York Complaint

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 1 of 55
IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF COLORADO
CIVIL ACTION NUMBER: 1:16-CV-01754 WJM-KMT
DWIGHT D. YORK, aka Malachi Z. York
Plaintiff,
vs.
THE FEDERAL BUREAU OF PRISONS,
Defendant.
FIRST AMENDED COMPLAINT
Plaintiff, Dwight D. York, aka Malachi Z. York, respectfully files this First Amended
Complaint as follows against Defendant, the Federal Bureau of Prisons (BOP), and hereby
submits this First Amended Complaint for violations of his rights under the Eighth Amendment to
the United States Constitution.
TABLE OF CONTENTS
I.
NATURE & OBJECTIVE OF THIS ACTION ......................................................................................................2
II. JURISDICTION & VENUE .....................................................................................................................................8

III. PARTIES .................................................................................................................................................................8
IV. FACTUAL BACKGROUND..................................................................................................................................9
A. Previous Lawsuits ......................................................................................................................................... 12
V. GENERAL ALLEGATIONS ................................................................................................................................. 13
A. Background and Standard Operation of ADX. .............................................................................................. 13
B. Extended & Continued Neglect of Angioedema Causes Devastating Medical Effects and Has Led to Death
of Inmate in a Colorado State Prison. ............................................................................................................... 14
(1) Medical Community Standards Relative to Patient Care for Sufferers of Hereditary Angioedema. ......... 17
C. The BOP Violates Written Policies Concerning Treating The Medical Needs of Plaintiff. .......................... 18
1
DWIGHT D. YORK FIRST AMENDED COMPLAINT
Cause Number 1:16-cv-01754 WJM-KMT
(1) Patient Care Program Statement Number 6031.04. ................................................................................. 18

D. Health Care Treatment at ADX is Woefully and Constitutionally Inadequate.............................................. 24
(1) Plaintiffs Chance for Surviving Severe Angioedema Attack Greatly Increase As An Inmate Resident of
A Level 3 Medical Care Facility. ............................................................................................................... 25
E. Defendants Have Displayed Sustained Deliberate Indifference to The Medical Needs of Plaintiff. ............ 28
(1) Although Ignored by Defendant, Plaintiffs Hereditary Angioedema was obvious, well documented, and
witnessed by Prison Staff, The BOP Acted With Blatant Disregard to Plaintiffs Dire Medical Condition.
................................................................................................................................................................... 28
(2) Defendant Demonstrates Deliberate Indifference by Contending Plaintiff Does Not Have Angioedema
and by Ignoring the Opinions of Plaintiffs Physician and Prior BOP Medical Staff Who Knew or Should
have Known of The Substantial Risk to Plaintiff....................................................................................... 39
VI: EXHAUSTION OF ADMINISTRATIVE REMEDIES & CONCERN FOR PLAINTIFFS RIGHT TO
UNOBSTRUCTED ATTORNEY CLIENT RELATIONS ......................................................................................... 45
VII. CLAIMS FOR RELIEF ........48
FIRST CLAIM FOR RELIEF ............................................................................................................................ 49
SECOND CLAIM FOR RELIEF ....................................................................................................................... 51
VIII. CONCLUSION & PRAYER FOR RELIEF ....................................................................................................... 51
I. NATURE & OBJECTIVE OF THIS ACTION
This suit brought by Plaintiff, an inmate at the United States penitentiary Administrative
Maximum facility in Florence, Colorado (ADX). Plaintiff seeks declaratory and injunctive relief
from the treatment he has endured. Plaintiff seeks said remedies in order to require the Federal
Bureau of Prison to comply with its existing policies regarding medical treatment of a prisoner,
who is also a senior citizen who suffers from a life threatening illness.
Defendant violated the rights of Plaintiff, under the Eighth Amendment of the Constitution,
by turning a blind eye to his well-known and well documented medical needs. No civilized society
should treat its elderly prisoners in such a way as to knowingly and with deliberate indifference
violate their constitutional rights. The Eighth Amendment proscribes deliberate indifference to the
2
serious medical needs of prisoners.1 A claim of deliberate indifference has two components: 1) an
objective component requiring that the pain or deprivation be sufficiently serious; and 2) a
subjective component requiring that the offending officials act with a sufficient culpable state of
mind.2
A medical need is serious if it either has been diagnosed by a physical as mandating
treatment or is so obvious that even a lay person would recognize the necessity for treatment. 3 And
as to the subjective component, a prisoner must allege more than a negligent failure to provide
medical treatment.4 Instead, the prisoner must allege facts supporting an unnecessary and wanton
infliction of pain, in particular, that the official knew [or should have known] about and
disregarded an excessive risk of harm to the inmates health.5
The Defendant has consistently denied Plaintiff reasonable medical treatment for a serious
medical condition, thereby causing him extensive physical pain and suffering, as well as emotional
suffrage. Plaintiff seeks for the Court to declare that ADX is not an appropriate facility for Plaintiff
to remain at based on his serious, chronic, hereditary, life threatening condition, elderly status,
high blood pressure, lack of violent history while imprisoned, and ailing needs associated with the
aging process.
Most importantly, due to the nature of Plaintiffs medical condition, remaining in this
facility could result in death the next time he suffers from a severe Angioedema attack. Thus,
Plaintiff seeks a medical transfer to a level 3 care facility that has medical personnel available 24
See, Estelle v. Gamble, 429 U.S. 97, 104 (1976).

See, Handy v. Price, 996 F.2d 1064, 1067 (10th Cir. 1993).
3 See, Oxendine v. Kaplan, 241, F.3d 1272, 1276 (10th Cir. 2001); See also, Riddle v. Mondragon, 83 F.3d 1197, 1202 (10th Cir.
1996); accord Shook v. Bd. Of County Comrs of County of El Paso, 2006 WL 1801379, *8 (D. Colo. June 28, 2006) (Matsch, J.)
(noting that a serious medical need has been defined as a condition that has been diagnosed by a physician as mandating
treatment or one that is so obvious that a lay person would recognize it as needing medical attention).
4 See, Handy, 996 F.2d at 1067.
5 See, Whitley v. Albers, 475 U.S. 312, 31920 (1986); See also, Farmer v. Brennan, 511 U.S. 825, 837 (1994 ).
2
3
hours per day, whereby he can receive the medication and care he has a constitutional right to
receive by professionals trained to deal with his specific medical needs. Plaintiffs limited medical
records indicate the presence of other medical conditions, namely: asthma, chest pain, high
cholesterol, high blood pressure, and neglected dental needs. Due to the age of Plaintiff and the
combination of medical conditions from which he suffers that can prove life threatening, it is of
the utmost importance that swift action is taken.
ADX is the most secure federal penitentiary in the United States. It currently houses
approximately 450 men. Staff at ADX often refer to it as the Alcatraz of the Rockies.6 ADX was
built to house prisoners whom the Defendant believes present the greatest threats to the
correctional staff or to other prisoners, a description not hardly fitting of Plaintiff.
Upon information and belief, the Defendant acknowledges that its policy of extended
confinement in isolation and the institutions disciplinary practices pose substantial risks to
prisoners mental, emotional, and physical health, and can be particularly harmful for prisoners
who had serious health problems prior to being confined in such harsh conditions, which is the
case for Plaintiff, as his medical history was well documented prior to arriving at ADX.
The Defendant is the Federal Bureau of Prisons. Defendant is responsible for operating
ADX and for ensuring the Plaintiffs constitutional and other legal rights are upheld. Prisoners at
ADX spend at least 20 and often as many as 24 hours per day locked alone in isolated cells, and
are subject to a harsh and unforgiving disciplinary regimen. Such isolation and brutal discipline
are inappropriate for prisoners who have life threatening illnesses, are senior citizens, and are in
danger of mental illness or suicidal tendencies as a result of this inhumane treatment, all three of
Even a former ADX warden described the place as "a cleaner version of Hell"."Supermax: A Clean Version Of Hell". CBS
News. October 14, 2007. Retrieved 2009-05-31.
4
which describe the Plaintiff, who is 71 years old, suffers from Hereditary Angioedema, has high
blood pressure, and suffers from a bad left leg that was injured when he had a stroke in his cell and
fell, only to wake up from an unconscious state to find his left side and left leg numb.
The Eighth Amendment to the United States Constitution guarantees to every person
imprisoned at ADX adequate medical care, and that guarantee undoubtedly extends to a clear
process for assessing necessary health care and providing a seamless gateway to that care. If the
Defendant chooses, despite its policies, to assign or house prisoners at ADX who either are or
become senior citizens during their sentence and who have documented pre-existing, chronic and
serious medical conditions, it must provide adequate medical health screening, medication, and
treatment, taking into account the isolated conditions of confinement and harsh disciplinary regime
of ADX and the extra stress and strain those conditions contribute to an already fragile inmate.
The Defendant has fallen woefully short of providing this constitutionally guaranteed level of care,
thus causing the Plaintiff considerable pain since his arrival at ADX.
"Deliberate indifference to serious medical needs of prisoners constitutes the `unnecessary
and wanton infliction of pain,' as proscribed by the Eighth Amendment. This is true whether the
indifference is manifested by prison doctors in their response to the prisoner's needs or by prison
guards in intentionally denying or delaying access to medical care or intentionally interfering with
the treatment once prescribed. Regardless of how evidenced, deliberate indifference to a prisoner's
serious illness or injury."7
This lawsuit seeks to remedy the deficient medical health system at ADX by means of an
injunction, requiring the BOP to honor its own policies and the constitutional rights of Plaintiff by
providing medical health diagnostic and treatment services, including transferring Plaintiff, a 71
Estelle, 429 U.S. at 104-05 (internal citation omitted).
5
year old sickly senior citizen not convicted of a violent crime, to a more suitable facility, such as
The Federal Medical Center at Butner, North Carolina, to ensure that when he has his next
Angioedema attack he does not perish for lack of proper medical care or adequate medication.8
This lawsuit seeks to remedy the deficient medical health system at ADX by means of an
injunction, requiring the BOP to honor its own policies and the constitutional rights of Plaintiff by
providing medical health diagnostic and treatment services, including continued access to
pharmaceuticals that could be life giving to Plaintiff in the event of a severe Angioedema attack.
In order to satisfy the requirements of the Eighth Amendment, an institutional health
system in a facility such as ADX must provide care consistent with contemporary community
standards and evolving standards of decency. Whether in the community or in a prison, any
comprehensive system of health services provides care in different treatment settings, or levels of
care: primary, secondary, tertiary and quaternary.
Defendant is in charge of identifying the BOP medical staff vacancies at ADX, and
understaffing of medical staff negatively impacts the quality of prisoners' medical care.
Defendants general understaffing of medical staff has led to a delay and denial of medical care to
Plaintiff.
a) Primary Health Care The first and most generalized form of care. The patient
will develop symptoms that were not previously present and consider that they may have
contracted a cold, flu or other bacterial or viral disease. Patients may also seek out primary care
for a broken bone, a sore muscle, a skin rash or any other acute medical problem. In addition,
Located outside Durham, North Carolina, the Butner Federal Correctional Complex (FCC) houses over 4,000 medium,
minimum, and low security prisoners. The Federal Medical Center (FMC) is an administrative facility where about 950 male
inmates of all security levels reside. Over 100 Commissioned Corps officers are stationed at Butner FMC, which also lays claim
to being the first in the Federal Prison System to do oncology and orthopedic surgery in house and to have a linear accelerator,
MRI, CT, and PET scan.
6
primary care should be coordinating care and is administered by doctors, nurse practitioners or
physician assistants.
b) Secondary Health Care - If a patient has ever seen a specialist after being referred
by a primary care provider, then they are experiencing what is referred to as secondary health care.
Secondary health care simply means the patient will be taken care of by someone who has more
specific expertise in whatever problem the patient is having. Secondary care is where most of
patients end up when they have a medical condition to deal with that can't be handled by primary
care.
c) Tertiary Health Care - Once a patient is hospitalized and needs a higher level of
specialty care within the hospital, he or she may be referred to tertiary care. Tertiary care requires
highly specialized equipment and expertise such as coronary artery bypass surgery, renal or
hemodialysis, some plastic surgeries or neurosurgeries, severe burn treatments or any other very
complex treatments or procedures. A small local hospital may not be able to provide these services
and patients may need to be transferred to a medical center that provides these highly specialized
tertiary level services.
d) Quaternary Health Care - Quaternary care is considered to be an extension of
tertiary care, but even more specialized and highly unusual, and because it is so specialized, not
every hospital or medical center even offers quaternary care. The types of care that might be
considered quaternary would be experimental medicine and procedures, and highly uncommon,
specialized surgeries.
Given the attributes of ADX, including its physical design and operational priorities, it may
well be impossible for the BOP to provide such treatment within the confines of ADX to prisoners
who require it. Indeed, the BOP typically provides inpatient care onsite, but whether Defendant is
7
operating at a standard commensurate with Plaintiffs constitutional rights is questionable. In any

