Haywood v. Wexford Health Source Inc., et al

Filing 147

MEMORANDUM Opinion and Order signed by the Honorable Elaine E. Bucklo on 6/6/2019. Mailed notice. (mgh, )

IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION
Donald Haywood
Plaintiff,
v.
Wexford Health Sources, Inc.,
et al.
Defendants.

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No. 16 C 2472

MEMORANDUM OPINION AND ORDER
Donald Haywood, an inmate at Pontiac Correctional Center since
July of 2016, and previously incarcerated at Stateville Correctional
Center, has sued the doctors who treated him at these two institutions
and their employer, Wexford Health Sources, Inc.1 He claims that the
doctors provided constitutionally inadequate medical care and that they
did

so

pursuant

practice.

He

to

Wexford’s

alleges

that

unconstitutional

beginning

in

late

policy,
2013,

custom,

he

or

repeatedly

complained of a constellation of symptoms including chest pain, back
pain, side pain, wrist pain, joint pain and swelling, shoulder pain,
dizziness, numbness in his leg and back, dental cavities, and stomach
problems.

Plaintiff

also

suffered

from

mental

illnesses

requiring

The Stateville physicians are Drs. Saleh Obaisi (now deceased and
substituted in this action by the executor of his estate) and Alma
Martija, and the Pontiac physician is Dr. Andrew Tilden.
1

treatment that is the subject of a separate case also pending before
me. See Case No. 16-cv-3566 (N.D. Ill.). While certain of plaintiff’s
physical ailments were related to falls or accidents, others eluded a
firm diagnosis. Eventually, a rheumatologist diagnosed plaintiff with
an autoimmune disease called Sjogren’s Syndrome, and plaintiff later
began taking medications for that condition.2
Plaintiff alleges that the reason it took years for his Sjogren’s
diagnosis to emerge is that the frequency of his requests for medical
attention—the record reflects that in addition to regular visits to the
prison’s asthma clinic and mental health providers, plaintiff visited
the health care unit just about every month, often several times a
month, and sometimes several times a week during the relevant period—
led defendants to peg him as a malingerer whose symptoms were more
imagined than real. As a result, plaintiff posits, they did not take
his complaints seriously and performed only superficial examinations
until late 2015, when Dr. Obaisi ordered blood tests that revealed
abnormalities prompting a referral to a rheumatologist, who eventually
diagnosed plaintiff with Sjogren’s Syndrome. But plaintiff’s problems
did not end there, he claims, because he even after receiving his

Sjogren’s Syndrome is an autoimmune exocrine dysfunction in which
glands that make secretions—typically the salivary and tear glands—
become infected or inflamed. Alghafeer Dep., Exh. 9 to Def.’s L.R.
56.1(a) Stmt., at 52. It can become systemic and affect other organs
such as the kidneys, lungs, nervous system, and skin. Id. In most cases,
the disease remains limited to the salivary and tear glands, but in
some cases, patients can later develop lung or kidney disease. Id. at
52-53.
2

2

diagnosis, defendants allegedly failed to follow the rheumatologist’s
recommendations for managing his condition. In plaintiffs’ view, the
defendant physicians’ conduct reflects their deliberate indifference to
his serious medical condition.
Before me is defendants’ motion for summary judgment. Defendants
argue that plaintiff is not entitled to a trial because the objective,
undisputed evidence establishes that the treatment he received was
consistent with the standard of care, and that any delays plaintiff
experienced in receiving treatment for his Sjogren’s Syndrome (or any
other condition) did not result in a compensable injury. For the reasons
that follow, the motion is granted.
I.
Summary judgment is appropriate if there is no genuine dispute of
material fact and the moving party is entitled to judgment as a matter
of law. Fed. R. Civ. P. 56(a). I must view the evidence and draw all
reasonable inferences in favor of plaintiff, as the non-moving party.
Greeno v. Daley, 414 F.3d 645, 652 (7th Cir. 2005). To survive summary
judgment,

plaintiff

must

“present

specific

facts

establishing

a

material issue for trial, and any inferences must rely on more than
mere speculation or conjecture.” Giles v. Godinez, 914 F.3d 1040, 1048
(7th Cir. 2019).
The Eighth Amendment protects prisoners from prison conditions
that cause “the wanton and unnecessary infliction of pain,” Rhodes v.
Chapman, 452 U.S. 337, 347 (1981). Evidence that prison medical staff
3

