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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 February 11, 2016*

Decided March 18, 2016

Before

DIANE P. WOOD, Chief Judge

RICHARD A. POSNER, Circuit Judge

ANN CLAIRE WILLIAMS, Circuit Judge

No. 15-1653

ROBERT MADDEN,

Plaintiff-Appellant,

v.

ENRIQUE LUY, and

DAVID FOLEY,

Defendants-Appellees.

Appeal from the United States District 

Court for the Eastern District of Wisconsin.

No. 13-C-549

Rudolph T. Randa,

Judge.

O R D E R

Robert Madden, a Wisconsin inmate, appeals the grant of summary judgment 

against him in this suit under 42 U.S.C. § 1983, asserting that two doctors (one at the 

prison where he was incarcerated, and one at a hospital to which he was referred) were 

deliberately indifferent to his serious medical needs when they failed appropriately to 

 

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

unnecessary. Thus the appeal is submitted on the briefs and 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NONPRECEDENTIAL DISPOSITION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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treat complications and pain he experienced following a surgical procedure. The district 

court concluded that no jury could rule in Madden’s favor. We affirm.

Madden, who had a history of chronic hepatitis C, was an inmate during the time 

in question at the Racine Correctional Institution. After a scan revealed a small tumor in 

his liver, Madden was referred to the Primary Liver Tumor Clinic at the University of 

Wisconsin (UW) Hospital.

Two weeks later he was examined by Dr. David Foley, a liver and kidney 

transplant surgeon employed by the UW Hospital, who confirmed the presence of a 1.4 

centimeter tumor. Dr. Foley acknowledged that Madden was a suitable candidate for 

resection, but believed (for reasons on which he did not elaborate) that a “microwave 

ablation” was Madden’s best treatment option. Microwave ablation is a technique that 

involves sticking a microwave-emitting probe directly into the tumor for the purpose of 

destroying it. 

Less than a week later, the microwave ablation was performed by two 

radiologists at the hospital. Medical records reflect that there were complications in the 

form of a small area of “diaphragmatic burn and intercostal musculature burn”—in 

other words, burns to some of the tissue surrounding the liver. Madden says he was 

never informed of these burns, though he was admitted for inpatient care under Dr. 

Foley, the surgeon on duty. While hospitalized, Madden ran fevers as high as 102 and 

experienced pain, and Dr. Foley treated him with oral medication. Six days later 

Dr. Foley discharged Madden. This was his final interaction with Madden.

Madden returned to Racine and came under the care of Dr. Enrique Luy, the 

prison’s staff physician. Dr. Luy prescribed methadone for pain caused by the burns and 

otherwise monitored Madden’s liver condition. An MRI taken roughly 18 months after 

the first ablation revealed a possible second tumor, and so Dr. Luy referred Madden 

back to the UW Hospital’s Liver Tumor Clinic. 

At that clinic Madden was examined by Dr. Alexandru Musat, a transplant 

hepatologist, who noted his complaints of continuing pain at the site of the previous

ablation. Dr. Musat wrote to Dr. Luy that Madden’s case should be evaluated by the 

Hospital’s Multidisciplinary Tumor Board to determine whether he should be treated 

again with a “local regional therapy” (such as another ablation) or evaluated for a liver 

transplant. Dr. Musat also recommended that Dr. Luy refer Madden to the 

UW Hospital’s Pain Clinic to determine whether a nerve block would better manage 

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Madden’s pain if a repeat ablation were not going to be performed “at this time.” The 

Board recommended that Madden be referred for a transplant evaluation and that the 

lesion be monitored and possibly treated with a second ablation. 

Dr. Luy referred Madden for the transplant evaluation but declined to send him

to the pain clinic because the Board had not ruled out a second ablation. Instead Dr. Luy

maintained Madden’s methadone prescription.

Over the next year, Dr. Luy continued to collaborate with Dr. Musat to monitor 

Madden’s second tumor and coordinate his care. After one exam Dr. Musat found that 

the tumor had increased in size to 2.3 cm and opined that it needed to be removed. He 

also noted that Madden had suffered a “significant” muscle injury from the earlier 

ablation and recommended that Madden’s methadone dosage be increased. Madden 

underwent a procedure to remove the second tumor shortly thereafter. Throughout the 

following year, Dr. Luy adjusted Madden’s methadone dosage three times based on 

recommendations from Dr. Musat (Dr. Luy noted on one of the authorizations that 

Madden had twice been caught selling methadone to other inmates, but that he “could 

not discontinue methadone liquid because this was recommended by Dr. Musat for 

pain”). Madden remained on methadone for 18 months after the second tumor was 

removed. He told Dr. Luy that he wished to discontinue taking the drug, at which point

Dr. Luy referred him to the UW Hospital’s Pain Clinic, which found that there was “no 

good interventional or surgical solution” for his pain. Madden was transferred to 

another facility shortly thereafter and had no further contact with Dr. Luy.

Madden brought this deliberate-indifference suit against Dr. Foley and Dr. Luy. 

He asserted that Dr. Foley injured him during the ablation and then prolonged his pain 

and suffering by failing to tell him about the complications from the procedure. Madden

further charged that Dr. Luy displayed deliberate indifference to his pain by keeping 

him on addictive medication rather than referring him to the pain clinic when Dr. Musat 

first recommended the referral.

