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Proctor v. Sood

United States Court of Appeals, Seventh Circuit

July 13, 2017

Daniel Proctor, Plaintiff-Appellant,
Kul Sood, et al., Defendants-Appellees.

          Submitted July 5, 2017

         Appeal from the United States District Court for the Central District of Illinois. No. 14-1228 - Sue E. Myerscough, Judge.

          Before Posner, Kanne, and Sykes, Circuit Judges.

          Per Curiam.

         Daniel Proctor, an Illinois prisoner who was confined for seven years at Hill Correctional Center, suffers from chronic abdominal pain and spasms in his colon. He sued a number of medical providers working at Hill for Wexford Health Sources-the contractor providing healthcare to Illinois prisoners -as well as several corrections officials, claiming that they violated the Eighth Amendment by not ordering a colonoscopy and endoscopy to diagnose his persistent abdominal pain. The district court granted summary judgment for the defendants. We affirm that decision.

         The pertinent facts are not in dispute, except where noted, and we recount them in the light most favorable to Proctor, as the opponent of summary judgment. See Dewitt v. Corizon, Inc., 760 F.3d 654, 655-56 (7th Cir. 2014). Proctor-who is now 55-was confined at Hill from 2007 until 2014, and during this time all of his medical care was provided by Wexford employees working at the prison. He had been experiencing daily pain in his lower abdomen and occasional colon spasms since 1999, when he was confined at a different prison. The abdominal discomfort limited his participation in daily activities, including running and lifting weights, and his spasms were so sharp that they woke him at night. Abdominal and upper and lower gastrointestinal X-rays taken in 2000 had shown nothing remarkable. The discomfort intensified beginning in 2007, progressively worsening to constant, mild pain, day and night. The colon spasms also intensified to the point of flaring for about fifteen minutes every other day and causing excruciating pain.

         Proctor first sought and began receiving ongoing medical care for his abdominal and colon pain in 2006. He initially took Metamucil, a fiber supplement, to treat the rectal pressure from his colon spasms. After Proctor arrived at Hill, a nurse practitioner, Pamela Bloomfield, ordered more X-rays and an ultrasound of his abdomen, but the results were unremarkable. Bloomfield then ordered further tests to determine if a bacterial infection might be causing the abdominal discomfort. Those tests also returned negative results. Proctor started a regimen of Bentyl, an antispasmodic drug, to treat his abdominal pain and spasms. Shortly thereafter, in 2008, Proctor made a one-time visit to Dr. Richard Shute, who diagnosed possible irritable bowel syndrome (commonly called IBS) and a spastic colon.

         At a routine examination in 2009, Proctor told Amy John, a physician assistant, that he was having abdominal tenderness but getting some relief with the Bentyl. John's physical exam showed nothing, but nevertheless she ordered a battery of blood tests. The results were normal. John examined Proctor again a few months later because he still was complaining of cramping and abdomen pain. As before, she found nothing noteworthy. She advised Proctor to avoid dairy products that worsened his symptoms, and she ordered a dozen tests for inflammation, thyroid function, pancreatic function, digestive and bacterial infections, parasites, and antibodies related to celiac disease. All of these tests returned normal results. John switched Proctor from Bentyl to Levsin, another antispasmodic medication that provided additional relief. When Proctor reported increased spasms, John temporarily raised his Levsin dosage. Proctor last visited John in July 2011.

         Over time Proctor became increasingly insistent that he should see a gastroenterologist for a colonoscopy and endoscopy. Proctor complained of intense colon pain to Dr. Kul Sood in 2011. Dr. Sood reviewed Proctor's medical history and performed a physical exam. He concluded that Proctor could be suffering from IBS or from diverticulitis (an infection of small pouches that develop on the intestines), and he prescribed a course of antibiotics to treat the possible infection. Dr. Sood also renewed the Levsin prescription. He gave the same probable diagnoses when he saw Proctor again in late 2012. He ordered another battery of tests, switched Proctor back to Bentyl (the Levsin had caused adverse side effects), and added an antigas medication. Once again the tests results were normal. Dr. Sood advised Proctor to avoid eating rice, milk, beans, and gluten if possible.

         In May 2013, Proctor reported to Bloomfield, the nurse practitioner, that he was suffering from ongoing abdominal pain, alternating constipation and multiple bowel movements each day, and excessive gas. He also told Bloomfield that he was experiencing bloating and cramping, but not bloody or mucousy diarrhea, nausea, or vomiting. Bloomfield continued the Bentyl, added a prescription medication to treat cramping and muscle pain, and prescribed a stool softener and a laxative to treat his bowel symptoms. Bloomfield monitored Proctor's condition during frequent visits throughout 2013 and 2014. Proctor had kept a journal describing his daily abdominal pain, which he consistently rated as a 1 out of 10 except for periods of excruciating pain due to his colon spasms. At one of his visits, Proctor insisted that his journal entries be added to his medical file, but Bloomfield declined. Like Dr. Sood, previously, she recommended dietary changes, including eating fewer beans and soy products and drinking more water. Dr. Sood also saw Proctor multiple times in 2014 and prescribed fiber supplements to address his irregular bowel movements. But he too declined to add Proctor's journal entries to the medical file.

         Proctor filed numerous grievances, complaining that these Wexford employees had not eliminated his persistent pain or even definitely diagnosed its source. He insisted on having more diagnostic tests, including a colonoscopy, and said he could not abide the dietary advice to avoid beans, soy, and milk because the prison's meal plan would not accommodate him. All of these grievances were denied on the recommendation of Lois Lindorff, a Department of Corrections employee serving as the administrator of Hill's healthcare unit, who advised Proctor to research the appropriate diet to manage his symptoms and to address his concerns with the healthcare providers. Lindorff stated that only a doctor could request additional testing. Hill's warden and the director of the Illinois Department of Corrections approved the denials.

         Proctor sent a copy of one grievance to Dr. Louis Shicker, the medical director for the Department of Corrections, asking for a referral to an outside specialist. After reviewing Proctor's medical file, Dr. Shicker replied that medical staff were monitoring his condition and advised Proctor to make better dietary choices at the prison commissary. Proctor also sent a copy to Wexford Health Sources, which replied that he should follow the grievance procedure at Hill.

         Proctor filed suit under 42 U.S.C. § 1983 in June 2014. He claimed that nurse practitioner Bloomfield, physician assistant John, Dr. Shute, Dr. Sood, and Wexford (the "Wexford defendants") acted with deliberate indifference by not ordering a colonoscopy or endoscopy and not diagnosing his condition with certainty. He contended that Wexford had a policy of denying referrals to outside specialists in order to save costs. Proctor also claimed deliberate indifference by healthcare administrator Lindorff, medical director Dr. Shicker, the warden, and the director of the Department of Corrections (the state defendants) because they processed his grievances yet never sent him to an outside specialist. Proctor asked the district court to recruit a lawyer to assist him. The district court denied that motion without prejudice, reasoning that Proctor had some litigation experience and could testify about his symptoms. See Pruitt v. Mote, 503 F.3d 647, 654-55 (7th Cir. 2007).

         After that, in October 2014, Proctor was transferred to Big Muddy River Correctional Center, where he was approved to receive a colonoscopy and other tests. The colonoscopy, a CT scan of his abdomen and pelvic region, and an ultrasound of his kidney revealed minimal diverticula (the small pouches on the intestines), a lesion on the left kidney, and hernias in his groin and nave. Proctor viewed the results as abnormal and indicating a condition other than IBS, but his physician at Big Muddy River concluded that the tests had shown him to have a healthy colon. The diverticula were asymptomatic, the doctor opined, and clinically insignificant. ...

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