problems and headaches. Defendant Clark's Motion for Summary
Judgment Ex. F. By plaintiff's own admission, he never told Dr.
Clark that he had pain in his hand, or asked her if he could
receive Darvocet. See Plaintiff's Aff. ¶ 17.
Based on this evidence, I find that plaintiff's claim against
Dr. Clark cannot stand. Her decision to countermand Dr.
Siegrist's Darvocet prescription was based on her medical
judgment, and her reasonable concern about providing narcotics to
jail inmates. See Holleman v. Duckworth, 202 F.3d 273 (table)
1999 WL 1082511 *1 (7th Cir. 1999) ("A prison has a legitimate
interest in limiting the use of narcotics by prisoners").*fn1
While I realize that the reasons for her actions come from her
own affidavit, I do not believe that this requires me to make
determinations of credibility that are impermissible on a motion
for summary judgment. The record simply contains no evidence to
suggest that Dr. Clark's actions were based on anything other
than her medical judgment. Certainly there is no indication that
she acted with "criminal recklessness." Hemmings, 134 F.3d at
In addition, the fact that her directive may have been contrary
to Dr. Siegrist's prescription does not indicate that Dr. Clark
acted for culpable reasons. Not every physician will treat every
ailment in exactly the same manner. That does not mean that one
of the physicians must be acting with deliberate indifference to
the patient's needs. That is particularly true when one of the
physicians is more familiar with the jail or prison environment,
and therefore more sensitive to the need to restrict narcotics
use. See Thomas v. O'Haver, 142 F.3d 440 (table), 1998 WL
171270 * 4 (7th Cir. 1998) ("Physicians will disagree about
whether a particular course of treatment is appropriate, or even
if treatment is appropriate at all, but a disagreement in
treatment alone will not support a constitutional violation")
(citing Snipes v. DeTella, 95 F.3d at 586, 590 (7th Cir. 1996),
cert. denied, 519 U.S. 1126, 117 S.Ct. 980, 136 L.Ed.2d 863
(1997)); Foote v. Nevada Dept. of Prisons, 139 F.3d 904
(table), 1998 WL 74993 *1 (9th Cir. 1998) ("A difference of
opinion, whether between an inmate and physician or between
physicians, does not give rise to an Eighth Amendment violation")
(citing Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir. 1989));
Taylor v. Dutton, 85 F.3d 632 (table), 1996 WL 253856 *2 (7th
Cir. 1996) ("Mere differences of opinion among medical personnel
over questions of treatment do not give rise to an Eighth
Amendment claim") (citing Estelle, 429 U.S. at 107, 97 S.Ct.
285); Hanson v. Smith, 9 F.3d 1557 (table), 1993 WL 499831 *2
(10th Cir. 1993) ("Even should medical opinions differ among
prison doctors, such a difference of opinion does not support a
claim of cruel and unusual punishment") (citing Ramos v. Lamm,
639 F.2d 559, 575 (10th Cir. 1980), cert. denied,
450 U.S. 1041, 101 S.Ct. 1759, 68 L.Ed.2d 239 (1981)); Sanders v. Vigil,
917 F.2d 28 (table), 1990 WL 160964 *2 (9th Cir. 1990) (evidence
of disagreements between outside doctors and prison doctors might
be sufficient to overcome summary judgment motion in simple
malpractice action, but even if proven, such evidence would not
demonstrate deliberate indifference); Cruz v. Ward,
558 F.2d 658, 662 (2d Cir. 1977) ("it is to be expected that prison
physicians should sometimes disagree with the opinions of the
hospital staff"), cert. denied, 434 U.S. 1018, 98 S.Ct. 740, 54
L.Ed.2d 765 (1978); Gardner v. Zaunbrecher, No. 95-CV-1543,
1996 WL 507072 *2 (N.D.N.Y. Sept. 4, 1996) (disagreement among
plaintiff's physicians over proper course of treatment did not
show conscious or callous indifference to serious medical need);
Webb v. Jackson, No. 92 Civ. 2149, 1994 WL 86390
*3 (S.D.N.Y. Mar. 16, 1994) ("It is well established that a mere
differences [sic] in opinion, whether between doctors or laymen,
based on medical care does not give rise to an Eighth Amendment
violation of inadequate medical treatment pursuant to section
1983"), aff'd, 47 F.3d 1158 (2d Cir. 1995).
