Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca7-15-02601/USCOURTS-ca7-15-02601-0/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 June 23, 2016*

Decided June 27, 2016

Before

FRANK H. EASTERBROOK, Circuit Judge

ILANA DIAMOND ROVNER, Circuit Judge

DIANE S. SYKES, Circuit Judge

No. 15‐2601

ROBERT MARTIN,

Plaintiff‐Appellant,

v.

UNITED STATES OF AMERICA, et al.,

Defendants‐Appellees.

Appeal from the United States District

Court for the Southern District of Indiana,

Terre Haute Division.

No. 2:13‐cv‐59‐WTL‐MJD

William T. Lawrence,

Judge.

O R D E R

Robert Martin, a federal inmate, brought this action under the Federal Tort

Claims Act (“FTCA”), 28 U.S.C. § 1346(b), and Bivens v. Six Unknown Named Agents of

Federal Bureau of Narcotics, 403 U.S. 388 (1971). Martin contends that medical

personnel—the clinical director at the prison in Terre Haute, the prison’s health‐services

administrator, and the assistant health‐services administrator—rendered deficient

                                                 

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

argument is unnecessary. Thus, the appeal is submitted on the briefs and the 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NONPRECEDENTIAL DISPOSITION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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treatment by failing to supervise an outside cardiologist who implanted Martin’s

defibrillator and by inadequately treating his other heart and gastrointestinal problems.

The district court entered summary judgment for the defendants. The court concluded

(1) that Martin could not prevail under the FTCA because he lacked evidence that the

medical treatment he had received fell below the applicable standard of care and

(2) that his Bivens claims were barred because they stemmed from the same subject

matter as his failed FTCA claims. These conclusions are correct, so we affirm the district

court’s judgment.

We construe the record in Martin’s favor and begin with the evidence regarding

his heart condition. Martin suffered a heart attack in 1996 (at the age of 42), and since

then he has been on medication to treat his cardiovascular problems. While incarcerated

in Terre Haute in 2010, he experienced chest pain and difficulty breathing, and prison

staff sent him to a local hospital for treatment. A diagnostic test revealed several

complications: coronary artery disease, abnormal contractions of the left ventricle of

Martin’s heart, and ventricular tachycardia, a rapid heartbeat that “can develop as an

early or late complication of a heart attack,” Ventricular tachycardia, MEDLINEPLUS,

https://www.nlm.nih.gov/medlineplus/ency/article/000187.htm (last updated June 7,

2016). (In this order we cite online medical reference aids to give the reader context for

Martin’s medical conditions and treatment.) The cardiologist who performed the test

recommended that Martin consider “internal defibrillator implantation.”

Martin saw another cardiologist at the hospital, Dr. Sameh Lamiy, whom the

United States had hired as an independent contractor. Dr. Lamiy confirmed that an

implantable cardioverter defibrillator was an appropriate treatment for Martin’s

ventricular tachycardia. This type of defibrillator is battery powered, placed under the

skin, and connected to the heart with thin wires. Implantable Cardioverter Defibrillator

(ICD), AMERICAN HEART ASSOCIATION, http://www.heart.org/HEARTORG/Conditions/

Arrhythmia/PreventionTreatmentofArrhythmia/Implantable‐Cardioverter‐Defibrillator‐

ICD_UCM_448478_Article.jsp#.V22vmHz2Z7d (last updated May 10, 2016). The

defibrillator keeps track of the patient’s heart rate and, when it detects that the heart is

beating irregularly and too fast, delivers “an electric shock to restore a normal

heartbeat.” Id. Dr. Lamiy implanted the defibrillator in February 2010.

Six months after the surgery, Martin again saw Dr. Lamiy because the

defibrillator sometimes shocked him even when his heart rate was not elevated.

Dr. Lamiy recalibrated the defibrillator, noting that it may have been misfiring in part

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because Martin had stopped taking his beta blockers. As best we can tell, the

defibrillator stopped misfiring shortly after Dr. Lamiy recalibrated it. (Martin wrote in a

grievance that the shocks stopped a month after the recalibration.) Nonetheless, around

this time Martin began insisting that he did not need the defibrillator and asked to have

it removed. He maintained that his heart was healthy and that the defibrillator misfired

because of his abdominal pains and a stomach infection. Martin saw a private

cardiologist in 2011 who recommended that the defibrillator not be removed.  

