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UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION ESTATE OF RICHIE MAJORS, et al., Plaintiffs, Case No. 16-cv-13672 v. HON. MARK A. GOLDSMITH ROGER A. GERLACH, et al., Defendants. ___________________________________/ OPINION & ORDER DENYING (1) DEFENDANTSâ MOTION FOR SUMMARY JUDGMENT (Dkt. 201) AND (2) DEFENDANTSâ MOTION FOR ORDER AND JUDGMENT (Dkt. 199) This action is before this Court on remand after the United States Court of Appeals for the Sixth Circuit found that Plaintiffsâ Eighth Amendment claims survived summary judgment against two Defendants. Pending are Defendantsâ renewed motion for summary judgment (Dkt. 201) and Defendantsâ motion for an order and judgment in their favor (Dkt. 199). For the reasons that follow, the Court denies Defendantsâ motions.1 I. BACKGROUND The material facts are summarized in this Courtâs opinion granting Defendantsâ earlier motion for summary judgment, see Est. of Majors v. Gerlach, No. 16-cv-13672, 2019 WL 1242778, at *1â*5 (E.D. Mich. Mar. 18, 2019), and the Sixth Circuitâs opinion reviewing that decision on appeal, see Est. of Majors v. Gerlach, 821 F. Appâx 533, 534â536 (6th Cir. 2020).  1 Because oral argument will not aid the Courtâs decision, the motion will be decided based on the partiesâ briefing. See E.D. Mich. LR 7.1(f)(2). In addition to Defendantsâ motions, the briefing includes Plaintiffsâ response to Defendantsâ motion for summary judgment (Dkt. 204) and Defendantsâ reply in support of that motion (Dkt. 205). A. Richie Majorsâs Multiple Sclerosis Condition Richie Majors began serving a prison sentence with the Michigan Department of Corrections at the Richard A. Handlon Correctional Facility in March 2010, at which time Majors informed medical staff that he had been diagnosed and treated for multiple sclerosis. Majors, 821 F. Appâx at 535. Majors manifested two apparent MS relapses while incarcerated at that facility between March 2010 and December 2012. Id. In December 2012, Majors was transferred to the Gus Harrison Correctional Facility, where he received care from Defendant physicianâs assistant Savithri Kakani. Id. He remained under Kakaniâs care at that facility until July 2014, when Majors was transferred to the West Shoreline Correctional Facility. Id. Here, Majors was treated by medical providers including Defendant physicianâs assistant Thomas LaNore. Id. at 535â536. Majorsâs condition declined throughout 2015, and he suffered relapses after being discharged in October 2015. Id. at 536. Majors passed away due to conditions related to MS in a Detroit nursing home in June 2016. Id. B. Initiation of Present Action and Dismissal of Certain Claims Plaintiffs are Majorsâs estate and Majorsâs sister ReâShane Lonzo, as personal representative of his estate. They initiated this action against twelve medical providers, alleging deliberate indifference in violation of the Eighth Amendment and wrongful death under Mich. Comp. L. § 600.2922. See Am. Compl. (Dkt. 24). This Court dismissed certain claims and one Defendant based on the expiration of the statute of limitations. See Majors v. Gerlach, No. 16-cv-13672, 2017 WL 3581321, at *4 (E.D. Mich. Aug. 18, 2017). After Plaintiffs failed to conduct any expert discovery or submit witness lists or exhibit lists, they filed a motion to extend this caseâs scheduling order, which this Court denied. See 8/29/18 Op. & Order Denying Pl. Mot. to Extend (Dkt. 123). This Court subsequently granted one Defendantâs motion to dismiss based on lack of proper service. See 8/29/18 Op. & Order Granting Def. Mot. to Dismiss (Dkt. 125). C. Earlier Grant of Summary Judgment This Court then granted summary judgment in favor of the remaining Defendants on all remaining claims. See Majors, 2019 WL 1242778, at *14. In granting summary judgment, this Court recited the substance of an Eighth Amendment claim alleging deliberate indifference toward an incarcerated individualâs medical needs, which remains applicable to the issues presently before the Court. A plaintiff must demonstrate two components: (i) the objective component, which ârequires that the deprivation alleged be âsufficiently serious,ââ id. at *6 (quoting Farmer v. Brennan, 511 U.S. 825, 837 (1994)); and (ii) the subjective component, which ârequires a showing that prison officials have âa sufficiently culpable state of mind in denying medical care,ââ id. at *7 (quoting Blackmore v. Kalamazoo Cty., 390 F.3d 890, 895 (6th Cir. 2004) (punctuation modified)). To prevail on the objective prong, a plaintiff must first demonstrate that he or she had âserious medical needs.