In the 

United States Court of Appeals 

For the Seventh Circuit ____________________ 

No. 23-1220 

RICHARD RODGERS, 

Plaintiff-Appellant, 

v.

WILLIAM RANKIN, et al., 

Defendants-Appellees. 

____________________ 

Appeal from the United States District Court for the 

Central District of Illinois. 

No. 4:20-cv-04121-SLD-JEH — Sara Darrow, Chief Judge. 

____________________ 

ARGUED NOVEMBER 28, 2023 — DECIDED APRIL 23, 2024

____________________ 

Before EASTERBROOK, HAMILTON, and BRENNAN, Circuit 

Judges. 

HAMILTON, Circuit Judge. Plaintiff-appellant Richard 

Rodgers entered the East Moline Correctional Center with a 

history of scoliosis and back pain that had been treated surgically by implanting steel rods in his back. His back pain persisted during his time in prison. At some point during his imprisonment, the rods in his back broke. The broken hardware 

went undetected for more than a year after two radiologists 
2 No. 23-1220 

misread his x-rays. Eventually, the jail’s primary care physician, defendant-appellee Dr. William Rankin, discovered the 

broken hardware when he double-checked Rodgers’ x-ray 

images. Dr. Rankin arranged for Rodgers to receive corrective 

surgery. After that surgery, Rodgers needed another after developing an infection. 

After this ordeal, Rodgers sued the radiologists and Dr. 

Rankin, as well as other defendants not at issue in this appeal. 

The district court screened Rodgers’ complaint under 

28 U.S.C. § 1915A and dismissed his Eighth Amendment 

claims against the radiologists because Rodgers did not state 

a viable constitutional claim against them. The court allowed 

Rodgers to proceed against Dr. Rankin but eventually granted 

summary judgment for him. The court found that Rodgers 

had not come forward with evidence that would allow a reasonable jury to find that Dr. Rankin had violated the Eighth 

Amendment by acting with deliberate indifference toward 

Rodgers’ serious medical condition. Rodgers has appealed. 

We affirm the judgment of the district court. Regarding the 

radiologists, the Eighth Amendment requires allegations of 

more than mere negligence to state a viable claim. Rodgers 

alleged no more than negligence by the radiologists. As for 

Dr. Rankin, we agree with the district court that the evidence 

would not support a reasonable finding that Dr. Rankin acted 

with deliberate indifference to Rodgers’ serious medical condition. In fact, Dr. Rankin deserves the credit for having found 

the radiologists’ errors in reading the x-rays and putting 

Rodgers on the path to the corrective surgery he needed. 
No. 23-1220 3

I. Factual and Procedural Background 

Richard Rodgers endured scoliosis for years before entering the East Moline Correctional Center. Sometime before his 

imprisonment, he had metal rods known as Harrington rods 

implanted in his back to straighten his spine. Twice before his 

imprisonment, those rods had broken, requiring further surgery. 

Rodgers’ back problems persisted at the prison. In December 2016, Rodgers met with Dr. William Rankin, the physician 

for the prison, to discuss his back pain and other ailments. 

Rodgers told Dr. Rankin that he had Harrington rods in his 

back and that they had broken previously. Dr. Rankin had 

never before treated a patient with Harrington rods. After 

noting that Rodgers had some tenderness along his spine, Dr.

Rankin gave him ibuprofen and Robaxin, a muscle relaxer. 

Dr. Rankin also ordered a low-bunk permit and an extra blanket to reduce stress on Rodgers’ back. 

Rodgers’ medical records show that he next complained 

of back pain in May 2018. Rodgers and Dr. Rankin met again 

for an appointment that month. Rodgers complained that he 

had been feeling “sharp, throbbing, and constant pain” at the 

base of his neck for a couple of months. Dr. Rankin ordered xrays and a follow-up appointment. 

The x-rays came back a few days later. Dr. Naveed Yousuf, 

the radiologist who examined Rodgers’ x-rays, reported that 

Rodgers’ hardware “appears to be intact and in satisfactory 

alignment.” Despite that promising report, Dr. Rankin decided to increase Rodgers’ Robaxin dosage because he was 

still experiencing back pain. 
4 No. 23-1220 

Rodgers’ medical records do not reflect that he complained of back pain again until December 2018, when he reported to a nurse that he had “nervy” back pain that “comes 

and goes.” Dr. Rankin added a prescription for gabapentin to 

Rodgers’ treatment regimen of Ultram, Robaxin, and Tylenol. 

