Brown v. Corizon Inc.

EASTERN DISTRICT OF MISSOURI

NORTHERN DIVISION

RICHARD F. BROWN, )

)

Plaintiff, )

)

v. ) Case No. 2:22 CV 52 DDN

)

CORIZON INC., et al., )

)

Defendants. )

OPINION, MEMORANDUM AND ORDER

Self-represented Plaintiff Richard F. Brown brings this action under 42 U.S.C. § 1983,

alleging deliberately indifferent medical and dental care in violation of the Eighth Amendment.

The matter is now before the Court upon the motion of Plaintiff for leave to proceed in forma

pauperis, or without prepayment of the required filing fees and costs. ECF No. 14. Having

reviewed the motion and the financial information submitted in support, the Court will grant the

motion and waive the filing fee in this matter. See 28 U.S.C. § 1915(a)(1). Furthermore, after

reviewing the complaint, the Court will partially dismiss the complaint under 28 U.S.C. §

1915(e)(2)(B) for failure to state a claim upon which relief may be granted. However, the Court

will direct the Clerk of Court to issue process or cause process to be issued against defendant Dr.

Joule Stevenson, in her individual capacity only, and against defendant Corizon. Furthermore, as

there is no constitutional right to appointment of counsel in civil cases and it would be premature

to grant appointment at this stage in the proceeding, the Court will deny Plaintiff’s motion for

counsel, subject to refiling at a later date.

Motion to Proceed In Forma Pauperis

Plaintiff was a prisoner on August 18, 2022, when he initiated this action. On September

28, 2022, the Court granted Plaintiff’s first Motion to Proceed In Forma Pauperis (ECF No. 2)

dated October 26, 2022, Plaintiff informed the Court that he had been released from prison. See

ECF No. 12. Because the financial information before the Court was no longer an accurate

representation of Plaintiff’s financial situation, the Court directed him to file a new Motion to

Proceed In Forma Pauperis with accompanying financial affidavit. See ECF No. 13 at 2. Plaintiff

filed that motion on November 29, 2022, indicating that he is unemployed and owns no valuable

assets. ECF No. 14. As such, the Court will grant Plaintiff’s new Motion to Proceed In Forma

Pauperis (ECF No. 14) and waive the filing fee in this matter.

Legal Standard on Initial Review

Under 28 U.S.C. § 1915(e)(2), the Court may dismiss a complaint filed in forma pauperis

if the action is frivolous or malicious, fails to state a claim upon which relief can be granted, or

seeks monetary relief against a defendant who is immune from such relief. When reviewing a

complaint filed by a self-represented person under 28 U.S.C. § 1915, the Court accepts the well-

pleaded facts as true, White v. Clark, 750 F.2d 721, 722 (8th Cir. 1984), and it liberally construes

the complaint. Erickson v. Pardus, 551 U.S. 89, 94 (2007); Haines v. Kerner, 404 U.S. 519, 520

(1972). A “liberal construction” means that if the essence of an allegation is discernible, the district

court should construe the plaintiff’s complaint in a way that permits the claim to be considered

within the proper legal framework. Solomon v. Petray, 795 F.3d 777, 787 (8th Cir. 2015).

However, even self-represented plaintiffs are required to allege facts which, if true, state a claim

for relief as a matter of law. Martin v. Aubuchon, 623 F.2d 1282, 1286 (8th Cir. 1980); see also

Stone v. Harry, 364 F.3d 912, 914-15 (8th Cir. 2004) (refusing to supply additional facts or to

construct a legal theory for the self-represented plaintiff).

To state a claim for relief, a complaint must plead more than “legal conclusions” and

“[t]hreadbare recitals of the elements of a cause of action [that are] supported by mere conclusory

claim for relief, which is more than a “mere possibility of misconduct.” Id. at 679. “A claim has

facial plausibility when the plaintiff pleads factual content that allows the court to draw the

reasonable inference that the defendant is liable for the misconduct alleged.” Id. at 678.

Determining whether a complaint states a plausible claim for relief is a context-specific task that

requires the reviewing court to draw on its judicial experience and common sense. Id. at 679.

The Complaint

Plaintiff is a recently released Missouri Department of Corrections (“MDOC”) prisoner,

who was confined at Northeast Correctional Center (“NECC”) in Bowling Green, Missouri. ECF

Nos. 1 at 1, 12 at 1. He brings this action under 42 U.S.C. § 1983, alleging violations of his civil

rights against eleven defendants associated with providing medical and dental care at NECC: (1)

Corizon Inc.; (2) Centurion Inc.1; (3) Dr. Joule Stevenson (Plaintiff’s physician and former

Medical Director); (4) Regina Gonia (Health Services Administrator); (5) Pasha Allen (Director

of Nurses); (6) Diane Wade (nurse); (7) Cathy Griffin (nurse); (8) Dr. Ernest Jackson (Missouri

Director of Dental Services); (9) Jewel Cofield (Constituent Services grievance officer); (10) Dr.

Thomas Bredeman (Regional Medical Director); and (11) Dr. John Spears (contract spinal

surgeon). ECF No. 1 at 1-2. Plaintiff names all defendants in their individual and official

capacities. Id. at 2.

A. Allegations Regarding Medical Care

Prior to arriving at NECC, Plaintiff had a history of degenerative discs dating back to 2005;

he had multiple spinal fusions in 2008 and 2012; and he had a total left hip replacement in 2015.

