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Nature of Suit Code: 550
Nature of Suit: Prisoner - Civil Rights (U.S. defendant)
Cause of Action: 

---

In the 

United States Court of Appeals 

For the Seventh Circuit ____________________

No. 14‐3591

DEREK J. BURTON,

Plaintiff‐Appellee,

v.

MICHAEL DOWNEY, et al.,

Defendants‐Appellants.

____________________

Appeal from the United States District Court for the

Central District of Illinois.

No. 3:11‐CV‐03171 — Sue E. Myerscough, Judge.

____________________

ARGUED SEPTEMBER 17, 2015 — DECIDED OCTOBER 8, 2015

____________________

Before FLAUM, MANION, and SYKES, Circuit Judges.

FLAUM, Circuit Judge. Plaintiff‐appellee Derek J. Burton

filed a civil rights action under 42 U.S.C. § 1983, alleging that

members of the staff at the Jerome Combs Detention Center

(“JCDC”) violated his constitutional rights while he was de‐

tained for eighteen months awaiting trial. The district court

denied defendants’ motion for summary judgment, ruling

that a reasonable jury could conclude that defendants were

deliberately indifferent to Burton’s serious medical needs—

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2 No. 14‐3591

the standard to prove a constitutional violation under the

Due Process Clause of the Fourteenth Amendment. Because

it found that triable issues of fact existed as to whether de‐

fendants’ conduct violated Burton’s constitutional rights, the

district court also rejected defendants’ defense of qualified

immunity. Defendants appeal, and for the reasons that fol‐

low, we reverse the district court’s decision denying sum‐

mary judgment.

I.  Background

Burton was detained at the JCDC from September 23,

2009 to March 17, 2011, while he awaited trial and sentenc‐

ing for charges of home repair fraud, false impersonation of

a firefighter, and driving on a revoked license. Before his de‐

tention, Burton had been treated by Dr. Zumwalt, a primary

care physician, for numerous health issues, including chron‐

ic back pain, chronic anxiety, acid reflux, herpes simplex,

hyperlipidemia, and depression. In addition to other medi‐

cations, Dr. Zumwalt intermittently prescribed Norco, an

opioid pain medication similar to Vicodin, to help Burton

manage pain associated with these conditions.  

In 2008, Dr. Zumwalt diagnosed Burton with avascular

necrosis, which is a loss of blood circulation that causes bone

death, in Burton’s hip. He prescribed Norco for the pain and

recommended that Burton speak to Dr. Verghese, an ortho‐

pedic surgeon, for treatment options.

One week before Burton’s detention, Dr. Verghese per‐

formed a core decompression surgery to treat Burton’s avas‐

cular necrosis and prescribed Ultram, a synthetic opiate also

known as Tramadol, as a pain reliever. In his deposition, Dr.

Verghese explained that he did not like to prescribe narcotic

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pain medication such as Norco and preferred Ultram for

pain relief because it has less addictive potential. At that

time, Dr. Verghese did not know that Burton was also taking

Norco.

On the day of Burton’s surgery, Dr. Zumwalt refilled Bur‐

ton’s Norco prescription without consulting Dr. Verghese.

Dr. Zumwalt stated in his deposition that he did not intend

for Burton to be taking Norco for long, and that the prescrip‐

tion should have run out on September 29, 2009. Although

Dr. Zumwalt conceded that Norco is addictive, he testified

that the dose prescribed to Burton would not be addictive if

taken over several weeks, and that it could have been

stopped or interrupted without causing serious withdrawal

symptoms or health issues.  

On September 23, 2009, Burton was arrested and booked

into the JCDC. Burton had taken a Vicodin pill about an

hour before his arrest. At the time of his detention, all of Bur‐

ton’s prescribed medications, including Lexapro for depres‐

sion, Xanax for anxiety, Zantac for acid reflux, two types of

prescription cream for herples simplex, and Norco, were

confiscated pursuant to JCDC policies and procedures.  

Approximately thirty‐five hours later, Physician’s Assis‐

tant Timothy Menard examined Burton. Burton claims that

during his examination, he informed Menard that he was

experiencing severe pain as well as withdrawal symptoms

because he had been taking Norco for the past year, and re‐

quested that Menard contact Dr. Zumwalt. Menard contact‐

ed Dr. Verghese about Burton’s surgery and health issues,

but did not call Dr. Zumwalt or prescribe Norco. Menard in‐

stead prescribed Ultram, Xanax, Zantac, and cholesterol‐

lowering medication. Burton was allowed to take the Zantac

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and cholesterol medicine back to his cell to self‐dispense, but

the Ultram and Xanax were dispensed by the JCDC staff.  

