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LeBaron v. Massachusetts Partnership for Correctional Healthcare

United States District Court, D. Massachusetts

December 1, 2017



          M. Page Kelley United States Magistrate Judge.

         I. Introduction.

         Originally filed in the state superior court, this case was removed to the federal court in November of 2014. When the complaint was filed, plaintiff Nathan Marquis LeBaron was an inmate in the custody of the Massachusetts Department of Corrections (DOC). He has since been released.

         In Count I of the complaint, LeBaron alleges a claim for retaliation. (#1-2 ¶¶ 153-58.) Count II incorporates claims under the Religious Land Use and Institutionalized Persons Act (RLUIPA) and the First Amendment. Id. ¶¶ 160-66. A number of federal constitutional claims under 42 U.S.C. § 1983, and state constitutional claims under Massachusetts General Laws chapter 12, §§ 11H and 11I, are alleged in Count III. Id. ¶¶ 168-71. In Count IV, LeBaron asserts a conspiracy claim under 42 U.S.C. § 1985. Id. ¶¶ 173-92.

         On October 24, 2017, defendants collectively filed a motion for summary judgment, together with a memorandum in support and a statement of undisputed material facts. (##182, 183, 184.) LeBaron has filed no response to the dispositive motion.

         II. Facts.

         A. The Parties.

         To the extent that they are supported by the record, defendants' material facts shall be accepted as true.[1] Since July of 2013, defendant Massachusetts Partnership for Correctional Healthcare (MPCH) has been under contract with the Massachusetts DOC to provide certain medical and mental health services to inmates in the custody of the department. (#184 ¶ 2.)[2] At all relevant times, defendant Lynn Gillis, RN, was a Health Services Administrator (HSA) at Massachusetts Correctional Institution - Shirley (MCI-Shirley) and an employee of MPCH. Id. ¶ 3. Defendant James Thompson, M.D., was a psychiatrist employed by MPCH. Id. ¶¶ 5-6. Defendant Neal Norcliffe, LICSW, was the mental health director at Old Colony Correctional Center (OCCC) and an MPCH employee. Id. ¶¶ 5, 9. Defendant Keelin Garvey, M.D., was a psychiatrist at OCCC employed by MPCH. Id. ¶¶ 5, 10. Defendant Joseph Toomey, Ph.D., was a psychologist at OCCC and an MPCH employee. Id. ¶¶ 5, 11. Defendant Linda Albohn, [3] LPN, was the prisoner Grievance and Appeals Coordinator employed by MPCH. Id. ¶¶ 5, 13. Defendant Paul Caratazzola was an HSA at OCCC and an MPCH employee. Id. ¶¶ 5, 14.

         B. Plaintiff's Grievances.

         In a grievance dated February 24, 2014, and received by HSA Gillis on March 5, 2014, LeBaron complained that on February 15, 2014, he had urinated blood and large clots. Id. ¶ 16. Gillis responded to LeBaron on March 6, 2014, stating that LeBaron had been evaluated by both nursing staff and a medical provider for his symptoms, and that a doctor would see him for a follow-up appointment. Id. On April 11, 2014, LeBaron appealed this grievance; the appeal was received by defendant Albohn on April 29, 2014. Id. ¶ 17. In her May 2, 2014 response, Albohn stated that LeBaron's urine sample had been sent to the laboratory for testing and that a doctor would review the results with him. Id.

         In a June 23, 2014 grievance which was received on June 26, 2014, LeBaron complained to HSA Caratazzola at OCCC that the HSA at MCI-Shirley, defendant Gillis, had ignored a grievance he had allegedly filed on April 11, 2014. Id. ¶ 18. In his response four days later, Caratazzola informed LeBaron that his grievance was being forwarded to the HSA at MCI-Shirley for disposition. Id. On August 23, 2014, LeBaron appealed this grievance. Id. ¶ 19. Albohn received the appeal on August 28, 2014, and responded on September 3, 2014, [4] stating that after a thorough investigation, there was no evidence that plaintiff had filed an April 11, 2014 medical grievance. Id. ¶ 19.

