FELITA MCGEE, Independent Administrator of the Estate of Michael Carter, Sr., Deceased v. Larry Parsano

In the
United States Court of Appeals
for the Seventh Circuit
____________________
No. 20-2414
F ELITA MCGEE, Independent
Administrator of the Estate of
Michael Carter, Sr., Deceased,
and as next of kin,
Plaintiff-Appellee,
v.
L ARRY PARSANO, et al.,
Defendants-Appellants.
____________________
Appeal from the United States District Court
for the Central District of Illinois.
No. 16-CV-2221 — Colin S. Bruce, Judge.
____________________
A RGUED JANUARY 21, 2021 — D ECIDED D ECEMBER 15, 2022
____________________
Before SYKES , Chief Judge, and MANION and ST. EVE,
Circuit Judges.
SYKES , Chief Judge. Five days after Michael Carter, Sr., was
booked into the Macon County Jail, he tragically died of
diabetic ketoacidosis—a serious complication of diabetes. In

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2 No. 20-2414
the hours preceding his death, Carter exhibited symptoms
commonly associated with diabetic ketoacidosis: confusion,
lethargy, and labored breathing. But he was denied timely
medical care because the jail nurse thought he was faking his
condition. She assured the corrections officers tasked with
transferring Carter out of the medical unit that his vitals
were within a normal range. Relying on the nurse’s medical
judgment, the officers declined to intervene and proceeded
to relocate Carter, believing that his failure to follow orders
stemmed from deliberate refusal, not medically induced
incapacity.
Following Carter’s death, Felita McGee, the administra-
tor of his estate, sued the Macon County Sheriff’s Depart-
ment and the medical and corrections staff who attended to
him before he died. She filed numerous claims under
42 U.S.C. § 1983, including one against the five corrections
officers. This appeal concerns only whether those officers are
entitled to qualified immunity. The district judge denied the
officers’ motions for summary judgment on that issue,
finding there to be a material factual dispute over whether
they had reason to know that Carter was receiving inade-
quate medical care and thus had a duty to intervene. McGee
v. Macon Cnty. Sheriff’s Dep’t, 473 F. Supp. 3d 818, 839 (C.D.
Ill. 2020). We reverse. Established circuit precedent entitles a
corrections officer to defer to the judgment of medical
professionals. See, e.g., King v. Kramer, 680 F.3d 1013 (7th Cir.
2013). Because that is what the officers did here, they are
entitled to qualified immunity.
I. Background
As the summary-judgment standard requires, we recount
the facts in the light most favorable to McGee as the non-

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No. 20-2414 3
moving party. After Michael Carter, Sr., was charged with
attempted cocaine distribution, a warrant was issued for his
arrest. On July 13, 2015, officers arrested Carter and booked
him into the Macon County Jail. Carter’s intake form indi-
cated that he was diabetic and used insulin. A medical-
administration record completed the same day noted that
Carter had been prescribed two medications to manage his
Type 2 diabetes: Metformin and Glyburide.
Over the next few days, Carter intermittently received
Metformin but never Glyburide. Then on July 16 he submit-
ted a sick-call request stating that he felt exhausted and had
been vomiting. Nurse Edna Morgan responded to Carter’s
request and administered Zofran, an anti-nausea medica-
tion. The next day a call from Carter’s worried mother
prompted Nurse Ashley Mattingly to also examine Carter.
She observed that he was experiencing tachycardia and low
blood pressure, so she moved him into the medical unit for a
23-hour observation.
That evening Dr. Robert Braco briefly examined Carter in
the medical unit. Dr. Braco mistakenly believed that Carter
had been experiencing only respiratory symptoms. So while
he gave Carter two medications to alleviate his coughing
and anxiety, he did nothing to address his diabetes.
Carter remained in the medical unit overnight. Early in
the morning of July 18, Nurse Jo Bates informed Corporal
Randall West that Carter was ready to leave the medical unit
and return to general population. West instructed Officer
Larry Parsano to relay this news to Carter. But when
Parsano arrived at Carter’s medical cell shortly after 9 a.m.,
Carter neither looked at nor responded to him. Parsano soon
requested the assistance of other officers.

