United States District Court, M.D. Tennessee, Columbia Division
CYNTHIA SMITH RUSSELL, Individually, and as Adminstratix of the ESTATE OF JASON WAYNE HENDRIX, Deceased, and on behalf of all other wrongful death beneficiaries, Plaintiff,
OTIS CAMPBELL, JR., M.D; ELLEN FOWLKES, R.N.; AMANDA DAVIS, R.N.; LINDA FLOWERS, R.N.; and MHM HEALTH PROFESSIONALS INC. Defendants.
WAVERLY D. CRENSHAW, JR., CHIEF UNITED STATES DISTRICT JUDGE
before the Court is the Motion for Partial Summary Judgment
(Doc. No. 36) filed by Defendants Otis Campbell, Jr., M.D.,
Ellen Fowlkes, R.N., Amanda Davis, R.N., and Linda Flowers,
R.N., to which Plaintiff Cynthia Smith Russell has responded
in opposition (Doc. No. 43) and Defendants have replied (Doc.
No. 48). For the reasons that follow, the Motion will be
granted in part and denied in part.
an action for deliberate indifference and wrongful death
under 42 U.S.C. § 1983, and for violations of the
Tennessee Health Care Liability Act, Tenn. Code Ann. ¶
29-16-101. It is brought by Plaintiff, individually, and on
behalf of the estate of her son, Jason Wayne Hendrix.
Hendrix was an inmate at the Turney Center Industrial Complex
(“Turney Center”), a TDOC facility. The
individual Defendants all provided medical services at the
facility: Otis Campbell, Jr. as a physician; and Ellen
Fowlkes, Amanda Davis, and Linda Flowers as registered
November 8, 2015, Mr. Hendrix fell on the metal commode in
his cell, injuring his shoulder. Plaintiff attributes the
fall to Mr. Hendrix having eaten undercooked chicken that had
been served to several inmates at the Turney Center on
November 3, 2015. (PSOF ¶¶ 6, 8).
Campbell examined Mr. Hendrix's shoulder on November 8,
2015, and ordered an x-ray of Mr. Hendrix's shoulder and
side. Dr. Campbell also prescribed Motrin, Toradol, and an
analgesic balm. (Id. ¶ 9).
November 13, 2015, Plaintiff called his mother and told her
that he had shoulder and severe stomach pain. He also told
her that he was in his cell, but expected to be transferred
to the Turney Center's on-site clinic on November 16,
2015. (Id. 10, 11).
approximately 7:30 p.m. on November 17, 2015, Mr. Hendrix was
transferred to the clinic. (TDOC p. 270). At the time, he
told Nurse Fowlkes that he had been experiencing diarrhea and
vomiting for two days. He also reported pain, a dry mouth,
dizziness, and nausea upon standing. (PSOF ¶ 1). Noting
“[d]ehydration and possible fluid deficit, ”
Nurse Fowlkes, pursuant to Dr. Campbell's instructions,
started an intravenous (“IV”) line and provided
Mr. Hendrix with Vicodin and Parafon Forte, the latter of
which he refused to take. (Id.; TDOC p. 270). Nurse
Fowlkes' shift ended around 10:00 p.m., and Nurse Flowers
assumed responsibility for Mr. Hendrix's care.
(Fowlkes' Aff. ¶ 5).
10:05 p.m., Mr. Hendrix fell while guards were escorting him
down a clinic corridor. He was helped to a chair in the
hallway and then walked unescorted to Room 2 where he told
Nurse Flowers, “I don't know what happened, I think
I passed out.” (TDOC p. 270). Mr. Hendrix also stated,
“I told y'all that I was hurting bad, ” and
that, “I'm really sick. I'm not making this
up.” (PSOF ¶ 14; TDOC p. 270).
Flowers found Mr. Hendrix to be “diaphoretic”
(i.e. sweating heavily), and he stated that he was
too sick to take off his clothing in order to be examined.
His pulse rate at the time was 120 beats per minute (bpm).
(PSOF ¶¶ 15, 16; TDOC p. 269). Because Mr. Hendrix
claimed to be hot, Nurse Flowers brought him a fan. (TDOC
269). As Nurse Flowers was leaving the room Mr. Hendrix asked
if he could turn off the light, but Nurse Flowers demurred,
saying she wanted to keep an eye on him. (Id.).
than thirty minutes later, at approximately 10:40 p.m., Nurse
Flowers return to Mr. Hendrix's room, at which time he
disrobed so that he could be examined. After the examination,
Mr. Hendrix was provided with a urinal and given instructions
on how to use it so that the medical staff could see how much
urine he produced. (Id. at 268). Before leaving,
Nurse Flowers showed Mr. Hendrix how to use the call light if
he needed attention.
Hendrix was rechecked by Nurse Flowers at 1:10 a.m. on
November 18, 2015, who noted that his skin was warm and dry
to the touch, his lung sounds were clear, and bowel sounds
were heard in all four quadrants. Nurse Flowers also examined
Mr. Hendrix's neck “for obvious injury, ” but
none was found. (Id. at 270).When asked, Mr. Hendrix
was able to move his neck freely from side-to-side. At that
time, Mr. Hendrix stated, “If I try to stand up I feel
like I will faint.” (Id. at 267-268).
a.m. on November 18, 2015, Mr. Hendrix was observed on camera
going to the bathroom. Upon finishing, he activated the call
light to summon Nurse Flowers. She found that Mr.