provided grossly inadequate medical care can support an Eighth Amendment
violation if the plaintiff shows: 1) that he suffers from an objectively
serious medical condition, and 2) that prison officials knew about the
condition and the risk it posed but recklessly disregarded the risk.
Pyles v. Fahim, 771 F.3d 403, 408-09 (7th Cir. 2014) (citation omitted).
The plaintiff’s burden of proof is heavy, as an Eighth Amendment
violation requires more than negligence or even medical malpractice.
Id. at 409. Indeed, because the second prong of the analysis requires
a plaintiff to show that the defendant had a “sufficiently culpable
state of mind,” the plaintiff must produce evidence that the treatment
he received was “so blatantly inappropriate as to evidence intentional
mistreatment.” Greeno, 414 F.3d at 653 (citing Farmer v. Brennan, 511
U.S. 825, 834 (1994) (Eighth Amendment violation requires proof of an
intentional or criminally reckless tort)). In addition, a plaintiff
whose deliberate indifference claim is based upon an alleged delay in
providing medical treatment must not only prove the objective and
subjective components of his claim, he must also offer “verifying
medical evidence” that the delay, rather than the underlying condition,
caused him harm. Jackson v. Pollion, 733 F.3d 786, 790 (7th Cir. 2013)
(citations omitted).
A doctor’s decision to forego diagnostic tests is “a classic
example of a matter of medical judgment.” Estelle v. Gamble, 429 U.S.
97,

107

(1976).

Accordingly,

a

plaintiff

whose

claim

rests

on

allegations that prison doctors failed to conduct appropriate testing
4

to discover his serious medical condition must come forward with proof
that

the

doctor’s

decision

“departed

significantly

from

accepted

professional norms.” Pyles, 771 F.3d at 411. Similarly, a plaintiff who
challenges a doctor’s decision not to refer him to a specialist must
establish

either

that

the

doctor

actually

knew

of

his

need

for

specialized treatment, or that the need would have been obvious even to
a layperson, such that that the decision not to engage a specialist
“permits

an

inference

that

a

medical

provider

was

deliberately

indifferent to the inmate’s condition.” Id. at 412 (citing Greeno, 414
F.3d at 654).
II.
Given the breadth of plaintiff’s ailments in this case, it is
helpful at the outset to focus the analysis on the medical condition
that defendants’ failure timely to detect and treat allegedly caused
him

a

constitutional

injury:

Sjogren’s

Syndrome.

Indeed,

although

plaintiff asserts that he has been diagnosed with numerous conditions,
the “gist” of his complaint “is that between 2012-2015, Mr. Haywood
appeared many times before the Defendant physicians and presented
symptoms of Sjogren’s Syndrome,” but because Drs. Obaisi and Martija
viewed him as “a malingerer and a complainer...they made no bona fide
attempt to diagnose or treat him for this condition until years later,”
and that after his diagnosis, they, and later Dr. Tilden, interfered
with his treatment. Opp. at 1; see also Pl.’s L.R. 56.1(b)(3) Stmt. at
¶¶ 20. But the record simply does not support this characterization of
5

the facts. To the contrary, plaintiff’s medical record establishes that
defendants

consistently

responded

to

plaintiff’s

complaints,

and

plaintiff identifies no evidence to suggest that the treatment decisions
they made reflected anything other than their medical judgment.
By his own account, plaintiff first reported joint pain—a symptom
associated with Sjogren’s Syndrome—in June of 2014, and he points to a
document that reflects a complaint about pain in his shoulder. But
plaintiff’s

medical

record

also

reveals

that

he

received

prompt

treatment for this complaint: an x-ray of his shoulder was taken on
June 27, 2014, and in the meantime, he was prescribed medication and
“instructed to hold off heavy weight lifting till asymptomatic.” See DN
133-1 at 1794; Exh. 1 to Pl.’s L.R. 56.1(b)(3) Stmt. at IDOC 481.3
Similarly, after plaintiff complained of knee pain in August of 2014,
he was prescribed ibuprofen and a cold pack and was advised to elevate
his knee and to avoid bearing weight. See IDOC 486. Plaintiff offers no
evidence to suggest that the treatment he received on these occasions
was inappropriate, much less that it was “blatantly” so. Plaintiff also
points to the numerous cavities he had filled between 2013 and 2015 and
argues that given the joint problems and skin rashes for which he was

I pause here to deplore both parties’ practice of identifying cited
portions of plaintiff’s medical records only by Bates number and failing
to indicate where on the docket these documents can be found (for
example with reference to an exhibit number and the document to which
the exhibit is attached). This practice has done little to aid in the
ascertainment of genuine factual disputes and much to frustrate prompt
and efficient resolution of defendants’ motion.
3

