Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca7-19-01857/USCOURTS-ca7-19-01857-0/pdf.json

Parties Involved:
Deborah Hale
Appellee
Dustin James
Appellant

Document Text:

In the 

United States Court of Appeals 

For the Seventh Circuit ____________________ 

No. 19-1857 

DUSTIN JAMES, 

Plaintiff-Appellant, 

v.

DEBORAH HALE, 

Defendant-Appellee. 

____________________ 

Appeal from the United States District Court 

for the Southern District of Illinois. 

No. 3:15-cv-01335-JPG-MAB — J. Phil Gilbert, Judge. 

____________________ 

ARGUED FEBRUARY 14, 2020 — DECIDED MAY 14, 2020 

____________________ 

Before RIPPLE, SYKES, and SCUDDER, Circuit Judges. 

SYKES, Circuit Judge. It is axiomatic that the first step in 

the summary-judgment process is to ask whether the evidentiary record establishes a genuine issue of material fact 

for trial. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247–48 

(1986). To decide this question, the judge may disregard an 

affidavit that attempts to create a sham issue of fact. The 

“sham affidavit rule” exists in every circuit. This case illustrates the wisdom of the rule. 

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2 No. 19-1857 

Dustin James, a former pretrial detainee at the St. Clair 

County Jail in Belleville, Illinois, filed a pro se civil-rights 

lawsuit against Deborah Hale, the administrator of the jail 

infirmary, accusing her of inadequately treating his medical 

needs.1 He later acquired counsel, and significant discovery 

followed, including the production of jail infirmary and 

outside medical records that contradicted allegations in his 

complaint. 

Through counsel James obtained leave from a magistrate 

judge to file an amended complaint, but the factual section 

simply repeated the allegations in the original pro se version. In a subsequent deposition, James contradicted those 

factual assertions. When Hale moved for summary judgment, James responded by swearing out an affidavit incorporating by reference the allegations in the amended 

complaint. 

The magistrate judge disregarded the affidavit, as well as 

an affidavit submitted by James’s mother, and recommended that the district court grant the motion. The district judge 

excluded the affidavits under the sham-affidavit rule and 

entered summary judgment for Hale. 

We affirm. Not only is James’s affidavit a sham, it was an 

improper attempt to convert the allegations in the complaint 

into sworn testimony to avert summary judgment. The 

exclusion of his mother’s affidavit was a mistake, but the 

error was harmless because she added nothing of substance. 

1 Hale’s first name is spelled “Debra” in the district court’s docket and 

final order but is in fact spelled “Deborah” according to the disclosure 

statement and her deposition. 

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No. 19-1857 3 

The constitutional claim lacks factual support, so summary 

judgment in Hale’s favor was proper. 

I. Background

On the evening of January 11, 2015, Dustin James, a pretrial detainee in the St. Clair County Jail, was assaulted by 

another inmate and sustained severe facial injuries. At 

11:15 p.m. he was taken to the jail infirmary. His civil-rights 

suit centers on the response by Deborah Hale, the jail’s 

Health Services Administrator. We ask the reader’s patience 

as we provide the details and dates; their importance will 

become clear later. 

James’s injuries were serious enough to send him to the 

hospital. Just before midnight he arrived in the emergency 

room at St. Elizabeth’s Hospital where he received a CT scan 

and was diagnosed with a left zygomatic arch fracture and 

facial laceration. He received two morphine injections for 

pain and the laceration was sutured. The ER doctor’s discharge instructions required removal of the stitches in five 

days and recommended a follow-up visit with an otolaryngologist (known colloquially as an “ENT” specialist). The 

doctor also referred James to Dr. Paul Szewczyk, an ophthalmologist, for follow-up care. James arrived back in the 

jail infirmary at 3 a.m. on January 12. 

Nursing staff cared for James until he was seen on 

January 13 by a jail physician, who prescribed Motrin for ten 

days, referred James to an ophthalmologist and an ENT, and 

kept him in the jail infirmary. Three days later James was 

transported to Quantum Vision Centers where Dr. Szewczyk 

examined him and determined that “[n]o treatment [was] 

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4 No. 19-1857 

currently required.” The doctor recommended a follow-up 

visit in one week. 

