United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
Honorable Edmond E. Chang, United States District Judge
Norman Johnson, a prisoner at Stateville Correctional Center,
brings this civil rights lawsuit, 42 U.S.C. § 1983,
alleging a violation of his Eighth Amendment
rights. Defendants are Wexford Health Sources,
Inc., a private corporation that provides medical services at
Stateville, and Wexford doctor Saleh Obaisi, who was
Stateville’s medical director. The Defendants filed a
motion for summary judgment on December 28, 2018. R.
For the reasons explained below, the Defendantsâ motion is
granted in part and denied in part.
case arises out of the treatment of two medical conditions
suffered by Norman Johnson: a varicocele on his left testicle
and a lipoma on his head. R. 151, Pl.’s Resp. Br. at
For clarity’s sake, this Opinion will address each
medical condition separately, though the relevant events
overlap chronologically. The facts narrated here are
undisputed unless otherwise noted. At the summary judgment
stage, the Court views the evidence in the light most
favorable to Johnson, the non-moving party. Matsushita
Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574,
early August 2013, Johnson filled out a request asking the
prison’s medical staff to treat a lump on his left
testicle. R. 72, Third Am. Compl., Exh. 1 at 3. On January
23, 2014, Johnson complained specifically to Dr. Obaisi about
the lump. R. 142, DSOF ¶ 37; DSOF, Exh. B, Obaisi Dep.
Tr. at 116:6-17. Dr. Obaisi prescribed 100mg of Minocycline
(an antibiotic) twice a day for three weeks, and planned for
a follow-up visit in four weeks. Obaisi Dep. Tr. at
119:10-14. Around four weeks later, on February 27, Dr.
Obaisi saw Johnson again, DSOF ¶ 38, but the parties
dispute whether Johnson complained of left-testicle pain at
this visit. Obaisi testified that Johnson made no complaint
of testicle or scrotal pain. Obaisi Dep. Tr. at 120:12-18.
According to Johnson, though, “[e]very time [he]
talk[s] to [Obaisi] [he] tell[s] him everything that’s
going on with [him], he [Obaisi] just don’t write it
down.” DSOF, Exh. A, Johnson Dep. Tr. at 86:20-24.
Johnson also wrote, on an August 2014 grievance form, that he
was given Cephalexin 500mg on February 25, 2014 for his
testicle pain and that he was still in pain. Third Am.
Compl., Exh. 1 at 7.
March 2014, Dr. Obaisi saw Johnson again. This time, it is
undisputed that Johnson complained of discomfort and
testicular pain. DSOF ¶ 39; Obaisi Dep. Tr. at 135:6-13.
Obaisi diagnosed Johnson with chronic epididymitis,
changed the antibiotic to Levaquin, and added Prednisone to
make the Levaquin more potent. DSOF ¶ 39; Obaisi Dep.
Tr. at 135:22-24. In his deposition, Obaisi confirmed that he
elevated Johnson’s treatment to a more intense
prescription regimen based on Johnson’s continued
complaints. Obaisi Dep. Tr. at 136:3-7. In early April 2014,
Obaisi ordered a urinalysis for Johnson to rule out a urinary
tract infection as the source of the testicular pain; the
urinalysis result was within normal range. DSOF ¶ 40;
Obaisi Dep. Tr. at 136:8-19. A repeat urinalysis and a
syphilis test performed in May 2014 were both negative. DSOF
¶ 41; Obaisi Dep. Tr. at 137:1-16.
4, 2014, Johnson filed another grievance, complaining again
about a painful lump on his left testicle that had not been
alleviated by his prescription, and about not receiving a
biopsy for that lump, as promised by Dr. Obaisi. Third Am.
Compl., Exh. 1 at 6. Although it is unclear from the record
what response Johnson received after he filed his grievance,
it appears that he appealed it. In January 2015, the
Administrative Review Board responded to the May 2014
grievance and denied Johnson’s request on the merits,
finding that the issue was appropriately addressed by the
prison and adding that “the ordering of tests must be
done by attending physician.” Third Am. Compl., Exh. 5.