1 On November 15, 2021, ‘Centurion Health’ replaced ‘Corizon Health, Inc.’ as the medical services company

contracted with MDOC to provide statewide correctional healthcare – including medical and mental health services

for incarcerated people at nineteen (19) correctional facilities and two (2) community transition centers across the

state of Missouri.

to NECC in December 2018. Id. Plaintiff’s complaint is a diary-like listing by date of his medical

and dental issues from December 2018 until August 2022. Id. at 3-13. The allegations against

each specific defendant are a little difficult to decipher because Plaintiff details actions taken by

many NECC employees who are not named defendants,2 and he intertwines his medical and dental

complaints together.

As best as the Court can decipher, Plaintiff’s medical complaints started in June 2019 when

he began having “strange[] nerve sensations” and feeling that his walking gait “was not quite

right.” Id. at 3. He states that he started “seeking medical help” in the summer of 2019, but he

does not name how he sought help or who he sought it from. At the end of August 2019, a non-

defendant nurse practitioner ordered x-rays of Plaintiff’s spine, which were done in early

September. According to Plaintiff, the x-rays showed “significant lumbar deterioration.” At the

end of October, Plaintiff reported more difficulty walking and pain “radiating in his lower back

and hip” and he requested a hip x-ray. Id.; see also ECF No. 1-1 at 1-7. Plaintiff saw defendant

Dr. Stevenson in mid-November regarding his pain and difficulty with walking and sleeping. Dr.

Stevenson “raised his [C]ymbalta3 dosage,” but she denied his request for an MRI, stating that his

symptoms did not warrant it. ECF No. 1 at 3. Plaintiff saw Dr. Stevenson again in early February

2 For example, Plaintiff discusses actions taken by dentists Drs. Spence, Stovall, and Moeller; nurse practitioner

Tamara Crouch; and other unknown actors, including Karma, Sgt. Adams, Hillary, Sgt. Rubio, nurse Johnna, Sgt.

Welch, Renee Oakley, Olivia, Melanie, and Callie. ECF No. 1 at 3-13. None of these persons are named defendants

in this action.

3 The Court assumes Plaintiff was prescribed Cymbalta “to help relieve nerve pain” associated with his “ongoing …

chronic back pain.” Cymbalta – Uses, Side Effects, and More, https://www.webmd.com/drugs/2/drug-

91491/cymbalta-oral/details (last visited Dec. 13, 2022). It can also help improve sleep. Id.

[G]abapentin4” and ordered a hip x-ray, but she again denied his request for an MRI.

In mid-February 2020, Plaintiff felt a “pop” in his lower back that resulted in immediate

and excruciating pain. Id. After no response to the emergency call button in his cell all night

long,5 Plaintiff “self declared” to a non-defendant correctional officer in the morning. However,

no one ever came to get him for sick call and on the following day, Plaintiff was told he needed to

go up medical himself but he “was too sick.” He was then denied the use of a wheelchair by an

unnamed nurse, but Plaintiff states that he was using another inmate’s chair. Four days after the

“pop,” Plaintiff made it to sick call but he was refused a wheelchair since he did not have a doctor

“layin for one.” However, a nurse gave Plaintiff a chair two days later. About thirteen (13) days

after the “pop,” at the end of February, Plaintiff saw Dr. Stevenson. Plaintiff complained of

“incontinence, pain, [and his] leg giving out when [he tried] to stand.” Dr. Stevenson gave him a

wheelchair and reported that his x-ray results were “normal.” Id. However, based on exhibits

attached to the complaint, it appears that Plaintiff’s hip x-rays in February 2020, had results

“outside of acceptable limits.” ECF No. 1-1 at 26-27.

In mid-March, Plaintiff again requested an MRI and a medication adjustment while at sick

call. ECF No. 1 at 4. He saw Dr. Stevenson at the end of March. Id. at 5. According to Plaintiff,

Dr. Stevenson reported that “all they would do was treat and deal with symptoms and not the cause

because of the expense.” When Plaintiff expressed his concern about becoming permanently

disabled, Dr. Stevenson responded that “she was not sure she could prevent that.” Dr. Stevenson

denied Plaintiff’s request for specific medications that Plaintiff had taken in the past and she told

4 Again, the Court assumes that Plaintiff was taking Gabapentin for its use “to relieve nerve pain.” Gabapentin –

Uses, Side Effects, and More, https://www.webmd.com/drugs/2/drug-14208-8217/gabapentin-oral/gabapentin-

oral/details (last visited Dec. 13, 2022).

5 The Court notes that according to the affidavit signed by Plaintiff’s cellmate at this time, Austin Fisher, Plaintiff

did not hit the “Help Button” in the cell until around 5 am, after suffering for “7-8 hours.” ECF No. 7 at 7. A non-

defendant correctional officer responded to the button push. Id.

cautioned him that “it would not be approved.” In early April, Dr. Stevenson informed Plaintiff

that the MRI request had been denied. Plaintiff states that “physical therapy exercises” were

recommended instead; however, Dr. Stevenson later denied that recommendation was made. Id.

At the end of April, Plaintiff went to sick call complaining of difficulty standing; pain,

numb spots, burning and tingling in his legs; incontinence causing accidents multiple times a week;

sleeping difficulties; strength and dexterity problems in his right hand; spasms and cramps in his

back, legs, and inner thighs; and his toes involuntarily curling and cramping. Id.; see also ECF

No. 1-1 at 8-14. Plaintiff saw Dr. Stevenson twice in May but on the first visit “she would only

deal with blood press[ure].” However, at the end of May, Dr. Stevenson “added” Robaxin and

Ultram to Plaintiff’s prescribed medications. At this visit, Plaintiff complained about “losing

control of [his] legs and bowels almost daily.” ECF No. 1 at 5.

