Carlton v. Getachew et al

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Case 1:24-cv-00514-JRR Document99 _ Filed 02/10/26 Page 1 of 24

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF MARYLAND

DAVID L. CARLTON, *
Plaintiff, *
v. * Civil Action No. JRR-24-0514

ASRESAHEGAN GETACHEW, MD, etal., *

Defendants. *
2k ok ok

MEMORANDUM OPINION

Plaintiff David L. Carlton, currently incarcerated at Western Correctional Institution
(“WCI”), filed this civil rights action pursuant to 42 U.S.C. § 1983 alleging a delay and denial of
medical care. ECF No. 1. The operative pleadings are the Amended Complaint and Supplement
to the Amended Complaint. ECF Nos. 14, 15.

Carlton’s remaining claim is against medical providers alleging medical treatment was
delayed and denied in violation of the Eighth Amendment to the United States Constitution. See
Memorandum Opinion and Order, ECF No. 17, 18. Pending are three dispositive motions filed by
medical providers.! Defendant Dr. Tesfaye filed a Motion to Dismiss or, in the Alternative, for
Summary Judgment and Carlton filed a Response in Opposition. ECF Nos. 50, 86.2 Defendants

Drs. Bartles, Berger, Getachew, and RN Ernst? (“Medical Provider Group”) filed a Motion to

' Service has been attempted but not effectuated on Defendants Benhur Mohammed and Patrick
O’Neil. See ECF Nos. 60, 65, 70. Further, the Court is unable to direct service on unidentified
Defendants, namely, Unknown Utilization Management Staff, and Unknown, WCI Medical.

Carlton filed a motion for an extension of time to respond to Tesfaye’s Motion, which shall be
granted nunc pro tunc. ECF No. 85.

> Defendants have clarified that Defendant M. Ernst MD is Mignon Ernst, RN. The Clerk will be
directed to revise the docket accordingly. ECF Nos. 14, 62, 62-1.