The parties dispute how quickly Burton received Ultram

after this examination. Burton contends that he did not re‐

ceive pain medication until October 1, nine days after he was

detained. He did not raise this argument in his complaint—it

first appears in his response to defendants’ motion for sum‐

mary judgment, which was filed on November 13, 2013. The

only evidence to support his claim is a document from

Riverview Pharmacy showing that an Ultram prescription

was filled on October 1.  

Burton’s deposition taken in January 2012 tells a different

story. In that deposition, Burton made several statements in‐

dicating that he began taking Ultram on September 25,

meaning that he was only deprived of pain relief for approx‐

imately thirty‐five to forty‐eight hours from the start of his

detention. Specifically, Burton acknowledged that Nurse

Heather Gill ordered his prescription for Ultram on Septem‐

ber 25 and that he received Ultram after Menard’s September

25 examination. Burton also admitted that when he met with

Dr. Verghese on September 29, less than a week after his de‐

tention, he told Dr. Verghese that he was taking Ultram. Bur‐

ton’s statements are consistent with JCDC medical records

that show that Ultram was dispensed on September 25.  

On September 29, 2009, less than a week after he was de‐

tained, Burton saw Dr. Verghese for a follow‐up appoint‐

ment and complained that he was experiencing severe post‐

surgical pain. After conducting a physical examination and

reviewing his X‐rays, Dr. Verghese refilled Burton’s prescrip‐

tion for Ultram for seven to ten days and instructed that he

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No. 14‐3591 5

use Tylenol after his Ultram prescription ran out. As before,

Dr. Verghese did not prescribe Norco.  

Dr. Verghese saw Burton again on October 27, 2009. Dr.

Verghese stated in his deposition that at this time, Burton

appeared to be recovering well. Dr. Verghese once again re‐

fused to prescribe narcotics, despite Burton’s continued re‐

quests. He instead advised that Burton continue to take Ty‐

lenol for pain relief and begin weaning off of his crutches.  

On November 17, 2009, in a hearing for Burton’s pending

criminal case, Burton explained to Illinois Circuit Judge

Clark Erickson that he was not receiving the medications

that he had been prescribed before he was detained and that

he was experiencing severe pain from sleeping on a thin

mattress. The government made no objection to Burton’s oral

motion and no evidence or testimony was taken. At the end

of the hearing, Judge Erickson ordered that the sheriff pro‐

vide Burton with an extra mattress and furnish him with all

medicines that were prescribed for him. But the JCDC did

not provide Burton with an extra mattress, nor did it supply

Burton with any prescriptions written by Dr. Zumwalt be‐

fore Burton’s detention, including Norco.  

Burton saw Dr. Verghese again on November 24, 2009. At

this time, Burton complained that he continued to suffer

from severe hip pain and that he was developing pain in his

elbow from the crutches. Dr. Verghese diagnosed Burton

with tennis elbow and recommended physical therapy to

help his recovery progress more quickly. Dr. Verghese stated

in his deposition that he taught Burton some simple stretch‐

ing exercises, but Burton contends that he was unable to un‐

derstand the instructions.  

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Sometime after Burton’s November 24 appointment,

Nurse Gill called Dr. Verghese to inquire about his recom‐

mendation of physical therapy. Dr. Verghese informed her

that Burton could do physical therapy exercises in his cell.

Nurse Gill then gave Burton written instructions on how to

complete physical therapy exercises with a towel and also

provided a towel. The jail did not provide Burton with out‐

side physical therapy. Burton continued to use crutches for

the remainder of his detention.  

Dr. Verghese saw Burton for the last time on February 25,

2010. Burton again complained about elbow and hip pain

and admitted he had not been doing the stretches that Dr.

Verghese and Nurse Gill had suggested. Dr. Verghese con‐

cluded that Burton should stretch his muscles surrounding

his hip and elbow and recommended physical therapy, on

the condition that Burton could convince the court that he

should receive it.  

During each appointment, Dr. Verghese examined Burton

and determined that his avascular necrosis was improving.

In fact, Dr. Verghese stated in his deposition that as of No‐

vember 24, 2009, he found no evidence of any avascular ne‐

crosis at all. But Burton continued to complain about severe

pain and to request narcotic pain medication, which Dr. Ver‐

ghese refused to prescribe. Dr. Verghese also refused to pre‐

scribe or recommend a thicker mattress despite Burton’s re‐

quests because he did not believe that a second or different

mattress would affect Burton’s underlying medical condi‐

tion.  

