MURRELL v. MOSCICKI (2025)

DECISION AND ORDER

INTRODUCTION

Pro se plaintiff Constantine Murrell (“Plaintiff”) alleges pursuant to 42 U.S.C. § 1983 that defendants Nurse Practitioner Henry Moscicki (“Moscicki”) and Nurse Terese Bryan (“Bryan”) (collectively “Defendants”) violated his Fourteenth Amendment rights when he slipped and fell in the shower area of the Genesee County Jail and was denied adequate medical treatment for his injury. (Dkt. 17).¹ Each party moved for summary judgment. (Dkt. 74; Dkt. 75; Dkt. 76). For the reasons that follow, Plaintiff's motion (Dkt. 74) is denied; Moscicki's motion (Dkt. 76) is granted; and Bryan's motion (Dkt. 75) is granted.

BACKGROUND

I. Factual Background

The following facts are taken from the parties’ Statements of Undisputed Facts (Dkt. 74 at 2-7; Dkt. 75-11; Dkt. 84 at 3-6), and the exhibits the parties submitted.² Unless otherwise noted, the facts set forth below are undisputed.

On November 1, 2018, while in custody at the Genesee County Jail (“Jail”) as a pre-trial inmate, Plaintiff slipped and fell in the Jail's shower, injuring his lower back. (Dkt. 17 at ¶ 3; Dkt. 75-11 at ¶¶ 4-6). Plaintiff was then examined by Bryan, who was employed as a Jail Nurse (Dkt. 75-7 at ¶ 1), and transported via ambulance to United Memorial Medical Center (“UMMC”), a local hospital. (Dkt. 17 at ¶¶ 4-5; Dkt. 75-11 at ¶¶ 7-9). At UMMC, an x-ray of Plaintiff's lower back revealed a minor chronic compression fracture in Plaintiff's lumbar spine, but did not show an acute fracture or subluxation in Plaintiff's sacrum or coccyx.³ (Dkt. 75-3 at 16). A CT scan also indicated that there was no acute fracture but showed minor degenerative disc changes in Plaintiff's lower spine. (Dkt. 75-4 at 25; Dkt. 76-14 at ¶ 5). Plaintiff was diagnosed with a lumbar contusion, instructed to take Tylenol and ibuprofen for pain, and discharged back to the Jail. (Dkt. 75-11 at ¶ 12; Dkt. 75-3 at 14).

On November 8, 2018, Plaintiff was seen by Moscicki, who worked with the Jail as a Nurse Practitioner, because he was still experiencing lower back pain. (Dkt. 75-11 at ¶ 15; Dkt. 75-3 at 19-20; Dkt. 76-14 at ¶¶ 1, 7). Moscicki reviewed Plaintiff's imaging from UMMC, noting the minor compression fracture in Plaintiff's lumbar spine but observed there was “no acute process,” and prescribed Baclofen for Plaintiff's pain treatment plan, in addition to the Tylenol. (Dkt. 75-11 at ¶¶ 15-16; Dkt. 75-3 at 19-20; Dkt. 76-14 at ¶¶ 7-8). A week later, Plaintiff indicated that the Tylenol, Baclofen, and lidocaine patches were not effective at controlling his pain during another encounter with Moscicki. (Dkt. 75-11 at ¶¶ 17-18; Dkt. 75-3 at 21-22; Dkt. 76-14 at ¶ 9). Moscicki discontinued the lidocaine and Baclofen and prescribed Aspercreme. (Dkt. 75-11 at ¶ 19; Dkt. 75-3 at 22; Dkt. 76-14 at ¶ 9). At that follow-up visit, Moscicki also noted that Plaintiff had a “slowed forward gait” but had no swelling. (Dkt. 75-3 at 22). Plaintiff's pain persisted and Moscicki referred Plaintiff to a neurology clinic. (Dkt. 17 at ¶ 7; Dkt. 75-11 at ¶¶ 20-21; Dkt. 75-3 at 24-26; Dkt. 76-14 at ¶ 9).

In early December, Plaintiff attended an appointment with outside neurologists at Rochester Neurosurgery Partners, and reported lower back pain, numbness in his thighs, and pain while standing and walking. (Dkt. 75-11 at ¶ 23; Dkt. 75-5 at 13; Dkt. 76-14 at ¶ 11). Another CT scan of Plaintiff's lower back was performed, which was “negative for fracture or canal compromise,” and Plaintiff was prescribed meloxicam and physical therapy. (Dkt. 75-11 at ¶ 23; Dkt. 75-5 at 14; Dkt. 76-14 at ¶ 11). Shortly thereafter, Plaintiff was referred to a sports rehabilitation facility, which recommended physical therapy two times a week for four weeks. (Dkt. 75-11 at ¶¶ 24-27; Dkt. 75-3 at 27). Plaintiff attended the scheduled physical therapy sessions. (Dkt. 75-11 at ¶¶ 28, 31, 37; Dkt. 75-3 at 28-29, 32-35, 42-45).

