In the
United States Court of Appeals
For the Seventh Circuit
____________________
No. 16‐1889
DONALD CHARLES WILSON,
Plaintiff‐Appellant,
v.
LORI ADAMS, PATRICK MURPHY, and WISCONSIN DEPARTMENT
OF CORRECTIONS,
Defendants‐Appellees.
____________________
Appeal from the United States District Court for the
Western District of Wisconsin.
No. 14‐cv‐222 — Barbara B. Crabb, Judge.
____________________
ARGUED APRIL 19, 2018 — DECIDED AUGUST 23, 2018
____________________
Before RIPPLE, MANION, and KANNE, Circuit Judges.
KANNE, Circuit Judge. Since entering the custody of the
Wisconsin Department of Corrections in 2009, Donald Wilson
has sought medical treatment for dementia and Alzheimer’s
disease, neck and throat pain, and difficulty breathing and
swallowing. He alleges that medical staff at Oshkosh Correc‐
tional Institution were deliberately indifferent in their treat‐
ment of these ailments in violation of his Eighth Amendment
2 No. 16‐1889
rights. The district court, however, found that no reasonable
jury could find that the doctors were deliberately indifferent.
We agree and affirm the grant of summary judgment in favor
of the defendants.
I. BACKGROUND
Donald Wilson was incarcerated at the Oshkosh Correc‐
tional Institution in December 2009 after violating his parole.
Shortly thereafter he sought treatment for cognitive problems
as well as problems with his neck and throat.
Dr. Adams, a psychology supervisor at Oshkosh, first re‐
viewed Wilson’s mental health records shortly after Wilson
arrived. The records indicated that Wilson had been diag‐
nosed with a possible cognitive disorder. Dr. Adams ob‐
served Wilson exhibit symptoms associated with cognitive
disorders and referred him to a psychiatrist, Dr. Thompson.
Initially, Dr. Thompson also observed Wilson to be disori‐
ented and struggling with memory. Later that spring, how‐
ever, after talking with other prison staff‐members, she deter‐
mined that Wilson was likely feigning his symptoms in the
presence of medical staff. She reported this to Dr. Adams.
Nevertheless, Dr. Adams sent Wilson to the Wisconsin Re‐
source Center—a specialized mental health facility for prison‐
ers—for testing and medical observation. While there, Wilson
received a CT scan and counseling. After eight months of ob‐
servation, no evidence of dementia or Alzheimer’s was re‐
vealed, and Wilson was returned to Oshkosh. When asked
about Wilson’s diagnosis by another treating physician, Dr.
Adams reported that she had seen no evidence of cognitive or
memory deficiency.
No. 16‐1889 3
During this time, Wilson also began to complain of neck
and throat problems. He additionally reported experiencing
dizziness, double vision, and breathing trouble. Dr. Murphy,
Wilson’s primary care provider at Oshkosh, coordinated with
a number of different specialists at the University of Wiscon‐
sin Hospital over the course of several years to try to diagnose
the problems and address Wilson’s symptoms.
Initially, Dr. Murphy provided Wilson with naproxen for
pain and ordered testing to determine whether the problems
were caused by Wilson’s thyroid. An endocrinologist eventu‐
ally ruled that diagnosis out and instead thought Wilson
might have laryngeal cancer or a hypopharyngeal lesion. Dr.
Murphy scheduled an appointment with an otolaryngologist,
prescribed Wilson an antibiotic and a soft diet to accommo‐
date his trouble swallowing, and continued to provide
naproxen for pain.
After two endoscopies, it was determined that hardware
from an earlier spinal fusion surgery was likely the cause of
Wilson’s problems. Dr. Murphy referred Wilson to a surgeon
to determine whether the hardware could be removed. Dr.
Murphy also extended Wilson’s soft diet indefinitely upon
the recommendation of a speech pathologist who performed
a swallow evaluation, and changed Wilson’s pain manage‐
ment regime from naproxen to daily extra‐strength aceta‐
minophen.
In April 2013, a surgeon determined that the spinal fusion
hardware could not be removed without a high risk of mor‐
bidity. When this was explained to Wilson, he requested a sec‐
ond opinion.
4 No. 16‐1889
Throughout that spring, Wilson continued to seek treat‐
ment for pain. Dr. Murphy scheduled a tooth extraction, be‐
lieving some of the pain was caused by decaying teeth. Ini‐
tially, Wilson did not consent to the procedure. Another time
the procedure could not be completed because Wilson’s blood
pressure was too high. Once the extraction was completed,
however, the swelling in Wilson’s neck subsided.