â Blackmore, 390 F.3d at 896 (punctation modified). The plaintiff may do so by showing that either (i) a doctor diagnosed the medical need, or (ii) âthe prisoner has an obvious problem that any layperson would agree necessitates care.â Phillips v. Tangilag, 14 F.4th 524, 534 (6th Cir. 2021). In addition, the plaintiff must make a sufficient showing as to the level of care provided. He or she can succeed by demonstrating that âdoctors effectively provide[d] no care for [the medical need].â Id. The plaintiff may alternatively show that âdoctors provide[d] some careâ but that âtheir treatment choices [were] inadequate.â Id. at 534â535. Or the plaintiff can show that doctors âdelayed careâ and that the delay had a âdetrimental effectâ on the treatment. Id. at 538 (punctuation modified). In relevant part, this Court found that Plaintiffs had failed to satisfy the objective prong as to their claim against Kakani based on the care she provided in 2013. Majors, 2019 WL 1242778, at *8. The Court held that Plaintiffs were required to put forth ââverifying medical evidence in the record to establish the detrimental effect of the delay in medical treatment,ââ whichâwithout a witness listâthey would be unable to do. Id. (quoting Santiago v. Ringle, 734 F.3d 585, 590 (6th Cir. 2013) (finding that plaintiff could not meet objective component on claim alleging that doctorâs delay in providing dermatological care caused serious injury because plaintiff did not present âmedical proofâ)). The Court also found that Plaintiffs could not prevail on the subjective prong on this claim. Id. at *9. Kakani also cared for Majors in 2014, and this Court determined that Plaintiffs might survive on the objective component for a claim based on Kakaniâs treatment in this year, but that they could not establish the subjective component. Id. at *8â*9. As to LaNore, this Court found that Plaintiffs had failed to establish either the objective prong or the subjective prong in challenging the adequacy of LaNoreâs treatment. Id. at *11. D. Sixth Circuit Decision The Sixth Circuit affirmed this Courtâs dismissal and grant of summary judgment on all of Plaintiffsâ claims, except that it reversed the grant of summary judgment on Plaintiffsâ claims against Kakani and LaNore. Majors, 821 F. Appâx at 548. i. Kakani As to Plaintiffsâ claim based on Kakaniâs care in 2013, the Sixth Circuit found thatâ notwithstanding the absence of âverifying medical evidence in the recordââthe objective criterion was satisfied because âa reasonable jury could find that Majorsâ need for treatment was obvious . . . and that the treatment rendered by Kakani was so cursory as to amount to no treatment at all . . . .â Majors, 821 F. Appâx at 542 (punctuation modified). The Sixth Circuit noted that Kakani was aware of Majorsâs MS diagnosis and Majorsâs complaints, but she did not âtreat Majorsâ[s] MS symptoms or even request an MRI to monitor his disease.â Id. Rather, she âdid nothing beyond evaluate him in May 2013 and record her notes.â Id. The record reflected that Kakaniâs only âfollow-up action was to request Minnesota prison medical records detailing Majorsâ[s] 2008 MRI and neurology consultation.â Id. (punctuation modified). A jury could find that Kakaniâs response in this circumstance was the equivalent of âno treatment at all.â Id. at 543 (punctuation modified). As to Plaintiffsâ claim based on Kakaniâs care in 2014, the Sixth Circuit again found that âa reasonable jury could find that Plaintiffs meet the objective componentâ because material issues of fact remained as to whether (i) Majorsâs condition was obvious, and (ii) Kakaniâs level of care was the equivalent of no treatment at all. Id. at 543. While under Kakaniâs care, Majors repeatedly âcomplained of MS symptoms and requested medication for them.