Back at the jail, Nurse Jennifer Sabaleski removed the sutures in James’s eyebrow on January 19. She also noted his 

complaint of facial numbness. On January 24 she documented James’s request for an extension of his pain medication. 

The next morning she examined him; he voiced no complaints of pain. James later complained of recurring facial 

pain to a different nurse, and a jail physician prescribed ten 

more days of Motrin. 

In accordance with the discharge instructions, James was 

examined by an ENT at Archview Medical Specialists on 

January 26. The doctor recommended a referral to a plastic 

surgeon for a possible reduction of the left orbital rim. Two 

days later at a follow-up appointment at Quantum Vision, 

Dr. Szewczyk noted that James’s vision, alignment, eye 

movements, retina, and optic nerve were all doing well. He 

also recommended a referral to a plastic surgeon for a 

complaint of cheek numbness. 

On February 19 James asked to see Hale, complaining of 

facial pain. He requested more pain medication, but Hale 

told him that there was no current order for ibuprofen and 

he would need to see a doctor to obtain a new prescription. 

She noted facial swelling and planned to refer him to a 

doctor, but the on-site physician wasn’t at the jail that day. 

James had an appointment scheduled with an off-site specialist the next day, so Hale did not submit a physician 

referral. 

The following morning—Friday, February 20—James 

was transported to a clinic connected with St. Louis UniverCase: 19-1857 Document: 35 Filed: 05/14/2020 Pages: 19
No. 19-1857 5 

sity Hospital where Dr. Bruce Kraemer, a plastic surgeon, 

examined him. James denied having any visual disturbances 

or eating difficulties. The exam revealed an elevated temperature, facial swelling, and pain; however, Dr. Kraemer noted 

no overt evidence of infection other than the facial swelling. 

He ordered another CT scan because he apparently did not 

have access to the earlier one, so James was taken to radiology for that test. James was supposed to see Dr. Kraemer after 

the scan was completed, but he never returned to the clinic. 

After reviewing the results of the CT scan later that day, 

Dr. Kramer made the following observations in a 6:42 p.m. 

addendum to his examination notes: 

Given the paucity of radiographic findings[,] 

his swelling[, and] his temperature[,] I called 

the jail where he is residing[.] I left a message 

with the medical Department that I would recommend putting him on Cipro 500 mg twice 

daily[,] and I gave them my cell number to call 

me over the weekend if they have questions 

and we will try to reach them again Monday 

morning. 

The addendum also reflects a recommendation for a followup visit in two weeks. 

As promised, on Monday morning, February 23, someone from Dr. Kraemer’s office called the jail infirmary and 

recommended that James be given Cipro, an antibiotic. He 

received the first dose that evening during the next scheduled medication pass. He was released from custody the 

next day. 

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6 No. 19-1857 

In December 2015 James filed a pro se civil-rights complaint against Hale seeking damages under 42 U.S.C. § 1983 

for denial of medical care in the jail.2 He claimed that on or 

about January 20, he reported to Hale that his eye was nearly 

swollen shut, his face was numb, and he was hardly able to 

open his mouth on one side. He alleged that she gave him a 

“sick call form” with instructions to fill it out, and he did so 

repeatedly between January 20 and 28 but “was never seen 

by any medical staff.” He alleged that his mother, Patricia 

Powell, called the jail the following week and spoke to Hale, 

but he “still received no medical attention to the problems at 

hand or was even seen by medical staff.” He further alleged 

that he woke up on February 20 with pain and facial swelling and requested to see Hale, but when she saw him, she 

“stated to him he was fine.” He alleged more generally that 

between January 20 and February 28 he suffered from vision 

loss, pain, facial swelling, and an inability to eat due to 

Hale’s “medical neglect.” The complaint sought $100,000 in 

compensatory damages and $5,000 in punitive damages. The 

case was referred to a magistrate judge in January 2016. 