AUTHENTICATED
U.S. GOVERNMENT
INFORMATION

GPO

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Dismiss or, in the Alternative, for Summary Judgment; Carlton filed a Response in Opposition;
and Medical Provider Group filed a Reply. ECF Nos. 62, 87, 93.4 	Defendant Dr. Kathuria filed a
Motion to Dismiss or, in the Alternative, for Summary Judgment; Carlton filed an Opposition in
Response; and Kathuria filed a Reply. ECF Nos. 67, 90, 94.
The Court has reviewed the pleadings and papers, and finds a hearing unnecessary. Local
Rule 105.6 (D. Md. 2025). For the reasons stated below, Tesfaye’s Motion, construed as a motion
for summary judgment, will be denied. 	The Medical Provider Group’s Motion will be denied
without prejudice. 	Kathuria’s Motion, construed as a motion for summary judgment, will be
granted. The Court will appoint counsel to represent Carlton.
In addition, on August 26, 2025, the Court issued a Memorandum Opinion and Order
granting a Motion to Dismiss or, in the Alternative, for Summary Judgment, construed as a motion
for summary judgment, on Carlton’s claims against Defendants Weber, Cartwright, Jenkins, and
Woolford (the Department of Public Safety and Correctional Services, or “DPSCS” Defendants).
ECF Nos. 46, 79-80. Carlton filed a Motion for Reconsideration of the Order granting Defendant
DPSCS’s motion, ECF No. 82, which will be granted; and the Court reaffirms the Memorandum
Opinion and Order dated August 26, 2025.
4 	Carlton filed a motion for an extension of time to file a sur-reply, ECF No. 95, to which the
Medical Provider Group filed an opposition response, ECF No. 96, and Carlton also filed a motion
for leave to file excess pages. ECF No. 98. As the dispositive motion will be denied, Carlton’s
motions will be denied as moot.
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I. 	BACKGROUND
A. Carlton’s Allegations5
The Amended Complaint alleges that Defendants caused delays and denials of necessary
medical treatment to Carlton. 	ECF No. 14. 	Specifically, Carlton complains that since June 8,
2020, he has not received adequate medical care for Dupuytren Contracture,6 	and this has left him
unable to properly use his left hand and left foot. 	Id. 	7-14. 	Carlton further complains that since
March 14, 2019, he has not received proper medical care for pain and bone fragments in his right
elbow. 	Id. 	at 14-15. 	Carlton also complains that, although he should be receiving care for his
diagnosis of Hepatitis C, he is not. 	Id. 	at 15-16. Carlton seeks declaratory and injunctive relief,
as well as monetary damages. 	Id. 	at 21-22.
Carlton alleges that the Medical Provider Group, namely Dr. Getachew, Dr. Bartles, RN
Ernst, and Dr. Burger, employed by Corizon and then YesCare, provided constitutionally
inadequate medical care. ECF No. 14. Carlton claims that Dr. Bartles and RN Ernst, both part of
Utilization Management, denied off-site orthopedic consultations submitted by WCI medical staff.
Id. 	at 5. Carlton claims Dr. Getachew, the Regional Medical Director, was directly responsible for
providing him with adequate medical care and failed to do so. 	Id. 	Carlton claims that Dr. Berger,
onsite podiatrist, did not implement a plan of care or provide monthly follow up visits. 	Id. 	at 14.
5 	Carlton’s Amended Complaint is 23 pages long and contains detailed allegations about the
medical care he received. ECF No. 14. Only the allegations relevant to the Court’s opinion are
included.
6 	Dupuytren contracture is an abnormal thickening of the skin in the palm of the hand at the base
of the fingers. This thickened area may develop into a hard lump or thick band. Over time, it can
cause one or more fingers to curl (contract), or pull sideways or in toward the palm. The ring and
little fingers are most commonly affected. In many cases, it affects both hands. Rarely, feet may
also be affected. 	https://www.hopkinsmedicine.org/health/conditions-and-diseases/dupuytrens-
contracture 	(last checked 2/10/26).
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Carlton alleges that Dr. Tesfaye was employed by Corizon, now YesCare, during the
relevant time, directly responsible for his chronic care, was a Regional Medical Director, and part
of the Utilization Management Staff, and failed to provide constitutionally adequate medical care.
Id. 	at 5-6.
Carlton states that Defendant Dr. Kathuria is employed by an outside radiology service
with a contractual relationship with Corizon, now YesCare, to provide service to individuals
housed at WCI. 	Id. 	at 4. Carlton alleges that Dr. Kathuria failed to properly interpret x-rays of his
left hand and right elbow. 	Id. 	at 4-5. On July 9, 2020, Dr. Kathuria interpreted x-rays that were
taken of Carlton’s left hand due to lumps in the palm of his hand. 	ECF No. 14 at 7. 	The x-ray
report notes a history/complaint of left-hand pain. 	ECF No. 15-4 at 7. 	Dr. Kathuria found no
evidence of an acute fracture, discoloration or subluxation, phalanges and carpal bones intact,
alignment anatomical, and no acute osseous abnormality. 	Id.; ECF No. 14 at 7. On April 27 and
June 22, 2021, additional x-rays were taken of the left hand. 	Id. 	at 9. 	The x-ray reports note a
history/complaint of left hand pain and left hand 5th 	digit pain, respectively. ECF No. 15-4 at 24,
30. Dr. Kathuria interpreted both sets of x-rays with the same finding as his initial interpretation.
Id.; ECF No. 15-4 at 24, 30.
Carlton further alleges that on April 27, 2021, Dr. Kathuria interpreted x-rays of his right
elbow. ECF No. 14 at 15. The x-ray report notes a history/complaint of right elbow pain. ECF
No. 15-7 at 7. 	Kathuria found no evidence of an acute fracture, dislocation, or subluxation,
alignment anatomical, and no acute osseous abnormality. 	Id.; ECF No. 14 at 15. 	Carlton notes
that Dr. Kathuria’s report contrasts with an x-ray taken of his right elbow on August 30, 2019, and
interpreted by Dr. Syed, which additionally included a finding that there were corticated fragments
at the radial head and lateral epicondyle suggestive of prior injury. 	Id. 	at 14; ECF No. 15-7 at 5.
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Carlton alleges that, as a result of receiving inadequate care, the Medical Provider Group,
Dr. Tesfaye, and Dr. Kathuria, are responsible for his pain, deformity, permanent disability, and
scarring. ECF No. 14.
B. Defendants’ Response7
Dr. Tesfaye
In a Declaration, Dr. Tesfaye states that at times relevant to Carlton’s Amended Complaint
he only provided treatment to inmates for chronic care conditions such as hypertension, diabetes,
