Jackson v. Santos et al
Filing
74
ORDER granting 49 Motion for Summary Judgment and granting 57 Motion for Summary Judgment. The Court finds in favor of Venerio Santos, Jessica Knebel, Susan Walker, and Ann Lahr against Sparky Jackson. Further, the Court DIRECTS the Clerk of the Court to enter judgment reflecting the same and close the case. Jackson shall take nothing from this case. Signed by Magistrate Judge Gilbert C. Sison on 6/30/2020. (klh)
UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ILLINOIS
SPARKY JACKSON,
Plaintiff,
v.
VENERIO SANTOS,
JESSICA KNEBEL,
SUSAN WALKER, and
ANN LAHR,
Defendants.
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Case No. 3:17-cv-1135-GCS
MEMORANDUM & ORDER
SISON, Magistrate Judge:
INTRODUCTION AND BACKGROUND
Pending before the Court are motions for summary judgment filed by Defendants
Knebel and Santos (Doc. 49, 50, 64) and Defendants Lahr and Walker (Doc. 57, 58). 1
Jackson only filed an opposition to the summary judgment motion filed by Knebel and
Santos. (Doc. 56). Based on the reasons delineated below, the Court GRANTS the
motions for summary judgment.
On October 23, 2017, Jackson filed a complaint pursuant to 42 U.S.C. § 1983
alleging that his constitutional rights were violated while he was housed at Centralia
1
Pursuant to Federal Rule of Civil Procedure 56, Timms v. Frank, 953 F.2d 281 (7th Cir. 1992) and
Lewis v. Faulkner, 689 F.2d 100 (7th Cir. 1982), Defendants filed the required notices informing Jackson of
the consequences of failing to respond to the motions for summary judgment. (Doc. 51, 59).
Page 1 of 17
Correctional Center (“Centralia”). (Doc. 1). Specifically, Jackson alleges that Defendants
were deliberately indifferent to his serious medical needs in violation of the Eighth
Amendment. On November 27, 2017, the Court conducted its preliminary review of
Jackson’s complaint pursuant to 28 U.S.C. § 1915A. The Court allowed Jackson to proceed
on one count of deliberate indifference to serious medical needs in violation of the Eighth
Amendment against Santos, Knebel, Lahr, and Walker regarding his symptoms of rectal
pain, abdominal pain, constipation, bad breath, and dry mouth in violation of the Eighth
Amendment. (Doc. 7).
FACTS2
The following facts are taken from the record and presented in the light most
favorable to Jackson, the non-moving party, and all reasonable inferences are drawn in
his favor. See Ricci v. DeStefano, 557 U.S. 557, 586 (2009).
The events surrounding this lawsuit occurred at Centralia. Jackson is an inmate
within the Illinois Department of Corrections (“IDOC”) and currently housed at Dixon
Correctional Center (“Dixon”). Defendant Santos is a physician at Centralia. Defendant
Knebel is a nurse at Centralia. Defendant Walker is a grievance officer, not a physician.
Defendant Lahr is a member of the Administrative Review Board (“ARB”), not a
physician.
Jackson was transferred to Centralia sometime in April 2016. On August 9, 2016,
2
These facts are not in dispute unless noted.
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Jackson first reported to the healthcare unit for hemorrhoids. Jackson complained of
rectal burning and protrusion from the rectum. There were no complaints of bleeding or
itching. The nurse observed slight protrusion but there were no signs of trauma. The
nurse referred Jackson to the physician.
Jackson was first seen by Santos on August 12, 2016. At this visit, Santos performed
a rectal exam on Jackson. He diagnosed Jackson with internal hemorrhoids, ordered
Jackson to keep the area clean, and prescribed anti-hemorrhoid cream.
On August 21, 2016, Jackson sent a request to healthcare stating that he saw Santos
on August 12, 2016 and that his condition had gotten worse. Jackson returned to the
healthcare unit on August 23, 2016. He complained of blood in his stool the night before
and complained of burning. The nurse noted the inspection of the anal area was within
normal limits, and there were no signs of bleeding or trauma around the anal area. The
nurse referred Jackson to a physician. Jackson contends that he told the nurse that the
hemorrhoids were causing severe pain, swelling and burning with a little speck of blood
on the tissue.
