by Kevin W. Bliss
After an Illinois prisoner developed a painful anal abscess and fistula, his medical care was “appalling” and the prison healthcare system was “dysfunctional.” But that’s just negligence, and the Constitution doesn’t protect prisoners from that.

That’s the takeaway from a ruling by the U.S. Court of Appeals for the Seventh Circuit on February 23, 2022, which held that a lower federal court correctly granted summary judgment to Illinois prison officials and their privately contracted healthcare provider, Wexford Health Sources, in a suit brought by a former prisoner over his negligent medical care.

The prisoner, Michael Reck, was held by the state Department of Corrections (DOC) at Menard Correctional Center (MCC) in 2015 and 2016. He had a history of Crohn’s disease with perianal abscesses and fistulae, and he had already received surgeries for seton placement, fistulotomy, fistula plug and anorectal flap, according to the complaint he later filed.

That complaint alleged that through much of 2015 he submitted several request slips to be seen by a doctor for a perianal abscess and extreme pain he was experiencing. He said many of these requests were ignored, and when he finally was treated for his condition, both Wexford Dr. John Trost and Nurse Tonya Smith delayed treatment or continued treatment already proven to be unhelpful. Other claims against DOC stated the sick call system was ineffective and that understaffing prevented proper treatment. He also accused medical staff of failing to place him in a chronic care clinic and promptly recommend him to a specialist.

Reck filed suit pro se under 42 U.S.C. § 1983 in federal court for the Southern District of Illinois on October 17, 2015, accusing Wexford, Trost and Smith, as well as MCC Health Care unit Administrator Gail Walls of deliberate indifference to his serious medical needs, in violation of his Eighth Amendment right to freedom from cruel and unusual punishment.

“Defendants do not dispute Plaintiff suffers from Crohn’s disease or that his anal fistula constituted a serious medical need,” the district court observed. But it didn’t find any of Reck’s accusations rose to the level of deliberate indifference, so it granted all defendants summary judgment on July 9, 2019. See: Reck v. Wexford Health Sources, Inc., 2019 U.S. Dist. LEXIS 114653 (S.D. Ill.).

On appeal, the Seventh Circuit affirmed, holding that none of the actions allegedly committed by any of the defendants were deliberately indifferent. Deliberate indifference claims, the Court explained, require more than an accusation of negligence; instead a defendant must be reckless in his actions. The Court said neither Trost nor Smith recklessly delayed Reck’s treatment. Both testified that the prisoner seemed to be responding to the original treatment prescribed, and when it ultimately – eventually – proved unsuccessful, Reck was referred to specialists for colonoscopy and later surgery.

The Court also ruled that defendants were not responsible for the sick call procedure at the prison or filling employment vacancies; that was up to others in DOC. Furthermore, Reck had not alleged the sick call process was inadequate nor that DOC policies governing hiring were so adverse as to preclude filling of vacancies.

Thus the Court found no error in the district court’s ruling that Reck’s claims failed to rise to the level of a constitutional violation and correctly entered an order for summary judgment.

In his concurring opinion, Judge David F. Hamilton elaborated on the case, noting that “Reck’s Eighth Amendment claims are blocked by current precedents under 42 U.S.C. § 1983 that focus primarily on individual liability of prison officials and medical staff, and that set … a high bar for Wexford’s corporate liability under Monell v. Dep’t of Soc. Servs., 436 U.S. 658 (1978).”

“But we should not lose sight of the larger picture,” he continued. “Existing precedents encourage private companies that provide health care in prisons to set up labyrinthine procedures and organizational structures that save money by delaying and denying needed medical care for prisoners while also diffusing responsibility so widely that no individual can be held legally responsible for avoidable suffering.”

So he would prefer to see Wexford lose the Monell shield and face respondeat superior liability. “The circuit precedents on the question are overdue for a careful reexamination,” Hamilton added.

Reck was represented before the Court by attorneys from Jones Day in Chicago. See: Reck v. Wexford Health Sources, Inc., 27 F.4th 473 (7th Cir. 2022).

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