Thornton v. Doe

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ILLINOIS

CHARLES THORNTON #Y19115, )

)

Plaintiff, )

)

vs. ) Case No. 19-CV-1371-SMY

)

WEXFORD HEALTH SOURCES, INC., )

et al, )

)

Defendants. )

MEMORANDUM AND ORDER

YANDLE, District Judge:

Plaintiff Charles Thornton, an inmate in the custody of the Illinois Department of

Corrections (“IDOC”), filed this lawsuit pursuant to 42 U.S.C. § 1983. He claims the defendants

were deliberately indifferent to his serious medical needs at Menard Correctional Center by

denying him medical care, allowing LPNs and CMTs to render medical services they are not

qualified to provide, and failing to enforce the prison deadlock policy or protocol.

The case is now before the Court for consideration of the motion for summary judgment

filed by Defendants Dr. Mohammad Siddiqui, Wexford Health Sources, Inc., and Mary Jo Zimmer

(Doc. 209). Plaintiff opposes the motion (Doc. 232). For the following reasons, the motion is

GRANTED in its entirety.

Factual Background

The following relevant facts are undisputed unless otherwise noted: prior to his

incarceration, Thornton was shot in the face with a handgun (Doc. 232, p. 85 at 44:17-23). The

bullet lodged itself against his cervical vertebrae (Id., p. 86 at 43:1-5). The shooting resulted in

long-term neck, right shoulder, and nerve pain that occasionally flared up and for which Thornton

received treatment at Menard Correctional Center during the relevant period (Id., p. 88 at 50:1-

18).

On April 13, 2018, Thornton met with medical personnel at Menard regarding complaints

of pain in his neck that had been recently exacerbated by an inmate chokehold (Doc. 211-1, p. 6;

Doc. 232, pp. 15-16 at ¶ 6-11). The staff member recorded his vital signs, noted that he showed

no signs of obvious discomfort, and directed him to return to the Healthcare Unit (“HCU”) if his

symptoms worsened (Doc. 211-1, p. 6). According to Thornton, during this visit, he met with a

“Jane Doe” who “was unqualified and did not have the educational preparation or scope of practice

to examine patients” (Declaration of Charles Thornton, Doc. 232, p. 17 at ¶ 14). Thornton asked

for, but did not receive, a “stronger dosage of his prescribed medication” (Id. at p. 16 at ¶ 9).

Thornton received a sick call pass to see Dr. Siddiqui on June 11, 2018, but did not attend

the appointment because a correctional officer did not honor his pass (Id. at pp. 18-19 at ¶¶ 23-

25). The Menard medical note states, “Not seen due to [inmate] refused. Signed refused in chart”

(Doc. 211-1, p. 7).

On July 29, 2018, Thornton refused to submit to a mouth check to ensure that he had taken

his medication. (Id.) The administration of his medication had changed to a crush and float matter.

(Id.)

On August 3, 2018, Thornton refused to take his medication as administered in a crush and

float manner, stating, “I’m not taking it like that” (Id. at p. 8). Thornton again refused to take his

medication in a crush and float manner on August 5, August 7, and August 8, 2028 (Id. at p. 9).

On August 8, 2018, Thornton presented to the HCU and spoke with a nurse about being

administered his medication in a crush and float manner (Id. at p. 10). The nurse noted, “Angry

about meds being crushed and floated . . . [Thornton] refused to discuss medical problems, just

kept repeating over and over who he was suing . . . argumentative and just kept saying, ‘I’ll see

you in court!’” (Id.) According to Thornton, the nurse “became very irate with [him] then threw

him out of the sick call” after he complained of “constant pain in the inside of his neck”

(Declaration of Charles Thornton, Doc. 232, p. 20 at ¶ 28).

On August 9, 2018, Thornton met with Nurse Zimmer. During his deposition, Thornton

testified that he initially told Zimmer that his pain medication was either not working or the method

of administering it (a crush and float form) was ineffective and asked her for a higher dosage (Doc.

