QUIGLEY v. HARTZELL

IN THE UNITED STATES DISTRICT COURT

FOR THE WESTERN DISTRICT OF PENNSYLVANIA

ERIE DIVISION

JOSHUA QUIGLEY, )

)

Plaintiff ) 1:24-CV-00336-RAL

)

vs. ) RICHARD A. LANZILLO

) Chief United States Magistrate Judge

INSTITUTIONAL EYE CARE, LLC, )

SCOTT HARTZELL, MD, JAQUELINE ) MEMORANDUM OPINION ON

CARINGOLA, OD, ) DEFENDANTS’ MOTION TO DISMISS

)

Defendants ) IN RE: ECF NOS. 30, 32

)

Pending before the Court are two motions to dismiss Plaintiff’s Complaint under Fed. R.

Civ. P. 12(b)(6), one filed by Defendant Dr. Scott Hartzell, MD (ECF No. 30), and the second, by

Defendant Jacqueline Caringola, OD (ECF No. 32). For the reasons stated herein, the Defendants’

motions will be denied.1

I. Procedural Background

Plaintiff Joshua Quigley (“Quigley”) is an inmate in the custody of the Pennsylvania

Department of Corrections (“DOC”) at its State Correctional Facility at Forest (“SCI-Forest”). His

Amended Complaint—the operative pleading before the Court—names three defendants: Scott

Hartzell, MD (“Dr. Hartzell”), Jacqueline Caringola, OD (“Dr. Caringola”), and Institutional Eye

Care, LLC (“IEC”). Count I of Quigley’s two-count Amended Complaint asserts an Eighth

Amendment claim against both Dr. Hartzell and Dr. Caringola under 42 U.S.C § 1983 based on

allegations that each acted with deliberate indifference to Quigley’s serious medical needs.

1 The parties have consented to the jurisdiction of a United States Magistrate Judge in these proceedings under 28

U.S.C. § 636(c).

Count II is a professional negligence claim against all Defendants, including a vicarious liability

claim against IEC based on it alleged status as Dr. Caringola’s employer.2

Dr. Hartzell and Dr. Caringola have each moved to dismiss Count I of the Amended

Complaint on the grounds that Quigley’s allegations do not support a plausible inference that either

acted with deliberate indifference to his serious medical needs. See ECF Nos. 31 (Dr. Hartzell’s

brief), 33 (Dr. Caringola’s brief). Dr. Hartzell further urges the Court to decline to exercise

supplemental jurisdiction over Quigley’s state law medical negligence claims upon dismissal of

his Eighth Amendment claim. See ECF No. 31, p. 5. Quigley has filed briefs in opposition to each

Defendant’s motion. See ECF Nos. 41, 42.

II. Standard of Review

A motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6) tests the legal

sufficiency of the complaint. Kost v. Kozakiewicz, 1 F.3d 176, 183 (3d Cir. 1993). In deciding a

Rule 12(b)(6) motion to dismiss, the court must accept as true all factual allegations of the

complaint and views them in a light most favorable to the plaintiff. See, Phillips v. Cnty. of

Allegheny, 515 F.3d 224, 228 (3d Cir. 2008) (citing Worldcom, Inc. v. Graphnet, Inc., 343 F.3d

651, 653 (3d Cir. 2003). In making its determination under Rule 12(b)(6), the court is not opining

on whether the plaintiff is likely to prevail on the merits; rather, the plaintiff must only present

factual allegations sufficient “to raise a right to relief above the speculative level.” Bell Atlantic

Corp. v. Twombly, 550 U.S. 544, 556 (2007) (citing 5 C. Wright & A. Miller, Federal Practice and

Procedure § 1216, pp. 235-36 (3d ed. 2004)). Furthermore, a complaint should only be dismissed

pursuant to Rule 12(b)(6) if it fails to allege “enough facts to state a claim to relief that is plausible

on its face.” Id. at 570.

2 IEC has filed an Answer in which it denies it is Dr. Caringola’s employer. ECF No. 47, ¶4.

While a complaint does not require detailed factual allegations to survive a motion to dismiss, it

must provide more than labels and conclusions. Id. at 555. A “formulaic recitation of the elements

of a cause of action will not do.” Id. (citing Papasan v. Allain, 478 U.S. 265, 286 (1986)).

Moreover, a court need not accept inferences drawn by a plaintiff if they are unsupported by the

facts alleged in the complaint. See Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). Nor must the court

accept legal conclusions disguised as factual allegations. See Twombly, 550 U.S. at 555; McTernan

v. City of York, Pennsylvania, 577 F.3d 521, 531 (3d Cir. 2009) (“The tenet that a court must accept

as true all of the allegations contained in a complaint is inapplicable to legal conclusions.”).