In May 2013, Wilson was taken to a hospital, where the
doctors also indicated the hardware was likely the source of
Wilson’s pain. When Wilson returned from the hospital, Dr.
Murphy prescribed an antibiotic and narcotic pain medica‐
tion. Wilson was also provided with a wheelchair, an order
that someone push the wheelchair, and six months’ worth of
a nutritional supplement to address his weight loss.
Wilson attended follow‐up appointments at the Univer‐
sity of Wisconsin Hospital in July 2014 and January 2015. Spe‐
cialists there recommended a bronchoscopy, an airway exam,
lab tests, a transthoracic echocardiogram, and a CT scan of
Wilson’s chest. Dr. Murphy ensured that all of the procedures
were scheduled and performed.
In 2015, Wilson sought a court order obliging the defend‐
ants to transport him to the doctor of his choice for an evalu‐
ation regarding the spinal fusion hardware. The court granted
the order, and Wilson was transported to see Dr. Kalmjit Paul.
Dr. Paul requested that Dr. Murphy schedule Wilson for a se‐
ries of tests, which he did. Dr. Paul reviewed the results with
Wilson at a subsequent appointment and informed Wilson
that he agreed that surgery would not improve his condition.
Instead, he recommended conservative treatment. In a fol‐
low‐up letter to Wilson’s attorney, Dr. Paul explained that
“conservative treatment” includes many different types of
No. 16‐1889 5
treatment, including pain medication. He did not recommend
any more specific type of treatment for Wilson.
Wilson sued Dr. Adams, Dr. Murphy, and the Wisconsin
Department of Corrections for violating the Americans with
Disabilities Act and the Rehabilitation Act and for violating
his Eighth Amendment rights, on the basis that they had been
deliberately indifferent to his medical needs. He also claims
they were negligent under state law. The district court
granted summary judgment for the defendants in full. Wilson
does not appeal the entry of judgment on his Americans with
Disabilities Act or Rehabilitation Act claims, but he does ap‐
peal the district court’s dismissal of his Eighth Amendment
claim and his state‐law negligence claim.
II. ANALYSIS
We review the district court’s grant of summary judgment
de novo, construing all facts and reasonable inferences in the
light most favorable to Wilson, the non‐moving party. Zaya v.
Sood, 836 F.3d 800, 804 (7th Cir. 2016). We will affirm if there
are no genuine issues of material fact and the defendants are
entitled to judgment as a matter of law. Fed. R. Civ. P. 54.
A. Wilson’s § 1983 deliberate indifference claims
“[D]eliberate indifference to serious medical needs of pris‐
oners constitutes the ‘unnecessary and wanton infliction of
pain’ proscribed by the Eighth Amendment.” Whiting v. Wex‐
ford Health Sources, Inc., 839 F.3d 658, 661–62 (7th Cir. 2016)
(alteration in original) (quoting Estelle v. Gamble, 429 U.S. 97,
104 (1976)). Wilson, seeking damages pursuant to 42 U.S.C
§ 1983, claims the medical staff at Oshkosh were deliberately
indifferent to his medical needs. To prove such a claim, he
6 No. 16‐1889
needed to establish that he suffered from “an objectively seri‐
ous medical condition” and that the “defendant was deliber‐
ately indifferent to that condition.” Petties v. Carter, 836 F.3d
722, 728 (7th Cir. 2016). “To determine if a prison official acted
with deliberate indifference, we look into his or her subjective
state of mind.” Petties, 836 F.3d at 728; see Farmer v. Brennan,
511 U.S. 825, 834 (1994). An official is deliberately indifferent
when he disregards a known condition that poses “an exces‐
sive risk to inmate health or safety.” Dunigan v. Winnebago
County, 165 F.3d 587, 590 (7th Cir. 1999); see Farmer, 511 U.S.
at 837; Whiting, 839 F.3d at 662. Mere negligence or malprac‐
tice is insufficient. Petties, 836 F.3d at 728; Whiting, 839 F.3d at
662.
Wilson claims Dr. Adams was deliberately indifferent in
her treatment of Wilson’s mental health and that Dr. Murphy
was deliberately indifferent in his treatment of Wilson’s phys‐
ical health. We review each claim in turn.
1. Dr. Adams was not deliberately indifferent in her treatment of
Wilson’s mental health.
