by Lonnie Burton

In a pair of cases, the Seventh Circuit Court of Appeals reinstated lawsuits filed by Illinois prisoners alleging inadequate medical care.

First, on August 25, 2016, the appellate court, sitting en banc, issued an amended decision that reversed a district court’s order granting summary judgment to two private prison doctors in a deliberate indifference case filed by an Illinois state prisoner. The 6-3 ruling also rejected the doctors’ claim of qualified immunity, as such a defense is not available to private medical providers employed by state prisons.

Tyrone Petties, incarcerated at the Stateville Correctional Facility in Illinois, sued two prison doctors under 42 U.S.C. § 1983 for deliberate indifference in violation of the Eighth Amendment, alleging that he received inadequate medical care after rupturing his Achilles tendon.

In January 2012, Petties was walking up a flight of stairs in his cell block when he heard a loud pop and felt excruciating pain in his left Achilles tendon. His injury was initially treated by Stateville medical director Dr. Imhotep Carter with crutches, ice and pain killers, along with authorization for a lower bunk and meals served in his cell. Petties was also referred to a specialist, but that did not occur until six weeks later.

Dr. Carter, who was employed by Wexford Health Sources – a private contractor that provides medical services at Stateville – did not place Petties’ foot in a boot, cast or any other device that would immobilize it. Petties returned to the infirmary several times and complained that his tendon was “killing him,” but Carter still did not give him a splint.

Petties finally saw an ankle specialist in July 2012, who determined that the lack of any sort of cast created a gap at the rupture site that was causing Petties’ pain and preventing his injury from healing.

Petties sued Dr. Carter, along with Dr. Saleh Obaisi, who replaced Carter at Stateville in August 2012. According to the complaint, Dr. Obaisi refused to authorize the physical therapy and surgery ordered by the ankle specialist because they were “too expensive.”

Petties’ lawsuit was dismissed on the doctors’ motion for summary judgment, with the district court finding that because he had received some treatment for his injury, he could not show the doctors acted with deliberate indifference.

The Seventh Circuit disagreed and reversed. Noting that Dr. Carter had testified that the proper course of treatment for an Achilles rupture is to immobilize the ankle, and that another doctor testified he would “always immobilize a ruptured Achilles tendon,” there was a “reasonable inference that Dr. Carter knew that the failure to immobilize an Achilles rupture would impede Petties’ recovery and prolong his pain,” the Court of Appeals wrote.

The Court held that the delay in getting Petties to a specialist, combined with the failure of Dr. Carter to give him any sort of cast or boot “without a clear justification for either,” meant the district court had erred in granting summary judgment on the record before it.

Finding that the refusal to follow the specialist’s order for physical therapy and corrective surgery was a clear departure from the accepted and usual course of medical treatment, the Seventh Circuit held that Dr. Obaisi was not entitled to summary judgment, either.

“Petties has the right for a jury to hear Dr. Obaisi’s justifications for his treatment decisions (or lack thereof) and to determine if Dr. Obaisi was deliberately indifferent, rather than simply incompetent, in treating his injury.”

Finally, the appellate court rejected the doctors’ claim of qualified immunity, citing Shields v. Illinois Dep’t of Corrections, 746 F.3d 782 (7th Cir. 2014) [PLN, Jan. 2016, p.26], which held that private medical providers working in state prisons are not eligible to raise a qualified immunity defense. The case remains pending before the district court on remand. See: Petties v. Carter, 836 F.3d 722 (7th Cir. 2016) (en banc), cert. denied.

In the second, unrelated case, on September 6, 2016 the Seventh Circuit reinstated a lawsuit filed by an Illinois prisoner whose broken wrist was left untreated for seven weeks. The ruling overturned a district court order granting summary judgment to a prison physician.

While held at the Henry Hill Correctional Center in Galesburg, Joni Zaya fell and broke his left wrist on January 14, 2012. He reported to the infirmary where he was examined and X-rays were taken. Two days later he was seen by Dr. Kul B. Sood, employed by Wexford Health Sources. Dr. Sood diagnosed Zaya with a broken wrist. Zaya was then sent to an off-site orthopedic surgeon, who confirmed that diagnosis. The surgeon directed that Zaya return in three weeks so he could evaluate whether the break was healing properly.

Dr. Sood received the off-site doctor’s instructions but ignored them. Zaya was not returned to the orthopedic surgeon until seven weeks later. By that time his wrist was causing him pain and discomfort, and it was later discovered that his wrist bone was healing at an incorrect angle, would have to be re-broken and required surgery.

Zaya sued Dr. Sood under 42 U.S.C. § 1983, claiming that the delay in sending him back to the orthopedic surgeon amounted to deliberate indifference. Dr. Sood moved for summary judgment, arguing that his decision to delay Zaya’s follow-up appointment was merely an “exercise in medical judgment.”

The district court granted the motion, reasoning that a difference of opinion among medical professionals was not enough to establish deliberate indifference.

Zaya appealed and the Seventh Circuit reversed, noting that the deference owed to the professional judgment of a medical practitioner can be overcome with evidence that the doctor disregarded, as opposed to disagreed with, a particular course of treatment.

“A jury can infer conscious disregard of a risk from a defendant’s decision to ignore instructions from a specialist,” the Court of Appeals wrote. The Court noted that Dr. Sood offered no explanation for his decision to wait seven weeks before Zaya returned to the orthopedic surgeon.

The appellate court held that a genuine factual dispute existed as to whether Dr. Sood disagreed with the off-site physician’s instructions or simply ignored them, and that the district court had therefore erred in granting summary judgment. Following remand, the case settled under confidential terms in April 2017. See: Zaya v. Sood, 836 F.3d 800 (7th Cir. 2016). 

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