Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca7-14-01990/USCOURTS-ca7-14-01990-0/pdf.json

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

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In the

United States Court of Appeals

For the Seventh Circuit ____________________

No. 14-1990

JIMMY DALE MILLER,

Plaintiff-Appellant,

v.

JEANNE CAMPANELLA, et al.,

Defendants-Appellees.

____________________

Appeal from the United States District Court

for the Southern District of Illinois.

No. 3:11-cv-00436-MJR-SCW — Michael J. Reagan, Chief Judge.

____________________

SUBMITTED JUNE 18, 2015 — DECIDED JULY 27, 2015

____________________

Before POSNER, MANION, and WILLIAMS, Circuit Judges.

POSNER, Circuit Judge. Before us is an appeal by an inmate 

at Lawrence Correctional Center (an Illinois state prison) 

named Miller who has sued medical and administrative personnel at the prison under 42 U.S.C. § 1983, claiming that 

they were deliberately indifferent to his gastroesophageal 

reflux disease (GERD), which can cause severe heartburn. 

Serious forms of the disease are commonly treated with a 

drug called ranitidine, which is commonly sold under the 

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2 No. 14-1990

trade name “Zantac.” (In the district court Miller also complained that prison personnel were deliberately indifferent

to a skin infection that he has, but he doesn’t pursue the issue in his appeal.) The district court granted summary 

judgment in favor of the defendants.

When Miller arrived at the prison in November 2010 (a 

transferee from a different Illinois prison), he had been taking Zantac for his GERD, but his prescription had expired. 

At his intake screening on the day of his arrival he told the 

screener that he suffers from GERD and that he takes a prescription medication for it. Shortly afterward, at an orientation program for new inmates, he told the director of nursing that he wanted his prescription for Zantac renewed. According to Miller, she did nothing. A month later he saw another nurse, who scheduled him to see a doctor the following day, but the appointment was cancelled because the 

prison was on lockdown, during which prisoners are permitted to see doctors only in emergencies. It was four weeks before he was seen by one. A guard whom he told that he

needed to see a doctor replied that he should file a grievance, which he did. Though he marked it “emergency,” the 

warden, who reviewed the grievance, determined that it was 

not an emergency, which meant that it would be resolved 

through the normal grievance procedure and therefore Miller could not see a doctor until the lockdown ended. The 

warden is not a doctor, and so far as appears did not consult 

a doctor before deciding there was no emergency.

It was two months after Miller’s arrival at the prison before he was allowed to see a doctor. During that period he 

complained repeatedly to the nursing staff about his GERD 

symptoms, but to no avail. On one occasion during this periCase: 14-1990 Document: 33 Filed: 07/27/2015 Pages: 6
No. 14-1990 3

od, upon vomiting stomach acid he pressed the emergency 

button in his cell and a guard responded and told Miller 

“you are not bleeding, you are not dead, you are talking to 

me, so it can’t be an emergency.” Later that morning he was 

able to tell a nurse about his vomiting; her response was that 

she would check his chart. Nothing came of that. When at 

last he was seen by the doctor, the doctor renewed his prescription for Zantac.

The district judge ruled that the delay in renewing Miller’s prescription was one month rather than two months. 

Without explanation the judge calculated the delay from the 

first scheduled doctor’s appointment (on December 29, 2010) 

to the time that Miller finally saw a doctor, rather than beginning with Miller’s first requests for Zantac in late November. The judge’s reasoning was that Miller’s first appointment with a doctor (later cancelled because of the lockdown) was for a month after he arrived at the prison, and he 

could not expect to get his prescription renewed before he 

saw the doctor. That misses an essential point. Zantac is both 

an over-the-counter drug (for Zantac pills containing only 75 

to 150 milligrams of ratinidine) and a prescription drug (for 

300-milligram pills). QualityPrescriptionDrugs, “Zantac: Over 

the Counter, or Prescription?” November 18, 2011, www.qua

lityprescriptiondrugs.com/blog/2011/11/zantac-counter-pres

cription.html (visited July 25, 2015, as were the other websites cited in this opinion); MedicineNet, “Ranitidine, Zantac,” 

www.medicinenet.com/ranitidine/article.htm. Because of the 

severity of his condition, Miller takes the 300-milligram pill; 

hence the prescription. Some types of nurse, such as nurse 

practitioners, are authorized to write prescriptions, others 

not; it’s unclear whether any of the prison nurses had authority to give Miller 150-milligram Zantac pills, two of 

Case: 14-1990 Document: 33 Filed: 07/27/2015 Pages: 6
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which equate to one 300-milligram pill. It’s true that a Dr. 

