govinfo:USCOURTS-mdd-1_26-cv-00435-0

IN THE UNITED STATES DISTRICT COURT 
FOR THE DISTRICT OF MARYLAND 
 
JAIME TRAVERSO, 
 
Plaintiff, 
 
v. 
 
WARDEN and 
CENTURION HEALTH, 
 
Defendants. 
 
 
 
Civil No. 26-435-BAH 
 
MEMORANDUM OPINION 
 Plaintiff Jaime Traverso (“Traverso”) filed a letter on February 2, 2026, which the Court 
construed as a civil complaint, in which he states that he has been waiting for an urgent shoulder 
surgery for over a month. ECF 1. Traverso filed a supplement in which he names Warden M. 
Brittingham and Centurion Health (“Centurion”) as Defendants. ECF 6. The Court issued an 
Order requiring Centurion to show cause why Traverso should not be granted injunctive relief. 
ECF 7. Centurion responded on April 28, 2026. ECF 14. At the Court’s direction, ECF 15, 
Centurion provided additional briefing on May 29, 2026, ECF 19. Traverso has also filed an 
Emergency Motion to Expedite Order for Injunction. ECF 20. Centurion has opposed the Motion. 
ECF 21. For the reasons discussed herein, Traverso’s Motion and request for a preliminary 
injunction will be denied. 
 The Court previously summarized Traverso’s allegations as follows: 
Traverso states that following two slip and fall incidents, he was advised that he 
had a possible pinched nerve. ECF 1, at 1. He was told he would be scheduled to 
see a neurosurgeon but this never occurred. Id. On December 30, 2025, Traverso 
fell inside his cell and broke his shoulder. Id. at 2. Following an x- ray, he was 
transferred to the Tidal Health Hospital but later returned because the hospital could 
not perform the necessary surgery. Id. Traverso was still awaiting surgery almost 
a month later and asserts that Dr. Donald Alves has been deliberately indifferent to 

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the urgency of his need for a shoulder replacement. Id. at 2. He seeks an order 
from this Court directing Centurion to have his shoulder surgery scheduled and 
completed as soon as possible. 
 
ECF 15, at 1. The records provided by Centurion showed that the surgical providers were requiring 
various evaluations before Traverso’s surgery could proceed. However, because it was unclear 
whether the providers were properly coordinating amongst each other or that the necessary 
evaluations were being ordered, the Court ordered Centurion to provide additional briefing on 
these issues. Id. at 4. 
 Centurion filed their additional briefing with a supplemental affidavit from Dr. Donal 
Alves, a physician employed by Centurion that provides medical services at the Eastern 
Correctional Institute. ECF 19-1, at 2 ¶ 2. Centurion clarifies at the outset, however, that it is not 
necessary for the providers treating Traverso’s cervical spine issues and shoulder injury to 
coordinate with one another before Mr. Traverso undergoes surgery on his shoulder . ECF 19, at 
2. In the affidavit, Dr. Alves explains that Traverso was being assessed by neurosurgery for neck 
pain prior to the fall injuring his shoulder. ECF 19-1, at 2 ¶¶ 4–5. Following the injury, Traverso 
was sent out for an orthopedic consultation at Johns Hopkins Hospital at which it was decided that 
in order for him to undergo surgical repair, he would need two clearances. See id. at 3 ¶¶ 6 –8. 
First, Traverso needed to be cleared by neurology to confirm that he had adequate balance to 
tolerate the subsequent recovery from shoulder surgery, and second, he needed to be cleared by 
cardiology for the surgery itself. Id. ¶ 8. 
 Separate from the clearances needed for his shoulder surgery, Traverso also had a 
neurosurgery consult ation during this time in relation to neck pain, at which point it was 
recommended he undergo surgery for “cervical spine disc disease.” Id. ¶ 9. Traverso did not want 
to undergo that surgery, however. Id. The parallel tracks of these evaluations—and the similarity 

