Johnson v. Wexford Health Source Inc. et al
Filing
98
MEMORANDUM Opinion and Order: Defendants' motion for summary judgment 75 is granted in part and denied in part. A status hearing is set for 9:30 a.m. on July 6, 2020. Signed by the Honorable Sharon Johnson Coleman on 5/5/2020. Mailed notice. (ym, )
Case: 1:17-cv-03213 Document #: 98 Filed: 05/05/20 Page 1 of 9 PageID #:799
IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION
MARK JOHNSON,
Plaintiff,
v.
WEXFORD HEALTH SOURCE, INC.;
ESTATE OF DR. SALEH OBAISI,
Deceased; and LATANYA WILLIAMS,
Defendants.
)
)
)
)
)
)
)
)
)
)
)
Case No. 17-cv-3213
Judge Sharon Johnson Coleman
MEMORANDUM OPINION AND ORDER
Plaintiff Mark Johnson brings this 42 U.S.C. § 1983 action against Wexford Health Source,
Inc. (“Wexford”), Ghaliah Obaisi, as Independent Executor of the Estate of Saleh Obaisi, M.D.
(“Dr. Obaisi”), and physician’s assistant Latanya Williams (“PA Williams”). Johnson claims that Dr.
Obaisi and PA Williams were deliberately indifferent by failing to provide him with timely medical
care for his umbilical hernia. Johnson also asserts a claim against Wexford under Monell v. Dep’t of
Soc. Servs., 436 U.S. 658, 694, 98 S. Ct. 2018, 56 L. Ed. 2d 611 (1978). Currently before the Court is
defendants’ motion for summary judgment. For the reasons discussed below, the Court denies the
motion with respect to Dr. Obaisi and PA Williams and grants the motion as to Wexford.
Background
The Court relies on the Local Rule 56.1 statements of undisputed material facts and
supporting exhibits and construes the facts in the light most favorable to Johnson, the nonmoving
party. Johnson is an inmate in the custody of the Illinois Department of Corrections at Stateville
Correctional Center (“Stateville”), where he has been incarcerated since 1995 and is serving a natural
life sentence. Wexford is a private corporation that was contracted to provide medical services to
Stateville inmates. At all relevant times, Dr. Obaisi was employed by Wexford as its Medical
Case: 1:17-cv-03213 Document #: 98 Filed: 05/05/20 Page 2 of 9 PageID #:800
Director and, as a general surgeon, he had skills, knowledge, and training that exceeded other
primary care providers. PA Williams was also employed by Wexford. As a physician’s assistant, she
was required to handle the “sick call” at Stateville, which was the process by which inmates were
seen for illnesses and other medical problems. She also performed physical examinations and minor
surgical procedures, as well as sometimes covering the urgent care area.
In early 2016, Johnson first felt a “knot” in his abdominal area, which would later be
diagnosed as a hernia. The Wexford Medical Guidelines classify hernias as reducible, incarcerated,
or strangulated. Reducible hernias “generally pose no medical risk to the patient,” incarcerated
hernias “are at risk for strangulation and require urgent surgical surveillance,” and strangulated
hernias “represent a surgical emergency.” According to the medical records, PA Williams examined
Johnson’s abdomen on June 17, 2016 for an umbilical protuberance, which she noted “goes in and
out.” She diagnosed Johnson with a small, reducible, non-tender umbilical herniation, that is, a
hernia that can be manually inserted back into the abdominal cavity. She advised Johnson to
continue to observe his condition and to request another appointment if he observed a significant
change in the size of the hernia, experienced pain, or his bowel habits changed. Johnson testified
that he complained of pain at the June 17 visit and that PA Williams said something like “people live
with hernias.” PA Williams testified that Johnson did not complain of pain on June 17.
On October 25, 2016, Johnson had a medical visit with Dr. Obaisi, who tried to push the
hernia in to Johnson’s abdominal cavity but it popped back out, which, according to Johnson, was
painful. Johnson requested surgical repair but Dr. Obaisi told him that it was not medically
indicated because he was diagnosing him with a reducible small umbilical hernia. He advised
Johnson to follow up again in six months. According to Johnson, Dr. Obaisi also stated that hernia
patients were not sent out for surgery. On October 27, Johnson filed a grievance stating, inter alia,
that he was being denied treatment and that he needed his hernia “cut off.”
