Judkins et al v. Pfister et al
Filing
118
MEMORANDUM Opinion and Order. Signed by the Honorable Manish S. Shah on 5/5/2021: Obaisi's motion for summary judgment 101 is granted. Enter judgment and terminate civil case. [For further detail see attached order.] Notices mailed. (psm, )
UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION
JONATHAN JUDKINS,
Plaintiff,
No. 17 CV 6540
v.
GHALIAH OBAISI, Independent
Executor of the ESTATE OF SALEH
OBAISI,
Judge Manish S. Shah
Defendant.
MEMORANDUM OPINION AND ORDER
Plaintiff Jonathan Judkins suffered from chronic knee pain while incarcerated
at Stateville Correctional Center, where defendant Saleh Obaisi was the medical
director. Judkins alleges that on two occasions he reported his knee pain to Obaisi
and Obaisi refused to treat him. Judkins accuses Obaisi of deliberate indifference to
his serious medical needs in violation of the Eighth Amendment. Obaisi’s estate
moves for summary judgment. 1 For the reasons that follow, the motion is granted.
I.
Legal Standards
Summary judgment is appropriate if the movant shows that there is no
genuine dispute as to any material fact and he is entitled to judgment as a matter of
law. Fed. R. Civ. P. 56(a). A genuine dispute as to any material fact exists if “the
evidence is such that a reasonable jury could return a verdict for the nonmoving
Obaisi died in 2017, and Obaisi’s estate replaced him as the named defendant in the case.
For simplicity, I refer to Obaisi individually as the party.
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party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). I construe all facts
and draw all inferences in favor of the nonmoving party. Robertson v. Dep’t of Health
Servs., 949 F.3d 371, 377–78 (7th Cir. 2020).
II.
Background
Judkins was an inmate at Stateville Correctional Center until November 2016,
when he was transferred. [111] ¶¶ 1, 43. 2 Defendant Ghaliah Obaisi is the
independent executor of the estate of Dr. Saleh Obaisi, who was the medical director
at Stateville. [111] ¶ 2.
Judkins began to experience pain in his knees in 2005. [111] ¶¶ 12–13, 22;
[114] ¶¶ 84–85. His knee pain was caused by a combination of a basketball injury,
wear and tear over time, and his weight. [111] ¶¶ 47–48, 67. Judkins’s doctors told
him that losing weight could help alleviate his symptoms. [111] ¶¶ 19–20, 47–48. The
pain prevented him from lying down comfortably and bending his knees for long
periods of time, such as when using the bathroom. [114] ¶ 84.
Judkins was diagnosed with bursitis, which is inflammation of the lining of the
joint; tendinitis, which is inflammation of tendons in the knee; and osteoarthritis, a
common form of arthritis that occurs when protective cartilage on the bones wears
down over time. [111] ¶¶ 65–67. Osteoarthritis is a chronic degenerative disease and
The facts are taken from Judkins’s response to Obaisi’s Local Rule 56.1 statement of facts,
[111], and Obaisi’s response to Judkins’s statement of additional facts, [114], where both the
asserted fact and the opposing party’s response is set forth in one document. Any fact not
properly controverted is admitted. N.D. Ill. Local R. 56.1(e)(3); see Cracco v. Vitran Exp., Inc.,
559 F.3d 625, 632 (7th Cir. 2009). I disregard legal arguments in the statements of facts, see
Cady v. Sheahan, 467 F.3d 1057, 1060 (7th Cir. 2006), and ignore additional facts included
in response to the asserted fact that do not controvert the asserted fact. N.D. Ill. Local R.
56.1(e)(2).
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damage to joints is irreversible, though progression of the disease can be slowed. [111]
¶¶ 61, 66. The standard treatment for osteoarthritis is anti-inflammatory
medication. [111] ¶¶ 60–61. According to Obaisi’s expert witness, bursitis, tendinitis,
and osteoarthritis are not objectively serious medical conditions. [111] ¶ 65.
A number of healthcare professionals treated Judkins for knee pain while he
was incarcerated. [111] ¶¶ 12–13. At different times, he received arch support for his
shoes, elastic knee support, a permit for knee braces, and a permit for a low bunk.
