Dixon

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF INDIANA

SOUTH BEND DIVISION

KELVIN WAYNE DIXON,

Plaintiff,

v. CAUSE NO. 3:25-CV-817 DRL-SJF

DANIELLE HAMLIN, KRISTIN

PARTAIN, and WARDEN OF MIAMI

CORRECTIONAL FACILITY,

Defendants.

OPINION AND ORDER

Kelvin Wayne Dixon, a prisoner without a lawyer, filed a complaint and a motion

for a preliminary injunction regarding his post-cancer and other medical care at Miami

Correctional Facility. ECF 9. “A document filed pro se is to be liberally construed, and a

pro se complaint, however inartfully pleaded, must be held to less stringent standards

than formal pleadings drafted by lawyers.” Erickson v. Pardus, 551 U.S. 89, 94 (2007)

(quotations and citations omitted). Nevertheless, under 28 U.S.C. § 1915A, the court must

review the merits of a prisoner 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.

Mr. Dixon alleges in May 2023 he was diagnosed with a cancerous tumor in his

abdomen. The cancer was a stage 3 gastrointestinal stromal tumor (GIST)—spindle cell

type. He was put on the cancer drug Imatinib, which he says caused two side effects: his

muscles would suddenly spasm and cramp, causing extreme pain and uncontrolled

movement, and the medication was damaging his kidneys. His oncologist addressed

these side effects with a prescription for the muscle relaxant Flexeril and Bengay cream

as needed to relieve pain and cramping. Mr. Dixon was also prescribed a pre-renal diet

for the kidney damage.

Mr. Dixon had surgery just over a year later on July 31, 2024, to remove the tumor.

After the surgery, he was transferred to Miami Correctional Facility, where he is currently

located. Mr. Dixon alleges his medical care at Miami is handled primarily by Nurse

Hamlin, with additional care from other providers when she is not available. He sues

thirteen defendants for various issues with his medical care at Miami.

To state an Eighth Amendment claim for the denial of the right to adequate

medical care, a prisoner must allege (1) he had an objectively serious medical need and

(2) the defendant acted with deliberate indifference to that medical need. Estelle v. Gamble,

429 U.S. 97, 104 (1976). A medical need is “serious” if it is one that a physician has

diagnosed as mandating treatment, or one that is so obvious even a lay person would

recognize as needing medical attention. Greeno v. Daley, 414 F.3d 645, 653 (7th Cir. 2005).

On the second prong, deliberate indifference represents a high standard.

“[N]egligence, gross negligence, or even recklessness as the term is used in tort cases is

not enough” to state an Eighth Amendment claim. Hildreth v. Butler, 960 F.3d 420, 425–26

(7th Cir. 2020). Instead, the inmate must allege “a culpability standard akin to criminal

recklessness.” Thomas v. Blackard, 2 F.4th 716, 722 (7th Cir. 2021). “[C]onduct is

deliberately indifferent when the official has acted in an intentional or criminally reckless

manner, i.e., the defendant must have known that the plaintiff was at serious risk of being

harmed and decided not to do anything to prevent that harm from occurring even though

he could have easily done so.” Board v. Farnham, 394 F.3d 469, 478 (7th Cir. 2005) (cleaned

up). “Deliberate indifference occupies a space slightly below intent and poses a high

hurdle and an exacting standard requiring something approaching a total unconcern for

the prisoner’s welfare in the face of serious risks.” Stockton v. Milwaukee Cnty., 44 F.4th

605, 615 (7th Cir. 2022) (quotations and citation omitted); see also Rasho v. Jeffreys, 22 F.4th

703, 710 (7th Cir. 2022) (stating that deliberate indifference claims will fail absent evidence

of “callous disregard” for inmate wellbeing).

For a medical professional to be held liable for deliberate indifference to an

inmate’s medical needs, she must make a decision that represents “such a substantial

departure from accepted professional judgment, practice, or standards, as to demonstrate

that the person responsible actually did not base the decision on such a judgment.”

Jackson v. Kotter, 541 F.3d 688, 697 (7th Cir. 2008). As the Seventh Circuit has explained:

[M]edical professionals are not required to provide proper medical

treatment to prisoners, but rather they must provide medical treatment that

reflects professional judgment, practice, or standards. There is not one

proper way to practice medicine in a prison, but rather a range of acceptable

courses based on prevailing standards in the field. A medical professional’s

treatment decisions will be accorded deference unless no minimally

competent professional would have so responded under those

circumstances.

