RECOMMENDED FOR FULL-TEXT PUBLICATION 

Pursuant to Sixth Circuit I.O.P. 32.1(b) 

File Name: 17a0059p.06 

UNITED STATES COURT OF APPEALS

FOR THE SIXTH CIRCUIT 

TODD MATTOX, 

Plaintiff-Appellant, 

v. 

ADAM EDELMAN, M.D.; CORIZON HEALTH, INC., 

Defendants, 

ADRIANNE NEFF, P.A.; HARESH PANDYA, M.D.;

KENNETH JORDAN, M.D.; WILLIAM BORGERDING,

D.O., 

Defendants-Appellees. 

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No. 16-1412 

Appeal from the United States District Court 

for the Eastern District of Michigan at Detroit. 

No. 2:12-cv-13762—Laurie J. Michelson, District Judge. 

Argued: January 25, 2017 

Decided and Filed: March 15, 2017 

 Before: MERRITT, CLAY, and DONALD, Circuit Judges. 

_________________ 

COUNSEL 

ARGUED: Susan M. Razzano, EIMER STAHL LLP, Chicago, Illinois, for Appellant. Carly 

Van Thomme, CHAPMAN LAW GROUP, Troy, Michigan, for Appellee Neff. Allan J. Soros, 

OFFICE OF THE MICHIGAN ATTORNEY GENERAL, Lansing, Michigan, for Appellees 

Pandya and Borgerding. ON BRIEF: Susan M. Razzano, EIMER STAHL LLP, Chicago, 

Illinois, David M. Shapiro, SOLANGE MACARTHUR JUSTICE CENTER, Chicago, Illinois, 

for Appellant. Carly Van Thomme, Ronald W. Chapman, Kevin A. McQuillan, CHAPMAN 

LAW GROUP, Troy, Michigan, for Appellee Neff. Kevin Himebaugh, OFFICE OF THE 

MICHIGAN ATTORNEY GENERAL, Lansing, Michigan, for Appellees Pandya and 

Borgerding. 

>
No. 16-1412 Mattox v. Edelman, et al. Page 2

_________________ 

OPINION 

_________________ 

CLAY, Circuit Judge. Plaintiff Todd Mattox, a Michigan prisoner, appeals from the 

orders entered by the district court granting various dispositive motions filed against Mattox’s 

Eighth Amendment deliberate indifference claims against three doctors and a physician’s 

assistant who allegedly provided him deficient care for his heart condition. On appeal, Mattox 

argues that the district court erred in: (i) granting summary judgment on his claims against 

Defendants Haresh Pandya and William Borgerding for failure to exhaust administrative 

remedies; (ii) sua sponte dismissing his claims against Defendant Kenneth Jordan for failure to 

exhaust administrative remedies; and (iii) granting Defendant Adrianne Neff’s motion to dismiss 

for failure to state a claim. We have subject matter jurisdiction over this appeal pursuant to 

28 U.S.C. § 1291. For the reasons set forth below, we AFFIRM IN PART and REVERSE IN 

PART the district court’s judgment, and REMAND for further proceedings. 

BACKGROUND

I. Factual History 

 Mattox is currently an inmate at the Lakeland Correctional Facility in Coldwater, 

Michigan. During most of the events relevant to this lawsuit, Mattox was an inmate at the G. 

Robert Cotton Correctional Facility in Jackson, Michigan. 

 On July 25, 2011, Mattox complained to prison medical officials that he was 

experiencing pain and tightness in his chest, neck, shoulders, and arms, as well as shortness of 

breath, fatigue, and dizziness. The nurse on duty performed an electrocardiogram (“EKG”) test, 

which indicated a sinus rhythm with left axis deviation. After this test, Mattox was taken to the 

emergency room, where he was seen by an outside cardiologist. On July 26, 2011, the outside 

cardiologist performed an echo stress test on Mattox’s heart, which suggested a possible 

ischemia in the heart’s basal inferior wall.1 The cardiologist recommended that Mattox undergo 

 1

In layman’s terms, the test suggested that part of Mattox’s heart was not receiving sufficient blood or 

oxygen. 
No. 16-1412 Mattox v. Edelman, et al. Page 3

a cardiac catheterization procedure to rule out coronary artery disease, and determine whether he 

needed a stent or surgery in order to prevent a future heart attack. 

 Mattox’s request for a cardiac catheterization procedure was referred to Defendant Adam 

Edelman, an employee of Defendant Corizon Health, Inc., for approval.2 Corizon is a health 

care contractor for the Michigan Department of Corrections, and employed all of the doctors and 

physician’s assistants Mattox has sued in this lawsuit. Dr. Edelman reviewed Mattox’s EKG 

results, and was not convinced that a cardiac catheterization was necessary; accordingly, he 

denied approval for the procedure. 

 Mattox was thereafter briefly hospitalized at the Duane L. Waters Hospital, a prison 

hospital associated with the Michigan Department of Corrections, and was released back to the 

Cotton Facility on August 2, 2011, with instructions to seek immediate evaluation if his chest 

pains recurred. On August 3, 2011, Mattox filed an administrative grievance with the prison 

numbered JCF-2011-08-1632-1202 (“JCF-1632” or “first grievance”), naming Dr. Edelman, and 

requesting the cardiac catheterization test that the outside cardiologists had recommended. After 

the grievance was denied, Mattox fully exhausted his appeals pursuant to Michigan Department 

of Corrections policy, but did not obtain any relief. 

At about 11:00 p.m. on August 14, 2011, Mattox experienced the same symptoms he had 

complained of on July 25, 2011. He immediately reported to the prison’s infirmary, notified the 

nurse on duty of his symptoms, and told her that the nitroglycerine tablets he had been given 

during his last hospitalization were not working. The nurse performed an EKG on Mattox, and 

then called an off-site physician’s assistant, Defendant Adrianne Neff, and left P.A. Neff a 

voicemail message describing the EKG results, Mattox’s recent hospital stay, and the records of 

the stress test Mattox received on July 26, 2011. P.A. Neff returned the nurse’s call, and ordered 

that Mattox be sent back to his housing unit rather than to the emergency room. 