[111] ¶¶ 14–16, 32. He was prescribed medications such as Motrin, Tylenol, CTMS,
and Colace; ice therapy and heated balms; and steroid injections. [111] ¶¶ 14–18, 21–
23, 27, 32, 37–38. Although the steroid injections helped alleviate Judkins’s pain, he
refused them occasionally. [111] ¶¶ 27, 37, 51. He also received physical therapy.
[111] ¶¶ 17–18. Because Judkins had gunshot fragments in his thigh, he could not
undergo an MRI, but he did receive multiple x-rays. [111] ¶¶ 16, 21–24, 32, 37.
In September 2012, Obaisi diagnosed Judkins with tendinitis in his knees and
recommended an injection to the right patellar tendon. [111] ¶ 25. Obaisi saw Judkins
again a month later and observed that Judkins had full range of motion in his knees.
[111] ¶ 26. Obaisi advised Judkins to avoid sports for a month and prescribed him
Mobic twice daily. [111] ¶ 26. Judkins declined Obaisi’s offer of a steroid injection.
[111] ¶ 26. In March 2014, Judkins asked for an injection, and Obaisi ordered the
medication. [111] ¶¶ 29–30. Six months later, Judkins injured his knee playing
basketball, and a physician’s assistant referred him to Obaisi. [111] ¶ 31. Obaisi
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planned to give Judkins a steroid injection and prescribed Mobic twice daily for 60
days. [111] ¶ 33.
In early 2016, a physician’s assistant referred Judkins to Obaisi after he
reported that his knees were hurting and tender, and his range of motion was limited
when bending. [111] ¶¶ 36–38. On March 23, Judkins saw Obaisi for pain in his right
knee. [111] ¶ 39; [114] ¶ 88. The parties dispute what happened at that visit.
According to Judkins, Obaisi didn’t examine him. [114] ¶ 91; [104-1] 77:11–78:9.
Instead, Judkins asked Obaisi about seeing a specialist, and Obaisi responded that
there was nothing wrong with Judkins and ordered Judkins out of his office. [114]
¶ 89. 3 According to the medical records, Obaisi examined Judkins, found mild
tenderness, gave Judkins Voltaren (a new medication to treat osteoarthritis pain),
and offered him a steroid injection, which Judkins refused. [111] ¶ 39.
Obaisi objects to a number of facts taken from Judkins’s deposition on the ground that the
facts are “self-serving testimony by an interested party against a deceased party with no
opportunity to defend himself.” [114] ¶¶ 87, 89–90, 92. Obaisi does not cite to any case law or
rule of evidence to explain why that makes the statements inadmissible. A lot of testimony
is self-serving, so that’s not a basis for disputing a fact. See Koger v. Dart, 950 F.3d 971, 974
(7th Cir. 2020) (a witness’s self-interest “does not prevent a trier of fact from crediting a
statement based on personal knowledge”); Hill v. Tangherlini, 724 F.3d 965, 967 (7th Cir.
2013) (the term self-serving “must not be used to denigrate perfectly admissible evidence
through which a party tries to present its side of the story at summary judgment”). Obaisi’s
statements to Judkins are statements of a party opponent. See Fed. R. Evid. 801. That Obaisi
is deceased doesn’t render the statements inadmissible. “A statement by a declarant,
deceased at the time of trial, may be admissible” under Rule 801. Fischer v. Forestwood Co.,
525 F.3d 972, 984–85 (10th Cir. 2008) (quoting Savarese v. Agriss, 883 F.3d 1194, 1201 (3d
Cir. 1989)); see also United States v. Chappell, 698 F.2d 308, 311–13 (7th Cir. 1983). That the
testimony is unable to be rebutted goes to its weight, not its admissibility. Finally, though
Obaisi disputes that he told Judkins to leave his office, he doesn’t cite to anything in the
record to dispute it, so the fact is admitted.
