The opinion of the court was delivered by: Simandle, District Judge
This matter is presently before the Court on three motions for summary judgment on a claim arising out of Plaintiff Stanley B. Smith, Jr.'s treatment while a pretrial detainee at Gerard L. Gormley Justice Facility ("GGJF"). Defendants Gary Merline, the Division Director of GGJF, Captain Geraldine Cohen, Sergeant Michael Kelly, and Diana Bader (collectively, "Prison Defendants"), ask for summary judgment on the grounds that Plaintiff did not exhaust his administrative remedies [Docket Item 73]. Defendants CFG Medical Company LLC, Dr. James Neal, and Nurse Jerry Connors (collectively, "CFG Defendants") similarly seek summary judgment for failure to exhaust, but CFG Medical Company also seeks summary judgment on the issue of municipal liability [Docket Item 77]. Finally, Plaintiff has filed a cross motion for partial summary judgment, arguing there is no genuine dispute that he has serious medical needs that require adequate medical treatment under the Fourteenth Amendment [Docket Item 81]. For the reasons expressed below, the Court will deny the Prison Defendants' motion for summary judgment, grant in part and deny in part the CFG Defendants' motion for summary judgment, and grant in part and deny in part Plaintiff's motion for partial summary judgment.
I. FACTS AND PROCEDURAL HISTORY
These motions, with the exception of Defendant CFG's request for summary judgment due to the absence of municipal liability, do not involve Plaintiff's alleged mistreatment while at GGJF. Consequently, in summarizing the facts, the Court will focus on evidence of CFG's liability, taking Plaintiff's evidence to be true and construing that evidence in favor of Plaintiff to the extent Plaintiff is the non-moving party.
It is undisputed that at all times relevant to this action, Plaintiff suffered from end-stage renal failure, "a serious medical condition whereby the kidneys cease to function well enough to maintain homeostasis," and congestive heart failure, "a serious medical condition in which excess fluid is in the lungs, causing difficulty with oxygen delivery to the blood stream." (Iannuzzelli Report at 1, 2, Korn Decl. Exh. G; Neal Dep. at 34-39, 39-40, Korn Decl. Exh. I.) For these conditions he receives dialysis. (Pl. Dep. at 29-32, Def. CFG Exh. A.) In addition, he may have had a condition called calciphylaxis, a complication of renal failure that "involves deposition of calcium in small vasculature, ultimately leading to obstruction of the vessel." (Iannuzzelli Report at 2, Korn Decl. Exh. G; Neal Dep. at 34-39, 39-40, Korn Decl. Exh. I.) There is no evidence in the record that Plaintiff was ever diagnosed with this condition.
On August 3, 2006, Plaintiff was incarcerated as a pretrial detainee at GGJF, where he remained for approximately one year, until he was sentenced and transferred to South Woods State Prison. For almost all of his time at GGJF, Plaintiff was housed in the medical unit, where he was the "tier representative" and spoke on behalf of himself and the other prisoners in the medical unit. (Pl. Dep. at 48, Def. CFG Exh. A.) In February and March 2007, Plaintiff wrote four letters to prison officials complaining about CFG staff interfering in prison disciplinary matters. (Gorman Decl. Exhs. L-1, M-1, & N-1.) As a result of Plaintiff's complaints, on or about February 26, 2007, Captain James Murphy instructed CFG staff not to intervene. (Korn Decl. Exh. A.) According to Plaintiff, however, the CFG staff continued to interfere in prison matters. (Gorman Decl. Exhs. M-1 & N-1.)
Plaintiff asserts that Nurse Conners retaliated against him by reporting to prison officials that Plaintiff's sister, then a prison guard at a neighboring facility, was impermissibly "fraternizing" with her brother. As evidence of this, Plaintiff offers Conners' own statement to Captain Cohen that the exchanges between Plaintiff and his sister made Plaintiff "even more arrogant and belligerent." (Korn Decl. Exh. B.) On a subsequent investigation, Nurse Conners modified her story, stating that Plaintiff spoke to his sister only two days a week (rather than "practically every day") and clarified that she had never heard any of their conversations. (Korn Decl. Exh. C.)
