Matthew T. Doughty v. Karl Hoffmann

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted May 9, 2025*
Decided May 27, 2025
Before
MICHAEL Y. SCUDDER, Circuit Judge
AMY J. ST. EVE, Circuit Judge
JOSHUA P. KOLAR, Circuit Judge
No. 24-2306
MATTHEW T. DOUGHTY,
Plaintiff-Appellant,
v.
KARL HOFFMANN,
Defendant-Appellee.
Appeal from the United States District
Court for the Western District of
Wisconsin.
No. 23-cv-21-wmc
William M. Conley,
Judge.
O R D E R
Matthew Doughty, a Wisconsin prisoner, asserts that Dr. Karl Hoffmann treated
him with deliberate indifference in violation of the Eighth Amendment and negligently
under Wisconsin law by misdiagnosing his knee pain and delaying proper treatment.
The district court granted Dr. Hoffmann’s motion for summary judgment and
* 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NONPRECEDENTIAL DISPOSITION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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relinquished jurisdiction over Doughty’s state-law claim. We affirm because Doughty
did not marshal evidence of conduct rising to the level of deliberate indifference.
We recount the facts in the light most favorable to Doughty, the party opposing
summary judgment. See Jones v. Anderson, 116 F.4th 669, 677 (7th Cir. 2024). In
September 2017, Doughty underwent hip replacement surgery. Later, an outside
specialist examined him and found that his right leg was one inch shorter than his left
leg. The specialist determined that Doughty needed a lift added to his right shoe to
accommodate the leg-length disparity.
After the hip replacement, Doughty experienced ongoing pain in his knee and
back. Throughout 2018 and 2019, Doughty wrote repeatedly to the Health Services Unit
at the prison, New Lisbon Correctional Institution. He complained of knee pain and
other ailments that he believed stemmed from his hip surgery and leg-length disparity.
Doughty had his first appointment with Dr. Hoffmann in January 2020. He
reported knee pain and discomfort with his shoe lift. Dr. Hoffmann examined
Doughty’s feet to rule out causes of his knee pain beside the leg-length disparity. Based
on Doughty’s medical records, the specialist’s diagnosis of his leg-length disparity,
Doughty’s own complaints, and the examination of Doughty’s feet, Dr. Hoffmann
concluded that the most likely cause for Doughty’s knee pain was his leg-length
disparity. Dr. Hoffmann developed a treatment plan that included pain medication and
physical therapy. Dr. Hoffmann did not examine Doughty’s knee, and he did not order
imaging because a specialist had diagnosed Doughty’s condition already.
Three months later, Doughty had a follow-up appointment with Dr. Hoffmann
to evaluate routine lab results. Doughty complained of knee pain (Dr. Hoffmann
disputes this), chronic pain from arthritis in his back, and discomfort from his shoe lift,
which was too hard and heavy. Dr. Hoffmann adjusted Doughty’s medication and
ordered a consultation with the offsite specialist who had created his shoe lift.
Dr. Hoffmann did not examine Doughty’s knee at this appointment, either.
Four months later, Doughty had another appointment with Dr. Hoffmann to
follow up on blood tests and to address issues with his shoe lift and back pain. Doughty
reported that he was not able to exercise as much as he usually would because of his
back and knee pain. Dr. Hoffmann ordered new labs and did not examine Doughty’s
knee.

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No. 24-2306 Page 3
In February 2021, Doughty saw Dr. Hoffmann for the last time. When Doughty
mentioned his knee pain, Dr. Hoffmann responded that the appointment was to follow
up on Doughty’s labs, shoe lift, and back pain, not to discuss his knee pain. Again, he
did not examine Doughty’s knee. Dr. Hoffmann retired shortly after this appointment.
In November 2021, Doughty met with another doctor. This doctor examined
Doughty’s knee and, finding it to be tender, ordered x-rays and physical therapy. In the
next follow-up visit for his knee, the doctor ordered an MRI, and the results showed
that Doughty had severe arthritis, a torn ligament, and torn menisci in his knee.
Doughty was informed he needed a total knee replacement.
Doughty filed this lawsuit asserting that Dr. Hoffmann was deliberately
indifferent to his serious medical needs in violation of his rights under the Eighth
Amendment, see 42 U.S.C. § 1983, and that Dr. Hoffmann acted negligently under
Wisconsin state law. During discovery, Doughty filed two motions for the recruitment
of counsel and one motion for the appointment of a neutral expert witness. The court
denied these. It reasoned that the motions were premature and that Doughty was
capable of litigating his case. And it concluded that it was familiar with the medical
claims at issue, and so a court-appointed expert was unnecessary. Doughty renewed
both requests in response to Dr. Hoffmann’s motion for summary judgment.
The court granted Dr. Hoffmann’s motion for summary judgment, concluding
that Dr. Hoffmann made treatment decisions based on his medical judgment and
therefore was not deliberately indifferent as a matter of law. The court then
relinquished supplemental jurisdiction over Doughty’s medical negligence claim.
See 28 U.S.C. § 1367(c)(3). The court did not comment on Doughty’s renewed motions.
On appeal, Doughty challenges the grant of summary judgment for
Dr. Hoffmann. He first argues that Dr. Hoffmann could not defer to the specialist’s
diagnosis of leg-length disparity as the cause of his knee pain because the specialist did
not examine his knee, and that Dr. Hoffmann delayed effective treatment of his knee,
which unnecessarily prolonged his severe pain. We review the summary-judgment
decision de novo. Petties v. Carter, 836 F.3d 722, 727 (7th Cir. 2016) (en banc).
To establish a violation of his rights under the Eighth Amendment, Doughty
must show that he had an objectively serious medical condition and that Dr. Hoffmann
was deliberately indifferent to that condition. Id. at 728 (citing Farmer v. Brennan,
511 U.S. 825, 834 (1994)). Dr. Hoffmann concedes that “only the second element—
deliberate indifference—is at issue here,” so we focus on whether Doughty presented