James acquired counsel in January 2017, and counsel obtained James’s jail infirmary and outside medical records 

through discovery. The records contradicted or clarified the 

allegations in the complaint in numerous respects. A sample: 

x In his complaint James alleged that on or about 

February 20, he woke up with pain and facial swelling 

2 James also sued St. Clair County Jail Captain Thomas Trice alleging 

that he punished him with segregation time in retaliation for seeking 

medical care. The claim later settled and was dismissed with prejudice. 

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No. 19-1857 7 

and requested to see Hale. The jail infirmary records clarified that these events took place on February 19. 

x The complaint alleged that James repeatedly complained of facial pain and swelling between January 20 

and February 28 and received no medical attention. The 

jail infirmary records show that members of the nursing 

staff conducted daily rounds during this time period and 

dispensed ibuprofen to him three times a day between 

January 13 and 23, when his initial ten-day prescription 

expired; he was examined by Nurse Sabaleski on 

January 24 and 25, and a jail physician thereafter extended his ibuprofen prescription for ten more days; he was 

examined on January 26 and 28 by an outside ENT and 

ophthalmologist, respectively, and by Dr. Kraemer (the 

plastic surgeon) on February 20. 

x In his complaint James alleged that from January 20 to 

February 28 he suffered from vision loss and was unable 

to eat. The medical records show that he denied suffering 

from either of these problems at his February 20 appointment with Dr. Kraemer. 

x The complaint alleged that the January 12 CT scan revealed a possible concussion. The medical records reflect 

no concussion. 

Notwithstanding these contradictions and clarifications, 

in July 2017 James—through his counsel—obtained leave to 

file an amended complaint in which he simply repeated the 

factual allegations from his original complaint. In his 

February 2018 deposition, James directly contradicted many 

of the allegations in the amended complaint. 

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8 No. 19-1857 

Hale eventually moved for summary judgment. In response James attached his deposition testimony, 

Dr. Kraemer’s deposition testimony, a copy of the amended 

complaint, and an expert report by Dr. Michael Angarone, 

D.O. James later moved for leave to supplement his response 

with two affidavits—one from himself and one from his 

mother, Patricia Powell. The magistrate judge granted the 

motion. Both affidavits simply incorporated by reference 

factual allegations from the amended complaint, directly 

contradicting James’s deposition testimony and the infirmary and outside medical records. 

The case was then transferred to a different magistrate 

judge who disregarded the affidavits, pointing out that they 

merely cross-referenced allegations in the amended complaint and reasoning that it was not his job to construct 

James’s argument from the record. Based on the remaining 

evidence, the magistrate judge found no factual support for 

James’s claim and recommended that the district court grant 

the summary-judgment motion. 

The district judge disagreed with some of the magistrate 

judge’s reasoning but ultimately adopted his recommendation. Relying on our decision in Ford v. Wilson, 90 F.3d 245, 

247 (7th Cir. 1996), the judge determined that the affidavits 

were not impermissible merely because they simply swore 

to the truth of allegations in the amended complaint. The 

judge instead excluded the affidavits under the shamaffidavit rule. Examining the remainder of the evidence, the 

judge held that no reasonable jury could find that Hale’s 

actions were objectively unreasonable in violation of James’s 

right to due process. The judge accordingly entered summary judgment in Hale’s favor. 

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No. 19-1857 9 

II. Discussion 

James challenges the exclusion of the two affidavits and 

the judge’s decision on the merits. We review evidentiary 

rulings for an abuse of discretion. United States v. Trudeau, 

812 F.3d 578, 590 (7th Cir. 2016). We review the judge’s 

summary-judgment order de novo, construing the record in 

the light most favorable to James and drawing all reasonable 

inferences in his favor. Estate of Simpson v. Gorbett, 863 F.3d 

740, 745 (7th Cir. 2017). 

A. Ford v. Wilson

Before turning to the sham-affidavit rule, we pause to 

address the district court’s application of our decision in 

Ford v. Wilson. The judge assumed that Ford generally authorizes a plaintiff to convert allegations in a complaint into 

an affidavit that is capable of defeating summary judgment. 