III. Material Facts

The following factual allegations of the Amended Complaint are accepted as true for

purposes of the Defendants’ motions to dismiss. On February 16, 2023, around 3:00 am, Quigley

was attacked by his cellmate who had a history of violent conduct. ECF No. 19, ¶ 10. Quigley’s

injuries from the attack included an orbital fracture, a hematoma to the back of the left side of his

head, lacerations, bruising, swelling, and blurred vision in his left eye. Id., ¶ 11, 12.

A registered nurse initially assessed Quigley at 7:55 am that morning. At 2:54 pm that

afternoon, Dr. Caringola performed an optometric examination upon Quigley. Id., ¶¶ 12, 13. She

recorded that Quigley did not have vision changes and that his acuity was 20/25. Id., ¶ 13.

Dr. Caringola recommended Quigley return to the eye clinic in two weeks and follow up in a

month. Id., ¶ 14. She did not perform a peripheral retinal examination. Id., ¶¶ 34, 35.

Dr. Caringola again saw Quigley on March 16, 2023, and noted that he had lasting pain

around his left eye, distorted vision, pigment in the vitreous of his left eye, and “slight irregular

pupil border bowman 2:30 and 3 o’clock OS [left eye].” Id., ¶ 15. She concluded that Quigley had

“visual distortion/blur 360 periphery OS [left eye] since BFT [blunt force trauma] w/ no obvious

cause on today’s exam.” Id. She referred Quigley to the on-site retina clinic for further evaluation

and prescribed him acetaminophen for sixty days. Id, ¶ 16. Dr. Caringola did not perform a

peripheral retinal examination. Id., ¶¶ 34, 35.

Quigley first saw Hartzell at the prison’s on-site retinal clinic on April 5, 2023. Dr. Hartzell

assessed Quigley’s vision acuity had reduced to 20/70 but noted “no evidence of pathology.” Id, ¶

17. Dr. Hartzell directed that Quigley reconsult at the IEC clinic as needed. Id. ¶ 18. Dr. Hartzell

did not perform a peripheral retinal examination. Id., ¶¶ 34, 35.

Later in April, Quigley submitted two Medical Sick Call Request forms complaining of

worsening vision. Id., ¶ 19. He submitted two additional Medical Sick Call Requests on May 5

and May 7, 2023, complaining of loss of peripheral vision, blurred vision, and flashes of light. Id,

¶ 20. He received no response to any of these requests. Id., ¶¶ 19, 20. On June 8, 20233, Quigley

submitted a fifth Medical Sick Call Slip Request to which he received the response, “I’ve made

you an appointment at our next available Eye Clinic.” Id., ¶ 21.

On July 6, 2023, Quigley was seen in the prison medical department by a certified nurse

practitioner (CRNP) who reported his acuity as 20/200 and noted that he had very little vision in

his left eye. Id., ¶¶ 22, 23. The CRNP then referred him to an offsite retina clinic for evaluation as

soon as possible. Id., ¶ 23.

Later on July 6, 2023, Quigley saw Dr. Caringola again at the on-site optometry clinic. Id.,

¶ 24. She noted that he “feels [left eye] has been steadily getting worse over the last couple months.

Can’t see to temp [temporal] side or bottom OS [left eye], flashes when closed eye for about 2

months. Feels started about 1 month after I last saw him. Did have evaluation with IEC

[Institutional Eye Care] clinic, no pathology noted.” Id. She also concluded, “No overt RD [retinal

3 The Amended Complaint gives the date of this sick call request as June 8, 2024. ECF No. 19, ¶ 21. This appears to

be a typographic error as the sequence of all events place this request in 2023.

detachment] noted OS [left eye], vision and field loss seems worse than what retina looks like.

Possible far periph [peripheral] detachment vs schisis.” Id., ¶ 25. She referred Quigley to an off-

site retinal specialist. Id.

On July 17, 2023, a non-party retinal specialist at Retina Vitreous Consultants diagnosed

Quigley’s vision loss as retinal detachment in his left eye. Id., ¶ 26.4 The doctor also noted PVR

[proliferative vitreoretinopathy], signifying a complex detachment originating from a large tear,

and scheduled Quigley for retinal surgery. Id., ¶ 30. On July 26, 2023, Quigley underwent surgery

for his detached retina. Id., ¶ 31.

