William Buck v. Debra Connors-Johnson

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted December 2, 2024 *
Decided December 3, 2024
Before
FRANK H. EASTERBROOK, Circuit Judge
AMY J. ST. EVE, Circuit Judge
NANCY L. MALDONADO, Circuit Judge
No. 23-3128
WILLIAM BUCK,
Plaintiff-Appellant,
v.
DEBRA CONNORS-JOHNSON, et al.,
Defendants-Appellees.
Appeal from the United States District
Court for the Northern District of
Illinois, Eastern Division.
No. 18-cv-04195
Mary M. Rowland,
Judge.
O R D E R
William Buck, an Illinois prisoner, accuses Illinois officials and Wexford Health
Sources, Inc., of violating his Eighth Amendment rights by deliberately ignoring his
serious dental needs. See 42 U.S.C. § 1983. The district court entered summary judgment
in two stages. It correctly concluded that Buck failed to exhaust his administrative
* 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. FED . 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NONPRECEDENTIAL DISPOSITION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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remedies on some claims and did not furnish evidence of deliberate indifference on the
others. We therefore affirm.
Background
Because the case involved cross-motions for summary judgment, we recount the
facts in the light most favorable to the losing party—here, Buck. Holcomb v. Freedman
Anselmo Lindberg, LLC, 900 F.3d 990, 992 (7th Cir. 2018). Buck’s claims arise from his
time at Stateville Correctional Center and Menard Correctional Center. In September
2016, while at Stateville, Buck saw Dr. Jacqueline Mitchell, a dentist at the prison, for
pain in his mouth. Dr. Mitchell wrote that Buck’s two wisdom teeth (nos. 17 and 32)
were impacted and decaying and causing two adjacent teeth (nos. 18 and 31) to decay.
She referred Buck to an outpatient oral surgeon to remove the two impacted teeth.
Debra Connors-Johnson, the Medical Records Director at Wexford, prepared a form
approving the referral and wrote that Dr. Mitchell had recommended extracting all four
teeth. The oral surgeon noticed the discrepancy between the referral (remove two teeth)
and the approval (remove four). He testified that he sees mistakes in paperwork from
Wexford about 10% of the time, and he makes his own judgment before extracting
teeth. He decided that all four teeth required extraction and removed them.
After the extraction, Buck experienced complications. These included infected
open sores with exposed bone at the extraction sites, significant facial swelling that
made speaking difficult, and intense pain. Dr. Mitchell and others prescribed
antibiotics, pain relievers, and heat packs (two to three times daily) for Buck to reduce
the swelling and pain. The nursing staff provided the antibiotics and pain relievers. To
receive the heat packs, Buck had to go to the infirmary where a nurse would walk to the
kitchen to heat the pack. Buck testified that three Wexford nurses, Lidia Lewandowska,
Tina Tomaras, and Tiffany Utke sometimes refused to allow Buck to come to the
infirmary or gave him unheated or lukewarm packs that did not reduce his pain. Buck
wrote grievances and complained about the nurses to little avail. His medical record—
on which nurses signed their initials after providing treatment—showed missing
signatures for more than 70% of entries for the provision of the daily packs.
Apart from the problems with the packs, Buck continued to receive care at
Stateville. The day after the procedure, Dr. Mitchell asked Wexford to approve a dental
prosthetic to replace the two additionally extracted teeth. She also asked that Buck
remain at Stateville and scheduled appointments to see him over the next two months.

