Cobb v. Wexford Health Services

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF INDIANA

SOUTH BEND DIVISION

MALCOM D. COBB, JR.,

Plaintiff,

v. CAUSE NO. 3:23-CV-437-GSL-JEM

WEXFORD HEALTH SERVICES, et al.,

Defendants.

OPINION AND ORDER

Malcom D. Cobb, Jr., a prisoner without a lawyer, is currently housed at the

Miami Correctional Facility. He filed a complaint alleging he is being denied

constitutionally adequate medical treatment. ECF 1. The court previously granted him

leave to proceed against the Warden of the Miami Correctional Facility in an official

capacity to obtain permanent injunctive relief to receive constitutionally adequate

medical care for his urinary, bowel, and blood pressure issues as required by the Eighth

Amendment. ECF 6 at 3. The rest of his claims were taken under advisement for later

screening. Id. His request for preliminary injunctive relief was also taken under

consideration at that time. The Warden was ordered to respond “describing/explaining

how Malcom D. Cobb, Jr., is being provided constitutionally adequate medical

treatment for his urinary, bowel, and blood pressure issues.” ECF 6 at 4. After

considering the Warden’s response—which contained over 175 pages of medical

records—the court denied the motion(s) for preliminary injunction. See ECF 24.

Under 28 U.S.C. § 1915A, the court must screen the complaint and dismiss it if

the action is frivolous or malicious, fails to state a claim upon which relief may be

granted, or seeks monetary relief against a defendant who is immune from such relief.

To proceed beyond the pleading stage, a complaint must contain sufficient factual

matter to “state a claim to relief that is plausible on its face.” Bell Atlantic Corp. v.

Twombly, 550 U.S. 544, 570 (2007). “A claim has facial plausibility when the plaintiff

pleads factual content that allows the court to draw the reasonable inference that the

defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009).

The court must give a pro se complaint liberal construction. Erickson v. Pardus, 551 U.S.

89, 94 (2007). That said, a plaintiff can plead himself out of court if he pleads facts that

preclude relief. See Atkins v. City of Chicago, 631 F.3d 823, 832 (7th Cir. 2011); McCready v.

Ebay, Inc., 453 F.3d 882, 888 (7th Cir. 2006).

Cobb alleges from August 21, 2020, to November 15, 2020, he stopped eating

which caused pain in his stomach and stool changes. When he stopped defecating, he

was taken to the hospital on September 24, 2020, where he remained for a week. While

there, tests were performed, and he received treatment to “unconstipate” him. ECF 1 at

3. When he was transferred back to the prison, Health Services Administrator LeeAnn

Ivers and N.P. Kim Myers put him in a room with four other inmates who had Covid-

19. Cobb subsequently tested positive for Covid-19, and the other inmates passed away.

This affected him “mentally,” and the pain in his stomach “never went away.” Id. Nurse

Myers misdiagnosed his stomach pain as being from Covid, and nothing further was

done about it at that time. On November 20, 2020, he was released from the infirmary.

Between March 23, 2021, and April 27, 2021, Cobb was returned to the infirmary

because he wasn’t able to eat, had pain in his lower left side, was throwing up, and had

trouble urinating. A catheter was placed, but Nurse Myers refused to do anything for

the pain and reduced all of his medication in half. His blood pressure remained high.1

Cobb repeatedly informed Nurse Myers that he was “very sick and in a lot of pain,” but

she refused to help and told him to, “man up and handle the pain.” Id. at 5. He was

eventually sent to an outside hospital where an infection was discovered.

On April 21, 2021, he spoke with Dr. Merandia—a prison doctor not named as a

defendant—who informed him that Dr. Brumfield, an outside gastrointestinal specialist

whom Cobb had previously seen, diagnosed him with bowel obstructions which could

be remedied with surgery and a colostomy bag. Dr. Brumfield and Dr. Merandia then

informed the rest of the medical staff at the prison about the potential surgery. Instead

of scheduling the surgery, Nurse Myers took all of his pain medication away and said

she didn’t believe Dr. Brumfield. On April 27, 2021, Administrator Ivers had Cobb

moved out of the infirmary, and he was informed the surgery wouldn’t be scheduled

because Centurion Health (formally known as Centurion Health of Indiana, LLC), was

going to be taking over care at the prison for Wexford Health Service (formally known

as Wexford of Indiana, LLC) on July 1, 2021. Cobb attributes this decision to both

Administrator Ivers and Wexford Regional Director Dr. Mitchiff. At that time, Cobb

1 Cobb also complains about his broken wheelchair and placement in segregation during the

spring of 2021, but those claims were previously raised and dismissed. See Cobb v. Hyett, et al., cause no.

