Opinion ID: 183790
Heading Depth: 4
Heading Rank: 1

Heading: Sufficiency of the Evidence to Support Mr. Roe's Deliberate Indifference Claim

Text: We begin with an evaluation of the elements of Mr. Roe's deliberate indifference claim. We believe that there is sufficient evidence in the record to support the jury's conclusion that Mr. Roe established both an objective serious medical need and that the policy Dr. Elyea implemented evinces a deliberate indifference to that need. First, sufficient evidence supported the jury's conclusion that Mr. Roe had an objectively serious medical need for treatment in 2004. As we acknowledged in Edwards v. Snyder, 478 F.3d 827 (7th Cir.2007), our cases demonstrate that a broad range of medical conditions may be sufficient to meet the objective prong of a deliberate indifference claim, including a dislocated finger, a hernia, arthritis, heartburn and vomiting, a broken wrist, and minor burns sustained from lying in vomit. Id. at 831 (collecting cases); [15] see also Berry v. Peterman, 604 F.3d 435, 440 (7th Cir.2010) (holding that tooth decay can constitute an objectively serious medical condition). Based on the evidence submitted by Mr. Roe in support of his claim, the jury was entitled to conclude that his HCV infection and resultant physical condition were sufficiently serious to meet that standard. Specifically, as the FBOP Guidelines make clear, at least for some patients, HCV infection is a serious medical condition that can lead to irreversible physical damage and even life-threatening situations. Mr. Roe's own medical records show not only that he had been diagnosed with HCV infection, but that his enzyme levels were repeatedly twice normal over a period of several years. Given his particular history, the FBOP Guidelines counseled, at minimum, biopsy of the liver and consideration for antiviral therapy. [16] The recommendations set forth by the federal prison system, read together with Mr. Roe's medical history and testimony regarding his symptoms, are sufficient evidence to permit the jury to conclude that Mr. Roe's HCV infection amounted to a serious medical need. Second, Mr. Roe presented sufficient evidence from which a jury could conclude that Dr. Elyea acted with a sufficiently culpable state of mind in setting the IDOC policy that resulted in a denial of the treatment recommended under the Guidelines to Mr. Roe. Under that policy, inmates were denied further testing and treatment for HCV infection categorically based on the expected length of their continued incarceration in an IDOC facility. In addition to mandating that inmates have one year of incarceration left for a treatment regimen to begin, the policy required an additional year to allow for enzyme level checks six months apart and an additional six months to allow the vendor ample time for some unspecified workup prior to the biopsy. R.110 at 127 (testimony of Dr. Elyea). IDOC justified this policy because the Guidelines note that an interrupted course of treatment may pose further health risks and because, with respect to some (but not all) genotypes, forty-eight weeks was the recommended course of treatment. According to Dr. Elyea, IDOC adopted the policy because it wanted to keep its protocols consistent for all of the people who had hepatitis C. Id. at 113. The failure to consider an individual inmate's condition in making treatment decisions is, as we already have concluded, precisely the kind of conduct that constitutes a substantial departure from accepted professional judgment, practice, or standards, [such] as to demonstrate that the person responsible actually did not base the decision on such a judgment. Sain, 512 F.3d at 895 (internal quotation marks omitted). Indeed, at trial, Dr. Elyea confirmed his deposition testimony that, [a]t the time we set this up, there may not have been any real medical reason for the policy of presuming a forty-eight-week treatment period for all inmates, regardless of genotype, other than to keep it simple for folks. R.110 at 123. Although administrative convenience and cost may be, in appropriate circumstances, permissible factors for correctional systems to consider in making treatment decisions, the Constitution is violated when they are considered to the exclusion of reasonable medical judgment about inmate health. See Johnson v. Doughty, 433 F.3d 1001, 1013 (7th Cir.2006) (The cost of treatment alternatives is a factor in determining what constitutes adequate, minimum-level medical care, but medical personnel cannot simply resort to an easier course of treatment that they know is ineffective. (citations omitted)). Given Dr. Elyea's own testimony, this is simply not a case where the jury was required to conclude that Mr. Roe's care plan was a result of a deliberate decision by a doctor to treat a medical need in a particular manner. Jackson v. Kotter, 541 F.3d 688, 698 (7th Cir.2008) (quotation marks omitted). Rather, it was entitled to conclude that Dr. Elyea's action constituted a failure to exercise medicalas opposed to administrativejudgment at all. [17] Under these circumstances, the district court did not err in denying judgment as a matter of law to Dr. Elyea on the ground that Mr. Roe failed to present sufficient evidence from which a jury could conclude that he had satisfied both the objective and subjective elements of a deliberate indifference claim.