 The next morning, Mattox’s chest pains continued, and he reported to the prison’s 

attending physician, Dr. Karen Rhodes. Dr. Rhodes did not prescribe Mattox any new 

 2

Mattox has abandoned his claims against Dr. Edelman and Corizon on appeal, and so we do not discuss 

them. 
No. 16-1412 Mattox v. Edelman, et al. Page 4

medication, but instead sent him to the emergency room, where outside doctors once again 

recommended that Mattox undergo a cardiac catheterization test. After Mattox returned to the 

prison, Dr. Rhodes prescribed a medication called Imdur, but later took Mattox off of that 

medication because it caused Mattox intolerable dizziness. Dr. Rhodes once again asked 

Dr. Edelman for authorization to perform a cardiac catheterization test, but Dr. Edelman denied 

the request. 

 On August 18, 2011, Mattox filed another grievance numbered JCF-2011-08-1747-12DI 

(“JCF-1747” or “second grievance”), complaining that P.A. Neff did not send him to the hospital 

as requested on the evening of August 14, 2011. Mattox was denied relief at all steps of this 

grievance, and his appeals were finally exhausted on December 8, 2011. 

 On September 18, 2011, Mattox filed a third grievance numbered JCF-2011-09-1974-

12D1 (“JCF-1974” or “third grievance”), complaining that his medication was ineffective at 

controlling his cardiac symptoms. This grievance was also denied at every administrative step, 

and was finally exhausted on December 28, 2011. 

 In October 2011, Mattox’s chest pains once again returned, and once again he was sent to 

the emergency room. While there, an outside cardiologist recommended that Mattox be started 

on a heart drug called Ranexa. However, Ranexa was not on the prison’s formulary, and so 

Dr. Rhodes was required to seek the approval of Defendant Haresh Pandya before Ranexa could 

be given to Mattox. On October 12, 2011, Dr. Pandya denied permission to give Mattox Ranexa, 

and instead ordered Mattox to remain on medication that had previously made him dizzy. 

 Mattox’s chest pains continued intermittently over the next two and a half years, 

requiring multiple hospitalizations. Of note during this period, on April 23, 2012, Mattox finally 

received the cardiac catheterization test he had been seeking, which ruled out heart disease, and 

suggested that his symptoms be treated with medication. After a hospitalization for chest pain in 

March 2013, Mattox’s outside doctors once again recommended that he be prescribed Ranexa, 

rather than the Imdur and other medications prison officials had been giving him, because those 

medications had proven ineffective at controlling his pain. Mattox requested Ranexa from 
No. 16-1412 Mattox v. Edelman, et al. Page 5

Defendant Kenneth Jordan in early 2013, but was denied; Dr. Jordan gave Mattox another 

prescription for Imdur instead. 

 On April 4, 2013, Mattox filed a fourth grievance numbered LCF 2013-04-0355-12D1 

(“LCF-0355” or “fourth grievance”), alleging that the medications prison officials were giving 

him were ineffective at controlling his pain, and requesting the Ranexa several outside doctors 

had prescribed him. This grievance, like the others, was denied at every step and was finally 

exhausted on June 24, 2014. 

 After yet another hospitalization in mid-June 2013, Mattox was finally given a six-month 

prescription for Ranexa by Dr. Pandya. Mattox did not experience any cardiac symptoms during 

those six months. In January 2014, after the Ranexa prescription ran out, Mattox’s chest pains 

returned. Mattox sought a renewal of his Ranexa prescription, but was informed by a 

physician’s assistant that Defendant William Borgerding had denied approval because Corizon 

felt that Ranexa was too expensive. Dr. Borgerding persisted in his refusal to provide Mattox 

with Ranexa even after Mattox was hospitalized again while on Imdur. 

 On February 4, 2014, Mattox filed a fifth grievance numbered LCF 2014-02-0159-12F3 

(“LCF-0159” or “fifth grievance”), again complaining about his Ranexa denials. This grievance 

was denied at every step and fully exhausted on June 24, 2014. 

II. Procedural History 

On August 24, 2012, after exhausting his first three grievances, Mattox filed a pro se 

complaint in the Eastern District of Michigan against Dr. Edelman and P.A. Neff alleging 

deliberate indifference to his serious medical needs in violation of 42 U.S.C. § 1983 and the 

Eighth Amendment. As to P.A. Neff, Mattox alleged that she was deliberately indifferent by not 

sending to him to the emergency room on August 14, 2011, when he presented to the prison 

infirmary with chest pains. On July 30, 2013, the district court adopted a magistrate judge’s 

Report and Recommendation and granted P.A. Neff’s motion to dismiss, concluding that Mattox 

had not pled that he suffered from an objectively serious medical need on August 14, 2011. 

Mattox v. Edelman, No. 12–13762, 2013 WL 3936424, at *3–4 (E.D. Mich. July 30, 2013). 
No. 16-1412 Mattox v. Edelman, et al. Page 6

 Subsequently, Mattox sought leave to amend his complaint to add claims against 

additional defendants. The district court granted this motion as to Dr. Pandya, and the magistrate 

judge later granted Mattox leave to add Dr. Jordan, Dr. Borgerding, and Corizon as defendants. 

 Mattox’s amended complaint asserted deliberate indifference claims against Dr. Pandya, 

Dr. Jordan, and Dr. Borgerding, and a Monell claim against Corizon, related to these defendants’ 

various denials of his request for Ranexa, and Corizon’s allegedly unconstitutional practice of 

denying necessary medical care for purely budgetary reasons. Dr. Pandya and Dr. Borgerding 

moved for summary judgment, arguing inter alia that Mattox had failed to exhaust his 

administrative remedies against them. 

 On January 12, 2016, the magistrate judge granted the dispositive motions filed by 

Defendants, and also recommended dismissing Mattox’s claims against Dr. Jordan sua sponte.