3:20-CV-623-DRL-MGG (filed Jul. 7, 2020; dismissed Jan. 8, 2021); see also Cobb v. Payne, et al., cause no.

3:20-CV-837-MGG (filed Oct. 5, 2020; dismissed Feb. 6, 2023). They cannot be relitigated here.

was in pain and couldn’t urinate or have a bowel movement on his own, but

Administrator Ivers, Wexford Regional Director Dr. Mitchiff, and Nurse Myers refused

to provide him with any treatment and instead told him “good luck” with Centurion.

Id. at 6.

On August 20, 2021, after Centurion had taken over, Cobb was put back into the

infirmary because he had pain in his lower left side, he couldn’t have a bowel

movement, and his blood pressure was high. Nurse Myers told him he was scheduled

for an outside consultation with a gastroenterologist, so she had him perform a bowel

preparation which was painful. When he went to the appointment, it was for the

“wrong test,” and he received a CT scan of his bowels instead which showed no

obstruction. Id. at 7. Nurse Myers and Administrator Ivers prescribed Ensure nutritional

drink to help with the weight he had lost.

On September 21, 2021, he asked Nurse Myers for a test for his urinary tract, and

when the results came back they showed a urinary tract infection. Nurse Myers

discontinued his blood pressure medication because she said it was causing

constipation. This course of treatment differed than that suggested by Dr. Brumfield.

Administrator Ivers directed the staff to take Cobb’s blood pressure several times when

he was being checked and to only record the lower numbers. Cobb believes the records

were falsified because only low numbers were recorded even though his blood pressure

medication “ha[d] been tripled,”2 so he began refusing the vital checks. Id. at 8.

2 This contradicts his previous statement that his blood pressure medication had been

discontinued.

During this time, Nurse Myers refused to change his catheter and refused to give

him any cream or pain medication, which caused his penis to split open. She blamed the

lack of catheter change on Cobb’s own refusal to attend medical examinations, which he

denies. Nurse Myers informed him Dr. Kuenzli would be taking over his care.

Cobb told Dr. Kuenzli about the blood in his urine, his split penis, the pain he

was experiencing, and the fact that he was coughing up blood, but Dr. Kuenzli didn’t

provide him with any treatment because he believed Cobb was lying about the pain.

Cobb showed two nurses that he had coughed up blood. A few days later he asked Dr.

Kuenzli to treat his painful split penis and infections. Dr. Kuenzli prescribed Tylenol

500, but Cobb’s medical paperwork indicated he was allergic to it, so Cobb didn’t get

any pain relief. On September 23, 2021, Dr. Kuenzli sent him to a new

gastroenterologist, Dr. Chin, who gave him “some pills.” Id. at 10. A few days later,

Cobb told Dr. Kuenzli, Nurse Myers, and Administrator Ivers that he was going to take

things into his own hands and “end it all,” but they relied with “whatever.” Id. at 11.

On December 31, 2021, Cobb attempted to hang himself with a bedsheet. He was

cut down and placed into segregation on suicide watch for three days. In that cell, he

wasn’t allowed to have his wheelchair, so he had to lay on the floor in his own urine.

He was seen by a psychiatrist, who told him he was “not crazy or suisidal (sic) I just

need medical attention for my illness.” Id. The psychiatrist wasn’t able to help him with

his medical care, and he was released from suicide watch. Dr. Kuenzli then prescribed

him Tylenol three times a day and referred him to an outside urinary specialist named

Dr. Miller.

During that appointment, Dr. Miller told Cobb he was “shocked” his catheter

hadn’t been changed in eight months, that his penis had been split twice, and that his

prostate was swollen and filled with blood clots. Id. Dr. Miller recommended

scheduling surgery as soon as possible,3 but Dr. Kuenzli refused to give Cobb pain

medication other than Tylenol 3—which he was allergic to—in the meantime. However,

Cobb did receive the recommended surgery for his urinary issues shortly thereafter.