Starting in late May through November 2020, Plaintiff reports that he fell many times while

trying to stand and walk. Id. at 5-10. In June, Plaintiff sent a letter to the Health Services

Administrator, defendant Regina Gonia, and to Director of Nurses, defendant Pasha Allen, “asking

for help.” Id. at 6. Plaintiff saw Dr. Stevenson multiple times in June. Plaintiff states that Dr.

Stevenson refused to give him anything for his incontinence and refused to increase his pain

medications to three times per day, but she did refer him to a neurosurgeon. However, once the

neurosurgeon referral was denied, Dr. Stevenson “supposedly suggested a referral for MRI.”

When Plaintiff requested more pain medication again, Dr. Stevenson stated that she wanted to see

the results of the MRI. Id.

During this same time period, Plaintiff states that he was also fighting for a wheelchair and

incontinence products. Id. at 6-7. According to Plaintiff, in June 2020, Dr. Stevenson did not

renew Plaintiff’s wheelchair “layin” but instead allowed him use of a cane. Id. at 6. Plaintiff states

pads, because Plaintiff reported having accidents three times a day. Plaintiff states that Dr.

Stevenson “refused” but “finally conceded to putting in [a] request for Depends.” Id. According

to one of Plaintiff’s attached exhibits, in July 2020, Plaintiff had medical lay-ins for “one pack of

depends per month, a wheelchair, no high places or use of ladders, and a bottom bunk.” ECF No.

1-1 at 11. However, it appears he was not receiving the depends frequently enough or on-schedule,

because he had to write “two kites” and a “HSR” in an attempt to get more. Id. at 38.

In late June, Plaintiff fell and dislocated his hip. ECF No. 1 at 7; see also ECF No. 1-1 at

19. Dr. Stevenson was called and she ordered an x-ray6 for the following weekday. Three days

later, Plaintiff was taken to a non-prisoner medical center to have his “hip [put] back into socket.”

According to Plaintiff, the nurses and doctors at the private medical center “said they would have

expected NECC to bring [him] in the same day as the dislocation.” They also said that they

normally would do a “reduction” procedure in the emergency room but since the dislocation was

so bad, it had to be done in the operating room under sedation. When Plaintiff returned to NECC

the same day, defendant Regina Gonia “interrogat[ed]” him about the letter that he sent her. Gonia

advised Plaintiff that she would “continue Stevenson’s treatment plan.” ECF No. 1 at 7.

In early July, Plaintiff had a follow-up appointment with Dr. Stevenson regarding the hip

reduction. Dr. Stevenson would not address Plaintiff’s concerns about his back and his MRI

referral, but instead she advised Plaintiff to put in a health services request. Id. About a week

later, Plaintiff had a telemedicine visit with the private doctor who performed his reduction. Id. at

8. That non-defendant doctor reported that Plaintiff’s x-rays looked good and he recommended

that Plaintiff see a spinal specialist immediately about his back. The doctor suggested defendant

6 According to a medical x-ray report filed by Plaintiff, he had a left hip x-ray “2 days post fall” that showed a

“dislocation of [his] left total hip prosthesis.” ECF No. 4-1 at 14.

had an MRI of his spine and on the following day, he saw Dr. Stevenson. She refused to give

Plaintiff the specific medications in specific dosages that he requested, stating that she wanted to

see the MRI results before making any decisions. But she did put in the referral to Dr. Spears.

At the end of July, Plaintiff met with Dr. Stevenson regarding the MRI results. According

to Dr. Stevenson, the results “indicated there was no reason why [Plaintiff] should be experiencing

the symptoms” that he had and that “there was no reason [Plaintiff] should be having the problems”

that he was reporting. Dr. Stevenson did note mild stenosis at “L3-5” but that “nothing on the

report indicated that [Plaintiff’s] hardware was not in the correct spots.” Plaintiff continued to

describe his pain as “burning, stabbing, shooting pains in [his] legs and groin.” Dr. Stevenson

responded that “there wasn’t much more to do.” Id.

In early August, Plaintiff saw “spinal surgeon” Dr. Spears. Id. at 9. He recommended a

“decompression at L1-L2” due to spondylolisthesis in that area. When questioned, Dr. Spears

suggested that Plaintiff may not have developed his current symptoms if he had been treated

earlier. Dr. Spears advised Plaintiff to discontinue his ibuprofen and blood thinners in preparation

for the surgery. Plaintiff met with Dr. Stevenson soon after this to discuss Dr. Spears’

recommendation. Dr. Stevenson said she would put in the referral for surgery but she would not

prescribe a replacement for the discontinued ibuprofen. See also ECF No. 1-1 at 14. From late

August through early December, Plaintiff had to frequently report to medical to have the dressing

changed on a hip pressure wound which he developed from spending so much time in a wheelchair.

ECF No. 1 at 9-11.

Two months after it was recommended, in early October, Plaintiff had the spinal

decompression surgery. Id. at 10. In a follow-up telemedicine visit with a non-defendant doctor

a few weeks later, Plaintiff reported that he was still in “quite a bit of pain” but that he could walk

now be damaged permanently” and that it is possible that earlier treatment might have had different

results.