Wilson claims Dr. Adams should have done more to treat
his Alzheimer’s disease and dementia. But he has failed to
prove that he actually suffers from either condition. He relies
on the report of a psychologist who saw him in 2003 in re‐
sponse to an application for disability benefits. The report in‐
dicates he had some cognitive disorder. None of the testing
done at Oshkosh or at the Wisconsin Resource Center, how‐
ever, provided any evidence that Wilson suffered from a cog‐
nitive disorder. We recognize that these disorders are difficult
to identify and diagnose, but without such evidence, Wilson
cannot show that he suffered a serious medical condition, let
No. 16‐1889 7
alone that Dr. Adams was indifferent in her treatment of that
condition.
Furthermore, the record indicates Dr. Adams investigated
Wilson’s mental health condition. She referred him to a psy‐
chiatrist and sent him to a specialty center for extensive ob‐
servation. She only refused to provide further treatment after
these specialists reported that they were not diagnosing Wil‐
son and that they were suspicious that he was feigning his
symptoms when in the presence of medical professionals.
There is nothing in the record that would allow a reasonable
juror to find that Dr. Adams believed that Wilson suffered
from Alzheimer’s disease or dementia and refused to provide
proper treatment. Therefore, the district court did not err
when it granted summary judgment for the defendants on
this claim.
2. Dr. Murphy was not deliberately indifferent in his treatment of
Wilson’s physical health.
Wilson also contends the district court should not have en‐
tered summary judgment on his claim that Dr. Murphy was
deliberately indifferent in his treatment of Wilson’s neck,
back, and throat pain. The district court assumed for purposes
of the summary judgment motion that this pain constitutes a
serious medical condition, as do we. “[W]e look at the totality
of [Wilson’s] medical care when considering whether that
care evidences deliberate indifference to serious medical
needs.” Petties, 836 F.3d at 728.
The record is replete with evidence of Dr. Murphy’s at‐
tempts to diagnose the source of Wilson’s pain. He worked
with endocrinologists, an otolaryngologist, a speech
pathologist, a pulmonologist, a neurosurgeon, and a dentist.
8 No. 16‐1889
He repeatedly coordinated with these specialists to schedule
follow‐up appointments, procedures, and tests. By the time
Wilson brought this suit, the Department had also made ar‐
rangements for Wilson to receive a second opinion regarding
the removal of his spinal fusion hardware from a doctor of his
choosing, albeit after the court ordered the Department to do
so.
Wilson’s strongest argument is that Dr. Murphy was in‐
different in his treatment of Wilson’s pain while he under‐
went these attempts to diagnose the source of the pain. For
most of the relevant time period, Dr. Murphy provided Wil‐
son with naproxen. It is true that continuing the same treat‐
ment despite no results can constitute indifferent treatment,
Kelley v. McGinnis, 899 F.2d 612, 616 (7th Cir. 1990), but Wilson
makes no suggestion that Dr. Murphy was withholding an‐
other more effective available treatment option. Wilson pre‐
sents no evidence tending to show this is a situation in which
the medical professional “chooses an ‘easier and less effica‐
cious treatment’ without exercising professional judgment.”
Petties, 836 F.3d at 730. Furthermore, Wilson saw a number of
other medical professionals, and none suggested his pain
management regime was insufficient. At most, Dr. Paul sug‐
gested there were a number of potential treatment options,
but he did not indicate that the pain medication provided was
insufficient or that some other treatment should be provided.
Wilson also asserts that Dr. Murphy failed to comply with
the recommendation of a pulmonologist regarding numbness
in Wilson’s hand. The pulmonologist noted that Wilson “may
need further evaluation with Neurology.” (R. 62‐1 at 108.) Dr.
Murphy declined to schedule any such further evaluation. “A
jury can infer conscious disregard of a risk from a defendant’s
No. 16‐1889 9
decision to ignore instructions from a specialist.” Zaya, 836
F.3d at 806; see Petties, 836 F.3d at 729. But that does not mean
that a doctor must always follow the recommendation of a
specialist. See Petties, 836 F.3d at 729 (“[E]vidence that some
medical professionals would have chosen a different course
of treatment is insufficient to make out a constitutional
claim.”); Jackson v. Kotter, 541 F.3d 688, 698 (7th Cir. 2008) (“A
medical professional’s treatment decisions will be accorded
deference ‘unless “no minimally competent professional
would have so responded under those circumstances.”’”)
(quoting Sain v. Wood, 512 F.3d 886, 894–95 (7th Cir. 2008)).
Dr. Murphy explained that he was aware of Wilson’s hand
condition before sending him to the pulmonologist, that Wil‐
son had been examined by a neurologist earlier in the year,
and that he decided the best course of action was to continue
providing pain medication and monitoring the numbness in
Wilson’s hand. Wilson presents no evidence that this decision
was “a substantial departure from accepted professional
judgment, practice, or standards.” Sain, 512 F.3d at 895 (quot‐
ing Collignon v. Milwaukee Cty., 163 F.3d 982, 988 (7th Cir.