On January 3, 2019, Plaintiff reported to Moscicki that he continued to experience lower back pain that only abated when he laid down. (Dkt. 75-11 at ¶ 29; Dkt. 75-3 at 30; Dkt. 76-14 at ¶ 12). Moscicki saw Plaintiff again on January 24, 2019, and Plaintiff complained of a sudden onset of neck pain and that the meloxicam and physical therapy were not improving his pain. (Dkt. 75-11 at ¶¶ 32-33; Dkt. 75-3 at 36; Dkt. 76-14 at ¶ 14). At this appointment, Plaintiff also stated that he was told that he had a coccyx fracture, but Moscicki noted that “we have no verification of this.” (Dkt. 75-3 at 36). Moscicki prescribed new pain medication, gabapentin, and ordered a new x-ray. (Dkt. 75-11 at ¶ 34; Dkt. 75-3 at 36-37; Dkt. 76-14 at ¶ 14). The new x-ray revealed normal alignment of Plaintiff's cervical spine with “mild spurring” and “no significant bilateral neural foraminal narrowing.” (Dkt. 75-3 at 39). No acute fractures were noted. (See id.; Dkt. 75-11 at ¶ 36).

On January 29, 2019, Plaintiff was seen at the Jail by Alan Barcomb, M.D. (“Dr. Barcomb”), a medical doctor who served as a consulting physician for the Jail. (Dkt. 75-11 at ¶ 38; Dkt. 75-3 at 41; Dkt. 75-8 at ¶¶ 1, 5). Dr. Barcomb adjusted Plaintiff's pain medication and ordered a back brace. (Dkt. 75-11 at ¶ 38; Dkt. 75-3 at 41). Plaintiff attended a follow-up appointment at Rochester Neurosurgery Partners on February 15, 2019. (Dkt. 17 at ¶ 9-10; Dkt. 75-11 at ¶ 40; Dkt. 75-3 at 46). At this appointment, Plaintiff's imaging was reviewed again, but this time he was diagnosed with a “potential fracture in the coccyx” and prescribed a sitting pillow and referred to pain management specialists associated with Rochester Neurosurgery Partners for a steroid injection. (Dkt. 17 at ¶ 10; Dkt. 75-5 at 29; Dkt. 75-11 at ¶¶ 41-43; Dkt. 75-3 at 46).

There is a dispute about what happened next regarding the prescribed steroid injection. Generously construed, Plaintiff alleges that Defendants delayed providing him the steroid injection for four months due to a deliberate indifference of his medical care. (Dkt. 17 at ¶¶ 10, 25-26). On the other hand, Bryan contends that the reason for the delay was that she had difficulty scheduling an appointment with a pain management clinic. (Dkt. 75-7 at ¶¶ 4-16). Bryan asserts that the Rochester Neurosurgery Partners’ pain management clinic rejected Plaintiff's referral because that clinic does not treat incarcerated individuals. (Dkt. 75-7 at ¶¶ 4-5). According to Bryan, she then contacted a pain clinic associated with UMMC in April and scheduled an initial consultation for Plaintiff on May 9, 2019, with Simer Singh, M.D. (“Dr. Singh”). (Dkt. 75-11 at ¶¶ 51, 53; Dkt. 75-7 at ¶ 9; Dkt. 75-6 at 4). After the consultation, Bryan contends that she called the UMMC pain clinic three times to schedule the steroid injection, but was told that Dr. Singh's availability was not known at that time and that she should try to schedule an appointment through Unity Hospital. (Dkt. 75-11 at ¶¶ 54-56; Dkt. 75-3 at 6; Dkt. 75-7 at ¶¶ 11-12). Plaintiff finally received the steroid injection on June 11, 2019, through a clinic associated with Unity Hospital called the Spine Center. (Dkt. 17 at ¶ 26; Dkt. 75-11 at ¶ 58; Dkt. 75-3 at 66).

