Jeffrey E. Akard v. Wexford of Indiana, LLC

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted December 22, 2025*
Decided December 22, 2025
Before
MICHAEL B. BRENNAN, Chief Judge
MICHAEL Y. SCUDDER, Circuit Judge
AMY J. ST. EVE, Circuit Judge
No. 25-1636
JEFFREY E. AKARD,
Plaintiff-Appellant,
v.
WEXFORD OF INDIANA, LLC, et al.,
Defendants-Appellees.
Appeal from the United States District
Court for the Southern District of
Indiana, Indianapolis Division.
No. 1:21-cv-02133-JMS-CSW
Jane Magnus-Stinson,
Judge.
O R D E R
Jeffrey Akard, an Indiana prisoner, appeals from a summary judgment on his
civil rights action against the Commissioner of the Indiana Department of Correction,
his prison’s superintendent, and two private health-care contractors. He asserted that
* 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NONPRECEDENTIAL DISPOSITION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 F ED. R. APP . P. 32.1

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the defendants denied him treatment for his medical conditions in violation of his rights
under the Eighth and Fourteenth Amendments, see 42 U.S.C. § 1983, and failed to
accommodate his disability in violation of the Rehabilitation Act, see 29 U.S.C. §§ 701–
797. The district court dismissed some of Akard’s claims at screening and entered
summary judgment for three of the defendants. We affirm.
I.
Because Akard challenges the dismissal of some of his claims at screening,
see 28 U.S.C. § 1915A, we begin with the allegations in his complaint. As he alleges, this
case stems from the care he received for his medical conditions—gastroesophageal
reflux disease (GERD) and chronic back and shoulder pain—while incarcerated within
the Indiana Department of Correction, first at Wabash Valley Correctional Facility in
Carlisle, Indiana (2019–2020), and later at New Castle Correctional Facility in New
Castle, Indiana.
Akard sued the Commissioner of the Indiana Department of Correction; Mark
Sevier, the superintendent at New Castle; Wexford of Indiana, LLC (which provided
medical care for the Indiana Department of Correction from 2019 to July 2021); and
Centurion Health of Indiana, LLC (which thereafter took over as the Department’s
health-care provider). In his operative complaint, Akard asserted that Wexford and
Centurion were deliberately indifferent to his serious medical conditions in violation of
his rights under the Eighth Amendment. He alleged, for instance, that Wexford’s and
Centurion’s policies resulted in the cancellation of his prescribed GERD medication, the
denial of his requests to be prescribed a different medication (Omeprazole), and the
denial of a bottom-bunk pass to accommodate his chronic shoulder and back pain.
Next, he alleged that the Department of Correction and Sevier subjected him to
unconstitutional conditions of confinement because prison rules prevented him from
leaving his cell to prepare special “GERD-friendly” meals using a microwave or hot
water machine. Akard also alleged that all four defendants violated his rights under the
Rehabilitation Act by denying him accommodations for his disability, including a
special mattress, a lumbar roll, and a prison job that did not involve prolonged standing
or repetitive use of his left shoulder. Finally, he alleged that he was denied equal
protection in violation of the Fourteenth Amendment because the treatment of his
conditions while in state custody differed from the treatment he received during his
prior federal custody.

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The district court screened Akard’s operative complaint, see 28 U.S.C.
§ 1915A(b)(1), and dismissed his equal protection claim because he did not allege that
he was treated differently than similarly situated incarcerated persons. The district
court dismissed his Rehabilitation Act claims against all defendants except the
Commissioner (in his official capacity) because there was no personal liability under the
statute. The court allowed Akard to proceed against Wexford and Centurion with his
deliberate-indifference claims that the two providers had policies, practices, or customs
that caused him to be denied medication and a bottom-bunk pass. See Monell v. Dep't of
Soc. Servs., 436 U.S. 658, 690 (1978). Finally, the court allowed Akard to move forward
on his claim against Sevier (in his official capacity) that New Castle’s policies prevented
him from leaving his cell to prepare his own meals.1
After discovery, each defendant individually moved for summary judgment. The
evidence, which we view in Akard’s favor, see Thomas v. Blackard, 2 F.4th 716, 720
(7th Cir. 2021), fills out the picture of how the defendants handled Akard’s requests for
medication and bunk accommodations. First, Wexford providers stated in affidavits
that nationwide supply shortages led to the initial cancellation of his prescription in
2020. Additionally, Wexford and Centurion providers attested that their policies—
informed by new medical research and concerns about long-term use—limited
prescriptions of certain medications, including Omeprazole, and that Akard’s condition
did not meet the qualifying criteria. Medical staff therefore denied his requests and
instructed him to obtain over-the-counter medication from the commissary, which
Akard admitted during discovery that he was able to do. As for the bottom-bunk pass,
Wexford and Centurion introduced evidence that they limited bottom-bunk availability
to prisoners with specific conditions that Akard was determined—after a physician’s
evaluation—not to have. And after Centurion took over his care in 2021, Akard did not
renew his requests for a bottom-bunk pass.
In separate but similarly worded orders, the court entered summary judgment
for Wexford and Centurion. The court concluded that no reasonable jury could find an
Eighth Amendment violation because there was no evidence suggesting that Wexford’s
and Centurion’s decision-makers knew that their policies would cause patients to go
untreated or face a substantial risk of harm. As to the medication, Akard admitted that
he had “never gone without” some medication and could obtain over-the-counter
medication from the commissary to manage his symptoms. As for the bottom-bunk
1 The court eventually entered summary judgment for Sevier on this claim for
reasons that are not at issue in this appeal, and so we say nothing further about it.