case, the constitution requires that the BOP either provide such treatment at ADX when medically
necessary or ensure that ADX prisoners requiring inpatient medical health care are timely
identified, cared for in accordance with community standards, or transferred to a suitable facility
and provided such care.
As detailed below, many prisoners remain at ADX despite their obvious need for inpatient
medical health care at a more medically qualified facility. Even among professionals not
specifically trained in the symptoms of Angioedema, the presence of severe swelling can be
mistaken for an allergic reaction or acute abdominal condition. Misdiagnosis can lead to
ineffective therapies, unnecessary surgeries, or other inappropriate medical procedures in onequarter of patients with Angioedema presenting to emergency departments.9
II. JURISDICTION & VENUE
This court possesses subject matter jurisdiction pursuant to 28 U.S.C. 1331 and venue is
proper in the District of Colorado pursuant to 28 U.S.C. 1391(b) because all the occurrences
giving rise to this complaint occurred in this judicial district.
III. PARTIES
Plaintiff is a Federal prisoner at ADX. The Defendant is the Federal Bureau of Prisons,
which operates and manages ADX. Defendant is a Federal law enforcement agency subdivision of
the United States Department of Justice, and is responsible for the administration of the federal
prison system. The BOP maintains physical custody of Plaintiff. The BOP is charged with
Santos CB, Lunn ML, Craig TJ. Shortcomings in the Diagnosis of Hereditary Angioedema: Are We Adequately Screening
Family Members of Affected Patients? [Abstract P50]. Ann Allergy Asthma Immunol.. (2009). ;102:A38.
8
establishing policies and regulations that are safe, humane, and secure for all federal penitentiaries
and other prison facilities. Defendant knew of, supported, adopted and approved, and ratified the
policy, custom, or practice of violating the constitutional rights of Plaintiff.
IV. FACTUAL BACKGROUND
Plaintiff is a 71 year old man being held in the custody of the United States Bureau of
Prisons at the United States Penitentiary, Florence Administrative Maximum located in Florence,
Colorado, which is a Level VI facility. Plaintiff has been housed at ADX since March 2, 2006.
Plaintiff suffers from a serious medical condition known as Acute Hereditary AngioNeurotic Edema (Angioedema), for which he was diagnosed in 2000. Angioedema is a rare,
potentially fatal genetic disorder typified by the rapid swelling (edema) of the skin, mucosa and
submucosal tissues. Angioedema causes a type of swelling similar to that of hives, however, the
swelling is beneath the skin rather than on the surface, producing what is commonly referred to as
welts. In the United States, as many as 30,000 annual visits to emergency departments result from
Angioedema.10
In February 2003, Plaintiffs physician sent a letter to the Probation Officer of the Middle
District of Georgia, informing the office that Plaintiff suffered from Angioedema, a serious
medical condition that causes painful episodic attacks of swelling that restricts Plaintiffs ability
to breath, causing him to lose consciousness. Additionally, Plaintiffs pre-sentencing report
describes his life threatening condition, which has on numerous occasions been ignored and the
severity of his condition been consistently discounted and downplayed by the BOP.
10
Moore GP, Hurley WT, Pace SA. Hereditary Angioedema. Ann Emerg Med.. (1988). ;17(10):1082-1086.
9
Plaintiffs symptoms include, but because of the nature of this illness cannot conclusively
be limited to, swelling of the throat that can cause asphyxiation, migraine headaches, extreme
breakout of hives accompanied with burning sensations, nausea, vomiting, dizziness, throat
tightness, respiratory difficulty, and seizures. Often stressful conditions can trigger an episode of
Angioedema and under the right circumstances, death is imminent. In addition to Angioedema,
Plaintiff has been treated for other medical complaints, including left chest pain, hay fever, tension
and, musculoskeletal strain of left shoulder, right knee sprain, and hypertension.
Angioedema can also cause swelling in the digestive tract and other organs and is
characterized as a deficiency or dysfunction of the plasma. According to the United States
Hereditary Angioedema Association, Angioedema, is a rare, potentially fatal genetic disorder that
causes severe attacks and dramatic swelling of the throat, hands, arms, feet, face, and abdomen.
Since March of 2006, Plaintiff has been in the most restrictive of units at ADX and confined
23-24 hours a day in a small, barred, cement, solitary cell with no work, no training, nor other
programs. His allotted out-of-cell time is limited to no more than 3-5 hours a week. But since his
chronic condition is acute and can be brought on by a myriad of unknown variables, including but
not limited to, stress, fear, sunlight, dirt, contaminants in bad food, allergens, unclean air vents,
etc., and due to the facilities leisurely medical response time, insufficient nearby community
medical resources, and the overall general malaise and lack of attention to his condition, Plaintiff
is extremely careful of his day to day activities.
According to eyewitnesses, on September 4, 2010, Plaintiff suffered a severe Angioedema
attack at ADX during a social visit with family members and had to be immediately removed from
the visit. Plaintiff experienced swelling in the facial area, a breakout of large hives over the arm
area, showed signs of losing his breath, became weak, and lost complete consciousness. This is
10
particularly dangerous because of the increased risk of asphyxiation from laryngeal involvement
during facial attacks.11 Plaintiff was removed from the visitation booth via stretcher with shackles
around his wrist held together by a steel constructed metal box, which restricted movement and
being connected to large linked chains around his waist and around his feet as evidenced by written
affidavits.
Plaintiff currently does not utilize his allotted out-of-cell time to avoid stressful conditions
that could bring on a severe attack. Additionally, ambulating is difficult because Plaintiff must be
transported in a wheelchair. During what Plaintiff characterized as a stroke, he passed out after
being awakened in the middle of the night with a migraine. He arose to use the restroom and
collapsed onto the ground. When he came to consciousness, he was soiled in his urine experiencing
numbness on the left side of his face. He crawled to the bed and noticed his entire left side went
numb and he had a limp.12
Defendant has neglected to put a panic button in the yard, thus in the event of an
emergency, being locked outside in the yard without the ability to regain access to the facility
would place Plaintiffs very life in jeopardy, especially when it takes less than five minutes to die
from asphyxiation, which is known to happen with an acute onset of Angioedema. This is
particularly frightening since Plaintiff already experienced being ignored while outdoors during
an Angioedema attack. Although there is a panic button in his cell, Plaintiff has difficulty accessing
the panic button when under an Angioedema attack because he cant breathe and often losses
consciousness, rendering the button in his cell useless.
11
Bork K, Barnstedt SE. Laryngeal edema and death from asphyxiation after tooth extraction in four patients with Hereditary
Angioedema. J Am Dent Assoc.. (2003). ;134(8):1088-1094.
12 In 2006, Plaintiff arrived at ADX able to ambulate with no assistance. Since this injury he was issued a wheelchair by
Defendant. No documentation regarding the issuance of said wheelchair has ever been discovered. Neither Plaintiff nor Counsel
are aware of the actual injury or harm that brought about the necessity for a wheelchair.
11
Although ADX confinement may not produce visible scars or bruises, its impact on
prisoners can be comparable to physical torture, especially for the more fragile inmates, such as
the elderly or those suffering from chronic pain or illnesses, such as Plaintiff. As Senator John
McCain, who experienced five years of solitary confinement as a prisoner of war, wrote, [i]ts an
awful thing, solitary. It crushes your spirit and weakens your resistance more effectively than any
other form of mistreatment.13
ADX prisoners have almost no access to educational or recreational activities or other
sources of mental stimulation and are usually handcuffed, shackled and escorted by two or three
correctional officers every time they leave their cells. Assignment to ADX housing is usually for
an indefinite period that may continue for years. Although ADX facilities are ostensibly designed
to house incorrigibly violent or dangerous inmates, many of the inmates confined in ADX do not
meet those criteria, and neither does Plaintiff.14
A.
Previous Lawsuits
Plaintiff has been unsuccessful in prior litigious attempts concerning virtually the same
claims raised here against Defendant in this very court. The first litigation was originally filed Pro
Se in case number 1:07:cv-01297. Attorney Leta Holden eventually took over the case and
withdrew, at which time Plaintiff became Pro Se again and no licensed attorney was re-hired. This
litigation included named Defendant and a host of Federal Bureau of Prisons officials, incorporated
herein by reference only, who were unable to be served with notice of the suit. The case was
ultimately dismissed without prejudice after this court granted Summary Judgment in favor of
13
John McCain, Faith of My Fathers 206 (Random House, 1999).