In the interim period, Plaintiff continued to receive care from the Jail medical staff and associated providers. Dr. Barcomb saw Plaintiff on February 26, 2019, and adjusted the gabapentin dosage and referred Plaintiff to a chiropractor. (Dkt. 75-11 at ¶ 47; Dkt. 75-3 at 49). At that appointment, Dr. Barcomb also noted that the Rochester Neurosurgery Partners pain clinic refused to schedule an appointment for Plaintiff. (Dkt. 75-3 at 49). Plaintiff attended an appointment with a chiropractor on March 6, 2019. (Dkt. 75-11 at ¶ 48; Dkt. 75-3 at 50). A few days after the chiropractor appointment, Plaintiff was seen by Moscicki, who noted Plaintiff's continued back pain and that the Rochester Neurosurgery Partners pain clinic refused to schedule the steroid injection. (Dkt. 75-11 at ¶ 49; Dkt. 75-3 at 51).

After Plaintiff received the steroid injection, he returned to the UMMC pain management clinic for a four-week follow-up appointment and reported decreased pain in his coccyx but new pain in his left leg and numbness in his feet.⁴ (Dkt. 75-11 at ¶ 61; Dkt. 75-3 at 67, 69-73). Plaintiff's pain medication was adjusted again and he was prescribed an anti-inflammatory and continued on the gabapentin. (Dkt. 75-3 at 73). The UMMC pain management clinic also ordered a new x-ray and CT scan of Plaintiff's lumbar spine. (Dkt. 75-3 at 68). The results of those scans are not included in the record provided to the Court.

According to Plaintiff, he was transferred out of the Jail to the Elmira Correctional Facility in July 2019. (Dkt. 75-2 at 50-52). After two weeks at the Elmira Correctional Facility, Plaintiff was transferred to the Attica Correctional Facility. (See id. at 52).

II. Procedural Background

Plaintiff commenced this action on September 10, 2021. (Dkt. 1). Upon screening the complaint pursuant to 28 U.S.C. §§ 1915(e)(2)(B) and 1915A, Plaintiff was granted leave to file an amended complaint. (Dkt. 15). Plaintiff filed an amended complaint on July 8, 2025, which serves as the operative pleading in this matter. (Dkt. 17). After screening the amended complaint, the Court permitted Plaintiff to proceed to service on his Fourteenth Amendment claims of deliberate indifference against Moscicki and Bryan for their alleged failure to treat his injury before it was diagnosed as a possible coccyx fracture and failure to arrange the steroid injection for four months. (Dkt. 22 at 15, 21).

After the completion of discovery, the parties each filed a motion for summary judgment. (Dkt. 74; Dkt. 75; Dkt. 76). On December 23, 2024, Plaintiff filed a response, but did not indicate which motion he was opposing. (Dkt. 79). Moscicki and Bryan each responded to Plaintiff's motion as well (Dkt. 80; Dkt. 81), and Plaintiff thereafter filed an unauthorized reply (Dkt. 84). On January 27, 2025, counsel for Moscicki filed a letter indicating that his summary judgment motion papers mailed to Plaintiff at the Attica Correctional Facility had been refused and were returned to sender. (Dkt. 87). Moscicki's counsel thereby sought an extension of time to serve Plaintiff. (Id.). The Court granted Moscicki's requested extension and his subsequent service was deemed timely. (Dkt. 89). The Court set a scheduling order on Moscicki's motion, requiring Plaintiff to respond to the motion by February 25, 2025. (Id.). Plaintiff never filed a response to Moscicki's motion.

DISCUSSION

I. Legal Standard for Summary Judgment

Rule 56 of the Federal Rules of Civil Procedure provides that summary judgment should be granted if the moving party establishes “that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). The Court should grant summary judgment if, after considering the evidence in the light most favorable to the nonmoving party, the Court finds that no rational jury could find in favor of that party. Scott v. Harris, 550 U.S. 372, 380, 127 S.Ct. 1769, 167 L.Ed.2d 686 (2007) (citing Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586-87, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986)).

“The moving party bears the burden of showing the absence of a genuine dispute as to any material fact․” Crawford v. Franklin Credit Mgmt. Corp., 758 F.3d 473, 486 (2d Cir. 2014). “Where the non-moving party will bear the burden of proof at trial, the party moving for summary judgment may meet its burden by showing the evidentiary materials of record, if reduced to admissible evidence, would be insufficient to carry the non-movant's burden of proof at trial.” Johnson v. Xerox Corp., 838 F. Supp. 2d 99, 103 (W.D.N.Y. 2011) (citing Celotex Corp. v. Catrett, 477 U.S. 317, 322-23, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986)). Once the moving party has met its burden, the opposing party “must do more than simply show that there is some metaphysical doubt as to the material facts, and may not rely on conclusory allegations or unsubstantiated speculation.” Robinson v. Concentra Health Servs., Inc., 781 F.3d 42, 44 (2d Cir. 2015) (quoting Brown v. Eli Lilly & Co., 654 F.3d 347, 358 (2d Cir. 2011)). The non-moving party “must come forward with specific evidence demonstrating the existence of a genuine dispute of material fact.” Brown, 654 F.3d at 358. Indeed, “the mere existence of some alleged factual dispute between the parties will not defeat an otherwise properly supported motion for summary judgment; the requirement is that there be no genuine issue of material fact.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986).