1998)).
Finally, Wilson claims Dr. Murphy delayed an appoint‐
ment for three‐and‐a‐half months, despite Wilson’s repeated
requests for treatment. Delaying treatment, even if not life
threatening, can be evidence of deliberate indifference. Gut‐
tierrez v. Peters, 111 F.3d 1364, 1371 (7th Cir. 1997); see Petties,
836 F.3d at 730; Perez v. Fenoglio, 792 F.3d 778, 777–78 (7th Cir.
2015). But delays can also be reasonable. See Petties, 836 F.3d
at 730 (noting that delays are common in prison and that
length of the delay, seriousness of the condition, and ease of
providing treatment must be considered when evaluating
10 No. 16‐1889
whether a delay is “tolerable”). The defendants assert that de‐
lays during that time were common because Dr. Murphy was
the only physician treating more than two thousand inmates
and he needed to prioritize his appointments. Furthermore, a
plaintiff must prove the delay in treatment “exacerbated the
injury or unnecessarily prolonged pain,” Petties, 836 F.3d at
730–31, and Wilson is unable to identify any evidence that
such resulted from the delay. See Knight v. Wiseman, 590 F.3d
458, 466 (7th Cir. 2009) (explaining that an Eighth Amend‐
ment claim based on delay will fail “unless the plaintiff intro‐
duces verifying medical evidence that shows his condition
worsened because of the delay”).
No reasonable jury could find that Dr. Murphy was delib‐
erately indifferent in his treatment of Wilson’s physical
health—either in seeking a diagnosis or in treating Wilson’s
symptoms. The district court did not err when it entered sum‐
mary judgment for the defendants on this claim.
B. Wilson’s state‐law negligence claim
Wilson also claims the defendants were negligent in their
treatment of his healthcare. This is a state‐law claim. The dis‐
trict court properly exercised its supplemental jurisdiction
and considered the claim along with Wilson’s federal‐law
claims. 28 U.S.C. § 1367; see Hansen v. Bd. of Trs., 551 F.3d 599,
607 (7th Cir. 2008) (noting that “[t]he district court has broad
discretion in deciding whether to retain supplemental
claims”).
Wisconsin law requires that an expert witness testify to es‐
tablish the standard of care in a medical malpractice case, un‐
less “the situation is one where the common knowledge of
laymen affords a basis for finding negligence.” Christianson v.
No. 16‐1889 11
Downs, 279 N.W.2d 918, 921 (Wis. 1979); see also Carney‐Hayes
v. Nw. Wis. Home Care, Inc., 699 N.W.2d 524, 537 (Wis. 2005).
Wilson offered no expert medical testimony. On appeal, Wil‐
son argues that expert testimony was not necessary in this
case, or, alternatively, that the report from Dr. Paul should be
treated as expert testimony.
Expert testimony was necessary in this case, because ordi‐
nary laymen would not know what medical treatment was
necessary based on the symptoms Wilson presented. In fact,
the evidence presented indicates that a team of well‐qualified
specialists struggled to identify the cause of Wilson’s pain or
to diagnose any cognitive functioning problem. And Dr.
Paul’s report is not sufficient for these purposes, because it
does not include any opinion regarding the proper standard
of care or whether Dr. Murphy had provided proper care.
Without expert testimony, Wilson could not prove his claim.
Therefore, the district court did not err when it entered sum‐
mary judgment for the defendants on this claim.*
* We have in the past expressed doubt concerning the applicability of Wis‐
consin’s expert‐evidence rule in diversity cases. Gil v. Reed, 381 F.3d 649,
659 (7th Cir. 2004). We need not resolve that issue here. We have observed
that the federal rule (“no expert testimony is needed when the symptoms
exhibited are not beyond a layperson’s grasp”) may be indistinguishable
from the Wisconsin rule. See Gil v. Reed, 535 F.3d 551, 558 n.2 (7th Cir.
2008) (quoting Gil, 381 F.3d at 659). And under either rule, Wilson has not
presented any evidence from which a jury could reasonably determine the
defendants’ conduct fell below the appropriate standard of care.
12 No. 16‐1889
III. CONCLUSION
Because we conclude the grant of summary judgment was
appropriate, we do not consider the defendants’ arguments
regarding qualified immunity.
The judgment of the district court is AFFIRMED.