Denon Taylor v. Samuel Byrd

We recount the facts in the light most favorable to Taylor, the party opposing summary judgment. See Sanders v. Moss, 153 F.4th 557, 561 (7th Cir. 2025). Beginning in 2016, Dr. Samuel Byrd, a physician at Wabash Valley Correctional Facility, treated Taylor's knee pain and immobility. In January 2017, he referred Taylor to Dr. Kurt Madsen, a private orthopedic surgeon. In March 2017, Dr. Madsen performed a total knee replacement surgery on Taylor's left knee. At a follow-up appointment one month later, Dr. Madsen recommended that Taylor start physical therapy, which Dr. Byrd ordered. Dr. Madsen assessed Taylor again in July 2017 after Taylor reported that he had knee pain and could not straighten his leg. The next month, Dr. Madsen performed a second surgery. At an appointment after the second surgery, Dr. Madsen recommended x-rays and physical therapy, which Dr. Byrd ordered. In March 2018, Dr. Madsen evaluated Taylor again and recommended a third surgery followed by physical therapy, both of which Dr. Byrd ordered. At Taylor's request, Dr. Byrd also prescribed Tofranil (a medication used to treat chronic pain). Later that month, Dr. Madsen performed the third surgery and discharged Taylor with instructions to use a motorized therapy machine daily. Taylor used the machine for six weeks and attended physical therapy. While Taylor was recovering in the prison infirmary, Dr. Byrd offered Tramadol and Tylenol #3 with codeine (both prescription opioid pain relievers), but Taylor refused both medications. Dr. Byrd observed that Taylor's range of motion had improved since his initial knee replacement. At a follow- up appointment in April 2018, Dr. Madsen concluded that there were no remaining surgical options to improve Taylor's condition and released Taylor from his care. But in the months after the third surgery, Taylor's knee was swollen and he had increasing pain. At an appointment in July 2018, Dr. Byrd noted that Taylor's condition had improved following his completion of physical therapy, though he still had limited range of motion. In October 2018, Taylor reported to Dr. Byrd that he had reduced range of motion and more pain than before his first surgery. At Taylor's request, Dr. Byrd prescribed Cymbalta (a medication for chronic pain). Dr. Byrd also ordered x- rays and consulted with Wexford Health Sources's regional medical director. The next month, Dr. Byrd provided Taylor with a knee brace.

In July 2020, Taylor requested from Dr. Byrd a referral to a different orthopedist. Dr. Byrd ordered x-rays and again discussed the case with Wexford's regional medical director. Based on Dr. Madsen's determination that additional surgery could not improve Taylor's condition, the medical director concluded that Taylor should first attempt physical therapy and weight loss.

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For six weeks beginning in November 2020, Taylor had weekly physical therapy sessions. In March 2021, the physical therapist concluded that Taylor had improved range of motion and discharged Taylor with instructions to continue exercises on his own. The therapist concluded that no additional therapy could improve Taylor's condition beyond the improvements he had achieved.

But shortly after Taylor was discharged from physical therapy, he complained to Dr. Byrd that his pain persisted. Noting the improvement of Taylor's condition with physical therapy and the risk of exacerbating his condition with further surgery, Dr. Byrd advised a conservative treatment plan of continued pain medication and exercises.

Seven months later, after Taylor continued to experience pain, Dr. Byrd consulted with an independent, unnamed specialist who concluded that Dr. Madsen had implanted a prosthesis in Taylor's knee that was "too large for his native anatomy."

Dr. Byrd shared this information with Taylor at an appointment in October 2021 and referred him for a second opinion. In June 2022, the second orthopedist performed a successful revised knee replacement on Taylor's left knee.

Taylor sued Dr. Madsen and Dr. Byrd under 42 U.S.C. § 1983.^†Both defendants filed a motion for summary judgment, which the district court granted. The court concluded that Dr. Madsen was not a state actor because his treatment decisions were not influenced by the state or Taylor's status as a prisoner. Moreover, Dr. Madsen could not be liable as the state for Taylor's medical care where his treating relationship with Taylor consisted of only three surgeries and related appointments. Alternatively, the court concluded that no reasonable jury could find that Dr. Madsen was deliberately indifferent to Taylor's medical needs. As for Dr. Byrd, the court concluded that Taylor's claims pre-dating March 2018 were barred by Indiana's two-year statute of limitations. Moreover, no reasonable jury could conclude that Dr. Byrd had persisted in providing ineffective treatment after March 2018. The court explained that Dr. Byrd regularly adjusted Taylor's treatment plan, including ordering physical therapy and medication, and later referred Taylor for further surgery when those treatments were ineffective. On appeal, Taylor first challenges the district court's conclusion that Dr. Madsen did not act under color of state law. Taylor insists that Dr. Madsen effectively assumed the state's role to provide Taylor with healthcare. Whether Dr. Madsen, a private † Taylor also sued Wexford and two Wexford officials. The district court dismissed these claims, and Taylor does not challenge their dismissal on appeal.