In other words, if James’s affidavit hadn’t turned out to be a 

sham, the district judge would not have adopted the magistrate judge’s recommendation to disregard it. Still, the judge 

disapproved of James’s use of this “conversion” technique, 

particularly since he was represented by counsel. He suggested that the tactic “makes a mockery of how summary 

judgment is supposed to work.” 

The judge’s point is well-taken, so we take this opportunity to clarify Ford’s scope. Roy Ford filed a verified pro se 

civil-rights complaint against a police officer who arrested 

him after a traffic stop. The officer moved for summary 

judgment, and the judge granted the motion because Ford 

had not submitted an affidavit or other evidence in opposition. Ford, 90 F.3d at 246–47. Although we ultimately affirmed the judgment, we reasoned that because Ford had 

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10 No. 19-1857 

verified his complaint, some of its contents “were affidavit 

material.” Id. at 247. 

We began our analysis with the general principle that a 

plaintiff may not rely on mere allegations or denials in his 

complaint when opposing a properly supported motion for 

summary judgment. Id. at 246–47. We explained, however, 

that a verified complaint—signed, sworn, and submitted 

under penalty of perjury—can be considered “affidavit 

material” provided the factual allegations otherwise satisfy 

the affidavit criteria specified in Rule 56 of the Federal Rules 

of Civil Procedure and the declarant complies with 28 U.S.C. 

§ 1746, which sets forth the requirements for verification 

under penalty of perjury. Id. at 247. 

We took pains, however, to sound a cautionary note. Because this tactic undermines the function of Rule 56, we 

pointedly said that “[w]e do not mean to commend the 

practice.” Id. We explained that Rule 56 requires “the submission of evidentiary material in response to a motion for 

summary judgment as a means of sharpening the issues, so 

that the judge can determine just what if anything must be 

tried.” Id. Merely pointing to assertions in a verified complaint “is bound to make the identification of genuine issues 

of material fact difficult, complicating the work of the 

judge.” Id. Still, we did not think that this “departure from 

proper practice” was “so egregious or such a burden on the 

court as to warrant the fell sanction of dismissal” in Ford’s 

case, especially since he was litigating pro se and had not 

been warned against this approach. 

Importantly, every out-of-circuit case we relied on for 

support in Ford dealt with a litigant who was not represented by counsel when he verified his complaint. See Colon v. 

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No. 19-1857 11 

Coughlin, 58 F.3d 865, 868 (2d Cir. 1995); Schroeder v. 

McDonald, 55 F.3d 454, 456 (9th Cir. 1995); King v. Dogan, 

31 F.3d 344, 345 (5th Cir. 1994). Not once in the 24 years since 

Ford was decided have we allowed a represented party to 

resist summary judgment by submitting an affidavit swearing to the allegations in the complaint after significant 

discovery. We see no reason to make this case the first. Ford

struck a delicate balance between issue clarification and 

equity. James asks us to upset this balance, insisting that we 

accept an affidavit that reaches back past extensive discovery 

conducted with the assistance of counsel to repeat assertions 

in a pro se complaint. That approach obscures rather than 

clarifies the determination of material factual issues. In 

addition, the equities are quite different when a party is 

represented by counsel.

In sum, Ford should not be understood as a general authorization for a represented plaintiff to defeat summary 

judgment after extensive discovery by the simple expedient 

of swearing in an affidavit that the allegations in the complaint are true. There is no authority in this circuit for such 

“reach back” complaint verification. 

B. Sham-Affidavit Rule 

The principal function of summary judgment is to prevent unnecessary trials by screening out factually unsupported claims. Albiero v. City of Kankakee, 246 F.3d 927, 932 

(7th Cir. 2001). Rule 56(c)(4) serves this screening function by 

permitting a party to use an affidavit or declaration to 

support or oppose a motion for summary judgment only if 

the affidavit (1) attests to facts of which the affiant has 

“personal knowledge”; (2) “set[s] out facts that would be 

admissible in evidence”; and (3) “show[s] that the affiant or 

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12 No. 19-1857 

declarant is competent to testify on the matters stated.” 