3

 

Mattox v. Edelman, No. 12-13762, 2016 WL 398242, at *1 (E.D. Mich. Jan. 12, 2016) (“Mattox 

II”). The magistrate judge reasoned that none of Mattox’s first three grievances properly 

exhausted claims as to Dr. Pandya, Dr. Borgerding, or Dr. Jordan because those grievances, 

which generally sought cardiac catheterization, had not given Defendants a fair chance to address 

Mattox’s Ranexa claims on the merits. Id. The magistrate judge then determined that Sixth 

Circuit precedent rendered Mattox’s fourth and fifth grievances ineffective, because they were 

not exhausted prior to the filing of Mattox’s original complaint. Id. at *2. 

 Mattox appealed the magistrate judge’s conclusion to the district court. On March 14, 

2016, the district court adopted the magistrate judge’s Report and Recommendation, largely 

echoing the magistrate judge’s legal reasoning. Mattox v. Pandya, No. 2:12-cv-13762, 2016 WL 

945340, at *1 (E.D. Mich. Mar. 14, 2016) (“Mattox III”). That same day, the district court 

entered judgment dismissing all of Mattox’s claims. Mattox filed a timely notice of appeal. 

 3

Mattox is proceeding in forma pauperis. 28 U.S.C. § 1915(e)(2)(B)(ii) requires a district court to dismiss 

an IFP complaint if at any point it determines that the complaint “fails to state a claim on which relief may be 

granted.” The magistrate judge invoked this authority in sua sponte dismissing Mattox’s claims against Dr. Jordan, 

despite the fact that Dr. Jordan has not been served and has not answered. See Carbe v. Lappin, 492 F.3d 325, 328 

(5th Cir. 2007) (“[A] court can dismiss a case prior to service on defendants for failure to state a claim, predicated 

on failure to exhaust, if the complaint itself makes clear that the prisoner failed to exhaust.”). 
No. 16-1412 Mattox v. Edelman, et al. Page 7

DISCUSSION 

Mattox argues that he properly exhausted his claims as to Dr. Pandya, Dr. Jordan, and 

Dr. Borgerding, and also challenges the district court’s dismissal of his deliberate indifference 

claim against P.A. Neff. We address each of these issues in turn. 

I. Claims Against Dr. Pandya, Dr. Jordan, and Dr. Borgerding 

 A. Standard of Review 

We review de novo the district court’s “[d]ismissal of a prisoner’s civil rights claim for 

failure to exhaust administrative remedies.” See, e.g., Risher v. Lappin, 639 F.3d 236, 239 (6th 

Cir. 2011); Boyd v. Corr. Corp. of Am., 380 F.3d 989, 993 (6th Cir. 2004). Mattox’s claims 

against Dr. Pandya and Dr. Borgerding were dismissed at the summary judgment stage. 

“Summary judgment is appropriate only if defendants establish the absence of a ‘genuine dispute 

as to any material fact’ regarding non-exhaustion.” Risher, 639 F.3d at 240 (quoting Fed. R. Civ. 

P. 56(a)). “When ruling on a motion for summary judgment, a court must consider the evidence 

‘in the light most favorable to the party opposing the motion.’” Id. (quoting Matsushita Elec. 

Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587–88 (1986)). Mattox’s claim against 

Dr. Jordan was dismissed on the face of the complaint. We review de novo the district court’s 

dismissal at the pleading stage for failure to exhaust administrative remedies. See, e.g. Fry v. 

Napoleon Cmty. Sch., 788 F.3d 622, 624 (6th Cir. 2015); Hall v. Knott Cty. Bd. of Educ., 

941 F.2d 402, 406 (6th Cir. 1991). “A complaint is subject to dismissal for failure to state a 

claim if the allegations, taken as true, show the plaintiff is not entitled to relief. If the 

allegations, for example, show that relief is barred by [an affirmative defense], the complaint is 

subject to dismissal for failure to state a claim.” Jones v. Bock, 549 U.S. 199, 215 (2007). 

 B. Applicable Legal Principles 

The Prison Litigation Reform Act requires state prisoners to follow and exhaust all 

applicable state grievance procedures before filing suit in a federal court.4

 See 42 U.S.C. 

 4

Specifically, the PLRA’s exhaustion provision provides that “No action shall be brought with respect to 

prison conditions under section 1983 of this title, or any other Federal law, by a prisoner confined in any jail, prison, 
No. 16-1412 Mattox v. Edelman, et al. Page 8

§ 1997e(a); Woodford v. Ngo, 548 U.S. 81, 90 (2006). This requirement is not jurisdictional; 

rather, exhaustion is an affirmative defense that must be pleaded and proved by the defendants. 

Jones, 549 U.S. at 212. When the defendants in prisoner civil rights litigation move for 

summary judgment on administrative exhaustion grounds, they must prove that no reasonable 

jury could find that the plaintiff exhausted his administrative remedies. Surles v. Andison, 

678 F.3d 452, 455–56 (6th Cir. 2012). 

 There is no uniform federal exhaustion standard. A prisoner exhausts his remedies when 

he complies with the grievance procedures put forward by his correctional institution. Jones, 

549 U.S. at 217–19. “This court requires an inmate to make ‘affirmative efforts to comply with 

the administrative procedures,’ and analyzes whether those ‘efforts to exhaust were sufficient 

under the circumstances.’” Risher, 639 F.3d at 240 (quoting Napier v. Laurel Cty., 636 F.3d 

218, 224 (6th Cir. 2011)). 

 The relevant grievance procedures for Michigan inmates are set forth in Michigan 

Department of Corrections Policy Directive 03.02.130 (effective July 9, 2007), available at

http://www.michigan.gov/documents/corrections/03_02_130_200872_7.pdf (“MDOCPD 130”). 