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of their names (“neuro”)––appear to have created some confusion for Traverso , considering that 
when he was told that a n order had been placed for Traverso to see a neurologist for shoulder 
surgery clearance, he was adverse to it since he had already expressed that he did not want the 
neurosurgery related to his spine. See id. ¶ 12. 
Traverso’s resistance prompted Dr. Alves to send a physical therapist’s note to the Hopkins 
orthopedic team to inquire whether clearance by a neurologist was absolutely necessary to go 
forward with the shoulder surgery. Id. at 4 ¶ 13. The Hopkins orthopedic team informed Dr. Alves 
that it was. Id. Dr. Alves explains that neurology and neurosurgery are separate specialties and 
that Traverso’s resistance delayed scheduling and therefore delayed the surgery. See i d. at 3–4 
¶¶ 12–13. Centurion has since scheduled a neurology clearance appointment. Id. at 4 ¶ 14. It was 
originally scheduled for June 9, 2026, but was rescheduled for August 6, 2026 due to the 
neurologist being on medical leave. Id. Dr. Alves states that Centurion will be notified if an earlier 
appointment becomes available. Id. 
 Dr. Alves further states that because cardiology clearances have a limited life span, they 
must be performed close to the scheduled surgery. Id. ¶ 15. The appointment had been scheduled 
for June 23, 2026, but due to the delay in the neurology clearance, it will have to be rescheduled 
for a later date. Id. Dr. Alves explains that once Hopkins approves the neurology evaluation, the 
cardiology appointment will be scheduled. Id. ¶¶ 16–17. All the surgical prerequisites that can be 
scheduled have been, an d Traverso remains in the infirmary on an effective pain management 
regimen. Id. ¶¶ 18–19. 
“An injunction is a drastic and extraordinary remedy, which should not be granted as a 
matter of course.” Monsanto Co. v. Geertson Seed Farms, 561 U.S. 139, 165 (2010); see also SAS 
Inst., Inc. v. World Programming Ltd., 874 F.3d 370, 385 (4th Cir. 2017) (satisfying the four-prong 

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test for a preliminary injunction is “a high bar, as it should be.”). A party seeking a preliminary 
injunction or temporary restraining order must establish the following elements: (1) a likelihood 
of success on the merits; (2) a likelihood of suffering irreparable harm in the absence of preliminary 
relief; (3) that the balance of equities tips in the party’s favor; and (4) tha t an injunction is in the 
public interest. Winter v. Nat. Res. Def. Council, Inc., 555 U.S. 7, 20 (2008); The Real Truth About 
Obama, Inc. v. Fed. Election Comm ’n, 575 F.3d 342, 346–47 (4th Cir. 2009). As to irreparable 
harm, the movant must show the harm to be “neither remote nor speculative, but actual and 
imminent.” Direx Israel, Ltd. v. Breakthrough Med. Corp., 952 F.2d 802, 812 (4th Cir. 1991) 
(citation omitted). “Issuing a preliminary injunction based only on a possibility of irreparable 
harm is inconsistent with [the Supreme Court’s] characterization of injunctive relief as an 
extraordinary remedy that may only be awarded upon a clear showing that the plaintiff is entitled 
to such relief.” Winter , 555 U.S. at 22 (citing Mazurek v. Armstrong, 520 U.S. 968, 972 (1997) 
(per curiam)). 
Based on the information provided by Centurion, it does not appear that Traverso is in 
imminent danger of irreparable harm . A movant must show the harm to be “neither remote nor 
speculative, but actual and imminent.” Direx Israel, Ltd., 952 F.2d at 812 (citation omitted). In 
another context, the Fourth Circuit has “held that the irreparable harm prong is satisfied where the 
plaintiff suffers from ‘ diminished access to high -quality health care suited to the individual 
plaintiff’s needs.’” PFLAG, Inc. v. Trump, 769 F. Supp. 3d 405, 449 (D. Md. 2025) (quoting 
Planned Parenthood S. Atl. v. Baker , 941 F.3d 687, 707 (4th Cir. 2019) ). However, the record 
shows that Centurion is coordinating the various clearance appointments Traverso needs before 
his shoulder surgery, and further that Traverso is being provided quality healthcare in the interim. 
See ECF 19 -1, at 5 ¶ 19 (“In the meantime, Mr. Traverso remains in the infirmary, able to 