On November 30, 2020, Plaintiff fell in his prison wing when he lost his balance taking

out the trash. Id. He was unable to walk after the fall and his leg was swollen and bruised. On

the following day, Plaintiff went to sick call about his leg and was informed that he was already

scheduled to see the doctor soon. Four days after the fall, Plaintiff had a visit with Dr. Stevenson

regarding pain medicine. According to Plaintiff, Dr. Stevenson “wouldn’t look at [his leg] or

examine it,” but she did say she would order an x-ray. After multiple trips to sick call in an attempt

to get that x-ray, Plaintiff finally had an x-ray of his left hip ten (10) days after the fall. Id. Plaintiff

had broken his femur in multiple places where the “rod” (presumably from his hip replacement

surgery) “was forced down into the bone.” Id. at 10-11. In mid-December, Dr. Stevenson referred

Plaintiff for an orthopedic consult regarding his leg. Plaintiff saw a non-defendant orthopedic

doctor in mid-January 2021. Id. at 11. That doctor advised Plaintiff “to try to use [a] walker at

50% weight” and opined that if the rod doesn’t move, Plaintiff would be fine and no new hip would

be necessary. A few weeks later, Plaintiff met with a non-defendant medical employee at NECC

for a “wheelchair wellness check.” When Plaintiff explained the conservative approach suggested

by the orthopedic doctor, the NECC employee told Plaintiff that “Corizon makes it SO hard on the

doctors to actually DO anything.”

About seven (7) months following the leg break, in early July 2021, Plaintiff saw Dr.

Stevenson about pain and neuropathy in his bottom and private parts. Id. Later in July, Plaintiff

had a six-month follow-up with the orthopedic doctor who found Plaintiff’s leg to be “stable.” Id.

at 12. At Plaintiff’s request, the doctor measured Plaintiff for a lift and recommended orthopedic

shoes for stability. Plaintiff reports that at this time he was in “the most horrible pain.” He was

clothing. Plaintiff also complains that his three (3) requests for physical therapy, made both before

and after his spinal surgery, were all denied by Dr. Stevenson. Her stated reason for denial was

that such therapy had not been recommended by a specialist. Plaintiff states that his leg muscles

had atrophied due to not walking “in almost a year” and without physical therapy, it caused him

to “walk with a pronounced limp and an unbalanced, uneven gait.”

At the end of 2021,7 Plaintiff met with a non-defendant doctor about his labs, back history,

and bowel problems. The doctor suggested that Plaintiff may have permanent nerve damage and

that his bowel issues may persist. Id. In March and April 2022, Plaintiff filed grievances about a

“L5-S1 herniated disc that has needed repair since [he] had back surgery in 2020” and his

neuropathy. Id. at 13. In May, Plaintiff met with a non-defendant doctor about abdomen/bowel

x-rays, but it is unclear what the results were. In June, Plaintiff requested an x-ray and MRI of his

back, reporting “miserable pain,” “more difficulty walking,” and “burning in [his] legs, thighs,

back, butt, [and] crotch.” Apparently, Plaintiff did receive a new wheelchair and compression

hose at this time. In August, Plaintiff saw a non-defendant doctor for a prostate exam, socks, and

x-ray of L5-S1. Plaintiff reports that the vertebrae were “very out of alignment,” that there was

“[n]o disc left around [the] spinal canal,” and that there was a “3/4” gap in between vertebra.”

Plaintiff initiated this lawsuit soon after.

Plaintiff attached years of prison grievance filings with his complaint. ECF No. 1-1. He

began complaining about Dr. Stevenson, inadequate pain medications, and the need for further

testing for diagnosis in October 2019. Id. at 1. It appears he filed approximately nine (9) informal

resolution requests between October 2019 and May 2022, complaining about his medical care. Id.

7 The Court notes that by this time period of alleged complaints, Centurion had taken over for Corizon as the MDOC

inmate healthcare provider.

prisoners who either lived with him or lived in his prison wing. ECF Nos. 7, 10.8 In these

affidavits, the fellow prisoners attest to witnessing Plaintiff’s pain, difficulty walking, use of a

wheelchair, need for assistance, multiple falls, and problems with incontinence. Id.

B. Allegations Regarding Dental Care

Plaintiff names only one individual defendant related to dental care – Dr. Ernest Jackson –

who Plaintiff describes as the Missouri Director of Dental Services and the person responsible for

providing and coordinating offender dental services at NECC. Id. at 2. Plaintiff complains about

a delay in receiving dentures and other routine dental care.

Sometime in the summer of 2019, Plaintiff began “trying to get dental treatment for his

upper partial impression,” which was a problem originally noted at his prior place of incarceration.

Id. at 3. He says that he went to sick call in October 2019, but he does not specify his complaint

or the response. In January 2020, Plaintiff saw a new dentist at NECC (not a named defendant),

who recommended the “same treatment plan.” Plaintiff does not specify what that treatment plan

was. Id. According to grievance filings, Plaintiff complained of a delay in dental care that caused

“blisters, open sores, pain, [and] an inability to eat properly.” ECF No. 1 at 65.

In March 2020, Plaintiff saw a different non-defendant dentist who “took impressions” and

stated that they would be back in two (2) to three (3) weeks. ECF No. 1 at 4. In June, Plaintiff

“[w]ent to sick call re partials. Into the 21st month now.” Id. at 6. The unnamed nurse at sick call

refused to refer him to dental because she said they “weren’t doing filing or extractions yet.” Id.

A few days later, Plaintiff was informed that “Dr. Jackson supposedly made a decision statewide

8 Plaintiff’s requests to submit these affidavits in support of his claims will be considered requests for the Court to

consider the documents as exhibits to the complaint. See ECF Nos. 7 at 1 & 10 at 1. Based on the Federal Rules,

the Court will treat these attachments as part of the pleadings. See Fed. R. Civ. P. 10(c) (“A copy of a written

instrument that is an exhibit to a pleading is part of the pleading for all purposes”).

wrote a letter to Dr. Jackson “re getting partials done.” Id. at 9. In November, Plaintiff saw a non-

defendant dentist regarding pulling broken teeth and he decided to “pull the remaining uppers and

do [a] full plate.” Id. at 10. In December, the same dentist removed Plaintiff’s left-side, top teeth.

Id. at 11.