and hepatitis. ECF No. 50-2 at ¶ 4. Since 2022, Dr. Tesfaye has treated Carlton for hepatitis-C
which was cured several years ago. 	Id. 	at ¶ 6. 	He has continued to provide follow up care to
Carlton once yearly since that time. 	Id. 	At no time relevant to Carlton’s Amended Complaint did
Dr. Tesfaye serve as Regional Medical Director for WCI or ECI. 	Id. 	at ¶ 5. Dr. Tesfaye did not
treat Carlton for Dupuytren Contracture disease, or his left hand, left foot, or right elbow. 	ECF
No. 50-2 at ¶ 9.
Dr. Kathuria
In a Declaration, Dr. Kathuria attest that he is the owner of S & L Readings, LLC, which
had a contract with Lakewood Healthcare Associates to review x-rays from Maryland Correctional
Institutions, and that Lakewood had a contract with the correctional institution. ECF No. 67-2 at
¶¶ 4-5. 	Regarding interpretation of x-rays, the only information provided are the reasons for the
study (as noted on the radiology report). 	Id. 	¶ 9. As the radiologist, Dr. Kathuria does not have
access to clinical records of the individual; nor does he order testing or treatment. 	Id 	at 1-2 ¶¶ 8,
7 	For the reasons that follow, the Medical Provider Group’s motion will be denied without
prejudice. For this reason, the allegations presented with their motion are not included in this
section.
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12. Dr. Kathuria also avers that x-rays are not used to diagnose Dupuytren’s Contracture. 	Id. 	at ¶
10.
II. STANDARD OF REVIEW
A. Motion to Dismiss
Each of the dispositive motions is styled as a motion to dismiss under Federal Rule of Civil
Procedure 12(b)(6) or, in the alternative, for summary judgment under Federal Rule of Civil
Procedure 56. A motion styled in this manner implicates the Court’s discretion under Rule 12(d)
of the Federal Rules of Civil Procedure. 	Kensington Volunteer Fire Dep’t, Inc. v. Montgomery
Cnty., 788 F. Supp. 2d 431, 436–37 (D. Md. 2011). Ordinarily, a court “is not to consider matters
outside the pleadings or resolve factual disputes when ruling on a motion to dismiss.” 	Bosiger v.
U.S. Airways, 510 F.3d 442, 450 (4th Cir. 2007). 	Under Rule 12(b)(6), however, a court, in its
discretion, may consider matters outside the pleadings, pursuant to Rule 12(d). If the court does
so, “the motion must be treated as one for summary judgment under Rule 56,” but “[a]ll parties
must be given a reasonable opportunity to present all the material that is pertinent to the motion.”
FED. 	R. 	CIV. 	P. 12(d); 	Adams Hous., LLC v. City of Salisbury, Maryland, 672 F. App’x 220, 222
(4th Cir. 2016) (per curiam). 	As is the case here, when a movant titles its motion “in the
alternative” as one for summary judgment, and submits matters outside the pleadings for the
Court’s consideration, the parties are deemed on notice that conversion under Rule 12(d) may
occur; the Court “does not have an obligation to notify parties of the obvious.” 	Laughlin v. Metro.
Washington Airports Auth., 149 F.3d 253, 261 (4th Cir. 1998).
A district judge has “complete discretion to determine whether or not to accept the
submission of any material beyond the pleadings [] offered in conjunction with a Rule 12(b)(6)
motion and rely on it, thereby converting the motion, or to reject it[,] or simply not consider it.” 5
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C Wright & Miller, FEDERAL 	PRACTICE 	& PROC. § 1366, at 159 (3d ed. 2004, 2011 Supp.). This
discretion “should be exercised with great caution and attention to the parties’ procedural rights.”
Id. 	at 149. In general, courts are guided by whether consideration of extraneous material “is likely
to facilitate the disposition of the action,” and “whether discovery prior to the utilization of the
summary judgment procedure” is necessary. 	Id. 	at 165, 167.
B. Discovery
Ordinarily, summary judgment is inappropriate “where the parties have not had an
opportunity for reasonable discovery.” 	E.I. du Pont de Nemours & Co. v. Kolon Indus., Inc., 637
F.3d 435, 448–49 (4th Cir. 2011); 	Putney v. Likin, 656 F. App’x 632, 638–39 (4th Cir. 2016) (per
curiam); 	McCray v. Maryland Dep’t of Transp., 741 F.3d 480, 483 (4th Cir. 2014). However, “the
party opposing summary judgment ‘cannot complain that summary judgment was granted without
discovery unless that party has made an attempt to oppose the motion on the grounds that more
time was needed for discovery.’” 	Harrods Ltd. v. Sixty Internet Domain Names, 302 F.3d 214,
244 (4th Cir. 2002) (quoting 	Evans v. Techs. Applications & Serv. Co., 80 F.3d 954, 961 (4th Cir.
1996)). To raise adequately the issue that discovery is needed, the non-movant typically must file
an affidavit or declaration pursuant to Rule 56(d) (formerly Rule 56(f)), explaining why, “for
specified reasons, it cannot present facts essential to justify its opposition,” without needed
discovery. 	FED. 	R. 	CIV. 	P. 	56(d); 	see also Harrods Ltd., 302 F.3d at 244–45 (discussing affidavit
requirement of former Rule 56(f)).
“[T]o justify a denial of summary judgment on the grounds that additional discovery is
necessary, the facts identified in a Rule 56 affidavit must be ‘essential to [the] opposition.’” 	Scott
v. Nuvell Fin. Servs. LLC, 789 F. Supp. 2d 637, 641 (D. Md. 2011) (alteration in original) (citation
omitted). 	A non-moving party’s Rule 56(d) request for additional discovery is properly denied
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“where the additional evidence sought for discovery would not have by itself created a genuine
issue of material fact sufficient to defeat summary judgment.” 	Strag v. Bd. of Trustees, Craven
Cmty. Coll., 55 F.3d 943, 954 (4th Cir. 1995); 	see Amirmokri v. Abraham, 437 F. Supp. 2d 414,
420 (D. Md. 2006), 	aff’d, 266 F. App’x. 274 (4th Cir.), 	cert. denied, 555 U.S. 885 (2008).
If a non-moving party believes that further discovery is necessary before consideration of
summary judgment, the party fails to file a Rule 56(d) affidavit at his peril, because “‘the failure
to file an affidavit … is itself sufficient grounds to reject a claim that the opportunity for discovery
was inadequate.’” 	Harrods Ltd., 302 F.3d at 244 (citations omitted). Despite the absence of the
non-moving party’s Rule 56(d) affidavit, however, the Court shall not issue a summary judgment
ruling that is obviously premature. 	Although the Fourth Circuit places “‘great weight’” on the
Rule 56(d) affidavit, and holds that mere “‘reference to Rule 56(f) [now Rule 56(d)] and the need
for additional discovery in a memorandum of law in opposition to a motion for summary judgment
