Daniels

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF NEW YORK

ROBERT DANIELS,

Plaintiff, 9:23-cv-983

(ECC/CBF)

v.

PRITI MANDALAYWALA,

Defendant.

TODD BRIGLIN,

Plaintiff, 9:23-cv-1001

(ECC/CBF)

v.

GERALD CAHILL,

Defendant.

Amy J. Agnew, Esq., for Plaintiffs

Oriana L. Kiley, Esq., for Defendants

Hon. Elizabeth C. Coombe, United States District Judge:

MEMORANDUM-DECISION AND ORDER

I. INTRODUCTION

The Plaintiffs in the above-captioned, related actions allege deliberate indifference to their

medical needs while in the custody of the Department of Corrections and Community Supervision

(DOCCS), in violation of the Eighth Amendment under 42 U.S.C. §1983. Presently before the

Court are the Defendants’ respective motions for summary judgment, pursuant to Rule 56 of the

Federal Rules of Civil Procedure. Daniels v. Mandalaywala (Daniels), Case No. 9:23-cv-983

(N.D.N.Y.) at Dkt. No. 56; Briglin v. Dinello (Briglin), Case No. 9:23-cv-1001 (N.D.N.Y.) at Dkt.

No. 75. Defendants in both actions have also requested the Court preclude the opinion and

testimony of the Plaintiffs’ expert. Id. The motions are fully briefed. Daniels at Dkt. Nos. 63, 64,

66, 68, 69, 70, 71, 72, 75; Briglin at Dkt. Nos. 76, 77, 78, 87, 88, 90, 93. For the reasons that

follow, the Daniels motion for summary judgment is granted in part and denied in part, the Briglin

motion for summary judgment is denied, and the motions to preclude the opinion and testimony

of Dr. Carinci are denied without prejudice to renew as a motion in limine.

II. BACKGROUND

A. The MWAP Policy1

In 2017, DOCCS adopted the Medications with Abuse Potential (MWAP) Policy. The

MWAP Policy regulated the prescription of certain medications that were deemed to carry a risk

of abuse or dependence. Under the MWAP Policy, primary care providers in DOCCS facilities

seeking to prescribe a designated medication had to complete and submit a request form to a

Regional Medical Director (RMD) for approval. As relevant to these related actions, medication

that required RMD approval under the MWAP Policy included Neurontin, known by its generic

name Gabapentin, and Lyrica, known by its generic name Pregabalin. Defendants, in their roles

as DOCCS physicians, were obligated to follow the MWAP Policy.

In February 2021, DOCCS rescinded the MWAP Policy and adopted Health Services

Policy 1.24(A). Policy 1.24(A) reformed DOCCS’s process for prescribing pain management

medication and eliminated the RMD’s prior role entirely.

1 The facts contained in this section giving context to the MWAP Policy are undisputed by the

parties, and are taken from the Statement of Material Facts, and responses thereto, in each of the

related actions. See Daniels at Dkt. No. 64 ¶¶ 1, 3, 4-7, 9, 20-22; Briglin at Dkt. No. 87 ¶¶ 100-

103.

B. MWAP Policy Class Action Litigation

The MWAP Policy has since been subject to class-action litigation brought by several

named DOCCS inmates on behalf of a class of individuals in DOCCS custody whose medications

were denied or discontinued pursuant to the policy. See Allen v. Koenigsmann, No. 19-cv-8173,

2023 WL 2731733 (S.D.N.Y. Mar. 31, 2023). Plaintiffs in the class action asserted deliberate

indifference to medical needs claims pursuant to 42 U.S.C. § 1983. Ultimately, the Allen plaintiffs

were granted a permanent injunction enjoining implementation of the MWAP Policy and awarded

attorneys’ fees. Allen v. Koenigsmann, 700 F. Supp. 3d 110, 145 (S.D.N.Y. 2023). The permanent

injunction, among other things, required DOCCS to complete an “individualized assessment” of

incarcerated individuals who suffer from chronic pain and were denied or discontinued from

medication pursuant to the MWAP Policy. Allen, No. 19-cv-8173 (S.D.N.Y.), Dkt. No. 813 at 12-

14.

The Allen Court denied the plaintiffs’ motion to certify a class to pursue damages for

liability. Allen, 2023 WL 2731733, at *6. Thus, various plaintiffs have since filed individual suits

for damages against DOCCS employees alleging violations of § 1983 based on deliberate

indifference to their serious medical needs.

III. STANDARD OF REVIEW

Under Rule 56(a), summary judgment may be granted only if all the submissions taken

together “show that there is no genuine issue as to any material fact and that the moving party is

entitled to judgment as a matter of law.” Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986); see

also Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247–48 (1986). The moving party bears the

initial burden of demonstrating “the absence of a genuine issue of material fact.” Celotex, 477 U.S.

at 323. A fact is “material” if it “might affect the outcome of the suit under the governing law,”

and is genuinely in dispute “if the evidence is such that a reasonable jury could return a verdict for

the nonmoving party.” Anderson, 477 U.S. at 248; see also Jeffreys v. City of New York, 426 F.3d

549, 553 (2d Cir. 2005) (citing Anderson). The movant may meet this burden by showing that the

nonmoving party has “fail[ed] to make a showing sufficient to establish the existence of an element

essential to that party’s case, and on which that party will bear the burden of proof at trial.” Celotex,

477 U.S. at 322; see also Selevan v. N.Y. Thruway Auth., 711 F.3d 253, 256 (2d Cir. 2013)

(explaining that summary judgment is appropriate where the nonmoving party fails to “‘come forth

with evidence sufficient to permit a reasonable juror to return a verdict in his or her favor on’ an

essential element of a claim” (quoting In re Omnicom Grp., Inc. Sec. Litig., 597 F.3d 501, 509 (2d

Cir. 2010))).

If the moving party meets this burden, the nonmoving party must “set out specific facts

showing a genuine issue for trial.” Anderson, 477 U.S. at 248, 250; see also Celotex, 477 U.S. at

323–24; Wright v. Goord, 554 F.3d 255, 266 (2d Cir. 2009). “When ruling on a summary judgment

motion, the district court must construe the facts in the light most favorable to the non-moving

party and must resolve all ambiguities and draw all reasonable inferences against the movant.”

Dallas Aerospace, Inc. v. CIS Air Corp., 352 F.3d 775, 780 (2d Cir. 2003). Still, the nonmoving

party “must do more than simply show that there is some metaphysical doubt as to the material

facts,” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986), and cannot

rely on “mere speculation or conjecture as to the true nature of the facts to overcome a motion for

summary judgment,” Knight v. U.S. Fire Ins. Co., 804 F.2d 9, 12 (2d Cir. 1986) (quoting Quarles

v. Gen. Motors Corp., 758 F.2d 839, 840 (2d Cir. 1985)). Furthermore, “[m]ere conclusory

allegations or denials . . . cannot by themselves create a genuine issue of material fact where none

would otherwise exist.” Hicks v. Baines, 593 F.3d 159, 166 (2d Cir. 2010) (quoting Fletcher v.

Atex, Inc., 68 F.3d 1451, 1456 (2d Cir. 1995)).

