Opinion ID: 2708833
Heading Depth: 1
Heading Rank: 3

Heading: Merits of the Expanded Negligence Claim

Text: Because the district court construed Buechel’s claim too narrowly, the court did not consider evidence related to Buechel’s theory that in 2006, FCI-Greenville had policies in place to control infections such as MRSA, that it failed to follow those policies, and that its failures proximately caused No. 13-2278 19 him to contract MRSA. Buechel argues that this evidence, properly considered, proves causation and that the district court’s judgment should be reversed. Ordinarily we review factual findings claims for clear error. See Fed. R. Civ. P. 52(a)(6). Here, however, neither side has had a full opportunity to present its evidence on this theory and the district court has not had the opportunity to address it. We therefore remand to the district court to consider this evidence in the first instance. See FMS, Inc. v. Volvo Constr. Equipment N.A., 557 F.3d 758, 763 (7th Cir. 2009) (“When the parties brief an issue that has not been addressed by the district court, it is not unusual for this court to remand so that the district court may consider the issue in the first instance.”). Illinois law governs Buechel’s broader claim. See 28 U.S.C. § 1346(b)(1) (predicating FTCA liability “in accordance with the law of the place where the act or omission occurred”). To establish a claim for negligence under Illinois law, a plaintiff must prove the existence of a duty of care owed by the defendant to the plaintiff, a breach of that duty, and an injury proximately caused by that breach. Thompson v. Gordon, 948 N.E.2d 39, 45 (Ill. 2011). Under Illinois law, that means Buechel must show that FCI-Greenville breached a duty to him and that its breach was both a “cause in fact” and a “legal cause” of his MRSA infection. Simmons v. Garces, 763 N.E.2d 720, 732 (Ill. 2002). “A defendant’s conduct is a ‘cause in fact’ of the plaintiff’s injuries only if that conduct is a material element and a substantial factor in bringing about the injury.” Abrams v. City of Chicago, 811 N.E.2d 670, 675 (Ill. 2004). A defendant’s conduct is a material element and a substantial factor in bringing about injury if, absent that conduct, the 20 No. 13-2278 injury would not have occurred. First Springfield Bank & Trust v. Galman, 720 N.E.2d 1068, 1072 (Ill. 1999). On the other hand, legal cause is largely a question of foreseeability. Abrams, 811 N.E.2d at 675. The relevant inquiry is whether the injury is of a type that a reasonable person would see as a likely result of his or her conduct. Galman, 720 N.E.2d at 1072, citing Lee v. Chicago Transit Auth., 605 N.E.2d 493, 503 (Ill. 1992). Buechel contends that FCI-Greenville had three primary infection control policies in place in 2006: (1) the Bureau of Prisons MRSA Guidelines; (2) a memorandum issued by FCIGreenville Warden Sara Revell on May 1, 2006; and (3) the BOP program statement on Infectious Disease Management. Pl. Exs. 9, 10, 11. Among other things, these policies required that infected inmates whose wound drainage could not be controlled with dressings be housed in single cells, that inmates with MRSA and non-MRSA staph infections be placed in special housing if drainage from their wounds could not be controlled with dressings, and that inmates with MRSA and non-MRSA staph infections be evaluated by medical staff to determine whether it was appropriate for them to work in the prison. Buechel argues that he has proved that FCI-Greenville breached its policies that required MRSA-positive inmates with uncontrolled draining wounds to be segregated from the general inmate population, and thus has proved that Buechel’s MRSA infection was caused by this failure. Buechel is incorrect. First, the district court never found that FCI-Greenville breached the policies at issue. Even if the district court finds on remand that Buechel has satisfied that burden, for FCI-Greenville to be liable, he must also prove that FCI-Greenville’s breach of these policies caused his infection. In No. 13-2278 21 other words, if FCI-Greenville failed to adhere to its MRSAcontainment policies in 2006, then Buechel must show by a preponderance of the evidence that its failure was a material element and a substantial factor in his infection and that his infection was a foreseeable result. Buechel’s reliance on Duvall v. Dallas County, 631 F.3d 203, 208–09 (5th Cir. 2011) and DeGidio v. Pung, 920 F.2d 525, 529–31 (8th Cir. 1990), is not persuasive at this stage of the case for the simple reason that in each case, the court of appeals was evaluating the sufficiency of the evidence supporting a verdict for the plaintiff. Here, we have no findings of fact on Buechel’s expanded negligence claim, much less findings