Cesal v. Moats

851 F.3d 714, 2017 WL 1046113, 2017 U.S. App. LEXIS 4959
CourtCourt of Appeals for the Seventh Circuit
DecidedMarch 20, 2017
DocketNo. 15-2562
StatusPublished
Cited by2,137 cases

This text of 851 F.3d 714 (Cesal v. Moats) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cesal v. Moats, 851 F.3d 714, 2017 WL 1046113, 2017 U.S. App. LEXIS 4959 (7th Cir. 2017).

Opinions

WOOD, Chief Judge.

While lifting a heavy door at his prison job at the Pekin Correctional Institution on March 21, 2008, Craig J. Cesal heard a “snap” in his back and felt pain in his leg and hip. He promptly sought treatment from the prison’s medical staff, but he was dissatisfied with their response. He alleges that he received only a three-year long medical runaround during which his pain was ignored. Worse, he says, Pekin’s Clinical Director, Dr. Scott Moats, canceled Cesal’s insulin prescription in retaliation for Cesal’s filing of a complaint about the inadequate care for his back. Without the prescription, Cesal — an insulin-dependent diabetic — was unable to control his blood sugar and consequently suffered additional unnecessary pain and physical harm. He filed a second complaint with the prison about the insulin deprivation.

Cesal ultimately sued Dr. Moats and Dr. Andreas Molina, another Pekin physician, alleging that they exhibited deliberate indifference in the care they gave him. At the screening phase, see 28 U.S.C. § 1915A, the district court identified two claims in Cesal’s pro se complaint: an Eighth Amendment deliberate-indifference claim regarding his back treatment, and a First Amendment retaliation claim related to the withholding of insulin. The district court granted summary judgment for the defendants on both issues, reasoning that the statute of limitations on his complaints had run and that, in any event, there was no question of material fact that would justify allowing his case to move forward. Cesal appeals only the judgment in favor of Dr. Moats, and so we largely disregard Dr. Molina’s role in these events. Although Cesal’s allegations are troublesome, we conclude in the end that the district court’s judgment must be affirmed.

I

Because this is an appeal from the grant of summary judgment, our review is de novo. Conley v. Birch, 796 F.3d 742, 746 (7th Cir. 2015). At this stage of the litigation, we assume that the facts alleged by Cesal are true, and we draw all reasonable inferences in his favor. Dixon v. Cnty. of Cook, 819 F.3d 343, 346 (7th Cir. 2015). Summary judgment is appropriate when there are no genuine disputes of material fact and the movant is entitled to judgment as a matter of law. Fed. R. Civ. P. 56; Celotex Corp. v. Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986).

Between March 21, 2006, and March 28, 2011, Cesal was serving a life sentence at the Pekin Federal Correctional Institution, which is run by the Bureau of Prisons (BOP). There, he worked as a welder — a physically demanding job that required him to move 320-pound doors. He was lifting one such door on Friday, March 21, 2008, when he heard a “snap” in his back and felt sharp pain in his left hip and knee. He immediately sought care at the medical unit, but was told that the facility was closing and instead to report to sick-call on [718]*718Monday, March 24. He did so, meeting with a nurse that day. By then, Cesal had been given a wheelchair and was temporarily excused. from his job. Dr. Moats gave him a verbal order for Motrin (the active ingredient of which is ibuprofen) but was not otherwise involved in his treatment that day.

Cesal was next seen by a physician assistant on March 27. Cesal reiterated his report of pain and numbness in his leg and hip. Although he still was using the wheelchair, the physician assistant noted that Cesal had “no difficulties getting up to sit on exam table” and that Cesal displayed normal gait and posture. During the exam, the physician assistant reviewed x-rays of Cesal’s back. These x-rays had been taken on March 12, 2008 — before Cesal’s lifting accident — in response to his earlier reports of hip pain and numbness in his knee and thigh. The physician assistant prescribed Cesal ibuprofen for another ten days.

Dr. Molina saw Cesal at a follow-up appointment on March 31, when Cesal reported having moderate low-back pain and some numbness in his leg. Four days later, on April 3, the medical staff took an x-ray of Cesal’s lumbar spine, which is the area between the rib cage and pelvis. That x-ray showed that Cesal had degenerative joint disease and disc disease, a diagnosis which previously had shown up in a different x-ray. Otherwise it revealed no problems.

The very next day Cesal filed an informal complaint — the first step in the administrative grievance process — about the treatment he was receiving for his back. In this complaint, Cesal reported that he had “acute pain in my hip and knee, also numbness along the front of my thigh” and that he could not “stand or walk for a worthwhile duration.” He said that he “ha[d] been to Medical Dept, repeatedly, but examination or care have been denied.” Cesal asked for a medical evaluation and appropriate treatment. .

His complaint was rejected. On May 6, 2008, Cesal appealed this denial to the Warden — the proper next step for an inmate who is unsatisfied by the response to an informal complaint. Cesal alleged that he had been evaluated only superficially and never seen by a doctor for acute pain in his left hip and knee and numbness in his left thigh. He did not allege back pain. The Warden rejected Cesal’s appeal on June 9, 2008, noting that Cesal’s medical records indicated that he was receiving appropriate care.

The Warden’s denial also noted that medical officials were awaiting the results of a June 4, 2008, MRI of Cesal’s lumbar spine. This scan had been requested on April 15, and was approved sometime in the interim. By June 16, 2008, the results were in. The MRI revealed a few problems — mild stenosis (narrowing of the spinal canal) in one spot, and disc degeneration with mild bulging elsewhere without major stenosis. But this diagnosis did not assuage Cesal’s concerns. He appealed the denial of his grievance on June 25, 2008, moving up another rung on BOP’s grievance ladder.

Two days after Cesal filed that appeal, on June 27, Dr. Moats saw him in the prison’s chronic care clinic for what Cesal describes as a “non-routine visit.” As Cesal tells it, Dr. Moats had learned of Cesal’s grievance for the treatment of his back issue and was angry. Dr. Moats told Cesal that he would “show him” what providing no medical care looked like, and then abruptly terminated Cesal’s prescription for insulin for no medical reason. Cesal is an insulin-dependent Type II diabetic; he had been taking sliding scale insulin. Without insulin, Cesal was left to manage his blood sugar through diet, exercise, and metformin, a prescription drug that Dr. [719]*719Moats did not cancel, which is commonly-used for type II diabetes to control high blood sugar. Metformin, WebMD, http:// www.webmd.eom/drugs/2/drug-112857061/ metformin-oral/metformin — oral/details (last visited March 20, 2017). “Metformin works by helping to restore your body’s proper response to the insulin you naturally produce. It also decreases the amount of sugar that your liver makes and that your stomach/intestines absorb.” Id. Cesal skipped meals or went for runs when his blood sugar level got too high. But despite these efforts, Cesal’s blood sugar soared. As a result, he felt dizzy and saw stars, and his toenails fell off. '

Cesal’s back pain also continued to bother him. Dr.

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851 F.3d 714, 2017 WL 1046113, 2017 U.S. App. LEXIS 4959, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cesal-v-moats-ca7-2017.