Opinion ID: 4654718
Heading Depth: 2
Heading Rank: 1

Heading: Deliberate Indiﬀerence

Text: “To determine if the Eighth Amendment has been violated in the prison medical context, we perform a two-step analysis, first examining whether a plaintiff suffered from an objectively serious medical condition, and then determining whether the individual defendant was deliberately indifferent to that condition.” Petties v. Carter, 836 F.3d 722, 727–28 (7th Cir. 2016) (en banc) (citing Farmer v. Brennan, 511 U.S. 825, 834 (1994)). Here, Defendants do not dispute that Peterson suffered from an objectively serious medical condition. We turn then to the second step and consider whether Peterson alleged facts plausibly stating a claim that Mays, Coleman, Dr. Davida, and Wexford were deliberately indifferent to his condition. To satisfy this subjective step, the complaint must allege that the defendants acted with a “sufficiently culpable state of mind.” Farmer, 511 U.S. at 834 (quoting Wilson v. Seiter, 501 U.S. 294, 297 (1991)). “[D]eliberate indifference entails something more than mere negligence” but “something less than acts or omissions for the very purpose of causing harm or with knowledge that harm will result.” Id. at 835; see also Estelle v. Gamble, 429 U.S. 97, 106 (1976) (“Medical malpractice does not become a constitutional violation merely because the victim is a prisoner.”). “[T]he official must both be aware of facts from which the inference could be drawn that a No. 19-2592 7 substantial risk of serious harm exists, and he must also draw the inference.” Farmer, 511 U.S. at 837. “Prison officials must provide inmates with medical care that is adequate in light of the severity of the condition and professional norms.” Perez v. Fenoglio, 792 F.3d 768, 777 (7th Cir. 2015). Demonstrating that the inmate received some treatment “does not automatically defeat a claim of deliberate indifference.” Id. (quoting Edwards v. Snyder, 478 F.3d 827, 831 (7th Cir. 2007)). “Deliberate indifference may occur where a prison official, having knowledge of a significant risk to inmate health or safety, administers ‘blatantly inappropriate’ medical treatment … .” Id. (quoting Edwards, 478 F.3d at 831). In other words, “[a] plaintiff can show that the professional disregarded the need only if the professional’s subjective response was so inadequate that it demonstrated an absence of professional judgment, that is, that ‘no minimally competent professional would have so responded under those circumstances.’” Arnett v. Webster, 658 F.3d 742, 751 (7th Cir. 2011) (quoting Roe v. Elyea, 631 F.3d 843, 857 (7th Cir. 2011)); see also Holloway v. Del. Cnty. Sheriff, 700 F.3d 1063, 1073 (7th Cir. 2012).
In the operative complaint, Peterson alleges that Podocon25 contains “a powerful caustic and severe irritant” and that its packaging repeatedly and prominently warns that it is to be applied only by a physician and is not to be dispensed to the patient. Peterson then makes allegations specific to the individual defendants. He alleges that Dr. Davida “prescribed for plaintiff a medication known as ‘Podocon-25’” and that he 8 No. 19-2592 “ignored the FDA mandated warnings and directed that a non-physician apply the Podocon-25 to plaintiff’s genital warts.” The remaining allegations against Dr. Davida relate to his employment under Wexford. Regarding Mays and Coleman, Peterson alleges that “[t]he job duties of defendant Mays included applying the Podocon25 to plaintiff’s genital warts” and that “Mays refused to apply the Podocon-25 to plaintiff’s genital warts, instructing plaintiff to do it himself.” He further alleges that “Mays knew that plaintiff would suffer personal injuries if plaintiff attempted to apply the Podocon-25 to his genital warts.” Peterson makes the same allegations against Coleman. In response to Mays and Coleman’s motion to dismiss, Peterson supplemented the complaint’s allegations. 2 He listed the possible “adverse reactions” described on the packaging and stated that Podocon-25 is to be “sparingly” applied and then “thoroughly removed” with alcohol or soap and water, which were not available to him. To state a claim for deliberate indifference against these defendants, Peterson must allege that they were “aware … that a substantial risk of serious harm exist[ed],” Farmer, 511 U.S. at 837, and that their “subjective response was so inadequate that it demonstrated an absence of professional judgment,” Arnett, 658 F.3d at 751. As the district court pointed out, Peterson makes conclusory allegations that these defendants had the requisite state of mind, stating that they “ignored 2 In “opposing a Rule 12(b)(6) motion,” Peterson was free to “elaborate on his factual allegations so long as the new elaborations are consistent with the pleadings.” Geinosky v. City of Chicago, 675 F.3d 743, 745 n.1 (7th Cir. 2012). No. 19-2592 9 the FDA mandated warnings” and “knew that [Peterson] would suffer personal injuries.” There are no related factual claims from which we could draw an inference that they “actually kn[e]w about yet disregard[ed] a substantial risk of harm to [Peterson’s] health or safety.” Rasho v. Elyea, 856 F.3d 469, 476 (7th Cir. 2017) (citing Petties, 836 F.3d at 728). We acknowledge that “Rule 9(b) allows states of mind to be alleged generally,” Armstrong v. Daily, 786 F.3d 529, 547 (7th Cir. 2015); see also Burks v. Raemisch, 555 F.3d 592, 594 (7th Cir. 2009), but the deliberate indifference standard is not satisfied by these conclusory statements alone. Peterson’s allegations regarding his treatment