Steven Ingalls, Jr. v. Centurion Health of Indiana, LLC

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted June 9, 2026*
Decided June 10, 2026
Before
MICHAEL B. BRENNAN, Chief Judge
CANDACE JACKSON-AKIWUMI, Circuit Judge
REBECCA TAIBLESON, Circuit Judge
No. 25-2179
STEVEN INGALLS, JR.,
Plaintiff-Appellant,
v.
CENTURION HEALTH OF INDIANA,
LLC, et al.,
Defendants-Appellees.
Appeal from the United States District
Court for the Southern District of
Indiana, Terre Haute Division.
No. 2:22-cv-00358-JMS-MG
Jane Magnus-Stinson,
Judge.
O R D E R
Steven Ingalls, an Indiana inmate, sued Centurion Health of Indiana, LLC, the
health services provider contracted by the Indiana Department of Correction (IDOC),
and Richard Malott, a correctional sergeant, alleging they were deliberately indifferent
* 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NONPRECEDENTIAL DISPOSITION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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to his serious medical needs in violation of the Eighth Amendment.1 See 42 U.S.C.
§ 1983. The district court granted summary judgment for both defendants. We affirm.
We consider the facts in the light most favorable to Ingalls, the party opposing
summary judgment. Hildreth v. Butler, 960 F.3d 420, 425 (7th Cir. 2020). On June 12,
2022, Ingalls, who is incarcerated at Wabash Valley Correctional Facility, was suffering
from a painful buildup of earwax that interfered with his hearing. He submitted a
healthcare request form seeking treatment. The next day, when the pain had become
unbearable, Ingalls used the emergency intercom system in his cell to contact prison
staff and request immediate assistance. Ingalls spoke with Malott and explained his
symptoms. Malott said he would contact medical staff and call Ingalls back.
Malott promptly spoke with an unknown member of the medical staff and
reported Ingalls’s symptoms of ear pain and hearing loss. The staff person advised
Malott that medical staff and the specific medication needed to treat Ingalls’s ear were
unavailable at that time, so no one could respond to Ingalls’s request for immediate
care. Because immediate treatment was unavailable and the medical staff member did
not state that Ingalls required emergency care, Malott called Ingalls back via the
intercom and told him to submit another healthcare request and a grievance about the
nursing staff shortage. Ingalls submitted both.
On July 14, 2022, a month after he first requested treatment, Ingalls was seen by a
nurse (employed by Centurion) who told him that Wabash had “been understaffed”
and apologized for the delay in treatment. She examined both of his eardrums, reported
a “scant amount of blood” in his left ear canal, and referred him to a physician who
examined Ingalls a week later. The physician ordered over-the-counter ear drops to
help soften and remove earwax, a prescription antibiotic, and an audiogram test. Ingalls
received the ear drops and his pain gradually dissipated over the next few weeks, but
he did not receive the antibiotic or an audiogram.
A month later, Ingalls filed this lawsuit alleging that Centurion and Malott
violated his rights under the Eighth Amendment by acting with deliberate indifference
to his ear condition. See Farmer v. Brennan, 511 U.S. 825, 843 (1994). He alleged that
1 Ingalls also sued Barbara Riggs, a nurse, and Shelby Crichfield, a correctional
officer, for violating his rights under the Eighth Amendment. The district court granted
summary judgment for Riggs, and a jury found Crichfield not liable at trial. Ingalls does
not raise any arguments related to these individuals on appeal, so we do not discuss
them further.