See Human Rights Watch, Cold Storage: Super-maximum Security Confinement in Indiana (New York: Human Rights Watch,
1997) and Red Onion State Prison: Super-Maximum Security Confinement in Virginia (New York: Human Rights Watch, 1999).
14
12
Defendant on May 29, 2009, largely in part for Plaintiffs failure to exhaust the administrative
remedies.
The second litigation was filed by Attorney Charles Tucker, who serves as co-counsel in
this action, under case number 1:14-cv-01242. This litigation named only the Federal Bureau of
Prisons as a Defendant and was dismissed without prejudice, again by way of Summary Judgment
for Plaintiffs failure to complete and exhaust the administrative remedies on February 27, 2015.
Since that time, the named attorneys in this suit have worked diligently to ensure Plaintiff has
fulfilled all the necessary administrative requirements to ensure this lawsuit is ripe for litigation.
V. GENERAL ALLEGATIONS
A.
Background and Operation of ADX.
ADX opened in November 1994. At a capacity of 484, ADX is the BOP's flagship
Supermax, solitary confinement facility and is touted by the mainstream media as "the prototype
for the nation's super-maximum-security prisons." At any given time, between 400 and 500
prisoners are housed at ADX in nine different maximum-security housing units, which are divided
into six security levels.
The residents of Fremont County welcomed the prison as a source of employment. At the
time, the county was already the overloaded home to nine existing prisons. Now, twenty one years
later, the Veteran residents of Fremont County were given an opportunity for employment with
the BOP. U.S. service veterans who meet certain qualifications were recently welcomed to the
BOP for a two day direct hiring event during the month of May, 2016. The BOP was looking to
hire approximately 60 correctional officers, ranging from medical personnel, warehouse and
13
maintenance workers, electricians, and a cook foreman.15 The event was open to all honorably
discharged veterans including honorable under general conditions. There was no mention in the
article as to the type of medical training, certifications, or skills needed for medical personnel.
Last summer, President Obama directed Attorney General Loretta E. Lynch and the Justice
Department to review the overuse of solitary confinement across U.S. prisons. They found that
there are circumstances when solitary confinement is a necessary tool, such as when certain
prisoners must be isolated for their own protection or in order to protect staff and other inmates.
Neither of which is the case here, since Plaintiffs conviction did not involve a violent crime and
he personally poses no risk or threat to staff or other inmates.
B.
Extended & Continued Neglect of Angioedema Causes Devastating Medical Effects

and Has Led to Death of Inmate in a Colorado State Prison.
Plaintiff suffers from a serious medical condition that can cause debilitation and deadly
swelling in various parts of the body, including the airways of the throat, if left untreated. However,
the dangerous aspects of Angioedema can be controlled effectively with prescribed medications
such as Winstrol, which is a steroid-like drug which costs approximately $35.00 per month and is
administered regularly.
Since being transferred to ADX, Plaintiff has never been routinely prescribed or
administered any medication by any medical or staff personnel to prevent or control his severe,
and potentially deadly, symptoms brought on by Hereditary Angioedema, despite consistently
reciting that he has this life threatening illness and requesting medication.
15
Canon City, Daily Record, Bureau seeks veterans to hire. Wednesday, May 18, 2016, pages 1, 8A.
14
It has long been established that delaying an inmates prescribed medical treatment can
violate the inmates Eight Amendment Constitutional rights.16 In the ultimate showing of a
constitutional violation, neglect leading to death, similarly situated to the case at bar is the case of
Decedent, Jeffrey Buller, who while incarcerated at Kit Carson Correctional Center (KCCC) in
Burlington, Colorado, was not given the medication Winstrol, also known as Stanozolol, a
synthetic anabolic steroid derived from dihydrotestosteronev, for his known Hereditary
Angioedema condition.
KCCC staff knew of the seriousness of his medical condition and its potentially fatal
nature. In the several weeks prior to Mr. Bullers death, he was repeatedly assured his prescription
would be refilled throughout his stay and that he would be provided at least a thirty day supply of
Winstrol when he left the facility. Regretfully, the Kit Carson medical staff deliberately failed to
follow through and during a severe Angioedema attack, Mr. Buller drew his last breathe and
perished.
After being given the wrong medication and complaining of a swollen feeling in his throat,
accompanied with raspiness, Mr. Buller was having difficulty swallowing food and liquids. He
repeatedly informed the clinic staff that the Prednisone he had been given by KCCC was not
working and he needed the medication Winstrol to prevent an Angioedema attack. He literally
begged staff to obtain help for him, however, the clinic staff made no effort to obtain Winstrol or
have him examined by a qualified medical professional who specialized in Angioedema or
transport him to a medical treatment facility.
KCCC staff also knowingly delayed his treatment by deciding to allow Mr. Buller to
remain at the facility without Winstrol until his release. On or about May 1, 2001, Mr. Buller
16
See, Hung v. Uphoff, 199 F.3d 1220, 1224 (10th Cir. 1999).
15
continued to have great difficulty swallowing and talking. His throat was visibly swollen. While
he was in his cell packing in preparation for his impending release, Mr. Bullers breathing became
very labored. He pushed the call button in his cell to alert staff that he needed help. He also
grabbed his throat and motioned to his cellmate that he could not speak. He wrote on a pad of
paper that he could not breathe. Mr. Bullers cellmate began pushing the call button, banging on
the cell door, and shouting for help. As much as a half hour to forty-five minutes passed before
unit staff responded.
On information and belief, Mr. Bullers face began to turn blue and he was on the verge of
passing out and by the time he was being helped out of his cell, he lost consciousness. When
emergency medical treatment personnel finally arrived at the scene, Mr. Buller was not breathing
and had no carotid pulse. Attempts to revive him were futile. Mr. Buller died shortly thereafter.
The autopsy report indicates that Mr. Buller died of asphyxiation caused by Hereditary
Angioedema. In an effort to save an insignificant amount of money, KCCCs actions were the
proximate cause of over a week of physical and mental suffering for Mr. Buller, and ultimately,
the cause of his death. In Bullers case, the KCCCs intentional refusal to render appropriate
medical care upon observing his ever worsening condition is unfathomable and most assuredly
shocks the conscious.
Here, Plaintiff, suffers from the exact same condition that took the life of Inmate Buller,
and Plaintiff has never been provided with or had his Angioedema medication administered to him
throughout his stay at ADX. Pursuant to Defendants written policies and procedures, BOP
personnel should have reordered and obtained a new supply of Plaintiffs Angioedema medication
upon his transfer to the ADX.
16
It is documented that Plaintiff was at one time treated in the Chronic Care Clinic where his
Asthma and Angioedema were monitored quarterly and medications prescribed when he was
housed at USP Atlanta in 2002. However, once he arrived at ADX the Chronic Care Clinic visits
were discontinued and illness specific medications were never reordered, despite Decedents
repeated requests for it.
Conversely, ADX steadfastly rejects the very notion that Plaintiff even suffers from
Angioedema. Although a Medical Duty Status report by Health Services Staff Wilson, CA DO,
dated September 28, 2012 stated that:
Inmate has Hereditary Angioedema which can cause his airway to
swell and respiratory distress, please call medical to evaluate
immediately if inmate calls for distress or Inmate appears in
distress.
(1)
Medical Community Standards Relative to Patient Care for Sufferers of Hereditary

Angioedema.
Hereditary Angioedema is an inherited condition associated with a substantial disease

burden and an increased risk of medical emergency. Symptoms are mediated by the
overproduction of bradykinin and subsequent edema, resulting from a deficiency of or a
dysfunction in C1-INH. Symptoms can be unpredictable and may vary considerably even among
related individuals.
Insufficient awareness of Angioedema among physicians can contribute to a substantial lag
in diagnosis, with some patients waiting more than 20 years for an accurate diagnosis of their
condition. Therefore, all patients who present with recurrent bouts of swelling without a known
17
cause and all patients with a family history of episodic swelling should be evaluated for
Angioedema. For patients suspected of having Angioedema, medical emergencies are typically
not associated with extremity and urogenital attacks.
However, abdominal attacks with hypotension and all laryngeal attacks constitute medical
emergencies that must be addressed to prevent hypovolemic shock and airway obstruction. The
FDA has approved medications for management of acute Angioedema attacks and routine
prophylaxis of Angioedema attacks. These new medications are directed at the underlying
pathologic mechanisms of Angioedema.
C.
The BOP Violates Written Policies Concerning Treating The Medical Needs of
Plaintiff.
(1) Patient Care Program Statement Number 6031.04.
The purpose and scope of this Program Statement is to effectively deliver medically
necessary health care to inmates. To that end, the expected result of the program is to provide
services in accordance with the proven standards of care without compromising safety concerns.
Defendant is obligated to provide the following five major levels of care to Plaintiff and other
inmates, which are:
1. Medically Necessary Acute or Emergent;
2. Medically Necessary Non-Emergent;
3. Medically Acceptable Not Always Necessary;

4. Limited Medical Value;
5. Extraordinary.
18
For our purposes here, we will focus on the first two levels of care.
Medical conditions that are of an immediate nature that are subject to cause rapid
deterioration of an inmates health, possibly significant irreversible loss of function, or liable to be
life threatening all meet the criteria of a medically necessary situation. Conversely, medical
conditions that are not immediately life threatening but which without proper care, the inmate
could not be maintained without significant risk of premature death, possible irreparable damage
without treatment, or significant pain or discomfort which impairs the inmates participating in
activities of daily living.
Examples of conditions that fall into the first two categories are not limited to those stated
in the Program Statement. Plaintiff proffers that good cause exists to strongly consider and include
Hereditary Angioedema as a condition that falls under the first two major levels of care.
Notwithstanding the facts that Plaintiff is a senior citizen, under duress with high blood pressure
and a leg condition from a stroke suffered while at ADX that requires he be transported in a
wheelchair.
The Patient Care Program Statement goes on to state that each institution will have an
Institutional Supplement for providing 24 hour medical, dental and mental health care.
Administration of Correctional Agencies (ACA) standards require a four minute response to life
or limb threatening medical emergencies. Institutions without 24 hour on site medical coverage,
of which ADX is one, are required to have procedures incorporated into the institution supplement
by which the ACA standards can be met.
According to the Emergency/Urgent Care portion of this Program Statement, a team of
first responders should be established for each shift, with documented training in first aid and
CPR. The Health Services Unit (HSU) will conduct two emergency disaster drills per year. All
19
drills will be critiqued to identify deficiencies and opportunities for improvement and
documentation will be maintained in the Health Services Assistants office.
This Program Statement also requires the ADX to have Primary Care Provider Teams
(PCPT) that are designed to improve health care services delivery by enhancing continuity of care
and promoting preventive health care measures. Under the PCPT model, each inmate is assigned
to a medical team of health care providers and support staff who are responsible for managing the
inmates healthcare needs. However, for this model to be effective, teams must be designed with
support staff, such as nurses, medical assistants, health information technicians, and medical
clerical staff, to perform duties and services which support the MLPs and physicians.
This is virtually impossible at ADX because the city population simply does not have the
concentrated number of needed professionals in this area to support the medical requirements
outlined in the United States Department of Justice, Federal Bureau of Prisons Program Statement,
seeing the population was 3,881 at the 2010 census,17 up from 3,653 in 2000. The 2014 census
denotes a drop in population from 3,881 to 3,852, which indicates that Florence must hire from far
outside the city limit in order to effectively staff ADX to accommodate the prisons employment
needs.
For example, as outlined in the Program Statement, a day shift PCPT staffing pattern for a
1,000 general population inmates will have one physician, three mid-level practitioners, a
registered nurse, one or two licensed practical nurses, and/or medical assistants, two health
information technicians, and a medical clerical staff person. Based on this example, each MLP
would be assigned a caseload of approximately 330 inmates. The demographics and education
17
"Geographic Identifiers: 2010 Census Summary File 1 (G001): Florence City, Colorado". American Factfinder. U.S. Census
Bureau. Retrieved April 21, 2016.
20
level of Florence, Colorados general population simply cannot accommodate the rules outlined in
the Defendants Program Statement with regard to the medical needs of ADX.
Clearly, insufficient staffing will have an adverse effect on the quality and continuity of
healthcare for inmates as the case at bar and in a recent filing whereby Federal prisoner Michael
Alan Crooker filed suit under the Federal Tort Claims Act alleging malicious prosecution,
negligence, and medical maltreatment by the United States Marshals Service (USMS) and the
United States Bureau of Prisons (BOP). Proceeding pro se, he survived a motion for summary
judgment and eventually obtained an $8,000.00 settlement from prison officials.
Crooker was a diligent advocate for his own health care, refusing to tolerate a continuing
pattern of inadequate BOP medical treatment. He then had to endure the BOPs common practice
of making life difficult for any prisoner who dares to challenge medical indifference. As a result,
prison staff denied him proper corrective eyewear, and he had good time taken away in a
questionable disciplinary proceeding.
Crooker complained that the USMS and the BOP had failed to abide by a court order
requiring Crookers pre-trial detention at a facility where he could be treated for liver disease,
failed to provide him eyeglasses for one year, denied him non-emergency dental treatment for
nine-and-one-half years, and had denied him cataract surgery for four years, After the Defendants
failed to have the suit dismissed, they commenced settlement negotiations.18
BOP policies requires that all prisoners are to be given medical screening upon arrival at
ADX, if such screening has not already occurred at another federal facility. For an inmate
transferring from another Federal Bureau of Prisons institution, staff need not conduct a second
18
Crooker v. United States, U.S.D.C. (D. Mass.), Case No. 3:13-cv-30199-FDS; 2015 U.S. Dist. LEXIS 12386.
21