IV. APPLICABLE LAW

A. Personal Involvement

It is well-settled that, to establish a defendant’s individual liability in a suit brought under

Section 1983, a plaintiff must show “the defendant’s personal involvement in the alleged

constitutional deprivation.” Grullon v. City of New Haven, 720 F.3d 133, 138 (2d Cir. 2013)

(citations omitted). A plaintiff must “allege a tangible connection between the acts of a defendant

and the injuries suffered.” Bass v. Jackson, 790 F.2d 260, 263 (2d Cir. 1986). There is “no special

rule for supervisory liability,” and “a plaintiff must plead and prove ‘that each Government-official

defendant, through the official’s own individual actions, has violated the Constitution.’” Tangreti

v. Bachmann, 983 F.3d 609, 618 (2d Cir. 2020) (quoting Ashcroft v. Iqbal, 556 U.S. 662, 676

(2009)). The Second Circuit has explained that “[t]he factors necessary to establish a [§ 1983]

violation will vary with the constitutional provision at issue because the elements of different

constitutional violations vary,” and “[t]he violation must be established against the supervisory

official directly.” Id. (second alteration in original) (internal quotations and citations omitted).

B. Deliberate Indifference

The Eighth Amendment explicitly prohibits the infliction of “cruel and unusual

punishment.” U.S. Const. amend. VIII. This prohibition encompasses the provision of medical

care involving “the unnecessary and wanton infliction of pain.” Hathaway v. Coughlin, 37 F.3d

63, 66 (2d Cir. 1994) (citations omitted). However, not “every injury” a prisoner suffers “translates

into constitutional liability for prison officials.” Farmer v. Brennan, 511 U.S. 825, 834 (1994). In

order to establish an Eighth Amendment claim for medical indifference, a plaintiff must allege that

the defendant was deliberately indifferent to a serious medical need. See id. This standard requires

proof of both an objective and subjective element.

1. Objective Element

There is a two-part inquiry to determine whether an alleged deprivation is “objectively

serious.” Benjamin v. Pillai, 794 F. App’x 8, 11 (2d Cir. 2019) (citing Salahuddin v. Goord, 467

F.3d 263, 279-80 (2d Cir. 2006)). The first question is whether the plaintiff was actually deprived

of adequate medical care. Id. Prison officials who act “reasonably” in response to an inmate-

health risk will not be found liable under the Eighth Amendment because the official’s duty is only

to provide “reasonable care.” Salahuddin, 467 F.3d at 279-80 (citing Farmer, 511 U.S. at 844-47).

The second part of the objective test asks whether the purported inadequacy in the medical

care is “sufficiently serious.” Benjamin, 794 F. App’x at 11 (citing Salahuddin, 467 F.3d at 280).

The court must examine how the care was inadequate and what harm the inadequacy caused or

will likely cause the plaintiff. Salahuddin, 467 F.3d at 280 (citing Helling v. McKinney, 509 U.S.

25, 32-33 (1993)). If the “unreasonable care” consists of a failure to provide any treatment, then

the court examines whether the inmate’s condition itself is “sufficiently serious.” Id. (citing Smith,

316 F.3d at 185-86). However, in cases where the inadequacy is in the medical treatment that was

actually afforded to the inmate, the inquiry is narrower. Id. If the issue is an unreasonable delay

or interruption of ongoing treatment, then the “seriousness” inquiry focuses on the challenged

delay itself, rather than on the underlying condition alone. Benjamin, 794 F. App’x at 11. The

court in Benjamin reiterated that although courts speak of a “serious medical condition” as the

basis for a constitutional claim, the seriousness of the condition is only one factor in determining

whether the deprivation of adequate medical care is sufficiently serious to establish constitutional

liability. Id. (citing Smith, 316 F.3d at 185).

2. Subjective Element

The second element is subjective and asks whether the official acted with “a sufficiently

culpable state of mind.” Benjamin, 794 F. App’x at 11 (citing Hathaway v. Coughlin, 511 U.S.

825, 553 (2d Cir. 1996)). In order to meet the second element, plaintiff must demonstrate more

than a “negligent” failure to provide adequate medical care. Salahuddin, 467 F.3d at 280 (citing

Farmer, 511 U.S. at 835-37). Instead, plaintiff must show that the defendant was “deliberately

indifferent” to that serious medical condition, that the charged official possessed “‘a state of mind

that is the equivalent of criminal recklessness.’” Benjamin, 794 F. App’x at 11 (quoting Hathaway,

99 F.3d at 553).

In order to rise to the level of deliberate indifference, the defendant must have known of

and disregarded an excessive risk to the inmate’s health or safety. Abreu v. Lipka, 778 F. App’x

28, 32 (2d Cir. 2019) (quoting Smith, 316 F.3d at 184). The defendant must both be aware of the

facts from which the inference could be drawn that a substantial risk of serious harm exists, and

he or she must draw that inference. Chance v. Armstrong, 143 F.3d 698, 702 (2d Cir. 1998)

(quoting Farmer, 511 U.S. at 837). The defendant must be subjectively aware that his or her

conduct creates the risk; however, the defendant may introduce proof that he or she knew the

underlying facts, but believed that the risk to which the facts gave rise was “insubstantial or non-

existent.” Farmer, 511 U.S. at 844. The court stated in Salahuddin that the defendant’s belief that

his conduct posed no risk of serious harm “need not be sound so long as it is sincere,” and “even

if objectively unreasonable, a defendant’s mental state may be nonculpable.” Salahuddin, 467 F.3d

at 281.

Additionally, a plaintiff’s disagreement with prescribed treatment does not rise to the level

of a constitutional claim. Riddick v. Maurer, 730 F. App’x 34, 38 (2d Cir. 2018) (quoting Chance,

143 F.3d at 703). Prison officials have broad discretion in determining the nature and character of

medical treatment afforded to inmates. Sonds v. St. Barnabas Hosp. Correctional Health Services,

151 F. Supp. 2d 303, 311 (S.D.N.Y. 2001) (citations omitted). An inmate does not have the right

to treatment of his choice. Dean v. Coughlin, 804 F.2d 207, 215 (2d Cir. 1986). Because plaintiff

might have preferred an alternative treatment or believes that he did not get the medical attention

he desired does not rise to the level of a constitutional violation. Id.

C. Qualified Immunity

“Qualified immunity shields federal and state officials from money damages unless a

plaintiff pleads facts showing (1) that the official violated a statutory or constitutional right, and

(2) that the right was ‘clearly established’ at the time of the challenged conduct.” Ashcroft v. al-

Kidd, 563 U.S. 731, 735 (2011). “Even if an officer violated a plaintiff’s clearly established rights,

he ‘will still be entitled to qualified immunity if it was objectively reasonable for him to believe

that his acts did not violate those rights.’” Clark v. Valletta, 157 F.4th 201, 209 (2d Cir. 2025)

(quoting Outlaw v. City of Hartford, 884 F.3d 351, 367 (2d Cir. 2018)). “These protections

‘balance[ ] two important interests—the need to hold public officials accountable when they

exercise power irresponsibly and the need to shield officials from harassment, distraction, and

liability when they perform their duties reasonably.’” Id. (quoting Pearson v. Callahan, 555 U.S.

223, 231 (2009)).

“A Government official’s conduct violates clearly established law when, at the time of the

challenged conduct, the contours of a right are sufficiently clear that every reasonable official

would have understood that what he is doing violates that right.” al-Kidd, 563 U.S. at 741 (cleaned

up). “The Supreme Court has repeatedly told courts not to define clearly established law at a high

level of generality, instead emphasizing that clearly established law must be particularized to the

facts of the case.” Clark, 157 F.4th at 209 (citing Francis v. Fiacco, 942 F.3d 126, 146 (2d Cir.

