Appeal from the United States District Court for the Northern District of Illinois, Eastern Division.
No. 89 C 6455--Warren K. Urbom, Judge.
Before CUDAHY, ESCHBACH, and COFFEY, Circuit Judges.
Derrick Williams was allegedly subjected to repeated acts of medical malpractice while he was an inmate at Joliet Correctional Center ("Joliet") and Stateville Correctional Center ("Stateville"). Contending that this amounted to a constitutional violation, Williams brought an action under 42 U.S.C. sec. 1983 against those responsible for his medical care. He now appeals from the district court's grant of a judgment as a matter of law on qualified immunity grounds in favor of two of the defendants, Dr. Arthur Brewer and Dr. George Kurian. We affirm.
On January 7, 1986, Williams fractured his left femur in an automobile accident and a metal plate and screws were inserted into his leg to help the healing process. Unfortunately, when the metal plate and screws were removed on April 25, 1987, Dr. Michael Greenwald determined that Williams suffered from a chronic condition known as osteomyelitis, a bone infection which causes inflammation of the bone marrow and adjacent bone.
Williams entered Joliet in January 1988. In March, prison officials sought a consultation from Greenwald on Williams' condition and he advised them that Williams still suffered from osteomyelitis and should be treated with an antibiotic known as Duricef. When his condition did not improve, Williams was hospitalized on August 4, 1988 for intravenous antibiotic treatment. According to a culture report taken while Williams was in the hospital, his osteomyelitis appeared to be caused by an organism known as pseudomonas aeruginosa, a relatively uncommon cause of osteomyelitis, accounting for no more than five to ten percent of the cases. Greenwald advised Joliet officials that he should now be treated with an antibiotic known as Ciprofloxacin, which is appropriate for the treatment of pseudomonas aeruginosa. However, after being returned to Joliet, Williams was never given Ciprofloxacin as prescribed. On August 22, 1988, Williams was transferred from Joliet to Stateville.
At Stateville, Williams was first examined by Dr. George Kurian, a staff physician, on August 23, 1988. According to Williams' medical records, he was examined by physicians on 24 separate occasions in 1989 and on 15 separate occasions in 1990. Dr. Arthur Brewer, Stateville's medical director, personally examined Williams on May 8, June 5, and August 28 of 1990. Brewer asked the Stateville officers to allow Williams to use a cane and to live in a low gallery cell so as to minimize the amount of steps he would have to climb. Brewer and Kurian also prescribed several antibiotics to address Williams' osteomyelitis, including Duricef, Keflex, and Velosef, but they never prescribed or administered Ciprofloxacin. At the time, these three antibiotics were recommended when an infection was caused by an organism known as staphylococcus aureus, which accounts for almost ninety percent of the osteomyelitis cases. Brewer admitted that he had not examined the August 1988 culture report indicating pseudomonas aeruginosa and Dr. Greenwald's subsequent prescription for Ciprofloxacin.
After examining Williams' leg on May 8, 1990, Brewer sent a letter of consultation to the University of Illinois Hospital. Williams was sent on three occasions to the University of Illinois Hospital for antibiotic treatment before finally undergoing debridement surgery on December 4, 1990, a procedure to remove decayed bone. The antibiotic which eventually proved successful in treating Williams' condition was Vancomycin, which is ineffective against pseudomonas aeruginosa. Apparently, there has never been a definitive diagnosis as to the organism causing Williams' continued problems.
Williams brought this action against various officers and doctors at the institutions where he resided from 1988 until 1990. Count I alleged that nine individuals were deliberately indifferent to his medical care at Joliet from January 1988 until August 22, 1988, and Count II alleged that sixteen individuals were deliberately indifferent to his medical care at Stateville after August 22, 1988. *fn1 Eventually, trial commenced on September 2, 1993 against Sergeant Leroy Banks, Warden Salvatore Godinez, Captain Clyde E. Nash, Brewer and Kurian. *fn2 At the close of Williams' case-in-chief, the district court granted judgment as a matter of law to defendants Banks, Godinez and Nash. The case proceeded against Brewer and Kurian and ended with the judge declaring a mistrial because of a hung jury. A judgment as a matter of law was granted in favor of the defendants on qualified immunity grounds. Williams filed a timely notice of appeal. *fn3
The principal matter on appeal is whether Brewer and Kurian are entitled to qualified immunity for any actions taken in their capacity as medical director and staff physician, respectively, at Stateville. Williams challenges both the district court's implicit finding that Brewer and Kurian were public officials entitled to raise the qualified immunity defense and its explicit conclusion that it was not clearly established during the period in question that the defendants' actions amounted to a constitutional violation. We ...