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4 No. 20-2414
The disturbing events that followed were captured on the
jail’s surveillance camera. But because the video lacks audio,
our account of the dialogue comes from the parties’
summary-judgment filings. A few minutes after Officer
Parsano requested assistance, Corporal West arrived at
Carter’s medical cell and learned that Carter was not re-
sponding to orders. He was sitting near the shower, leaning
against the wall and the toilet. Though Carter’s medical
condition at this time is unclear, Nurse Bates remarked that
his vital readings were better than her own and that he was
“faking” an illness. However, West did not observe Bates
check Carter’s vitals. She instead used smelling salts to
determine whether Carter was “playing possum”—or in her
words, “playing like [he was] dead.” Carter responded to
the smelling salts by slightly moving his head, but he did not
follow Corporal West’s order to stand.
Officer Joshua Page then arrived. Page had been assigned
to meal duties the morning of July 18, so he knew Carter was
diabetic. He also thought Carter appeared sick, in part
because his breathing was labored. But Nurse Bates told
Page that Carter was “faking” an illness. According to
Officer Page, it was not uncommon for inmates at the jail to
fake symptoms of an illness.
The video next shows Corporal West kicking Carter sev-
eral times with varying degrees of force. He also stood on
Carter’s hand while twisting his foot back and forth. Believ-
ing that Carter was refusing to comply with his orders, West
decided to move Carter to “deadlock”—the disciplinary
portion of the jail.
Corporal Michael Patton and Officer Terry Collins then
joined the group of jail staff, though Patton stood outside

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No. 20-2414 5
Carter’s cell. Patton recalls Nurse Bates telling him that
Carter’s vitals were within a normal range, so he figured that
Carter was likely faking his symptoms. Bates similarly told
Officer Collins upon his arrival that she had taken Carter’s
vitals and that he was fine. But again, the video never shows
Bates performing any vital checks. Collins observed that
Carter appeared lethargic, like he was drunk. And both Page
and Collins noticed red Kool-Aid powder throughout
Carter’s cell and on his hands and feet.
Around 9:15 a.m. Nurse Bates entered Carter’s cell with a
pulse oximeter. Because she was unable to secure it to his
finger, she left without obtaining a reading. Then Officer
Parsano, who had positioned himself behind Carter, applied
a pressure-point technique designed to encourage Carter to
stand. This proved unsuccessful, so together Parsano and
Collins dragged Carter to the door of his cell.
Once the officers had positioned Carter near the door,
Nurse Bates spent about two minutes tending to him. Officer
Page noticed Carter was cool to the touch, so he asked Bates
to check Carter’s oxygen levels. The video shows Bates
doing so. But beyond that, not much is clear—several offic-
ers gathered around Carter, making it difficult to identify
from the video which tests she performed. McGee contends
that Nurse Bates never checked Carter’s blood pressure or
other vital signs. Because the video does not clearly contra-
dict her contention and because we must construe the facts
in her favor, we adopt this interpretation as our own.
Shortly before 9:25 a.m. the officers lifted Carter into a
wheelchair and transported him to deadlock. Officer
Brandon Wallar, the corrections officer assigned to deadlock
on July 18, noticed that Carter appeared sick; he was inco-