2019)). “We do not require a case directly on point, but existing precedent must have placed the

statutory or constitutional question beyond debate.” Taylor v. Barkes, 575 U.S. 822, 825 (2015)

(quotation marks omitted). In the context of deliberate indifference in violation of the Eighth

Amendment, assertions of qualified immunity “are not analyzed body-part by body-part” or with

“specificity as to the site and cause of pain[.]” Collymore v. Myers, 74 F.4th 22, 30 (2d Cir. 2023).

However, “the clearly established right must be defined with specificity,” and the “dispositive

question is whether the violative nature of particular conduct is clearly established.” Vega v.

Semple, 963 F.3d 259, 275 (2d Cir. 2020) (emphasis in original) (internal quotations and citations

omitted). The Court must therefore undertake this inquiry “in light of the specific context of the

case, not as a broad general proposition.” Id.

V. DISCUSSION

A. Plaintiff Robert Daniels2

1. Facts3

Daniels was an incarcerated individual housed at Franklin Correctional Facility (Franklin

C.F.) from 2019 through his release from DOCCS custody in 2022. Dkt. No. 64 ¶¶ 67, 319.

Daniels suffers from numerous chronic ailments, including Type II diabetes, diabetic neuropathy,

radiating back pain, and a prior “crush injury” of the right forearm with hand pain. Id. at ¶ 26. He

was also diagnosed with gout. Id. at ¶ 41. Daniels was prescribed Gabapentin after he suffered

from a back injury in approximately 2012. Id. at ¶ 27. Daniels injured his right extremity in 2019,

before entering DOCCS custody, when his right hand was caught in a cell door. Id. at ¶¶ 29-32.

2 All references to docket entries in this section refer to those filed in Daniels v. Mandalaywala,

Case No. 9:23-cv-983 (N.D.N.Y), unless otherwise noted.

3 The facts are drawn from the parties’ submissions, including Dr. Mandalaywala’s Statement of

Material Facts, Dkt. No. 56-1, and Daniels’ response to that statement, Dkt. No. 64, to the extent

those facts are well-supported by pinpoint citations to the record and the exhibits the parties have

submitted. Disputed facts are noted. The facts are construed in the light most favorable to Daniels

as the non-moving party. Gilles v. Repicky, 511 F.3d 239, 243 (2d Cir. 2007).

In October 2019, before his transfer into DOCCS’s custody, Daniels’ prescribed

medications included Tylenol #3 and Gabapentin. Dkt. No. 64 ¶ 40. On October 17, 2019, Daniels

was transferred into DOCCS custody at Downstate Correctional Facility (Downstate C.F.) and was

admitted to the infirmary. Id. at ¶ 42. He underwent a full medical examination, and his

prescriptions for Tylenol #3 and Gabapentin were continued. Id. at ¶¶ 43-44. Approval under the

MWAP Policy was not necessary, because Downstate C.F. was a reception center. Id. at ¶ 45.

The parties dispute to what extent the Tylenol #3 and Gabapentin controlled Daniels’ pain while

he was at Downstate C.F. Dkt. Nos. 56-1 ¶¶ 46-57, 64 ¶¶46-57.

Daniels was transferred to Franklin C.F. on October 29, 2019, and admitted to the infirmary

upon arrival. Dkt. No. 64 ¶ 67. At some point, his prescriptions for Gabapentin and Tylenol #3

were discontinued. Id. at ¶ 69; Dkt. No. 57-2 at 106. The parties dispute whether Daniels’

prescriptions were discontinued by RN Kimberly Clark or by Defendant Dr. Mandalaywala. Dkt.

Nos. 56-1 ¶ 69; 64 ¶ 69.

Dr. Mandalaywala’s first encounter with Daniels occurred on October 30, 2019, the day

after he arrived at Franklin C.F. Dkt. No. 64 ¶ 70. Dr. Mandalaywala reviewed Daniels’ medical

records and submitted a request to prescribe Gabapentin, pursuant to the MWAP Policy. Id. at ¶

71. The request was denied by Dr. David Dinello, an RMD. Id. at ¶ 73. The parties dispute to

what extent Dr. Mandalaywala could challenge, appeal or otherwise dispute an RMD’s denial of

a request to prescribe medication under the MWAP Policy. Dkt. Nos. 56-1 ¶¶ 8, 11, 12, 13, 16;

64 ¶¶ 8, 11, 12, 13, 16. Dr. Mandalaywala contends that after Dr. Dinello denied her request, she

treated Daniels “with a trial-and-error approach” featuring “various medications and treatment

regimens which, in her medical judgment, were reasonable and efficacious.” Dkt. No. 56-1 ¶¶ 84-

86. Daniels contends that the efforts taken by Dr. Mandalaywala as alternative treatments for his

neuropathy and radiculopathy were deficient. Dkt. No. 64 ¶¶ 84-86. Specifically, Dr.

Mandalaywala submitted an order to begin Daniels on Lamictal. Dkt. No. 64 ¶¶ 87-88. She also

prescribed Daniels insulin for his diabetes and diabetic neuropathy, and Prednisone for his gout.

Id. at ¶¶ 94-96, 100. In addition, Dr. Mandalaywala ordered Daniels a wheelchair. Id. at ¶ 98.

Daniels received a wheelchair on November 1, 2019, and was discharged from the

infirmary to the general population at Franklin C.F. Dkt. No. 64 ¶ 106. At times during the

following twelve months, Daniels complained of and was treated for a variety of medical ailments,

including ongoing neuropathy and radiculopathy pain, both by Dr. Mandalaywala and other

medical providers. On February 20, 2020, Dr. Mandalaywala referred Daniels for an emergency

telemedical appointment to address Daniels’ complaints of “right arm pain and prickling” after

recent surgery on his right arm. Id. at ¶ 131-34. The examining physician made a note to the

providers at Franklin C.F. to “[c]onsider adding gabapentin to pain regimen[.]” Id. at ¶ 136. In

May 2020, Dr. Mandalaywala prescribed Glizpizide and Januvia to treat Daniels’ high blood sugar.

Dkt. No. 64 ¶¶ 175-76. She also referred Daniels to occupational therapy to address his hand pain

following surgery. Dkt. No. 64 ¶¶ 178-79.

The record reflects that, for reasons and to a degree subject to some dispute among the

parties, Daniels was not always compliant with his medical regimen, at times refusing to attend

appointments and take medication. Dkt. Nos. 56-2 ¶¶ 160-61, 165, 166, 173-74, 195, 213, 224-

26; 64 ¶¶ 160-61, 165, 166, 173-74, 195, 213, 224-26. In June 2020, Dr. Mandalaywala prescribed

Daniels Depakote, after noting his “diabetic peripheral neuropathy” and prior refusal of Lamictal.

Dkt. No. 64 ¶ 187. Dr. Mandalaywala also approved the reinstatement of Daniels’ special diet

request in August 2020 after it was discontinued, “with the hope that he would abide by it and that

it would alleviate his overall pain condition.” Id. at ¶ 198.

In August 2020, Dr. Mandalaywala referred Daniels for a follow-up appointment with his

hand-surgeon, and pursued a recommendation that Daniels undergo an electromyogram

(EMG)/nerve conduction study. Dkt. No. 64 ¶¶ 199, 206. Daniels refused to attend the

EMG/nerve conduction study due to swelling in his feet and legs, and his high pain levels. Id. at

¶ 209; Dkt. No. 57-2 at 303. Daniels complained of bilateral leg swelling to Dr. Mandalaywala on

September 30, 2020, and expressed an unwillingness to continue on Depakote. Dkt. No. 64 ¶¶

210, 216. Dr. Mandalaywala prescribed Daniels Elavil to treat his pain. Id. at ¶¶ 216-17. The

same day, Dr. Mandalaywala referred Daniels for a Nephrology evaluation. Id. at ¶ 221; Dkt. No.

