Knight v. Zahtz

CourtDistrict Court, N.D. Illinois
DecidedMarch 27, 2025
Docket3:21-cv-50183
StatusUnknown

This text of Knight v. Zahtz (Knight v. Zahtz) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Knight v. Zahtz, (N.D. Ill. 2025).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS WESTERN DIVISION Jeffery Knight, ) ) Plaintiff, ) ) Case No. 3:21-cv-50183 v. ) ) Judge Iain D. Johnston Merrill J. Zahtz, et al., ) ) Defendants. ) MEMORANDUM OPINION AND ORDER For the reasons stated below, Defendants’ motion for summary judgment [87] is granted.1 In short, this entire motion could be resolved based on a single undisputed fact. On about September 20, 2021, Plaintiff underwent elective hernia surgery at KSB Hospital by Dr. Hefty. The surgery was completed without complications. Dr. Hefty testified that he saw no need for Plaintiff’s hernia surgery to occur earlier than September 20, 2021. Dkt. 114 ¶ 54. This undisputed fact sinks Plaintiff’s claims. But, for the sake of completeness, the Court explains in detail— spanning nearly 20 pages—why summary judgment must be granted. I. Background2 In May 2021, Plaintiff Jeffery Knight filed the instant lawsuit under 42 U.S.C. § 1983, alleging civil rights violations arising out of the medical care and treatment he received for his hernia while incarcerated at Dixon Correctional Center (“Dixon”).

1 The Court thanks recruited counsel for their time and efforts representing Plaintiff in this action. 2 The following facts are taken from the parties’ Local Rule 56.1 statement of material facts. Dkts. 91, 113– 15. The facts are undisputed except where noted. Dkt. 1. As set out in the operative amended complaint, Knight was allowed to proceed on claims against Defendants Dr. Merrill J. Zahtz, Dr. Carlos Fior, Dr. Stephen Ritz, and Wexford Health Sources, Inc., alleging deliberate indifference to his serious

medical needs in violation of the Eighth Amendment. Dkts. 12–13. In June 2016, while incarcerated at Danville Correctional Center, Knight was diagnosed with a left inguinal hernia after moving a property box in his cell. Dkt. 114 ¶ 21. Knight received a low bunk permit while at Danville. Dkt. 115 ¶ 2. On April 15, 2019, Knight was transferred to Dixon. Dkt. 115 ¶ 4. Wexford is a private company that contracted with the State of Illinois to provide medical care

and treatment to inmates at Dixon. Dkt. 114 ¶ 5. Zahtz, the medical director, and Fior, the associate medical director, were physicians employed by Wexford at Dixon. Dkt. 114 ¶¶ 2–3. Ritz was Wexford’s corporate utilization management medical director until July 2020, when he became the chief medical officer. Id. ¶ 4. Ritz participated in collegial reviews regarding referral requests for off-site medical services. Id. ¶ 4. On August 27, 2019, Knight saw nurse practitioner Susan Tuell for a complaint

of a hernia. Dkt. 114 ¶ 22. Knight reported that his hernia increased in size and was impacting his activities of daily living. Id. Tuell assessed Knight with a left inguinal hernia that was easily reducible. Id. ¶¶ 22–23. Tuell submitted a request for a surgical consultation for Knight’s hernia and gave him a low bunk permit for one year, noting that he had Tylenol and was wearing a hernia belt. Id. ¶ 23. On September 5, 2019, Zahtz participated in a collegial review with Ritz regarding Tuell’s referral request. Dkt. 114 ¶ 24. Ritz reviewed the referral request and supporting documentation, and he discussed the referral with Zahtz. Id. Based

on the information available to him and his professional judgment, Ritz recommended an alternative treatment plan for Knight’s hernia instead of a surgical consultation. Id. ¶ 25. This plan included using a hernia belt to stabilize Knight’s hernia, instructing him to refrain from lifting anything, managing his weight if indicated, and instructing Knight to continue using analgesics for pain. Id. ¶ 25. The alternative treatment plan was based on the fact that Knight’s hernia was easily reducible and

