Palmer v. Baldwin

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ILLINOIS

BILLY PALMER,

Plaintiff,

v. Case No. 3:19-CV-313-NJR

JOHN R. TROST, JOHN COE,

GARY M. REAGAN, and DR. RITZ,

Defendants.

MEMORANDUM AND ORDER

ROSENSTENGEL, Chief Judge:

This matter is before the Court on the motions for summary judgment on the issue

of exhaustion of administrative remedies filed by Defendant Dr. Gary M. Reagan

(Doc. 45), Defendant Dr. John R. Trost (Doc. 47), Defendant Dr. John Coe (Doc. 50), and

Defendant Dr. Stephen Ritz (Doc. 53).1 Dr. Reagan also has filed a Motion to Dismiss for

Failure to State a Claim (Doc. 36). For the reasons set forth below, the motion for summary

judgment on the issue of exhaustion of administrative remedies filed by Dr. Trost is

granted, but the remaining motions are denied.

BACKGROUND

Plaintiff Billy Palmer, a 65-year-old inmate of the Illinois Department of

Corrections (IDOC), filed this action pursuant to 42 U.S.C. § 1983 for alleged deprivations

of his constitutional rights. Specifically, Palmer claims Defendants were deliberately

indifferent to his serious medical needs in violation of the Eighth Amendment when they

1 The Clerk of Court is DIRECTED to correct Dr. Ritz’s name on the docket to Dr. Stephen Ritz.

failed to properly treat his prostate cancer (Doc. 1-2).

Palmer alleges that from January 2014 to December 2015, he had elevated prostate-

specific antigen (PSA) levels on seven occasions (Doc. 1-2, p. 4; Doc. 1, p. 14). At that time,

he was housed at Menard Correctional Center and was treated by Dr. Trost, who

prescribed Flomax and Hytrin for his elevated PSA levels and enlarged prostate but

ordered no additional diagnostic testing (Doc. 1-2 at p. 5).

On December 29, 2015, Palmer was transferred to Lawrence Correctional Center,

where Dr. Ritz and Dr. Coe reviewed his medical chart regarding the need for an

oncology consult. At that time, Dr. Ritz noted that Palmer had a history of elevated PSA

and benign prostatic hyperplasia (BPH) but had not had a prostate biopsy and had not

been diagnosed with prostate cancer (Doc. 1-2, pp. 5-6; Doc. 1-1, p. 25). Palmer alleges

that Dr. Ritz, in conjunction with Dr. Coe, denied Palmer an oncology consultation and

instead directed Lawrence Correctional Center to look through Palmer’s medical records

for a “rationale” for an oncology consultation (Doc. 1-2 at p. 6).

Palmer alleges that on February 25, 2016, Dr. Coe recorded in Palmer’s medical

records that, “after coming to Lawrence, I could find no proof of cancer and needed to

see you first. You are now approved to see urologist for his opinion.” (Id.). Dr. Coe then

referred Palmer to Dr. Reagan, an outside provider at Crossroads Urology and Women’s

Health (“Crossroads”) (Doc. 1-2, p. 6; Doc. 1, pp. 26, 27, 28).

On March 14, 2016, Palmer saw Dr. Reagan, who noted that Palmer had a two-

year history of elevated PSA levels. Dr. Reagan recommended an ultrasound guided

prostate needle biopsy (Id.). Dr. Coe made the referral for the biopsy, which was

approved and performed in April 2016 (Doc. 1-2, p. 8; Doc. 1, pp. 35, 37).

The needle biopsy indicated “prostatic adenocarcinoma,” leading Dr. Reagan to

order a whole-body nuclear medicine bone scan based on the diagnosis of primary

malignant neoplasm of prostate (Doc. 1-2, p. 9; Doc. 1-1, p. 1). Dr. Coe made the referral

for the whole-body scan and referred Palmer back to Dr. Reagan (Doc. 1-2, p. 9; Doc. 1-1,

p. 7). In the rationale for the referral Dr. Coe stated, “He had been followed at Menard by

Illinois Oncology LTD for suspected prostate CA since Jan 2014 and no one there even

mentioned a prostate exam.” (Doc. 1-2 at p. 9; Doc. 1-1 at p. 5).

After the bone scan, Dr. Coe again referred Palmer to Dr. Reagan, noting that

Palmer “has prostate cancer and negative bone scan. He needs to consider therapy.”

