact by [citing to materials in the

record including affidavits, relevant documents or other materials] the court may . . . grant

summary judgment if the motion and supporting materials – including the facts considered

undisputed – show that the movant is entitled to it.”) A genuine dispute of material fact

exists when the nonmoving party produces evidence that would allow a reasonable factfinder to return a verdict in its favor. Greenberg, 498 F.3d at 1263.

In civil actions filed by inmates, federal courts

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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 (2006) (internal citation omitted). Consequently, to

survive the defendants’ properly supported motion for summary judgment, Jones is

required to produce “sufficient [favorable] evidence” which would be admissible at trial

supporting his claim for relief. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986);

Fed. R. Civ. P. 56(e). “If the evidence [on which the nonmoving party relies] is merely

colorable . . . or is not significantly probative . . . summary judgment may be granted.” Id.

at 249-50. “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, 1576-77 (11th Cir. 1990). Conclusory

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 Assocs., Inc., 276 F.3d 1275, 1279 (11th Cir. 2001);

Holifield v. Reno, 115 F.3d 1555, 1564 n.6 (11th Cir. 1997) (plaintiff’s “conclusory

assertions . . . , in the absence of [admissible] supporting evidence, are insufficient to

withstand summary judgment.”); Harris v. Ostrout, 65 F.3d 912, 916 (11th Cir. 1995)

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(grant of summary judgment appropriate where inmate produces nothing beyond “his own

conclusory allegations” challenging actions of the defendants); Fullman v. Graddick, 739

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

Inc., 814 F.2d 607, 609 (11th Cir. 1987) (If on any part of the prima facie case the plaintiff

presentsinsufficient evidence to require submission of the case to the trier of fact, granting

of summary judgment is appropriate).

Forsummaryjudgment purposes, onlydisputes involving materialfacts are relevant.

United States v. One Piece of Real Property Located at 5800 SW 74th Ave., Miami, Fla.,

363 F.3d 1099, 1101 (11th Cir. 2004). What is material is determined by the substantive

law applicable to the case. Anderson, 477 U.S. at 248; Lofton v. Sec’y of the Dep’t of

Children & Family Servs., 358 F.3d 804, 809 (11th Cir. 2004) (“Only factual disputes that

are material under the substantive law governing the case will preclude entry of summary

judgment.”). “The mere existence of some factual dispute will not defeat summary

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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 (11th Cir. 2003)

(citation omitted). To demonstrate a genuine dispute of material fact, the party opposing

summary judgment “must do more than simply show that there issome 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 [dispute] 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 dispute 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 323-24 (Summary judgment is appropriate where

pleadings, evidentiary materials and affidavits before the court show there is no genuine

dispute as to a requisite material fact); Waddell, 276 F.3d at 1279 (To establish a genuine

dispute of materialfact, the nonmoving partymust 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

dispute of material fact. Beard, 548 U.S. at 525; Brown v. Crawford, 906 F.2d 667, 670

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(11th Cir. 1990). Thus, the 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,

Jones fails to demonstrate a requisite genuine dispute of material fact in order to preclude

summary judgment. Matsushita, supra.

III. DISCUSSION

A. Absolute Immunity

With respect to any claim lodged against 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 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 (11th Cir. 1990) (citations

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

officials are immune from claims brought against them in their official capacities.”

Lancaster v. Monroe Cnty., 116 F.3d 1419, 1429 (11th Cir. 1997). In light of the

foregoing, it is clear to the court that the defendants are state officials entitled to sovereign

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immunity under the Eleventh Amendment for any claim seeking monetary damages from

them in their official capacities. Lancaster, 116 F.3d at 1429; Jackson v. Georgia Dep’t

of Transp., 16 F.3d 1573, 1575 (11th Cir. 1994); Parker v. Williams, 862 F.2d 1471 (11th

Cir. 1989).

