812 F.3d 594
7th Cir.2016Background
- Mathison, a federal inmate with chronic hypertension, awoke at 3 a.m. with classic heart-attack symptoms (severe chest and left-arm pain) and summoned guard Wickman.
- Wickman alerted supervisory lieutenant Omelson, who spoke with Mathison from outside the cell and tried for 20 minutes to reach on-call nurse Wall; Omelson believed Mathison might be having a heart attack but did not call 911.
- Wall, contacted later, concluded there was no emergency based on Omelson’s report and instructed Mathison to wait until morning; Mathison was kept in his cell and went to the infirmary at 6:45 a.m.
- At the infirmary (around 6:45–8:00 a.m.) medical staff recognized a serious problem, gave oxygen/aspirin/nitroglycerin, and arranged ambulance transport; he was later transferred to a Peoria hospital and received a cardiac stent.
- Disputed medical evidence: a Pekin ER troponin level of 0.32 ng/ml six hours after onset (normal ≤0.07), later peaking at 33.8 ng/ml; prison doctor Moats opined (based largely on another doctor’s statements) that delay caused no heart damage, but Moats lacked cardiology expertise.
- Procedural posture: Mathison sued under Bivens for deliberate indifference; district court granted summary judgment for defendants. This court affirms in part, reverses in part, and remands.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether delay in responding to acute chest pain violated Eighth Amendment (deliberate indifference) | Delay of ~4–5 hours in cell and additional delay before infirmary amounted to deliberate indifference to a serious medical need | Denied deliberate indifference; argued actions followed protocol, nurse’s non-emergency call was reasonable, and some defendants lacked medical training | Reversed as to lieutenant Omelson and nurse Wall: factual record supports claims of deliberate indifference; affirmed as to guard Wickman and Dr. Moats |
| Whether troponin evidence and medical opinion defeat causation / substantial harm element | Elevated troponin levels and expert testimony show risk/occurrence of myocardial damage tied to delay | Moats opined (unqualifiedly) there was no heart damage; district judge credited this | Court rejects Moats’s unqualified cardiology opinion as unreliable and notes troponin levels support a dispute of material fact |
| Whether non-medical staff (guard/lieutenant) can be liable for failing to summon emergency care | Omelson had authority to summon ambulance and inferred heart attack; failure to act amounted to liability | Wickman followed protocol by notifying Omelson; Omelson deferred to nurse Wall and did not summon ambulance | Wickman not liable (properly notified superior); Omelson potentially liable for failing to summon emergency assistance when unable to reach nurse |
| Whether prison doctor Moats is liable for deliberate indifference by delayed treatment | Plaintiff contends Moats’s delayed examination and limited testing contributed to harm | Moats treated promptly upon awareness at ~8 a.m. and summoned ambulance; lacked cardiology specialization | Moats not liable: acted promptly when informed and provided emergency care; however, his expert opinion on lack of heart damage is unreliable |
Key Cases Cited
- Williams v. Liefer, 491 F.3d 710 (7th Cir. 2007) (delay in treating chest pain can support deliberate indifference claim)
- Rowe v. Gibson, 798 F.3d 622 (7th Cir. 2015) (limits on expert testimony and qualifications)
- Farmer v. Brennan, 511 U.S. 825 (1994) (deliberate indifference standard in Eighth Amendment claims)
- Cavalieri v. Shepard, 321 F.3d 616 (7th Cir. 2003) (supervisory liability and Eighth Amendment duties)
- Gayton v. McCoy, 593 F.3d 610 (7th Cir. 2010) (medical personnel duties and Eighth Amendment evaluation)
- Sain v. Wood, 512 F.3d 886 (7th Cir. 2008) (prisoner medical care standards and liability)