Paul Blake v. Wexford Health Sources, Inc.

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted April 21, 2026*
Decided April 24, 2026
Before
KENNETH F. RIPPLE, Circuit Judge
DIANE S. SYKES, Circuit Judge
REBECCA TAIBLESON, Circuit Judge
No. 24-2940
PAUL BLAKE,
Plaintiff-Appellant,
v.
WEXFORD HEALTH SOURCES, INC.,
Defendant-Appellee.
Appeal from the United States District
Court for the Central District of Illinois.
No. 3:20-cv-03261-SLD-JEH
Sara Darrow,
Chief Judge.
* 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NONPRECEDENTIAL DISPOSITION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. 24-2940 Page 2
O R D E R
Paul Blake, an Illinois prisoner, appeals the district court’s grant of summary
judgment based on his failure to exhaust administrative remedies under 42 U.S.C.
§ 1997e(a). We affirm.
In 2015, while incarcerated at Stateville Correctional Center, Blake was
diagnosed with a hernia. The doctor informed him that Wexford Health Sources, Inc.,
(the company that contracted with the Illinois Department of Corrections to provide
medical care to inmates) would approve surgery to repair his hernia only if it burst or
became strangulated, neither of which had happened. So the doctor prescribed pain
medication. Blake was seen several more times that year for hernia pain and eventually
received a hernia belt. In 2016, he was transferred to Western Correctional Center and
continued to have medical visits for pain.
In August of 2018, Blake filed his first of three grievances about Wexford’s denial
of corrective hernia surgery and treatment for unrelated back pain.1 Blake maintains
that the grievance was returned by his grievance officer, Tara Goins, for failing to
specify the dates of the complained-of incidents. He asserts that he then resubmitted the
grievance with the relevant dates, but Goins never responded, apart from telling him
repeatedly to be patient while it was under review.
In November of 2019, Blake reprised his complaints in a second grievance
(No. 19-2572), which he marked as an emergency. The prison’s chief administrative
officer returned the grievance to Blake after determining that the circumstances did not
constitute a true emergency. Blake appealed to the Administrative Review Board, but
the Board declined to review the grievance because he did not provide necessary
materials (a copy of the original grievance and the prison’s response) or specify the
dates of the complained-of incidents.
In May of 2020, Blake filed a third grievance (No. 20-1794), stating that Wexford
caused him months of unnecessary pain by denying him an MRI that a doctor had
recommended in October of 2018. Wexford did not approve the MRI until June of 2019.
1 This grievance, the existence of which Wexford disputes, does not appear in the
record. Our description of the circumstances relating to the grievance draws from
Blake’s testimony at an evidentiary hearing later conducted in the district court under
Pavey v. Conley, 544 F.3d 739, 742 (7th Cir. 2008).

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No. 24-2940 Page 3
After receiving the MRI, Blake was approved for unspecified injections to ease his pain
and was told that if the pain did not improve, he would be considered for surgery in six
to eight weeks.2 Because Blake received the MRI in June of 2019, a grievance officer
denied the grievance as moot. Days later, Blake appealed the denial to the
Administrative Review Board, which dismissed the grievance as untimely.
In October of 2020, Blake brought this deliberate indifference suit, asserting that
Wexford denied him effective hernia treatment in violation of his rights under the
Eighth Amendment. See 42 U.S.C. § 1983. The district judge screened Blake’s complaint
under 28 U.S.C. § 1915A and allowed him to proceed on his claim that Wexford
maintained a policy or practice of denying effective hernia treatment to prisoners in the
Illinois Department of Corrections. See Monell v. Dep’t of Soc. Servs., 436 U.S. 658, 694–95
(1978).
Wexford moved for summary judgment for failure to exhaust administrative
remedies, as required under the Prison Litigation Reform Act (PLRA), 42 U.S.C.
§ 1997e(a). Wexford argued that Blake filed only two grievances related to his Monell
claim and that those two grievances were procedurally defective. The district judge
referred Wexford’s motion to a magistrate judge to conduct a hearing under Pavey v.
Conley, 544 F.3d 739, 742 (7th Cir. 2008), in order to resolve disputed facts about
exhaustion.
At the hearing, the magistrate judge heard testimony from five witnesses. First,
Wexford presented testimony from a grievance officer about why he denied Grievance
No. 20-1794 as moot. Wexford also presented testimony from Goins, who denied having
received any grievance in August of 2018 and explained why she found Grievance
No. 19-2572 to be procedurally defective. Blake then presented testimony from two
prisoners who asserted that they had submitted grievances to Goins that were later lost.
Finally, Blake testified about the process by which he submitted each of his three
grievances.
In a report and recommendation, the magistrate judge recommended granting
summary judgment to Wexford based on Blake’s failure to exhaust administrative
remedies. The magistrate judge found that (1) Grievance No. 19-2572 was procedurally
defective because Blake failed to attach the required documents in his appeal to the
Administrative Review Board; (2) Grievance No. 20-1794, dated May 2020, was
2 Blake eventually had a hernia operation in April of 2023.