is not an adequate substitute for [an] affidavit,’” the appellate court has “not always insisted” on a
Rule 56(d) affidavit. 	Id. 	(internal citations omitted).
Failure to file an affidavit may be excused “if the nonmoving party has adequately
informed the district court that the motion is premature and that more discovery is necessary” and
the “nonmoving party’s objections before the district court ‘served as the functional equivalent of
an affidavit.’” 	Harrods Ltd., 302 F.3d at 244–45 (internal citations omitted); 	see also Putney, 656
F. App’x at 638; 	Nader v. Blair, 549 F.3d 953, 961 (4th Cir. 2008). Moreover, “[t]his is especially
true where, as here, the non-moving party is proceeding pro se.” 	Putney, 656 F. App’x at 638.
Here, Carlton has responded to the motions and, in response to both Dr. Tesfaye’s motion
and Dr. Kathuria’s motion, has requested discovery. ECF Nos. 86-4; 90-4. Carlton’s requests for
discovery are addressed below.
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C. Summary Judgment
Summary judgment is governed by Federal Rule of Civil Procedure 56(a), which provides
in pertinent part: “The court shall grant summary judgment if the movant shows that there is no
genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.”
The Supreme Court has clarified that this does not mean that any factual dispute will defeat the
motion. “By its very terms, this standard provides that 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 (1986) (emphasis in original).
“The party opposing a properly supported motion for summary judgment ‘may not rest
upon the mere allegations or denials of [his] pleadings,’ but rather must ‘set forth specific facts
showing that there is a genuine issue for trial.’” 	Bouchat v. Baltimore Ravens Football Club, Inc.,
346 F.3d 514, 525 (4th Cir. 2003) (alteration in original) (quoting FED. 	R. 	CIV. 	P. 	56(e)). 	The
Court “view[s] the evidence in the light most favorable to … the nonmovant, and draw[s] all
inferences in her favor without weighing the evidence or assessing the witnesses’ credibility.”
Dennis v. Columbia Colleton Med. Ctr., Inc., 290 F.3d 639, 644–45 (4th Cir. 2002); 	see F.D.I.C.
v. Cashion, 720 F.3d 169, 173 (4th Cir. 2013).
The district court’s “function” is not “to weigh the evidence and determine the truth of the
matter but to determine whether there is a genuine issue for trial.” 	Anderson, 477 U.S. at 249.
Moreover, the trial court may not make credibility determinations on summary judgment. 	Jacobs
v. N.C. Admin. Off. of the Cts., 780 F.3d 562, 569 (4th Cir. 2015); 	In re French, 499 F.3d 345, 352
(4th Cir. 2007); 	Black & Decker Corp. v. United States, 436 F.3d 431, 442 (4th Cir. 2006); 	Dennis,
290 F.3d at 644–45. Therefore, in the face of conflicting evidence, such as competing affidavits,
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summary judgment is generally not appropriate, because it is the function of the factfinder to
resolve factual disputes, including matters of witness credibility.
Nevertheless, to defeat summary judgment, conflicting evidence, if any, must give rise to
a genuine dispute of material fact. 	Anderson, 477 U.S. at 247–48. If “the evidence is such that a
reasonable jury could return a verdict for the nonmoving party,” then a dispute of material fact
precludes summary judgment. 	Id. 	at 248; 	Libertarian Party of Virginia v. Judd, 718 F.3d 308, 313
(4th Cir. 2013). On the other hand, summary judgment is appropriate if the evidence “is so one-
sided that one party must prevail as a matter of law.” 	Id. 	at 252. 	And, “the mere existence of a
scintilla of evidence in support of the plaintiff’s position will be insufficient; there must be
evidence on which the jury could reasonably find for the plaintiff.” 	Id.
Because Carlton is self-represented, his submissions are liberally construed. 	Erickson v.
Pardus, 551 U.S. 89, 94 (2007). 	That notwithstanding, the Court must abide the “‘affirmative
obligation of the trial judge to prevent factually unsupported claims and defenses from proceeding
to trial.’” 	Bouchat, 346 F.3d at 526 (internal quotation marks omitted) (quoting 	Drewitt v. Pratt,
999 F.2d 774, 778–79 (4th Cir. 1993), and citing 	Celotex Corp. v. Catrett, 477 U.S. 317, 323–24
(1986)).
III. ANALYSIS
A. Medical Provider Group
The Medical Provider Group asserts that claims against them should be dismissed for
failure to state a claim or alternatively that they are entitled to summary judgment because they
were not deliberately indifferent to Carlton’s medical needs. ECF No. 62-1. 	In support of their
motion, the Medical Provider Group provides over 300 pages of Carlton’s medical records, ECF
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Nos. 62-3 – 62-11, and Declarations of Defendants Dr. Getachew, ECF No. 62-2; Dr. Bartels, ECF
No. 62-12; Dr. Berger, ECF No. 62-13; and RN Ernst, ECF No. 62-14.
The Court has spent considerable time trying to make sense of the medical records provided
by the Medical Provider Group. The records are docketed as nine separate filings of 34 to 35 pages,
uniformly titled “Exhibit A-1,” and unindexed. 	ECF Nos. 62-3 – 62-11. 	The four Declarations
are also unindexed or labeled. ECF Nos. 62-2, 62-12 – 62-14. In his Declaration, Dr. Getachew
references every medical document as Exhibit A-1, with the page number provided by the
institutional medical records numbering system (“MR”) noted at the bottom of each page of the
medical documents. ECF No. 62-2. This numbering system, provided without an index, requires
the Court to search all nine docketed filings to determine the medical document being referenced.
Under Local Rule 105.5 (D. Md. 2025) “[i]f any motion, memorandum, or brief is accompanied
by more than five exhibits, the exhibits shall be tabbed and indexed.” The Medical Provider Group
has not complied with the Local Rule.
The Court’s task is further impeded and complicated by medical records provided that
appear duplicated and out of order. 	See, iMR 105-139 located both at ECF No. 62-6 at 1-35 and
ECF No. 62-7 at 1-35. But certainly, more concerning and critical are the pages missing from the
medical records that are heavily relied on by the Medical Provider Group in their Memorandum
of Law and in the Declarations provided. Specifically, pages MR 140-174 appear not to have been
filed at all and no medical records were filed after page number MR 314. 	ECF No. 6-7 ending
with MR 139, and ECF No. 6-8 starting with MR 175, representing 36 missing pages, and ECF
No. 6-11 at 35, showing the last medical record provided, labeled MR 314. The result is that the
