Opinion ID: 1445166
Heading Depth: 2
Heading Rank: 2

Heading: Popoalii's Medical Care at WERDCC

Text: During intake at the WERDCC in mid-March, Popoalii reported her medical history to CMS defendant nurse Earl Cox, including her recent hospitalization for viral encephalitis. Popoalii told another unidentified nurse that she could not see. Cox visited Popoalii again a short while later when she complained of head pain. She told Cox that she had a constant headache due to the encephalitis. Cox evaluated her vital signs, which were normal, and gave her a lay-in restriction, which allowed her to stay in bed at all times except during medical care and meals. Cox also told her to report to sick call for further evaluation. Popoalii spoke to an unidentified nurse who gave her ibuprofen for her headache, which she continued to receive regularly during her stay at WERDCC. The next day CMS defendant nurse Marilyn Meyer saw Popoalii due to her severe headache. Meyer assessed Popoalii's vital signs as within normal limits and examined Popoalii's pupils to verify that they were equal and reactive to light. Meyer found Popoalii to be alert, oriented and balanced. Meyer noted that Popoalii was uncomfortable, and she instructed Popoalii to report to sick call for further care. CMS defendant nurse practitioner Wendy Hull saw Popoalii on March 21, 2004, for a severe headache. Popoalii told her that she had been previously hospitalized for viral meningitis, which was causing her headaches. Hull assessed Popoalii's vital signs as within normal limits and provided her with a 24 hour lay-in. Hull saw Popoalii again on April 1, 2004, when Popoalii was admitted to the TCU for evaluation and observation. Hull evaluated Popoalii, as is required, before Popoalii was transferred out of TCU back to administrative segregation. Popoalii complained of a headache and Hull gave her ibuprofen, but because Popoalii's vital signs were normal Hull deemed Popoalii medically fit for a transfer to administrative segregation. April 4, 2004, after Popoalii was moved to a padded cell, Hull again evaluated her. Popoalii told Hull that she could not see, and Hull performed eye reflex tests and checked whether her eyes were equal and reactive to light. Hull also tested Popoalii's neurological function and vital signs. Hull remained with Popoalii for an hour to observe her, during this time Popoalii's condition did not change or decline. CMS defendant nurse Debbie Welch saw Popoalii for complaints of a headache on the morning of March 22, 2004. Popoalii told Welch that she had been recently discharged from the hospital with viral meningitis (as opposed to encephalitis). Welch took her vitals, checked that her pupils were equal and reactive to light, checked that her smile was equal on both sides and that she could grip, push and pull. Welch saw that Popoalii was uncomfortable and contacted CMS defendant Dr. Sripatt Kulkanthorn to request a course of medical treatment. Dr. Kulkanthorn prescribed ibuprofen, which Welch administered. CMS defendant nurse Carrie Oliver evaluated Popoalii on March 22, 2004, after Popoalii complained of a severe headache. Popoalii told Oliver that she had recently had viral meningitis, and Oliver had Popoalii sign a release to obtain prior medical records. Oliver also called defendant Dr. Raymond Bloomquist to come evaluate Popoalii. Dr. Bloomquist evaluated Popoalii's neck and found it was flexible. Popoalii was responsive, coherent, and her vital signs were stable. Dr. Bloomquist ordered ibuprofen for Popoalii's pain. Dr. Bloomquist does not recall being aware of her reported history of encephalitis or meningitis, or that she was sensitive to light. According to Dr. Bloomquist, had he known of the light sensitivity in conjunction with a history of encephalitis, it would have been a red flag. CMS defendant Dr. Kulkanthorn met Popoalii first on March 22, 2004, when Welch consulted him about Popoalii's headaches. Dr. Kulkanthorn prescribed ibuprofen. On April 1, 2004, Dr. Kulkanthorn saw Popoalii again for a scheduled appointment regarding her headaches, and she reported head pain and said that she had not been able to see for a couple of days. She reported a history of headaches and a recent diagnosis of viral encephalitis. Dr. Kulkanthorn examined her head, neck, and eyes. Her neurological exam was normal, and he placed Popoalii in the TCU for observation. Dr. Kulkanthorn encouraged more fluid intake and ordered a blood count; he prescribed ibuprofen and a shot of Visteril (for the headache), and he ordered her to lie flat and to be placed on fall precaution because of her visual problems. On April 1, 2004, Popoalii was placed in a room for observation by CMS defendant nurse Teresa Vanlandingham who assessed her skin, eyes, and vital signs as normal. CMS defendant nurse Vicki Dixon observed Popoalii during the early morning of both April 1 and 2, 2004, and she assessed Popoalii's vital signs, neurological signs, eyes and facial movements as normal. Dixon did note that Popoalii began making noises and picking at things in the air. Dixon refused a request from Popoalii for pain medication once because it was not time to administer the medication, and Dixon did not have permission to give extra medicine. Dr. Kulkanthorn saw Popoalii again on April 2, 2004, and she still complained of headaches but could walk normally and put her chin to her chest. Her eye movement and neurological function were normal. Dr. Kulkanthorn attributed her headaches to her previously diagnosed encephalitis, poor vision, and depression. Dr. Kulkanthorn reviewed Popoalii's medical records that her mother had faxed to the WERDCC sometime on or before April 2, and he saw her encephalitis diagnosis and negative CT scan. He obtained results of new blood work and liver and thyroid tests. He ordered that Popoalii remain in the TCU, but despite his order she was removed to administrative segregation on April 3 by MDOC staff. On April 5th, when Dr. Kulkanthorn discovered Popoalii had been removed to administrative segregation, he ordered that she be returned back to the TCU. When Popoalii told Dr. Kulkanthorn that she could not see any light, he requested a consultation with an ophthalmologist. On April 6th, the opthalmologist evaluated Popoalii's complaints and recommended an immediate MRI. Popoalii was taken to a hospital for an MRI and CT scan and was then correctly diagnosed with cryptococcal meningitis.