In January 2021, Plaintiff had another two teeth pulled. The dentist indicated at that

appointment that it could take weeks or months to “get the impression” because “they were behind”

and “lab problems.” The following month Plaintiff went to sick call concerning a gum infection

and found out that the NECC dentist had quit. Id. According to grievance filings, it appears

Plaintiff did see a dental provider for first impressions in April 2021. ECF No. 1-1 at 77-79.

However, in December 2021, Plaintiff filed another grievance about gum infection and denture

delay because he had been put in for the same treatment plan four times. Id. at 82-83; ECF No. 1

at 12. His grievance was denied the following month as duplicative. Id.

At the end of February 2022, Dr. Jackson did the “bite for final denture” and told Plaintiff

that he would expedite his dentures since he had been waiting so long. Id. at 13. In April when

Plaintiff still had not received his dentures, he self-declared and the dentures were located.

However, when Plaintiff went to get them two days later, a non-defendant dentist thought Plaintiff

needed a wax impression. Plaintiff received his dentures in June 2022.

For relief on both his medical and dental claims, Plaintiff seeks declaratory judgment and

compensatory damages from all defendants. Id. at 16.

Discussion

It is well established that the government has an obligation to provide medical and dental

care to those whom it is punishing by incarceration. Estelle v. Gamble, 429 U.S. 97, 103 (1976).

To demonstrate constitutionally inadequate medical or dental care, the inmate must show that a

1237-38 (8th Cir. 1997).

Plaintiff alleges a documented history of back and hip problems when he was transferred

to NECC in December 2018. Over the subsequent four years, Plaintiff’s health problems

progressively worsened while he experienced continuous and increasing pain; difficulty walking

and standing; and incontinence. His condition deteriorated to the point where he had to use a

wheelchair and he fell multiple times, suffering injuries. He alleges a delay in the diagnosis of his

medical conditions and in the treatment of the pain those conditions caused. Also, when

transferred to NECC in 2018, Plaintiff had already completed his first impressions for dentures yet

he did not actually receive dentures until June 2022.

Accepting Plaintiff’s allegations as true, the Court finds that Plaintiff has plead sufficient

facts to state a claim of deliberate indifference against defendant Dr. Joule Stevenson and Corizon.

Dr. Stevenson was Plaintiff’s primary physician over the time period at issue. Plaintiff claims that

Dr. Stevenson was aware of his medical needs but that she did not take the appropriate steps to

diagnose and treat them in a timely manner, resulting in long-term, detrimental side effects for

Plaintiff. Plaintiff also asserts that Corizon’s custom or policy of doing the minimal tests and

treatment as necessary, in order to save money, resulted in pain, delayed medical diagnosis, and

physical damage. These allegations are sufficient to state a claim pursuant to 28 U.S.C. §

1915(e)(2)(B). The Court will direct the Clerk of Court to issue process on Plaintiff’s complaint

against defendants Dr. Joule Stevenson, in her individual capacity, and Corizon.

On the other hand, Plaintiff’s claims of deliberate indifference against defendants

Centurion, Regina Gonia, Pasha Allen, Diane Wade, Cathy Griffin, Dr. Ernest Jackson, Jewel

Cofield, Dr. Thomas Bredeman, and Dr. John Spears are not sufficiently plead to state a claim of

deliberate indifference. As discussed below, these defendants will be dismissed.

A. Dental Claims against Dr. Jackson

Plaintiff brings this action pursuant to 42 U.S.C. § 1983, which was designed to provide a

“broad remedy for violations of federally protected civil rights.” Monell v. Dep’t of Soc. Servs,

436 U.S. 658, 685 (1978). One such federally protected right is the Eighth Amendment’s

prohibition on cruel and unusual punishment, which protects prisoners from deliberate indifference

to serious medical needs. Luckert v. Dodge Cnty., 684 F.3d 808, 817 (8th Cir. 2012). To prevail

on a deliberate indifference claim, a prisoner plaintiff must demonstrate that he suffered from an

objectively serious medical need, and that defendants actually knew of and disregarded that need.

Roberts v. Kopel, 917 F.3d 1039, 1042 (8th Cir. 2019); Dulany, 132 F.3d at 1239. A “serious

medical need” is “one that has been diagnosed by a physician as requiring treatment, or one that

is so obvious that even a layperson would easily recognize the necessity for a doctor’s attention.”

Holden v. Hirner, 663 F.3d 336, 342 (8th Cir. 2011) (quoted case omitted).

“[D]eliberate indifference requires a highly culpable state of mind approaching actual

intent.” Kulkay v. Roy, 847 F.3d 637, 643 (8th Cir. 2017) (quoted case omitted). An inmate must

demonstrate that a prison health care provider’s actions were “so inappropriate as to evidence

intentional maltreatment or a refusal to provide essential care.” Jackson v. Buckman, 756 F.3d

1060, 1066 (8th Cir. 2014) (quoted case omitted). Allegations of mere negligence in giving or

failing to supply medical treatment will not suffice. Estelle v. Gamble, 429 U.S. 97, 106 (1976).

Nor will a prisoner’s “mere disagreement with treatment decisions” support a claim of deliberate

indifference. Jones v. Minn. Dep’t of Corr., 512 F.3d 478, 482 (8th Cir. 2008).

Deliberate indifference may also be demonstrated by prison officials who intentionally

deny or delay access to medical care. Estelle, 429 U.S. at 104-05. When a delay in treatment is

alleged to have violated an inmate’s constitutional rights, a court measures the objective severity

F.3d 1114, 1119 (8th Cir. 2016) (internal quotation marks omitted) (quoting Laughlin v. Schriro,

430 F.3d 927, 929 (8th Cir. 2005)). To support a claim based on a delay in treatment, a plaintiff

must present “verifying medical evidence” showing that the delay in treatment had detrimental

effects. Id. at 1119-20; see also Holden, 663 F.3d at 342 (“[a] prisoner alleging a delay in treatment

must present verifying medical evidence that . . . [the] delays adversely affected his prognosis.”).

