Cornelius Brown v. Reynal Caldwell

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted February 24, 2026*
Decided February 25, 2026
Before
MICHAEL B. BRENNAN, Chief Judge
THOMAS L. KIRSCH II, Circuit Judge
JOSHUA P. KOLAR, Circuit Judge
No. 24-3000
CORNELIUS BROWN,
Plaintiff-Appellant,
v.
REYNAL CALDWELL, et al.,
Defendants-Appellees.
Appeal from the United States District
Court for the Central District of Illinois.
No. 19-3243-SLD
Sara L. Darrow,
Chief Judge.
O R D E R
Cornelius Brown appeals summary judgment rejecting his claim that prison
medical providers delayed surgical treatment for his hernias in violation of the Eighth
Amendment. See 42 U.S.C. § 1983. We affirm the judgment.
* 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NONPRECEDENTIAL DISPOSITION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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No. 24-3000 Page 2
We summarize the facts in the light most favorable to Brown, the party opposing
summary judgment. Johnson v. Dominguez, 5 F.4th 818, 824 (7th Cir. 2021). Brown first
noticed pain from a hernia in his groin in 2016 while he was incarcerated at Stateville
Correctional Center in Joliet, Illinois. Staff there gave him a hernia belt. In April 2017,
Brown transferred to Menard Correctional Center in Menard, Illinois.
Dr. Reynal Caldwell was a doctor at Menard, and he and Brown dispute how
involved Dr. Caldwell was in Brown’s care. Although Dr. Caldwell denied treating
Brown, Brown asserted in a declaration that he saw Dr. Caldwell in spring of 2017 to
complain of pain from his hernia and constipation. Brown said he asked Dr. Caldwell
for surgery, and Dr. Caldwell responded that the hernia was not big enough to require
surgery and they had to wait until the hernia became incarcerated (no longer able to be
pushed back in or “reduced”) or strangulated (incarcerated and cutting off blood
supply) before he could refer Brown for surgery. Dr. Caldwell provided Brown with a
hernia belt and pain medication. When Brown complained that these were not helping,
Dr. Caldwell responded that he had given Brown all the treatment he needed and
Brown was “going to have to learn to live with some discomfort until surgery became
appropriate.”
In February 2018, Brown was transferred to Pontiac Correctional Center in
Pontiac, Illinois. By this point, he had two hernias—the inguinal hernia in his groin and
an umbilical hernia near his navel—that were each slightly bigger than the size of a
grape. On his arrival, a physician assistant saw Brown for his complaints of hernia pain.
The physician assistant prescribed a painkiller and fiber supplement and told Brown he
did not need surgery. Brown asserted that by this point, the pain from his hernias
prevented him from lifting weights or working his job in the prison kitchen.
Brown then brought his concerns to Cheryl Hansen, a nurse practitioner, starting
in November 2018. He told her he continued to experience pain and constipation from
his hernias. She noted that his hernias were still reducible, and she prescribed the same
fiber supplement. In December 2018, she again noted that his hernias were reducible
when he complained of pain. Hansen told Brown his hernias were not big enough to
refer for surgery and that she could not recommend him for surgery until his hernias
became strangulated. Hansen prescribed Brown another painkiller, though Brown had
told her that medication had not previously alleviated his pain. When Brown saw other
nurses during this period and complained of his hernia pain, they continued to provide
pain medication and fiber supplements. In spring of 2020, Hansen renewed Brown’s
permit for a hernia belt. When he explained that he could not climb to the top bunk
because of the strain it caused on his hernias, Hansen approved a lower bunk permit.

