The opinion
IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ILLINOIS
CHARLES FITZPATRICK,
Plaintiff,
v. Case No. 20-CV-01218-SPM
WEXFORD HEALTH
SOURCES, INC., et al.,
Defendants.
MEMORANDUM AND ORDER
McGLYNN, District Judge:
Pending before the Court are two Motions for Summary Judgment—one filed
by Defendants Wexford Health Sources, Inc.; Mohammed Siddiqui, M.D.; Alisa
Dearmond; Michael Moldenhauer; and Mary Jo Zimmer (Doc. 88) and the second filed
by Defendants Rob Jeffreys and Anthony Wills (Doc. 91). Pro se Plaintiff Charles
Fitzpatrick filed a Response. (Doc. 94). Having been fully informed of the issues
presented, this Court GRANTS both Motions for Summary Judgment.
RELEVANT FACTUAL AND PROCEDURAL BACKGROUND
Pro se Plaintiff Charles Fitzpatrick is an inmate presently incarcerated at
Menard Correctional Center in Menard, Illinois. (See Doc. 1). The instant case arises
from treatment Fitzpatrick received for an abdominal lump (later determined to be
abdominal wall pain) while at Menard. (See id.). Fitzpatrick filed the instant lawsuit
on November 9, 2020. (See id.). This Court conducted preliminary review of
Fitzpatrick’s Complaint pursuant to 28 U.S.C. § 1915A on September 27, 2021. (Doc.
11). The Court consolidated Fitzpatrick’s claims as follows: (1) a claim that he was
denied adequate medical care by Defendants Dr. Siddiqui; Nurse Practitioners
Deamond, Moldenhauer, and Zimmer; and Healthcare Unit Administrator Crain1
and that Defendants Jeffreys (the Director of the Illinois Department of Corrections)
and Wills (the Warden at Menard) failed to intervene in violation of the Eighth
Amendment (Doc. 11, p. 5 (citing Doc. 1, pp. 13–15)); (2) that Defendant Wexford’s
alleged cost-saving practices resulted in his abdominal lump and associated pain
being improperly treated (Id., p. 6); and (3) that Defendants Jeffreys and Wills “knew
that the healthcare unit was understaffed through grievances he filed and filed by
other inmates and ‘deliberately turned a blind eye.’” (Id. (citing Doc. 1, p. 12)).
Defendants Wexford, Siddiqui, Dearmond, Moldenhauer, and Zimmer filed a
Motion for Summary Judgment on March 24, 2022 (Doc. 46); Defendants Jeffreys,
Wills, and Crain filed a separate Motion for Summary Judgment on April 25, 2022
(Doc. 53). The Court denied both motions on October 28, 2022. (See Doc. 63). The
Court held a Pavey hearing on January 19, 2023 (see Doc. 69) and determined on June
29, 2023 that Fitzpatrick had exhausted his administrative remedies against all of
the Defendants with the exception of Defendant Crain; Fitzpatrick’s claims against
her were dismissed with prejudice. (See Doc. 75). Each group of Defendants filed a
Motion for Summary Judgment on June 6, 2024. (See Docs. 88, 91). Fitzpatrick
responded on July 31, 2024. (See Doc. 94). Defendants Wexford, Siddiqui, Deamond,
Moldenhauer, and Zimmer filed a Reply on August 14, 2024. (See Doc. 95).
1 The Court dismissed Fitzpatrick’s claims against two unnamed individuals on October 28, 2022 for
failure to file a motion to substitute their actual names by the Court’s deadlines. (See Doc. 63).
APPLICABLE LAW AND LEGAL STANDARDS
The court shall grant summary judgment “if the movant shows that there is no
genuine dispute as to any material fact and the movant is entitled to judgment as a
matter of law.” Spurling v. C & M Fine Pack, Inc., 739 F.3d 1055, 1060 (7th Cir. 2014)
(quoting Fed. R. Civ. P. 56(a)). Once the moving party has set forth the basis for
summary judgment, the burden then shifts to the nonmoving party who must go
beyond mere allegations and offer specific facts showing that there is a genuine issue
of fact for trial. Fed. R. Civ. P. 56(e); see Celotex Corp. v. Catrett, 477 U.S. 317, 322–
23 (1986). Stated another way, the nonmoving party must offer more than
“[c]onclusory allegations, unsupported by specific facts,” to establish a genuine issue
of material fact. Payne v. Pauley, 337 F.3d 767, 773 (7th Cir. 2003) (citing Lujan v.
Nat’l Wildlife Fed’n, 497 U.S. 871, 888 (1990)).
In determining whether a genuine issue of fact exists, the Court must view the
evidence and draw all reasonable inferences in favor of the party opposing the motion.
Bennington v. Caterpillar Inc., 275 F.3d 654, 658 (7th Cir. 2001); see also Anderson v.
Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). “A genuine issue of material fact arises
only if sufficient evidence favoring the nonmoving party exists to permit a jury to
return a verdict for that party.” Faas v. Sears, Roebuck & Co., 532 F.3d 633, 640–41
(7th Cir. 2008) (quoting Springer v. Durflinger, 518 F.3d 479, 483 (7th Cir. 2008)).
