Request for Court Injunction Against ‘Opioid Safety Initiative’
[This is the actual paperwork filed by plaintiff, Robert D. Rose Jr., in Greeneville Federal Courthouse, 220 W Depot St # 200, Greeneville, TN 37743 (423) 639–3105 on May 7, 2018.]
Comes now plaintiff, Robert D. Rose Jr., and hereby requests the Court and the Clerk of the Court to enter the following request for a Preliminary Injunction suspending the Department of Veterans Affairs and Department of Defense policy entitled: VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain; Version 3.0–2016. Approved and published nationwide February 2017. This request is made pursuant Federal Civil Rules of Civil Procedure, Title VIII. Provisional & Final Remedies. Rule 65.
Additionally the plaintiff makes the following requests of the Court and the Clerk of the Court:
a. This injunction request not be sealed. This case is the only hope thousands of veterans and civilians have that one day soon their healthcare needs will once again be met by medical professionals across the country.
b. The same as in the denied Ex Parte Injunction, the plaintiff respectfully requests an open hearing at the earliest possible convenience of the Court at which witness, veterans, loved ones and caregivers, can be provided detailing the harm the Department of Veteran Affairs’ opioid safety initiative is causing within the veteran community as well as in the civilian community. This request for testimony also includes civilians being affected by the Centers for Disease Control (CDC) copied and adopted a majority of the VA/DOD policy into the controversial CDC Opioid Guidelines targeting the elderly, cancer patients and the disabled.
c. Pursuant to advice from the clerk’s office, it is hereby requested in view that many witnesses are homebound and/or located in other states the court allow teleconferencing testimony from these witnesses either by Skype or other technology allowing their voices to be heard regarding this policy which is adversely effecting so many of our nations heroes.
Reasons for request for Preliminary Injunction:
In Doc 56, the court states “Plaintiff has managed to last a year and a half without “[p]roper pain management treatment,” he has failed to show that an immediate injury will occur…” The plaintiff’s response to this statement is as follows:
First, plaintiff has not died or committed suicide as have so many others since beginning the forced taper in November 2016 after being denied all pain medications on December 29. 2016. As a Christian, the plaintiff will never commit suicide and dishonor Jesus Christ our Lord and Savior or jeopardize being in His presence again.
The first incidence in which the plaintiff was in the presence of Jesus Christ was in 1991 when plaintiff incurred most of the injuries to his spine as he fell from a cliff into the Mediterranean Sea. As the plaintiff was drowning, plaintiff was surrounded by the most wonderful white light filled with unconditional love erasing all of plaintiff’s pain and worries. The plaintiff’s Savior embraced him in that moment and the plaintiff heard in his head “Not yet.” Although the plaintiff looks forward to being in His presence again, the plaintiff would prefer to remain around many more years to see his grandchildren.
As to the plaintiff’s being able to “manage[…]” the past one year, six months, two days, or 548 days with unrelenting pain speaks to plaintiff’s WILL to live; not to the plaintiff’s QUALITY of life. Since the beginning of the forced taper and ultimately the denial of all lifesaving medications AND ensuring a quality of life medications, the plaintiff’s quality of life has dropped to being less than the plaintiff’s worse day in Marine Corps boot camp during the summer of 1983 at Parris Island, sand fleas and all. Here are a few additional examples to supplement what was already included in the initial complaint and amended complaint.
a. Unable to attend son’s fiancé’s college graduation, December 2017 or after party because of pain and high blood pressure.
b. Summer 2017, mowing my yard required about two hours. Each time resulted in plaintiff being homebound for three or four days more if rainy. This did not include weed eating, blowing the driveway or trimming my trees or bushes. The plaintiff being unable to care for any of the many flowers in plaintiff’s gardens resulted in most dying. Spring 2018, Washington County city workers ruined trees and bushes shading plaintiff’s patio. Summer 2018, plaintiff is paying for minimal yard care.