From January 18, 2022, to January 20, 2022, Cobb remained in the hospital to recover

from the surgery.4

Cobb claims the surgery wasn’t successful because his bladder won’t hold urine

and he has to wear condom catheters. He alleges Administrator Ivers doesn’t order the

supplies he needs—including urine pads, condom catheters, urine bags, and wipes—in

a timely manner, so he often has to sit in urine and blood for several days. He claims

she does this to save Centurion money.

On January 30, 2022, Cobb asked Dr. Kuenzli to help with the pain related to his

bladder, rectum, and bowels. Dr. Kuenzli prescribed two Tylenol 3 pills, three times a

day. Cobb couldn’t take these because he was allergic to it. He told Dr. Kuenzli he was

going to attempt suicide, and he tried to hang himself again. Nurse Myers and

3 Dr. Miller indicated the surgery “may or may not help but there’s a chance because of extent of

damage done.” ECF 1 at 12.

4 Cobb was also sent to see Dr. Chin, the outside gastroenterologist, for a second time, and he

recommended surgery for his bowel issues. Instead, Dr. Kuenzli, Nurse Myers, and Administrator Ivers

sent him back to Dr. Brumfield, another outside gastroenterologist, who “wondered what happened to

[him] because he had told [Cobb he] needed surgery last time.” ECF 1 at 12. Cobb mentions Centurion

Regional Director Dr. Wilks in this section of his complaint, but he doesn’t describe any actions taken by

Dr. Wilks. Instead, Cobb simply concludes he violated his rights. Id.

Administrator Ivers saw this attempt and simply laughed at him. He was “saved” by

several correctional officers and Nurse Pom. Id. at 14. He was evaluated by a

psychiatrist who told him he was “not crazy just want help for pain and not having

supplies.” Id.

Dr. Kuenzli arranged for Cobb to see Dr. Brumfield again, who referred him to a

different gastrointestinal specialist, Dr. Catts. After reviewing his medical history, Dr.

Catts told Cobb he believed that his rectum and most of his colon could have been

“saved” if he had had surgery in 2021, but “now the rectum has quit working,” he

would lose part of his colon, and he would need a colostomy bag and a urine

bag/catheter. Id. at 15.

Cobb stopped eating again because peanut butter was making things worse.

When he told Administrator Ivers this, she gave him three times the amount of peanut

butter. He got a special “lacto ovel diet approved” from Indiana Department of

Correction officials, but Administrator Ivers overruled this decision and kept giving

him peanut butter. Id. He began urinating blood, and Administrator Ivers told him,

“You are dying so good luck with that good bey (sic).” Id. at 16. Shortly thereafter, Cobb

“let them send me to hospital so I could get help.” Id. When the hospital found out he

had to dig stool out of his rectum, they sent him back to the prison infirmary.

Cobb claims he was released from the prison infirmary on May 22, 2023, but he

alleges he continues to suffer from a variety of ailments related to his bladder, penis,

urinary tract, intestines, rectum, and bowels.5 He has sued Wexford Health Services,

Centurion Health, Wexford Medical Regional Director Dr. Mitchiff, Centurion Medical

Regional Director Dr. Wilks, Health Service Administrator LeeAnn Ivers, Dr. Kuenzli,

and N.P. Kim Myers for compensatory and punitive damages. He also seeks injunctive

relief in the form of receiving gastrointestinal and urinary surgery, scheduling an

appointment with a pain management doctor, and replacing Dr. Kuenzli, Nurse Myers,

and Administrator with other “qualified” individuals. Id. at 19.

Under the Eighth Amendment, inmates are entitled to adequate medical care for

serious medical conditions. Thomas v. Blackard, 2 F.4th 716, 722 (7th Cir. 2021). They are

“not entitled to demand specific care,” Walker v. Wexford Health Sources, Inc., 940 F.3d

954, 965 (7th Cir. 2019), nor are they entitled to “the best care possible.” Forbes v. Edgar,

112 F.3d 262, 267 (7th Cir. 1997); see also Johnson v. Doughty, 433 F.3d 1001, 1013 (7th Cir.

2006) (“The Eighth Amendment does not require that prisoners receive unqualified

access to health care.”). Rather, they are entitled to “reasonable measures to meet a

substantial risk of serious harm.” Forbes, 112 F.3d at 267. Courts must “defer to medical

professionals’ treatment decisions unless there is evidence that no minimally competent

professional would have so responded under those circumstances.” Walker, 940 F.3d at