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Centurion maintained an express policy or, alternatively, a widespread practice, of
understaffing and withholding medication to save costs. See Monell v. Dep't of Soc.
Servs., 436 U.S. 658, 694–95 (1978). Ingalls alleged that Malott was deliberately
indifferent because he denied Ingalls medical care when Ingalls first reported his
symptoms. See Farmer, 511 U.S. at 844–45.
During discovery, Ingalls requested a copy of Centurion’s “technical proposal”
and its contract with the IDOC, asserting the documents were relevant to his Monell
claim. Centurion objected to the request, so Ingalls moved to compel production. The
district court denied Ingalls’s motion without addressing Centurion’s objection.
The defendants moved for summary judgment, and the court granted the
motion. Assuming that Ingalls’s medical condition was serious, the court determined he
failed to present evidence from which a reasonable jury could conclude that Centurion’s
practices were constitutionally deficient. The court acknowledged that Ingalls waited
approximately one month for treatment and received only one of the two medications
prescribed to him. The court concluded, however, that there was “no evidence in the
record that Centurion maintained any policy or practice that caused a violation of”
Ingalls’s rights under the Eighth Amendment, that the delay in treatment was “the
result of a deliberate policy or practice, or that other inmates also experienced delays in
receiving examinations or lapses in medication.” See Hildreth, 960 F.3d at 426. The court
also concluded that no reasonable jury could find that Malott violated Ingalls’s
constitutional rights where Malott relied on the professional judgment of medical staff.
See Giles v. Godinez, 914 F.3d 1040, 1049 (7th Cir. 2019).
On appeal, Ingalls first challenges the denial of his motion to compel production
of Centurion’s technical proposal and contract with IDOC. We review a district court’s
denial of a motion to compel for abuse of discretion and will reverse only if the denial
“resulted in actual and substantial prejudice.” Gonzalez v. City of Milwaukee, 791 F.3d
709, 713 (7th Cir. 2015). In Ingalls’s view, these documents would have helped him
prove that Centurion maintained an unconstitutional policy of understaffing facilities
and withholding medications as cost-saving measures. But in his opening brief, Ingalls
explains that he now has a copy of the documents, which are publicly available,2 and he
reproduces the portions that he says support his claim. But those sections do not
support his theory. For example, he points to Centurion’s statements that using generic
2 State of Indiana Public Contract Seach, I ND. DEP ’ T OF A DMIN .: I NDIANA
TRANSPARENCY PORTAL , https://contracts.idoa.in.gov/idoacontractsweb/PUBLIC/D25-22-
54061-000.pdf (last visited June 2, 2026).

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medications and educating patients to participate in their own care are associated with
lower costs. But those statements, focused on methods of providing cost-effective
medical care, do not alone reflect a policy inconsistent with the Eighth Amendment.
See Petties v. Carter, 836 F.3d 722, 730 (7th Cir. 2016) (en banc) (administrative
convenience and cost are permissible considerations for correctional systems in
providing medical care so long as they are not considered to the exclusion of reasonable
medical judgment). Thus, Ingalls cannot show that he was prejudiced by the district
court’s denial.
For the same reason, Ingalls’s argument that the district court erred in
determining that Centurion’s policies did not cause a constitutional injury fails. He
again insists that provisions of the contract discussing generic medication and patient
participation in care reflect an unconstitutional policy. But nothing on the face of these
policies amounts to an express instruction to provide constitutionally deficient medical
care. See J.K.J. v. Polk Cnty., 960 F.3d 367, 377 (7th Cir. 2020) (en banc).
Ingalls argues in the alternative that Centurion maintained a practice of
understaffing and withholding medications, and that it knew these practices would
lead to constitutional violations. The failure to correct known “[d]eficiencies in staffing
and delays in treatment can give rise to a deliberate indifference claim.” Reck v. Wexford
Health Sources, Inc., 27 F.4th 473, 489 (7th Cir. 2022). But Ingalls would need evidence
sufficient to show “such systemic and gross deficiencies in staffing, facilities,
equipment, or procedures that the inmate population is effectively denied access to
adequate medical care.” Id. (quoting Wellman v. Faulkner, 715 F.2d 269, 274 (7th Cir.
1983)). The district court was correct that neither the nurse’s comment that Centurion
had “been understaffed” nor Malott’s statement that medical staff was unavailable to
immediately respond to Ingalls suggests that, in this case, Centurion intentionally
understaffed its facilities or withheld medication or knew that the practice existed and
needed correcting. Though Ingalls waited for treatment, he did receive care, including
ear drops that reduced his pain. And, though there are no “‘bright-line rules’ defining a
widespread practice or custom,” Ingalls’s evidence of his personal experience is
insufficient to establish a systemic breakdown or widespread failure in care. Hildreth,
960 F.3d at 427 (quoting Thomas v. Cook Cnty. Sheriff’s Dep’t, 604 F.3d 293, 303 (7th Cir.
2010)).
Lastly, Ingalls contends that the district court erred in granting summary
judgment to Malott. He insists that Malott was trained to respond to emergencies, had a
duty to ensure he received medical care, and could have administered care to him but
did not. But the undisputed evidence shows that Malott responded promptly to

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Ingalls’s request for care by contacting medical staff and relaying Ingalls’s symptoms.
When medical staff explained that Ingalls could not be seen immediately, Malott told
Ingalls to submit another healthcare request. Malott was entitled to rely on the
professional judgment of medical officials that Ingalls’s condition did not require
immediate intervention and could be addressed through the ordinary healthcare
request process. See Giles, 914 F.3d at 1049.
AFFIRMED

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