6

also treated during the same period, Drs. Obaisi and Martija should
have investigated whether the cavities were a symptom of Sjogren’s
Syndrome. Yet, plaintiff points to no evidence of any professional norms
mandating

diagnostic

testing

under

these

circumstances

prior

to

December 2015 to determine whether these symptoms were linked by an
underlying disorder.
Indeed, plaintiff offers no evidence at all to controvert the
testimony of defendants’ expert witness, who opined that the treatment
plaintiff received for each of his complaints was well within the bounds
of accepted professional standards. Plaintiff’s core theory—that the
defendant physicians’ view of him as a “malingerer” and a “complainer”
replaced their exercise of professional judgment—rests entirely on his
subjective sense that his complaints were brushed off and the meaning
he attributes to a handful of notations in his medical records. For
example, plaintiff claims that the emphasis in a notation from a visit
on August 8, 2015, which states that plaintiff was “brought up for chest
pains, third time this week,” IDOC 541 (original emphasis), reflects
Dr. Martija’s “frustration” with his frequent visits to the prison
health

care

unit.

Similarly,

plaintiff

reads

skepticism

into

the

observation recorded on September 23, 2015, that plaintiff “has been
evaluated multiple times by different providers” for complaints of a
racing heart and chest pain. IDOC 559. But plaintiff does not dispute
that these notations are factually accurate, and even assuming the
inferences he draws from their emphasis is correct, the objective
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medical

record

establishes

that

prison

medical

staff

nevertheless

investigated and treated his complaints: In response to his complaint
of August 8, plaintiff received a physical examination, a blood pressure
check, a respiration and heart rate check, and an EKG, all of which
produced normal results, see IDOC 541, and on September 23, plaintiff
had his temperature, pulse, blood pressure, and respiration checked and
was scheduled for a follow up appointment with the prison medical
director on October 13, 2015. Plaintiff’s subjective belief that these
treatments were “superficial” and designed to “get[] him to go away and
stop bothering” the prison medical staff is not substantiated by any
competent medical evidence. Pl.’s L.R. 56.1(b)(3) Stmt. ¶ 43. At all
events, courts “look at the totality of an inmate’s medical care when
considering whether that care evidences deliberate indifference to
serious medical needs.” Petties v. Carter, 836 F.3d 722, 730-31 (7th
Cir. 2016) (en banc). Plaintiff’s medical records comprise over a
thousand pages, and the isolated remarks he points to on a handful of
entries fall far short of establishing defendants’ unconstitutional
disregard for his Sjogren’s Syndrome.4

Plaintiff argues that defendants’ treatment of his ailments “unrelated
to Sjogren’s Syndrome [is] immaterial to this lawsuit.” Opp. at 10
(objecting to evidence that Drs. Obaisi and Martija provided appropriate
care for dizziness, chest and stomach pain, and asthma). But because
“deliberate indifference” requires an analysis of the totality of the
care defendants provided, the physician defendants’ treatment of
plaintiff’s other conditions is relevant to the subjective component of
the Eighth Amendment analysis. What is true, however, is that plaintiff
relies exclusively on his Sjogren’s diagnosis to satisfy the objective
component of the analysis—the existence of a serious medical condition.
4

8

Plaintiff insists that the record contains “copious evidence” of
a “lengthy pattern of unconstitutional behavior” by the physician
defendants. Opp. at 6. But the “evidence” he cites boils down to his
subjective view that it took too long for Drs. Obaisi and Martija to
recognize the need for specialized treatment and speculation about the
reasons for the perceived delay. For example, plaintiff cites as
evidence

of

these

doctors’

foot

dragging

the

failure

to

provide

specialists with “relevant portions” of plaintiff’s medical file in
advance of his consultations. Yet, so far as the record reveals, that
was entirely consistent with standard practices; and even if it was
not,

plaintiff

offers

no

evidence

that

the

doctors

intentionally

withheld his medical files or that they recklessly failed to ensure
that the files were timely transmitted to the specialists.
In any event, it appears that plaintiff would not have been treated
any sooner for Sjogren’s Syndrome if his medical records had been sent
to

his

rheumatologist

rheumatologist,

earlier.

testified

that

Dr.
even

Alghafeer,
after

plaintiff’s

confirming

first

plaintiff’s

diagnosis, he “wasn’t that concerned...that I needed to initiate any
treatment,” and decided instead upon a course of “managed observation.”
Alghafeer Dep., DN 133-8 at 60. Moreover, even if plaintiff could show
that defendants’ conduct prevented him from receiving timely treatment
for Sjogren’s Syndrome, a delay in treatment gives rise to an Eighth

