Free Motion for Summary Judgment - District Court of Colorado - Colorado

Case 1:03-cv-01959-MSK-PAC

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Filed 07/28/2006

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IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO Civil Action No. 03-cv-01959-MSK-PAC AHMED M. AJAJ, Plaintiff, v. UNITED STATES OF AMERICA, ROBERT A. HOOD, JAMES BURRELL, DAVID DUNCAN, C. CHESTER, and J.C. ZUERCHER, Defendants.

DECLARATION OF STEVEN NAFZIGER, M.D.

1.

I, Steven Nafziger, M.D., hereby declare that I am a Medical Officer

(General Practice) at the United States Department of Justice, Federal Bureau of Prisons ("Bureau") facility known as the United States Penitentiary, Administrative Maximum ("ADX"), located in Florence, Colorado. I have held this position since May 22, 2006. I have been employed by the Bureau since January 9, 2006. 2. As a Medical Officer (General Practice), I provide professional health care

services for the federal prisoners confined at the ADX. My specific duties involve all aspects of health care delivery and I work in concert with both institution staff and consultant specialists in various clinical areas. I perform all my duties in accordance with current accepted medical practices and procedures.

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3.

Inmate Ahmed Ajaj, Federal Register Number 40637-053, is presently

confined at the ADX. I am familiar with inmate Ajaj, his medical history and his medical file because I am his treating physician. I am aware of the allegations that inmate Ajaj raises in his Third Amended Complaint filed in the above-captioned lawsuit. I am also aware of the Bureau policies and procedures applicable to the provision of medical care to inmates at the ADX. I make this Declaration in support of the Federal Officers' Motion for Summary Judgment. 4. Medical transfers are approved by the Central Office Medical Designator in

the Office of Medical Designations and Transportation (OMDT), Central Office. The Central Office Medical Designator assigns inmates to medical referral centers, institutions with appropriate medical resources, or non-Bureau community care centers to provide the required services. Medical Transfers are classified as either "Emergency, Routine/Urgent, or Routine." 5. These requests are generally referred as a "770 transfer" or a "770 referral."

These transfers are appropriate if the treating physician determines that the inmate has a serious medical need that cannot be met at the institution where the inmate is housed. A treating physician or clinical director has the authority to request a medical transfer if that transfer is appropriate based on the physician's medical judgment that the inmate has a serious medical need which cannot be addressed at the institution. Such transfers have been approved in the past to obtain treatment for cancer, surgery, diagnostic testing or

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other medically necessary treatments unavailable at the ADX. 6. An emergency transfer is a medical transfer so declared by medical staff.

This includes inmates medically not capable of transport via routine Bureau surface or air conveyance. An inmate's condition may require medical staff to declare a medical emergency. Emergency referrals may require special transportation, including air ambulance, air charter, or emergency ground transportation. 7. An emergency transfer request is made on a Warden-to-Warden basis, via

Medical/Surgical and Psychiatric Referral Request (BP-S770.060) with a copy to the OMDT. The Health Services Administrator (HSA) at the originating institution shall complete the Medical/Surgical and Psychiatric Referral Request (BP-S770.060) to ensure all essential medical information is communicated to the referral medical center. Emergency cases are referred to the most appropriate medical center or other facility, considering medical resources available, proximity, security needs, and bed space availability. The referring facility and the accepting institution notify the OMDT of referrals and acceptances via GroupWise at the time of referral and acceptance. Any emergency referral denied shall be immediately forwarded to the referring facility, with a copy to the OMDT. 8. A routine/urgent medical transfer is any transfer whereby an inmate's

condition may require direct travel to a medical center within 14 calendar days. Routine/Urgent referrals are made via BP-S770.060, through the Warden. The HSA

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coordinates and routes the completed BP-S770.060 to the OMDT. The OMDT reviews and ultimately approves transfer requests. 9. A routine medical transfer is any transfer not designated as an emergency

and time en route is not critical. Routine referrals are made via the BP-S770.060, through the Warden. The HSA coordinates and routes the completed BP-S770.060 to the OMDT. The OMDT reviews and approves transfers requests. 10. A review of inmate Ajaj's medical records reveals that from September

2002 until November 2004, no requests for a medical transfer were ever made for inmate Ajaj by any treating physician or medical professional based upon a medical need for inmate Ajaj to be housed in a smoke-free environment. 11. In addition, a review of inmate Ajaj's medical records indicates that from

September 2002 until the present time, no requests for a medical transfer were ever sought for inmate Ajaj by any treating physician or medical professional based upon a medical need for inmate Ajaj to be housed at a low altitude. 12. Although it was a medical concern to house inmate Ajaj in a location where

his exposure to smoke would be limited, inmate Ajaj's medical records do not reflect any medical orders by treating physicians or medical professionals from 2002 until the present necessitating that inmate Ajaj be housed in a totally smoke-free environment. 13. A review of inmate Ajaj's medical records for the time period from

September 2002 through September 2004 when he was allegedly exposed to

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environmental tobacco smoke, or second-hand smoke, reveals that he was in no acute distress. Inmate Ajaj's blood oxygen saturation levels were well within the normal range. 14. Inmate Ajaj's medical records from 2002 until the present do not reflect any

medical complications for inmate Ajaj relating to exposure to altitude. 15. Inmate Ajaj's medical records reflect that in June 2003, inmate Ajaj was

sent for an medical evaluation by an outside pulmonology consultant, Dr. Craig Shapiro, who found that there was no medical necessity to transfer inmate Ajaj to an institution located at a lower altitude. Pursuant to the provisions of 28 U.S.C. 1746, I declare under penalty of perjury that the foregoing is true and correct to the best of information, knowledge, and belief. Executed on this 28 th day of July, 2006, at Florence, Colorado.

s/ Steven Nafziger, M.D. Steven Nafziger, M.D. Clinical Director Health Services Department United States Penitentiary, Administrative Maximum

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