Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-alnd-7_16-cv-01315/USCOURTS-alnd-7_16-cv-01315-0/pdf.json

Nature of Suit Code: 550
Nature of Suit: Prisoner - Civil Rights (U.S. defendant)
Cause of Action: 42:1983 Prisoner Civil Rights

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UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ALABAMA

WESTERN DIVISION

JAMES STACKHOUSE,

 Plaintiff,

v.

DR. PAVLOKOVIC, et al.,

 Defendants.

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Case No. 7:16-cv-01315-VEH-JHE

 

MEMORANDUM OPINION AND ORDER

On August 12, 2016, plaintiff James Stackhouse filed a pro se prisoner 

complaint pursuant to 42 U.S.C. § 1983. (Doc. 1). He names Dr. Pavlakovic, 

Captain John Hutton, and Warden Willie Thomas as defendants. (Id. at 3). In his 

complaint, the plaintiff alleges that he has severe headaches and vision loss due to 

arterial swelling. (Id. at 3-4). He declares Dr. Hooks informed him the swelling is 

the result of improperly performed surgery, and that he could die if the artery is not 

repaired. (Id. at 5). The plaintiff has received no help from the defendants despite 

pleas for assistance. (Id. at 5-6). As part of his request for relief, the plaintiff 

demands “immediate action.” (Id. at 4). 

I. Procedural History

On August 19, 2016, the undersigned construed the plaintiff’s request for 

‘immediate action’ to be a motion for preliminary injunctive relief. (Doc. 3 at 2-3). 

FILED

 2016 Sep-20 PM 04:55

U.S. DISTRICT COURT

N.D. OF ALABAMA

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The defendants were directed to show cause why the relief should not be granted. 

(Id. at 4). On September 15, 2016, the defendants filed a response supported by 

affidavits and other evidence. (Doc. 9). 

II. The plaintiff’s allegations and the defendants’ response

The undersigned has carefully examined the plaintiff’s allegations, and the 

defendants’ affidavits and medical records submitted in opposition to the plaintiff’s 

request for preliminary injunctive relief. (Doc. 9). Defendants Thomas and Hutton 

deny having any knowledge of the plaintiff’s condition, (docs. 9-4; 9-5), and Dr.

Pavlakovic attests he has consistently provided timely evaluation, testing, and 

treatment for the plaintiff’s symptoms. (Doc. 9-1). 

The medical records attached to the defendants’ response reveal that the 

plaintiff began complaining of severe headaches and vision loss in January 2015. 

(Doc. 9-2 at 104-107). Examinations of the plaintiff were unremarkable and it was 

noted that he was taking ibuprofen. (Id.). In April 2015, Dr. Hooks, the 

ophthalmologist, thought the plaintiff might have chronic conjunctivitis and 

observed a lipoma on the plaintiff’s left eyelid. (Doc. 9-3 at 18).1

 Between April 

and July 2015, Dr. Pavlakovic monitored the plaintiff’s complaints of headaches 

and soreness on the right side of his head, prescribed steroids, and referred the 

 1 Dr. Hooks noticed this “large conjunctival cyst” on the plaintiff's left eyelid in April 2014 and 

discussed surgical options with him at that time. (Doc. 9-3 at 22). It does not appear the lipoma 

is in any way related to the plaintiff’s headaches and blurry vision.

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plaintiff to an ear, nose and throat (ENT) specialist who performed an MRI and 

took a biopsy of the affected area to rule out temporal arteritis. (Id. at 1-12). The

results of the July 2015 biopsy were normal. (Id. at 9-12). Thus, contrary to the 

plaintiff allegations, he did not undergo surgery to relieve arterial pressure on the 

right side of his head.

 In his complaint, the plaintiff declares that “[l]ater” in 2015, his “artery 

beg[a]n to swell again with the same problem.” (Doc. 1 at 4). The medical records 

submitted by the defendants reveal that in August 2015, the plaintiff complained 

that his vision was worsening, and that he felt as though something was cutting his 

eye and that his eye would pop out. (Doc. 9-2 at 88-94). According to the 

examining nurse, the plaintiff had a whitish discharge coming from his eyes and a 

conjunctival growth on his left eye. (Id. at 88-89). The plaintiff had artificial tears 

to treat this eye condition. (Id. at 92). 