For these reasons, at a later hearing in Burton’s criminal

case, Illinois Circuit Judge Kathy Bradshaw denied Burton’s

request that the court order the sheriff and the jail to provide

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No. 14‐3591 7

him with narcotic medication, a second mattress, and a dif‐

ferent orthopedist. Judge Bradshaw determined that Burton

had no current prescriptions for the medication he was re‐

questing and was being seen by a competent orthopedist, Dr.

Verghese, who had not recommended an additional mattress

or prescribed Norco.

A few months after Burton’s February 25 appointment

with Dr. Verghese, the JCDC offered to make Burton a fol‐

low‐up appointment, but Burton refused to go. In his depo‐

sition, Burton explained that he did not think Dr. Verghese

was helping him get better, and that Dr. Verghese was writ‐

ing prescriptions for physical therapy that the jail was not

going to fill, so he did not want to waste time with another

appointment.  

Between June and August of 2010, Menard contacted

other orthopedists in the area to try to schedule an appoint‐

ment for Burton, but his efforts were unsuccessful. In a Janu‐

ary 24, 2011 healthcare review document, Menard and Nurse

Gill noted that all orthopedic doctors in the area refused to

see Burton. The review also noted that Burton had recently

been caught hoarding and selling Xanax, Seroquel, and Ul‐

tram in jail.  

Burton continued to complain about his hip and elbow

pain and was seen by the JCDC medical staff several times.

Burton also received medical treatment for other conditions,

including a rash and rectal bleeding, while detained. Burton

does not allege that he was ever denied an appointment with

the medical staff, who saw him twenty‐six times during his

eighteen‐month period of detention.  

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On May 3, 2011, Burton filed a complaint against the

JCDC; Kankakee County Sheriff Timothy Bukowski, Chief of

Corrections Michael Downey, and Assistant Chief of Correc‐

tions Chad Kolitwenzew (the “non‐medical defendants”);

and Menard, Physician’s Assistant Tiniki White, Nurse Gill,

and Nurse Charee Sangster (the “medical defendants”). Bur‐

ton requested monetary relief under 42 U.S.C. § 1983 for al‐

leged violations of his constitutional rights while he was de‐

tained. The district court denied defendants’ motion to dis‐

miss, finding that Burton had stated a claim that defendants

were deliberately indifferent to his serious medical needs.1  

After the close of discovery, defendants moved for sum‐

mary judgment, arguing that no reasonable jury could find

for Burton and that they were entitled to qualified immunity

because their actions were consistent with clearly established

law. On September 16, 2014, the district court denied de‐

fendants’ motion for summary judgment.  

Defendants moved for reconsideration of the district

court’s order on October 6, 2014, arguing that the non‐

medical defendants should be dismissed from the case. The

district court denied the motion, reasoning that it could not

determine the non‐medical defendants’ personal involve‐

ment in the creation and implementation of jail policies that

were responsible for Burton’s alleged constitutional depriva‐

tions. Defendants now appeal.

                                                 

1 Kankakee County was later added as a necessary party under Carver v.

Sheriff of LaSalle Cnty., 324 F.3d 947 (7th Cir. 2003), but the County is not a

party to this appeal.  

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No. 14‐3591 9

II.  Discussion

On appeal, defendants contend that the district court

erred by denying their motion for summary judgment be‐

cause, even after resolving all factual inferences in favor of

Burton, no reasonable jury could conclude that they were

deliberately indifferent to his serious medical needs. De‐

fendants also claim that they were entitled to invoke the de‐

fense of qualified immunity, which shields government offi‐

cials from liability “for actions taken while performing dis‐

cretionary functions, unless their conduct violates clearly es‐

tablished statutory or constitutional rights of which a rea‐

sonable person would have known.” Brokaw v. Mercer Cnty.,

235 F.3d 1000, 1022 (7th Cir. 2000). Like the district court, we

combine our analysis of whether there is a genuine issue of

material fact with respect to Burton’s constitutional claim

and whether defendants were entitled to qualified immunity,

as the issues are inextricably linked in this case. See Walker v.

Benjamin, 293 F.3d 1030, 1037 (7th Cir. 2002) (“The district

court blended together its analysis of whether there was a

genuine issue of material fact with respect to Walker’s claim

and whether the defendants were entitled to qualified im‐

munity. Under certain circumstances, such as those present‐

ed here, the two inquiries effectively collapse into one.”).  

