Justia U.S. 7th Circuit Court of Appeals Opinion Summaries

Machicote, a Wisconsin inmate underwent surgery to remove damaged bone, tissue, and cartilage in his ankle after he suffered an injury while playing basketball in the prison yard. After the procedure, the surgeon supplied Machicote with oxycodone and warned that he would be in “extreme pain” when the medication wore off. He was discharged with instructions recommending narcotic-strength painkillers every six hours. At the prison, Dr. Herweijer ordered Tylenol #3, as needed every six hours for three days. Because of Nurse Stecker’s scheduling of the doses, Machicote woke at 3:30 a.m. in “excruciating pain.” Machicote continued to have trouble accessing the medication that had been ordered; the prison’s medication distribution schedule did not match Machicote’s prescription. Concerned about pain during the night, Machicote was told: “That’s how it will go.” Machicote’s medication order ran out completely and he began experiencing agonizing pain around the clock. Nurse Stecker refused to contact a doctor. Five days later, Dr. Hoffman prescribed him another painkiller, Tramadol. Machicote did not receive the medication for two more days, and his medical records show that the pain required management for several more weeks.In Machicote’s suit under 42 U.S.C. 1983, the district court granted the defendants summary judgment. The Seventh Circuit affirmed as to the other defendants but vacated in part; a factual issue remains as to the deliberate indifference of Nurse Stecker. View "Machicote v. Roethlisberger" on Justia Law

When Zhao gave birth to her son “S.,” he suffered an avoidable brachial plexus injury that severely and permanently impaired the function of his right arm. During her pregnancy and S.’s birth, Zhao was attended by an obstetrician employed by a federally supported grant clinic in southern Illinois, who is considered an employee of the U.S. Public Health Service under 42 U.S.C. 233(g), Zhao sued for medical malpractice under the Federal Tort Claims Act. The court found that the obstetrician had been negligent and awarded Zhao, on behalf of S., $2.6 million in lost earnings and $5.5 million in noneconomic damages. S. was not five years old at the time of trial. The Seventh Circuit affirmed, rejecting the government’s argument that the calculation of S.’s future lost earnings was improperly speculative, given the uncertainties inherent in projecting a five‐year‐old’s career opportunities. The question may have been difficult, but there was no reversible error. The court took a reasonable approach to estimate the lost earnings award based on data provided in expert testimony. The government also challenged the award of non-economic damages as arbitrary and excessive in comparison to similar cases. The court could have provided a more detailed explanation of its comparative process, but its reasoning did not amount to reversible error. View "Zhao v. United States" on Justia Law

The Drug Enforcement Administration investigated Dr. Ley and his opioid addiction treatment company, DORN, conducted undercover surveillance, and decided Ley did not have a legitimate medical purpose in prescribing Suboxone. Indiana courts issued warrants, culminating in arrests of four physicians and one nurse and seven non-provider DORN employees. Indiana courts dismissed the charges against the non-providers and the nurse. Ley was acquitted; the state dismissed the charges against the remaining providers. DORN’s providers and non-provider employees sued, alleging false arrest, malicious prosecution, and civil conspiracy. The district court entered summary judgment for the defendants, holding probable cause supported the warrants at issue. The Seventh Circuit affirmed as to every plaintiff except Mackey, a part-time parking lot attendant. One of Ley’s former patients died and that individual’s family expressed concerns about Ley; other doctors voiced concerns, accusing Ley of prescribing Suboxone for pain to avoid the 100-patient limit and bring in more revenue. At least one pharmacy refused to fill DORN prescriptions. Former patients reported that they received their prescriptions without undergoing any physical exam. DORN physicians prescribed an unusually high amount of Suboxone; two expert doctors opined that the DORN physicians were not prescribing Suboxone for a legitimate medical purpose. There was evidence that the non-provider employees knew of DORN’s use of pre-signed prescriptions and sometimes distributed them. There were, however, no facts alleged in the affidavit that Mackey was ever armed, impeded investigations, handled money, or possessed narcotics. View "Vierk v. Whisenand" on Justia Law

