Steven Ingalls, Jr. v. Centurion Health of Indiana, LLC

serious medical needs in violation of the Eighth and Fourteenth Amendments. See 42 U.S.C. § 1983. The district court granted the defendants' motions for summary judgment. 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). In January 2022, Ingalls was suffering from abdominal pain related to his diet. He submitted a health care request form seeking treatment. A nurse saw him three days later and ordered labs to test for a potential soy allergy. The test results were negative for the allergy and so Ingalls did not receive a therapeutic diet.

Ingalls filed other health care request forms in February, March, and July of 2022, requesting treatment for the same kind of pain. Ingalls had an appointment with Dr. Samuel Byrd about a week after he submitted the July form. Ingalls asserts that Dr. Byrd said he "must observe a starvation diet to become clinically underweight"

before he could be treated. It is undisputed that Dr. Byrd recommended that Ingalls try avoiding the foods that he believed were causing symptoms of intolerance. This recommendation was consistent with IDOC policy, which states that individuals with food intolerances may be required to follow an elimination diet, unless doing so would

"adversely affect the patient's body weight or health." See IDOC MANUAL OF POLICIES AND PROCEDURES, REGULAR AND THERAPEUTIC DIETS, § III.B. Dr. Byrd explained that if that were to happen, the "intolerance would be considered significant and an alternative diet could be pursued."

Also in July, Ingalls filed two grievances, both of which grievance specialist Shelby Crichfield rejected. Crichfield rejected Ingalls's first grievance because it violated institution policy by including profanity and grieving multiple issues. In his second grievance, which he filed four days after his appointment with Dr. Byrd, Ingalls described his stomach pain and stated that "Dr. Byrd … advised that I must starve myself to the end of becoming severely underweight before he will consider prescribing me any diet-treatment." He also described an unrelated medical issue he had been dealing with "for over a month." Crichfield rejected the second grievance without addressing the allegations about Dr. Byrd, stating only "if you have been dealing with this for over a month now, you have had plenty of time to grieve."

The following month, Ingalls filed this lawsuit alleging that Centurion, Dr. Byrd, and Crichfield violated his Eighth Amendment rights. He alleged that Centurion maintained an express policy or, alternatively, a widespread practice of failing to

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provide treatment.¹See Monell v. Dep't of Soc. Servs., 436 U.S. 658, 694-95 (1978). He alleged that Dr. Byrd was deliberately indifferent because he knew of Ingalls's ongoing pain and yet failed to treat him. See Farmer v. Brennan, 511 U.S. 825, 847 (1994). And he alleged that Crichfield was deliberately indifferent because she rejected grievances relating to his medical concerns. See id.

The district court granted the defendants summary judgment. The court assumed that Ingalls's medical condition was objectively serious but found no evidence from which a jury could conclude that Dr. Byrd acted with deliberate indifference, where he had exercised medical judgment in treating that condition. The court also concluded that Ingalls failed to introduce sufficient evidence to show that Centurion maintained practices or policies that led to constitutional violations, noting that Ingalls received continuing care and had not shown that other inmates experienced intentional disregard. Finally, the court concluded that no reasonable jury could find that Crichfield had violated Ingalls's constitutional rights when she returned his grievances. On appeal, Ingalls first argues that the district court erred by granting Dr. Byrd summary judgment. To establish his claim of deliberate indifference, Ingalls needed to introduce evidence showing that Dr. Byrd knew of and disregarded an objectively serious medical condition. Barnes v. Wexford Health Sources, Inc., 177 F.4th 825, 832 (7th Cir. 2026). Dr. Byrd acknowledges that he knew of Ingalls's condition, and we will adopt the district court's presumption that the condition was objectively serious. Thus, we need only determine whether Dr. Byrd disregarded the condition by responding as

"no minimally competent professional" would. Id. at 833 (quoting Clemons v. Wexford Health Sources, Inc., 106 F.4th 628, 637 (7th Cir. 2024)). Ingalls's evidence does not meet that standard. The record supports the district court's conclusion that Dr. Byrd exercised medical judgment in determining that a therapeutic diet was not yet necessary. Ingalls has not introduced any evidence from which a jury could conclude that Dr. Byrd's decision fell below minimal competence. Ingalls establishes only that he would prefer to receive a therapeutic diet, but he cannot demonstrate deliberate indifference simply because he wanted Dr. Byrd to take "some other course of action." Id. Though prisoners must receive adequate medical care, they are not "entitled to demand a specific kind of care." Id. at 835.