c. A trip to the grocery store requires plaintiff to lie in bed for several hours before plaintiff is able to prepare minimal subsistence meals. Many days dinner consists of grilled cheese and bologna sandwiches.
d. Monday, April 23, 2018, it required approximately four (4) hours to travel to Greeneville Federal Courthouse, to file the Ex Parte Injunction (Doc. 53) and return to plaintiff’s in Gray, Tennessee. This one trip left plaintiff mostly homebound in bed for the following two and half days unable to complete basic hygiene or care for his 100% disabled wife, Pilar A. Rose.
e. Unable to decorate home with even a small Christmas tree or manger scene, December 2016 and December 2017.
f. Plaintiff is extremely frustrated at being unable to remember small things which were formerly committed to memory such as the Lord’s Prayer when pain levels explode.
g. Spring 2018, unable to go with wife to a special dinner prepared by son at his new apartment with his fiancé.
h. With much shame, the plaintiff has prayed multiple times to God to take him home as the pain has gotten too unbearable. Thankfully, God has ignored these pleas so that plaintiff might live to fight another day. Each morning and evening, regardless of suffering, plaintiff gives thanks to God for allowing plaintiff to remain for one more glorious day. “I can do all things through Jesus Christ which strengthens me.” Philippians 4:13
For each of the items listed, plaintiff can add additional items as to why plaintiff’s quality of life has diminished so dramatically. However, the plaintiff is a United States Marine. The plaintiff believes with all his heart he was spared in 1991 with these injuries so as to defend the right for quality healthcare for all his Brother and Sister WARRIORS in all branches of the Armed Forces. As long as their lives are in jeopardy by this policy and the Department of Veteran Affairs continue to deny veterans quality healthcare; the plaintiff refuses to die!
As to failing to show an “immediate injury will occur;” plaintiff has no answer. The complications associated to untreated pain were very clear and specific in the Ex Parte Injunction, (Doc 53) and other documents provided to the court. Plaintiff will testify that on multiple occasions he has taken Benadryl to lower pain induced high blood pressure and severe chest pains. Plaintiff can attest to being afraid to return to Mountain Home VAMC Emergency Room for fear of being arrested or discharged again without the benefit of proper medical care. Diagnosed years ago with Major Depressive Disorder, plaintiff assures the Court these conditions have worsened to the point of desperation most days: depressed mood, loss of interest or pleasure, significant change in appetite/weight, insomnia/hypersomnia, psychomotor agitation/slowing/loss of energy, feelings of worthlessness, inability to concentrate, recurrent thoughts of suicide.
Plaintiff can attest to not having sufficient funds to go to a civilian hospital for treatment of these conditions at the present time. Plaintiff has secured private insurance at significant cost which will go into effect July 1, 2018. It is the plaintiff’s desire with proper medical care,; this case will be better researched and presented in future correspondence and/or motions and especially at any hearings. The defendants will not stand a chance of anything less than GUILTY of all allegations by a jury of our peers.
In response to statement in Doc 56, in that plaintiff “fails to comply with the requirements of Rule 65(b)(1) in that “neither his original nor his amended complaint is verified,” the plaintiff is including the following summary of the original and amended complaints in hopes it is sufficient for the Court. Additionally, plaintiff makes the following declaration:
“As God is my witness and by the notary by and for the State of Tennessee located at the end of this Preliminary Injunction request, every statement and every document plaintiff, Robert D. Rose Jr., has made, is making or will make to the Eastern District Federal Court regarding Case #2:17-cv-204 Rose v Roe is truthful and factual to the best of the plaintiff’s ability, so help me God. May it be known now and forever.” “For there is nothing covered, that shall not be revealed; neither hid, that shall not be known.” Luke 12:2.
