Insurance Dispute Lawyer Blog
Rick Sheppard, an inmate in the custody of the Louisiana Department of Public Safety and Corrections, injured his left shoulder two separate times while participating in the Angola Prison Rodeo. After seeing two specialists, Sheppard maintained that the medication and physical therapy regimen he had been following was ineffective. When Sheppard filed an administrative petition, he requested reparative surgery, treatment by a chiropractor, injections into the shoulder, blood testing to determine the effects of his medication, related medical records, and reimbursement of all costs.
In a two-step response, DPSC first stated that Sheppard’s request for proper medical attention had been granted since he had improved after receiving injections and physical therapy for his shoulder. In the second response, they asserted that Sheppard’s past treatment and ongoing care plan were adequate, and no further investigation into his claim would occur.
Under Louisiana law, all civil and criminal actions arising out of the incarceration of state prisoners are heard by a commissioner. This commissioner makes recommendations for the disposition of a case, which are submitted to a district judge. The district judge then accepts, modifies, or rejects the recommendation. La. R.S. l3:713(C)(l), (2), & (5)
When the commissioner reviewed the claim, he found that DPSC had addressed Sheppard’s need to see a medical doctor but had not investigated his request for surgery. The commissioner remanded the matter back to DPSC to reconsider this claim. In their response, DPSC detailed Sheppard’s care thus far, including steroid injections, chiropractic care, oral medications, and physical therapy exercises. DPSC again asserted that this medical care was adequate. DPSC, Sheppard, and the commissioner had several more conferences regarding the claim over the next two years. Finally, Sheppard filed a motion requesting a ruling on the merits, asking that he receive surgery.
The commissioner subsequently issued a recommendation stating that DPSC’s decision was “arbitrary and capricious” and ordering that DPSC obtain treatment with an orthopedist who could perform surgery within 30 days if indicated. However, the commissioner amended the recommendation months later to include stronger language, stating that the surgery should be “performed as expeditiously as possible” if necessary.
In response to this recommendation, DPSC presented the commissioner with several exhibits consisting of notes from physicians who saw Sheppard for his injury, all of which noted that surgery was not recommended in his case. Despite this, the district court adopted the commissioner’s recommendation and ruled that surgery should be performed within 15 days.
DPSC appealed the district court’s judgment, alleging they erred in ruling (1) That surgery was necessary, (2) That DPSC’s administrative decision was “arbitrary and capricious,” and (3) That DPSC should pay all costs of the surgery. The Court of Appeals is not required to defer to the district court’s ruling under La. R. S. 15: 1177. After reviewing the record, they disagreed with the district court’s ruling.
The Court of Appeals held Physician’s notes from visits between 2011 and 2016 indicated that surgery was not required and Sheppard had improved enough with physical therapy to be discharged from the program. In addition, the Court reasoned notes on a 2014 MRI performed by a neurosurgeon also stated, “NOT SURGICAL CASE.” The Court of Appeals then reversed the previous ruling. Instead, it remanded the case to the district court, instructing them to have Sheppard seen by another orthopedist to determine his treatment plan.
In this case, the appeals court held the content of Sheppard’s medical records did not support his claim that surgery was necessary to treat his shoulder injuries. Although DPSC underwent many years of litigation in this matter, its efforts were vindicated by the legal process.
Other Sources: RICK SHEPPARD # 108703 VERSUS LOUISIANA DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONS
Article Written by a Berniard Law Firm Writer
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