II. Fourteenth Amendment Claims

As noted above, Plaintiff was permitted to proceed to service on his deliberate indifference claims against Bryan and Moscicki for failure to provide adequate medical care after his injury was misdiagnosed and failure to timely arrange the steroid injection. (Dkt. 22 at 15, 17-18, 21). Because Plaintiff was a pretrial detainee at the time of the allegations, his claim is governed by the Fourteenth Amendment's Due Process Clause. See Darnell v. Pineiro, 849 F.3d 17, 29 (2d Cir. 2017) (“A pretrial detainee's claims are evaluated under the Due Process Clause because, pretrial detainees have not been convicted of a crime and thus may not be punished in any manner—neither cruelly and unusually nor otherwise.” (cleaned up)). “A detainee's rights are ‘at least as great as the Eighth Amendment protections available to a convicted prisoner.’ ” Id. at 29 (quoting City of Revere v. Mass. Gen. Hosp., 463 U.S. 239, 244, 103 S.Ct. 2979, 77 L.Ed.2d 605 (1983)). To prevail, “Plaintiff[’s] Fourteenth Amendment claim must meet two requirements: (1) that Plaintiff[ ] had a serious medical need ․ and (2) that the Defendants acted with deliberate indifference to such needs.” Charles v. Orange County, 925 F.3d 73, 86 (2d Cir. 2019).

The first requirement—serious medical need—is objective and analyzed the same under both the Eighth and Fourteenth Amendments. Darnell, 849 F.3d at 30. To determine “whether a medical need is sufficiently serious ․ [courts] consider factors such as whether a reasonable doctor or patient would find the injury important and worthy of treatment, whether the medical condition significantly affects an individual's daily activities, and whether the illness or injury inflicts chronic and substantial pain.” Charles, 925 F.3d at 86.

The second requirement—deliberate indifference—requires a plaintiff asserting a Fourteenth Amendment claim to prove the defendants “ ‘acted intentionally’ in denying adequate medical care, ‘or recklessly failed to act with reasonable care ․ even though the defendant[s] knew, or should have known, that the condition posed an excessive risk to health or safety.” Dumel v. Westchester County, 656 F. Supp. 3d 454, 465 (S.D.N.Y. 2023) (quoting Darnell, 849 F.3d at 35). Evidence that a defendant acted negligently is insufficient to establish deliberate indifference. Darnell, 849 F.3d at 36 (“A detainee must prove that an official acted intentionally or recklessly, and not merely negligently.”). “The Second Circuit has found that a delay in treatment can give rise to a constitutional violation, but only in particularly egregious circumstances.” Lawrence v. Evans, 136 F. Supp. 3d 486 (W.D.N.Y. 2015) (collecting cases), aff'd, 669 F. App'x 27 (2d Cir. 2016).

As noted above, Plaintiff's deliberate indifference claim was permitted to proceed on two bases: (1) Defendants provided inadequate treatment by failing to re-examine and treat Plaintiff's pain before he was diagnosed with a possible fractured coccyx; and (2) Defendants impermissibly delayed the steroid injection. (Dkt. 22 at 21). For the reasons explained below, no reasonable jury could find that these alleged inadequacies in the medical care provided by Defendants violated Plaintiff's Fourteenth Amendment rights and therefore the Court grants summary judgment in favor of Defendants.

A. Inadequate Treatment

1. Serious Medical Need

Claims alleging inadequate medical treatment involve a two-part assessment. A court must first determine “whether the [plaintiff] was actually deprived of adequate medical care.” Salahuddin v. Goord, 467 F.3d 263, 279 (2d Cir. 2006), abrogated on other grounds by Kravitz v. Purcell, 87 F.4th 111 (2d Cir. 2023). If so, then a court must next determine “whether the inadequacy in medical care is sufficiently serious.” Id. at 280. Plaintiff alleges that Defendants provided inadequate medical care because they “refused to re-examine [his] back” after his initial diagnosis from UMMC. (Dkt. 17 at ¶ 20). Contrary to Plaintiff's claims, the record in this case is clear that the treatment Plaintiff received from Defendants before his injury was diagnosed as a possible coccyx fracture was adequate medical care.

