21-1647 | Omnilex

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In the
United States Court of Appeals
For the Seventh Circuit
____________________
No. 21-1647
DANA BROWN ,
ě-Appellant,
v.
K URT O SMUNDSON ,
TERRY EDWARDS, and
BRITANY BEARD (M ILLER ),
Defendants-Appellees.
____________________
Appeal from the United States District Court for the
Central District of Illinois.
No. 17-cv-04284 — Jonathan E. Hawley, Magistrate Judge.
____________________
A RGUED J UNE 2, 2022 — DECIDED J UNE 27, 2022
____________________
Before EASTERBROOK, S T. EVE, and JACKSON -A KIWUMI , Cir-
cuit Judges.
ST. EVE, Circuit Judge. Dana Brown, a prisoner in the Illi-
nois River Correctional Center, started to feel some ab-
dominal pain. A few days later, he told the prison’s nurse
practitioner about his symptoms, who prescribed some pain
medicine. Brown then returned to his cell, but the pain

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2 No. 21-1647
became more severe. Brown was taken to the prison’s ęȬ
mary, where the prison’s nurses and doctor treated him over
three-and-a-half days. Despite the treatment, the symptoms
worsened, and Brown needed to be transported to a hospital.
There, he was diagnosed with appendicitis, which required
surgery to remove his appendix.
Brown sued ȱȱȱĜȱ ȱcared for him in the
prison’s hospital, alleging violations of his Eighth Amend-
ment rights. The district court granted summary judgment for
ȱ ǯȱ ȱ Ĝ. Tȱ ȱ ȱ ěȱ ȱ ȱ
ȱ ȱȱ¢ȱȱěǰȱȱȱȱȬ
der current precedent, toward Brown’s serious medical con-
dition.
I. Background
While working in the prison’s bakery on February 20,
2017, Brown began experiencing abdominal pain, which he
Ĵȱȱ a preexisting hernia. The next day though, the
pain had worsened. He could not bend down to take bread
out of the oven, needing to rely on his coworker to cover his
work. By the end of his shift, Brown was sweating profusely,
was unable to leave his bed, and had to use a jug in his cell to
urinate. Despite the pain, Brown decided to wait to consult
medical personnel for two days, when he went to see Nurse
Practitioner Britany Miller for an appointment he previously
scheduled before his abdominal pain began.
At the appointment, Brown reported “back pain [at] nine
out of ten on the pain scale with groin discomfort.” N.P. Mil-
ler believed that Brown had a problem with his right hernia.
She prescribed some Ibuprofen, a hernia belt, and a “no
work” permit for three days. Brown returned to his cell and

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No. 21-1647 3
did not leave his bed for two days; during this time, he even-
tually stopped drinking and eating altogether. On the night of
February 25, Brown asked for help, and the guards took him
to the medical wing.
Nurse Terry Edwards saw Brown upon his arrival. Brown
could not stand, was clutching his abdomen, complained of
constant stabbing pain, which was a “ten out of ten,” and had
an elevated blood pressure. His abdomen was “swollen and
tender to the touch.” Nurse Edwards called Dr. Kurt Os-
mundson, who ordered that Brown be given an injection of
pain medicationǰȱ ȱȱĴȱȱȱȱǰ and placed
him on 23-hour observation. The next day, a non-defendant
nurse saw Brownǰȱ ȱ ȱ ěȱ ȱ abdominal pain,
and called Dr. Osmundson to report his condition. Dr. Os-
mundson formall¢ȱĴ Brown ȱȱę¢ and or-
dered a urinalysis, vital checks, and Motrin three times a day.
On February 27, two days after Brown entered the prison’s
medical wing, Dr. Osmundson examined Brown in-person
and detected positive bowel sounds. He ordered an x-ray, reg-
ular vital checks, a painkiller, diet and activities as tolerated,
an Accu-Chek, a blood count, a metabolic panel, and another
urinalysis. 1
Brown’s pain subsided Ě¢ later that day, but by the
evening, it had returned. Brown called for a nurse as he con-
tinued to vomit throughout the night in increasingly worri-
some colors, such as “bright yellow with … brown colored
Ě,” and his blood pressure started to spike. At midnight,
one nurse observed that Brown’s abdomen appeared hard to
1 Brown alleges, in his deposition, that N.P. Miller returned to work and
“refused” to see Brown during this time.

