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Ronald Rahman v. Eric Taylor

September 20, 2011


The opinion of the court was delivered by: Hon. Jerome B. Simandle


SIMANDLE, District Judge:


This matter arises out of Plaintiff Ronald Rahman's six-month period of detention in the Camden County Correctional Facility ("CCCF") in the second half of 2009. Plaintiff claims to have suffered dangerously overcrowded and unsanitary conditions and been subjected to constitutionally infirm medical treatment, including exposure to and insufficient treatment of tuberculosis, during his tenure at the CCCF as a pre-trial detainee. Defendants in this action are Eric Taylor, Warden of CCCF; CFG Health Systems, LLC; and Jeffrey D. Pomerantz, Medical Director at CCCF. The matter is currently before the Court on the motion of Defendant CFG Health Systems, LLC (hereafter, "CFG" or "Defendant") to dismiss Plaintiff's Amended Complaint as to CFG for failure to state a claim upon which relief can be granted or, in the alternative, for summary judgment against Plaintiff's claims against CFG. [Docket Item 18.]

Defendant argues that Plaintiff's Amended Complaint does not state a plausible claim for relief against it under 42 U.S.C. § 1983 and, additionally, that Plaintiff cannot point to a dispute of material fact regarding whether Plaintiff was, in fact, exposed to tuberculosis while in Defendant's care, or that his medical treatment amounted to deliberate indifference to a serious medical condition. Plaintiff argues that the record evidence presents at least a dispute of fact over whether he was exposed to tuberculosis while at the CCCF and whether Defendant punitively extended his period of potential exposure. Additionally, after opposition and reply briefs were filed, Plaintiff submitted two objections to evidence put forward by Defendant and additionally requested that the Court take judicial notice of various scientific facts. [Docket Item 34.]

Both parties have referred to facts outside the pleadings, so this motion will be addressed as a summary judgment motion. As explained below, because the Court concludes that Plaintiff has not pointed to a dispute of fact regarding his exposure to tuberculosis or the adequacy of his medical treatment, the Court will grant Defendant's motion for summary judgment pursuant to Fed. R. Civ. P. 56(a).


As the Court treats alleged facts differently on a Rule 12(b)(6) motion than a Rule 56(a) motion, the Court will recount the relevant allegations in Plaintiff's Second Amended Complaint ("S.A.C.") [Docket Item 38]*fn1 and, where appropriate, include facts that are supported by evidence in the record; the Court will also note what facts, if any, are meaningfully disputed in the record.

Plaintiff was held as a pre-trial detainee in CCCF from June 11, 2009 until January 19, 2010. S.A.C. at 2 ¶ 4. Plaintiff alleges that, during the six months he was held at CCCF, the facility was "overpopulated" and "exceptionally understaffed, creating an unsafe, unhealthy, and unsanitary environment for the Plaintiff." Id. 5 ¶ 3. When Plaintiff was first admitted to CCCF, he was initially housed in the Intake/Diagnostic ("I/D") Unit, where he remained for approximately 21 days, from June 11, 2009 until July 2, 2009. Id. 11 ¶ c; 16 ¶ d. In general, inmates at CCCF are not transferred from the I/D Unit into the general population until they are tested for tuberculosis and a physical exam is completed. Vargas Cert. ¶ 7. Plaintiff alleges that this quarantine and clearance process "usually" takes approximately three to seven days. S.A.C. 15 ¶ a. Throughout the time Plaintiff was housed in the I/D Unit, he was housed in a cell with two or three other inmates. Id. 15 ¶ c. Over the course of Plaintiff's stay in the I/D Unit, he shared a cell with approximately 50 other inmates. Id. 11 ¶ c. Defendant CFG has no authority over or responsibility for inmate housing decisions, "including the number of inmates placed in a cell and which inmates are placed in a cell," those decisions are "made by the classification department at CCCF" and not by Defendant CFG. Vargas Cert. ¶ 6.