declarations cite multiple documents that were not provided, are not in the record, and cannot be
reviewed by the Court or Carlton. Getachew Declaration, ECF No. 62-2 at 13-19, 23-24; Bartel
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Declaration (citing Getachew Declaration and MR record numbers, ECF No. 62-12); Berger
Declaration, ECF No. 62-13 (citing Getachew Declaration and MR record numbers); and Ernst
Declaration, ECF No. 62-14 (citing Getachew Declaration and MR record numbers).
The Court’s concerns continue. 	The Medical Provider Group relies heavily on the
activities of the YesCare Utilization Management (“UM”) Committee; and yet it appears it failed
to provide these documents to the Court. Memorandum of Law, ECF No. 62-1. 	Carlton filed a
Supplement to the Amended Complaint, which includes portions of his UM medical records, ECF
No. 15-5, but the Court cannot determine if Carlton’s submission is complete regarding UM
activities. The Court also cannot determine if Carlton’s submission contains any of the missing
records cited by the Medical Provider Group. 	See 	ECF Nos. 15-5.
The Court cannot reconcile the record and has spent considerable judicial resources in an
effort to do so. This is an undue burden on the Court and Carlson. The motion will be denied
without prejudice. ECF No. 62.
B. Defendant Dr. Tesfaye
Dr. Tesfaye asserts that claims against him should be dismissed for failure to state a claim
or, alternatively, he is entitled to summary judgment because he was not deliberately indifferent
to Carlton’s medical needs; his medical malpractice claim should be dismissed for failure to satisfy
state law requirements; and qualified immunity bars the claim. ECF No. 50-1.
Dr. Tesfaye argues that Carlton has merely alleged, without providing evidence, that he
provided general medical services to inmates, was a Regional Medical Director, and was part of
the Utilization Management staff. 	ECF No. 50-1 at 3. 	Then, relying solely on his Declaration
without reference to medical records, Dr. Tesfaye asserts there is no genuine dispute of material
fact that he did not treat Carlton for Dupuytren Disease, and at no time relevant to Carlton’s
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Amended Complaint did he serve as Regional Medical Director for WCI or ECI. 	8 	Id. 	at 3, 6;
ECF No. 50-2 at ¶¶ 5, 8. 	Dr. Tesfaye does not state whether he served on the Utilization
Management committee. 	See id.
Counter to Dr. Tesfaye’s assertions, Carlton alleged in his Amended Complaint that
Tesfaye was a Regional Medical Director and part of UM staff during the relevant time period.
ECF No. 14 ¶ 14. Additionally, in his Supplement to the Amended Complaint, Carlton provided
medical records that contradict Tesfaye’s assertions. For example, medical records document that
on August 1, 2021, Tesfaye appears to have been notified that an alternative treatment plan
(“ATP”), rather than an orthopedic consult, be provided. 	See 	ECF No. 15-5 at 2. 	The entry
includes Tesfaye’s name and states “RMD” (Regional Medical Director) Determination and
appears to be at the direction of the Utilization Management Committee (noting Drs. Ernst and
Bartles). 	Id. 	Carlton provided an additional medical record that seems to provide similar
information. 	ECF No. 86-5 at 2. 	Further, medical records Carlton provided document that on
April 8, 2022, Carlton was seen by Dr. Mehta for a left planter contracture referral that interferes
with his activities of daily living (“ADL”); the condition was noted to be “chronic”; and it was
ordered that Carlton should be scheduled for the chronic care clinic. ECF No. 15-4 at 54-55. On
August 2, 2022, Carlton had a chronic care visit and included on the list of chronic medical
problems was Dupuytren’s Contracture on his left hand. 	ECF No. 15-11 at 5. 	The medical
provider for this appointment was noted to be Dr. Tesfaye. 	Id. 	at 7. Dr. Tesfaye does not address
8 	Dr. Tesfaye does not provide any medical records. Instead, he relies on Carlton’s allegations in
his Amended Complaint, documents provided by Carlton in the Supplement to the Amended
Complaint, and his own Declaration. ECF Nos. 50-1, 50-2. Dr. Tesfaye states that he reserves the
right to file a subsequent motion for summary judgment based on Carlton’s medical records if the
Court does not grant this motion and dismiss him from the lawsuit. ECF No. 50-1 at 15 n. 4.
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the medical records previously provided by Carlton and contradict his declaration regarding
involvement in Carlton’s care.
The Court finds that material facts are in genuine dispute that preclude summary judgment
in favor of Dr. Tesfaye. Dr. Tesfaye’s motion will be denied.9 	Further, as the motion will be
denied, Carlton’s discovery request will be denied without prejudice to renew. ECF No. 90-4.
C. Dr. Kathuria
Dr. Kathuria asserts that Carlton has failed to state a claim against him; alternatively, he
asserts he is entitled to summary judgment because he was not deliberately indifferent to Carlton’s
medical needs. ECF Nos. 67, 67-1.
Carlton alleges, both in his Amended Complaint and in response to the motion, that Dr.
Kathuria issued incorrect x-ray findings, which caused him to suffer delay in receiving medical
treatment. ECF No. 14 at 4-5, 14-15; ECF No. 90-3. Carlton asserts that other medical providers
made visual findings that contradict the x-ray reports, and another physician interpreted an earlier
x-ray of Carlton’s elbow with additional findings. ECF No. 90-3 at 5. Dr. Kathuria counters that
he was not charged with providing treatment or making clinical decisions, and his limited role in
reviewing and interpreting radiological images cannot establish that he was deliberately indifferent
to Carlton’s medical needs. 	ECF No. 67-2 at ¶¶ 	12; ECF No. 67-1. 	In his Declaration, Dr.
Kathuria avers that when he interprets an x-ray the only information he receives is the indication
for the study, as noted on the radiology report. 	ECF No. 67-2 at ¶ 	12. 	The indications for the
9 	The Court will not address Dr. Tesfaye’s argument regarding a state law claim of medical
malpractice, as the Court has construed Carlson’s claim solely as based on the Eighth Amendment.
ECF Nos. 17-18. 	As for Dr. Tesfaye’s argument pertaining to qualified immunity, the material
facts pertaining to Dr. Tesfaye’s involvement in Carlton’s medical care are clearly in dispute; such
a determination is premature. 	Anderson v. Liberty Lobby, Inc., 	477 U.S. 242, 251-52 (1986).
