GREGORY McMILLEN v. Wexford Health Sources, Inc.

United States Court of Appeals
For the Seventh Circuit
Chicago, Illinois 60604
Submitted September 2, 2025*
Decided September 4, 2025
Before
FRANK H. EASTERBROOK, Circuit Judge
THOMAS L. KIRSCH II, Circuit Judge
DORIS L. PRYOR, Circuit Judge
No. 23-1836
GREGORY McMILLEN,
Plaintiff-Appellant,
v.
WEXFORD HEALTH SOURCES, INC.,
et al,
Defendants-Appellees.
Appeal from the United States District
Court for the Northern District of
Illinois, Eastern Division.
No. 17-cv-00999
John F. Kness,
Judge.
O R D E R
Gregory McMillen, an Illinois prisoner, appeals the entry of summary judgment
on his claims that prison doctors were deliberately indifferent to his eye, heart, and lung
diseases, in violation of his rights under the Eighth Amendment. Because no reasonable
* 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NONPRECEDENTIAL DISPOSITION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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jury could find that the prison doctors were deliberately indifferent or that their actions
aggravated his injuries, we affirm the judgment.
McMillen’s suit arises from loss of vision caused by complications from diabetes
and two stays in the hospital triggered by acute cardiac and pulmonary symptoms. We
recount the facts in the light most favorable to McMillen, the party opposing summary
judgment. See Arce v. Wexford Health Sources, Inc., 75 F.4th 673, 678 (7th Cir. 2023).
McMillen has suffered from diabetes-related eye issues for over a decade. In 2013
Dr. Saleh Obaisi, then the medical director at Stateville Correctional Center, approved
McMillen to see an outside ophthalmologist, Dr. Joseph Civantos, who diagnosed
McMillen with diabetic retinopathy and macular edema. At that appointment,
Dr. Civantos recommended treating these conditions with either laser surgery or
intravitreal injections, and McMillen chose the laser surgery. In April 2016, he was taken
to see another outside ophthalmologist, Dr. Jennifer Lim, who provided him intravitreal
injections for the first time and recommended that he return for a follow-up
appointment in a month. But despite repeatedly reminding medical staff, McMillen was
not taken by prison staff for his next appointment until that August. Similarly, after
Dr. Lim provided injections in November 2016, she again recommended that he return
in a month, but McMillen was not brought for a follow-up until February 2017. At that
appointment, Dr. Lim determined that McMillen now had macular atrophy in his left
eye, and she administered an injection only to his right eye. McMillen began receiving
intravitreal injections to both eyes from Dr. Civantos on a prompter schedule, but in
December 2017, Dr. Civantos concluded that the loss of vision in the left eye was
permanent, so any further injections in that eye would not improve McMillen’s vision.
In addition to these vision problems, McMillen has long received a variety of
prescriptions for cardiac and breathing problems. In April 2017, he was hospitalized for
a week because of severe chest pain. In the preceding five months, he had complained
to medical staff of chest pain and difficulty breathing, and Dr. Obaisi prescribed
repeated nebulizer treatments for McMillen’s pre-existing asthma, though McMillen
had insisted the pain was not related to his asthma. Eventually, in July 2017 and
January 2018, he saw an outside cardiologist, who recommended that McMillen also be
referred to a pulmonologist. Meanwhile, Dr. Rozel Elazegui, who served as interim
medical director after Dr. Obaisi’s death, continued treating McMillen through April
2018, when he was hospitalized again, suffering from pneumonia and exacerbated
chronic obstructive pulmonary disease. After his discharge, he received a portable
defibrillator and participated in two sessions of occupational therapy. That June he saw