In this case, based on Plaintiff’s statements, it wasn’t until February of 2022 that Plaintiff

saw defendant Dr. Jackson for dental care. At that time, Dr. Jackson ordered Plaintiff’s dentures

and told Plaintiff he would expedite them due to prior delays. Later, a different dentist determined

Plaintiff need one additional impression, but Plaintiff did receive his dentures in June 2022. The

majority of Plaintiff’s dental care at NECC was provided by dentists not named as defendants.

Plaintiff describes Dr. Jackson as the Missouri Director of Dental Services. However, “[a]

supervisor may not be held liable under § 1983 for the constitutional violations of a subordinate

on a respondeat superior theory.” Tlamka v. Serrell, 244 F.3d 628, 635 (8th Cir. 2001) (citing

Boyd v. Knox, 47 F.3d 966, 968 (8th Cir. 1995)). “Liability under § 1983 requires a causal link to,

and direct responsibility for, the deprivation of rights.” Madewell v. Roberts, 909 F.2d 1203, 1208

(8th Cir. 1990). To be cognizable under § 1983, a claim must allege that the defendant was

personally involved in or directly responsible for the incidents that deprived the plaintiff of his

constitutional rights. Martin v. Sargent, 780 F.2d 1334, 1338 (8th Cir. 1985).

To the extent that Plaintiff alleges that Dr. Jackson is the person responsible for deciding

that dental services would be limited in June 2020 due to COVID, this decision does not support

Plaintiff’s allegation of a delay in dental services since Plaintiff admits to seeing a dentist in

November and December 2020 and again in January 2021. Plaintiff also states that he wrote Dr.

Dr. Jackson for dental services until February 2022, and he received his dentures four months later.

Plaintiff’s allegations are insufficient to state a claim of deliberate indifference against Dr.

Jackson. Nothing in Plaintiff’s allegations suggests intentional maltreatment or criminal

recklessness by Dr. Jackson. Plaintiff received his dentures four months after first seeing Dr.

Jackson. This does not constitute deliberate indifference. See Johnson v. Leonard, 929 F.3d 569,

576 (8th Cir. 2019) (“Many cases finding deliberate indifference due to a delay in dental care

involve almost a complete lack of treatment leading to an infection or worsening condition.”).

Defendant Dr. Jackson will be dismissed from this action for failure to state a claim against him.

B. Medical Claims Against Individual Defendants

a. Dr. Joule Stevenson

Dr. Stevenson was Plaintiff’s primary treating physician while he was incarcerated at

NECC. Dr. Stevenson had knowledge of Plaintiff’s history of back and hip problems. Plaintiff

complained to her for years about increased problems walking and standing, continuous pain, and

incontinence. Plaintiff fell multiple times, resulting in a dislocated hip and broken leg. Despite

Plaintiff’s surgical history and complaints, Dr. Stevenson denied requests for further testing and

changes to the pain treatment plan. Dr. Stevenson admitted that she would only treat and deal with

symptoms and not the cause of Plaintiff’s pain, because of the expense. Dr. Stevenson chose to

treat Plaintiff’s medical problems with less expensive medical procedures and to delay treatment

at times to save money. Plaintiff alleges that Dr. Stevenson was personally involved in his medical

care, and directly responsible for the fact that Plaintiff now appears to have permanent nerve

damage and bowel problems. Plaintiff has alleged sufficient facts to state a claim for deliberate

indifference to his serious medical need against defendant Dr. Stevenson pursuant to §

1915(e)(2)(B).

Dr. Stevenson’s employer during the relevant time period, Corizon, has also been named as a

defendant and as discussed below, process will also issue against Corizon. Plaintiff’s official

capacity claims against Dr. Stevenson are redundant of his claims against Corizon itself. See King

v. City of Crestwood, Mo., 899 F.3d 643, 650 (8th Cir. 2018) (“[A]s a suit against a government

official in his official capacity is functionally equivalent to a suit against the employing

governmental entity, a suit against a government official in only his official capacity should be

dismissed as redundant if the employing entity is also named.”). Therefore, process shall issue

against Dr. Stevenson on the complaint in her individual capacity only.

b. Regina Gonia, Pasha Allen, Diane Wade, Cathy Griffin, Jewel Cofield, and Dr.

Thomas Bredeman

Plaintiff asserts that defendants Jewel Cofield, Dr. Thomas Bredeman, Regina Gonia,

Pasha Allen, Cathy Griffin, and Diane9 Wade “did at all times relevant show deliberate

indifference to plaintiff’s serious medical needs … in that they were all purportedly in positions

of authority but failed to investigate, respond to, and reasonably attempt to resolve matters around

inmate medical needs and where grievances were involved.” ECF No. 1 at 15. As such, Plaintiff

does not assert that these defendants were personally involved in his medical care decisions, but

that they should have recognized that his medical care needs were not being adequately addressed

when they responded to his grievances and complaints.

To be cognizable under § 1983, a claim must allege that the defendant was personally

involved in or directly responsible for the incidents that deprived the plaintiff of his constitutional

rights. Martin, 780 F.2d at 1338. However, a plaintiff may, under a theory of direct liability,

9 Plaintiff actually refers to this defendant as “Dawn Wade” but the Court construes this a typo. See ECF No. 1 at

15.

control actions of a subordinate is such that it constitutes deliberate indifference to plaintiff’s

serious medical needs. Moyers v. Buescher, 806 F.Supp. 218, 220 (E.D. Mo. 1992). “[A]

supervisor’s liability arises if: ‘he directly participates in a constitutional violation or if a failure to

properly supervise and train the offending employee caused a deprivation of constitutional rights.’”