For four years, nurse practitioner Jordan treated Clanton’s severe hypertension. Jordan, an employee of the U.S. Public Health Service, failed to properly educate Clanton about his disease or to monitor its advancement. Clanton’s hypertension developed into Stage V kidney disease requiring dialysis and a transplant. Clanton successfully sued the government under the Federal Tort Claims Act. The court determined that Clanton had not contributed at all to his own injuries, noting that Clanton did not understand why it was important to take his medication and to attend appointments. The court awarded $30 million in damages. The Seventh Circuit vacated, finding that the court erred in its analysis of comparative negligence. Clanton’s subjective understanding does not end the inquiry. Illinois law requires the court to take the additional step of comparing Clanton’s understanding of his condition to that of a reasonable person in his situation. Clanton was in the position of a person whose caregiver failed to provide information about the severity of his condition but he had external clues that he was seriously unwell: two employment-related physicals showed that he had dangerously high blood pressure. The court upheld the court’s method of calculating damages and agreed that Clanton’s Medicare benefits are collateral to his damages award under Illinois law, so the government is not entitled to a partial offset. View "Clanton v. United States" on Justia Law

Illinois requires medical-malpractice plaintiffs to file an affidavit stating that “there is a reasonable and meritorious cause” for litigation. The plaintiff needs a physician’s report, indicating that the physician has reviewed the plaintiff’s medical records and justifying the conclusion that “a reasonable and meritorious cause” exists. This requirement applies to malpractice litigation in federal court because it is a substantive condition of liability. The suit at issue is against the United States under the Federal Tort Claims Act, which says that the government is liable to the same extent as a private person, 28 U.S.C. 1346(b)(1). The Seventh Circuit found the rule applicable. The court noted that a prisoner may have insuperable difficulty obtaining a favorable physician’s report before filing a complaint and concluded that a complaint in federal court cannot properly be dismissed because it lacks an affidavit and report under 5/2-622. Federal, not state, rules often apply to procedural matters—such as what ought to be attached to pleadings—in federal suits, whether they arise under federal or state law. In federal court, supporting documents come later. Illinois wants insubstantial medical-malpractice suits resolved swiftly. That goal can be achieved in federal court under summary-judgment practice. View "Young v. United States" on Justia Law

Knight, a Wisconsin prisoner, sought treatment for a knee injury. Dr. Grossman, who worked at a hospital that provided medical services to state prisoners, diagnosed Knight with a tear in his anterior cruciate ligament and performed reconstruction surgery. A few years later, Knight reinjured his knee and returned for treatment. Dr. Grossman examined Knight, ordered x-rays, and, without consulting an MRI, diagnosed him with a torn ACL revision. Dr. Grossman offered Knight the option of undergoing a revision procedure to repair the tear. During surgery, he determined that Knight did not have a tear but had degenerative joint disease or arthritis. Not knowing when Knight would be available for surgery again, Grossman performed an alternate procedure, which he had not discussed with Knight. Knight did not learn of the change in course until his follow-up visit. In Knight’s suit under 42 U.S.C. 1983, the Seventh Circuit affirmed summary judgment in favor of Dr. Grossman. The court stated that prisoners retain a liberty interest in refusing forced medical treatment while incarcerated, with an implied right to the information necessary to make an informed decision about treatment. Knight did not establish a violation of that right because no reasonable jury could find that Dr. Grossman acted with deliberate indifference to Knight’s knee condition or to his right to refuse treatment. View "Knight v. Grossman" on Justia Law

Davis, an Illinois prisoner suffering from kidney disease, received dialysis on a Saturday. He subsequently told a prison nurse that his mind was fuzzy and his body was weak. Both complaints were similar to side effects he had experienced in the past after dialysis. The nurse called Dr. Kayira, the prison’s medical director, who asked her whether Davis had asymmetrical grip strength, facial droop, or was drooling—all classic signs of a stroke. When she said “no,” Dr. Kayira determined that Davis was experiencing the same dialysis-related side effects as before rather than something more serious. He told the nurse to monitor the problem and call him if the symptoms got worse. Dr. Kayira did not hear anything for the rest of the weekend. On Monday morning he examined Davis and discovered that Davis had suffered a stroke. Davis sued, alleging deliberate indifference to his medical needs in violation of the Eighth Amendment and a state-law medical-malpractice claim. The Seventh Circuit affirmed summary judgment in favor of Kayira. The deliberate-indifference claim failed because there is no evidence that Kayira was aware of symptoms suggesting that Davis was suffering a stroke. The state-law claim failed because Davis lacked expert testimony about the appropriate standard of care. A magistrate had blocked Davis’s sole expert because he was not disclosed in time, Davis never objected to that ruling before the district court. View "Davis v. Kayira" on Justia Law

