Buchanan

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ILLINOIS

MEIKO BUCHANAN,

Plaintiff,

v. Case No. 3:23-CV-512-NJR

STEVEN BOWMAN, DR. PERCY

MYERS, ALISA DEARMOND, JILIAN

CRANE, and ANTHONY WILLS,

Defendants.

MEMORANDUM AND ORDER

ROSENSTENGEL, District Judge:

Plaintiff Meiko Buchanan, an inmate of the Illinois Department of Corrections

(“IDOC”) who is currently incarcerated at Menard Correctional Center (“Menard”), filed

this action pursuant to 42 U.S.C. § 1983 for alleged deprivations of his Eighth Amendment

rights while housed at both Pinckneyville Correctional Center (“Pinckneyville”) and

Menard. Specifically, Buchanan claims that Defendants were deliberately indifferent to

his serious medical needs when they failed to properly treat his left ear pain, delayed

treatment, and failed to refer him to an outside provider to address his ear pain and

hearing loss.

Now pending before the Court are Motions for Summary Judgment filed by three

medical providers employed by Wexford Health Sources, Inc.: Defendants Jilian

Crane, NP (Doc. 102), Alisa Dearmond, NP (Doc. 105), and Percy Myers, M.D. (Doc. 108)

(collectively, “the Wexford Defendants”). Also pending is a Motion for Summary

Judgment filed by IDOC employees Steven Bowman and Anthony Wills (collectively,

“the IDOC Defendants”) (Doc. 117). The Court appointed counsel for Buchanan, and

counsel filed timely responses to Defendants’ motions. (Docs. 133, 135, 137, 139). Each

Defendant also filed a reply brief. (Docs. 140, 141, 142, 145). For the reasons set forth

below, Defendants’ motions are granted.

BACKGROUND

I. Local Rule 56.1 and Federal Rules of Evidence

The Court first addresses general evidentiary issues raised by the parties’

summary judgment briefing. Both parties object to the Statement of Material Facts filed

by the opposing party on various grounds.

Buchanan objects to the undisputed material facts stated by NP Crane,

NP Dearmond, and Dr. Myers because the facts are not within the witnesses’ personal

knowledge, Defendants have not been disclosed as expert witnesses, and no foundation

has been laid for their testimony. Buchanan also objects to certain “facts” that are actually

legal argument disguised as expert witness opinion. Finally, Buchanan argues that the

factual statements are compound and not in separately numbered paragraphs as required

by Local Rule 56.1.

In their replies, the Wexford Defendants provided the Court with their Rule

26(a)(2)(C) expert disclosures, which include NP Crane, NP Dearmond, and Dr. Myers,

and comprehensively detail the subject matter of their expected testimony. (Doc. 141-1).

The disclosures were mailed to Buchanan on April 1, 2025, and supplemental disclosures

were mailed on April 30, 2025. (Id.). The Court appointed counsel for Buchanan on

August 13, 2025, so the Court presumes that counsel was unaware of Defendants’

disclosures. Because the Wexford Defendants were disclosed as experts under Rule

26(a)(2)(c), the Court overrules Buchanan’s objections to their opinions. However, the

Court will not consider any portion of a factual statement that contains improper legal

arguments or conclusions. See Patterson v. Ind. Newspapers, Inc., 589 F.3d 357, 359–60 (7th

Cir. 2009) (affirming decision to disregard “argumentative” facts submitted in support of

summary judgment).

The Court also notes that the Wexford Defendants disregarded Local Rule 56.1

when they lumped numerous statements of fact into one numbered paragraph. Each

material fact should be set forth in its own, separately numbered paragraph so that

opposing parties can easily admit or deny the facts with appropriate citations to the

record. SDIL-LR 56.1(a). Notwithstanding this violation, the Court notes that Buchanan

was able to respond to the statements. Accordingly, the Court will not impose sanctions

in this instance. See Cichon v. Exelon Generation Co., 401 F.3d 803, 809–10 (7th Cir. 2005)

(a district court has discretion to impose a penalty when a litigant does not comply with

the court’s local rules regarding summary judgment).

For their part, the Wexford Defendants object to any facts that rely on Buchanan’s

grievances or sick call slips, asserting that the documents consist of inadmissible hearsay

under the Federal Rules of Evidence.

While prison grievances are hearsay when considered for the truth of their

contents, the Seventh Circuit has recognized that summary judgment evidence “does not

need to be admissible in form; it only needs to be admissible in content.” Wheatley v.

Factory Card & Party Outlet, 826 F.3d 412, 420 (7th Cir. 2016). Because the statements

within a prisoner’s grievances are within his personal knowledge, and he can testify

about them at trial, some district courts consider them on summary judgment. See, e.g.,

Matthews v. Illinois Dep’t of Corr., No. 16-CV-11214, 2024 WL 867087, at *2 (N.D. Ill. Feb.

29, 2024); Salley v. Parker, No. 18-CV-5700, 2022 WL 2952818, at *9 (N.D. Ill. July 26, 2022).

Here, the statements within Buchanan’s grievances are within his personal

knowledge and he could testify to their contents at trial. Moreover, the grievances could

be admissible for a purpose other than the truth of the matter asserted, including to

demonstrate that Defendants had notice of his complaints. Therefore, the Court will not

disregard them for purposes of summary judgment, and Defendants’ objection is

overruled. As to Buchanan’s sick call slips, the statements within them were made to

request medical treatment and describe his symptoms, see FED. R. EVID. 803(4), and

Buchanan can testify as to his personal knowledge of their contents at trial. Therefore,

Defendants’ objection is again overruled.