In the meantime, Johnson filed another grievance, this time
on August 7, 2014, reporting pain and a growing
“cyst” on his left testicle, as well as
difficulty urinating. Third Am. Compl., Exh. 1 at 7.
days later, on August 12, Johnson again complained to Dr.
Obaisi of continuing pain in his left testicle. DSOF ¶
42; Obaisi Dep. Tr. at 137:17-23. Obaisi assessed chronic
pain in Johnson’s left testicle and requested approval
for an ultrasound. Obaisi Dep. Tr. at 138:6-7, 16-21. The
ultrasound was completed in early September 2014, and it
showed a small left varicocele. Id. at 139:7-140:8.
Obaisi did not examine Johnson again for more than a month,
on October 29, when Johnson again reported pain in his left
testicle. Id. at 140:17-23. Noting the results of
the ultrasound, Obaisi diagnosed Johnson with a varicocele
and put in a prescription order for a scrotal support device.
Id. at 141:13-142:2. Johnson stated in his affidavit
that he did not receive the scrotal support until December
23, nearly two months after it was prescribed. R. 151-1,
Pl.’s Supp. Exh. G, Johnson’s Affidavit at ¶
29. Neither party has offered any evidence to explain the
forwarding to 2015, on September 23 of that year, Johnson
again complained to Dr. Obaisi of left testicle pain. DSOF
¶ 46; Obaisi Dep. Tr. at 143:2-18. Obaisi requested a
physician collegial review to discuss a potential urology
consultation for Johnson’s varicocele and for his
complaints of testicular pain. DSOF ¶ 46; Obaisi Dep. Tr.
at 144:8-23. The collegial-review discussion took place 12
days later, on October 5. R. 151-2, Pl.’s Resp. DSOF
¶ 45; Obaisi Dep. Tr. at 144:8-19. The urology
consultation was not approved; instead, the physicians agreed
on an alternative treatment plan, that is, to continue with
the scrotal support device. Obaisi Dep. Tr. at 145:10-15. Dr.
Obaisi agreed to re-consult the physician collegial review
upon completion of the alternative plan, if indicated.
Id. at 145:19-146:6.
three months later, on January 25, 2016, Johnson had an
appointment with Physician Assistant LaTanya Williams; he
complained to her that his testicle pain was the same. DSOF,
Exh. D, Williams Dep. Tr. at 62:6-12. Williams assessed
Johnson as having chronic testicular pain and noted that she
would refer Johnson to the medical director for
“[c]hronic headaches/hydrocele/testicular pain
chronic.” Id. at 62:22-63:15. She prescribed
pain medication: Atenolol 100mg daily and Naproxen 500mg as
needed or twice a day (although it is unclear whether this
was meant to alleviate Johnson’s testicular pain or
headaches or both). Id. at 63:1-15. In early
February 2016, Johnson saw Dr. Obaisi. DSOF ¶ 49; Obaisi
Dep. Tr. at 147:7-15. During this visit, Johnson reported
that his left testicle pain had worsened during the last few
days. Id. Obaisi’s assessment was tenderness
epididymis with slight swelling. Obaisi Dep. Tr. at
147:16-18. Obaisi prescribed an injectable antibiotic for
five days, in addition to scrotal support and follow-up in
four weeks. Id. at 147:19-22. But Johnson asserts in
his affidavit that he did not see Obaisi again until May 3,
2016, around three months later. Johnson’s Affidavit at
¶ 38. According to Johnson, Obaisi stated that the
varicocele had progressed to a moderate size and prescribed
Johnson 200mg of Tegretol twice daily, in addition to the
scrotal support. Id. In June 2016, another
collegial-review discussion was held, and Wexford approved
Johnson for a urology evaluation at the University of
Illinois-Chicago (which is commonly referred to as UIC). DSOF
¶ 50; Obaisi Dep. Tr. at 148:7-20.