Plaintiff was transported to UMMC the same day he slipped and fell in the shower. (Dkt. 17 at ¶¶ 4-5; Dkt. 75-11 at ¶¶ 7-9). At the hospital, an x-ray was taken of Plaintiff's lower back, and a radiologist reported that the images did not indicate a fracture of Plaintiff's coccyx or sacrum. (Dkt. 75-3 at 16). A CT scan also did not indicate any acute fracture. (Dkt. 75-4 at 25; Dkt. 76-14 at ¶ 5). Plaintiff was discharged to the Jail with instructions to apply ice as needed and to take Tylenol or ibuprofen for pain. (Dkt. 75-3 at 14).

When Plaintiff reported to Moscicki a week later that he continued to experience lower back pain, Moscicki reviewed the CT imaging from UMMC, noting that there was no indication of an acute fracture, and prescribed an additional pain medication. (Dkt. 75-3 at 19-20; Dkt. 76-14 at ¶¶ 7-8). As Plaintiff's pain persisted, Moscicki adjusted the pain medication plan and referred him to Rochester Neurosurgery Partners on November 21, 2018, three weeks after Plaintiff's initial fall. (Dkt. 75-3 at 21-22, 24-26; Dkt. 76-14 at ¶ 9). The neurologists at Rochester Neurosurgery Partners ordered another CT scan, which also did not indicate a fracture, and prescribed new pain medication and physical therapy. (Dkt. 75-5 at 13-14). Thereafter, Plaintiff regularly attended physical therapy sessions. (Dkt. 75-3 at 28-29, 32-35, 42-45).

In January 2019, Plaintiff continued to report to Moscicki that he was experiencing pain and Moscicki responded by, once again, adjusting the pain medication and ordering an additional x-ray. (Dkt. 75-3 at 36-37; Dkt. 76-14 at ¶ 14). That x-ray also did not indicate an acute fracture. (Dkt. 75-3 at 39; Dkt. 75-11 at ¶ 36). In February, Plaintiff was transported to a follow-up appointment with Rochester Neurosurgery Partners, and a physician reviewed Plaintiff's imaging once again and indicated that it “show[ed] [a] potential fracture in the coccyx though [the] read is negative.” (Dkt. 75-5 at 29) (emphasis added).

The record is clear that Defendants’ actions did not result in the deprivation of adequate medical care. In support of her motion, Bryan submitted a declaration of Dr. Barcomb, a board-certified medical doctor licensed to practice medicine in New York, who opined that Plaintiff's treatment at the Jail was appropriate for his injury. (Dkt. 75-8). In preparation for rendering his opinion, Dr. Barcomb reviewed Plaintiff's medical records and his claims. (Id. at ¶ 5). Based on his review of the records, Dr. Barcomb opined:

Plaintiff received proper and adequate care from the Genesee County Jail's medical staff․ Coccygeal injuries are difficult to treat and respond best to “time to heal.” The time it takes for a coccygeal injury to heal varies between patients and can take anywhere from several months to several years. Coccygeal injuries are generally treated with anti-inflammatories, muscle relaxers, off-loading with air pillows, chiropractic care, and/or physical therapy. Plaintiff received all these treatments while at the Jail.

(Id. at ¶¶ 9-14) (internal citations omitted). Indeed, Defendants swiftly responded to Plaintiff's continued complaints of back pain. Bryan arranged Plaintiff's transportation to a hospital immediately after his fall and Moscicki adjusted Plaintiff's pain management when he reported his medications were not effective, reviewed Plaintiff's imaging, which did not indicate a fractured coccyx, arranged referrals to outside specialists, and ordered new imaging when Plaintiff's complaints persisted. The record indicates that Plaintiff attended 15 appointments with a range of providers, including Moscicki and the Jail medical staff, specialists at Rochester Neurology Partners, and an outside physical therapist, in the three-and-a-half months between his fall and when he was diagnosed with a potential coccyx fracture. (See Dkt. 75-3 at 3-5). Multiple imaging tests of Plaintiff's lower back did not indicate a coccyx fracture and Defendants pursued several options to address Plaintiff's persistent pain.