On August 25, 2016, Santos examined Jackson for the second time for complaints
of rectal pain and burning. The medical records reveal and Santos’s affidavit state that
Jackson denied any constipation and refused the rectal examination. Santos continued
Jackson on the anti-inflammatory cream. Jackson counters that he was not physically
examined by Santos at this visit, that he told Santos the cream was not working and that
it made his situation worse and that Santos refused to treat his condition. Jackson further
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counters that he told Santos that he was reluctant to use the bathroom and that Santos
did not mention a rectal examination.
On September 9, 2016, Jackson returned to the healthcare unit complaining of
blood in his stool. The nurse examined Jackson and found no signs of hemorrhoids,
redness, or swelling present. Jackson was admitted to the infirmary for a 23 hour period
to monitor his condition. Jackson contends that he went to the bathroom reluctantly. He
had pain, burning, and swelling and saw a lot of blood in the stool and on the tissue after
wiping. Jackson contends that the nurse told him she was going to need three stool
samples, and in response, Jackson told her that he really did not want to use the toilet
due to all the pain, burning and swelling. Jackson gave the nurse three stool samples and
contends that the nurse noted blood, hemorrhoid and a mucus like substance.
Jackson was discharged from the infirmary on September 10, 2016. Jackson was
educated on the need to increase his fluids and fiber intake. Jackson was placed on the
schedule to see a physician.
On September 12, 2016, Santos examined Jackson for complaints of blood in his
stool. At that time, Jackson complained of burning defecation. Santos performed a rectal
examination and ordered a hemoccult test, which was negative. Santos diagnosed
Jackson with internal hemorrhoids and continued him on hemorrhoid cream. Jackson
contends that the problem with Santos is that he never changed his method of treatment.
According to the medical records, Jackson did not return to the healthcare unit
regarding any complaints of rectal pain or burning until December 2016. Jackson
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contends that he wrote Lisa Krebs on October 31, 2016, indicating there was no reason for
him to see Santos because every time he went to see Santos, Santos did nothing and he
did not prescribe different treatment.
On December 5, 2016, Jackson put in a request slip to healthcare for complaints of
swelling, pain, and burning to his rectum while using the toilet. Jackson contends that he
asked not to see Santos and he signed a refusal slip for Santos. On December 10, 2016,
Jackson sent another request slip to healthcare, described his symptoms and asked to be
examined by any doctor other than Santos.
On December 12, 2016, Jackson returned to the healthcare unit. Jackson
complained of blood in his stool and pain in his rectal area. The nurse noted that the
hemorrhoids were visualized, but that there was no sign of blood or trauma. The nurse
referred Jackson to the doctor. Jackson contends he told the nurse that he did not want to
see Santos because he keeps prescribing the same cream that he thought was causing the
pain.
On December 14, 2016, Dr. Garcia examined Jackson. He diagnosed Jackson with
an anal tear and prescribed antibiotics TAO and Keflex. Dr. Garcia also counseled Jackson
on the need to ensure his rectal area remained clean. Jackson contends that Dr. Garcia
told him to stop using the hemorrhoid cream.
On January 17, 2017, Santos saw Jackson for complaints of abdominal pain,
burning in the rectal area and a foul order coming from his mouth. According to the
medical records, Santos completed a rectal examination. Santos did not find any signs of
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tearing and diagnosed Jackson with rectal pain and irregular bowel movements. Further,
Santos ordered an x-ray of Jackson’s abdomen, prescribed fiberlax stool softener, and
educated Jackson on anal hygiene. Santos did not find any significant issues with
Jackson’s breath. Jackson contends that at this visit Santos gave him a colon cancer
physical. Jackson disagrees with Santos’s opinion about his breath.
On January 18, 2017, Dr. Garcia examined Jackson for complaints of foul order
from his mouth and burning to his rectum. Dr. Garcia diagnosed Jackson with possible
GERD and hemorrhoids. 3 Dr. Garcia prescribed Jackson Pepcid, continued him on
fiberlax and educated him on proper anal hygiene.
On March 11, 2017, Jackson saw a dentist/oral hygienist about the foul order
coming from his mouth. The dentist/oral hygienist indicated that everything looked fine
and asked Jackson if he saw a doctor, and he told her yes.
