Williams, David v. Liefer, John

In the

United States Court of Appeals

For the Seventh Circuit

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No. 06-3493

DAVID WILLIAMS,

Plaintiff-Appellee,

v.

JAMES LIEFER, BRENT HOFFMAN,

and JAMES MASSEY,

Defendants-Appellants.

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Appeal from the United States District Court

for the Southern District of Illinois.

No. 01 C 986—William D. Stiehl, Judge.

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ARGUED MAY 25, 2007—DECIDED JULY 5, 2007

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Before BAUER, CUDAHY, and FLAUM, Circuit Judges.

FLAUM, Circuit Judge. David Williams sued several

employees of the Illinois Department of Corrections

under 42 U.S.C. § 1983, claiming that they were deliber-

ately indifferent to his medical needs in violation of the

Eighth and Fourteenth Amendments. On July 5, 2006, a

jury returned a verdict in favor of Williams and awarded

him $4,500 in compensatory damages. The defendants

appeal, claiming that they were entitled to judgment as a

matter of law. For the following reasons, we affirm the

jury’s verdict.

2 No. 06-3493

I. BACKGROUND1

David Williams, an obese inmate who suffers from high

blood pressure, was housed in the segregation building

of Menard Correctional Center in Menard, Illinois. On

October 27, 2000, Williams was scheduled to be trans-

ferred from the segregation unit to protective custody in

the general population. On that day around 6:30 a.m.,

Williams awoke with chest pain, numbness in his left arm,

and dizziness. He also felt nauseous and began vomiting.

Around 7:00 a.m., Williams complained about his

symptoms to Officer James Massey, who was doing the

morning cell count, but Massey did not respond and

continued walking down the gallery. After Massey fin-

ished the count, he walked past Williams’ cell again, and

Williams said, “Officer Massey, man, I’m having chest

pain real bad, try to get me help or something.” Massey

reminded Williams that he was getting out of segregation

that day and told him that he should wait until the

transfer was completed.

Around 10:30 a.m., Massey escorted Williams, in hand-

cuffs, down four flights of stairs to the segregation build-

ing’s exit. Massey uncuffed Williams and placed his

personal property on a push cart. Williams asked Massey

if he could see a medical technician before he left the

building, but Massey denied the request, telling Williams

to speak with someone from the property building. Several

officers escorted Williams and six other inmates as they

pushed the carts containing their personal property

from the segregation building to the property building,

which was approximately 100 yards away.

1

We recount the facts in the light most favorable to the jury’s

verdict.

No. 06-3493 3

At the property building, Williams told Officer Brent

Hoffman that he was having chest pains, his arm was

numb, and he was sick. Williams was sweating profusely

and asked to see a doctor or paramedic. Hoffman ignored

Williams’ request for medical attention, instructing him

to help the other inmates retrieve their belongings.

Williams retrieved additional property from the building

and placed his property box, which weighed approximately

200 pounds, onto his cart. As he was loading the cart,

Williams repeated that he was in a lot of pain, but

Hoffman simply told Williams to push his cart.

From there, Williams pushed his cart 200-250 yards to

the clothing building and then pushed it another 100 yards

to his cellhouse. Williams was then required to carry his

box of personal property to his cell. As he walked through

the cell gallery carrying the heavy box, Williams began to

feel lightheaded and his pain level increased. Williams

spotted Officer Liefer, who had summoned a paramedic

for him on a prior occasion. He asked Liefer to “holler at

the Sarge,” and said that he was experiencing bad chest

pain. Liefer did not respond, so Williams asked him for

help carrying his belonging up the stairs. When Liefer

refused, Williams showed him an identification card,

which stated that Williams suffered from chronic hyper-

tension. Still, Liefer did not get Williams medical attention

or help him carry his property box.

At approximately 1:00 p.m., Williams began carrying his

box of personal property up fifteen stairs to his cell. As he

climbed the stairs, he blacked out and fell backwards

down the stairs. Medical technicians responded and sent

Williams to the prison emergency room, where, around

1:30 p.m., he received nitroglycerin, which quickly re-

lieved his pain.

At the hospital, Williams rated his pain an eight out of

ten. His blood pressure was 159/100 (120/80 being nor-

4 No. 06-3493

mal), and his pulse was 104 beats per minute (an adult’s

resting heart rate should fall between 60 and 100 beats per

minute). Medical personnel took Williams’ electrocardio-

gram (“EKG”), and it indicated an abnormal heart rate.

The examining physician, Dr. Stephen C. Doughty, diag-

nosed Williams with chest pain and hypertension. Wil-

liams’ blood pressure decreased after about an hour, but

he remained in the infirmary for six days.

To treat Williams’ condition, Dr. Doughty recommended

dietary restrictions and prescribed Williams several

medications: Lasix, a diuretic; Catapres, an anti-hyperten-

sion medicine; Lanoxin, a cardiac medication; Captopril,

another anti-hypertension medicine; and a potassium

supplement. Another doctor prescribed Isordil, a medicine

for low blood flow. A second EKG revealed that Williams

had a first-degree AV block, which could signify either

coronary artery disease or acute hypertension.