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4 No. 21-1647
the touch. Early the next morning, on February 28, Nurse Ed-
wards called Dr. Osmundson to report these symptoms. Six
hours later, Dr. Osmundson saw Brown, who was in consid-
erable pain but whose blood and urine tests returned essen-
tially to normal; he also did not have a fever, chills, or ab-
dominal guarding. An x-ray was taken in the late afternoon.
Shortly thereafter, when Brown’s abdomen became distended
ȱęǰ Dr. Osmundson ordered that he be transferred to
the emergency room. The ě there diagnosed him with ap-
pendicitis and a perforated appendix. Brown was then rushed
into emergency laparotomy surgery, which was successful.
Brown brought suit under 42 U.S.C. § 1983 against Dr. Os-
mundson, Nurse Edwards, and N.P. Miller, 2 alleging viola-
tions of his Eighth Amendment rights. He argued that had the
ȱěȱȱȱȱȱȱ¡ rup-
tured, it could have been treated with a simpler laparoscopy,
which requires only minor incisions, instead of a laparotomy,
ȱȱĴȱȱȱȱȱȱȱȬ
pendix. The defendants moved for summary judgment. In
deposition testimony, Dr. Bernard, an emergency-room phy-
sician at Graham Hospital, opined that Brown’s symptoms
ȱȱȱȱęc to any abdominal issue. He ex-
ǰȱ ȱǰȱȱȱȱȱĜȬ
cult to diagnose. The “classic case” of appendicitis—dis-
tended abdomen, fever, nausea, vomiting, and an elevated
white blood cell count—occurs infrequently. The district
2 Brown also sued Wexford Health Sources, Inc. The district court dis-
missed the claim with prejudice, and Brown has not appealed that dismis-
sal.

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No. 21-1647 5
court granted summary judgment for the defendants. This
timely appeal follows.
II. Discussion
Brown contends that the defendants violated the Eighth
Amendment’s Cruel and Unusual Punishment Clause by de-
priving him of necessary medical care. See U.S. Const. amend.
VIII. We review a grant of summary judgment de novo, draw-
ing all reasonable inferences in favor of the nonmovant.
Driveline Sys., LLC v. Arctic Cat, Inc., 936 F.3d 576, 579 (7th Cir.
2019). “Summary judgment is appropriate when there is no
genuine dispute of material fact, and the moving party is en-
ȱȱȱȱȱĴȱȱ ǯȄȱUnited States ex rel. Proc-
tor v. Safeway, Inc., 30 F.4th 649, 658 (7th Cir. 2022). A genuine
ȱȱȱȱ¡ȱ¢ȱȱȃȱȱĜȱdence
favoring the nonmoving party for a jury to return a verdict for
that party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249
(1986).
“The Constitution ‘does not mandate comfortable pris-
ons,’ but neither does it permit inhumane ones ….” Farmer v.
Brennan, 511 U.S. 825, 832 (1994) (quoting Rhodes v. Chapman,
452 U.S. 337, 349 (1981)); see also Ĵȱǯȱ, 836 F.3d 722,
727 (7th Cir. 2016) (en banc). Because depriving a prisoner of
medical care serves no valid penological purpose, “deliberate
ěȱȱȱmedical needs of prisoners constitutes
ȱȁ¢ȱȱ ȱĚȱȱȂȱȱ¢ȱ
the Eighth Amendment.” Estelle v. Gamble, 429 U.S. 97, 104
(1976) (quoting Gregg v. Georgia, 428 U.S. 153, 173 (1976)). To
succeed on a deprivation-of-medical-care claim, ȱ ě
must show that “(1) he had an objectively serious medical
need (2) to which [the defendants] ȱ¢ȱěȬ
ent.” Dean v. Wexford Health Sources, Inc., 18 F.4th 214, 241 (7th