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physician, acted under color of state law is a fact-intensive inquiry. Rodriguez v. Plymouth Ambulance Serv., 577 F.3d 816, 826 (7th Cir. 2009). We engage in a "functional analysis," focusing on the relationship between the state, the provider, and the prisoner to weigh whether the provider's actions may be "fairly attributable to the state." Id. As part of this analysis, we consider the extent to which the provider is "controlled or influenced by the state," and whether he has a direct relationship with the prisoner. Id. at 827-28. Where a provider has "only an incidental and transitory relationship with the state's penal system," he is not generally considered a state actor. Id. at 827. Here, we agree with the district court that no reasonable jury could conclude that Dr. Madsen was a state actor. Taylor insists that Dr. Madsen assumed the state's responsibility for his care because Dr. Madsen voluntarily took Taylor as a patient and accepted payment from a third-party insurer. But accepting a referral as a specialist does not confer on a provider the responsibility of managing the patient's continued care. See Shields v. Ill. Dep't of Corr., 746 F.3d 782, 798 (7th Cir. 2014). And despite Taylor's contention that Dr. Madsen was the "go-to" orthopedist for Indiana prisoners, he was not a state employee, and he did not contract with the state. Indeed, less than 2% of Dr. Madsen's patients were prisoners or detainees. That Dr. Madsen accepted Taylor and other prisoners as patients does not alone "establish the kind of close relationship"

between Dr. Madsen and Wexford to find that he was a state actor. See id. Taylor further argues that his relationship with Dr. Madsen was not incidental or transitory where Dr. Madsen saw him 11 times and performed 3 surgeries. But the number of visits does not determine whether a provider has assumed the role of the state in providing medical care. See Rodriguez, 577 F.3d at 828 ("[W]hat is fairly attributable to the state is a matter of normative judgment, and the criteria lack rigid simplicity." (internal quotation omitted)). Rather, it is "the degree to which the work of the private medical provider is controlled or influenced by the state." Id. at 827. And here, Taylor has not provided any evidence that Dr. Madsen was directed or influenced by prison staff in his treatment decisions. Further, it was Dr. Byrd, not Dr. Madsen, who managed Taylor's medical care. Dr. Byrd regularly examined Taylor, prescribed medication and physical therapy, determined whether outside consultation was necessary, and implemented any recommendations from specialists like Dr. Madsen. Dr. Madsen did not initiate follow-up appointments beyond the standard post-operative appointment after each surgery or provide any other medical care to Taylor.

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Taylor next contends that Dr. Madsen acted under color of state law because he treated Taylor in a unit of the hospital dedicated to prisoners. Taylor says the unit, like the prison, has guards, secured doors, and restraints. The setting in which medical care is rendered can be relevant to whether a provider treating a prisoner acts under color of state law. See Rodriguez, 577 F.3d at 826. But the appropriate inquiry remains "the degree to which the professional decisions made in rendering the care are influenced by the status of the patient as a prisoner and the directives of the state … with respect to the manner and the mode of care." Id. at 827. And Taylor has not presented evidence that any of these security measures influenced Dr. Madsen's care, nor does he point to any state directive that altered the course of Dr. Madsen's treatment in this setting. But even if Dr. Madsen were a state actor, we agree with the district court that no jury could find that Dr. Madsen was deliberately indifferent to Taylor's medical needs. Taylor would need some evidence that Dr. Madsen knew of and disregarded an objectively serious medical condition. Farmer v. Brennan, 511 U.S. 825, 834 (1994); McDaniel v. Syed, 115 F.4th 805, 832 (7th Cir. 2024). Taylor maintains that Dr. Madsen did not adequately treat his pain after the first failed surgery. But Dr. Madsen was not responsible for Taylor's post-operative care following that surgery, which was managed by Dr. Byrd. When Dr. Madsen re-examined Taylor following the first surgery, he recommended physical therapy and, when that was not successful, performed a second surgery. Although these interventions did not relieve Taylor's pain, Dr. Madsen did not disregard Taylor's complaints. To the extent that Taylor argues that Dr. Madsen was negligent in performing the failed knee surgeries, "[n]egligence or even objective recklessness" is not enough to prove deliberate indifference. McDaniel, 115 F.4th at 832. Taylor next argues that Dr. Byrd was deliberately indifferent following the third knee surgery in March 2018 by continuing to order pain medication and physical therapy instead of requesting a second opinion from a different orthopedist. Taylor contends that the three-and-a-half-year delay caused him unnecessary pain. But we agree with the district court that no reasonable juror could find that Dr. Byrd was deliberately indifferent to Taylor's pain. We defer to medical professionals who reasonably exercise their medical judgment unless "no minimally competent professional would have so responded under [the] circumstances." Pyles v. Fahim,

771 F.3d 403, 409 (7th Cir. 2014) (quoting Sain v. Wood, 512 F.3d 886, 894-95 (7th Cir. 2008)). After the third surgery, Dr. Byrd prescribed Taylor medication to treat his continued pain and ordered a knee brace. When Taylor reported the medication was ineffective, Dr. Byrd tried different pain medications. These actions reflect Dr. Byrd's

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reasonable attempts to treat Taylor's ongoing and long-term knee pain. Taylor counters that no competent doctor would have persisted with conservative treatment for over three years while Taylor's symptoms did not improve. But Dr. Byrd was entitled to rely on Dr. Madsen's opinion that there were no remaining surgical options and on the physical therapist's evaluation that Taylor's condition was improving. See Rodgers v. Rankin, 99 F.4th 415, 422 (7th Cir. 2024). Moreover, Dr. Byrd explained to Taylor that additional surgery risked worsening his condition. When it became clear that physical therapy was no longer effective and Taylor's pain persisted, Dr. Byrd sought another opinion and Taylor received corrective surgery from a different specialist.

AFFIRMED

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