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three x-rays he interpreted were noted to be left hand pain; right elbow and left hand pain; and
lefthand 5th 	digit. 	Id. 	at ¶ 11. In interpreting the x-rays, Dr. Kathuria did not observe a “serious
medical condition.” 	Id. 	at ¶ 13.
Carlton responded to the motion and included a declaration asserting that he needs
discovery to dispute the motion for summary judgment. 	ECF No. 90; ECF No. 90-4. 	Carlton
specifically seeks the x-ray films taken of his elbow and hand; depositions of Dr. Syed who
interpreted the earlier of two x-rays of his elbow; and nurses Clark and Swan who can testify as to
the discrepancies between the x-ray reports and medical reports. 	Id.
Carlton’s request for discovery and the analysis of the summary judgment motion both turn
on the elements of an Eighth Amendment claim for denial of medical care. The question here is
whether incorrect x-ray reports are sufficient to state an Eighth Amendment claim in the provision
of medical care.
To state an Eighth Amendment claim for denial of medical care, a plaintiff must
demonstrate that the actions of the defendants, or their failure to act, amount to deliberate
indifference to a serious medical need. 	Estelle v. Gamble, 429 U.S. 97, 106 (1976); 	Anderson v.
Kingsley, 877 F.3d 539, 543 (4th Cir. 2017). 	Deliberate indifference to a serious medical need
requires proof that, objectively, the prisoner plaintiff suffered from a serious medical need and
that, subjectively, the prison staff were aware of the need for medical attention but failed either to
provide it or to ensure it was available. 	Farmer v. Brennan, 511 U.S. 825, 834–37 (1994); 	Heyer
v. United States Bureau of Prisons, 849 F.3d 202, 209–10 (4th Cir. 2017); 	King v. Rubenstein, 825
F.3d 206, 218 (4th Cir. 2016); 	Iko v. Shreve, 535 F.3d 225, 241 (4th Cir. 2008). Objectively, the
medical condition at issue must be serious. 	See Hudson v. McMillian, 503 U.S. 1, 9 (1992) (there
is no expectation that prisoners will be provided with unqualified access to health care); 	Jackson
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v. Lightsey, 775 F.3d 170, 178 (4th Cir. 2014). Proof of an objectively serious medical condition,
however, does not end the inquiry.
The subjective component requires “subjective recklessness” in the face of the serious
medical condition. 	Farmer, 511 U.S. at 839, 840; 	Anderson, 877 F.3d at 544. Under this standard,
“the prison official must have both ‘subjectively recognized a substantial risk of harm’ and
‘subjectively recognized that his[/her] actions were inappropriate in light of that risk.’” 	Anderson,
877 F.3d at 545 (quoting 	Parrish ex rel. Lee v. Cleveland, 372 F.3d 294, 303 (4th Cir. 2004)); 	see
also Rich v. Bruce, 129 F.3d 336, 340 n.2 (4th Cir. 1997) (“True subjective recklessness requires
knowledge both of the general risk, and also that the conduct is inappropriate in light of that risk.”).
“Actual knowledge or awareness on the part of the alleged inflicter … becomes essential to proof
of deliberate indifference ‘because prison officials who lacked knowledge of a risk cannot be said
to have inflicted punishment.’” 	Brice v. Virginia Beach Corr. Ctr., 58 F.3d 101, 105 (4th Cir.
1995) (quoting 	Farmer, 511 U.S. at 844).
The subjective knowledge requirement can be met through direct evidence of actual
knowledge or through circumstantial evidence tending to establish such knowledge, including
evidence “that a prison official knew of a substantial risk from the very fact that the risk was
obvious.” 	Scinto v. Stansberry, 841 F.3d 219, 226 (4th Cir. 2016) (quoting 	Farmer, 511 U.S. at
842). If the requisite subjective knowledge is established, an official may avoid liability “if [he]
responded reasonably to the risk, even if the harm ultimately was not averted.” 	Farmer, 511 U.S.
at 844; 	see also Cox v. Quinn, 828 F.3d 227, 236 (4th Cir. 2016) (“[A] prison official’s response
to a known threat to inmate safety must be reasonable.”). 	Reasonableness of the actions taken
must be judged in light of the risk the defendant actually knew at the time. 	See Brown v. Harris,
240 F.3d 383, 390 (4th Cir. 2001) (citing 	Liebe v. Norton, 157 F.3d 574, 578 (8th Cir. 1998) (focus
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must be on precautions actually taken in light of suicide risk, not those that could have been
taken)); 	see also Jackson, 775 F.3d at 179 (physician’s act of prescribing treatment raises fair
inference that he believed treatment was necessary and that failure to provide it would pose an
excessive risk). Further, “a complaint that a physician has been negligent in diagnosing or treating
a medical condition does not state a valid claim of medical mistreatment under the Eighth
Amendment. Medical malpractice does not become a constitutional violation merely because the
victim is a prisoner.” 	Estelle, 429 U.S. at 106.
Carlton seeks discovery to support his claim that Dr. Kathuria misread the x-rays. 	ECF
No. 90-4. 	A misreading of an x-ray report alone, however, does not establish deliberate
indifference. 	Pevia v. Syed, No. CV SAG-22-837, 2022 WL 4225478, at *2 (D. Md. Sept. 13,
2022) (dismissing prisoner civil rights complaint against radiologist who provided an incorrect
diagnosis) citing 	Carrera v. California, 2008 WL 3931182 *10 (C.D. CA 2008) (dismissing
prisoner civil rights complaint against radiologist who misread x-ray). 	See Gibbs v. Wexford
Health Sources, Inc., 	No. 2:20-CV-00867, 2021 WL 5986995, at *13 (S.D.W. Va. Sept. 14, 2021)
report and recommendation adopted, No. 2:20-CV-00867, 2021 WL 5451775 (S.D.W. Va. Nov.
22, 2021), 	aff'd, No. 21-7667, 2022 WL 604052 (4th Cir. Mar. 1, 2022) (assertions that medical
staff misidentified a finding on an X-ray did not allow for a conclusion that medical staff was
aware of and disregarded a serious risk to his health).
Even assuming that Carlton can establish that Dr. Kathuria’s x-ray report contained
incomplete or incorrect information, without more, Carlton does not meet the subjective standard
of a deliberate indifference claim. Carlton has not alleged that Dr. Kathuria had actual knowledge
of his serious medical condition and the excessive risk posed by his action or inaction. 	See
Jackson, 775 F.3d 170, 178 (4th Cir. 2014). Carlton’s request for discovery will be denied because
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the discovery he requests will not lead to evidence that supports his claim that Dr. Kathuria acted
with deliberate indifference to a serious medical need.
Similarly, the record lacks sufficient allegations that Dr. Kathuria read the x-rays with a