We review the denial of summary judgment de novo and

resolve all factual disputes in the nonmovant’s favor. See

Gibbs v. Lomas, 755 F.3d 529, 536 (7th Cir. 2014). But the exist‐

ence of a factual dispute will not preclude summary judg‐

ment when the dispute does not involve a material fact. See

Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986) (“Only

disputes over facts that might affect the outcome of the suit

under the governing law will properly preclude the entry of

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summary judgment. Factual disputes that are irrelevant or

unnecessary will not be counted.”). And “[w]hen opposing

parties tell two different stories, one of which is blatantly

contradicted by the record, so that no reasonable jury could

believe it, a court should not adopt that version of the facts

for purposes of ruling on a motion for summary judgment.”

Scott v. Harris, 550 U.S. 372, 380 (2007).  

As an initial matter, we reject Burton’s argument that the

district court’s decision denying qualified immunity for de‐

fendants was not an appealable final decision. See Mitchell v.

Forsyth, 472 U.S. 511, 530 (1985) (“[A] district court’s denial

of a claim of qualified immunity, to the extent that it turns on

an issue of law, is an appealable ‘final decision’ ... .”). De‐

fendants’ arguments do not turn on factual disputes—

defendants argue that even after drawing all factual infer‐

ences in Burton’s favor, it is evident that their conduct did

not violate his constitutional rights. The case therefore turns

on issues of law, which may be resolved in this appeal.  

In determining whether a government official is entitled

to qualified immunity, we make two inquiries: “(1) whether

the facts, taken in the light most favorable to the plaintiff,

make out a violation of a constitutional right, and (2) wheth‐

er that constitutional right was clearly established at the time

of the alleged violation.” Williams v. City of Chicago, 733 F.3d

749, 758 (7th Cir. 2013). Burton’s constitutional rights as a

pretrial detainee are derived from the Due Process Clause of

the Fourteenth Amendment, which prohibits deliberate in‐

difference to his serious medical needs. Pittman v. Cnty. of

Madison, 746 F.3d 766, 775 (7th Cir. 2014). This standard is

essentially the same as the Eighth Amendment’s prohibition

against cruel and unusual punishment, which applies to

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No. 14‐3591 11

convicted prisoners. See Smego v. Mitchell, 723 F.3d 752, 756

(7th Cir. 2013).  

To prove a claim for deliberate indifference, Burton must

show that the alleged conditions were objectively serious

enough to amount to a constitutional deprivation and that

defendants possessed a sufficiently culpable state of mind.

See Chapman v. Keltner, 241 F.3d 842, 845 (7th Cir. 2001). The

subjective element “requires more than negligence and it

approaches intentional wrongdoing. The Supreme Court has

compared the deliberate indifference standard to that of

criminal recklessness.” Holloway v. Delaware Cnty. Sheriff, 700

F.3d 1063, 1073 (7th Cir. 2012) (internal citation omitted).  

In denying defendants’ motion for summary judgment,

the district court found that disputed questions of material

fact existed as to whether defendants were deliberately indif‐

ferent to Burton’s serious medical needs. Specifically, the dis‐

trict court held that a reasonable jury could find that the fol‐

lowing conduct violated Burton’s constitutional rights: (1)

stopping Burton’s prescribed medication, including his pain

medication, for over a week after he was detained; (2) refus‐

ing to contact Burton’s primary care physician or prescribe

narcotic pain medication, despite Burton’s supposedly pain‐

ful withdrawal symptoms; (3) refusing to provide Burton

with a second mattress; and (4) refusing to provide Burton

with physical therapy and failing to effectively treat Burton’s

rash and rectal bleeding. We address each of these issues in

turn.  

A. Delay in Receiving Medication  

When Burton checked into the JCDC, he had nine differ‐

ent prescription medications with him, including Norco.

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Under JCDC policy, when an inmate is booked into jail, his

medications are confiscated and must be approved by the

jail medical department before they are dispensed. Burton

contends, and the district court accepted, that after Burton’s

booking on September 23, 2009, he did not receive any medi‐

cation until October 1, 2009. But Burton’s own sworn state‐

ments conflict with this version of the facts. In his deposi‐

tion, which took place months before Burton first raised this

argument before the district court, Burton stated that he re‐

ceived Ultram after meeting with Menard on September 25,

that Nurse Gill ordered his Ultram on September 25, and

that he had informed Dr. Verghese that he was taking Ul‐

tram on September 29. These statements are consistent with

JCDC medical records, which show that Ultram was dis‐

pensed on September 25, 2009.  