B. Disposition of Deliberate Indifference Claim

In September of 2008, Jones arrived at Elmore and the “defendants . . . prescribed

medication and [sustenance]for plaintiff because plaintiff cannot[swallow]solid food; but

will not order the treatment necessary to [determine and] eliminate the [exact] problem.”

Pl.’s Compl. (Doc. No. 1) at 3. Jones alleges the defendants failed to provide adequate

medical treatment for his chronic constipation which caused him to “suffer with serious

stomach pain” and experience significant weight loss. Id. The defendants deny they acted

with deliberate indifference to Jones’ medical condition and, instead, maintain they

provided Jones 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 (11th Cir. 2000);

McElligott v. Foley, 182 F.3d 1248 (11th Cir. 1999); Waldrop v. Evans, 871 F.2d 1030,

1033 (11th Cir. 1989); Rogers v. Evans, 792 F.2d 1052, 1058 (11th Cir. 1986).

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Specifically, medical personnel may not subject inmates to “acts or 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 (11th Cir. 1989). When seeking

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 (4th Cir. 1998) (defendant must have actual 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’sfailure

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

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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 onlywhen 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 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 asto the latter’s diagnosis or course of treatmentsupport

a claim of cruel and unusual punishment. See Waldrop, 871 F.2d at 1033

(citing Bowring v. Godwin, 551 F.2d 44, 48 (4th Cir. 1977)).

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

actors 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 (11th Cir.

1995); Hamm v. DeKalb Cnty., 774 F.2d 1567, 1575 (11th Cir. 1985) (mere fact that prison

inmate desires a different mode of medical treatment does not amount to deliberate

indifference violative of the Constitution); Garvin v. Armstrong, 236 F.3d 896, 898 (7th

Cir. 2001) (“A difference of opinion as to how a condition should be treated does not give

rise to a constitutional violation.”); Franklin v. Oregon, 662 F.2d 1337, 1344 (9th Cir.

1981)(prison medical personnel do not violate the Eighth Amendmentsimplybecause their

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

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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 (11th Cir. 2001). Thus, for Jones to survive

summary 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 Jones’ confinement at

Elmore correctional medical personnel, in accordance with their professional judgment and

as dictated by their assessment of his condition, consistently provided treatment to Jones

for his constipation and resulting bowel discomfort. Def.’s Ex. A (Aff. of Donald

McArthur - Doc. No. 16-1) at 1-11; Def.’s Ex. B (Aff. of Paul Corbier, M.D.- Doc. No. 16-

2) at 2-6; Def.’s Ex. A (Medical Records of Frank Jones - Doc. No. 16-1) at 13-204. The

probative evidentiarymaterials before the courtfurther demonstrate that the prison medical

staff routinely examined Jones, thoroughly evaluated his complaints, carried out requisite

tests, performed x-rays, referred him to a free-world physician specializing in

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gastroenterology for additional evaluation and treatment, provided medical profiles

allowing contravention of normal correctional procedures, and prescribed various

medications for both pain relief and in an effort to alleviate his constipation. The

prescribed medications included Prilosec, Zantac, Reglan, Milk of Magnesia, Lactulose,

Colace, Mylanta, Simethicone, Phenergan, Dulcolax, Fleets Enema, Magcitrate, Ultram,

Percogesic, Tylenol and hemorrhoid cream. Medical personnel followed all orders

regarding Jones’ treatment in accordance with the instructions issued by the attending

physician, physician’s assistant and the free-world physician.

Defendant McArthur sets forth the following summary of medical treatment

provided to Jones regarding the claim presented in the instant complaint:

During my employment at Staton, I did participate in the provision of

medical services to Mr. Jones . . . . Because of the close proximity of Staton

and Elmore Correctional Facility (“Elmore”), the medical staff at Staton is

often involved in and/or responsible for the provision of medical services to

those inmates at Elmore. Mr. Jones first arrived at Elmore Correctional

Facility on September 8, 2008 . . . .