complete initial physical assessment if the inmate does not present with any new medical problems
and has already had a complete health assessment for this period of confinement.19
In reality, incoming prisoners at ADX generally are given only perfunctory interviews that
are wholly inadequate as a form of screening or diagnosis. The screening provided by the facility
typically consists of a few questions asked in a minute or two, often at a time when the prisoner
has just completed a lengthy cross-country trip while tightly chained, and is apprehensive about
his arrival. Follow-up monitoring and screening is virtually nonexistent.
Even when the BOP does carry out the medical screening of a new arrival, it often ignores
key factors indicating serious, chronic, or life threatening medical conditions, such as, for example,
the fact that the prisoner was taking medication for a serious medical condition immediately before
arriving at ADX and possibly even being administered the medication at another, more adequate
and conscientious, Federal facility.
And finally, page 15 of the U.S. Department of Justice Federal Bureau of Prisons Program
Statement, Patient Care denotes that for inmates with ongoing or multiple medical needs, there
will be a tracking system put in place and these patients will be seen by a healthcare provider at
clinically appropriate intervals. The Program Statement goes further to ensure that high risk or
medically complex chronic inmates will be seen more frequently in accordance with good clinical
judgment.
Plaintiff has not been considered for a Chronic Care Clinic for his potentially life
threatening complex condition, nor has Defendant considered Plaintiffs specialized medical need
as being part of his right to medical care consistent with that in the local community, because if
Defendant had done that, they would have realized that Plaintiffs Hereditary Angioedema falls
19
U.S. Department of Justice Federal Bureau of Prisons Program Statement Number 6031.0, Physical Examinations,
p. 26.
22
within the tertiary and quaternary levels of care due to its illusive nature and ease of mistaken this
deadly disorder for a simple, reversible allergic reaction.
During a severe Angioedema attack Plaintiff suffered in the middle of the night, the guard
had no medical personnel to call because there is no full time, on call qualified doctor capable of
handling Plaintiffs complicated medical needs. Plaintiff suffered through an attack with no
medical assistance. According to the Plaintiff, when the pill doctor made rounds the following
afternoon, he mentioned hearing about the Angioedema attack to Plaintiff, but said there was
nothing he could do.
On September 29, 2007, the dangerous and elusive aspects of Hereditary Angioedema were
duly noted by Attorney David Lane, who has found himself fighting for the constitutional rights
of inmates in the same situation as the Plaintiff and against Defendant. He stated in a letter to ADX
on behalf of Plaintiff York, it is a relatively rare condition and many doctors do not have any
experience with it and do not know how to handle it. If left untreated it can be fatal if the throat
and airways begin to swell and close.
Defendant has not properly staffed the facility with experienced medical professionals.
Furthermore, those who Defendant has staffed the facility with are inexperienced and lack the
requisite training for Plaintiffs specialized needs, which places the Plaintiff in imminent harm and
risk of death if they fail to properly administer care in the event of a life threatening Angioedema
attack. Since Plaintiff has been resuscitated from life threatening Angioedema attacks in the past,
it is highly foreseeable there would be safety, civil rights and administrative violations facing the
Federal Bureau of Prison if Plaintiffs health concerns could not be adequately dealt with in a life
23
or death situation. Approximately half of patients with Angioedema will have at least one laryngeal
attack in their lifetime.20
Laryngeal attacks are associated with statistically significant mortality21,22 and frequently
necessitate intubation or tracheotomy to prevent asphyxiation.23 Therefore, patients with laryngeal
swelling will require an emergency department visit and, if the attack does not dissipate,
hospitalization. To prevent asphyxiation from laryngeal involvement, it is imperative that all
patients with facial Angioedema episodes be treated as emergency cases.
Defendant has failed to adequately train or hire adequate medical professionals and
Plaintiff has reason to believe that Defendants failure to do so will likely be the cause of the
deprivation of Plaintiffs Eighth Amendment rights. Defendant has failed to adequately train or
hire medical professionals who possess the requisite training and experience to properly operate
and administer the medical unit at ADX and respond appropriately to medical emergencies.
D.
Health Care Treatment at ADX is Woefully and Constitutionally Inadequate.

Plaintiff is 71 years old and has been imprisoned at ADX a medically ill-equipped,
maximum security prison designed to contain extremely dangerous, violent inmates for ten years.
Prior to Plaintiffs transfer to ADX, he was imprisoned first in USP Leavenworth and then in USP
Marion, both of which were medium security prisons, which are far more equipped to provide the
20
Agostoni A, Aygoren-Pursun E, Binkley KE, et al. Hereditary and Acquired Angioedema: problems and progress: proceedings
of the third C1 esterase inhibitor deficiency workshop and beyond. J Allergy Clin Immunol. Sep(2004). ;114(3 suppl):S51-S131.
21
Agostoni A, Cicardi M. Hereditary and Acquired C1-inhibitor deficiency: Biological and Clinical Characteristics in 235
Patients. Medicine (Baltimore).. (1992). ;71(4):206-215.
22
Bork K, Barnstedt SE. Laryngeal Edema and Death From Asphyxiation After Tooth Extraction in Four Patients with
Hereditary Angioedema. J Am Dent Assoc.. (2003). ;134(8):1088-1094.
23
Frank MM, Gelfand JA, Atkinson JP. Hereditary angioedema: the clinical syndrome and its management. Ann Intern Med..
(1976). ;84(5):580-593.
24
constitutionally required level of medical care for his life threatening, chronic condition,
Hereditary Angioedema.
(1) Plaintiffs Chance for Surviving Severe Angioedema Attack Greatly Increase As An
Inmate Resident of A Level 3 Medical Care Facility.
Defendant has a custom, policy, or practice of acting knowingly and with deliberate
indifference in denying necessary medications and medical services to Plaintiff. Defendant knew
of Plaintiffs potentially life-threatening medical condition. They also knew that Plaintiff had
previously been prescribed Epinephren, Diphenhydramin, Zyrtec, Hydroxyzine, Danocrine, and
Methyltestostrone in the past to either prevent or reduce the severity of episodes of Angiodema, as
characterized by his personal physician, Dr. Williams Thompson on May 11, 2002, prior to his
incarceration.
The Federal Drug Administration has approved three products for preventing and treating
Angioedema, which include Cinryze, Berinert, Kalbitor, none of which have ever been prescribed
to the Plaintiff while housed at ADX. Plaintiff has repeatedly requested medication, and recently
requested medication prior to his most recent severe Angioedema attack in January 2016, which
was denied.
Defendant repeatedly told Plaintiff to purchase antihistamines from the commissary to treat
his Angioedema and refused to provide any of the medications noted above as suggested by the
Federal Drug Administration for the treatment of Angioedema. Amongst healthcare professionals
that specialize in Angioedema, it is widely known that Antihistamines are a poor, even deadly,
substitute for approved medications because they can quickly and easily exacerbate the intensity
of attacks and increase chances of death due to asphyxiation.
25
Under that same premise, we posture that Defendant has either intentionally or negligently
allowed Plaintiff to undergo extreme and unnecessary suffering, tantamount to cruel and inhuman
torture causing Plaintiff considerable and unnecessary pain over the past ten years since being
transferred to ADX. It is, therefore, urgent that Plaintiff be immediately transferred to a more
equipped facility. One such facility is the Federal Medical Center in Butner, North Carolina, which
is within a 500 mile radius from his residence in Charlotte, North Carolina.24
A transfer to this facility would be ideal, as it would be in keeping with the Defendants
existing policy of placing inmates near their family.25 This federal facility offers 24 hour medical
care and houses inmates with ongoing complex medical problems and/or multiple medical
problems.26 At a medical facility such as the Federal Medical Center in Butner, Plaintiff will be
enrolled in the Chronic Care Program, as he was prior to his transfer to ADX, where regular
assessments of his medical status is performed and renewal of prescriptions is practiced.
Additionally, the Federal Medical Center at Butner, North Carolina schedules routine
specialist to come into the institution.27 With proper and prompt medical care, Hereditary
Angioedema attacks can be greatly reduced and in some instances preventable, notwithstanding
severe Angioedema attacks require immediate care or death may be imminent, which is evidenced
24
Generally and in accordance with 28 C.F.R. 549, inmates requiring specialized medical care are able to remain in regular
institutions because many of them are equipped with special facilities and services and/or have augmented these services with
contracts with community health care providers. Inmates whose healthcare requirements exceed those services available in a
typical institution can be transferred to one of the BOPS medical referral centers, which are in Butner, North Carolina; Fort
Worth, Texas; Devens, Massachusetts; Lexington, Kentucky; Rochester, Minnesota and Springfield, Missouri.
25
Program Statement 5100.08, Inmate Security and Custody Classification manual. Prior to a designation occurring, the DSCC
must receive for consideration all sentencing material regarding the offender. These documents are received from the sentencing
Court, U.S. Probation Office, and the U.S. Marshals Service and processed. The Bureau attempts to designate inmates to facilities
commensurate with their security and program needs within a 500-mile radius of their release residence. If an inmate is placed at
an institution that is more than 500 miles from his/her release residence, generally, it is due to specific security, programming, or
population concerns. The same criteria apply when making decisions for both initial designation and re-designation for transfer to
a new facility.
26
The mission of the Federal Medical Center, Butner, North Carolina is to provide protection to society by providing
confinement services for committed offenders. They provide a safe, secure, and humane environment, providing an opportunity
for positive change while carrying out the judgments of the Federal Courts. In addition as a Federal Medical Center they provide
extensive medical services and mental health care to the inmate population and are capable of providing all the necessary medical
services to Plaintiff.
27
Federal Medical Facility Butner, Bureau of Prisons Admission and Orientation Handbook, p. 17, 18.
26
by the ten year history at ADX. Plaintiff has a greater chance of minimizing the suffering and harm
of less severe attacks and actually surviving a life threatening attack should the court grant his
request for a medical transfer.
Angioedema is an elusive type of disease and symptoms overlap with those of other
disorders that feature Angioedema. Therefore, an appropriate management strategy cannot be
determined until the root cause of the attacks is identified. Figure 1 depicts an algorithm to guide
diagnosis of Hereditary Angioedema. 28,29 Because of the complexity of this disease, the diagnosis
Figure 1
28
Differential diagnostic algorithm for Hereditary Angioedema (HAE) and other forms of Angioedema (AE). A low level of C1
inhibitor (C1-INH) supports a diagnosis of HAE in the absence of a family history, because 25% of HAE cases are spontaneous.
C1 and C4 are complement proteins.
29 Zingale LC, Beltrami L, Zanichelli A, et al. Angioedema without urticaria: a large clinical survey. CMAJ.. (2006).
;175(9):1065-1070.
27
should be confirmed by an allergy and immunology specialist who has experience with Hereditary
Angioedema. Initial management decisions can be made in conjunction with the specialist, and the
patient with Angioedema should see the specialist for periodic follow-up to ensure optimum
control of symptoms.
E.
Defendants Have Displayed Sustained Deliberate Indifference to The Medical Needs