By contrast, Plaintiff does not provide or point to any evidence showing that his medical treatment during this period was inadequate and his bare allegation that Defendants “neglected” to treat him (Dkt. 17 at ¶ 20) is insufficient to raise a dispute of material fact. No reasonable factfinder could conclude that Defendants’ timely and robust responses to Plaintiff's complaints amounted to inadequate medical care. See Singletary v. Russo, 377 F. Supp. 3d 175, 188 (E.D.N.Y. 2019) (“[A] reasonable jury could not find that a one-month delay in referring [plaintiff] to a specialist constituted a deprivation of adequate medical care.”); Gomez v. Chill, No. 11-CV-6844 CM JLC, 2015 WL 1853110, at *14 (S.D.N.Y. Apr. 17, 2015) (plaintiff received adequate medical care where he was transported to a local hospital after his injury and saw prison medical staff 14 times after the injury), report and recommendation adopted, No. 11 CIV. 6844 CM JLC, 2015 WL 3862709 (S.D.N.Y. June 9, 2015).

2. Deliberate Indifference

Even if Defendants deprived Plaintiff of adequate medical treatment in the period between Plaintiff's fall and the diagnosis of a potential coccyx fracture, nothing in the record indicates that Defendants acted with the requisite culpability—i.e. that Defendants acted intentionally to deprive Plaintiff of adequate medical care or recklessly failed to act with reasonable care. See Dumel, 656 F. Supp. 3d at 465 (quoting Darnell, 849 F.3d at 35). To the contrary, the record shows that Plaintiff received prompt and frequent medical treatment.

Plaintiff argues that “[he] informed the [D]efendants about the serious pain he [was] suffering from in his lower back” and that his complaints were only met with “deliberate indifference.” (Dkt. 74 at 8). He further contends that he had to file medical grievances in order to receive medical treatment. (Id. at 8, 11). But Plaintiff does not offer any explanation as to when these grievances were filed and no such grievances are included in the record. The Court therefore would only be speculating on whether the grievances were a factor motivating Defendants to attend to Plaintiff's medical needs. See Martinez v. City of New York, 564 F. Supp. 3d 88, 104 (E.D.N.Y. 2021) (whether defendants acted with deliberate indifference “is a question of fact subject to demonstration in the usual ways, including inference from circumstantial evidence” (quoting Charles, 925 F.3d at 87)).

Despite Plaintiff's arguments to the contrary, the record is clear that Defendants did not act with deliberate indifference to Plaintiff's medical needs. Plaintiff was immediately transported to the hospital after his fall and attended regular appointments with a range of medical providers, including Jail medical staff, specialists at Rochester Neurosurgery Partners, and a physical therapist. X-ray and CT imaging of Plaintiff's lower back did not indicate that Plaintiff had a fractured coccyx and as Plaintiff continued to report lower back pain, Moscicki adjusted Plaintiff's pain medication, made referrals to neurologists, and ordered additional imaging. No reasonable jury could find that Defendants acted with deliberate indifference to Plaintiff's medical needs by providing such prompt and robust medical care. See Gray v. Kang Lee, No. 9:13-CV-258 GLS/DEP, 2015 WL 1724573, at *3 (N.D.N.Y. Apr. 15, 2015) (holding that medical prisoner staff member did not act with deliberate indifference where plaintiff was “frequently treated, prescribed pain medication, tested with an x-ray and MRI, and referred to an orthopedic specialist.”). Accordingly, the Court grants summary judgment in favor of Defendants on Plaintiff's claim that Defendants did not provide adequate medical care before he was diagnosed with a potential coccyx fracture.

B. Delayed Treatment

Plaintiff also alleges that the four-month delay in receiving the steroid injection constituted deliberate indifference to his medical care in violation of his Fourteenth Amendment rights. (Dkt. 17 at ¶¶ 18, 26).

1. Serious Medical Need

In cases that allege a delay in treatment, rather than a total denial of care, the inquiry into the seriousness of the medical need is narrower. Smith v. Carpenter, 316 F.3d 178, 186 (2d Cir. 2003). In such cases, the “seriousness inquiry should focus on ‘the severity of the temporary deprivation ․ rather than the [detainee's] underlying medical condition․” Dumel, 656 F. Supp. 3d at 464 (quoting Smith, 316 F.3d at 186). Overall, “[a]ctual medical consequences that flow from” the alleged deprivation of care are indicative of a serious medical need. Charles, 925 F.3d at 86. “[C]ases where delays of medical care have been held to satisfy the objective requirement have involved either a needlessly prolonged delay or a delay that caused extreme pain or exacerbated a serious illness.” Massey v. Morgan, No. 18CV3994ALCKHP, 2021 WL 3887947, at *6 (S.D.N.Y. Aug. 31, 2021)

