United States District Court, N.D. Illinois, Eastern Division
TYRESE T. ROLAND, Plaintiff,
THOMAS DART, Sheriff of Cook County, Defendant.
MEMORANDUM OPINION AND ORDER
REBECCA R. PALLMEYER United States District Judge
2014, Plaintiff Tyrese T. Roland, then a detainee at the Cook
County Department of Corrections (CCDOC), injured his right
eye during a basketball game. Roland slowly lost vision in
the eye. By June 2015, his vision had deteriorated to the
point that he could no longer perceive light out of his right
eye. Plaintiff has sued the County of Cook and Cook County
Sheriff Tom Dart in his official capacity (collectively,
"Defendants"), pursuant to 42 U.S.C. § 1983
and Monell v. Department of Social Services, 436
U.S. 658 (1978), alleging that their policies and practices
demonstrated deliberate indifference to Plaintiff's
medical needs and exacerbated the severity of his eye injury.
Plaintiff also brought suit against one of his treating
physicians, Dr. Muhammad Rafiq, but all claims against Dr.
Rafiq have since been dismissed. Defendants have each filed
motions for summary judgment  . For the reasons
discussed below, the court denies Defendants' motions.
parties have filed statements of material facts in accordance
with Local Rule 56.1(a)(3). Where the parties have failed to
cite to support in the record to dispute directly facts set
forth in the statements, the court deems those facts to be
admitted. See Local Rule 56.1(b) ("All material
facts set forth in the statement required of the moving party
will be deemed to be admitted unless controverted by the
statement of the opposing party."); see also F.T.C.
v. Bay Area Bus. Council, Inc., 423 F.3d 627,
633 (7th Cir.2005) ("Because of the important function
local rules like Rule 56.1 serve in organizing the evidence
and identifying disputed facts, we have consistently upheld
the district court's discretion to require strict
compliance with those rules.").
Plaintiff's Injury and Treatment
was incarcerated at CCDOC, primarily in Division XI, from
April 2014 until his transfer to the Illinois Department of
Corrections (IDOC) in December 2014. (Defs.' Jt. Rule
56.1 Stmt. of Mat. Facts , hereinafter "Defs.'
56.1, " ¶¶ 1-2.) While playing basketball on
June 28, 2014, Plaintiff suffered an injury when he was poked
in his right eye. (Id. ¶ 20.) The following
day, Plaintiff had watery, crust-covered eyes and vision
difficulties, and he requested medical assistance. (Dep. of
Tyrese Roland, Ex. A to Defs.' 56.1 [78-2], hereinafter
"Roland Dep., " 34:24-35:14.) A CCDOC officer
transported Plaintiff to the Division XI dispensary, where
Elizabeth Santos, a registered nurse (RN), evaluated him and
sent him to the emergency room at Cermak Health Services,
CCDOC's on-site medical facility. (Defs.' 56.1
¶¶ 21-22.) During Dr. Rafiq's evaluation of
Plaintiff at Cermak, Plaintiff told him about the injury he
suffered the previous day. (Id. ¶ 23.) After
examining Plaintiff, Dr. Rafiq diagnosed conjunctivitis, an
eye infection that usually resolves on its own, and
prescribed the antibiotic ointment erythromycin.
(Id. ¶¶ 24-25.) Plaintiff asserts that
following this visit with Dr. Rafiq, he made at least two
oral requests to CCDOC staff members to be taken to the
division dispensary to visit a doctor. Each time, he asserts,
the officer denied his request and instructed him to fill out
a health service request ("HSR") form instead.
(Pl.'s Rule 56.1 Stmt. of Add'l Facts ,
hereinafter "Pl.'s 56.1, " ¶ 21; Roland
Dep. 43:1-16.) Defendant denies that officers ever refused
Plaintiff’s requests, and assert that detainees'
requests to be taken to the dispensary are never refused.
(Defs.' Resp. to Pl.'s 56.1  ¶ 21.)
weeks after seeing Dr. Rafiq at Cermak, Plaintiff continued
to have vision problems. On August 3, 2014, he filled out and
submitted an HSR form, which is the primary method by which
CCDOC inmates request non-emergency healthcare. (Id.
¶¶ 4, 26.) Inmates at CCDOC place HSR forms in lock
boxes that only Cermak personnel can access. (Id.