conscious disregard of an excessive risk to Carlton’s health, or that he was aware of the need for
medical attention and failed to ensure its availability. 	Even if Carlton can establish that Dr.
Kathuria misread his x-rays, this, alone, fails to state a claim of deliberate indifference. Dr.
Kathuria’s motion, construed as a motion for summary judgment, will be granted.
IV. MOTION FOR RECONSIDERATION
On August 26, 2025, the Court issued a Memorandum Opinion and Order granting the
DPSCS Defendants’ dispositive motion, construed as a motion for summary judgment, and
Carlton’s claims against the DPSCS Defendants were dismissed. 	ECF Nos. 46, 79-80. 	The
Court’s Memorandum Opinion notes that Carlton had not responded to the motion. ECF No. 79
at 1. 	The Court had previously granted Carlton an extension of time to respond to the motion, and
the final extension expired on July 28, 2025. ECF No. 77.
On August 29, 2025, three days after issuing its Memorandum Opinion and Order
dismissing the claims, the Court received Carlton’s response to the DPSCS motion, which was
docketed as correspondence, as the motion had already been resolved. ECF No. 81. On September
12, 2025, the Court received Carlton’s Motion for Reconsideration of the Court’s Order. ECF No.
82. 	In his motion, Carlton states that on July 23, 2025, he signed his response to the DPSCS
motion and on July 26, 2025, he placed his response to motion in the hands of prison officials for
mailing. 	Id. 	at 1; 	see also 	ECF No. 81-1 at 27 (same). Carlton asserts that it is beyond his control
that the response was not timely received by the Court. 	ECF No. 82. Carlton includes with his
motion the Declaration of DPSCS employee Michael Conley who attests that on July 26, 2025, he
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accepted Carlton’s legal mail, and that neither he nor Carlton have control over when the mail
leaves Western Correctional Institution. 	ECF No. 82-1; 	see also 	ECF No. 81-1 at 27. 	DPSCS
Defendants have not responded to Carlton’s motion.
The prison mailbox rule governs pleadings filed by a prisoner litigant who uses the prison
mail system to send pleadings to the Court. Under this rule, a document is deemed filed the date
it was delivered to prison officials for mailing. 	See Houston v. Lack, 487 U.S. 266, 270 (1988)
(holding the pro-se prisoner “filed his notice within the requisite 30-day period when ... he
delivered the notice to prison authorities for forwarding to the District Court). Here, Carlton has
provided his verified motion accompanied by a prison employee’s declaration supporting that the
response to the motion was timely filed.
The Federal Rules of Civil Procedure do not contain an express provision for a “motion for
reconsideration” of a final judgment. 	Katyle v. Penn Nat’l Gaming, Inc., 637 F.3d 462, 470 n.4
(4th Cir.), 	cert. denied, 132 S. Ct. 115 (2011). But, to avoid elevating form over substance, a
motion to reconsider may be construed as a motion to alter or amend judgment under Fed. R. Civ.
P. 59(e), or a motion for relief from judgment under Fed. R. Civ. P. 60(b). 	MLC Auto., LLC v.
Town of S. Pines, 532 F.3d 269, 278-80 (4th Cir. 2008). Because the motion was filed within 28
days of the Court’s judgment, Rule 59(e) controls. 	Bolden v. McCabe, Weisberg & Conway, LLC,
No. DKC-13-1265, 2014 WL 994066, at *1 n.1 (D. Md. Mar. 13, 2014); 	see also 	Fed. R. Civ. P.
59(e) (stating that “[a] motion to alter or amend a judgment must be filed no later than 28 days
after the entry of the judgment”).
“Federal Rule of Civil Procedure 59(e) permits the district court to reconsider a decision
in certain circumstances.” 	Ross v. Early, 899 F. Supp. 2d 415, 420 (D. Md. 2012) (citing Fed. R.
Civ. P. 56(e)), 	aff’d, 746 F.3d 546 (4th Cir. 2014). But, the plain language of Rule 59(e) does not
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provide a particular standard by which a district court should evaluate a motion to alter or amend
judgment. However, the Fourth Circuit has clarified: “Our case law makes clear, however, that
Rule 59(e) motions can be successful in only three situations: (1) to accommodate an intervening
change in controlling law; (2) to account for new evidence not available at trial; or (3) to correct a
clear error of law or prevent manifest injustice.” 	Zinkand v. Brown, 478 F.3d 634, 637 (4th Cir.
2007) (internal quotations omitted); 	see also United States ex rel. Carter v. Halliburton Co., 866
F. 	3d 	199, 	210-11 	(4th 	Cir. 	2017), 	cert. 	denied, 	2018 	WL 	587746 	(June 	25, 	2018).
“‘[R]econsideration of a judgment after its entry is an extraordinary remedy which should be used
sparingly.’” 	Pac. Ins. Co. v. Am. Nat. Fire Ins. Co., 148 F.3d 396, 403 (4th Cir. 1998) citing 11
Wright et al., 	Federal Practice and Procedure 	§ 2810.1, at 124 (2d ed. 1995).
Carlton’s response to DPSCS’s motion was timely filed under the prison mailbox rule. It
would be unjust, and contrary to law, to hold Carlton responsible for mail delays that are beyond
his control. The motion for reconsideration will be granted and his response will be considered by
the Court in ruling on DPSCS’s motion. 	For the reasons that follow, the Court reaffirms the
Memorandum Opinion and Order previously issued.
In the Opinion, the Court granted DPSCS’s motion, construed as a motion for summary
judgment, stating the following:
In view of the undisputed facts, Cartwright, Jenkins, and Woolford’s limited role
does not establish personal liability for unconstitutionally inadequate medical care.
None of these Defendants investigated Carlton’s substantive complaints regarding
his medical care or was otherwise involved with the provision of medical care. 	See
Chukwurah v. Corizon Health Care, No. CV PX-22-212, 2023 WL 4268556, at *6
(D. Md. June 29, 2023) (citing 	Gallagher v. Shelton, 587 F.3d 1063, 1069 (10th
Cir. 2009) (allegation that warden “rubber stamped” grievances was not enough to
establish personal participation) (citing 	Whitington v. Ortiz, 307 F. App’x 179, 193
(10th Cir. 2009) (unpublished) (“denial of the grievances alone is insufficient to
establish personal participation in the alleged constitutional violations.”)), 	aff'd,
No. 23-6716, 2024 WL 1405885 (4th Cir. Apr. 2, 2024).
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The Court turns next to Carlton’s allegations against Warden Weber. Officials like
Warden Weber may be found liable if the plaintiff shows the official “acted
personally in the deprivation of the plaintiff[’s] rights.” 	Vinnedge v. Gibbs, 550