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Judkins reported Obaisi to the assistant warden. [114] ¶ 93. Six days later,
Obaisi saw Judkins again. [111] ¶ 40; [114] ¶ 95. According to Judkins, Obaisi
unexpectedly summoned him for an appointment. [114] ¶ 94. Obaisi disputes this;
according to the medical records, Obaisi had scheduled the March 29 appointment
earlier in March, before the March 23 incident. [114] ¶ 94. At the appointment,
Judkins asked Obaisi again for a referral to a specialist. [111] ¶¶ 40, 53; [114] ¶ 95,
97. Obaisi denied that request because Judkins’s bursitis was mild, so no referral was
necessary. [111] ¶¶ 40, 53; [114] ¶ 95, 97. Obaisi renewed the Voltaren prescription
for four weeks, and Judkins declined a steroid injection. [111] ¶ 40. 4 A few days later,
Judkins filed a written grievance. [114] ¶ 98.
Six months later, Obaisi treated Judkins for intermittent knee pain that he
had been feeling for a few weeks. [111] ¶ 41. Judkins’s x-ray was normal and he had
full range of motion. [111] ¶ 41. Obaisi diagnosed him with bursitis in the right knee
and planned to give him a steroid injection and follow up in 10 weeks. [111] ¶ 41.
Obaisi saw Judkins again a month later, when Judkins’s knee pain had improved.
[111] ¶ 42. Obaisi recommended a knee sleeve and Voltaren twice daily for 90 days.
[111] ¶ 42.
Judkins was later transferred to three different prisons, where he received the
same or similar treatment from other doctors that he received from Obaisi. [111]
¶¶ 43–44, 54–55; [114] ¶ 103. In October 2017, a new doctor examined Judkins and
Facts 39 and 40 are admitted over Judkins’s objection. Judkins asserts that “the medical
record is inaccurate,” but only cites to his own statement of additional facts to controvert the
fact, rather than sections of the record to controvert it. See N.D. Ill. Local Rule 56.1(e)(3).
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found no abnormalities of the knees and no internal derangement. [111] ¶ 62. Judkins
asked that doctor for a referral to a specialist, and the doctor denied the request. [111]
¶¶ 43–44, 54; [114] ¶ 103. The doctor ordered physical therapy and gave Judkins a
low-bunk permit. [114] ¶ 105. In January 2018, a nurse practitioner requested
approval for Judkins to see a specialist. [114] ¶ 101.
According to Obaisi’s expert, neither surgery nor referral to an expert was
necessary to treat Judkins’s knee issues. [111] ¶¶ 65, 67–70. Judkins had never been
diagnosed with dislocation of his knee or torn ligaments, and medication and steroid
injections were the only available treatment for his diagnoses. [111] ¶¶ 52, 68. The
expert opined that Obaisi provided medically adequate care at all times, including on
the two dates in March 2016 when Judkins accuses him of deliberate indifference.
[111] ¶ 72, 74, 78–79. For example, Obaisi changed Judkins’s medications to address
new or changing pain. [111] ¶ 73. The expert saw no evidence that Obaisi’s actions on
March 23 or 29 caused or exacerbated Judkins’s injury, because Judkins had a
chronic, degenerative condition. [111] ¶¶ 75–76. 5 Likewise, not referring Judkins to
a specialist had no impact on his condition because he was not a candidate for a
specialty consultation. [111] ¶ 77.
III.
Analysis
The Eighth Amendment prohibits deliberate indifference to the serious
medical needs of prisoners. Machicote v. Roethlisberger, 969 F.3d 822, 827 (7th Cir.
Judkins disputes the expert’s findings because, he contends, the expert didn’t consider the
totality of the evidence. But he doesn’t cite to any evidence in the record to controvert the
expert’s findings. The expert’s testimony is admitted.
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2020) (citing Estelle v. Gamble, 429 U.S. 97, 104 (1976)). An inmate alleging
deliberate indifference must show that he faced a “substantial risk of serious harm,”
and that prison officials knew about that risk and disregarded it by “failing to take
reasonable measures to abate it.” Farmer v. Brennan, 511 U.S. 825, 847 (1994);
Murphy v. Wexford Health Sources Inc., 962 F.3d 911, 915 (7th Cir. 2020). So a
plaintiff bringing a claim of deliberate indifference to medical needs must offer
evidence that he suffered from an objectively serious medical condition, and that the
defendant actually knew of and disregarded a substantial risk of harm. Murphy, 962
F.3d at 915. Obaisi argues that Judkins has failed to present evidence from which a
reasonable jury could find either element.