II. Procedural History

On February 16, 2023, Buchanan filed his Complaint alleging deliberate

indifference with regard to treatment of pain in his left ear. (Doc. 1). Along with his

Complaint, Buchanan filed a Motion for Preliminary Injunction. (Doc. 4). After the Court

conducted a review of the Complaint pursuant to 28 U.S.C. § 1915A, Buchanan was

allowed to proceed on the following claims:

Count 1: Eighth Amendment deliberate indifference claim against Dr.

Myers for failing to properly treat Buchanan’s ear pain and

allowing him to be transferred to Menard without treatment.

Count 2: Eighth Amendment deliberate indifference claim against

NP Dearmond and NP Crane for refusing to refer Buchanan

for outside care of his left ear pain and hearing loss despite

Menard lacking an onsite treating physician.

Count 3: Eighth Amendment deliberate indifference claim against

Bowman (individual capacity only) for failing to hire an

onsite medical doctor at Menard, delaying medical treatment

through the collegial review process, failing to adequately

hire and train staff, and failing to keep medical records

requests.

(Doc. 8). To the extent Buchanan sought injunctive relief in the form of an outside referral

to a specialist, the Court added Warden Anthony Wills (in his official capacity only) for

the purpose of implementing any injunctive relief awarded. (Id. at p. 5).

On June 28, 2023, after holding a hearing on the matter, the Court denied

Buchanan’s Motion for Preliminary Injunction. (Docs. 61, 62).

III. Undisputed Material Facts

A. The Wexford Defendants

On January 18, 2022, Buchanan wrote a grievance to prison officials at

Pinckneyville complaining that he had a bug infestation in his cell and requesting that

his cell be sprayed immediately. (Doc. 133-2 at p. 1). Three days later, on January 21, 2022,

Buchanan submitted a sick call slip to see health care because he woke up with hearing

loss, pain, and a feeling like there was something in his ear that he could not get out. (Id.

at p. 2). Buchanan saw a nurse the next day who noted that his tympanic membrane

(eardrum) was red. (Id. at p. 3). The nurse instructed Buchanan not to put anything in his

ear, prescribed Tylenol for discomfort, prescribed Debrox drops for earwax, referred him

to the clinic for follow-up after five days for ear flushing with warm water, and told him

to return to sick call if his symptoms worsened or persisted. (Id.).

On January 24, 2022, Buchanan wrote another sick call slip complaining that it still

felt like something was in his ear and that the Debrox drops and Tylenol were not

working. (Id. at p. 4). The next day, January 25, 2022, Buchanan again filled out a sick call

slip stating that he could not hear out of his left ear and the pain medication and ear drops

were not working. (Id. at p. 5). On January 26, 2022, a nurse wrote a note stating that

Buchanan was not seen at nurse sick call because he was in a group meeting. (Id. at p. 4).

Dr. Myers examined Buchanan on January 28, 2022. (Id. at p. 6). Dr. Myers was the

Medical Director at Pinckneyville from June 13, 2018, to September 21, 2024. (Doc. 110-1

at ¶ 1). Buchanan complained to Dr. Myers of left ear problems, saying it felt like there

was something in his ear. (Doc. 133-2 at p. 6). Upon probing his ear, Dr. Myers found no

pertinent clinical findings to report, indicating a normal left ear canal. (Doc. 110-1 at ¶ 14).

However, due to Buchanan’s complaints, length of symptoms, and lack of clear objective

clinical findings, Dr. Myers diagnosed Buchanan with mild otitis in his left ear and

prescribed Maxitrol drops, three times per day for seven days, and Tylenol 325 mg as

needed up to three times per day for 10 days. (Id.). Dr. Myers educated Buchanan that the

Maxitrol drops were different from the Debrox drops previously prescribed. (Doc. 133-2

at p. 6). While Debrox is for earwax, Maxitrol addresses mild ear infections by combining

two antibiotics with the anti-inflammatory effects of a corticosteroid. (Doc. 110-1 at ¶ 17).

Buchanan returned to nurse sick call on February 1, 2022, where he complained

that his ear pain was 10 out of 10, the antibiotics were not working, and he had both

drainage and hearing loss. (Doc. 133-2 at 9). The nurse charted Buchanan’s affected ear

as his right ear, but Buchanan attested that he has never complained of issues in his right

ear, only his left ear. (Doc. 133-1 at ¶ 10). Buchanan reported that he had put water and

his fingers in his ear. (Doc. 133-2 at p. 9). At that point, Buchanan’s antibiotics had only

been prescribed four days prior. (Id.).

The next day, Buchanan wrote a grievance complaining about his left ear and the

treatment he had received so far. (Id. at pp. 10-11). As relief, he requested to be sent to an

outside specialist to have his ear looked at or flushed to remove anything inside of it.

(Id. at p. 10).

Buchanan next wrote a sick call slip on February 10, 2022. (Id. at p. 12). He stated

that he was still having pain in his left ear despite the medications and ear drops he had

been prescribed. (Id.). Buchanan also thought there was something in his ear and stated

that it was messing with his sleep and mental state. (Id.). He wrote another sick call slip

on February 11, 2022, because he was in the mental health group when the nurse came

for sick call. (Id. at p. 13).

A nurse saw Buchanan at sick call on February 12, 2022. (Id. at p. 14). The nurse

charted Buchanan’s complaints as being with his right ear, which Buchanan again

disputes. (Id.). Buchanan reported that his pain level was 8 out of 10 and that he had

hearing loss. (Id.). Upon objective physical examination, Buchanan’s tympanic

membranes, ear cavities, and oral cavities were within normal limits. (Id.). He failed a

finger rub hearing test in his left ear, and the nurse referred Buchanan to the doctor. (Id.).