Summary of complaint and reasons needed for Preliminary Injunction barring further harm by the Department of Veterans Affairs and Department of Defense policy entitled: VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain; Version 3.0–2016. Approved and published nationwide February 2017.
a. October 2016, defendant nurse practitioner Christina Craft, whom plaintiff had never met, called to inform per new VA policy to deny 90% of all veterans (elderly, cancer patients & disabled) all pain medications, she was going to put plaintiff on forced taper to zero. When objected, defendant stated the plaintiff had the normal spine of any other fifty year old male and that plaintiff had no choice. She refused for an in-person consult. She refused to provide this directive in writing.
b. October 15, 2016 after contacting the office of defendant David Hecht, an appointment with defendant Craft was granted. At this visit defendant repeated claims from the phone conversation. Defendant refused to look at years of medical records documenting injuries by Veterans Affairs medical personnel, civilian doctors and US Navy doctors (plaintiff has a copy of medical files from the United States Marines with inclusive records from 1983 to 1994) brought to the appointment by the plaintiff. Defendant again refused to provide a hard copy of guideline or directive she was using to force taper.
c. October 28, 2016, defendant James Crider, defendant’s Crafts supervising medical doctor, secretly entered into plaintiff’s VA medical records that plaintiff had broken “pain contract” for not complying with forced taper. Defendant Crider had never met or spoken to plaintiff. Beginning November 1, 2016 through December 29, 2016 plaintiff was forced to taper from 180mg Morphine Sulfate (three 60mg tabs daily) to zero. Plaintiff was advised of this entry in the plaintiff’s medical records by defendant Dale Whitson on October 24, 2017 in a secure message email notification of why he was refusing to treat veteran’s chronic pain disease: “Official violation of pain agreement was entered in chart on October 28, 2016 by Dr. James Crider. Apparently was taking morphine inappropriately, not according to his taper schedule.” This was the first time plaintiff was informed of this violation by any member of Mountain Home VAMC staff.
d. November 29, 2016 plaintiff went to Mountain Home VAMC Emergency Room for chest pains, difficulty breathing and excruciating pain (for full details, please see Amended Complaint Doc. 22 for full details). Defendant Suzanne Allen eventually discharged plaintiff apologizing for being unable to do more per opioid safety initiative. Defendant Allen refused to provide copy of policy or directive; a one page document stating to 1) continue with taper: 2) Moist heat to neck and back; 3) Use muscle relaxers as prescribed; 4) Call PCP for pain management referral; was all the discharge paperwork plaintiff was provided by discharge person. This occurred even though plaintiff was still experiencing same complaint as when first arrived and having an excessively high blood pressure reading (approximately 220/175 or 225/170) which was in the heart attack stroke range.
e. December 2019 defendant Craft called plaintiff to offer a return to a reduced 120mg Morphine Sulfate daily per excessively high blood pressure in Emergency Room and difficulty dealing with pain levels. Defendant Craft indicated it would only be temporary until plaintiff would be forced taper to zero. No exception. Plaintiff declined offer.
f. December 15, 2016 defendant John Hendricks met with plaintiff for the first time. In forty minutes or less defendant had determined the plaintiff suffered from “opioid use disorder,” “substance abuse disorder” and something else dealing with drug abuse. Plaintiff pointed out in clear terms, the plaintiff’s behaviors, actions and accomplishments in nearly twenty years or pain management did not meet the DSMV or DSMIV criteria for these diagnoses. Defendant Hendricks then strongly urged plaintiff to go through the detox program at Bay Pines Rehabilitation facility in Florida. Plaintiff declined per primary caregiver for 100% disabled wife, Pilar A. Rose. Defendant then urged plaintiff to accept Suboxone as an alternative to Morphine Sulfate as a pain management tool. Plaintiff declined for several reasons including the following:
a. Plaintiff is not an addict.
b. Suboxone is illegal to be prescribed off-label in Tennessee; it is only for addicts addicted to ILLEGAL fentanyl, heroin and illegally acquired opioid analgesics.