In other words, plaintiff does not claim to have been injured by the
medical care he received for any of his other medical conditions.
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Amendment violation only where the plaintiff provides “independent
evidence

that

the

delay

exacerbated

the

injury

or

unnecessarily

prolonged pain.” Petties, 836 F.3d at 730-31 (7th Cir. 2016) (en banc).
Plaintiff offers no evidence of this sort.5
This leaves only the question of whether plaintiff is entitled to
a trial on his theory that the treatment he received after his Sjogren’s
diagnosis violated the Eighth Amendment. Plaintiff argues that each of
the physician defendants manifested deliberate indifference to his
serious medical condition by failing to follow the treatment regimen
that his rheumatologists recommended for Sjogren’s Syndrome. It is true
that the specialists’ recommendations were not followed to the letter,
notably with respect to the length of time between visits to monitor
plaintiff’s

condition.

Still,

that

shortcoming

does

not

entitle

Defendants assert that there is no evidence of any disease progression,
vital organ involvement, or system complications attributable to their
treatment of plaintiff’s Sjogren’s Syndrome. See Def.’s L.R. 56.1(a)
Stmt., ¶¶ 118, 139. Plaintiff purports to dispute these statements with
citations to “Arami Exh. A” to show his putative diagnosis of Sjogren’srelated fibromyalgia. See Pl.’s L.R. 56.1(b)(3) Stmt., ¶¶ 118, 139. But
the only exhibits attached to plaintiff’s responsive factual statements
are numbered 1-3, and if there is an “Exh. A” to any document plaintiff
submitted, I have been unable to find it. Plaintiff also cites the
deposition of Dr. Arami—evidently one of his treating physicians—to
support his position on the issue of disease progression, but he again
fails to identify any record entry corresponding to his citation.
Meanwhile, defendants identify Dr. Arami’s deposition transcript as
Exhibit 10 to their factual statement; but Exhibit 10 (like Exhibits 9
and 11) is the transcript of Dr. Alghafeer’s deposition. As best I can
determine based on my unguided review of the three thousand page,
predominantly sealed record in this case, Dr. Arami’s deposition
transcript is not before me, leaving no “verifying medical evidence” to
support plaintiff’s delay-based Eighth Amendment claim.
5

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plaintiff to a trial absent some evidence that these delays, or the
occasional unavailability of plaintiff’s prescribed medication, were
the result of the doctors’ culpable state of mind. See Gaston v. Ghosh,
920 F.3d 493, 496 (7th Cir. 2019) (affirming summary judgment where
plaintiff offered no evidence to show “who was responsible for the
delays (the four physicians named as defendants? back-office staff?
someone

else?)

plaintiff]’s

or

pain

why

those

continue?

delays

occurred

indifference

to

(a

desire
his

that

pain?

[the

simple

negligence? medical judgment?)”) (original emphasis). The suggestive
language plaintiff uses to color his responses to defendants’ factual
statements, see, e.g., Pl.’s L.R. 56.1(b)(3) Stmt., ¶ 93 (admitting
that

Dr.

Tilden

“begrudgingly

complied”

with

Dr.

Alghafeer’s

recommendations), does not substitute for competent medical evidence
suggesting that defendants’ treatment decisions fell so far outside the
field of reasonable professional competence as to allow a jury to infer
deliberate indifference to plaintiff’s serious medical condition.
There is no doubt that plaintiff has received a great deal of
medical treatment while incarcerated. Indeed, he does not dispute that
he consulted multiple specialists—a rheumatologist, a cardiologist, a
gastroenterologist, an optometrist, and an orthopedic spine specialist—
upwards of twenty times between June of 2016 and June of 2018. Plaintiff
believes that his Sjogren’s Syndrome should have been diagnosed sooner,
and that he should have received more frequent monitoring and more
consistent pharmaceutical treatment for that condition. Nevertheless,
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the totality of the record is not such as would allow a reasonable jury
to conclude: a) that the defendant doctors intentionally or recklessly
disregarded plaintiff’s symptoms of Sjogren’s Syndrome; b) that the
defendant doctors failed to authorize or provide treatment for that
condition after it was diagnosed; or c) that plaintiff suffered a
constitutional
Accordingly,

injury

the

as

physician

a

result

of

defendants—and

any

delay

thus

all

in

treatment.

defendants—are

entitled to summary judgment. See Gaston, 920 F.3d at 497 (to hold
Wexford liable for its employees’ conduct under any theory, plaintiff
must show that “someone whose acts are imputed to Wexford violated the
Eighth Amendment”).
III.
For the foregoing reasons, defendants’ motion is granted.

ENTER ORDER:

__________________________
Elaine E. Bucklo
United States District Judge
Dated: June 5, 2019

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