Hampton v. Hulipas

          MEMORANDUM OPINION AND ORDER

          JEFFREY VINCENT BROWN, UNITED STATES DISTRICT JUDGE

         State inmate Jarrett Hampton (TDCJ #816800) filed a complaint under 42 U.S.C. § 1983 (Dkt. 1) alleging that he was denied adequate medical care in violation of his constitutional rights. The only claim that remains in this lawsuit is Hampton's allegation that Dr. Edgar Hulipas violated his rights under the Eighth Amendment by delaying his access to medical care by specialists for a chronic condition known as sarcoidosis (Dkt. 21). Hampton has filed an amended complaint concerning this allegation (Dkt. 23) and he has also provided a more definite statement of the facts in support of this claim (Dkt. 26). Dr. Hulipas has filed a motion for summary judgment (Dkt. 41). In response, Hampton has filed a declaration with exhibits (Dkt. 46), a brief in opposition (Dkt. 47), and a statement of “disputed factual issues” (Dkt. 48). After reviewing all of the pleadings, the parties' briefing, the exhibits, and the applicable law, the court will grant the defendant's motion and dismiss this case for the reasons that follow.

         I. BACKGROUND

         Throughout this lawsuit Hampton has been incarcerated by the Texas Department of Criminal Justice - Correctional Institutions Division (“TDCJ”) at the Darrington Unit in Rosharon (Dkt. 1, at 1).^[1] Dr. Hulipas is a physician employed by the University of Texas Medical Branch (“UTMB”), who works in the clinic located at the Darrington Unit (Id. at 3). As detailed more fully below, Hampton contends that Dr. Hulipas violated his rights by delaying his access to treatment by specialists with the dermatology department at the UTMB Hospital in Galveston, which provides care for state inmates confined in TDCJ through a variety of specialty clinics.

         A. Records of Hampton's Medical Care

         Dr. Hulipas has provided records of the medical care that Hampton received during the period of time relevant to this lawsuit (Dkt. 42-1, at 3-105). He has also provided an affidavit from Dr. Steven Bowers, who is employed by UTMB (Dkt. 42-3, at 2-7), which summarizes those records in chronological order (Id., at 8-98). Hampton has also provided medical records with his response to the motion for summary judgment (Dkt. 46, Exhibits 1-8) which duplicate many of those provided by the defendant.

         The medical records show that on October 17, 2014, Hampton was seen for a follow-up appointment with an otolaryngologist at the UTMB Hospital Ear Nose and Throat (“ENT”) Department, where he was receiving treatment for problems associated a chronic sinus infection and a history of “left sided nasal obstruction” that was the result of “nasal trauma” sustained by Hampton “7-8 years ago” (Dkt. 46-8, at 2, 4-5). At some point, a provider authorized endoscopic surgery to correct Hampton's deviated septum, which was scheduled to take place on January 8, 2015 (Dkt. 46-1, at 3). The procedure could not be performed as scheduled, however, because the surgeon (Dr. Paul Brindley) noted that Hampton had what appeared to be an acute staph infection affecting his columella, which is the bridge or column separating the nostrils at the cleft of the upper lip (Dkt. 42-3, at 14). Those symptoms were treated with antibiotics and steroids (Id.).

         When the symptoms of infection persisted, the ENT department ordered a biopsy of the affected area on May 19, 2015 (Id. at 17). Because Hampton's infection implicated the skin around his nose, he was referred for an examination by a specialist in dermatology (Id. at 14).

         On November 17, 2015, Dr. Rebecca Phillips examined Hampton at the UTMB Hospital Dermatology Department for what was described as a “rash on [his] nose” (Dkt. 42-3, at 17). After considering Hampton's history of nasal trauma, Dr. Phillips observed that his symptoms were consistent with a diagnosis of sarcoidosis (Id. at 17-20).

         Dr. Bowers explains that “[s]arcoidosis is a disease characterized by the growth of tiny collections of inflammatory cells (granulomas), ” which can occur in any part of the body, but appear “most commonly [in] the lungs and lymph nodes” (Dkt. 42-3, at 6). According to Dr. Bowers, sarcoidosis can also affect “the eyes, skin, heart and other organs” (Id.). The symptoms, which consist of inflammation or lesions on the affected tissues, can be relieved with medication, but there is no known cure for sarcoidosis (Id.). Although there is no known cure, Dr. Bowers notes that “in many cases, it goes away on its own” (Id.).

