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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 April 30, 2020*

Decided May 6, 2020

Before

FRANK H. EASTERBROOK, Circuit Judge

DIANE S. SYKES, Circuit Judge

AMY J. ST. EVE, Circuit Judge

No. 18-3314

AARON MILLER,

Plaintiff-Appellant,

v.

WEXFORD HEALTH SOURCES, INC., et al.,

Defendants-Appellees.

Appeal from the United States District 

Court for the Southern District of Illinois.

No. 15-cv-1077-SCW

Stephen C. Williams,

Magistrate Judge.

O R D E R

Aaron Miller, an Illinois inmate, developed bacterial and fungal infections at the 

site of an open abdominal wound where a feeding tube had been removed. He sued 

prison doctors and officials for deliberate indifference to his serious medical needs, as 

well as for retaliation under the First Amendment after he filed grievances over those 

needs. The district court ruled that the record did not support a finding of any

constitutional violations and entered summary judgment for the defendants. We affirm.

* We 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NONPRECEDENTIAL DISPOSITION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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Upon his incarceration in 2011, Miller had already undergone several surgeries 

for gunshot wounds to his abdomen, necessitating a feeding tube being placed into his 

stomach. When the feeding tube was removed two years later, he was diagnosed with a 

gastrocutaneous fistula (an abnormal connection between the stomach and skin) that his 

surgeons expected to close on its own. He also had a ventral hernia (an opening in the 

abdominal wall muscles), for which he was told to follow up with a doctor for 

treatment. At that follow-up visit, he was told that he would not be a candidate for 

hernia-repair surgery until he lost 30 pounds. 

In early 2015, a couple weeks after his transfer to Pinckneyville Correctional 

Center, Miller complained to a nurse of tenderness and burning from an open wound

on his abdomen that was the size of a “small bean.” He was evaluated two days later by

Nurse Practitioner Angel Rector, who bandaged the wound after noting clear drainage 

and no sign of infection. At a follow-up visit two weeks later, Miller’s wound was 

unchanged, and Rector referred him to a doctor. 

Around this time Miller also complained of two episodes where he was made to 

carry heavy objects, which exacerbated his pain, increased the drainage from his 

wound, and caused blood in his stool. First, Correctional Officer Paul McGuire forced 

him to haul his mattress and laundry bag (approximately 30 pounds) from one housing 

unit to another. Miller objected because of his stomach injuries, even lifting his shirt to 

prove that he could not carry anything, but McGuire ignored his objections because 

medical staff had not prescribed a lifting restriction for him. Second, an unknown 

correctional officer made Miller carry an 80-pound property box up a flight of stairs.

In March 2015 Miller began receiving care from Dr. Vipin Shah, Pinckneyville’s 

medical director. Dr. Shah reviewed Miller’s medical records, learned about the fistula 

and hernia diagnoses, and then examined Miller’s wound. Dr. Shah ordered that a 

drainage culture be tested; the test revealed a bacterial infection that Dr. Shah treated 

with antibiotics. Dr. Shah thereafter saw Miller every couple of weeks. At a visit the 

following month, Miller complained of continuing drainage, and Dr. Shah ordered that 

the bandages be changed twice a day. When Miller developed a fungal infection soon 

thereafter, Dr. Shah treated it with an antifungal medication and continued bandage

changes. The following month Miller’s fungal infection worsened, and he developed an 

additional bacterial infection. Dr. Shah prescribed an increased dose of the antifungal 

medication, an antibiotic, and daily bandage changes.

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Miller says that by the summer he was no longer receiving all of the prescribed 

bandage changes. He attested that Correctional Officer Brandi Walla instructed nurses 

not to change his bandages in retaliation for grievances he had filed over his medical 

care. (Miller disputes the accuracy of medical records reflecting that he received regular

bandage changes during this time.)

By late summer Dr. Shah identified drainage that appeared to come from deeper 

inside Miller’s wound. Dr. Shah referred Miller to a general surgeon, who in turn 

recommended that he be seen by a trauma surgeon. In late fall a trauma surgeon

evaluated Miller and recommended that the fistula be surgically repaired—a 

recommendation that was approved by collegial review (a board of doctors that reviews

and approves medical requests). Miller underwent fistula surgery in early 2016. After 

he had healed, a nonparty doctor submitted a request to also repair his hernia. Collegial 

review denied the request, stating that conservative treatment—such as an abdominal 

binder—had not yet been tried for the hernia, and a 2015 CT scan had revealed the 

hernia was not “incarcerated” (meaning that the tissue was not trapped and thus did 

not require prompt medical attention).

Dissatisfied with the treatment of his fistula and hernia, Miller sued several 

nurses, Nurse Practitioner Rector, Dr. Shah, and Wexford Health Sources, Inc. (their 

employer). He asserted that the defendants acted with deliberate indifference when 

they provided insufficient bandage changes, denied him pain medication, delayed

surgery for his fistula, and denied his request for hernia surgery. He also sued two 

correctional officers—McGuire for deliberate indifference when forcing him to carry

heavy items despite his injuries and Walla for retaliating against him for filing 

grievances.

The defendants moved for summary judgment. Through his court-recruited 

attorney, Miller responded to the motions, but he did not dispute the defendants’ facts

or put forth his own facts, so the judge treated the defendants’ factual submission as 

undisputed and entered summary judgment in their favor. See FED. R. CIV. P. 56(e)(2). 

