United States District Court, N.D. Illinois
J. Lombardo One of the Attorneys for Defendants, WEXFORD
HEALTH SOURCES, INC., LA TANYA WILLIAMS, P.A., and DEFENDANT,
GHALIAH OBAISI, as Independent Executor of the Estate of
SALEH OBAISI, M.D., Deceased.
DEFENDANTS' FED. R. CIV. P. 50 MOTION FOR
JUDGMENT AS A MATTER OF LAW IN A JURY TRIAL
JOHNSON COLEMAN JUDGE.
COME Defendants, WEXFORD HEALTH SOURCES, INC.
(“Wexford”), LA TANYA WILLIAMS, P.A.
(“Williams”), and DEFENDANT, GHALIAH OBAISI, as
Independent Executor of the Estate of SALEH OBAISI, M.D.
(“Dr. Obaisi”), Deceased, by and through their
attorneys, Matthew H. Weller and Joseph J. Lombardo of
CASSIDAY SCHADE LLP, and for their Fed.R.Civ.P. 50 Motion for
Judgment as a Matter of Law in a Jury Trial, hereby state as
Plaintiff Did Not Come Forth with Sufficient Evidence to
Support a Monell Claim Against Wexford
Monell v. Dep't of Soc. Servs., 436 U.S. 658 (1978), the
Supreme Court established that a municipality may face
liability for money damages under § 1983 only if the
unconstitutional act about which the plaintiff complains was
caused by (1) an official policy adopted and promulgated by
its officers; (2) a governmental practice or custom that,
although not officially authorized, is widespread and well
settled; or (3) an official with final policy-making
authority. Thomas v. Cook Cnty. Sheriff's
Dep't, 604 F.3d 293, 303 (7th Cir. 2010) (citing
Monell, 436 U.S. at 690). Wexford, a private
corporation contracted by IDOC, is subject to a Monell claim
just like any municipality would be. See, e.g., Minix v.
Canarecci, 597 F.3d 824, 832 (7th Cir. 2010). "To
establish municipal liability, a plaintiff must show the
existence of an 'official policy' or other
governmental custom that not only causes but is the
"moving force" behind the deprivation of
constitutional rights." Teesdale v. City of
Chicago, 690 F.3d 829, 833-34 (7th Cir. 2012). Thus,
to prevail on his Monell claim against Wexford, Plaintiff
must show that "his injury was caused by a Wexford
policy, custom, or practice of deliberate indifference to
medical needs, or a series of bad acts that together raise
the inference of such a policy." Shields v. Ill.
Dep't of Corr., 746 F.3d 782, 796 (7th Cir. 2014).
Wexford's Policies and Practices Were Not the
“Motivating Force” Behind the Alleged Deprivation
of Plaintiff's Constitutional Rights
Plaintiff has not met the extremely high burden of proving
Wexford's policies and procedures were the
“motivating force” behind his alleged
constitutional claim. To this end, Plaintiff's primary
argument in support of his claim against Wexford is based
upon its written guidelines, which were presented to the jury
on several occasions. However, this argument is misguided on
several levels. First, Wexford's written Medical Policies
and Procedures do not state that patients with manually
reducible inguinal hernias are not candidates for surgical
consultation. (See “Exhibit 1”- Plaintiff's
Trial Exhibit 6.1: Wexford's Guidelines regard the Repair
of Abdominal Wall/Inguinal Hernias). Instead, they state
“patients with stable abdominal wall hernias are not,
in general, candidates for herniorrhaphy and will be
monitored and treated with appropriate non-surgical
therapy.” Id. [emphasis added]. Here,
Plaintiff's alleged medical condition is a very small
manually reducible inguinal hernia. As such, despite
Plaintiff's contention to the contrary, Wexford does not
have an express written policy that states patients
presenting with manually reducible inguinal hernias, such as
Wilson, are not candidates for surgery.
the decision to treat Plaintiff conservatively before
referring him for a general surgery evaluation was not the
result of Wexford's policies or practices. Instead, the
uncontroverted evidentiary record reveals the course of
treatment provided to Wilson for his hernia was based solely
upon the medical judgment of Plaintiff's treating
physicians. This is not surprising, as Wexford's Medical
Policies and Procedures regarding treatment of hernias
explicitly state that “[d]ecisions regarding patient
suitability for consideration of abdominal wall herniorrhaphy
must be made on a case-by-case basis. These recommendations
are intended only as a guide for the site physicians are not
intended to replace hands-on clinical judgment.”
testimonial evidence in this case further supports the
conclusion that Wexford's written guidelines had no
bearing on the treatment of Plaintiff's hernia. To this
end, it is undisputed that as Medical Director, Dr. Obaisi
was the individual that was charged with making the decision
as to whether Plaintiff would be evaluated for surgery. Upon
being questioned regarding the role Wexford's written
guidelines played in his decision regarding the management of
Wilson's hernia, Dr. Obaisi testified as follows:
“Q: How often do you, if you do, review the policies
and procedures of Wexford?
A: Not very often.
Q: Can you tell me since you've been Medical Director
whether you read the policies and procedures regarding the
repair of abdominal wall and inguinal hernias?
A: No, I have not read.
Q: Isn't it part of your responsibilities to be familiar
with the substance of those policies and procedures?
A: Basically, I am a surgeon, I fixed a lot of hernias so I
know the rules and I know when to send the patient. I take it
as my own personal ...