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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 December 2, 2024*

Decided December 3, 2024 

Before 

FRANK H. EASTERBROOK, Circuit Judge 

AMY J. ST. EVE, Circuit Judge

NANCY L. MALDONADO, Circuit Judge 

No. 23-3128 

WILLIAM BUCK, 

Plaintiff-Appellant, 

v. 

DEBRA CONNORS-JOHNSON, et al.,

 Defendants-Appellees.

 

Appeal from the United States District 

Court for the Northern District of 

Illinois, Eastern Division. 

No. 18-cv-04195 

Mary M. Rowland, 

Judge. 

 O R D E R 

William Buck, an Illinois prisoner, accuses Illinois officials and Wexford Health 

Sources, Inc., of violating his Eighth Amendment rights by deliberately ignoring his 

serious dental needs. See 42 U.S.C. § 1983. The district court entered summary judgment 

in two stages. It correctly concluded that Buck failed to exhaust his administrative 

*

 We have agreed to decide the case without oral argument because the briefs and record 

adequately present the facts and legal arguments, and oral argument would not significantly aid the 

court. 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NONPRECEDENTIAL DISPOSITION 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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No. 23-3128 Page 2 

remedies on some claims and did not furnish evidence of deliberate indifference on the 

others. We therefore affirm. 

Background 

 Because the case involved cross-motions for summary judgment, we recount the 

facts in the light most favorable to the losing party—here, Buck. Holcomb v. Freedman 

Anselmo Lindberg, LLC, 900 F.3d 990, 992 (7th Cir. 2018). Buck’s claims arise from his 

time at Stateville Correctional Center and Menard Correctional Center. In September 

2016, while at Stateville, Buck saw Dr. Jacqueline Mitchell, a dentist at the prison, for 

pain in his mouth. Dr. Mitchell wrote that Buck’s two wisdom teeth (nos. 17 and 32) 

were impacted and decaying and causing two adjacent teeth (nos. 18 and 31) to decay. 

She referred Buck to an outpatient oral surgeon to remove the two impacted teeth. 

Debra Connors-Johnson, the Medical Records Director at Wexford, prepared a form 

approving the referral and wrote that Dr. Mitchell had recommended extracting all four 

teeth. The oral surgeon noticed the discrepancy between the referral (remove two teeth) 

and the approval (remove four). He testified that he sees mistakes in paperwork from 

Wexford about 10% of the time, and he makes his own judgment before extracting 

teeth. He decided that all four teeth required extraction and removed them. 

 After the extraction, Buck experienced complications. These included infected 

open sores with exposed bone at the extraction sites, significant facial swelling that 

made speaking difficult, and intense pain. Dr. Mitchell and others prescribed 

antibiotics, pain relievers, and heat packs (two to three times daily) for Buck to reduce 

the swelling and pain. The nursing staff provided the antibiotics and pain relievers. To 

receive the heat packs, Buck had to go to the infirmary where a nurse would walk to the 

kitchen to heat the pack. Buck testified that three Wexford nurses, Lidia Lewandowska, 

Tina Tomaras, and Tiffany Utke sometimes refused to allow Buck to come to the 

infirmary or gave him unheated or lukewarm packs that did not reduce his pain. Buck 

wrote grievances and complained about the nurses to little avail. His medical record—

on which nurses signed their initials after providing treatment—showed missing 

signatures for more than 70% of entries for the provision of the daily packs. 

 Apart from the problems with the packs, Buck continued to receive care at 

Stateville. The day after the procedure, Dr. Mitchell asked Wexford to approve a dental 

prosthetic to replace the two additionally extracted teeth. She also asked that Buck 

remain at Stateville and scheduled appointments to see him over the next two months. 

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Nevertheless, about a month after the surgery, another official transferred Buck to 

Menard. 

Buck did not receive the same level of treatment at Menard as at Stateville. The 

day after Buck arrived there, Dr. Steven Newbold, a dentist, evaluated him and ordered 

an x-ray and medicine. But the dentist stopped treating Buck soon after. Three months 

after Buck’s arrival, in December 2016, Wexford approved Dr. Mitchell’s request for the 

dental prosthetic, but it never supplied the prosthetic to Buck. 