211-2, p. 5 at 154:20-25). Due to pain from his bullet injury, he asked Nurse Zimmer to look into

whether he needed a variation in his pain medication. (Id., p. 6 at 155:14-20). Nurse Zimmer

refused to provide him with pain medication, did not issue him a permit for a front cuff, and

threatened him with a disciplinary ticket (Doc. 232, p. 20 at ¶ 31). Zimmer’s medical notes from

the appointment indicate that Thornton refused his medications, worried about being poisoned by

the nursing staff, and became hostile (Doc. 211-1, p. 11).

Dr. Siddiqui did not treat Thornton but responded to several of his grievances (Doc. 232,

p. 10). In grievance # 467-4-18, Thornton complained about his April 13, 2018 appointment,

stating that he wants to know “why [he has] been denied adequate medical treatment for so long

and to see a doctor immediately” (Doc. 211-3, p. 19). In a subsequent memorandum, Dr. Siddiqui

noted that he had reviewed the medical record and grievance and concluded that, “The medical

co-pay of $5.00 was charged correctly and does not mean you will automatically be referred to the

MD. The nurse instructed [Thornton] on 4/13/2018 to return to see the provider if symptoms

worsen or interfere with daily functioning. No further sick call has been submitted.” (Id. at pp.

19, 22).

In grievance # 2-5-18, Thornton complained about a shakedown on April 26, 2018, when

he was instructed to keep his head lowered and denied front cuffing. (Id. at p. 15). Dr. Siddiqui

reviewed the grievance and indicated that Thornton had no “alternate cuffing permit,” and that he

had refused to be treated by Dr. Siddiqui on June 11, 2018. (Id.)

In grievances # 325-6-18 and # 11-7-18, Thornton complained that he had a medical pass

from June 11, 2018 that had not been honored. (Id. at pp. 8-13). Dr. Siddiqui reviewed the

grievance # 325-6-18 with a nursing supervisor and determined that, “Nothing noted to

substantiate offender grievance other than he refused his pass on 6-11-18. Proper procedure is to

honor call passes for medical.” (Id. at p. 8). Grievance # 11-7-18, was later denied as moot because

it was a duplicate of # 325-8-18. (Id. at p. 11).

In grievance # 252-8-18, Thornton complained of a sick call on August 8, 2018 and an

appointment with Nurse Zimmer on August 9, 2018. (Id. at p. 4). Dr. Siddiqui noted, “The

progress note states offender was seen for neck pain, and offender was angry and argumentative;

she attempted to discuss his situation but offender kept saying I’ll see you in court. Offender was

referred to MD/NP to discuss concerns. On 8-9-18 offender was seen by the NP, where offender

became hostile and kept interrupting the NP and the visit was terminated.” (Id. at p. 4).

In grievance # 341-2-18, Thornton complained that he had been harassed by a member of

the medical staff who had made him “open his mouth wide and stretch his tongue up and down

and side-to-side.” (Id. at p. 24). Although Dr. Siddiqui is not named, the Grievance Office

reviewed and determine that the “Healthcare Unit responded appropriately.” (Id.)

Discussion

Thornton filed the instant lawsuit pursuant to 42 U.S.C. § 1983 (Doc. 1). Following the

initial screening, motions to amend the complaint, and a settlement with many of the defendants,

Thornton is proceeding on the following claims:

Count 4: Eighth Amendment deliberate indifference to serious medical needs claim

against Defendant Nurse Practitioner Zimmer for denying Plaintiff medical

care on August 9, 2018;

Count 5: Eighth Amendment deliberate indifference to serious medical needs claim

against Defendants Wexford for its policy and/or custom of permitting

unqualified medical personnel to perform licensed professional’s duties

and/or allowing LPNs and CMTs to render medical services they are not

qualified to provide.