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No. 24-3000 Page 3
Brown testified that he told Hansen his hernias were painful and asked for surgery, but
she again said his hernias were not big enough for surgery.
In early 2021, Brown saw an outside urologist for an assessment of testicular
swelling. The urologist noted Brown’s two reducible hernias and recommended surgery
to determine whether the hernias were causing Brown’s testicular discomfort. Based on
this recommendation, a prison doctor referred Brown for an evaluation by a general
surgeon, who recommended surgical repair. Wexford Health Sources, Inc.—the prison’s
contractor—approved the surgery, and Brown’s hernias were repaired in May 2021.
Brown had already filed this lawsuit in October 2019, alleging that Dr. Caldwell,
Hansen, and Wexford violated the Eighth Amendment when they declined to provide
surgical treatment for his painful hernias. In particular, he alleged that Wexford had an
unconstitutional policy of always refusing surgical treatment of reducible hernias.
The defendants eventually moved for summary judgment and the district court
granted that motion. The court reasoned that even if Dr. Caldwell had been involved in
Brown’s care, he and Hansen were entitled to summary judgment because the
undisputed medical evidence demonstrated that reducible hernias do not generally
pose a serious risk of harm. The court also concluded that Brown had not offered
evidence to show that Hansen or Dr. Caldwell acted with a sufficiently culpable state of
mind because he had demonstrated only disagreement with their medical opinions. The
court similarly determined Wexford was entitled to summary judgment on Brown’s
Monell claim because Brown offered no evidence of a practice or custom that violated
his rights. See Monell v. Dep’t of Soc. Servs., 436 U.S. 658, 694 (1978).
On appeal, Brown first argues that the district court erred in granting summary
judgment for Hansen because his complaints of pain provided evidence of a serious
medical need that Hansen ignored by continuing to prescribe ineffective painkillers. To
withstand summary judgment, Brown was required to provide evidence that Hansen
was deliberately indifferent, which requires far more than showing potential
malpractice or negligence and demands proof from which a jury could find she
subjectively knew of and disregarded a substantial risk of harm. See Farmer v. Brennan,
511 U.S. 825, 837 (1994). We afford great deference to a medical provider’s treatment
decisions unless they were so inadequate as to demonstrate an absence of professional
judgment. See Stewart v. Wexford Health Sources, Inc., 14 F.4th 757, 763 (7th Cir. 2021).
Brown failed to produce evidence that would allow a reasonable factfinder to
overcome this deference and find deliberate indifference. Hansen asserted that she did

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No. 24-3000 Page 4
not recommend surgery based on her professional judgment that the hernias remained
small and reducible and her belief that Brown did not complain of any symptoms or
complications that would demonstrate a need for surgery. Although persisting with
ineffective treatments can be evidence of deliberate indifference, Brown provided no
evidence that conservative, non-surgical treatment of his hernia pain with painkillers,
fiber supplements, a hernia belt, and a low bunk permit was so inadequate that a
reasonable jury could find Hansen was not, in fact, exercising her professional
judgment. See Johnson v. Dominguez, 5 F.4th at 825–26. Brown may understandably have
preferred the permanent solution of surgery sooner, instead of treating only the
symptoms as they arose. But the Constitution entitles a prisoner only to adequate
medical care, not the specific care he desires. See Johnson v. Doughty, 433 F.3d 1001,
1013–14 (7th Cir. 2006).
Next, Brown argues that the district court erred by entering summary judgment
for Dr. Caldwell because Brown’s testimony and medical records—including a page
signed “Caldwell”—are evidence from which a reasonable jury could find Dr. Caldwell
was personally involved in his care. But Brown does not engage with the district court’s
determination that even if Dr. Caldwell was involved in his care, there was no evidence
from which a jury could conclude he acted with deliberate indifference. For the same
reasons as Hansen, a reasonable jury could not find on this record that Dr. Caldwell’s
early non-surgical treatment of Brown’s hernias was a serious departure from accepted
professional judgment. See Johnson v. Dominguez, 5 F.4th at 825–26.
Finally, Brown argues that he provided evidence from which a jury could find
that Wexford had a practice or custom of denying surgery for reducible hernias to save
money. But a Monell claim requires that the plaintiff first identify an underlying
constitutional violation, and Brown has not done so. See Johnson v. Prentice, 29 F.4th 895,
905 (7th Cir. 2022). In any event, this court has previously concluded that Wexford’s
hernia policy (which states that “patients with stable abdominal wall hernias are not, in
general, candidates” for surgery), “leaves no room for a reasonable jury to find” that the
policy blocked prisoners from obtaining surgical correction of their hernias if medical
providers exercise their professional judgment. Wilson v. Wexford Health Sources, Inc.,
932 F.3d 513, 521–22 (7th Cir. 2019). The evidence here, too, shows that the providers’
professional judgment, rather than any policy or custom, was the moving force behind
their decisions to delay (but ultimately allow) surgical repair of Brown’s reducible
hernias.
AFFIRMED

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