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Pyles v. Fahim

United States Court of Appeals, Seventh Circuit

November 13, 2014

CHRISTOPHER PYLES, Plaintiff-Appellant,
MAGID FAHIM, Doctor, Medical Director, Menard CC, et al., Defendants-Appellees

Submitted August 28, 2014.

Appeal from the United States District Court for the Southern District of Illinois. No. 3:11-cv-000378-SCW -- Stephen C. Williams, Magistrate Judge.

Christopher Pyles, Plaintiff - Appellant, Pro se, Menard, IL.

For MAGID FAHIM, Doctor, Medical Director, Menard Correctional Center, WEXFORD HEALTH SERVICES, Employer of Menard Correctional Center's Medical Staff, Defendants - Appellees: Timothy Patrick Dugan, Attorney, Sandberg Phoenix & Von Gontard P.C., St. Louis, MO.

Before WOOD, Chief Judge, and EASTERBROOK and RIPPLE, Circuit Judges.


Page 404

Ripple, Circuit Judge.

Christopher Pyles, an Illinois prisoner, injured his back when he slipped on wet stairs at Menard Correctional Center. Mr. Pyles sometimes used those stairs when showering, and a month before his fall he had alerted the warden, Donald Gaetz, that this stairway can be treacherous because of the water tracked from the nearby showers. Mr. Pyles contends, in this action under 42 U.S.C. § 1983, that

Page 405

Warden Gaetz was deliberately indifferent to the hazard, and that Wexford Health Sources (" Wexford" ), which provides contract medical care to Menard inmates, and a Wexford physician, Magid Fahim, were deliberately indifferent to his back injury. Mr. Pyles alleged that, after initially being treated for his fall, he suffered ongoing, significant pain, yet Dr. Fahim refused to investigate its cause.

At screening, see 28 U.S.C. § 1915A, the district court dismissed Mr. Pyles's claim against the warden. A magistrate judge (presiding by consent) later granted summary judgment for Wexford and Dr. Fahim on the medical claim. On appeal, Mr. Pyles challenges the adverse rulings on both of his Eighth Amendment claims.

Although we do not fully agree with the district court's analysis, we conclude that the court correctly reasoned that the slipping hazard about which Mr. Pyles complained was not sufficiently dangerous to support an Eighth Amendment claim. We also agree with the district court that, from the evidence submitted at summary judgment, a finder of fact could not reasonably conclude that Mr. Pyles's medical claim rests on more than a disagreement with Dr. Fahim about the appropriate course of treatment. We therefore affirm the judgment of the district court.




In late June 2009, Mr. Pyles addressed and sent to Warden Gaetz an emergency grievance in which he complained that the stairs that he and others in the cell block use to access the " six gallery" showers become dangerously slick from water tracked by the inmates' shower shoes.[1] This footwear was required, but the inmates had no means of drying the soles before accessing the stairs, and the stairs themselves lacked measures to reduce the slipping hazard caused by accumulated water. In his grievance, Mr. Pyles recounted his own difficulties with safely traversing the stairs and requested that additional precautions be taken to address the issue.[2] As far as the record shows, no one replied to Mr. Pyles's grievance.

Then, on July 25, 2009, roughly five weeks after he submitted his emergency grievance, Mr. Pyles fell on the wet stairs while returning from the " six gallery" showers.[3] He struck his head on a step and then injured his lower back as he tumbled down the stairs. He lost consciousness and was temporarily paralyzed from the waist down. He first was taken to a local hospital. CT scans did not reveal spinal damage, but a radiologist recommended an MRI " [i]f there remains a clinical concern for injury." [4] An MRI, the radiologist explained, " is more sensitive in evaluating the soft tissues." [5] Before the day ended, Mr. Pyles was airlifted from the local hospital to a hospital in St. Louis, Missouri. During his stay at that facility, doctors obtained MRI views of Mr. Pyles's head, neck, and spine. His treating physicians also ordered additional CT scans. The attending radiologists reported that

Page 406

none of these diagnostic procedures showed abnormal results.[6] The doctors in St. Louis diagnosed Mr. Pyles with a spinal contusion.

Mr. Pyles was seen by both a physical therapist and an occupational therapist in St. Louis. After observing Mr. Pyles's unsteady gait and lingering mobility problems, each prescribed some therapy to improve Mr. Pyles's functional mobility. Mr. Pyles returned to Menard after five days in St. Louis. He remained in the prison infirmary for another four days, where he was seen daily by staff. Afterward, he was released to the general population, but continued to complain about extreme pain in his lower back. Doctors examined him six times in the next two months. Each time, the treating physician concluded that only a painkiller, usually nonprescription ibuprofen, was warranted.[7] Two back X-rays revealed " [p]ost [t]raumatic [a]rthritic changes" in Mr. Pyles's spine, but no fracture or other abnormality.[8]

In late September 2009, two months after Mr. Pyles's injury, Dr. Fahim joined Wexford as the medical director at Menard. When Dr. Fahim first examined Mr. Pyles in January 2010, he wrote in the medical file that he had not detected any abnormality. He substituted, nevertheless, a muscle relaxer and a prescription painkiller for the nonprescription ibuprofen that Mr. Pyles previously had been receiving. Dr. Fahim also instructed Mr. Pyles on the " proper exercise [and] stretching of [b]ack mus[c]les" that could alleviate his back pain.[9] Mr. ...

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