69-9 at 20. Soon after, Daniels refused his Elavil prescription because it made him drowsy, and

requested to stop taking it. Dkt. No. 64 ¶ 223-24.

Daniels was seen by Dr. Mandalaywala on October 26, 2020. Dr. Mandalaywala contends

that Daniels was seen for a “sick call” for wrist pain. Dkt. Nos. 56-1 ¶ 227; 57-3 at 7. Daniels

maintains that he was seen by Dr. Mandalaywala to receive his reassessment as ordered pursuant

to the class-action litigation over the MWAP Policy. Dkt. Nos. 64 ¶ 227; 66-16. Dr.

Mandalaywala submitted a second request form to prescribe Gabapentin that day. Dkt. No. 64 ¶

235. The request was approved on October 27th, the following day. Id. at ¶ 236.

2. Summary Judgment Analysis

i. Personal Involvement

Dr. Mandalaywala argues that Daniels cannot establish her personal involvement in the

challenged deprivation of care. Dkt. No. 56-2 at 12-14. Specifically, Dr. Mandalaywala argues

that (1) she did not discontinue Daniels’ medications; (2) she was Daniels’ only treating provider

to submit requests to prescribe Gabapentin; and (3) Daniels’ claim is actually against Dr. Medved,

a different medical provider initially identified by Daniels. In response, Daniels contends that

there is ample evidence of record establishing Dr. Mandalaywala’s personal involvement in the

alleged violation, and that any questions of fact in this regard should be left to the jury. Dkt. No.

72 at 32-33.

Daniels has raised a genuine dispute of material fact as to Dr. Mandalaywala’s personal

involvement in the alleged deliberate indifference, for purposes of defeating summary judgment.

As an initial matter, a reasonable juror could conclude that Dr. Mandalaywala discontinued

Daniel’s prescriptions upon intake to Franklin C.F. Dr. Mandalaywala does not deny that she

discontinued the prescriptions for purposes of this motion, nor does she deny that the notations to

“DC” medications appearing in the margin of RN Clark’s form are hers.4 Instead, Dr.

Mandalaywala relies on Daniels’ allegation in the initial complaint as a concession that the

medication was discontinued by RN Clark. See Dkt. No. 12 ¶ 327. Daniels, however, has

submitted evidence including medical records and the testimony of former DOCCS medical

personnel, suggesting that nurses did not have the authority to discontinue medication, and that

Dr. Mandalaywala discontinued the Gabapentin and Tylenol #3 in conjunction with her

examination of Daniels on October 30, 2019. Dkt. Nos. 66-6 at 54-55; 68-4 at 8, 14.

Dr. Mandalaywala’s argument that Daniels has confused her with Dr. Medved is also

unpersuasive. As explained below, the narrow issue surviving Dr. Mandalaywala’s motion for

summary judgment in this action is whether she was deliberately indifferent to Daniels’ serious

medical condition by failing to pursue a prescription for Gabapentin for approximately twelve

months after the initial denial. Notwithstanding Daniels’ initial confusion over the identity of Dr.

Mandalaywala and Dr. Medved, the medical evidence of record viewed in the light most favorable

to Daniels establishes that Dr. Mandalaywala examined Daniels the day after his intake into

4 Dr. Mandalaywala concedes that she “made additional notes” in the “bottom right-hand corner”

of RN Clark’s form, but declines to confirm or deny whether the “DC” notations in the margin are

hers. Dkt. No. 57 ¶ 62.

Franklin C.F., discontinued his Gabapentin pursuant to the MWAP Policy, and immediately

submitted a request to prescribe Gabapentin, which was denied. Dr. Mandalaywala also

subsequently treated Daniels on various occasions, including for chronic pain, neuropathy and

radiculopathy. It is also undisputed that she submitted a second request to prescribe Gabapentin

approximately twelve months later, which Daniels contends was submitted only after the scrutiny

and lawsuit surrounding the MWAP Policy. On these facts, Daniels has raised a genuine dispute

sufficient to overcome summary judgment for lack of personal involvement.

Finally, to the extent Dr. Mandalaywala argues that she was not personally involved in any

deliberate indifference because she was the only provider to request a prescription for Gabapentin,

her conduct surrounding these requests are the crux of Daniels’ claim. Thus, to the extent Dr.

Mandalaywala concedes her involvement, summary judgment is not appropriate on this basis for

lack of personal involvement.

ii. Objective Prong

Dr. Mandalaywala argues that Daniels cannot demonstrate that she objectively deprived

him of adequate medical care in a manner that exposed Daniels to a substantial risk of harm or

serious adverse consequence. Dkt. No. 56-2 at 14-23. Specifically, Dr. Mandalaywala contends

that Daniels has not established that the treating provider’s various medical regimens constituted

a deprivation of reasonable care, nor has he established that any alleged inadequacy caused or was

likely to cause him harm. Id. Daniels argues that he has met the objective prong for purposes of

summary judgment, to the extent that the receipt of “extensive” medical care does not preclude a

claim for deliberate indifference if the “gravamen of Plaintiff’s problem is not addressed.” Dkt.

No. 72 at 35-36.

With respect to Dr. Mandalaywala’s alleged failure to pursue a prescription for Gabapentin

after the denial of her initial request, Daniels has raised a genuine dispute of material fact

sufficiently serious to satisfy the objective prong of the deliberate indifference standard. In Allen

v. Mueller, one of several damages action commenced by a class-action member, the court

grappled with nearly identical facts. No. 23-cv-5651, 2024 WL 3090141 (S.D.N.Y. June 21,

2024). Similar to Daniels, Allen had been prescribed Neurontin to treat his chronic pain prior to

the MWAP Policy implementation in June 2017. Id. at *2-3. After implementation, the defendant-

medical provider submitted a request under the MWAP Policy to prescribe Neurontin to Allen,

and that request was denied by the RMD. Id. at *3-5. The defendant-medical provider thereafter

weaned Allen off Neurontin and pursued alternative courses of treatment for Allen’s pain,

including alternative medication not covered by the MWAP Policy. Id. at *4. Allen complained

several times about the pain he was experiencing as he was weaned off Neurontin and after. Id. at

5.

In determining whether Allen could show a deprivation of care sufficiently serious to

satisfy the objective prong, the court considered the defendant-medical provider’s argument that

she had provided Allen with “numerous other prescriptions and accommodations” to treat his pain

for purposes of providing adequate care under the Eighth Amendment. 2024 WL 3090141, at *10.

The court, however, concluded that this argument “misses the mark.” Id. The court went on to

reason:

Even though [the defendant-medical provider] may have provided [Allen]

numerous treatment alternatives to Neurontin and Lyrica, such alternative care may

still have deprived Plaintiff of adequate care by creating “particular risks” that he

would suffer “chronic and substantial pain” without the requested medication.

Because the decision to provide Plaintiff these alternative treatments – rather than

Neurontin and Lyrica – gave rise to a risk that Plaintiff would suffer chronic pain

to a greater degree than he would have on those medications, the alleged

deprivation of care is sufficiently serious under the objective prong of the Eighth

Amendment inquiry.

Id. (internal citations omitted).