The non-movant cannot simply rely on its pleadings; the non-movant must present
admissible evidence that sufficiently shows the existence of each element of its case
on which it will bear the burden of proof at trial. Midwest Imps., Ltd. v. Coval, 71
F.3d 1311, 1317 (7th Cir. 1995) (citing Serfecz v. Jewel Food Stores, 67 F.3d 591, 596
(7th Cir. 1995); Greater Rockford Energy & Tech. Corp. v. Shell Oil Co., 998 F.2d 391,
394 (7th Cir. 1993), cert. denied, 510 U.S. 1111 (1994); Celotex, 477 U.S. at 323–24).
ANALYSIS
The Eighth Amendment prohibits cruel and unusual punishment and
deliberate indifference to the “serious medical needs of a prisoner [which] constitutes
the unnecessary and wanton infliction of pain forbidden by the Constitution.”
Rodriguez v. Plymouth Ambulance Serv., 577 F.3d 816, 828 (7th Cir. 2009) (citation
omitted). A prisoner is entitled to “reasonable measures to meet a substantial risk of
serious harm”—not to demand specific care. Forbes v. Edgar, 112 F.3d 262, 267 (7th
Cir. 1997).
Claims for deliberate indifference have an objective and a subjective
component. Estelle v. Gamble, 429 U.S. 97 (1976). Fitzpatrick must establish that he
suffered from an objectively and sufficiently serious medical condition. Cesal v.
Moats, 851 F.3d 714, 721 (7th Cir. 2017). He must also show that the Defendants
actually knew of, but disregarded, a substantial risk to the inmate’s health. Cesal,
851 F.3d at 721. “Intentional delays in medical care may constitute deliberate
indifference, even if the inmate’s medical condition is non-life threatening.” Id. at 722
(quoting Arnett v. Webster, 658 F.3d 742, 753 (7th Cir. 2011)). “A doctor’s choice of
‘easier and less efficacious treatment’ for an objectively serious medical condition also
may be sufficient . . . [,] [b]ut ‘mere disagreement with a doctor’s medical judgment’
is not enough to support an Eighth Amendment violation.” Id. (first quoting Estelle,
429 U.S. at 104 & n.10; then quoting Berry v. Peterman, 604 F.3d 435, 441 (7th Cir.
2010)).
Additionally, it is well-settled that mere negligence is not enough to establish
a Defendant’s deliberate indifference. See, e.g., Davidson v. Cannon, 474 U.S. 344,
347-48 (1986). In fact, even gross negligence is insufficient. King v. Kramer, 680 F.3d
1013, 1018 (7th Cir. 2012). Instead, deliberate indifference is comparable to criminal
recklessness. Thomas v. Blackard, 2 F.4th 716 (7th Cir. 2021) (citing King, 680 F.3d
at 1018). “‘Reckless’ describes conduct so dangerous that the deliberate nature of the
defendant’s actions can be inferred.” Jackson v. Illinois Medi-Car, Inc., 300 F.3d 760,
765 (7th Cir. 2002) (quoting Qian v. Kautz, 168 F.3d 949, 955 (7th Cir. 1999)).
Assessing the subjective prong is more difficult in cases alleging inadequate
care as opposed to a lack of care. Without more, a “mistake in professional judgment
cannot be deliberate indifference.” Whiting v. Wexford Health Sources, Inc., 839 F.3d
658, 662 (7th Cir. 2016). The Seventh Circuit has explained:
By definition a treatment decision that’s based on professional judgment
cannot evince deliberate indifference because professional judgment
implies a choice of what the defendant believed to be the best course of
treatment. A doctor who claims to have exercised professional judgment
is effectively asserting that he lacked a sufficiently culpable mental
state, and if no reasonable jury could discredit that claim, the doctor is
entitled to summary judgment.
Id. (quoting Zaya v. Sood, 836 F.3d 800, 805–06 (7th Cir. 2016)). This is in contrast
to a case “where evidence exists that the defendant knew better than to make the
medical decision that [he] did.” Id. (quoting Petties v. Carter, 836 F.3d 722, 731 (7th
Cir. 2016)) (cleaned up). A medical professional’s choice of an “easier and less
efficacious treatment” can rise to the level of violating the Eighth Amendment,
however, where the treatment is known to be ineffective but is chosen anyway. Berry,
604 F.3d at 441 (quoting Estelle, 429 U.S. at 104 & n.10). The Seventh Circuit has
“characterized the standard as imposing a high hurdle on plaintiffs because it
requires a ‘showing as something approaching a total unconcern for the prisoner’s
welfare in the face of serious risks.’” Rosario v. Brawn, 670 F.3d 816, 821 (7th Cir.
2012) (quoting Collins v. Seeman, 462 F.3d 757, 762 (7th Cir. 2006)).
