Crow v. Robison et al

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IN THE UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF ARKANSAS
FAYETTEVILLE DIVISION
HOLDER PAUL CROW 	PLAINTIFF
v. 	Civil No. 5:25-cv-05053-TLB-CDC
TRACEY ROBISON, Charge Nurse; and
TURN KEY HEALTH CLINICS, LLC 	DEFENDANTS
MAGISTRATE JUDGE’S REPORT AND RECOMMENDATION
This is a civil rights action filed pursuant to 42 U.S.C. § 1983. Pursuant to the provisions
of 28 U.S.C. § 636(b)(1) and (3), the Honorable Timothy L. Brooks, Chief United States District
Judge, 	referred 	this 	case 	to 	the 	undersigned 	for 	the 	purpose 	of 	making 	a 	Report 	and
Recommendation. Currently before the Court are the Motion for Summary Judgment (ECF No.
27) filed by Defendants Tracey Robison and Turn Key Health Clinics, LLC (“Turn Key”), as well
as their Brief in Support (ECF No. 28) and Statement of Material Facts in Support (ECF No. 29).
Also before the Court are Plaintiff Holder Paul Crow’s Motion for Summary Judgment (ECF No.
35) and Defendants’ Response in Opposition (ECF No. 36) and Statement of Material Facts in
Opposition (ECF No. 37). 	For the reasons given below, the undersigned recommends that
Defendants’ Motion be GRANTED and that Plaintiff’s Motion be DENIED.
I. BACKGROUND
Plaintiff’s Complaint (ECF No. 1) brings one claim, concerning medical issues he
experienced while incarcerated at the Benton County Detention Center (“BCDC”). Specifically,
Plaintiff alleges that while at the BCDC he suffered a hernia, and that “Nurse Tracey Robison
acting in capacity of medical director of [BCDC] employed by TK Health stated that the hernia
surgery I require to be an elective surgery,” and therefore “refused to sign off on surgery knowing
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I needed it.” 	See id. at 4–5. 	Plaintiff asserts that this constitutes inadequate medical care in
violation of his constitutional right to be free from cruel and unusual punishment. Id. As relief,
Plaintiff seeks $100,000.00 in compensatory damages for pain and suffering, plus the cost of the
hernia surgery he wishes to undergo, as well as $20,000.00 in punitive damages. 	See id. at 9.
Defendants have moved for Plaintiff’s claim to be dismissed with prejudice on summary judgment.
See ECF No. 27. Plaintiff filed a document that he styled as a motion for summary judgment, but
which appears in substance to be a response in opposition to Defendants’ motion. See ECF No.
35. Both motions are now ripe for decision.
II. LEGAL STANDARD
Summary judgment is appropriate if, after viewing the facts and all reasonable inferences
in the light most favorable to the non-moving party, Matsushita Elec. Indus. Co. v. Zenith Radio
Corp., 475 U.S. 574, 587 (1986), the record “shows 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).
“Once a party moving for summary judgment has made a sufficient showing, the burden rests with
the non-moving party to set forth specific facts, by affidavit or other evidence, showing that a
genuine issue of material fact exists.” 	National Bank of Commerce v. Dow Chemical Co., 165
F.3d 602, 607 (8th Cir. 1999).
The non-moving party “must do more than simply show that there is some metaphysical
doubt as to the material facts.” Matsushita, 475 U.S. at 586. “They must show there is sufficient
evidence to support a jury verdict in their favor.” National Bank, 165 F.3d at 607 (citing Anderson
v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986)). “A case founded on speculation or suspicion is
insufficient to survive a motion for summary judgment.” Id. (citing Metge v. Baehler, 762 F.2d
621, 625 (8th Cir. 1985)). 	“When opposing parties tell two different stories, one of which is
blatantly contradicted by the record, so that no reasonable jury could believe it, a court should not
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adopt that version of the facts for purposes of ruling on a motion for summary judgment.” Scott
v. Harris, 550 U.S. 372, 380 (2007).
III. ANALYSIS
Defendants supported their Motion with extensive medical records from Plaintiff’s time at
the BCDC, the authenticity of which Plaintiff does not dispute.1 	Those records establish the
following undisputed facts. 	Plaintiff suffered a hernia on or about July 28, 2024, while he was
incarcerated at BCDC, and four days later, on August 1, he filed a medical request to see a nurse.