of Plaintiff.
(1) Although Ignored by Defendant, Plaintiffs Hereditary Angioedema was obvious, well
documented, and witnessed by Prison Staff, The BOP Acted With Blatant Disregard
to Plaintiffs Dire Medical Condition.
Notwithstanding the fact that BOP knew and knows about Plaintiffs Angioedema,
Defendants have demonstrated ongoing deliberate indifference to his serious medical needs. This
deliberate indifference includes the failure to treat Plaintiffs Angioedema, the failure to accurately
test Plaintiff for Angioedema, the failure to allow Plaintiff access to outside medical experts for
the testing and treatment of his Angioedema, the failure to consult with outside medical experts
regarding the treatment of Plaintiffs Angioedema, the failure to transfer Plaintiff to a BOP medical
facility, and the continued incarceration of Plaintiff in a facility that Defendant knows or should
have known is incapable of providing Plaintiff with adequate medical care.
The BOPs failure to address Plaintiffs Angioedema at ADX began on March 2, 2006,
when Plaintiff arrived at the facility. Records indicate that on March 2, 2006, Dr. Lawrence Leyba,
D.O., Clinical Director at ADX, reviewed Plaintiffs medical records and noted only that Plaintiff
had asthma. Plaintiff was not medically examined. Plaintiff was never referred to a specialist for
Angioedema, despite the fact that his private physician, Dr. Thompson, who diagnosed and treated
28
Plaintiff for approximately three years prior to his incarceration, notified the BOP in May of 2002
that Plaintiff suffered from Angioedema and required special treatment.
The evidence is indisputable that by the time Plaintiff was transferred to ADX,
Angioedema was identified in Plaintiffs medical history as noted by BOP Regional Director R.E.
Holt in a letter dated September 10, 2003, concerning Plaintiffs Angioedema diagnosis and
treatment at the United States Penitentiary in Atlanta, Georgia. Mr. Holt indicated Plaintiff received
care in the Chronic Care Clinic to monitor his pre-existing medical diagnosis of Childhood Asthma
and Acquired Angioedema, during which time he was prescribed medication to prevent and
decrease the severity of his symptoms. (See, Exhibit 1).
On June 14, 2007, Plaintiff was observed in his cell suffering from symptoms of what was
described as a hereditary problem. A medical record entry, signed off by Dr. Nafziger, Clinical
Director, indicated that Plaintiff had swelling to both upper and lower lips mainly on left side.
I/M also with viticaria to abdomen (L) side and upper arms. A treatment plan including Benadryl
and epinephrine was recommended, which are both woefully inadequate medications that can
worsen the attack. Furthermore, no emergency care or follow-up treatment was provided.
Plaintiffs medical records dated July 9, 2007, further indicate that Plaintiff suffered from
increasing episodes of generalized pruitis and angioedema. As far as treatment, the records only
reflected [t]akes antihistamines prn from commissary. Plaintiff prescribed an Albuterol Inhaler
for respiratory distress. Dr. Nafziger and Dr. Stallkamp, a pharmacist, signed off on this medical
record entry. Thus, rather than provide Plaintiff with proper medication for his Angioedema attack,
these employees of the BOP apparently interpreted that attack as an allergic reaction or asthmarelated incident and simply instructed Plaintiff to go to the commissary for antihistamines and
prescribed an inhaler.
29
Plaintiff suffered another severe Angioedema attack on August 23, 2007, at approximately
6:00 a.m. During this attack Plaintiff awoke with facial deformities around his mouth, including
lips and tongue, swelling of his throat, and hives on his arms, wrist, and stomach. No one arrived
to assist Plaintiff until 11:17 a.m., after Plaintiff suffered prolonged and considerable pain and
discomfort for approximately five hoursduring which time it was entirely possible that Plaintiff
could have died from asphyxiation.
Following this August 23, 2007, attack, Dr. Nafziger approved of instructions that involved
only Plaintiff taking one Zantac (Ranitidine) twice daily 150 mg by mouth (not dissolved in a full
6-8 oz. glass of water). However, Plaintiff should not have been given Zantac, which has warnings
indicating that one should stop using the medication if suffering from signs of allergic reaction
including: hives, facial swelling including the lips, tongue or throat, or breathing difficulty. Thus,
the signs of an allergic reaction to Zantac were the same as the symptoms for which Plaintiff was
told to take Zantac for relief.
Despite its obvious institutional limitations, rather than provide Plaintiff with an outside
specialist for his Angioedema or even prescribe him medications taken prior to his arrest and
detention, the BOP, through employees Nafziger and Gladbach, only instructed Plaintiff to treat
himself with commissary pharmaceuticals that were known to be ineffective.
In response to a September 29, 2007, letter from Plaintiffs then legal counsel who
expressed concern to BOP Warden Wiley regarding the lack of medical attention Plaintiff received
for his Angioedema attacks that left him unconscious in his cell, Warden Wiley wrote on
November 2, 2007, that Plaintiffs Angioedema attacks are documented as mild and usually
responsive to antihistamines. There are no documented episodes of him having breathing or
swallowing difficulties.
30
On January 5, 2008, Plaintiff was visited by family members at ADX and was witnessed
suffering from hives and also from extraordinary pain from a decaying tooth. On March 21, 2008,
Plaintiff sent a cop-out to the medical department expressing how he was suffering from great pain
and had been for a long time. He requested to be seen by a dentist and to have his teeth removed.
Finally, due to non-restorable bone loss, according to Defendant in a Bureau of Prisons
Health Services Clinical Encounter form dated July 14, 2008, Plaintiff received relief from
considerable pain that caused sleeplessness and an inability to chew. (See, Exhibit 2). The report
indicates that Plaintiff underwent an extraction of tooth #31 for which he had suffered extreme
pain for the preceding six months to a year. Plaintiff again suffered dental pain in November 2009
when aggressive periodontitis was cited on his Health Services Report.30
According to the Defendants Clinical Practice Guidelines for the Management of
Hypertension, dentists should review the inmates medical chart prior to beginning any dental
encounter, looking for any diagnostic history of hypertension and the current status of the
inmates condition. It is recommended that inmates have their blood pressure monitored at each
dental treatment encounter. At a minimum, inmates should have their blood pressure monitored
prior to and during invasive dental procedures.
The dental records Plaintiff has uncovered from his July 14, 2008 procedure does not
reflect that his blood pressure was taken into consideration when his tooth was removed. But what
is clear is that Plaintiff suffered great pain for a long time with his teeth and requested to be
seen by a dentist to have them removed for months before the procedure was performed.
Defendant has continually shrugged their constitutional responsibility to provide for all of
30
During a prior legal proceeding, Plaintiff had in his possession one gold tooth and one regular tooth that had fallen out of his
mouth when dental care was not timely administered by Defendant in accordance with community standards. Plaintiffs then
attorney, Leta Holden, was forced to give the teeth to Defendant and they were never returned to Plaintiff or Plaintiffs counsel.
31
Plaintiffs health care needs, even going so far as claiming he feigns illnesses. However, in a
letter from Federal Prison Consultants Case Manager, Adam Hurst, he describes the neglect
suffered by Plaintiff relative to his unattended to dental needs, which expresses that Plaintiffs lack
of dental care resulted in extreme pain from loss and infected teeth. Tooth decay and permanent
tooth loss meant Plaintiff had to learn how to chew with his tongue in order to avoid further pain
and suffering.
On April 26, 2010, a BOP medical report authored by Dr. Vanman stated that while
speaking with Plaintiff she notice[d] his upper lip swelling slightly. Observed two raised hives
on inside of right AC area. Plaintiff was provided antihistamines and the incident was reported
as an allergic response and hypertension, rather than the Angioedema that Plaintiff reported to Dr.
Vanman.
On April 26, 2010, a BOP medical report authored by Dr. Rogers observes that Plaintiff
had right anterior aspect of forearm appears to have urticarial [hives] and edema to lips. The
assessment in the report was listed as other or possible unknown type reaction, rather than
Angioedema, despite the fact that Plaintiff told Rogers that he had Angioedema.
On September 4, 2010, a BOP medical report written by Dr. Camacho indicated that
Plaintiff had swelling of upper lip and even stated mild angioedema noted on upper lip.
Despite recognizing Plaintiff as having an Angioedema attack, there were no steps taken for
treatment. Instead, the written disposition plan was simply: Follow-up at Sick Call as Needed;
Return Immediately if Condition Worsens; Discharged to Housing Unit-No Restrictions.
This September 4, 2010, Angioedema attack was also witnessed by a social visitor, who
visited Plaintiff at ADX and saw the upper part of Plaintiffs left lip swollen and protruding over
his bottom lip. She also witnessed Plaintiffs dizziness and large red bumps on his arms. As the
32
visit continued, Plaintiffs conditioned worsened and the visitor witnessed Plaintiff eventually pass
out before a guard was able to even place his body on a stretcher.
The same social visitor returned to visit Plaintiff on September 5, 2010, and was told by
Plaintiff that he was not allowed to see a doctor, but instead was only taken to a physician assistant.
This physician assistant asked Plaintiff what Angioedema was, and only took Plaintiffs blood
pressure and sugar levels. The physician assistant performed no other tests, but instead sent
Plaintiff back to his cell and told him to lie down.
On September 14, 2010, Dr. Allred wrote a BOP Clinical Encounter-Administrative Note,
in which he wrote, The question of this inmate having hereditary angioedema continues. Dr.
Allred continued and wrote that he noted recent medical evaluations when Plaintiff reported
distress, but none of which describe any evidence of life threatening edema, pulmonary or cardiac
distress. Defendant Allred stated that minimal swelling or a rash on the arm appears to be the
most common presentation. He ordered laboratory testing and noted that at least one previous
Clinical Director had reviewed Plaintiffs issue.
In a report dated October 14, 2010, Dr. Allred wrote that he reviewed Plaintiffs medical
chart numerous times and found nothing to document a past history of Angioedema that
Plaintiff described, including being unconscious, and that he found no evidence of any
documented edema, notwithstanding the numerous records and reports to the contrary.
On or about February 24, 2013, Plaintiff suffered an Angioedema attack that caused him to
pass out in his cell. After a long period of time, Dr. Camacho came into Plaintiffs cell and took
Plaintiffs blood pressure, which he deemed to be too high. Dr. Camacho ignored information
regarding Plaintiffs Angioedema. Plaintiff did not receive any medication or treatment for
Angioedema. Instead, Plaintiff was given Amlodipine, which can be lethal due to adverse reactions
33
during an Angioedema attack, and Doxazosin. Plaintiff took the Doxazosin but ended up passing
out again, and self-revived hours later on the floor in a pool of his own urine.
In not one of these numerous incidents was Plaintiff correctly diagnosed and treated for his
Angioedema. But even if Defendant correctly diagnosed Plaintiffs Angioedema, Defendant
would not be able to provide him with adequate medical attention because ADX simply lacks the
proper medical facilities and personnel to treat Plaintiffs Angioedema when he suffers attacks.
Plaintiffs Angioedema requires close monitoring because a severe attack of Angioedema can
occur at any time of day or evening and if preventative measures are not being taken leading up to
a severe attack.
Evidencing the lack of appropriate care facilities at ADX, Plaintiff had to be transferred on
an emergency basis to Parkview Medical Center in Pueblo, Colorado on March 27, 2007, at around
3:00 a.m. after suffering from chest pain. Parkview Medical Center is approximately 45 miles
from ADX. The emergency room report from March 27, 2007, notes Angioedema in Plaintiffs
past medical history.
Medical records regarding this hospitalization at Parkview Medical Center indicate that
Plaintiff was discharged in large part because he was an inmate at ADX. Discharge notes from a
dictating physician, Joslin, Carol J., state as follows:
I contacted Dr. George Gibson, our cardiologist on call, who felt
that since patient does come from Super-Max, a prison facility it
would be best if we could send him home after having the stress test
the case was discussed with the prison MD over the phone.
Plaintiff also described this incident in a letter to his family and wrote how his hives and
swelling comes over night so each morning (sic) I wake swollen and during the day I get hives and
34
more. No I dont get anything and no one checks on me.

