Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca7-15-01539/USCOURTS-ca7-15-01539-0/pdf.json

Nature of Suit Code: 555
Nature of Suit: Prisoner - Prison Condition
Cause of Action: 

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United States Court of Appeals 

For the Seventh Circuit

Chicago, Illinois 60604

Submitted May 6, 2016*

Decided June 1, 2016

Before

JOEL M. FLAUM, Circuit Judge

DANIEL A. MANION, Circuit Judge

ANN CLAIRE WILLIAMS, Circuit Judge

No. 15‐1539

OMAR RAMIREZ,

Plaintiff‐Appellant,

v.

MAGID FAHIM and WEXFORD

HEALTH SERVICES, INC.,

Defendants‐Appellees.

Appeal from the United States District

Court for the Southern District of Illinois.

No. 12‐cv‐01197‐MJR‐SCW

Michael J. Reagan,

Chief Judge.

O R D E R

Omar Ramirez, an Illinois prisoner at Menard Correctional Center, alleged that

Dr. Magid Fahim and Wexford Health Services had denied appropriate treatment for an

injury to his left knee despite numerous complaints that the knee joint would dislocate,

causing pain. He claimed that the course of treatment constituted deliberate

indifference to a serious medical need under the Eighth Amendment, see 42 U.S.C.

§ 1983, and medical malpractice under Illinois law, see Sullivan v. Edward Hosp.,

                                                 

* After examining the briefs and record, we have concluded that oral argument is

unnecessary. Thus the appeal is submitted on the briefs and record. See FED. R. APP. P.

34(a)(2)(C).

NONPRECEDENTIAL DISPOSITION

To be cited only in accordance with Fed. R. App. P. 32.1

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806 N.E.2d 645, 653 (Ill. 2004). Three times Ramirez asked the district court to recruit a

lawyer to assist him, but the court denied each request. The court also dismissed the

malpractice claim because Ramirez had not submitted a physician’s certification of

“reasonable and meritorious cause” for that claim. See 735 ILCS 5/2‐622(a). The

defendants later prevailed at summary judgment on the Eighth Amendment claim, but

in this appeal Ramirez challenges only the district court’s refusal to recruit counsel and

the dismissal of the malpractice claim. We affirm the judgment.

In his 2012 complaint Ramirez alleged that he had injured his left knee playing

basketball at a different prison in 2004. He was treated with ice, ibuprofen and bed rest,

he said, but over time the knee joint worsened and began dislocating when he

descended stairs. After transferring to Menard, Ramirez continued, he was seen by Dr.

Fahim during 2009 and 2010 but never referred to an orthopedic specialist or scheduled

for an MRI to evaluate his knee condition. Two X‐rays had shown only mild

osteoarthritis but, according to Ramirez, X‐rays were not enough. A Wexford policy of

denying care to save money, Ramirez asserted, had caused Dr. Fahim’s inadequate

treatment. Ramirez attached to his complaint medical records relating to his knee and

submitted a request for help in obtaining counsel.   

At screening, see 28 U.S.C. § 1915A, the district court allowed the Eighth

Amendment claim to proceed but told Ramirez that state‐mandated documentation

was needed before his malpractice claim could go forward. Under Illinois law, the court

explained, Ramirez was required to submit an affidavit from a physician certifying the

existence of grounds for the malpractice claim. The court gave Ramirez 60 days to

obtain the certification and warned that the malpractice claim would be dismissed

without prejudice unless certification was supplied.   

Ramirez reacted to the screening order by reminding the district court of his (still

unresolved) request for counsel. Obtaining a physician’s certification without a lawyer,

Ramirez asserted, would be “near impossible” because, as a prisoner, he could not

afford the fee a doctor likely would charge to evaluate his medical records. He already

had sent his records to a few doctors, Ramirez explained, but had not received a

response.

The district court declined to recruit counsel with the explanation that Ramirez

appeared able to litigate the suit himself. The court noted that Ramirez’s submissions

were clearly written and easy to understand, and opined that the lawsuit was not

complicated. The court added that Ramirez’s imprisonment was not reason enough to

recruit counsel, lest every inmate wanting to pursue a claim for medical malpractice

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under Illinois law would be entitled to a lawyer’s help in getting a physician’s

certification. The district court gave Ramirez an extra 30 days to submit the certification

and warned him again that the malpractice claim would be dismissed without it. A

month after this extended deadline, Ramirez still had not tendered the certification,

prompting the court to dismiss the claim without prejudice.   