See ECF No. 29-1, p. 214. Later that same day, a Turn Key nurse saw and evaluated Plaintiff’s
hernia, gave him pain relievers for it, and scheduled a follow-up appointment with him. See id. at
16, 38–39, 61–62. Four days later, a Turn Key doctor ordered an ultrasound to further evaluate
Plaintiff’s hernia, which was performed on August 6, 2024. See id. at 16–17, 147. Later that day,
a Turn Key APRN ordered naproxen and a scrotal hernia support for Plaintiff. See id. at 16–17,
40–41, 62, 147. 	Over the next three and a half months, Plaintiff seen by Turn Key medical
providers for his hernia at least nine more times, over the course of which period multiple
additional ultrasounds were performed, additional medications and support garments were
ordered, and one trip to an emergency room was conducted. 	See id. at 18–23, 26–30, 116–17,
126–27, 137–39, 148, 184, 191–210.
On November 23, 2024, Plaintiff filed a grievance with BCDC regarding his hernia,
complaining that it was getting progressively worse, giving him unbearable pain, and preventing
him from eating or sleeping. See id. at 186. He complained that “[t]his facility has failed to give
1 Plaintiff’s Motion/Response states generically that “[t]he evidence is disputed that TK
Health medical personnel, including Nurse Robison was indifferent to the Plaintiff’s injury,” see
ECF No. 35, ¶ 2, but does not dispute the authenticity of any medical records provided by
Defendants nor the accuracy of any facts provided in Defendants’ Statement of Material Facts
(ECF No. 29). 	His Motion/Response also includes what appears to be a request for additional
discovery, see ECF No. 35, ¶ 4, but this comes several months after the deadline to conduct
discovery has expired, see ECF No. 17, § I.C.
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me the appropriate medical attention.” See id. The following day, in response to his grievance,
Defendant Robison offered to move Plaintiff to the medical pod so Plaintiff could more easily lie
down as needed, but Plaintiff refused this offer. See id. at 227; ECF No. 29-2, ¶ 10. Defendant
Robison then responded the next day to Plaintiff’s grievance as follows:
This Pt has been seen by the provider 5 times, had 4 [ultrasound tests], and been
seen in the ER for his hernia. We have provided him with a hernia belt and offered
medical housing so he can lay down as needed. He refused medical housing and a
refusal is noted in the chart.
See ECF No. 29-1, p. 186. On November 25, 2024, Plaintiff submitted another grievance, stating
that he wished to appeal the prior one because “I need surgery” and “every day my situation
worsens.” See id. at 240. BCDC denied Plaintiff’s appeal, stating that “[y]our condition has been
reviewed by multiple providers and has been deemed non-life threatening. Your hernia surgery
repair is considered an elective surgery and can be treated upon release.” 	See id. at 240. 	On
November 26, 2024, a Turn Key doctor reaffirmed this conclusion, determining that Plaintiff had
a “small right hernia suspected. This is self-reducing and can be repaired after release.” See id. at
148.
Plaintiff was seen or evaluated by Turn Key providers at least four more times relating to
his hernia over the next two months. See id. at 23–25, 30–31. 	On February 23, 2025, Plaintiff
drafted and signed the Complaint initiating this lawsuit, which was filed on March 10, 2025. See
ECF No. 1, p. 11. 	As previously mentioned, Plaintiff’s claim in this lawsuit is that deliberate
indifference was shown to his medical needs, in violation of his constitutional rights, when
Defendant Robison “stated that the hernia surgery I require [is] an elective surgery” and “refused
to sign off on surgery knowing I needed it.” See id. at 4–5.
The Eighth Amendment governs prisoners’ claims of deliberate indifference to medical
needs generally, but the Fourteenth Amendment governs such claims when they are brought by
pretrial detainees. See Perry v. Adams, 993, F.3d 584, 587 (8th Cir. 2021). However, the same
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analytical standard applies to such claims regardless of which Amendment is properly invoked.