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6 No. 20-2414
herent and pale. He recommended that Carter be taken back
to the medical unit. Officer Page likewise felt that Carter
should have remained in the medical unit. But the transport-
ing officers opted to leave Carter in deadlock.
The jail’s deadlock unit lacks continuous surveillance, so
our description of the remaining events comes solely from
the parties’ summary-judgment filings. After Carter had
been moved to deadlock, Officer Parsano returned to
Carter’s medical-unit cell to clean and prepare it for another
inmate. While cleaning, Parsano found two uneaten trays of
food, both marked “D” for diabetic. Figuring that Carter was
diabetic—a fact he had not previously known—Parsano told
Officer Collins to have Nurse Bates check Carter for low
blood sugar. Collins located Bates and told her about the
discovery of the untouched trays. When he asked her to
check Carter’s blood-glucose level, she remarked, “[I]f you
want me to, I guess I can.”
Officers Collins and Page accompanied Nurse Bates to
Carter’s deadlock cell and watched her check Carter’s vitals
and conduct a finger-prick blood-glucose test. Carter’s
blood-glucose level exceeded the glucometer’s maximum
reading of 500 milligrams per deciliter. Diabetic ketoacido-
sis, a process where acid accumulates in the bloodstream, is
associated with levels above 300.1 But neither Collins nor
Page understood the reading’s significance, and Nurse Bates
did not appear alarmed.
1 Diabetic ketoacidosis, M AYO C LINIC, https://www.mayoclinic.org/
diseases-conditions/diabetic-ketoacidosis/symptoms-causes/syc-
20371551 (last visited Dec. 15, 2022) (advising an individual to seek
emergency care if his blood-sugar level exceeds 300 milligrams per
deciliter for more than one test).

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No. 20-2414 7
Bates then located Corporal West and stated that she
wanted to give Carter a shot. West understood this to mean
that Bates wanted to administer an insulin injection. So
around 10:15 a.m. West escorted Nurse Bates back to
Carter’s cell and watched her give the injection. Bates told
West that Carter’s symptoms should improve within about
ten minutes and that she would check on him in an hour.
About a half-hour after Carter received his insulin injec-
tion, his lawyer arrived at the jail and asked to meet with
him. Officer Page went to retrieve Carter from his cell. At
that time Page learned from Corporal West that Nurse Bates
had given Carter a medication. When Officer Page asked
Carter whether he wanted to see his lawyer, Carter nodded
in agreement. Because Carter had previously removed his
jail uniform, he began trying to dress himself. For the next
few minutes, he struggled to put his pants on. He ultimately
gave up, and jail staff informed his lawyer that Carter was
unable to meet with him.
Around 11:15 a.m. Officer Page and Corporal Ronke
Austin—the command officer in charge on July 18—
accompanied Nurse Bates back to Carter’s cell for another
blood-glucose test. His blood-glucose level still exceeded
500 milligrams per deciliter. Austin—who is diabetic—
recognized the reading as dangerously high. According to
Corporal Austin, Carter looked “like he was in a daze.”
Austin expressed her concern to Nurse Bates, who then
contacted Dr. Braco. After doing so, Bates assured Austin
that Dr. Braco would “see [Carter] when he [came] in at
three.” But because Corporal Austin interjected that Carter
would die by then, Bates agreed to send Carter to the hospi-
tal by squad car.

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8 No. 20-2414
Corporal Austin summoned several officers, including
Officer Page and Corporal Patton, to locate a wheelchair for
Carter. As Page approached Carter’s cell, he noticed that
Carter was leaning against the wall and had drool running
down his chest. While Officer Page ran to obtain the auto-
mated external defibrillator, Corporal Patton grabbed
Carter’s wrist to check his pulse. Unable to find one, the
officers delivered a shock with the defibrillator and per-
formed CPR. Carter was pronounced dead upon his arrival
at the hospital.
Felita McGee, the administrator of Carter’s estate, sued
the Macon County Sheriff’s Department, Decatur Memorial
Hospital, Dr. Braco, Nurse Bates, and five of the corrections
officers who encountered Carter on the morning of his
death: West, Parsano, Collins, Patton, and Page. Though
McGee filed a host of state and constitutional claims, only
the § 1983 claim against the corrections officers is relevant to
this appeal. McGee alleges that the officers deprived Carter
of his Fourteenth Amendment due-process right to adequate
medical care as a pretrial detainee. The officers moved for
summary judgment on qualified-immunity grounds, but the
district judge ruled against them. He concluded that a
material factual dispute existed as to whether the officers
had reason to know that the medical staff was failing to
provide adequate care. The officers appealed.
II. Discussion
The Fourteenth Amendment’s Due Process Clause gov-
erns McGee’s medical-care claim because Carter was arrest-
ed on a warrant and remained in custody at the Macon
County Jail as a pretrial detainee. Kingsley v. Hendrickson,
576 U.S. 389, 400 (2015); Miranda v. County of Lake, 900 F.3d