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6 No. 21-1647
Cir. 2021). Brown can easily satisfy the ę inquiry. Appendi-
citis is an “objectively serious medical condition” that, left un-
treated, leads to a perforated (or ruptured) appendix, requir-
ing invasive surgery to avoid serious injury and death. Brown
has not, however, ȱ Ĝȱ ȱ ȱ ȱ ȱ
ȱȱȱȱę that the defendants were “deliberately in-
ěȄȱ ȱȱȱs.
ȱěȱȱa look into the subjective
state of the defendants’ mind. Wilson v. Adams, 901 F.3d 816,
820 (7th Cir. 2018) (quoting Ĵ, 836 F.3d at 728). A prison
Ĝȱs ȱȱě only when he “actu-
ally [knows] of and disregard[s] a substantial risk of harm.”
Dean, 18 F.4th at 241 (quoting PeĴ, 836 F.3d at 728). “This is
a high bar ‘because it requires a showing [of] something ap-
proaching a total unconcern for the prisoner’s welfare in the
face of serious risks.’” ȱǯȱ ě¢, 22 F.4th 703, 710 (7th
Cir. 2022) (quoting Rosario v. Brawn, 670 F.3d 816, 821 (7th Cir.
2012)). “[M]ere negligence” or even civil “objective reckless-
ness” simply “is not enough.” Ĵ, 836 F.3d at 728; see also
Farmer, 511 U.S. at 836–38. ȱȃĜl’s failure to alleviate a
ęȱȱȱȱȱȱȱȱȱ …
cannot … ȱ ȱ ȱ ȱ Ěȱ ȱ .”
Farmer, 511 U.S. at 838. Moreover, medical malpractice “does
not become a constitutional violation merely because the vic-
tim is a prisoner.” Estelle, 429 U.S. at 106; see also McGee v. Ad-
amsǰȱŝŘŗȱǯřȱŚŝŚǰȱŚŞŗȱǻŝȱǯȱŘŖŗřǼȱǻȃȱěȱ
is not medical malpractice.”).
A ěȱȱȱǰȱȱȱȱȬ
stantial, to prove deliberaȱ ě. Ĵ, 836 F.3d at
728. Direct evidence, we have observed, is rarely forthcoming.
Id. ȱĜȱdo not typically proclaim that they violated

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No. 21-1647 7
the Constitution by ignoring a known risk. Instead, “[m]ost
cases turn on circumstantial evidence.” Id. Several circum-
stances can permit a jury to reasonably infer deliberate indif-
ference, such as denial of medical treatment altogether, Id. at
729, delay of medical care, Dobbey v. Mitchell-Lawshea, 806 F.3d
938, 940 ǻŝȱǯȱŘŖŗśǼǰȱȱěȱǰȱCon-
ley v. Birch, 796 F.3d 742, 747 (7th Cir. 2015), “a substantial de-
parture from accepted professional judgment, practice, or
standards,” Estate of Cole by Pardue v. Fromm, 94 F.3d 254, 261–
62 (7th Cir. 1996), ignoring an obvious risk, Ěȱǯȱ,
439 F.3d 392, 396 (7th Cir. 2006), and refusing care because of
cost, Ralston v. McGovern, 167 F.3d 1160, 1162 (7th Cir. 1999).
Brown has no direct evidence that any of the defendants
ȱ¢ȱěȱȱȱ. Instead, he
relies on circumstantial evidence, arguing that a reasonable
¢ȱ ȱ ęȱ ȱ ȱ ȱ ȱ ¡¢ȱ ¢ȱ
ǰȱȱȱȱȱȱěȱǰȱȱ
grossly violated the standard of care.
The claim against Dr. Osmundson ultimately falls short of
the demanding standard for deliberaȱ ě. See
Farmer, 511 U.S. at 838. “[D]elays are common in the prison
Ĵȱ ȱȱȱǳǯȄȱĴ, 836 F.3d at 730. It is
uncontested that appendicitis ȱ Ĝȱ ȱ diagnose; its
symptoms mirror those of other abdominal ailments. Nurse
ȱęȱȱǯȱȱȱ Ȃȱȱ
on February 25, several days after he developed symptoms.
Dr. Osmundson provided some care by prescribing pain kill-
ers and ordering Brown be placed on 23-hour observation.
The next morning, a non-defendant nurse told Dr. Osmund-
son that Brown was still in “discomfort,” and Dr. Osmundson
¢ȱĴȱ ȱȱȱę¢ǯȱAfter the pain