The first question before the Court is whether Fitzpatrick’s abdominal lump
qualified as a “serious” medical condition. Fitzpatrick argues that it was (see Doc. 1,
p. 7) and Defendants Jeffreys and Wills argue that his abdominal lump and
associated pain were not “life-threatening” and “did not constitute a substantial risk
to the Plaintiff’s safety or represent injuries for which failure to treat could result in
further significant injury to Plaintiff.” (Doc. 91, pp. 13–14 (quoting id., ¶ 9)).
First, “the Supreme Court contemplated that medical conditions far less
critical than ‘life-threatening’ would be encompassed by the term.” Gutierrez at 1370.
“Indeed, the inmate in Estelle based his medical care claim ‘solely on the lack of
diagnosis and inadequate treatment of his back injury,’ which had been diagnosed by
prison doctors as a lower back strain and treated with muscle relaxants and pain
medication.” Id. at 1370–71 (quoting Estelle at 107). The Seventh Circuit concluded
in Gutierrez that an infected pilonidal cyst was a sufficiently “serious” medical need,
like the back injury in Estelle; injuries from an assault by prison guards in Cooper v.
Casey, 97 F.3d 914, 917–17 (7th Cir. 1996); and psychological treatment in Antonelli
v. Sheahan, 81 F.3d 1422, 1432 (7th Cir. 1996). See Gutierrez at 1371–72. However,
the Seventh Circuit put common colds, toes with removed toenails, and mild asthma
as being outside the ambit of “serious” medical needs. See id. at 1372 (citing Gibson
v. McEvers, 631 F.2d 95 (7th Cir. 1980); Snipes v. DeTella, 95 F.3d 586, 591 n.1 (7th
Cir. 1996), cert. denied, 519 U.S. 1126 (1997); Oliver v. Deen, 77 F.3d 156 (7th Cir.
1996)).
With all of the above in mind, the Seventh Circuit noted that “[i]t is a far easier
task to identify a few exemplars of conditions so plainly trivial and insignificant as to
be outside the domain of Eighth Amendment concern than it is to articulate a
workable standard for determining ‘seriousness’ at the pleading stage.” Id. at 1372.
Notably, Gutierrez involved a suit dismissed at the pleadings, not a case at the point
of summary judgment as in the instant case. The Seventh Circuit has “recognized
that ‘a hernia can be an objectively serious medical problem’ and that for some
hernias, the ‘chronic pain presents a separate objectively serious condition.’” Wilson
v. Wexford Health Sources, Inc., 932 F.3d 513, 521 (7th Cir. 2019) (quoting Gonzalez
v. Feinerman, 663 F.3d 311, 314 (7th Cir. 2011)). While a hernia was eventually ruled
out as the cause of Fitzpatrick’s pain, he does describe the abdominal lump as being
painful. (See Docs. 1, 94). Because Fitzpatrick’s lump caused him “excruciating pain”
(Doc. 94, p. 18) and required various treatments as well as diagnostic labs and
imaging, the Court holds that Fitzpatrick’s abdominal lump was a sufficiently serious
medical need in line with the first prong of the deliberate indifference standard. See
Cesal, 851 F.3d at 721.
I. Defendants Siddiqui, Dearmond, Moldenhauer, and Zimmer
We then move to the question of whether each of the medical provider
Defendants were deliberately indifferent to Fitzpatrick’s abdominal lump. In Cesal,
the Seventh Circuit found that a prison physician was not deliberately indifferent to
an inmate’s back injury because there was not “any reason in this record to think that
starting with the physician assistant and nurse was not a reasonable step.” Id. at
723. While Fitzpatrick argues that there were significant delays in his treatment, the
Seventh Circuit has stated that “[o]ne thing which has long been clear in our Eighth
Amendment cases is that the amendment is not coterminous with a medical
malpractice claim.” Forbes v. Edgar, 112 F.3d 262, 266 (7th Cir. 1997) (citing Bryant
v. Madigan, 84 F.3d 246 (7th Cir. 1996); Oliver v. Deen, 77 F.3d 156 (7th Cir. 1996);
Snipes v. DeTella, 95 F.3d 586 (7th Cir. 1996), cert. denied, 519 U.S. 1126 (1997)).
Additionally, prisoners are “not entitled to the best care possible” but rather “to
reasonable measures to meet a substantial risk of serious harm to her.” Forbes v.
Edgar, 112 F.3d 262, 267 (7th Cir. 1997). When a prisoner sought “specific treatment
and foolproof protection from infection,” the Seventh Circuit stated that “[t]he Eight
[sic] Amendment does not provide her with either.” Forbes, 112 F.3d at 266.
Fitzpatrick began experiencing what he describes as a painful lump on the left
side of his abdomen while making noodles at a sink in October 2019; he first sought
treatment for it at sick call on November 15, 2019 and was prescribed antacid tablets.