The day after Plaintiff was admitted, he completed a medical history screening, an oral/dental screening, and a mental health screening. Rahman Medical Records, Def.'s Ex. B, at Rahaman CCCF 2-4.*fn2 He was not, however, given a physical assessment on that date; his medical records indicate that he refused a skin test for tuberculosis exposure ("PPD") and a different test ("RPR") on that date. Rahman CCCR 5-6, 9, 15. His records indicate that he refused one of these tests on approximately nine other occasions between June 12 and July 1, 2009. Rahman CCCR 6. As a result, his records indicate, Plaintiff was kept in "medical lock in" until he was medically cleared on July 1, 2009. Rahman CCCR 9, 13. Plaintiff claims, in his opposition brief, that many of the medical records provided by Defendant regarding his refusal to take the PPD test were fabricated, but points to no evidence from which a reasonable factfinder could so conclude. Pl.'s Opp. at ¶ D.1.

Plaintiff claims for the first time in his opposition brief, without attaching an affidavit attesting to such allegations, that on June 12, after completing the dental, mental health, and medical history screenings, he initially agreed to the PPD test as well, but changed his mind when he observed the way the test was going to be conducted. Pl.'s Opp. ¶ A. He states that the attending nurse "picked up a prefilled syringe from amongst hundreds" and denied Plaintiff's request to show him the "vial from which the solution [in the syringe] was drawn." Id. Additionally, when Plaintiff was shown, after he so insisted, a test vial of the solution, "the lot number and expiration date [had been] obliterated." Id. As a result, he refused the PPD test, but was told, at the time, that "he would be cleared for general population housing after three days" which he supports by noting a check mark next to "general population" in the "placement" box on his June 12, 2009 medical history screening form. Id.; Rahman CCCF 2.

Plaintiff alleges, in his opposition brief, that it was not until several hours later that the nurse came back and told him that the medical director had insisted that if Plaintiff did not consent to a PPD test, he would not be cleared for the general population, but Plaintiff continued to refuse the test. Id. Plaintiff claims that he has proof of these allegations in the form of an identification card imprinted with the words "medical loc", which he says he would "produce[] at trial . . . ." Id.

Plaintiff alleges that, while he languished for three weeks in the I/D Unit, he suffered several deprivations, including an absence of cleaning materials, adequate soap, grievance forms, reading or writing materials, religious services, laundry services (or any ability to clean the single jumpsuit he had to wear), or visits from family or friends. S.A.C. 16-17. In addition, Plaintiff alleges that the air filtration system in the I/D Unit was faulty, exposing Plaintiff to any contagious airborne illnesses of the other inmates of the I/D Unit, including tuberculosis. Id. 22 ¶ a. Additionally, Plaintiff alleged that while he was being housed in the I/D Unit, he shared a cell with another inmate, "E.E.", who he claims was "known to harbor a resistant strain of tuberculosis in active pathogenic form." Id. 22 ¶ b.

Plaintiff alleges that on June 29, 2009, E.E. told Plaintiff that he had been given a chest x-ray that morning. Id. 22 ¶ c. The following day, Plaintiff alleges, E.E. was removed from the I/D Unit by "gloved and masked officers and members of the medical staff." Id. 22 ¶ d. Plaintiff alleges that he later learned from another inmate that E.E. had been transferred to an outside hospital "with the diagnosis of tubercular pneumonia." Id.

The following day, July 1, 2009, Plaintiff alleges that he and his cellmates were directed to the medical unit where they were told that they must have chest x-rays performed. Id. 23 ¶ e. The medical director allegedly informed Plaintiff that he was being given a chest x-ray because he had been exposed to tuberculosis, apparently due to contact with E.E. Id. 24 ¶ e. Plaintiff allegedly consented to the chest x-ray after hearing this news on the condition that he be allowed to "peruse[]" the x-ray film later. Id. 24 ¶ f. However, Plaintiff's medical records indicate that he refused a PPD test on that day. Rahman CCCF 9, 16. After his consult with the medical director and his chest x-ray, Plaintiff was cleared to transfer to the general population of CCCF, which occurred July 2, 2009. Id. 24 ¶ g. Plaintiff's x-ray report, prepared by Rose Liu, M.D., Radiologist, states that Plaintiff's "lung fields are clear, without mass, infiltrate, or effusion. The osseous structures are unremarkable. No tuberculosis is seen. Impression: Normal chest examination, without tuberculosis." Rahman CCCF 8.

