1. Introduction

Vernell Freeman, an Indiana prisoner, sued Nurse Kimberly Myers and Dr. Noe Marandet under 42 U.S.C. § 1983, alleging Eighth Amendment deliberate indifference to serious medical needs. The dispute arose after Freeman fell from a top bunk, later received a CT scan showing a chronic subdural hematoma, and continued to have access to Excedrin (contains aspirin, a blood thinner). He later suffered worsening symptoms, culminating in an emergency craniotomy.

The appeal primarily presented two questions:

• Myers: After learning of the subdural hematoma, did she nevertheless advise Freeman to keep taking Excedrin and fail to stop the prescription—conduct that could reflect deliberate indifference rather than mere negligence?
• Marandet: Did his involvement in recommending conservative management after the first CT scan, without evidence of awareness of Excedrin use, support liability?

2. Summary of the Opinion

The Seventh Circuit vacated summary judgment in part and remanded on a narrow claim: a reasonable jury could find that Myers was deliberately indifferent “on or after June 26, 2018” if she advised Freeman to keep taking Excedrin after learning he had a subdural hematoma and failed to terminate the prescription or provide safer alternatives.

The court otherwise affirmed:

• No deliberate indifference by Myers before the CT-confirmed diagnosis; her initial clinical assessment and treatment plan could support, at most, negligence.
• No deliberate indifference by Marandet; conservative management alone was not shown medically inappropriate, and the record did not tie him to Excedrin or knowledge of blood-thinner use.

3. Analysis

3.1 Precedents Cited (and how they shaped the decision)

• Wood v. Sec. Credit Servs., LLC: The court invoked this case for the summary-judgment lens—drawing reasonable inferences for the nonmovant (Freeman). That framing was decisive because the dispute centered on what Myers told Freeman on June 26.
• Petties v. Carter: Provided the governing Eighth Amendment standard: the plaintiff must show officials “actually knew of and disregarded a substantial risk of harm,” and where risks may be “imperceptible to a lay person,” liability turns on action “in the absence of professional judgment.” It also supplied benchmarks for inferring deliberate indifference from unexplained departures and delayed action under scrutiny.
• Stockton v. Milwaukee County: Used in two ways: (1) to reject deliberate indifference premised solely on misdiagnosis after an examination (supporting affirmance as to pre-CT conduct), and (2) to reinforce that causation is “typically a question reserved for the jury,” limiting summary judgment on disputed medical worsening.
• Omnicare, Inc. v. UnitedHealth Grp., Inc.: Anchored the procedural error the panel found in the district court’s approach—courts cannot weigh credibility or resolve conflicting evidence at summary judgment. That principle prevented crediting Myers’s “Tylenol only” account over Freeman’s sworn statement.
• Riley v. Waterman: Clarified the boundary between reasonable professional disagreement (no deliberate indifference) and a “significant departure from accepted professional standards” (triable deliberate indifference). The panel used it to say: if advising Excedrin post-diagnosis is never medically acceptable (and Myers essentially conceded contraindication), then the “professional disagreement” safe harbor does not apply.
• Arnett v. Webster: Reinforced that treatment “so far afield of accepted professional standards” can allow an inference that the provider was not exercising medical judgment. This supported sending Myers’s post-diagnosis advice issue to a jury.
• Goodloe v. Sood: Supplied two strands: (1) deliberate indifference is “particularly strong” when a provider knows a specific task is needed and fails to do it (here, stop contraindicated medication); (2) consultation history alone does not establish another provider’s culpable mental state (supporting affirmance for Marandet).
• Gil v. Reed: Cited for the proposition that failing to prescribe safer alternatives despite known risk can support deliberate indifference—used to emphasize the significance of not switching Freeman promptly to safer analgesics.
• Gayton v. McCoy: Used to limit summary judgment on causation: only appropriate where the plaintiff offers “no evidence” the defendant exacerbated injury. Myers’s admission that blood thinners can aggravate a subdural hematoma supplied at least some evidence.
• Thomas v. Martija: Supported affirmance for Marandet: a prisoner’s disagreement with “conservative treatment” does not create a triable claim absent evidence other treatment was medically indicated.

3.2 Legal Reasoning

The panel separated the case into two phases: pre-diagnosis and post-diagnosis.

Phase 1: Pre-diagnosis (affirmed as to Myers)

Before the June 8 CT scan, Myers treated Freeman based on an exam, record review, x-rays, neurological testing, and migraine history. Even if she was wrong, the court deemed the record consistent with a clinical judgment call rather than knowing disregard of a substantial risk—placing the conduct in negligence territory, not deliberate indifference (relying on Stockton v. Milwaukee County).

