Alexander D. Cambronero v. CHRYSTAL MELI and CHERYL JEANPIERRE

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted August 3, 2023*
Decided August 3, 2023
Before
AMY J. ST. EVE, Circuit Judge
THOMAS L. KIRSCH II, Circuit Judge
DORIS L. PRYOR, Circuit Judge
No. 22-2103
ALEXANDER D. CAMBRONERO,
Plaintiff-Appellant,
v.
CHRYSTAL MELI and CHERYL
JEANPIERRE,
Defendants-Appellees.
Appeal from the United States District
Court for the Eastern District of
Wisconsin.
No. 20-cv-1635-bhl
Brett H. Ludwig,
Judge.
O R D E R
Alexander Cambronero, a Wisconsin prisoner, sued Cheryl Jeanpierre, a prison
doctor, for deliberate indifference to his medical needs after she ended his prescription
for gabapentin, which Cambronero took for chronic pain. The district court entered
summary judgment for Dr. Jeanpierre, deferring to her decision to end the prescription
* 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NONPRECEDENTIAL DISPOSITION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 F ED. R. APP . P. 32.1

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because Cambronero had been caught with an alcoholic drink, and drinking alcohol
while taking gabapentin can cause dangerous side effects. We affirm.
While Cambronero was imprisoned at Waupun Correctional Institution, he
complained of chronic wrist and back pain, and Dr. Jeanpierre prescribed gabapentin in
September 2018. The following January, Cambronero complained that he was still in
pain. Dr. Jeanpierre diagnosed him with carpal tunnel syndrome and increased his
gabapentin dosage. As a condition of that increase, Cambronero signed a pain-
management agreement prohibiting him from, among other things, using alcohol. In
March, however, a guard found Cambronero in the prison’s greenhouse, holding an
open cup of an alcoholic drink, and on April 5 he was convicted of possessing an
intoxicant. See W IS . A DMIN . C ODE § DOC 303.43.
The same day, Dr. Jeanpierre discontinued Cambronero’s gabapentin
prescription because he had been caught with alcohol, which she believed violated the
agreement, and because he had alternatives for pain relief—lidocaine cream, naproxen,
and acetaminophen. But Cambronero filed health services requests with Waupun’s
medical unit, asking for more gabapentin and insisting that he had not drunk any of the
alcohol. Nonparty medical staff denied the requests because Cambronero had been
caught with alcohol. The following month, Dr. Jeanpierre left Waupun to work at a
different prison.
Over the next year, Cambronero repeatedly filed medical requests reporting that
his medications were not helping his pain and requesting gabapentin. Nonparty
medical staff again denied the requests and prescribed other treatments because of
Cambronero’s conviction for possessing alcohol.
Dr. Jeanpierre temporarily returned to Waupun to fill in and saw Cambronero
one more time in September 2020. She requested approval from a medical-unit director
to resume Cambronero’s gabapentin prescription but told him that the request would
likely be rejected because of the alcohol. As predicted, the director denied the request,
citing the conviction.
Cambronero then sued a Waupun health-services manager (Chrystal Meli) and
an unknown doctor (later identified as Dr. Jeanpierre) under 42 U.S.C. § 1983, alleging
that they had acted with deliberate indifference to his medical needs in violation of the
Eighth Amendment by canceling his gabapentin prescription. He also asserted that he
had not breached the pain-management agreement because he had only possessed
alcohol and had not drunk it. (Cambronero also brought state-law negligence claims,