MDOCPD 130 creates a three-step grievance procedure Michigan prisoners must follow in order 

to exhaust their administrative remedies. Relevant here, MDOCPD 130 requires prisoners to 

provide the following information at Step I of the grievance procedure: 

The issues [underlying the grievance] should be stated briefly but concisely. 

Information provided is to be limited to the facts involving the issue being grieved 

(i.e., who, what, when, where, why, how). Dates, times, places, and names of all 

those involved in the issue being grieved are to be included. 

MDOCPD 130 ¶ R (underlining in original, italics added). 

 We have explained that a prisoner ordinarily does not comply with MDOCPD 130—and 

therefore does not exhaust his administrative remedies under the PLRA—when he does not 

specify the names of each person from whom he seeks relief. See Reed-Bey v. Pramstaller, 

603 F.3d 322, 324–25 (6th Cir. 2010) (“Requiring inmates to exhaust prison remedies in the 

 or other correctional facility until such administrative remedies as are available are exhausted.” 42 U.S.C. 

§ 1997e(a). 
No. 16-1412 Mattox v. Edelman, et al. Page 9

manner the State provides—by, say, identifying all relevant defendants—not only furthers [the 

PLRA’s] objectives, but it also prevents inmates from undermining these goals by intentionally 

defaulting their claims at each step of the grievance process, prompting unnecessary and wasteful 

federal litigation in the process.”). An exception to this rule is that prison officials waive any 

procedural irregularities in a grievance when they nonetheless address the grievance on the 

merits. See id. at 325. We have also explained that the purpose of the PLRA’s exhaustion 

requirement “is to allow prison officials ‘a fair opportunity’ to address grievances on the merits, 

to correct prison errors that can and should be corrected and to create an administrative record 

for those disputes that eventually end up in court.” Id. at 324. 

C. Interaction Between the PLRA and Rule 15 

 Mattox argues that his fourth and fifth grievances properly exhausted his Ranexa-based 

claims against the three doctor defendants. The magistrate judge and district court disagreed, 

concluding that grievances exhausted after the commencement of a lawsuit can never satisfy the 

PLRA’s exhaustion requirement.5 Mattox challenges this conclusion by arguing that: (i) nothing 

in the PLRA purports to disrupt the normal operation of Federal Rule of Civil Procedure 15(d), 

which allows plaintiffs to file a supplemental complaint alleging claims based on events that 

occurred after the lawsuit was filed; and (ii) permitting plaintiffs to amend their complaints to 

allege newly exhausted claims is consistent with the purpose of the PLRA’s exhaustion 

requirement. After a careful review of the relevant law, we agree with Mattox. 

 5

The district court also concluded that Mattox waived his right to argue that he was permitted to add newly 

exhausted claims through Rule 15(d) because he did not challenge “the Magistrate Judge’s view of the law” in his 

objections to the magistrate judge’s Report and Recommendation. Mattox III, 2016 WL 945340, at *6. 

We disagree. In his objections, Mattox argued that when he “first moved to amend his original complaint, it was 

only to include discovered defendants whose actions covered plaintiff’s original claim of deliberate indifferences 

resulting from defendants [sic] refusal to provide adequate medical treatment. Thus, contrary to the magistrate 

Judge’s conclusion, there was never an issue of failure to exhaust administrative remedies at issue in this case, 

because exhaustion was completed on each named defendant.” (R. 150, Mattox Objections, at 5–6.) This was 

sufficient to preserve this issue, particularly in light of the liberal standards that apply to filings by pro se litigants. 

See, e.g., Boswell v. Mayer, 169 F.3d 384, 387 (6th Cir. 1999) (“Pro se plaintiffs enjoy the benefit of a liberal 

construction of their pleadings and filings.”). Moreover, we are confident that the district court understood the 

import of Mattox’s argument because the magistrate judge acknowledged that several cases had determined that 

claims exhausted post-filing can be validly added via Rule 15(d), and we presume that the district court read the 

Report and Recommendation it adopted. Mattox II, 2016 WL 398242, at *3 (collecting cases). 
No. 16-1412 Mattox v. Edelman, et al. Page 10

 Federal Rule of Civil Procedure 15(d) provides that: 

On motion and reasonable notice, the court may, on just terms, permit a party to 

serve a supplemental pleading setting out any transaction, occurrence, or event 

that happened after the date of the pleading to be supplemented. The court may 

permit supplementation even though the original pleading is defective in stating a 

claim or defense. The court may order that the opposing party plead to the 

supplemental pleading within a specified time. 

Fed. R. Civ. P. 15(d). Rule 15 sets a liberal policy in favor of permitting parties to amend their 

pleadings, and courts have interpreted the rule to allow parties to add new claims, defenses, and 

parties to the lawsuit. See Charles A. Wright & Arthur R. Miller, et al., Federal Practice and 

Procedure § 1504 (3d ed. 2016) (collecting cases). 

 Our sister circuits have unanimously concluded that Rule 15 permits a prisoner to amend 

his complaint to add new claims that have only been exhausted after the commencement of the 

lawsuit. See Cano v. Taylor, 739 F.3d 1214, 1221 (9th Cir. 2014) (vacating district court’s 

dismissal of prisoner’s claims “because it was based on the determination that Cano had not 

exhausted his administrative remedies prior to the filing of his initial complaint, rather than his 

amended complaint.”); Rhodes v. Robinson, 621 F.3d 1002, 1005 (9th Cir. 2010) (“Defendants’ 

argument that the PLRA requires the newly-added claims in the SAC to have been exhausted 

before the original complaint was ‘brought’ on January 4, 2002, fails because it ignores the 

general rule of pleading that the SAC completely supercedes any earlier complaint, rendering the 

original complaint non-existent and, thus, its filing date irrelevant.”); Cannon v. Washington, 

418 F.3d 714, 719 (7th Cir. 2005) (per curiam); Boone v. Nose, 530 F. App’x 112, 113 n.1 (3d 

Cir. 2013) (“Under the Prison Litigation Reform Act, prisoners may file supplemental 

complaints if the claims in question 1) have truly accrued since the beginning of the suit and 

2) are exhausted per 42 U.S.C. § 1997e(a) before the supplement is filed.”). 