On February 15, 2022, Buchanan wrote a sick call slip to complain again about pain

in his left ear and a feeling like there was something in it. (Id. at p. 15). He was seen by a

nurse on February 16, 2022, and described his left ear pain as stabbing and constant. (Id.

at p. 16). He also reported a feeling of a foreign object in his ear. (Id.). He denied sticking

any objects in his ear. (Id.).

Dr. Myers examined Buchanan two days later, on February 18, 2022. (Id. at p. 17).

Dr. Myers noted that Buchanan was previously given ear drops to use for seven days, but

he continued to have ear pain. (Id.). Dr. Myers observed through physical examination

that Buchanan had otitis. (Id.). Dr. Myers further charted that when Buchanan was seen

on January 28, he was argumentative about the drops; therefore, it was questionable

whether Buchanan actually used the drops. (Id.). Dr. Myers thus prescribed Augmentin,

an oral antibiotic, twice per day for seven days, and ordered nursing staff to watch

Buchanan take the medication. (Id.; Doc. 110-1 at ¶ 23).

Dr. Myers did not see Buchanan again after February 18, 2022. (Doc. 110-1 at ¶ 27).

Dr. Myers opined that, given Buchanan’s subjective complaints and Dr. Myers’s objective

findings during this short period of time, there was no clinical need or medical necessity

to refer Buchanan to an ENT or audiologist for consultation or testing. (Id. at ¶ 33).

Between January 21, 2022, and March 10, 2022, Buchanan made at least

16 complaints regarding his ear pain through sick call notes, grievances, and in his

physical examinations. (See Doc. 139-2). On March 10, 2022, Buchanan was transferred

from Pinckneyville to Menard. (Doc. 104-8 at p. 11).

Buchanan first saw a nurse for his left ear at Menard on March 31, 2022. (Id. at

p. 12). Buchanan reported a pain level of 8 out of 10 in his left ear, as well as hearing loss,

but he denied he had any drainage. (Id.). The nurse noted a history of antibiotics and pain

medication ongoing for the past two months. (Id.). She could not visualize the tympanic

membranes, but she did not see any redness. (Id.). The nurse referred Buchanan to a

doctor and advised Buchanan not to put anything in his ear. (Id.).

Buchanan was scheduled to see NP Crane on Friday, April 1, 2022, for evaluation

of his “ear pain x 2 months.” (Id. at p. 13). NP Crane is a licensed nurse practitioner in the

State of Illinois and was employed as a full-time NP at Menard until November 1, 2024.

(Doc. 106-4 at ¶ 1). Buchanan failed to appear for his appointment because he “went to

[the] yard.” (Doc. 104-8 at p. 13). Buchanan testified that he could not recall this specific

appointment, but he explained that Tuesdays and Fridays are the only days they can

access the phones and make legal calls or reach their families. (Doc. 104-7 at pp. 72-73).

On April 6, 2022, Buchanan was seen in nurse sick call at Menard. (Doc. 104-8 at

p. 14). The nurse flushed Buchanan’s left ear and a “small dark blockage” was removed

from his ear canal. (Id.). Upon completion, the ear canal was clear. (Id.). Buchanan testified

that he saw the blockage after it was removed and he knew it was a roach or spider

because it had legs on it. (Doc. 104-7 at p. 75). After his ear was flushed, Buchanan could

feel there was nothing in his ear, but he still had ear pain. (Id. at p. 76).

Buchanan returned to nurse sick call on April 18, 2022, for complaints of left ear

pain at a level 4 out of 10. (Doc. 104-8 at p. 15). Buchanan also reported drainage and

hearing loss, and he told the nurse he flushed his ear using water and a cable cord. (Id.).

The nurse recorded that Buchanan’s temperature was normal and his ear, nose, and

throat were open with no redness, drainage, or swelling. (Id.). Additionally, his bilateral

tympanic membranes were intact with no redness, and his external ears and oral cavity

were open and clear with no redness or swelling and no perforations visualized. (Id.).

However, he failed a finger rub hearing test in his left ear. (Id.). Buchanan was referred

to a provider and educated not to put anything in his ear. (Id.). Buchanan explained at his

deposition that he attached a hollow cable cord to his sink and ran hot water by his ear—

not directly in his ear—to help soothe his pain. (Doc. 104-7 at p. 78).

On April 20, 2022, Buchanan saw NP Crane for the first time. (Doc. 104-8 at p. 16).

Buchanan reported that his ear still hurt at a level 6 out of 10, and he had taken antibiotics

“a while back” but they did not work. (Id.). NP Crane examined Buchanan’s ears and

noted that the left and right tympanic membranes were both visualized and within

normal limits. (Id.). She also charted that Buchanan “may have slight bulge” but he had

a clear canal without erythema (redness). (Id.). She could not find a physiological reason

for his ear pain. (Id.). NP Crane ordered an on-site hearing test, 500 mg of Tylenol to be

taken twice per day as needed for one month, Debrox ear drops twice per day for five

days, and Claritin 10 mg to be taken orally every day for one year. (Id.). NP Crane attested

that inflammation and allergy symptoms can lead to feelings of ear pain, so she

prescribed Claritin and Tylenol to address his complaints. (Doc. 110-5 at ¶ 35). NP Crane

also attested that she always instructs patients to refrain from sticking or putting

anything in their ears except for prescribed medication. (Id. at ¶ 17).

The on-site hearing test was performed on May 4, 2022. (Doc. 104-8 at pp. 17-19).

Buchanan failed the hearing test and was referred to a provider to request an audiogram.