This Court reaches the same conclusion with respect to Daniels’ ability to establish the

objective prong of the deliberate indifference inquiry. Viewing the evidence in the light most

favorable to the non-moving party, Daniels suffered serious, chronic pain issues and the

Gabapentin had, to a disputed-degree, helped alleviate that pain and assisted in his mobility. To

the extent Dr. Mandalaywala initially sought to continue Daniels’ Gabapentin regimen to address

his chronic pain, she arguably observed some benefit to maintaining him on this medication. Thus,

a reasonable jury could conclude that the decision to provide Daniels alternative treatments to

Gabapentin created particular risks that he would suffer chronic and substantial pain without the

requested medication, and deprived him of adequate care. Accordingly, summary judgment is not

warranted on this basis.

iii. Subjective Prong

Dr. Mandalaywala argues that Daniels cannot establish that she acted with criminal

recklessness when she provided “innumerable treatments” to him “in a trial and error approach”

to treat his complaints of pain. Dkt. No. 56-2 at 23-32. Daniels contends that there remain

questions of fact about Dr. Mandalaywala’s state of mind, rendering summary judgment improper.

Dkt. No. 72 at 37-38.

The parties agree that in order to establish liability for deliberate indifference Daniels

would have to prove that in failing to pursue a prescription for Gabapentin, Dr. Mandalaywala

“consciously ch[ose] an easier and less efficacious treatment plan” to address Daniels’ chronic

pain, in disregard to an excessive risk to his health. Wright v. Martin, No. 23-7762, 2025 WL

1091221, at *3 (2d Cir. Apr. 8, 2025) (quoting Chance, 143 F.3d at 703). To the extent Dr.

Mandalaywala argues that there is no evidence she knew Gabapentin was an effective treatment,

a reasonable jury could disagree. Viewing the facts in the light most favorable to Daniels, Dr.

Mandalaywala reviewed Plaintiff’s medical records upon his intake to Franklin C.F., initially

sought a prescription for Gabapentin after determining that it had been an effective medication for

treating Daniel’s chronic pain, and then made a second request to prescribe Gabapentin under

circumstances suggesting it would be easier to obtain.

Dr. Mandalaywala also argues that after her initial request to prescribe Gabapentin pursuant

to the MWAP Policy was denied, she lacked any authority to otherwise provide Gabapentin to

Plaintiff, and thus cannot be found to have consciously chosen an easier and less efficacious

treatment plan. In support of this contention, Dr. Mandalaywala has submitted sworn statements

that she was not permitted to prescribe any MWAP medications without an approval from an

RMD, that she was not aware of any appeal procedure under the MWAP Policy to challenge an

RMD’s denial of a medication, and that she was “not aware of any way in which [she] could obtain

an MWAP medication once an RMD denied an MWAP request.” Dkt. No. 56 ¶¶ 37-40.

In opposition to Defendant’s argument, Daniels has offered evidence of testimony from

former DOCCS medical officials – including the RMD who is alleged to have denied Dr.

Mandalaywala’s request to prescribe Gabapentin – suggesting that the pursuit of a medication

under the MWAP Policy was not categorically precluded upon receipt of the RMD’s initial denial.

Dkt. No. 72 at 37-38. This includes a provider’s ability to submit a new form and/or provide

additional evidence to substantiate the request, call an RMD or write back with additional

information that would support the need for a prescription, or even seek approval directly from the

Chief Medical Officer. Dkt. No. 64 ¶¶ 8, 11, 12. There is also evidence that the RMD who denied

Dr. Mandalaywala’s request “invited informal conversations with treating providers to discuss the

circumstances of a denial of an MWAP request.” Id. at 13. Finally, Daniels contends that “nothing

in the MWAP Policy prohibited a treating provider from submitting another MWAP request that

was previously denied at any time,” in particular in February 2020, when Dr. Mandalaywala

reviewed an emergency physician’s recommendation for adding Gabapentin to Plaintiff’s pain

regiment. Dkt. No. 72 at 38.

As Dr. Mandalaywala points out, it is not enough for a plaintiff to show that a defendant

should have known of the excessive risk to the plaintiff’s health; the standard is subjective and

requires a defendant’s specific knowledge. However, “[w]hether a prison official had the requisite

knowledge of a substantial risk is a question of fact subject to demonstration in the usual ways,

including inference from circumstantial evidence, and a factfinder may conclude that a prison

official knew of a substantial risk from the very fact that the risk was obvious.” Farmer, 511 U.S.

at 842. On this record, a reasonable juror could conclude that there were available alternative

pathways for Dr. Mandalaywala to get approval for the Gabapentin that were obvious or otherwise

must have been known by her, but she disregarded those options. See Vega, 963 F.3d at 273 (“We

have observed that “[e]vidence that a risk was ‘obvious or otherwise must have been known to a

defendant’ may be sufficient for a fact finder to conclude that the defendant was actually aware of

the risk.”). At minimum, Dr. Mandalaywala’s second request for Gabapentin, which she contends

was made after a 12-month trial-and-error approach to addressing Daniels’ pain, evidences

knowledge that she could submit a follow-up request, notwithstanding the RMD’s initial denial.

Accordingly, summary judgment is not warranted on this basis.

For the sake of clarity, Daniels has not established a genuine dispute of material fact, and

is not entitled to a jury trial, with respect to aspects of Dr. Mandalaywala’s treatment not related

to her failure to pursue a prescription for Gabapentin. Specifically, no reasonable jury could

conclude on this record that Dr. Mandalaywala deprived Daniels of adequate medical care by

discontinuing and/or failing to represcribe his prescription for Tylenol #3 in deliberate indifference

to his medical needs. Daniels concedes that he was initially prescribed Tylenol #3 prior to his

intake at Franklin C.F., “to treat the pain from his hand crush injury.” Dkt. No. 64 ¶¶ 55, 57. It

is undisputed that Dr. Mandalaywala did not submit a request to continue Daniels’ Tylenol #3

under the MWAP Policy, but instead determined that Ibuprofen and Tylenol were appropriate

alternatives to treat Daniels’ hand pain, and that they were safer options because they have less

serious side effects. Id. ¶¶ 102-05. On these undisputed facts, any disagreement Daniels has with

Dr. Mandalaywala’s determination not to prescribe Tylenol # 3 is not actionable under the Eighth

Amendment. See Washington v. Westchester Cty. Dep’t of Corr., No. 13 Civ. 5322, 2014 WL

1778410, at *6 (S.D.N.Y. Apr. 25, 2014) (“The law is clear that the medication a doctor selects to

treat the patient’s conditions is a medical judgment and does not rise to the level of deliberate

indifference.”); Adams v. Smith, No. 9:15-cv-913 (BKS/DJS), 2018 WL 1363495, at *4 (N.D.N.Y.

Mar. 16, 2018) (“Courts have repeatedly rejected medical indifference claims based upon a failure

to provide stronger pain medication.”) (collecting cases). Daniels concedes that he “makes no

claim for the discontinuation of Tylenol #3, as it was not administered to treat his neuropathy.”

Dkt. No. 64 ¶ 49. Accordingly, Dr. Mandalaywala’s motion for summary judgment is granted as

to any claim of of deliberate indifference concerning the discontinuation of Tylenol #3.

iv. Qualified Immunity

Dr. Mandalaywala argues that she is entitled to qualified immunity because Daniels’ rights

were not clearly established at the time of the alleged violation, and even if they were her conduct

was objectively reasonable. Dkt. No. 56-2 at 33-37. Daniels contends that, when considering the

relevant right, disputed facts preclude a finding of qualified immunity at this juncture. Dkt. No.

72 at 39.

The parties dispute the particular right clearly established by law as applicable to this case.