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ambulate, with an effective pain management regimen.”) . Traverso has not represented that his 
pain and condition is not now being managed in the infirmary, nor has he indicated to the Court 
that he believes he is suffering from collateral severe or life-threatening ailments due to the delay. 
Cf. Beck v. Hurwitz , 380 F. Supp. 3d 479, 484–85 (M.D.N.C. 2019) (finding that plaintiff was 
“likely to suffer irreparable harm in that further delays may result in the spread of her cancer and 
potentially in the further deterioration of her condition and/or death” due to “defendants’ failures 
to provide prompt and effective medical treatment for her cancer”). 
In the absence of an indication that Traverso’s condition or health is deteriorating, the Court 
will not issue preliminary injunctive relief at this time. While the Court understands Traverso’s 
frustration and discomfort while waiting, it appears based on the record currently before the Court 
that the clearances required by the Hopkins surgeons are the reason for the delay. Nothing in this 
record suggests that Traverso is at risk of suffering any further harm to his shoulder by continuing 
to wait in the infirmary, where his pain can be monitored and managed. At this stage, any alleged 
irreparable harm is only speculative and therefore Traverso is not entitled to preliminary injunctive 
relief. His Emergency Motion , in which he restates his need for injunctive relief, ECF 20, will 
thus be denied without prejudice. 
I. Amend Complaint 
Sections 1915(e)(2)(B) and 1915A of Title 28 of the United States Code require this Court 
to conduct an initial screening of this Complaint and to dismiss any complaint that (i) is frivolous 
or malicious; (ii) fails to state a claim upon which relief may be granted; or (iii) seeks monetary 
relief against a defendant who is i mmune from such relief. See 28 U.S.C. §§ 1915(e)(2)(B), 
1915A(b); see also Lomax v. Ortiz -Marquez, 590 U.S. 595 (2020). Here, the Complaint is 

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deficient because Traverso does not name appropriate defendants, nor does he explain how each 
of them participated in violating his right to adequate medical care under the Eighth Amendment. 
To state an Eighth Amendment claim for denial of medical care, a plaintiff must 
demonstrate that the actions of the defendants, or their failure to act, amounted to deliberate 
indifference to a serious medical need. See Estelle v. Gamble, 429 U.S. 97, 106 (1976); see also 
Anderson v. Kingsley, 877 F.3d 539, 543 (4th Cir. 2017) . Deliberate indifference to a serious 
medical need requires proof that, objectively, the prisoner plaintiff was suffering from a serious 
medical need and that, subjectively, the prison staff were aware of the need for medical attention 
but failed to either provide it or ensure it was available. See Farmer v. Brennan, 511 U.S. 825, 
834-7 (1994); see also Heyer v. U.S. Bureau of Prisons , 849 F.3d 202, 209–10 (4th Cir. 2017); 
King v. Rubenstein, 825 F.3d 206, 218 (4th Cir. 2016); Iko v. Shreve , 535 F.3d 225, 241 (4th Cir. 
2008). 
Objectively, the medical condition at issue must be serious. See Hudson v. McMillian, 503 
U.S. 1, 9 (1992) (there is no expectation that prisoners will be provided with unqualified access to 
health care); Jackson v. Lightsey, 775 F.3d 170, 178 (4th Cir. 2014). After a serious medical need 
is established, a plaintiff must show that a defendant was subjectively reckless in treating or failing 
to treat the serious medical condition. See Farmer, 511 U.S. at 839–40. Under this standard, “the 
prison official must have both ‘subjectively recognized a substantial risk of harm’ and 
‘subjectively recognized that his[/her] actions were inappropriate in light of that risk.’” Anderson, 
877 F.3d at 545 (quoting Parrish ex rel. Lee v. Cleveland, 372 F.3d 294, 303 (4th Cir. 2004)); see 
also Rich v. Bruce, 129 F.3d 336, 340 n.2 (4th Cir . 1997) (“True subjective recklessness requires 
knowledge both of the general risk, and also that the conduct is inappropriate in light of that risk.”). 
“Actual knowledge or awareness on the part of the alleged inflicter . . . becomes essential to proof 