(See Doc. 89, Ex. C, p. 1; Doc. 91, ¶ 7 (citing Doc. 91, Ex. A, 27:19–28:7; 29:9–15;
110:4–8)). He was seen again at sick call on March 5, 2020; Fitzpatrick refused both
acetaminophen and ibuprofen for his pain. (See Doc. 89, Ex. C, pp. 3–5). On March
26, 2020, he was seen by Defendant Moldenhauer, who prescribed Colace and
submitted a collegial review. (See id., Ex. C, p. 5). A request for an ultrasound was
sent on April 7, 2020. (See id., Ex. C, p. 6). Fitzpatrick was seen again on April 13 and
14, 2020; it was noted that labs were ordered and that Fitzpatrick had zero pain with
palpation of the lump, although he did describe the pain as “excruciating” on April
13. (id., Ex. C, p. 7; see id., Ex. C, pp. 7–8). He was seen again by Defendant
Moldenhauer on April 21, 2020, who indicated that Fitzpatrick was awaiting testing.
(See id., Ex. C, p. 9). Fitzpatrick was next seen at sick call on May 19, 2020 and it was
noted that he was waiting for an x-ray. (See id., Ex. C, pp. 10–11). He was seen by
Defendant Siddiqui on May 26, 2020, who noted no indications of a hernia and “no
lumps on back or head.” (See id., Ex. C, p. 12).
Fitzpatrick had an ultrasound on May 28, 2020 and was seen by Defendant
Zimmer later the same day. (See id., Ex. C, p. 13). Fitzpatrick subsequently had a
chest x-ray and kidney, ureter, and bladder x-ray on June 18, 2020. (See id., Ex. C, p.
14). Fitzpatrick saw Defendant Dearmond on June 19, 2020 and was informed that
none of the imaging indicated that a hernia was present; Defendant Dearmond
prescribed “capsaicin cream to apply twice a day as needed for six months” and “400
milligrams of Neurontin to be taken twice daily for six months.” (Doc. 89, ¶21; see id.,
Ex. C, p. 15). Fitzpatrick was next seen by Dr. Reynal Caldwell on July 29, 2020; Dr.
Caldwell ordered an upper GI barium test. (See id., Ex. C, p. 16). At collegial review,
Fitzpatrick’s upper GI barium test was denied and an alternative treatment plan was
adopted including checking Plaintiff’s commissary list, a fecal occult blood test, trial
H2 blockers, and Bentyl. (See id., Ex. C, p. 17). Fitzpatrick’s appointment with
Defendant Zimmer on August 25, 2020 was cancelled due to “institutional deadlock.”
(See id., Ex. C, p. 18). Defendant Moldenhauer next saw Fitzpatrick on September 1,
2020 and discussed the alternative treatment plan, which included “urinalysis
(“UA”), comprehensive metabolic panel (“CMP”), complete blood count (“CBC”) with
a stool occult blood test on three consecutive bowel movements”; Fitzpatrick was
prescribed “20 milligrams of Bentyl twice daily and 40 milligrams of Prilosec both for
three months.” (Id., ¶ 31 (citing id., Ex. C, p. 63; Ex. F, ¶ 7)).
Fitzpatrick saw Defendant Siddiqui on November 11, 2020. (See id., Ex. C, p.
20). Fitzpatrick “reported no nausea or bowel symptoms” and “reported that Bentyl
and Prilosec were not effective in treating his symptoms” and “demanded an outside
referral.” (Id., ¶ 33). “Dr. Siddiqui noted that all testing, including the ultrasound,
was normal” and that Plaintiff’s abdomen was flat and nontender with no discernable
hernia.” (Id.). “His diagnosis during this encounter was that Plaintiff had nonspecific
pain in his abdomen.” (Id.).
Fitzpatrick was next seen by a nurse on March 27, 2021 and by Defendant
Moldenhauer on April 2, 2021. (See id., Ex. C, pp. 21–23). A collegial review was
submitted for an abdominal CT scan. (See id., Ex. C, p. 23). The CT scan was
performed on May 19, 2021 and “found no acute abnormalities in the abdomen or
pelvis and a potential prostatic utricle cyst.” (Id., ¶ 36; see id., Ex. C, p. 24).
Fitzpatrick had another x-ray on April 11, 2023 and another CT scan on April 28,
2023, both of which showed no abnormalities. (Id., ¶¶ 38–39 (citing Plaintiff’s Medical
Records Produced by IDOC, Ex. E, pp. 676, 793; Ex. D, ¶¶ 28–29)). An MRI on May
31, 2023 showed “a prostatic utricle cyst and potential scarring or prostatitis.” (Id., ¶
40 (citing Ex. D, ¶ 30; Ex. E, p. 698)). On June 1, 2023, an outside doctor “noted that,
given the character of the pain as sharp, transient, and aggravated by movement, as
well as the unremarkable labs and CT scan, he was given a diagnosis of abdominal
wall pain.” (Id., ¶ 42 (citing Ex. A, 78:10–18; Ex. E, pp. 702–05)).
The record is clear that Fitzpatrick was seen numerous times by Nurse
Practitioners Dearmond, Moldenhauer, and Zimmer as well as by Dr. Siddiqui. (See
Doc. 89, pp. 2–8; Doc. 91, pp. 2–7). The medical providers ordered diagnostic imaging
to assess Fitzpatrick’s abdominal lump, including an ultrasound; kidney, ureter, and
bladder x-ray; chest x-ray; CT scans; and an MRI. (See Doc. 89, pp. 2–8; Doc. 91, pp.
