Roger Graham v. Dushan Zatecky, 20-2999

Aug. 2017: Graham injured by a wood fragment in Pendleton Correctional Facility woodshop; taken to outside hospital where surgeon removed wood, sutured, and prescribed antibiotics.
Late 2017–Jan. 2018: Persistent hand pain; initial X‑ray negative; later ultrasound showed wood splinters leading to a second surgery in May 2018 to remove splinters.
Post‑second surgery: Graham continued to report retained wood; exams showed full range of motion, no infection, and functioning hand (working in the woodshop and performing ADLs).
June 2019: X‑ray revealed a small splinter in the fourth finger; medical staff (including regional medical director and outside hand surgeon) recommended conservative, non‑surgical care given splinter location, hand function, and elevated surgical risk due to Graham’s type II diabetes and weight.
Procedural posture: Graham sued under 42 U.S.C. § 1983 claiming Eighth Amendment deliberate indifference for denial of a third surgery; district court denied recruitment of counsel and entered summary judgment for defendants; Seventh Circuit affirmed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Dr. Talbot was deliberately indifferent by refusing a third surgery	Graham: retained foreign material and ongoing pain required a third operation	Talbot: exercised professional judgment; hand functional, no infection; splinter manageable non‑surgically; other clinicians concurred; diabetes/weight increased surgical risk	Summary judgment for Talbot — no deliberate indifference
Whether Wexford is liable under Monell for a policy/custom causing inadequate care	Graham: Wexford’s policies or practices resulted in denial of needed surgery	Wexford: care provided was constitutionally adequate, so no municipal‑style liability	Summary judgment for Wexford — no Monell liability
Whether the district court abused its discretion by denying appointment of counsel	Graham: needed counsel (and an expert) to litigate effectively	Defendants/District Court: Graham litigated coherently; help limited to typing; request raised late in discovery	Denial was not an abuse of discretion
Whether evidence created a genuine dispute of materially inadequate care after second surgery	Graham: continued pain and complaints showed need for further surgery	Defendants: objective findings (ROM, no infection, X‑ray/US results) and professional consensus supported conservative care	No genuine dispute; summary judgment appropriate

Petties v. Carter, 836 F.3d 722 (7th Cir. 2016) (en banc) (deliberate‑indifference standard for medical claims by prisoners)
Pyles v. Fahim, 771 F.3d 403 (7th Cir. 2014) (deference to reasonable professional medical judgment defeats deliberate‑indifference claim)
Monell v. Dep’t of Soc. Servs., 436 U.S. 658 (1978) (municipal or corporate entity liability requires a policy or custom causing the constitutional violation)
Pruitt v. Mote, 503 F.3d 647 (7th Cir. 2007) (en banc) (standard for appointment of counsel in civil cases)
Henderson v. Ghosh, 755 F.3d 559 (7th Cir. 2014) (consideration of inmate’s personal litigation abilities when evaluating counsel requests)
Stevo v. Frasor, 662 F.3d 880 (7th Cir. 2011) (timeliness of discovery‑related requests and counsel appointment considerations)