(Doc. 1-2 at p. 9). Dr. Reagan saw Palmer on July 11, 2016, for a follow-up after the whole-

body scan and chest x-rays, which did not show metastatic disease at that time (Doc. 1-1

at p. 8). Dr. Reagan recommended he have a repeat biopsy in one year but did not offer

or provide any other treatment at that time (Doc. 1-2, p. 10; Doc. 1-1 p. 8).

Dr. Reagan again saw Palmer in December 2016, and Palmer expressed concern

about his prostate cancer (Doc. 1-2, p. 11; Doc. 1-2 pp. 10-11). Dr. Reagan told Palmer it is

common for men in his age group to have a small area of low-grade prostate cancer

(Doc. 1-2, p. 11 ; Doc. 1-1 p. 12-15). They also discussed a repeat ultrasound biopsy as part

of an observation protocol (Id.).

Palmer next saw Dr. Reagan in August 2017 after Dr. Ritz approved a request for

a repeat needle biopsy (Doc. 1-2, p. 12; Doc. 1-1, p. 20). On September 18, 2017, after the

biopsy again showed adenocarcinoma, Dr. Reagan discussed various treatment options

with Palmer, including another observation period, a radical prostatectomy, or radiation

therapy (Doc. 1-2, p. 13; Doc. 1-1, pp. 29-30). Palmer decided on radiation therapy, which

Dr. Reagan noted was a “reasonable decision.” (Id.).

In October 2017, another doctor at Crossroads recommended a CT scan of Palmer’s

abdomen and pelvis, as well as a bone scan, to rule out metastatic disease (Doc. 1-2, p. 14;

Doc. 1-1, p. 37). That doctor also indicated he would coordinate with Dr. Reagan

regarding the PolyMark placement (Id.). On January 9, 2018, Palmer was taken to

Crossroads for placement of the polymarker by Dr. Reagan (Doc. 1-1 at p. 39). Palmer

alleges the polymarker placement did not go as planned, and he was rushed to Lawrence

County Community Hospital for treatment (Doc. 1-2 at p. 15). Palmer learned his blood

was infected by the improper placement of the polymarker (Id.).

In February 2018, Palmer began radiation therapy, which he tolerated well (Doc. 1-

2, pp. 16-17). As of early 2019, however, Palmer continued to have blood in his urine and

pain when he urinates (Id.). Palmer alleges that at no time before late 2017 did Dr. Reagan

or any other doctor tell him that radiation was an option as opposed to “observation

therapy” (Doc. 1-2 at p. 14). Had he known that radiation was an option in 2016, he would

have immediately opted for radiation therapy instead of allowing a year and a half to

pass before a second biopsy showed the cancer had spread to the right and left apex (Id.).

Palmer filed one grievance related to his prostate cancer treatment (Doc. 46-1). The

grievance, filed on October 11, 2017, at Lawrence Correctional Center states:

In July of 2016, the doctor’s [sic] said I had cancer. Wexford Health care

refused to start treatment for 15 months, and now the Cancer has grown.

The doctor who diagnosis [sic] said that every old person Has small

amounts of cancer in them. Therefore, since I am a prisoner I did not need

cancer treatment. Now the cancer has spread and grown and become life

threatening because of wexfords inaction in not seeking [a] second opinion.

The cancer has caused me pain and suffering. I am in pain and health care

really does not care. . . .

(Id.). Palmer also stated that he needed the Counselor to help him get his medical records

in order to file for clemency and to be added to the deadline list for the law library (Id.).

As relief, Palmer requested $1 million for pain and suffering and for Wexford refusing

medical treatment for 15 months; information as to why his cancer had to grow and

spread before treatment could start; and information as to why Wexford did not

aggressively seek treatment in 2016 for his cancer diagnosis (Id.).

A counselor responded to Palmer’s grievance on November 21, 2017, noting, in

relevant part, that per the Healthcare Unit, “Offender Palmer has been seen & treated and

continues to be seen & treated by licensed Illinois Physician within community standards

of care.” (Id.).

The Grievance Officer received Palmer’s grievance on December 4, 2017 (Doc. 46-

2). The Grievance Officer noted that Palmer “has had numerous visits to HCU and nurse

sick call visits.” (Id.). The Grievance Officer found that Palmer’s medical treatment was

not being neglected “at this time.” (Id.). Accordingly, the Grievance Officer recommended

the grievance be denied (Id.). The Chief Administrative Officer concurred with the

Grievance Officer’s recommendation on December 18, 2017 (Id.).

