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Lytle v. United States

United States District Court, E.D. Kentucky, Central Division, Lexington

October 23, 2018

ALVIN LYTLE, Plaintiff,
v.
UNITED STATES OF AMERICA, ET AL., Defendants.

          MEMORANDUM OPINION AND ORDER

          KAREN K. CALDWELL, CHIEF JUDGE.

         Alvin Lytle was recently a prisoner at the Federal Medical Center (FMC) in Lexington, Kentucky. Proceeding without a lawyer, Lytle filed a complaint challenging the sufficiency of the medical care he received at the prison. [R. 1]. Lytle asserts civil rights claims against two prison medical professionals, as well as a claim against the United States of America pursuant to the Federal Tort Claims Act (FTCA). The defendants have now filed a motion to dismiss Lytle's claims or, in the alternative, a motion for summary judgment [R. 27], Lytle has filed his response [R. 33], and the defendants have filed their reply [R. 34]. This matter is therefore ripe for a decision. For the reasons set forth below, the Court will grant the defendants' dispositive motion in part and deny it in part. The Court will then refer this case to a Magistrate Judge for further proceedings, including the initiation of discovery.

         I.

         Lytle arrived at FMC-Lexington in 2014 with multiple health problems, including diabetes. [R. 27-3 at 2]. Lytle was assigned to Dr. Terre Adams's caseload, meaning that Dr. Adams was ultimately responsible for the full range of primary medical care that the prison provided Lytle. [Id. at 1]. In November 2016, Dr. Adams personally evaluated Lytle. [Id. at 2]. Based on Lytle's history of diabetes and a previous non-healing foot ulcer, Dr. Adams scheduled Lytle for a diabetic foot examination at the prison's physical therapy department. [Id.]. A physical therapist conducted the exam and noted that Lytle had dry skin on his lower left extremity and a callus on the right fifth metatarsal head. [Id. at 18]. That said, Lytle had no pre-ulcers or ulcers, and his examination was otherwise unremarkable. [Id. at 2, 18].

         On February 28, 2017, Lytle went to sick call and complained that he had been experiencing pain and redness in his right great toe for three days. [R. 27-3 at 2, 20-21]. Practitioner Tony Banta evaluated Lytle and determined that he had no drainage or bleeding, his skin was intact, and he had a full range of motion. [Id. at 23-24]. However, Lytle did have swelling, erythema, and tenderness, and the area was not warm to the touch. [Id. at 24]. Practitioner Banta also noted that Lytle had a “[s]imilar incident previously in [his] l[eft] great toe resulting in partial amputation.” [Id. at 23]. Practitioner Banta prescribed Lytle Bactrim for 10 days and acetaminophen/codeine for three days, ordered him a uric acid test, and scheduled him for a follow-up examination three days later. [Id. at 24]. Dr. Adams then reviewed Practitioner Banta's clinical notes and cosigned on the treatment he provided to Lytle. [Id. at 26].

         Lytle alleges in documents attached to his complaint that, at some point prior to March 1, 2017, he spoke to Dr. Adams and said that he thought his foot was infected and that he needed to go to the hospital. [R. 1-2 at 3]. According to Lytle, Dr. Adams told Lytle he would “not be going to the hospital” and that “[a]nything they can do there, we can do here.” [Id.].

         From March 1, 2017 until March 7, 2017, FMC-Lexington was on a modified operations status. [R. 27-3 at 2]. As a result, prison officials cancelled medical appointments during that time, including Lytle's March 3, 2017 follow-up examination. [Id. at 2-3]. Still, prison medical staff made rounds in each housing unit twice per day, and on March 4, 2017, the staff renewed Lytle's acetaminophen/codeine prescription for three more days. [Id. at 3, 27]. Lytle acknowledges that he was “given extra antibiotics” while the prison was on modified operations, but he also claims that he had to “endure excruciating pain” and his “condition was deteriorating” during this time. [R. 1-2 at 3].

