Sanville, Martha v. McCaughtry, Gary , 266 F.3d 724 ( 2001 )


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  • In the
    United States Court of Appeals
    For the Seventh Circuit
    No. 00-2933
    Martha Sanville, individually and as
    trustee for the heirs and next of kin
    of Matthew A. Sanville, deceased,
    Plaintiff-Appellant,
    v.
    Gary McCaughtry; Jane Gamble; Curtis Bender;
    Ivy Scaburdine (f/k/a Ivy Podish); Eric
    Schroeder; Glenn Gilgenbach; Jodine Deppisch; Narinder
    Saini, Ph.D.; Gary Ankarlo, Ph.D.; Stephen
    J. Fleck, Ph.D.; Yogesh Pareek, Ph.D.; Carl
    L. Cihlar, Ph.D.; John Does Nos. 1-5, all
    in their individual and official
    capacities,
    Defendants-Appellees.
    Appeal from the United States District Court
    for the Eastern District of Wisconsin, Milwaukee Division.
    No. 99 C 715--Rudolph T. Randa, Judge.
    Argued February 13, 2001--Decided September 21, 2001
    Before Manion, Kanne, and Evans, Circuit
    Judges.
    Kanne, Circuit Judge. Matt Sanville, a
    mentally ill inmate incarcerated at the
    Waupun Correctional Institution in
    Wisconsin, committed suicide when he was
    left unsupervised for approximately five
    hours. His mother, Martha Sanville, filed
    this lawsuit in federal district court,
    alleging that a number of prison
    officials violated Matt’s Eighth
    Amendment rights through their deliberate
    indifference to Matt’s/1 serious medical
    needs. While we affirm the district
    court’s dismissal of plaintiff’s claims
    against the prison wardens and the
    medical professionals who treated Matt,
    we find that Mrs. Sanville has pleaded
    sufficient facts to survive a motion to
    dismiss her complaint against several
    prison guards. We thus affirm in part and
    reverse in part, and remand the remaining
    claims for further proceedings.
    I.   History
    Matt Sanville suffered, as do a
    significant number of prison inmates,
    from a serious mental health problem. At
    various times in his life, doctors
    diagnosed Matt with major depressive
    disorder, aggressive conduct disorder,
    bipolar disorder, dysthymic disorder,
    adjustment disorder, mixed personality
    disorder, and manic depression. While
    they might have disagreed as to Matt’s
    precise medical condition, the doctors
    unanimously agreed that Matt needed to be
    medicated to control his illness. His
    adult life was characterized by a history
    of suicide attempts, hospitalizations,
    and drug treatments directed towards
    managing his multiple mental disorders.
    Matt did not agree that he needed to be
    medicated and, during an unmedicated
    period in July 1997, he was arrested for
    assaulting his mother. When prosecutors
    charged Matt with assault, his court-
    appointed attorney moved for a competency
    evaluation, which the state judge
    ordered. The medical professional who
    examined Matt, Harlan R. Heinz, Ph.D.,
    concluded that he was "significantly
    depressed and acutely psychotic,
    rendering him incompetent to stand
    trial." He also found that Matt 1)
    "showed significant lack of insight by
    reporting his thinking was fine," 2) "was
    not able to make his needs known," and 3)
    was "not competent to refuse medication
    or treatment for his mental condition."
    Matt’s attorney agreed with this
    assessment and prepared an incompetency
    defense.
    Matt, however, would not admit his
    incompetency, and his first attorney
    withdrew as a result. Matt’s second
    attorney acceded to Matt’s assessment of
    his own competency and Matt was allowed
    to plead no contest to the battery
    charge. His presentence investigation
    report noted that Matt had received
    thirty conduct reports during his
    confinement--for such infractions as
    covering his cell light, plugging
    toilets, and throwing feces and urine on
    staff--all of which occurred while he was
    not medicated. At sentencing on January
    5, 1998, Matt’s mother pleaded with the
    court not to send Matt to prison,
    asserting that he was not a danger as
    long as he was medicated. The prosecutor
    concurred, stating that he disagreed with
    the PSI’s recommendation that Matt should
    go to prison--he even went so far as to
    note that "I do not believe that sending
    a person to the Wisconsin State Prison
    system is the best place to deal with a
    person’s mental illness." Although the
    Judge noted that Matt was probably
    mentally ill, he sentenced him to the
    maximum term in prison. Matt began
    serving his sentence at the Dodge
    Correctional Institute (hereinafter
    "Dodge") on January 7, 1998.
    Mrs. Sanville wrote a letter to the
    evaluator at Dodge explaining that Matt’s
    conduct was the result of mental illness
    and relaying the opinions conveyed about
    Matt’s mental health during the court
    proceedings. On Matt’s second day at
    Dodge, Dr. Carl L. Cihlar, the first of
    the doctor-defendants, performed an
    intake screening of Matt and incorrectly
    reported that Matt did not have a mental
    illness. While noting Matt’s history of
    suicide attempts, the report also stated
    that Matt had never taken any medication
    to help with "anxiety, depression, mood
    swings, thinking problems, hearing voices
    or seeing things, or controlling [his]
    behavior." Plaintiff alleges that Dr.
