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Seventh Circuit Court of Appeals Reinstates Prisoner's Deliberate Indifference Claim against Illinois Prison Medical Officials

By Derek Gilna

In a decision published in July, 2010, the Seventh Circuit Court of Appeals vacated and remanded a decision from the United States District Court for the Southern District of Illinois. The appeals court reinstated a prisoner’s § 1983 action stemming from complications from an upper molar extraction in January of 2007, at Menard Correctional Center in Illinois. The extraction site did not heal, and became infected, and a November, 2007 surgery to close the hole left by the extraction became necessary.

The lawsuit deals with the actions of the dentist that performed the extraction, the prison's dental director, the regular prison physician, and the prison warden, whom plaintiff said were all negligent and deliberately indifferent to his suffering.

At screening, the district court dismissed the complaint with prejudice for failure to state a claim, but McGowan moved for reconsideration with respect to Dr. John Gardner, the dentist who performed the extraction, and Dr. Chapman, the prison's dental director. The district court also denied this motion, and plaintiff filed his appeal.

The record as noted by the court set forth a litany of medical difficulties that only increased as time went on. First, McGowan requested a filling, but agreed to an extraction at Gardner's insistence. Then the tooth fragmented during the extraction.

After the procedure the pain increased, and McGowan was given only aspirin. At this point the stiches broke and McGowan could not close his mouth. After complaining of the pain, Plaintiff was seen on an emergency basis by another prison dentist who diagnosed him with a sinus perforation with fistula tract, resulting in infection causing more pain and swelling, and leading to causing weight loss. After numerous grievances, and delays in treatment, an ENT specialist ordered a CT scan, and sinus surgery was performed on August 3, and again on November 2, to finally close the hole.

The district court acknowledged that McGowan's treatment had been dragged out over a long time, but, thought that "a delay in process does not constitute deliberate indifference."

The Court of Appeals did not agree, citing Estelle v. Gamble for the proposition the "deliberate indifference to serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain proscribed by the Eighth Amendment... The issue here is whether the complaint also plausibly suggest that either Gardner or Chapman or both were deliberately indifferent to that need... Delay is not a factor that is either always, or never significant. Instead the length of delay that is tolerable depends on the seriousness of the condition and the ease of providing treatment... Grieveson v. Anerson, 538 F.3d 763, 778- 80

The court further noted: "McGowan's complaint alleges with specificity a number of troubling delays in his treatment. He was forced to wait three months to see a dentist after he first complained of dental pain. That unexplained delay could support a deliberate-indifference claim... Even when it was clear that the extraction had led to a sinus perforation, Chapman stalled in authorizing a referral to an outside surgeon..."

The court further noted that it took a grievance from McGowan to obtain a new referral to the oral surgeon, but it still took Chapman two weeks before approving the prison dentist's request to speed up the referral to the ENT specialist. It also noted that, “the complaint recounts several instances of delayed scheduling with the ENT specialist, including a missed appointment." See: McGowan v. Hulick, 612 F. 3d 636 (7th Cir. 2010).

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Related legal case

McGowan v. Hulick