Mark Nelson v. Kira Labby

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted January 27, 2026*
Decided January 28, 2026
Before
MICHAEL Y. SCUDDER, Circuit Judge
AMY J. ST. EVE, Circuit Judge
CANDACE JACKSON-AKIWUMI, Circuit Judge
No. 25-1468
MARK NELSON,
Plaintiff-Appellant,
v.
KIRA LABBY,
Defendant-Appellee.
Appeal from the United States District
Court for the Eastern District of
Wisconsin.
No. 23-CV-1567
William E. Duffin,
Magistrate Judge.
O R D E R
Mark Nelson, a Wisconsin state prisoner, appeals the summary judgment
rejecting his claim that a prison doctor, Kira Labby, was deliberately indifferent to his
pain after he fractured his shoulder. See 42 U.S.C. § 1983. We affirm.
* 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NONPRECEDENTIAL DISPOSITION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. 25-1468 Page 2
We recount the facts in the light most favorable to Nelson, the party opposing
summary judgment, and draw all reasonable inferences in his favor. See Riley v.
Waterman, 126 F.4th 1287, 1295 (7th Cir. 2025). On February 14, 2022, Nelson,
incarcerated at Redgranite Correctional Institution, tripped over a fan cord in the
bathroom and fractured his left shoulder. He was sent to a nearby emergency room,
where he was prescribed hydrocodone-acetaminophen for pain and recommended to
use a sling. Nelson took the medication until February 22.
In the meantime, Dr. Labby, a primary-care physician at Redgranite, took over
Nelson’s care. The two give different accounts of their first meeting on February 28:
Nelson states that he told Dr. Labby that his pain was tolerable only when he used the
hydrocodone-acetaminophen. Dr. Labby says that Nelson told her that his pain was
tolerable with just the acetaminophen. She adds that if Nelson had complained that the
acetaminophen was not working, she would have prescribed something like tramadol
(a milder opioid) or a muscle relaxant.
On March 7, Nelson was seen for an “urgent consult,” at Dr. Labby’s direction,
by an orthopedic surgeon at the University of Wisconsin School of Medicine and Public
Health in Madison. The surgeon noted that Nelson’s shoulder was healing, opined that
surgery was not necessary, recommended that Nelson use physical therapy to increase
his range of motion in his shoulder, and prescribed oxycodone for the first two weeks of
physical therapy.
Three days later, Dr. Labby ordered physical therapy but did not order
oxycodone because opioids are rarely prescribed in prisons, given safety and security
concerns. Dr. Labby did, however, prescribe anti-inflammatory medications,
acetaminophen, and topical muscle rubs to manage Nelson’s pain.
Nelson took his prescribed medications and began physical therapy, but within a
couple of weeks, he refused further sessions because the exercises caused him severe
pain. He was soon seen again by Dr. Labby, who examined him and assured him that
recent x-rays showed that his fracture was healing appropriately. When he complained
of experiencing “ongoing pain,” Dr. Labby continued to prescribe anti-inflammatory
medications, acetaminophen, and topical muscle rubs.
In June, Nelson had a follow-up visit with the orthopedic surgeon, who again
prescribed oxycodone to use for pain management before physical therapy. Dr. Labby

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No. 25-1468 Page 3
told Nelson she could not order oxycodone for security reasons, and she offered him a
muscle relaxant if he would agree to return to physical therapy. Nelson attested that he
declined the muscle relaxant because Dr. Labby offered it to him as a “bribe” in
exchange for his return to physical therapy.
In early 2023, Nelson sued Dr. Labby in the Western District of Wisconsin,
asserting that she violated his rights under the Eighth Amendment by failing to treat his
pain and delaying his initial visit with the surgeon. See 42 U.S.C. § 1983.
In September 2023, the district judge screened Nelson’s complaint, see 28 U.S.C.
§ 1915A, and allowed Nelson to proceed only on his theory that Dr. Labby was
deliberately indifferent to his medical needs by not having him seen urgently by an
orthopedist who could properly treat him. Two months later, the judge granted
Nelson’s unopposed motion to transfer the case to the Eastern District of Wisconsin.
Around this time, Dr. Labby referred Nelson to a pain-management specialist,
who determined that an undiagnosed torn rotator cuff was causing the pain.
Dr. Labby later moved for summary judgment. Nelson responded, and in doing
so, argued for the first time that Dr. Labby was also deliberately indifferent by failing to
diagnose his torn rotator cuff.
The magistrate judge granted Dr. Labby’s motion for summary judgment. The
judge determined that no reasonable jury could conclude that Dr. Labby’s treatment of
Nelson’s shoulder was blatantly inappropriate. In the judge’s view, Nelson received
extensive medical care—including tests, x-rays, specialist visits, and hospital visits—
and Dr. Labby's decision to prescribe acetaminophen and anti-inflammatories instead of
opioids was an exercise of her professional judgment. As for Nelson’s contention about
the undiagnosed torn rotator cuff, the judge declined to consider it because it exceeded
the scope of the screening order.
On appeal, Nelson maintains that he provided sufficient evidence that
Dr. Labby’s withholding of stronger pain medication was contrary to professional
medical standards. But to defeat Dr. Labby’s motion for summary judgment, Nelson
needed to provide enough evidence from which a reasonable jury could conclude that
Dr. Labby was deliberately indifferent to his pain—meaning that she “actually knew of
and disregarded a substantial risk of harm.” McDaniel v. Syed, 115 F.4th 805, 832
(7th Cir. 2024). We defer to a medical professional’s treatment decisions unless there is

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No. 25-1468 Page 4
“such a substantial departure from accepted professional judgment . . . as to
demonstrate that the person responsible actually did not base the decision on such a
judgment.” Id. Nelson cannot meet this burden. He introduced no evidence to call into
question Dr. Labby’s specific treatment decisions that included several pain-
management options—anti-inflammatory medications, acetaminophen, and topical
muscle rubs—over the course of several months. Nor does Nelson offer evidence to
undermine Dr. Labby’s statement that she did not prescribe opioids because of the risks
associated with dispensing that medication in a prison. Nelson may have preferred
receiving an opioid medication recommended by the orthopedic surgeon, but a
“[d]isagreement . . . between two medical professionals[] about the proper course of
treatment generally is insufficient, by itself, to establish an Eighth Amendment
violation.” Pyles v. Fahim, 771 F.3d 403, 409 (7th Cir. 2014).
We have considered Nelson’s remaining arguments, and none has merit.
AFFIRMED

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