Count 6: Eighth Amendment deliberate indifference to serious medical needs claim

against Defendant Dr. Siddiqui for allowing LPNs and CMTs to render

medical services they are not qualified to provide.

Count 7: Eighth Amendment deliberate indifference to serious medical needs claim

against Defendants Wexford and Dr. Siddiqui for the failure to enforce the

prison deadlock policy or protocol.

Count 9: Eighth Amendment claim against Defendant Dr. Siddiqui for deliberate

indifference to Plaintiff’s serious medical needs.

(Doc. 55, pp. 7-8).

Summary judgment is proper if the moving party can demonstrate that there is no genuine

issue as to any material fact — that is where the non-moving party “has failed to make a sufficient

showing on an essential element of her case with respect to which she has the burden of proof.”

Fed. R. Civ. P. 56(a); Celotex Corp. v. Catrett, 477 U.S. 317, 322-323 (1986). If the evidence is

merely colorable or is not sufficiently probative, summary judgment should be granted.

Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249-50 (1986). Any doubt as to the existence of a

genuine issue of material fact must be resolved against the moving party. Lawrence v. Kenosha

County, 391 F.3d 837, 841 (7th Cir. 2004).

The Eighth Amendment prohibits deliberate indifference to the serious medical needs of

prisoners. Machicote v. Roethlisberger, 969 F.3d 822, 827 (7th Cir. 2020) (citing Estelle v.

Gamble, 429 U.S. 97, 104 (1976)). To prevail on a claim for deliberate indifference to a serious

medical need, a plaintiff must first demonstrate that they suffered from an objectively serious

medical condition. Dunigan ex rel. Nyman vy. Winnebago Cnty., 165 F.3d 587, 590-592 (7th Cir.

1999). Second, the plaintiff must establish that the defendant actually knew of and disregarded a

substantial risk of harm. Murphy v. Wexford Health Sources Inc., 962 F.3d 911, 915 (7th Cir.

2020).

“An objectively serious medical need is ‘one that has been diagnosed by a physician as

mandating treatment or one that is so obvious that even a lay person would easily recognize the

necessity for a doctor’s attention.’” King v. Kramer, 680 F.3d 1013, 1018 (7th Cir. 2012).

Thornton’s testimony regarding intermittent neck and shoulder pain from a decade-old injury does

not support a finding of a diagnosed medical condition mandating treatment, or a need for medical

attention that a lay person would recognize. And even if Thornton’s neck and shoulder pain was

a chronic or degenerative condition, to qualify as an objectively serious condition it must have

been able to cause “harm that may escalate and have significant future repercussions unless

adequately treated.” McDonald v. Hardy, 821 F.3d 882, 889 (7th Cir. 2016) (discussing high

cholesterol as such a condition that can “progress over an extended period without apparent side

effects before eventually reaching a crisis point”). Thornton has neither established that his neck

pain could escalate nor that it poses some future risk of becoming a serious medical issue.!

Moreover, based on the evidence on record, no reasonable jury could conclude that Defendants

acted with deliberate indifference to Thornton’s medical needs.

Thornton requests that this Court take judicial notice of two cases in the Northern District of Illinois that found he

had an objectively serious medical condition, but they only found he had an objectively serious condition after

sustaining another injury. Thornton v. Dr. Baker, 13-cv-8029, ECF No. 126, pg. 6 (N.D. Ill. Aug. 24, 2016) (‘plaintiff

suffered a serious medical condition after the July 18, 2012 fall [a slip and fall] to create a genuine issue of □□□□□□□

Thornton v. Dr. Baker, 14-cv-6477, ECF No. 98, p. 4 (N.D. Ill. Aug. 24, 2016) (“Plaintiff asserted that he was pushed

to the ground during a fight and injured”). Neither case resulted in a finding that his decade-old bullet injury was, by

itself, an objectively serious condition.