In September 2019, Rodgers complained of “shooting” 

pain, saying it felt like there was “something digging” into his 

back. Dr. Rankin ordered a second round of x-rays. Again, the 

x-ray report—this time signed by Dr. Jonathan Foss—said 

that the “hardware appears intact.” 

This time, however, Dr. Rankin reviewed the x-rays himself. He thought the Harrington rods appeared to be broken. 

Dr. Rankin asked Dr. Foss to look at the x-rays again. Dr. Foss 

did so and revised his report. He agreed that the Harrington 

rods appeared fractured. Dr. Rankin later acknowledged that, 

upon further review, Rodgers’ first x-ray from May 2018 also 

showed a broken Harrington rod, though Dr. Rankin at that 

time had accepted Dr. Yousuf’s report that they were intact. 

Having determined that the Harrington rods were broken, 

Dr. Rankin sought out specialists to treat the issue. He first 

referred Rodgers to an orthopedic specialist, but that specialist was unable to provide the treatment Rodgers needed. Dr. 

Rankin next referred Rodgers to a neurosurgeon. Dr. Rankin 

also ordered a CT scan and in the meantime increased Rodgers’ Robaxin dosage. Eventually, in March 2020, Rodgers met 

with the neurosurgeon. 

The neurosurgeon recommended surgery to replace the 

Harrington rods. Rodgers received care in the prison infirmary until the surgery finally occurred in June 2020, in the 

midst of the COVID-19 pandemic. After the surgery, Rodgers 
No. 23-1220 5

developed an infection while staying in the prison infirmary 

to recover. He underwent another procedure to treat the infection. Dr. Rankin monitored Rodgers’ condition throughout 

this time by ordering monthly labs and other tests. In December 2021, Rodgers had yet another surgery to replace his Harrington rods, this time with a material less prone to infection. 

Believing that his medical care had fallen beneath constitutional standards, Rodgers filed this suit against Dr. Rankin, 

Dr. Yousuf, Dr. Foss, and the prison’s corporate healthcare 

provider, Wexford Health Sources, Inc. Pursuant to 28 U.S.C. 

§ 1915A, the district court screened Rodgers’ complaint. The 

court construed the complaint as alleging Eighth Amendment 

claims against all defendants. With this understanding, the 

court determined that Rodgers stated an Eighth Amendment 

claim against Dr. Rankin and Wexford Health Sources for deliberate indifference to a serious medical need. But the district 

court also concluded that Rodgers did not state an Eighth 

Amendment claim against Dr. Yousuf or Dr. Foss because, 

even taking Rodgers’ allegations as true, he did not allege that 

those doctors’ actions exhibited anything worse than negligent treatment. 

After discovery, Dr. Rankin and Wexford Health Sources 

moved for summary judgment. The district court granted 

their motion, concluding that Rodgers failed to establish a 

genuine dispute of material fact as to whether Dr. Rankin 

acted with deliberate indifference in dealing with him. Without an underlying constitutional violation, the district court 

also ruled that Rodgers’ claim against Wexford failed. 
6 No. 23-1220 

II. Analysis 

Injuries and illnesses are common behind prison walls, 

and because prisoners are unable to obtain their own medical 

treatment, the government bears responsibility for providing 

necessary medical care. If government officials fail to provide 

medical treatment or act with deliberate indifference toward 

a serious medical need, they may be held liable for violating 

the Eighth Amendment. Failure to treat injuries and illnesses 

appropriately can inflict pain and suffering that serve no legitimate penological purpose. Estelle v. Gamble, 429 U.S. 97, 

103 (1976). 

Prison officials do not violate the Constitution every time 

they fail to heal a prisoner’s injury or cure an illness. Id. at 106 

(“Medical malpractice does not become a constitutional violation merely because the victim is a prisoner.”); McGee v. Adams, 721 F.3d 474, 481 (7th Cir. 2013) (“Deliberate indifference 

is not medical malpractice ....”), quoting Duckworth v. Ahmad, 

532 F.3d 675, 679 (7th Cir. 2008). Only when government officials act with “deliberate indifference to serious medical 

needs of prisoners” do they cause “unnecessary and wanton 

infliction of pain” that violates the Eighth Amendment. Estelle, 429 U.S. at 104. Determining whether medical treatment 

in a prison setting violates the Eighth Amendment involves a 

two-step inquiry: first, did the plaintiff have an objectively serious medical condition, and second, did the defendant-official act with deliberate indifference to that condition? Petties 

v. Carter, 836 F.3d 722, 728 (7th Cir. 2016) (en banc). The parties agree that Rodgers’ scoliosis was a sufficiently serious 

medical condition, so we focus on deliberate indifference. 