â Id. Although Kakani knew that Majors had suffered MS relapses and had previously received Interferon injections to treat his MS, she âneither treated Majors with Interferon nor ordered a diagnostic test to confirm his diagnosis.â Id. at 535. The Sixth Circuit noted that Kakani also referred Majors to an optometrist, id. at 544, but even taking this point under consideration, the court found that the objective prong of the claim against Kakani should be put to the jury, id. at 543. The Sixth Circuit also found that there was a genuine issue of material fact as to whether Plaintiffs had satisfied the subjective component on claims based on Kakaniâs care in both 2013 and 2014 because Kakani âknew from [Majorsâs] records that he had MS, [knew that he] had been treated with Interferon and steroids before, and was aware of his requests to resume Interferon treatment,â and yet she âignored the documented signs of Majorsâ[s] MS in refusing to treat him or even request diagnostic testing.â Id. at 544. The claims against Kakani, therefore, withstood summary judgment. Id. ii. LaNore The Sixth Circuit also found that Plaintiffsâ claim against LaNore satisfied the objective component because there was a factual dispute as to whether (i) the medical need was obvious and (ii) Majorsâs needs were addressed in a reasonable time. Id. at 545. The court noted that, after Majors was transferred to LaNoreâs care in April 2014, âLaNore himself noted that Majors was presenting with MS.â Id. at 545. Majors âhad muscle spasms, he dragged his left foot, his speech was slurred, and his smile was uneven with a left-side droop.â Id. Despite these symptoms and Majorsâs documented diagnosis of and treatment for MS, âLaNore did not evaluate him until August 12, 2014âa month after Majors arrived in West Shoreline.â Id. at 546. After waiting another month for receipt of earlier medical records that never arrived, LaNore did eventually provide treatment; âon September 18, 2014, LaNore successfully requested an MRI for Majors which re-confirmed his diagnosis and resulted in the resumption of Interferon treatment the following month.â Id. at 545. The Sixth Circuit found an issue of material fact on whether this care violated the objective component of Plaintiffsâ Eighth Amendment claim, stating: âgiven the severity of Majorsâ[s] condition[,] his need for treatment was not necessarily addressed quickly enough.â Id. Plaintiffs also satisfied the subjective component on their claim against LaNore because âevery day that Majors did not receive treatment was a day that his disease continued without any intervention designed to slow or mitigate its effects,â and thus âa reasonable jury could find that LaNore was aware of a substantial risk of serious harm to Majors and disregarded it.â Id. at 546 (punctuation modified). II. ANALYSIS2 Before this Court are Defendantsâ renewed motion for summary judgment and motion for an order and judgment in their favor. In the circumstances of this case, the law-of-the-case doctrine requires a denial of Defendantsâ motions. This doctrine âprecludes reconsideration of issues decided at an earlier stage of the case.â Caldwell v. City of Louisville, 200 F. Appâx 430, 433 (6th Cir. 2006) (reversing district courtâs grant of summary judgment under law-of-the-case doctrine where Sixth Circuit had already found that substantive due process claim survived summary judgment). The Sixth Circuit has already determined that material issues of fact preclude a grant of summary judgment on Plaintiffsâ claims against Kakani and LaNore. Majors, 821 F. Appâx at 542â546. This Court cannot depart from this decision. See Caldwell, 200 F. Appâx at 433. There is an exception to the law-of-the-case doctrine âwhere a subsequent contrary view of the law is decided by the controlling authority,â id. (punctuation modified), which Defendants suggest is the case here. In Defendantsâ view, the Sixth Circuitâs holding that Plaintiffsâ claims against Kakani and LaNore survive summary judgment is no longer good law and has been implicitly abrogated by Phillips, 14 F.4th 524. In Phillips, the Sixth Circuit found that an incarcerated plaintiff had failed to satisfy the objective prong of his Eighth Amendment medical  2 In assessing whether Defendants are entitled to summary judgment, the Court applies the traditional summary judgment standard as articulated