Joseph Conley v. Kimberly Birch
2015 U.S. App. LEXIS 13739
| 7th Cir. | 2015Background
- On Dec. 22, 2009, inmate Joseph Conley injured his right hand in an altercation and heard a "pop." Over two days his hand swelled, discolored, and lost function.
- On Dec. 24 nurse Tracy Potts examined Conley, recorded "throbbing," "severe" swelling, limited motion of all fingers and thumb, and noted a "possible/probable fracture" (questioning "? Fracture"). Potts called physician Kimberly Birch per facility protocol.
- Potts provided ice and ibuprofen; only Dr. Birch (who was on holiday) could order x-rays. Dr. Birch did not order an x-ray during the Dec. 24 call and did not examine Conley in person until Dec. 29, when she ordered an x-ray.
- The x-ray was not performed until Jan. 2010 (Conley later signed a refusal form on the initially scheduled date); eventual imaging confirmed a fracture and Conley now suffers chronic pain and limited mobility.
- Conley sued under 42 U.S.C. § 1983 alleging Eighth Amendment deliberate indifference; the district court granted summary judgment for Dr. Birch; the Seventh Circuit reversed and remanded for trial.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Conley's hand injury was an objectively serious medical condition | Conley: Potts’s notes ("possible/probable fracture," severe swelling, loss of function) show a serious condition | Birch: Symptoms could indicate a contusion; nurse’s notes showed uncertainty and mild pain rating | Held: Jury could find the injury objectively serious given the documented swelling, discoloration, loss of function, and "probable fracture" notation |
| Whether Birch was aware of and strongly suspected a fracture | Conley: Potts’s contemporaneous notes were conveyed by phone and would have led Birch to strongly suspect a fracture | Birch: She defers to the reporting nurse’s judgment and may have perceived uncertainty | Held: Triable issue exists—reasonable jury could infer Birch strongly suspected a fracture based on Potts’s notes and protocol for telephone referrals |
| Whether providing only ice and ibuprofen (and delaying x‑ray) constituted deliberate indifference | Conley: Appropriate care for probable fracture was splinting + prompt x‑ray within 3–5 days; failure to immobilize and delay were reckless | Birch: Providing conservative treatment was reasonable; delay over holidays and nurse uncertainty justified approach | Held: Triable issue exists—a jury could find treatment insufficient and that Birch knowingly disregarded risk |
| Whether Conley proved causation from Birch’s delay | Conley: Birch’s omission of prompt x‑ray/immobilization during early healing could have worsened outcome; expert testimony supports harm from delayed care | Birch: Conley cannot attribute specific lasting harm to her brief role in the overall diagnostic delay | Held: Causation is normally for the jury; Birch’s own testimony that callus forms quickly permits a jury to find her delay contributed to permanent injury |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (establishes Eighth Amendment deliberate indifference standard for medical care)
- Farmer v. Brennan, 511 U.S. 825 (deliberate indifference requires reckless disregard of substantial risk)
- Sherrod v. Lingle, 223 F.3d 605 (prisoner need not be literally ignored; minimal treatment can still be deliberate indifference)
- Ortiz v. Webster, 655 F.3d 731 (elements to survive summary judgment: objective seriousness and awareness/knowing disregard)
- Jackson v. Pollion, 733 F.3d 786 (delay-in-treatment cases require medical evidence that delay caused harm)
- Johnson v. Koppers, 726 F.3d 910 (standard of de novo review for summary judgment)
- Mkt. St. Assocs. Ltd. P’ship v. Frey, 941 F.2d 588 (state of mind is generally for jury to decide)
- Collins v. Am. Optometric Ass’n, 693 F.2d 636 (causation is normally a jury question)