The deliberate indifference standard ensures that liability 

is imposed only on prison officials who act with a sufficiently 
No. 23-1220 7

culpable state of mind. To satisfy the standard, prisonerplaintiffs must show that a prison official “actually knew of 

and disregarded a substantial risk of harm.” Id. Mere negligence, or even objective recklessness, is not enough. A medical professional’s erroneous treatment decision violates the 

Eighth Amendment only where it represents “such a substantial departure from accepted professional judgment, practice, 

or standards as to demonstrate that the person responsible 

did not base the decision on such a judgment.” Id. at 729, quoting Estate of Cole v. Fromm, 94 F.3d 254, 261–62 (7th Cir. 1996). 

We apply these standards first to the radiologists and then to 

Dr. Rankin. 

A. The Radiologists 

In a screening order, the district court construed the allegations against the radiologists, Dr. Yousuf and Dr. Foss, as 

Eighth Amendment claims and dismissed them. We agree 

with the district court’s order. To state a claim for deliberate 

indifference under the Eighth Amendment, Rodgers needed 

to allege that the radiologists “actually knew of and disregarded a substantial risk of harm.” Petties, 836 F.3d at 728 (emphasis omitted). His complaint failed to do so. He alleged only 

that “[t]he statements in the report are not true to the images 

taken.” He did not allege that the radiologists intentionally 

misrepresented their findings, knowingly committed some 

other form of wrongdoing, or did not care whether their readings were correct or not. Without such allegations, the complaint fails to state an Eighth Amendment claim. 

Also, at no point in the district court proceedings did 

Rodgers indicate that he intended to bring state-law claims 

for medical malpractice. In oral argument on appeal, as well, 

Rodgers disclaimed intending to bring such a claim. So while 
8 No. 23-1220 

we assume the factual allegations in Rodgers’ complaint 

could support claims for medical malpractice or negligence, 

that theory has been waived. 

B. Dr. Rankin 

Rodgers contends next that Dr. Rankin’s chosen course of 

treatment demonstrated deliberate indifference to his back 

pain. According to Rodgers, Dr. Rankin—who had no prior 

experience with Harrington rods—ignored Rodgers’ concern 

that his rods had broken and refused to consult a specialist 

about the matter. Instead, to treat Rodgers’ back pain, Dr. 

Rankin prescribed pain medication and monitored the situation. This course of treatment allegedly delayed correction of 

the broken Harrington rods by more than a year. 

To prove an Eighth Amendment claim for deliberate indifference to a serious medical condition, a prisoner does not 

need to show that a physician or nurse literally ignored his 

condition. Where the prisoner received some care, however, 

it is not easy to prove deliberate indifference. One path, as 

noted, is to show that a medical professional’s treatment decision was “such a substantial departure from accepted professional judgment, practice, or standards as to demonstrate 

that the person responsible did not base the decision on such 

a judgment.” Estate of Cole, 94 F.3d at 261–62. Another path is 

to show that a medical professional refused to consult a 

needed specialist and/or persisted in a course of treatment 

that the professional knew was not effective when reasonable 

alternatives were available. E.g., Pyles v. Fahim, 771 F.3d 403, 

411–12 (7th Cir. 2014); Berry v. Peterman, 604 F.3d 435, 441–42 

(7th Cir. 2010); Greeno v. Daley, 414 F.3d 645, 655 (7th Cir. 

2005). 
No. 23-1220 9

Rodgers essentially points out that his broken Harrington 

rods could have been identified sooner if a different course of 

treatment had been pursued. We assume he could have been 

saved from significant pain if that had happened. But to survive summary judgment on his deliberate indifference claim, 

Rodgers needed to submit evidence creating a dispute as to 

whether Dr. Rankin’s course of treatment followed one of 

these inappropriate paths. Rodgers did not do so. The district 

court properly granted summary judgment. 