Palmer appealed the denial of his grievance to the Administrative Review Board

(ARB), which received the appeal on January 4, 2018 (Doc. 46-4). Palmer also sent a letter

to the ARB as part of his appeal, stating that the Grievance Officer did not address his

complaint about the delay in and denial of medical care for more than 15 months (Doc. 46-

3). As a result, the cancer had now spread and caused him serious pain and other

complications. Palmer complained that the Grievance Officer’s response was non-

responsive and failed to address the main issue of his grievance. (Id.).

The ARB responded to Palmer on January 16, 2018, stating: “Offenders grv fails to

meet DR 504.810. No review. Also requests do not go on grv form. Simply write to

appropriate staff/unit.” (Doc. 46-4).

Palmer filed this lawsuit on March 15, 2019.

DISCUSSION

I. Motion to Dismiss for Failure to State a Claim

The Court first addresses Dr. Reagan’s motion to dismiss for failure to state a claim

under Rule 12(b)(6) of the Federal Rules of Civil Procedure (Doc. 37). Dr. Reagan argues

that Palmer’s claims against him should be dismissed because Palmer failed to allege any

facts that would support a finding of deliberate indifference on the part of Dr. Reagan.

He further argues that Palmer’s claims against him are barred by the statute of

limitations.

A motion to dismiss under Federal Rule of Civil Procedure 12(b)(6) is meant to

“test the sufficiency of the complaint, not to decide the merits” of the case. Gibson v. City

of Chi., 910 F.2d 1510, 1520 (7th Cir. 1990) (citation omitted). To survive a Rule 12(b)(6)

motion to dismiss, the plaintiff only needs to allege enough facts to state a claim for relief

that is plausible on its face. Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). A plaintiff

need not plead detailed factual allegations, but must provide “more than labels and

conclusions, and a formulaic recitation of the elements.” Id. For purposes of a motion to

dismiss under Rule 12(b)(6), the Court must accept all well-pleaded facts as true and draw

all possible inferences in favor of the plaintiff. McReynolds v. Merrill Lynch & Co., Inc., 694

F.3d 873, 879 (7th Cir. 2012). Taken together, the factual allegations contained within a

complaint must “raise a right to relief above the speculative level, on the assumption that

all the allegations in the complaint are true (even if doubtful in fact).” Twombly, 550 U.S.

at 555 (internal citations omitted).

A. Failure to Adequately Plead Deliberate Indifference

To state a claim for deliberate indifference, a plaintiff must allege that (1) he

suffered from an objectively serious medical condition; and (2) defendant was

deliberately indifferent to a risk of serious harm from that condition. Petties v. Carter, 836

F.3d 722, 727 (7th Cir. 2016).

Dr. Reagan argues that Palmer has failed to allege facts stating a claim for

deliberate indifference against Dr. Reagan. Instead, he argues, Palmer has only alleged

facts that show Dr. Reagan worked to diagnose, monitor, and treat Palmer’s medical

condition. At best, Palmer’s allegations show merely that he was unhappy with the

course of treatment he received, which is not enough to state a claim for deliberate

indifference.

The Court disagrees. As the Court noted in its threshold order permitting Palmer

to proceed on his claim against Dr. Reagan (Doc. 11), Palmer alleges Dr. Reagan was

deliberately indifferent to his serious medical need in July 2016 when he recommended

that Palmer receive another biopsy in one year but did not offer or provide treatment at

that time. Palmer also alleges Dr. Reagan failed to properly advise him of the available

treatment options for his prostate cancer. Palmer claims that Dr. Reagan’s failure to

advise him of treatment options other than “observation therapy” allowed his cancer to

spread and placed him at a substantial risk of serious harm.

Assuming those allegations are true, as the Court must at this juncture, Palmer has

sufficiently alleged that he suffered from an objectively serious medical condition—

prostate cancer—and that Dr. Reagan was deliberately indifferent to a risk of serious

harm by failing to treat Palmer’s cancer sooner. Accordingly, Dr. Reagan’s motion to

dismiss for failure to state a claim will be denied on this basis.

B. Statute of Limitations

Dr. Reagan also argues that Palmer’s claims are barred by the statute of limitations.

Section 1983 does not contain an express statute of limitations, so federal courts adopt the

forum state’s statute of limitations for personal injury claims. Wilson v. Garcia, 471 U.S.