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8 No. 21-1647
worsened in the night, Dr. Osmundson saw the patient the
next morning and detected positive bowel signs. He ordered
imaging, vital checks, painkillers, a blood count, a metabolic
panel, and a urinalysis. Several nurses observed Brown in
pain over the next day, but it was not until very early in the
morning that one of them relayed the information to Dr. Os-
mundson, who examined Brown six hours later. Even then,
Brown’s blood and urine tests were essentially normal, and
Brown did not have a fever, chills, or abdominal guarding—
the classic symptoms of appendicitis. Finally, once Brown’s
abdomen became distended, Dr. Osmundson immediately
sent him to the hospital only three-and-a-half days after he
learned of and began treating Brown’s symptoms. Even an
emergency-room physician there noted that Brown’s symp-
ȱ ȱȱȱȱ¢ȱęǯȱWhile Dr. Os-
ȱȱȱȱȱĴǰȱȱȱ care
after only minimal, not inexcusable or excessive, delay. Contra
Miller v. Campanella, 794 F.3d 878, 880 (7th Cir. 2015) (a two-
ȱ¢ȱȱȱȱěȱȱ-esophageal
Ě¡ȱ Ǽǲȱ Ĵȱ ǯȱ , 658 F.3d 742, 752 (7th Cir.
2011) (a ten-ȱ¢ȱȱȱȱěȱȱȬ
matoid arthritis).
Additionally, Brown has not presented evidence that Dr.
Osmundson knowingly persisted ȱ ȱ ȱ ȱ ěȱ
treatment. See Greeno v. Daley, 414 F.3d 645, 655 (7th Cir. 2005).
Throughout the three-and-a-half days, Dr. Osmundson grad-
ually changed his treatment in response to Brown’s worsen-
ȱ¢ǯȱȱęǰȱȱȱ ȱȱers and ob-
ǯȱȱȱȱȱȱǰȱȱĴȱ
ȱȱȱę¢ȱȱȱǰȱȱȱ¡ȱ¢ǰȱ
he ordered imaging, vital checks, and a urinalysis. Brown’s
condition still declined, so Dr. Osmundson examined him,

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No. 21-1647 9
waited for an x-ray, and sent him to the hospital as soon as a
nurse reported Brown’s abdomen became distended. His re-
sponses to Brown’s health, even if negligent, do not amount
ȱ ȱ ȃȱ ȱ ȱ ȱȱ ȱ ȱ ȱ ěȬ
tive.” Ĵ, 836 F.3d at 730.
Nor did Dr. Osmundson administer care that was “such a
substantial departure from accepted professional judgment,
practice, or standards as to demonstrate that the person re-
sponsible did not base the decision on such a judgment.” Cole,
94 F.3d at 261–62; see also Ĵ, 836 F.3d at 729 (“E]vidence
that some ȱȱ ȱȱȱȱěȱ
ȱȱȱȱĜȱȱȱȱȱȱ
claim.”); Ě, 439 F.3d at 396 (“[T]he decision must be so
far ęȱȱȱȱȱȱȱȱȱȬ
ference that it was not actually based on a medical judg-
ment.”); Steele v. Choi, 82 F.3d 175, 179 (7th Cir. 1996) (“[T]he
Supreme Court's holding in Estelle that the Eighth Amend-
ment does not constitutionalize medical malpractice implies
that there will be cases in which treatment falls below accepta-
ble standards that do not state a claim for constitutional pur-
poses.”). Brown has furnished no evidence for his “substan-
tial departure” assertion in the form of an expert opinion or
otherwise. Dr. Osmundson treated Brown by gradually in-
creasing monitoring and testing as his conditions worsened,
and when necessary, he sent Brown to the hospital. At no
point did Dr. Osmundson abandon his duties as a physician
such that “no minimally competent professional would have
so responded.” Collignon v. Milwaukee County, 163 F.3d 982,
989 (7th Cir. 1998).
Brown relies on Conley v. Birch, 796 F.3d 742, and Sherrod
v. Lingle, 223 F.3d 605 (7th Cir. 2000), to Ĵ avail. In Conley,

