O R D E R
Vernell Freeman, an Indiana prisoner, alleges that Nurse Kimberly Myers and Dr. Noe Marandet, medical providers at Miami Correctional Facility, violated his rights under the Eighth Amendment. See 42 U.S.C. § 1983. The district court denied Freeman's * We have agreed to decide the case without oral argument because the briefs and record adequately present the facts and legal arguments, and oral argument would not significantly aid the court. FED. R. APP. P. 34(a)(2)(C).
NONPRECEDENTIAL DISPOSITION
To be cited only in accordance with FED. R. APP. P. 32.1
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motion for summary judgment and granted the defendants' motion. But a reasonable factfinder could conclude that Myers was deliberately indifferent to Freeman's medical needs when she advised Freeman to take a medication containing a blood thinner after he was diagnosed with a subdural hematoma. So we vacate the judgment as to that claim. In all other respects, we affirm.
Because the case was resolved on cross-motions for summary judgment, we recount the facts and draw all reasonable inferences in favor of Freeman, the losing party. See Wood v. Sec. Credit Servs., LLC, 126 F.4th 1303, 1308 (7th Cir. 2025). On April 30, 2018, Freeman fell from a top bunk and hit his head on a desk in his cell. His cellmate alerted correctional staff, who discussed the fall with Freeman and told him to fill out a Health Care Request form. Three days later, Freeman told a triage nurse that he was nauseous, dizzy, and in pain. He said that clumps of blood came out of his nose, mouth, and eye when he blew his nose, and the nurse noted that he had a broken blood vessel in his eye. Freeman requested to see another nurse two weeks later, on May 17, reporting that he felt "intense pressure" and "like liquid" was in his head. Myers examined Freeman and diagnosed him with a head contusion on May 18. Myers reviewed Freeman's records, examined his x-rays, conducted a neurological test, and discussed Freeman's history of migraines. At Freeman's request, she renewed his six-month prescription for Excedrin, a pain-relief medication that contains aspirin, which is a blood thinner. Freeman and Myers dispute whether she specifically advised him to take Excedrin for his headaches at this visit, though Myers acknowledges that she renewed the prescription because "it was a routine medication for him," "there were no signs nor symptoms of any neurological damages nor intracranial bleeding present," and she believed his symptoms were consistent with his history of migraines. Out of caution, Myers referred Freeman for a CT scan to rule out any underlying issues. The scan on June 8 revealed that Freeman had a small, chronic subdural hematoma—bleeding under the outer layer of the brain that may occur after a head injury.†Myers and Marandet, a doctor at the prison, discussed the results and determined that no treatment was needed at that time.
When Freeman next saw Myers on June 26, she informed him of the results of the CT scan. Freeman attests that Myers told him to keep taking Excedrin, while Myers contends that she told him to take only Tylenol, which is not a blood thinner. The † Subdural Hematoma, Medline Plus (June 13, 2024), https://medlineplus.gov/ ency/article/000713.htm.
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medical record from that day is silent as to which medication Myers verbally advised Freeman to take, but that record and subsequent medical records show that Freeman continued to have a prescription for Excedrin.
The parties also dispute which medications Freeman took after this visit. Nursing staff provided Freeman with Excedrin up to three times a week. But Freeman denies taking ibuprofen, an NSAID pain reliever that also functions as a blood thinner. On July 4, a dentist prescribed him a five-day course of naproxen, another NSAID, after he reported "tremendous pain" in his jaw. Myers did not know about the naproxen prescription until after Freeman finished taking it, and Freeman attested that he did not remember whether he had taken the naproxen.
Freeman's headaches grew worse. On July 15, he reported that he had suffered from a headache with "9 out of 10" pain and was admitted to the infirmary. Early the next morning, he pressed the emergency call button, reporting that he had passed out. The parties dispute whether he also hit his head. On July 17, Myers prescribed several new medications to Freeman "to get him to stop the NSAIDs and the Excedrin."