2
Case: 1:17-cv-03213 Document #: 98 Filed: 05/05/20 Page 3 of 9 PageID #:801
Johnson was next seen by Dr. Obaisi on April 5, 2017 at which time he was diagnosed with
an incarcerated hernia and prescribed an abdominal binder, which is a medical brace with a Velcro
closure prescribed generally to support a person’s abdomen or lower back. Johnson testified at his
deposition that he told Dr. Obaisi at both the 2016 and 2017 visits that the hernia was painful, but
Dr. Obaisi never provided him any pain medication. On April 11, 2017, Dr. Steven Ritz, the
Corporate Medical Director for Wexford, participated in a collegial review meeting that Dr. Obaisi
had called to request a surgical evaluation for Johnson. During the collegial review, Dr. Ritz
authorized Johnson to be seen at the University of Illinois at Chicago Medical Center (UIC) for a
general surgical evaluation.
On April 12, 2017, PA Williams saw Johnson for his annual physical examination. Her
notes from that appointment state that Johnson’s hernia was still small and reducible and, at her
deposition, she testified that there was consequently no medical need for additional work-up by a
doctor. She also testified that Johnson did not complain about hernia pain during his visit with her
because, had he done so, she would have documented his complaints in his medical records.
Another collegial review meeting was held on October 10, 2017, during which Wexford
approved Johnson for hernia repair surgery at UIC. On October 25, 2017, Johnson underwent a
laparoscopic hernia repair surgery. At his deposition, Johnson testified that he complained about
hernia pain from the time he first noticed the hernia until he had surgery. He also stated that during
that time the hernia grew or changed colors, and the pain worsened. During the year and a half
between the time Johnson was first diagnosed with a hernia and when he had the repair surgery, he
continued to work unloading trucks and in the kitchen at Stateville. He also stated that he continued
to exercise, with his workouts including lifting weights, but he discontinued performing squats and
limited his workouts to his upper body.
3
Case: 1:17-cv-03213 Document #: 98 Filed: 05/05/20 Page 4 of 9 PageID #:802
Johnson has brought this section 1983 action claiming deliberate indifference to his hernia
and hernia-related pain. Defendants oppose his claims and move the Court for summary judgment.
Legal Standard
Summary judgment is appropriate “if the movant shows that there is no genuine dispute as
to any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a);
see also Celotex Corp. v. Catrett, 477 U.S. 317, 322-23, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). A
material fact is one that “might affect the outcome of the suit,” and a genuine dispute as to a
material fact exists if “the evidence is such that a reasonable jury could return a verdict for the
nonmoving party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S. Ct. 2505, 2510, 91 L.Ed.
2d 202 (1986). When determining whether a genuine dispute as to any material fact exists, the Court
views the evidence and draws all reasonable inferences in favor of the nonmoving party. Id. at 255;
McDaniel v. Progress Rail Locomotive, Inc., 940 F.3d 360, 367 (7th Cir. 2019). After “a properly
supported motion for summary judgment is made, the adverse party ‘must set forth specific facts
showing that there is a genuine issue for trial.’” Id., 477 U.S. at 255 (citation omitted). The party
seeking summary judgment bears the burden of establishing that there is no genuine issue of
material fact and that it is entitled to judgment as a matter of law. Celotex, 477 U.S. at 323.
Discussion
Deliberate indifference claims against Dr. Obaisi and PA Williams
Johnson alleges that Dr. Obaisi and PA Williams were deliberately indifferent to his hernia
by delaying his request for surgery and failing to provide him with any medication despite his
complaints of pain. Dr. Obaisi and PA Williams argue that Johnson was cared for properly with a
conservative course of treatment until he was found to be medically indicated for surgery.
Defendants also assert that Johnson has not produced medical evidence to support a finding that the
professional judgment of Dr. Obaisi and PA Williams should not be entitled to deference.
4
Case: 1:17-cv-03213 Document #: 98 Filed: 05/05/20 Page 5 of 9 PageID #:803
Prison officials violate the Eighth Amendment’s proscription against cruel and unusual
punishment when they display “deliberate indifference to serious medical needs of prisoners.”
Estelle v. Gamble, 429 U.S. 97, 104 (1976). Officials have a duty to ensure that inmates receive
adequate medical care. Farmer v. Brennan, 511 U.S. 825, 835, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994).
A prison official is deliberately indifferent if he knew or was aware of a substantial risk of harm to an
inmate’s health, yet disregarded it. See Goodloe v. Sood, 947 F.3d 1026, 1030-31 (7th Cir. 2020). More
specifically, a prison official is deliberately indifferent when he, “having knowledge of a significant
risk to inmate health or safety, administers blatantly inappropriate medical treatment, acts in a
manner contrary to the recommendation of specialists, or delays a prisoner’s treatment for nonmedical reasons, thereby exacerbating his pain and suffering.” Perez v. Fenoglio, 792 F.3d 768, 777
(7th Cir. 2015) (internal quotation marks and citations omitted).