    Cihlar was aware of Matt’s troubled
    history, including the conclusions of Dr.
    Heinz’s pretrial competency evaluation.
    Towards the end of the month, Matt was
    again evaluated, this time by a
    classification specialist at Dodge, and
    she determined that Matt was presently
    medicated with psychotropic drugs. Her
    report also noted Matt’s numerous
    behavioral problems during his
    unmedicated stay in the county jail.
    Matt arrived at Waupun Correctional
    Institution (WCI) on February 26, 1998. A
    week after his admission, Matt was seen
    for a psychiatric follow-up by Dr. Yogesh
    Pareek, the second of the doctor-
    defendants. Because Matt was having
    problems with nausea and vomiting, Dr.
    Pareek advised him to go off his
    psychotropic medication until the
    problems subsided. As it turned out, Matt
    had an inflamed appendix, which required
    an emergency appendectomy on March 6,
    1998.
    While in the hospital, Matt remained off
    his medication. On March 10, his mother
    contacted the hospital to express concern
    that Matt had been taken off his
    medication. After the prison was
    contacted, the staff physician assured
    her that Matt’s anti-psychotic medication
    had been reordered.
    On March 26, 1998, about a week after
    his release from the hospital, Matt saw
    Dr. Pareek for the second time. Dr.
    Pareek noted that Matt had a "history of
    psychotic disorder, but he [was] refusing
    to take medication" and that Matt denied
    "ever hearing voices or ever seeing
    things [or] ever being paranoid." The
    doctor decided to discontinue
    psychotropic medication "at the patient’s
    request." His notes indicated that he
    would "see [Matt] again in eight weeks.
    The patient is competent and he knows
    what is right and wrong." A week later,
    however, Matt and Dr. Pareek had another
    session. Matt had not taken any
    medication since the date of the
    appendicitis incident, March 5, and indi
    cated that he no longer wanted medication
    or psychiatric services. Dr. Pareek’s
    treatment plan stated "I will not
    schedule him as he is not taking any
    medication and he does not want to."
    While he was unmedicated, Matt’s
    behavior became increasingly bizarre. In
    April, he defied an order to return to
    his cell, for which he was sent to
    solitary confinement. In early May, he
    scrawled venomous, nonsensical threats on
    his bed sheets ("kill the rapest [sic]
    and snitches" and "go to hell"). On June
    9, he flushed his socks and underwear
    down the toilet. Yet he also displayed
    some evidence of competence (perhaps
    consistent with his diagnosis that he
    exhibited "very paranoid behavior with
    sense of reality"). The day prior to the
    sock flushing incident he requested that
    he be placed in an anger management class
    (he was placed on a waiting list). He
    also filed a lawsuit based upon the
    failure of one correctional officer to
    respond to his requests for medical
    attention during the appendicitis
    incident.
    In late June, Matt asked to see a
    psychiatrist. When Dr. Pareek arrived,
    Matt reported no mental health concerns
    and persisted in his decision to remain
    off his medication. Dr. Pareek provided
    neither treatment nor medication to Matt.
    At this point, Matt had lost seventeen
    pounds since his admission to WCI.
    On July 11, 1998, Matt assaulted another
    inmate and was placed in segregation.
    Just prior to being placed there, Matt
    drafted a document that he entitled his
    last will and testament. This document--
    collected by correctional staff at an
    undetermined time--was addressed to
    Matt’s mother and contemplated Matt’s
    imminent death.
    While in segregation, Matt’s bizarre
    behavior continued. After receiving
    conduct reports for refusing to return
    his meal tray and bag lunch, Matt was
    served "nutri-loaf"--a meal ground up
    into a loaf that could be eaten without
    utensils. He did not eat these loaves and
    thus began to lose weight rapidly. His
    subsequent autopsy confirmed that he lost
    about forty-five pounds during his five
    months at WCI, nearly twenty-five of
    which were in the final month of his life
    (after his placement in segregation).
    Matt wrote to his mother and complained
    about the nutri-loaf;/2 upon receipt of
    the letter, she called the manager of the
    Health Services Unit at WCI and relayed
    her concern that Matt was paranoid,
    suicidal, and in serious trouble.
    On July 24, 1998, Dr. Stephen Fleck, the
    third doctor-defendant, visited Matt in
    his cell in response to Mrs. Sanville’s
    phone call. Dr. Fleck was, however,
    satisfied with Matt’s insistence that he
    had no plans to harm himself. Matt again
    refused clinical and psychiatric
    services. Dr. Fleck’s report did not make
    any reference to Matt’s weight.
