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Young v. Smith

November 5, 2009


The opinion of the court was delivered by: Charles J. Siragusa United States District Judge



This is an action pursuant to 42 U.S.C. § 1983 ("Section 1983") in which Christopher Young ("Plaintiff"), a prison inmate confined at Attica Correctional Facility ("Attica"), claims that Dr. Alan Smith and Dr. Gerald Coniglio ("Defendants") violated his Eighth Amendment rights by denying him appropriate medical treatment for a knee injury. Now before the Court is Defendants' motion [#19] for summary judgment. For the reasons that follow, the application is granted.


Unless otherwise noted, the following are the facts of the case viewed in the light most-favorable to Plaintiff. On March 30, 2006, Plaintiff was playing basketball in the prison recreation yard when he suffered a ruptured patellar tendon in his left knee. Plaintiff was taken to Wyoming County Community Hospital ("the hospital"), where he was examined by defendant Alan Smith, M.D. ("Smith"), an emergency room physician. Smith was employed by a private medical group which had contracted with the hospital to provide medical services. Smith determined that Plaintiff required surgery, and scheduled him to see an orthopedic surgeon the following morning. In the meantime, Smith provided Plaintiff with pain medication, a leg "immobilizer" and crutches. Smith discharged Plaintiff from the hospital early in the morning of March 31, 2006.

Later that morning, Plaintiff was examined at Attica's orthopedic clinic by Gerald Coniglio, M.D. ("Coniglio"), an orthopedic surgeon. Coniglio provided orthopedic medical services to inmates pursuant to a contract with the New York State Department of Correctional Services ("DOCS"). Congilio scheduled surgery to take place on April 4, 2006.

On April 4, 2006, Coniglio performed orthopedic surgery to repair Plaintiff's fractured patella, using a procedure that re-attached the patella using surgical wire. Coniglio also prescribed "extensive physical therapy/rehabilitation." (Plaintiff's Memo of Law at 10). Following the surgery, Plaintiff complained "of the wires being extremely to[o] tight, and [of] the fact that he couldn't bend his knee," to which Coniglio responded that the knee "would loosen up eventually." Id.

Almost two months later, on June 24, 2006, Plaintiff was riding an exercise bicycle when he began to experience pain in the knee. On June 26, 2006, Coniglio examined Plaintiff and diagnosed another fracture of the patella, requiring further surgery. (Coniglio Affidavit [#22], Exhibit B) ("There is nonunion at the junction of the main patellar fragment and the distal fragment."). Prior to surgery, Plaintiff told Coniglio that he did not want his patella removed, unless he could have a prosthetic patella, to which Coniglio responded that "there was no such thing as a prosthetic knee cap without a total knee replacement." Id. at ¶ 9. On June 27, 2006, Coniglio performed a second surgery to repair the patella, during which he removed "several small fragments of [P]laintiff's knee." Id. at ¶ 10. On July 20, 2006, Coniglio noted that he removed the bone fragments "because they were necrotic."*fn1 (Plaintiff's Opposition to Summary Judgment [#30-2] at 67).

On June 22, 2007, Plaintiff commenced the instant action. With regard to Smith, Plaintiff asserts claims for "medical malpractice - personal injury (violating Eighth Amendment)," based on Smith's alleged improper placement of a leg brace, and on his decision not to provide surgery on an emergency basis. As for Coniglio, Plaintiff describes his claim as "medical malpractice violation of my Eighth Amendment rights." In that regard, Plaintiff alleges that Coniglio improperly delayed for four days, and then botched the initial surgery by installing surgical wire too tightly. Further, Plaintiff states that, during the second surgery, Coniglio removed part of his knee cap against his wishes, and failed to provide a prosthetic replacement.