1. Failure to Consult a Specialist 

Failure to consult a specialist can demonstrate deliberate 

indifference to a serious medical condition if the doctor’s decision was “blatantly inappropriate.” Pyles, 771 F.3d at 411, 

quoting Roe v. Elyea, 631 F.3d 843, 858 (7th Cir. 2011). The undisputed evidence shows this was not such a case. To the extent that Rodgers disputes portions of the evidentiary record, 

he has not provided evidence that creates a genuine dispute 

of material fact. We take the events chronologically. 

a. December 2016

When Rodgers first met Dr. Rankin in December 2016, he 

reported only generalized back pain. Dr. Rankin examined 

Rodgers and noted some “tenderness along the spine.” He 

did not diagnose broken Harrington rods, and there simply is 

no evidence that he should have done so at that time, let alone 

that any competent physician would have done so. Dr. Rankin prescribed ibuprofen and a muscle relaxer, and he ordered some special accommodations for Rodgers to ease the 

stress on his back. According to the evidence in the record, 

Rodgers did not complain to the medical staff about back pain 

again for more than a year. This factual record does not create 
10 No. 23-1220 

a dispute of material fact as to whether Dr. Rankin’s treatment 

in December 2016 exhibited deliberate indifference. If anything, from Dr. Rankin’s perspective, it would have appeared 

that the treatment was effective given the lack of follow-up by 

Rodgers. 

Rodgers disputes this evidentiary record. He asserts that 

he complained of worsening pain throughout 2017. But the 

only evidence he offers to support this assertion is a prison 

grievance he wrote two years later, in 2019. The statements in 

that grievance were not made under oath and they do not contemporaneously corroborate his version of events. Nobody, 

including Rodgers himself, testified to the veracity of the 

statements in his grievance. Admissible evidence was needed 

to create a genuine dispute of material fact on the point. Fed. 

R. Civ. P. 56(c); Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 252 

(1986). That is lacking here. 

b. May 2018

Dr. Rankin next saw Rodgers about his back in May 2018. 

Rodgers complained of “sharp, throbbing and constant pain” 

at the base of his neck for a few months. Dr. Rankin testified 

that he examined Rodgers and noted that he walked “well”

but had some muscles bulging out more on the right side of 

his back than on his left. Dr. Rankin ordered x-rays for Rodgers. 

The x-ray report came back a few days later. Dr. Naveed 

Yousuf, the radiologist, reported that Rodgers’ hardware “appears to be intact and in satisfactory alignment.” (That finding 

later turned out to be wrong.) This x-ray report presented Dr. 

Rankin with a medical puzzle: Rodgers reported an increase 

in pain, yet there was no identifiable reason for it. Because 
No. 23-1220 11

Rodgers’ pain was not “severe,” Dr. Rankin decided to increase his muscle relaxer dosage and continue to monitor his 

progress.1

A doctor who is stumped by a patient’s serious condition 

cannot just throw up his hands when it is obvious that expert 

attention is needed. Pyles, 771 F.3d at 412. Consider, for example, Berry v. Peterman, 604 F.3d 435 (7th Cir. 2010). We reversed 

summary judgment in favor of a jail physician because the 

physician refused to refer a prisoner to a dentist despite repeated complaints of prolonged and serious tooth pain and 

the proven ineffectiveness of pain medication. Id. at 441–42. 

Rodgers’ situation was quite different. The information 

available to Dr. Rankin at the time indicated that the pain 

medication and other accommodations were working. Rodgers did not report back pain again until December 2018.2

We assume that other doctors might have decided to conduct additional testing or consult sooner with a specialist to 

determine the root cause of Rodgers’ back pain. But Rodgers 

has not presented any evidence that Dr. Rankin’s course of 

treatment departed so substantially from professional standards of care as to support an inference that he was not exercising his professional judgment. Rodgers submitted an 

1 Rodgers contends that he told Dr. Rankin he believed the pain was 

caused by his Harrington rods and that he asked to see a specialist. Again, 

these assertions are supported only by Rodgers’ unsworn 2019 prison 

grievance and fail to establish a genuine dispute of a material fact. We express no opinion on whether admissible evidence of such a request by 

Rodgers would have been material to the outcome here. 

2 In December 2018, Rodgers complained of “nervy” back pain that 

“comes and goes.” Dr. Rankin added a prescription for gabapentin to his 

existing regimen of Ultram, Robaxin, and Tylenol. 
12 No. 23-1220 

expert witness report by Dr. Ryan Herrington, but that report 

failed to dispute the adequacy of Dr. Rankin’s treatment. 

Large sections of the report do nothing more than reiterate 

portions of Dr. Rankin’s deposition. To the extent that the report disagreed with Dr. Rankin’s course of treatment, it 

showed only that one person—Dr. Herrington himself—

would have made different choices. The report does not raise 

a genuine dispute as to whether medical professionals more 

generally would view Dr. Rankin’s course of treatment as ineffective or inappropriate. See Petties, 836 F.3d at 729 (“[E]vidence that some medical professionals would have chosen a 

different course of treatment is insufficient to make out a constitutional claim.”). 

c. September 2019

Nine more months passed before Rodgers complained of 

back pain again. In September 2019, he reported feeling 

“shooting” pain in his back. He said it felt like something was 

digging into his back. In response to the marked increase in 

pain, Dr. Rankin ordered a second round of x-rays. Again, the 

x-ray report—signed this time by Dr. Jonathan Foss—said erroneously that Rodgers’ Harrington rods “appear[ed] intact.”