5 He mentions a wheelchair “that broke ‘no breaks’” and cut his back, plus a prosthetic he was

supposed to receive after his last surgery on his “nub that Wexford refused to do and pay for and a knee

replacement that they refused to pay for and now Centurion refuses to pay for.” ECF 1 at 17. These

allegations too vague to state a claim. See e.g., Swanson v. Citibank, N.A., 614 F.3d 400, 403 (7th Cir. 2010)

(“[A] plaintiff must do better than putting a few words on paper that, in the hands of an imaginative

reader, might suggest that something has happened to her that might be redressed by the law.”) (emphasis

in original). Moreover, as noted above, the allegations regarding the broken wheelchair have already

been litigated. See Cobb v. Hyett, et al., cause no. 3:20-CV-623-DRL-MGG (filed Jul. 7, 2020; dismissed Jan.

8, 2021); see also Cobb v. Payne, et al., cause no. 3:20-CV-837-MGG (filed Oct. 5, 2020; dismissed Feb. 6,

2023).

965 (citation and quotation marks omitted). However, ignoring an inmate’s complaints

of pain or delaying necessary treatment can amount to deliberate indifference,

particularly where the delay “exacerbates the plaintiff’s condition or unnecessarily

prolongs suffering.” Goodloe v. Sood, 947 F.3d 1026, 1031 (7th Cir. 2020) (citations and

internal quotation marks omitted).

Giving Cobb the benefit of the inferences to which he is entitled at this stage, he

has sufficiently alleged he has serious medical needs related to his bladder, penis,

urinary tract, rectum, bowels, and blood pressure. He has adequately alleged that

Administrator Ivers, Dr. Kuenzli, and Nurse Myers have been deliberately indifferent to

those needs. Although it is evident he has received evaluation of and treatment for his

various problems throughout the years, he claims the aforementioned defendants often

purposely denied him pain medication, delayed treatment, and/or failed to provide

him with constitutionally adequate care. He will be permitted to proceed further

against these defendants on his claims for monetary damages.6

As to Wexford Regional Director Dr. Mitchiff and Centurion Regional Director

Dr. Wilks, “[t]he personal-involvement requirement of § 1983 can be satisfied if a

defendant knew of and consented to a constitutional violation.” Lee v. Carr, No. 21-1309,

2022 WL 519890, at *1 (7th Cir. Feb. 22, 2022) (citing Mitchell v. Kallas, 895 F.3d 492, 498

6 That said, prior to March 23, 2021, Mr. Cobb doesn’t state any plausible claims. The fact that he

was placed in a room in the infirmary with Covid-19 positive patients sometime in September–November

2020 after returning from the hospital isn’t sufficient to suggest any of the defendants committed a

constitutional violation, nor is his vague allegation of a subsequent misdiagnosis. See e.g., Swanson v.

Citibank, N.A., 614 F.3d 400, 403 (7th Cir. 2010) (“[A] plaintiff must do better than putting a few words on

paper that, in the hands of an imaginative reader, might suggest that something has happened to her that

might be redressed by the law.”) (emphasis in original).

(7th Cir. 2018)). However, knowledge of the staff is not automatically attributed to an

official, “[n]or does § 1983 allow for [their] liability based on what [the] staff did or

failed to do.” Id. (citing Taylor v. Ways, 999 F.3d 478, 493–94 (7th Cir. 2021). “With

exceptions not relevant here, government officials are liable only for their own

misconduct.” Id. Cobb has alleged Wexford Regional Director Dr. Mitchiff personally

knew he had a bowel obstruction in April of 2021 that could be remedied with surgery

but refused to allow the surgery to proceed or to provide him with any other treatment

solely because Centurion was replacing Wexford as the medical provider. In fact, he

claims Dr. Mitchiff told him “good luck” starting over with Centurion. These

allegations are sufficient to state an Eighth Amendment claim against Dr. Mitchiff in his

individual capacity.

However, Cobb has not plausibly alleged Centurion Regional Director Dr. Wilks

knew of or consented to any constitutional violations. He is mentioned only twice in the

factual body of the complaint (ECF 1 at 12–13), but Cobb doesn’t describe any specific

actions taken by Dr. Wilks. Instead, he simply lists Dr. Wilks along with various other

defendants and concludes his rights were violated. These sparse allegations are

insufficient to state a claim against him. See Horshaw v. Casper, 910 F.3d 1027, 1029 (7th

Cir. 2018) (“Liability under § 1983 is direct rather than vicarious; supervisors are

responsible for their own acts but not for those of subordinates, or for failing to ensure

that subordinates carry out their tasks correctly.”); see also Swanson v. Citibank, N.A., 614

F.3d 400, 403 (7th Cir. 2010).