Tlamka, 244 F.3d at 635 (quoting Andrews v. Fowler, 98 F.3d 1069, 1078 (8th Cir. 1996) (citations

omitted)); see also Otey v. Marshall, 121 F.3d 1150, 1155 (8th Cir. 1997).

Plaintiff does not allege that any of these defendants directly participated in his medical

care decisions. The fact that Plaintiff sent some of these defendants a letter in June 2020

complaining about his medical care is not enough to show personal involvement. See ECF No. 1-

1 at 93-95. Plaintiff also does not assert that any of them were responsible for supervising and

training Dr. Stevenson – the doctor who provided most of Plaintiff’s medical care at NECC.

Plaintiff cannot state a § 1983 claim against these defendants based on their handling of grievances

alone. See Buckley v. Barlow, 997 F.2d 494, 495 (8th Cir. 1993) (a prison officials’ failure to

process or investigate grievances, without more, is not actionable under § 1983; grievance

procedure is procedural right only and does not confer substantive right on inmate). As such, the

Court finds that Plaintiff’s complaint fails to state a § 1983 claim against defendants Regina Gonia,

Pasha Allen, Diane Wade, Cathy Griffin, Jewel Cofield, and Dr. Thomas Bredeman. These

defendants will be dismissed.

c. Dr. John Spears

Plaintiff states no specific legal claims against Dr. Spears. Regardless, as he is not a state

actor, he is not subject to suit under 42 U.S.C. § 1983. The essential elements of a constitutional

claim under § 1983 are that the defendant acted under color of state law, and that the alleged

wrongful conduct deprived the plaintiff of a constitutionally protected federal right. Schmidt v.

liable under § 1983. Carlson v. Roetzel & Andress, 552 F.3d 648, 650 (8th Cir. 2008); see also

Sanders v. Sears, Roebuck & Co., 984 F.2d 972, 975 (8th Cir. 1993) (citing Jackson v. Metro.

Edison Co., 419 U.S. 345, 349 (1974)) (stating that § 1983 secures constitutional rights from

government infringement, not infringement by private parties).

Dr. Spears is described by Plaintiff as a contract spinal surgeon. Plaintiff was referred to

Dr. Spears by Corizon and Centurion medical employees for consultation and surgery. Dr. Spears

is a doctor in private practice and therefore a private party. Furthermore, Plaintiff states in his

complaint that Dr. Spears “is a party to this solely for the purposes of discovery and medical

testimony” and Plaintiff states no claims against him in the ‘Legal Claims’ section of his complaint.

ECF No. 1 at 2 & 14-16. As such, it appears that Plaintiff is not actually alleging any claims of

deliberate indifference against Dr. Spears. Because a party should not be named as a defendant

for purposes of discovery and because Dr. Spears is not a state actor, he will be dismissed as a

defendant in this § 1983 action. Plaintiff fails to state a § 1983 claim against Dr. Spears.

C. Claims against Contracted Medical Providers: Corizon and Centurion

Plaintiff names Corizon and Centurion as defendants in the caption of his § 1983 complaint

but he states no specific claims against them in the ‘Legal Claims’ section of his complaint. ECF

No. 1 at 1, 14-16. In the complaint’s ‘Facts of the Case,’ Plaintiff discusses a conversation he had

with a non-defendant NECC medical employee about his broken leg. See ECF No. 1 at 11. When

Plaintiff explained that he was waiting six weeks to follow-up with the orthopedic specialist to see

if his prosthesis moved, the NECC employee “said that Corizon makes it SO hard on the doctors

to actually DO anything” and she said that a doctor recommending the “smallest” surgical option

is an example of “how Corizon operates.” Id.; see also ECF No. 4-1 at 19 (where specialist

recommends the “smallest surgery” that can be performed). In an additional filing, Plaintiff alleges

[in receipt of medical and dental care,] according to staff statements.” ECF No. 4 at 1.

“A corporation acting under color of state law cannot be liable on a respondeat superior

theory.” Smith v. Insley’s Inc., 499 F.3d 875, 880 (8th Cir. 2007). Rather, to support a claim

against such a corporation, the plaintiff “must show that there was a policy, custom, or official

action that inflicted an actionable injury.” Johnson v. Hamilton, 452 F.3d 967, 973 (8th Cir. 2006);

see also Stearns v. Inmate Services Corp., 957 F.3d 902, 906 (8th Cir. 2020) (explaining that the

“proper test” for determining whether a corporation acting under color of state law is liable under

42 U.S.C. § 1983 “is whether there is a policy, custom, or action by those who represent … official

policy that inflicts injury actionable under § 1983”).

Liberally construing Plaintiff’s allegations here, Plaintiff complains that Corizon has a

policy or custom that requires doing the minimal treatment possible, that delays and denies

necessary diagnostic tests like MRIs, that treats symptoms instead of overall problems due to

expense, and that results in extensive delays in the receipt of necessary dental care. Plaintiff asserts

that this Corizon policy or custom of cost-savings measures has delayed and/or denied him access

to adequate medical and dental care. According to Plaintiff, he would not currently have the

medical problems that he has, if Corizon had not delayed medical care. Also, Plaintiff alleges

many years of delays in receipt of dental care that resulted in pain and suffering. See, e.g., Dadd

v. Anoka Cnty., 827 F.3d 749, 755 (8th Cir. 2016) (“Delay in the provision of treatment or in

providing examinations can violate inmates’ rights when the inmates’ ailments are medically

serious or painful in nature.”). The Court finds that Plaintiff has stated a sufficient claim under

the Eighth Amendment to survive initial review under 28 U.S.C. § 1915(e)(2) against Corizon.