See Barton v. Taber, 908 F.3d 1119, 1123–24 (8th Cir. 2018). 	To establish a constitutional
violation based on deliberate indifference, a plaintiff must show that he suffered from an
objectively serious medical need and that the defendant had actual knowledge of that need but
deliberately disregarded it. See Barton v. Taber, 908 F.3d 1119, 1124 (8th Cir. 2018). “‘Deliberate
indifference’ entails a level of culpability equal to the criminal law definition of recklessness, that
is, a prison official ‘must both be aware of facts from which the inference could be drawn that a
substantial risk of serious harm exists, and he must also draw the inference.’” Bender v. Regier,
385 F.3d 1133, 1137 (8th Cir. 2004) (quoting Farmer v. Brennan, 511 U.S. 825, 837 (1994)).
Mere negligence in diagnosis or treatment does not rise to the level of an Eighth Amendment
violation, nor does an inmate’s mere disagreement with the course of his medical treatment. See
id.
The Eighth Circuit has directly addressed whether refusal to provide surgery for a reducible
hernia constitutes deliberate indifference to a serious medical need. 	In Hancock v. Arnott, the
Eighth Circuit affirmed the district court’s finding on summary judgment that the prisoner did have
an objectively serious medical need for surgery to repair his reducible hernia, because he did not
present any evidence that any delay in his hernia repair surgery created any excessive risk of harm
or changed his prognosis. See 39 F.4th 482, 487 (8th Cir. 2022). (By contrast, the defendants in
Hancock introduced evidence that although the plaintiff did have a hernia, surgical repair was not
required during his incarceration because there were never changes to the plaintiff’s vitals, he
engaged in physical activity without difficulty, and was not at any imminent risk of harm or to his
health or well-being. See id.) However, the Eighth Circuit also held in the alternative that even if
the plaintiff’s hernia constituted a serious medical need, it was indisputable that the defendants did
not deliberately disregard it, because he received adequate care for that need. 	See id. at 488.
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Specifically, the uncontroverted evidence showed that he “was seen by the jail physician or nurses
more than thirty times and made only intermittent complaints related to his hernia,” and that
although he did experience pain, “objective observations did not indicate” that his pain was
“severe” or that he was “forced to limit his activities.” See id.
The facts of the instant matter are strongly analogous to those in Hancock—so much that
Hancock is controlling and dispositive here. As discussed above, and like in Hancock, Defendants
here gave Plaintiff medical attention on many different occasions and provided him with extensive
treatment for his hernia; but they simply declined to provide him surgical repair for it, concluding
that such a procedure was elective because the hernia was reducible. And like in Hancock, Plaintiff
intermittently reported pain from the hernia, but there is no evidence in the record that the lack of
surgery placed him at any imminent risk of harm, worsened his prognosis, or even caused him to
limit his activities. Indeed, Plaintiff even refused the first pain medicine that he was prescribed,
see ECF No. 29-1. p. 26, and later declined Defendants’ offer to be placed in a medical pod. And
when seen by a Turn Key nurse several weeks after filing this lawsuit, he reported experiencing
hernia pain at a level of only 1 on a scale of 1 to 10. See id. at 25–26. In accordance with Hancock,
then, the undersigned believes this Court must find that even if Plaintiff’s hernia constituted a
serious medical need, it is indisputable that Defendants did not deliberately disregard it by
declining to provide him surgical repair for it. Thus Plaintiff did not suffer any violation of his
constitutional rights, and his claims must be dismissed on summary judgment.
IV. CONCLUSION
Accordingly, it is recommended that Defendants Tracey Robison’s and Turn Key Health
Clinics, LLC’s Motion for Summary Judgment (ECF No. 27) be GRANTED, that Plaintiff Holder
Paul Crow’s Motion for Summary Judgment (ECF No. 35) be DENIED, and that Plaintiff’s
Complaint (ECF No. 1) be DISMISSED WITH PREJUDICE.
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The parties have fourteen days from receipt of the Report and Recommendation in
which to file written objections pursuant to 28 U.S.C. § 636(b)(1). The failure to file timely
objections may result in waiver of the right to appeal questions of fact. 	The parties are
reminded that objections must be both timely and specific to trigger de novo review by the
district court.
DATED this 8th day of April 2026.
/s/ Christy Comstock
HON. CHRISTY COMSTOCK
UNITED STATES MAGISTRATE JUDGE
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