ROSE v. HEFLIN
1:23-cv-01822
| S.D. Ind. | Jul 18, 2025Background
- Ronald L. Rose, an IDOC inmate with lifelong asthma/allergies, experienced progressive respiratory decline while incarcerated, including repeated hemoptysis and very low FEV1 readings (as low as ~20–39%).
- Allergy specialist Dr. Leena Padhye and pulmonologist Dr. Moallem diagnosed severe, poorly controlled asthma and recommended biologic therapy (Nucala/Fasenra), Spiriva/Tudorza, allergen immunotherapy, and follow-up testing.
- Centurion providers (primary doctor Dr. John Heflin, Site Director Dr. Kate Wilks, Statewide Medical Director Dr. Stephanie Riley) either denied or delayed non-formulary biologics and did not timely implement specialist recommendations; formulary-exception requests for Nucala/Fasenra were denied or deferred.
- Rose repeatedly complained, filed grievances, and documented nurses witnessing blood-tinged sputum; the court granted preliminary injunctive relief ordering Tudorza and sputum testing, which later led to identification of infection and IV vancomycin treatment that Rose says improved his FEV1 to ~75%.
- Procedural posture: Defendants moved for summary judgment (Denial in full). Court denied summary judgment on Eighth Amendment deliberate-indifference claims against all defendants, kept supplemental jurisdiction over state-law negligence claims, granted/modified preliminary injunction relief earlier, denied later injunctive motions as moot or as improperly new claims.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Deliberate indifference by treating physician (Heflin) | Heflin disregarded specialists, persisted in ineffective treatment, delayed testing, ignored hemoptysis, causing deterioration | Heflin exercised professional judgment, provided meds, breathing treatments, referrals; objective findings did not show distress; some refusals by Rose | Summary judgment denied; factual disputes (refusal to follow specialists, persistence in ineffective regimen, timing of changes) present jury question |
| Supervisory liability (Wilks, Riley) | Supervisors denied/blocked biologics or delayed alternatives, possibly for cost or convenience, and turned blind eye to failing care | They relied on provider reports, weighed infection/immunosuppression risks, exercised medical judgment | Summary judgment denied as to both; factual disputes over whether decisions were medical judgment or cost/administrative-driven and whether they knowingly facilitated mistreatment |
| Grievance/administrative response (Gobber) | Gobber misreported records, failed adequately to investigate, minimized complaints (including witnessed hemoptysis) | He merely relayed information from medical providers and had no medical role | Summary judgment denied; issues exist whether he conducted a reasonable investigation or turned a blind eye |
| Supplemental jurisdiction over state-law negligence claims | Rose: federal claims remain so state claims should proceed | Defendants sought relinquishment if federal claims failed | Court denied relinquishment because federal Eighth Amendment claims survive summary judgment |
| Injunctive relief (prelim/reconsider/permanent) | Rose sought immediate testing, bronchoscopy, Tudorza, ongoing nebulizers and remedial staffing relief | Defendants argued compliance or that some requests concerned other entities/new claims | Earlier preliminary relief granted in part (Tudorza, sputum testing); later motions denied as moot; permanent-injunction motion denied as improperly presenting a new/severed case (Rose may elect to open new case) |
Key Cases Cited
- Farmer v. Brennan, 511 U.S. 825 (1994) (Eighth Amendment requires humane conditions and adequate medical care)
- Greeno v. Daley, 414 F.3d 645 (7th Cir. 2005) (standards for objectively serious medical need and that subjective complaints can show severity)
- Zaya v. Sood, 836 F.3d 800 (7th Cir. 2016) (professional-judgment deference; pretext inquiry when a provider's explanation is implausible)
- Petties v. Carter, 836 F.3d 722 (7th Cir. 2016) (en banc) (use of context clues to infer subjective knowledge and deliberate indifference)
- Reck v. Wexford Health Sources, Inc., 27 F.4th 473 (7th Cir. 2022) (persistence in ineffective treatment can establish deliberate indifference)
- Goodloe v. Sood, 947 F.3d 1026 (7th Cir. 2020) (continued ineffective treatment can raise jury question on Eighth Amendment claim)
- Johnson v. Dominguez, 5 F.4th 818 (7th Cir. 2021) (deliberate-indifference two-part test: objective seriousness and subjective indifference)
- Perez v. Fenoglio, 792 F.3d 768 (7th Cir. 2015) (medical care must be adequate in light of severity and professional norms)