Forcing Plaintiff to travel 45 miles to a hospital for treatment in the case of an emergency
amounts to an unnecessary delay and could be the difference between life or death considering
Plaintiffs fragile and multiple medical needs. Had any of his Angioedema attacks involved the
swelling of his airway, Plaintiff would have surely been put in great risk of death due to the distance
required to travel to the Parkview Medical Center.
Moreover, the very nature of Plaintiffs solitary confinement in ADX prevents him from
receiving adequate medical care and does not aid in minimizing overall wellness by the reduction
of Angioedema attacks, which can strike at virtually any time. At ADX, Plaintiff is kept in solitary
confinement in a small, 12 feet by 7 feet 4 inch, cell. Plaintiff has no congregate dining, exercise,
and has been continually denied pastoral visits.
The furniture in his cell consists of a desk, stool, and shelf that are made of poured concrete.
The overall stress of the environment at ADX puts Plaintiff at a continual risk of a severe
Angioedema attack due to his exacerbated stress levels, which was duly noted by his private
physician, Dr. William Thompson, in a letter dated April 12, 2001, where he stated the following:
Due to the nature of these ailments and their direct relation to
stressful situations, it is my recommendation that this patient not be
placed in any situation or participate in any activity that may induce
mental stress. This recommendation is based on the potential for
airway obstruction leading possibly to asphyxiation and death as a
result of Angioedema of the airway.
Plaintiffs meals are shoved through a food port in the door of his cell. Plaintiffs cell is
sealed off by two steel doors. One door is barred and the other is solid steel. These doors prevent
35
communication with other prisoners. Even when medical staff has seen Plaintiff after he endures
hours of suffering from Angioedema attacks, due to the two steel doors in Plaintiffs cell at ADX,
medical staff examines Plaintiff from outside the first steel door, a distance of approximately 5 feet
from the inside steel door.
The very nature of this cell and Plaintiffs confinement at ADX makes it difficult, if not
impossible, for Plaintiff to communicate with others and others to communicate with him,
particularly on an emergency basis. Hence the reason he holds up a handwritten sign whenever he
has an Angioedema attack to warn all that he is having an attack. (See, Exhibit 3).
As would be expected under such circumstances, in the rare occasions when Plaintiff is
seen in his cell for medical reasons, it takes ADX medical staff a number of hours to see Plaintiff
after he complains, if they see him at all. For example, in a letter dated approximately August 25,
2007, Plaintiff wrote describing the August 23, 2007 attack and stated that ADX staff do not know
how to deal with breakouts and that it took 6 hours for a P.A. to come to my cell.
Rather than afford Plaintiff with appropriate medical care to proactively treat his
Angioedema, the BOP provides Plaintiff with a duress button for the purpose of informing
Defendant he is having an Angioedema attack. This duress button is further evidence Defendant
knows of Plaintiffs Angioedema, but has not taken adequate measures to prevent attacks by
medically address Plaintiffs condition. Plaintiff has pressed the duress button during Angioedema
attacks only to be ignored by BOP staff. The ineffective duress button is a clear example of
ADXs inability to prevent, ameliorate, and treat Plaintiffs Angioedema and of their knowledge
that a serious medical condition exists.
This history of Angioedema attacks and the failure of ADX to afford proper medical
treatment to Plaintiff in a single instance provides clear and convincing evidence of Defendants
36
ongoing deliberate indifference to the obvious serious medical needs of Plaintiff, knowing that
potentially fatal consequences could be suffered by Plaintiff by failing to properly hire, train and
supervise those who provide medical care to Plaintiff.
Defendant could have easily pursued reasonable methods for the training and supervising
of such employees, but failed to do so. Defendants policies, customs, or usages in failing to
properly train, hire, and/or supervise its employees were the moving forces and proximate cause
of the violation of Plaintiffs Eighth Amendment rights.
On or around April 20, 2016, Plaintiff was taken to visit Dr. V. Nwangum, M.D. at the
BOP who noted that Plaintiffs blood pressure was extremely high, but then prescribed
Amlodipine 10mg. Plaintiff mentioned his Hereditary Angioedema, but the medical doctor did
not respond and went on to discuss Plaintiffs very high blood pressure.
The doctor did not reflect on the Plaintiffs chart to determine what conditions existed that
could interact negatively with Amlodipine and when he had the chance to investigate the matter
further, he neglected to do so. Dr. Nwangum prescribed the blood pressure medication without
forethought as to the damage it could potentially cause Plaintiff.
Amoldipine is an ACE inhibitor and is known to affect the frequency and intensity of
Angioedema attacks. It can have a direct and adverse effect on people who suffer from seizures,
and if Plaintiff took this medication and suffered from an Angioedema attack, were this
medication still coursing through his body, it could quickly result in death.
Amoldipine is not recommended if the patient has a history of Angioedema with
accompanying symptoms, such as swelling of the hands, face, lips, eyes, throat, or tongue,
difficulty swallowing or breathing or unusual hoarseness. This is a clear indication of the
Defendants failure to adequately hire and train those administering care to Plaintiff at ADX
37
because Plaintiffs medical chart is full of those exact symptoms. The acts or omissions of
Defendant cause Plaintiff mental anguish day and night because he knows he is at risk and in
grave danger of the possibility of an Angioedema attack that could terminate his life.
Case in point, in January 2016, Plaintiff had a severe attack during the hours when no
medical professional personnel is on the premises of ADX, which is between 10pm and 8am.
This severe attack left Plaintiff, a 71 year old senior citizen, with a distorted and unrecognizable
face and barely breathing. A night officer was patrolling and passed Plaintiffs cell. He flashed
the light on Plaintiffs face. He noticed the disfigurement and asked Plaintiff what was wrong.
Plaintiff could not communicate to the night officer due to the immense swelling, so he
slid his I have Angioedema note under the door. The night officer said he would get the
Lieutenant. According to Plaintiff, the men took a long time to return and when the Lieutenant
gazed upon Plaintiff he was alarmed and asked if Plaintiff had fallen. At which point, Plaintiff
pulled his shirt up so they could see the swelling and hives.
Neither the Lieutenant or night officer knew what to do and stated, there is no doctor on
staff. The Doctor did not show up until 11:00am the next morning, but was not a specialist and
did not examine Plaintiff, nor did he administer any medication. He was actually making rounds
to distribute pills to the inmates and not there specifically to examine Plaintiff. He told Plaintiff
he knew about the attack, but there was nothing he could do.
Naturally, this attack occurred during the hours when there was no medical personnel on
site, which are the hours most of Plaintiffs attacks occur. Plaintiff had to wait the attack out in
considerable, prolonged discomfort with no medication or hope of medical assistance. He
suffering in pain and agony with his breath shortening caused by the collapsing of the airways,
which could easily result in death by asphyxiation.
38
As recent as September 17, 2016, Plaintiff suffered yet another episode that left him in a
pool of his own feces in the yard. Plaintiff was in the yard around 10:30 a.m. and in a casual
conversation with other inmates when he started feeling a tingling on his left side and the bottom
of his left foot. Plaintiff became instantly weak, could not breath, and defecated on himself. While
he was attempting to clean himself, he became unconscious falling to the ground.
Eventually, Plaintiff could hear other inmates screaming, man down, man down. When
the guards arrived they brought no medical necessities, no gurney, no wheelchair, nothing to assist
the Plaintiff in his weakened, frail, and immensely humiliated condition. However, they did arrive
with guns. The guards did not assist Plaintiff, a 71 year old man, out of the cage. They only
beckoning for him to get up on his own.
The actions of Defendant as described herein intentionally deprive Plaintiff of the
securities, rights, privileges, liberties, and immunities secured by the Constitution of the United
States of America by not properly training, supervising, and or hiring the necessary medical
personnel to provide the standard of care for his aging, deteriorating body.
(2)
Defendant Demonstrates Deliberate Indifference by Contending Plaintiff Does Not

Have Angioedema and by Ignoring the Opinions of Plaintiffs Physician and Prior
BOP Medical Staff Who Knew or Should have Known of The Substantial Risk to
Plaintiff.
Since the beginning of Plaintiffs incarceration his private physician, Dr. William S.
Thompson M.D., has alerted Defendant of Plaintiffs complex medical needs. In a letter dated
May 11, 2002, from Dr. William S. Thompson to Defendant of the success of certain drugs
when treating Angioedema was noted:
Although Benadryl is used regularly by the patient to help prevent
attacks, it has not been shown to prevent the several episodes of severe
39
attacks
[Plaintiff]
has
experienced.
Maintenance
doses
of
Methyltestosterone and Hydroxyzine Pamoate are critical in correcting

the effects of Abnormal C-1 esterase inhibitor, but most importantly, it
is a must that the patients stress level be as limited as possible as well
as well as the patient himself being regularly monitored for any signs of
impending airway obstruction given the present level of stress under
which he is subject to.
Since 2002, Dr. Thompson has communicated to different prison officials, at
approximately seven correctional facilities, his concerns related to Plaintiffs crucial ailments
and Plaintiffs mandated level of care. Despite Dr. Thompsons notations, no tests were
performed and Plaintiff did not see a specialist related to Angioedema. Defendant has also
exhibited deliberate indifference by refusing to provide medical care based on their own
interpretation of blood tests that purportedly indicate that Plaintiff does not have Angioedema.
These tests directly contradict years of BOP records that state Plaintiff does have
Angioedema. Defendant has also ignored Plaintiffs expert physician, who explained that
Plaintiffs symptoms are in fact indicative of Angioedema; that specific blood tests must still be
done and that Plaintiff requires specific treatment for his Angioedema, including an emergency
plan.
About early October 2010, Plaintiff had blood drawn at ADX. Notwithstanding the
numerous BOP records acknowledging that Plaintiff has Angioedema, on October 28, 2010, Dr.
Allred informed Plaintiff that the tests run on Plaintiffs blood were negative for Hereditary
Angioedema. Dr. Allreds letter, captioned as Response to Inmate Request to Staff Member
stated:
40
I received the report of the blood tests drawn earlier this month.
These tests were recommended by the National Organization for
Hereditary Angioedema.
I then discussed these results with a
physician referred by that organization. Based upon these results the

non-BOP specialist was confident that you do NOT have Hereditary
Angioedema. I have already ordered a repeat of these tests in order
to be absolutely certain that I didnt obtain erroneous results. If you
can provide documentation to dispute these tests, Id be happy to
receive a copy. If these tests remain normal, I am confident that you
are NOT at any increased risk of having an acute life-threatening
event due to swelling or throat congestion.
However, Plaintiff was has never been provided with the names of the doctors who
performed the tests, a description of the tests that were performed on his blood, names of the
physician referred by the National Organization for Heredity Angioedema, or copies of the
laboratory results so that Plaintiff could send those results to his lawyers and his expert for
independent testing.
Due to the complex nature of Angioedema, when it is suspected, a referral to an
allergist/clinical immunologist for definitive diagnostic procedures and treatment is
appropriate, because not all physicians have experience with Hereditary Angioedema and not
all laboratories are equipped to handle the necessary blood specimens31 Additionally,
Angioedema patients should have serum levels of C4 measured. A low serum C4 level (C4
<30% of mean normal level) is an excellent screening test, because C4 levels are invariably
31Nzeako
UC, Frigas E, Tremaine WJ. Hereditary Angioedema: A Broad Review for Clinicians. Arch Intern Med.
2001;161(20):2417-2429.
41
low in untreated patients with either type I or type II Hereditary Angioedema.32