ultimately sink his complaint. Let’s consider the course of treatment as described by the complaint. Peterson did receive treatment for his genital warts. Of course, the “receipt of some medical care does not automatically defeat a claim of deliberate indifference if … the treatment was ‘so blatantly inappropriate as to evidence intentional mistreatment likely to seriously aggravate’ a medical condition.” Edwards, 478 F.3d at 831 (quoting Snipes v. DeTella, 95 F.3d 586, 592 (7th Cir. 1996)) (emphasis in original). But Peterson does not allege that prescribing Podocon-25 was “blatantly inappropriate.” Id. Indeed, the complaint asserts that one of the components of Podocon-25 is “prescribed for the removal of soft genital warts.” Peterson’s claim instead relies on how the medication was administered. Significantly, the administration of Podocon-25 is where the complaint is most lacking. The complaint says only that Dr. Davida directed a “non-physician” to apply the medication. As Peterson’s counsel clarified at oral argument, “nonphysician” refers to a nurse rather than an inmate. So Peterson has alleged only that Dr. Davida, a licensed physician, 10 No. 19-2592 instructed a licensed nurse to apply a prescribed medication appropriate for treating the patient’s condition. Although Peterson cites Echols v. Craig in support, Dr. Davida’s alleged actions do not come close to the alleged conduct in Echols. See Echols v. Craig, 855 F.3d 807, 812 (7th Cir. 2017) (finding “no difficulty concluding that [the plaintiff] state[d] a plausible claim of deliberate indifference” where he alleged that the doctor “knew he broke a drill bit during the [tooth] extraction, … sutured his gum without accounting for the broken pieces, … obtained an X-ray that confirmed its presence but did nothing to address the problem”). As for the nurses, Peterson alleges only that it was within their “job duties” to apply the medication, yet they instructed Peterson to apply the Podocon-25 himself. It does not matter whether Dr. Davida instructed them or whether they independently chose to dispense the medication to Peterson. Holloway, 700 F.3d at 1075 (“A nurse may … act with deliberate indifference if he or she ‘ignore[s] obvious risks to an inmate’s health’ in following a physician’s orders.” (quoting Rice ex rel. Rice v. Corr. Med. Servs., 675 F.3d 650, 683 (7th Cir. 2012))). Regardless, the allegations fail to state a claim that their actions were “so inadequate that [they] demonstrated an absence of professional judgment, that is, that ‘no minimally competent professional would have so responded under those circumstances.’” Arnett, 658 F.3d at 751 (quoting Roe, 631 F.3d at 857). At bottom, Peterson’s complaint fails to allege that any of these three defendants were “aware … that a substantial risk of serious harm exist[ed],” Farmer, 511 U.S. at 837, and that their “subjective response was so inadequate that it demonstrated an absence of professional judgment.” Arnett, 658 F.3d at 751. Peterson’s allegations that Dr. Davida prescribed an No. 19-2592 11 appropriate medication and instructed the nurses to administer it and that Mays and Coleman dispensed that medication to Peterson for him to apply himself do not evince “something approaching a total unconcern for the prisoner’s welfare in the face of serious risks.” Donald v. Wexford Health Sources, Inc., 982 F.3d 451, 458 (7th Cir. 2020) (quoting Rosario v. Brawn, 670 F.3d 816, 821 (7th Cir. 2012)). We therefore conclude that Peterson failed to state a claim for deliberate indifference against Dr. Davida, Mays, and Coleman.
Peterson has likely waived any arguments directed to the district court’s judgment in favor of Wexford by simply failing to raise them on appeal. Gable v. City of Chicago, 296 F.3d 531, 538 (7th Cir. 2002) (finding that the plaintiffs “waived two of their arguments on appeal by not developing them in their opening brief”); see also Henry v. Hulett, 969 F.3d 769, 785–86 (7th Cir. 2020) (explaining that “waiver is the ‘intentional relinquishment or abandonment of a known right’” (quoting United States v. Olano, 507 U.S. 725, 733 (1993)). But even absent waiver, Peterson’s complaint fails to state a claim against Wexford for deliberate indifference. Peterson asserts that Wexford is liable under § 1983 “for the wrongdoing of its employee defendant Davida under the doctrine of respondeat superior.” This theory fails. Under Monell and its progeny, a corporation can be liable under § 1983 only for its own policies and practices, not under a theory of respondeat superior. Monell v. Dep’t of Soc. Servs. of New York, 436 U.S. 658, 691 (1978); accord Whiting v. Wexford Health Sources, Inc., 839 F.3d 658, 664 (7th Cir. 2016); Shields v. Ill. Dep’t of Corrs., 746 F.3d 782, 796 (7th Cir. 2014); Iskander v. Village of Forest Park, 690 F.2d 126, 128 (7th Cir. 1982). Despite 12 No. 19-2592 calls to reconsider our precedent, “we have chosen to leave Iskander undisturbed,” Wilson v. Wexford Health Sources, Inc., 932 F.3d 513, 522 (7th Cir. 2019) (citing Gaston v. Ghosh, 920 F.3d 493, 498 (7th Cir. 2019) (Hamilton, J., concurring)), and Peterson presents no reason for us to take another look. Furthermore, “‘if the plaintiff’s theory of Monell liability rests entirely on individual liability,’ as [Peterson’s] does here, then ‘negating individual liability will automatically preclude a finding of Monell liability.’” Donald, 982 F.3d at 463 (quoting Whiting, 839 F.3d at 664). This claim against Wexford must therefore, at any rate, meet the same fate as the claim against Dr. Davida.