* * *

Prior to his arrival at Elmore . . . , Mr. Jones had experienced chronic

constipation and bowel discomfort over a significant period of time. In fact,

as of the time of his arrival at Elmore, Mr. Jones had been heavily dependent

upon laxatives for some period of time in order to achieve any bowel

movement. In February of 2006, Mr. Jones underwent an EGD study [or

esophago gastroduodenoscopy which entails the use of a fiber optic scope to

view the esophagus and stomach] during his incarceration at Bibb

Correctional Facility, which was . . . inconclusive and only resulted in a

recommendation [from the free world physician] that Mr. Jones continue

taking Prilosec (a proton pump inhibitor) and consider further study if the

symptoms persisted. In the month prior to his transfer to Elmore, x-rays of

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Mr. Jones’s abdomen and chest did not reveal any specific condition leading

to his complaints of chronic constipation.

Upon his arrival at Elmore, Mr. Jones began receiving medications,

medical treatment and evaluations on a regular basis for his complaints of

chronic constipation. From the time of his arrival at Elmore in September of

2008 through April of 2009 [the period of time relevant to this case], Mr.

Jones wasseen byme and/or Dr. Corbier on a least twenty-five (25) different

occasions, averaging roughly three examinations per month.

Mr. Jones did not submit any sick call request forms requesting . . .

medical treatment between September and December of 2008, but he did

submit a total of 13 sick call request forms between January 1, 2009, and

May 14, 2009. Though some of the sick call request forms submitted by Mr.

Jones during this period of time did relate to other non-urgent medical

conditions, a majority of the sick call request forms did relate to his

complaints of chronic constipation [and associated pain]. Asindicated in his

medical records, on each occasion that Mr. Jones requested any medical

attention during this period of time, he was promptly seen by members of the

medical staff at Staton. In addition to the occasions when Mr. Jones

requested non-urgent medical attention through the sick call process, he also

was brought to the health care unit for immediate evaluation on nine (9)

different occasions between January and May of 2009. As indicated in [the

plaintiff’s medical records submitted herewith], on each occasion that Mr.

Jones made complaints which were deemed urgent in nature or warranting

immediate evaluation by the medicalstaff, he wasimmediately brought to the

attention of the medicalstaff and was evaluated promptly by a member of the

medical staff.

Throughout hisincarceration at Elmore, Mr.Jones hasreceived orders

from me and other members of the medical staff (including Dr. Corbier) to

receive a dietary supplement, Ensure. We regularly attempted to re-evaluate

and adjust Mr. Jones’s medication regime to find the combination of

medications best suited to address his complaints. I, along with Dr. Corbier,

attempted to control Mr. Jones’s chronic constipation through numerous

different medications including: Prilosec (proton pump inhibitor), Zantac,

Reglan, Milk of Magnesia, laxatives (Lactulose), stool softeners (Colace),

anti-gas medications (Mylanta and Simethicone), anti-nausea medication

(Phenergan),suppositories(Dulcolax), bowel preparationsto clear his bowel

(Fleets enema and Magcitrate), pain medications (Ultram, Percogesic,

Tylenol) and hemorrhoid cream.

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Because ofthe various medications prescribed for him, it has been and

is important for Mr. Jones to take his medication, as prescribed. Mr. Jones

has demonstrated difficulty in complying with the pill call process whereby

he is provided his medication by members of the medical staff. As indicated

through his medical records, Mr. Jones failed to appear for pill call at

approximately 6:00 a.m. [the early morning pill call] on at least sixteen (16)

different occasions in the beginning of March 2009 to receive his Lactulose

(laxative medication). More recently, Mr. Jones has been permitted to keep

possession of his own medication without going through the pill call process.

While this process does make the medication more accessible to Mr. Jones,

it also eliminates [the medical staff’s] ability to monitor his day-to-day

medication administration and requires him to notify us in the event that his

medication unexpectedly needs refilling or if he has lost or otherwise been

unable to take his medication. Therefore, in the event that Mr. Jones has not

recently received any of this medications, it is due to his failure to notify the

medicalstaff that he has either run out of medication, or for whatever reason,

misplaced or lost his medication so that it cannot be taken.