F.2d 926, 928 (4th Cir. 1977) (quoting 	Bennett v. Gravelle, 323 F. Supp. 203, 214
(D. Md. 1971)). 	See also Kelly v. Miller, No. CV ELH-20-2531, 2022 WL
2703827, at *22 (D. Md. July 12, 2022) citing 	Wright v. Collins, 766 F.2d 841, 850
(4th Cir. 1985) (additional citations omitted) (receipt of letters by prison officials
may be evidence of personal knowledge).
Carlton alleges in his verified complaint that on November 22, 2021, he sent a letter
to Defendant Weber and included a copy of the first and second ARPS and photos
of his left-hand pinky bent and twisted. 	ECF No. 15-14 at 16-17; ECF No. 14 at
17. 	The copy of the letter and attachments, provided by Carlton, addressed to
“WARDEN/TO WHOM IT MAY CONCERN,” states that Carlton is appealing his
second filed ARP, references the inventory numbers for both ARPs, and is stamped
as received on December 3, 2021, and also on February 1, 2022, by the ARP/IGP
unit. ECF No. 15-14 at 10-16.
It is undisputed that Warden Weber did not process either of Carlton’s ARPs or was
aware that Carlton had filed any ARPs pertaining to medical care. ECF No. 46-2
at ¶ 6. 	Emerick, the current administrative aide/litigation coordinator at WCI
confirms without opposition by Carlton that there is no record on the Warden’s mail
log regarding any appeal of an ARP by Carlton from July 2021 through April 2022,
which is during the time Carlton alleges he sent his letter to the Warden. ECF No.
46-6 at ¶ 2-3 (Decl. Emerick). Further, it is undisputed that any letter expressing
an intent to appeal an ARP or referencing an ARP would have been forwarded to
the ARP Coordinator’s Office to handle. 	Id. 	at ¶ 6. 	Emerick asserts, without
opposition by Carlton, that the mail log for the Warden’s Office documents only
one piece of correspondence came from Carlton from December 2021 through
January 2022, and it was noted to be in reference to Carlton’s request for permission
to communicate with his brother who was incarcerated at another facility. 	Id. 	at ¶
4. This, too, is undisputed.
The 	undisputed 	record 	evidence 	is 	that 	Carlton’s 	letter 	addressed 	to
“WARDEN/TO WHOM IT MAY CONCERN” was processed as an appeal the
ARP denial. This document is stamped as received on both December 3, 2021, and
February 1, 2022, by the ARP/IGP unit. 	ECF No. 15-14 at 16-17. 	In this letter,
Carlton states he is appealing his first ARP 1979-21 and provides the inventory
numbers for both ARPS (0143703 and 0106664). 	Id. 	at 16; ECF No. 14 at 17.
Jenkins, the ARP Coordinator, sent Carlton a Memorandum dated December 3,
2021, stating that the letter will not be accepted for processing because “[w]e are
unable to determine your intent.” ECF 15-14 at 18.
… Carlton fails to allege personal involvement of Warden Weber. In addition,
although addressed by Defendants, Carlton does not allege Weber is responsible
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under a theory of supervisory liability. Indeed, Carlton makes no allegations to this
effect.
ECF No. 79 at 16-19.
The Court has reviewed Carlton’s response to the motion. 	In his response, Carlton does
not provide evidence that there are material facts in genuine dispute that preclude summary
judgment; rather, he argues that the law supports his claim and that summary judgment should be
denied for that reason.
Carlton’s 	response 	does 	not 	alter 	the 	analysis 	or 	conclusion 	in 	the 	Court’s 	prior
Memorandum Opinion and Order finding that Cartwright, Jenkins, and Woolford’s limited role
does not establish personal involvement for unconstitutionally inadequate medical care, and that
Weber was not personally involved or responsible under a theory of supervisory liability. 	This
was the basis for the Court’s decision.
The Court reaffirms its prior Memorandum Opinion and Order granting the DPSCS
Defendants’ dispositive motion, construed as a motion for summary judgment, and dismissing
Carlton’s claims against the DPSCS Defendants. ECF Nos. 46, 79-80.
V. 	APPOINTMENT OF COUNSEL
As claims are proceeding against the Medical Provider Defendants and Dr. Tesfaye, the
Court assesses Carlton’s need for appointment of counsel. 	[D]istrict courts have discretion to
appoint counsel in civil cases and abuse that discretion by declining to do so where the case of an
indigent person presents exceptional circumstances.” 	Jenkins v. Woodard, 109 F.4th 242, 247 (4th
Cir. 2024) (citation and quotations omitted). Exceptional circumstances exist if (1) plaintiff has a
“colorable claim” and (2) considering the claim’s objective complexity and his subjective abilities,
plaintiff “lacks the capacity to present it.” 	Id. 	(citation and quotations omitted).
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The Court determines that Carlton has presented exceptional circumstances. Carlton is
presently incarcerated. 	He seeks significant discovery regarding the responsibilities of medical
providers for the delay in his receipt of what he alleges is necessary medical treatment for a serious
medical illness. 	Based on Carlton’s filings to date, the nature of the claims, and the need for
discovery, the Court determines that exceptional circumstances exist that warrant the appointment
of an attorney to represent Carlton under 28 U.S.C. § 1915(e)(1).
VI. 	CONCLUSION
For the foregoing reasons, the Medical Provider Group’s Motion will be denied without
prejudice. 	Carlton’s motions for an extension to file an opposition response and to file excess
pages to that motion will be denied as moot. Carlton’s motion for an extension of time to respond
to Tesfaye’s Motion shall be granted 	nunc pro tunc. Dr. Tesfaye’s Motion, construed as a Motion
for Summary Judgment, will be denied. Carlton’s request for discovery pertaining to Dr. Tesfaye
will be denied without prejudice. The Medical Group Providers and Dr. Tesfaye will be directed
to answer the Amended Complaint and Supplement to the Amended Complaint. 	Dr. Kathuria’s
Motion, construed as a motion for summary judgment, will be granted, and Carlton’s related
request for discovery will be denied.
Carlton’s Motion to Reconsider the Court’s August 26, 2025 Order, granting Defendant
DPSCS’s Motion to Dismiss or for Summary Judgment, will be granted. The Court, however,
reaffirms the Memorandum Opinion and Order dated August 26, 2025.
Carlton will be appointed counsel who may renew motions for discovery and complete
service on remaining defendants. A separate Order follows.
/S/
February 10, 2026 	_____________________________
Julie R. Rubin
United States District Judge
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