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Washington Prisoner Granted Injunction Ordering Outside Orthopedic Evaluation

Washington Prisoner Granted Injunction Ordering Outside Orthopedic Evaluation

by Mark Wilson

A Washington federal district court issued a preliminary injunction ordering prison officials to have an orthopedic specialist evaluate a prisoner’s shoulder injury.

Washington prisoner Shawn Francis began complaining of shoulder pain in February 2007. After six months of ineffective treatment efforts, he was referred to Dr. James Swenson, an outside orthopedic specialist. In September 2007, Dr. Swenson recommended an MRI and other treatment; however, the prison medical director refused to authorize an MRI.

Francis saw Dr. Swenson again in February 2008. Noting that “he previously thought [Francis] had an acromioclavicular joint injury,” the doctor again recommended an MRI to rule out a rotator cuff or labral pathology.

An April 2008 MRI revealed “osteoarthritic changes at the acromioclavicular joint and a small anterior labral tear.” Francis declined further treatment at that time.

Francis re-injured his shoulder in March 2011. When steroid medication proved ineffectual, he was referred for physical therapy. Four months later, however, the physical therapist concluded “No improvement. Needs ortho. consult.” Despite that recommendation and medical staff noting five months of increasing pain, the prison’s Care Review Committee denied the referral for a consultation.

In September 2011, Francis reported increasing pain and difficulty “dressing and cleaning himself,” and said “his sleep was interrupted every time he rolled on the shoulder.” In December, medical providers requested that Francis “receive further shoulder evaluation in the form of an MR Arthrogram”; however, the Care Review Committee denied that request.

When Francis complied with a January 2012 order to pick up his property box, he “heard a pop in his right shoulder,” felt “extreme pain and ... dropped the box.” Treatment for his pain was limited to high doses of ibuprofen, which caused stomach problems.

Francis filed a federal lawsuit alleging deliberate indifference to his serious medical needs. He also moved for a preliminary injunction, seeking an “order that defendants refer him to an orthopedic specialist for further evaluation and treatment.”

On March 4, 2013, a magistrate judge recommended granting the injunction in part and ordering prison officials to “send plaintiff to an orthopedic specialist for a full evaluation of his right shoulder including a magnetic resonance image test (‘MRI’).”

The district court concluded “that plaintiff’s condition is a serious medical need” and the defendants had acted with deliberate indifference. Noting that Francis’ symptoms met the Care Review Committee’s definition of “intractable pain,” the court found “that the decision to deny diagnostic treatment [was] unreasonable” and that if Francis did not receive a “full and complete orthopedic evaluation, then this is likely to result in irreparable injury (if it hasn’t already).”

Finally, the balance of hardships tipped “sharply in plaintiff’s favor,” even though prison officials would “need to expend funds for an orthopedic evaluation and for plaintiff’s transport” to an outside specialist. “When adjudicating a preliminary injunction motion, the Ninth Circuit expects lower courts to protect physical harm to an individual over monetary costs to government entities,” the court wrote.

On April 10, 2013, the district court adopted the magistrate’s recommendations and granted injunctive relief, ordering prison officials to “make arrangements to have plaintiff’s right shoulder fully evaluated by an outside orthopedic specialist within 21 days.” The defendants appealed.

At oral argument, however, the defendants advised the Ninth Circuit that they had already complied with the injunction, and the appeal was dismissed as moot on November 14, 2013.See: Francis v. Hammond, 544 Fed.Appx. 784 (9th Cir. 2013).

The parties filed cross-motions for summary judgment, and the district court adopted the magistrate’s recommendations on April 14, 2015, denying Francis’ motion for partial summary judgment, granting the defendants’ motion for summary judgment and dismissing the case with prejudice. Francis has since appealed the court’s judgment and his appeal remains pending. See: Francis v. Hammond, U.S.D.C. (W.D. Wash.), Case No. 3:12-cv-06023-RBL; 2013 U.S. Dist. LEXIS 51885.


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Related legal cases

Francis v. Hammond

Francis v. Hammond