United States District Court, N.D. Iowa, Central Division
REPORT AND RECOMMENDATION ON DEFENDANTS' MOTION FOR SUMMARY JUDGMENT
LEONARD T. STRAND, Magistrate Judge.
Plaintiff James Fergus Rasmussen, an inmate in Iowa's state prison system, commenced this lawsuit on October 12, 2012. He then filed a pro se complaint on February 8, 2013. Rasmussen alleges the defendants were deliberately indifferent to his medical condition of Dupuytren's contractures while he was an inmate at the Fort Dodge Correctional Facility (FDCF). He seeks both short and long-term medical treatment at the University of Iowa Hospitals and Clinics (UIHC) at the expense of the Iowa Department of Corrections (DOC), including but not limited to surgery and medication.
Defendants have filed an answer in which they deny Rasmussen's claim. Doc. No. 11. No party has demanded a jury trial. Defendants have now moved for summary judgment. (Doc. No. 18). Rasmussen has not filed a resistance. Judge Bennett referred the motion to me for the preparation of a report and recommended disposition. No party has requested oral argument and, in any event, I find that oral argument is not necessary. See N.D. Ia. L.R. 7(c). The motion is fully submitted.
II. RELEVANT FACTS
Unless otherwise noted, the following facts are undisputed for purposes of defendants' motion:
The Parties. Rasmussen was committed to the custody and care of the Iowa prison system for a second time on June 3, 2011. He was incarcerated at FDCF from July 21, 2011, through November 13, 2013, when he was transferred to the North Central Correctional Facility (NCCF) in Rockwell City, Iowa, where he is currently incarcerated. Defendant James McKinney is the Warden of FDCF and defendant Jana Hacker is a nurse practitioner at FDCF and NCCF.
Rasmussen's Treatment History. A physical exam was completed on Rasmussen in June 2011 when he came into the custody of the DOC. At that time, medical staff took note of his Dupuytren's contractures on his 5th digits bilaterally. Rasmussen reported a history of contractures on his hands and feet for the past 10 years. His feet had started to contract two years ago and his left hand had recently started to contract. The contractures were worse on his right hand and he had multiple hard masses along his tendons. He also reported pain around his knuckles. In addition, Rasmussen was diagnosed with Seizure Disorder, Type II Diabetes Mellitus, Gastroesophageal Reflux Disease, Benign Prostatic Hypertrophy, Chronic Obstructive Pulmonary Disease and Hypertension. Medical staff recommended daily stretching and massage options to slow the progression of his contractures and explained that surgery was elective at that time and would most likely not be performed while he was in prison depending on the condition's progression.
While at FDCF, Rasmussen first complained of his hands on June 1, 2012. He stated that his hands were getting worse and more fingers were starting to contract. He presented information from the Mayo Clinic website indicating that surgery was a treatment option for his condition. Rasmussen saw Hacker on June 5, 2012, for his contractures and demanded to be sent somewhere for treatment. Hacker recommended keeping his fingers warm and doing stretching exercises. She also discussed the progression of the disease with him.
Rasmussen reported to health services again on June 11, 2012, claiming the contractures were now affecting his penis and throat. Rasmussen requested surgery to release the tendons as described in the Mayo Clinic information. Hacker indicated that she would present Rasmussen's case to the DOC medical review committee to determine if anything further should be done. The case was presented on July 24, 2012. The committee determined it was not medically indicated to refer Rasmussen to UIHC for his Dupuytren's contractures. Hacker informed Rasmussen of the committee's decision and noted no intervention would be necessary until the contractures were severe or interfered with his activities of daily living.
On August 21, 2012, Hacker performed an annual physical exam on Rasmussen. She noted he had partial contracture of the 5th digits on both hands and mild contracture of the 4th digits. He had no difficulty with activities of daily living and no contractures of the toes. Rasmussen next reported to health services on November 15, 2012, complaining of pain in his knuckles and expressing concern that his contractures were now occurring in his face and head. The nurse reassured him that Hacker was aware of his condition and he could speak to her about his concerns at his next scheduled appointment. The treatment notes from his next appointment with Hacker do not indicate that he complained of his contractures at that time.