2–7). They also ordered blood testing and prescribed various medications to treat
Fitzpatrick’s symptoms. (See Doc. 89, pp. 2–8; Doc. 91, pp. 2–7). While Fitzpatrick
argues that he was in “constant pain” (Fitzpatrick Dep. 100:13; 103:18–22) and
described it as “excruciating” on April 13, 2020 (Doc. 89, Ex. C, p. 7), the pertinent
medical documentation states that Fitzpatrick had zero pain with palpation of the
lump and it was noted that the paint was “chronic” and “transient,” not constant as
Fitzpatrick claims. (Doc. 89, ¶ 42 (citing Ex. A, 78:10–18; Ex. E, pp. 702–05)).
Additionally, Fitzpatrick refused acetaminophen and ibuprofen when he was offered
it for pain management. (See Doc. 89, Ex. C, pp. 3–5).
Although Fitzpatrick did file grievances regarding his medical treatment, his
grievance from August 26, 2020 (Doc. 1, p. 32) states that he had been having pain
since March 2020, not from October 2019 as he indicated in his Deposition. See
Fitzpatrick Dep. 110:3–8. While Fitzpatrick states in his Deposition that the “whole
process is terrible” (id. 111:2–3), the medical record indicates that his concerns were
acknowledged via numerous sick call visits, imaging, and diagnostic analysis, most
of which showed no abnormalities. While Fitzpatrick takes issues with specific delays
in his care due to an influenza quarantine and because of delays associated with
collegial review, neither of these facts indicate that the medical provider Defendants
were deliberately indifferent to his medical needs; instead, Fitzpatrick’s medical
record showed that the Defendants addressed his concerns through various
medications, diagnostics tests, and treatment plans.
Fitzpatrick also argues that the medical provider Defendants intentionally
delayed his treatment as a cost-saving measure. (See Doc. 1, pp. 4–11; Doc. 94, pp. 6–
11). However, he has not provided any evidence that he was denied treatment as a
cost-saving measure by any of the medical provider Defendants. See Fitzpatrick Dep.
84:23–88:24.
Therefore, construing the evidence in favor of Fitzpatrick, the Court holds that
a jury could not find that Defendants Siddiqui, Dearmond, Moldenhauer, or Zimmer
were deliberately indifferent to Fitzpatrick’s abdominal lump in violation of the
Eighth Amendment. For this reason, their Motion for Summary Judgment must be
granted.
II. Defendant Wexford Health Sources, Inc.
The Seventh Circuit has held that “a private corporation is not vicariously
liable under § 1983 for its employees’ deprivations of others’ civil rights.” Wilson, 932
F.3d at 521 (quoting Iskander v. Village of Forrest Park, 690 F.2d 126, 128 (7th Cir.
1982)). “The plaintiff may try, however, to demonstrate that a private corporation has
a company policy or rule that is the ‘moving force of the constitutional violation.’” Id.
(quoting Iskander at 128); see Monell v. Dep’t of Soc. Servs. of City of N.Y., 436 U.S.
658, 694 (1978). Fitzpatrick argues that Wexford “has a policy to deliberately
understaff its Healthcare Unit (HCU) at Menard to save money,” that it “has allowed
non-medical persons [to] make medical decisions,” that “medical staff are allowed to
constantly break the rules without consequence or discipline,” and that they are
aware of these issues because of grievances filed by inmates and because of “the many
many many [sic] 1983 lawsuits that have been filed about these medical staff
deliberately denying medical care to inmates.” (Doc. 1, pp. 4, 8, 9, 10). Fitzpatrick
argues that the sick call forms show that Wexford has “a policy in place . . . to give
only Tylenol & Ibuprofen for pain to save money even though they know that this
does not help with managing the pain or stopping the pain” and that he “made it
known that he was in excruciating pain & the medications the Defendants were
giving him were not helping to manage or stop his pain.” (Id., pp. 13–14). He argues
that the prison sick call forms evince “a procedure called standard protocol or
standing protocol about the Tylenol, the Ibuprofen.” Fitzpatrick Dep. 83:18–20.
Fitzpatrick also points to the “civil class action lawsuit Lippert v. Godinez/Baldwin
filed in 2010 & believed to be settled in 2019” as evidence of Wexford’s deliberate
understaffing. (Doc. 94, p. 10).
Wexford argues that “Plaintiff’s evidence of the Wexford policy of deliberate
understaffing consists of his personal observations as well as vague statements of
unidentified nurses.” (Doc. 89, p. 15). They also argue that “Plaintiff’s evidence of a
Wexford policy of giving only Tylenol and Ibuprofen rests solely on the fact that those
two medications are listed on the outpatient progress note form” and that “Plaintiff’s
own medical records reflect that other medications can be written on these forms, and
also that Tylenol and Ibuprofen are often not prescribed.” (Id., p. 16 (citing id., Ex.
