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Reaves v. Department of Correction

United States District Court, D. Massachusetts

July 31, 2019




         Timothy M. Reaves (“Mr. Reaves”) is a 54-year-old quadriplegic inmate currently in the custody of the DOC. Since January 2016, he has been living in a single cell in the Health Services Unit (“HSU”) at MCI Shirly. He suffers from significant complications of his quadriplegia, severe hearing loss, and traumatic brain injury.

         Mr. Reaves was convicted of first-degree murder on a theory of joint venture. See Commonwealth v. Reaves, 434 Mass. 383 (2001). Massachusetts does not recognize capital punishment, yet the Department of Corrections (“DOC”) is, through its lack of treatment of his quadriplegia and its complications, slowly killing him. Before that happens, and for the reasons stated below, he will be transferred to a facility better equipped and more amendable to care for his medical needs.

         Findings of Fact [1]

         In 1994, Mr. Reaves was involved in a high-speed motor vehicle chase, during which he was a passenger in the back seat of a vehicle being pursued by the police. The chase occurred immediately after a drive-by shooting and ended when the vehicle crashed at a high rate of speed. Mr. Reaves suffered a spinal cord injury, which resulted in quadriplegia. Mr. Reaves's spinal cord injury is a “C6 ASIA B” injury. “ASIA” stands for “American Spinal Injury Association.” “C6” refers to the injury's level in the spine. “B” classifies the injury as motor complete, meaning that Reaves cannot contract any muscles below the level of injury, but sensory incomplete, meaning that he has some preserved sensation.

         In addition to the spinal cord injury, Mr. Reaves suffered a traumatic brain injury. Ex. 39, at 1. In 1996, a CT Scan revealed bi-frontal brain atrophy. Ex. 39, at 2. He has been diagnosed with a personality disorder and episodes of atypical depression. Ex. 18, at 8. He is also hearing-impaired. Id. These additional injuries have complicated his quadriplegia care and have significantly impacted his incarceration.

         DOC contracts with a private company to provide medical care for the Commonwealth's inmates. The current medical provider is Wellpath. Defendant Stephanie Collins, DOC's Assistant Deputy Commissioner of Clinical Services, is responsible for overseeing the provision of medical services and monitoring the compliance of companies contracted to provide services.

         Collins also has the authority to require staffing changes to meet evolving medical needs and penalize contractors for deficient performance. Dr. Maria Angeles is the Medical Director at MCI Shirly and Mr. Reaves' current treating physician. She has no specialized training in spinal cord injuries. See Ex. 33.

         Collins testified that she has received correspondence from and on behalf of Mr. Reaves expressing concerns about his medical care. For instance, she received a letter from Mr. Reaves' counsel outlining the claims against her prior to this case being filed. Defendant Collins also received a copy of the Complaint and is aware of this Court's Preliminary Injunction issued on July 15, 2016 against the DOC. She also received the monthly reports from the monitor appointed by the Court as part of its Preliminary Injunction Order. See Reaves v. Dep't of Correction, 195 F.Supp.3d 383, 427 (D. Mass. 2016). Finally, she received the monthly status reports submitted by the DOC's previous medical contractor.

         On November 28, 2016, February 28, 2017, and April 12, 2018, the DOC and its contractor sent Mr. Reaves to Dr. Stephanie Cho at Spaulding Rehabilitation Hospital for specialty consultations related to his spinal cord injury.[2] Following the first appointment, Dr. Cho made several recommendations to improve Mr. Reaves care. See Ex. 19. She recommended that Mr. Reaves be referred to Massachusetts General Hospital (“MGH”) to be evaluated for tendon release surgery, which would release the contractures in his knees and hips and allow him to sit upright. Id. at 2. The ability to sit would increase Mr. Reaves quality of life and possibly assist his bowel movements.[3] Dr. Cho also recommended that Mr. Reaves undergo a urodynamic study to evaluate his neurogenic bladder. Id. The DOC has not sent Mr. Reaves to have this study and has proffered no explanation why. Dr. Cho also recommended that Mr. Reaves have an evaluation with a gastroenterologist. Id. Mr. Reaves has not been evaluated by a gastroenterologist, again with no explanation.