By July 18, Freeman's headaches had intensified, so Myers referred him for another CT scan at a local hospital. That scan revealed that the hematoma had grown significantly, so surgeons performed an emergency craniotomy. Freeman remained in the hospital for four days. While he was hospitalized, doctors terminated the Excedrin prescription and prescribed new medications. Freeman reports that he suffers side effects from the procedure, including seizures, headaches, and personality changes. Freeman filed suit, alleging that Myers was deliberately indifferent to the risks of prescribing and recommending Excedrin to him after he fell and hit his head. He also asserted that Myers and Marandet were deliberately indifferent by pursuing no treatment following the initial discovery of his hematoma.
The parties moved for summary judgment. In a declaration, Myers explained that her initial decision to prescribe Excedrin on May 18 was appropriate because, at that time, she was not yet "aware of any neurological damage, nor of the chronic subdural hematoma." Myers stated that after the first CT scan, Freeman "should not have continued to take Excedrin." Likewise, when discussing the dentist's treatment decisions, she asserted that naproxen—another NSAID and blood thinner—"should not have been prescribed nor dispensed to Mr. Freeman as it could have attributed [sic] to herniation of the subdural hematoma."
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The district court entered summary judgment for the defendants. It reasoned that Myers's actions related to Freeman's medications were at most negligent. Specifically, the court did not address Freeman's sworn statement that Myers advised him to keep taking Excedrin at the June 26 appointment. Instead, the court credited Myers's assertion that she told Freeman to take only Tylenol following the discovery of the hematoma. Moreover, the court reasoned that the plan to provide no treatment after the first CT scan was supported by professional judgment. Finally, the court concluded that no reasonable jury could find that Marandet acted with deliberate indifference where he was not involved in the treatment decisions related to the Excedrin and did not personally treat Freeman until after the craniotomy.
On appeal, Freeman maintains that Myers and Marandet were deliberately indifferent and that the court improperly credited Myers's account that she advised Freeman to take only Tylenol on June 26. To establish a violation of his rights under the Eighth Amendment, Freeman must show that the defendants were deliberately indifferent to his serious medical condition—that is they "actually knew of and disregarded a substantial risk of harm." Petties v. Carter, 836 F.3d 722, 728 (7th Cir. 2016). And because the risks that Freeman alleges his medical providers ignored might be "imperceptible to a lay person," he must also show that they acted in the absence of professional judgment. Id. at 729. (The parties do not dispute that Freeman's medical condition was "objectively serious." Id. at 728.)
Freeman cannot show that Myers acted with deliberate indifference before she reviewed the results of his CT scan diagnosing him with a subdural hematoma. Until that point, Myers had little reason to believe prescribing Excedrin presented a serious risk. Myers first treated Freeman for his head injury on May 18. At that visit, she read his file and evaluated his symptoms before determining that he had a minor head contusion and was suffering from his usual migraines. Myers asserts that it was medically reasonable to prescribe Excedrin—a medication Freeman had taken for years—to a patient with this diagnosis. Freeman counters that Myers should have known that he was suffering from a serious head injury, denied his request to refill the Excedrin, and advised him to stop taking it. But no reasonable jury could conclude that Myers's misdiagnosis constitutes deliberate indifference where she thoroughly examined Freeman and determined that his symptoms were consistent with a minor contusion. See Stockton v. Milwaukee County, 44 F.4th 605, 615-16 (7th Cir. 2022). But there is a genuine dispute of material fact regarding whether Myers was deliberately indifferent after she learned of the results of Freeman's CT scan.
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Specifically, Myers admitted in her declaration that she knew that Excedrin would be contraindicated for a patient with a subdural hematoma because blood-thinning medication could cause the hematoma to herniate. But Freeman attested that Myers advised him to continue taking Excedrin during the June 26 visit to review the CT scan results, and undisputed evidence shows that he continued to have a prescription for Excedrin after this visit. In other words, Freeman has provided some evidence from which a jury could infer that Myers knew of but disregarded a substantial risk of harm. See Petties, 836 F.3d at 728-29.