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Mary Jo Zimmer, LPN

Thornton alleges that Nurse Zimmer was deliberately indifferent to his needs by denying

him medical care on August 9, 2018, which was Thornton’s only appointment with Zimmer. Nurse

Zimmer’s alleged refusal to provide Thornton with additional or modified pain medication cannot

support a finding of deliberate indifference as Thornton has not established a medical need for

such medication aside from his own preferences. Forbes v. Edgar, 112 F.3d 262, 266–67 (7th Cir.

1997) (Eighth Amendment does not mandate that providers offer specific treatment or the

treatment of Plaintiff’s choice). And even crediting Thornton’s testimony that Nurse Zimmer did

not issue a front cuff permit to him as requested, there is no evidence establishing the front cuff

was medically necessary or that Nurse Zimmer was responsible for issuing such permits in Menard

Correctional Center.

Wexford Health Sources, Inc.

Thornton claims that Wexford violated the Eighth Amendment by allowing unqualified

medical personnel to perform licensed professional’s duties and/or allowing LPNs and CMTs to

render medical services they are not qualified to provide, and by failing to enforce the prison

deadlock policy or protocol. Thornton’s claim against Wexford for hiring unqualified

professionals is based on part on the Illinois Nurse Practice Act, 225 ILCS § 65/50-10 (“the Nurse

Act”). Although Thornton could not identify any specific violation of the Nurse Act, he alleges

that the report in Lippert v. Baldwin outlined a violation of it. Lippert v. Baldwin, No. 10 C 4603,

2017 WL 1545672, at *1 (N.D. Ill. Apr. 28, 2017) (referencing the report of a court-appointed

medical expert, Dr. Ronald Shansky). Thornton attaches several pages of the report that detail an

investigation that occurred at Menard between May 21 to May 25, 2018 (Doc. 232, p. 104). The

investigation did find “systematic issues that present ongoing risk of harm to patients” and an

“extraordinary number of vacancies” but the excerpt that Thornton attaches does not reference the

Nurse Act. (Id.)

The Nurse Act generally prohibits any unlicensed person from engaging in the practice of

nursing. 225 ILCS § 65/50-50(a) (“No person shall . . . (2) Practice professional nursing without a

valid license as a registered professional nurse”). However, the Nurse Act authorizes delegating

nursing interventions to other unlicensed personnel based on a number of factors, including the

stability and condition of the patient, the potential for harm, and the complexity of the nursing

intervention. 225 ILCS § 65/50-75(b)(1). The Nurse Act defines a “Nursing Intervention” as, “any

treatment based on clinical nursing judgment or knowledge that a nurse performs.” 225 ILCS §

65/50-10. Plaintiff alleges that these other individuals are not qualified to perform medical

assessments and formulate treatment plans without the supervision of a registered nurse” (Doc. 55,

pg. 6).

The above exceptions in the Nurse Act permit unlicensed medical personnel to work in

medical environments if the delegation of the tasks satisfies the factors outlined in the Nurse Act.

225 ILCS § 65/50-75(b)(1). Even if Thornton is correct that there were unlicensed nurses

practicing at Menard, the Nurse Act is clear that “delegation” is not synonymous with “oversight”:

“’Delegation’ means transferring to a specific individual the authority to perform a specific nursing

intervention in a specific situation.” 225 ILCS § 65/50-75(a). Thornton has not shown that any

such persons were working completely independently or that any delegations were improper, in

violation of the Nurse Act. More importantly, Thornton has not shown that he was treated by any

independent and unlicensed personnel on the dates at issue, or that it personally caused him harm.

Higgason v. Farley, 83 F.3d 807, 810 (7th Cir. 1996) (plaintiffs lack standing in §1983 actions

where they allege that the constitutional rights of other inmates were violated, but not that their

individual rights were violated). Thornton only alleges that he met a Jane Doe who was

“unqualified” to treat him but fails to substantiate these allegations or show how they affected his

treatment (Doc. 232, pp. 16-17 at ¶¶ 9-14).