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10 No. 21-1647
the prisoner broke his hand in a physical altercation with an-
other inmate. 796 F.3d at 744. On Christmas Eve, he went to
the healthcare unit for his pain, and the nurse believed there
may have been a fracture. Id. She called the physician as-
signed to the facility, and upon consultation, the nurse pre-
scribed an ice pack and some ibuprofen. Id. at 745. The doctor
ȱȱ ȱȱȱ¢ȱęȱ¢ȱȱȱ¡Ȭ
ined the patient. Id. She then ordered an x-ray, which ulti-
mately revealed a fracture. Id. Conley sued over the delays in
providing medical care. Id. In determining that summary
judgment was not appropriate, we emphasized the nurse’s
note of a “possible/probable fracture” indicated that she
might have relayed the information to the doctor, who could
have ignored the serious medical condition. Id. at 747. Thus, a
reasonably jury could have found, based on the phone con-
versation, that the doctor “strongly suspected that [the plain-
ěȂǾ hand was fractured.” Id. Brown, though, lacks any evi-
dence that Dr. Osmundson ever knew of and disregarded a
substantial risk of appendicitis. No notes appear in Brown’s
ȱǰȱȱȱȱęȱȱȱȱ ȱǯȱ
Sherrod is similarly distinguishable. See 223 F.3d 605. The
prisoȱȱȱěȱȱǯȱId. at 608. He
requested assistance, ęȱȱMarch 9, 1995, but was never ad-
ĴȱȱǯȱId. He returned two days later, and a
nurse wrote “rule out appendicitis.” Again though, the pris-
oner was sent back to his cell despite complaints of abdominal
pain and a lack of bowel activity. Id. On March 17, the doctor
transferred him to the emergency room—at least eight days
ȱȱęȱ¢ǯȱId. at 609. The emergency-room doc-
tor prescribed pain medication and a shot of a medication
with orders to return for more testing, but the prison hospital
ěȱȱęȱȱȱ ȱȱȱȱn for more

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No. 21-1647 11
tests even as a nurse again noted “rule out appendicitis.” Id.
Eventually, the prisoner was treated for a ruptured appendix
ȱ ȱ ŘŚǰȱ ȱ ȱ ȱ ȱ ȱ ęȱ ȱ the
prison’s medical ěȱ ȱ ȱ ¢ǯȱ Id. Like in Conley,
summary judgment was inappropriate because the prisoner’s
symptoms worsened over two weeks, a nurse noted possible
ǰȱȱȱĜȱȱ¢ȱȱ—an as-
pirin and an enema—before sending him back to his cell. Id.
at 610–12. Brown’s facts, however, ȱȱěǱȱhe de-
fendants in Sherrod ¢ȱȱȱę¢ȱȱȱ
Dr. Osmundson (fourteen days compared to the three-and-a-
half days here), and evidence indicated that they knew of the
risk of appendicitis. Id. at 611–12; see also Conley, 796 F.3d at
744.
Brown may have received subpar care in the prison’s in-
ę¢. Dr. Osmundson waited two days after Brown was
wheeled into the prison’s medical wing to examine the patient
in-person. After Brown vomited through the entire night, and
a nurse described his abdomen as “hard” at one point, a
symptom of appendicitis, Dr. Osmundson refrained from
sending him to the hospital immediately, instead opting to
continue the pain treatment and take x-rays six hours later. In
the words of one physician, Dr. Osmundson’s decisions “led
to … worsening of the patient’s outcome and a more compli-
cated and dangerous surgical procedure with increased
length of time for recovery and hospitalization.” Nothing in
this opinion seeks to £ȱ Ȃȱěǯȱȱmedical
malpractice is not a constitutional violation. McGee, 721 F.3d
at 481. ȱȱȱȱĜȱǰȱ ȱ
direct or circumstantial, to prove that Dr. Osmundson “actu-
ally knew of and disregarded a substantial risk of harm.”
Dean, 18 F.4th at 241 (quoting PeĴ, 836 F.3d at 728).