c. Research articles suggest Suboxone is specifically designed to be a more addictive synthetic opioid replacement drug with harsh withdrawal symptoms if attempting to end treatment. Additional research suggests Suboxone has a 66% (sixty-six percent) fail rate at helping addicts and/or chronic pain patients.
d. Manufactures, Indivior, have a twenty plus page of dangers associated with this addiction treatment drug.
g. December 15, 2016 Dr. Lisa Paderna, plaintiff’s psychologist for many years, after observing her supervisor’s “interview” secretly entered in plaintiff’s medical records “opioid use disorder.” The accompanying note by Dr. Paderna suggests this diagnosis was ordered by her supervisor, defendant Hendricks. Plaintiff was unaware of this entry for many months until plaintiff accidently stumbled upon an “administrative note” entered in plaintiff’s medical record not meant for veteran’s eyes.
h. December 2016, defendant Craft doubled three separate blood pressure medications to control excessive high blood pressure readings (heart attack & stroke levels) due to the untreated chronic pain from injuries sustained in the United States Marines. As the court can ascertain by the dosages, these doses are now at highest recommended levels:
a. Hydrochlorothiazide 25 mg
b. Benazepril HCL 40 mg tablet
c. Amlodipine Besylate 10 mg tab
i. January 2017 at behest of defendant Dean Borsos, plaintiff met with defendant, defendants Mark Crider, Thomas Edwards (dismissed from case by court), David Hecht via telephone conferencing and a roomful of other staff members. The purpose of the meeting was to convince plaintiff to stop misbehaving and objecting to the force taper. Edwards promised he would do everything in his power to provide aid and quality medical care for injuries to spine. All present refused to look at military records or civilian records demonstrating the extent of damage to spine, hips, legs and ankles stating they understood the damage was extensive. All present refused to provide hard copy of policy/directive.
j. May 20, 2017 met with defendant Mark Vernon. Defendant stated plaintiff should never have been removed from established pain management protocols. Stated all medical staff was under new guidelines/directives preventing any prescribing of opioid medications. Stated plaintiff should continue to smoke to help with the stress of being in pain all the time. Although diabetic, plaintiff should continue drinking Mt Dew as the sugar molecules would attach to the pain receptors in the brain and block some of the pain signals. Although plaintiff had last dose of pain medications on December 29, 2016, defendant ordered a drug screen. This test was negative for ALL pain medications for spine, hip, leg and ankle issues; more importantly it was negative for all ILLEGAL substances.
k. May 23, 2017 met with Thomas Edwards and defendant Teresa Odom. During this encounter, defendant Odom offered wheelchair yoga class as a solution to the unrelenting pain but no medications to get plaintiff from home to the classes. Declined offer. Keep in mind, last dose of pain medications was on December 29, 2016 and drug screen on May 20, 2017 was negative for illicit drugs, Edwards offered the detox program at Bay Pines Rehabilitation facility in Florida. Plaintiff declined. Edwards then offered Suboxone for treatment of pain. Plaintiff declined for same reason explained above. Edwards then commented that plaintiff was out to destroy him and all doctors at Mountain Home VAMC. Plaintiff agreed to this statement by including statement “by all legal means available.” Plaintiff followed up this encounter with a Secure Message email re-stating “by all legal means available” and forwarded it to the leadership at the Department of Veterans Affairs and the Congressional VA Committees. Edwards and defendant Odom had plaintiff’s medical record “red-flagged” as being a threat to himself, others and the staff at the VA facility. The result of such a flag meant if plaintiff reported for any appointment at the VA facility the plaintiff would have been arrested and detained if not being properly escorted by VA facility law enforcement officers. Plaintiff was unaware of this flag until June when he received a letter ordering plaintiff to report to the Disruptive Behavior Clinic located in the VAMC police department.