Two expert witnesses (whose opinions the defendants submitted at summary

judgment) also contradict Martin’s contention that because of his stomach problems, his

defibrillator should be removed. Dr. James VanTassel (a cardiologist) stated that “[t]he

implantation of the [defibrillator was] appropriate”; that Martin’s stomach infection had

“no effect on [Martin’s] cardiac condition” or the defibrillator; and that although the

defibrillator could have been managed “a little tighter” or could be removed or turned

off without threatening Martin’s life, its use “was within the standard of care.”

Dr. Colin Howden (a gastroenterologist) also concluded that Martin’s heart symptoms

were not caused by his stomach infection.  

Martin’s other complaint about medical treatment concerns his stomach. His

gastric problems began in 2010, and from then through 2013, he underwent numerous

diagnostic tests and saw gastroenterologists several times for diagnosis and treatment.

In October 2010 he underwent a biopsy that detected an H. pylori infection in his

stomach. (H. pylori is a type of bacteria that may cause peptic ulcers, although most

people with the infection “never get sick from it.” H. pylori infection, MAYO CLINIC,

http://www.mayoclinic.org/diseases‐conditions/h‐pylori/basics/definition/con‐20030903

(last visited June 23, 2016).) Martin received a 14‐day course of medications, but he

continued experiencing stomach pain, reflux, and other gastrointestinal distress. Tests

performed on Martin in 2011 did not detect H. pylori, but he received treatment for

other gastrointestinal problems that had been diagnosed, such as his reflux. In February

2012 a biopsy again revealed that Martin had an H. pylori infection, and prison doctors

prescribed another round of medications. Prison medical staff tested him again for

H. pylori in October 2012 and March 2013; both tests were negative.   

Dr. Howden (the gastroenterologist whose expert opinion the defendants

submitted) opined that although Martin had experienced two “minor” lapses in the

“overall management” of his H. pylori infection, he had not received substandard care.

When Martin was diagnosed with H. pylori for the second time, prison doctors gave

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him the same drugs that he received after his first diagnosis. This was inappropriate,

Dr. Howden explained, because one of the medications “should not [have] be[en] used

a second time since initial failure with this medicine probably means that the patient’s

H. pylori infection is resistant to it.” Dr. Howden also stated that Martin should not have

been taking a proton pump inhibitor when prison staff tested him for H. pylori in

October 2012 and March 2013 because that drug “can reduce the sensitivity and

reliability of the test[s],” both of which had been negative. But Dr. Howden concluded

that, despite these shortcomings, Martin had received treatment within the standard of

care.

In granting the defendants’ motion for summary judgment, the district court first

concluded that to the extent Martin was pursuing an FTCA claim based on Dr. Lamiy’s

actions, sovereign immunity barred the claim. The court reasoned that the doctor was a

contractor, not an employee of the United States, and that the court therefore lacked

subject‐matter jurisdiction. Next, the court stated that the FTCA claims based on the

actions of employees at the federal prison could not survive summary judgment

because Martin had “provided no expert testimony to support [his] malpractice claims.”

Finally, the district court concluded that 28 U.S.C. § 2676 precluded Martin’s Bivens

claims because, like his failed FTCA claims, they were “based on the care Mr. Martin

received for his heart and stomach problems.” (Section 2676 provides that a judgment in

an action under the FTCA “shall constitute a complete bar to any action by the claimant,

by reason of the same subject matter, against the employee of the government whose act

or omission gave rise to the claim.” 28 U.S.C. § 2676; see Simmons v. Himmelreich, No. 15‐

109, 2016 WL 3128838, at *4 (U.S. June 6, 2016). Under § 2676 a judgment on an FTCA

claim bars a Bivens claim that is “of the same subject matter”—meaning one that arises

“out of the same actions, transactions, or occurrences”—even when a plaintiff brings the

FTCA and Bivens claims in the same suit. Manning v. United States, 546 F.3d 430, 433–34

(7th Cir. 2008) (internal quotation marks omitted).)

On appeal Martin does not challenge the district court’s conclusion that the

United States is not liable under the FTCA for the actions of Dr. Lamiy because he is a

contractor, not a government employee. We pause only to note that although the district

court was correct that the FTCA generally does not waive the sovereign immunity of the

United States for torts committed by contractors, see 28 U.S.C. §§ 1346(b), 2671;

United States v. Orleans, 425 U.S. 807, 813–14 (1976), the court was mistaken to state that

sovereign immunity deprived the court of jurisdiction: Sovereign immunity is an

affirmative defense, not a jurisdictional doctrine, see Sung Park v. Ind. Univ. Sch. of

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Dentistry, 692 F.3d 828, 830 (7th Cir. 2012); Wis. Valley Improvement Co. v. United States,

569 F.3d 331, 333 (7th Cir. 2009). But this error does not affect the outcome of this case,

so we proceed to the merits.