Thornton’s claim against Wexford for allegedly hiring unqualified professionals fails to

meet the Monell standard as well. A private corporation that has contracted to provide essential

government services is subject to liability under Section 1983. Monell v. New York City Dep't of

Soc. Servs., 436 U.S. 658 (1978). But to succeed on a Monell claim, the plaintiff must “show a

direct causal connection between the policy or practice and his injury.” Rice ex rel. Rice v. Corr.

Med. Servs., 675 F.3d 650, 675 (7th Cir. 2012). Thornton has not shown that any policy or practice

of hiring unqualified professionals related to his neck pain.

Thornton also claims that Wexford’s failure to implement a deadlock policy (locking his

cell so that other inmates could not access it) constitutes deliberate indifference. To state a failure

to protect claim, a prisoner must allege that (1) he is incarcerated under conditions posing a

substantial risk of serious harm, and (2) the defendant(s) acted with deliberate indifference to that

risk. Brown v. Budz, 398 F.3d 904, 909 (7th Cir. 2005). “’Deliberate indifference’ . . . is merely

a synonym for intentional or criminally reckless conduct,” or “conduct ‘that reflects complete

indifference to risk — when the actor does not care whether the other person lives or dies, despite

knowing that there is a significant risk of death.’” Salazar v. City of Chicago, 940 F.2d 233, 238

(7th Cir. 1991). To find deliberate indifference, there must be “substantial indifference in the

individual case, indicating more than mere negligent or isolated occurrences of neglect.” Gutierrez

v. Peters, 111 F.3d 1364, 1375 (7th Cir. 1997). Therefore, “[a] finding that a defendant’s neglect

of a prisoner’s condition was an isolated occurrence . . . . to the defendant’s overall treatment of

the prisoner ordinarily militates against a finding of deliberate indifference.” Id.

Here, Thornton failed to proffer evidence that there was any reason for his cell to be

deadlocked, much less that any alleged failure by Wexford constituted deliberate indifference to

any risk to his person. As such, Wexford will be granted summary judgment on this basis as well.

Dr. Mohammad Siddiqui

For the reasons stated above, Dr. Siddiqui is also entitled to summary judgment on

Thornton’s Eighth Amendment claims for (1) allowing unqualified medical personnel to perform

licensed professional’s duties and/or allowing LPNs and CMTs to render medical services they

are not qualified to provide, and for (2) failing to enforce the prison deadlock policy or protocol.

Although Dr. Siddiqui was a medical director for the Menard facility, there is no evidence that he

was involved in any policy to improperly staff the facility or failing to enforce a deadlock policy.

The only remaining claim against Dr. Siddiqui is deliberate indifference to Thornton’s

medical issues. Because Dr. Siddiqui never treated Thornton directly, deliberate indifference can

only arise from Dr. Siddiqui’s responses to Thornton’s various grievances. While Thornton may

disagree with Dr. Siddiqui’s responses, he answered every grievance with responses evidencing

his medical and professional judgments. And although Thornton argues that Dr. Siddiqui ignored

his complaints of constant pain, there is no evidence of this in the record. Thornton was

consistently offered pain medication in the crush and float manner. Thornton asserts that Dr.

Siddiqui should have done more to treat his condition, he has provided no evidence to support this

vague assertion. See Snipes v. DeTella, 95 F.3d 586, 592 (7th Cir. 1996) (“Constitution is not a

medical code that mandates specific medical treatment”).

Conclusion

For the foregoing reasons, Defendants Dr. Mohammad Siddiqui, Wexford Health Sources,

Inc., and Mary Jo Zimmer’s Motion for Summary Judgment (Doc. 209) is GRANTED. As no

claims remain, the Clerk of Court is DIRECTED to enter judgment accordingly and close this

case.

IT IS SO ORDERED. Aol Ge

DATED: March 31, 2024

STACI M. YANDLE

United States District Judge

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