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No. 20-2414 9
335, 350 (7th Cir. 2018); Pulera v. Sarzant, 966 F.3d 540, 549
(7th Cir. 2020) (“Before a finding of probable cause, the
Fourth Amendment protects an arrestee; after such a find-
ing, the Fourteenth Amendment protects a pretrial detain-
ee.”). So the standard that applies to McGee’s claim differs
from that which governs the claims of convicted prisoners
under the Eighth Amendment. In Kingsley the Supreme
Court specifically advised courts to heed the important
distinctions between the Eighth Amendment’s Cruel and
Unusual Punishment Clause and the Fourteenth Amend-
ment’s Due Process Clause. Under the Due Process Clause,
the appropriate standard is “solely an objective one.”
Kingsley, 576 U.S. at 397.
Kingsley involved an excessive-force claim brought by a
pretrial detainee, but in Miranda, 900 F.3d at 350–52, we
extended its logic to a detainee’s medical-care claim. Apply-
ing Kingsley, we concluded that a pretrial detainee must
prove only that the defendant’s challenged conduct was
objectively unreasonable; he need not also demonstrate, as the
Eighth Amendment requires, that the defendant was subjec-
tively aware that his conduct was unreasonable. Id. at 352.
The objective-reasonableness standard requires that we
“focus on the totality of facts and circumstances” in the case
and “gauge objectively—without regard to any subjective
belief held by the individual—whether the response was
reasonable.” McCann v. Ogle County, 909 F.3d 881, 886 (7th
Cir. 2018).
Although pretrial detainees have a right under the
Fourteenth Amendment to adequate medical care, we have
“long recognized” that correctional institutions typically
“engage in the division of labor” between medical profes-

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10 No. 20-2414
sionals and other security and administrative staff. Miranda,
900 F.3d at 343. “When detainees are under the care of
medical experts, non-medical jail staff may generally trust
the professionals to provide appropriate medical attention.”
Id. So “the law encourages non-medical security and admin-
istrative personnel at jails and prisons to defer to the profes-
sional medical judgments of the physicians and nurses …
without fear of liability for doing so.” Berry v. Peterman,
604 F.3d 435, 440 (7th Cir. 2010). An exception exists only if a
jail official “had reason to know that the[] medical staff w[as]
failing to treat or inadequately treating an inmate.” Miranda,
900 F.3d at 343.
But even if that exception applies, the doctrine of quali-
fied immunity may still shield a jail official from damages
liability. Rooted in the idea of fair notice, qualified immunity
“protects ‘all but the plainly incompetent or those who
knowingly violate the law.’” Mullenix v. Luna, 577 U.S. 7, 12
(2015) (quoting Malley v. Briggs, 475 U.S. 335, 341 (1986)).
According to the Supreme Court, the doctrine strikes the
proper balance between the significant costs of personal
suits for damages and the need for a remedy against those
who abuse their power. Harlow v. Fitzgerald, 457 U.S. 800, 814
(1982). It therefore attaches unless (1) a government official
“violated a federal statutory or constitutional right, and
(2) the unlawfulness of [his] conduct was clearly established
at the time.” District of Columbia v. Wesby, 138 S. Ct. 577, 589
(2018) (quotation marks omitted).
We review a denial of summary judgment on qualified-
immunity grounds de novo and ask “whether viewing the
facts in the light most favorable to the plaintiff,” the gov-
ernment official is entitled to qualified immunity. Howell v.

