Steven Ingalls, Jr. v. Shelby Crichfield

to his serious medical needs in violation of the Eighth Amendment.¹See 42 U.S.C. § 1983. The district court granted summary judgment for both defendants. We affirm. We consider the facts in the light most favorable to Ingalls, the party opposing summary judgment. Hildreth v. Butler, 960 F.3d 420, 425 (7th Cir. 2020). On June 12, 2022, Ingalls, who is incarcerated at Wabash Valley Correctional Facility, was suffering from a painful buildup of earwax that interfered with his hearing. He submitted a healthcare request form seeking treatment. The next day, when the pain had become unbearable, Ingalls used the emergency intercom system in his cell to contact prison staff and request immediate assistance. Ingalls spoke with Malott and explained his symptoms. Malott said he would contact medical staff and call Ingalls back. Malott promptly spoke with an unknown member of the medical staff and reported Ingalls's symptoms of ear pain and hearing loss. The staff person advised Malott that medical staff and the specific medication needed to treat Ingalls's ear were unavailable at that time, so no one could respond to Ingalls's request for immediate care. Because immediate treatment was unavailable and the medical staff member did not state that Ingalls required emergency care, Malott called Ingalls back via the intercom and told him to submit another healthcare request and a grievance about the nursing staff shortage. Ingalls submitted both.

On July 14, 2022, a month after he first requested treatment, Ingalls was seen by a nurse (employed by Centurion) who told him that Wabash had "been understaffed"

and apologized for the delay in treatment. She examined both of his eardrums, reported a "scant amount of blood" in his left ear canal, and referred him to a physician who examined Ingalls a week later. The physician ordered over-the-counter ear drops to help soften and remove earwax, a prescription antibiotic, and an audiogram test. Ingalls received the ear drops and his pain gradually dissipated over the next few weeks, but he did not receive the antibiotic or an audiogram.

A month later, Ingalls filed this lawsuit alleging that Centurion and Malott violated his rights under the Eighth Amendment by acting with deliberate indifference to his ear condition. See Farmer v. Brennan, 511 U.S. 825, 843 (1994). He alleged that

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Centurion maintained an express policy or, alternatively, a widespread practice, of understaffing and withholding medication to save costs. See Monell v. Dep't of Soc. Servs., 436 U.S. 658, 694-95 (1978). Ingalls alleged that Malott was deliberately indifferent because he denied Ingalls medical care when Ingalls first reported his symptoms. See Farmer, 511 U.S. at 844-45.

During discovery, Ingalls requested a copy of Centurion's "technical proposal"

and its contract with the IDOC, asserting the documents were relevant to his Monell claim. Centurion objected to the request, so Ingalls moved to compel production. The district court denied Ingalls's motion without addressing Centurion's objection. The defendants moved for summary judgment, and the court granted the motion. Assuming that Ingalls's medical condition was serious, the court determined he failed to present evidence from which a reasonable jury could conclude that Centurion's practices were constitutionally deficient. The court acknowledged that Ingalls waited approximately one month for treatment and received only one of the two medications prescribed to him. The court concluded, however, that there was "no evidence in the record that Centurion maintained any policy or practice that caused a violation of"

Ingalls's rights under the Eighth Amendment, that the delay in treatment was "the result of a deliberate policy or practice, or that other inmates also experienced delays in receiving examinations or lapses in medication." See Hildreth, 960 F.3d at 426. The court also concluded that no reasonable jury could find that Malott violated Ingalls's constitutional rights where Malott relied on the professional judgment of medical staff. See Giles v. Godinez, 914 F.3d 1040, 1049 (7th Cir. 2019).

On appeal, Ingalls first challenges the denial of his motion to compel production of Centurion's technical proposal and contract with IDOC. We review a district court's denial of a motion to compel for abuse of discretion and will reverse only if the denial

"resulted in actual and substantial prejudice." Gonzalez v. City of Milwaukee, 791 F.3d 709, 713 (7th Cir. 2015). In Ingalls's view, these documents would have helped him prove that Centurion maintained an unconstitutional policy of understaffing facilities and withholding medications as cost-saving measures. But in his opening brief, Ingalls explains that he now has a copy of the documents, which are publicly available,²and he reproduces the portions that he says support his claim. But those sections do not support his theory. For example, he points to Centurion's statements that using generic

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medications and educating patients to participate in their own care are associated with lower costs. But those statements, focused on methods of providing cost-effective medical care, do not alone reflect a policy inconsistent with the Eighth Amendment. See Petties v. Carter, 836 F.3d 722, 730 (7th Cir. 2016) (en banc) (administrative convenience and cost are permissible considerations for correctional systems in providing medical care so long as they are not considered to the exclusion of reasonable medical judgment). Thus, Ingalls cannot show that he was prejudiced by the district court's denial.

For the same reason, Ingalls's argument that the district court erred in determining that Centurion's policies did not cause a constitutional injury fails. He again insists that provisions of the contract discussing generic medication and patient participation in care reflect an unconstitutional policy. But nothing on the face of these policies amounts to an express instruction to provide constitutionally deficient medical care. See J.K.J. v. Polk Cnty., 960 F.3d 367, 377 (7th Cir. 2020) (en banc). Ingalls argues in the alternative that Centurion maintained a practice of understaffing and withholding medications, and that it knew these practices would lead to constitutional violations. The failure to correct known "[d]eficiencies in staffing and delays in treatment can give rise to a deliberate indifference claim." Reck v. Wexford Health Sources, Inc., 27 F.4th 473, 489 (7th Cir. 2022). But Ingalls would need evidence sufficient to show "such systemic and gross deficiencies in staffing, facilities, equipment, or procedures that the inmate population is effectively denied access to adequate medical care." Id. (quoting Wellman v. Faulkner, 715 F.2d 269, 274 (7th Cir. 1983)). The district court was correct that neither the nurse's comment that Centurion had "been understaffed" nor Malott's statement that medical staff was unavailable to immediately respond to Ingalls suggests that, in this case, Centurion intentionally understaffed its facilities or withheld medication or knew that the practice existed and needed correcting. Though Ingalls waited for treatment, he did receive care, including ear drops that reduced his pain. And, though there are no "'bright-line rules' defining a widespread practice or custom," Ingalls's evidence of his personal experience is insufficient to establish a systemic breakdown or widespread failure in care. Hildreth,

960 F.3d at 427 (quoting Thomas v. Cook Cnty. Sheriff's Dep't, 604 F.3d 293, 303 (7th Cir.

2010)).

Lastly, Ingalls contends that the district court erred in granting summary judgment to Malott. He insists that Malott was trained to respond to emergencies, had a duty to ensure he received medical care, and could have administered care to him but did not. But the undisputed evidence shows that Malott responded promptly to

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Ingalls's request for care by contacting medical staff and relaying Ingalls's symptoms. When medical staff explained that Ingalls could not be seen immediately, Malott told Ingalls to submit another healthcare request. Malott was entitled to rely on the professional judgment of medical officials that Ingalls's condition did not require immediate intervention and could be addressed through the ordinary healthcare request process. See Giles, 914 F.3d at 1049.

AFFIRMED

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