Martin first argues that he has a triable FTCA claim against the United States

because, he maintains, a jury reasonably could find that the prison’s medical staff failed

to “properly oversee the service of Dr. Lamiy” outside the prison. We reject this

argument. Indiana’s law of medical malpractice applies to Martin’s FTCA claims.

See 28 U.S.C. § 1346(b)(1); Gipson v. United States, 631 F.3d 448, 450–51 (7th Cir. 2011).

Martin cites—and we have found—no Indiana case law holding that medical staff who

have referred a matter to an outside, licensed specialist have a duty to second‐guess that

specialist’s clinical decisions. To the contrary, had the prison’s staff disregarded

Dr. Lamiy’s diagnosis and interfered with his prescribed treatment of Martin, they

could have exposed themselves to a claim of deliberate indifference. See Perez v.

Fenoglio, 792 F.3d 768, 778 (7th Cir. 2015) (“Allegations that a prison official refused to

follow the advice of a medical specialist for a non‐medical reason may at times

constitute deliberate indifference.”).

Pursuing his FTCA claim from another angle, Martin next argues that a jury

could reasonably find that the staff had negligently ignored his heart condition after Dr.

Lamiy implanted the defibrillator. He maintains that—based on Dr. VanTassel’s

statement that the defibrillator could be removed or turned off without threatening

Martin’s life—he “did not need” the defibrillator, so the staff should have ordered it

removed. But Martin furnished no expert evidence, as he must, to contradict the

conclusions of the defendant’s expert witnesses, who opined that the decision to keep

the defibrillator implanted and active reflected acceptable medical care. See Sterk v.

Redbox Automated Retail, LLC, 770 F.3d 618, 627 (7th Cir. 2014) (explaining that once the

party moving for summary judgment “inform[s] the district court why a trial is not

necessary,” the nonmovant must produce evidence “sufficient to establish the existence

of an element essential to that party’s case” (internal quotation marks omitted)). Such

rebuttal expert evidence was necessary because the defendants’ conduct is not

“understandable without extensive technical input or so obviously substandard that

one need not possess medical expertise to recognize the breach.” Gipson, 631 F.3d at 451

(internal quotation marks omitted). And contrary to Martin’s assertions, Dr. VanTassel

does not suggest that treating Martin’s heart condition with the defibrillator fell below

the standard of care. Dr. VanTassel explains in his report that sound medical criteria

support the decision to implant, retain, and use the defibrillator. His statement that the

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defibrillator may be safely turned off suggests that doctors may reasonably provide

alternative treatments for Martin’s condition; it does not imply that the treatment

Martin received was inappropriate.

Finally, Martin argues that the district court mistakenly concluded that his Bivens

claims are “of the same subject matter” as his FTCA claims and thus barred by 28 U.S.C.

§ 2676. Martin asserts that his claims are not of the same subject matter because, he says,

his FTCA claims concern solely the implantation and management of his defibrillator

while his Bivens claims relate to the other treatments for his heart condition as well as

the treatment of his H. pylori infection.  

For several reasons, the district court correctly entered judgment against Martin

on the Bivens claims. First, in his filings in the district court, Martin did not distinguish

between the subject matter that is the basis of his FTCA claims and the conduct that

undergirds his Bivens claim. Even in his appellate brief, he muddles any supposed

distinction: When discussing his FTCA claims, Martin refers to the prison officials’

treatment of his heart condition and his H. pylori infection; he then describes his Bivens

claims as based on the defendants’ “acts or omissions in treating his [c]ontinuing heart

palpitations, shocks from the [defibrillator], and his gastrointestinal problem that has

been proven to be the re‐occurrence of an H‐pylori infection” (internal quotation marks

omitted).  

But even if we assume that Martin’s FTCA and Bivens claims arise from different

conduct, the Bivens claims fail anyway. Martin supplied no evidence that the members

of the prison’s medical staff whom he sued were personally involved in the treatment

that he objects to. See Ashcroft v. Iqbal, 556 U.S. 662, 677 (2009). Beyond that Martin

asserts only that he preferred a different treatment; he provides no evidence that the

treatment he did receive violated the constitution. To the contrary, as we have already

noted, the record shows that his treatment with a defibrillator was reasonable and that

even though he experienced two minor lapses in the treatment of his H. pylori infection,

that treatment was still acceptable. See Pyles v. Fahim, 771 F.3d 403, 409 (7th Cir. 2014)

(“Disagreement between a prisoner and his doctor . . . about the proper course of

treatment generally is insufficient, by itself, to establish an Eighth Amendment

violation.”).

AFFIRMED.

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