Prior to July 6, 2023, neither Dr. Hartzell nor Dr. Caringola had conducted an examination

of Quigley’s peripheral retina. Id., ¶¶ 34, 35. The Amended Complaint alleges that the delay in

Quigley’s treatment of his retinal detachment, specifically Dr. Caringola and Dr. Hartzell’s failure

to conduct a timely and thorough peripheral retina examination, has caused him to suffer moderate

to severe irreversible loss of quality and quantity vision in his left eye. Id., ¶¶ 32, 34. A peripheral

retina examination closer to the incident on February 16, 2023, would have detected Quigley’s

torn or detached retina, and such earlier detection would have materially improved his chances of

good postoperative vision. Id., ¶¶ 37-39.

IV. Discussion

Dr. Caringola and Dr. Hartzell argue that Quigley’s Eighth Amendment claim must be

dismissed because their respective conduct, as alleged in the Amended Complaint, does not

support a finding that either acted with deliberate indifference to Quigley’s serious eye condition.

Under the Eighth Amendment, state prisoners have a right to medical care. See Estelle v. Gamble,

4 Retinal detachment is a very serious injury that usually begins as a retinal tear. Id., ¶¶ 26, 28. Early treatment can

prevent a retinal tear from becoming detached. Id., ¶ 28. When a retinal tear does lead to detachment, it will result in

loss of peripheral vision, which can progress to total loss of vision. Id.

429 U.S. 97 (1976) (recognizing that “deliberate indifference to serious medical needs of prisoners

constitutes the unnecessary and wanton infliction of pain proscribed by the Eighth Amendment”)

(internal quotation omitted). To state a claim for violation of his constitutional right to medical

care, a plaintiff must allege facts that support findings that: (1) he had a serious medical need, and

(2) acts or omissions by the defendant prison officials acted with deliberate indifference to that

need.5 Rouse v. Plantier, 182 F.3d 192, 197 (3d Cir. 1999). A prison official acts with deliberate

indifference to a prisoner’s medical needs only when he or she “knows of and disregards an

excessive risk to inmate health or safety.” Farmer v. Brennan, 511 U.S. 825, 837 (1994). “That is

the equivalent of recklessness.” Wall v. Bushman, 639 Fed. Appx. 92, 94 (3d Cir. 2015) (citing

Farmer, 511 U.S. at 836–37). Such indifference may be manifested by an intentional refusal to

provide care, delayed medical treatment for non-medical reasons, denial of prescribed medical

treatment, a denial of reasonable requests for treatment that results in suffering or risk of injury,

Durmer v. O’Carroll, 991 F.2d 64, 68 (3d Cir. 1993), or “persistent conduct in the face of resultant

pain and risk of permanent injury.” White v. Napoleon, 897 F.2d 103, 109 (3d Cir. 1990).

In contrast, “an inmate’s dissatisfaction with a course of medical treatment, standing alone,

does not give rise to a viable Eighth Amendment claim.” Tillery v. Noel, 2018 WL 3521212, at

*5 (M.D. Pa. June 28, 2018) (collecting cases). Such complaints fail as constitutional claims

because “the exercise by a doctor of his professional judgment is never deliberate indifference.”

Gindraw v. Dendler, 967 F. Supp. 833, 836 (E.D. Pa. 1997) (citing Brown v. Borough of

Chambersburg, 903 F.2d 274, 278 (3d Cir. 1990) (“[A]s long as a physician exercises professional

5 Dr. Caringola and Dr. Hartzell do not dispute that Quigley’s detached retina and resulting impairment constitute a

serious medical need. Indeed, while “a ‘very slight visual impairment’ does not constitute a serious medical need [for

Eighth Amendment purposes],” an individual’s “optometry needs are serious ... if they are sufficiently severe to cause

complications such as significant blurring, double vision, dizziness, or walking or falling into objects.” Parker v.

Boring, 2016 WL 3381287, at *8 (M.D. Pa. May 19, 2016) (quoting Tormasi v. Hayman, 452 Fed. Appx. 203, 206

(3d Cir. 2011)) (quoting Borelli v. Askey, 582 F. Supp. 512, 513 (E.D. Pa. 1984)), report and recommendation adopted,

2016 WL 3227250 (M.D. Pa. June 13, 2016).

judgment his behavior will not violate a prisoner’s constitutional rights.”)). “Therefore, where a

dispute in essence entails nothing more than a disagreement between an inmate and doctors over

alternate treatment plans, the inmate’s complaint will fail as a constitutional claim under § 1983.”