To survive summary judgment on a claim that medical care violated the Eighth Amendment,
Johnson must furnish evidence of an “objectively serious medical condition” and that defendants
were “deliberately indifferent to that condition.” Petties v. Carter, 836 F.3d 722, 728 (7th Cir. 2016)
(en banc). An objectively serious medical need is one that a physician has diagnosed as mandating
treatment or one “that is so obvious that even a lay person would easily recognize the necessity for a
doctor’s attention.” Wynn v. Southward, 251 F.3d 588, 593 (7th Cir. 2001) (per curiam) (internal
quotation marks omitted). As for the subjective component, the inmate must establish that prison
officials acted with a “sufficiently culpable state of mind.” Roe v. Elyea, 631 F.3d 843, 857 (7th Cir.
2011). Though negligence or inadvertence will not be sufficient to show deliberate indifference, “it
is enough to show that the defendants knew of a substantial risk of harm to the inmate and
disregarded the risk.” Id. (quoting Greeno v. Daley, 414 F.3d 645, 653 (7th Cir. 2005)). In other
words, “an inmate need not establish that prison officials actually intended harm to befall him from
the failure to provide adequate medical care.” Roe, 631 F.3d at 857.
5
Case: 1:17-cv-03213 Document #: 98 Filed: 05/05/20 Page 6 of 9 PageID #:804
A hernia condition can be an objectively serious medical problem and defendants do not
really dispute this element of Johnson’s case. See, e.g., Johnson v. Doughty, 433 F.3d 1001, 1010, 10121014 (7th Cir. 2006); Heard v. Sheahan, 253 F.3d 316, 317-18 (7th Cir. 2001). “[F]or some hernias,
the chronic pain presents a separate objectively serious condition.” Wilson v. Wexford Health Sources,
Inc., 932 F.3d 513, 521 (7th Cir. 2019) (internal quotations and citation omitted). Further, delaying
treatment of a non-life threatening, but painful, condition for nonmedical reasons can constitute
deliberate indifference. McGowan v. Hulick, 612 F.3d 636, 640 (7th Cir. 2010). This is true even if
the delay in treatment does not exacerbate the injury. Smith v. Knox Cty. Jail, 666 F.3d 1037, 1040
(7th Cir. 2012). To summarize, if Johnson can show that the surgery, which was ultimately
performed, was unnecessarily delayed in the face of worsening symptoms and ongoing complaints
of pain, he can establish a claim for deliberate indifference.
The Court finds that Dr. Obaisi and PA Williams are not entitled to summary judgment on
Johnson’s deliberate-indifference claims. There is a genuine dispute as to whether Johnson
complained to them of pain throughout the year and a half between when he first presented with the
hernia condition and when he finally obtained surgical repair. See Anderson, 477 U.S. at 255. The
Court notes that there are no notations in the Stateville medical record, authored by either Dr.
Obaisi or PA Williams, recording that Johnson complained about pain during his hernia-related
medical visits. Moreover, PA Williams testified that had Johnson told her he was experiencing pain,
she would have documented his complaints. Yet Johnson testified that he complained of hernia
pain to PA Williams at his June 2016 and April 2017 visits with her and to Dr. Obaisi at the October
2016 and April 2017 visits with him.
Construing the evidence in favor of Johnson, a reasonable jury could find that Dr. Obaisi
and PA Williams were deliberately indifferent to Johnson’s hernia-related complaints of pain during
the period between the June 2016 visit and the October 2017 surgery. See Wilson, 932 F.3d at 521
6
Case: 1:17-cv-03213 Document #: 98 Filed: 05/05/20 Page 7 of 9 PageID #:805
(district court erred in granting judgment as matter of law in defendant’s favor because jury could
find that defendant was deliberately indifferent during 14-month period between when plaintiff
presented with hernia pain and when he was referred for surgery); see also Duckworth v. Ahmad, 532
F.3d 675, 679 (7th Cir. 2008) (“A jury can infer deliberate indifference on the basis of a physician’s
treatment decision [when] the decision [is] so far afield of accepted professional standards as to raise
the inference that it was not actually based on a medical judgment.”) Whether Johnson’s testimony
is believable is ultimately a credibility determination for the jury. See Wilson, 932 F.3d at 521 (citing
Cooper v. Casey, 97 F.3d 914, 917 (7th Cir. 1996) (“[T]his is a case about pain . . . the textbook
example of a uniquely subjective experience.”)); see also Rasho v. Elyea, 856 F.3d 469, 477 (7th Cir.