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No. 20-2414 11
Smith, 853 F.3d 892, 897 (7th Cir. 2017). Before applying that
standard to this case, we must assess a threshold jurisdic-
tional question.
A. Appellate Jurisdiction
McGee argues that we lack jurisdiction to hear the offic-
ers’ interlocutory appeal. While a pretrial order denying
summary judgment usually is not an appealable “final
decision” under 28 U.S.C. § 1291, it is well settled that an
order denying qualified immunity is immediately appeala-
ble under § 1291 and the collateral-order doctrine. Mitchell v.
Forsyth, 472 U.S. 511, 527–30 (1985). This is so because
“[q]ualified immunity is ‘an immunity from suit rather than
a mere defense to liability.’” Plumhoff v. Rickard, 572 U.S. 765,
771–72 (2014) (quoting Pearson v. Callahan, 555 U.S. 223, 231
(2009)). Absent an interlocutory appeal, a pretrial order
denying qualified immunity is effectively unreviewable: By
the time the trial court enters its final order, “the immunity
from standing trial will have been irretrievably lost.” Id. at
772.
In Johnson v. Jones, 515 U.S. 304 (1995), the Supreme Court
announced a narrow exception to immediate appealability.
Johnson involved a claim of excessive force under the Fourth
Amendment. The plaintiff sued five police officers, alleging
that they had beaten him and caused him to suffer several
broken ribs. Id. at 307. Three officers moved for summary
judgment, asserting that the plaintiff lacked evidence that
they had participated in the beating. Id. But the judge denied
their motion because the parties’ deposition testimony raised
a genuine factual issue over whether the three officers had
been involved. Id. at 308. Though the officers appealed the
judge’s order, the Supreme Court held that it was not imme-

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12 No. 20-2414
diately appealable because it “raised a genuine issue of fact
concerning [the officers’] involvement in the alleged beat-
ing.” Id. at 313. A defendant otherwise “entitled to invoke a
qualified immunity defense[] may not appeal a district
court’s summary judgment order insofar as that order
determines whether or not the pretrial record sets forth a
‘genuine’ issue of fact for trial.” Id. at 319–20.
The Court has since clarified the exceedingly limited
scope of Johnson’s holding, cabining it to pretrial orders that
determine only “a question of ‘eviden[tiary] sufficiency,’ i.e.,
which facts a party may, or may not, be able to prove at
trial.” Plumhoff, 572 U.S. at 772 (quoting Johnson, 515 U.S. at
313). Such orders do not determine an officer’s entitlement to
qualified immunity; they are merely “garden-variety
summary-judgment ruling[s] about whether the evidentiary
record shows a merits-related factual dispute for trial.” Smith
v. Finkley, 10 F.4th 725, 751 (7th Cir. 2021) (Sykes, J., dissent-
ing). They are therefore not “final decisions” under § 1291
and not immediately appealable. But when a case raises a
pure question of law—like, for example, whether a defend-
ant’s conduct violated clearly established law—we may
exercise our appellate jurisdiction. Plumhoff, 572 U.S. at 773.
Indeed, “deciding legal issues of this sort” is one of our
“core responsibilit[ies].” Id.
Still, “[t]he line between a non-appealable factual dispute
and an appealable abstract legal question is not always
clear.” Smith, 10 F.4th at 735. “[A] great number of orders
denying qualified immunity at the pretrial stage are linked
closely to the merits of the plaintiff’s claim.” Id. (quoting
Jones v. Clark, 630 F.3d 677, 679 (7th Cir. 2011)). Our task then
is to decide whether the judge’s ruling centers on pure

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No. 20-2414 13
questions of historical fact—“questions of who did what,
when or where, how or why.” Id. at 747 (quoting U.S. Bank
N.A. v. Vill. at Lakeridge, LLC, 138 S. Ct. 960, 966 (2018)). A
ruling identifying such a merits-related factual dispute
cannot be immediately appealed, even if “entered in a
‘qualified immunity’ case.” Johnson, 515 U.S. at 313. But if the
judge’s order instead applies the familiar qualified-
immunity inquiry to undisputed historical evidence, nothing
impedes us from exercising our jurisdiction on interlocutory
appeal. Quite the opposite in fact; we are obligated to do so.
Plumhoff illustrates this jurisdictional principle. At issue
in Plumhoff was whether police officers used excessive force
during a high-speed car chase. The officers had fired multi-
ple shots at the fleeing car, which caused the car to crash and
ultimately killed both the driver and passenger. 572 U.S. at
770. The officers moved for summary judgment on qualified-
immunity grounds, but the judge denied their motion. Id.
After reviewing the available video evidence, he concluded
that the officers had violated clearly established Fourth
Amendment law. Estate of Allen v. City of West Memphis,
No. 05-2489, 2011 WL 197426, at *1 (W.D. Tenn. Jan. 20,
2011). The Sixth Circuit affirmed. 509 F. App’x 388 (6th Cir.
2012).
The Supreme Court reversed on the merits, though it first
addressed the issue of appellate jurisdiction. It held that the
narrow exception articulated in Johnson did not foreclose
immediate appellate review of the judge’s summary-
judgment ruling. Plumhoff, 572 U.S. at 773. The petitioners
did “not claim that other officers were responsible for [the]
shooting.” Id. “[R]ather, they contend[ed] that their conduct
did not violate the Fourth Amendment and, in any event,

