Lazerek Austin v. Cheryl Hansen

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted August 14, 2024*
Decided June 6, 2025
Before
FRANK H. EASTERBROOK, Circuit Judge
DAVID F. HAMILTON, Circuit Judge
MICHAEL B. BRENNAN, Circuit Judge
No. 23-2946
LAZEREK AUSTIN,
Plaintiff-Appellant,
v.
CHERYL HANSEN, et al.,
Defendants-Appellees.
Appeal from the United States District
Court for the Central District of Illinois.
No. 1:20-cv-01399-JES
James E. Shadid,
Judge.
O R D E R
Lazerek Austin is a state prisoner who sued three medical providers working at
Pontiac Correctional Center in Illinois. He alleged that nurse Josephina Torrez-Brady,
nurse practitioner Cheryl Hansen, and Dr. Andrew Tilden violated the Eighth
Amendment by acting with deliberate indifference to his serious medical needs: a
* 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. App. P. 34(a)(2)(C).
NONPRECEDENTIAL DISPOSITION
To be cited only in accordance with F ED. R. APP . P. 32.1

-- 1 of 6 --

No. 23-2946 Page 2
urinary tract infection and a hernia.† The district court granted summary judgment for
the defendants, determining that Austin failed to offer evidence from which a
reasonable jury could find any of the defendants liable. In this order, we address all
Austin’s appellate arguments except his contention that the district court erroneously
declined to find a volunteer lawyer for him after repeated efforts to do so were not
successful. We address that issue in a companion opinion issued today in which we
conclude there was no abuse of discretion. With respect to the issues we address in this
order, we also find no reversible error.
We construe the summary-judgment record in the light most favorable to Austin
as the non-moving party. See Johnson v. Dominguez, 5 F.4th 818, 824 (7th Cir. 2021). On
October 28, 2018, Austin was incarcerated at Pontiac. On October 28, 2018, after noticing
a painful lump in his abdomen and blood in his urine, he saw nurse Torrez-Brady at
sick call. Austin told her of his symptoms, and she referred him to a higher-level
provider. Accordingly, Nurse Practitioner Hansen saw Austin two days later and
ordered a urinalysis as well as X-rays of Austin’s kidneys, urinary tract, and bladder.
She also conducted a physical examination and concluded that the lump was a
palpable, reducible hernia.
Over the next week or so, Austin told Torrez-Brady of his persisting symptoms
when she was distributing medication to patients in their housing units. During these
interactions, Austin asked for antibiotics, insisted that he needed to see a doctor, and
complained that the urinalysis ordered by NP Hansen had not been performed.
According to Austin, Torrez-Brady was dismissive of his pain and sarcastically
observed that he was not the only patient in the prison seeking medical attention. After
submitting an urgent-care request, Austin was seen by NP Hansen on November 8 and
was X-rayed that day. The next day, the urinalysis was completed. Dr. Tilden reviewed
the results of these tests and found no sign of an infection.
The next month, in December 2018, Austin reported urinating blood and pus. Dr.
Tilden ordered a urine dipstick test and placed Austin in the infirmary for 23 hours of
observation. After the test produced abnormal findings, Dr. Tilden prescribed an
antibiotic. The next day, Austin complained of stomach pain. Dr. Tilden diagnosed him
with a urinary tract infection, ordered more lab work, and then discharged him from
the infirmary. Austin saw Dr. Tilden twice more that month, reporting discomfort while
† During the course of litigation, Dr. Tilden died, and the Administrator of his
Estate (Pamela E. Hart) was substituted as a defendant.