While serving a prison sentence at the Lawrence Correctional Center in Illinois, Gabb experienced severe back pain whenever he stood too long (15-20 minutes). After treatments he received did not relieve his pain, Gabb sued two members of Lawrence’s medical staff, Dr. Coe and Nurse Kimmel, alleging they were deliberately indifferent to his back pain in violation of his constitutional right to be free from cruel and unusual punishments. Gabb also sued Wexford, the private company that provided medical services at Lawrence. The district court rejected the claims on summary judgment. The Seventh Circuit affirmed. Gabb has not presented any evidence showing the defendants caused him any harm. The lack of evidence of what the “better” treatments were and whether they would have been effective would leave a jury entirely to its own imagination about what could have been done. View "Gabb v. Wexford Health Sources, Inc." on Justia Law

SC, an outpatient surgical center, permits outside physicians to perform day surgery at its facility. Its insurance limited APA’s liability to $1 million per claim. In 2002, Dr. Hasson, an outside physician, performed outpatient laparoscopic surgery on Tate at SC. Hasson did not see Tate or sign her discharge instructions before SC released her; SC’s anesthesiologist discharged Tate, giving Tate's boyfriend discharge instructions. Days later, Tate checked into the hospital with a perforated bowel that rendered the previously-healthy 34‐year‐old a quadriplegic. Tate sued Hasson and SC. APA hired attorneys to defend SC. APA set the “Reserve” (money the Michigan Department of Insurance required APA to put aside to cover an adverse verdict) at $560,000. APA believed the damages could exceed the policy limit but that SC was not likely to be found liable. In 2007, APA rejected Tate's offer to settle for policy limits. Hasson’s insurer settled for his policy limit ($1 million). After the Illinois Appellate Court remanded the issue of whether SC’s nursing staff breached the standard of care, APA raised the Reserve to $1 million, stating that it still believed the case was defensible. Before the second trial, APA rejected Tate's second settlement demand for the policy limit. The jury returned a $5.17 million verdict. SC then sued APA for bad faith. The Seventh Circuit affirmed judgment as a matter of law in favor of APA. SC did not establish that anyone involved in litigating the case believed there was more than a mere possibility SC would be found liable; the mere possibility of liability is insufficient under the Illinois Supreme Court’s reasonable probability standard. View "Surgery Center at 900 North Michigan Avenue, LLC v. American Physicians Assurance Corp., Inc." on Justia Law

Gaston, an Illinois prisoner, first complained about pain in his left knee in May 2009. Drugs did not help. After some delay, Gaston saw an orthopedic surgeon in September 2010. An MRI exam was approved but not conducted until February 2011. In August 2011, Gaston had arthroscopic surgery. While Gaston’s left knee was healing, Wexford (the corporation that provides prison medical care) delayed approving an MRI of his right knee; one knee had to be sound before treatment of the other. In May 2012 Gaston had an MRI exam on the right knee. It showed serious problems. Another arthroscopic surgery occurred in October 2012. This did not bring relief. Arthroplasty (knee replacement) was delayed while specialists determined whether Gaston’s pulmonary and cardiology systems would handle the strain but took place in February 2015 and was successful. Gaston claimed that the delays while waiting for surgeries reflect deliberate indifference to his pain so that the pain became a form of unauthorized punishment in violation of the Eighth Amendment. Defendants offered evidence that the delays could be chalked up to a preference for conservative treatment before surgery and never to any desire to injure Gaston or indifference to his pain. The district court granted summary judgment to the individual defendants, ruling that none acted (or delayed acting) with the state of mind required for culpability. The Seventh Circuit affirmed and affirmed judgment in favor of Wexford. Private corporations, when deemed to be state actors in suits under 42 U.S.C. 1983, are not subject to vicarious liability. Wexford could be liable for its own unconstitutional policies, but the policies to which Gaston pointed, reflected medical judgment rather than a constitutional problem. View "Gaston v. Ghosh" on Justia Law