United States District Court, S.D. Texas, Galveston Division
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 ...