Buck then sought legal relief. While at Menard, he filed a grievance with the 

Administrative Review Board of the Illinois Department of Corrections. In it, he 

protested the extraction of the two extra teeth, the heating-pack problem, and his 

transfer to and care at Menard. The Board responded, identifying technical flaws in his 

submission and writing that his grievance “will not be addressed.” Buck then sued. 

With the aid of recruited counsel, and as relevant on appeal, he sought damages from 

Connors-Johnson for causing two extra teeth to be removed, the three nurses for 

disregarding his post-operative needs, Wexford for tolerating systemic paperwork 

errors, and Dr. Newbold and Wexford for Buck’s care at Menard. (Buck brought a claim 

against the official who transferred him from Stateville, but he has settled that claim.) 

The parties filed two rounds of motions for summary judgment. In the first, 

Dr. Newbold and Wexford argued that Buck had not exhausted his administrative 

remedies against them. The court agreed in part: For events that occurred after his 

transfer to Menard, Buck bypassed the required step of filing a grievance first with his 

counselor at Menard. See ILL. ADMIN. CODE tit. 20, § 504.810(a) (2016). But for events that 

preceded the transfer, Buck rightly filed his grievance directly with the Administrative 

Review Board. Id. § 504.870(a)(4). The court thus ruled that Buck failed to exhaust only 

those claims against Dr. Newbold and Wexford about events after his transfer. 

The second round of motions addressed the merits. Buck argued that 

Connors-Johnson recklessly ignored the referral, which said to extract only two teeth, 

and the three nurses deliberately disregarded Buck’s need for heat packs. Buck also 

contended that, while he was at Stateville, Wexford ignored systemic paperwork 

problems with dental referral orders, and when he was at Menard, it failed to fill orders 

that it had approved, such as the dental prosthetic. The district court accepted that 

Buck’s ailments were serious, but it ruled that the mistake Connors-Johnson made was 

not deliberate. It also ruled that the nurses at Stateville had not ignored a known and 

substantial risk of serious harm to Buck because he received antibiotics, pain 

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medication, and at least some heat packs. Finally, it concluded that Wexford was not 

liable for conduct that occurred while Buck was housed at Stateville. It also reiterated 

that, to the extent that Buck continued to pursue a claim for Wexford’s conduct that 

occurred after he moved to Menard, that claim was not properly exhausted. 

Analysis 

A. Nurses Lewandowska, Tomaras, and Utke at Stateville 

On appeal, Buck first contends that a reasonable jury could find the nurses 

deliberately disregarded his serious medical needs when they ignored Dr. Mitchell’s 

orders to provide him with the heated packs. To stave off summary judgment, Buck 

needed to furnish evidence that the defendants knew of and disregarded a substantial 

risk of harm. Farmer v. Brennan, 511 U.S. 825, 837 (1994). This standard is akin to 

criminal recklessness. Id. at 836–37. Although defying a medication order can evince 

deliberate indifference to a serious condition, see Machicote v. Roethlisberger, 969 F.3d 

822, 827 (7th Cir. 2020), “we must examine the totality of an inmate’s medical care,” 

Lockett v. Bonson, 937 F.3d 1016, 1023 (7th Cir. 2019) (quoting Dunigan ex rel. Nyman v. 

Winnebago County, 165 F.3d 587, 591 (7th Cir. 1999)). 

Buck has not met his burden to justify a trial. Like the district court, we accept 

that after his surgery, Buck faced a serious condition based on his infected sores, open 

extraction site, severe swelling, and intense pain. But in examining the totality of Buck’s 

care, see id., a jury could not find that the nurses deliberately disregarded his condition. 

Dr. Mitchell prescribed antibiotics (which the nursing staff provided), pain relievers 

(which the nursing staff provided), a follow-up dental appointment (which he received 

before his transfer), and heat packs, which the nurses provided at least some of the 

time. We recognize that, according to Buck—whose testimony we accept for present 

purposes—the nurses honored only about one third of his prescribed amount of fully 

heated packs, and they thus deviated from Dr. Mitchell’s orders. But Buck has not cited 

evidence, as is his burden as the plaintiff, suggesting that when the nurses did not 

provide heat packs, they knew that the antibiotics, pain medication, and other care he 

was receiving were substantially inadequate. Without evidence that the nurses 

deliberately disregarded his well-being in this way, he cannot prevail. 