¶ 6.) According to a Cermak written policy (Policy #
E-07), which is dated November 2, 2012 and entitled
"NONEMERGENCY HEALTH CARE REQUESTS AND SERVICES, "
HSR forms must be picked up daily and reviewed by a nurse or
other qualified health care professional within 24 hours of
collection. (Id. ¶ 5; Cermak Policy E-07, Ex. K
to Defs.' 56.1 [78-12], hereinafter "Policy
E-07.") If the HSR form describes a "clinical
symptom, " a "qualified health professional"
must conduct a face-to-face evaluation of the patient on the
next business day in the division's dispensary or other
clinical setting. (Id.) "Qualified health care
professionals" include RNs and licensed nurse
practitioners (LPNs). (Id. ¶ 19.) Any medical
symptom, such as a headache, constitutes a "clinical
symptom." (Pl.'s Rule 56.1 Stmt. of Additional Facts
, hereinafter "Pl.'s 56.1, " ¶ 4.) In
Division XI, Nurse Santos typically collects and reviews the
HSR forms and determines whether the detainees who submitted
the forms should be transported to the dispensary for
evaluation. (Defs.' 56.1 ¶ 15.). If she is not
working on a particular day, other Cermak employees can
collect the forms, and all Cermak personnel working in
Division XI share the responsibility of entering HSR forms
into detainees' electronic medical records. (Id.
¶¶ 16, 18.)
Locke, an LPN at Cermak, reviewed Plaintiff's August 3
HSR form on August 10, 2014 and entered the form into his
electronic medical record. (Id. ¶ 30; Defs.'
Answer to Pl.'s First Request to Admit, Ex. 5 to
Pl.'s Resp. to Defs.' 56.1 [80-2], ¶ 3.) On the
form, Plaintiff stated that he had been given erythromycin to
treat his vision but that his vision was getting worse.
(Defs.' 56.1 ¶ 26.) Though vision loss is a
"clinical symptom, " Nurse Locke did not conduct a
face-to-face evaluation of Plaintiff. (Defs.' 56.1 ¶
30.) Instead, she requested a "routine" appointment
for Plaintiff to see the optometrist at Cermak on October 10,
2014. (Id. ¶ 31.) It is unclear from the record
whether such an appointment was ever scheduled, nor is it
clear why Nurse Locke requested an appointment date two
months away. Defendant asserts that October 10 was the
optometry department's next available date. (Defs.'
56.1 ¶ 30.) Nurse Locke testified at her deposition that
she "just came up with that date . . . a couple of weeks
out" because she could see the optometry's
department schedule and could see that they were "booked
up." (Dep. of Lisa M. Locke, Ex. D to Defs.' 56.1
[78-5], hereinafter "Locke Dep."
72:24-73:6.). Plaintiff avers that he submitted another
HSR form at the end of August 2014 in which he repeated his
complaint of vision loss. (Pl.'s 56.1 ¶ 25; Roland
Dep. 30:14-20.) Defendants have no record of any such form
and deny that it was submitted.
undisputed, however, that Plaintiff completed and submitted
another HSR form on October 1. On the October 1 form, he
stated, "My vision is going out due to trauma, "
and reported that he had had the problem for five months.
(Defs.' 56.1 ¶ 37.) Nurse Locke reviewed that form
on October 3 (Id. ¶ 38), and requested an
appointment with the optometrist for December 10, 2014.
(Pl.'s Medical Records, Ex. M to Defs.' 56.1 [78-14],
at CCU 27.) Plaintiff submitted two additional HSR forms,
dated October 4, 2014, in which he complained of symptoms
unrelated to his eye. (Defs.' 56.1 ¶ 40.) Nurse
Santos picked up these forms on October 5, and conducted a
face-to-face evaluation of Plaintiff that day. (Id.)
She made a note that Plaintiff reported having blurry vision
in his right eye since May 2014 and that he had occasional
headaches but no nausea, vomiting, or dizziness. (Pl.'s
56.1 ¶ 33.) On October 14, the optometrist at Cermak
examined Plaintiff and made a referral to Cermak's
on-site ophthalmologist; the medical record called the
referral “urgent.” (Defs.' 56.1 ¶ 42;
Pl.'s Medical Records CCU 50.) The next day, Plaintiff
visited an ophthalmologist, who observed that his retina was
detached and initiated a request for Plaintiff to see a
retinal specialist. (Def.'s 56.1 ¶ 43-44.) The
following day, October 16, Plaintiff visited the Stroger
Hospital eye clinic and was diagnosed with "chronic
retinal detachment with the macula off." (Id.