         During her initial evaluation on November 17, 2015, Dr. Phillips ordered further tests of the specimen collected during the biopsy on May 19, 2015, to confirm the diagnosis of sarcoidosis and to determine whether there was “systemic involvement” (Dkt. 42-3, at 20). Additional tests, which were completed on November 17, 2015, included chest x-rays, an EKG, urinalysis, CBC, and a complete metabolic panel (Id.). Hampton was also scheduled for an eye examination and pulmonary function test at a later date (Id. at 23).

         On November 30, 2015, Dr. Phillips confirmed that the specimen taken from the biopsy of Hampton's left nasal vestibule on May 19, 2015, was consistent with the diagnosis of sarcoidosis, but determined from his other test results that the disease was limited to the skin around his nose and that there was no evidence of systemic involvement (Dkt. 42-3, at 23). Dr. Phillips reviewed the expected course of treatment and management options for sarcoidosis of the skin with Hampton's “unit provider” by telephone (Id.). The parties do not dispute that Dr. Hulipas was Hampton's unit provider and that he is the one who spoke with Dr. Phillips on this occasion. According to her proposed plan of care, Dr. Phillips prescribed a topical steroid (fluocinonide 0.05% cream) to be applied to the affected area on Hampton's nose (Id.). If there was “no response” to the topical cream, Dr. Phillips recommended considering “intralesional kenalog” treatment (Id.). If there was “still no response, ” then the plan was to consider another steroid, such as “hydroxychloroquine” (Id.). Dr. Phillips recommended a follow-up appointment for Hampton at the dermatology department in three months (Id.).

         On December 1, 2015, a nurse practitioner met with Hampton at the Darrington Unit clinic and reviewed the plan of care that was proposed by Dr. Phillips to treat sarcoidosis of the skin (Dkt. 42-3, at 26). Consistent with the proposed treatment plan, Hampton was given a prescription for fluocinonide cream with instructions to apply a thin layer to the affected area twice a day (Id. at 27). Dr. Hulipas approved the treatment that was dispensed by the nurse practitioner (Id.).

         On December 3, 2015, Hampton saw Dr. Hulipas in the clinic for a follow-up appointment at the Darrington Unit clinic (Dkt. 42-3, at 29-30). Dr. Hulipas noted that Hampton was “doing fine” and discussed Hampton's lab results as well as the prescribed medication regimen (Id.).

         On December 10, 2015, Hampton submitted a “sick call request” to the clinic at the Darrington Unit, requesting a refill for “saline nasal spray” and to find out when he was scheduled to return to the UTMB Hospital in Galveston (Dkt. 42-3, at 32). That same day, Dr. Hulipas approved the requested refill and advised Hampton that appointments with both the ENT and Dermatology departments were pending (Id.).

         On January 19, 2016, Hampton returned to the ENT department for a follow-up visit with an otolaryngologist regarding his chronic sinus issues and history of nasal obstruction (Dkt. 42-3, at 38-40). Hampton reported that he had been using saline spray to treat nasal dryness and noted that he had a sore throat (Id. at 38). After strep throat was ruled out, the treating physician prescribed Claritin, Nasilide nasal spray, and saline nasal spray as needed to treat Hampton's symptoms (Id. at 40). After discussing his symptoms, the treatment provider recommended further deferring surgery to correct Hampton's deviated septum until after the inflammation around his nose was resolved (Id. at 39).

         On January 21, 2016, Hampton submitted a sick-call request asking for the medication recommended by the ENT department (Dkt. 42-3, at 45). Dr. Hulipas noted that the prescription for Claritin had been ordered, but that Nasilide nasal spray and another prescription for the antibiotic Levaquin required a non-formulary request (Id.). Dr. Hulipas submitted the non-formulary requests, which were approved by the prison pharmacy that same day (Dkt. 42-3, at 46-47).

         On March 1, 2016, Hampton attended a follow-up appointment at the hospital in Galveston with Dr. Alison Lowe of the dermatology department (Dkt. 42-3, at 51-56). Dr. Lowe noted “significant improvement” in Hampton's “nasal lesion” with the topical cream that had been prescribed by Dr. Phillips on November 30, 2015 (Id. at 51). Hampton reported that he previously experienced an episode of dizziness and chest pain, but Dr. Lowe noted that his most recent EKG was “within normal limits” (Id.). The results of a recent pulmonary-function test, which was performed on January 25, 2016, were also normal (Id. at 54). Dr. Lowe elected to continue Hampton's treatment with fluocinonide 0.05% cream and recommended a routine follow-up visit to the dermatology department in six months (Id. at 54-55). With regard to Hampton's complaints of chest pain, Dr. Lowe noted that arrhythmia was a concern due to his diagnosis of sarcoidosis, but that he was ...