         In a July 10, 2014 grievance received on July 11, 2014, LeBaron claimed he needed dental braces. Id. ¶ 20. Responding on July 14, 2014, Caratazzola stated that he had reviewed LeBaron's medical file and discussed the matter with the dental assistant. Id. Plaintiff was advised to submit a sick call request slip to the dental assistant to meet and discuss his concerns. Id. LeBaron appealed this grievance on July 20, 2014; the appeal was received by Albohn on August 4, 2014. Id. ¶ 21. Responding two days later, Albohn advised plaintiff that after investigation and discussion with the dental team, his request for braces would not be granted. Id.

         LeBaron filed a grievance dated July 22, 2014, which was received by HSA Caratazzola on July 25, 2014, in which plaintiff raised issues about the mental health department. Id. ¶ 22. Caratazzola responded on July 29, 2017, explaining that he had discussed plaintiff's concerns with defendant Norcliffe, the Mental Health Director, and that the doctors and the mental health team at OCCC had determined that LeBaron's mental health case should remain open based on clinical information and risk factors. Id. Plaintiff's August 4, 2014 appeal of this grievance was received by Albohn on August 25, 2014. Id. ¶ 23. Responding two days later, Albohn stated that, in accordance with the mental health team's review, his mental health case would remain open. Id.

         In a grievance dated July 23, 2014, that was received by HSA Caratazzola on July 30, 2014, LeBaron took issue with certain urology appointments and requested specific medical treatment. Id. ¶ 24. Caratazzola responded on July 31, 2014, noting that plaintiff had been examined by the doctor two days previously and that the doctor had submitted a dermatology referral which was waiting for approval. Id. LeBaron appealed the grievance on August 14, 2014; the appeal was received by the grievance appeals coordinator on August 25, 2014. Id. ¶ 25. Albohn responded on August 27, 2014, stating that the request for a dermatological consult was still pending and that plaintiff's request for a biopsy could not be granted at that time. Id. Albohn also enclosed a copy of the MPCH grievance and appeal form, which included the new address to which appeals were to be sent. Id.

         On August 19, 2014, plaintiff filed a grievance regarding a cavity. Id. ¶ 26. HSA Caratazzola received the grievance on August 21, 2014, and responded the same day, stating that LeBaron had not reported this issue to any medical personnel and suggested that he submit a sick call request slip. Id.[5] Plaintiff appealed the grievance on August 14, 2014, which appeal was received by Albohn on August 28, 2014. Id. ¶ 27. Albohn responded on September 3, 2014, stating that she had learned plaintiff had been transferred to another facility and informed him that he must submit a sick call request slip to be seen by a dentist at that institution. Id.

         During the remainder of 2014, LeBaron filed five grievances and five appeals; Albohn responded to each appeal that was filed. Id. ¶ 28.

         C. Plaintiff's Medical Treatment.

         On February 15, 2014, LeBaron alerted MPCH staff at MCI-Shirley that he was urinating blood. Id. ¶ 29. He gave a urine sample that was witnessed by DOC staff, and the nurse performed a urinalysis on it. Id. The testing showed that the urine, which was clear yellow, had no indication of blood or any other irregularities. Id. Later that same day, plaintiff brought a urine cup of purple-colored liquid to the Health Services Unit (HSU) from population. Id. ¶ 30. The registered nurse on duty examined this unwitnessed sample and observed that the liquid had no characteristics of urine; the liquid was opaque, completely purple and had no odor. Id. When a urinalysis was performed, no blood was found. Id. LeBaron was informed that a urine sample must be collected at, and tested in, the HSU. Id.

         Four days later on February 19, 2014, LeBaron was seen by the medical staff after complaining that his “urine was pure blood for about a minute and about 20 inches of one-inch-thick blood clots at the end.” Id. ¶ 31, Exh. B ¶ 6, Exh. 1 at 003. LeBaron spewed profanities and stormed out of the HSU; staff noted he had an “odd affect.” Id. That same day, in light of his behavior regarding his urine issues, plaintiff met with Roselle Mann, LICSW, for a one-on-one mental health session. Id. ¶ 32. LeBaron told Mann that he “was pissing blood” and that the HSU staff “tested it and said it was nothing.” Id., Exh. B ¶ 7, Exh. 1 at 004. Plaintiff thought the medical staff was lying to him, stating that he was “almost bleeding to death.” Id. When Mann empathized, LeBaron started crying. Id. Mann was unable to dissuade plaintiff with logic, at which point she noted that he “clearly [had] a persistent fixed delusion and somatoform disorder, probably.” Id., Exh. B ¶ 7, Exh. 1 at 005. Mann observed that LeBaron “appeared his baseline self . . . but fixed in his belief that he has a sickness and medical doesn't care (see all notes/sick slips, past medical work-ups that reveal no issues).” Id. Plaintiff agreed to meet with Mann on a monthly basis; Mann opened a mental health case on LeBaron. Id.