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which he has abandoned on appeal, and he conceded that Meli was entitled to
summary judgment, so we say no more on these topics.)
Dr. Jeanpierre moved for summary judgment. She conceded that Cambronero’s
chronic pain constituted an objectively serious condition but argued that she had
exercised her professional judgment in discontinuing the gabapentin. She attested that
she did so because drinking alcohol while taking gabapentin can cause drowsiness and
dizziness that would endanger Cambronero and those around him, Cambronero’s
possession of alcohol meant he was at significant risk of drinking it, and Cambronero
still had the non-gabapentin medications. She added that Cambronero had also violated
the pain-management agreement by possessing the alcohol. Cambronero responded
that summary judgment was not warranted because he did not drink the alcohol and
because Dr. Jeanpierre knew that his other medications were ineffective.
The district court entered summary judgment for Dr. Jeanpierre, deferring to her
medical judgment. Her decision to end the prescription warranted deference, the court
explained, because Cambronero had offered no evidence that minimally competent
doctors would have responded differently and because Dr. Jeanpierre had reasonably
inferred from his possession of alcohol that he was at risk of drinking it.
On appeal, Cambronero argues that a reasonable jury could find that
Dr. Jeanpierre acted with deliberate indifference because, he says, she knew that his
other medications were ineffective but canceled his gabapentin prescription anyway.
To be liable for deliberate indifference, the defendant must have consciously
known of and disregarded an excessive risk to the plaintiff. Farmer v. Brennan, 511 U.S.
825, 837 (1994). One way to establish the requisite mental state is to show that a doctor
persisted in a course of treatment despite knowing that it was ineffective. Thomas v.
Martija, 991 F.3d 763, 772 (7th Cir. 2021). This is Cambronero’s theory of relief.
But Cambronero offered no evidence that Dr. Jeanpierre knew, at the time she
discontinued his gabapentin, that the other medications were ineffective. Cambronero
points to his medical requests complaining about his pain and asking for changes to his
medications. The only requests relevant to Dr. Jeanpierre would be from the two-month
span after she ended his prescription and before she left Waupun. But Cambronero
provided no evidence that Dr. Jeanpierre saw these requests or was made aware of
them by the staff members who replied to them. The only evidence suggesting
otherwise is Cambronero’s declaration attesting that he believed that Dr. Jeanpierre
knew his non-gabapentin medications were ineffective. But declarations must be based

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on personal knowledge, not unsupported conclusory assertions. F ED. R. C IV. P. 56(c)(4);
Simpson v. Franciscan All., Inc., 827 F.3d 656, 662 (7th Cir. 2016). Cambronero did not
attest that he told Dr. Jeanpierre that he was still in great pain despite his other
medications, and he states no other basis for his belief about what she knew. His
declaration, therefore, amounts to speculation rather than competent evidence sufficient
to raise a factual dispute about Dr. Jeanpierre’s knowledge. See Pulera v. Sarzant, 966
F.3d 540, 550–51 (7th Cir. 2020).
Cambronero also contends that Dr. Jeanpierre’s decision to take him off
gabapentin was not owed deference because she based that decision not on her medical
training but on a “personal view” that patients at high risk of drinking alcohol should
not receive prescription medications like gabapentin. But, without evidence that no
minimally competent professional would have responded similarly, the court correctly
deferred to Dr. Jeanpierre. See Pyles v. Fahim, 771 F.3d 403, 409 (7th Cir. 2014).
Dr. Jeanpierre attested—based on her medical education and experience—that she
canceled the prescription because Cambronero had been found with alcohol, and taking
gabapentin while drinking alcohol is dangerous. Cambronero offered no competent
evidence that this reasoning is inconsistent with an exercise of medical judgment.
Additionally, Cambronero insists that Dr. Jeanpierre was not entitled to
judgment because he simply possessed and did not drink the alcohol; therefore, he
contends, Dr. Jeanpierre was wrong to say he violated the pain-management
agreement. But § 1983 provides a cause of action for violations of the Constitution, not
for violations of state law or administrative policies. Hunter v. Mueske, No. 22-1340,
2023 WL 4553391, *4 & n.1 (7th Cir. July 17, 2023). Whether Dr. Jeanpierre violated the
prison policy embodied by the pain-management agreement is therefore irrelevant to
Cambronero’s § 1983 claim. See id. (rejecting argument that violation of prison policy,
on its own, violated Eighth Amendment).
Finally, Cambronero contends that a reasonable jury could find that
Dr. Jeanpierre caused him pain by canceling the prescription. But even if she did, she
can be liable only if canceling the prescription constituted deliberate indifference to
Cambronero’s medical condition. See Stockton v. Milwaukee County, 44 F.4th 605, 614–15
(7th Cir. 2022). And, as we have explained, it did not: Dr. Jeanpierre canceled the
prescription based on her medical judgment that taking gabapentin while drinking
alcohol is dangerous and specifically considered that Cambronero had other pain
medications. And Cambronero lacks evidence that Dr. Jeanpierre knew that those other
medications were ineffective.

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AFFIRMED

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