l. June 6, 2017, plaintiff reported to Mountain Home VAMC police station as ordered met with defendant Jerry Shelton and four other individuals plaintiff had never seen before or since. The defendant Shelton had his badge, a sidearm and handcuffs prominently displayed for the plaintiff to see. The tone and atmosphere established defendant Shelton as an interrogator in an apparent effort of intimidation. Defendant Shelton did not provide or state his medical training which would have qualified defendant to determine mental health status of plaintiff. The entire meeting seemed to be targeted at getting plaintiff to accept the opioid safety initiative and to stop creating waves with medical personnel, the Department of Veterans Affairs leadership in Washington and numerous congressional leaders which had been contacted regarding the policy to deny 90% of all veterans, the elderly, cancer patients and the disabled, all pain medications. Plaintiff advised defendant he would continue to fight the policy using all legal means available. The flag was “cleared” meaning the plaintiff will not be arrested but remains as a warning to other providers’ plaintiff is seeking legal relief from these policies as they continually refuse to provide said policies in writing.
m. July 3, 2017 complete details of encounter with Mountain Home VAMC law enforcement acting on behalf of Defendant Roe and/or his staff was provided with Doc 31, at 01, 02 and 03 to the courts on March 22, 2018. Considering that information deals with criminal acts, plaintiff will not add to this request for a Preliminary Injunction against the Department of Veterans Affairs’ opioid safety initiative.
n. September & October 2017 plaintiff was informed defendant Vernon had been replaced by new primary care physician (PCP) defendant Whitson. Plaintiff made numerous attempts to contact defendant by phone, leaving messages each time to please return to call(s). Defendant never responded to these calls. October 11, 2017, Dr. Provence, Chief of Primary Care, whom the plaintiff had never met, called advising “my doctor” without naming the individual was out of town. Plaintiff sent secure message email on this date to Provence (Attachment 01) describing the difficulties contacting the new PCP, defendant Whitson. Then on October 24, 2017 defendant’s nurse advised via secure message defendant Whitson would not treat any pain conditions due to defendant Crider’s entry on October 28, 2016 stating the defendant had violated the patient pain contract.
o. October 9, 2017 plaintiff called and spoke with defendant Dean Borsos regarding the death of his sister Melissa Anne Rose on October 8, 2017. Plaintiff explained how at Sycamore Shoals Hospital, Elizabethton, Tennessee, plaintiff collapsed from the stress of pain, increased blood pressure and emotional loss simply from the forty minute drive to see his sister in the hospital (she was deceased by the time plaintiff arrived). Plaintiff begged the defendant for enough pain medication for one week to be with family and friends during this tragic period. He refused any medical treatment however throughout this week of grief; plaintiff received multiple calls from woman identifying herself as being in charge of hospice for Mountain Home VAMC, Dr. May. This person repeatedly insisted plaintiff should go to the Johnson City Medical Center or the Sycamore Shoals Hospital anytime there were chest pains, extremely high blood pressure or excruciating pain as the Department of Veterans Affairs would pay for the emergency room visit. Plaintiff advised Dr. May that defendant Borsos had stated the VA would not pay for such a hospital visit and defendant Lonnie Hatton had made similar statements on multiple occasions. Dr. May insisted the plaintiff could trust her and to just go to the emergency room. Plaintiff requested multiple times by phone and through secure messaging email (Attachment 02) for Dr. May to put these statements “the VA would pay for such medical treatment” in writing. After the secure message was sent, plaintiff never heard from Dr. May again.
p. January 5, 2018 the plaintiff was referred to East Tennessee Brain and Spine Center by Mountain Home VAMC for pain management treatment. On this date was plaintiff forced to provide drug screen; negative for thirteen (13) ILLICIT drug classes.
q. January 2018 plaintiff finally met with defendant Whitson. During this appointment the defendant made some extremely troubling statements.
a. Plaintiff should never have been removed from the pain management protocols established considering the dose had remained stable and effective with no violations of the pain contract as previously indicated by defendant Crider.
b. Medical staff, doctors and nurses were provided lists of five to ten [veterans’] names and told to discontinue all opioid related pain medications. Medical staff could request waivers from the administration but these were all denied. No exceptions.