Hendrix's stools were “black (tarry) and showed
‘frank'[i.e. visible] blood.” (TDOC
p. 267). Mr. Hendrix admitted that, within a two-day period,
he had ingested 30 Naproxen pills, 24 Motrin pills, and most
of a prescription for Mobic tablets. (PSOF ¶ 1; TDOC p.
266). He claimed to have taken that medicine because his
shoulder was still hurting. (TDOC p. 267). Nurse Flowers told
Mr. Hendrix that so much medicine in such a short period
could cause a “GI bleed” and “make him feel
like he was going to faint and feel very weak.”
(Id.). Nurse Flowers noted on the chart “G.I.
bleed/ previous shoulder injury.” (Id.).
finishing with Mr. Hendrix, Nurse Flowers called Dr. Campbell
to inform him about what she had learned. (PSOF ¶ 20,
TDOC p. 266). Nurse Flowers was instructed to keep Mr.
Hendrix in the clinic, observe him, and monitor his vital
signs every two hours until Dr. Campbell came into the
clinic. (TDOC p. 266).
two hours latter, at 3:30 a.m. on November 18, 2015, Nurse
Flowers went in to see Mr. Hendrix and told him that Dr.
Campbell had been called and would examine him that morning.
Mr. Hendrix reported that he was still very weak. Nurse
Flowers told him that this could be caused by a “GI
Bleed” given the medications he had taken. (TDOC p.
265). Plaintiff characterizes Nurse Flowers's note to
that effect as being a diagnosis that Mr. Hendrix had a
gastrointestinal hemorrhage. (PSOF ¶ 21).
a.m. that day, Nurse Flowers looked in on Mr. Hendrix again
and found his skin to be “slightly clammy/warm.”
(TDOC p. 264). She wrote in her notes “GI Bleed,
” (id.), which Plaintiff again characterizes
as a diagnosis of a “gastrointestinal
hemorrhage.” (DSOF ¶ 21). Nurse Flowers updated
Dr. Campbell on Mr. Hendrix's condition and was
instructed to continue monitoring him. Dr. Campbell also
ordered a complete blood count (“CBC”) to
determine blood loss, but those results did not return until
after Mr. Hendrix left the Turney Center clinic. (PSOF
¶¶ 4, 5).
Davis relieved Nurse Flowers at around 6:00 a.m. on November
18, 2015. When Nurse Davis went to see Mr. Hendrix at 7:30
a.m., he stated, “I'm hurting so bad in my stomach
and my neck, you've got to help me.” (TDOC p. 264).
Mr. Hendrix was examined and his heart rate was 109 bpm.
Davis drew blood for the CBC as ordered by Dr. Campbell, a
procedure that Mr. Hendrix “tolerated well.”
(Id.). Further, because Mr. Hendrix's skin was
clammy and he complained of being hot, he was given a cold
compress to place on his head and ice water. He was also
provided breakfast. (Id.).
9:00 a.m., Mr. Hendrix used the call light to summon Nurse
Davis. When she entered the room, Mr. Hendrix stated that he
was unable to sit and felt “like he would pass
out.” (PSOF ¶ 25). He also stated, “My head
hurts now with my neck and I think it[']s to do with that
fall.” (TDOC p. 263). Upon examination, Mr.
Hendrix's skin was found to be “pale and clammy,
” and he had a heart rate of 118 bpm. (Id.).
Davis called Dr. Campbell and was instructed to continue
monitoring Mr. Hendrix. Dr. Campbell also ordered an x-ray of
Mr. Hendrix's spine and skull.
Hendrix was not examined again by Nurse Davis through the
remainder of her shift. However, Nurse Davis claims that she
and other nurses continued to monitor him by camera, until
her shift ended around 2:00 p.m. (Doc. No. 36-2, Davis Aff.
¶¶ 8, 9).
Hendrix was examined by Dr. Campbell at 1:00 p.m. on November
18, 2015. At the time, Mr. Hendrix reported that he was
hurting all over. His temperature was 98.4E degrees
Fahrenheit, his blood pressure was 138/70 and his pulse rate
was 120 bpm. Upon examination, Dr. Campbell found “mild
tenderness along [the] C-spine, as well as “mild
epigastric tenderness of the abdomen.” (TDOC p. 263).
Campbell diagnosed a “GI hemorrhage, ” secondary
to “NSAID toxicity.” (Id.). In an
affidavit filed in support of Defendants' Motion, Dr.
Campbell asserts that he believed Mr. Hendrix “likely
suffered from gastritis due to ingesting an excessive amount
of nonsteroidal anti-inflammatory drugs
(‘NSAIDs').” (Doc. No. 36-1, Campbell Aff.
¶ 13). Dr. Campbell prescribed intravenous fluids, along
with a liter of D5NS, (TDOC p. 263), which is a fluid
containing electrolytes and calories. He also prescribed
Lortab for pain, Benadryl for nausea, and ...