Id. at 697-698. Negligence, incompetence, or even medical malpractice do not amount to

deliberate indifference. Pierson v. Hartley, 391 F.3d 898, 902 (7th Cir. 2004). But at a certain

point, persisting with a course of treatment known to be ineffective becomes deliberate

indifference. Berry v. Peterman, 604 F.3d 435, 441 (7th Cir. 2010).

First, Mr. Dixon complains the prison is not following his oncologist’s instructions

about follow-up visits. He says his oncologist instructed that for the next three years he

receive a CT scan every 90 days with a follow-up visit to monitor for recurrence of the

cancer. He explains that GIST has a high rate of return, so it is important that he be seen

every 90 days to catch promptly any sign of the cancer’s return. However, he says, the

visits have been late, anywhere from a week to a month after the 90-day mark.1 This does

not state an Eighth Amendment claim because follow-up visits being moderately

delayed, even by a month, does not demonstrate a total unconcern for his well-being.

Even in the unincarcerated world, follow-up visits for cancer treatment can be delayed

without anyone attributing ill motives to physicians or other caregivers.

Next, Mr. Dixon complains that he has had difficulties in consistently receiving his

various medications, and he names as defendants several nurses and other medical staff,

who presumably were responsible for administering his medication. He takes several

different medications. One group of medication is designated as “may carry,” and these

include meclizine (for dizzy spells), Lopressor (for a heart arrythmia), ezetimibe (for

cholesterol), fenofibrate (for cholesterol), fiber pills, lisinopril (for blood pressure),

finasteride (for his prostrate), and omeprazole (for nausea and vomiting). He is given a

30-day supply and is responsible for taking them on his own. Seven days before he runs

1 Mr. Dixon also reported that in June 2025 Nurse Hamlin said she was changing the oncology

follow-up to every 180 days instead of 90 days. He says she told him that his medical care had

already cost more than $500,000, and his offsite visits were taking up too many of the limited slots

available for outside medical trips. However, Mr. Dixon reports that he had another cancer follow

up in September 2025, so it appears the 90-day follow-ups are still being done.

out of these medications, he is required to submit a healthcare request form requesting

renewal.

The other group of medications consists of the cancer drug Imatinib and the

muscle relaxant Flexeril. These medications are distributed by medical staff each day.

Mr. Dixon is supposed to receive Imatinib once a day in the morning and Flexeril twice a

day, in the morning and evening. He alleges that medical staff are responsible for

reordering this medication when it is time.

Mr. Dixon’s medication problems began a couple weeks after his arrival at Miami

when he was released from the infirmary into the general population. After the move, he

says he received neither Imatinib nor Flexeril the first three days. Then, he identifies three

occasions he did not receive Imatinib at all—January 30, January 31, and March 14, 2025.

Mr. Dixon identifies more instances in which he went without Flexeril. In addition

to the three days right after he was placed in general population, he went without any

Flexeril on four days—July 17-19, 2025, and July 25, 2025—and on several other days he

went without one of the two daily doses:

 January 13, 2025;

 January 27, 2025;

 January 28, 2025;

 March 10, 2025;

 July 26, 2025;

 August 1, 2025; and

 September 6, 2025.

Mr. Dixon says that when he misses a dose of Flexeril, he is in extreme pain because his

whole body cramps up. It often prevents him from sleeping.

Mr. Dixon also alleges problems with timely refilling his “may carry” medications.

Although he says he was diligent in requesting renewals, there were several occasions

where his “may carry” medications were late. Overall, he identifies five occasions some

or all of his “may carry” medications were late, sometimes lasting just a day and the

longest being eight days. In addition, he says that he went without his hemorrhoid

medication for a month, leaving him unable to sit down because of the pain.

Mr. Dixon does not identify an individual defendant whose actions resulted in

him not getting his medications over all this time or who could be said to be deliberately

indifferent. Deliberate indifference requires more than negligence—that is, merely

forgetting to do something. He does not allege facts that allow a reasonable inference that

any defendant’s actions were done intentionally or recklessly. Often, the amended

complaint simply says he did not get his medications and claims that this alone

constitutes an Eighth Amendment violation. In looking at the grievance responses he

attached to the complaint, some of the delays were attributed to the medications not

arriving at the prison on time (ECF 9-1 at 13), in one instance it was reported he slept

through the evening med pass (ECF 9-1 at 22), another time the nurse made a mistake

(ECF 9-1 at 26), other times the medication was not restocked or the medical assistant

couldn’t find it (ECF 9-1 at 40, 45). These reasons aren’t necessarily true, but they

demonstrate that the various problems Mr. Dixon had with his medications are not easily

ascribed to one reason, much less deliberate indifference, or to one person. Based on the

allegations here, no one individual can plausibly be said to have acted with deliberate

indifference regarding any particular instance of medication being missing.