 We find the reasoning of these cases compelling. As we have noted, the PLRA’s 

exhaustion requirement is designed to give prison officials a fair opportunity to address a 

prisoner’s claims on the merits before federal litigation is commenced. Reed-Bey, 603 F.3d at 

324. If a prisoner exhausts some of his claims after a proper federal lawsuit has been filed as to 

other claims, and then moves to amend his complaint to add the newly exhausted claims, the 
No. 16-1412 Mattox v. Edelman, et al. Page 11

policy behind the PLRA’s exhaustion requirement is still met because prison officials will have 

had a fair opportunity to address the new claims on the merits. As the Seventh Circuit has 

persuasively explained: 

The district court dismissed the [plaintiff’s] claims . . . because [the plaintiff] 

failed to exhaust his administrative remedies on those claims before filing his 

original complaint. The court correctly noted that a prisoner may not file a 

lawsuit before exhausting his administrative remedies, even if he exhausts those 

remedies while the litigation is pending. See [Perez v. Wisc. Dep’t of Corrs., 

182 F.3d 532, 535 (7th Cir. 1999)]. As we have previously observed, this 

exhaustion requirement is designed to alert prison officials to perceived problems 

and to enable them to take corrective action without first incurring the hassle and 

expense of litigation. See [Riccardo v. Rausch, 375 F.3d 521, 524 (7th Cir. 

2004)]; Ford v. Johnson, 362 F.3d 395, 398 (7th Cir. 2004); McCoy v. Gilbert,

270 F.3d 503, 510 (7th Cir. 2002). Permitting a prisoner to sue first and then ask 

the prison to address issues that are now the subject of pending litigation defeats 

the purpose of the PLRA’s exhaustion requirement. 

But [the plaintiff’s] 1998 grievance concerning the alleged attack at [the prison] 

gave prison officials precisely the type of opportunity to address his complaints 

that the PLRA contemplates. The sole objective of § 1997e(a) is to permit the 

prison's administrative process to run its course before litigation begins. See 

Ford, 362 F.3d at 399. [The plaintiff’s] November 1998 grievance apprised 

prison officials of the alleged attack at [the prison], and he did not hale those 

defendants into court until he had pursued all of the administrative remedies 

available to him. That he raised these claims by amending his complaint in an 

already pending case rather than initiating an entirely new proceeding is 

irrelevant to the objectives of § 1997e(a). 

Cannon, 418 F.3d at 719 (emphasis added). Moreover, we note the Supreme Court has 

admonished that “courts should generally not depart from the usual practice under the Federal 

Rules on the basis of perceived policy concerns” when interpreting the PLRA, further lending 

support to the idea that the ordinary operation of Rule 15(d) should be allowed in his case. See 

Jones, 549 U.S. at 212. 

 In reaching the contrary conclusion, the court below determined that it was bound by our 

decision in Cox v. Mayer, 332 F.3d 422, 428 (6th Cir. 2003). There, we held that the PLRA’s 

exhaustion requirement applies to persons who are incarcerated when the federal lawsuit is filed, 

but have been released from custody when the exhaustion issue is litigated. Id. at 424. The 

plaintiff in Cox had not exhausted his administrative remedies as to any claim before filing suit. 
No. 16-1412 Mattox v. Edelman, et al. Page 12

Id. The plaintiff argued that this defect could nevertheless be “cured” through application of 

Rule 15(d). Id. at 428. We held that the plaintiff waived any application of Rule 15(d) by failing 

to file a motion to supplement his pleadings before the district court. Id. However, in dicta, we 

briefly stated that: 

But, even assuming that plaintiff had made such a motion, the outcome would be 

no different. This is because a procedural rule “cannot overrule a substantive 

requirement or restriction contained in a statute (especially a subsequently enacted 

one).” Harris v. Garner, 216 F.3d 970 (11th Cir. 2000) (en banc) (decliningunder similar circumstances-to apply Rule 15(d) to excuse plaintiff's failure to 

comply with an analogous provision of the PLRA, § 1997e(e)). 

Id. 

 The Cox panel’s dicta do not bind us. See, e.g., BDT Prods., Inc. v. Lexmark Int’l, Inc., 

602 F.3d 742, 750 (6th Cir. 2010) (“[O]ne panel of [the Sixth Circuit] is not bound by dicta in a 

previously published panel opinion.” (quoting United States v. Burroughs, 5 F.3d 192, 194 (6th 

Cir. 1993))). But in any event, as Mattox correctly argues, Cox is distinguishable. The plaintiff 

in Cox had not exhausted any of his claims before filing suit in federal court. Cox, 332 F.3d at 

424. The Cox panel was thus likely correct that Rule 15(d) could not save an action that did not 

comply with the PLRA’s exhaustion requirement in any way. See Floyd v. U.S. Postal Serv., 

105 F.3d 274, 278 (6th Cir. 1997), (holding that subsequently enacted federal statutes trump the 

Rules of Civil Procedure), abrogated on other grounds by Callihan v. Schneider, 178 F.3d 800, 

803–04 (6th Cir. 1999). Here, by contrast, Mattox filed his original complaint after properly 

exhausting his claims as to Dr. Edelman and P.A. Neff. Therefore, because Mattox had 

exhausted his remedies before his “action” was “brought,” Cox is inapposite. 42 U.S.C. 

§ 1997e(a). 

 The parties also dispute the applicability of our decisions in Harbin-Bey v. Rutter, 

420 F.3d 571, 580 (6th Cir. 2005), and Utley v. Campbell, 84 F. App’x 627, 629 (6th Cir. 2003). 

In Harbin-Bey, we held that the district court did not abuse its discretion in declining to permit 

the plaintiff prisoner to supplement his complaint and add a new claim against the defendant. 