Moreover, Dr. Clark did not direct the nursing staff to
withhold all pain medication from plaintiff, but just one
particular, narcotic medication. That does not show sufficient
disregard to plaintiff's medical needs to give rise to a
constitutional claim. See Reeves v. Caldwell, No. Civ.
98-363-ST, 1999 WL 375580 *5 (D.Or. Mar. 3, 1999) (plaintiff's
allegations that Tylenol did not sufficiently alleviate his pain,
and that defendant should have increased pain medication sooner,
did not rise to level of deliberate indifference sufficient to
amount to constitutional violation); Sanocki v. Reno, No. Civ.
A. 96-3603, 1998 WL 184460 *5 (D.Kan. Mar.16, 1998) (medical
decision to provide different pain relief medication than that
recommended by consulting surgeon did not represent cruel and
unusual punishment); Hendrickson v. Emergency Med. Servs., No.
Civ.A. 95-4392, 1996 WL 472418 *2 (E.D.Pa. Aug.20, 1996)
(although plaintiff argued that he should have been given
something stronger than Advil or Tylenol for pain, "mere
disagreements over medical judgment do not state Eighth Amendment
claims") (quoting White v. Napoleon, 897 F.2d 103, 110 (3d Cir.
1990)); Jones-Bey v. Wright, No. 3:93cv0440, 1996 WL 277961 *6
(N.D.Ind. May 14, 1996) (defendant physician's decision to
discontinue pain medication that plaintiff had been taking at
county jail was decision regarding appropriate medical treatment,
and plaintiff's disagreement with that decision did not establish
deliberate indifference); Floyd v. Owens, No. 86-7176, 1987 WL
11906 *1 (E.D.Pa. June 2, 1987) (plaintiff's allegation that
"medical staff" should have prescribed pain medication more
potent than Motrin did not state claim under § 1983); see also
Dean v. Coughlin, 804 F.2d 207, 215 (2d Cir. 1986) (prisoner
does not have absolute right to treatment of his choice).
In addition, it is noteworthy that plaintiff, on the occasions
when he did see Dr. Clark at sick call, never complained of
pain in his hand. He states in his affidavit that this was
because he believed that Dr. Siegrist was the only physician
charged with caring for his hand injury. Whatever the reason,
however, the fact remains that based on her interactions with
plaintiff, Dr. Clark had no reason to believe that plaintiff was
suffering from pain in his hand, or that his over-the-counter
medications were not adequately relieving his pain. Thus, there
is no basis for a claim against her.
IV. Claim Against Nurse Stanwick
I find that defendant Stanwick is entitled to summary judgment
as well. For one thing, much of what I have stated concerning Dr.
Clark applies to Stanwick as well. She did provide plaintiff with
Tylenol, and there is no evidence that she acted with deliberate
indifference to a serious medical need. In addition, as with Dr.
Clark, plaintiff admits that he never directly complained to
Stanwick of pain in his hand. Plaintiff's Aff. ¶ 17. Although he
did apparently complain of pain to some members of the nursing
staff, there is no basis upon which to infer that Stanwick
should, or even could, have known that the Tylenol or other
over-the-counter medication being given to plaintiff was not
adequate to control his pain.
In addition, Stanwick clearly did not unilaterally decide to
countermand Dr. Siegrist's directives and withhold Darvocet from
plaintiff. Rather, she acted in compliance with Dr. Clark's
instructions, which, as explained above, were objectively
reasonable. As a Jail physician, Dr. Clark, not Dr. Siegrist, was
the physician to whom Stanwick had to turn for instructions on
patient care, and there is no evidence to suggest that there was
any reason that she should have questioned Dr.
Clark's judgment in this regard. While a violation might exist if
a nurse, blindly following the instructions of a physician who
had not personally observed an inmate or detainee, completely
ignored obvious signs of severe pain, that is not what happened
here. Plaintiff never said anything to Stanwick about his pain,
and from the reports that she received, there was no reason for
Stanwick to think that the medication being given to plaintiff
was inadequate to relieve his pain. In short, there is no basis
for a claim against Stanwick at all.
Defendant Linda Clark, M.D.'s motion for summary judgment
(Docket Item 34), and defendant Marilyn Stanwick's motion for
summary judgment (Docket Item 39) are granted, and the complaint
IT IS SO ORDERED.