Cobb also brings claims against Wexford and Centurion. Both are private

companies that contracted with the Indiana Department of Correction to provide

medical care to inmates housed at the Miami Correctional Facility.7 There is no

respondeat superior liability under 42 U.S.C. § 1983, and a private company cannot be

held liable for damages simply because it employed a medical professional who

engaged in wrongdoing. J.K.J. v. Polk Cty., 960 F.3d 367, 377 (7th Cir. 2020). A private

company performing a public function can be sued under Monell v. Dep’t of Soc. Servs. of

City of New York, 436 U.S. 658 (1978), but only if the “unconstitutional acts of their

employees . . . were carried out pursuant to an official custom or policy.” Grieveson v.

Anderson, 538 F.3d 763, 771 (7th Cir. 2008) (citations omitted). The purpose of this

requirement is to “distinguish between the isolated wrongdoing of one or a few rogue

employees and other, more widespread practices.” Howell v. Wexford Health Sources, Inc.,

987 F.3d 647, 654 (7th Cir. 2021). To allege a viable Monell policy claim, the plaintiff

must identify an official policy that caused him injury. Grieveson, 538 F.3d at 771.

Alternatively, a plaintiff pursuing an official custom or practice theory “must allege

facts that permit the reasonable inference that the practice is so widespread so as to

constitute a governmental custom.” Gill v. City of Milwaukee, 850 F.3d 335, 344 (7th Cir.

2017).

7 Wexford’s contract with the Indiana Department of Correction ended in July 2021, and it was

replaced by Centurion Health. See Baldwin v. Westville Corr. Facility, No. 3:21-CV-682-DRL-MGG, 2021 WL

5759136, at *2 (N.D. Ind. Dec. 3, 2021).

As to Wexford, Cobb claims they had a policy or practice in place that prevented

him from receiving necessary bowel surgery—or any care at all—from April 27, 2021,

until July 1, 2021, because Centurion was scheduled to take over medical care at the

prison. As noted by the Seventh Circuit, “administrative convenience and cost may be,

in appropriate circumstances, permissible factors for correctional systems to consider in

making treatment decisions.” Roe v. Elyea, 631 F.3d 843, 863 (7th Cir. 2011) (emphasis in

original). However, the Constitution is only violated when those factors are considered

“to the exclusion of reasonable medical judgment about inmate health.” Id. (emphasis in

original). It can plausibly be inferred from Cobb’s complaint that, as the end of its

contract with the Indiana Department of Correction approached, Wexford had a policy

of considering cost savings to the exclusion of reasonable medical judgment. Thus,

Cobb will be permitted to proceed against Wexford of Indiana, LLC.

As to Centurion, he speculates they have a policy of refusing medical care due to

their concerns about “money and profit.” ECF 1 at 16. The only fact that directly relates

to this contention is the assertion that Administrator Ivers “was and is to date saving

money for Centurion Medical” by not ordering him medical supplies in a timely

manner. Id. at 13. However, the actions of one individual delaying the ordering of

supplies for one inmate cannot plausibly support a Monell claim against Centurion. See

Elyea, 631 F.3d at 863; see also Bell Atlantic Corp, 550 U.S. at 570 (A complaint must

contain sufficient factual matter to “state a claim to relief that is plausible on its face.”).

This is especially true in light of the fact that Cobb’s complaint is replete with instances

in which he admits he did receive medical care after Centurion assumed

responsibility—he was taken for a CT scan of his bowels, was prescribed a nutritional

drink, was sent to a new outside gastroenterologist (Dr. Chin) who gave him

medication at the first visit, was evaluated by an outside urinary specialist (Dr. Miller)

and received surgery for his urinary issues, and was referred to a different

gastroenterologist (Dr. Catts) who recommended surgery and a colostomy bag. Thus, it

cannot be plausibly inferred that Centurion has a policy that places cost savings and

profit above the health of inmates to the exclusion of all other medical judgment.

Therefore, Centurion Health will be dismissed.

As noted above, the court previously granted Cobb leave to proceed against the

Warden of the Miami Correctional Facility in an official capacity to obtain permanent

injunctive relief to receive constitutionally adequate medical care for his urinary, bowel,

and blood pressure issues as required by the Eighth Amendment. ECF 6 at 3. For the

reasons stated in the original screening order (ECF 6), that claim will remain pending.