The collective allegations raise concerns nonetheless. In looking at his medication

delivery as a whole, Mr. Dixon has plausibly alleged a breakdown in the system such that

his medication administration could be constitutionally deficient. See generally Glisson v.

Indiana Dep’t of Corr., 849 F.3d 372 (7th Cir. 2017). Perhaps through discovery Mr. Dixon

will learn that one particular person bears the necessary culpability to be considered

deliberately indifferent, in which case he may seek to amend his complaint to add those

allegations and that defendant. But repeated acts of negligence by different people cannot

be combined to hold them all, collectively, responsible for deliberate indifference. See

Zentmyer v. Kendall Cnty., 220 F.3d 805, 811 (7th Cir. 2000) (“Zentmyer does not present

evidence that any individual defendant failed to administer so many doses that the

defendant’s actions by themselves instantiate deliberate indifference, nor does Zentmyer

allege any agreement among the defendants to deprive him of medical care.”); Andreyev

v. Kjorlie, 455 F. Appx. 693, 696 (7th Cir. 2011) (“This is not a case where a single jailer

denied a prisoner a toothbrush and toothpaste 15 times, in which case a reasonable trier

of fact might conclude that the jailer was on notice of the prisoner’s lack of toothpaste.

No single defendant refused Andreyev a toothbrush more than four times, and most of

the defendants turned him down no more than once or twice.”) (citation omitted). But a

private company providing medical care in a prison can be sued under Monell v. Dep’t of

Soc. Servs. of City of New York, 436 U.S. 658 (1978), so long as 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). Mr. Dixon has plausibly

alleged that the medication distribution and renewal system put into place by the prison’s

medical provider, Centurion Health Services, is so obviously deficient that the company

was aware that prisoners’ medical care will be deficient as a result. See Glisson, 849 F.3d

at 378-82 (discussing when Monell liability exists for company providing medical care in

prison, even though no individual medical provider was deliberately indifferent to a

serious medical need). He may proceed against Centurion Health Services, but not the

individual staff members who were involved in providing his medication.

Next, Mr. Dixon complains that, in June 2025, Nurse Hamlin refused to re-order

the Bengay cream his oncologist recommended to use for muscle cramps and pain.

Instead, she told him to order the pain relief cream available through the commissary.

Mr. Dixon told her the commissary cream—CareALL—was not strong enough, and he

needed Bengay, but she refused. When he saw his oncologist again in September 2025,

that doctor again recommended Bengay after his told her how he was in extreme pain

throughout the day and night. When he returned to the prison, Nurse Hamlin told Mr.

Dixon that, though the oncologist had ordered the Bengay cream, it was her opinion that

he did not need it. He reiterated that he was in extreme pain and Bengay gives him relief,

but the commissary brand does not. He notes Bengay has a stronger dosage of medicine

than the commissary brand.2

2 The active ingredients in Bengay are 4% camphor, 10% menthol, and 30% methyl salicylate.

Ultra Strength BENGAY® Non-Greasy Topical Pain Relief Cream,

https://www.bengay.com/products/ultra-strength-cream (last visited Jan. 7, 2026). The active

ingredients in CareAll Muscle Rub are 10% menthol and 15% methyl salicylate 15%. CareALL:

Muscle Rub Greaseless Pain Relieving Cream, https://careallproducts.com/products/muscle-

rub/ (last visited Jan. 7, 2026).

It violates the Eighth Amendment to persist in an ineffective course of treatment.

Mr. Dixon has plausibly alleged Nurse Hamiln’s decision to keep him on CareALL

cream, which Mr. Dixon asserts is ineffective, constitutes deliberate indifference. It is

possible that, through discovery, Mr. Dixon will learn that she used her medical judgment

to reject Bengay. But giving Mr. Dixon the inferences he is entitled to at this stage, this

claim may proceed.

Next, Mr. Dixon complains that his pre-renal diet was discontinued, right at a time

when his kidney damage worsened. Mr. Dixon says that on August 5, 2025, Dr. Partain

informed him that she was not going to renew the pre-renal diet that his oncologist had

ordered as a treatment for kidney damage. It appears she may have made this decision

because he had been eating food that was not compliant with that diet. When he

submitted a healthcare request form about the change in diet, he was told that he no

longer meets the criteria for a medically prescribed diet. ECF 9-1 at 85. His pre-renal diet

was renewed at a September 2025 oncologist visit, but Nurse Hamlin said she was not

going to honor that because she did not find that Mr. Dixon qualified for the pre-renal

diet. Mr. Dixon believes the damage to his kidneys has progressed from borderline

kidney disease to stage 1 kidney disease. He alleges, therefore, that his oncologist

upgraded the diet from a pre-renal diet to a renal diet, but the medical providers at Miami

will not comply with the orders.