         On March 7, 2017, the prison returned to normal operations, and Practitioner Banta examined Lytle in the clinic. [R. 27-3 at 3, 28]. Lytle indicated that he had a sharp pain in his right great toe but denied that he had any bleeding or draining. [Id. at 28]. Practitioner Banta also noticed that Lytle had no areas of active bleeding or drainage, but he did see that Lytle still had erythema and a “rash and other nonspecific skin eruption.” [Id. at 28-29]. As a result, Practitioner Banta prescribed Lytle oral doxycycline for 14 days and ceftriaxone intramuscular injections for 3 days, with the first injection given in the clinic. [Id. at 29].

         On March 8, 2018, Practitioner Banta renewed Lytle's acetaminophen/codeine prescription for three more days, and Dr. Adams cosigned the prescription renewal. [R. 27-3 at 31]. Practitioner Banta also ordered radiographs of Lytle's right foot due to his edema and pain. [Id. at 33].

         On March 9, 2018, Lytle returned to the clinic and complained that his right great toe was bleeding and draining. [R. 27-3 at 3, 35]. Practitioner Banta checked Lytle's temperature, pulse, respiratory rate, blood pressure, and oxygen saturation level. [Id. at 35-36]. Practitioner Banta also examined Lytle's toe and took a culture of his wound. [Id. at 36]. Practitioner Banta determined that Lytle's toe infection, pain, and appearance had all worsened, and he specifically recalled Lytle's past partial amputation of his left great toe. [Id.]. Practitioner Banta discussed Lytle's condition and history with Dr. Adams and, together, they decided to transfer Lytle to the University of Kentucky Medical Center for further evaluation and treatment. [Id. at 3, 36-38]. Lytle was admitted to the University of Kentucky Medical Center on March 9, 2017, and doctors amputated Lytle's great right toe the next day. [Id. at 39-47]. Lytle remained in the hospital until March 13, 2017, when he returned back to FMC-Lexington. [Id. at 47].

         Lytle disputes this timeline in his complaint. To be sure, Lytle acknowledges that Practitioner Banta examined and treated him on March 9, 2017. [R. 1 at 2]. However, Lytle claims that on that date he “urged” Practitioner Banta to “take him to the local hospital because he was experiencing extreme pains, but that Practitioner Banta refused, saying, ‘Anything the hospital can do for you, we can do for you.'” [Id.]. Lytle then claims that he returned to the prison clinic on March 10, 2017, and only then did Practitioner Banta decide to send him to the hospital. [Id.]. Lytle's medical records, however, show that he was admitted to the University of Kentucky Medical Center on March 9, 2017, had his surgery on March 10, 2017, and returned to FMC-Lexington on March 13, 2017. [R. 27-3 at 39-47].

         Shortly thereafter, Lytle filed an administrative tort claim with the Bureau of Prisons. [Rs. 1-2, 1-3]. Lytle claimed, among other things, that the loss of his great right toe was “the result of negligence, malpractice, refusal of medical care, and deliberate indifference.” [R. 1-2 at 2]. The Bureau of Prisons, however, denied Lytle relief. [R. 1-4 at 2].

         Lytle then filed this lawsuit. [R. 1]. Lytle's complaint is difficult to follow; however, construing his pro se submission liberally, it appears that Lytle is asserting two types of claims. First, Lytle appears to be bringing Eighth Amendment deliberate indifference claims against Dr. Adams and Practitioner Banta; after all, Lytle names both of these individuals as defendants, alleges they “failed to properly handle [his] ongoing pain and suffering from the infection, ” and attaches exhaustion documents in which he claims that they displayed “deliberate indifference” to his medical needs [R. 1 at 5, R. 1-2 at 2]. Second, Lytle claims these individuals committed medical malpractice and, as a result, the United States is liable pursuant to the FTCA.[1] [R. 1 at 3-7]. Ultimately, the crux of Lytle's complaint and attached exhibits is that Dr. Adams and Practitioner Banta did not properly treat his toe because, among other things, they failed to send him to the hospital sooner despite his repeated requests.

         The defendants have now filed a motion to dismiss Lytle's claims or, in the alternative, a motion for summary judgment [R. 27], Lytle has filed his response [R. 33], and the defendants have filed ...


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