did not meet other criteria that would necessitate surgery, such as strangulation, incarceration, or infection of the hernia. Id. ¶ 25. On September 12, 2019, Zahtz saw Plaintiff to discuss the non-approval of Tuell’s surgical consultation. Dkt. 114 ¶ 27. Zahtz noted that Knight’s hernia did not need surgery because it was easily reducible and was causing minimal pain. Id. Zahtz examined Knight’s hernia and told him it was hard to tell he had a hernia. Id. ¶ 28. Knight reported that his constipation and straining was putting pressure on his

hernia, but he admitted he was not taking the medications that helped his constipation. Id. ¶ 27. Zahtz instructed Knight to adhere to the treatment plan for his constipation and to keep using his hernia belt, Tylenol, and fiber tabs. Id. ¶¶ 27– 28. On December 5, 2019, nurse practitioner Kristina Mershon saw Knight for a chronic clinic visit and noted that Knight’s hernia was non-tender to palpation. Id. ¶ 30. On April 8, 2020, Fior saw Knight at his cell for his hernia. Dkt. 114 ¶ 31. On examination, Fior noted that Knight’s hernia was not incarcerated, strangulated, or infected and it was still fully reducible. Id. ¶ 32. Fior assessed Knight with a reducible

inguinal hernia and instructed him to follow up with the medical staff if his hernia worsened. Id. ¶ 32. It was Fior’s clinical opinion and professional judgment that Knight’s hernia did not warrant a surgical referral at that time. Id. ¶ 33. Knight had been provided appropriate conservative treatment measures for his hernia, including a hernia belt and pain medication, and Fior did not believe that additional pain medications or further treatment were medically necessary. Id. ¶ 33.

Fior avers in his declaration that Knight was not in any acute distress at the time of the examination because he would have noted such in the medical record. Dkt. 114 ¶ 31. However, Knight testified that he told Fior that the hernia was still causing him a significant amount of pain and that he could no longer wear his hernia belt because he was outgrowing it. Dkt. 115 ¶ 7. Knight testified that Fior informed him that “you already know the policy, that unless [your hernia] doesn’t go back in, they are not going to do nothing for you.” Id. However, Fior avers that he did not tell

Knight this. Dkt. 115 ¶ 7; Dkt. 91-4 ¶ 20. It is undisputed that Fior has no knowledge of such a policy or that one exists. Dkt. 114 ¶ 34. It is also undisputed that the prevailing guidance from Wexford and the Illinois Department of Corrections was simply to utilize his professional clinical judgment when treating patients, and he was under no limitations as to when he could refer a patient for surgical treatment of a hernia. Id. Knight also testified that he continued to file grievances about his worsening hernia but has failed to attach these grievances to his statement of additional material facts to support to contents of these grievances. See Dkt. 115 ¶ 5. On December 11, 2020, nurse practitioner Chelsea Sword saw Knight for a

complaint of hernia pain. Dkt. 114 ¶ 35. Knight informed Sword that sometimes the Tylenol “doesn’t even touch the pain.” Id.; Dkt. 92, Exhibit 7. On examination, Sword noted that Knight was in no acute distress and his hernia was small, not bulging, and fully reducible but was tender to palpation. Dkt. 114 ¶ 36. Sword prescribed Knight Tramadol and instructed him to continue wearing his hernia belt and to avoid activities that exacerbate his pain. Id.

On February 8, 2021, Sword saw Knight for the management of his pain medications. Dkt. 114 ¶ 37. In response to Knight’s request, Sword prescribed him Ultram and instructed him to continue using his hernia belt and to avoid activities that exacerbate his pain. Id. On April 21, 2021, Sword saw Knight for a complaint that his pain medications were no longer working. Id. ¶ 38. Knight told Sword that his hernia remained fully reducible, and on examination he was in no acute distress. Id. ¶ 38.

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Knight v. Zahtz, Counsel Stack Legal Research, https://law.counselstack.com/opinion/knight-v-zahtz-ilnd-2025.