Christopher Jacob v. MICHAEL FIELD and DILIP TANNAN

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted January 7, 2025*
Decided January 10, 2025
Before
AMY J. ST. EVE, Circuit Judge
JOHN Z. LEE, Circuit Judge
JOSHUA P. KOLAR, Circuit Judge
No. 24-1426
CHRISTOPHER JACOB,
Plaintiff-Appellant,
v.
MICHAEL FIELD and DILIP TANNAN,
Defendants-Appellees.
Appeal from the United States District
Court for the Eastern District of
Wisconsin.
No. 22-C-875
William C. Griesbach,
Judge.
O R D E R
Christopher Jacob, a Wisconsin prisoner, appeals the summary judgment entered
in favor of a doctor and a nurse who treated Jacob’s hypertension and attention deficit
hyperactivity disorder. He contends that they deliberately ignored these two conditions
in violation of his Eighth Amendment rights. See 42 U.S.C. § 1983. But the undisputed
* 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NONPRECEDENTIAL DISPOSITION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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No. 24-1426 Page 2
record shows that the defendants exercised acceptable medical judgment when treating
Jacob. Because they complied with his Eighth Amendment rights, we affirm.
We recite the facts with all reasonable inferences drawn in favor of Jacob, the
non-movant at summary judgment. McDaniel v. Syed, 115 F.4th 805, 821–22 (7th Cir.
2024). From 2017 through 2022, Dr. Dilip Tannan treated Jacob for hypertension. After
one year of treating Jacob’s persistently high blood pressure with medication, Tannan
contacted the psychiatrists treating Jacob for his ADHD. Based on his medical training,
Tannan suspected that Jacob’s amphetamine-based ADHD medicine might be raising
Jacob’s blood pressure, and he wanted to discuss halting that medication. Jacob’s
psychiatrists rejected this proposal. They reasoned that the ADHD medication was
necessary to treat his ADHD symptoms and to help him focus while at work.
The following year, Michael Field, a psychiatric nurse, began treating Jacob’s
ADHD. Tannan intervened again and contacted Field to reprise his inquiry from a year
earlier about discontinuing Jacob’s ADHD medication. In November 2020, Field
stopped that treatment, citing Jacob’s high blood pressure, Tannan’s concerns that the
ADHD drug was keeping Jacob’s blood pressure high, and the fact that Jacob had not
worked for months, obviating one reason for the ADHD drug.
Jacob objected to Field’s decision to halt the amphetamine-based ADHD drug.
He refused to see Field for three months, until early 2021. In October 2021, eight months
after he was willing to see Field again, Jacob reported to Field deep depression, anxiety,
and ADHD, symptoms that, Jacob argues to us on appeal, he experienced as soon as
Field stopped his amphetamine-based medication. On Tannan’s recommendation, Field
prescribed in succession two non-amphetamine drugs for ADHD. Jacob tried them but
stopped taking them within a month, complaining of side effects.
Tannan continued to see Jacob regularly for his hypertension until May 2022.
During this period, Jacob sometimes refused to take his blood pressure medicine.
Tannan proposed alternative drugs for Jacob and advised him to consume fewer salty
foods. Tannan did not order a low-sodium diet for Jacob or send him to a hypertension
specialist because none of Jacob’s test results suggested that he needed a specialist.
Jacob has now sued Tannan and Field, accusing them of deliberate indifference
to his medical conditions. The two defendants moved for summary judgment, which
the district court entered. The court reasoned that no reasonable jury could find that
Tannan was deliberately indifferent to Jacob’s hypertension or ADHD because Tannan
repeatedly tried to lower Jacob’s blood pressure and his suggestion that Field stop