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12 No. 21-1647
Turning to the nursesǰȱ ȱ ȱ Ĵȱ ȱ ȱ
that N.P. Miller and Nurse Edwards did not act with deliber-
ȱěȱward Brown’s serious medical needs. N.P.
Miller only saw Brown once, on February 23, 2017, for an orig-
inally unrelated appointment. There, Brown discussed his re-
ȱ¢ǰȱȱȱȱȱȱȱěȱȱȱȬ
nia before, N.P. Miller could reasonably think that diagnosis
caused this pain as well. She also acted promptly, prescribing
medication to alleviate his pain. Brown argues that a jury
ȱ ȱ ȱ ěȱ ȱ her refusal to see
Brown when she returned from her vacation on February 27.
That contention reads too much into an alleged (overheard)
ȱ¢ȱ ǯȱǯǯȱȱȱȱȱě of
nurses who regularly checked on Brown at the same time Dr.
Osmundson was treating him as well. A lone decision to not
to reevaluate Brown when others, including a physician, were
Ĵȱȱȱȱȱȱȱȱěǯȱ
Nurse Edwards, too, diligently cared for Brown. She wrote
down his symptoms, checked his vitals, relayed necessary in-
formation to Dr. Osmundson, and performed her assigned
duties. The advanced treatment required to manage appendi-
citis cannot be given, in most cases, by a nurse. Only Dr. Os-
mundson could make the important decisions on whether
and how to treat Brown’s symptoms. Nurse Edwards could
not override his judgment. Thus, she did not act with deliber-
ȱěȱǯȱ
III. Conclusion
ȱȱǰȱ ȱĜȱȱȱȱȱȱ
court.

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No. 21-1647 13
JACKSON -A KIWUMI , Circuit Judge, concurring. I agree with
the majority that Dana Brown cannot meet the exceptionally
high standard of deliberate indifference and therefore sum-
mary judgment in favor of all three defendants was appropri-
ate. I write separately on two points.
First, the majority opinion describes Dr. Osmundson’s six-
hour delay before examining Brown on February 28 as “min-
imal” and “not … excessive,” and contrasts that delay with
the months-long delay at issue in Miller v. Campanella, 794
F.3d 878 (7th Cir. 2015) (two months) and Arnett v. Webster,
658 F.3d 742 (7th Cir. 2011) (ten months). But “the length of
delay that is tolerable depends on the seriousness of the con-
dition and the ease of providing treatment.” Smith v. Knox
Cnty. Jail, 666 F.3d 1037, 1040 (7th Cir. 2012) (citation omitted);
see also Gillis v. Litscher, 468 F.3d 488, 492 (7th Cir. 2006) (cita-
tions omitted) (“Determining whether [a prisoner’s] constitu-
tional rights have been violated [under the Eighth Amend-
ment] requires a ‘fact-intensive inquiry under constitutional
standards.’”). The cases the majority opinion highlights, Mil-
ler and Arnett, involved chronic conditions—gastro-esopha-
geal reflux and rheumatoid arthritis, respectively. Brown’s
case involves an acute condition—appendicitis, which the
record reflects can worsen to near fatal levels in a matter of
days.
In our cases involving acute conditions or emergency
medical situations, we have held that a delay of mere days or
even hours can qualify as deliberate indifference. One such
example is the two-week delay in our other appendicitis case,
Sherrod v. Lingle, 223 F.3d 605, 611–12 (7th Cir. 2000). See also
Smith, 666 F.3d at 1040 (citations omitted) (“Even a few days’
delay in addressing a severely painful but readily treatable