We therefore reject Burton’s belated attempt to claim that

his medications were withheld for nine days. This claim is

“blatantly contradicted” by his deposition testimony, and as

such, the district court should not have accepted this version

of the facts, even when ruling on a motion for summary

judgment. Scott, 550 U.S. at 380.  

In considering whether a two‐day delay in receiving

medication implicates the Constitution, we must keep in

mind that “the infliction of suffering on prisoners can be

found to violate the Eighth Amendment only if that inflic‐

tion is either deliberate, or reckless in the criminal law

sense.” Duckworth v. Franzen, 780 F.2d 645, 652–53 (7th Cir.

1985), abrogated on other grounds; see also Wilson v. Seiter, 501

U.S. 294, 297 (“[O]nly the unnecessary and wanton infliction

of pain implicates the Eighth Amendment, a prisoner ad‐

vancing such a claim must, at a minimum, allege deliberate

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No. 14‐3591 13

indifference to his serious medical needs.” (internal citation

and quotation marks omitted)). “Negligence, gross negli‐

gence, or even ‘recklessness’ as that term is used in tort cas‐

es, is not enough.” Shockley v. Jones, 823 F.2d 1068, 1072 (7th

Cir. 1987).  

Here, Burton does not claim, or present any evidence that

would support a claim, that defendants deliberately or even

recklessly delayed the distribution of his pain medication.

Although we recognize the importance of prompt medical

aid for a patient’s necessary medical treatment when he is

detained or incarcerated, without evidence that defendants

acted with the requisite bad intent in delaying the dispensa‐

tion of his medication, Burton’s allegations are insufficient to

sustain a deliberate indifference claim. Put simply, a two‐day

delay is not enough, standing alone, to show a culpable

mental state. The delay may or may not have been negligent,

but it did not constitute deliberate indifference for purposes

of the Due Process Clause of the Fourteenth Amendment.  

B. Failure to Contact Burton’s Primary Care Physician

or Prescribe Norco

Burton next contends that because the medical staff ig‐

nored his requests for narcotic pain medication and refused

to contact his primary care physician who had previously

prescribed Norco, he suffered extreme post‐surgical pain

and withdrawal symptoms. We agree with defendants that

no reasonable jury could conclude that the failure to pre‐

scribe narcotic pain medication or contact a doctor who

would prescribe it amounted to deliberate indifference. Sure‐

ly Burton would have preferred Vicodin to Ultram, or to

have seen a doctor who would have prescribed narcotics, but

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detainees are not entitled to receive “unqualified access to

healthcare.” Hudson v. McMillian, 503 U.S. 1, 9 (1992).  

Moreover, we recognize that “[t]here is not one ‘proper’

way to practice medicine in a prison, but rather a range of

acceptable courses based on prevailing standards in the

field.” Jackson v. Kotter, 541 F.3d 688, 697 (7th Cir. 2008). Ac‐

cordingly, to demonstrate that defendants acted with delib‐

erate indifference, Burton must show that the medical de‐

fendants’ refusal to prescribe Norco was “such a substantial

departure from accepted professional judgment, practice, or

standards, as to demonstrate that the person responsible ac‐

tually did not base the decision on such a judgment.” Id.

(quoting Sain v. Wood, 512 F.3d 886, 895 (7th Cir. 2008)).  

Burton presented no such evidence; in fact, the record

suggests that the decision to prescribe non‐narcotic pain

medication was a reasonable one. This was the course of

treatment recommended by Dr. Verghese—Burton’s own or‐

thopedic surgeon—immediately after his surgery. The deci‐

sion to prescribe non‐narcotic pain medication was reaf‐

firmed by Dr. Verghese several times after thorough exami‐

nations, and was supported by a reasonable medical expla‐

nation: synthetic opiates have less addictive potential than

non‐synthetic opiates such as Norco.  

Although Dr. Zumwalt followed a different course of

treatment in prescribing Norco, “[m]ere differences of opin‐

ion among medical personnel regarding a patient’s appro‐

priate treatment do not give rise to deliberate indifference.”

Estate of Cole v. Fromm, 94 F.3d 254, 261 (7th Cir. 1996). In oth‐

er words, evidence that another doctor would have followed

a different course of treatment is insufficient to sustain a de‐

liberate indifference claim.