On December 18, 2001, Williams filed suit against the

Department of Corrections and various individual defen-

dants under 42 U.S.C. § 1983, claiming that the delay in

treatment violated his Eighth Amendment rights. On

June 28, 2006, a three-day jury trial commenced. During

the trial, Dr. Doughty testified that any delay in treatment

“[did not] appear to have had any significant adverse

effect” on Williams’ condition. Williams testified that, as

a result of his October 27, 2000 injuries, he could not

walk long distances or work on a job, meaning he could

not earn money in prison.

At the close of the trial, the defendants moved for

judgment as a matter of law, claiming that any delay in

treatment did not harm Williams and that the officers

were entitled to qualified immunity. The district court

denied the motion, and the jury returned a verdict in

favor of Williams and against Liefer, Massey, and Hoff-

man. It awarded Williams $4,500 in compensatory dam-

No. 06-3493 5

ages. After the entry of judgment, Liefer, Massey, and

Hoffman renewed their motion for judgment as a matter of

law, and, in the alternative, asked for a new trial. The

district court denied the renewed motion, and the defen-

dants appeal.

II. ANALYSIS

The defendants argue that they are entitled to judgment

as a matter of law. Specifically, they contend that Williams

offered no verifying medical evidence that the delay in

treatment harmed him, and they contend that they are

entitled to qualified immunity. In the alternative, they

request a new trial.

A. Evidence of Harm

This Court reviews the denial of the defendants’ motion

for judgment as a matter of law de novo. Erickson v. Wis.

Dep’t of Corrs., 469 F.3d 600, 601 (7th Cir. 2006). We

consider whether the evidence presented, drawing all

reasonable inferences in favor of the non-movant, was

sufficient to support the verdict. Davis v. Wis. Dep’t of

Corrs., 445 F.3d 971, 975 (7th Cir. 2006). The Court will

disregard any evidence that was favorable to the defen-

dants that the jury was not required to believe, but it

must give credence to evidence that was uncontradicted

and comes from disinterested witnesses. Reeves v. Sander-

son Plumbing Prods. Inc., 530 U.S. 133, 150-51 (2000). The

verdict should be overturned only if no reasonable jury

could have found in Williams’ favor. Erickson, 469 F.3d

at 601.

The Supreme Court has interpreted the Eighth Amend-

ment’s prohibition of cruel and unusual punishment,

incorporated through the Fourteenth Amendment, as

6 No. 06-3493

imposing a duty on states to provide medical care to

incarcerated individuals. Estelle v. Gamble, 429 U.S. 97,

103 (1976). Prison officials violate the Constitution if

they are deliberately indifferent to prisoners’ serious

medical needs. Id. at 104. A claim based on deficient

medical care must demonstrate two elements: 1) an

objectively serious medical condition, and 2) an official’s

deliberate indifference to that condition. See Johnson v.

Snyder, 444 F.3d 579, 584 (7th Cir. 2006). An objectively

serious medical need includes both diagnosed conditions

requiring treatment and conditions “so obvious that even

a lay person would easily recognize the necessity for a

doctor’s attention.” See Zentmyer v. Kendall County, Ill.,

220 F.3d 805, 810 (7th Cir. 2000) (internal quotation and

citation omitted).

In cases where prison officials delayed rather than

denied medical assistance to an inmate, courts have

required the plaintiff to offer “verifying medical evidence”

that the delay (rather than the inmate’s underlying

condition) caused some degree of harm. See, e.g., Petty v.

County of Franklin, Ohio, 478 F.3d 341, 344 (6th Cir.

2007); Laughlin v. Schriro, 430 F.3d 927, 929 (8th Cir.

2005); Surber v. Dixie County Jail, 206 Fed. App’x 931, 933

(11th Cir. 2006). That is, a plaintiff must offer medical

evidence that tends to confirm or corroborate a claim

that the delay was detrimental.

This Court adopted the verifying medical evidence

requirement in Langston v. Peters, 100 F.3d 1235, 1240

(7th Cir. 1996) (citing Beyerbach v. Sears, 49 F.3d 1324,

1326 (8th Cir. 1995). In Langston, the plaintiff claimed

that a one-hour delay in medical treatment after he was

raped by another inmate violated the Constitution. 100

F.3d at 1240. We affirmed summary judgment in favor of

the defendants because the plaintiff did not produce

any evidence that the one-hour delay had a detrimental

No. 06-3493 7

effect; the rape had already occurred, and there was no

evidence that it had caused any serious physical injury. Id.

at 1241. We did not, however, articulate what qualified as

verifying medical evidence.

The parties dispute whether Williams offered sufficient

verifying medical evidence in this case, and they disagree

about what constitutes verifying medical evidence. While

the defendants claim that expert testimony is the only

acceptable form of verifying medical evidence, Williams

claims that his testimony, his medical records, and his

treatment are sufficient to show the delay’s detrimental

effect. Clearly, expert testimony that the plaintiff suf-

fered because of a delay in treatment would satisfy the

requirement. See, e.g., Coleman v. Rahija, 114 F.3d 778,

785 (8th Cir. 1997) (concluding that expert testimony

satisfied the verifying medical evidence requirement). On

the other hand, evidence of a plaintiff ’s diagnosis and

treatment, standing alone, is insufficient if it does not

assist the jury in determining whether a delay exacerbated

the plaintiff ’s condition or otherwise harmed him. See

Laughlin, 430 F.3d at 929.