In addition to the medication prescribed for him, [the medical staff]

has also conducted other testing and ordered additional consultations

regarding his complaints of chronic constipation. The medical staff has

conducted extensive laboratory testing, i.e. blood work and urinalyses in

order to attempt to derive some understanding as to the cause of Mr. Jones’s

continued complaints of constipation and abdominal discomfort without any

clear cut answers. When necessary, Mr. Jones has been housed in the

infirmary or “Medical Observation Unit” at Staton so that he could receive

fluids intravenously. Mr. Jones underwent a barium enema which also did

not reveal any cause for his symptoms. In October of 2008, Mr. Jones

developed an anal fissure (likely secondary to his chronic constipation),

which was eventually resolved through various medications.

[The medical staff] regularly entered orders permitting Mr. Jones to

deviate from the protocols and requirements imposed upon the inmate

population by the ADOC policies and procedures, allowing him to remain in

his bunk for extended periods of time over the course of [the time allowed

by the pertinent profile].

Ultimately, we elected to refer Mr. Jones to a gastroenterologist in .

. . February of 2009, for further evaluation of his complaints. Following a

February, 2009, appointment with a gastroenterologist, the medical staff

scheduled Mr. Jones for two procedures recommended by the

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gastroenterologist: a colonoscopy and an esophago gastroduodenoscopy,

also known as an “EGD”. Mr. Jones [subsequently] underwent a

colonoscopy on March 26, 2009, which did not result in any findings of any

significance other than a hemorrhoid and one colon polyp that was not likely

the cause of his continued complaints of constipation. At that time, he also

underwent the EGD in which the specialist determined that Mr. Jones likely

suffered from an inflammation of his digestive tract, but did not find any

specific reasonsfor Mr.Jones’s chronic constipation. As part of Mr.Jones’s

March, 2009, consultation with the gastroenterologist, the medical staff at

Staton received the [free-world] specialist’s opinion and recommendations

that Mr. Jones continue taking medication for gastritis (i.e inflammation of

the stomach lining) and be scheduled for a follow-up colonoscopy in March

of 2010.

In addition to treatment for his chronic constipation, Mr. Jones has

also received regular treatment for hypertension, which included

management of his condition with prescription medication and frequent

monitoring of his condition through chronic care clinics held by the medical

staff on a regular basis.

As of the date of this affidavit, I along with Dr. Corbier have made

substantial efforts in order to identify the origin or cause of Mr. Jones’s

complaints of chronic constipation. We have conducted numerous and

extensive diagnostic testing including invasive procedures such as a

colonoscopy and an EGD, as well as imaging studies. None of these

extensive tests or the additional blood work or urinalyses conducted by the

medical staff, have resulted in any findings of any kind which would enable

us (or the independent gastroenterologist) to identify any specific disease

and/or medical condition causing Mr. Jones’s chronic constipation which

could be specifically addressed either through surgical intervention or

medication. Though [correctional medical personnel] have referred Mr.

Jonesto a gastroenterologist for another opinion, this consultation including

the studies directly ordered by the gastroenterologist have not resulted in any

additionalfindings orrecommendations with regard to this particular patient.

At this time, the gastroenterologist has recommended that the medical staff

continue the current treatment regimen of medication designed to alleviate

Mr. Jones’s symptoms. In short, we simply cannot identify any cure for Mr.

Jones’s chronic constipation and there does not appear to be any medication

regimen which would completely alleviate or eliminate his symptoms.

I have not at any time ignored any request by Mr. Jones for medical

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treatment. I have not deliberately ignored any medical complaints made by

Mr. Jones or interfered in any way with the provision of medical care to Mr.