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B. Connors-Johnson at Stateville 

 

Buck next argues that the district court erred in entering summary judgment for 

Connors-Johnson, but the record does not support his contention. He views as reckless 

her misinterpretation of Dr. Mitchell’s referral (ordering the extraction of two decaying 

teeth adjacent to two also-decaying teeth) as an order to extract all four teeth. And he 

adds that the oral surgeon’s statement that the surgeon receives paperwork errors from 

Wexford about 10% of the time corroborates his case against Connors-Johnson. But 

Buck did not provide evidence that Connors-Johnson deliberately ignored a known risk 

of harm: He furnished no evidence suggesting that Connors-Johnson knew that 

Dr. Mitchell did not want all four decaying teeth extracted and approved their 

extraction anyway. Further, given that Dr. Mitchell’s referral stated that all four teeth 

were decaying, Connors-Johnson’s misinterpretation of the referral was not deliberate 

or criminally reckless. See Farmer, 511 U.S. at 836–37. Finally, the evidence of other 

paperwork errors has no bearing on the case against Connors-Johnson because Buck did 

not present sufficient evidence tying her to them. 

C. Wexford at Stateville 

Next, Buck relies again on the oral surgeon’s statement about paperwork errors 

at Wexford to argue that he presented a triable claim that Wexford culpably caused the 

needless extraction of two of his teeth. But Buck cites no evidence to rebut Wexford’s 

defense that, even if this paperwork problem exists, it nonetheless did not cause Buck’s 

injury. The oral surgeon attested without contradiction that he noticed the paperwork 

discrepancy, but he extracted all four teeth based on his independent dental judgment. 

Without evidence that the discrepancy caused the extraction, this claim fails. See Dean v. 

Wexford Health Sources, Inc., 18 F.4th 214, 235, 239–40 (7th Cir. 2021). 

D. Dr. Newbold and Wexford at Menard 

Finally, Buck contends that the district court erred in ruling that he failed to 

exhaust his administrative remedies on his claims against Dr. Newbold and Wexford 

regarding their conduct at Menard. (Recall that Buck alleges that Dr. Newbold provided 

inadequate treatment of Buck’s mouth at Menard and that Wexford failed to fill orders 

that it approved, such as his dental prosthetic, in December 2016). He argues that, after 

he filed his grievance directly with the Administrative Review Board, its response about 

his defective filing confused him because he believed that he had filed his grievance 

with the Board correctly. If the exhaustion process is “so opaque” that “no ordinary 

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prisoner [could] discern or navigate it,” exhaustion may be excused. See Ross v. Blake, 

578 U.S. 632, 643–44 (2016). But that is not the case here. State law defines the relevant 

procedures. Jackson v. Esser, 105 F.4th 948, 956 (7th Cir. 2024). And Illinois law required 

that, for events occurring at Menard, Buck should have filed grievances first with his 

counselor at Menard, a step he bypassed, rather than directly with the Administrative 

Review Board, as he did. See ILL. ADMIN. CODE tit. 20, §§ 504.810(a), 504.870(a)(4) (2016). 

Because he did not exhaust these claims properly and he could have done so, Buck 

cannot now bring them in court. Jones v. Bock, 549 U.S. 199, 211 (2007). 

Bucks replies that the Board considered the merits of his grievance, so we may 

deem the claims exhausted. Because Buck did not preserve this argument in the district 

court, we need not consider it. Williams v. Dieball, 724 F.3d 957, 961 (7th Cir. 2013). In 

any event, the Board’s response was not on the merits—it wrote that the grievance “will 

not be addressed.” Thus the court properly ruled that the claims pertaining to treatment 

after his transfer to Menard were unexhausted. 

We have considered Buck’s remaining contentions on appeal, and none warrants 

further discussion. We thus AFFIRM the judgment. 

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