Plaintiff has adequately plead that Corizon’s deliberate indifference, by an intentional delay in or

Court will order that process be issued against Corizon on the complaint.

Centurion replaced Corizon as the provider of healthcare for MDOC inmates in mid-

November 2021. There was approximately nine months from when Centurion took over and

Plaintiff filed this lawsuit. In that period, Plaintiff saw multiple health care providers, he requested

and received x-rays of his back, he got a new wheelchair and compression hose, he had a prostate

exam, and he finally received his dentures. Plaintiff does not make any allegations of a

constitutional violation resulting from a policy, custom, or action of Centurion. Therefore, the

Court will dismiss Plaintiff’s claims brought against defendant Centurion for failure to state a

claim upon which relief may be granted.

Appointment of Counsel

Finally, Plaintiff has filed a motion for appointment of counsel. ECF No. 4. The

appointment of counsel for an indigent plaintiff in a civil matter lies within the discretion of the

Court. Phillips v. Jasper Cnty. Jail, 437 F.3d 791, 794 (8th Cir. 2006). There is no constitutional

or statutory right to appointed counsel in civil cases. Nelson v. Redfield Lithograph Printing, 728

F.2d 1003, 1004 (8th Cir. 1984). Once the plaintiff has alleged a prima facie claim, the Court must

determine the plaintiff’s need for counsel to effectively litigate his claim. In re Lane, 801 F.2d

1040, 1043 (8th Cir. 1986). The standard for appointment of counsel in a civil case is whether

both the plaintiff and the Court would benefit from the assistance of counsel. Edgington v. Mo.

Dep’t of Corr., 52 F.3d 777, 780 (8th Cir. 1995), abrogated on other grounds by Doe v. Cassel,

403 F.3d 986, 989 (8th Cir. 2005). This determination involves the consideration of several

relevant criteria, including “the factual complexity of the issues, the ability of the indigent person

to investigate the facts, the existence of conflicting testimony, the ability of the indigent person to

Edgington, 52 F.3d at 780).

In this matter, the Court finds that appointment of counsel is not warranted at this time.

The action appears to involve straightforward questions of fact rather than complex questions of

law. Further, the request for counsel is premature, as defendants have not yet been served, and the

Court has not issued any Case Management Order. The Court concludes that the appointment of

counsel would not be of sufficient benefit to the Court or to Plaintiff at this time, and will deny

Plaintiff’s motion for appointment of counsel, without prejudice.

Conclusion

Plaintiff’s motion to proceed in forma pauperis will be granted and the filing fee will be

waived. Because Plaintiff’s complaint states sufficient factual allegations to state a claim of

deliberate indifference against defendant Dr. Joule Stevenson, process shall issue against this

defendant in her individual capacity only. In addition, Plaintiff states a sufficient custom or policy

claim for process to issue against defendant Corizon. However, as to all other defendants, Plaintiff

fails to state a § 1983 claim under 28 U.S.C. § 1915(e)(2)(B). Defendants Centurion, Regina

Gonia, Pasha Allen, Diane Wade, Cathy Griffin, Dr. Ernest Jackson, Jewel Cofield, Dr. Thomas

Bredeman, and Dr. John Spears will be dismissed. Finally, Plaintiff’s motion for appointment of

counsel will be dismissed without prejudice to refiling at a later date.

Accordingly,

IT IS HEREBY ORDERED that Plaintiff’s motion for leave to proceed in forma pauperis

[ECF No. 14] is GRANTED and the filing fee is waived. See 28 U.S.C. § 1915(a)(1).

IT IS FURTHER ORDERED that the Clerk shall not issue process or cause process to

issue upon the complaint as to defendants Centurion Inc., Regina Gonia, Pasha Allen, Diane Wade,

Cathy Griffin, Dr. Ernest Jackson, Jewel Cofield, Dr. Thomas Bredeman, and Dr. John Spears

because, as to these defendants, the complaint fails to state a claim upon which relief can be granted

under 28 U.S.C. § 1915(e)(2)(B). Plaintiffs claims against defendants Centurion Inc., Regina

Gonia, Pasha Allen, Diane Wade, Cathy Griffin, Dr. Ernest Jackson, Jewel Cofield, Dr. Thomas

Bredeman, and Dr. John Spears are DISMISSED without prejudice.

IT IS FURTHER ORDERED that the Clerk shall issue process or cause process to issue

upon the complaint as to defendant Dr. Joule Stevenson, in her individual capacity only, as to

Plaintiff's claims of deliberately indifferent medical care. This defendant should be served

pursuant to the service agreement the Court maintains with Corizon.

IT IS FURTHER ORDERED that the Clerk shall issue process or cause process to issue

upon the complaint as to defendant Corizon, as to Plaintiff's claims of deliberately indifferent

medical and dental care. This defendant should be served pursuant to the service agreement the

Court maintains with Corizon.

IT IS FURTHER ORDERED that the Clerk shall not issue process or cause process to

issue upon the complaint as to defendant Dr. Joule Stevenson in her official capacity because

these claims are redundant and shall be dismissed under 28 U.S.C. § 1915(e)(2)(B).

IT IS FURTHER ORDERED that Plaintiff’s motion for appointment of counsel [ECF

No. 4] is DENIED without prejudice.

An Order of Partial Dismissal will accompany this Opinion, Memorandum and Order.

Dated this 10" day of January, 2023.

UNITED STATES DISTRICT JUDGE

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