Similarly, Rule 56(h) permits a judge to sanction a party who 

presents an affidavit “in bad faith or solely for delay.” FED.

R. CIV. P. 56(h). Rule 56 thus requires a judge to scrutinize 

the substance of an affidavit offered in response to a 

summary-judgment motion to determine whether a reasonable jury could rely on the factual statements it contains. 

Jiminez v. All Am. Rathskeller, Inc., 503 F.3d 247, 252 (3d Cir. 

2007). 

In furtherance of this screening function and in support 

of a judge’s duty at the summary-judgment stage, every 

federal court of appeals permits a judge to disregard a 

“sham” affidavit—typically an affidavit that contradicts 

prior deposition testimony. See Babrocky v. Jewel Food Co.,

773 F.2d 857, 861 (7th Cir. 1985); Colantuoni v. Alfred Calcagni 

& Sons, Inc., 44 F.3d 1, 4–5 (1st Cir. 1994); Sinskey v. Pharmacia 

Ophthalmics, Inc., 982 F.2d 494, 498 (Fed. Cir. 1992); Martin v. 

Merrell Dow Pharm., Inc., 851 F.2d 703, 706 (3d Cir. 1988); 

Franks v. Nimmo, 796 F.2d 1230, 1237 (10th Cir. 1986); Reid v. 

Sears, Roebuck & Co., 790 F.2d 453, 460 (6th Cir. 1986); Albertson v. T.J. Stevenson & Co., 749 F.2d 223, 228 (5th Cir. 1984); 

Van T. Junkins & Assocs., Inc. v. U.S. Indus., Inc., 736 F.2d 656, 

657–59 (11th Cir. 1984); Barwick v. Celotex Corp., 736 F.2d 946, 

960 (4th Cir. 1984); Camfield Tires, Inc. v. Michelin Tire Corp., 

719 F.2d 1361, 1364–65 (8th Cir. 1983); Radobenko v. Automated 

Equip. Corp., 520 F.2d 540, 544 (9th Cir. 1975); Perma Research 

& Dev. Co. v. Singer Co., 410 F.2d 572, 577–78 (2d Cir. 1969).

In this circuit the sham-affidavit rule prohibits a party 

from submitting an affidavit that contradicts the party’s 

prior deposition or other sworn testimony. Dunn v. Menard, 

Inc., 880 F.3d 899, 910 (7th Cir. 2018). We also disregard an 

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No. 19-1857 13 

affidavit that contradicts a statement made under penalty of 

perjury, even if the statement was not made in the course of 

litigation. See United States v. Funds in the Amount of 

$30,670.00, 403 F.3d 448, 466 (7th Cir. 2005) (applying the 

sham-affidavit rule to statements in an affidavit that contradicted representations in the affiant’s bankruptcy filing and 

tax returns). The organizing principle of our sham-affidavit 

practice is simply stated: a genuine issue of material fact 

cannot be conjured out of nothing. We adopted the shamaffidavit rule “to weed out unfounded claims, specious 

denials, and sham defenses.” Babrocky, 773 F.2d at 861. 

By incorporating by reference the assertions from his 

amended complaint, James’s affidavit contradicted his 

deposition testimony in numerous respects. A few of the 

contradictions include: 

x Paragraph 17 of the amended complaint alleges that 

James was “never seen by any medical staff” “for a 

week” spanning from approximately January 20 to 28, 

and paragraph 22 alleges that he thereafter “received 

no medical attention to the problems at hand or was 

even seen by medical staff.” In his deposition James 

acknowledged that he saw nurses in the jail infirmary 

“daily”; he “had the opportunity” to speak to them; 

and he was “seen by an outside physician, whether it 

be at the ER or by a specialist, a total of five times between January 11th and February 24th.” 

x Paragraphs 32 to 34 of the amended complaint describe an interaction between Hale and James “on or 

around the date of February 20” in which he complained of facial pain and swelling. According to 

James’s deposition testimony and the medical recCase: 19-1857 Document: 35 Filed: 05/14/2020 Pages: 19
14 No. 19-1857 

ords, this event actually took place on February 19. 