Plaintiff alleges that he "lost more than 25 pounds" in the period of time after his exposure to E.E. S.A.C. 20 ¶ a. He also alleges that over the next several months, he "was unable to obtain follow-up x-rays or weight determinations despite more than thirty (30) sick call request[s]." Id. Plaintiff's medical records reflect his many requests to review his July 1 x-ray and to have other x-rays performed. Rahman CCCF 19-41. On the first of these occasions, Plaintiff's records indicate that he was offered the opportunity to discuss the results of his x-ray and be examined by a nurse, but he refused, as he only wanted to review the x-ray films himself. See, e.g. Rahman CCCF 19.

Defendant produced, under seal, the medical consultation records of E.E., Plaintiff's cellmate suspected of having tuberculosis. Consultation Records, Def.'s Ex. C. The consultation, performed by Joseph A. Kuchler, M.D. at Our Lady of Lourdes Hospital, indicates that E.E. was admitted to the hospital on June 30, 2009 and discharged on July 6, 2009. Ex. C. at 1. The consultation records an "impression" that "the patient has bilateral infiltrates with cavitary lesion." Id. Dr. Kuchler's consultation further states that "the patient underwent bronchoscopy and so far cultures are negative for tuberculosis." Id. Apparently on the basis of this impression, Sandra Vargas states in her certification that E.E. "was found to not have tuberculosis." Vargas Cert. ¶ 10.

Plaintiff was transferred from CCCF on January 19, 2010.

S.A.C. 2 ¶ 4. Two days later, on January 21, 2010, Plaintiff alleges that he had a "tuberculin skin test" performed at the Salem County Correctional Facility, which "remained nonreactive," indicating a negative result for tuberculosis. Id. 25 ¶ 19. Two months later, on March 18, 2010, Plaintiff alleges that he had a new "tuberculin skin test" performed that revealed a "positive reaction." Id. Plaintiff alleges that "this infectious response is consistent with the close contact experienced at CCCF." Id.

Plaintiff, proceeding pro se, filed his first Complaint in this action on January 22, 2010. [Docket Item 1.] On May 27, 2010, the Court dismissed the Complaint sua sponte for, among other reasons, failure to comply with Rules 8(a)(2) and (d)(1) of the Federal Rules of Civil Procedure, finding the allegations insufficiently specific as to particular actions taken by particular defendants. [Docket Items 4 & 5.] Plaintiff later moved to reopen the case and to file an Amended Complaint, which the Court granted on December 6, 2010. [Docket Item 9.] The Court, however, dismissed Plaintiff's claims against all Defendants except Defendant Eric Taylor, Defendant CFG Health Systems, LLC, and the (at the time) unidentified Medical Director of CCCF.

Defendant CFG later filed the instant motion to dismiss for failure to state a claim or, alternatively, for summary judgment. Plaintiff filed opposition to the motion in both a memorandum brief and a subsequent letter brief. [Docket Items 27 & 26.] Defendant's Reply brief followed [Docket Item 28], and was docketed on the same day as Plaintiff's motion for leave to file a Second Amended Complaint. [Docket Item 31.] The Second Amended Complaint is, in all material respects relevant to the instant motion, identical to his First Amended Complaint; it added Defendant Jeffrey D. Pomerantz, Medical Director at CCCF to the pleading and removed the allegations and defendants dismissed by the Court in its December 6, 2010 Order. Plaintiff's motion for leave to file was granted as unopposed. [Docket Item 37.]

After filing his motion for leave to amend, Plaintiff submitted further opposition to Defendant's motion in the form of three evidentiary objections and requests. [Docket Item 34.] Specifically, Plaintiff first objects to the certification of Sandra Vargas pursuant to Federal Rule of Evidence 602, on the grounds that she cannot testify about Plaintiff's treatment at CCCF on the basis of personal knowledge because she did not treat him. Second, Plaintiff objects to the consultation records of E.E., attached as Defendant's Exhibit C, pursuant to Fed. R. Ev. 106, claiming that the consultation record should be accompanied by a full hospital admission record and discharge summary. Finally, Plaintiff asks the Court to take judicial notice, pursuant to Fed. R. Ev. 201, of ...

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