United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
Z. Lee United States District Judge
William Horton is an inmate at the DuPage County Jail who
suffers from liver disease, Hepatitis C, and esophageal
varices. He brings suit pursuant to 42 U.S.C. § 1983
against Defendants Dr. Gerardo Guzman, Dr. Evaristo
Aguinaldo, Sheriff John Zaruba, and DuPage County, alleging
deliberate indifference to his medical needs. Defendants have
moved to dismiss the claims in Plaintiff's Fourth Amended
Complaint. For the reasons set forth below, Guzman and
Aguinaldo's motion to dismiss  is denied,
Zaruba's motion to dismiss  is denied, and DuPage
County's motion to dismiss  is granted in part and
denied in part.
is a detainee at the DuPage County Jail (hereinafter,
“the Jail”). 4th Am. Compl. ¶ 3. Defendant
Gerardo Guzman is a doctor and serves as the medical director
of the Jail. Id. ¶ 7. Similarly, Defendant
Evaristo Aguinaldo is a doctor who provides medical care at
the Jail. Id. ¶ 8. Plaintiff is suing Guzman
and Aguinaldo in their individual and official capacities.
Id. ¶¶ 7-8. Defendant John Zaruba is the
Sheriff of DuPage County and is being sued in his official
capacity. Id. ¶¶ 9-10.
September 22, 2015, before Plaintiff was booked at the Jail,
he was evaluated by Dr. Joseph Vicari, a gastroenterologist,
who concluded that Plaintiff has cirrhosis secondary to
chronic Hepatitis C. Id. ¶¶ 12, 14. Vicari
also noted that Plaintiff had undergone multiple endoscopies
to remedy internal bleeding caused by esophageal varices.
Id. ¶ 15. Vicari recommended that Plaintiff
make an appointment with a liver clinic for a transplant
evaluation. Id. ¶ 16. He also recommended an
additional endoscopy and banding to address the internal
bleeding. Id. ¶ 17. Furthermore, on November
30, 2015, Vicari instructed Plaintiff to begin taking a drug
called Harvoni to treat his Hepatitis C, to obtain another
endoscopy with possible additional banding, and to
“follow up with Loyola liver clinic” regarding a
transplant evaluation. Id. ¶ 23.
December 9, 2015, Plaintiff was booked at the Jail.
Id. ¶ 12. Soon thereafter, Plaintiff visited
Defendants Guzman and Aguinaldo for medical appointments.
Id. ¶¶ 26, 31. Guzman and Aguinaldo were
provided with Vicari's medical reports, which contained
all of the medical information described above. Id.
¶¶ 27, 29, 31. According to Plaintiff, Guzman told
him during an appointment on December 11, 2015, that
“Plaintiff ‘should get out [of jail] as soon as
possible' because the Jail would not pay for the
treatment of Plaintiff's liver disease and Hepatitis
C.” Id. ¶ 49. In addition, employees of
the DuPage County Sheriff's Office stated on January 15,
2016, that they were not required to provide Harvoni to treat
Plaintiff's Hepatitis C because the treatment cost $90,
000 and Plaintiff's condition was not life-threatening.
Id. ¶ 50.
January 22, 2016, Plaintiff was evaluated by Dr. Scott Cotler
of Loyola University Medical Center, who ordered tests to
determine whether Plaintiff needed an evaluation for a liver
transplant. Id. ¶¶ 32-33. On January 25,
2016, Plaintiff was seen again by Vicari, who ordered
Plaintiff to begin taking Harvoni “as soon as
possible.” Id. ¶ 34. Plaintiff alleges
that, despite their awareness of these recommendations from
Cotler and Vicari, Defendants Guzman and Aguinaldo refused to
permit Plaintiff to obtain a liver function test or to
receive further diagnosis and treatment. Id.
¶¶ 39, 56, 67.
addition, around February 29, 2016, Vicari instructed Guzman
to begin treating Plaintiff with Harvoni. Id. ¶
40. On March 21, 2016, Plaintiff again met with Cotler, who
recommended that Plaintiff obtain a liver transplant
evaluation at the University of Illinois Hospital.
Id. ¶ 44. Still, however, Defendants continued
to refuse to procure Harvoni and also refused to refer
Plaintiff for a transplant evaluation anywhere. Id.
¶¶ 41, 44.
14, 2016, Plaintiff collapsed and became unconscious at the
Jail as a result of his degenerating liver disease.
Id. ¶ 45. Plaintiff was transported to the
Central DuPage Hospital's intensive care unit and placed
on a ventilator to assist his breathing. Id.
Plaintiff alleges that, shortly thereafter, the Jail
“furloughed” him until December 5, 2016, so that
it would not be responsible for the cost of the medical care
that Central DuPage Hospital provided. Id.
¶¶ 4, 52.
on these allegations, Plaintiff claims that Guzman and
Aguinaldo were deliberately indifferent to his serious
medical needs. Id. ¶¶ 56-77. He also
claims that the DuPage County Sheriff's Department, under
the control of Zaruba and DuPage County, has a policy and
practice of unreasonably denying medical care to detainees
based on the cost of such care and without regard to the
severity of detainees' medical conditions. Id.
¶¶ 47-48. Defendants have moved to dismiss the
claims against them pursuant to Federal Rule of Civil
Procedure (“Rule”) 12(b)(6).
motion under Rule 12(b)(6) challenges the sufficiency of the
complaint. Bell v. City of Country Club Hills, 841
F.3d 713, 716 (7th Cir. 2016). Under the federal notice
pleading standards, “[a] plaintiff's complaint need
only provide a short and plain statement of the claim showing
that the pleader is entitled to relief, sufficient to provide
the defendant with fair notice of the claim and its
basis.” Tamayo, 526 F.3d at 1081 (internal
quotation marks omitted); Fed R. Civ. P. 8(a)(2). When
considering a motion to dismiss under Rule 12(b)(6), the
Court must “accept[ ] as true all well-pleaded facts
alleged, and draw[ ] all possible inference in [the
plaintiff's] favor.” Tamayo, 526 F.3d at
a complaint must allege “sufficient factual matter,
accepted as true, to ‘state a claim to relief that is
plausible on its face.'” Ashcroft v.
Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl.
Corp. v. Twombly, 550 U.S. 544, 570 (2007)). To have
facial plausibility, a claim must plead “factual
content that allows the court to draw the reasonable
inference that the defendant is liable for the misconduct
alleged.” Id. “The plausibility standard
is not akin to a ‘probability requirement, ' but it
asks for more than a sheer possibility that a defendant has
acted unlawfully.” Id. Plausibility, however,