To be sure, Myers disputes Freeman's account of the June 26 visit. She says that she advised Freeman to take only Tylenol. But the medical records are silent on this point, and Freeman swears that Myers told him to keep taking Excedrin. We are not permitted to resolve fact disputes at summary judgment. See Omnicare, Inc. v. UnitedHealth Grp., Inc., 629 F.3d 697, 704-05 (7th Cir. 2011) (weighing conflicting evidence and making credibility determinations is "the province of the jury"). Notably, there is no hint in the record—whether in Myers's declaration or elsewhere—that advising a patient with a subdural hematoma to take Excedrin would be an appropriate medical decision. Where reasonable medical professionals could disagree as to a course of treatment, there is no deliberate indifference. See Riley v. Waterman, 126 F.4th at 1287, 1296 (7th Cir. 2025). But Myers's sworn statements that Excedrin is contraindicated for a patient with a subdural hematoma and that Freeman should not have been taking it reveals that her advice to Freeman to continue taking Excedrin was unequivocally inappropriate. See id. at 1295 (jury could infer treatment was "so significant a departure from accepted professional standards or practices that it calls into question whether the provider actually was exercising professional judgment"
(citation modified)); Arnett v. Webster, 658 F.3d 742, 751 (7th Cir. 2011) (treatment decision may be "so far afield of accepted professional standards as to raise the inference that it was not actually based on a medical judgment" (citation omitted)). Moreover, Myers's failure to terminate the Excedrin prescription after the discovery of Freeman's hematoma is additional evidence the jury may consider in determining whether she failed to exercise medical judgment. In the context of a provider's persistence in a course of treatment known to be ineffective, we have noted that "when a doctor is aware of the need to undertake a specific task and fails to do so, the case for deliberate indifference is particularly strong." Goodloe v. Sood, 947 F.3d 1026, 1031 (7th Cir. 2020). Similarly, a jury may infer deliberate indifference when a provider knows the risk of a course of treatment but fails to prescribe safer, alternative
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medications, see Gil v. Reed, 381 F.3d 649, 664 (7th Cir. 2004), or when a provider fails to pursue adequate treatment until after she comes under scrutiny, see Petties, 836 F.3d at 732. Here, Myers knew that Freeman needed to stop taking Excedrin after he was diagnosed with a subdural hematoma, but she did not prescribe an available, safer alternative until July 17, after Freeman was admitted to the prison infirmary and the day before his emergency craniotomy.
Freeman has presented sufficient evidence from which a jury could conclude that that Myers "knew better than to make the medical decisions that [she] did." Id. at 731. Myers admitted that she knew Freeman should not be taking Excedrin after he was diagnosed with a subdural hematoma, Freeman attested that Myers told him to keep taking it on June 26, and Myers did not terminate the Excedrin prescription or provide safer, alternative medications during that visit.
Although Myers disputes whether her actions caused Freeman's condition to worsen, "the causal link between a defendant's deliberate indifference and a plaintiff's injury is typically a question reserved for the jury." Stockton, 44 F.4th at 615. Freeman's use of other NSAIDs and the disputed second fall may have contributed to the worsening of his hematoma. But summary judgment on causation is proper only where
"a plaintiff can proffer no evidence that [the defendants' actions] exacerbated an injury." Gayton v. McCoy, 593 F.3d 610, 624 (7th Cir. 2010). Here, Myers admits that blood-thinning medications like Excedrin can aggravate a subdural hematoma. Finally, we turn to Freeman's claims against Marandet. Freeman insists that Marandet's recommendation to take no action after the hematoma was initially discovered amounts to deliberate indifference. But Freeman's disagreement that conservative treatment was appropriate is insufficient to defeat summary judgment where Freeman has presented no evidence from which a jury could infer that any other treatment was medically indicated. See Thomas v. Martija, 991 F.3d 763, 772 (7th Cir. 2021). And no evidence links Marandet to Freeman's prescription for Excedrin or the advice to continue taking it. Although Marandet and Myers discussed Freeman's first CT scan, there is no evidence that Marandet knew Freeman was taking Excedrin or any other blood thinners. See Goodloe, 947 F.3d at 1032 (provider's history of consulting with treating physician did not establish culpable role or mental state). Accordingly, we VACATE the judgment with respect to Freeman's claim against Myers that she acted with deliberate indifference on or after June 26, 2018, when she advised Freeman to keep taking Excedrin after he was diagnosed with a subdural
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hematoma, and we REMAND for further proceedings. The balance of the judgment is
AFFIRMED.
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