420 F.3d at 580. The Harbin-Bey panel’s sparse reasoning was as follows: 
No. 16-1412 Mattox v. Edelman, et al. Page 13

Although Harbin–Bey filed a new administrative grievance against Rutter, he did 

so only after commencing this lawsuit. This court has held that a prisoner “may 

not exhaust administrative remedies during the pendency of the federal suit.” 

Freeman v. Francis, 196 F.3d 641, 645 (6th Cir.1999) (dismissing an Ohio 

prisoner’s suit because he filed his federal complaint before completing the 

administrative process). We therefore conclude that the district court did not 

abuse its discretion in refusing to allow Harbin–Bey to supplement his complaint. 

Id. As Mattox correctly argues, although Harbin-Bey is related to this case, it does not control 

the outcome here. The issue of whether a prisoner can amend a complaint to assert claims that 

were only exhausted after the commencement of the lawsuit was not squarely before the HarbinBey panel. Rather, the district court denied leave to supplement the complaint “because HarbinBey failed to exhaust his administrative remedies through the prison’s grievance procedures with 

regard to [the defendant’s] most recent alleged misconduct.” Id. Accordingly, Harbin-Bey is 

distinguishable because the district court there did not allow the prisoner to file a supplemental 

complaint, and because the prisoner had not fully exhausted the new claims he was trying to add 

before filing his Rule 15 motion. Here, by contrast, the magistrate judge did allow Mattox to file 

an amended complaint, and Mattox’s fourth and fifth grievances were fully exhausted before the 

amended complaint was filed. 

Freeman v. Francis, the case cited by the Harbin-Bey panel, does not command a 

contrary result. In Freeman, as in Cox, the plaintiff had not properly exhausted any claims 

before filing the original complaint. 196 F.3d at 642. Freeman thus does not speak to the issue 

of whether an inmate can add newly exhausted claims to a lawsuit originally based on separate, 

fully exhausted claims. 

 In Utley, a panel of this Court held that the district court did not abuse its discretion in 

denying the plaintiff’s “second and third motions to amend and supplement the complaint.” 

84 F. App’x at 629. In passing, the Utley panel stated that the “district court properly noted that 

Utley had not exhausted his administrative grievances of the claims he sought to add until after 

this case was filed, and therefore they could not be appended to this litigation.” Id. Although 

this language in Utley is on point, Utley was an unsigned, unpublished order with no reasoning 

beyond a citation to Freeman, which did not address the issue before us in this case. We do not 
No. 16-1412 Mattox v. Edelman, et al. Page 14

find Utley persuasive in light of the better-reasoned authority we have cited from the Seventh 

and Ninth Circuits. Accordingly, we disapprove Utley to the extent it conflicts with this opinion. 

 Finally, Dr. Pandya and Dr. Borgerding argue that the Seventh and Ninth Circuit cases 

holding that Rule 15 can be used to add new claims that were exhausted after the lawsuit was 

filed were wrongly decided because they conflict with the plain language of § 1997e(a). 

Specifically, these defendants argue that when § 1997(e)(a) says that “[n]o action shall be 

brought” alleging improper prison conditions until after the plaintiff has exhausted prison 

remedies, it means that no lawsuit may be brought until administrative remedies for every claim 

asserted in the suit have been exhausted, and therefore, new claims that were exhausted postfiling cannot be added to the suit. Defendants concede that § 1997e(a) would allow a plaintiff to 

amend a valid lawsuit to assert newly exhausted claims if the word “action” in “no action shall 

be brought” meant “claim.” 

 However, as Mattox correctly points out, the Supreme Court has already rejected the 

argument that the word “action” in § 1997e(a) means something different than “claim.” Jones, 

549 U.S. at 220. In Jones, the Court considered whether § 1997e(a) requires courts to dismiss an 

entire lawsuit if any of the claims in the suit are unexhausted. Id. Similar to Defendants here, 

the respondents in Jones argued “that if Congress intended courts to dismiss only unexhausted 

claims while retaining the balance of the lawsuit, the word ‘claim’ rather than ‘action’ would 

have been used in [§ 1997e(a)].” Id. In rejecting this argument, the Court explained that the 

“statutory phrasing—‘no action shall be brought’—is boilerplate language,” and “generally, 

statutory references to an ‘action’ have not typically been read to mean that every claim included 

in the action must meet the pertinent requirement before the ‘action’ may proceed.” Id. at 220–

21. Accordingly, because the word “action” in § 1997e(a) is synonymous with the word “claim,” 

Defendants have effectively conceded that Mattox did not run afoul of the PLRA’s exhaustion 

requirement by amending his complaint to add newly exhausted claims to this lawsuit. 

 In sum, we hold that the PLRA and Federal Rule of Civil Procedure 15 permit a plaintiff 

to amend his complaint to add claims that were exhausted after the commencement of the 

lawsuit, provided that the plaintiff’s original complaint contained at least one fully exhausted 
No. 16-1412 Mattox v. Edelman, et al. Page 15

claim.6 Because Mattox’s original complaint contained fully exhausted claims, we will now 

assess whether Mattox’s various grievances properly exhausted his claims as to Dr. Pandya, 

Dr. Jordan, and Dr. Borgerding. 

 D. Exhaustion 

 1. Dr. Pandya 

 Mattox argues that he exhausted his claims against Dr. Pandya in two ways: (i) by 

complaining that he was receiving inadequate medication in his first three grievances; and (ii) by 

protesting his denial of Ranexa in his fourth and fifth grievances. We hold that Mattox’s first 

three grievances were insufficient to exhaust claims against Dr. Pandya, but that a jury could find 

that Mattox’s fifth grievance properly exhausted his claims. 