However, his requests for preliminary injunctive relief were denied. See generally

ECF 24. A review of the voluminous medical records the Warden submitted indicate:

[Cobb] has been seen by outside medical specialists over fifteen (15) times

from December 2020 to the present. ECF 17-1 at 1–3. Those appointments

included a colonoscopy and several follow-ups, a CT of his abdomen and

pelvis, several appointments with a gastroenterologist, a consult with a

urologist, a transurethral resection of the prostate (TURP) surgical

procedure and several follow-ups, a general surgery consult which

resulted in a Sitz marker study being completed at MCF, and the approval

of a second colorectal surgery specialist consult which was scheduled for

sometime in July 2023. Id. Of particular relevance to the instant motion,

Nurse Ivers also attests that Mr. Cobb has been seen by medical staff at

MCF on a near daily basis from May 6, 2023 to June, 16, 2023, the date the

response was docketed, ‘unless he refuses, or on rare occasions, the

medical staff is not able to locate him.’ Id. at 3–4; see also ECF 17-2 & ECF

17-3 (medical records and list of medications administered). Those

assessments include administering multiple medications for his pain,

urinary, blood pressure, and colorectal issues. Id.

Id. at 3–4 (footnotes omitted). Cobb didn’t directly dispute any of the medical

documents in his response but instead argued generally that Administrator Ivers is the

one who “runs the joint” and “decides on how you live or die.” Id. at 4 (quoting ECF 18

at 2). He claimed he remained in pain and was not consistently being provided with

supplies, but the court assessed the medical documentation as a whole and concluded

that “[a]lthough it is obvious Mr. Cobb has a variety of serious medical ailments, he

hasn’t adequately shown the defendants are currently failing to treat them.” Id. at 7

(citing Doe v. Univ. of S. Ind., 43 F.4th 784, 792 (7th Cir. 2022)). The court also reviewed a

second motion for preliminary injunctive relief and noted that Cobb admitted he was

taken to a new colorectal surgeon for a surgical consult after his first motion had been

filed. See ECF 24 at 10 (citing ECF 22 at 3–4). With regard to medical supplies, Cobb

claimed he was being denied condom catheters, wipes, and urine pads, but in a

healthcare request form attached to a separate reply, Cobb admitted he was later

brought his medication and supplies. See id. at 9 (citing ECF 19-1 at 3). Moreover,

medical records from Nurse Myers showed that, in her opinion, the condom catheters

were likely contributing to his medical problems, so she discontinued their use and

implemented a hygiene plan instead. The court acknowledged Cobb’s disagreement but

concluded it “doesn’t establish he is currently failing to receive adequate medical care.”

Id. at 10 (citing Lockett v. Bonson, 937 F.3d 1016, 1024 (7th Cir. 2019) (disagreement

between inmate and doctor or “even between two medical professionals” does not

violate the Constitution) and Walker v. Wexford Health Sources, Inc., 940 F.3d 954, 965 (7th

Cir. 2019) (inmates are “not entitled to demand specific care”).

Since that time, Cobb has filed a variety of motions associated with this case.

Many are titled “updates” and purport to provide the court with additional information

about his condition and general confinement. See ECF 26 (indicating he was treated in

the hospital in late June of 2023, was seen by colorectal surgeon Dr. Floyd in July of

2023, received the recommended surgery from Dr. Floyd on August 26, 2023, and

recovered in the hospital and infirmary until he was sent back to the general population

against his will in mid-September by Administrator Ivers and Nurse Myers); ECF 29

(stating that “on 8-28-23 I finally got my surgery after 3 years of fighting with medical,”

noting he was experiencing post-surgery bleeding and was not receiving adequate

cleaning supplies from Administrator Ivers or Nurse Myers, and complaining about his

lack of “medical idle pay”); ECF 30 (informing the court he was worried about the lack

of supplies); ECF 31 (indicating he was transported to Duke’s Hospital and later to Fort

Wayne Lutheran Hospital on December 13, 2023, where he received surgery and IV

antibiotics for five days due to an infection caused by the lack of medical/cleaning

supplies, and when he returned to the prison Administrator Ivers, Nurse Myers, and

