44 F.4th 605
7th Cir.2022Background
- Michael Madden was booked into Milwaukee County Jail on Sept. 29, 2016; he had a history of IV drug use and a congenital heart defect, placing him at risk for infective endocarditis.
- Between early October and Oct. 14, nurses repeatedly saw Madden for symptoms (elevated heart rate, low-grade fever, new faint heart murmur, weight loss, diarrhea/dehydration) but did not order blood tests or ECG; a nurse (Mahaga) diagnosed dehydration/withdrawal and advised fluids.
- A high-priority sick-call slip was filed Oct. 25 and scheduled for Oct. 26, but Madden was not seen then; medical staffing shortages were alleged in the record.
- In the early morning of Oct. 28 Madden became acutely ill in his cell, was handled roughly by officers during transport, became unconscious, and was declared dead; the medical examiner attributed death to infective endocarditis.
- Stockton (special administrator) sued under § 1983 for deliberate indifference (multiple defendants), Monell and supervisory liability (County and Armor), and excessive force (officer Piasecki). The district court granted summary judgment to defendants on all federal claims; the Seventh Circuit affirmed in part and reversed and remanded as to the excessive-force claim against Piasecki.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Deliberate indifference — Nurse Mahaga | Mahaga knew risk factors and symptoms on Oct. 14 and failed to diagnose or order tests for endocarditis | Mahaga reasonably treated symptoms as dehydration/withdrawal; no evidence she subjectively concluded endocarditis risk | Affirmed for Mahaga — no evidence she subjectively drew inference of substantial risk; her medical judgment entitled to deference |
| Deliberate indifference — Adriano & Andrykowski (Oct. 28 conduct) | Leaving cell/failed CPR showed deliberate indifference | Last possible lifesaving intervention was Oct. 27; Oct. 28 actions did not cause death | Affirmed — no causation; no evidence their Oct. 28 acts worsened or caused death |
| Monell liability — County and Armor (staffing & sick-call practices) | Systemic understaffing and sick-call failures caused Madden to miss care after Oct. 25, showing policy/custom and deliberate indifference | No admissible evidence of multiple similar injuries; Shansky reports inadmissible hearsay for truth; no proof timely response would have diagnosed or saved Madden | Affirmed — plaintiff failed to show pattern of constitutional injuries, deliberate indifference, or moving‑force causation |
| Supervisory liability — Clarke, Schmidt, Evans | Supervisors knew/allowed deficient medical practices and are liable for injuries | No personal involvement or evidence they knew of and approved unconstitutional practices | Affirmed — no underlying constitutional violation or personal culpability shown |
| Excessive force — Piasecki; qualified immunity | Piasecki deliberately moved legs and allowed vulnerable Madden to fall and hit his head; that conduct was unconstitutional | Denied excessive force or alternatively entitled to qualified immunity | Reversed and remanded on Count III — jury question on excessive force; qualified immunity denied because conduct was clearly unlawful in context |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (established deliberate indifference test for prisoner medical care)
- Monell v. Department of Social Services, 436 U.S. 658 (municipal liability requires policy, custom, or final policymaker action)
- Hudson v. McMillian, 503 U.S. 1 (excessive force standard: malicious and sadistic vs. good-faith discipline)
- Whitley v. Albers, 475 U.S. 312 (factors for assessing wantonness in force claims)
- Hope v. Pelzer, 536 U.S. 730 (rare cases where unlawfulness is obvious for qualified immunity purposes)
- Gayton v. McCoy, 593 F.3d 610 (Seventh Circuit deliberate indifference framework: subjective awareness and culpable state of mind)
- Zaya v. Sood, 836 F.3d 800 (subjective knowledge may be shown by circumstantial evidence and obvious risks)
- Roe v. Elyea, 631 F.3d 843 (medical judgment deference in § 1983 deliberate indifference claims)
- Pyles v. Fahim, 771 F.3d 403 (declining diagnostic tests is a matter of medical judgment)
- Taylor v. Riojas, 141 S. Ct. 52 (per curiam recognition that some conditions of confinement are obviously unconstitutional)