Tyrone Robinson v. Joan Hannula

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted August 12, 2025*
Decided August 12, 2025
Before
MICHAEL B. BRENNAN, Circuit Judge
JOHN Z. LEE, Circuit Judge
JOSHUA P. KOLAR, Circuit Judge
No. 24-2816
TYRONE ROBINSON,
Plaintiff-Appellant,
v.
JOAN HANNULA,
Defendant-Appellee.
Appeal from the United States District
Court for the Western District of
Wisconsin.
No. 22-cv-282-wmc
William M. Conley,
Judge.
O R D E R
Tyrone Robinson, a Wisconsin prisoner, sued Dr. Joan Hannula under 42 U.S.C.
§ 1983, alleging that she delayed his treatment for an allergic reaction in violation of his
rights under the Eighth Amendment. The district court granted Dr. Hannula’s motion
for summary judgment, determining that no reasonable jury could conclude that she
was deliberately indifferent to Robinson’s condition. We affirm.
* We have agreed to decide the case without oral argument because the briefs and record
adequately present the facts and legal arguments, and oral argument would not significantly aid the
court. F ED . R. A PP. P. 34(a)(2)(C).
NONPRECEDENTIAL DISPOSITION
To be cited only in accordance with FED. R. A PP. P. 32.1

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No. 24-2816 Page 2
In October 2017 while incarcerated at Stanley Correctional Institution in Stanley,
Wisconsin, Robinson developed a rash all over his body, a sore throat, a left earache,
taste problems, and dry, peeling lips and skin. For five days, prison nursing staff treated
him with antihistamines, pain medication, Vaseline, and topical lotion. But his rash
worsened, leading to an emergency room visit where he was diagnosed with “allergy
hives” and prescribed a five-day regimen of steroids. Robinson alleged that the
emergency room physician recommended future providers investigate the cause of the
allergic reaction.
Two weeks after the emergency room visit, Dr. Hannula first examined
Robinson. Robinson reported that, although the steroid had helped, the rash had since
returned. Dr. Hannula observed extremely dry skin; flat-discolored areas with small,
raised bumps; and no signs of infection. She diagnosed Robinson with eczema and a
possible allergic reaction and said that she wanted to rule out scabies as the cause of
Robinson’s symptoms. Accordingly, her initial treatment plan included another
five-day steroid prescription, twice-daily topical cream, a one-year antihistamine
prescription, and a new body cleanser.
Dr. Hannula examined Robinson twice more, on November 6 and 13, largely
maintaining Robinson’s treatment plan with minor adjustments. These included
introducing a nerve pain medication, which Dr. Hannula increased during the second
visit.
After his third visit with Dr. Hannula, Robinson saw nursing staff twice to
address continued pain and itching and occasional bleeding from scabs. During those
visits, he requested a skin culture.
On November 29, two weeks after Dr. Hannula had last seen Robinson, she
examined him again. She found his rash largely resolved but noted dry skin and several
new red lesions. To investigate further, she ordered a skin biopsy, took a culture of one
lesion, and slightly altered Robinson’s medications.
On December 7, Dr. Hannula reviewed the biopsy results, which showed that
Robinson’s symptoms might be medication related. The next day, Dr. Hannula
discontinued Robinson’s psychiatric medication, carbamazepine, which he had started
two months before his symptoms appeared. Dr. Hannula later testified that it is
uncommon for psychiatric medications to cause an allergic reaction months after
initiation. By mid-January 2018, Robinson’s symptoms had significantly improved, and
he stopped seeing Dr. Hannula.