Here, Mr. Dixon has plausibly alleged he has a serious medical need due to kidney

damage. A difference of opinion between two medical professionals about the proper

course of treatment does not violate the Eighth Amendment. But giving Mr. Dixon the

inferences to which he is entitled, he may proceed on this claim against Nurse Hamlin

and Dr. Partain. However, he may not proceed against Nurse Shalana Seifert, whom he

also blames for the diet decision. Her involvement was limited to discouraging Dr.

Partain from taking a blood sample to run tests to confirm whether Mr. Dixon needed the

pre-renal diet. There are no allegations that Nurse Seifert had any decisionmaking

authority. ECF 9-1 at 87 (stating medical director made the decision not to renew).

In addition, because Mr. Dixon alleges his problems concerning the inadequate

administration of medication, his muscle pain and cramps, and the need for a medical

diet to address alleged kidney damage is ongoing, he may proceed on a claim for

injunctive relief to receive adequate medication administration, medical care for his

muscle pain and cramps, and medical care for his kidney damage. The Warden of Miami

Correctional Facility has both the authority and the responsibility to ensure that

Mr. Dixon receives constitutionally adequate medical care as required by the Eighth

Amendment. See Gonzalez v. Feinerman, 663 F.3d 311, 315 (7th Cir. 2011). Therefore, the

Warden will be made a defendant and Mr. Dixon will be granted leave to proceed on an

official capacity claim for permanent injunctive relief to receive adequate medical care for

these issues.

Finally, Mr. Dixon alleges he has difficulty walking, and he complains that Nurse

Hamlin is not providing adequate medical care for his condition. He says he often

experiences blurred vision, dizziness, and pain in his body that leaves him unable to

walk, and he cannot walk more than 15-20 steps without falling down. While Nurse

Hamlin was on maternity leave, Dr. Partain was treating him, and she had been taking

steps to get him tested and move towards a consultation with a neurologist. Dr. Partain

ordered a head CT scan to occur at the same time he was going to have an abdominal CT

scan, but all those plans stopped in June 2025 when Nurse Hamlin returned. In response

to a healthcare request form he submitted about the canceled testing, Dr. Partain

explained to him that once she was able to review the imaging he has had and all the

hospitalization documentation, she no longer thought the CT scan and neurologist

referral was appropriate. ECF 9-1 at 81. Mr. Dixon complains that when he tells Nurse

Hamlin about his symptoms, she does not provide him any treatment. Instead, she tells

him about how her aunt and grandmother handle pain and falling down, and then she

sends him on his way without further treatment. Mr. Dixon has plausibly alleged that

Nurse Hamlin and Dr. Partain are providing constitutionally inadequate medical care for

his walking difficulties, and he may proceed against them.

Mr. Dixon filed a motion for a preliminary injunction. ECF 12. He asks the court

to order the health care providers to stop delaying his cancer follow up appointments, to

follow his oncologist’s orders for a renal diet, and to follow his oncologist’s directions in

providing his cancer medications.

“[A] preliminary injunction is an extraordinary and drastic remedy, one that

should not be granted unless the movant, by a clear showing, carries the burden of

persuasion.” Mazurek v. Armstrong, 520 U.S. 968, 972 (1997) (emphasis in original). A

plaintiff seeking a preliminary injunction must establish that he is likely to succeed on

the merits, that he is likely to suffer irreparable harm in the absence of preliminary relief,

that the balance of equities tips in his favor, and that an injunction is in the public interest.

Winter v. Nat. Res. Def. Council, Inc., 555 U.S. 7, 20 (2008).

On the first prong, “the applicant need not show that [she] definitely will win the

case.” Illinois Republican Party v. Pritzker, 973 F.3d 760, 763 (7th Cir. 2020). However, “a

mere possibility of success is not enough.” Id. at 762. “A strong showing . . . normally

includes a demonstration of how the applicant proposes to prove the key elements of

[her] case.” Id. at 763 (quotations omitted). In assessing the merits, the court does not

simply “accept [the plaintiff’s] allegations as true” or “give him the benefit of all

reasonable inferences in his favor, as would be the case in evaluating a motion to dismiss

on the pleadings.” Doe v. Univ. of S. Indiana, 43 F.4th 784, 791 (7th Cir. 2022). Instead, the

court must assess the merits as “they are likely to be decided after more complete

discovery and litigation.” Id.

