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Scott v. Correctional Medical Services

July 21, 2008


The opinion of the court was delivered by: Bumb, United States District Judge

[Doc. No. 50]



This matter comes before the Court on a partial motion for summary judgment, brought by Defendants Correctional Medical Services, Inc. ("CMS"), Deepa Bock, N.P. ("Bock"), John Godinsky, M.D. ("Dr. Godinsky"), and Clavel Nelson, R.N., N.P. ("Nelson") (collectively, "Defendants"). Plaintiff is an inmate at South Woods State Prison in Bridgeton, New Jersey, which is operated by the New Jersey Department of Corrections ("NJDOC"). Defendant CMS is a private corporation that provides and manages the medical care system for the NJDOC. Defendants Bock, Godinsky, and Nelson are medical professionals who work under contract for CMS and were involved in Plaintiff's medical care at South Woods State Prison.

On November 20, 2006, Plaintiff filed a Complaint against Defendants (as well as the NJDOC and NJDOC Commissioner, George Hayman)*fn1 alleging five claims: 1) medical malpractice; 2) violation of his Eighth Amendment rights under 28 U.S.C. § 1983; 3) corporate negligence; 4) intentional infliction of emotional distress; and 5) negligent infliction of emotional distress. (Compl. ¶¶ 38-72). Defendants now seek partial summary judgment as to Plaintiff's Eighth Amendment claim (Count II).


Plaintiff, a 45 year-old man, was committed to Northern State Prison in May 2004. On June 21, 2004, Plaintiff presented at the prison medical clinic with complaints of a nine-month history of intermittent blood spotting from his rectum. He saw Defendant Deepa Bock, N.P. who performed a full physical, including a rectal examination. N.P. Bock identified an internal growth in Plaintiff's rectum which she diagnosed as a small internal hemorrhoid and prescribed Plaintiff Anusol and Colace to ease his symptoms. Apparently, no doctor reviewed this note and no colonoscopy, sigmoidoscopy or other lower GI work was ordered. However, N.P. Bock did conduct an occult blood stool test, which was negative. Plaintiff returned to the clinic one month later, on July 21, 2004, with complaints of constipation. He was given Milk of Magnesia by Nurse Stephens.

Plaintiff did not complain about his gastrointestinal symptoms again for almost two months. However, on September 16, 2004, he came back to the clinic with complaints of anal itching at night. N.P. Bock noted that he had a thirteen pound weight loss and a questionable history of hemorrhoids. She prescribed Plaintiff a 90-day course of Anusol, Thermaderm lotion and Milk of Magnesia. Again, no further testing was done at this time.

On November 26, 2004, Plaintiff returned to the clinic with complaints of constipation, rectal itch and intermittent rectal bleeding. He saw Clavel Nelson, N.P. who did not conduct a rectal exam but prescribed Plaintiff Metamucil, Mylanta and Anusol.

Plaintiff returned to the clinic again on December 21, 2004, with complaints of constipation, rectal bleeding and anal itching. N.P. Bock performed another rectal exam and noted an internal hemorrhoid. She also found that his stool was guaiac negative. She prescribed Plaintiff Anusol and instructed him to follow-up if the bleeding increased. No further diagnostic testing was done.

On January 18, 2005, Plaintiff came to the clinic complaining of a lump in his left groin area. N.P. Bock and Dr. Godinsky diagnosed the lump as an enlarged lymph node 1 cm in size and advised him to return if it did not go away within a few weeks. On February 7, 2005, N.P. Nelson found that the mass in Plaintiff's groin had grown to 3x2 cm and an ultrasound was ordered. This test was performed on February 25 and it showed a probable enlarged lymph node.*fn2 By April 28, 2005, the node in Plaintiff's groin had become so enlarged that it was causing pain in his leg. Plaintiff was referred to surgery. However, Dr. Richard Hellander, the utilization review manager, denied the surgical consult because the referral did not contain enough "documentation describing this mass" and why it needed to be removed. On May 9, 2005, Plaintiff was seen in the clinic by Dr. Hochberg who noted that the left inguinal mass was now causing pain in Plaintiff's buttocks. Dr. Hochberg also recommended a surgical evaluation and discussed the situation with Dr. Godinsky. However, apparently, no surgical consult was done.

Thereafter, Plaintiff's visits to the clinic continued on a frequent basis. On May 16, he came to the clinic with complaints of pain in his lower left quadrant as well as hemorrhoids and blood spotting. Joel Bucholtz, P.A. prescribed him Colace and Anusol. On May 27, 2005, Plaintiff complained of rectal fullness which was painful and unresponsive to suppositories and cream. Patricia Stephens, N.P. performed a rectal exam and described his rectal tone to be flaccid with a hard indurated circular mass in the rectal area which was tender to palpitation. She recommended a GI consult. Plaintiff was seen again on June 3, 2005 with complaints of pain which he thought was due to an internal hemorrhoid. He was given Motrin and awaited a GI consult.

Finally, on June 15, 2005, one year after his initial complaints, Plaintiff saw a GI specialist who said the history and physical examination was very suggestive of squamous cell carcinoma and ordered a colonoscopy. However, the colonoscopy was not done until July 18, over a month after the specialist had ordered it. In the meantime, Plaintiff saw Joel Buchholtz in the clinic for hemorrhoidal pain and was prescribed medication. The colonoscopy was done on July 27, 2005, over thirteen months after Plaintiff's initial complaints of rectal bleeding. A biopsy was also performed and forwarded to Dr. Godinsky. Although no definitive invasive carcinoma was identified, further evaluation was strongly recommended, as indicated on Plaintiff's chart on August 8, 2005. Dr. Godinsky also consulted with the GI doctor who suggested removal of the left inguinal node.

Another month passed before Plaintiff met with Dr. Hertzog for a surgery consult on August 30, 2005. At that time, it was noted that Plaintiff probably had cancer and urgently needed to be admitted to St. Francis Medical Center. However, despite the urgency of his medical situation, Plaintiff was not admitted to surgery because the tissue diagnosis was not complete. Instead, on September 13, 2005, Plaintiff was seen by Dr. Godinsky back in the clinic where he was told that he likely had cancer and a poor prognosis. On September 27, Plaintiff ...

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