end of November 2016, Johnson went to UIC and saw Dr. Simone
Crivellaro, a urologist. DSOF, Exh. G, Crivellaro Dep. Tr. at
21:5-7. Neither party has explained why it took nearly six
months to schedule Johnson for this consultation. In any
event, during the appointment, Johnson described his pain as
“sharp” and “intermittent, ”
localized to the area of the testicle, and at a pain level of
6 out of 10. Id. at 23:2-6, 38:5-24; see
also Pl.’s Supp. Exh. F at 32-33. The clinic note
described a nontender and enlarged left testicle, normal
epididymitis (meaning no inflammation), and a Grade Two
spermatic cord left varicocele. Crivellaro Dep. Tr. at
22:10-24:18; see also Pl.’s Supp. Exh. F at
32-33. Dr. Crivellaro prescribed Johnson with Ibuprofen for
pain management. Crivellaro Dep. Tr. at 27:17-28:5.
early August 2017, Johnson had a follow-up appointment with
Dr. Crivellaro. DSOF ¶ 52; Crivellaro Dep. Tr. at
29:5-7. Johnson complained that the swelling had worsened,
and the physician noted that the “pain is sharp in
nature, localized, and does not radiate.” Pl.’s
Resp. DSOF ¶ 51; Crivellaro Dep. Tr. at
29:17-23. The varicocele was classified as a
clinically nonsignificant Grade One, which Dr. Crivellaro
testified means that surgical treatment is not indicated.
DSOF ¶ 52; Crivellaro Dep. Tr. at 31:11-18, 32:6-19,
32:20-33:2. Crivellaro’s treatment plan consisted of
pain control with Tramadol based on Johnson’s
complaints of worsening pain, as well as scrotal support.
Pl.’s Resp. DSOF ¶ 51; Crivellaro Dep. Tr. at
months later, in mid-November 2017, Johnson asserts in his
affidavit that Dr. Obaisi referred him for a scrotal
sonogram. Johnson’s Affidavit at ¶ 45. Johnson
also says that he was again prescribed a scrotal support a
few days later by another doctor. Id. Johnson
continues to experience testicular pain to this day. R.
151-2, PSOF ¶ 113; Johnson’s Affidavit at ¶
mid-June 2011, Johnson filed his first grievance relating to
a large lump on his head, as well as a headache. PSOF ¶
89; Pl.’s Supp. Exh. B. In February 2012, Johnson
complained to Physician Assistant Williams that he has had a
lump on his head for the past 12 months and that he
experienced pain when combing his hair. DSOF ¶ 53;
Johnson Dep. Tr. at 79:11-19. Williams assessed Johnson with
a mass on the forehead and planned to refer Johnson to urgent
care for possible aspiration. Johnson Dep. Tr. at 79:11-19;
Williams Dep. Tr. at 50:6-24. A few weeks later, on February
23, Williams re-evaluated Johnson and found him to be
“within normal limits.” DSOF ¶ 54; Williams
Dep. Tr. at 37:7-10. She noted that the bump on his head was
small (1.5cm x 1.5cm), mobile, nontender to touch, well
circumscribed, and solid. DSOF ¶ 54; Williams Dep. Tr.
at 36:15-37:1. Williams diagnosed a “cyst
forehead/hairline” and set a treatment plan for
observation and follow-up in six months. Williams Dep. Tr. at
37:7-15. She also testified that she educated Johnson on
things to look out for with respect to the mass. Id.
at 37:16-19. In early April 2012, Williams learned that
Johnson had filed a grievance, and she added a progress note-
without seeing Johnson-assessing a lesion on the forehead and
a plan to refer to “M.D. urgent care for second
opinion.” Id. at 42:4-13.
1, 2012, Johnson filed another grievance, this time stating:
“I was informed by Dr. Dubrick that I would need
surgery to have it removed but also that I would
inconvenience him to do so. He then stated that if Dr.
Williams wanted to do it, she could. At that point he asked
Dr. Williams if she would because he won’t do it and
she also stated that she won’t do it because Stateville
will not pay for it. This is the second time she has told me
this-the tumor has become very painful … .”
Pl.’s Supp. Exh. C; see also PSOF ¶ 90.
Assistant Williams saw Johnson again on September 30, 2013,
and wrote in the progress note that the lump on
Johnson’s forehead had not changed in size, and that it
was palpable, soft, mobile, nontender, and well
circumscribed. Williams Dep. Tr. at 56:15-57:5. She assessed
a lipoma and ordered a follow-up at the clinic in six months
for reevaluation. Id. at 57:7-13. One week later,
Johnson filed another grievance about the lump on his head.