On March 14, 2007, Nurse Conners claimed to feel threatened by a letter Plaintiff had written almost two weeks earlier and in response GGJF officials transferred Plaintiff to the high security unit. (Pl. Dep. at 63, 82-85, 119-20, 127-28, Def. CFG Exh. A.) Although Plaintiff was exonerated at a hearing three days later, he remained in the high security unit for approximately three more weeks, when he was transferred back to the medical unit. (Id. at 84.) While in the high security unit there were no medical staff members monitoring Plaintiff. (Id. at 54, 74.) When his blood pressure plummeted, staff would send him back to his cell with water to drink, instead of sending him to the emergency room as would have occurred before the allegedly threatening letter. (Id. at 67-69, 150-51.)
On March 12, March 19, and April 9, 2007, Plaintiff's dialysis doctors wrote three different requests that Plaintiff be sent to a dermatologist "as soon as possible" to "rule out calliphylaxis," because Plaintiff had calcium deposits on his hands. (Korn Decl. Exh. E.) On April 17, 2007, Defendant Neal indicated that these requests would be denied because they were "elective" or "cosmetic." (Korn Decl. Exh. F.)
After being returned to the medical unit, Plaintiff was moved back and forth between different cells in the unit without any reason.*fn1 (Pl. Dep. at 55-56, Def. CFG Exh. A.)
B. Administrative Review Process
Plaintiff has offered evidence that GGFJ had two alternative, but equally acceptable, means of making requests and expressing grievances. GGFJ has a formal review process that is described in the Inmate Handbook. (Gorman Decl. Exh. A at II-1.) Through that process inmates must first make an informal grievance by completing an inmate request form and that grievance is to be presented through the chain of command. (Id.) If the informal process does not resolve the problem, inmates may submit a formal grievance, using a grievance form, to the Director. (Id.) Inmates must file their grievance within ten days of the incident and the Director has fifteen "working days" from the date of receipt in which to respond. (Id. at II-1 to -2.) Certain matters, however, "are not grievable issues." (Id. at II-1.) Those are: "1. Matters out of the facilities control (Probation, parole, Sentences); 2. Disciplinary matters taken against the grieving inmate or any other inmates; 3. Housing assignments and classification status." (Id.)
Plaintiff was aware of this process and used inmate request forms to ask for things that he needed. (Pl. Dep. at 43-47, Def. CFG Exh. A.) He used the forms to ask for information about Rule 11 of the Federal Rules of Criminal Procedure, plea bargains, ineffective assistance of counsel, and substance abuse treatment. (Id. at 45-46.) He asked for clean sheets and case law. (Id. at 45-47.)
Plaintiff used, and GGJF staff apparently accepted, an alternative route for making grievances. (Gorman Decl. Exhs. F-1 to N-2.) From September 2006 until he was transferred to high security on March 14, 2007, Plaintiff submitted at least nine handwritten grievances to GGJF staff (generally to Director Merline), all of which the GGJF staff (often Director Merline himself) addressed on the merits. (Id.) Plaintiff used these handwritten grievances to express concerns about receiving his medication at proper intervals, (Exhs. F-1 and H-1)), service of his meals during Ramadan, (Exh. G-1), access to newspapers, (Exh. I-1), prison safety, (Exhs. J-1 and K-1), medical staff interference with prison discipline, (Exhs. L-1 and M-1), and problems with laundry, (Exh. N-1). Each of these letters received a response, usually from Defendant Merline. (Gorman Decl. Exhs. F-2, G-2, H-2, I-2, J-2, K-2, L-2, M-2, N-2.) Plaintiff states that prison officials never refused to ...