On September 2, 2015, the plaintiff told the nurse that the off-site ENT 

stated he had something blocking his vision that could cause him to go blind. 

(Doc. 9-2 at 13). However, the ENT reports contain no notation that the plaintiff 

had any eye blockage, much less that he could go blind from it. (Doc. 9-3 at 9-12).

On October 6, 2015, the plaintiff submitted one grievance concerning his head 

condition. (Id. at 109). The plaintiff wrote that he had not received monitoring or 

the results of the “surgery.” (Id.). On October 12, 2015, Nurse Clabo responded 

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that his biopsy was normal, and that Dr. Pavlakovic had reported to her that he 

already had explained to the plaintiff that the biopsy was normal. (Id.). The 

plaintiff alleges he did not receive this response. (Doc. 1 at 2). 

The plaintiff also declares that sometime later in 2015, Dr. Hooks told him 

that the artery was again swollen, the July 2015 surgery had been performed 

incorrectly, and that he could die if the artery burst. (Doc. 1 at 5). The medical 

records reveal that Dr. Hooks examines the plaintiff on January 7, 2016. (Doc. 9-3 

at 17). This exam was conducted after the plaintiff complained to a nurse that “his 

eyes” had been hurting for the past month and he had previously undergone eye 

surgery. (Doc. 9-2 at 81). Dr. Hooks recorded the plaintiff’s vision as being 

“20/50” and “20/40,” and noted there was no significant vision change when 

compared to the plaintiff’s previous exam. (Doc. 9-3 at 17). While there is a 

notation concerning a history of temporal arteritis, the only observation Dr. Hooks 

made was the presence of the temporal conjunctival lipoma. (Doc. 9-3 at 17). 

The plaintiff admits Dr. Hooks prescribed medication, but simultaneously 

complains he has received no help at the prison. (Doc. 1 at 5). 

On January 15, 2016, the plaintiff complained about itchy eyes to Dr. 

Pavlakovic, and Pavlakovic noted Hooks had provided treatment. (Doc. 9-2 at 14). 

Pavlakovic attests he reviewed the plaintiff’s normal biopsy results and saw no 

“evidence of any kind of trauma or abnormality with” the plaintiff’s eyes upon 

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examination. (Doc. 9-1 at 14). On February 2, 2016, the plaintiff complained

about being charged a co-pay because he is a chronic care patient, and that his eyes 

were still hurting him. (Doc. 9-2 at 104).

On May 30, 2016, Dr. Pavlakovic examined the plaintiff during chronic care 

clinic, as the plaintiff has a long history of gastroesophageal reflux disease and 

hypertension. (Doc. 9-2 at 119). Dr. Pavlakovic referred the plaintiff to the eye 

doctor (id.) though he attests the plaintiff did not complain about his eyes (doc. 9-1 

at 14). In June 2016, the plaintiff filled out another request for medical assistance, 

writing that he had surgery in July 2015 to relieve pressure on his artery, and that it 

was swelling up again. (Doc. 9-2 at 77). During a June 9, 2016, nursing encounter 

with the plaintiff, staff contacted Dr. Pavlakovic, and he explained the plaintiff’s

“actual medical history.” (Doc. 9-1 at 15; Doc. 9-2 at 78-79). The nurse then 

“spent time discussing with Mr. Stackhouse his condition.” (Id.). 

Dr. Pavlakovic attests that the plaintiff’s complaint 

recite[s] many of the misconceived ideas and theories which he has 

stated to me during his prior medical appointments. In simplest terms, 

I along with other members of the Bibb medical staff have devoted a 

countless amount of time attempting to inform and educate Mr. 

Stackhouse about his prior medical condition, his prior medical 

treatment and his current condition. Despite these efforts, he either 

refuses to accept our attempts to resolve his misunderstandings or 

insists upon perpetuating his incorrect version of events

(Doc. 9-1 at 8). Pavlakovic also testifies that he

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along with other members of the medical staff ensured that Mr. 

Stackhouse received an evaluation in response to his complaints. We 

ensured that his complaints of headaches and sore spots on his head 

received specialty evaluations by an ophthalmologist as well as an 

ENT specialist. There is no indication that his headaches are anything 

other than a possible result of the occasions when his hypertension is 

not well-controlled, and I have not received any recommendation 

from any type of specialist for any further evaluation, imaging study 

or testing beyond the examinations done to date. 

