Tyrone Petties v. Imhotep Carter
836 F.3d 722
| 7th Cir. | 2016Background
- In January 2012 prisoner Tyrone Petties suffered an Achilles tendon rupture at Stateville and experienced severe pain and impaired mobility for years thereafter.
- Dr. Imhotep Carter (Stateville medical director, Wexford employee) diagnosed the rupture, provided crutches, pain medication, and a specialist referral, but did not immobilize the tendon (no splint/boot) for about six weeks despite Wexford protocol recommending a splint.
- An MRI in March 2012 confirmed a rupture with ~4.7 cm gapping; orthopedist Dr. Puppala recommended and supplied an orthopedic boot and suggested surgery might be necessary; Dr. Carter later authorized the boot but allegedly refused surgery as "too costly."
- In July 2012 Petties saw ankle specialist Dr. Chmell (ordered a second MRI and physical therapy); Dr. Saleh Obaisi (Carter’s successor) approved the second MRI but declined to authorize physical therapy and allegedly cited cost concerns.
- Petties sued under 42 U.S.C. § 1983 alleging Eighth Amendment deliberate indifference; the district court granted summary judgment for defendants; the Seventh Circuit (en banc) reversed and remanded, finding triable issues about the doctors’ subjective knowledge.
Issues
| Issue | Petties' Argument | Defendants' Argument | Held |
|---|---|---|---|
| Whether Dr. Carter was deliberately indifferent by not immobilizing the ruptured tendon and delaying specialist care | Carter knew immobilization was necessary; his failure to splint for six weeks and delay referral caused pain and gapping | Carter followed some protocol, gave crutches/analgesics, relied on lockdowns for delay, and disputed knowledge of shortage of splints | Reversed: factual disputes (protocol, Carter’s own testimony, specialists’ opinions, delay, and possible cost-motives) permit a jury to infer deliberate indifference |
| Whether Dr. Obaisi was deliberately indifferent by refusing ordered physical therapy | Obaisi disregarded a specialist’s PT recommendation and post-hoc rationalizations (patient "knew exercises") are implausible | Obaisi said PT unnecessary because Petties previously knew exercises and could walk to strengthen ankle | Reversed: material factual dispute exists—jury must decide whether Obaisi’s refusals reflected deliberate indifference versus permissible judgment |
| Whether an inmate who received some care (palliative measures) can state an Eighth Amendment claim | Even where palliative care was provided, a course of treatment that a jury could find knowingly inadequate can constitute deliberate indifference | Defendants and dissent: Estelle means provision of some medical care (even palliative) generally precludes a constitutional claim; malpractice belongs in state court | Majority: Estelle does not bar Eighth Amendment claims when circumstantial evidence lets a jury infer the provider knew the treatment created a substantial risk of harm |
| Whether defendants are entitled to qualified immunity | Petties: if jury finds doctors knew care was inadequate, law was clearly established that such conduct violates the Eighth Amendment | Defendants: qualified immunity or private-employee immunity should shield them | Qualified immunity inappropriate at summary judgment here; private prison medical personnel not entitled to immunity and, if jury finds knowledge, Eighth Amendment violation is clearly established |
Key Cases Cited
- Farmer v. Brennan, 511 U.S. 825 (deliberate indifference requires actual knowledge of substantial risk)
- Estelle v. Gamble, 429 U.S. 97 (not all inadequate medical care amounts to an Eighth Amendment violation; palliative care can satisfy constitutional minimum but deliberate indifference remains actionable)
- Cole v. Fromm, 94 F.3d 254 (a medical decision so substantially outside accepted judgment can support inference of conscious disregard)
- Arnett v. Webster, 658 F.3d 742 (refusal to follow specialist or persistently ignoring deterioration can show deliberate indifference)
- Shields v. Illinois Dep’t of Corrections, 746 F.3d 782 (private prison medical personnel are not entitled to qualified immunity)
- Grieveson v. Anderson, 538 F.3d 763 (inexplicable delay in treatment that causes harm can support Eighth Amendment claim)