261, 276, 105 S.Ct. 1938, 85 L.Ed.2d 254 (1985); Ashafa v. City of Chicago, 146 F.3d 459, 461

(7th Cir. 1998). In Illinois, the limitations period for § 1983 cases is two years. Johnson v.

Rivera, 272 F.3d 519, 521 (7th Cir. 2001); see 735 ILL. COMP. STAT. 5/13-202. Furthermore,

“a federal court relying on the Illinois statute of limitations in a § 1983 case must toll the

limitations period while a prisoner completes the administrative grievance process.”

Terry v. Spencer, 888 F.3d 890, 894 (7th Cir. 2018).

Accrual of a claim, however, is governed by federal law. Wilson v. Wexford Health

Sources, Inc., 932 F.3d 513, 517–18 (7th Cir. 2019). And the Seventh Circuit has recognized

that “a section 1983 Eighth Amendment claim based on deliberate indifference in the

delivery of medical care does not necessarily allege a single event or a series of events,

but may describe an ongoing denial of care.” Wilson, 932 F.3d at 517 (citing Heard v.

Sheahan, 253 F.3d 316, 319 (7th Cir. 2001)). That ongoing denial of care constitutes a

continuing violation for accrual purposes. Id. “The alleged wrong—the refusal to provide

medical care—‘continue[s] for as long as the defendants [have] the power to do

something about [the plaintiff’s] condition.’” Id. (quoting Heard, 253 F.3d at 318).

In this case, Dr. Reagan argues that he was not responsible for Palmer’s continuous

care and supervision, but rather only saw Palmer on a handful of occasions. Furthermore,

the only appointment where Palmer claims Dr. Reagan was deliberately indifferent

occurred on July 11, 2016. And the latest date that Dr. Reagan saw Palmer while he was

still on the “observation protocol” was in December 2016. Because his interactions with

Palmer were discrete and individualized, Dr. Reagan argues that the continuing violation

doctrine does not apply, and Palmer was required to file his lawsuit by December 2018

at the absolute latest. Because Palmer did not file until March 2019, his claims against Dr.

Reagan are time-barred.

Again, the Court disagrees. Palmer asserts that Dr. Reagan failed to advise him of

the available treatment options for his prostate cancer in July 2016, and that he did not

become aware of those options until at least September 2017. See Wilson v. Giesen, 956 F.2d

738, 740 (7th Cir. 1992) (civil rights claims accrue when the plaintiff knows or should have

known his constitutional rights have been violated). Thus, regardless of the continuing

violation doctrine, the Court finds that Palmer had at least until August 2019 to file suit.

Furthermore, the statute of limitations was tolled while Palmer completed the grievance

process. Terry, 888 F.3d at 894. Palmer filed his grievance on October 11, 2017, and the

process was not complete until the ARB responded to his appeal on January 18, 2018.

Given that Palmer did not become aware of the alleged violation of his

constitutional rights until August 2017 and the statute of limitations was tolled during

the grievance process, the Court finds that Palmer’s March 2019 lawsuit was timely filed

and Dr. Reagan’s motion to dismiss based on the statute of limitations must be denied.

II. Motions for Summary Judgment on Exhaustion of Administrative Remedies

Each Defendant has filed a motion for summary judgment arguing that Palmer’s

claims must be dismissed against them because Palmer failed to exhaust his

administrative remedies before filing this lawsuit.

Summary judgment is proper if the pleadings, discovery materials, disclosures,

and affidavits demonstrate no genuine issue of material fact and the movant is entitled

to judgment as a matter of law. FED. R. CIV. P. 56(a). Lawsuits filed by inmates are

governed by the provisions of the Prison Litigation Reform Act (“PLRA”). 42 U.S.C.

§ 1997e(a). That statute states, in pertinent part, that “no action shall be brought with

respect to prison conditions under section 1983 of this title, or any other Federal law, by

a prisoner confined in any jail, prison, or other correctional facility until such

administrative remedies as are available are exhausted.” Id. The Seventh Circuit requires

strict adherence to the PLRA’s exhaustion requirement. Dole v. Chandler, 438 F.3d 804, 809

(7th Cir. 2006). Exhaustion must occur before the suit is filed. Ford v. Johnson, 362 F.3d 395,

398 (7th Cir. 2004).

