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Moore v. Corizon Health Services

United States District Court, D. Idaho

September 27, 2018

JIMMY C. MOORE, Plaintiff,




         The Court has before it a motion for summary judgment filed by defendants, along with a number of motions filed by plaintiff. The motions are fully briefed and at issue. For the reasons explained below, the Court will grant the motion for summary judgment and deny the motions filed by plaintiff.


         Plaintiff Moore, an inmate incarcerated with the Idaho Department of Corrections, (IDOC) filed this lawsuit against various health care providers at the prison, claiming that they were deliberately indifferent to his medical conditions. Moore complains that he was in pain from knee and shoulder problems, and that the defendants repeatedly denied his requests for surgery to alleviate the pain. Following an Initial Review Order, Moore's remaining claims are that defendants Drs. Young and Migliori were deliberately indifferent to his knee and shoulder problems.

         Moore first started complaining of pain in both shoulders and his left knee in September of 2015. His medical records show that he had surgery to repair a torn rotator cuff on his left shoulder in 1989 and again in 2013, and the same surgery on his right shoulder in 2013 and 2014.

         In the first two months of his incarceration at the IDOC, Moore was treated by a Physician's Assistant and two Nurse Practitioners. They found that (1) Moore demonstrated a full range of motion in his shoulders; (2) x-rays of his shoulders showed an impingement - that is a rubbing between tendon and bone - and degenerative changes; (3) inflammation and the consequent pain would be reduced by a corticosteroid shot (Kenalog); and (4) conservative treatment including physical therapy was indicated rather than surgery. Moore refused any conservative treatment and demanded surgery.

         Moore was first seen by defendant Dr. Migliori on November 9, 2015. Dr. Migliori is employed by Corizon as a medical doctor at the prison. See Dr. Migliori Declaration (Dkt. No. 25-3) at p. 2. On that day, Moore complained of shoulder pain; there was no treatment requested or given for knee pain. Moore believed his rotator cuffs had been torn during his arrest and he wanted surgery to repair the injuries. Dr. Migliori responded that surgery was not the best option until more conservative treatment options - like physical therapy, intra-articular steroid injections, and pain medications - were tried. Id. at ¶ 11. Dr. Migliori based this opinion on the fact that Moore could perform the activities of daily life, and that Moore's prior shoulder surgeries made it less likely that surgery would be successful. Id. Moore rejected the option of pursuing conservative treatments.

         Moore returned to Dr. Migliori about three months later, again for shoulder pain. Moore wanted an MRI of his shoulders and surgery on his rotator cuffs, but Dr. Migliori again recommended conservative treatment for the same reasons. In addition, Moore suffered from malignant hyperthermia, a rare disorder that produces a dangerous reaction to general anesthesia, causing high body temperature, severe muscle spasms, and a fast heart rate. Id. at ¶ 13. Dr Migliori concluded that “[w]hile Mr. Moore's susceptibility to malignant hypothermia did not categorically rule out surgical intervention, it was an additional reason to first try conservative treatment options.” Id. In both visits, Dr. Migliori prescribed Tylenol, the only pain medication he would take.

         After this visit, Dr. Migliori consulted (by telephone) with defendant Dr. Murray Young, about Moore's shoulder problems. Dr. Young was then Corizon's Regional Medical Director and the supervisor of Dr. Migliori. Id. at ¶ 12. Based on the information Dr. Young received from Dr. Migliori, Dr. Young agreed that conservative treatment should be attempted first. See Young Declaration (Dkt. No. 25-8) at ¶ 6.

         Over the next nine months, Moore was seen dozens of times by six different health care providers for his knees and shoulders. The result was the same: Moore demanded surgery and rejected the recommendations that conservative treatment - including physical therapy and corticosteroid injections - must be attempted first. The providers all noted that Moore gesticulated in anger with no apparent pain, took his shirt off with no obvious pain or range-of-motion difficulty, and continued to be able to perform his activities of daily living. Migliori Declaration, supra at ¶ 16.

         In November of 2016, Moore finally agreed to meet with a physical therapist. He went to four sessions before the therapist determined that Moore was not a good candidate for physical therapy due to his unwillingness to participate. Id. at ¶ 21.

         In December of 2016, Moore was referred to an orthopedist, Dr. Homaechevarria. (Id. at ¶ 22). Dr. Homaechevarria prescribed corticosteroid injections every four to six months in his knee, with further follow up if that treatment is unhelpful. Although Moore had rejected such injections when they were recommended by Corizon health care providers, he accepted them from Dr. Homaechevarria. Dr. Homaechevarria did an MRI of Moore's shoulder and it confirmed a rotator cuff tear. See Medical Records (Dkt. No.

         Moore was then referred to another orthopedic surgeon, Dr. Roman Schwartsman, for evaluation of surgical options on Moore's shoulder. Dr. Schwartsman stated that they could proceed with a surgical option, but that the surgery may very well not be successful ...

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