in Scott v. Harris, 550 U.S. 372, 380 (2007). The movant is entitled to summary judgment if that party shows that there is no genuine dispute as to any material fact and that the movant is entitled to judgment as a matter of law. Fed. R. Civ. P. 56(a). If the movant makes an initial showing that there is an absence of evidence to support the nonmoving partyâs case, the nonmovant can survive summary judgment only by coming forward with evidence showing there is a genuine issue for trial. Celotex Corp. v. Catrett, 477 U.S. 317, 324â325 (1986). indifference claim where he challenged the adequacy of the care he had received for an alleged swelling in his leg. 14 F.4th at 536â539. The court assumed that the plaintiff had successfully demonstrated a serious medical need. Id. at 536. Nonetheless, his claim failed on the objective prong because it was âundisputedâ that he âreceived extensive care,â meaning that the plaintiff âneeded to present expert medical evidence describing what a competent doctor would have done and why the chosen course was not just incompetent but grossly so.â Id. His claim failed because he âfailed to introduce any such medical evidence.â Id. Defendants now argue that Phillips requires a grant of summary judgment in their favor, as Plaintiffs are unable to present expert witnesses in support of their medical indifference claims. See Def. Br. in Supp. Mot. Summ. J. at 17â24. Plaintiffs, in contrast, argue that Phillips is not dispositive to the specific facts presented by their case. See Pl. Resp. to Mot. Summ. J. at 2â5. The Court addresses these arguments as to each Defendant, and it finds that Phillips does not trigger an exception to the law-of-the-case doctrine because it âdoes not directly overrule or supercede [sic] the [Sixth Circuitâs] analysis previously applied to the facts inâ this case. Caldwell, 200 F. Appâx at 435. The Court, therefore, denies Defendantsâ motions. A. Kakani Regarding Plaintiffsâ claim against Kakani, Defendants submit that, â[w]ithout an expert or any other lay witness to call at trial or even an exhibit list, it is impossible for Plaintiff[s] to provide âmedical proof that the provided treatment was not an adequate medical treatment of [Majorsâs] condition or pain,â let alone challenge the opinions of Defendantsâ experts.â Def. Br. in Supp. Mot. Summ. J. at 19â20 (quoting Santiago 734 F.3d at 591). Defendants assert that Plaintiffs will be unable to carry their burden to ââplace verifying medical evidence in the record to establish the detrimental effect of the delay in medical treatment,ââ or to show that the ââcourse of treatment was incompetent.ââ Id. at 20 (quoting Phillips, 14 F.4th at 538, 537) (punctuation modified). Defendants have failed to upset the Sixth Circuitâs holding that Plaintiffsâ claim against Kakani may proceed, even without expert testimony. The Majors court examined the specific facts relevant to Kakaniâs care in 2013 and determined that âa reasonable jury could find that Majorsâ[s] need for treatment was obvious . . . and that the treatment rendered by Kakani was so cursory as to amount to no treatment at all . . . .â Id. at 542 (punctuation modified). The Sixth Circuit made the same finding as to Kakaniâs care in 2014. Id. at 543. Nothing in Phillips renders this holding void. The claim in Phillips was based on the theory that although the plaintiff received care, it was grossly inadequate. 14 F.4th at 536â539. Phillips does not indicate that an Eighth Amendment claim based on Plaintiffsâ theory in this caseâthat Kakani provided the equivalent of no medical treatmentârequires expert testimony. In fact, the Phillips court distinguished the case before itâone featuring âsubstantial careââfrom Blackwood, where allegations of âobviousâ medical needs and âcursoryâ treatment did not require this type of expert evidence. See Phillips, 14 F.4th at 537 (citing Blackmore, 390 F.3d at 900 (reversing grant of summary judgment to officers who left plaintiffâs âobviousâ appendicitis condition unaddressed for two days, despite plaintiffâs lack of âverifying medical evidenceâ)). The Majors court made clear that a âno treatmentâ claim like that brought against Kakani can succeed âeven without such verified medical evidence.