United States Court of Appeals 

For the Seventh Circuit 

Chicago, Illinois 60604 

Submitted May 17, 2019*

Decided May 20, 2019 

Before 

MICHAEL S. KANNE, Circuit Judge 

AMY C. BARRETT, Circuit Judge 

MICHAEL B. BRENNAN, Circuit Judge

No. 18-3151 

LITTLETON E. JACKSON, 

Plaintiff-Appellant, 

v. 

SONYA L. ANDERSON, et al., 

 Defendants-Appellees.

 Appeal from the United States District 

Court for the Eastern District of Wisconsin.

No. 17-C-34 

William C. Griesbach, 

Chief Judge. 

O R D E R 

Littleton Jackson, a Wisconsin inmate, sued multiple nurses and prison medical 

staff for disregarding his complaints about a broken facial bone in violation of the 

Eighth Amendment and for retaliating against him in violation of the First Amendment 

after he filed grievances against the health staff. The district court entered summary 

judgment for the defendants, finding that Jackson lacked sufficient evidence to 

persuade a reasonable factfinder that he suffered from a serious medical issue, that any 

 

*

 We have 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. See FED. R. APP. P. 34(a)(2)(C). 

NONPRECEDENTIAL DISPOSITION 

To be cited only in accordance with Fed. R. App. P. 32.1 
No. 18-3151 Page 2 

defendant knew or recklessly disregarded such an issue, or that he suffered a 

deprivation that would likely deter future First Amendment activity. We affirm. 

We construe the facts and draw all reasonable inferences in favor of Jackson, who 

is the nonmoving party. See Arnett v. Webster, 658 F.3d 742, 749 (7th Cir. 2011). Jackson 

hit his face against a metal bar while he was exercising, prompting him to submit a 

health-services request. He expressed concern that he had broken a bone in his face. (He 

also mentioned a host of other unrelated ailments.) A prison nurse offered to examine 

him two days later, but Jackson refused because he did not want security staff in the 

examination room. Later that day, Jackson filed a second request, reiterating concern 

about the bone but complaining mostly about a bump near his right ear. The next day 

the same nurse examined Jackson, applied slight pressure to both sides of his face, but 

saw no facial bruising, swelling, or physical discomfort. The nurse told Jackson that he 

would schedule an appointment with a doctor and offered ibuprofen or Tylenol for any 

pain, but Jackson declined the medicine. 

Several months later, Jackson filed inmate grievances about his lack of medical 

treatment. He complained that the health-services staff ignored both the bump on his 

ear and the injury to his face in retaliation for grievances he had filed months earlier 

after being overcharged for a health appointment. The health-services manager 

recommended dismissing these grievances because Jackson already had seen medical 

staff and was on the list to see an off-site doctor. 

Jackson then saw an off-site nurse practitioner, who examined him but did not 

observe a broken bone. Although Jackson expressed his concern that a bone was 

broken, he did not complain of any facial pain. 

Weeks later, Jackson submitted two more health-services requests to receive an 

x-ray but did not get one. After the first request, a nurse examined both sides of his face 

and saw no abnormality. Jackson again refused pain medicine. He followed up two 

weeks later with a second request, and health staff told him that he was on the waiting 

list to see the doctor. 

During his second appointment with the nurse practitioner, Jackson complained 

about the broken bone, the bump near his right ear, and hypertension. The nurse 

practitioner noted that Jackson did not appear to be in any distress. She referred him to 

a dermatologist to evaluate the bump near his ear and prescribed medication for his 

hypertension. Although Jackson voiced concern of a possible broken bone, he did not 
No. 18-3151 Page 3 

complain of pain, so the nurse practitioner told him to submit a health request. Soon 

after the appointment, Jackson then submitted another health request for an x-ray. 

At Jackson’s final appointment with the nurse practitioner (to check his blood 

pressure), he did not discuss any concerns related to a broken bone. Rather, he said that 

he was feeling fine and did not complain of any facial pain. 

Jackson then sued the nurses, the nurse practitioner, and the health-services 

manager for deliberate indifference to his complaints about a broken bone. He also 

asserted that the prison health staff ignored his requests for treatment in retaliation for 

his grievance that he was overcharged for an appointment. 

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

concluded, first, that Jackson failed to show that he has an objectively serious medical 

condition because he presented no evidence that he had suffered a broken bone (or even 

any facial deformity such as swelling or bruising that might suggest a broken bone), nor 

did the record reflect that he was in substantial pain. And even if Jackson had presented 

evidence of an objectively serious medical condition, the court added, no reasonable 

factfinder could infer deliberate indifference based on the evidence that the health staff 

had responded attentively to his medical needs. And Jackson’s retaliation claim failed 

because there was no evidence that the health staff ever ignored his treatment requests. 

On appeal, Jackson first challenges the entry of summary judgment on his 

deliberate-indifference claim because a material dispute exists over whether the nurses 

knew that his bone was broken. He maintains that he told the nurses about his broken 

bone, a clearly serious medical condition, and their failure to order an x-ray or provide 

treatment necessarily amounts to deliberate indifference. 

But the district court properly concluded that no reasonable factfinder could 

infer that the nurses were deliberately indifferent. Although Jackson told the nurses 

about a possible broken facial bone, they were not required to adopt his diagnosis or 

demands for an x-ray once they ruled out any signs of a broken bone from their own 

examinations. “A medical professional is entitled to deference in treatment decisions 

unless no minimally competent professional would have so responded under those 

circumstances.” See Pyles v. Fahim, 771 F.3d 403, 409 (7th Cir. 2014) (internal quotations 

omitted). And the nurses’ responses to Jackson’s complaints—examining his face, 

offering pain medicine, and scheduling or advising him to see a doctor—were not so 
No. 18-3151 Page 4 

inadequate that they demonstrated an “absence of professional judgment” or suggested 

“intentional wrongdoing.” Arnett, 658 F.3d at 751. 

Jackson next argues that the district court overlooked evidence that the 

health-services manager knew about his possible broken bone from his two 

health-services requests yet did nothing to address his treatment needs. It is true that 

“[a]n inmate's correspondence to a prison administrator may [] establish a basis for 

personal liability under § 1983 where that correspondence provides sufficient 

knowledge of a constitutional deprivation,” Perez v. Fenoglio, 792 F.3d 768, 781–82 

(7th Cir. 2015). Because the manager did not provide direct patient care, she is liable 

only if she condoned or acquiesced in others’ unconstitutional treatment of Jackson. 

See Minix v. Canarecci, 597 F.3d 824, 833–34 (7th Cir. 2010). But there is no evidence here 

of a constitutional deprivation, let alone one that the manager willfully ignored. 

Finally, on his retaliation claim, Jackson maintains that medical staff ignored his 

health requests in retaliation for the earlier grievance he had filed regarding his 

overpayment. But as the district court correctly determined, Jackson did not furnish any 

evidence that his health requests were ever ignored. 

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

AFFIRMED