This is a crucial interaction, and by the time of the 

summary-judgment motion, James and his attorney 

knew the actual date. There is no basis to accept an affidavit swearing to an important transactional date 

that James and his attorney knew was wrong. 

x Paragraphs 51 to 56 describe a series of events spanning from February 25 to March 1 that, according to 

James’s testimony, could not have happened on the 

specified dates. The amended complaint asserts that 

James contacted his criminal attorney from jail on 

February 25 asking for his help in getting released so 

he could seek medical attention. The amended complaint also asserts that James visited with his attorney 

from the jail via videoconference on February 27 and 

was released from custody on March 1. None of this is 

true: James was released from custody on 

February 24, as he acknowledged in his deposition. 

These contradictions do not concern minor details. The 

gravamen of James’s constitutional claim is that Hale’s 

response to his medical needs was objectively unreasonable. 

The claim entails a context-sensitive, fact-bound inquiry into 

the intentionality of the defendant’s conduct and the totality 

of the circumstances. See McCann v. Ogle County, 909 F.3d 

881, 886 (7th Cir. 2018). The contradictory dates matter 

because the timing of the events is central to James’s contention that Hale failed to adequately address his medical 

needs. When James requested to see Hale and whether he was 

seen by medical professionals over a particular period 

between his injury in late January through his release from 

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No. 19-1857 15 

the jail in late February 2015 are factual issues that would be 

focal points in any subsequent trial. 

James responds that the judge relied on contradictions 

between his reach-back affidavit and the contents of records 

from the infirmary and outside medical providers. He insists 

that this cannot establish any contradiction between sworn 

statements made by him. He also notes that we have in 

several cases said that the sham-affidavit rule is narrow and 

should be applied with caution. See Castro v. DeVry Univ., 

Inc., 786 F.3d 559, 571 (7th Cir. 2015) (cautioning that the 

sham-affidavit rule “must be applied with great care ... 

because summary judgment is not a tool for deciding questions of credibility”). 

It’s true that the sham-affidavit rule applies to contradictions between an assertion in a party’s summary-judgment 

affidavit and the party’s prior sworn testimony. But this 

does not help James’s position. The contradictions between 

James’s reach-back affidavit and his deposition testimony 

fall squarely within the core of the sham-affidavit rule. 

For the sake of completeness, it’s worth noting that we 

have recognized three exceptions to the sham-affidavit rule. 

An affidavit that contradicts prior testimony but contains 

newly discovered evidence is allowed. Adelman-Tremblay v. 

Jewel Cos., Inc., 859 F.2d 517, 520 (7th Cir. 1988). And because 

a deponent may be confused by a question and his memory 

may fail, a judge may also consider an affidavit that contradicts a statement in a deposition if the statement is demonstrably mistaken. Russell v. Acme-Evans Co., 51 F.3d 64, 68 

(7th Cir. 1995). We also allow the submission of a supplemental affidavit that clarifies ambiguous or confusing 

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16 No. 19-1857 

deposition testimony. Bank of Ill. v. Allied Signal Safety 

Restraint Sys., 75 F.3d 1162, 1171–72 (7th Cir. 1996). 

None of these exceptions applies here. James’s reachback affidavit did not clarify ambiguous or confusing deposition testimony, see Buckner, 75 F.3d at 292, and he hasn’t 

demonstrated that the relevant deposition statements were 

mistaken, see Russell, 51 F.3d at 67–68. His affidavit contains 

no newly discovered evidence—to the contrary, it fails to 

acknowledge the known, newly discovered evidence. See 

Adelman-Tremblay, 859 F.2d at 520. James’s affidavit was 

properly excluded as a sham. 