 None of Mattox’s first three grievances can be fairly read to request relief from any 

action or lack of action attributable to Dr. Pandya. Mattox’s claims against Dr. Pandya fault him 

for failing to give Mattox the heart drug Ranexa, despite allegedly knowing that Ranexa was 

more effective than the other drugs Mattox was given. However, as the magistrate judge aptly 

noted, “Ranexa was not even recommended by any physician until October 7, 2011, after the 

above grievances were filed.” Mattox II, 2016 WL 398242, at *1. None of Mattox’s original 

three grievances mentioned Ranexa, or requested anything other than a heart catheterization to 

determine whether sufficient blood flow was going to Mattox’s heart. We hold that no 

reasonable jury could find that Mattox’s first three grievances exhausted claims that Dr. Pandya 

failed to give him a heart drug that was not even at issue until after the grievances were filed, and 

that Mattox did not yet request. 

 Mattox argues that his JCF-1747 and JCF-1974 grievances each alleged that the 

nitroglycerine tablets he was being prescribed were ineffective at treating his symptoms, and 

therefore prison officials were on notice that Mattox was seeking different medication than the 

drugs that Dr. Pandya was approving. He alleges that this notice is sufficient for him to have 

 6

We have addressed the interaction between the PLRA’s exhaustion requirement and Rule 15(d) because 

the magistrate judge construed Mattox’s motion for leave to amend as a motion pursuant to Rule 15(d). We note, 

however, that the result would have been the same if Mattox had moved to amend his complaint pursuant to Rule 

15(a). See Cannon, 418 F.3d at 720. 
No. 16-1412 Mattox v. Edelman, et al. Page 16

exhausted administrative remedies against Dr. Pandya on his claims that Dr. Pandya violated the 

Eighth Amendment by failing to prescribe him Ranexa. As the district court correctly 

determined, however, Mattox’s original three grievances consistently and solely requested a 

cardiac catheterization—and not any particular medication. The grievances did not give prison 

officials a fair opportunity to address Mattox’s claim on the merits by providing Ranexa, or any 

other prescription drug, because the grievances can only be fairly read to request a cardiac 

catheterization. 

 Mattox additionally argues that his original three grievances generally gave all relevant 

medical officials notice of his claim that he was receiving inadequate heart treatment, and that 

this general notice was sufficient to exhaust all possible claims related to his heart treatment. We 

cannot credit Mattox’s argument, however, because it would effectively collapse the PLRA’s 

exhaustion requirement. If generalized dissatisfaction with an inmate’s medical care were 

sufficient to exhaust all possible claims related to that care, then prisoners could bring claims in 

federal court without ever giving prison staff a fair chance to remedy a prisoner’s complaints. 

When an inmate is receiving little or no medical care at all, it might arguably be appropriate to 

generally allege inadequate medical care. However, where, as here, an inmate is receiving care, 

we hold that the inmate can only exhaust claims where he notifies the relevant prison medical 

staff as to which facets of his care are deficient. This rule better comports with MDOCPD 130, 

which requires inmates to describe the “who, what, when, where, why, [and] how” of their claim. 

Because Mattox repeatedly made clear that the “what” he was requesting was cardiac 

catheterization, we cannot agree that his first three grievances exhausted claims as to 

Dr. Pandya’s failure to provide Ranexa. 

 However, we agree that a jury could find that Mattox’s fifth grievance properly exhausted 

his claims as to Dr. Pandya. That grievance noted that: (i) Mattox suffers from angina pain; 

(ii) Mattox had been repeatedly prescribed Ranexa to control his pain; (iii) Mattox’s pain was 

completely eliminated when taking Ranexa; (iv) Dr. Pandya nevertheless denied a request from 

Mattox’s on-site medical providers to approve the continuation of Mattox’s Ranexa prescription; 

and (v) this denial allegedly violated Mattox’s constitutional right to be free from pain and 

suffering when relief was readily available. The grievance was sufficient to give prison officials 
No. 16-1412 Mattox v. Edelman, et al. Page 17

notice that Mattox was challenging Dr. Pandya’s conduct in contributing to the denial of 

Mattox’s Ranexa prescription, and to satisfy the gatekeeping requirements of MDOCPD130. We 

therefore hold that the district court erred in granting summary judgment on Mattox’s claims 

against Dr. Pandya. 

 2. Dr. Jordan and Dr. Borgerding 

 Next, Mattox argues that a jury could find that his fourth and fifth grievances properly 

exhausted his claims against Dr. Jordan and Dr. Borgerding. We agree. 

 Mattox’s fourth grievance specifically named Dr. Jordan, noted that Mattox had been 

prescribed Ranexa many times by outside doctors, and requested that prison medical staff 

provide him with Ranexa. Mattox’s fifth grievance complained that an unnamed RMO had 

contributed to the Ranexa denial, and alleged that the denial violated Mattox’s constitutional 

right to be free from gratuitous pain and suffering. In Mattox’s step two grievance appeal, 

Mattox clarified that the unnamed RMO was Dr. Borgerding. A reasonable jury could find that 

this information was sufficient under the circumstances presented here to satisfy the relatively 

minimal gatekeeping requirements of MDOCPD130. See Reed-Bey, 603 F.3d at 324 (observing 

that a prisoner complies with MDOCPD130 by specifying the “‘[d]ates, times, places and names 

of all those involved in the issue being grieved’ in their initial grievance” (citation omitted)); see 

also Woodford, 548 U.S. at 90 (a grievance is sufficient if the inmate follows the “critical 

procedural rules” set out by the prison’s grievance policy). Accordingly, we hold that the district 

court erred in determining that: (i) Mattox’s failure to exhaust administrative remedies as to 

Dr. Jordan is apparent from the face of Mattox’s complaint; and (ii) no reasonable jury could 

find that Mattox exhausted his remedies as to Dr. Borgerding.7

 7

We note that our opinion only holds that Defendants are not entitled to summary judgment on their 

administrative exhaustion defense. The issue of whether there are genuine issues of material fact going to the merits 

of Mattox’s claims is not before us in this appeal. Our opinion should not be misconstrued as precluding the district 

court from considering any other properly filed dispositive motions on remand. 
No. 16-1412 Mattox v. Edelman, et al. Page 18

II. Claims Against P.A. Neff 

A. Standard of Review 

We review de novo the district court’s dismissal of a deliberate indifference claim on the 

pleadings. See, e.g., D’Ambrosio v. Marino, 747 F.3d 378, 383 (6th Cir. 2014). 