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No. 24-2940 Page 4
untimely because it was not filed within 60 days of the problem giving rise to the
grievance—the lack of treatment in late 2018 or early 2019; and (3) the administrative
remedies for any non-documented grievance could not have been exhausted by
conversations Blake may have had with Goins. On this latter point, the magistrate judge
credited Goins’s denial that she spoke with Blake about the non-documented grievance.
Over Blake’s objections, the district judge adopted the magistrate judge’s findings and
granted summary judgment to Wexford.
On appeal, Blake maintains that the magistrate judge erred by finding that none
of his three grievances was sufficient to exhaust administrative remedies. We review the
magistrate judge’s findings of fact and credibility assessments from the Pavey hearing
for clear error. See Wilborn v. Ealey, 881 F.3d 998, 1004 (7th Cir. 2018).
First, regarding the non-documented first grievance, Blake argues that the
magistrate judge should have viewed the record in the light most favorable to him, the
nonmovant, and credited his testimony that he filed a grievance in August of 2018. But
the judge, having held a Pavey hearing, was entitled to make findings about disputed
facts over exhaustion.3 Id. And though the administrative process would be deemed
unavailable if Goins had thwarted Blake’s efforts, see Ross v. Blake, 578 U.S. 632, 644
(2016), we cannot say here that the magistrate judge—having heard the testimony of
several witnesses—clearly erred in finding more credible Goins’s testimony that she
never received, lost, or destroyed Blake’s grievances.
Next, regarding Grievance No. 19-2572, Blake argues that his “emergency”
appeal to the Administrative Review Board should not have been rejected for lack of
documentation because the decisionmakers had notice of his ongoing hernia problem
and could have addressed it. But to exhaust administrative remedies, prisoners must
strictly comply with the prison’s administrative rules. Breyley v. Fuchs, 156 F.4th 845,
847–48 (7th Cir. 2025); Pozo v. McCaughtry, 286 F.3d 1022, 1025 (7th Cir. 2002). Illinois
3 This appeal is not affected by the Supreme Court’s recent decision in Perttu v.
Richards, 605 U.S. 460 (2025). Exhaustion disputes like those here are typically resolved
in the district court through a Pavey hearing, without the participation of a jury. Pavey,
544 F.3d at 741–42. While this appeal was pending, the Court issued its decision in
Perttu and held that “parties are entitled to a jury trial on PLRA exhaustion when that
issue is intertwined with the merits of a claim protected by the Seventh Amendment.”
Perttu, 605 U.S. at 479. But because Wexford’s policy for hernia surgeries is unrelated to
the exhaustion issues, Perttu does not affect these proceedings.

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requires that appeals to the Board be supplemented with copies of the grievance
officer’s report and the chief administrative officer’s decision. 20 Ill. Admin. Code
§ 504.850(a). Because Blake did not supply the Board with those materials, the
magistrate judge rightly found that Blake failed to comply with administrative
procedures.
As for Grievance No. 20-1794, Blake challenges the finding that it was untimely
and urges that Wexford’s policy toward hernia treatment constituted a continuing
violation of his constitutional rights. The continuing violation doctrine applies when the
state actor has a policy or practice that creates a “fresh violation each day”. Tobey v.
Chibucos, 890 F.3d 634, 646 (7th Cir. 2018) (internal quotation omitted). A violation is
continuing if “it would be unreasonable to require or even permit [a prisoner] to sue
separately over every incident of the defendant’s unlawful conduct.” Turley v. Rednour,
729 F.3d 645, 651 (7th Cir. 2013) (quoting Heard v. Sheahan, 253 F.3d 316, 319 (7th Cir.
2001)). Blake suggests that the magistrate judge construed his grievance too narrowly—
characterizing it as complaining only about the lack of treatment between October of
2018 and July of 2019—and overlooked other statements that allude to the continuing
nature of ineffective treatment. In the grievance, Blake says, for instance, he “was told
that Wexford only repaired hernias in emergencies.” He also lists many medical
appointments for hernia pain between April of 2015 and December of 2019, none of
which resulted in surgery.
We cannot say that the magistrate judge’s interpretation of the grievance was
clearly erroneous. Blake devotes most of the grievance to complaining about Wexford’s
delay in conducting an MRI that his doctor had recommended in October of 2018. As he
expressly says in the grievance, “I am grieving the fact that Wexford denied [the
doctor]’s original assessment of my condition and recommended treatment of having
an MRI done to determine the best course of treatment.” This episode is the crux of the
grievance, which, filed as it was in May of 2020, was well beyond 60 days of the
underlying events. See 20 Ill. Admin. Code § 504.810(a).
We have reviewed Blake’s remaining arguments, and none has merit.
AFFIRMED

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