Third Am. Compl., Exh. 1 at 4. He filed another one on
November 5, asserting, “I’ve been having really
bad headaches (lately). Sometimes it hurts so bad, I’m
unable to sleep. I’ve also been having blurred vision
in my left eye. I talk to ‘Physician Assistant
Williams’ and was told that I have a
‘Tumor’ in my head, but Statesville
wouldn’t pay for the surgery. I’m am [sic] asking
to see an ‘outside specialist’ because my life
may be in danger.” Id. at 5. Under
“Relief Requested, ” Johnson wrote: “To be
seen by outside specialist to remove the ‘Tumor.’
Because it is getting bigger.” Id.
three months later, on February 26, 2014, a nurse recorded
that the lipoma now measured 3.5cm by 3cm. PSOF ¶ 95;
Johnson Dep. Tr. at 85:5-22. Over five months later, in
mid-August 2014, Dr. Obaisi saw Johnson, and noted
Johnson’s complaints of “[h]eadache episodes over
left eye with a blurred vision. Pounding headache. Episode
several hours every few days.” Obaisi Dep. Tr. at
137:17-4. The clinic note does not show that Johnson received
any medication for the symptoms on that day. See Id
. at 137:17-138:11. Another month went by, and on
October 29, 2014, Johnson complained again to Obaisi that he
had blurred vision and pain in his left eye since 2012, and
relayed that Dr. Dunn-a prison optometrist-had recommended an
MRI. Id. at 121:18-122:2. Obaisi referred Johnson
for an ophthalmology follow-up, an MRI, and an HVF study.
PSOF ¶ 97; Johnson Dep. Tr. at 96:11-15. It is not clear
from the record whether the MRI was ever
one week later, on November 4, a collegial-review discussion
between Dr. Obaisi and Dr. Ritz, Wexford’s Corporate
Director for Utilization Management, resulted in approval of
a CT scan of Johnson’s head. DSOF ¶ 61; Obaisi
Dep. Tr. at 122:21-123:15. After the CT scan was performed at
UIC in January 2015, Johnson was diagnosed with “a well
encapsulated low attenuation lipoma” measuring 1.4cm by
3.7cm by 4.4cm. PSOF ¶ 98; Johnson Dep. Tr. at 99:1-22.
saw Dr. Obaisi again in mid-March 2015, and Johnson reported
eye pain, headache, and blurred vision. PSOF ¶ 99;
Johnson Dep. Tr. at 101:15-102:4. Obaisi prescribed Atenolol,
HCL cream, a follow-up in eight weeks, and a referral for an
optometry consultation. R. 158, Defs.’ Resp. PSOF at
¶ 99; Johnson Dep. Tr. at 101:20-102:4. At the end of
April 2015, an optometrist saw Johnson and prescribed him
with warm compresses and artificial tears for dry eyes, as
well as 500mg of acetaminophen for the headaches. PSOF ¶
100; Johnson Dep. Tr. at 102:5-17.
time, despite the prescribed treatment of Atenolol, HCL
cream, and Tylenol, Johnson was still experiencing symptoms.
PSOF ¶ 101; Johnson Dep. Tr. at 102:20-105:8. In May
2015, Johnson was approved for an ophthalmology appointment
at UIC. Johnson Dep. Tr. at 105:9-18. On August 24, 2015, the
UIC ophthalmologist found no ocular reason for
Johnson’s headaches and recommended a neurology
consultation, as well as a consultation with general surgery
for a possible excision of Johnson’s lipoma. DSOF
¶ 64; Defs.’ Resp. PSOF ¶ 101; Johnson Dep.
Tr. at 102:20-105:8. The next day, Obaisi submitted the
general-surgery and neurology referral requests to Wexford
collegial review, which consisted of a discussion between Dr.
Ritz and Dr. Obaisi. Obaisi Dep. Tr. at 126:16-128:5. Neither
request was approved. Instead, Ritz and Obaisi decided on an
alternative treatment plan to re-evaluate Johnson onsite and