Anthony J. Machicote v. Doctor Roethlisberger, 969 F.3d 822

Plaintiff Anthony Machicote underwent ankle surgery in prison and was discharged with narcotic pain control (oxycodone) and warned of "extreme pain" when it wore off.
Dr. Marie Herweijer ordered Tylenol #3 (acetaminophen/codeine) as needed every six hours for three days per the surgeon’s discharge instructions.
Nurse Kimberly Stecker forced Machicote to take an early dose, told him she “did not care” about his pain, and later resisted administering doses outside the prison’s regular med lines, prompting a medication-order change to fit the prison schedule.
After the order lapsed, Stecker treated bandages but refused to contact a physician despite Machicote’s repeated reports of excruciating pain; it took multiple requests and days before Dr. Karl Hoffman prescribed tramadol and it was finally dispensed.
Machicote sued under 42 U.S.C. § 1983 alleging Eighth Amendment deliberate indifference by Drs. Herweijer, Kuber, Hoffman, health services manager Candace Warner, and Nurse Stecker; the district court granted summary judgment for all and denied recruitment of counsel.
The Seventh Circuit affirmed summary judgment for the doctors and Warner, vacated as to Nurse Stecker (finding triable issues about deliberate indifference), and affirmed the denial of appointed counsel; case remanded for trial as to Stecker.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Nurse Stecker was deliberately indifferent to serious medical needs	Stecker delayed/denied prescribed meds, dismissed his complaints, altered schedule for convenience, and failed to consult physicians when pain worsened	Actions reflected administrative practices or negligence, not recklessness or conscious disregard	Triable issue exists as to Stecker; summary judgment vacated and remanded for trial
Whether Dr. Herweijer or Dr. Kuber were deliberately indifferent	Initial q6h prescription and later schedule change caused prolonged pain; physician choices inadequate	Prescriptions reflected medical judgment or attempts to align with prison logistics; no evidence they knew changes would cause serious harm	Summary judgment for Herweijer and Kuber affirmed
Whether Dr. Hoffman and health services manager Warner were liable	Hoffman as supervising physician should have monitored and prevented delays; Warner failed to intervene	No evidence Hoffman knew of dispensing delays; Warner had no personal involvement or authority to override clinical decisions	Summary judgment for Hoffman and Warner affirmed
Whether district court abused discretion denying appointed counsel	Machicote lacked resources and needed counsel for complex medical-constitutional claims	Machicote had not shown sufficient effort to find counsel and appeared competent early on	Denial affirmed; plaintiff may renew request on remand

Estelle v. Gamble, 429 U.S. 97 (Eighth Amendment deliberate-indifference standard for serious medical needs)
Anderson v. Liberty Lobby, Inc., 477 U.S. 242 (summary-judgment standard — genuine dispute for trial)
Gil v. Reed, 381 F.3d 649 (denial of prescribed medication can support inference of deliberate indifference)
Walker v. Benjamin, 293 F.3d 1030 (refusal to provide ordered pain medication may show reckless disregard)
Roe v. Elyea, 631 F.3d 843 (administrative convenience cannot displace reasonable medical judgment)
Petties v. Carter, 836 F.3d 722 (persisting with ineffective treatment may show deliberate indifference)
Pyles v. Fahim, 771 F.3d 403 (limits on challenging medical-treatment decisions; durations must be flagrantly inappropriate)
Arnett v. Webster, 658 F.3d 742 (knowledge/recklessness requirement for Eighth Amendment medical claims)
Pruitt v. Mote, 503 F.3d 647 (standard for recruitment of counsel in § 1983 prison cases)
Minix v. Canarecci, 597 F.3d 824 (supervisory liability requires personal involvement)