         Plaintiff had a urinalysis done on March 4, 2014, that tested positive for blood. Id. ¶ 33. The following day plaintiff met with Dr. Hugh Silk, complaining that he had blood and blood clots in his urine, there was a delay in getting a urine sample and there was a conspiracy against him. Id. Dr. Silk noted that while the urinalysis was positive for blood, it was negative for anything else. Id. He determined that plaintiff's blood and urine should be retested with a follow-up in two weeks. Id.

         On March 10, 2014, Elizabeth Louder, LICSW, completed a Mental Health Status Update on plaintiff to evaluate his suitability to go into segregation due to his involvement in a physical altercation. Id. ¶ 35. While LeBaron had a provisional diagnosis of delusional disorder, Louder saw no sign of delusions during her meeting with him. Id. Plaintiff denied suicidal ideation, intent or plan. Id. Louder concluded that plaintiff presented with a low risk for self-harm, but had mild paranoia at the time of evaluation and overall displayed symptoms consistent with somatic delusions. Id. Two days later LeBaron was placed on a mental health watch, meaning that his mental health was to be monitored more closely. Id. ¶ 36. This change in status resulted from his expression of delusional thinking and concern for his safety in the special management unit (SMU). Id.

         On March 12, 2014, Mann completed a crisis treatment plan for plaintiff's mental health watch. Id. ¶ 37. She wrote that LeBaron was “beat up in a fight” two nights earlier, and that he felt despairing, unsafe, and “physically and emotionally dying.” Id. Plaintiff was noted as having a history of suicidal behavior, and he expressed belief in delusions that he was very sick and that the DOC was conspiring to cover his illness. Id. LeBaron believed that he had lost two quarts of blood through his penis and that he “wouldn't mind if God sent him on a mission to war … and [he] died honorably in battle.” Id. While plaintiff enjoyed a positive rapport with Mann, historically he was paranoid with other medical and mental health staff. Id. Mann placed plaintiff on a mental health watch so he would be monitored until the next morning when a psychiatrist could evaluate him for an 18(a) admission[6] to Bridgewater State Hospital (BSH), a psychiatric care facility controlled by the DOC. Id.

         Mann completed an 18(a) Referral for LeBaron on March 12, 2014. (#184 ¶ 39.) The stated reasons for the referral were that plaintiff:

appears to have decompensated significantly with the past few weeks with increasingly bizarre beliefs and delusions. He appears unable to function within population or SMU, unable to keep himself safe. . . . [He] has had long-standing ideas about his physical ailments since 2010 that seem to have dramatically exacerbated within the past few weeks with persistent fixed delusions worsening.

Id. After reiterating that plaintiff appeared to be quickly decompensating, delusional and despairing, Mann requested that the BSH treatment team address the following questions: 1. Is the inmate presenting with a delusional disorder? 2. Would medication be helpful? 3. What treatment recommendations would the team make? 4. How can this inmate be helped to cope with prison life? Id.

         LeBaron was seen by Jeffrey Vanderyacht, LMHC, before his transfer to BSH on March 13, 2014. Id. ¶ 40. Plaintiff expressed the belief that he had a serious disease but that the medical staff was covering it up, deliberately destroying evidence and inciting other inmates to harass him. Id. Vanderyacht recorded that plaintiff wanted to go into population where he was likely to be assaulted, stating “I'm willing to sacrifice myself for a noble cause . . . I'd rather be beaten to a bloody pulp than deteriorate slowly.” Id. Vanderyacht determined LeBaron should be referred for psychiatric evaluation to be considered for an 18(a) transfer for evaluation and inpatient treatment. Id.