B. Analysis 

Mattox’s claim against P.A. Neff alleges that she was deliberately indifferent to his 

serious medical needs by failing to send him to the emergency room on the night of August 14, 

2011, when Mattox presented to the prison infirmary with heart attack symptoms. The district 

court dismissed Mattox’s claim for failure to plead that Mattox suffered from an objectively 

serious medical condition on the night in question. Mattox argues that the risk to his health was 

so patently obvious that he did not need to provide any proof that he actually suffered a cardiac 

event. We disagree. 

The Eighth Amendment prohibits prison officials and doctors from showing deliberate 

indifference to an inmate’s serious medical needs. See Estelle v. Gamble, 429 U.S. 97, 104 

(1976). In order to establish a deliberate indifference claim, the prisoner must show that the 

defendant was “aware of facts from which the inference could be drawn that a substantial risk of 

serious harm exists, and he must also draw the inference.” Farmer v. Brennan, 511 U.S. 825, 

837 (1994). Put differently, a deliberate indifference claim “has objective and subjective 

components.” Blackmore v. Kalamazoo Cty., 390 F.3d 890, 895 (6th Cir. 2004). “The objective 

component requires the existence of a ‘sufficiently serious’ medical need.” Id. (quoting Farmer, 

511 U.S. at 834). “The subjective component requires an inmate to show that prison officials 

have ‘a sufficiently culpable state of mind in denying medical care.’” Id. (quoting Brown v. 

Bargery, 207 F.3d 863, 867 (6th Cir. 2000)). 

This Circuit recognizes two theories under which a plaintiff can demonstrate the 

objective component of an Eighth Amendment deliberate indifference claim. First, if a plaintiff 

suffered from a minor or non-obvious medical condition, he can show that his condition was 

objectively serious “if it is ‘one that has been diagnosed by a physician as mandating treatment.’” 
No. 16-1412 Mattox v. Edelman, et al. Page 19

Id. at 897 (quoting Gaudreault v. Municipality of Salem, 923 F.2d 203, 208 (1st Cir. 1990)). 

Second, “where a plaintiff’s claims arise from an injury or illness ‘so obvious that even a 

layperson would easily recognize the necessity for a doctor’s attention,’” the plaintiff can meet 

the objective prong by showing “that he actually experienced the need for medical treatment, and 

that the need was not addressed within a reasonable time frame.” Id. at 899–900 (quoting 

Gaudreault, 923 F.2d at 208). 

Citing Blackmore and our decision in Estate of Carter v. City of Detroit, 408 F.3d 305, 

311–12 (6th Cir. 2005), Mattox argues that: (i) his heart attack symptoms were so obvious that 

he does not need to show medical evidence verifying that he needed treatment; and (ii) there is 

no requirement that he show that he was actually suffering from a serious medical condition as 

long as he can show that prison staff failed to respond to circumstances that created a substantial 

risk of serious harm. 

Mattox’s arguments flatly misstate the law. As we explained in Blackmore, when a 

plaintiff can show that his need for medical care was so obvious that even a layperson should 

recognize it, he is not required to provide objective evidence that he needed medical care at the 

time he was experiencing the symptoms. Blackmore, 390 F.3d at 899–900. This makes sense—

if a plaintiff has been stabbed, for instance, he should not require a doctor’s diagnosis of internal 

bleeding before prison staff should be expected to tend to his medical needs. But the “obvious 

malady” theory does not excuse a plaintiff from showing that he actually needed medical care. 

As Blackmore itself recognizes, a plaintiff proceeding under this theory must still show “that he 

actually experienced the need for medical treatment, and that the need was not addressed within 

a reasonable time frame.” Id. at 900 (emphasis added). 

As the district court correctly noted, it is clear from the face of Mattox’s complaint that 

he did not actually need medical care on August 14, 2011. The complaint does not allege that 

Mattox suffered a heart attack that night. Moreover, Mattox was seen by a prison doctor on 

August 15, 2011, who did not prescribe him any medication. He was then sent to a hospital for 

consultation with a cardiologist, who also apparently did not prescribe Mattox any medication. 

When, in April 2012, Mattox received a cardiac catheterization test, it did not show a serious 

heart problem. Because Mattox has not demonstrated that he actually suffered a heart attack or 
No. 16-1412 Mattox v. Edelman, et al. Page 20

some similarly serious problem on August 14, 2011, the district court correctly determined that 

he has not pleaded an objectively serious medical condition. 

The cases Mattox relies upon in support of his argument are distinguishable. In Estate of 

Carter, the plaintiff actually suffered a fatal heart attack. 408 F.3d at 306. Similarly, in 

Westlake v. Lucas, 537 F.2d 857, 858–60 (6th Cir. 1976), the plaintiff suffered from a formally 

diagnosed medical condition—a bleeding stomach ulcer—that went untreated. Finally, in 

Helling v. McKinney, 509 U.S. 25, 33 (1993), the Supreme Court recognized that prisoners can 

state a deliberate indifference claim for future, as well as present harm. However, the plaintiff in 

Helling alleged that he was being regularly exposed to toxic tobacco smoke, while Mattox has 

not alleged any similar ongoing injury here. Id. at 28–29. 

Accordingly, we hold that Mattox failed to plead that he suffered from an objectively 

serious medical condition on August 14, 2011, and that his claim against P.A. Neff was therefore 

properly dismissed. Because Mattox did not plead an objectively serious medical condition, 

there is no need to analyze whether he sufficiently pleaded the subjective prong of his deliberate 

indifference claim. 

CONCLUSION 

For the foregoing reasons, we AFFIRM the dismissal of Mattox’s claims against 

P.A. Neff, and REVERSE the dismissal of his claims against Dr. Pandya, Dr. Jordan and 

Dr. Borgerding. We REMAND for further proceedings consistent with this opinion.