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Jacob’s ADHD medicine was based on medical judgment. Regarding Field, the court
ruled that the record compelled the conclusion that he halted the amphetamine-based
ADHD drug after carefully considering Jacob’s health needs; further, any delay in
prescribing a replacement was explained by Jacob’s insistence on a stimulant-based
drug.
On appeal, Jacob contests the adverse summary judgment. To get to a trial on his
Eighth Amendment claims, he must furnish evidence that would permit a jury to find
that the defendants showed “deliberate indifference” to his “serious medical needs.”
Farmer v. Brennan, 511 U.S. 825, 835 (1994). Deliberate indifference requires evidence
that the defendants knew of and disregarded a substantial risk of harm. Id. at 837.
Further, we defer to a medical professional’s judgment unless no minimally competent
professional would have so responded. McDaniel, 115 F.4th at 832.
Jacob first argues that a jury could find that Tannan was deliberately indifferent
to his hypertension by pursuing an ineffective course of treatment from 2017 to 2020,
but the record does not support this contention. He insists that, after Tannan increased
the dosage of his blood pressure medication in 2017, he did nothing until 2020 despite
seeing Jacob’s condition deteriorate. But it is undisputed that, beginning in 2018, once
Tannan saw that the new dosage had not reduced Jacob’s blood pressure, he explored
other reasonable options: Relying on his medical training and awareness that stimulant-
based ADHD drugs can aggravate hypertension, Tannan twice intervened to discuss
halting that drug, eventually succeeding in stopping that treatment. To avoid summary
judgment on his contention that these interventions, or their timing, substantially
departed from acceptable practice, Jacob had to offer expert testimony or other
comparable evidence on that contention. See White v. Woods, 48 F.4th 853, 862 n.4 (7th
Cir. 2022). But no evidence suggests that the timing or fact of Tannan’s efforts to take
Jacob off his ADHD medication in order to lower his blood pressure departed at all, let
alone substantially, from acceptable medical judgment.
Jacob has two unavailing replies. First he argues that his unresolved high blood
pressure alone is sufficient evidence that Tannan was deliberately indifferent to his
condition. But an ineffective treatment by itself does not evince a violation of the Eighth
Amendment. See Thomas v. Martija, 991 F.3d 763, 772 (7th Cir. 2021). Second, Jacob
contends that Tannan deliberately ignored Jacob’s needs because he did not order
low-sodium meals for Jacob or send him to see a specialist. But without evidence that
these steps were essential, a disagreement over treatment does not require a trial on an
Eighth Amendment claim. Johnson v. Dominguez, 5 F.4th 818, 826 (7th Cir. 2021).

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That brings us to Field. Jacob first conjectures that Field stopped prescribing
amphetamine-based drugs for his ADHD because Field distrusted Jacob’s self-reported
ADHD symptoms. But emails and notes from Field incontrovertibly reflect that he
discontinued the ADHD drug because Jacob’s blood pressure stayed high, the ADHD
drug was arguably keeping it high, and Jacob no longer needed that drug because he
was not working. This evidence shows that Field permissibly relied on medical
judgment. See Wilson v. Wexford Health Sources, Inc., 932 F.3d 513, 520 (7th Cir. 2019).
Next, Jacob contends that Field’s decision to stop ADHD medicine “cold turkey” was
inappropriate. But Jacob does not provide any medical evidence in support.
Finally, Jacob argues that Field deliberately ignored his mental health needs for
eight months—between the time that Jacob was willing to resume seeing Field in early
2021 and late 2021, when Field began prescribing non-stimulant ADHD drugs. Jacob
asserts in his brief on appeal that during this eight-month gap he told Field that he was
feeling suicidal, and Field did nothing. But Jacob did not attest in an affidavit that he
told Field about suicidal thoughts during these eight months; thus he cannot get to trial
on a claim that Field ignored a known threat of suicide. Quinn v. Wexford Health Sources,
Inc., 8 F.4th 557, 566 (7th Cir. 2021). Further, Jacob’s medical records undisputedly show
that when he did report these symptoms to Field, in October 2021, Field prescribed new
medication. On this record, a reasonable jury could not find that Field deliberately
ignored Jacob’s mental-health needs.
AFFIRMED

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