The affidavit from his mother is another matter. Patricia 

Powell did not testify in deposition or make any other sworn 

statements about these events before swearing out her 

affidavit incorporating the complaint’s allegations about her 

phone call to Hale. But any error in excluding her affidavit 

was harmless. The factual assertions that Powell incorporated by cross-reference add nothing of importance to 

James’s case. The amended complaint alleges only that she 

contacted Hale in January 2015 regarding James’s medical 

care and that Hale “assured [her] the situation would be 

taken care of.” 

The lack of detail here vitiates any evidentiary value. If 

the call had taken place, say, on January 29 after James had 

been seen by nursing staff and by specialists, and if Powell 

had told Hale that James’s condition had considerably 

worsened, and if Hale had then declined to act, that might

give Powell’s conversation with Hale some substance. But as 

it stands the assertion does not support a reasonable inference that Hale’s conduct was objectively unreasonable. 

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No. 19-1857 17 

Although Powell’s affidavit should not have been excluded, 

it does not change anything. 

C. Merits

A § 1983 claim that a state pretrial detainee has received 

inadequate medical care is predicated on the rights secured 

by the Fourteenth Amendment’s Due Process Clause. 

Miranda v. County of Lake, 900 F.3d 335, 346–47 (7th Cir. 

2018). Claims of inadequate medical care while in pretrial 

detention are subject to an objective-reasonableness standard. Id. at 352. Hale was employed by a private company 

that contracted with St. Clair County to provide medical 

care, so she was a state actor amenable to suit under § 1983. 

Id. at 346–47. 

The plaintiff bears the burden to demonstrate objective 

unreasonableness, and he must make a twofold showing. 

First, he must show that the defendant acted purposefully, 

knowingly, or recklessly when considering the consequences 

of his response to the medical condition at issue in the case. 

McCann, 909 F.3d at 886. Second, the plaintiff must show 

that the challenged conduct was objectively unreasonable in 

light of the totality of the relevant facts and circumstances. 

Id. James has not presented sufficient evidence for a reasonable jury to find in his favor on either element of the claim. 

To the extent that James contends that Hale’s actions 

were objectively unreasonable because she did not provide 

additional pain medication, our decision in McCann is 

instructive. There we held that a nurse who administered 

medicine in accordance with a doctor’s prescription but 

failed to take the detainee’s vital signs did not act purposefully, knowingly, or recklessly. Id. So too here: doctors 

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18 No. 19-1857 

prescribed medication on three occasions during the relevant time period. Overnight on January 11–12 James received morphine for pain in the emergency room and a tenday prescription for Motrin when he returned to the jail 

infirmary. On January 25 the Motrin prescription was extended for another ten days. And on the morning of 

February 23, Dr. Kraemer’s office called the jail infirmary 

and recommended Cipro. In each case James received the 

prescribed medication without significant incident. 

Dr. Angarone, James’s expert, offered his opinion that 

James “developed an abscess on the left side of his face at 

the site of his left zygomatic fracture due to negligence by the 

[d]efendant by not obtaining [a] timely evaluation for the 

[p]laintiff by a physician and [not] dealing the administration of antibacterials prescribed by Dr. Kraemer on 

Feb[ruary] 20, 2015.” (Emphasis added.) But more than 

negligence or even gross negligence is required for a viable 

§ 1983 claim for inadequate medical care. Id. at 887. 

James argues that it was objectively unreasonable for 

Hale not to send him to the emergency room on February 19. 

However, James saw Dr. Kraemer the very next day, and the 

doctor did not find his condition severe enough to require an 

emergency-room trip. Dr. Kraemer ordered a CT scan and 

recommended that James be given Cipro and return for a 

follow-up visit in two weeks. James contends that Hale 

unreasonably delayed his receipt of the antibiotic, but the 

record shows otherwise. No evidence suggests that Hale was 

aware of Dr. Kraemer’s recommendation before the morning 

of February 23. And she immediately contacted a doctor to 

fill the prescription. James received his first Cipro dose that 

evening during the next scheduled medication pass. 

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No. 19-1857 19 

* * * 

Because a reasonable jury could not find for James on his 

constitutional claim against Hale, summary judgment in her 

favor was appropriate. 

AFFIRMED

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