On November 21, 2008, Defendants filed the subject motion for summary judgment.*fn2 Smith maintains that he cannot be liable under Section 1983, because when he provided medical treatment to Plaintiff, he was not acting "under color of state law." In that regard, Smith contends that when he treated Plaintiff, he was a private physician with a contract to provide medical services to Wyoming County Community Hospital. Smith was not employed by DOCS or Attica, and had no agreement with them to treat inmates. Smith further states that he provided appropriate emergency medical care to Plaintiff, by diagnosing a torn patellar tendon, immobilizing the leg, providing Plaintiff with crutches and pain medication, and referring him to Coniglio for follow-up care. Smith states that "[t]he need for surgery was not immediate and it would have been inappropriate for [him] to have operated on [P]laintiff." (Smith Affidavit [#21] at ¶ 16).

Coniglio, on the other hand, concedes that he acted under color of state law, since he provided orthopedic services to DOCS pursuant to a service agreement. However, he maintains that he provided Plaintiff with appropriate medical care. In that regard, he states, first, that the delay in operating on the knee was appropriate, because "by waiting the fractures heal better." (Coniglio Affidavit [#22] at ¶ 6). Coniglio further states that on April 4, 2006, he correctly performed surgery to repair Plaintiff's fractured patella: "Plaintiff complains that I caused the second surgery by making the wires too tight. This is inaccurate as the wires were placed with the proper tension." Id. at ¶ 13. Coniglio indicates that on June 26, 2006, he saw Plaintiff again and determined that further surgery was needed to repair the patella. Coniglio agrees that Plaintiff told him that he did not want the patella removed unless he could have a prosthetic knee cap, but he maintains that he correctly advised Plaintiff that "there was no such thing as a prosthetic knee cap without a total knee replacement." Id. at ¶ 9. Coniglio further contends that during the surgery, "[t]here were several small fragments of [P]laintiff's knee that had to be removed, but [he] did not remove the patella." Id. at ¶ 10. Additionally, Coniglio states that the removal of "4 or 5 pieces of comminuted bone" was "medically necessary and left the knee cap intact." Id. at ¶ 14.

In opposition, Plaintiff contends that Smith acted under color of law, since he "was an employee of a company wh[ich] was under contract with the hospital, wh[ich] was essentially under contract with [DOCS]." (Plaintiff's Memo of Law at 1). Plaintiff further states that Smith treated him in an area of the hospital that was a "secure designated area specifically designed for the inmate patients from [DOCS]," and therefore "knew of a working relationship and contract between the hospital and [DOCS]." (Plaintiff's Memo of Law at 7). Plaintiff also maintains that Smith should have performed surgery to repair his knee on the night of the injury. Plaintiff contends that Smith's decision to refer Plaintiff to Coniglio resulted in him "suffering" for four days while he awaited surgery. (Plaintiff's Memo of Law at 1). Plaintiff further states that "Smith's choice to place an immobilizer on [the leg while Plaintiff's] knee-cap [was] still sitting on his thigh muscle area caused muscle damage to the thigh muscle." (Plaintiff's Statement of Facts ¶ 7). As for Coniglio, Plaintiff states that Coniglio must have over-tightened the wires in his knee, since the patella subsequently broke while Plaintiff was "performing physical therapy exercises that Dr. Coniglio ordered." Id. at ¶ 13. Plaintiff further states that Coniglio told him that during the second surgery, he intended to remove the entire patella, and that Plaintiff objected to such removal, unless Coniglio was going to install a prosthetic patella. According to Plaintiff, Coniglio responded "that there is no such thing as a prosthetic knee-cap, and that it was common practice to remove the entire knee-cap replacing it with nothing." Id. at ¶ 17. Plaintiff states that he subsequently reiterated to Coniglio that he wanted the knee cap repaired or replaced, but not removed, to which Coniglio responded that he would assess the damage but not remove the knee cap. Plaintiff maintains, though, that during surgery Congilio removed "one fourth (1/4) of his knee-cap" without his consent.

Id. at ΒΆ 21. Plaintiff further contends that he eventually required a third surgery, to repair mistakes that Coniglio made during ...

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