Jackson did not return to the healthcare unit until July 20, 2017. At this time,
Jackson complained of abdominal pain.
On July 21, 2017, Santos examined Jackson regarding the abdominal pain, noted
the abdomen was soft and his bowel sounds were normal. A urinalysis was performed,
and the results came back negative. Santos diagnosed Jackson with urethritis and told
Jackson to increase his fluid intake.
On August 5, 2017, Jackson maintains that he sent a request slip to Knebel about
3
Jackson agrees that Dr. Garcia diagnosed him with GERD; he is not sure about the hemorrhoids.
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all of his health issues and asked for a face-to-face meeting with her to discuss.
On August 9, 2017, Jackson saw a nurse at the healthcare unit and complained
about pain in his stomach, foul odor coming from his mouth and hemorrhoids. Jackson
also told her that he did not want to see Santos.
On August 11, 2017, Santos saw Jackson for complaints of upper adnominal pain.
Santos ordered a second KUB x-ray of Jackson’s abdomen and a follow-up to discuss the
results. Jackson contends that he asked Santos why he had not seen a specialist after all
his complaints and that Santos said it was not necessary.
The results of the KUB produced a finding of mild increased gas in the stool and
in the colon. There was also no obstruction of free air, no mass and organomegaly, nor
were there any abdominal calcifications noted.
On August 19, 2017, Jackson was seen by Dr. Butalid, who discussed the KUB
results. Dr. Butalid examined Jackson and ordered Pepcid 20 mg twice a day and a followup in three weeks. Dr. Butalid noted that if Jackson’s symptoms did not improve, an
ultrasound might be needed.
On September 14, 2017, Santos saw Jackson for his abdominal pain. Jackson
indicated that he was not experiencing any relief from his abdominal pain. Santos
examined Jackson, assessed that gallbladder disease needed to be ruled out and
submitted a referral to collegial review for approval of the ultrasound. Santos also
ordered Jackson not to eat any spicy foods.
During collegial review on September 18, 2017, the Director of Utilization
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Management, Dr. Ritz, ordered an alternate treatment plan to obtain a CBC and metabolic
profile, to consider adding a stool softener, and to implement diet modifications based
on a review of Jackson’s commissary records. Dr. Ritz noted that if Jackson’s symptoms
persisted after 6 to 8 weeks to resubmit for the ultrasound. The alternative treatment plan
was implemented on September 25, 2017.
Eight weeks after the expiration of the alternative treatment plan, Jackson was still
experiencing symptoms of abdominal pain. Thus, on December 18, 2017, Santos appealed
the collegial decision from September 18, 2017 and requested that Jackson be sent for an
ultrasound. Dr. Ritz approved the ultrasound.
On December 21, 2017, Santos saw Jackson for a follow-up on his blood results.
Santos informed Jackson that the results were negative for H. Pylori. Jackson did not have
any complaints at this time. The ultrasound was performed on Jackson’s right upper
quadrant. The results of the ultrasound were negative for gallbladder disease.
On January 4, 2018, Santos saw Jackson regarding his ultrasound and CBC
results. Jackson indicated he had no complaints at that time. Santos informed Jackson that
his test results were negative for gallbladder disease and that his CBC was normal.
Jackson made no further complaints to Santos regarding abdominal pain in 2018.
However, on February 7, 2018, Jackson spoke with Dr. Garcia about his CBC and
abdominal pain.
Jackson has never spoken to Knebel in person regarding any of the concerns
contained in his complaint. He only communicated to Knebel through a letter. Jackson
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admitted that if Knebel never received the letter, he would not have any allegations
against her. Jackson also testified that he does not understand why she would not have
received the letter.
With respect to the other Defendants, Grievance #17-8-59 is the only contact
Jackson had with Defendant Walker concerning his medical treatment. Grievance #17-859 is the only grievance Defendant Lahr received from Jackson concerning his medical
needs.
LEGAL STANDARDS
Federal Rule of Civil Procedure 56 governs motions for summary judgment.
Summary judgment is appropriate if the movant shows that there is no genuine dispute
as to any material fact and that the movant is entitled to judgment as a matter of law. See
Archdiocese of Milwaukee v. Doe, 743 F.3d 1101, 1105 (7th Cir. 2014)(citing FED. R. CIV. PROC.