Defendant has not provided proof of the type of testing performed on Plaintiff and
certainly has not stated whether the doctor performing the test did so under the necessary
standards and levels of care commensurate with a specialist or expert trained to diagnose and/or
treat this complex disease. Plaintiff never received documentation of the results of any blood
tests allegedly performed by Dr. Allred.
In response to Allreds invitation for Plaintiff to provide documentation to dispute
these tests, Plaintiff offered the services of Dr. Paula Busse, an expert on Angioedema. Dr.
Busse is a doctor who specializes in immunology who practices medicine and teaches at Mt.
Sinai Hospital in New York, New York. Dr. Busse wrote letters to Plaintiff, the Central Office,
Health Services Division, Warden Blake Davis, and Dr. Allred suggesting that Plaintiffs
physical conditions are consistent with Angioedema and that the 2010 test cannot rule out nonhereditary forms of Angioedema, such as Angioedema consistent with idiopathic origins.
However, to this date, Allred and the other doctors from the BOP have never contacted Dr.
Busse for her opinion, counsel, or expertise regarding Plaintiffs Angioedema.
Plaintiff also identified Dr. Busse as part of his Formal Request made during his
administrative complaint process, which he exhausted. In his Formal Request, Plaintiff
provided Dr. Busses name and phone number to the BOP and stated that she reviewed all of
his medical files.
Plaintiff said that he provided this information in his Formal Request in response to Dr.
Allreds invitation in his October 28, 2010 letter for Plaintiff to provide documentation to
dispute Dr. Allreds conclusion that Plaintiff did not have Angioedema. Plaintiff further stated
32
Zuraw B. Clinical practice. Hereditary Angioedema. N Engl J Med. 2008;359 (10):1027-1036.
42
in his Formal Request that Dr. Busse could explain why the tests purportedly relied upon by Dr.
Allred were unreliable and inconclusive. However, and as noted above, Dr. Busse was never
contacted even after she was identified in Plaintiffs Formal Request.
Dr. Busse reviewed Plaintiffs medical records in great detail. She also reviewed
Defendant Allreds October 28, 2010, report. Notwithstanding Dr. Allreds conclusion that the
October 2010 test results showed that Plaintiff did not have Hereditary Angioedema, Dr. Busse
insisted that the physical symptoms described in Plaintiffs complaints were consistent with
Angioedema. In a July 19, 2012, letter that Dr. Busse sent to Dr. Allred, Mr. Davis, then Warden
at ADX, and to Dr. Newton E. Kendig, Assistant Director of BOP Health Services Division,
Dr. Busse wrote as follows:
Assuming that the 2010 tests results are sufficient to rule out Hereditary
Angioedema, they do not rule out other non-hereditary forms
of
angioedema. The physical symptoms described in the documents I have

reviewede.g. Yorks complaints regarding swelling of his face and hives
and
his
difficulty breathinga
are consistent with angioedema.
Angioedema is defined as fluid in the dermal tissues which arises from

leakiness of the veins and capillaries. When the vessels dilate, fluid from
the vessels enters the surrounding tissue and patients experience swelling.
There are many causes of angioedema including allergic, drug induced,
idiopathic to hereditary. We loosely classify angioedema as histaminemediated (includes allergic) or bradykinin-mediated (which includes
hereditary angioedema). If we do not find a specific cause of angioedema,
which is not infrequent, it is labeled as idiopathic.
43
In this letter, Dr. Busse further recommended that an emergency action plan should be in
place should Plaintiffs airway swell. Under this emergency action plan, Epipen should be
injected intramuscularly. Dr. Busse also recommended that for minor swelling, major swelling,
and a drop in blood pressure, an antihistamine or prednisone are often effective. To prevent
Angioedema attacks, Dr. Busse stated, one needs to take medication to control the disorder.
In her July 19, 2012, letter, Dr. Busse also recommended that Plaintiff undergo further
blood tests to help determine the type of Angioedema from which he suffers, and stated as
follows:
In my practice I would also prescribe an epi-pen for use in an emergency.
However, I do not know if that is a practical solution in a prison setting.
Perhaps Mr. York could be given an emergency kit that would have two 20
mg Prednisone tablets and some antihistamine tablets. If not already done, I
would also prescribe the following blood tests: C4, C1-INH antigen level,
C1-INH functional level, CBC, tryptase, TSH, ANA for a complete and
thorough evaluation. If these tests come back normal; he would be defined as
having idiopathic angioedema.
To date, Defendant has failed to contact Dr. Busse or adopt any of her recommendations
regarding the proper testing. This testing would, on information and belief, undermine the
purported results set forth in Dr. Allreds October 28, 2010, report. Furthermore, Defendants have
systematically and conveniently ignored and failed to inquire into Dr. Busses opinion that
Plaintiffs symptoms are consistent with Angioedema regardless of the results of the blood tests.
Nor have Defendants adopted an emergency action plan consistent with Dr. Busses
recommendation, or any of her recommendations regarding treatment in general, which can result
44
in Plaintiffs death due to a severe Angioedema, as in the case of Decedent and former inmate of
ADX, Mr. Buller.
VI:
EXHAUSTION OF ADMINISTRATIVE REMEDIES & CONCERN FOR
PLAINTIFFS RIGHT TO UNOBSTRUCTED ATTORNEY CLIENT RELATIONS
The Prison Litigation Reform Act (PLRA), 42 U.W.C. Section 1997e(a), provides that
[n]o action shall be brought with respect to prison conditions under Section 1983 of this title, or
any other Federal law, by a prisoner confined in any jail, prison, or other correctional facility until
such administrative remedies as are available are exhausted.33 Although, this First Amended
Complaint does not state any Section 1983 claims for which redress is sought, we felt it prudent
to show that Plaintiff has exhausted all available administrative remedies as an act of good faith
hoping to resolve this matter without the need for protracted litigation.
In accordance with the primary objectives of the PLRA, which is to allow the BOP the first
opportunity to redress and resolve claims prior to its assertion in federal court, Plaintiff has made
every concerted effort for settlement. On information and belief, Plaintiff has sought redress
through the administrative process for the lack of appropriate medical care for his Angioedema at
ADX.
The BOP has a four step procedure for addressing inmate grievances, which Plaintiff
followed when he made his requests known to the BOP in the manner specified in the PLRA.
Plaintiff first completed the Federal Correctional Complex Informal Resolution Form, where he
complained of not receiving sufficient medical care for his Hereditary Angioedema. Plaintiff
33
See, Porter v. Nussle, 534 U.S. 516, 524 (2002).

45

described how the attacks have left him in pain with severe swelling in his limbs, face, mouth, and
airways.
He even described how his Angioedema attacks left him unconscious on his cell floor with
a disfigured face. Then being told by guards that no medical personnel would be available until
the morning, leaving him to suffer in pain. Plaintiff even describes being ignored when he pushed
the emergency button in his cell. The steps denoted by the Correctional Counselor was for Plaintiff
to sign up for sick call to address his medical concerns. (See, Exhibit 4).
Then he made his Request for Administrative Remedy (Form BP9) to the Warden on June
23, 2015, stating that he was not receiving adequate care for Hereditary Angioedema and for relief
he requested a medical transfer, citing a deliberate indifference to his serious medical needs and
the fact that ADX is unable to treat the attacks he has, which could result in death. The Defendant,
through Warden J. Oliver, responded with a denial of the request on August 21, 2015 stating that
tests conducted at the facility resulted in a negative finding of Hereditary Angioedema and that
Plaintiffs self-reported diagnosis was unconfirmed. (See, Exhibit 5).
On August 26, 2016, Plaintiff completed the Request for Administrative Remedy Appeal
(Form BP10), where Plaintiff cited suffering from severe swelling in his limbs, face, and airway
tract and being denied proper medication and necessary treatment. Though the institutional staff
knows this medical condition first hand, I am being denied the proper medication and treatment
necessary. Plaintiff requested a transfer to a medical facility that can accommodate his chronic,
life threatening condition. (See, Exhibit 6).
On November 13, 2015, Defendant through Regional Director Sara M. Revell, concurred
with the previous ruling of the Warden and denied the request for a transfer, citing that Plaintiff
had consistently been provided timely and appropriate medical care in accordance with Program
46
Statement 6031.04, Patient Care and the National Drug Formulary. Defendant further remarked
that during Plaintiffs September 15, 2015 examination for his Angioedema, the Health Services
physician did not recommend a medical transfer, thus the request was denied and Plaintiff
admonished to sign up for sick call and be re-evaluated.
Then on November 25, 2015, Plaintiff completed the Central Office Administrative
Remedy Appeal (BP-11), which was received at the ADX Wardens Office on December 14, 2015.
However, this appeal was returned because according to Defendant the response from the Warden
was not included with the appeal. (See, Exhibit 7). Upon learning of this deficiency, Plaintiff
completed a second BP-11 on January 21, 2016, citing the same circumstances as the previous
complaints and pointing to the fact that he is a senior citizen of 70 years and with age his condition
will worsen without proper care and treatments.
And finally, on March 8, 2016, Defendant through National Inmate Appeals Administrator
Ian Connors, denied Plaintiffs appeal, citing to the fact that during his September 15, 2015
consultation with a clinical provider, Plaintiff said he was, okay with his Angioedema.
Interestingly Defendant conceded the fact that Plaintiffs condition is chronic, but marked
improvement was indicated as well as the decision to continue current management. (See, Exhibit
8).
Defendant again denied the request for a medical transfer to a medium security facility,
expressing there was insufficient diagnostic data to make a clinical determination of the need for
a medical transfer. Defendant maintained that Plaintiff was receiving medical care and treatment
in accordance with the evidence based standard of care and within the scope of services of the
Federal Bureau of Prisons.
47
Exhausting the administrative remedies has clearly not been without its challenges as
indicated at the beginning of this complaint and evidenced by the two prior litigious attempts that
were dismissed for lack of exhausting these remedies. In so much as, there were many occasions
throughout the administrative process that Plaintiff believed his legal mail was being tampered
with and his attorney client privileges were blatantly disregarded and violated. On several
occasions Defendant held up mail for weeks causing Plaintiff to miss crucial deadlines and
prompting obstruction of timely attorney client communications. All of that notwithstanding, the
administrative requirement has been met.
VII: CLAIMS FOR RELIEF