Jones at any time. I have not [knowingly] taken any action which has caused

Mr. Jones to experience any unnecessary pain and/or suffering. Much to the

contrary, I have made every effort to ensure that [correctional medical

personnel] have proactively sought out every reasonable course of medical

treatment and evaluation to identify the cause of Mr. Jones’s complaints and

alleviate or at a minimum reduce the symptoms that he has experienced.

Indeed, if I knew of a course of medical treatment that would eliminate Mr.

Jones’s chronic constipation, I would have recommended such a course of

action.

Def.’s Ex. A (Aff. of Donald McArthur - Doc. No. 16-1) at 3, 7-11 (citations to medical

records omitted).

During histenure asthe medical director at Staton, Dr.Corbier managed the medical

treatment provided to Jones from September of 2008 until March of 2009 when Corbier

accepted a position in Nashville, Tennessee. The affidavit filed by Dr. Corbier addresses

the claim before this court, in pertinent part, as follows:

As indicated in Mr. Jones’s medical records [filed herein] . . . , Mr.

Jones’s medical history demonstrated that he had experienced chronic

constipation for a period of time preceding his arrival at Elmore. At the time

of his arrival at Elmore, Mr. Jones had pending prescriptions for various

medications intended to control or reduce the symptoms associated with his

chronic bowel problems. As with any new inmate arriving at Elmore, I

reviewed his medicalrecords and prior medical treatment in conjunction with

my first examination of him. I specifically recall that Mr. Jones’s historical

medical treatment revealed a notable reliance upon laxatives, bowel

preparations and other medicationsintended to improve his bowel functions,

which had provided varying degrees of relief of his symptoms – the most

significant of which was constipation. Though the medical staff at Fountain

Correctional Facility (where Mr. Jones was previously incarcerated) did

make efforts to identify a cause of Mr. Jones’s bowel condition such as an

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esophago gastroduodenoscopy or “EGD,” lab work and other imaging

studies, none of these tests had provided any information leading to a

definitive diagnosis.

When Mr. Jones arrived at Elmore, I along with Mr. Donald

McArthur, a physician’s assistant working under my supervision and

direction, made a concerted effort to identify the cause of Mr. Jones’s

chronic constipation while attempting to control and limit his symptoms

through the use of various medication regimens. Though we initially

continued Mr. Jones’s existing prescriptions ordered by his prior physician,

we later elected to alter his medications when it became evident to usthat the

previously prescribed medications were not entirely effective in addressing

Mr. Jones’s complaints.

When Mr. Jones’s symptoms worsened during late 2008 and [the

beginning of] 2009, we continued to adjust his medication regimen to

provide him with relief. There was at least one occasion in the latter part of

November of 2008 when Mr. Jones[] complained of severe constipation and

discomfort and we elected to house Mr. Jones in the facility’s infirmary or

“Medical Observation Unit” in order to receive intravenous fluids. When

Mr. Jones’s symptoms subsided, he was eventually released back to the

general population at Elmore. Throughout the first roughly three (3) months

of Mr. Jones’s incarceration, we attempted to treat his chronic constipation

with medication. During this period of time, Mr. Jones received

prescriptions for various medications intended to address his complaints,

including a proton pump inhibitor, Zantac, Reglan, Milk of Magnesia,

laxatives, stool softeners, anti-gas medications, anti-nausea medication,

suppositories, bowel preparations to clear his bowel and pain medications.

Because Mr. Jones failed to regularly attend pill call to receive his

medications, we also provided his medications to him via the “Keep-on

Person” protocols so that he could self-administer his medication as

prescribed. Because of Mr. Jones’s condition, we also ordered him to take

the dietary supplement, Ensure, in an effort to ensure that he was maintaining

proper nutrition during this period of time. As we treated Mr. Jones’s

symptoms medically, we also continued to monitor Mr. Jones’s condition

through lab work, including blood testing and urinalyses. We also provided

Mr.Jones with physician’s orders(sometimes called “Profiles”) that allowed

him to deviate from the standard operating procedures of the Alabama

Department of Corrections, which, for example, allowed him to remain in his

bunk for extended periods of time.