(Id.). On May 9, 2022, NP Dearmond submitted the referral for Buchanan to see a licensed

audiologist for an audiogram and hearing evaluation. (Id. at p. 20). NP Dearmond is a

licensed Nurse Practitioner in the State of Illinois and was employed as a full-time NP at

Menard Correctional Center until December 4, 2024. (Doc. 107-3 at ¶ 1). NP Dearmond

did not see or examine Buchanan on May 9, 2022; she merely submitted the referral.

(Doc. 106-4 at ¶ 20-22). The referral was approved by Wexford’s Utilization Management

on May 16, 2022. (Id. at p. 22). NP Dearmond attested that the actual scheduling of the

audiologist was outside of her control. (Id. at ¶ 39). Instead, the time that an inmate is

seen by the specialist is controlled solely by the specialist. (Id.).

On June 17, 2022, NP Crane resubmitted the referral for Buchanan to see a licensed

audiologist for a hearing evaluation and audiogram. (Doc. 110-5 at p. 25). NP Crane

attested that she noticed the approved referral had not been scheduled, so she

resubmitted the referral in an attempt to expedite the hearing evaluation and audiogram.

(Doc. 110-5 at ¶ 36). Utilization Management again authorized the referral on June 27,

2022. (Id. at pp. 27-28).

Buchanan returned to nurse sick call on September 26, 2022, complaining of left

ear pain. (Doc. 104-8 at p. 26). Buchanan said his pain was at 7-8 out of 10, and he reported

hearing loss. (Id.). He also stated that he put warm water in his ear. (Id.). The nurse noted

swelling and redness and another failed finger rub hearing test. (Id.). NP Michael

Moldenhauer prescribed Amoxil, an oral antibiotic, and Floxin, an anti-bacterial ear drop.

(Id. at pp. 26, 40).

On October 28, 2022, Buchanan was seen in nurse sick call for complaints of left

ear pain for the past five days. (Id. at p. 27). Buchanan reported a greenish brown

discharge from his ear, hearing loss, and a pain level of 8 out of 10. (Id.). He also reported

using a tube to shoot water into his ear. (Id.). The otoscope was not working, so the nurse

could not look in Buchanan’s ear. (Id.). Buchanan failed the finger rub hearing test in his

left ear. (Id.). He was referred to the doctor for acute pain and prescribed Tylenol, 325 mg

three times per day for three days as needed. (Id.).

On November 11, 2022, Buchanan saw Dr. Glen Babich via telemedicine. (Id. at

p. 28). Dr. Babich charted that Buchanan subjectively reported pain and decreased

hearing in his left ear, a tympanic membrane bulge, and wax buildup. (Id.). Dr. Babich

could not visualize Buchanan’s tympanic membrane or ear canal due to the telemedicine

appointment, but he noted tenderness at the temporomandibular joint (TMJ). (Id.).

Dr. Babich’s assessment at this time was cerumen (earwax) in his ear with or without

hearing loss. (Id.). He ordered: an on-site dental appointment to assess Buchanan’s TMJ;

an on-site provider to visualize Buchanan’s left ear canal; a follow-up and audiology

exam and audiogram; Naprosyn 500 mg one tablet by mouth twice daily as needed for

six months; and cetirizine (antihistamine) 10 mg one tablet by mouth one time daily for

six months. (Id. at pp. 28, 41).

On December 21, 2022, Buchanan refused his scheduled audiology exam. (Id. at

30). A note by the Assistant ADA Coordinator states that Buchanan was not brought to

his onsite audiology appointment because Buchanan “refused” the appointment. (Id. at

p. 31). Buchanan testified that he had a legal call that day and did not know that the

appointment was with an audiologist. (Doc. 104-7 at p. 101). Had he known it was for a

hearing evaluation, he would not have refused the appointment. (Id. at p. 102).

Audiologist Dr. David Taylor examined Buchanan at a rescheduled appointment

on January 26, 2023. (Doc. 104-8 at pp. 44-45). Dr. Taylor noted that an otoscopy revealed

clear, unremarkable ear canals and tympanic membranes bilaterally. (Id.). Dr. Taylor

observed: “Audiometric testing revealed functional hearing loss. PTA and SRT were in

poor agreement, indicating poor test reliability. Note unmasked AC thresholds; crossover

not present where it would be expected, suggesting a malingering component.” (Id. at

p. 44). Dr. Taylor recommended retesting within six months to one year later. (Id. at p. 43).

NP Crane last examined Buchanan on March 14, 2023. (Id. at p. 34). She noted that

Buchanan reported his ear problem had been going on for 14 or 15 months and was not

getting any better. (Id.). NP Crane charted that Buchanan’s right ear tympanic membrane

and canal were normal. (Id.). His left ear tympanic membrane was creamy in color but

there was no drainage noted, and his left ear canal had erythema. (Id.). NP Crane assessed

Buchanan as having otitis media—an ear infection—in his left ear and prescribed

Augmentin, Ciprodex drops, and Tylenol. (Id.).

NP Crane opined, based on her education and experience treating similarly

situated patients and her training as a licensed nurse practitioner, that Buchanan’s

complaints on April 20, 2022, October 28, 2022, and November 11, 2022, were due to

transient otitis media with effusion. (Doc. 110-5 at ¶ 41). She further opined that transient

otitis media with effusion is treated with observation and re-examination every six

months. (Id.). Based on Buchanan’s subjective complaints and her objective findings

during her two examinations, NP Crane attested that there was no clinical need or

medical necessity to refer Buchanan to an ENT. (Id. at ¶ 42).