â 821 F. Appâx at 540 (punctuation modified). The Sixth Circuit stated that Kakaniâs treatment of Majors in 2013 was âat leastâif not moreâdeficient than that received by the plaintiff in Darrah.â Id. at 543 (citing Darrah v. Krisher, 865 F.3d 361, 370 (6th Cir. 2017) (reversing grant of summary judgment to defendantsâ without reference to any need for expert testimonyâwhere plaintiff alleged that doctorâs course of drug treatment âwas so ineffective . . . that it was essentially the equivalent of no treatment at allâ)); see also id. (citing Dominguez v. Corr. Med. Servs, 555 F.3d 543, 551 (6th Cir. 2009) (affirming denial of defendantsâ summary judgment motion on âno treatmentâ claim made without reference to expert testimony)). And though Defendants cite Santiago, 734 F.3d at 591 in support of the asserted need for expert testimony, the Majors court explicitly distinguished the care provided in Santiago from the care Kakani provided for Majors. The court stated that âMajorsâ[s] treatment [by Kakani in 2013] sharply differedâ from the treatment provided in Santiagoânoting in the same sentence that the latter case had ârequired verified medical evidence.â Id. at 543 (citing Santiago, 734 F.3d 585); see also id. (citing Rhinehart v. Scutt, 894 F.3d 721, 739 (6th Cir. 2018) (affirming grant of summary judgment to defendant doctors where plaintiff, rather than adequately allege âcursory treatment amounting to no treatment at all,â had challenged adequacy of care, but failed to present adequate medical evidence)). The Sixth Circuitâs decision in Phillipsâfinding that a plaintiff could not satisfy the objective component on a theory of inadequate careâdoes not undermine the Sixth Circuitâs standing conclusion that there is a genuine issue of material fact as to whether Plaintiffs here can meet the objective component on a âno treatmentâ theory, even without expert testimony. There may be merit to Defendantsâ arguments that Kakani adequately assessed Majorsâs condition while he was in her care, and that Plaintiffs cannot prove otherwise without an expert witness, see Def. Br. in Supp. Mot. Summ. J. at 19â20, but these arguments must be presented to a jury. Because Defendants have not identified any âsubsequent contrary view of the law [] decided by the controlling authority,â the law-of-the-case doctrine requires a finding consistent with the Sixth Circuitâs prior holding: Plaintiffsâ claim against Kakani survives summary judgment. Caldwell, 200 F. Appâx at 433. B. LaNore As to Plaintiffsâ claim against LaNore, Defendants argue that it will be âimpossibleâ for Plaintiffs to demonstrate at trial that âthe care provided to Mr. Majors was so cursory that it amounted to no care at all, nor will she be able to place âverifying medical evidence . . . to establish the detrimental effect of the delay in medical treatment.ââ Def. Br. in Supp. Mot. at 23 (quoting Phillips, 14 F.4th at 538â539); see also id. at 24 (citing Santiago, 734 F.3d at 591). In contrast, Plaintiffs insist that the Sixth Circuit already found that LaNore, like Kakani, provided the equivalent of no care at all. See Pl. Resp. to Mot. Summ. J. at 5. Again, the Sixth Circuit has already analyzed the law as applied to the facts presented by this claim. The Majors court found that Majorsâs condition was âobvious,â and that there was a question of material fact as to whether âhis need for treatment was . . . addressed quickly enough.â 821 F. Appâx at 545. Even without expert testimony, this claim survives summary judgment. See id. at 545â546. Phillips does not undermine this decision. The Phillips court noted that a claim based on a âdelayâ in medical care âtypically requires expert testimony,â andâbased on the facts specific to that caseâthe Phillips plaintiff needed to ââplace verifying medical evidence in the record to establish the detrimental effect of the delay in medical treatment.ââ 14 F.4th at 538â539 (quoting Santiago, 734 F.3d at 590) (emphasis added). Majors is consistent with Phillips in this regard. See Majors, 821 F. Appâx 539 (noting that the Sixth Circuit has âgenerally held that when a deliberate indifference claim is based on a delay in treatment, . . . the plaintiff must âplace verifying medical evidence in the record . . .ââ) (quoting Santiago, 734 F.3d at 590) (emphasis added).  