Tillery, 2018 WL 3521212, at *5 (citing Gause v. Diguglielmo, 339 Fed. Appx. 132 (3d Cir. 2009)

(characterizing a dispute over pain medication as the type of “disagreement over the exact contours

of [plaintiff’s] medical treatment” that does not violate the constitution)).

Similarly, “the mere misdiagnosis of a condition or medical need, or negligent treatment

provided for a condition, is not actionable as an Eighth Amendment claim because medical

malpractice standing alone is not a constitutional violation.” Tillery, 2018 WL 3521212, at *5

(quoting Estelle, 429 U.S. at 106). “Indeed, prison authorities are accorded considerable latitude

in the diagnosis and treatment of prisoners.” Durmer, 991 F.2d at 67 (citations omitted). Thus,

“courts have consistently rejected Eighth Amendment claims where an inmate has received some

level of medical care.” Hensley v. Collins, 2018 WL 4233021, at *3 (W.D. Pa. Aug. 15, 2018)

(quoting Clark v. Doe, 2000 WL 1522855, at *2 (E.D. Pa. Oct. 13, 2000)). See also Wisniewski v.

Frommer, 751 Fed. Appx. 192, 195-96 (3d Cir. Oct. 3, 2018) (noting that “there is a critical

distinction ‘between cases where the complaint alleges a complete denial of medical care and those

alleging inadequate medical treatment.’”) (quoting Pearson v. Prison Health Serv., 850 F.3d 526,

535 (3d Cir. 2017)).

“Nonetheless, there are circumstances in which some care is provided yet it is insufficient

to satisfy constitutional requirements.” Palakovic v. Wetzel, 854 F.3d 209, 228 (3d Cir. 2017).

These circumstances include, for example, where prison officials, “with deliberate indifference to

the serious medical needs of the inmate, opt for ‘an easier and less efficacious treatment’ of the

inmate's condition.’” Id. (quoting West v. Keve, 571 F.2d 158, 162 (3d Cir. 1978)) (internal citation

omitted). Similarly, prison officials may not deny reasonable requests for medical treatment when

such “denial exposes the inmate ‘to undue suffering or the threat of tangible residual injury,’” Id.

(quoting Monmouth County Corr. Inst. Inmates, 834 F.2d at 346 (internal citation omitted), or

intentionally refuse to provide care where the need for such care is acknowledged. Id. (citing

Ancata v. Prison Health Servs., 769 F.2d 700, 704 (11th Cir. 1985)).

In support of his position that Dr. Caringola’s conduct crossed the line from malpractice to

deliberate indifference, Quigley focuses on her repeated failures to perform or order a peripheral

retinal examination when presented with Quigley’s progressively deteriorating vision and other

symptoms. Courts have recognized that a plaintiff states a deliberate indifference claim where he

“alleges that a treatment decision about known symptoms ‘was a substantial departure from

accepted professional judgment, practice, or standards’ such that a reasonable jury could conclude

that she ‘actually did not base [her] decision on such judgment.’” Manna v. Harper, 2024 WL

5431555, at *9 (W.D. Pa. Aug. 12, 2024) (quoting Pearson v. Prison Health Serv., 850 F.3d 526,

538–39 (3d Cir. 2017)). Quigley argues that this failure so materially departed from the

professional standard of care for Quigley’s condition that a jury could reasonably conclude that

she did not rely upon her medical judgment. Quigley further asserts that the facts alleged supports

an inference that Dr. Caringola recognized his need for prompt follow-up care, including a

peripheral retinal examination, but permitted an unreasonable delay in that care. The Court agrees

that, at this stage of the case, Quigley’s allegations are sufficient to support an Eighth Amendment

claim against Dr. Caringola.

The Court reaches the same conclusion with respect to the claim against Dr. Hartzell. Dr.

Hartzell evaluated Quigley at the on-site retinal clinic on April 5, 2023; he noted that Quigley’s

vision in his left eye had decreased materially from 20/25 to 20/70 since his evaluation on

February 16, 2023, less than two months earlier. Rather than order a peripheral retina examination,

Dr. Hartzell merely directed that Quigley “reconsult” as needed. Quigley further faults Dr.

Hartzell with failing to follow up on this already inadequate treatment plan. As with the allegations

against Dr. Caringola, those against Dr. Hartzell sufficiently support an Eighth Amendment claim.

V. Conclusion

For the foregoing reasons, the motions to dismiss filed by Dr. Caringola (ECF No. 32) and

Dr. Hartzell (ECF No. 30) will be denied. A separate order follows.

DATED this 25th day of July, 2025.

BY THE COURT:

__________________________________________

RICHARD A. LANZILLO

CHIEF UNITED STATES MAGISTRATE JUDGE