Walls v. Mershon (7th Cir. 2025): Delineating Prisoners’ Informed-Consent Rights and Trial-Court Discretion to Sever Misjoined Claims

1. Introduction

In Nirin Walls v. N.P. Mershon, the United States Court of Appeals for the Seventh Circuit was asked to review a prisoner’s multifaceted civil-rights action against correctional and medical personnel. While the opinion is formally designated “nonprecedential,” it offers a lucid statement on two recurring litigation issues:

• Informed-Consent Rights in Prison: When (and how) a prisoner can state a Fourteenth-Amendment claim that medical staff failed to obtain informed consent.
• Severance of Misjoined Claims: The breadth of a district court’s discretion under Federal Rule of Civil Procedure 21 to sever unrelated claims and parties in order to manage prisoner litigation efficiently.

Plaintiff – appellant Nirin Walls, an Illinois inmate with chronic seizures, alleged that a medication change—implemented without consultation—triggered a chain of seizures, excessive-force incidents, threats, and ADA violations. After multiple opportunities to re-plead, the district court (Judge Iain D. Johnston) severed the claims, dismissed the core medication-consent allegations for failure to state a claim, and terminated the residual claims when Walls declined to pursue them separately.

2. Summary of the Judgment

In a brief per-curiam order (Judges Hamilton, Scudder, and Jackson-Akiwumi), the Seventh Circuit:

1. Affirmed severance. The appellate court held that the district court acted “well within its discretion” in splitting the case because the factual cores shared no “common thread” beyond Walls’s belief that every wrong flowed from the medication change.
2. Affirmed dismissal on the merits. The remaining informed-consent/deliberate-indifference claim failed because:
   • Prisoners have no constitutional entitlement to the medication of their choice (citing Abdul-Wadood),
   • Walls’s own refusal of the new medicine demonstrated that his right to refuse treatment was not impeded (citing Knight v. Grossman), and
   • The pleadings and attached exhibits showed he received post-seizure medical attention, negating deliberate indifference.
3. Rejected the “misjoinder dismissal” argument. The court clarified that the district court actually dismissed for failure to state a claim under 28 U.S.C. § 1915A—not for misjoinder—thereby obeying the bar in Rule 21 against dismissal solely because of joinder defects.

3. Analysis

3.1 Precedents Cited

The opinion relies heavily on Seventh Circuit and Supreme Court authority:

• George v. Smith, 507 F.3d 605 (7th Cir. 2007) – foundational rule: “Unrelated claims against different defendants belong in different suits.”
• Otis Clapp & Son, Inc. v. Filmore Vitamin Co., 754 F.2d 738 (7th Cir. 1985) – district court discretion to sever for judicial economy.
• Dorsey v. Varga, 55 F.4th 1094 (7th Cir. 2022) – misjoinder alone cannot justify dismissal.
• Washington v. Harper, 494 U.S. 210 (1990) & Knight v. Grossman, 942 F.3d 336 (7th Cir. 2019) – define prisoners’ qualified right to refuse unwanted medical treatment and the corollary right to adequate information.
• Petties v. Carter, 836 F.3d 722 (7th Cir. 2016) (en banc) – deliberate indifference standards; need evidence of plainly inappropriate medical judgment.
• Abdul-Wadood v. Nathan, 91 F.3d 1023 (7th Cir. 1996) – no right to the medication of one’s choosing.
• Estate of Simpson v. Gorbett, 863 F.3d 740 (7th Cir. 2017) – violation of policy ≠ constitutional violation absent knowledge of risk.

These authorities collectively drove the court’s twin holdings: broad discretion to sever and narrow contours of informed-consent claims.