On the second prong, “[i]ssuing a preliminary injunction based only on a

possibility of irreparable harm is inconsistent with . . . injunctive relief as an extraordinary

remedy that may only be awarded upon a clear showing that the plaintiff is entitled to

such relief.” Winter, 555 U.S. at 22. Mandatory preliminary injunctions—“those requiring

an affirmative act by the defendant”—are “cautiously viewed and sparingly issued.”

Mays v. Dart, 974 F.3d 810, 818 (7th Cir. 2020). Additionally, in the prison context, the

court’s ability to grant injunctive relief is limited. “[I]njunctive relief to remedy

unconstitutional prison conditions must be narrowly drawn, extend no further than

necessary to remedy the constitutional violation, and use the least intrusive means to

correct the violation of the federal right.” Westefer v. Neal, 682 F.3d 679, 681 (7th Cir. 2012)

(citation and quotations omitted); see also Rasho v. Jeffreys, 22 F.4th 703, 711-13 (7th Cir.

2022) (outlining strict limitations on granting injunctive relief in correctional setting).

Here, Mr. Dixon is proceeding on claims related to his kidneys, the treatment of

his muscle pain and cramps, and the administration of his cancer medication, and he

alleges these problems are ongoing. He has not stated a claim regarding his cancer follow-

up appointments, so he has no chance of success on the merits regarding those

appointments. The preliminary injunction motion will be limited to the provision of

constitutionally adequate administration of his medication, medical care for his alleged

kidney failure, and medical care for his muscle pain and cramps. In light of the deference

owed to prison medical providers and the limitations on granting injunctive relief in the

prison setting, the court will order the Warden to respond before taking further action on

Mr. Dixon’s motion for a preliminary injunction.

For these reasons, the court:

(1) DIRECTS the clerk to add as a defendant the Warden of Miami Correctional

Facility in his official capacity;

(2) GRANTS Kelvin Wayne Dixon leave to proceed against Centurion Health

Services in its official capacity for compensatory and punitive damages for putting into

place a constitutionally deficient system for dispensing and renewing medications in

violation of the Eighth Amendment;

(3) GRANTS Kelvin Wayne Dixon leave to proceed against Nurse Danielle Hamlin

in her individual capacity for compensatory and punitive damages for denying him a

prescription for Bengay or other adequate treatment for his muscle pain and cramps in

violation of the Eighth Amendment;

(4) GRANTS Kelvin Wayne Dixon leave to proceed against Nurse Danielle Hamlin

and Dr. Kristin Partain in their individual capacities for compensatory and punitive

damages for denying him a pre-renal or renal diet to address his alleged kidney damage

in violation of the Eighth Amendment;

(5) GRANTS Kelvin Wayne Dixon leave to proceed against Nurse Danielle Hamlin

and Dr. Kristin Partain in their individual capacities for compensatory and punitive

damages for failing to take further steps to address his walking difficulties in violation of

the Eighth Amendment;

(6) GRANTS Kelvin Wayne Dixon leave to proceed against the Warden of Miami

Correctional Facility in his official capacity for permanent injunctive relief to receive

constitutionally adequate medication administration, medical care for his muscle pain

and cramps, and medical care for his kidney damage to the extent required by the Eighth

Amendment;

(7) DISMISSES all other claims;

(8) DISMISSES LeeAnn Ivers, Shalana Seifert, Felisha Gray, Heather Motez,

Aramark Food Services, Kim Myers, McAllister, Newby, Debbie, and Sherr;

(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) the Warden of Miami Correctional Facility at the Indiana

Department of Correction, with a copy of this order, the complaint (ECF 9), and the

motion for a preliminary injunction (ECF 12);

(10) DIRECTS the clerk to fax or email a copy of the same documents to the Warden

of Miami Correctional Facility at Miami Correctional Facility;

(11) 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) Nurse Danielle Hamlin, Dr. Kristin Partain, and Centurion

Health Services at Centurion Health of Indiana, LLC, with a copy of this order, the

complaint (ECF 9), and the motion for a preliminary injunction (ECF 12);

(12) ORDERS the Indiana Department of Correction 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;

(13) ORDERS the Warden to file and serve a response to the plaintiff’s motion for

a preliminary injunction no later than February 6, 2026, with supporting documentation

and declarations from staff as necessary, addressing the plaintiff’s current medical needs

and the steps being taken to address those needs, with any reply due by February 20,

2026; and

(14) ORDERS, under 42 U.S.C. § 1997e(g)(2), Centurion Health Services, Nurse

Danielle Hamlin, Dr. Kristin Partain, and the Warden 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.

SO ORDERED.

January 14, 2026 s/ Damon R. Leichty

Judge, United States District Court