On June 3, 2013, Rasmussen asked to speak to nurse Karen Anderson. He stated Hacker had documented inaccurate information about his hands at his last appointment and that he wanted surgery. He asked her to change what was documented. Anderson told him she could not change the record, encouraged him to do the stretching exercises Hacker recommended and suggested he raise his concerns at his next scheduled appointment. At that appointment on August 19, 2013, Hacker performed a physical and noted his contractures were stable and unchanged and that Rasmussen performed activities of daily living without problems.
At an appointment on November 8, 2013, Hacker noted that there had been no progression of Rasmussen's Dupuytren's contractures and that he was still able to perform activities without problems, including his job at the facility. The condition was also stable in his feet. He had no problems ambulating, no pain and he was able to exercise.
The Grievance Process. Rasmussen filed an emergency grievance on June 1, 2012, stating he had attempted to resolve the issue informally and wanted to see a hand specialist. His grievance was processed as a standard grievance and denied on June 5, 2012, because he had been seen by Hacker who had explained the prognosis and treatment for his condition. Rasmussen filed an appeal on June 6, 2012. His appeal was denied over a year later on July 11, 2013, for having not followed the proper procedures. The notice stated that prison officials were "[t]rying to clean up grievance processing screen" and "due to not having information from the warden to complete and submit we are submitting without the needed information." Rasmussen did not appeal further.
Meanwhile, Rasmussen had filed a new grievance on July 26, 2012, stating he had attempted to resolve the issue with Hacker informally and still wanted to see a specialist regarding his Dupuytren's contractures. His grievance was denied because Hacker had presented Rasmussen's case to the medical review committee, which determined it was not severe enough to refer Rasmussen for surgery. Rasmussen did not appeal this grievance. He filed a third grievance on January 16, 2013. It was denied for the same reasons and Rasmussen did not appeal. Rasmussen filed his fourth grievance on June 5, 2013, stating he had attempted informal resolution with Karen Anderson and accused Hacker of inaccurately documenting his symptoms. His grievance was denied. Rasmussen appealed on June 8, 2013. His appeal was denied on June 12, 2013, by the Deputy Warden, who stated:
I have reviewed your Grievance. Mr. Rasmussen, I rely on our Nurse Practitioner to assess your medical needs while at FDCF. It's my understanding that you saw Ms. Anderson, Nurse Supervisor, on 6/3/2013. Ms. Anderson explained to you our process and discussed your situation with you for awhile. We do not like to see you in pain. Medical staff is providing you with what they think are [sic] adequate treatment based on your current situation/diagnosis.
Rasmussen appealed to the Central Office on June 17, 2013. His appeal was denied on June 20, 2013, as follows:
I have reviewed the Grievance Officer and Deputy Warden response to your grievance issue. I have also asked the DOC Medical Director to review your grievance issue. You are receiving the appropriate treatment for your medical condition. It is important that you follow all of the doctor's orders pertaining to all of your health issues. If you fail to follow order's [sic] for one of your health issues it can cause issues with another health issue. Grievance appeal denied.
Rasmussen commenced this case on October 12, 2012. Doc. No. 1. He brings his claim pursuant to 42 U.S.C. § 1983 and alleges the defendants were deliberately indifferent to his serious medical needs in violation of the Eighth Amendment. His complaint states that he has pain in both hands and feet and in his jaw. Doc. No. 6 at 7. He contends that he cannot extend some fingers and that the tendon in his jaw is also affected such that he bites it when eating, causing constant pain, breakage of skin and bleeding. Id. He claims Warden McKinney never responded to his appeal dated June 5, 2012. He seeks short and long-term treatment at UIHC at DOC expense, including, but not limited to, surgery and medication.
III. SUMMARY JUDGMENT STANDARDS
Any party may move for summary judgment regarding all or any part of the claims asserted in a case. Fed.R.Civ.P. 56(a). Summary judgment is appropriate when "the pleadings, depositions, answers to interrogatories, and admissions on file, together with affidavits, if any, show that there is no genuine issue of material fact and that the moving party is ...