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14 No. 20-2414
did not violate clearly established law.” Id. They had
“raise[d] legal issues … quite different from any purely
factual issues that the trial court might confront if the case
were tried.” Id. So the Sixth Circuit had “properly exercised
jurisdiction.” Id.
On the question of our appellate jurisdiction, this case is
indistinguishable from Plumhoff. Like in Plumhoff, we have a
video that captured much of the corrections officers’ relevant
conduct. Additionally, the parties do not dispute the perti-
nent historical facts. They agree that Carter was seriously ill
the morning of July 18 (and we now know this was due to
diabetic ketoacidosis). They also agree that Nurse Bates
assured the officers that Carter’s vitals were fine and that he
was “faking” his symptoms. But McGee and the officers part
ways over whether the officers reasonably deferred to
Bates’s medical judgment: While McGee contends that the
officers should have intervened to ensure that Carter re-
ceived adequate treatment, the officers argue that they were
legally entitled to defer to Bates, and even if not, no clearly
established law required that they override her judgment.
Underlying this dispute are two purely legal issues. The
first is whether the officers violated Carter’s right to due
process by deferring to the medical staff. The answer to this
question turns on the objective reasonableness of the offic-
ers’ conduct. Assuming for present purposes that the officers
acted unreasonably, we then ask whether qualified immuni-
ty nonetheless protects them because their mistake in judg-
ment was a reasonable one. With the video evidence and the
agreed-upon historical facts, we have all we need to answer
those questions.

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No. 20-2414 15
Nor did the district judge identify a factual dispute on
which our answers to these questions might turn. On the
question of the officers’ entitlement to qualified immunity,
he held that “[it] was sufficiently clear that failing to take
any action in light of a serious medical need was unconstitu-
tional at the time of Carter’s death.” McGee, 473 F. Supp. 3d
at 840. In sum, the judge addressed and decided the core
qualified-immunity question we confront here. For this
reason his order is subject to immediate appellate review;
our jurisdiction is secure.
B. Qualified Immunity
With the jurisdictional dilemma resolved, we return to
qualified immunity. We begin and end with step two of the
qualified-immunity inquiry: whether the unlawfulness of
the officers’ conduct was clearly established at the time of
Carter’s death. We choose this path in light of the Supreme
Court’s instruction that “lower courts ‘should think hard,
and then think hard again,’ before addressing both qualified
immunity and the merits of an underlying constitutional
claim.” Wesby, 138 S. Ct. at 589 n.7 (quoting Camreta v.
Greene, 563 U.S. 692, 707 (2011)). For a right to be clearly
established, “existing precedent must … place[] the statutory
or constitutional question beyond debate.” Ashcroft v.
al-Kidd, 563 U.S. 731, 741 (2011). Put differently, every rea-
sonable officer must have understood that deferring to the
judgment of medical staff in these circumstances was unlaw-
ful. Id. Here, our caselaw points decidedly in one direction,
but it does so in favor of the officers’ reasonableness. We
therefore hold that the corrections officers are entitled to
qualified immunity.