NP Dearmond saw Buchanan on August 17, 2023. (Doc. 104-8 at p. 50). Buchanan

told NP Dearmond he had experienced “constant” left ear pain for the past year and a

half. (Id.). He also told NP Dearmond he had a roach in his ear at Pinckneyville, decreased

hearing in his left ear but not deafness, and yellow green drainage from his ear two to

three weeks ago. (Id.). NP Dearmond examined Buchanan’s ears and noted that his

tympanic membranes were both pearly white, his right tympanic membrane had a slight

bulge, neither ear had earwax, active drainage, or redness, and both inner ears were very

clean. (Id.). She discussed the audiology test from January 26, 2023, which was

unremarkable, and she noted that the audiologist recommended repeating the hearing

test at a later date. (Id.). She also observed that Buchanan was able to understand and

hear her without difficulty, and that he left the office in good spirits. (Id.). NP Dearmond

explained to Buchanan that sometimes a slight bulge in the tympanic membrane can be

from seasonal allergies and can cause slight pain, but overall his ears looked good. (Id.).

She prescribed Zyrtec, Nasacort allergy spray, and ibuprofen. (Id.). This was the only time

that NP Dearmond saw Buchanan for an appointment relating to his left ear. (Id.).

No further audiology testing has been completed despite Dr. Taylor’s

recommendation that one be completed between six months and one year from January

26, 2023. (Doc. 139-1 at ¶ 20).

B. Defendant Bowman

At all times relevant to this case, Bowman was the Agency Medical Director of the

IDOC. (Doc. 104-7 at p. 21). Buchanan was never seen or treated by Bowman, nor did

Buchanan ever communicate with Bowman. (Id.). Buchanan testified that he sued

Bowman because “he’s over the IDOC” as the Agency Medical Director. (Id.).

As Agency Medical Director, Bowman attested, he provides administrative

oversight of the medical operations of the IDOC. (Doc. 118-1). He does not provide direct

medical care to any individual in custody. (Id.). Bowman also is not responsible for

staffing decisions for the licensed medical providers who provide care at IDOC facilities.

(Id.). Those responsibilities, including decisions regarding the hiring of facility medical

directors, medical doctors, nurse practitioners, or physician assistants, belong solely with

Wexford Health Sources, Inc.1 (Id.).

LEGAL STANDARD

Summary judgment is appropriate where there is no genuine dispute of material

fact and the movant is entitled to judgment as a matter of law. FED. R. CIV. P. 56(a). In

determining whether a genuine issue of fact exists, the Court views the evidence and

draws all reasonable inferences in favor of the non-moving party. Ziccarelli v. Dart,

35 F.4th 1079, 1083 (7th Cir. 2022). Once the moving party sets forth the basis for summary

judgment, the burden 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, 323-24 (1986). A moving party

is entitled to judgment as a matter of law where the non-moving party “has failed to make

a sufficient showing on an essential element of her case with respect to which she has the

burden of proof.” Celotex, 477 U.S. at 323.

1 Buchanan objects to this statement of fact because he believes Bowman would be providing medical

direction to Wexford as to the staffing, or lack thereof, at each facility. However, Buchanan has not pointed

to any specific evidence in the record to support his objection. FED. R. CIV. P. 56(c)(1). Therefore, the

objection is overruled.

DISCUSSION

I. Deliberate Indifference

“The Eighth Amendment proscribes ‘deliberate indifference to serious medical

needs of prisoners’ amounting to ‘the unnecessary and wanton infliction of pain.’” Arce

v. Wexford Health Sources Inc., 75 F.4th 673, 678–79 (7th Cir. 2023) (quoting Stockton v.

Milwaukee County, 44 F.4th 605, 614 (7th Cir. 2022)). “Deliberate indifference requires

‘[s]omething more than negligence or even malpractice.’” Id. at 679 (quoting Pyles v.

Fahim, 771 F.3d 403, 409 (7th Cir. 2014)). To succeed on an Eighth Amendment deliberate

indifference claim, a plaintiff must show: (1) he suffered from an objectively serious

medical condition; and (2) the individual defendant was deliberately, that is subjectively,

indifferent to that condition. Giles v. Godinez, 914 F.3d 1040, 1049 (7th Cir. 2019).

A medical condition is objectively serious if “a physician has diagnosed it as

requiring treatment, or the need for treatment would be obvious to a layperson.” Lockett

v. Bonson, 937 F.3d 1016, 1023 (7th Cir. 2019) (citation omitted). It is not necessary for a

condition to “be life-threatening to be serious; rather, it could be a condition that would

result in further significant injury or unnecessary and wanton infliction of pain if not

treated.” Gayton v. McCoy, 593 F.3d 610, 620 (7th Cir. 2010); accord Farmer v. Brennan, 511

U.S. 825, 828 (1994) (violating the Eighth Amendment requires “deliberate indifference to

a substantial risk of serious harm”) (internal quotation marks omitted) (emphasis added).

Prevailing on the subjective prong requires a plaintiff to show that a prison official

has subjective knowledge of—and then disregards—an excessive risk to inmate health.

Id. at 653. “When a prison medical professional is accused of providing inadequate

treatment (in contrast to no treatment), evaluating the subjective state-of-mind element

can be difficult.” Whiting v. Wexford Health Sources, Inc., 839 F.3d 658, 662 (7th Cir. 2016).

The plaintiff need not show the individual “literally ignored” his complaint, but that the

individual knew of the condition and either knowingly or recklessly disregarded it.

Hayes v. Snyder, 546 F.3d 516, 524 (7th Cir. 2008).

“Something more than negligence or even malpractice is required” to prove

deliberate indifference. Pyles v. Fahim, 771 F.3d 403, at 409 (7th Cir. 2014). The defendant

must have had “actual, personal knowledge of a serious risk, coupled with the lack of

any reasonable response to it.” Ayoubi v. Dart, 724 F. App’x 470, 474 (7th Cir. 2018).