After this, Ramirez shifted his attention to the Eighth Amendment claim, and

again he asked the district court to recruit counsel. In his motion (and a supplement)

Ramirez asserted that his lawsuit would involve “substantial investigation and

discovery.” He protested that he lacked legal training and was reliant on other inmates

for assistance, and he further asserted that he could not conduct discovery or procure

the required physician’s certification. The court was unpersuaded by this dim

self‐appraisal, noting that Ramirez already had won a motion to compel discovery and

overcome the defendants’ assertion that he failed to exhaust his administrative

remedies. Ramirez’s submissions, the court added, had included clear explanations of

the factual and legal bases for his arguments.

Ramirez asked for a lawyer a third and final time six months after the defendants

had moved for summary judgment on the Eighth Amendment claim. But this request

was premised on an asserted need for trial assistance, not for help in opposing the

motion for summary judgment. The district court eventually declined again to recruit

counsel after granting the defendants’ motion for summary judgment. A trial was

unnecessary, the court reasoned, because X‐rays and examinations had ruled out a torn

ligament and suggested only mild osteoarthritis and joint swelling. Dr. Fahim had

followed advice from colleagues to defer a referral to an orthopedic specialist and first

try strengthening exercises and an anti‐inflammatory to alleviate the swelling and

associated pain. Moreover, the court noted, Ramirez had not submitted evidence from

which a jury could infer that cost‐cutting pressure from Wexford had interfered with

Dr. Fahim’s exercise of medical judgment.

On appeal Ramirez raises just two procedural arguments. First he challenges the

dismissal of his malpractice claim on the ground that a physician’s certification is not a

substantive requirement and should be excused for litigants who sue in federal, rather

than state, court. We rejected this same argument in Hahn v. Walsh, 762 F.3d 617, 628–33

(7th Cir. 2014). See also Hines v. Elkhart Gen. Hosp., 603 F.2d 646, 647 (7th Cir. 1979)

(Indiana’s requirement that a plaintiff obtain approval of medical review board to

pursue malpractice claim applies to claims brought in federal court under diversity

jurisdiction); Feinstein v. Mass. Gen. Hosp., 643 F.2d 880, 885 & n.7 (1st Cir. 1981) (same

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result for similar Massachusetts law); DiAntonio v. Northampton‐Accomack Mem’l Hosp.,

628 F.2d 287, 290–91 (4th Cir. 1980) (same result for similar Virginia law). Under the

framework provided by Erie Railroad Company v. Tompkins, 304 U.S. 64 (1938), and

Hanna v. Plummer, 380 U.S. 460 (1965), the state’s requirement of a physician’s

certification does not conflict with federal procedural rules, and thus a district court

must dismiss a claim for medical malpractice arising under Illinois law if a physician’s

certification is not provided. See Hahn, 762 F.3d at 633. The district court allowed

Ramirez ample time to procure the physician’s certification, which he did not do.

Indeed, even when Ramirez’s claim of deliberate indifference reached summary

judgment, Ramirez still had not secured any type of medical expert. The certification

requirement is intended to reduce frivolous malpractice suits, see Sherrod v. Lingle,

223 F.3d 605, 613 (7th Cir. 2000); DeLuna v. St. Elizabeth’s Hosp., 588 N.E.2d 1139, 1142

(Ill. 1992), and nothing we have seen in the appellate record even hints that Ramirez’s

suit had merit.   

Ramirez’s remaining contention is that the district court abused its discretion in

not recruiting a lawyer to assist him. Ramirez rehashes the contentions he made in his

several motions, and insists that a lawyer “would have made a difference” during the

discovery phase. But the district court followed Pruitt v. Mote, 503 F.3d 647, 655

(7th Cir. 2007) (en banc), by considering Ramirez’s literacy, communication skills, and

litigation experience. Ramirez’s lawsuit involved relatively simple questions about the

treatment of his knee, and his well‐written submissions throughout the proceedings

show familiarity with the legal and factual issues. Despite his protestations, Ramirez

successfully navigated discovery issues and appropriately responded to the defendants’

motions. And although a pro se plaintiff’s “inability to investigate crucial facts by virtue

of his being a prisoner or of the remoteness of the prison from essential evidence” may

favor recruiting counsel, Junior v. Anderson, 724 F.3d 812, 815 (7th Cir. 2013); see Schlemm

v. Wall, 784 F.3d 362, 366 (7th Cir. 2015), Ramirez does not identify any evidence that he

was thwarted from obtaining. He possessed his medical records before he filed his

complaint, and he concedes that he was able to send those records to outside doctors to

request the medical certification. The medical records are not difficult to decipher, and

we are given no reason to believe that a lawyer could have made better use of them

than did Ramirez. See Olson v. Morgan, 750 F.3d 708, 712 (7th Cir. 2014); Snipes v. DeTella,

95 F.3d 586, 592–93 (7th Cir. 1996). Thus, we cannot conclude that the district court

abused its discretion.   

AFFIRMED.

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