56(a)). Accord Anderson v. Donahoe, 699 F.3d 989, 994 (7th Cir. 2012). A genuine issue of
material fact remains “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 (1986). Accord
Bunn v. Khoury Enterpr., Inc., 753 F.3d 676, 681-682 (7th Cir. 2014).
In assessing a summary judgment motion, the district court views the facts in the
light most favorable to, and draws all reasonable inferences in favor of, the nonmoving
party. See Anderson, 699 F.3d at 994; Delapaz v. Richardson, 634 F.3d 895, 899 (7th Cir. 2011).
As the Seventh Circuit has explained, and as required by Rule 56(a), “we set forth the
facts by examining the evidence in the light reasonably most favorable to the non-moving
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party, giving [him] the benefit of reasonable, favorable inferences and resolving conflicts
in the evidence in [his] favor.” Spaine v. Community Contacts, Inc., 756 F.3d 542, 544 (7th
Cir. 2014). The Court’s role at summary judgment is not to evaluate the weight of
evidence, to judge witness credibility, or to determine the truth of the matter. Instead, the
Court is to determine whether a genuine issue of fact exists. See Nat’l Athletic Sportwear
Inc. v. Westfield Ins. Co., 528 F.3d 508, 512 (7th Cir. 2008).
The Supreme Court has recognized that deliberate indifference to the serious
medical needs of prisoners may constitute cruel and unusual punishment under the
Eighth Amendment. See Estelle v. Gamble, 429 U.S. 97, 104 (1976). To prevail on a claim for
deliberate indifference to a serious medical need, there are “two high hurdles, which
every inmate-plaintiff must clear.” Dunigan ex rel. Nyman v. Winnebago Cnty., 165 F.3d
587, 590 (7th Cir. 1999). First, the plaintiff must demonstrate he suffered from an
objectively serious medical condition. Id. at 591-592. Second, the plaintiff must establish
the individual prison officials were deliberately indifferent to that condition. Id.
The first consideration is whether the prisoner has an “objectively serious medical
condition.” Arnett v. Webster, 658 F.3d 742, 750 (7th Cir. 2011). “A medical condition is
objectively serious if a physician has diagnosed it as requiring treatment, or the need for
treatment would be obvious to a layperson.” Pyles v. Fahim, 771 F.3d 403, 409 (7th Cir.
2014)(citations omitted). It is not necessary for such a medical condition to “be lifethreatening to be serious; rather, it could be a condition that would result in further
significant injury or unnecessary and wanton infliction of pain if not treated.” Gayton v.
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McCoy, 593 F.3d 610, 620 (7th Cir. 2010). Accord Farmer v. Brennan, 511 U.S. 825, 828
(1994)(violating the Eighth Amendment requires “deliberate indifference to a substantial
risk of serious harm”)(internal quotation marks omitted) (emphasis added)).
To show prison officials acted with deliberate indifference, a plaintiff must put
forth evidence that prison officials not only knew that the prisoner’s medical condition
posed a serious health risk, but they consciously disregarded that risk. See Holloway v.
Delaware Cnty. Sheriff, 700 F.3d 1063, 1073 (7th Cir. 2012). “This subjective standard
requires more than negligence and it approaches intentional wrongdoing.” Id. Accord
Berry v. Peterman, 604 F.3d 435, 440 (7th Cir. 2010)(stating that “[d]eliberate indifference
is intentional or reckless conduct, not mere negligence.”); McGowan v. Hulick, 612 F.3d
636, 640 (7th Cir. 2010)(stating that “negligence, even gross negligence does not violate
the Constitution.”).
Assessing the subjective prong is more difficult in cases alleging inadequate health
care as opposed to lack of care. Without more, a “mistake in professional judgment
cannot be deliberate indifference.” Whiting v. Wexford Health Sources, Inc., 839 F.3d 658,
662 (7th Cir. 2016). The Seventh Circuit explained:
By definition a treatment decision that is based on professional judgment
cannot evince deliberate indifference because professional judgment implies a
choice of what the defendant believed to be the best course of treatment. A
doctor who claims to have exercised professional judgment is effectively
asserting that he lacked a sufficiently culpable mental state, and if no
reasonable jury could discredit that claim, the doctor is entitled to summary
judgment.