Miller’s claims against the medical defendants failed because the undisputed medical 

evidence showed that the nurses and doctor were at all times responsive to his

complaints: They frequently cleaned and rebandaged his wound, prescribed antibiotics 

and antifungals, and when it became clear that his fistula would not heal, referred him 

for surgery. Further, the evidence showed that Miller’s hernia was nonincarcerated and

asymptomatic, so conservative treatment was appropriate. As for the deliberateCase: 18-3314 Document: 53 Filed: 05/06/2020 Pages: 6
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indifference claim against Correctional Officer McGuire, the judge determined that the 

evidence could not support the conclusion that he had subjective knowledge of—let 

alone disregarded—any excessive risk to Miller’s health by instructing him to move his 

property. Finally, regarding the retaliation claim against Correctional Officer Walla, the 

judge found that the evidence was undisputed that Miller was not deprived of medical 

care during the time Walla allegedly told nurses not to treat him and that Walla had not 

acted wrongly on account of Miller’s grievances. 

As a preliminary matter, Miller challenges the judge’s decision to accept the

defendants’ statement of facts as undisputed. He believes that the judge deprived him 

of his right to have the facts considered in his favor. But he misunderstands the effect of 

the judge’s ruling. The judge construed the defendants’ undisputed facts in the light 

most favorable to him. And because his court-recruited attorney failed (as Miller agrees) 

to admit or deny the facts presented in the defendants’ motion for summary judgment,

the judge did not abuse his discretion to consider the defendants’ factual submission 

undisputed for purposes of the motion. FED R. CIV. P. 56(e)(2); see Curtis v. Costco 

Wholesale Corp., 807 F.3d 215, 219 (7th Cir. 2015).

On the merits, Miller’s primary contention is that the judge failed to recognize

three material factual disputes over whether the defendants were deliberately 

indifferent to his medical needs. The first concerns evidence of the painful infections

that he developed, which Miller says establishes that the nurses had insufficiently 

changed his bandages. To avoid a summary judgment, however, Miller needed to 

present evidence that the defendants knew of and disregarded a serious risk to his 

health. See Farmer v. Brennan, 511 U.S. 825, 837 (1994); Petties v. Carter, 836 F.3d 722, 728 

(7th Cir. 2016). Miller’s medical records document that the defendant nurses changed 

his bandages as prescribed, and he points to no evidence that refutes this documented 

timeline. Nor does he call into question Dr. Shah’s opinion that even if there were 

isolated instances when he did not receive a bandage change, these would not have 

affected the overall healing process.

Miller’s second argument concerns what he sees as a deliberately indifferent 

three-year delay in receiving his fistula surgery. He argues that Dr. Shah must have 

known that his wound had to be treated surgically because his medical records (which 

Dr. Shah reviewed) reflected as much. But Miller needed to present evidence sufficient 

to show that Dr. Shah’s initial decision to treat Miller without surgery was “so far afield 

of accepted professional standards as to raise the inference that it was not actually 

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based on a medical judgment.” Norfleet v. Webster, 439 F.3d 392, 396 (7th Cir. 2006). And 

nothing in Miller’s medical records as of 2015, when Dr. Shah assumed his care,

suggests that any provider believed Miller’s fistula required surgical repair. Nor does 

Miller suggest that the treatment Dr. Shah prescribed before referring him for fistula

surgery—courses of antibiotics, antifungals, and bandage changes that ultimately 

eliminated the infections Miller complained of—was so unreasonable that it represented 

a complete abandonment of medical judgment. See Whiting v. Wexford Health Sources, 

Inc., 839 F.3d 658, 663–64 (7th Cir. 2016).

Next, Miller points to a supposed factual dispute over whether the defendants

were deliberately indifferent when they refused to authorize hernia surgery in 

disregard of the recommendation by another prison doctor who is not a party to this 

lawsuit. But “choosing one treatment recommendation over another does not amount to 

deliberate indifference where both recommendations are made by qualified medical 

professionals.” See Shields v. Ill. Dep’t of Corrs., 746 F.3d 782, 797 (7th Cir. 2014) (holding 

that it is not deliberate indifference for a prison to approve one doctor’s

recommendation for physical therapy though specialists recommended surgery). Such 

is the case here. No fact question exists over the defendants’ decision where the record 

shows that Miller’s hernia was neither incarcerated nor symptomatic. 

Miller also states that the defendants denied him pain medication for several 

months and that Wexford Health Sources is liable, as their employer, under Monell v. 

Department of Social Services, 436 U.S. 658 (1978). But his response to the motion for 

summary judgment made no mention of these claims, so they are waived on appeal. See 

Gates v. Bd. of Educ., 916 F.3d 631, 641 (7th Cir. 2019). 

Miller generally challenges the judge’s ruling regarding Correctional Officer 

McGuire. He maintains that a factual dispute exists over whether McGuire made him 

carry his 80-pound property box up a flight of stairs. But no evidence supports an 

inference that McGuire had subjective knowledge of any excessive risk to Miller’s

health because no physician had prescribed a lifting accommodation for him, see Leiser 

v. Kloth, 933 F.3d 696, 705 (7th Cir. 2019), and his need for one was not so obvious from 

the small wound that McGuire should have recognized it. Moreover, Miller testified

that he did not know if McGuire asked him to move the box or if McGuire even was 

present at the move. Though Miller now says he remembers that it was McGuire, he did 

not refute his testimony at summary judgment and may not do so now. See FED. R. CIV.

P. 56(e)(2).

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Finally, to the extent Miller now contends that Correctional Officer Walla told 

nurses to deny him bandage changes in retaliation for his filing grievances, his response 

to the defendants’ motion for summary judgment did not raise this claim so he has 

waived it. See Gates, 916 F.3d at 641.

We have considered Miller’s remaining arguments, and none has merit.

AFFIRMED

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