         On March 13, 2014, Dr. James Thompson evaluated plaintiff pursuant to Mass. Gen. L. c. 123 § 18(a) for transfer to BSH. Id. ¶ 41. In conducting this evaluation, Dr. Thompson reviewed plaintiff's medical records, spoke with Vanderyacht and interviewed LeBaron. Id. Dr. Thompson related that in support of his alleged severe kidney infection, plaintiff had recently presented health services staff with a urine cup he claimed was filled with bloody urine, but analysis revealed it contained neither blood nor urine. Id. Plaintiff then presented a specimen he claimed was part of his liver or a clot, but it was neither. Id. Dr. Thompson noted LeBaron's history of paranoid delusions as well as his belief that there was a conspiracy to ignore his medical problems when there was no concrete evidence of a medical problem. Id. Plaintiff presented with these somatic complaints and increased agitation. Id.

         LeBaron had been placed in SMU after a fight with a friend over a typewriter ribbon, and he had decompensated further. Id. Dr. Thompson noted that plaintiff had stated he planned to put himself in a situation with other inmates where he could get harmed or killed. Id. During his interview, plaintiff had noticeable psychomotor agitation, he was tangential in his thought patterns, and his judgment and insight were impaired. Id.

         Dr. Thompson agreed with the previous diagnosis of delusional disorder and PTSD. Id. He opined that plaintiff could not be managed in his current setting at MCI-Shirley, and that he should be transferred to BSH for evaluation and treatment. Id.

         Jean Berggren, M.D., is the Director of Psychiatry and Behavioral Health for Centurion, LLC. (#184, Exh. B ¶ 1.) Dr. Berggren is board certified in psychiatry, and is familiar with the practice of psychiatry in the penal setting, having worked for the contracted medical and mental health provider for the Vermont Department of Corrections as the Director of Psychiatry and Behavioral Health since 2015. Id., Exh. B ¶¶ 1-2. Dr. Berggren reviewed and was familiar with plaintiff's medical and mental health records from February 15, 2014 to April 4, 2014. Id., Exh. B ¶ 3. In Dr. Berggren's clinical opinion:

The mental health providers at MCI-Shirley provided [plaintiff] with the care clinically indicated for his conditions and were not deliberately indifferent to [plaintiff's] serious medical needs. After reviewing the documents Dr. Thompson relied upon in making his 18(a) evaluation, Dr. Thompson properly referred [plaintiff] for further psychiatric care at BSH. [Plaintiff] received appropriate and adequate care from the mental health staff at MCI-Shirley from February 15, 2014 to March 13, 2014.

Id., Exh. B ¶ 17.

         D. Bridgewater State Hospital.

         On March 13, 2014, LeBaron was transferred to BSH pursuant to Mass. Gen. L. c. 123 § 18(a). Id. ¶ 43. The Admission Note authored by Brittany Irwin, LCSW, reflects that Vanderyacht called her at BSH before plaintiff was transferred to report clinical issues. Id. In addition to reviewing plaintiff's recent mental health issues, Irwin noted that plaintiff had a provisional diagnosis[7] of delusional disorder and PTSD. Id.

         Plaintiff was evaluated by Dr. Christopher Myers upon admission to BSH on March 13, 2014. Id. ¶ 44. According to Dr. Myers, plaintiff told him that he had urinated two quarts of blood and large chunks of what looked to be pieces of his liver, and that this “evidence” had been discarded. Id. Plaintiff presented as unstable, hyperactive and paranoid with limited insight/judgment. Id. He had a rapid rate of speech and a tangential thought process. Id. He appeared agitated; presented as emotionally labile; and was noted to have thought disorganization and somatic delusions. Id. Dr. Myers deemed plaintiff to be an imminent risk of serious harm to others. Id.

         Plaintiff was held in seclusion throughout the night of March 13, 2014, into the morning of March 14, 2014. Id. ¶ 45. At three different times during the night and early morning hours, medical staff attempted to assess him, but he was sleeping. Id. ¶¶ 46-48. At 8:10 a.m. on March 14, 2014, Dr. Andrey Gagarin was able to evaluation LeBaron. Id. ¶ 49. He communicated in an angry, hyperverbal manner and was visibly disturbed. Id. Plaintiff believed he had multiple injuries and no one cared. Id. He was viewed as suffering from continued distress and agitation surrounding his delusional beliefs. Id. Dr. Gagarin found plaintiff was at substantial risk of committing serious physical assault and serious destructive behavior. Id. The doctor prescribed an intramuscular injection of Haldol and Benadryl, and approved the use of four point restraints to facilitate the administration of emergency involuntary treatment for LeBaron. Id. ¶ 50.