¶ 45.) Plaintiff visited the Stroger eye clinic again on
October 20 and 22. (Id. ¶ 47.) At his October
20 evaluation, he was still able to count fingers and see
motion. (Pl.'s 56.1 ¶ 35.)
Demitra Skondra, Plaintiff's retinal specialist,
determined that he did not require urgent surgery.
(Defs.' 56.1 ¶ 48.) At that time in October 2014,
Plaintiff was on trial for his criminal charges and faced the
possibility that he would be sentenced to serve time at an
IDOC correctional facility. (Id. ¶ 46.) Because
of the complicated nature of the surgery and recovery
Plaintiff required, Dr. Skondra believed it was more
important that Plaintiff have surgery at a time when he could
stay in one place afterward (either by having his sentencing
continued or by having surgery after transfer to the IDOC)
than to perform the surgery as soon as possible.
(Id. ¶¶ 48-52.) Dr. Skondra eventually
scheduled the surgery for December 16, believing that the
judge would keep Plaintiff in Chicago. (Id.
¶ 54.) Dr. Skondra eventually had to reschedule the
surgery for December 30 to address a more urgent case.
(Id. ¶¶ 54-55.) Despite Plaintiff's
attempts to stay the sentencing to allow him to recover from
surgery at CCDOC, Plaintiff was sentenced on December 18 and
transferred to the IDOC the following day. (Pl.'s 56.1
¶ 40.) Plaintiff's medical records were emailed to
IDOC on December 22. (Defs.' 56.1 ¶ 58.) Though
Plaintiff informed IDOC staff about his eye condition, as of
the date of briefing in this case he had still not had
surgery, and he no longer has vision (including perception of
light) in his right eye. (Pl.'s 56.1 ¶ 37.)
Defendants' Alleged Policies and Practices
Sheriff of Cook County (the "Sheriff") is
responsible for operating CCDOC. (Inter-Agency Agreement
Between the Office of the Sheriff of Cook County and the Cook
County Health and Hospitals System, Ex. 6 to Pl.'s 56.1
[80-2], hereinafter "Inter-Agency Agreement, " at
1.) Cook County itself (the "County"), specifically
the Cook County Health and Hospitals System (CCHS), is
responsible for operating Cermak, an entity separate from
CCDOC. (Id.) See also Boyce v. Moore, 314
F.3d 884, 887 n.1 (7th Cir. 2002). Though they are separate
entities, the Sheriff and CCHS have signed an inter-agency
agreement, under which CCDOC must "[p]articipate with
Cermak in a coordinated approach to the delivery of health
care to detainees [and] [d]evelop mutually acceptable
policies and procedures to accommodate both security
requirements and clinical needs for professional practice . .
. ." (Pl.'s 56.1 ¶ 2; Inter-Agency Agreement at
4-5.) A representative from the Sheriff's office attends
meetings with representatives from Cermak, Judge Kendall of
this court, and a medical monitor appointed in connection
with litigation concerning medical conditions at CCDOC,
United States v. Cook Cnty., No. 10 C 2946.
(Pl.'s 56.1 ¶ 8.)
asserts that the County and the Sheriff were aware that
Cermak had a shortage of nurses, which resulted in delayed
access to care for CCDOC inmates, including delayed responses
to inmates' HSR forms and delayed face-to-face
evaluations of inmates. At meetings and in reports issued in
connection with the litigation mentioned above, the medical
monitors appointed in that case expressed concerns regarding
nursing staff shortages and delays in access to care for
CCDOS inmates. (See Id. ¶¶ 9-13.) In
addition, the former head nurse at Cermak, Cynthia Kienlen,
made recommendations to the monitors that staffing be
increased to improve collection and processing of HSR forms.
(Id. ¶ 14.) The Sheriff's Office
acknowledged the findings made by the medical monitors
(see Id. ¶ 16), but Defendants dispute the
contents and reliability of both Nurse Kienlen's
testimony and the monitors' reports. (See
Defs.' Resp. to Pl.'s 56.1 ¶¶ 6, 9-16.)
Defendants argue that Nurse Kienlen's testimony may be
unreliably biased because Cermak fired her in April 2014 and
that the monitors' reports are inadmissible hearsay
generated in the adversarial context of another litigation.
Alleged Connection Between Defendants' Policies and