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Sunke v. Stonefeld

United States District Court, W.D. Wisconsin

April 1, 2019




         Pro se plaintiff Timothy Sunke is proceeding on a claim in this case that defendants Dr. Donald Stonefeld and Candace Whitman discontinued his medication for attention deficit hyperactivity disorder, in violation of his rights under the Eighth Amendment. (I have revised the caption to reflect the correct spelling of defendants' names.) Before the court are defendants' motion for summary judgment, dkt. #20, and plaintiff's motion to strike that motion on the ground that defendants filed their motion after the deadline for doing so, dkt. #34. For the reasons explained below, I am denying plaintiff's motion to strike, granting defendants' motion for summary judgment and closing this case.

         From defendants' proposed findings of fact, I find the following facts to be undisputed unless otherwise noted. (Plaintiff did not file any proposed findings of fact of his own.)


         A. The Parties

         At all times relevant to this case, plaintiff Timothy Sunke was an inmate at the Fox Lake Correctional Institution, where defendant Donald Stonefeld was employed as a psychiatrist and defendant Candace Whitman was the health services unit manager.

         Plaintiff suffers from Attention Deficit Hyperactivity Disorder (ADHD). As a psychiatrist, Dr. Stonefeld did not provide direct psychological consultation to plaintiff. Rather, psychologists and psychological unit staff work directly with patients and consult Stonefeld if they think that medication would complement the counseling therapy offered to the patient. (Plaintiff says that he met with Stonefeld on numerous occasions to discuss medications.) Stonefeld generally relies on a patient's psychological records in determining whether to prescribe psychotropic medications.

         Whitman is a licensed registered nurse and is not licensed to prescribe or discontinue medication or provide direct mental health services or psychological care to inmates. Only advanced care providers (including nurse practitioners) and physicians prescribe medications, with psychiatrists in particular being licensed to prescribe medications for psychological conditions. As the health services unit manager, Whitman does not provide direct care to patients and never provided medical care to plaintiff. Rather, she generally oversees and manages the administration of health care provided at the institution, has access to patient medical records, responds to inmate requests for health care on occasion, works with primary care providers and monitors nursing practices and documentation.

         B. Department Policy Regarding ADHD Treatment

         ADHD is a brain disorder marked by an ongoing pattern of inattention and hyperactivity-impulsivity that interferes with functioning or development. Inattention means a person wanders off task, lacks persistence, has difficulty sustaining focus and is disorganized. Hyperactivity means a person seems to move about constantly or excessively fidgets or talks. In adults, hyperactivity may include extreme restlessness or wearing others out with constant activity. Impulsivity means a person makes hasty actions that occur in the moment without first thinking about them and that may have high potential for harm.

         Because ADHD may affect an individual's ability to perform regular daily tasks, treatments such as medication, psychotherapy, education, therapy or some combination of these measures are used to increase function. Adderall is a stimulant that is used to treat ADHD, but it poses risks of abuse and side effects, especially with misuse. Therefore, other interventions like coaching to improve time management and task organization skills are often used to treat ADHD. According to defendant Stonefeld, medications are not medically necessary to treat ADHD.

         The Department of Corrections has strict guidelines for providing controlled medication in prison and instructs health care providers on how to manage medication misuse. Controlled substances are regulated by the Drug Enforcement Administration and pose a greater risk of misuse than non-controlled substances. Pursuant to Department of Adult Institution Policy 500.80.26-Medication Non-Adherence and Misuse, Procedure Section IV, when an inmate misuses a controlled medication, he receives a conduct report and his advanced care provider is notified. The provider then determines if a medication change is necessary. In all but the most exceptional circumstances, the provider will discontinue the medication or find alternatives that have less potential for misuse.

         As a result of the potential for misuse, stimulants are not commonly prescribed in prison. According to Dr. Jeffrey Anders, the Psychiatry Director for the Wisconsin Department of Corrections, it is department policy to prescribe medications used to treat ADHD in very limited circumstances. Typically, medications are prescribed only when the inmate is in school, working or participating in another intensive program and a teacher, work supervisor or program supervisor provides information that suggests that the inmate has a functional impairment. A functional impairment is significant behavioral dyscontrol or difficulty planning and sequencing purposeful activities. Therefore, according to Anders, psychiatrists only prescribe stimulants to treat ADHD symptoms after a review of the inmate's background, daily functioning and need of treatment to participate in work or school. (Plaintiff attempts to dispute the existence or enforcement of such a policy by pointing out that he began taking stimulants in 2012 but was not in school or working until 2015.)

         C. Plaintiff ...

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