Generally, in both medicine and law, physicians are entitled to rely upon expert opinions of specialists. Accordingly, 

our case law teaches that a physician can be deemed deliberately indifferent if he or she refuses, at least without good reason, to take instructions from a specialist. See Petties, 836 F.3d 

at 729, citing Arnett v. Webster, 658 F.3d 742, 753 (7th Cir. 2011). 

But here, after reading the second x-ray report, Dr. Rankin decided to review the x-rays himself. Exercising his own judgment to double-check the x-rays turned out to be the right 

course. He discovered that Rodgers’ Harrington rods were 
No. 23-1220 13

fractured. Dr. Rankin told Dr. Foss what he had found, and 

Dr. Foss double-checked and confirmed that the Harrington 

rods were indeed broken. He revised his x-ray report to note 

the broken hardware. Dr. Rankin immediately began to seek 

out specialists to treat the problem.

From this record, no reasonable jury could find that it was 

obvious that Dr. Rankin should have sought specialized advice earlier. Far from it. Dr. Rankin tried to discern the cause 

of Rodgers’ back pain. When those attempts failed, he prescribed pain medication that could at least manage Rodgers’ 

pain. When Rodgers’ pain increased, Dr. Rankin made renewed efforts to figure out why. He twice ordered x-rays that 

should have revealed Rodgers’ broken Harrington rods much 

earlier, and he personally discovered the broken rods after 

two erroneous reports from radiologists.

Rodgers contends that Dr. Rankin did not “monitor” him 

after May 2018. The factual record belies this assertion. In addition to the instances noted above in which Dr. Rankin examined Rodgers after he reported pain, Dr. Rankin saw Rodgers at least two additional times in September 2018 and April 

2019 for unrelated health matters. The evidence does not 

show that Rodgers reported back pain at either appointment.

Further, even if Rodgers’ assertion that Dr. Rankin failed 

to monitor him were true as a factual matter, Rodgers fails to 

explain why it would matter in relation to his deliberate indifference claim. He does not provide evidence that the prevailing standards of care dictated that Dr. Rankin monitor Rodgers more than he did. Again, Rodgers fails to establish a disputed material fact. 
14 No. 23-1220 

2. Delay 

It is well established that delayed treatment of painful conditions can demonstrate deliberate indifference. See Petties, 

836 F.3d at 730 (collecting cases). Arguing along those lines, 

Rodgers contends that Dr. Rankin’s course of treatment 

caused an inexcusable delay in resolving his back pain. We 

have no trouble assuming that Rodgers suffered severe pain 

due to his broken Harrington rods. Hindsight tells us that the 

rods had broken as early as May 2018, yet Rodgers did not 

undergo surgery until June 2020. It is easy to imagine that alternative courses of treatment could have eased his pain 

sooner. 

But liability under Section 1983 for an individual defendant is determined based on individual responsibility. Rodgers 

has not presented evidence showing that Dr. Rankin himself 

caused the delay through deliberate indifference to Rodgers’ 

condition. Other factors—especially Dr. Yousuf’s error in 

reading the May 2018 x-rays and later effects of COVID on 

healthcare in prisons—delayed the surgery Rodgers ultimately needed. Because Rodgers does not present evidence 

demonstrating that Dr. Rankin’s course of treatment 

amounted to deliberate indifference, we affirm summary 

judgment on this ground. 

3. Retaliation 

Finally, Rodgers argues that Dr. Rankin threatened to reduce his pain medication in retaliation for submitting medical 

complaints. To support this assertion, however, Rodgers 

again relies on only the statements in his unsworn 2019 prison 

grievance. The grievance fails to create a dispute of material 

fact for the reasons discussed above. All the other admissible 
No. 23-1220 15

evidence in the record controverts this claim. Every time 

Rodgers complained of an increase in pain, Dr. Rankin tried 

altering his pain medication to alleviate the symptoms. 

Simply put, Rodgers has not presented evidence creating a 

genuine dispute as to whether Dr. Rankin threatened to reduce his pain medication. 

The judgment of the district court is AFFIRMED.