Tyrone Gabb v. Wexford Health Sources, Inc., 945 F.3d 1027

Tyrone Gabb, an Illinois prisoner, suffered chronic lower-back pain and sought treatment at Lawrence Correctional Center between 2014–2015.
Dr. John Coe (medical director) ordered imaging, prescribed various conservative treatments (Motrin, Naproxen, Robaxin, Mobic, back support, exercises), and mentioned but declined to pursue more expensive "better" treatments.
Nurse Tammy Kimmel saw Gabb for abdominal complaints he attributed to Tylenol and did not refer him to a physician or provide alternative pain medication at those visits.
Gabb alleged Eighth Amendment deliberate indifference against Coe and Kimmel and a Monell-style claim against Wexford Health Sources, Inc. (the jail’s private medical provider).
The district court granted summary judgment to Coe and Kimmel and, sua sponte, to Wexford; the Seventh Circuit affirmed, holding Gabb offered no evidence that defendants’ actions caused him harm.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Coe was deliberately indifferent by continuing conservative care and refusing costlier "better" treatments	Coe persisted in ineffective treatment for cost reasons and refused referrals/specialist care, causing continued pain	Coe exercised medical judgment; treatment choices were reasonable conservative care	Even if deliberate indifference were shown, Gabb produced no evidence that any alternative would have improved his condition, so no actionable injury
Whether Kimmel was deliberately indifferent by not referring or changing medication	Kimmel refused to refer or provide different pain meds despite knowledge of back pain	Kimmel followed protocol for presenting complaint (abdominal pain) and did not render unconstitutional care	Even assuming deliberate indifference, Gabb showed no evidence the omission caused harm, so claim fails
Whether Wexford is liable under a Monell-style theory	Wexford’s policies caused denial of effective care	Wexford delegated medical judgment; any alleged policy-caused harm is speculative	Court erred procedurally by granting sua sponte judgment without notice but affirmed on the merits because Gabb cannot show any injury traceable to Wexford

Estelle v. Gamble, 429 U.S. 97 (Eighth Amendment requires provision of medical care to prisoners)
Petties v. Carter, 836 F.3d 722 (7th Cir.) (en banc) (deliberate indifference standard—subjective knowledge of substantial risk)
Berry v. Peterman, 604 F.3d 435 (7th Cir.) (distinguishing proof of "serious but avoidable pain")
Langston v. Peters, 100 F.3d 1235 (7th Cir.) (verifying medical evidence required to show detrimental effect of delay)
Roe v. Elyea, 631 F.3d 843 (7th Cir.) (§1983 elements include causation of injury)
Whiting v. Wexford Health Sources, Inc., 839 F.3d 658 (7th Cir.) (private providers liable under Monell-style theory)
Anderson v. Liberty Lobby, 477 U.S. 242 (summary judgment standard)
Celotex Corp. v. Catrett, 477 U.S. 317 (summary judgment burden-shifting principles)
Hudson v. McMillian, 503 U.S. 1 (Eighth Amendment prohibits wanton and unnecessary infliction of pain)
Hassebrock v. Bernhoft, 815 F.3d 334 (7th Cir.) (no remand when plaintiffs cannot win)