-- 2 of 6 --

No. 23-2946 Page 3
urinating, dizziness, and abdominal pain. Dr. Tilden determined that the urinary tract
infection was “in early resolution.” He prescribed a different antibiotic. As to Austin’s
other symptoms, Dr. Tilden noted stable vital signs and no obvious masses in Austin’s
abdomen.
In January 2019, Dr. Tilden saw Austin again to follow up on his abdominal pain
and dizziness. Dr. Tilden referred Austin for an ultrasound and conducted lab tests,
including another urinalysis. All yielded normal results. NP Hansen conducted a
physical examination, noting that a lump was palpable in his lower abdomen but
present only upon muscle flexion. She prescribed ibuprofen for Austin’s discomfort.
Over the next few months, Dr. Tilden continued seeing Austin for abdominal
pain. He ordered more diagnostic tests and prescribed a stool softener. A second
ultrasound showed normal results in June 2019. But Austin’s symptoms persisted, and
Dr. Tilden provided over-the-counter pain medication, a stool softener, an antacid, and
a topical analgesic. From July 2019 until November 2019, Austin was seen at sick call or
urgent care for complaints unrelated to his abdominal lump. Two months later, Austin
was transferred to a different prison.
Austin filed his § 1983 complaint in November 2020, alleging that nurse Torrez-
Brady, NP Hansen, and Dr. Tilden displayed deliberate indifference to his urinary tract
infection (all three defendants) and hernia (only the latter two). After these claims
survived screening under 28 U.S.C. § 1915A, discovery began. Austin filed a motion to
compel discovery from NP Hansen and Dr. Tilden, who had withheld, Austin asserted,
documents related to the order of his first urinalysis in November 2018 and the full
results of his December 2018 urine dipstick test. He insisted that the defendants
possessed responsive documents beyond those they had produced: his medical chart
noting the order for a urinalysis and a summary of the results of the dipstick test. NP
Hansen and Dr. Tilden responded that no other responsive documents existed. The
district court denied the motion to compel, agreeing that the defendants had responded
adequately to the request for production.
Next, the defendants (in two groups) moved for summary judgment. They
argued that, even if Austin had any serious medical conditions, the record established
that each of them responded appropriately by referring him for follow-up care,
investigating his symptoms with testing, and providing medication when the test
results were abnormal or Austin’s pain persisted.

-- 3 of 6 --

No. 23-2946 Page 4
Before responding to the summary-judgment motions, Austin filed two more
discovery motions. First, again asserting that the defendants withheld a urinalysis order
and lab results, Austin asked the court to compel production of these documents. He
asked the court to impose sanctions if the defendants did not comply by deeming it
admitted that NP Hansen did not order the first urinalysis as early as his medical chart
said and that the dipstick test did not thoroughly test for an infection. Second, he filed a
motion under Federal Rule of Civil Procedure 56(d) to reopen discovery. Austin said
that he needed to serve more interrogatories and document requests relating to the
policies or treatment protocols of the prison’s healthcare contractor. He also attested
that, since discovery had closed, a nurse at his new prison had provided him with a
harness for his hernia and suggested that he should have received one when the hernia
first appeared. The court denied both motions, explaining that discovery was long over,
but allowed Austin more time to respond to the summary-judgment motions.
In his response brief, Austin argued that his infection and hernia were serious
medical needs to which the defendants responded with deliberate indifference. With
respect to his urinary infection, Austin argued that all three defendants delayed
treatment and prolonged his suffering. As to the hernia, he argued that NP Hansen and
Dr. Tilden did not provide meaningful treatment. The district court questioned whether
Austin suffered from an objectively serious medical condition but concluded that,
regardless, Austin’s evidence was insufficient to raise a genuine issue of material fact
about whether any defendant acted with deliberate indifference. The court granted the
defendants’ motions.
Austin appeals, first challenging the summary-judgment decision, which we
review de novo, evaluating whether a reasonable jury could conclude that any
defendant was deliberately indifferent to a serious medical condition. Johnson, 5 F.4th at
824. We assume, as the district court did, that a urinary tract infection or blood in the
urine, a hernia, and the corresponding pain were objectively serious medical conditions.
See id. (explaining hernia and resulting pain can be an objectively serious medical
condition); Duckworth v. Ahmad, 532 F.3d 675, 677, 679 (7th Cir. 2008) (accepting that
blood in urine is an objectively serious medical condition). To avoid summary
judgment, Austin had to supply evidence that the defendants subjectively knew of and
disregarded or failed to respond reasonably to a risk of harm. Farmer v. Brennan,
511 U.S. 825, 847 (1994). He did not.
First, on this record, a reasonable jury could not conclude that any defendant was
deliberately indifferent to Austin’s bloody urine and infection. Torrez-Brady, the nurse,

