Opinion ID: 3008839
Heading Depth: 2
Heading Rank: 1

Heading: Delay in Receiving Medication

Text: When Burton checked into the JCDC, he had nine differ‐ ent prescription medications with him, including Norco. 12 No. 14‐3591 Under JCDC policy, when an inmate is booked into jail, his medications are confiscated and must be approved by the jail medical department before they are dispensed. Burton contends, and the district court accepted, that after Burton’s booking on September 23, 2009, he did not receive any medi‐ cation until October 1, 2009. But Burton’s own sworn state‐ ments conflict with this version of the facts. In his deposi‐ tion, which took place months before Burton first raised this argument before the district court, Burton stated that he re‐ ceived Ultram after meeting with Menard on September 25, that Nurse Gill ordered his Ultram on September 25, and that he had informed Dr. Verghese that he was taking Ul‐ tram on September 29. These statements are consistent with JCDC medical records, which show that Ultram was dis‐ pensed on September 25, 2009. We therefore reject Burton’s belated attempt to claim that his medications were withheld for nine days. This claim is “blatantly contradicted” by his deposition testimony, and as such, the district court should not have accepted this version of the facts, even when ruling on a motion for summary judgment. Scott, 550 U.S. at 380. In considering whether a two‐day delay in receiving medication implicates the Constitution, we must keep in mind that “the infliction of suffering on prisoners can be found to violate the Eighth Amendment only if that inflic‐ tion is either deliberate, or reckless in the criminal law sense.” Duckworth v. Franzen, 780 F.2d 645, 652–53 (7th Cir. 1985), abrogated on other grounds; see also Wilson v. Seiter, 501 U.S. 294, 297 (“[O]nly the unnecessary and wanton infliction of pain implicates the Eighth Amendment, a prisoner ad‐ vancing such a claim must, at a minimum, allege deliberate No. 14‐3591 13 indifference to his serious medical needs.” (internal citation and quotation marks omitted)). “Negligence, gross negli‐ gence, or even ‘recklessness’ as that term is used in tort cas‐ es, is not enough.” Shockley v. Jones, 823 F.2d 1068, 1072 (7th Cir. 1987). Here, Burton does not claim, or present any evidence that would support a claim, that defendants deliberately or even recklessly delayed the distribution of his pain medication. Although we recognize the importance of prompt medical aid for a patient’s necessary medical treatment when he is detained or incarcerated, without evidence that defendants acted with the requisite bad intent in delaying the dispensa‐ tion of his medication, Burton’s allegations are insufficient to sustain a deliberate indifference claim. Put simply, a two‐day delay is not enough, standing alone, to show a culpable mental state. The delay may or may not have been negligent, but it did not constitute deliberate indifference for purposes of the Due Process Clause of the Fourteenth Amendment. B. Failure to Contact Burton’s Primary Care Physician or Prescribe Norco Burton next contends that because the medical staff ig‐ nored his requests for narcotic pain medication and refused to contact his primary care physician who had previously prescribed Norco, he suffered extreme post‐surgical pain and withdrawal symptoms. We agree with defendants that no reasonable jury could conclude that the failure to pre‐ scribe narcotic pain medication or contact a doctor who would prescribe it amounted to deliberate indifference. Sure‐ ly Burton would have preferred Vicodin to Ultram, or to have seen a doctor who would have prescribed narcotics, but 14 No. 14‐3591 detainees are not entitled to receive “unqualified access to healthcare.” Hudson v. McMillian, 503 U.S. 1, 9 (1992). Moreover, we recognize that “[t]here is not one ‘proper’ way to practice medicine in a prison, but rather a range of acceptable courses based on prevailing standards in the field.” Jackson v. Kotter, 541 F.3d 688, 697 (7th Cir. 2008). Ac‐ cordingly, to demonstrate that defendants acted with delib‐ erate indifference, Burton must show that the medical de‐ fendants’ refusal to prescribe Norco was “such a substantial departure from accepted professional judgment, practice, or standards, as to demonstrate that the person responsible ac‐ tually did not base the decision on such a judgment.” Id. (quoting Sain v. Wood, 512 F.3d 886, 895 (7th Cir. 2008)). Burton presented no such evidence; in fact, the record suggests that the decision to prescribe non‐narcotic pain medication was a reasonable one. This was the course of treatment recommended by Dr. Verghese—Burton’s own or‐ thopedic surgeon—immediately after his surgery. The deci‐ sion to prescribe non‐narcotic pain medication was reaf‐ firmed by Dr. Verghese several times after thorough exami‐ nations, and was supported by a reasonable medical expla‐ nation: synthetic opiates have less addictive potential than non‐synthetic opiates such as Norco. Although Dr. Zumwalt