in his favor. In Duvall, the Fifth Circuit found that the evidence was sufficient to uphold a jury’s verdict in favor of an inmate who had contracted an infection in a county jail. The jury in that case heard evidence that the MRSA infection rate in the jail was close to twenty percent, while other jails had infection rates of one or two percent. The jury also heard evidence that it was possible to contain MRSA but that jail officials were not willing to take the necessary steps to control the outbreak. Duvall, 631 F.3d at 208. But even the evidence in Duvall did not result in a directed verdict for the plaintiff—which is essentially the result Buechel requests on appeal without the theory having even been tried. Instead, the evidence in Duvall went to the jury, and the jury found causation. We remand for just such an evaluation of the evidence in Buechel’s case. Likewise, in DeGidio, the district court held a bench trial on whether the procedures for tuberculosis prevention and control at the prison where the plaintiff was incarcerated violated the Eighth Amendment. 920 F.2d at 527–31 (reciting 22 No. 13-2278 district court’s findings regarding defendants’ failures to respond quickly and effectively to tuberculosis outbreak, exacerbating outbreak). Based on a series of factual findings, the appellate court upheld the district court’s verdict that the defendants’ reckless behavior amounted to deliberate indifference to the serious needs of inmates. Id. at 533. Again, here we have no such factual findings or legal conclusions in Buechel’s favor on his broader claim. Buechel must prove to the district court in the first instance that FCI-Greenville breached the MRSA-containment policies that were in effect in the prison in 2006, and that any such breaches caused his MRSA infection. The government protests that Buechel’s theory that FCIGreenville was negligent in failing to follow its own policies, possibly causing Buechel’s MRSA infection, amounts to a never-before-argued theory of res ipsa loquitur. We disagree. For the doctrine of res ipsa loquitur to apply, a plaintiff must prove that he or she was injured (1) in an occurrence that ordinarily does not happen in the absence of negligence, (2) by an agency or instrumentality within the defendant’s exclusive control. See Heastie v. Roberts, 877 N.E.2d 1064, 1076 (Ill. 2007), citing Gatlin v. Ruder, 560 N.E.2d 586, 590 (Ill. 1990); Metz v. Central Illinois Electric & Gas Co., 207 N.E.2d 305, 307 (Ill. 1965). Buechel does not rely on res ipsa loquitur to fill a causation gap in his negligence claim, however. He intends to offer evidence at trial concerning the prison’s policies, its deviations from those policies, and whether those deviations caused his MRSA infection. In all likelihood that evidence will be largely circumstantial, but circumstantial evidence of causation is still evidence. No. 13-2278 23 The doctrine of res ipsa loquitur could not have applied to Buechel’s claim in any case. Perhaps someday medicine will eradicate staph infections like MRSA, but in the present day, MRSA is prevalent enough that infections can and do occur in spite of adherence to best practices and by inadvertent means that cannot be attributed to institutional or individual negligence. See Centers for Disease Control and Prevention, Methicillin-resistant Staphylococcus aureus (MRSA) Infections, General Information about MRSA in the Community, http://www.cdc.gov/mrsa/community/index.html (last visited March 6, 2014) (“Studies show that about one in three people carry staph in their nose, usually without any illness. Two in 100 people carry MRSA.”). Also, though preventive measures can and should be put in place where possible, no measure is fail-safe even in the absence of negligence. Res ipsa loquitur is meant to bridge an evidentiary gap when an injury could not have happened but for the defendant’s negligence. That framework simply does not apply in a case like this one. MRSA infections can and do happen in the absence of institutional negligence. E.g., Centers for Disease Control and Prevention, Methicillin-resistant Staphylococcus aureus (MRSA) Infections, General Information about MRSA in Healthcare Settings, http://www.cdc.gov/mrsa/healthcare/ (last visited March 6, 2014) (“MRSA is usually spread by direct contact with an infected wound or from contaminated hands, usually those of healthcare providers. Also, people who carry MRSA but do not have signs of infection can spread the bacteria to others and potentially cause an infection.”) (emphasis added). Here, however, Buechel has circumstantial evidence of causation. It remains to be seen on remand whether that 24 No. 13-2278 evidence will be sufficient to prove causation and find that FCI-Greenville was negligent.