2017) (in evaluating evidence in the light most favorable to the non-moving party, the Court must
refrain from making credibility determinations or weighing evidence). Defendants are left to
contradict Johnson’s testimony at trial, by challenging his testimony through the crucible of cross
examination and the presentation of their own evidence. Because the Court concludes that the
individual defendants have not met their burden of establishing the lack of genuine disputes as to a
material fact, see Celotex, 477 U.S. at 323, their motion for summary judgment on the deliberateindifference claims is denied.
Monell claim against Wexford
Wexford moves for summary judgment on Johnson’s claim that it had a cost-cutting policy
to not send out patients for hernia repair surgery. Although section 1983 has been interpreted to
bar respondeat superior liability, a defendant like Wexford can be held liable if it has a policy or practice
that causes a constitutional violation. Monell, 436 U.S. at 691; Woodward v. Corr. Med. Servs. of Ill., Inc.,
368 F.3d 917, 927 (7th Cir. 2004) (observing that Monell extends to private entities like Wexford).
To prevail on his Monell claim, Johnson needs to show that Wexford’s policy, practice, or custom
caused a constitutional violation. Whiting v. Wexford Health Source, Inc., 839 F.3d 658, 664 (7th Cir.
7
Case: 1:17-cv-03213 Document #: 98 Filed: 05/05/20 Page 8 of 9 PageID #:806
2016). “An official policy or custom may be established by means of an express policy, a widespread
practice which, although unwritten, is so entrenched and well-known as to carry the force of policy,
or through the actions of an individual who possesses the authority to make final policy decisions on
behalf of the municipality or corporation.” Rice ex rel. Rice v. Corr. Med. Servs., 675 F.3d 650, 675 (7th
Cir. 2012); Waters v. City of Chi., 580 F.3d 575, 581 (7th Cir. 2009). Johnson must show a causal
connection between his injury and Wexford’s official custom or policy. Hahn v. Walsh, 762 F.3d 617,
640 (7th Cir. 2014).
Here, the evidence does not establish that Wexford had a policy or custom of denying offsite
surgical intervention for hernias where medically indicated. PA Williams flatly denied, under oath,
that Wexford had any cost-cutting or cost-savings policies. Further, Wexford’s written policies
provide guidance as to when surgical intervention is necessary for an inmate presenting with a
hernia. Johnson has not produced any evidence of a widespread custom or practice beyond the
circumstances of his own umbilical hernia condition. One instance of purported deliberate
indifference is not enough to support Monell liability resting on a practice or policy. Thomas v. Cook
Cty. Sheriff’s Dep’t, 604 F.3d 293, 303 (7th Cir. 2009) (“[T]here is no clear consensus as to how
frequently such conduct must occur to impose Monell liability, except that it must be more than one
instance, or even three....” (citations omitted)). At minimum, Johnson must show that “there is a
policy at issue rather than a random event.” Thomas, 604 F.3d at 303. Yet, he has presented
evidence only of what he deems less-than-acceptable care for his hernia condition. He has not
offered evidence supporting the inference that what occurred was the result of an express policy
rather than an isolated incident.
To raise a triable issue of fact, Johnson was required to set forth some evidence that it was
the policy of Wexford to not send out patients for hernias, see Celotex, 477 U.S. at 322. The Court
finds that Johnson has not done so, and that a reasonable jury could not conclude that Wexford had
8
Case: 1:17-cv-03213 Document #: 98 Filed: 05/05/20 Page 9 of 9 PageID #:807
such a blanket policy. See Heard v. Tilden, 774 Fed. Appx. 985, 989 (7th Cir. 2019) (summary
judgment in favor of Wexford affirmed where the court held that a reasonable jury could not
conclude from the record that Wexford maintained a blanket policy of denying non-emergency
hernia surgery); see also Wilson, 932 F.3d at 521-22 (Wexford entitled to judgment as a matter of law
based on the fact that its hernia policy--which the court found was not a flat prohibition against
surgical intervention for hernia--was not the moving force behind plaintiff’s alleged Eighth
Amendment violation). Wexford is entitled to summary judgment in its favor as to the Monell claim.
Conclusion
For the foregoing reasons, defendants’ motion for summary judgment [75] is granted in part
and denied in part. A status hearing is set for 9:30 a.m. on July 6, 2020.
IT IS SO ORDERED.
Date: 5/5/2020
Entered:
9
_____________________________
SHARON JOHNSON COLEMAN
United States District Judge
Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.
Why Is My Information Online?