Proving deliberate indifference “is a high bar ‘because it requires a showing [of]

something approaching a total unconcern for the prisoner’s welfare in the face of serious

risks.’” Rasho v. Jeffreys, 22 F.4th 703, 710 (7th Cir. 2022) (quoting Rosario v. Brawn, 670 F.3d

816, 821 (7th Cir. 2012)). “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.” Whiting v.

Wexford Health Sources, Inc., 839 F.3d 658, 662 (7th Cir. 2016).

Most cases of deliberate indifference turn on circumstantial evidence. Petties v.

Carter, 836 F.3d 722, 728 (7th Cir. 2016), as amended (Aug. 25, 2016); see also Brown v.

Osmundson, 38 F.4th 545, 550 (7th Cir. 2022). “Several circumstances can permit a jury to

reasonably infer deliberate indifference, such as denial of medical treatment altogether,

id. at 729, delay of medical care, Dobbey v. Mitchell-Lawshea, 806 F.3d 938, 940 (7th Cir.

2015), continued ineffective treatment, Conley v. Birch, 796 F.3d 742, 747 (7th Cir. 2015),

‘a substantial departure from accepted professional judgment, practice, or standards,’

Estate of Cole by Pardue v. Fromm, 94 F.3d 254, 261–62 (7th Cir. 1996), ignoring an obvious

risk, Norfleet v. Webster, 439 F.3d 392, 396 (7th Cir. 2006), and refusing care because of cost,

Ralston v. McGovern, 167 F.3d 1160, 1162 (7th Cir. 1999).” Brown, 38 F.4th at 550.

II. Objectively Serious Medical Need

The Wexford Defendants first assert they are entitled to summary judgment

because there is no evidence that Buchanan suffered from an objectively serious medical

condition.2 While they acknowledge that an ear infection can be deemed “objectively

serious where it inflicts prolonged suffering and requires extensive treatment,” they

contend that pain and/or hearing problems attributed to earwax buildup or irrigation

treatment do not rise to the level of an objectively serious medical need. The Wexford

Defendants each assert:

Buchanan’s condition, a suspected ear infection, did not inflict prolonged

suffering or require extensive treatment. [Buchanan’s] left ear condition

was not chronic and did not cause him substantial pain and did not

significantly affect (or affect at all) his daily activities. [Buchanan] was never

at a serious risk of harm for his sporadic, transitory, and benign left ear

complaints.

(Doc. 103 at p. 20, Doc. 106 at p. 18, Doc. 109 at p. 18).

The Court respectfully disagrees and finds that Buchanan’s ear pain and hearing

loss constituted an objectively serious medical condition. During his time at

Pinckneyville, Buchanan complained at least 16 times about his ear pain and the feeling

that something was in his ear. Once he was transferred to Menard, Buchanan continued

2 For the purposes of summary judgment only, Defendant Bowman does not dispute that Buchanan had

an objectively serious medical condition. (Doc. 118 at p. 7).

to complain of ear pain and hearing loss, resulting in a referral to an audiologist. The

audiologist’s testing then revealed functional hearing loss. While Dr. Taylor suspected

malingering, he also recommended retesting in six months to a year.

Defendants point to Buchanan’s refusal to see the audiologist on December 21,

2022, as evidence that his complaints were not serious. But, Buchanan testified that he

had a legal call and did not realize the appointment was with an audiologist. They also

refer to the “dozens of appointments” after Buchanan’s final appointment with NP Crane

where he did not report any left ear pain or discomfort. Setting aside the fact that those

dates fall outside the relevant time period, the Court notes that those records relate to a

left shoulder injury and subsequent physical therapy; no notes regarding ear pain would

be expected to be found in those records. To be sure, the records provided to the Court

show that Buchanan continued to complain about left ear pain as late as October 12, 2024.

(Doc. 104-8 at p. 74).

The record also refutes Defendants’ claims that Buchanan’s condition “did not

inflict prolonged suffering,” “was not chronic,” and “did not cause him substantial pain.”

During the relevant time frame, Buchanan consistently reported severe ear pain that, on

at least one occasion, he described as stabbing. It affected his sleep and his mental state.

Only once did he rate his left ear pain lower than 6 on a scale of 1 to 10. Buchanan’s

description of his pain is subjective, but “there is no requirement that a prisoner provide

‘objective’ evidence of his pain and suffering—self-reporting is often the only indicator a

doctor has of a patient’s condition.” Klein v. Wexford Health Sources, Inc., No. 16 C 8818,

2019 WL 2435850, at *9 (N.D. Ill. June 11, 2019) (quoting Greeno v. Daley, 414 F.3d 645, 655

(7th Cir. 2005)).

Viewing the evidence and all reasonable inferences in a light most favorable to

Buchanan, a jury could find that Buchanan’s ear pain and hearing loss was an objectively

serious medical condition.

III. Subjective Indifference to Buchanan’s Medical Condition

The Wexford Defendants also argue that, even if Buchanan’s ear pain and hearing

loss constituted an objectively serious medical condition, there is no evidence that they

knowingly or recklessly disregarded it.

A. Dr. Myers

As to Dr. Myers, Buchanan claims that Dr. Myers failed to properly treat his ear

pain, persisted in a course of treatment that was ineffective, and allowed him to be

transferred to Menard without treatment.

Dr. Myers first saw Buchanan on January 28, 2022, where he took Buchanan’s

history and used an otoscope to examine Buchanan’s left ear. Dr. Myers diagnosed

Buchanan with mild otitis and prescribed Maxitrol, a broad spectrum antibiotic that is

“highly effective” in addressing mild ear infections. (Doc. 110-1 at ¶ 17). He further

educated Buchanan about Maxitrol and how it is different from Debrox, an over-the-

counter medication used to remove earwax. (Id. at ¶ 18). When Dr. Myers saw Buchanan

less than a month later on February 18, 2022, he again performed a full examination,

diagnosed otitis, and prescribed an oral antibiotic to treat a suspected ear infection.