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14 No. 21-1647
condition suffices to state a claim of deliberate indifference.”);
Lewis v. McLean, 864 F.3d 556, 563–64 (7th Cir. 2017) (hour and
a half was excessive delay when muscle spasms and back pain
rendered prisoner immobilized); Williams v. Liefer, 491 F.3d
710, 716 (7th Cir. 2007) (citation omitted) (“[A] reasonable jury
could have concluded from the medical records that the [six-
hour] delay unnecessarily prolonged and exacerbated Wil-
liams’ pain and unnecessarily prolonged his high blood pres-
sure.”); Perez v. Fenoglio, 792 F.3d 768, 778 (7th Cir. 2015) (col-
lecting cases involving two-day delays).
In short, Brown’s appendicitis was an emergent issue that
required defendants to act quickly, and a six-hour delay could
run afoul of the Constitution depending on when the defend-
ants ascertained the seriousness of the condition. Brown’s
claim fails not because a six-hour delay is considered minimal
under our caselaw, but because he does not supply sufficient
evidence that Dr. Osmundson’s delay, no matter the length,
was the result of deliberate indifference.
Second, Brown argues in his appellate brief that Nurse Ed-
wards was deliberately indifferent because she failed to call
Dr. Osmundson when Brown’s condition did not improve, es-
pecially during the critical early hours of February 28.
Brown’s argument fails because it is undisputed that Nurse
Edwards did call Dr. Osmundson at least once after examin-
ing Brown during this time, which in any event, was after an-
other nurse took over Brown’s care.
The majority opinion states that Nurse Edwards could not
provide the “advanced treatment required to manage appen-
dicitis,” as that was in Dr. Osmundson’s purview, and she
“could not override [Dr. Osmundson’s] judgment,” “[t]hus,
she did not act with deliberate indifference.” But to be clear, a

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No. 21-1647 15
nurse is not immune from claims of deliberate indifference
simply because there is a supervising doctor with decision-
making power. “While nurses may generally defer to instruc-
tions given by physicians, they have an independent duty to
ensure that inmates receive constitutionally adequate care,”
Perez, 792 F.3d at 779 (citation omitted), and a nurse confront-
ing obvious indifference cannot turn a blind eye. Reck v. Wex-
ford Health Sources, Inc., 27 F.4th 473, 485–86 (7th Cir. 2022) (ci-
tations omitted) (“As a general matter, a nurse can, and in-
deed must, defer to a treating physician’s instructions. How-
ever, that deference cannot be ‘blind or unthinking.’ Under
some circumstances when a nurse is aware of an inmate’s
pain and the ineffectiveness of the medications, a delay in ad-
vising the attending physician or in initiating treatment may
support a claim of deliberate indifference. ‘Nurses, like phy-
sicians, may thus be held liable for deliberate indifference
where they knowingly disregard a risk to an inmate’s
health.’”); Lewis, 864 F.3d at 564–65; Holloway v. Del. Cnty.
Sheriff, 700 F.3d 1063, 1075 (7th Cir. 2012) (citation omitted);
Berry v. Peterman, 604 F.3d 435, 443 (7th Cir. 2010) (citations
omitted); cf. McCann v. Ogle Cnty., 909 F.3d 881, 887 (7th Cir.
2018) (citation omitted) (nurse was not deliberately indiffer-
ent by relying on doctor’s determination of proper dosage of
methadone, “especially when nothing about [doctor’s] pre-
scriptions or course of care more generally raised any obvious
risks of harm for McCann”).
I do not understand the majority opinion to be incon-
sistent with this rule about nurses. With that understanding,
I join the opinion.

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DANA BROWN , ě-Appellant v. KURT OSMUNDSON , TERRY EDWARDS, and BRITANY BEARD MILLER

Full text

Continue your research in ChatGPT or Claude

DANA BROWN , ě-Appellant v. KURT OSMUNDSON , TERRY EDWARDS, and BRITANY BEARD MILLER

Full text

Continue your research in ChatGPT or Claude

DANA BROWN , ě-Appellant v. KURT OSMUNDSON , TERRY EDWARDS, and BRITANY BEARD MILLER