“To exhaust remedies, a prisoner must file complaints and appeals in the place,

and at the time, the prison administrative rules require.” Pozo v. McCaughtry, 286 F.3d

1022, 1025 (7th Cir. 2002). Consequently, if a prisoner fails to properly utilize a prison’s

grievance process, “the prison administrative authority can refuse to hear the case, and

the prisoner’s claim can be indefinitely unexhausted.” Dole, 438 F.3d at 809. Under Pavey

v. Conley, “debatable factual issues relating to the defense of failure to exhaust

administrative remedies” are not required to be decided by a jury but are to be

determined by the judge. Pavey v. Conley, 544 F.3d 739, 740-41 (7th Cir. 2008). Because

there are no disputed issues of fact, the Court finds that no evidentiary hearing is required

in this case.

Illinois Administrative Code

The grievance procedure for inmates of the IDOC is laid out in the Illinois

Administrative Code. 20 ILL. ADMIN. CODE § 504.800, et seq. If the inmate’s grievance does

not involve an emergency, the inmate must first file a grievance with the counselor within

60 days of the discovery of an incident. Id. § 504.810(a). The grievance form must contain

factual details regarding what happened, when, where, and the name of each person who

involved in the complaint. Id. at 504.810(c). While this provision does not preclude an

offender from filing a grievance when the names of individuals are not known, he or she

must include as much descriptive information about the person as possible. Id.

Grievances that are unable to be resolved through the counselor are then sent to

the Grievance Officer. Id. at § 504.820(a). “The Grievance Officer shall consider the

grievance and report his or her findings and recommendations in writing to the Chief

Administrative Officer within two months after receipt of the grievance, when reasonably

feasible under the circumstances.” Id. at § 504.830(e). The Chief Administrative Officer

then reviews the findings and recommendation of the Grievance Officer and advises the

offender of his or her decision in writing. Id.

If the inmate is not satisfied with the response from the Chief Administrative

Officer, he or she can file an appeal the decision to the Administrative Review Board. Id.

at § 504.850(a). The appeal must be received by the ARB within 30 days after the date of

the CAO’s decision. Id. The ARB then must submit to the Director a written report of its

findings and recommendations. Id. at § 504.850(d). “The Director shall review the

findings and recommendations of the Board and make a final determination of the

grievance within 6 months after receipt of the appealed grievance, when reasonably

feasible under the circumstances.” Id. at § 504.850(e).

Defendants do not dispute that Palmer submitted a grievance on October 11, 2017,

regarding treatment of his prostate cancer, that the counselor, Grievance Officer, and

CAO responded to the grievance, and that Palmer appealed the CAO’s denial of his

grievance to the ARB. Defendant Dr. Reagan argues, however, that the appeal was

insufficient because the ARB returned it to Palmer, noting his submission did not meet

the requirements of DR 504.810 and, thus, no review was conducted.

But the ARB did not explain how Palmer’s submission did not meet the

requirements of DR 804.810 and, in fact, it appears that Palmer did comply with the rule

requirements. Palmer filed a timely grievance, received all the required institutional

responses, and then timely appealed the denial of his grievance to the ARB. Why the ARB

did not review the grievance is unknown, and Palmer should not have been left to guess

how to appropriately appeal the denial of his grievance. The ARB’s statement that he

should “simply write to appropriate staff/unit”—presumably regarding his request for

medical records and to be added to the law library list—is completely unresponsive to

his complaint regarding his medical care. And an administrative remedy “becomes

‘unavailable’ if prison employees do not respond to a properly filed grievance or

otherwise use affirmative misconduct to prevent a prisoner from exhausting.” Dole v.

Chandler, 438 F.3d 804, 809 (7th Cir. 2006) (citing Lewis v. Washington, 300 F.3d 829, 833

(7th Cir. 2002)). For those reasons, the Court finds that Palmer’s October 11, 2017

grievance served to exhaust his administrative remedies.

Defendants next argue that Palmer’s grievance was insufficient to exhaust his

specific claims against each defendant individually because he did not name them or

provide information that would put the prison on notice of the issue.

The Illinois Administrative Code sets forth what information must be included in

a grievance:

The grievance shall contain factual details regarding each aspect of the

offender’s complaint, including what happened, when, where, and the

name of each person who is the subject of or who is otherwise involved in

the complaint. This provision does not preclude an offender from filing a

grievance when the names of individuals are not known, but the offender

must include as much descriptive information about the individual as

possible.