Dr. Myers prescribed the oral antibiotic, which was to be taken in the presence of the

nursing staff, because, at his first visit, Buchanan had argued that the Maxitrol drops

would be useless. (Id. at ¶¶ 18, 23). Thus, Dr. Myers wanted to ensure compliance with

the antibiotic regimen. Dr. Myers attested that this would allow him to treat any possible

infection of the inner ear and also monitor Buchanan’s adherence to the treatment plan.

(Id. at ¶ 23).

It is clear that Dr. Myers used his professional judgment in diagnosing and treating

Buchanan for a suspected ear infection. Nothing about his treatment decision is “so far

afield of accepted professional standards as to raise the inference that it was not actually

based on a medical judgment.” Johnson v. Dominguez, 5 F.4th 818, 825 (7th Cir. 2021).

While Buchanan argues that Dr. Myers delayed his access to proper medical care by

denying his request for an ear flush, “[a] medical professional is entitled to deference in

treatment decisions unless ‘no minimally competent professional would have so

responded under those circumstances.’” Sain v. Wood, 512 F.3d 886, 894–95 (7th Cir. 2008)

(quoting Collingnon v. Milwaukee Cnty., 163 F.3d 982, 988 (7th Cir. 1998)).

Buchanan also asserts that Dr. Myers persisted in a course of treatment that he

knew to be ineffective because he continued to prescribe an oral antibiotic after Buchanan

told him the Maxitrol did not work. Even if Dr. Myers was incorrect in his suspicion that

Buchanan was not using the Maxitrol as directed, his decision to prescribe Augmentin

was not deliberate indifference. Augmentin is a different antibiotic that is taken orally

rather than in drop form, and thus could have a different result. Dr. Myers also attested

that a treatment plan consisting of Maxitrol and Augmentin is consistent with the

community standard of care for treating suspected infections with middle ear effusion.

(Doc. 110-1 at ¶ 31). Moreover, he attested, there was no clinical or medical necessity to

refer Buchanan to an ENT or audiologist at that time. (Id. at ¶ 33).

With regard to Buchanan’s claim that Dr. Myers allowed him to be transferred to

Menard without receiving treatment, Dr. Myers attested that he has no role or authority

in deciding when, where, or how inmates are transferred within the IDOC. (Id. at ¶ 50).

Dr. Myers, a Wexford employee, also cannot prevent an inmate from transferring

facilities because only the IDOC has authority over the placement of IDOC inmates. (Id.).

Buchanan further testified that he does not know whether Dr. Myers had any authority

or final say over inmate transfers. (Doc. 104-7 at p. 64). Thus, no reasonable jury would

find that Dr. Myers was deliberately indifferent in allowing Buchanan to be transferred

to Menard.

For these reasons, Dr. Myers is entitled to summary judgment.

B. NP Crane and NP Dearmond

Buchanan next claims that NP Crane and NP Dearmond were deliberately

indifferent when they refused to submit an urgent referral to an outside specialist for his

left ear condition, even though they knew of his left ear pain and hearing loss, and even

though Menard did not have an on-site doctor at that time.

Based on the summary judgment record, no reasonable juror would find NP Crane

or NP Dearmond deliberately indifferent for failing to mark his referral to the audiologist

as “urgent.” NP Crane examined Buchanan’s left ear and found no physiological reason

for his ear pain. His tympanic membrane was within normal limits, his ear canal was

clear, and there was no redness. Based on her medical judgment and training as a nurse

practitioner, NP Crane diagnosed Buchanan with unspecified ear pain and prescribed

Debrox, Claritin, and Tylenol. Although Buchanan did not complain about hearing loss

to NP Crane, based on his complaints to other medical providers, she referred him for an

on-site hearing test, which occurred on May 4, 2022.

After Buchanan failed the on-site hearing test, he argues, he should have been

referred for an Audiological Evaluation within 30 days pursuant to the Holmes settlement

agreement. See Holmes v. Baldwin, No. 11-cv-2961 (N.D. Ill. Apr. 23, 2018), Doc. 426-2. He

asserts Defendant Crane harmed him by delaying his referral to an audiologist by 44 days

beyond the failed hearing test.

This argument is unpersuasive considering NP Dearmond referred Buchanan to

the audiologist “per Holmes Settlement Agreement” on May 9, 2022, just five days after

his failed on-site hearing test. (Doc. 104-8 at p. 20). The Medical Furlough Clerk received

the referral on May 11, 2022, and sent it to Utilization Management for approval. (Id. at

p. 21). On May 16, 2022, the Medical Furlough Clerk received the authorization, and

Buchanan was referred to a licensed audiologist the next day. (Id. at p. 22). NP Crane

attested that she noticed the approved referral had not been scheduled, so she resubmitted

the referral on June 17, 2022, in an attempt to expedite an audiogram and hearing

evaluation. (Doc. 110-5 at ¶ 36). Thus, not only was Buchanan referred to an audiologist

for evaluation within 30 days of his failed onsite hearing test, but NP Crane followed up

and re-referred Buchanan so that his referral would not slip through the cracks. No

reasonable jury would consider this deliberate indifference.

NP Crane and NP Dearmond also attested that once they referred Buchanan to the

audiologist, the scheduling of that appointment was out of their control. (Doc. 110-5 at

¶ 37; Doc. 107-3 at ¶ 39). The specialists manage their own schedules, and neither

NP Crane nor NP Dearmond are responsible for the time between the referral approval

and the inmate’s appointment with a specialist. (Id.). Buchanan has not presented any

evidence to the contrary.

