Cornelius Brown, a prisoner in Illinois, sued prison medical providers and Wexford Health Sources, Inc., alleging that their delay in performing surgery for his hernias violated the Eighth Amendment. Brown first noticed hernia pain in 2016 and received a hernia belt. Over several years, he saw multiple providers, including Dr. Reynal Caldwell and Nurse Practitioner Cheryl Hansen, who consistently treated his condition conservatively with belts, pain medication, and fiber supplements. They refused to refer him for surgery until the hernias became incarcerated or strangulated, as they were initially reducible and not deemed immediately life-threatening. Brown eventually received surgery in May 2021 after an outside urologist recommended it. He sued in 2019, arguing that the providers ignored his pain and that Wexford had a policy of denying surgery to save money. The district court granted summary judgment for the defendants, and Brown appealed.
The Seventh Circuit applied the standard for deliberate indifference under the Eighth Amendment, which requires proof that a medical provider subjectively knew of and disregarded a substantial risk of harm. The court emphasized that the Constitution entitles a prisoner only to adequate medical care, not the specific care he desires. Regarding Nurse Practitioner Hansen, the court found that her decision to continue conservative treatment was based on professional judgment that the hernias remained small and reducible. The court noted that while persisting with ineffective treatments can be evidence of indifference, Brown provided no evidence that the conservative measures were so inadequate that a reasonable jury could find Hansen was not exercising professional judgment. Regarding Dr. Caldwell, the court found that even if he was involved in Brown's care, his early non-surgical treatment did not represent a serious departure from accepted professional judgment. Finally, the court rejected Brown's Monell claim against Wexford. A Monell claim requires an underlying constitutional violation, which Brown failed to establish. Furthermore, the court cited prior precedent stating that Wexford's policy does not block surgery if medical providers exercise their professional judgment, and the evidence showed that the providers' decisions were driven by medical judgment rather than a policy to deny care.
The decision reinforces the high bar for proving deliberate indifference in prison medical cases, clarifying that disagreement with a provider's medical judgment is insufficient to establish a constitutional violation. It confirms that conservative treatment of reducible hernias, even if painful, does not automatically violate the Eighth Amendment. The case is remanded with instructions to enter judgment for the defendants, effectively closing the litigation on these claims.
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