Dr. Kuenzli laughed at Cobb’s fears of getting sick again);8 ECF 32 (Cobb was sent to

medical on February 25, 2024, because the guards initially thought he was drunk, but

his symptoms were actually due to Nurse Myers’ refusal to give him proper blood

8 In a later filed document, Cobb admits he received seven days of antibiotics upon his return to

the prison. ECF 31 at 2.

pressure medication or antibiotics for an infection because she said he was scheduled

for surgery soon with Dr. Miller);9 ECF 40 (describing his issues with the grievance

process pertaining to the incidents above);10 ECF 41 (indicating his blood pressure was

high due to issues with medication distribution and infection, noting he was seen by the

outside urologist, Dr. Miller, on March 26, 2024, who referred him to a bladder surgeon,

and indicating he refused a medical follow-up visit with Nurse Myers because she took

too long to see him);11 ECF 42 (duplicate “update” of ECF 41).

It’s unclear what relief, if any, Cobb is seeking via these “updates.” The court

declines to construe them as requests for preliminary injunctive relief because Cobb has

not specifically sought such relief and because it’s clear Cobb knows how to file such a

motion if that is his intention. See ECF 4 & ECF 22 (both denied by ECF 24). Moreover,

as with his original requests for preliminary injunctive relief, he admits he has been

getting ongoing care for a variety of ailments including receiving the colorectal surgery

he has been seeking for years, being transported to outside hospitals for emergency

treatment, and being evaluated by an outside urology specialist for possible bladder

surgery. See e.g., Winter v. Nat. Res. Def. Council, Inc., 555 U.S. 7, 22 (2008) (“injunctive

9 Cobb states he was “told by the nurse they were going to change my cath [but] I refused

because they are trying to cover up what they haven’t done.” ECF 32 at 3.

10 Cobb also describes an incident on March 8, 2024, where he was denied food and treatment by

several officers (who are not named as defendants) because he wasn’t “dressed in blues pants.” ECF 40 at

2. These claims are not sufficiently related to the current case. Unrelated claims belong in different

lawsuits. See e.g. George v. Smith, 507 F.3d 605, 607 (7th Cir. 2007).

11 Cobb indicates his left leg and arm weren’t working for five days, so he received an x-ray of his

leg, hip, ankle on February 6, 2024. To the extent Cobb is claiming injuries to his leg and arm, these claims

aren’t sufficiently related to the current case. See George, 507 F.3d at 607.

relief [i]s an extraordinary remedy that may only be awarded upon a clear showing that

the plaintiff is entitled to such relief”); Univ. of S. Ind., 43 F.4th at 791 (in assessing a

preliminary injunction, courts do does not simply “accept [the plaintiff’s] allegations as

true, nor do[es] [it] give him the benefit of all reasonable inferences in his favor); see also

Lockett, 937 F.3d at 1024 (disagreement between inmate and doctor or “even between

two medical professionals” does not violate the Constitution); Walker, 940 F.3d at 965

(inmates are “not entitled to demand specific care”).

Cobb may be attempting to amend his complaint through these motions. A

plaintiff may not amend his complaint in a piecemeal fashion because an amended

complaint will supersede all earlier pleadings and control the case from that point

forward. French v. Wachovia Bank, 574 F.3d 830, 835 (7th Cir. 2009); see also Beal v. Beller,

847 F.3d 897, 901 (7th Cir. 2017) (“For pleading purposes, once an amended complaint is

filed, the original complaint drops out of the picture.”). The Local Rules of this District

also state that an amended pleading must “reproduce the entire pleading as amended,”

rather than simply incorporating a prior pleading by reference. N.D. Ind. L.R. 15-1. To

the extent Cobb is seeking to replace his original complaint with these piecemeal

updates, he may not do so. Accordingly, the motions will be denied as unnecessary.

However, in the interests of justice, the court has considered the additional relevant

facts (set forth above) in the context of the original pleading and will incorporate them

into the existing Eighth Amendment claims against Administrator Ivers, Nurse Myers,

and Dr. Kuenzli in their individual capacities and the Warden in his official capacity.

That said, Cobb is cautioned that if he intends to amend his complaint in the future, he

must do so in accordance with all federal and local rules.

Finally, Cobb has filed two discovery-related motions. See ECF 27 (requesting all

emails about Cobb’s supplies and medical treatment from 2019 to 2023) and ECF 28

(requesting interrogatories from Dr. Brumsfield, Dr. Chin, Dr. Katts, and Dr. Floyd).