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Ingalls also suggests that the "unmannerly" nature of Dr. Byrd's statements could support a deliberate indifference finding, because he has asserted that Dr. Byrd explicitly directed him to starve himself. Dr. Byrd has disputed that he would ever tell a patient to do so, but the dispute is immaterial, because even "[r]epugnant words … will seldom rise to an Eighth Amendment violation." Lisle v. Welborn, 933 F.3d 705, 719 (7th Cir. 2019). Standing alone, fleeting verbal harassment—that which is "too limited to have an impact"—does not violate the Eighth Amendment, and Ingalls has not presented any evidence that Dr. Byrd's words caused any independent harm or impact. See Beal v. Foster, 803 F.3d 356, 358-59 (7th Cir. 2015).

Ingalls next argues that the district court erred in granting Centurion summary judgment, pointing to various excerpts from Centurion's contract with IDOC. He asserts that these excerpts demonstrate that Centurion prioritized saving costs over providing adequate care, thus maintaining a policy, practice, or custom that violated his constitutional rights. But saving money is a permissible consideration for a correctional system in providing medical care, so long as it is not to the exclusion of reasonable medical judgment. See Petties v. Carter, 836 F.3d 722, 730 (7th Cir. 2016) (en banc). Nothing Ingalls points to in the contract amounts to an authorization or instruction to provide constitutionally deficient medical care. See J.K.J. v. Polk County, 960 F.3d 367, 377-78 (7th Cir. 2020) (en banc). And in any event, because Ingalls has failed to establish an underlying constitutional violation with respect to his medical care, Monell liability cannot attach to Centurion. See Barnes, 177 F.4th at 836.²

Lastly, Ingalls argues that reasonable jurors could have found that Crichfield was deliberately indifferent when she rejected his second grievance as untimely.³Under IDOC policy, a grievance is timely if it is filed within ten business days of the incident at

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issue. See IDOC MANUAL OF POLICIES AND PROCEDURES, OFFENDER GRIEVANCE PROCESS, § X. In rejecting the grievance, Crichfield stated that it was "[o]ut of time frame"

because Ingalls was complaining about an issue he had been dealing with "for over a month." To establish that her rejection of the grievance amounted to deliberate indifference, Ingalls needed to show that Crichfield "disregarded an excessive risk" to Ingalls's health. Giles v. Godinez, 914 F.3d 1040, 1052 (7th Cir. 2019). This might be found where, for example, a prison official has "reason to believe (or actual knowledge) that prison doctors … are mistreating (or not treating) a prisoner." Id. at 1049-50 (citation modified).

Ingalls has not met this standard. The grievance notified Crichfield that Dr. Byrd had seen Ingalls just days before. Because non-medical prison officials are generally

"justified in believing that [a] prisoner is in capable hands" when they know that the prisoner is "under the care of medical experts," Crichfield was entitled to rely on Dr. Byrd's treatment decisions. Id. at 1049 (quoting Greeno v. Daley, 414 F.3d 645, 656 (7th Cir. 2005)). And though the grievance states that Dr. Byrd told Ingalls to starve himself, Ingalls also wrote that what he wanted to accomplish through the grievance was for Crichfield "to ensure that [he] receive a prescription for a no-soy or renal diet,"

which he had just been denied. In other words, his grievance expressed a preference for other treatment. Without more, it did not give Crichfield reason to believe Dr. Byrd was failing to treat or mistreating him. See Barnes, 177 F.4th at 835. Finally, as the district court found, there is nothing in the record which suggests that Crichfield's rejection of the grievance caused a delay in Ingalls's care or exacerbated his condition. See id. at 833-34.

AFFIRMED

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