Buchanan additionally argues that when NP Crane first saw Buchanan on April

20, 2022, she prescribed Debrox, Claritin, and Tylenol, citing a normal physical

examination and absence of objective findings. The next time NP Crane saw Buchanan,

on March 14, 2023, she continued the same course of treatment even though she should

have been aware of both the failed onsite hearing test from May 4, 2022, and the

audiologist’s report of January 26, 2023. Buchanan argues that NP Crane’s use of the same

treatments despite his continuing pain and hearing loss constitutes deliberate

indifference. Similarly, Buchanan argues that NP Dearmond did not take any action or

initiate a referral when she saw him on August 17, 2023, despite knowing of his ear pain

since January 2022.

These claims are unexhausted. Buchanan filed his Complaint on February 16, 2023,

before NP Crane saw Buchanan a second time and before NP Dearmond examined

Buchanan at all. And, the Complaint only references these Defendants’ failure to submit

an urgent referral for Buchanan to see a specialist for his left ear pain and hearing loss.

Any other claims of deliberate indifference have not been exhausted and, thus, will not

be considered. See Jones v. Bock, 549 U.S. 199, 202 (2007) (“[T]he PLRA . . . requires

prisoners to exhaust prison grievance procedures before filing suit.”).

IV. Defendants Bowman and Wills

Buchanan is proceeding on one claim of deliberate indifference against Bowman,

the IDOC’s Agency Medical Director, in his individual capacity, for failing to hire an on-

site medical doctor at Menard. Buchanan contends that the lack of an on-site doctor

prevented him from receiving care for his left ear issues. Warden Wills was added as a

Defendant, in his official capacity only, for the sole purpose of implementing any future

injunctive relief that may be granted.

Bowman moves for summary judgment on the basis that he, as the Agency

Medical Director, is not a treating medical provider for the IDOC, nor is he authorized to

make hiring decisions regarding the licensed medical providers at IDOC facilities. As a

result, he lacked sufficient personal involvement in the alleged constitutional violation

and cannot be held liable under § 1983. Alternatively, he asserts he is protected by the

doctrine of qualified immunity. Defendants also argue that because Buchanan cannot

establish that he is entitled to any injunctive relief, the official capacity claim against Wills

should also be dismissed.

In response, Buchanan argues that Bowman was personally involved because he

knew not having an on-site doctor would hinder inmates’ access to medical care, and he

was aware of the issues plaguing IDOC facilities regarding treatment of hearing issues

because of the Holmes settlement. Buchanan asserts that, due to the lack of a prison doctor,

he only received care at sick call, he “received basic medication because nurses were not

authorized to diagnose medical conditions or write prescriptions,” and the staff

repeatedly continued the same ineffective treatment.

Section 1983 liability must be premised on personal liability; the individual must

have caused or participated in the constitutional deprivation. Rasche v. Vill. of Beecher,

336 F.3d 588, 597 (7th Cir. 2003). Here, however, Buchanan has not provided any evidence

that Bowman personally knew of Buchanan’s complaints and turned a blind eye to them.

Buchanan testified that he sued Bowman because “he’s over the IDOC” as the Agency

Medical Director, but Bowman attested that he only provides administrative oversight

over the medical operations, and he does not have the authority to hire licensed medical

providers—including doctors who provide treatment at IDOC facilities. At the time, that

was the responsibility of Wexford Health Sources, Inc. Buchanan has not refuted this

evidence. Moreover, Bowman cannot be held responsible for the acts and/or omissions

of any other IDOC employees because there is no respondent superior or “supervisor

liability” under 42 U.S.C. § 1983. See Chavez v. Illinois State Police, 251 F.3d 612, 651 (2001).

Furthermore, Buchanan’s complaints regarding a lack of treatment is not

supported by the record. Buchanan was examined by multiple licensed nurse

practitioners, including NP Crane and NP Dearmond, who are fully qualified to make

diagnoses, treat, make referrals, and write prescriptions. He also had a telehealth

appointment with Dr. Glen Babich. While Buchanan claims that he was only prescribed

“minimal pain medication,” there is no evidence that a stronger pain medicine or a longer

pain medicine regimen was indicated for his condition. In sum, there is no evidence that

Buchanan’s access to medical care would have been different if a medical doctor had been

on-site at Menard.

Finally, while Buchanan claims that Bowman knew about problems within the

IDOC and its treatment of hearing issues because of the Holmes settlement agreement, his

statement is based on pure speculation. Even if the Holmes case had any relevance here,

Buchanan fails to connect the dots and explain how Bowman’s knowledge of the Holmes

settlement agreement makes him liable for deliberate indifference in this case.

Because no reasonable jury would find that Bowman had the requisite personal

involvement in Buchanan’s alleged constitutional deprivations, Bowman is entitled to

summary judgment. Additionally, because Buchanan is not entitled to any injunctive

relief, Warden Anthony Wills shall be dismissed.

CONCLUSION

For these reasons, the Motions for Summary Judgment filed by Defendants Jilian

Crane, NP (Doc. 102), Alisa Dearmond, NP (Doc. 105), and Percy Myers, M.D. (Doc. 108)

are GRANTED.

The Motion for Summary Judgment filed by Steven Bowman and Anthony Wills

(Doc. 117) is also GRANTED.

Plaintiff Meiko Buchanan shall recover nothing. The Clerk of Court is DIRECTED

to enter judgment accordingly and close this case.

IT IS SO ORDERED.

DATED: March 16, 2026 Tl

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NANCY J. ROSENSTENGEL

United States District Judge

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