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a team of pulmonologists, who recommended further testing and speculated that he
might have pulmonary edema, but did not render a new diagnosis or recommend
changes to his treatment.
By that point, McMillen had already brought this suit against Dr. Obaisi’s estate
and Wexford Health Sources, Inc., the prison’s healthcare contractor. McMillen later
amended the complaint with the assistance of court-recruited counsel, adding
Dr. Elazegui as a defendant. As relevant to this appeal, McMillen alleged that Dr. Obaisi
was deliberately indifferent to his eye condition and that both doctors were deliberately
indifferent to his heart and lung conditions.
The court entered summary judgment in favor of all defendants. It concluded
that McMillen had not presented evidence to suggest that any delays in administering
the injections were the result of a lack of medical judgment, nor did he offer evidence
that the delays themselves caused any harm. He also had failed to present sufficient
evidence that Dr. Obaisi was aware of the danger of his heart conditions prior to his
2017 hospitalization, or that either doctor’s treatments leading up to his 2018
hospitalization fell short of constitutional guarantees.
On appeal, McMillen maintains that the various delays in his treatment between
2014 and 2018 were evidence of the doctors’ deliberate indifference to his conditions. To
withstand summary judgment on his Eighth Amendment claims, McMillen needed
evidence that he had an objectively serious medical condition and that the defendants
were subjectively aware of and disregarded an excessive risk to his health. See Farmer v.
Brennan, 511 U.S. 825, 834, 837 (1994). And to support his theories that the defendants
impermissibly delayed providing him treatment, he needed to present verifying
medical evidence that the delays, rather than the underlying conditions, caused any
harm. See Arce, 75 F.4th at 680. The defendants concede that McMillen’s conditions were
serious, so we focus on whether he presented enough evidence to allow a reasonable
jury to conclude that the defendants were aware of yet disregarded an excessive risk to
his health and that any delays caused his injuries.
Concerning his loss of vision, McMillen argues that a jury could find that
Dr. Obaisi ignored Dr. Lim’s recommended timeline for follow-up treatments. But
McMillen has failed to show that these delays caused some harm. See id.; Gabb v.
Wexford Health Sources, Inc., 945 F.3d 1027, 1034 (7th Cir. 2019). The defendants’ expert,
Dr. Walter Jay, opined that McMillen suffered no significant vision loss during the gaps
between treatments and that any loss he did suffer was a result of his underlying
conditions. McMillen presented no expert of his own to contradict Dr. Jay’s opinion or

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to explain how more frequent injections might have staved off vision loss in his left eye.
And a jury could not make such a medically complex determination based solely on
medical records that contain a “bare recitation of treatment received” and an
unadorned schedule for follow-up appointments. Williams v. Liefer, 491 F.3d 710, 715–16
(7th Cir. 2007) (discussing when treatment records can constitute “verifying medical
evidence” of harm from delay). Although McMillen reprises the allegation from his
amended complaint that Dr. Lim told him in 2016 that the delays in treatment caused
his vision loss, that allegation is not evidence, see Balle v. Kennedy, 73 F.4th 545, 549 n.3
(7th Cir. 2023), and he did not later support this assertion with admissible evidence
showing a causal connection.
Regarding his cardiac and pulmonary conditions, McMillen first argues that
Dr. Obaisi persisted in providing only nebulizer treatments for asthma, even as he
complained to staff that his symptoms were worsening before his 2017 hospitalization.
Although a doctor’s persistence with treatments he knows are ineffective may be
evidence of deliberate indifference, McMillen has not shown that four months of
nebulizer treatments for an asthmatic patient is so far afield of professional standards
that it amounts to cruel and unusual punishment. See Cesal v. Moats, 851 F.3d 714,
724–25 (7th Cir. 2017). And McMillen did not provide any details regarding how or
when he informed Dr. Obaisi that the nebulizer treatments were insufficient and so did
not demonstrate the doctor’s subjective knowledge that they were ineffective. A
prisoner’s mere disagreement with the course of treatment is not evidence of deliberate
indifference. See Lewis v. Sood, 126 F.4th 525, 531–32 (7th Cir. 2025).
McMillen otherwise argues that both doctors delayed his follow-up
appointments with the cardiologist and referral to a pulmonologist. But, again,
McMillen identified no evidence that his cardiac or breathing conditions were
exacerbated by any delay. See Arce, 75 F.4th at 680. He had not, for example, provided
evidence to suggest that a pulmonologist would have been able to diagnose and treat
the conditions for which he was hospitalized better than the medical staff who treated
him in the interim. Indeed, after he saw his pulmonologists in June 2018, they did not
recommend a change in treatment to any underlying conditions. We have only
McMillen’s speculation that an earlier consultation would have improved his health.
Because the record precludes a finding of deliberate indifference, we DENY
McMillen’s renewed motion for recruitment of counsel and AFFIRM the judgment of
the district court.

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