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No. 14‐3591 15

Burton also fails to present any objective evidence that

his painful withdrawal symptoms created a serious medical

need for Norco. Burton’s after‐the‐fact description of his

symptoms is not objective evidence of a serious medical

need for narcotic drugs, especially given that two trained

medical professionals concluded otherwise. Moreover, Bur‐

ton’s own primary care doctor testified that Burton had no

medical need for Norco whatsoever. In his deposition, Dr.

Zumwalt stated that Burton was not prescribed Norco for

long enough to become addicted, and that withholding nar‐

cotic medication would not put Burton at risk of medical

complications. Cf. Wilson v. Hosey, No. 09‐C‐7777, 2012 WL

957488, at *7 (N.D. Ill. Mar. 15, 2012) (granting summary

judgment for defendant where plaintiff’s only evidence that

he needed medical treatment was his testimony, which was

contradicted by testimony by plaintiff’s doctor).  

C. Failure to Provide a Second Mattress

Defendants also dispute that a triable issue of fact exists

as to whether the failure to give Burton a second mattress

amounted to cruel and unusual punishment. The district

court held that a reasonable jury could conclude that this

conduct deprived Burton of “the minimal civilized measure

of life’s necessities.” But the Supreme Court has clarified that

conditions of confinement of this kind involve “deprivations

of essential food, medical care, or sanitation.” Rhodes v. Chap‐

man, 452 U.S. 337, 348 (1981) (emphasis added). Burton pre‐

sents no evidence to support his allegation that sleeping on a

single mattress amounted to a deprivation of this magni‐

tude. Instead, Burton’s treating physician examined his con‐

dition and concluded that a second mattress was unneces‐

sary because it would not affect his condition at all. Without

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some evidence that defendants’ conduct deprived Burton of

essential medical care, no reasonable jury could conclude

that Burton’s conditions of confinement amounted to cruel

and unusual punishment.2  

D. In‐Cell Physical Therapy and Treatment for Burton’s

Rash and Rectal Bleeding

Finally, defendants contend that no reasonable jury could

find that defendants were deliberately indifferent to Burton’s

serious need for physical therapy and treatment for his rash

and rectal bleeding. We agree.  

Dr. Verghese twice prescribed physical therapy for Bur‐

ton’s hip and tennis elbow. The JCDC medical staff did not

ignore this advice; soon after Dr. Verghese issued his first

prescription, Nurse Gill called him to discuss it. In this

phone call, Dr. Verghese informed Nurse Gill that in‐cell

therapy would be sufficient, and that outside physical thera‐

py was unnecessary. Accordingly, Nurse Gill provided Bur‐

ton with instructions and a towel to perform in‐cell exercis‐

es. Burton admits that he did not follow these instructions,

supposedly because they were inadequate. When Dr. Ver‐

ghese again prescribed physical therapy several months lat‐

er, he did so on the condition that Burton convince the court

to allow it, which suggests that it was not medically neces‐

sary.

                                                 

2 Although the district court issued an order in Burton’s criminal case

requesting that the sheriff provide Burton with a second mattress, de‐

fendants’ failure to comply is insufficient in itself to sustain a deliberate

indifference claim, which requires some evidence of a serious medical

need. See Wilson, 501 U.S. at 298.  

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No. 14‐3591 17

Even assuming that Burton had a serious medical need

for outside physical therapy or more thorough instructions

from the JCDC staff, Burton fails to present evidence that the

medical defendants, who contacted Dr. Verghese and fol‐

lowed his recommendations for treatment, acted with the

requisite state of mind for deliberate indifference. On these

facts, it is difficult to even conclude that defendants were

negligent. There is therefore no evidence from which a rea‐

sonable jury could conclude that defendants consciously dis‐

regarded Burton’s serious medical need for physical therapy.  

Likewise, we disagree that a reasonable jury could find

that defendants’ treatment of Burton’s rash and rectal bleed‐

ing amounted to deliberate indifference. Burton does not

contend that he was ever denied treatment for these condi‐

tions—instead, the record shows that the medical defendants

promptly responded to Burton’s complaints and prescribed

medication. Burton does not present any evidence that de‐

fendants’ course of treatment fell below prevailing medical

standards, nor does he dispute that his conditions eventually

resolved, which suggests that the chosen course of treatment

was effective.  

III.  Conclusion

Because no reasonable jury could find that defendants’

conduct violated Burton’s constitutional rights, the medical

and non‐medical defendants were entitled to invoke the de‐

fense of qualified immunity, and the district court’s decision

denying defendants’ motion for summary judgment is

REVERSED and the case REMANDED for entry of judgment for

the defendants.  

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