Id. (citing Zaya v. Sood, 836 F.3d 800, 805-806 (7th Cir. 2016)).
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This is in contrast to a case “where evidence exists that the defendant [ ] knew
better than to make the medical decision[] that [he] did.” Whiting, 839 F.3d at 662 (quoting
Petties v. Carter, 836 F.3d 722, 731 (7th Cir. 2016)(alterations in the original). A medical
professional’s choice of an easier, less efficacious treatment can rise to the level of
violating the Eighth Amendment, however, where the treatment is known to be
ineffective but is chosen anyway. See Berry, 604 F.3d at 441. The Eighth Amendment does
not require that prisoners receive “‘unqualified access to health care.’ Rather, they are
entitled only to “‘adequate medical care.’” Johnson v. Doughty, 433 F.3d 1001, 1013 (7th
Cir. 2006)(citations omitted).
Defendants moved for summary judgment arguing that they were not deliberately
indifferent to Jackson’s serious medical needs. Jackson opposes the motions. As the
motions are ripe, the Court turns to address the merits of the motions.
ANALYSIS
I.
Medical Provider Defendants
A.
Serious Medical Need
First, Knebel and Santos argues that Jackson’s complaints of dry mouth and bad
breath do not constitute a serious medical condition. Specifically, Defendants argue that
there is not a single medical record that demonstrates any medical physician deemed
Jackson’s complaints for dry mouth or bad breath as requiring medical treatment. The
record does not establish that Jackson’s subjective complaints about bad breath and dry
mouth ever became a serious medical issue. There is also no medical evidence that his
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complaints of bad breath and dry mouth constituted an objectively serious condition that
mandated treatment. See, e.g., Guitierrez v. Peters, 111 F.3d 1364, 1372 (7th Cir. 1997)(noting
that not every ache, pain, or discomfort can support an Eighth Amendment claim.).
Jackson first complained about his bad breath while housed at Big Muddy Correctional
Center before he was transferred to Centralia. He saw a dentist who found that his oral
hygiene was very good and was informed that he should consult with a physician if he
thought there was a problem. Although the Court acknowledges that bad breath and dry
mouth is unpleasant, there is nothing to indicate that Jackson had a serious medical
condition and that Defendants failed to properly treat that condition. Thus, Defendants
Knebel and Santos are entitled to summary judgment regarding Jackson’s bad breath and
dry mouth claims. Out of an abundance of caution, however, the Court will also address
these conditions under the deliberate indifference standard.
B.
Deliberate Indifference
Construing the evidence in the light most favorable to Jackson, the Court finds that
he has not established that either Santos or Knebel was deliberately indifferent to his
medical needs regarding his hemorrhoids, abdominal pain, bad breath, dry mouth and
constipation. The record reveals that from August 2016 to January 2018 Santos provided
appropriate medical treatment to Jackson. Santos regularly saw Jackson, and Jackson
admitted that Dr. Santos prescribed him hemorrhoid cream, fiberlax, ordered a
hemoccult test, and educated him on anal hygiene. Additionally, Santos referred
Jackson’s abdominal pain complaints to collegial review for an ultrasound to rule out
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gallbladder disease. Santos also appealed the collegial review’s decision to provide
alternate treatment after that treatment did not work so that Jackson could get an
ultrasound. Obviously, the treatment was not the treatment Jackson wanted or
demanded. However, mere disagreement or dissatisfaction as to the treatment received
does not amount to deliberate indifference. See Edwards v. Snyder, 478 F.3d 827, 831 (7th
Cir. 2007); Forbes v. Edgar, 112 F.3d 262, 267 (7th Cir. 1997); Ciarpaglini v. Saini, 352 F.3d
328, 331 (7th Cir. 2003); Snipes v. DeTella, 95 F.3d 586, 592 (7th Cir. 1996). There is no
evidence that Santos’s treatment of Jackson’s hemorrhoids was such a substantial
departure from accepted professional judgment, or so plainly inappropriate, as to permit
the inference that he intentionally or recklessly disregarded Jackson’s serious medical
needs. Rather, Santos exercised his professional judgment and recommended a more
conservative course of treatment for the symptoms associated with Jackson’s
hemorrhoids, constipation, abdominal pain, bad breath and dry mouth.