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16 No. 20-2414
To support her contrary position, McGee mostly relies on
cherry-picked legal propositions about an inmate’s constitu-
tional entitlement to adequate medical care. See, e.g., Farmer
v. Brennan, 511 U.S. 825, 832 (1994) (“[P]rison officials must
ensure that inmates receive adequate food, clothing, shelter,
and medical care … .”); Estelle v. Gamble, 429 U.S. 97, 104–05
(1976) (classifying the intentional denial or delay of access to
medical care as deliberate indifference). Yet the Supreme
Court has “‘repeatedly told courts … not to define clearly
established law at a high level of generality’ since doing so
avoids the crucial question whether the official acted reason-
ably in the particular circumstances that he or she faced.”
Plumhoff, 572 U.S. at 779 (alteration in original) (citation
omitted) (quoting Al-Kidd, 563 U.S. at 742). So we narrow
our focus to cases that specifically address the situation we
confront here: whether a corrections officer may rely on a
nurse’s judgment that an inmate is faking symptoms of an
illness.
McGee responds that the “law has always been suffi-
ciently clear” that the corrections officers’ conduct was
unconstitutional. But at the time of Carter’s death—and still
now—our caselaw has said precisely the opposite. King
involved an almost identical set of facts, and we held that
the district judge correctly granted summary judgment in
the officers’ favor. In King the jail medical staff inexplicably
decided to wean an inmate off his anxiety medication.
680 F.3d at 1015. Abrupt withdrawal from that medication is
associated with symptoms of agitation, tremors, hallucina-
tions, and seizures. Id. at 1016. Those are exactly the symp-
toms the inmate experienced. The morning of his death, two
corrections officers found him “convulsing on the floor,
screaming and foaming at the mouth.” Id. But the on-call

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No. 20-2414 17
nurse accused the inmate of faking his seizure and told him
to “quit acting like a child and get up.” Id. at 1017. After the
inmate began convulsing again an hour later, the nurse
moved him to a padded cell, and from there she did nothing
more. That evening he died. Id.
The judge granted summary judgment in the officers’ fa-
vor and held that their deference to the nurse was not un-
lawful. We affirmed. “The officers were not responsible for
administering medical care” to the inmate. Id. at 1018.
Instead “they were ‘entitled to defer to the judgment of jail
health professionals.’” Id. (quoting Berry, 604 F.3d at 440).
The officers had properly notified the nursing staff when the
inmate was experiencing seizures. Id. But they “were not
trained to assess whether an inmate [was] genuinely experi-
encing seizures, and so they lacked the capacity to judge
whether [the nurse] made an inappropriate diagnosis.” Id.
King controls our decision here. Simply put, it dictates
that corrections officers are not constitutionally obligated to
override the judgment of medical professionals unless they
have reason to know that an inmate is receiving inadequate
treatment. This remains true even when an inmate is in
obvious distress and even when the medical staff has misdi-
agnosed an inmate—or worse, accused him of faking a very
real illness. Our cases since King have affirmed these princi-
ples. See, e.g., Miranda, 900 F.3d at 343 (affirming the dismis-
sal of claims against corrections officers who were assured
that the medical staff was monitoring an inmate who died
from a hunger strike); Estate of Perry v. Wenzel, 872 F.3d 439,
450, 459 (7th Cir. 2017) (affirming summary judgment for
corrections officers who stood next to an inmate who died

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18 No. 20-2414
“writh[ing] around” in a bloody spit mask while the observ-
ing nurses did nothing).
Importantly, King was decided at step one of the
qualified-immunity inquiry. In other words, it affirmatively
established that a corrections officer may trust jail medical
professionals to provide inmates with appropriate medical
care. There is accordingly no legal basis for McGee’s conten-
tion that at the time of Carter’s death, the law was clearly
established in her favor.
Still, McGee attempts to distinguish King and its proge-
ny. She contends that both Carter’s medical distress and the
inadequacy of Nurse Bates’s medical treatment was, or
should have been, obvious to the corrections officers. But the
obviousness of Carter’s deteriorating health—McGee’s first
point—has minimal relevance under our caselaw. Instead,
the appropriate inquiry for a medical-care claim is whether
the officers “ha[d] a reason to believe (or actual knowledge)”
that the medical staff was “mistreating (or not treating)” an
inmate. King, 680 F.3d at 1018 (quotation marks omitted). To
the extent the obviousness of Carter’s condition has any
relevance, we have found that corrections officers are enti-
tled to defer to the medical staff in circumstances far more
obvious than these. For example, in King the inmate experi-
enced severe shaking and foaming at the mouth. Carter’s
symptoms—lethargy, incoherence, and labored breathing—
were more subtle.
We thus constrain our analysis to McGee’s second point:
whether Nurse Bates provided Carter with obviously inade-
quate medical treatment. And we do so with the qualified-
immunity standard in mind. Under that standard the key
question is whether Bates’s treatment was so obviously