Because the complaint had not been fully screened at the time Cobb filed these

motions—and because not all defendants have yet been ordered to appear and respond

to Cobb’s claims—these requests will be stricken as premature. Once the defendants

have appeared and filed answers, the court will issue a scheduling order which will

include discovery deadlines. Cobb may refile his discovery requests at that time.12

For these reasons, the court:

(1) GRANTS Malcom D. Cobb, Jr., leave to proceed against the Warden of the

Miami Correctional Facility in an official capacity to obtain permanent injunctive relief

to receive constitutionally adequate medical care for his urinary, bowel, and blood

pressure issues as required by the Eighth Amendment;

(2) GRANTS Malcom D. Cobb, Jr., leave to proceed against Health Service

Administrator LeeAnn Ivers, Dr. Kuenzli, and N.P. Kim Myers in their individual

capacities for compensatory and punitive damages for failing to provide him with

12 Of note, it is not necessary to file motions to conduct routine, initial discovery requests. To do

so, Cobb must simply send discovery requests to the opposing parties (after the scheduling order is

issued) and file copies with the clerk as required by N.D. Ind. L.R. 26-2(a)(2)(A); see also Fed. R. Civ. P. 33

& 34.

constitutionally adequate medical care for his urinary, bowel, and blood pressure issues

beginning on March 23, 2021, in violation of the Eighth Amendment;

(3) GRANTS Malcom D. Cobb, Jr., leave to proceed against Wexford Regional

Director Dr. Mitchiff in his individual capacity for compensatory and punitive damages

for denying him constitutionally adequate medical care related to his urinary, bowel,

and blood pressure issues from April 27, 2021 through June of 2021, in violation of the

Eighth Amendment;

(4) GRANTS Malcom D. Cobb, Jr., leave to proceed against Wexford of Indiana,

LLC for compensatory and punitive damages for having a policy or practice in place at

the end of its contract with the Indiana Department of Correction of considering cost

savings to the exclusion of reasonable medical judgment that prevented him from

receiving constitutionally adequate medical care for his urinary, bowel, and blood

pressure issues from April of 2021 through June of 2021;

(5) DISMISSES all other claims;

(6) DISMISSES Centurion Health and Centurion Medical Regional Director Dr.

Wilks;

(7) DIRECTS the clerk, under 28 U.S.C. § 1915(d), to request Waiver of Service

from (and if necessary, the United States Marshals Service to use any lawful means to

locate and serve process on) the Warden of the Miami Correctional Facility at the

Indiana Department of Correction, with a copy of this order and the complaint (ECF 1);

(8) DIRECTS the clerk, under 28 U.S.C. § 1915(d), to request Waiver of Service

from (and if necessary, the United States Marshals Service to use any lawful means to

locate and serve process on) Health Service Administrator LeeAnn Ivers, Dr. Kuenzli,

and N.P. Kim Myers at Centurion Health of Indiana, LLC, with a copy of this order and

the complaint (ECF 1);

(9) DIRECTS the clerk, under 28 U.S.C. § 1915(d), to request Waiver of Service

from (and if necessary, the United States Marshals Service to use any lawful means to

locate and serve process on) Wexford Regional Director Dr. Mitchiff and Wexford of

Indiana, LLC at Wexford of Indiana, LLC, with a copy of this order and the complaint

(ECF 1);

(10) ORDERS the Indiana Department of Correction, Wexford of Indiana, LLC,

and Centurion Health of Indiana, LLC, to provide the full name, date of birth, and last

known home address of any defendant who does not waive service if it has such

information;

(11) ORDERS, under 42 U.S.C. § 1997e(g)(2), the Warden of the Miami

Correctional Facility, Health Service Administrator LeeAnn Ivers, Dr. Kuenzli, N.P. Kim

Myers, Wexford Regional Director Dr. Mitchiff, and Wexford of Indiana, LLC to

respond, as provided for in the Federal Rules of Civil Procedure and N.D. Ind. L.R. 10-

1(b), only to the claims for which the plaintiff has been granted leave to proceed in this

screening order;

(12) STRIKES the discovery motions (ECF 27 & ECF 28) as premature; and

(13) DENIES the motions to update the court (ECFs 26, 29, 30, 31, 32, 40, 41, & 42)

as unnecessary.

SO ORDERED on August 22, 2024

/s/Gretchen S. Lund

JUDGE

UNITED STATES DISTRICT COURT