         After being placed in restraints, plaintiff was checked by a nurse, was administered the medication fifteen minutes later, and was monitored by a mental health worker throughout the process. Id. He was released from the restraints immediately after the injections; he was in the restraints for a total of seventeen minutes. Id. Plaintiff continued to be monitored by the nursing staff. Id. ¶ 51.

         At 2:00 p.m. on March 14, 2014, plaintiff was again examined by Dr. Gagarin. Id. He was described as calm, cooperative and apologetic. Id. The doctor concluded he had improved sufficiently to be released from seclusion. Id. Although Dr. Gagarin ordered Risperidone at bed time that evening, plaintiff refused the medication and he was not forced to take it. Id. ¶ 52.

         In Dr. Berggren's clinical opinion,

[A]t 8:00 AM on March 13, 2014, [8] [plaintiff] required emergency psychiatric medication to prevent immediate and substantial deterioration in his medical condition. [Plaintiff] presented as an imminent risk of serious harm to others, and presented with a serious threat of extreme violence and personal injury. . . .
Dr. Gagarin acted appropriately in administering emergency medication for [plaintiff] given that [plaintiff] had been experiencing delusional beliefs prior to admission to BSH, his distress had been escalating to the extent that he required admission to BSH and was placed in seclusion, and given the risk of continued and possibly irreversible decline in his symptoms and mental illness. . . . Plaintiff was unable to make informed medical decisions on his own behalf. Dr. Gagarin provided [plaintiff] with the care clinically indicated for his condition and was not deliberately indifferent to [plaintiff's] serious medical needs.

Id. ¶¶ 54, 55.

         On April 10, 2014, LeBaron was transferred from BSH to MCI-Shirley. Id. ¶ 56. That same day Louder completed a mental status update on plaintiff, noting that he stated he was on a fast. Id. ¶ 57. On April 15, 2014, plaintiff was transferred to OCCC. Id. ¶ 58.

         E. Old Colony Correctional Center.

         On the day he arrived at OCCC, plaintiff was interviewed by Joseph Zimakas, LICSW. Id. ¶ 58. LeBaron stated that he did not need mental health services and requested that his case be closed. Id. Zimakas detailed the process by which a mental health case was closed, and plaintiff indicated his understanding. Id. LeBaron's mental health case remained open. Id. The following day plaintiff submitted a sick call request form wherein he wrote, “Very eager to meet with the MH worker appointed to help me work towards closing this ‘open mental health case.'” (#184, Exh. C at 007.)

         On April 23, 2014, plaintiff submitted a sick call request form about closing his mental health case so he could be transferred to MCI-Norfolk where there was a synagogue. (#184 ¶ 60.) Two days later he met with Vanessa Martino-Fleming, LMHC, who explained the case closure protocol and suggested plaintiff follow up with his primary care clinician. Id. LeBaron submitted a sick call request form on May 9, 2014, stating that he had yet to see the clinician doctor about closing his mental health case. Id. ¶ 62.

         On May 12, 2014, plaintiff met with Joseph Toomey, Ph.D., who explained the health services available at OCCC. Id. ¶ 63. Dr. Toomey told plaintiff he would discuss the status of his mental health case with the mental health director and psychiatry so as “to make an informed decision regarding [plaintiff's] need for mental health services.” Id. Dr. Toomey drafted an initial treatment plan for LeBaron on May 29, 2014. Id. ¶ 64. His primary diagnosis was adjustment disorder with mixed disturbance of emotions and conduct. Id. The doctor indicated that he planned to meet with plaintiff every thirty days, and set a target date of July 23, 2014, for resolution. Id. In the interim, plaintiff's status would be monitored by the mental health team in order to assess his adjustment and need for services. Id.

         On June 3, 2014, plaintiff wrote a letter to Dr. Toomey stating he would like to meet with a psychiatrist so his mental health case could be closed and he could be transferred to MCI-Norfolk where he would have access to typewriters and a law library. Id. ¶ 65. On June 9, 2014, Dr. Toomey met with plaintiff for their monthly appointment and gave him a copy of the initial treatment plan. Id. ΒΆ 66. While plaintiff understood the mental health staff's obligation to monitor him, he disagreed ...

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