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No. 23-3128 Page 3
Nevertheless, about a month after the surgery, another official transferred Buck to
Menard.
Buck did not receive the same level of treatment at Menard as at Stateville. The
day after Buck arrived there, Dr. Steven Newbold, a dentist, evaluated him and ordered
an x-ray and medicine. But the dentist stopped treating Buck soon after. Three months
after Buck’s arrival, in December 2016, Wexford approved Dr. Mitchell’s request for the
dental prosthetic, but it never supplied the prosthetic to Buck.
Buck then sought legal relief. While at Menard, he filed a grievance with the
Administrative Review Board of the Illinois Department of Corrections. In it, he
protested the extraction of the two extra teeth, the heating-pack problem, and his
transfer to and care at Menard. The Board responded, identifying technical flaws in his
submission and writing that his grievance “will not be addressed.” Buck then sued.
With the aid of recruited counsel, and as relevant on appeal, he sought damages from
Connors-Johnson for causing two extra teeth to be removed, the three nurses for
disregarding his post-operative needs, Wexford for tolerating systemic paperwork
errors, and Dr. Newbold and Wexford for Buck’s care at Menard. (Buck brought a claim
against the official who transferred him from Stateville, but he has settled that claim.)
The parties filed two rounds of motions for summary judgment. In the first,
Dr. Newbold and Wexford argued that Buck had not exhausted his administrative
remedies against them. The court agreed in part: For events that occurred after his
transfer to Menard, Buck bypassed the required step of filing a grievance first with his
counselor at Menard. See ILL . A DMIN. C ODE tit. 20, § 504.810(a) (2016). But for events that
preceded the transfer, Buck rightly filed his grievance directly with the Administrative
Review Board. Id. § 504.870(a)(4). The court thus ruled that Buck failed to exhaust only
those claims against Dr. Newbold and Wexford about events after his transfer.
The second round of motions addressed the merits. Buck argued that
Connors-Johnson recklessly ignored the referral, which said to extract only two teeth,
and the three nurses deliberately disregarded Buck’s need for heat packs. Buck also
contended that, while he was at Stateville, Wexford ignored systemic paperwork
problems with dental referral orders, and when he was at Menard, it failed to fill orders
that it had approved, such as the dental prosthetic. The district court accepted that
Buck’s ailments were serious, but it ruled that the mistake Connors-Johnson made was
not deliberate. It also ruled that the nurses at Stateville had not ignored a known and
substantial risk of serious harm to Buck because he received antibiotics, pain

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medication, and at least some heat packs. Finally, it concluded that Wexford was not
liable for conduct that occurred while Buck was housed at Stateville. It also reiterated
that, to the extent that Buck continued to pursue a claim for Wexford’s conduct that
occurred after he moved to Menard, that claim was not properly exhausted.
Analysis
A. Nurses Lewandowska, Tomaras, and Utke at Stateville
On appeal, Buck first contends that a reasonable jury could find the nurses
deliberately disregarded his serious medical needs when they ignored Dr. Mitchell’s
orders to provide him with the heated packs. To stave off summary judgment, Buck
needed to furnish evidence that the defendants knew of and disregarded a substantial
risk of harm. Farmer v. Brennan, 511 U.S. 825, 837 (1994). This standard is akin to
criminal recklessness. Id. at 836–37. Although defying a medication order can evince
deliberate indifference to a serious condition, see Machicote v. Roethlisberger, 969 F.3d
822, 827 (7th Cir. 2020), “we must examine the totality of an inmate’s medical care,”
Lockett v. Bonson, 937 F.3d 1016, 1023 (7th Cir. 2019) (quoting Dunigan ex rel. Nyman v.
Winnebago County, 165 F.3d 587, 591 (7th Cir. 1999)).
Buck has not met his burden to justify a trial. Like the district court, we accept
that after his surgery, Buck faced a serious condition based on his infected sores, open
extraction site, severe swelling, and intense pain. But in examining the totality of Buck’s
care, see id., a jury could not find that the nurses deliberately disregarded his condition.
Dr. Mitchell prescribed antibiotics (which the nursing staff provided), pain relievers
(which the nursing staff provided), a follow-up dental appointment (which he received
before his transfer), and heat packs, which the nurses provided at least some of the
time. We recognize that, according to Buck—whose testimony we accept for present
purposes—the nurses honored only about one third of his prescribed amount of fully
heated packs, and they thus deviated from Dr. Mitchell’s orders. But Buck has not cited
evidence, as is his burden as the plaintiff, suggesting that when the nurses did not
provide heat packs, they knew that the antibiotics, pain medication, and other care he
was receiving were substantially inadequate. Without evidence that the nurses
deliberately disregarded his well-being in this way, he cannot prevail.