As the Allen court cogently explained, the particular right at issue here is “the right to be free from

a physician’s deliberate indifference to his medical needs through ‘consciously choos[ing] an

easier and less efficacious treatment plan.’” 2024 WL 3090141 at *17 (citing Chance, 143 F.3d

at 703). “The Court of Appeals not only articulated this right in Chance v. Armstrong but

reaffirmed in Brock that it is a right protected by the Eighth Amendment.” Id. (citing Brock, 315

F.3d at 167). Because there remains a genuine dispute of material fact as to whether Dr.

Mandalaywala consciously chose an easier, less efficacious treatment plan subsequent to the

RMD’s denial of her request to prescribe Gabapentin, the Court cannot conclude as a matter of

law that she did not violate a clearly established right. These factual disputes also preclude a

finding that Dr. Mandalaywala’s conduct was objectively reasonable as a matter of law. Viewing

the facts in the light most favorable to Daniels, a reasonable juror could conclude that Dr.

Mandalaywala’s failure to resubmit, or otherwise pursue, the request for Gabapentin until twelve

months later was not objectively reasonable. Accordingly, summary judgment is not warranted

on this basis.

3. Daubert Motion

Dr. Mandalaywala seeks to preclude the report and testimony of Daniels’ expert, Dr. Adam

Carinci. Dkt. No. 56-2 at 37-41. Dr. Mandalaywala contends that Dr. Carinci’s opinion is

“irrelevant, unreliable, and presents a real risk of prejudice because he was not provided with key

evidence in forming his opinions . . . and he never opined on the specific actions undertaken by

[Dr. Mandalaywala] in this case.” Id. Dr. Mandalaywala further takes issue with the lack of

reference to Dr. Mandalaywala and/or his care of Daniels in Dr. Carinci’s expert report, and

Daniels’ attempts to cure these deficiencies by submitting improper “rebuttal” or “supplemental”

reports rendering opinions specific to Dr. Mandalaywala’s conduct. Id.

Although both Dr. Mandalaywala and Daniels refer to Dr. Carinci in their motion papers,

summary judgment is not warranted on Daniel’s deliberate indifference claim surrounding Dr.

Mandalaywala’s alleged failure to pursue a prescription for Gabapentin due to remaining factual

disputes and irrespective of the admissibility of Dr. Carinci’s opinion. Accordingly, it is not

necessary to reach Dr. Mandalaywala’s request at this juncture. See e.g., Sec. & Exch. Comm’n v.

AT&T, Inc., 626 F. Supp. 3d 703, 741 (S.D.N.Y. 2022) (explaining, “[t]he Court’s assessment of

the lay evidence . . . makes it unnecessary to resolve the Daubert motions at the summary judgment

stage” where there was both “sufficient lay evidence as to each element for the [the plaintiff’s]

claim to reach a jury” and “sufficient lay evidence on which a jury could find for the defendants”

and denying the parties’ motions “without prejudice to either side’s right to move anew under

Daubert should the case approach trial.”); Burdick v. Kurilovitch, No. 5:14-cv-1254 (BKS/TWD),

2017 WL 11500491, at *8 (N.D.N.Y. June 16, 2017) (denying the defendants’ motion to preclude

testimony from plaintiff’s expert witness “without prejudice to renewal prior to trial.”), aff’d, 792

F. App’x 868 (2d Cir. 2019); Doe No. 1 v. Putnam Cnty., No. 7:16-cv-08191, 2020 WL 7027596,

at *9 (S.D.N.Y. Nov. 30, 2020) (“With respect to the NYSOAG’s motion to preclude the expert

testimony and opinions of Dr. English, where a court determines that consideration of an expert’s

testimony in support of or opposition to a motion for summary judgment is unnecessary to the

determination of the summary judgment motion itself, it may deny the motion to preclude without

prejudice.”) (citations omitted).

Accordingly, and to the extent this Court’s decision has clarified the deliberate indifference

claim that will proceed to trial in this action, Dr. Mandalaywala’s motion to preclude expert

testimony and opinion is denied without prejudice to renewal as a motion in limine.

B. Plaintiff Todd Briglin5

1. Facts6

Briglin was an incarcerated individual in DOCCS custody from 2013 to 2015. Dkt. No.

87 ¶¶ 2-3. He was treated for a variety of health issues, including chronic pain, neuropathy,

degenerative disc disease, groin problems, spinal stenosis, sacroiliitis, neuralgia with neuritis,

pudendal nerve entrapment, lumbar disc herniation, and chronic radiculopathy. Id. at ¶¶ 26-27. In

2014, Plaintiff began a prescription for Neurontin. Id. at ¶ 33. Medical records suggest that after

Briglin complained of nausea with increases in his Neurontin dose, his medical provider

discontinued it. Id. at ¶ 39.

In 2015, Briglin was hit by a car. Dkt. No. 87 ¶ 47. In 2016, after his release from DOCCS

custody, Briglin sustained injuries in a slip and fall accident. Id. at ¶ 48. Following these accidents,

Briglin was prescribed several medications for headaches and neuropathic pain, including

Gabapentin. Id. at ¶¶ 49-54. Medical records indicate that Briglin experienced nausea, along with

other side effects, on the Gabapentin. Id. at ¶ 53. It was initially recommended that he continue

taking the Gabapentin at a lower dosage, however Briglin’s prescription was ultimately

discontinued by his pain management physician. Id. at ¶¶ 54-55. Briglin continued to be treated

with alternative medications, including Lyrica, Omeprazole, and Amitriptyline. Id. at ¶¶ 56-58.

He stopped taking Lyrica in approximately 2018, due to insurance coverage issues, and apparently

resumed treatment with Gabapentin. Id. at ¶¶ 67-69. Medical records indicate that the Gabapentin

5 All references to docket entries in this section refer to those filed in Briglin v. Cahill, Case No.

9:23-cv-1001 (N.D.N.Y.), unless otherwise noted.

6 The facts are drawn from the parties’ submissions, including Dr. Cahill’s Statement of Material

Facts, Dkt. No. 75-1, and Briglin’s response to that statement, Dkt. No. 87, to the extent those facts

are well-supported by pinpoint citations to the record and the exhibits the parties have submitted.

Disputed facts are noted. The facts are construed in the light most favorable to Briglin as the non-

moving party. Gilles v. Repicky, 511 F.3d 239, 243 (2d Cir. 2007).

caused nausea and diarrhea. Id. at ¶ 70. Per Briglin’s request, the Gabapentin was discontinued

and he was prescribed Lyrica. Id. at ¶¶ 71-72. Briglin continued to take Lyrica, along with a

regimen of other medications, to address his chronic pain through March 2019. Id. at ¶¶ 74-76.

On March 12, 2019, Briglin was incarcerated at Steuben County Jail. Dkt. No. 87 ¶ 77.

Upon admission, Briglin’s Lyrica prescription was discontinued and he was instead prescribed,

among other things, Gabapentin, Cyclobenzaprine and Amitriptyline for his pain. Id. at ¶ 78. He

was also given a wheelchair, because the jail did not permit canes. Id. at ¶ 79. The Gabapentin

caused Briglin nausea that sometimes interfered with his ability to eat. Id.at ¶ 80.

Briglin was transferred into DOCCS custody at Downstate C.F. on April 26, 2019. Dkt.

No. 87 at ¶ 81. He was immediately admitted to the infirmary for gait impairment associated with

spinal injuries. Id. Briglin’s Gabapentin prescription was continued through May 3, 2019, when

he was transferred to Franklin C.F. and admitted to the infirmary. Id. at ¶¶ 82-89. Briglin’s

Gabapentin prescription was discontinued at that time, by a provider other than Defendant Dr.