         Mr. Reaves is alarmingly malnourished. He has requested a diet that does not include red meat or pork (which he does not eat) and includes increased vegetables and fiber to address his nutritional deficiencies and mitigate his constipation. Dr. Cho has recommended three times that the fiber in Mr. Reaves' diet be increased, see Id. at 2, 10, 15, yet the DOC has not changed Mr. Reaves diet. When Mr. Reaves receives red meat or pork, he does not eat it and foregoes the main source of protein for that meal. Mr. Reaves' treatment plan also includes range of motion therapy. See, e.g., Ex. 10, at 2. However, Mr. Reaves does not receive regular range of motion care at MCI Shirly. While he has received occasional range of motion care, video footage shows that care is inadequate.

         Reaves's counsel retained Leslie Morse, DO, a physiatrist who specializes in spinal cord injuries to examine Reaves and testify at trial as a spinal cord injury specialist. See Ex. 34. Dr. Morse is board certified in physical medicine and rehabilitation. She is currently the Department Chair and Professor of Rehabilitation Medicine at the University of Minnesota School of Medicine. Id. She sees spinal cord injury patients as a direct provider and in the course of her research. She has also supervised medical students and residents in the field of spinal cord injury and produced numerous publications on the topic. Id.

         Dr. Morse testified that the current range of motion therapy includes too few repetitions and is done too quickly to be effective. Further, when the care is offered, it is at suspiciously inopportune times. For instance, Mr. Reaves testified that the DOC offered range of motion therapy during his deposition and during a meeting with his attorneys. And sometimes when he accepts the therapy, it is not provided. Mr. Reaves feels less tight and stronger when he receives range of motion therapy; it positively impacts his contractures and could help preserve the remaining movement he has. Loss of that movement, especially the movement that enables Mr. Reaves to feed himself, would be catastrophic to his well-being.

         Mr. Reaves currently has a pressure ulcer on his sacrum. This ulcer is caused by poor hygiene, inadequate nutritional intake, and inappropriate bedding. On November 28, 2016, Dr. Cho requested that the DOC provide Mr. Reaves with a Hill Rom bed with an airflow mattress and an overlay air mattress topper to prevent ulcers. Ex. 19, at 2. She has reiterated this recommendation after each of two later examinations, and the DOC has yet to provide the air mattress topper.

         According to Dr. Morse, Mr. Reaves is also at significant risk for Autonomic Dysreflexia, a life-threatening condition that occurs in people with a spinal cord injury above T6. Autonomic Dysreflexia is caused by an irritant below the level of the spinal injury. For instance, it may be caused by constipation, fecal impaction, a blocked catheter, ingrown toenails or fingernails, infections, or other irritants. Dr. Morse testified that, while reviewing Mr. Reaves' medical records, she observed instances of blood pressure changes indicative of Autonomic Dysreflexia.[4]On one occasion, his blood pressure was 57 over 49, which, according to Dr. Morse, is “not compatible long-term with . . . life.” Records indicate that Mr. Reaves has also complained of other symptoms of Autonomic Dysreflexia such as headache, visual disturbances, and sweating. It is Dr. Morse's opinion that staff at MCI Shirley do not respond appropriately to these symptoms. According to Mr. Reaves, when he reports symptoms such as lightheadedness, dizziness, or spots in his vision, medical staff does not do anything. Dr. Morse testified that these symptoms should be treated as a medical emergency.

         Mr. Reaves' fingernails have not been cut since last year. According to Dr. Angeles, Mr. Reaves refuses to let certain staff members cut his nails. Dr. Angeles also testified, however, that Mr. Reaves does allow a podiatrist to cut his toenails. In addition, there is nothing in Mr. Reaves' treatment plan that indicates who should trim his nails or how often they should be cut. Mr. Reaves testified that he does not refuse to have his nails cut. His fingernails are currently so long that they curl into the palms of his hands and are causing skin breakdown. He has a fungal infection in one fingernail and several toenails.[5] The overgrown nails also increase Mr. Reaves' likelihood of developing Autonomic Dysreflexia. Dr. Angeles testified that she never noticed his fingernails were long.[6]

