Cohorting Policies and the Eighth Amendment: Reasonable Prison Health Response in Pandemic Outbreaks

Introduction

Case Name: Booker T. Shipp v. Kenneth Lobenstein, et al.
Court: United States Court of Appeals for the Seventh Circuit
Date Decided: April 17, 2025
Lower Court: United States District Court for the Western District of Wisconsin

In this appeal, Wisconsin prisoner Booker T. Shipp challenged the decision of prison officials to quarantine him alongside a cellmate who tested positive for COVID-19. Shipp alleged that this “cohorting” policy violated his Eighth Amendment right against cruel and unusual punishment by exposing him to a substantial risk of serious harm. The key issues before the Seventh Circuit were whether the defendants acted with deliberate indifference to Shipp’s health and whether their response to an emergent outbreak of COVID-19 was constitutionally reasonable.

Summary of the Judgment

The Seventh Circuit affirmed summary judgment in favor of the defendants. It held that:

1. No reasonable jury could conclude that prison officials acted with deliberate indifference to Shipp’s health because they sought and followed the unanimous recommendation of medical experts in adopting a cohorting strategy.
2. Violation of CDC guidelines or internal policy, standing alone, does not establish an Eighth Amendment violation.
3. There was insufficient evidence that any named defendant personally approved earlier movements of infected inmates or knowingly misled medical advisors about the availability of isolation cells.

Accordingly, the court held that the defendants reasonably responded to the COVID-19 outbreak and exhibited no deliberate indifference under the Eighth Amendment.

Analysis

Precedents Cited

• Farmer v. Brennan, 511 U.S. 825 (1994): Defined the “deliberate indifference” standard for Eighth Amendment claims and held that an official must “know of and disregard an excessive risk” to inmate safety.
• Estelle v. Gamble, 429 U.S. 97 (1976): Established that prison officials have an obligation to provide basic medical care and that deliberate indifference to serious medical needs constitutes cruel and unusual punishment.
• Moore v. Western Illinois Correctional Center, 89 F.4th 582 (7th Cir. 2023): Clarified the standard of review for summary judgment in Eighth Amendment suits and the requirement to view undisputed facts in the light most favorable to the non-moving party.
• Simpson v. Gorbett, 863 F.3d 740 (7th Cir. 2017): Held that violation of administrative guidelines alone does not necessarily establish deliberate indifference under the Constitution.
• Mays v. Dart, 974 F.3d 810 (7th Cir. 2020): Emphasized deference to professional medical judgment in prison health decisions during a pandemic.
• Hunter v. Mueske, 73 F.4th 561 (7th Cir. 2023): Reinforced that reasonable responses to known risks shield defendants from liability under § 1983.
• Horshaw v. Casper, 910 F.3d 1027 (7th Cir. 2018): Affirmed the personal involvement requirement in § 1983 suits, holding that each defendant must have participated in or authorized the unconstitutional conduct.
• Johnson v. Myers, 53 F.4th 1063 (7th Cir. 2022): Reiterated that a plaintiff must present expert or medical evidence, not mere lay speculation, to prove causation in prison medical cases.

Legal Reasoning

The Seventh Circuit’s reasoning can be broken down into three core findings:

1. No Constitutional Violation from Policy Deviations: The court reaffirmed that prison officials are not automatically liable under § 1983 merely for failing to follow CDC or internal guidelines. Instead, liability hinges on whether officials were deliberately indifferent to a serious risk.
2. Unanimous Medical Expert Endorsement: The cohorting decision was based on consistent advice from three medical authorities (the institution’s health-services supervisor and two Department of Corrections medical directors). They concluded that:
   • Testing delays meant negative inmates could already be incubating the virus.
   • Moving infected prisoners risked exposing unaffected units and personnel.
   • “Cohorting in place” had successfully mitigated spread in another facility.
   The court held that reliance on this collective medical judgment was reasonable as a matter of law.
3. Absence of Deliberate Indifference or Personal Involvement: Shipp produced no evidence that any defendant knowingly disregarded a substantial risk. His allegation that the health-services supervisor “lied” about wet-cell capacity was insufficient because the record showed the cohort policy stemmed from expert medical rationale, not a misunderstanding of cell counts. Similarly, no named official was proven to have authorized the earlier movements of 11 infected inmates.

Impact

This decision carries several important implications for future prison-health litigation:

• Deference to Expert Judgment: Courts will continue to grant deference to prison officials’ reliance on qualified medical advice in emergency health situations.
• Limited Weight of Guidelines: Non-binding health guidelines—whether from the CDC or an institution’s own policy manual—are relevant but not dispositive in Eighth Amendment deliberate-indifference analysis.
• Higher Bar for Plaintiffs: Inmates must produce direct evidence that officials both recognized a serious health risk and consciously chose to ignore it; speculative or lay assertions will not suffice.
• Summary Judgment Remains Accessible: When the record demonstrates a reasonable and medically supported response, courts will not hesitate to dispose of claims prior to trial.

Complex Concepts Simplified

• Deliberate Indifference: A legal standard requiring proof that an official knew of a risk to inmate health or safety and consciously disregarded it. Mere negligence or disagreement with policy is not enough.
• Summary Judgment: A procedural device by which a court may resolve a case without a full trial if no genuine dispute of material fact remains and the moving party is entitled to judgment as a matter of law.
• § 1983 Claim: A lawsuit brought under 42 U.S.C. § 1983 for violations of constitutional rights by state or local officials acting “under color of law.”
• Cohorting vs. Isolation (“Wet” and “Dry” Cells):
  • Isolation: Removing an infected prisoner to a separate “wet cell” (with toilet and sink) for 14 days.
  • Cohorting: Keeping potentially exposed inmates together in their existing units to limit the spread outside that group.

Conclusion

The Seventh Circuit’s decision in Booker Shipp v. Lobenstein affirms that prison officials who secure and act upon reliable medical advice during a public-health crisis will not be deemed deliberately indifferent under the Eighth Amendment. Violations of non-binding guidelines alone do not establish constitutional liability. Rather, inmates challenging pandemic-response measures must show that officials consciously disregarded a known, substantial risk and that the challenged action was not a reasonable medical judgment. This precedent underscores judicial deference to expert-driven, policy-based responses in correctional healthcare and sets a high evidentiary bar for future Eighth Amendment claims arising from infectious‐disease outbreaks.