The Eight Amendment to the United States Constitution prohibits cruel and unusual
punishment and guarantees to every person imprisoned at ADX adequate medical care. That
guarantee includes access to an adequate process for assessing a prisoners need for medical care
and access to that medical need.
If the BOP chooses, despite its policies to the contrary, to assign or house prisoners with
serious medical conditions at ADX, then the BOP is required to provide adequate medical
screening and treatment, taking into account the isolated conditions of confinement and harsh
disciplinary regimens of ADX, which only make serious, chronic, life threatening ailments, such
as Heredity Angioedema, which is frequently triggered by stress, that much more dire.
48
FIRST CLAIM FOR RELIEF
Eighth Amendment Violation - Inadequate Medical Care & Failure to Provide Appropriate
Medical Care and Treatment for Plaintiffs Pre-existing Life Threatening Medical
Condition.
Plaintiff incorporates all other paragraphs of this Complaint for purposes of this claim. At
all times relevant to the allegations in this complaint, Defendants acted or failed to act under color
of federal law.
As described herein, by their policies and practices, Defendant subjected Plaintiff to a
substantial risk of serious harm and injury by failing to establish and maintain a treatment plan,
program, and/or practices to adequately diagnose, monitor, and treat his serious and deadly
medical condition. Defendant has acted deliberately indifferent to this substantial risk of serious
harm to Plaintiff.
At all times relevant to the allegations in this Complaint, the Defendant acted pursuant to
federal custom, policy, or practice in their acts and omissions pertaining to Mr. Yorks inadequate
medical care for his Hereditary Angioedema.
Defendant has been and are aware of all the deprivations complained of herein, and have
condoned or been deliberately indifferent to such conduct, and to Plaintiffs serious and life
threatening medical needs.
Under the Eighth Amendment to the Constitution, prison officials must provide adequate
medical care to prisoners, who rely entirely on the prison system for their medical needs.
Mr. York, while housed at ADX, was and is constitutionally entitled to receive adequate
medical care for his serious medical need, Hereditary Angioedema. The right to receive adequate
medical care is a clearly established right, and at no time during Mr. Yorks housing at ADX would
49
a reasonable prison official have thought it lawful to deny Mr. York his constitutional right to
adequate medical care.
Acting with deliberate indifference to Mr. Yorks constitutional right to receive adequate
medical care, the Defendant delayed and denied and continues to delay and deny Mr. Yorks
medical care in accordance with the community standards of care and BOP policies and procedures
for treating Hereditary Angioedema.
The delay and denial of inadequate medical care to Mr. York caused by the Defendant
caused and continues to cause him to be subject to substantial risk of serious harm and serves no
penological purpose, namely, considerable pain and suffering, loss of consciousness, which has
led to public defecation and urination, an extremely humiliating experience for Mr. York, and
imminent death.
The Defendant knew or should have known that their inadequate medical care caused Mr.
York to be subject to substantial harm and substantial risk of serious harm.
The Defendant promulgated, created, implemented or possessed responsibility for the
policies and procedures concerning Mr. Yorks medical care that caused him substantial harm and
substantial risk of serious harm. Defendant acted with a mindset of deliberate indifference because
Defendant knew or should have known that the policies and procedures at ADX caused Mr. York
to be subject to substantial harm and substantial risk of serious harm.
Defendants policies and practices are the proximate cause of the Plaintiffs deprivation of
rights under the Eighth Amendment of the United States Constitution.
50
SECOND CLAIM FOR RELIEF
Eighth Amendment Violation Inadequate Medical Care Based on Defendants Failure to

Train, Supervise, and Hire Qualified Medical Personnel For Plaintiffs Serious Medical
Needs.
Plaintiff incorporates all other paragraphs of this Complaint for purposes of this claim. At
all times relevant to the allegations in this complaint, Defendants acted or failed to act under color
of federal law.
As described herein, by their policies and practices, Defendant subjected Plaintiff to a
substantial risk of serious harm and injury by failing to hire, train, and supervise qualified medical
personnel to treat Plaintiffs serious and deadly medical condition. Defendant has acted
deliberately indifferent to this substantial risk of serious harm to Plaintiff.
Defendant have been and are aware of all the deprivations complained of herein, and have
condoned or been deliberately indifferent to such conduct, and to Plaintiffs serious and life
threatening medical needs.
Defendants policies and practices are the proximate cause of the Plaintiffs deprivation of
rights under the Eighth Amendment of the United States Constitution.
VIII. CONCLUSION & PRAYER FOR RELIEF
When Plaintiff was transferred to ADX, he was a 60 year old man with a life-threatening
medical condition; he is now 71 years old with rapidly declining health directly attributable to the
necessary medical treatment he has been denied during his 11 years of incarceration at ADX and
the immense stress put on inmates due to the treacherous, abusive, and violent conditions at the
facility. Although facts relative to Plaintiffs medical condition have been widely ignored by the
51
BOP, it was well documented at the time of his arrival and throughout his entire incarceration at
ADX. The inmates age and medical status should be considered when determining whether an
inmates classification warrants a transfer.34
And finally, although the Constitution does not mandate comfortable prisons,35 it does
require humane prisons that comport with the Eighth Amendments prohibition against
punishments that are incompatible with the evolving standards of decency that mark the progress
of a maturing society or which involve the unnecessary and wanton infliction of pain.36
More recently, the Supreme Court stated that [p]risoners retain the essence of human
dignity inherent in all persons. Respect for that dignity animates the Eighth Amendment
prohibition against cruel and unusual punishment.37 The Federal Bureau of Prisons, as extensively
implemented in the United States, falls tremendously short of this standard from a medical vantage
point and must be substantially reformed.
Therefore, Plaintiff respectfully seeks declaratory and injunctive relief requiring the
Federal Bureau of Prisons to comply with its own existing policies regarding medical provisions
and care of prisoners at ADX and with the requirements of the Eight Amendment regarding
medical care.
Plaintiff humbly requests that this Court grant the following relief:
1. A declaration that Plaintiff, Mr. York, has been deprived by Defendant of his right to
be free from cruel and unusual punishment in violation of the Eighth Amendment to
the United States Constitution.
34
BOP Program Statement 5100.08 at Ch. 4, p. 12; Ch. 5, p. 3; Ch. 6, p.8; Ch. 7, p.1.
35
Rhodes v. Chapman, 452 U.S. 337, 349 (1981).

Estelle v. Gamble, 429 U.S. 97 (1976).
37
Brown v. Plata, 131 S. Ct. 1910, 1928 (2011).
36
52
2. Immediately transfer Plaintiff, Mr. York, to a Level 3 Medical Care facility where he
will obtain the proper medical care for his specialized, chronic, life threatening medical
condition, known as Hereditary Angioedema.
3. Plaintiff, Mr. York, seeks the court to enter declaratory relief and permanent injunctions
directing that Defendant implement a program of medical care screening and diagnosis
for the benefit of Plaintiff, a senior citizen with a well-documented history of
Hereditary Angioedema, a chronic and potentially fatal condition that includes
continued access to Chronic Care Clinics and Consulting Clinics.
directing that Defendant staff medical health professionals at ADX provide the
requisite care in line with the incorporated community standards relative to
Angioedema and in accordance with BOP regulations as cited, as well as a program of
training ADX staff members on detection of a medically life threatening emergency.
directing that Defendant to implement an emergency plan in keeping with the fact that
Plaintiff suffers from a life threatening, very specialized illness that has gone ignored
by ADX since his arrival, that provides treatment at the appropriate level of care, and
shall require that, to the extent a level of care cannot be provided at ADX, Plaintiff will
be timely transferred to a facility where such care can be provided. This program of
treatment shall include, at the very minimum, the following:
a.
Regular and scheduled receipt of medications previously identified as FDA
approved for the treatment of Hereditary Angioedema, which will prevent severe
attacks and ultimately save Plaintiffs life.
53
b.
Not housing Plaintiff in a Control Unit, or any other unit in which
medications for his chronic medical condition are not provided.

c.
Declare that Hereditary Angioedema is a chronic, life threatening, and
specialized medical condition that requires Tertiary and Quaternary levels of care.
6. Grant any such relief as this Honorable Court deems, just and proper.
Dated this 30th day of September, 2016.
LAW OFFICE OF VICTORIA BROUSSARD

P.O. Box 393
21735 Texian Court
Spring, TX 77383
Tel: 512-963-7094
Fax: 512-672-7052
/s/_______________________
Victoria Broussard
Texas Bar No. 24053882
E-mail: victoria@broussardlegal.com
TUCKER LAW GROUP, LLP

16009 Lavender Dream Lane
Brandywine, MD 20613
Tel: 301-706-2242
Fax: 301-782-2960
Charles Tucker
/s/ _______________________
Charles Tucker Jr.
Bar No. 993515
E-mail: charles@tuckerlawgroupllp.com
54
CERTIFICATE OF SERVICE
I hereby certify that on the September 30, 2016, I electronically filed the within and
foregoing First Amended Complaint with the Clerk of the Court using the CM/ECF system which
will send notification of such filing to the following: Assistant United States Attorney Mark Pestal,
1225 Seventeenth Street, Suite 700, Denver, Colorado 80202, mark.pestal@usdoj.gov and
Attorney Charles Tucker, 16009 Lavender Dream Lane, Brandywine, Maryland 20613,
charles@tuckerlawgroupllp.com.
I also certify that I have mailed by the United States Postal Service the document to the
following non-CM/ECF participants in a properly addressed and stamped envelope as follows:
N/A.
VICTORIA BROUSSARD
ATTORNEY FOR DWIGHT YORK
BY:
/s/Victoria Broussard
55

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Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 1 of 55

IN THE UNITED STATES DISTRICT COURT

FIRST AMENDED COMPLAINT

NATURE & OBJECTIVE OF THIS ACTION ......................................................................................................2

II. JURISDICTION & VENUE .....................................................................................................................................8

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 2 of 55

(1) Patient Care Program Statement Number 6031.04. ................................................................................. 18

I. NATURE & OBJECTIVE OF THIS ACTION

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 3 of 55

See, Estelle v. Gamble, 429 U.S. 97, 104 (1976).

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 4 of 55

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 5 of 55

Estelle, 429 U.S. at 104-05 (internal citation omitted).

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 6 of 55

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 7 of 55

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 8 of 55

operating at a standard commensurate with Plaintiffs constitutional rights is questionable. In any

II. JURISDICTION & VENUE

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 9 of 55

IV. FACTUAL BACKGROUND

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 10 of 55

Case 1:16-cv-01754-WJM-KMT Document 19 Filed 09/29/16 USDC Colorado Page 11 of 55

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John McCain, Faith of My Fathers 206 (Random House, 1999).

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Background and Operation of ADX.

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Extended & Continued Neglect of Angioedema Causes Devastating Medical Effects

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Medical Community Standards Relative to Patient Care for Sufferers of Hereditary

Hereditary Angioedema is an inherited condition associated with a substantial disease

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3. Medically Acceptable Not Always Necessary;

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DWIGHT D. YORK FIRST AMENDED COMPLAINT

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Health Care Treatment at ADX is Woefully and Constitutionally Inadequate.

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Defendants Have Displayed Sustained Deliberate Indifference to The Medical Needs

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more. No I dont get anything and no one checks on me.

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Defendant Demonstrates Deliberate Indifference by Contending Plaintiff Does Not

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Methyltestosterone and Hydroxyzine Pamoate are critical in correcting

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