         In addition to his overgrown nails, Mr. Reaves' overall hygiene is incredibly poor. His bedding is often soiled and covered in dead skin from his legs and feet. His hair and beard are caked with dead skin and food. According to Mr. Reaves, no one offers to brush his teeth or cut his fingernails and he cannot perform these actions himself.[7]

         From January 27, 2019 to February 21, 2019, Mr. Reaves did not move his bowels. While Dr. Angeles indicated in her treatment plan that she must be notified if Mr. Reaves goes more than one day without a bowel movement, she is often unaware when Mr. Reaves goes several days without a bowel movement. Dr. Angeles met with Mr. Reaves four times between January 27, 2019 and February 21, 2019. See Ex. 16, at 33-34, 82-83, 123-24, 155-56. Nonetheless, she testified that she was unaware that Mr. Reaves had gone twenty-six days without a bowel movement.[8]

         Dr. Morse testified that Mr. Reaves' bowel program is inadequate. According to her, after several days without a bowel movement, treating physicians should order an x-ray, followed by magnesium citrate taken orally, and then another x-ray. This severe constipation puts Mr. Reaves at risk of developing Autonomic Dysreflexia. It also puts Mr. Reaves at risk of a bowel rupture, stroke, fistula, and can impact the function of other organs On several occasions, DOC staff have ordered medical staff to leave Mr. Reaves' room while providing care. Consequently, staff has left Mr. Reaves while bathing him, leaving him naked and wet without clothes or blankets. Mr. Reaves cannot put on his clothes or pull up his blankets. Instead, he is forced to wait until the next shift starts before staff can assist him.

         Mr. Reaves is a difficult patient. He admits that he often swears at staff. When he has an outburst, correctional officers often remove medical staff from Mr. Reaves' cell. Mr. Reaves testified that on several occasions, this has occurred during his bath. See e.g., Ex. 21, at 1. Consequently, Mr. Reaves was left naked, wet, and without blankets until the next shift assisted him.[9] Mr. Reaves also regularly refuses care. See generally Ex. 35. Often, those refusals occur, when care is offered by certain staff members. For instance, Mr. Reaves does not accept care from RN Kayla Hall or CNA Coleen Johnson.[10] He has filed grievances informing Dr. Angeles that he will not accept care offered by those staff members.[11] The Court appointed monitor repeatedly recommended that CNA Johnson no longer offer care to Mr. Reaves. See, e.g., Docket No. 225, at 2 (“Again, I reiterate that in the best interests of all parties involved, Ms. Johnson should not have any further contact with Mr. Reaves.” (emphasis in original)). Defendant Collins testified that the DOC failed to comply with these recommendations despite knowing that they were akin to orders from this Court.

         The monitor also recognized some of the deficiencies in Mr. Reaves noted above. For instance, on October 31, 2016, the monitor noted that “Mr. Reaves has still not been seen by a spinal cord case specialist since this Honorable Court's Order” and that “too much time has passed without this examination occurring. On numerous occasions, this Honorable Court has placed significant emphasis on this occurring, yet to date it has not.” (Docket No. 113, at 2). On April 6, 2017, the monitor noted photographs “supportive of [the] allegation” that Mr. Reaves received “a lack of appropriate care.” (Docket No. 155, at 2). The same day, the monitor noted that “Dr. Cho's recommendations are not followed as vigorously as might be expected given this Court's Order and impending trial.” Id. Specifically, the monitor repeatedly reported that the DOC has still not provided an air mattress overlay recommended by Dr. Cho. See Docket No. 200, at 2; Docket No. 203, at 1; Docket No. 207, at 2; Docket No. 209, at 2; Docket No. 212, at 1; Docket No. 225, at 2. The Defendants contended that the overlay would interfere with the ability to effectively weigh Reaves, since the scale was in his bed. (Docket No. 207, at 2). However, the monitor seemed to question the sincerity of this rationale by observing that “it doesn't appear that Mr. Reaves is weighed on a regular basis.” Id.

         Before testifying at this trial, Dr. Morse again examined Mr. Reaves. She concluded that he presently suffers from severe complications of his injury. She also noted a marked decline in his condition since she last saw him in ...

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