c. Medical staff, doctors and nurses, was forced by intimidation of implied threats regarding continued employment with the Department of Veterans affairs if they did not comply with these directives. Defendant Whitson stated he only had a few years till retirement and was terrified of what he would do if terminated this close to the finish line.
d. Defendant Whitson stated he did not fear the lawsuit as he and everyone else working for the Department of Veterans Affairs were only following orders and not complicit in any wrongdoing.
e. Defendant Whitson refused to provide copies of any policies/directives or lists reminding plaintiff his retirement was too important to mess up by providing evidence.
r. April 2018, plaintiff was advised of being assigned a new PCP; no name provided in letter. Sent blind secure message email to Mountain Home VAMC to request medical assistance (Doc 53, at 01) from the new PCP. Nurse Sherry Pierce’s denial response (Doc 53, at 02) by the new primary care physician (PCP), Dr. Avonda, is the first time any member of Mountain Home VA Medical Center has put in writing the specific reason for denying 90% (ninety percent) of all veterans, the elderly, cancer patients, the disabled, all pain medications.
It is for this reason, Sherry Pierce’s secure message (Doc 53, at 02) [copy below]that plaintiff again requests a Preliminary Injunction be enjoined against the Department of Veterans Affairs and Department of Defense policy entitled: VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain; Version 3.0–2016. Approved and published nationwide February 2017.
Plaintiff respectfully requests this Injunction endure until such time studies can be conducted to determine the number of deaths once a veteran has been forced tapered or denied all pain medications. The deaths should include those listed as natural causes (cancer, old age, heart attack, et cetera), illicit drug use and suicides AFTER the medical establishment abandoned all quality medical care/treatments, the Hippocratic Oath and scientifically proven lifesaving medications known as “opioids.”
Aren’t the lives of veterans worth the approximate $4 million dollars (advertising budget) it uses for media blackouts on the suicides, even on those VA properties and using it to proudly announce the statistical numbers of veterans denied these lifesaving medications without reporting the harm. Using the Department of Veteran Affairs’ own database, an external team should be able to quickly track these numbers from ALL fifty states, commonwealths and other VA/DOD medical system controlled facilities handling/submitting this information. It is imperative for an outside agency to conduct this research considering the level of misinformation put forth by the Department of Veterans Affairs and the Office of the Inspector General regarding the suicides since 2012 when the opioid safety initiative was first implemented in St Cloud, Fargo and Minneapolis Minnesota.
In reference to Courts Order (Doc 53), plaintiff “fails to certify any efforts made to give notice to defendants,” the plaintiff is providing certified mail certificates from the United States Postal Service as Attachment 03. Since these certificates are not possible prior to mailing, the defendants will not be receiving a copy of this specific attachment.
Again plaintiff makes the following declaration. As God is my witness, and by the notary by and for the State of Tennessee located at below of this Preliminary Injunction request, every statement and every document plaintiff, Robert D. Rose Jr., has made, is making or will make to the Eastern District Federal Court regarding Case #2:17-cv-204 Rose v Roe is truthful and factual to the best of the plaintiff’s ability, so help me God. May it be known now and forever: “And ye shall know the truth, and the truth shall make you free.” John 8:32
Robert D. Rose Jr.
BSW, MEd. USMC
Ex Parte Injunction — Federal Court Case 2:17-cv-204 — Rose v Roe
This is the actual paperwork filed by plaintiff, Robert D. Rose Jr., in Greeneville Federal Courthouse, 220 W Depot St # 200, Greeneville, TN 37743 (423) 639–3105 on April 23, 2018.
Apologies I Didn’t Die or Commit Suicide! — Judge McDonough’s Denial Ruling, April 30, 2018
This is the actual Court Order Denying the Ex Parte Injunction, TN 37743 (423) 639–3105 on April 30, 2018.