In January of 2009, it became evident that Mr.Jones’ssymptoms were

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not improving and that specialty consultations would be necessary to more

extensively investigate the cause of his continued complaints. At that time,

Mr. McArthur and I agreed to refer Mr. Jones to an outside

gastroenterologist for further evaluation. Mr. Jones first saw a

gastroenterologist in February of 2009. Following this appointment, the

gastroenterologist recommended that Mr. Jones undergo several procedures

including another EGD as well as a colonoscopy. The medicalstaff at Staton

scheduled these procedures for Mr. Jones, which occurred at the end of

March, 2009. Unfortunately, both the EGD and colonoscopy failed to reveal

the cause of Mr. Jones’s chronic constipation. Following these procedures,

the consulting gastroenterologist recommended that we continue to treat Mr.

Jones for bowel inflammation, also known as “gastris,” and conduct a

follow-up colonoscopy in one year. In other words, the gastroenterologist

recommended that we continue to attempt to alleviate Mr.Jones’s symptoms

through medication.

I am not aware of any occasion that Mr. Jones voiced complaints

regarding his condition [to health care personnel] and was not evaluated in

a timely fashion by the medical staff. Mr. Jones never indicated to me that

he believed we should be doing anything more than the care that was

provided to him. I was not aware that Mr. Jones was dissatisfied or

otherwise concerned about the scope of medical services provided to him

when he was under my care.

In my professional medical opinion, Mr.Jones’s chronic constipation

has been a condition of unknown origin or epidemiology throughout the time

he was under my care. Over the course of the last approximately ten (10)

months, we followed a well-accepted and clinically appropriate course of

treatment for Mr.Jones’s complaints of chronic constipation which involved

an initial treatment through medications with monitoring through lab and

diagnostic testing followed by specialty consultation with a board-certified

gastroenterologist which confirmed the propriety of the course of treatment

being provided to Mr. Jones. There is no objective medical evidence which

provided us with any definitive grounds for a medical diagnosis of Mr.

Jones’s condition. As confirmed by the consultation with a

gastroenterologist, there is no indication of any kind that Mr. Jones would

derive any benefit from surgical intervention of any kind. At this point, there

is no reason to believe that Mr. Jones’s condition is life-threatening, though

monitoring of his condition should continue consistent with the monitoring

provided in the past.

I have not at any time ignored any request by Mr. Jones for medical

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treatment. I have not deliberately ignored any medical complaints made by

Mr. Jones or interfered in any way with the provision of medical care to Mr.

Jones at any time . . . I have made every effort to ensure that [the

correctional medical staff] sought out every reasonable course of medical

treatment and evaluation to identify the cause of Mr. Jones’s complaints and

alleviate or at a minimum reduce the symptoms that he has experienced.

Def.’s Ex. B (Aff. of Paul Corbier, M.D. - Doc. No. 16-2) at 3-6. The undisputed medical

records support the assertions made by the defendants and contain additional details with

respect to the treatment provided to Jones.

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

Jones asserts he should have been provided a different treatment regimen for his chronic

constipation and related issues--a regimen he does not identify–this purely conclusory and

suppositious assertion clearly 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 Jones

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received significantmedical treatment as dictated byobjective evaluations of his condition.

Based on well settled law cited herein, his mere desire for a different mode of medical

treatment does not amount to deliberate indifference.

Jonesfailsto present any evidence which indicatesthe defendants knew the manner

in which they treated his medical condition 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 the defendants acted with deliberate

indifference to Jones’ chronic constipation. Consequently,summary judgment is due to be

granted in favor of the defendants. Carter, 352 F.3d at 1350.

A separate order will accompany this memorandum opinion.

Done this 15th day of December, 2011.

/s/ Wallace Capel, Jr.

WALLACE CAPEL, JR.

UNITED STATES MAGISTRATE JUDGE

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