A medical condition is objectively serious if it “has been diagnosed by a
physician as mandating treatment” or is “so obvious that even a lay person would
perceive the need for a doctor’s attention.” Perry v. Sims, 990 F.3d 505, 511 (7th Cir.
2021) (quoting Greeno v. Daley, 414 F.3d 645, 653 (7th Cir. 2005)). Though this
typically refers to an “acute” problem (e.g. a fracture or a wound), “chronic or
degenerative conditions” that may escalate if not treated properly can also be
objectively serious. McDonald v. Hardy, 821 F.3d 882, 889 (7th Cir. 2016); see also
Gray v. Hardy, 826 F.3d 1000, 1006 (7th Cir. 2016) (chronic and substantial pain can
constitute an objectively serious medical condition). Prison officials are not excused
from treating chronic or degenerative conditions simply because the risks of not
treating those injuries “reman latent or have not yet reached the point of causing
acute or life-threatening injuries.” McDonald, 821 F.3d at 889. A “broad range of
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medical conditions” may be sufficient to meet the objective part of the deliberateindifference test, including arthritis. Roe v. Elyea, 631 F.3d 843, 861 (7th Cir. 2011).
A reasonable jury could find that Judkins had a diagnosis for which a physician
mandated treatment, so he had an objectively serious medical condition. It’s
undisputed that Judkins was diagnosed with bursitis, tendinitis, and osteoarthritis
in his knees. And his doctors prescribed a variety of treatments: different types of
aspirin, steroid shots, arch support for his shoes, knee braces, a short bunk, ice
therapy, an icy balm, a heated balm, and so on. Further, Obaisi’s witnesses testified
that osteoarthritis is a chronic, degenerative disease. [111] ¶¶ 61, 66. Though the
parties don’t point to any evidence that Judkins’s arthritis, if left untreated, would
have developed into an acute injury, it’s reasonable to infer based on the frequency of
prescribed treatment that receiving no treatment would have resulted in some harm.
Finally, Obaisi doesn’t dispute Judkins’s assertions that his knee pain prevented him
from sitting or lying down comfortably for extended periods of time. If a jury credited
that testimony, it could find the pain Judkins described so obviously serious that even
a lay person would know Judkins required treatment. See Gray, 826 F.3d at 1006 (a
medical condition that significantly affects someone’s daily activities can be
objectively serious). A jury could also credit the testimony of Obaisi’s expert witness,
who said that Judkins didn’t suffer from an objectively serious medical condition. But
I draw inferences in favor of the nonmovant at this stage, and there is evidence from
which a jury could disagree with the expert’s conclusion.
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Judkins fails, however, to present evidence from which a jury could find that
Obaisi was indifferent to his objectively serious medical needs. A medical professional
displays deliberate indifference only if his decision was a substantial departure from
accepted professional judgment, practice, or standards. Donald v. Wexford Health
Sources, Inc., 982 F.3d 451, 458 (7th Cir. 2020). In applying this test, courts look to
the “totality of an inmate’s medical care” to decide “whether that care evidences
deliberate indifference to serious medical needs.” Lisle v. Welborn, 933 F.3d 705, 716
(7th Cir. 2019) (quoting Petties v. Carter, 836 F.3d at 728–29 (7th Cir. 2016)).
There’s a genuine factual dispute about whether Obaisi examined Judkins on
March 23 and prescribed him any medication. According to Judkins, Obaisi ordered
him out of his office without examining him or providing any treatment. According to
the medical records, Obaisi examined Judkins, found mild tenderness, gave Judkins
Voltaren, and offered him a steroid injection. There is some corroboration for
Judkins’s account; Obaisi doesn’t dispute that Judkins filed a grievance with the
warden related to Obaisi’s conduct on March 23. And, according to Judkins, Obaisi
summoned him to his office a few days later out of the blue. On the other hand, Obaisi
documented his response in medical records. Judkins doesn’t challenge the
admissibility of those medical records, and his suggestion that Obaisi retroactively
fabricated them to cover his tracks is purely speculative. Nevertheless, there’s
evidence from which a jury could credit either Judkins’s account or Obaisi’s medical
records. “Weighing evidence is for the factfinder, not the court.” Thomas v. Martija,
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991 F.3d 763, 767 (7th Cir. 2021). A jury could credit Judkins’s testimony that Obaisi
refused to treat him in March 2016.