James Fenoglio stated that inmates are not permitted to obtain Zantac unless a doctor prescribes it. But he may not be 

completely reliable. He was a defendant in another recent 

suit by an inmate at Lawrence Correctional Center, and we 

held that the inmate plaintiff had stated a claim against Dr. 

Fenoglio for unreasonable delay in treatment. Perez v. Fenoglio, 2015 WL 4092294, at *1–2, 4–6 (7th Cir. July 7, 2015). 

And in any event why, merely because a prison is on lockdown, can’t a prisoner see a doctor except in an emergency? 

That has not been explained.

GERD can, and so far as appears in the case of Miller 

does, produce persistent, agonizing pain and discomfort. It

can also produce “serious complications. Esophagitis can occur as a result of too much stomach acid in the esophagus. 

Esophagitis may cause esophageal bleeding or ulcers. In addition, a narrowing or stricture of the esophagus may occur 

from chronic scarring. Some people develop a condition 

known as Barrett’s esophagus. This condition can increase 

the risk of esophageal cancer.” WebMD, Heartburn/GERD 

Health Center, “What Are the Complications of Long-Term 

GERD?” www.webmd.com/heartburn-gerd/guide/reflux-dis

ease-gerd-1?page=4. The judge said in his opinion that one 

month “is a short amount of time [elsewhere he calls it a 

‘short delay’] to be treated for heartburn/GERD,” but he 

gave no reason for that medical speculation.

The plaintiff claims that the pain he experienced from his 

GERD was “so intense that he was not able to sleep at night. 

[He] felt like his insides were being pushed out, and this 

pain was constant.” He may be exaggerating, but that is a 

matter for resolution at a trial. Leaving a serious case of 

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No. 14-1990 5

GERD untreated for two months is a dereliction of medical 

duty, cf. Jett v. Penner, 439 F.3d 1091, 1097–98 (9th Cir. 2006), 

and given the extreme simplicity of treatment—supplying 

the sufferer daily with a few pills of an over-the-counter 

drug—a jury would not be irrational to conclude that the defendants (or at least some of them) knew that the plaintiff 

had a very unpleasant, potentially dangerous, yet readily 

treatable disease, yet they had done nothing for two months

because they were indifferent to the plaintiff’s condition

(“you are not bleeding, you are not dead, you are talking to 

me, so it can’t be an emergency”). A prison officer is deliberately indifferent if he “knows of and disregards an excessive 

risk to inmate health,” Williams v. O’Leary, 55 F.3d 320, 324 

(7th Cir. 1995), quoting Farmer v. Brennan, 511 U.S. 825, 837 

(1994).

We recently had occasion to note that “where an inmate 

alleges an objectively serious medical condition, it may be 

better to appoint counsel—so that he or she can investigate 

and flesh out any claim that may exist—than to dismiss a potentially meritorious claim and leave the prisoner in harm’s 

way.” Perez v. Fenoglio, supra, at *11. We placed particular 

emphasis on the case that has progressed from the pleading 

stage “to discovery or trial. Taking depositions, conducting 

witness examinations, applying the rules of evidence, and 

making opening statements are beyond the ability of most 

pro se litigants to successfully carry out. These tasks are 

even more challenging in cases ... where complex medical 

evidence (including expert testimony) is needed to assess the 

adequacy of the treatment received. District courts abuse 

their discretion where they fail to consider the complexities 

of advanced-stage litigation activities and whether a litigant 

is capable of handling them.” Id. at *12 (citations omitted). 

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These are points for the district court to bear in mind on remand.

Summary judgment for the defendants was inappropriate. The judgment must therefore be reversed and the case 

remanded for further proceedings consistent with this opinion. A number of the named defendants are not mentioned 

in Miller’s brief, however, and the district judge will have to 

decide on remand whether the claims against them have 

been abandoned and if not whether those defendants should 

be retained in, or dismissed from, the case.

REVERSED AND REMANDED.

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