C)). Wexford also argues that “Plaintiff presents no evidence of the alleged Wexford
policy of considering cost above all else when determining a course of medical
treatment” and that Wexford does not have any “policy, protocol, or practice, either
written or unwritten, of (1) not adequately training or supervising their medical staff,
(2) using the collegial review process to deny medical care, (3) limiting pain medicine
to only Tylenol and Ibuprofen, or (4) delaying or cancelling medical appointments at
correctional facilities to save money.” (Id.)
Wexford is correct that Fitzpatrick has provided zero evidence of any
unconstitutional policy at Wexford besides personal anecdotes and observations. As
Wexford states, “without evidence of an unconstitutional policy[,] Plaintiff’s claims as
to Wexford must be dismissed.” (Id., p. 15 (citing Shields v. Ill. Dep’t of Corr., 746
F.3d 782, 789 (7th Cir. 2014); Iskander, 690 F.2d at 128)). Therefore, even considered
the evidence in the light most favorable to him, Fitzpatrick has failed to rebut
Wexford’s assertion that there is not a genuine dispute of material fact sufficient for
his claims against Wexford to be presented to a jury.
III. Defendants Jeffreys and Wills
A. Sovereign Immunity
Defendants Jeffreys and Wills first argue that they are entitled to sovereign
immunity. (See Doc. 91, pp. 9–10). They argue that, because “[a] suit against a State
officer in his official capacity is actually against the State,” that Fitzpatrick’s Eighth
Amendment deliberate indifference claims are barred by sovereign immunity. (Id., p.
9 (citing Wilson v. Quinn, 2013 IL App. (5th) 120337)). They argue that the factors
elucidated in Shirley v. Harmon, 405 Ill. App. 3d 86 (2nd Distr. 2010) indicate that
sovereign immunity shields both of them in the instant case. (See Doc. 91, p. 9
(quoting Shirley at 91 (“An action will be considered against the State, and thus,
within the exclusive jurisdiction of the Court of Claims, where: “(1) [T]here are no
allegations that a state employee acted beyond the scope of his authority through
wrongful acts; (2) the employee did not allegedly breach a duty owed to the public
generally independent of his state employment; and (3) the complained-of actions
involve matters ordinarily within the employee’s normal and official functions with
the State.’”))). Defendants Jeffreys and Wills argue that “there is no allegation in the
complaint that either Defendant acted beyond the scope of his authority as the
director of the Illinois Department of Corrections (Jeffreys) or warden of Menard
(Wills)”; that “the alleged breaches are based upon what Plaintiff believes to be a duty
owed specifically to Plaintiff as an inmate at Menard Correctional Center, not the
public generally independent of Defendant’s state employment”; and that “the
complained-of actions involve matters ordinarily within Defendants’ normal and
official functions.” (Id., p. 10 (citations omitted)). Fitzpatrick does not respond to
Defendants Jeffreys’s and Wills’s sovereign immunity arguments.
The Seventh Circuit has upheld the determinations of district courts that
state agencies are not “‘persons’ amenable to suit under § 1983.” Cullen v. Saddler,
668 F. App’x 656 (7th Cir. 2016) (citing Will v. Mich. Dep’t of State Police, 491 U.S.
58, 71 (1989); Wagoner v. Lemmon, 778 F.3d 586, 592 (7th Cir.), cert. denied, 577 U.S.
925 (2015) (Mem.); Fairley v. Fermaint, 482 F.3d 897, 904 (7th Cir. 2006)). However,
while Defendants Jeffreys and Wills argue that Fitzpatrick’s claims against them are
actually against state agencies, Fitzpatrick is clear that he is suing them as
individuals, not merely as a means to attempt to sue state agencies. (See id., p. 9
(citing Wilson v. Quinn, 2013 IL App. (5th) 120337); see also Docs. 1, 94). As the
Seventh Circuit caselaw is clear, the Court holds that sovereign immunity does not
bar Fitzpatrick’s claims against Defendants Jeffreys and Wills.
B. Deliberate Indifference
Fitzpatrick brings two separate claims against Defendants Jeffreys and
Wills—he argues that the two of them were deliberately indifferent to his treatment
by Defendants Siddiqui, Dearmond, Moldenhauer, and Zimmer and that Jeffreys and
Wills “deliberately turned a blind eye” to the understaffing in the HCU. (Doc. 1, pp.
12–13). Jeffreys and Wills argue that they were not deliberately indifferent to
Fitzpatrick’s treatment (Id., pp. 12–18) and that Fitzpatrick’s claims about HCU
understaffing must fail because he has not provided any evidence besides his
allegation “is based entirely on his impressions and hearsay conversations Plaintiff
had with Wexford personnel.” (Id., p. 18).
The Seventh Circuit has stated that “[w]e have long recognized that the
division of labor within a prison necessitates that non-medical officials may
reasonably defer to the judgment of medical professionals regarding inmate
treatment.” Giles v. Godinez, 914 F.3d 1040, 1049 (7th Cir. 2019), cert. denied, 140 S.