The record before the Court shows that the steroid injection was “therapeutic” and intended to reduce inflammation as part of Plaintiff's pain management plan rather than a cure to his potentially fractured coccyx. (Dkt. 75-3 at 66; see Dkt. 75-5 at 29). Consequently, the focus of the deprivation is therefore on the pain Plaintiff experienced during that four-month period that could have been addressed by the injection. At Plaintiff's follow-up appointment with Rochester Neurosurgery Partners on February 15, 2019, he reported “unbearable” pain while sitting and was only able to walk approximately 15 feet at a time due to the pain. (Dkt. 75-5 at 27). The medical provider at that visit noted that Plaintiff's pain “significantly impact[ed] his day to day function.” (Id. at 29). A Plaintiff who “experience[s] great pain over an extended period of time and had difficulty walking” may suffer from a serious medical need. See Hathaway v. Coughlin, 37 F.3d 63, 67 (2d Cir. 1994) (holding that plaintiff's persistent hip pain and associated difficulty walking coupled with a two-year delay in treatment constituted a serious medical need).

Although Plaintiff experienced severe pain while the steroid injection was delayed, the record does not indicate that any medical consequences resulted from the delay. As noted above, the injection was part of Plaintiff's pain management plan and not a cure to his potential fracture. Furthermore, Plaintiff testified at his deposition that the injection only helped alleviate some of his pain for two months but did not completely stop the pain. (Dkt. 75-2 at 50, 90). By the time the effects of the injection wore off, Plaintiff had been transferred to the Elmira Correctional Facility. (Id. at 50-52). He also testified that he continues to experience the same level of pain in his tailbone as he did at the Jail. (Id. at 80). On this record, the Court cannot determine whether the four-month delay constituted a serious medical need. That said, the Court grants summary judgment in favor of the Defendants as the record demonstrates that Defendants did not cause the delay in treatment through deliberate indifference to Plaintiff's medical needs.

2. Deliberate Indifference

As discussed above, to establish Defendants’ deliberate indifference, Plaintiff must demonstrate that Defendants acted intentionally or recklessly in delaying the steroid injection. “Although a delay in providing necessary medical care may in some cases constitute unconstitutional deliberate indifference, such a classification is reserved for when ‘officials deliberately delayed care as a form of punishment; ignored a “life-threatening and fast-degenerating” condition for three days; or delayed major surgery for over two years.’ ” Sims v. City of New York, 788 F. App'x 62, 64 (2d Cir. 2019) (quoting Demata v. N.Y. State Corr. Dep't of Health Servs., 198 F.3d 233 (2d Cir. 1999)). The record before the Court shows that this is not such a case.

The undisputed facts show that the delay in Plaintiff's steroid injection was due to a series of administrative hurdles that Bryan had to navigate to schedule the appointment with a provider willing to see Plaintiff. As an initial matter, Bryan acknowledges that it was her responsibility to schedule appointments with outside providers when an inmate required treatment from a specialist. (Dkt. 75-7 at ¶ 2). When Rochester Neurosurgery Partners requested the steroid injection on February 15, 2019, the provider made the referral to a pain management clinic associated with that practice. (Dkt. 75-5 at 29). Bryan submitted a declaration in support of her motion in which she recalls that when she called the pain management clinic to schedule Plaintiff's appointment, she was informed that the clinic rejected the referral because it did not treat incarcerated individuals. (Dkt. 75-7 at ¶ 5). Bryan's notes also show that she called the pain management clinic five days after Rochester Neurosurgery Partners made the referral and was told that the clinic rejected the referral. (Dkt. 75-3 at 5). The rejected referral was also noted by Dr. Barcomb at an appointment with Plaintiff on February 26, 2019. (Dkt. 75-3 at 49).

Bryan states that she then sought a pain management clinic that would accept Plaintiff as a patient and had availability. (Dkt. 75-7 at ¶ 6). In April 2019, the UMMC pain clinic sent paperwork to the Jail for Plaintiff to complete and an initial consultation was scheduled for May 9, 2019, with Dr. Singh. (Dkt. 75-3 at 6; Dkt. 75-6 at 4-9). At that consultation, Dr. Singh adjusted Plaintiff's pain medication, advised the continued use of a donut pillow, and indicated that an appointment should be scheduled for the steroid injection. (Dkt. 75-6 at 9). The next day, Bryan called to schedule the appointment, but was told Dr. Singh's availability was not known at that time and that the clinic would call the Jail when an appointment was available. (Dkt. 75-7 at ¶ 11; Dkt. 75-3 at 6). Bryan called the UMMC pain clinic two times thereafter to schedule an appointment and was eventually advised to contact an affiliated hospital, Unity Hospital, to schedule the appointment. (Dkt. 75-7 at ¶¶ 12-13; Dkt. 75-3 at 6). On May 28, 2019, Bryan called the pain clinic affiliated with Unity Hospital, which was called the Spine Center, and made an appointment for June 11, 2019. (Dkt. 75-7 at ¶¶ 14-15; Dkt. 75-3 at 7). Plaintiff received the steroid injection at that appointment. (Dkt. 75-3 at 66).