-- 4 of 6 --

No. 23-2946 Page 5
provided the care within her authority by documenting Austin’s symptoms and
referring him to a nurse-practitioner or physician. See Brown v. Osmundson, 38 F.4th 545,
553 (7th Cir. 2022) (recognizing that a nurse can provide only limited care). Austin
contends that when he later complained to her during medication distribution about his
ongoing symptoms and incomplete urinalysis test, she should have ensured that he
immediately saw a doctor. In his view, her comments dismissing him and her failure to
take him to urgent care would allow a jury to find she unnecessarily prolonged his
suffering. But regardless of any callous comments Torrez-Brady may have made, there
is no evidence that her actions departed so substantially from the professional norm
that she acted with deliberate indifference. See Gayton v. McCoy, 593 F.3d 610, 623 (7th
Cir. 2010) (no deliberate indifference when nurse did not have patient immediately
examined by doctor). Furthermore, Austin lacks evidence that any delay during the
week he complained to Torrez-Brady exacerbated his condition or unnecessarily
prolonged pain. See Wilson v. Adams, 901 F.3d 816, 822 (7th Cir. 2018), quoting Petties v.
Carter, 836 F.3d 722, 730–31 (7th Cir. 2016). In fact, at his next appointment the
urinalysis and X-rays showed no signs of an infection.
Both NP Hansen and Dr. Tilden investigated Austin’s symptoms and treated his
infection. When NP Hansen first saw Austin in October, she ordered a urinalysis and X-
rays based on his symptoms. Even though those tests were not completed for about ten
days, Austin has no evidence that NP Hansen was responsible for the wait. Instead, he
speculates that she did not order the tests until later, despite what his medical chart
says, but he offers no evidence to support that speculation. See Giles v. Godinez, 914 F.3d
1040, 1048 (7th Cir. 2019) (conjecture is not enough to establish a dispute of material
fact). When Austin’s symptoms persisted, Dr. Tilden placed him under observation,
ordered more testing, and prescribed an antibiotic. At follow-up appointments, NP
Hansen and Dr. Tilden continued to order testing, monitored his vital signs, and
dispensed or prescribed new medications. In sum, the undisputed facts shows that NP
Hansen and Dr. Tilden exercised professional judgment in responding to Austin’s
urinary symptoms. See Johnson, 5 F.4th at 825–26. Austin’s disagreement with the course
of treatment—insisting he should have been tested differently and provided with
prescription medication earlier—is insufficient to prevent summary judgment. See id.
NP Hansen and Dr. Tilden also were entitled to summary judgment on Austin’s
claim about his hernia. Both providers repeatedly examined Austin’s abdomen and
ordered imaging tests to investigate his discomfort. The ultrasounds results were
consistently normal, but NP Hansen and Dr. Tilden continued to provide pain
medication in response to Austin’s complaints. There is no evidence that NP Hansen

-- 5 of 6 --

No. 23-2946 Page 6
and Dr. Tilden failed to exercise professional judgment when taking these actions.
See id. Austin insists that they did not provide meaningful treatment because his pain
persisted, and he points out the different treatment he received at another prison. The
Eighth Amendment does not “impose the unrealistic requirement that doctors keep
patients completely pain-free.” Arce v. Wexford Health Sources Inc., 75 F.4th 673, 681
(7th Cir. 2023). Differing opinions among medical providers about treatment plans are
insufficient to establish deliberate indifference. Shields v. Illinois Dep’t of Corrections,
746 F.3d 782, 797 (7th Cir. 2014).
Austin next challenges the denial of his motions to compel and for sanctions for
purportedly missing records related to his first urinalysis order and urine dipstick test
results. We review the district court’s rulings for abuse of discretion, James v. Hyatt
Regency Chi., 707 F.3d 775, 784 (7th Cir. 2013), and find none. Austin was not entitled to
prolong discovery to search for documents he merely assumed existed. See id. In any
case, as explained above, Austin did not establish that any delay in testing worsened his
condition nor that the treatment provided based on the test results was constitutionally
deficient. Thus, Austin cannot show, as required, that the denial of his motions to
compel resulted in actual and substantial prejudice. See id. Because he has nothing to
support his assertion that the defendants withheld documents, he was not entitled to
adverse inferences as a sanction. Norman-Nunnery v. Madison Area Tech. Coll., 625 F.3d
422, 428–29 (7th Cir. 2010).
Finally, Austin argues that the district court should have granted his motion to
reopen discovery. We review rulings on Rule 56(d) motions for an abuse of discretion.
Smith v. OSF HealthCare Sys., 933 F.3d 859, 865 (7th Cir. 2019). Austin supported his
motion by submitting an affidavit to explain why he sought further discovery to oppose
summary judgment: He attested that serving interrogatories and document requests
about the policies of the prison’s healthcare contractor would show that NP Hansen and
Dr. Tilden did not follow protocol when treating his hernia. See id. But obtaining the
treatment policies would not necessarily have helped Austin’s claims survive summary
judgment. An official’s failure to follow policies or protocols may be relevant evidence,
but not dispositive, for prison policies do not set the standard under the Eighth
Amendment. See Estate of Simpson v. Gorbett, 863 F.3d 740, 746 (7th Cir. 2017). The
district court therefore did not abuse its discretion in denying Austin’s motion to
prolong discovery to pursue the matter. See Smith, 933 F.3d at 866–67.
AFFIRMED.

-- 6 of 6 --