The evidence in this case falls somewhere in between a

bare recitation of treatment received and expert testimony

about the delay’s effect. Williams’ medical records and

Doughty’s testimony showed that when Williams arrived

at the hospital, he had elevated blood pressure, had an

abnormal EKG, was sweating, and complained of severe

pain. The medical records also showed that with treat-

ment, Williams’ symptoms, including his pain and high

blood pressure, quickly subsided. The only testimony from

a medical expert, Dr. Doughty, was that the delay did not

appear to have adversely affected Williams’ condition.2

2

The defendants contend that this Court must credit Doughty’s

testimony because it was uncontradicted testimony from a

(continued...)

8 No. 06-3493

Although no jury could determine, based on this record,

whether it was the delay in care or the underlying condi-

tion that necessitated Williams’ treatment or affected his

ability to work, a reasonable jury could have concluded

from the medical records that the delay unnecessarily

prolonged and exacerbated Williams’ pain and unnecessar-

ily prolonged his high blood pressure. See Gil v. Reed, 381

F.3d 649, 662 (7th Cir. 2004) (recognizing that “hours of

needless suffering” can constitute harm). The medical

records indicate that the nitroglycerin almost immediately

relieved his pain and lowered his blood pressure, so a jury

could find that the defendants’ delay caused Williams

six extra hours of pain and dangerously elevated blood

pressure for no good reason. Accordingly, we affirm the

district court’s denial of judgment as a matter of law.3

2

(...continued)

disinterested witness. See Reeves, 520 U.S. at 150. They argue

that although a prison employee generally is not a disinterested

witness, see Sapperstein v. Hager, 188 F.3d 852, 856 (7th Cir.

1999), Doughty was not a typical employee because 1) he was

employed by an independent medical vendor contracting with

the Department rather than the Department itself, 2) he no

longer worked at the prison when he testified, and 3) the

Department did not control his diagnoses and medical opinions.

We need not decide whether Doughty was a disinterested

witness, however, because the testimony he offered was not

uncontradicted. Indeed, as discussed in the text of this opinion,

Williams offered medical evidence suggesting, contrary to

Doughty’s testimony, that the defendants’ delay caused harm.

3

Although our sister circuits have come to different conclu-

sions about the need for verifying medical evidence in some

contexts, compare Laughlin, 430 F.3d at 929 (requiring verify-

ing medical evidence in all delayed treatment cases), with Black-

more v. Kalamazoo County, 390 F.3d 890, 898 (6th Cir. 2004)

(stating that verifying medical evidence is required only in cases

(continued...)

No. 06-3493 9

B. Motion for New Trial

Next, the defendants claim that the paucity of verifying

medical evidence required the district court to grant their

motion for a new trial. This Court reviews the denial of a

motion for a new trial for an abuse of discretion. Davis,

445 F.3d at 979. Because, as discussed above, the jury

had a reasonable basis in the record for returning a ver-

dict in favor of Williams, the district court did not err by

denying the defendants’ motion for a new trial.

C. Qualified Immunity

Finally, the defendants claim that they are entitled to

qualified immunity because it was not clearly established

that the defendants’ delay in procuring Williams medical

treatment violated his constitutional rights. See Saucier v.

Katz, 533 U.S. 194, 202 (2001) (recognizing that officers

are entitled to qualified immunity if they violated a

constitutional right that was not clearly established).

Specifically, the defendants claim that they could not

have known that they could be found liable based on the

kind of evidence Williams presented at trial. We reject this

argument. Even if the law concerning verifying medical

evidence was unclear at the time of the offense, the

defendants are not entitled to qualified immunity. The

purpose of qualified immunity is to shield public officers

from liability where “a change in the law or . . . enduring

legal uncertainty . . . makes it difficult for the officer to

3

(...continued)

“involving minor maladies or non-obvious complaints of a seri-

ous need for medical care”), we need not decide whether this

Court would require verifying medical evidence in all delayed

treatment cases because we conclude that Williams offered

sufficient verifying medical evidence in this case.

10 No. 06-3493

assess the lawfulness of the act in question before he does

it.” Ralston v. McGovern, 167 F.3d 1160, 1162 (7th Cir.

1999) (emphasis added). Whether a delay in provid-

ing medical treatment has negatively affected a plain-

tiff ’s well-being is an assessment that is made in hind-

sight, so it cannot affect an officer’s initial decision to

seek treatment for an inmate. In other words, because

the eventual presence or absence of verifying medical

evidence cannot bear on an officer’s decision to seek or

deny treatment, it cannot provide a basis for immunity.

III. CONCLUSION

For the foregoing reasons, we AFFIRM the jury’s ver-

dict in favor of Williams.

A true Copy:

Teste:

________________________________

Clerk of the United States Court of

Appeals for the Seventh Circuit

USCA-02-C-0072—7-5-07