Phase 2: Post-diagnosis (vacated and remanded as to Myers)

After the CT scan revealed a subdural hematoma, the risk profile changed. Two evidentiary points drove the reversal:

• Knowledge of risk: Myers admitted Excedrin would be contraindicated for a patient with a subdural hematoma because blood thinners could cause herniation.
• Disregard and departure: Freeman swore that Myers nevertheless told him on June 26 to keep taking Excedrin, and the prescription remained in place afterward.

The district court’s error was procedural and substantive: it effectively resolved the disputed June 26 conversation in Myers’s favor despite record silence and Freeman’s contrary sworn testimony, something forbidden under Omnicare, Inc. v. UnitedHealth Grp., Inc..

Substantively, the panel treated the alleged advice as potentially “unequivocally inappropriate” in light of Myers’s own statements about contraindication, pushing the case beyond ordinary treatment disagreement and into “significant departure” territory (drawing on Riley v. Waterman and Arnett v. Webster). The panel also emphasized inaction: failing to terminate the prescription and not providing safer alternatives until July 17—after infirmary admission and one day before the emergency craniotomy—could strengthen an inference of deliberate indifference (citing Goodloe v. Sood, Gil v. Reed, and Petties v. Carter).

Causation

Defendants argued intervening causes (other NSAIDs; a disputed second fall). The panel declined to take causation from the jury because Freeman had at least some evidence of exacerbation: Myers admitted blood thinners can aggravate a subdural hematoma, making it inappropriate to grant summary judgment unless Freeman had “no evidence” of worsening attributable to the challenged conduct (per Gayton v. McCoy and consistent with Stockton v. Milwaukee County).

Claims against Marandet (affirmed)

Freeman attacked Marandet’s recommendation of no immediate treatment after the first CT scan. The panel treated this as a disagreement with conservative management, insufficient without evidence that alternative treatment was medically required (Thomas v. Martija). Critically, there was no evidence Marandet knew Freeman was taking Excedrin or any blood thinners; consultation alone did not establish the necessary mental state (Goodloe v. Sood).

3.3 Impact

Although labeled “NONPRECEDENTIAL DISPOSITION,” the order is a useful roadmap for litigating (and defending) Eighth Amendment medical-care claims at summary judgment in the Seventh Circuit:

• Documented contraindication + continued exposure = triable risk: Where a provider acknowledges a medication is contraindicated for a diagnosed condition, alleged advice to continue it—and failure to discontinue an existing prescription—can support a finding of deliberate indifference.
• Silence in records does not defeat sworn testimony: When the chart does not memorialize verbal instructions, credibility disputes may still go to a jury rather than be resolved for the clinician.
• Role clarity matters for multi-provider suits: Without evidence of knowledge and involvement in the risky decision, consultants and non-treating physicians may secure summary judgment even if they participated in general case discussions.
• Causation commonly remains for trial: Competing potential causes (other drugs, intervening events) will not necessarily support summary judgment if the plaintiff offers competent evidence that the challenged conduct could have worsened the condition.

4. Complex Concepts Simplified

• Deliberate indifference (Eighth Amendment): More than medical malpractice. The plaintiff must show the provider knew of a substantial risk of serious harm and disregarded it.
• “Absence of professional judgment”: When the danger is not obvious to a layperson, courts look for signs the provider was not truly applying medical judgment—e.g., decisions far outside accepted standards.
• Summary judgment: A pretrial ruling allowed only when no genuine dispute of material fact exists. Courts cannot choose which witness is more believable; that is for the jury.
• Subdural hematoma: Bleeding between the brain and its outer covering, sometimes developing after head trauma. It can enlarge and become life-threatening.
• Contraindicated medication: A drug that should generally not be used with a particular condition because it poses heightened risk. Here, Excedrin contains aspirin (a blood thinner), which can worsen bleeding.
• Conservative treatment: Monitoring/watchful waiting rather than immediate intervention. Disagreeing with that approach is not enough; the plaintiff must show it was medically inappropriate in context.

5. Conclusion

The Seventh Circuit’s partial reversal turned on a narrow but potent combination: (1) a diagnosed intracranial bleed, (2) the provider’s own recognition that blood-thinning medication is contraindicated, and (3) the patient’s sworn testimony that the provider nevertheless advised continued use and did not stop the prescription. Under governing deliberate-indifference doctrine and summary-judgment constraints, that conflict must be resolved by a jury. At the same time, the court reaffirmed limits on Eighth Amendment liability for misdiagnosis based on an examination, for conservative management absent evidence of medical necessity for more, and for defendants not shown to have knowledge of (or participation in) the alleged risky medication decision.