3.2 Legal Reasoning

1. Severance Analysis
   • Rule 18(a) permits joinder of multiple claims against the same defendants, but Rule 20(a)(2) restricts joinder of different defendants unless the claims arise out of the “same transaction, occurrence, or series” and share common legal/factual questions.
   • Walls’s narrative spanned medication-changes, mace deployment, COVID-19 infection, threats, racial slurs, and ADA infractions involving different actors and time frames. Applying George, the district court identified misjoinder.
   • Under Rule 21, the court could “at any time” sever the action to foster manageable litigation—especially crucial in § 1983 inmate suits routinely screened under § 1915A.
   • The Seventh Circuit emphasized that such severance was not punitive; it was a case-management tool. The subsequent dismissal rested on Rule 12(b)(6)/§ 1915A standards, not on joinder technicalities, satisfying Dorsey.
2. Informed-Consent / Deliberate-Indifference Analysis
   • Eighth Amendment: A mere change in medication, devoid of factual allegations that it was medically unsound or that staff ignored a substantial risk, does not constitute deliberate indifference (Petties; Thomas v. Martija).
   • Fourteenth Amendment: The right to refuse unwanted treatment presupposes (i) lack of meaningful choice or (ii) inadequate disclosure of information. Here, Walls did refuse the new drug. By his own narrative, he successfully exercised his right—undercutting any claim that the prison thwarted informed decision-making.
   • Prison policy violations (failure to explain medication) do not automatically equate to constitutional breaches (Estate of Simpson). Constitutional liability flows from deliberate or reckless disregard, not negligent bureaucracy.
   • The record attachments (medical charts, grievance responses) showed seven follow-up visits, contradicting allegations of withheld care. Under Phillips v. Prudential, exhibits trump conclusory pleadings at screening.

3.3 Likely Impact of the Decision

Although officially “nonprecedential,” the order offers persuasive guidance, especially for district courts within the Seventh Circuit that manage high-volume prisoner filings:

• Prisoner Litigation Management: Confirms the propriety of proactive severance at the screening stage, so long as post-severance dismissals rely on substantive, not procedural, grounds.
• Informed-Consent Doctrine: Narrows the viable window for prisoner informed-consent claims. When an inmate demonstrably refuses treatment, the court will scrutinize causation—did lack of information actually impede refusal? If not, the claim collapses.
• Policy-vs-Constitution Distinction: Reinforces that internal policy breaches need an added layer of culpable mental state to mature into constitutional claims.
• Strategic Pleading Caution: Prisoners (and counsel) must craft complaints with unified factual nuclei or face fee-multiplying severance. Shotgun pleadings risk fragmentation and screening dismissal.

4. Complex Concepts Simplified

• Misjoinder: Suing multiple defendants for unrelated events in one lawsuit. Rules 18 & 20 allow joinder only when the defendants’ actions are part of the same transaction/occurrence and share common issues.
• Severance (Rule 21): Court’s power to split a lawsuit into separate cases. Each new case requires its own filing fee but enables focused adjudication.
• Deliberate Indifference: For prison-medical claims, plaintiff must show officials consciously ignored a substantial risk of serious harm—not merely made a negligent or reasonable medical decision.
• Informed Consent (Constitutional): Prisoners can refuse treatment if they have enough information to decide. Denial of information that unwanted treatment states a Fourteenth-Amendment claim.
• § 1915A Screening: Statutory mandate requiring courts to review prisoner complaints early and dismiss those that are frivolous, malicious, or fail to state a claim.

5. Conclusion

Walls v. Mershon stands as a concise yet instructive decision on two fronts. First, it validates robust use of Rule 21 severance in prisoner cases, provided subsequent merits decisions comply with Rule 21’s bar on dismissal solely for misjoinder. Second, it tightens the informed-consent window: a prisoner who successfully refuses treatment—and cannot plausibly link lack of information to any deprivation—will not clear the deliberate-indifference or substantive-due-process hurdles. Distinguishing policy violations from constitutional torts, the Seventh Circuit again reminds litigants that federal courts do not police medical disagreements; they remedy only wrongs.

Practitioners should heed the opinion’s dual lessons: plead with factual unity and specificity, and tether informed-consent allegations to concrete impediments to choice, lest the claims succumb at the screening gate.