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No. 20-2414 19
inadequate that every reasonable officer would have known
that he could not rely on her medical judgment.
The evidence pertinent to that question is undisputed. In
the days preceding his death, Carter experienced a variety of
symptoms, including nausea, exhaustion, tachycardia, low
blood pressure, and labored breathing. On July 17 he was
moved to the medical unit for a 23-hour observation. The
following morning Nurse Bates requested that Carter be
moved from the medical unit back to general population.
Five corrections officers ultimately participated in the trans-
fer because Carter was not responsive to their orders. At
least two of those officers, Page and Collins, noticed that
Carter appeared sick; he was exhibiting symptoms of lethar-
gy and labored breathing. Officer Page also knew that Carter
was diabetic.
Nurse Bates assured the officers that Carter was fine. She
told some that Carter was “faking” his symptoms (and this
was not an uncommon occurrence at the jail); she told others
that his vitals were normal (although it is possible that she
never checked them). Several officers observed Bates use
smelling salts, and Carter reacted by moving his head. The
officers thus proceeded with Carter’s transfer, though
Corporal West decided to move Carter to the disciplinary
unit because of his apparent refusal to cooperate. Both
Officers Page and Wallar thought that Carter should have
stayed in the medical unit. Wallar specifically thought Carter
seemed incoherent and sick.
Following the transfer, Officer Parsano realized that
Carter had left several meals uneaten; these meals were
marked “D” for diabetic. This discovery eventually prompt-
ed Nurse Bates to check Carter’s blood-glucose level.

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20 No. 20-2414
Though his level was dangerously high, the reading meant
nothing to Officers Collins and Page. Bates herself did not
appear alarmed, but she did administer an insulin shot.
After doing so, she informed West that Carter’s symptoms
should soon improve. An hour later, however, Carter’s
blood-glucose level had not dropped, so Corporal Austin
insisted that Carter be transported to the hospital. By then, it
was too late. Tragically, Carter died.
In hindsight we know that Carter was experiencing
symptoms of diabetic ketoacidosis. But like in King, the lay
corrections officers lacked the requisite medical training to
either identify or treat Carter’s medical condition. Similarly,
they “lacked the capacity to judge whether [Nurse Bates]
made an inappropriate diagnosis.” King, 680 F.3d at 1018.
And they later observed Bates attempt to treat what ap-
peared to be a diabetic-related illness. In short, McGee has
presented no evidence, other than her own sheer specula-
tion, that the officers knew or had reason to know that Nurse
Bates was providing inadequate care.
McGee emphasizes that at least two officers—Page and
Wallar—thought that Carter appeared sick and disagreed
with the decision to move him out of the medical unit. But
recognizing that someone is sick is not the same as knowing
that he is receiving inadequate care from a trained medical
professional. Additionally, McGee’s evidence is insufficient
to clear the qualified-immunity hurdle. To prevail, McGee
must show that every reasonable officer would have under-
stood that relying on Nurse Bates’s medical judgment was
unlawful. Simply put, she has not done so.
To reiterate, this case concerns only whether the five cor-
rections officers who transported Carter from the medical

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No. 20-2414 21
unit to the disciplinary unit are entitled to qualified immuni-
ty. Under our caselaw, corrections officers may reasonably
rely on the judgment of jail health professionals, and the
qualified-immunity doctrine protects officers from reasona-
ble mistakes when they do so. Accordingly, the corrections
officers here are entitled to qualified immunity. We REVERSE
the judgment of the district court and REMAND with instruc-
tions to enter judgment in the officers’ favor.

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