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B. Connors-Johnson at Stateville
Buck next argues that the district court erred in entering summary judgment for
Connors-Johnson, but the record does not support his contention. He views as reckless
her misinterpretation of Dr. Mitchell’s referral (ordering the extraction of two decaying
teeth adjacent to two also-decaying teeth) as an order to extract all four teeth. And he
adds that the oral surgeon’s statement that the surgeon receives paperwork errors from
Wexford about 10% of the time corroborates his case against Connors-Johnson. But
Buck did not provide evidence that Connors-Johnson deliberately ignored a known risk
of harm: He furnished no evidence suggesting that Connors-Johnson knew that
Dr. Mitchell did not want all four decaying teeth extracted and approved their
extraction anyway. Further, given that Dr. Mitchell’s referral stated that all four teeth
were decaying, Connors-Johnson’s misinterpretation of the referral was not deliberate
or criminally reckless. See Farmer, 511 U.S. at 836–37. Finally, the evidence of other
paperwork errors has no bearing on the case against Connors-Johnson because Buck did
not present sufficient evidence tying her to them.
C. Wexford at Stateville
Next, Buck relies again on the oral surgeon’s statement about paperwork errors
at Wexford to argue that he presented a triable claim that Wexford culpably caused the
needless extraction of two of his teeth. But Buck cites no evidence to rebut Wexford’s
defense that, even if this paperwork problem exists, it nonetheless did not cause Buck’s
injury. The oral surgeon attested without contradiction that he noticed the paperwork
discrepancy, but he extracted all four teeth based on his independent dental judgment.
Without evidence that the discrepancy caused the extraction, this claim fails. See Dean v.
Wexford Health Sources, Inc., 18 F.4th 214, 235, 239–40 (7th Cir. 2021).
D. Dr. Newbold and Wexford at Menard
Finally, Buck contends that the district court erred in ruling that he failed to
exhaust his administrative remedies on his claims against Dr. Newbold and Wexford
regarding their conduct at Menard. (Recall that Buck alleges that Dr. Newbold provided
inadequate treatment of Buck’s mouth at Menard and that Wexford failed to fill orders
that it approved, such as his dental prosthetic, in December 2016). He argues that, after
he filed his grievance directly with the Administrative Review Board, its response about
his defective filing confused him because he believed that he had filed his grievance
with the Board correctly. If the exhaustion process is “so opaque” that “no ordinary

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prisoner [could] discern or navigate it,” exhaustion may be excused. See Ross v. Blake,
578 U.S. 632, 643–44 (2016). But that is not the case here. State law defines the relevant
procedures. Jackson v. Esser, 105 F.4th 948, 956 (7th Cir. 2024). And Illinois law required
that, for events occurring at Menard, Buck should have filed grievances first with his
counselor at Menard, a step he bypassed, rather than directly with the Administrative
Review Board, as he did. See ILL . A DMIN. C ODE tit. 20, §§ 504.810(a), 504.870(a)(4) (2016).
Because he did not exhaust these claims properly and he could have done so, Buck
cannot now bring them in court. Jones v. Bock, 549 U.S. 199, 211 (2007).
Bucks replies that the Board considered the merits of his grievance, so we may
deem the claims exhausted. Because Buck did not preserve this argument in the district
court, we need not consider it. Williams v. Dieball, 724 F.3d 957, 961 (7th Cir. 2013). In
any event, the Board’s response was not on the merits—it wrote that the grievance “will
not be addressed.” Thus the court properly ruled that the claims pertaining to treatment
after his transfer to Menard were unexhausted.
We have considered Buck’s remaining contentions on appeal, and none warrants
further discussion. We thus AFFIRM the judgment.

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