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passes, the court emphasized that the policies gave physicians the discretion to request
exceptions, that Wexford providers denied Akard’s request after a thorough evaluation,
and that Akard never renewed his request after Centurion took over his care. The court,
however, denied the Commissioner’s motion for summary judgment on Akard’s
Rehabilitation Act claim, finding that fact questions remained over whether Akard had
been denied reasonable accommodations related to his sleep, self-care, and work. (The
parties later settled this claim.)
II.
On appeal, Akard generally challenges the court’s entry of summary judgment
on his claims that Wexford and Centurion were deliberately indifferent to his serious
medical needs based on policies that caused him to be denied medication and a bottom-
bunk pass. See Monell, 436 U.S. at 690. Regarding the denial of medication, he asserts
that the court overlooked facts that bore upon Wexford’s and Centurion’s knowledge of
the substantial risk to his health posed by their policies limiting Omeprazole
prescriptions: the intermittent unavailability of alternative over-the-counter
medications for purchase at the commissary, the daily limits on purchases of over-the-
counter medication at the commissary, and the necessity that these limitations created
to buy unspecified medication from other inmates at a higher price.
The district court properly entered summary judgment on this claim because no
reasonable jury could conclude there was an underlying constitutional violation giving
rise to liability under Monell. See Gaetjens v. City of Loves Park, 4 F.4th 487, 495 (7th Cir.
2021). As the court concluded, there is no indication that Wexford or Centurion acted
with conscious disregard toward a substantial risk of harm to Akard. See Farmer v.
Brennan, 511 U.S. 825, 837 (1994). The record reflects that Wexford’s and Centurion’s
policy of limiting Omeprazole prescriptions was based on medical concerns about side
effects associated with long-term use. And Akard admitted in a deposition that he had
“never gone without” some medication for his GERD, noting that he was able to obtain
it from the commissary or through other means. Even if Akard’s preferred medication
was at times unavailable at the commissary, no reasonable jury could find a pattern,
practice, or custom that caused a constitutional deprivation, much less one that
Wexford and Centurion consciously disregarded. See Dean v. Wexford Health Sources,
Inc., 18 F.4th 214, 235 (7th Cir. 2021).
As for the denial of the bottom-bunk pass, Akard contends that the court
overlooked evidence that Wexford’s and Centurion’s policies reflected conscious

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disregard for health risks. He suggests that the companies knew of his disability and
acted in bad faith by minimizing the severity of his condition. But the court did not err.
Akard’s purported evidence would not allow a reasonable jury to find that the
companies knew their policies would lead to constitutional violations. The record
shows that Akard was carefully evaluated by a Wexford physician who concluded
based on his medical judgment that Akard did not meet Wexford’s standard criteria for
a bottom-bunk pass. See Clemons v. Wexford Health Sources, Inc., 106 F.4th 628, 635
(7th Cir. 2024). And after Centurion took over his care, Akard did not renew his request
for a bottom-bunk pass.
Akard turns next to the district court’s screening order, see 28 U.S.C.
§ 1915A(b)(1), and asserts that the court wrongly dismissed his Rehabilitation Act claim
against Wexford, Centurion, and Sevier for lack of personal liability. Here too the court
did not err. To proceed on his claims under the Rehabilitation Act against all
defendants, Akard needed to plausibly allege that each defendant intentionally denied
him access to a service or program “solely by reason of … his disability.” 29 U.S.C.
§ 794(a); see Shaw v. Kemper, 52 F.4th 331, 335 (7th Cir. 2022). The court rightly noted that
Sevier was not a proper defendant because there is no personal liability under the Act.
See Stanek v. St. Charles Cmty. Unit Sch. Dist. No. 303, 783 F.3d 634, 644 (7th Cir. 2015).
And because Akard did not allege in his second amended complaint that Wexford and
Centurion—both private companies—receive federal funds (thus subjecting them to suit
under the Act), the court correctly dismissed Akard’s claims against them. See Jaros v.
Illinois Dep't of Corr., 684 F.3d 667, 671–72 (7th Cir. 2012).
Akard also challenges the court’s dismissal, at screening, of his equal protection
claim, which, he asserts, he later supplemented with allegations that similarly situated
prisoners were prescribed GERD medication and received accommodations for meal
preparation. But he filed these supplemental allegations too late. The court had warned
him that failure to include all relevant facts in his second amended complaint could
result in dismissal, see Vexol, S.A. de C.V. v. Berry Plastics Corp., 882 F.3d 633, 637–38
(7th Cir. 2018), and Akard already had made repeated, unsuccessful attempts to state an
equal-protection claim.
Akard lastly challenges the denials of his repeated efforts to obtain counsel. The
court had denied one such motion early in the litigation on grounds that Akard was
competent to litigate the case himself. The court gave a similar explanation when Akard

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twice renewed his request while discovery was underway.2 These rulings were well
within the court’s discretion. For each motion, the court correctly applied the standard
under Pruitt v. Mote, 503 F.3d 647, 654 (7th Cir. 2007) (en banc), and considered Akard’s
unsuccessful efforts to recruit counsel before determining—based on the nature of the
case and the relative clarity of Akard’s filings—that he appeared competent to litigate
the case himself. For similar reasons, we DENY Akard’s motion for reconsideration of
our order of June 10, 2025, denying his motion for recruitment of counsel.
We have considered Akard’s other arguments, and none requires discussion.
AFFIRMED
2 Later, after the district court denied the Commissioner’s motion for summary
judgment on Akard’s Rehabilitation Act claim, the court sua sponte reconsidered
Akard’s motion for counsel and granted it.

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