(Id. at 15). 

III. Analysis

Preliminary injunctive relief is “an extraordinary remedy that may only be 

awarded upon a clear showing that the plaintiff is entitled to such relief.” Winter v. 

Natural Resources Defense Council, Inc., 555 U.S. 7, 22 (2008). “In evaluating 

claims for preliminary relief, courts are bound by stringent standards.” Martinez v. 

Mathews, 544 F.2d 1233, 1242 (5th Cir. 1976).2

 These standards require 

the moving party [to] establish that (1) there is a 

substantial likelihood that he ultimately will prevail on 

the merits of the claim; (2) he will suffer irreparable 

injury unless the injunction issues; (3) the threatened 

injury to the movant outweighs whatever damage the 

proposed injunction may cause the opposing party; and 

(4) the public interest will not be harmed if the injunction 

should issue.

Cate v. Oldham, 707 F.2d 1176, 1185 (11th Cir. 1983). “Because a preliminary 

 2 In Bonner v. City of Prichard, 661 F.2d 1206, 1209 (11th Cir.1981) (en banc), the Eleventh 

Circuit adopted as binding precedent all Fifth Circuit decisions handed down prior to the close of 

business on September 30, 1981.

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injunction is ‘an extraordinary and drastic remedy,’ its grant is the exception rather 

than the rule, and plaintiff must clearly carry the burden of persuasion.” United 

States v. Lambert, 695 F.2d 536, 539 (11th Cir. 1983) (quoting Texas v. Seatrain 

International, 518 F.2d 175, 179 (5th Cir. 1975)). 

After careful consideration of the plaintiff’s allegations and the defendants’

responses, which are solidly corroborated by the medical records, the plaintiff has 

not clearly shown for preliminary injunctive relief purposes that there is a 

substantial likelihood he will prevail on the merits of his Eighth Amendment 

claims. 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.” Harris v. Thigpen, 941 F.2d 1495, 1505 (11th 

Cir. 1991) (internal citation omitted). The conduct of prison officials must run 

counter to “evolving standards of decency” or involve the “unnecessary and 

wanton infliction of pain” to be actionable under ' 1983. Estelle v. Gamble, 429 

U.S. 97, 105-06 (1976) (footnote omitted). Therefore, negligent diagnosis or 

treatment of a medical condition does not constitute a wrong under the Eighth 

Amendment. Estelle, 429 U.S. at 106; McElligot v. Foley, 182 F.3d 1248 (11th 

Cir. 1999). Likewise, a mere difference of opinion between an inmate and the 

prison medical staff or between members of the medical staff as to treatment or 

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diagnosis will not, alone, give rise to a cause of action under the Eighth 

Amendment. Harris, 941 F.2d at 1505.

In this case, the evidence does not clearly support the plaintiff’s contention 

that he is or has a history of suffering from temporal arteritis. Instead, the testing 

the plaintiff has undergone has produced normal results. The plaintiff has been 

and is being treated for his headache complaints, which Dr. Pavlakovic attests may 

be attributable to hypertension. There is no support for the plaintiff’s assertion that 

he is currently suffering from a life-threatening condition that the defendants have 

either refused to treat him or have refused to intervene on his behalf and secure 

treatment. The plaintiff has a difference of opinion with Dr. Pavlakovic regarding 

the procedure performed in July 2015 and his medical condition. However, this 

difference of opinion does not translate into a substantial likelihood that the 

plaintiff will prevail on his Eighth Amendment claims. Therefore, the plaintiff 

cannot establish that he will suffer irreparable injury if his motion is not granted, 

and that the threatened injury to him outweighs the possible damage to the 

defendants or the adverse impact to the public interest in the administration of the 

prison system. The extraordinary circumstances necessary to justify preliminary 

injunctive relief are not present, and therefore, the plaintiff’s request is DENIED. 

The Clerk is DIRECTED to send the plaintiff and counsel for the 

defendants a copy of this Order.

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DONE and ORDERED this September 20, 2016.

_________________________________

VIRGINIA EMERSON HOPKINS

UNITED STATES DISTRICT JUDGE

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