Even so, no reasonable jury could find that Obaisi’s refusal to treat Judkins on
one day amounted to deliberate indifference in light of the totality of the treatment
that Obaisi provided. Judkins doesn’t dispute that Obaisi repeatedly and adequately
responded to his complaints of knee pain. For example, in September 2012, Obaisi
diagnosed Judkins with bursitis and recommended a steroid injection; a month after
that, Obaisi offered him a steroid injection and prescribed him Mobic; in April 2014,
Obaisi ordered injections after Judkins asked for them; in November 2014, Obaisi
recommended a steroid injection and Mobic; in October 2016, Obaisi diagnosed
Judkins with bursitis and recommended a steroid injection; a month after that,
Obaisi recommended a knee sleeve and Voltaren. Judkins admitted that the steroid
injections were effective and helped ease his pain, and Obaisi changed and adjusted
Judkins’s medications as his pain evolved. Judkins doesn’t dispute that he received
comparable care from other doctors after he was transferred. Absent treating him on
March 23, Judkins doesn’t point to any evidence that Obaisi reasonably could have
done anything more for him. Obaisi’s expert witness offered unrebutted testimony
that neither surgery nor a referral to a specialist were necessary to treat Judkins’s
conditions, and a doctor at another prison also declined to refer Judkins to a
specialist. See Thomas, 991 F.3d at 772–73 (finding no deliberate indifference where
evidence showed defendant doctor “was not alone in his judgment”). To the extent
Judkins disagrees with Obaisi’s decision not to refer him to a specialist, disagreement
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with a doctor’s “medical judgment” typically does not constitute deliberate
indifference. Eagan v. Dempsey, 987 F.3d 667, 689–90 (7th Cir. 2021). And Judkins
points to no admissible evidence that not sending him to a specialist was a substantial
departure from the standard of care. If true, Obaisi’s failure to examine Judkins on
March 23 showed poor judgment. But no reasonable jury could rely on that one
incident to find that Obaisi deliberately disregarded a risk of substantial harm, given
the overall course of treatment Obaisi provided. See Clark v. Wexford Health Sources,
Inc., 833 Fed. App’x 18, 22 (7th Cir. 2020) (no deliberate indifference in light of “the
totality of the care provided,” rather than viewing one medication “in isolation”);
Tuduj v. Lawrence, 829 Fed. App’x 120, 124 (7th Cir. 2020) (same, where evidence
showed “the medical staff evaluated and treated [plaintiff] often to alleviate his
symptoms”).
Finally, Judkins’s argument appears to be that Obaisi delayed, rather than
denied, treatment. In such a case, a plaintiff must present “verifying medical
evidence” that the delay, not the underlying condition, caused “some harm.” Walker
v. Wexford Health Sources, Inc., 940 F.3d 954, 964 (7th Cir. 2019) (quoting Jackson
v. Pollion, 733 F.3d 786, 790 (7th Cir. 2013)). Put differently, Judkins must show not
only a risk of substantial harm—he must also “link that harm or the risk thereof to
the defendant.” Thomas, 991 F.3d at 770. Judkins fails to connect Obaisi’s alleged
conduct to any harm he suffered. That physical therapy had helped Judkins in the
past doesn’t bear on whether Obaisi’s conduct on March 23 caused any harm. No
reasonable jury could find that Obaisi’s refusal to treat Judkins’s chronic condition
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on one or two occasions accelerated the progression of his injury or caused him any
additional pain.
IV.
Conclusion
Obaisi’s motion for summary judgment [101] is granted. Enter judgment and
terminate civil case. 6
ENTER:
___________________________
Manish S. Shah
United States District Judge
Date: May 5, 2021
The court thanks Jeffrey Kulwin, and the firm Kulwin, Masciopinto & Kulwin, for
representing plaintiff as recruited counsel under the trial bar program for the Northern
District of Illinois.
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