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of deliberate indifference ‘because prison officials who lacked knowledge of a risk cannot be said 
to have inflicted punishment.’” Brice v. Va. Beach Corr. Ctr ., 58 F.3d 101, 105 (4th Cir. 1995) 
(quoting Farmer, 511 U.S. at 844). 
Traverso’s supplement states that the defendants he sought to sue by filing his letter were 
Warden Brittingham, Centurion Health, and/or Dr. Donald Alves. See ECF 6. However, Traverso 
does not attribute any of the alleged wrongdoing in his complaint to Warden Brittingham, nor does 
he specify how Dr. Alves and/or Centurion acted recklessly with respect to the treatment of his 
injury. See ECF 1. Liability under § 1983 attaches only upon personal participation by a defendant 
in the constitutional violation. See Trulock v. Freeh, 275 F.3d 391, 402 (4th Cir. 2001). Traverso 
must plead facts which show that ( 1) his medical need is serious and ( 2) each of the defendants 
was personally deliberately indifferent to the need. 
Because Traverso proceeds pro se, and has a potentially cognizable claim, he will be 
afforded an opportunity to file an amended complaint to provide additional facts supporting his 
claims and to name the appropriate defendants in a single pleading. See Johnson v. Silvers , 742 
F.2d 823, 825 (4th Cir. 1984) . In amending his c omplaint, Traverso should endeavor to provide 
the dates and locations of relevant events, name as defendants the individuals who personally 
participated in the alleged wrongdoing, explain how each named defendant acted or failed to act 
resulting in the violation of his constitutional rights, describe the harm he suffered as a result of 
their misconduct, and list the relief requested. 
Any proposed amended complaint must conform to Federal Rule of Civil Procedure 8 . 
Rule 8(a) requires that a complaint include a short and plain statement of the claim that shows the 
plaintiff is entitled to relief such that the defendant is fairly placed on notice of the claim and the 
“grounds upon which it rests.” Swierkiewicz v. Sorema N. A., 534 U.S. 506, 512 (2002) (quoting 

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Conley v. Gibson, 355 U.S. 41, 47 (1957) ); Fed. R. Civ. P. 8(a) . Rule 8(d)(1) requires that 
complaint allegations must be “simple, concise, and direct.” Fed. R. Civ. P. 8(d)(1). A complaint 
that includes only legal conclusions, labels, or a formulaic recitation of the elements of a cause of 
action does not satisfy Rule 8’s basic pleading requirements. See Ashcroft v. Iqbal, 556 U.S. 662, 
678 (2009) (quoting Bell Atl. Corp. v. Twombly , 550 U.S. 544, 555 (2007) ). Rule 10(a) requires 
that the complaint identify each defendant allegedly responsible for the wrongdoing. See Fed. R. 
Civ. P. 10(a). 
 Traverso is reminded that the amended complaint will replace the current c omplaint. See 
Young v. City of Mount Ranier, 238 F.3d 567, 572 (4th Cir. 2001) (quoting In re Crysen/Montenay 
Energy Co., 226 F.3d 160, 162 (2d Cir. 2000) (noting exception for purposes of appellate review 
of claims dismissed in original complaint that were not included in amended complaint)). 
Accordingly, Traverso must include all allegations against each of the defendants he names so that 
the amended complaint stands alone as the sole complaint in this case. Lastly, Traverso is warned 
that failure to file an amended complaint consistent with this order may result in the dismissal of 
the case with prejudice. See 28 U.S.C. § 1915(e)(2)(B)(ii) and 1915A(b)(1). If Traverso , while 
incarcerated, has three such actions or appeals dismissed pursuant to 28 U.S.C. 
§§ 1915(e)(2)(B)(i)(ii) and 1915A(b)(1), his right to file a complaint in federal court without first 
paying the filing fee ($405) will be greatly curtailed. See 28 U.S.C. § 1915(g). 
A separate implementing order will follow. 
 
 
Dated: June 12, 2026 /s/ 
 Brendan A. Hurson 
 United States District Judge 
 

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