48 F.4th 853
7th Cir.2022Background
- In June 2015 White injured his left knee playing basketball while incarcerated; he sought care from the prison medical unit at least 15 times through Nov. 2017.
- Nurse Practitioner Blake Woods and Dr. Alfonso David treated White with conservative measures (medication, crutches, X‑rays, physical therapy); no MRI was obtained until December 2017.
- The December 2017 MRI showed an ACL tear and meniscal tear; White later underwent surgery and alleges permanent worsening due to diagnostic delay.
- White sued Woods, Dr. David, and Wexford Health Sources under 42 U.S.C. § 1983 (Eighth Amendment deliberate indifference) and sought state medical‑malpractice claims; the district court screened out Wexford (Monell) and later denied leave to amend and granted summary judgment to Woods and Dr. David.
- White obtained an expert report from orthopedic surgeon Dr. Cannestra opining that ACL injuries must be diagnosed/treated within 2–6 weeks and that defendants’ delay caused irreversible harm; the Seventh Circuit found the expert unrebutted and the record created triable issues on deliberate indifference.
- The Seventh Circuit vacated summary judgment as to Woods and Dr. David (remanding for trial) and affirmed the district court’s rulings in all other respects (including denial of leave to amend and dismissal of Wexford at screening).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the district court erred at screening by dismissing Wexford instead of construing the complaint to include a state‑law negligence claim | White: complaint should have been read to include negligence (medical malpractice) against Wexford | Defendants: White waived that argument; he later characterized negligence as a new theory | Held: Waiver—White affirmatively treated malpractice as a new theory; district court did not err |
| Whether the district court abused its discretion by denying leave to amend to add malpractice claims and revive Monell claim | White: late counsel sought leave to add malpractice and Monell claims after discovery; no good cause to deny | Defendants: undue delay and prejudice (discovery completed, summary‑judgment motions, reopened discovery would prejudice) | Held: No abuse of discretion—denial affirmed due to undue delay and prejudice |
| Whether Woods and Dr. David were entitled to summary judgment on Eighth Amendment deliberate‑indifference claims | White: unrebutted expert and treatment record create a triable dispute that continued conservative care and delay in ordering MRI (and limited exams) amounted to deliberate indifference | Woods/Dr. David: conservative treatment was reasonable medical judgment; no deliberate indifference; delays reflect judgment calls, not constitutional violations | Held: Summary judgment vacated as to Woods and Dr. David—genuine factual disputes (expert testimony on critical 2–6 week window, limited exams, denied MRI) preclude judgment; remanded for trial |
Key Cases Cited
- Monell v. Department of Social Services, 436 U.S. 658 (municipal liability under § 1983 requires an official policy or custom)
- Farmer v. Brennan, 511 U.S. 825 (Eighth Amendment requires reasonable measures to provide adequate medical care)
- Estelle v. Gamble, 429 U.S. 97 (medical malpractice does not automatically equal Eighth Amendment violation)
- Petties v. Carter, 836 F.3d 722 (7th Cir. en banc) (two‑step deliberate‑indifference analysis: objective medical need and subjective state of mind)
- Conley v. Birch, 796 F.3d 742 (delay in treatment can support deliberate‑indifference claim if it substantially and unreasonably delays necessary care)
- Stewart v. Wexford Health Sources, Inc., 14 F.4th 757 (7th Cir.) (on review of summary judgment, take facts in light most favorable to nonmoving party)
- Pyles v. Fahim, 771 F.3d 403 (decision to forego diagnostic tests is typically a medical‑judgment question)
- Walker v. Wexford Health Sources, Inc., 940 F.3d 954 (departure from accepted professional judgment may support inference of deliberate indifference)