Likewise, there is no evidence that Knebel was deliberately indifferent to Jackson’s
serious medical needs. For example, Jackson has not established that Knebel was aware
of his complaints. Jackson admitted that he did not have a face-to-face conversation with
Knebel. He also admitted that his only interaction with Knebel was a letter he wrote to
her, and Jackson is unaware if Knebel ever received that letter. Thus, there is no evidence
that Knebel was deliberately indifferent to his serious medical needs. Thus, Santos and
Knebel are entitled to summary judgment.
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II.
Defendants Ann Lahr and Susan Walker
Prison officials, who are non-medical professionals, are entitled to rely upon the
judgment of medical professionals to avoid liability under the Eighth Amendment. See
Lee v. Young, 533 F.3d 505, 511 (7th Cir. 2008). For example, the Seventh Circuit found that
“as a layperson, the warden could rely on the medical staff’s expertise as long as he did
not ignore [an inmate] or his mistreatment.” Diggs v. Ghosh, 850 F.3d 905, 911 (7th Cir.
2017).
Lahr and Walker contend they cannot be liable because they reasonably relied on
the judgment of medical professionals. They also argue there is no evidence that Jackson’s
grievances were ignored or mishandled, and they were not personally involved in
Jackson’s medical treatment. Based on the record, the undersigned finds that Jackson has
not established that either Lahr or Walker was deliberately indifferent to Jackson’s
serious medical needs. Both Defendants were part of the grievance process and not
medical providers or professionals. Jackson was seen regularly in the healthcare unit.
The record reflects that Walker, a grievance officer, responded to only one
grievance regarding Jackson’s medical treatment, grievance #17-8-59. In response,
Walker responded as follows: “[i]t is this writer’s findings that the offender’s medical
records, the medical records are being addressed by the facility’s health care staff:
therefore, I recommend grievance denied. Only qualified Medical staff determine
medical care.” (Doc. 58-2, p. 1). Similarly, Lahr, a member of the ARB, denied grievance
#17-8-59 finding it was appropriately addressed by the facility Administration, and
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finding, “[p]er HCU, offender is receiving treatment for this issue.” (Doc. 58-2, p. 1).
The Eighth Amendment does not require that prisoners receive “unqualified
access to health care[.]” Rather, they are entitled only to “adequate medical care.” Johnson,
433 F.3d at 1013. The record reflects that Walker investigated the medical issues Jackson
complained of in grievance #17-8-59, and Walker provided Jackson with a response.
Likewise, the record reflects that Lahr, in the last step of the grievance process, denied
Jackson’s grievance. Walker and Lahr were entitled to rely on the advice and treatment
rendered by the medical professionals. Prison grievance procedures are not mandated by
the Constitution, and alleged mishandling of grievances by persons who otherwise did
not cause or participate in the underlying conduct states no claim. See Owens v. Hinsley,
635 F.3d 950, 953 (7th Cir. 2011). Similarly, prison officials who simply processed or
reviewed inmate grievances lack personal involvement in the conduct forming the basis
of the grievance, which precludes liability under Section 1983. See Owens v. Evans, 878
F.3d 559, 563 (7th Cir. 2017). Accordingly, no reasonable jury could find that there is
evidence that either Walker or Lahr was deliberately indifferent to Jackson’s serious
medical needs. Nor could any reasonable jury find that either Walker or Lahr ignored
Jackson’s medical concerns by simply reviewing and denying one grievance.
CONCLUSION
Accordingly, the Court GRANTS the motion for summary judgment filed by
Santos and Knebel (Doc. 49) and the motion for summary judgment filed by Lahr and
Walker (Doc. 57). The Court finds in favor of Venerio Santos, Jessica Knebel, Susan
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Walker, and Ann Lahr against Sparky Jackson. Further, the Court DIRECTS the Clerk of
the Court to enter judgment reflecting the same and close the case. Jackson shall take
nothing from this case.
IT IS SO ORDERED.
Digitally signed
by Judge Sison
Date: 2020.06.30
16:11:55 -05'00'
Dated: June 30, 2020.
____________________________________
GILBERT C. SISON
United States Magistrate Judge
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