Plaintiff does not provide or point to any evidence in the record to bolster his allegations that the delay in treatment resulted from Defendants’ deliberate indifference to his medical care. Plaintiff states that he received the steroid injection from a provider different from Rochester Neurosurgery Partners and had to wait four months for that injection. (Dkt. 84 at 6; see also Dkt. 17 at ¶ 10). That assertion is supported by the record and not contested by Defendants. Indeed, the record shows that Plaintiff received the injection from the Spine Center, which was affiliated with Unity Hospital, rather than the UMMC pain clinic affiliated with Dr. Singh. (Dkt. 75-3 at 66). But the suggestion that those two facts are evidence of Defendants’ deliberate indifference is not supported by the record. As discussed above, the reason Plaintiff had to see a different provider was that Rochester Neurosurgery Partners rejected the referral and the UMMC pain clinic would not provide Dr. Singh's availability and referred Plaintiff to Unity Hospital. (Dkt. 75-7 at ¶¶ 5, 12-13; Dkt. 75-3 at 5-6). The record before the Court conclusively establishes that Defendants diligently sought a provider willing and available to give Plaintiff the steroid injection. Such diligence cannot possibly be construed as deliberate indifference by a rational jury. Accordingly, Defendants are entitled to summary judgment on Plaintiff's claim that the delay in receiving the steroid injection violated his Fourteenth Amendment rights.

III. Qualified Immunity

Bryan also argues that she is entitled to qualified immunity as an alternative ground in support of her summary judgment motion. (Dkt. 75-12 at 19-22). As the Court holds that no rational jury could find in favor of Plaintiff on the record before it, the Court need not address Bryan's qualified immunity arguments. See Smith v. Sullivan, No. 920CV659DNHCFH, 2023 WL 3727447, at *19 (N.D.N.Y. May 3, 2023) (“[T]he Court need not address qualified immunity as an alternative ground to defendants’ summary judgment motion because plaintiff has not established a dispute of material fact as to whether defendants violated his constitutional rights”), report and recommendation adopted, No. 9:20-CV-659, 2023 WL 3722137 (N.D.N.Y. May 30, 2023).

CONCLUSION

For the foregoing reasons: Plaintiff's motion (Dkt. 74) is denied; Moscicki's motion (Dkt. 76) is granted; and Bryan's motion (Dkt. 75) is granted.

SO ORDERED.

FOOTNOTES

1.   The Court previously dismissed defendants William A. Sheron, Jr., United Memorial Medical Center, Rochester Neuro Spine Center, and William Zipfel from this action pursuant to 28 U.S.C. §§ 1915(e)(2)(B)(ii) and 1915A(b)(1). (Dkt. 22 at 21).

2.   Although Plaintiff submitted a document ostensibly entitled “Summary Judgment Motion – Local Rule 56 Statement of Facts,” that filing is light on factual statements and is akin to a memorandum of law. (See Dkt. 74 at 2-13). In order to determine areas of undisputed fact, the Court also considered the allegations made in Plaintiff's amended complaint, which was sworn under penalty of perjury. (See Dkt. 17 at 15); see also Brandon v. Kinter, 938 F.3d 21, 27 n.5 (2d Cir. 2019) (“[Plaintiff's] Amended Complaint was sworn under penalty of perjury. Therefore, his allegations in the complaint can be considered as evidence for summary judgment purposes.”). In his response papers, Plaintiff submitted a second document entitled “Statement of Undisputed Facts” (Dkt. 84 at 3-6) that the Court also considered in establishing the undisputed factual background.Moscicki did not submit his own Statement of Undisputed Facts and adopted Bryan's Statement of Undisputed Facts in support of his summary judgment motion. (See Dkt. 76-17 at 5).

3.   In her Statement of Undisputed Facts, Bryan (and by extension Moscicki) states that “[t]he x-rays did not reveal any acute fractures in Plaintiff's lumbar spine, or sacrum and coccyx.” (Dkt. 75-11 at ¶ 11) (emphasis added). Although no acute fractures were noted, the Radiology Diagnostic Report notes a “chronic compression fracture” in Plaintiff's lumbar spine. (Dkt. 75-3 at 16).

4.   Plaintiff testified at his deposition that the steroid injection alleviated his pain for two months but did not completely stop his pain. (Dkt. 75-2 at 51).

ELIZABETH A. WOLFORD, Chief Judge