United States District Court, D. Massachusetts
TIMOTHY M. REAVES, Plaintiff,
DEPARTMENT OF CORRECTION, CAROL HIGGINS O'BRIEN, MICHAEL RODRIGUES, PAMELA MACEACHERN, STEPHANIE COLLINS, MHM CORRECTIONAL SERVICES, INC., MASSACHUSETTS PARTNERSHIP FOR CORRECTIONAL HEALTHCARE, GERALDINE SOMERS, LEIGH PARISEAU, JULIE IRELAND, KHALID KHAN, AND BONNIE DAMIGELLA, Defendants.
AMENDED MEMORANDUM AND ORDER
TIMOTHY S. HILLMAN DISTRICT JUDGE.
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
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.
of Fact 
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.
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.
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.
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.
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
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. 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. 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
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.
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.
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
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.
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.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
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. The overgrown nails also
increase Mr. Reaves' likelihood of developing Autonomic
Dysreflexia. Dr. Angeles testified that she never noticed his
fingernails were long.
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
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.
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.
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. 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. He has filed grievances
informing Dr. Angeles that he will not accept care offered by
those staff members. 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.
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.”
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 ...