Ct. 50 (Mem.). “If a prisoner is under the care of medical experts . . . a non-medical
prison official will generally be justified in believing that the prisoner is in capable
hands.” Id. (quoting Greeno v. Daley, 414 F.3d 645, 656 (7th Cir. 2005)).
Additionally, “absent a reason to believe (or actual knowledge) that prison
doctors or their assistants are mistreating (or not treating) a prisoner, a non-medical
prison official . . . will not be chargeable with the Eighth Amendment scienter
requirement of deliberate indifference.” Id. at 1049–50 (quoting Spruill v. Gillis, 372
F.3d 218, 236 (3d Cir. 2004)). The Seventh Circuit has repeatedly affirmed district
courts’ grant of summary judgment “for non-medical prison officials who relied on the
professional judgment of prison medical staff.” Id. at 1050 (citing Hayes v. Snyder,
546 F.3d 516, 527–28 (7th Cir. 2008)). In both Giles and in Haynes, the Seventh
Circuit determined that such officials “’were entitled to rely on the professional
judgment of medical prison officials’” and “’nothing in [the medical] reports made it
obvious that [the inmate] might not be receiving adequate care.’” Id. (citing Hayes at
527–28). Notably, Giles “was receiving regular medical attention from psychologists,
psychiatrists, and mental health professionals,” had emergency appeals that “were
reviewed by the ARB, which found his complaints to be without merit upon
investigation,” and did not “present[] evidence that his grievances were ignored or
mishandled.” Id.
Defendants Jeffreys and Wills insist that Fitzpatrick’s grievances are
“conclusory statements [that] are not sufficient to satisfy a claim for deliberate
indifference.” (Doc. 91, p. 12 (citing Peterson v. Wexford Health Sources, Inc., 986 F.3d
746, 753 (7th Cir. 2021)). However, Peterson involved “conclusory allegations that
these defendants had the requisite state of mind” with the plaintiff “stating that they
‘ignored the FDA mandated warnings’ and ‘knew that [Peterson] would suffer
personal injuries.’” 986 F.3d at 753. Viewing the evidence in the light most favorable
to Fitzpatrick, the Court will assume that Jeffreys and Wills did receive Fitzpatrick’s
grievances and had notice of his medical care.
However, even assuming that Defendants Jeffreys and Wills were aware of
Fitzpatrick’s medical treatment, both Defendants were entitled to rely upon the
advice and course of treatment conducted by the physicians and medical personnel at
Menard. The instant case is analogous to both Giles and to Haynes because the record
shows that the medical staff at Menard addressed Fitzpatrick’s abdominal lump on
various occasions. (See Doc. 89, pp. 2–8; Doc. 91, pp. 2–7). As the Court previously
noted, Fitzpatrick’s abdominal lump was an objectively serious medical need because
it caused him “excruciating pain.” (Doc. 1, pp. 13–14; Doc. 89, Ex. C, p. 7; Doc. 94, p.
18). As stated above, a prisoner is entitled to “reasonable measures to meet a
substantial risk of serious harm”—not to demand specific care. Forbes v. Edgar, 112
F.3d 262, 267 (7th Cir. 1997). This standard was met here. Regardless of Fitzpatrick’s
assertions of deliberate indifference, it was reasonable for each of the non-physician
Defendants to rely upon the treatment provided by prison medical officials, who
continued to prescribe various treatments for Fitzpatrick’s abdominal lump and
associated pain. (See Doc. 89, pp. 2–8; Doc. 91, pp. 2–7). Additionally, while
Fitzpatrick argues that Defendants Jeffreys and Wills deliberately restricted his
ability to see medical staff because of prison lockdowns, Fitzpatrick admitted in his
deposition that Menard is a “high [sic] aggressive prison” and that this “happens quite
a lot.” Fitzpatrick Dep. 59:3–60:3; (see Doc. 91, p. 18 (citing the same)).
Fitzpatrick also claims that Defendants Jeffreys and Wills were aware that the
HCU at Menard was “understaffed & inadequately staffed.” (Doc. 1, ¶ 20). Defendants
Jeffreys and Wills argue that “Plaintiff’s allegation is based entirely on his
impressions and hearsay conversations Plaintiff had with Wexford personnel.” (Doc.
91, p. 18 (citing Doc. 1, ¶ 18)). In his Deposition, Fitzpatrick states that “I’ve, you
know, had a heated argument with certain nurses. Like, sure, I know I have issues
and she just trying to say, man, we ain’t got enough staff. So same thing with
Siddiqui. Siddiqui said it, too, before.” Fitzpatrick Dep. 34:15–19; see id. 33:5–34:19,
36:16–37:14. Apart from such impressions, Fitzpatrick has provided zero evidence of
this understaffing, so his claim here fails, as well.
In conclusion, while Fitzpatrick has adequately argued that his abdominal
lump was a “serious” medical condition requiring treatment, Seventh Circuit
precedent indicates that Defendants Jeffreys and Wills were entitled to rely upon the
medical judgment of Fitzpatrick’s medical treatment team; put another way, they did
not disregard a substantial risk to Fitzpatrick’s health. Cesal, 851 F.3d at 721.