20 ILL. ADMIN. CODE § 504.810(b).

The Seventh Circuit has recognized, however, that while the Illinois

Administrative Code now requires the name or a description of the persons involved in

the complaint, the “Department of Corrections has been slow to make that requirement

explicit on the forms it gives inmates.” Conley v. Anglin, 513 F. App’x 598, 601 (7th Cir.

2013) (“We have held that when a prisoner uses a grievance form asking only for a ‘Brief

Summary of Grievance,’ . . . then the omission of names or identifying information does

not necessarily mean that the prisoner failed to exhaust his administrative remedies so

long as he otherwise followed the grievance process.”). Thus, when a prisoner uses a

grievance form that only asks for a “Brief Summary of Grievance,” the Court of Appeals

has held that the omission of names or identifying information is not dispositive of the

issue. Id.; Maddox v. Love, 655 F.3d 709 (7th Cir. 2011).

Here, the form used by Palmer only asks for a “Brief Summary of Grievance.”

(Doc. 46-1). It did not instruct Palmer to set forth the name of each person involved or to

provide identifying information. (Id.). Even so, Palmer’s grievance clearly identifies those

who he believes are responsible for the untreated growth of his cancer—the doctors and

Wexford Health Sources, Inc. Prison officials clearly knew what doctors had treated

Palmer, for on November 21, 2017, the counselor responded: “Per HCUA Cunningham,

‘As documented in medical chart Offender Palmer has been seen & treated & continues

to be seen & treated by licensed Illinois Physician within community standards of care.’”

(Doc. 46-1). And Palmer’s medical chart from October and November 2017 references Dr.

Reagan, Dr. Coe, and Dr. Ritz, the latter two being Wexford employees. Moreover, Dr.

Reagan was the doctor who diagnosed Palmer with cancer and who initially decided on

an observation protocol. While he did not explicitly name Dr. Reagan, Palmer obviously

was referring to him.

Dr. Ritz also argues that the timing of the grievance was too late to grieve any

complaints Palmer had against him. Dr. Ritz asserts Palmer is only suing him for his

deliberate indifference from January 2014 to December 29, 2015, while Palmer was at

Menard Correctional Center. Yet, Palmer did not file a grievance until October 2017, well

after he left Menard.

Upon further review, the Court does not read Palmer’s complaint so narrowly.2

Palmer alleges that Dr. Ritz, in consultation with Dr. Coe, denied him an oncology

consultation in January 2016. Palmer further alleges that Dr. Ritz had subjective

knowledge of his elevated PSA levels, yet refused to provide any type of treatment to

determine whether he had cancer. It was not until September 2017 that Palmer discovered

his cancer had spread to both the right and left apex and that other treatment options

were available but not offered to him. He then filed his grievance a month later.

Accordingly, the Court finds that summary judgment is not proper as to Dr. Ritz.

The same cannot be said for Dr. Trost. Palmer’s allegations against Dr. Trost stem

from his treatment of Palmer at Menard from January 2014 until December 29, 2015, when

Palmer transferred to Lawrence. Palmer never wrote a grievance complaining about Dr.

Trost’s treatment while he was housed at Menard, and his October 11, 2017 grievance

does not mention Dr. Trost or Menard. Thus, the Court finds that summary judgment

should be granted to Dr. Trost.

2 In the Court’s preliminary review of Palmer’s Complaint pursuant to 28 U.S.C. § 1915A, Palmer’s claims

were divided into two counts, and his claims against Dr. Ritz were limited to the time period from January

2014 to December 2015. The Complaint, however, references actions taken by Dr. Ritz after December 2015.

CONCLUSION

For these reasons, the Motion to Dismiss for Failure to State a Claim (Doc. 36) and

the Motion for Summary Judgment on the Issue of Exhaustion of Administrative

Remedies (Doc. 45) filed by Dr. Gary M. Reagan are DENIED.

The Motion for Summary Judgment on the Issue of Exhaustion of Administrative

Remedies filed by Dr. John Coe (Doc. 50) is DENIED.

The Motion for Summary Judgment on the Issue of Exhaustion of Administrative

Remedies filed by Dr. Stephen Ritz (Doc. 53) is DENIED.

The Motion for Summary Judgment on the Issue of Exhaustion of Administrative

Remedies filed by Dr. John Trost (Doc. 47) is GRANTED. Plaintiff's claims against Dr.

Trost are DISMISSED without prejudice.

IT IS SO ORDERED.

DATED: July 27, 2020

NANCY J. ROSENSTENGEL

Chief U.S. District Judge

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