Although such a claim âtypicallyâ or âgenerallyâ requires verified medical evidence like expert testimony, there are circumstances in which expert testimony is not necessary. In fact, when holding that Majorsâs claim against LaNore survived summary judgment, the Sixth Circuit cited to two cases where medical indifference claims based in part on a delay in care survived summary judgment without any reliance on expert witnesses.3 The Sixth Circuit already considered the claim against LaNore on summary judgment and found that the claim survived. Majors, 821 F. Appâx at 545. Phillips does not present such a sea change in medical indifference doctrine that Majors is no longer good law. In some circumstances, a plaintiff can present a case to the jury based on a delay in medical care without expert testimony. The Sixth Circuit found that this is one of those cases. Id. Defendants have identified no controlling authority that âdirectly overrule[s] or super[s]ede[s] the [Sixth Circuitâs] analysisâ on this point. Caldwell, 200 F. Appâx at 435. Defendants insist that Plaintiffs cannot establish that LaNoreâs level of careâwhich included an evaluation of Majorsâs symptoms and eventually resulted in treatment for MSâ  3 See Majors, 821 F. Appâx at 545 (citing Blackmore, 390 F.3d at 899â900 (reversing grant of summary judgment to defendants, explaining: âwhere a plaintiffâs claims arise from an injury or illness so obvious that even a layperson would easily recognize the necessity for a doctorâs attention, . . . the plaintiff need not present verifying medical evidence to show that, even after receiving the delayed necessary treatment, his medical condition worsened or deteriorated. Instead, it is sufficient to show that he actually experienced the need for medical treatment, and that the need was not addressed within a reasonable time frame.â) (punctuation modified); Darrah, 865 F.3d at 369 (6th Cir. 2017) (reversing grant of summary judgment without reliance on medical experts where â[plaintiff] ha[d] sufficiently shown that genuine disputes of material fact exist[ed] as to whether [his doctor] was deliberately indifferent for failing to provide any [] treatment during this three-month period.â); see also id. (citing Mattox v. Edelman, 851 F.3d 583, 598 (6th Cir. 2017) (â[W]hen a plaintiff can show that his need for medical care was so obvious that even a layperson should recognize it, he is not required to provide objective evidence that he needed medical care at the time he was experiencing the symptoms. . . . [A] plaintiff proceeding under this theory must still show that he actually experienced the need for medical treatment, and that the need was not addressed within a reasonable time frame.â) (punctuation modified)). violated the Eighth Amendment standard, especially without the support of expert testimony. See Def. Br. in Supp. Mot. Summ. J. at 21â23. These points may persuade a jury. However, they provide no basis for upsetting the Sixth Circuitâs holding that material facts remain in dispute on Plaintiffsâ claim against LaNore. The Court denies Defendantsâ motion for summary judgment.4 III. CONCLUSION For the reasons explained above, the Court denies Defendantsâ renewed motion for summary judgment (Dkt. 201) and Defendantsâ motion for an order and judgment in their favor (Dkt. 199). SO ORDERED. Dated: December 16, 2022 s/Mark A. Goldsmith Detroit, Michigan MARK A. GOLDSMITH United States District Judge     4 Defendants also move for entry of an order and judgment in their favor on their understanding that this Court already found that Plaintiffs are precluded from proceeding to jury trial without expert witnesses. See Def. Mot. for O. and J. at 6â7. Defendants are mistaken. This Court declined to make a dispositive finding that Plaintiffs were permitted to proceed to trial without expert witnesses where that question was sparsely briefed, see 5/6/22 Order & Op. at 5â6 (denying plaintiffâs motion to name experts), but this Court did not affirmatively find that the absence of expert witnesses precludes Plaintiffsâ ability to proceed to trial. The Court denies Defendantsâ motion for an order and judgment.
Case Information
- Court
- E.D. Mich.
- Decision Date
- December 16, 2022
- Status
- Precedential