followed a different course of treatment in prescribing Norco, “[m]ere differences of opin‐ ion among medical personnel regarding a patient’s appro‐ priate treatment do not give rise to deliberate indifference.” Estate of Cole v. Fromm, 94 F.3d 254, 261 (7th Cir. 1996). In oth‐ er words, evidence that another doctor would have followed a different course of treatment is insufficient to sustain a de‐ liberate indifference claim. No. 14‐3591 15 Burton also fails to present any objective evidence that his painful withdrawal symptoms created a serious medical need for Norco. Burton’s after‐the‐fact description of his symptoms is not objective evidence of a serious medical need for narcotic drugs, especially given that two trained medical professionals concluded otherwise. Moreover, Bur‐ ton’s own primary care doctor testified that Burton had no medical need for Norco whatsoever. In his deposition, Dr. Zumwalt stated that Burton was not prescribed Norco for long enough to become addicted, and that withholding nar‐ cotic medication would not put Burton at risk of medical complications. Cf. Wilson v. Hosey, No. 09‐C‐7777, 2012 WL 957488, at  (N.D. Ill. Mar. 15, 2012) (granting summary judgment for defendant where plaintiff’s only evidence that he needed medical treatment was his testimony, which was contradicted by testimony by plaintiff’s doctor). C. Failure to Provide a Second Mattress Defendants also dispute that a triable issue of fact exists as to whether the failure to give Burton a second mattress amounted to cruel and unusual punishment. The district court held that a reasonable jury could conclude that this conduct deprived Burton of “the minimal civilized measure of life’s necessities.” But the Supreme Court has clarified that conditions of confinement of this kind involve “deprivations of essential food, medical care, or sanitation.” Rhodes v. Chap‐ man, 452 U.S. 337, 348 (1981) (emphasis added). Burton pre‐ sents no evidence to support his allegation that sleeping on a single mattress amounted to a deprivation of this magni‐ tude. Instead, Burton’s treating physician examined his con‐ dition and concluded that a second mattress was unneces‐ sary because it would not affect his condition at all. Without 16 No. 14‐3591 some evidence that defendants’ conduct deprived Burton of essential medical care, no reasonable jury could conclude that Burton’s conditions of confinement amounted to cruel and unusual punishment.2 D. In‐Cell Physical Therapy and Treatment for Burton’s Rash and Rectal Bleeding Finally, defendants contend that no reasonable jury could find that defendants were deliberately indifferent to Burton’s serious need for physical therapy and treatment for his rash and rectal bleeding. We agree. Dr. Verghese twice prescribed physical therapy for Bur‐ ton’s hip and tennis elbow. The JCDC medical staff did not ignore this advice; soon after Dr. Verghese issued his first prescription, Nurse Gill called him to discuss it. In this phone call, Dr. Verghese informed Nurse Gill that in‐cell therapy would be sufficient, and that outside physical thera‐ py was unnecessary. Accordingly, Nurse Gill provided Bur‐ ton with instructions and a towel to perform in‐cell exercis‐ es. Burton admits that he did not follow these instructions, supposedly because they were inadequate. When Dr. Ver‐ ghese again prescribed physical therapy several months lat‐ er, he did so on the condition that Burton convince the court to allow it, which suggests that it was not medically neces‐ sary. 2 Although the district court issued an order in Burton’s criminal case requesting that the sheriff provide Burton with a second mattress, de‐ fendants’ failure to comply is insufficient in itself to sustain a deliberate indifference claim, which requires some evidence of a serious medical need. See Wilson, 501 U.S. at 298. No. 14‐3591 17 Even assuming that Burton had a serious medical need for outside physical therapy or more thorough instructions from the JCDC staff, Burton fails to present evidence that the medical defendants, who contacted Dr. Verghese and fol‐ lowed his recommendations for treatment, acted with the requisite state of mind for deliberate indifference. On these facts, it is difficult to even conclude that defendants were negligent. There is therefore no evidence from which a rea‐ sonable jury could conclude that defendants consciously dis‐ regarded Burton’s serious medical need for physical therapy. Likewise, we disagree that a reasonable jury could find that defendants’ treatment of Burton’s rash and rectal bleed‐ ing amounted to deliberate indifference. Burton does not contend that he was ever denied treatment for these condi‐ tions—instead, the record shows that the medical defendants promptly responded to Burton’s complaints and prescribed medication. Burton does not present any evidence that de‐ fendants’ course of treatment fell below prevailing medical standards, nor does he dispute that his conditions eventually resolved, which suggests that the chosen course of treatment was effective.