O R D E R
Lyle Traxler sued Dr. Eric Nelson, alleging that he was deliberately indifferent when he recommended amputation to treat a disease in Traxler's leg. See 42 U.S.C. * 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NONPRECEDENTIAL DISPOSITION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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§ 1983. The district court entered summary judgment for Dr. Nelson. We affirm the judgment.
We recount the facts in the light most favorable to Traxler, the party opposing summary judgment, and draw all reasonable inferences in his favor. See Riley v. Waterman, 126 F.4th 1287, 1295 (7th Cir. 2025). Traxler, who was incarcerated at Waupun Correctional Center, reported pain in his right calf in October 2020. Two months later, a nurse noted that the front of his calf had thickening and hardening soft tissue and was at risk for infection. Traxler has diabetes, meaning his wounds are vulnerable to infection. Traxler's wound ultimately became infected and, despite a year's worth of treatment by prison and hospital providers, it did not heal. By October 2021, Traxler had an open wound in his leg measuring 4.5 by 5.7 by 9.5 centimeters and revealing his tibia.
On October 1, 2021, a surgeon performed a biopsy of Traxler's exposed bone. It showed that Traxler had osteomyelitis, a serious infection that can spread throughout the body.
Traxler then saw Dr. Karen Reynolds,†who asked Dr. Nelson, an orthopedic surgeon, to look at Traxler's wound and provide an informal opinion. Dr. Reynolds informed Dr. Nelson that the biopsy revealed osteomyelitis in Traxler's tibia. Dr. Nelson did not review any of Traxler's medical records. Dr. Reynolds and Dr. Nelson then informed Traxler that, because his wound would likely never heal, he could either live with the chronic wound for the rest of his life or undergo a below-the-knee amputation. Dr. Nelson recommended amputation. Dr. Reynolds and the hospital's physician overseeing Traxler's care agreed. Traxler states that when he requested replacing the bone with a steel rod as an alternative to amputation, Dr. Nelson ignored him. Based on his consultation with Dr. Nelson and Dr. Reynolds, Traxler consented to an amputation procedure. He signed a form that authorized Dr. Nelson to amputate his lower leg. The form stated that Traxler understood the "available alternatives" and that he had "all of the information about the procedure" that he wanted. † Dr. Reynolds was one of five original defendants to this lawsuit. The district court dismissed the claims against Dr. Reynolds at screening, see 28 U.S.C. § 1915A, and the other defendants settled. Traxler appeals only the summary-judgment order in favor of Dr. Nelson.
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Dr. Nelson amputated Traxler's lower right leg a month later. The surgery went without complication, and the pathology results confirmed the presence of chronic osteomyelitis in his tibia. Traxler met with Dr. Nelson three times after surgery. On one of these visits, Dr. Nelson noted that Traxler was experiencing his best-case scenario. Traxler sued Dr. Nelson, alleging two theories of how Dr. Nelson was deliberately indifferent to his medical needs when he recommended amputation. See 42 U.S.C. § 1983. First, Traxler argued that Dr. Nelson did not review Traxler's medical records before recommending amputation. Second, Traxler asserted that Dr. Nelson did not recommend an alternative to amputation, such as replacing the infected tibia with a steel rod.
The district court granted Dr. Nelson's motion for summary judgment. It first concluded that Dr. Nelson's failure to review Traxler's medical records was not constitutionally problematic because nothing in the record suggested that Dr. Nelson should not have relied on Dr. Reynolds's summary of Traxler's condition and treatment. Dr. Nelson also personally examined Traxler's wound, so the fact that he did not review Traxler's medical records did not render his recommendation unfounded. The district court next determined that Traxler did not show that no minimally competent professional would omit recommending a steel rod as a treatment option. Rather, the undisputed evidence showed that two other doctors agreed with Dr. Nelson's options: live with the wound or amputate.
On appeal, Traxler contends that the district court erred because the evidence shows that Dr. Nelson did not rely on his medical judgment when he failed to recommend alternative procedures like removing portions of the infected bone or replacing the infected tibia with a steel rod. To prevail against Dr. Nelson, Traxler must show that Dr. Nelson consciously disregarded a substantial risk of serious medical harm. Farmer v. Brennan, 511 U.S. 825, 839 (1994); Dean v. Wexford Health Sources, Inc.,
18 F.4th 214, 241 (7th Cir. 2021). A jury can infer deliberate indifference when a treatment decision is "so far afield of accepted professional standards as to raise the inference that it was not actually based on a medical judgment." Dean, 18 F.4th at 241 (citation omitted). "But where the evidence shows that a decision was based on medical judgment, a jury may not find deliberate indifference, even if other professionals would have handled the situation differently." Id.
Traxler asserts that Dr. Nelson did not rely on his medical judgment because he did not review Traxler's medical records before recommending amputation. But there is
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no dispute that Dr. Nelson knew Traxler's condition and was aware that he had osteomyelitis. Dr. Nelson spoke with Dr. Reynolds and looked at Traxler's wound himself. Dr. Nelson knew the wound was unlikely to heal and the osteomyelitis could spread beyond his tibia. Dr. Nelson's recommendation was based on his personal evaluation of Traxler's circumstances, a clear exercise of medical judgment. See id. at 242.
Traxler also argues that Dr. Nelson was deliberately indifferent because he did not recommend all available treatment options for osteomyelitis, such as surgery to remove the infected bone or a procedure to replace his tibia with a steel rod. But Traxler points to no evidence that Dr. Nelson consciously omitted these options despite knowing they were the best treatment for Traxler. See id. at 243. Rather, Dr. Nelson attested that he recommended amputation for Traxler because it both removed the infected bone and prevented the infection from spreading. Further, two other doctors— including the one treating Traxler throughout his year-long wound—also recommended amputation because the infection was non-healing and could spread. And even if one doctor had recommended an alternative procedure, nothing in the record suggests that no minimally competent medical professional would have attempted to prevent the spread of a serious disease in an at-risk patient through amputation, which, as Dr. Nelson attested, and Traxler did not dispute, is a recognized treatment for osteomyelitis. See Knight v. Grossman, 942 F.3d 336, 341 (7th Cir. 2019).
AFFIRMED
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