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No. 24-2816 Page 3
Robinson sued Dr. Hannula under 42 U.S.C. § 1983, alleging that Dr. Hannula’s
deliberate indifference to his symptoms caused a harmful delay in treatment. Both
parties sought summary judgment, and the district court entered judgment for
Dr. Hannula. The court assumed that Robinson’s condition was objectively serious but
concluded that Dr. Hannula did not consciously disregard Robinson’s medical needs.
The court found that Dr. Hannula examined Robinson multiple times within a month,
adjusting a complex treatment plan during each visit. Further, the court concluded that
Dr. Hannula had not impermissibly delayed ordering a skin biopsy and culture.
Although Robinson pointed to the emergency room physician’s recommendation in
October that providers should investigate the cause of Robinson’s allergy hives, the
court concluded that it did not change the result. The recommendation did not appear
in the medical note, and Dr. Hannula exercised her independent medical judgment in
treating Robinson.
Robinson appeals. We review the district court’s decision de novo, reviewing the
record and drawing all reasonable inferences from it in Robinson’s favor. Lockett v.
Bonson, 937 F.3d 1016, 1022 (7th Cir. 2019).
To establish a violation of his rights under the Eighth Amendment, Robinson
must show that Dr. Hannula was deliberately indifferent to an objectively serious
medical condition. Farmer v. Brennan, 511 U.S. 825, 837 (1994); Lockett, 937 F.3d at 1023.
There is no dispute that Robinson suffered from a serious medical condition, so we
consider only whether Dr. Hannula knew of and disregarded a substantial risk of
serious harm. Because Robinson alleges that Dr. Hannula provided constitutionally
deficient treatment, we frame his claim “as a challenge to ‘a deliberate decision by a
doctor to treat a medical need in a particular manner.’” Lockett, 937 F.3d at 1023
(quoting Snipes v. DeTella, 95 F.3d 586, 591 (7th Cir. 1996)).
Robinson argues that Dr. Hannula unreasonably delayed ordering a skin biopsy
and culture and terminating his carbamazepine prescription. From the time
Dr. Hannula began treating Robinson, 30 days elapsed before she ordered the lab tests,
and 39 days elapsed before she stopped the medication. Because it should have been
obvious when Dr. Hannula began treating him that his symptoms were caused by his
medication, Robinson says, the delayed testing and termination of the carbamazepine
prescription prolonged his suffering unnecessarily.
In support of his argument, Robinson points to two documents he submitted at
summary judgment that, he says, the district court overlooked. The first is a fact sheet
from WebMD that discusses the use, side effects, and precautions of carbamazepine.

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No. 24-2816 Page 4
The sheet explains that blood tests should be done before starting carbamazepine and
while taking it. It also explains that while a serious allergic reaction is rare, a person
should seek medical help right away for signs of an allergic reaction, including rash,
itching, or swelling. The second document, from the Mayo Clinic website, details the
symptoms of Stevens-Johnson syndrome, a rare disorder of the skin. The document
explains that certain psychiatric medications can trigger the condition. Robinson also
points out that in Dr. Hannula’s sworn declaration, she admits that she was aware that
Robinson was taking carbamazepine, knew of the warnings associated with it, and
understood that it could cause Stevens-Johnson Syndrome.
Even considering this evidence, we agree with the district court that no
reasonable jury could find that Dr. Hannula was deliberately indifferent to Robinson’s
symptoms. To be sure, Robinson has presented some evidence that carbamazepine can
cause a serious allergic reaction and possibly conditions like Stevens-Johnson syndrome
that affect the skin. But his evidence also confirms Dr. Hannula’s sworn statement that
these reactions are rare. And Robinson presents no evidence that conflicts with Dr.
Hannula’s statement that these reactions are even less likely to emerge months after
starting a medication. Given Robinson’s delayed allergic response and the rarity of
severe reactions, a jury could not find that Dr. Hannula’s actions were a gross deviation
from acceptable medical judgment. See Lockett, 937 F.3d at 1023 (citing Pyles, 771 F.3d at
409) (disagreement with medical expertise insufficient on its own to establish violation
of Eighth Amendment). Indeed, when Dr. Hannula first treated Robinson, she
identified a possible allergic reaction, prescribed more steroids and antihistamines, and
prescribed a new cleanser to help rule out scabies as the underlying cause. Dr. Hannula
monitored Robinson regularly for several weeks, and when changes to the prescribed
treatment regimen did not fully resolve Robinson’s symptoms, she ordered lab tests.
When those tests revealed a possible drug reaction, Dr. Hannula acted quickly to
terminate Robinson’s carbamazepine prescription.
Robinson counters that Dr. Hannula should have immediately ordered a lab test
based on the report from his emergency room visit. But that report stated only that
Robinson had “allergy hives.” It did not specify a potential cause. Even if the
emergency room physician had told Robinson that a skin biopsy was necessary to
determine the cause, Robinson presents no evidence that Dr. Hannula was aware of that
statement. Further, Dr. Hannula was entitled to rely on her own medical judgment
about the progression of Robinson’s symptoms to determine the appropriate course of
treatment. See Lockett, 937 F.3d at 1023. She spent only 30 days treating Robinson’s

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No. 24-2816 Page 5
complex symptoms before ordering further testing. No reasonable jury could conclude
that this delay was unreasonable under the circumstances.
AFFIRMED

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