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sufficient evidence from which a reasonable jury could conclude that Dr. Hoffmann
knew about, but consciously disregarded, Doughty’s chronic knee pain. See Farmer,
511 U.S. at 837, 839.
Doughty cannot show that Dr. Hoffmann acted with deliberate indifference
when he attributed Doughty’s knee pain to his leg-length disparity and ordered a
course of treatment based on that opinion. Dr. Hoffmann permissibly relied on the
specialist’s diagnosis that Doughty had a leg-length disparity. Cf. Zaya v. Sood, 836 F.3d
800, 806 (7th Cir. 2016) (a doctor’s decision to ignore instructions from a specialist can
suggest deliberate indifference). And Dr. Hoffmann physically examined Doughty’s
feet during his first appointment to rule out a different cause for the pain. Then, based
on the specialist’s diagnosis and his own medical judgment, Dr. Hoffmann concluded
that the most likely cause for Doughty’s knee pain was his leg-length disparity, and he
developed a treatment plan accordingly. Doughty does not offer evidence that
Dr. Hoffmann’s approach to diagnosing the cause of his pain was “such a substantial
departure from accepted professional judgment, practice, or standards as to
demonstrate” that it was not based on Dr. Hoffmann’s medical judgment, Petties,
836 F.3d at 729 (citation omitted), and “[b]y definition a treatment decision that’s based
on professional judgment cannot evince deliberate indifference,” Zaya, 836 F.3d at 805.
Similarly, Doughty cannot show that Dr. Hoffmann was deliberately indifferent
in delaying a correct diagnosis and proper treatment for Doughty’s knee. This theory of
deliberate indifference requires evidence that Dr. Hoffmann “persist[ed] in a course of
treatment known to be ineffective” or that he delayed proper treatment of Doughty’s
knee pain and thereby exacerbated the injury or unnecessarily prolonged the pain.
Petties, 836 F.3d at 729–31. Over the course of four appointments, Dr. Hoffmann
adjusted Doughty’s medication, referred him to an outside consultant to address
problems with his shoe lift, and prescribed him physical therapy. Even if
Dr. Hoffmann’s approach “may not have been the most appropriate treatment,”
Doughty was entitled only to “reasonable measures” to treat his knee pain. Arnett v.
Webster, 658 F.3d 742, 758 (7th Cir. 2011). Doughty has not offered evidence showing
that declining to order imaging tests was not based on medical judgment, see Petties,
836 F.3d at 729, or that it caused him harm that could have been avoided had
Dr. Hoffmann ordered the imaging, see Arce v. Wexford Health Sources Inc., 75 F.4th 673,
680 (7th Cir. 2023).
Doughty also argues on appeal that the district court erred by denying his
motions for appointment of a neutral expert witness and for recruited counsel. First, it

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appears from Doughty’s argument for a court-appointed expert that he actually seeks
an expert to advance his case, rather than to assist the court in understanding the
evidence. That is not a permissible purpose for a court-appointed neutral expert under
Federal Rule of Evidence 706. See Martin v. Redden, 34 F.4th 564, 569 (7th Cir. 2022).
Second, we reverse the denial of a motion for recruitment of counsel only if the district
court abused its discretion and it is reasonably likely that the recruitment of counsel
would have changed the outcome of the case. Pruitt v. Mote, 503 F.3d 647, 658–59
(7th Cir. 2007). Here, the district court denied Doughty’s first two motions for
recruitment of counsel because they were premature, but it never addressed the third
request, which came at a critical stage: in response to Dr. Hoffmann’s motion for
summary judgment. We note that district courts should make an individualized inquiry
about the plaintiff and the case when considering a plaintiff’s motion for recruitment of
counsel. Id. at 660–61. But reversal is not warranted here. Doughty has not shown that
the denial of counsel was prejudicial, i.e., that there would have been a reasonable
probability of a different outcome on his § 1983 claim had he been represented. See id.
at 659. Dr. Hoffmann might have acted negligently—we do not opine on Doughty’s
negligence claim—but providing inappropriate treatment based on medical judgment
does not amount to deliberate indifference. No attorney could have shown otherwise.
AFFIRMED

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