Moreover, there is no evidence that any of the Defendants exhibited deliberate
indifference to the point of criminal recklessness sufficient to provide them with the
scienter required for a deliberate indifference claim.
C. Qualified Immunity
In the alternative, Defendants Jeffreys and Wills also argue that they are
entitled to qualified immunity. (See Doc. 91, pp. 19–22). While the Court need not
assess Defendants Jeffreys and Wills’s qualified immunity argument by virtue of the
fact that Fitzpatrick’s Eighth Amendment claims do not survive Defendants Jeffreys
and Wills’s Motion for Summary Judgment (Doc. 91), the Court will briefly discuss
the applicability of qualified immunity to the instant facts.
In the alternative to their arguments against each of Fitzpatrick’s claims, the
Defendants argue that they are entitled to qualified immunity because “[g]overnment
officials performing discretionary functions generally are shielded from liability for
civil damages if their conduct does not violate clearly established statutory or
constitutional rights of which a reasonable person would have known.” (Doc. 91, p. 19
(citing Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982)). They argue that “the facts
alleged here do not give rise to a constitutional violation” and that “[e]ven if Plaintiff
disagreed with the care he was provided or felt he should have been treated sooner,
this does not rise to the level of a constitutional claim when they did not actually
participate in any aspect of Plaintiff’s medical care.” (Id., pp. 20–21). Fitzpatrick
argues that they are not entitled to qualified immunity because he argues that the
Defendants exhibited deliberate indifference toward his pain in violation of the
Eighth Amendment. (See Doc. 94, p. 19).
“Qualified immunity is an affirmative defense, but once it is raised the burden
shifts to the plaintiff to defeat it.” Holleman v. Zatecky, 951 F.3d 873, 877 (7th Cir.
2020) (citing Sparing v. Vill. of Olympia Fields, 266 F.3d 684, 688 (7th Cir. 2001)).
“To overcome qualified immunity, the facts viewed in the light most favorable to [the
plaintiff] must ‘show that the defendant[s] violated a constitutional right’ and that
‘the right was clearly established at [that] time.’” Id. (quoting Estate of Clark v.
Walker, 865 F.3d 544, 550 (7th Cir. 2017)).
Regarding Fitzpatrick’s Eighth Amendment claim, the Seventh Circuit has
established that “[w]hen considering deliberate-indifference claims challenging the
medical judgment of prison healthcare personnel, qualified-immunity analysis
requires us to frame the legal question with reasonable specificity.” Campbell v.
Kallas, 936 F.3d 536, 546 (7th Cir. 2019). In Campbell, the Seventh Circuit
determined that “[t]he proper inquiry is whether then-existing caselaw clearly
established a constitutional right to gender-dysphoria treatment beyond hormone
therapy” not “that ‘denying effective treatment’ for Campbell’s medical condition
violates the Eighth Amendment” because the latter “formulation—which is basically
a highly conceptualized version of the deliberate-indifference standard—is far too
general.” Id. at 546. Additionally, “‘[f]or purposes of qualified immunity, [the Eighth-
Amendment] duty’ to treat prisoners’ serious medical conditions ‘need not be litigated
and then established disease by disease or injury by injury.’” Id. at 548 (quoting Est.
of Clark, 865 F.3d at 553). Moreover, “[w]hen prison officials utterly fail to provide
care for a serious medical condition, the constitutional violation is obvious and
qualified immunity offers little protection.” Id. (citing Orlowski v. Milwaukee County,
872 F.3d 417, 422 (7th Cir. 2017)).
Here, Fitzpatrick cannot argue that his abdominal lump was not treated at all,
which is clearly not the case. His argument, then, must be that prison officials
persisted in treatment that was ineffective. See id. at 547 (quoting Greeno v. Daley,
414 F.3d 645, 655 (7th Cir. 2005) (citing Petties v. Carter, 836 F.3d 722, 729–30 (7th
Cir. 2016), as amended (Aug. 25, 2016)). This argument also fails because it has
clearly been established that the Defendants treated Fitzpatrick’s abdominal lump.
Like in Campbell, there is no Circuit precedent indicating that the course of care for
his abdominal lump violated a constitutional right, meaning the Defendants were not
on notice of a constitutional violation and would be entitled to qualified immunity if
the Court reached that question.
CONCLUSION
For the reasons set forth above, the Court GRANTS both Defendants
Defendants Wexford Health Sources, Inc.; Mohammed Siddiqui, M.D.; Alisa
Dearmond; Michael Moldenhauer; and Mary Jo Zimmer’s Motion for Summary
Judgment (Doc. 88) and Defendants Rob Jeffreys and Anthony Wills’s Motion for
Summary Judgment. (Doc. 91). This case is DISMISSED with prejudice. The Clerk
of Court is DIRECTED to close this case on the Court’s docket.
IT IS SO ORDERED.
DATED: September 10, 2024
/s/ Stephen P. McGlynn_
STEPHEN P. McGLYNN
U.S. District Judge