As the litigation unfolded, Madden repeatedly— and unsuccessfully—filed 

motions for recruitment of counsel and for assistance in obtaining discovery. Six times 

he moved to recruit counsel, and each time the court denied his motion, finding that he

was competent to litigate his claims, that the quality of his filings was high, and that the 

issues were not unduly complex. In addition, Madden moved three times to compel the 

defendants to produce his medical records. The court similarly denied each of these 

motions, noting that Madden could obtain his records directly from the UW Hospital 

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and the Department of Corrections, and that he actually had copies of the relevant 

records, which he received when the defendants attached them to their motion for 

summary judgment.

The district court granted summary judgment for the two doctors, concluding 

that Madden failed to identify any facts that pointed in the direction of deliberate 

indifference toward his medical needs. Not only was it undisputed that Dr. Foley did not 

perform the ablation but, even if he had, there was no issue of non-disclosure because 

Madden’s burns had been noted in his medical records and thus were made known to 

subsequent treating providers. Further, the court determined, Foley’s course of 

treatment—Tylenol and ibuprofen to treat Madden’s fevers and prescription 

medications for pain—was “not so far afield” as to allow an inference of deliberate 

indifference. Nor had Dr. Luy been deliberately indifferent to Madden’s pain: Madden

had premised his claim on Dr. Luy’s failure to refer him to the pain clinic, but Dr. Musat

had recommended such a referral only if the Board concluded that a second procedure

not be performed, and the Board had not, in fact, ruled out a second procedure. And it 

was not “blatantly inappropriate” for Dr. Luy to continue Madden’s methadone 

prescription “in collaboration with Dr. Musat.”

On appeal Madden generally challenges the grant of summary judgment against 

him, essentially reiterating the arguments he raised in the district court. But as the 

district court properly concluded, Madden failed to create a fact question on the 

question whether Dr. Foley treated him with deliberate indifference. To survive 

summary judgment, Madden needed to present evidence that Dr. Foley knew of and 

disregarded an excessive risk to his health or safety—in other words, that the doctor

exhibited a reckless disregard of harm. King v. Kramer, 680 F.3d 1013, 1018–19 (7th Cir. 

2012); Estate of Cole v. Fromm, 94 F.3d 254, 258–59 (7th Cir. 1996). Although a failure to 

treat serious, chronic pain may constitute deliberate indifference, Walker v. Benjamin, 293 

F.3d 1030, 1039–40 (7th Cir. 2002); Gutierrez v. Peters, 111 F.3d 1364, 1371 (7th Cir. 1997), 

disagreement about a proper course of treatment does not suffice. The treatment 

received must be “blatantly inappropriate.” Pyles v. Fahim, 771 F.3d 403, 409 (7th Cir. 

2014). The medical records confirm that Dr. Foley did not perform the ablation. And 

even if Dr. Foley somehow were at fault for not disclosing to Madden the nature of the 

complications from the ablation, Dr. Foley nevertheless treated his pain and noted the 

burns in his medical records, ensuring that the details of the burns would be available to 

subsequent treatment providers. The fact that Madden was given a powerful narcotic 

painkiller by Dr. Luy after he returned to Racine undermines Madden’s suggestion that 

the seriousness of his injuries was unknown.

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Madden also maintains that Dr. Luy was deliberately indifferent by ignoring until 

this case began Dr. Musat’s recommendation that he be referred to a pain clinic. But here 

too we agree with the district court that Madden has failed to raise a triable issue 

regarding deliberate indifference on the doctor’s part. Madden misunderstands 

Dr. Luy’s reason for not following Dr. Musat’s recommendation. Dr. Luy declined to 

make a referral because Dr. Musat premised his recommendation on a second procedure

not being performed. But even if Dr. Luy favored a method of pain treatment other than 

the one recommended by Dr. Musat, this would not amount to “so significant a 

departure from accepted professional standards or practices that it calls into question 

whether the doctor actually was exercising his professional judgment,” Pyles, 771 F.3d at 

409. Madden did receive treatment for his pain in the form of increasing doses of a 

powerful narcotic. (The fact that Madden was twice caught selling his methadone to 

other inmates also undercuts his assertion that his pain was not being effectively 

managed.) The lack of any evidence that he was harmed by Dr. Luy’s delay in referring 

him dooms his claim of deliberate indifference.

Madden also asserts that the district court erred by denying his motions to 

compel discovery of his medical records. But as the court explained in denying the 

motions, the defendants in their court filings provided him with addresses that he could 

use to obtain his own medical records. And in any event, Madden obtained the records 

he sought when the defendants attached them to their motion for summary judgment. 

He therefore suffered no prejudice by the court’s denial of his motions. See James v. Hyatt 

Regency Chicago, 707 F.3d 775, 784 (7th Cir. 2013).

Madden also contends that the district court abused its discretion by denying his 

motions to recruit counsel. But the district court committed no abuse of discretion when 

it denied his requests, because his claims were not novel or complex and he had proven 

competent to litigate the case. His arguments were straightforward and did not require 

interpretation of complex medical evidence, and he repeatedly demonstrated his ability 

to handle the litigation. Moreover, Madden has not shown a reasonable likelihood that 

representation would have changed the outcome of the case. Henderson v. Ghosh, 755 F.3d 

559, 564–65 (7th Cir. 2014); Johnson, 433 F.3d at 1007. 

AFFIRMED.

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