Cahill. Id. at ¶¶ 93-95. He was continued on other medications he had been taking for chronic

pain and neuropathy, including Cyclobenzaprine and Amitriptyline. Id. at ¶ 98.

The parties dispute what transpired during Dr. Cahill’s first medical encounter with Briglin

on May 28, 2019. Dkt. No. 87 ¶ 130. According to Dr. Cahill, he reviewed Briglin’s medical

history and medical intake forms prior to the examination, which records demonstrated to him that

Gabapentin was not effective in treating Briglin’s pain. Dkt. No. 75-1 ¶ 116. Dr. Cahill considered

Briglin’s past complaints of pain, even while taking Gabapentin. Id. at ¶¶ 119-20, 125. During

their encounter, Dr. Cahill documented in detail each complaint and request that Briglin made

during the appointment, which did not include a request for any specific medication. Id. at ¶¶ 131-

35. In light of Briglin’s prior complaints of side effects and significant pain while taking

Gabapentin, Dr. Cahill believed in his medical judgment that other medication was a medically

appropriate alternative in treating Briglin’s pain. Id. ¶ 151.

According to Briglin, however, Dr. Cahill did not have access to a significant portion of

his medical records prior to their May 28th encounter. Dkt. No. 87 ¶ 116. On May 15, 2019 – after

his prescriptions were discontinued but before to his May 28th encounter with Dr. Cahill – Briglin

filed a grievance requesting to continue his pain medication, including Gabapentin and/or Lyrica,7

as previously prescribed. Dkt. No. 88-44 at 7. Briglin further maintains that although he told Dr.

Cahill “exactly everything that was wrong” with him, Dr. Cahill “never looked” at him. Id. Briglin

maintains that he specifically “asked for his Gabapentin back.” Dkt. No. 87 ¶ 116. When Briglin

asked Dr. Cahill why his Gabapentin was being tapered, Dr. Cahill responded that he “wasn’t

allowed to prescribe it.” Id. When Briglin asked Dr. Cahill to prescribe him Gabapentin, Dr.

Cahill “refused.” Id.

On May 29, 2019, Dr. Cahill entered a referral to evaluate whether Briglin required any

additional surgeries. Dkt. No. 87 ¶ 136. Dr. Cahill also ordered a CT scan of Briglin’s pelvis, an

EMG test for lower extremity neuropathy, and entered orders for certain pain medication including

Amitriptyline and Tylenol. Id. at ¶ 143.

Dr. Cahill did not examine or meet with Briglin again until November 12, 2019.8 Dkt. No.

87 ¶ 161. In the interim, Briglin contends that he experienced ongoing pain and requested

“numerous times” that his Gabapentin be represcribed, and that he filed grievances to this effect.

Id. at ¶¶ 165-68, 176-77, 181-86. On November 12th, Dr. Cahill examined Briglin at a follow-up

7 The grievance suggests that Briglin mistook Lyrica and Gabapentin to be the same medication.

See Dkt. No. 88-44 at 7 (“Since my accident and my 7 surgeries, I have been on Lyrica

(Gamapentine) [sic] for my nerves.”).

8 In June 2019, Dr. Cahill prescribed Briglin medication to address facial swelling and pain in

response to a nurse’s report that he broke a tooth. Dkt. No. 87 ¶¶ 159-60.

appointment for his chronic pain syndrome and neuropathy. Id. at ¶¶ 191-95. The parties dispute

whether Briglin complained of pain to Dr. Cahill during this encounter. Dkt. Nos. 75-1 ¶ 196-201;

87 ¶¶ 196-201. Dr. Cahill noted that Briglin required “pain control.”9 Dkt. No. 76-2 at 20.

Following the appointment Dr. Cahill entered a referral for an EMG and MRI, referencing

Briglin’s history of neuropathy and symptoms that “have not improved with medication.” Dkt.

No. 87 ¶¶ 198-200. Dr. Cahill retired shortly after, and did not have any additional involvement

with Briglin’s treatment after December 31, 2019, at the latest. Id. at ¶ 206. Briglin received

continued treatment from other medical providers, including physical therapy and pain therapy.

Id. at ¶¶ 207-08, 218. The parties dispute the efficacy of his subsequent treatment in DOCCS

custody. Id. at ¶¶ 214-19. Briglin was released on parole on December 24, 2020. Dkt. No. 87 ¶

221.

2. Summary Judgment Analysis

i. Personal Involvement

Dr. Cahill argues that Briglin’s claim should be dismissed because it is based on actions

taken by individuals other than Dr. Cahill. Dkt. No. 75-2 at 14-16. Specifically, Dr. Cahill argues

that he did not discontinue Briglin’s Gabapentin; there is “no evidence in the medical record that

Briglin ever requested Gabapentin from Dr. Cahill;” and that even if Briglin did request

Gabapentin, Dr. Cahill cannot be held liable for deliberate indifference based on his medical

judgment that a different medication was a better option. Id. Briglin contends that Dr. Cahill was

personally involved in the alleged deliberate indifference violations. Dkt. No. 90 at 37.

9 The parties dispute whether Dr. Cahill’s note refers to pain control generally, or whether it refers

to pain control in conjunction with an MRI he requested. Dkt. No. 87 ¶ 201-02.

Dr. Cahill has not established that he is entitled to summary judgment for lack of personal

involvement in the alleged deliberate indifference to Briglin’s medical condition. Even though it

is undisputed that Dr. Cahill did not discontinue Briglin’s Gabapentin, there remains a genuine

dispute of material fact as to whether Briglin asked Dr. Cahill to prescribe certain medication, and

whether Dr. Cahill refused to prescribe medications because of the MWAP Policy limitations, as

opposed to his medical judgment. Accordingly, dismissal is not warranted on this basis.

ii. Objective Prong

Dr. Cahill argues that Briglin cannot establish the objective prong of his deliberate

indifference claim because the record demonstrates that he provided Briglin with prompt and

extensive medical care for his chronic pain and neuropathy that was consistent with the standard

of care. Dkt. No. 75-2 at 17-22. Dr. Cahill further argues that Briglin cannot establish that his

alleged refusal to prescribe Gabapentin was likely to cause harm, due to Briglin’s history of side

effects and pain while taking the medication. Id. at 22-26. In response, Briglin contends that Dr.

Cahill’s provision of other medical care is not dispositive, and a question of fact remains as to

whether he refused to prescribe adequate medication for an invalid purpose. Dkt. No. 90 at 38-40.

At the outset, Dr. Cahill’s arguments rely in large part on material facts which remain

disputed by the parties. For example, in arguing that his May 28, 2019 treatment of Briglin could

not amount to a deprivation of adequate medical care, Dr. Briglin relies on the contention that

“Plaintiff did not request any specific medications during this appointment, as Dr. Cahill would

have noted this in the record had any request been made.” Dkt. No. 75-2 at 18. Briglin, however,

specifically contends that he did request to be placed back on certain medication, both in a

grievance submitted days before his May 28th encounter with Dr. Cahill, and verbally at the

encounter itself. Dr. Cahill also relies on the purported lack of effectiveness Briglin experienced

on Gabapentin prior to his intake at Franklin C.F., and the admitted side effects he experienced on

this medication. Briglin disputes this contention, faulting Dr. Cahill for cherry-picking quotes

from certain medical records, noting that effective pain management may not equate to being pain-

free, and citing to the record evidence suggesting that Gabapentin and Lyrica were effective in

helping his pain.

In any event, the record suggests that Briglin had been consistently prescribed a regimen

of Gabapentin and/or Lyrica for years prior to his intake at Franklin C.F. to treat his neuropathy

and chronic pain. Viewing the evidence in the light most favorable to Briglin, his prescription for

Gabapentin was discontinued as a matter of course pursuant to the MWAP Policy. Although Dr.

Cahill did not discontinue Briglin’s Gabapentin prescription, he met with Briglin shorty thereafter

and professes to have conducted a “comprehensive review” of Briglin’s medical history prior to

their encounter. By that time, Briglin had submitted a grievance complaining about the

consequences of discontinuing his prescription medication. Further viewing the evidence in the

light most favorable to Briglin, he suffered ongoing pain and difficulty walking after his initial

evaluation with Dr. Cahill. Briglin contends that the alternative treatment regimen ordered by Dr.

Cahill –that did not include Gabapentin or Lyrica – was not adequate to address his ongoing

symptoms. The record evidence establishing Briglin’s chronic pain and difficulty walking as a

result of the failure to prescribe these medications is sufficient to establish a genuine issue of

material fact as to whether the interruption in his treatment constituted a “sufficiently serious”

deprivation of adequate care. See Chance v. Armstrong, 143 F.3d at 702. Accordingly, summary

judgment is not warranted on this basis.

iii. Subjective Prong

Dr. Cahill further argues that he did not possess the requisite state of mind for deliberate

indifference to Briglin’s medical needs. Specifically, he contends that his decision not to prescribe

Briglin certain medication was formed by his own medical judgment, and does not give rise to

subjective deliberate indifference. Dkt. No. 75-2 at 26-32. Briglin contends that there is sufficient

evidence suggesting that Dr. Cahill refused to prescribe the same medication because he could not

get it due to the restrictions under the MWAP Policy, and/or that it was easier to prescribe a less

efficacious treatment.

As previously discussed, “disagreements over medications . . . implicate medical

judgments and not the Eighth Amendment.” Wright v. Genovese, 694 F. Supp. 2d 137, 155

(N.D.N.Y. 2010), aff’d, 415 F. App’x 313 (2d Cir. 2011) (citing Sonds v. St. Barnabas Hosp. Corr.

Health Servs., 151 F. Supp. 2d 303, 312 (S.D.N.Y. 2001)). The decision not to prescribe stronger

pain medication does not evidence deliberate indifference. Vail v. Lashway, No. 9:12-cv-1245

(GTS/RFT), 2014 WL 4626490, at *14 (N.D.N.Y. Sept. 15, 2014) (“[T]he decision to choose one

form of pain medication over another . . . is not indicative of deliberate indifference.”); Scott v.

Perio, No. 02-cv-578A, 2005 WL 711884, at *6 (W.D.N.Y. Mar. 25, 2005); Veloz v. New York,

339 F. Supp. 2d 505, 525 (S.D.N.Y. 2004) (finding that inmate’s claim that medical providers

should have prescribed stronger pain medication than Tylenol did not state deliberate indifference

claim). Furthermore, “concern about prescribing narcotic pain medication, on which inmates . . .

could become dependent, may inform a medical judgment about what drugs to prescribe.” Wright,

694 F. Supp. 2d at 160.

Here, however, the issue is whether Dr. Cahill’s decision not to prescribe certain pain

medication was, in fact, informed by his independent medical judgment and consideration of

Briglin’s condition. Viewing the evidence in the light most favorable to Briglin, Dr. Cahill was

aware of Briglin’s longstanding history of treatment with Gabapentin and Lyrica by their first

encounter on May 28, 2019. Briglin had filed a grievance requesting that his medication be

represribed in order to manage his pain, and, according to Briglin, he specifically asked Dr. Cahill

to represcribe the medication. Although Dr. Cahill states in an affidavit in support of his pending

motion that his decision not to prescribe Gabapentin or Lyrica to Briglin was based on his own

independent medical judgment, there is nothing in the contemporaneous medical records to support

that such an assessment was made. Moreover, Briglin has offered evidence suggesting that Dr.

Cahill refused to prescribe this medication because of the restrictions under the MWAP Policy.

Accordingly, because there is conflicting evidence as to what Dr. Cahill knew about Briglin’s prior

effective course of treatment, and whether the decision not to prescribe a medication under the

MWAP Policy was medically justifiable or based on the improper application of a blanket policy,

Dr. Cahill is not entitled to summary judgment on this basis.

iv. Qualified Immunity

Dr. Cahill argues that he is entitled to qualified immunity because Briglin’s rights were not

clearly established, and even if they were Dr. Cahill’s conduct was objectively reasonable. Dkt.

No. 75-2 at 33-37. Briglin contends that disputed facts preclude an award of qualified immunity

when considering the relevant right. Dkt. No. 90 at 41.

As previously discussed, the particular right at issue in these actions is an incarcerated

individual’s “right to be free from a physician’s deliberate indifference to his medical needs

through ‘consciously choos[ing] an easier and less efficacious treatment plan.’” Allen, 2024 WL

3090141 at *17 (citing Chance, 143 F.3d at 703). Because there remains a genuine dispute of

material fact in this case about whether Dr. Cahill’s decision not to prescribe certain medication

was based on his own medical judgment or a conscious choice to pursue an easier, less efficacious

treatment plan, the Court cannot conclude as a matter of law that he did not violate a clearly

established right. These factual disputes also preclude a finding that Dr. Cahill’s conduct was

objectively reasonable as a matter of law. Accordingly, Dr. Cahill is not entitled to an award of

qualified immunity at this juncture, and summary judgment is denied on this basis.

3. Daubert Motion

Dr. Cahill seeks to preclude the report and testimony of Briglin’s expert, also Dr. Carinci,

because (1) Dr. Carinci’s initial report does not provide any opinions with respect to Dr. Cahill,

and (2) Dr. Carinci’s report is based on insufficient data. Dkt. No. 75-2 at 37-42. Because Briglin

has raised a genuine dispute of material fact as to the elements of his deliberate indifference claim,

even without the expert report of Dr. Carinci, it is not necessary to address Dr. Cahill’s Daubert

challenges at this juncture. See Section V.A.3., supra. Accordingly, Dr. Cahill’s motion is denied

without prejudice to renewal as a motion in limine.

VI. CONCLUSION

For these reasons, it is

ORDERED, that the Daniels motion for summary judgment, Case No. 9:23-cv-983 at Dkt.

No. 56, is GRANTED in part and DENIED in part; and it is further

ORDERED, that the Daniels motion for summary judgment is GRANTED in that

Daniels’ Eighth Amendment deliberate indifference claim under 42 U.S.C. § 1983 premised on

Dr. Mandalaywala’s alleged failure to prescribe Tylenol #3 is DISMISSED with prejudice; and

it is further

ORDERED, that the Daniels motion for summary judgment is in all other respects

DENIED; and it is further

ORDERED, that the Daniels motion to preclude Dr. Carinci’s testimony and report, Case

No. 9:23-cv-983 at Dkt. No. 56, is DENIED with leave to renew as a motion in limine; and it is

further

ORDERED, that the Briglin motion for summary judgment, Case No. 9:23-cv-1001 at

Dkt. No. 75, is DENIED, and it is further

ORDERED, that the Briglin motion to preclude Dr. Carinci’s testimony and report, Case

No. 9:23-cv-1001 at Dkt. No. 75, is DENIED with leave to renew as a motion in limine.

IT IS SO ORDERED.

Dated: March 2, 2026

Elizabeth C. Coombe

U.S. District Judge

31