    Matt repeatedly asked the guards to
    bring him a regular meal but his requests
    were ignored. He reported to many prison
    employees that he was unable to eat the
    nutri-loaf. His failure to eat and his
    corresponding weight loss was allegedly
    known to, at a minimum, the prison guards
    who fed him (including defendant Ivy
    Scaburdine).
    Matt mailed a letter to his mother on
    July 27, 1998, which prison officials
    read. The letter conveyed that Matt
    thought he was being retaliated against
    because of the lawsuit that he had filed,
    asked for help in finding an attorney,
    requested clinical services, and again
    told Mrs. Sanville that he was not eating
    the nutri-loaf. That same day Matt
    requested to see someone from clinical
    services, and Dr. Fleck visited him at
    his cell. Dr. Fleck’s report indicated
    that Matt said his mood was not good but
    that "[h]e denied any thoughts and plans
    to harm himself . . . ." The notes
    continued:
    I again recommended a face-to-face. He
    again refused, stating "I can take care
    of myself." I again suggested he put in
    an interview request to see Y. Pareek,
    M.D., Psychiatry, to discuss the option
    of medication. He stated, "I don’t need
    any drugs, I’m handling it myself." . . .
    I will follow up in four to six weeks to
    monitor his status.
    Later the same day, Matt again requested
    to see someone from clinical services.
    Dr. Fleck received this request on July
    28, and scheduled an appointment for July
    30, 1998, three days after the request.
    Matt told prison guards sometime during
    these two days that he was going to kill
    himself, but no action was taken.
    On July 29, 1998, the day of Matt’s
    suicide, correctional officer Ivy
    Scaburdine, one of the guard-defendants,
    made her morning rounds to pass out
    breakfast. Matt had covered all of the
    openings in his cell with paper--the
    vents, the call box, and the window--so
    that it was nearly impossible to see
    inside. This was in violation of prison
    policy. Scaburdine did not serve Matt
    breakfast, instead skipping his cell and
    continuing on her rounds. When she made
    the rounds to serve lunch, Matt’s window
    was still covered, thus she did not serve
    him at that time either. All of the
    defendant guards observed Matt’s covered
    cell window at some point during the day,
    but none took any action.
    While his cell window was covered, Matt
    ripped his pillowcase into strips, wet
    the strips in his sink, and then tied the
    strips together, thus fashioning a noose.
    He slid the noose around his neck and
    tied it to the handicap railing along the
    west wall of his cell. He managed to
    position himself so that his weight would
    pull the noose tighter until he gradually
    lost consciousness and died.
    At approximately 2:48 p.m., correctional
    officer Eric Schroeder, one of the guard-
    defendants, was making his rounds. When
    he passed Matt’s cell he noticed that
    "inmate Sanville was sitting on his floor
    in his cell up against the left wall of
    his cell with the left side of his body
    against the wall." He further noted that
    "[Matt] had his window partially covered
    with toilet paper making it somewhat
    difficult to see into his cell."
    Schroeder, who was not regularly assigned
    to the segregation unit, decided not to
    take any action. He had been instructed
    that he should assume inmates who ignored
    him were simply refusing supplies.
    Schroeder claims that he returned to
    Matt’s cell at 2:57 p.m. with officer
    Glenn Gilgenbach, another guard-
    defendant. Gilgenbach offered Matt his
    dinner several times and Matt did not
    respond. Schroeder wrote in his report
    that "I then went to the window and
    observed that he hadn’t moved since
    supplies were offered, nine minites [sic]
    ago." Schroeder then attempted to call
    the sergeant for the segregation block,
    Ann Ingolia, but was unable to reach her
    because the battery in his radio was
    dead.
    At approximately 3:00 p.m., Schroeder
    left to retrieve Ingolia. Ingolia
    followed Schroeder to the door of the
    cell, peered inside, and noticed that
    Matt had a sheet around his neck. She
    instructed Gilgenbach and Schroeder to
    continue feeding the other inmates while
    she called Captain Don Strahota to alert
    him to a possible suicide. Ingolia then
    returned to the cell to wait for the
    first responders. Upon arrival, they
    attempted unsuccessfully to revive Matt.
    At 3:10 p.m., rescue efforts ceased and
    Matt was pronounced dead. Matt was last
    seen alive by the defendants at 10:00
    a.m.
    The prison file provided to the doctor
    who performed the autopsy indicated "a
    past history of suicide attempt" and
    further disclosed that, as of February 7,
    1998, Matt was "psychotic but in
    remission with a Navane treatment."
    Matt’s weight was estimated at 110-120
    pounds. The autopsy concluded that "[a]
    diagnosis of suicide is reasonable but it
    sure would have been nice to have him
    more persuaded to take medication and
    seek psychiatric help."
    Mrs. Sanville filed this lawsuit in the
    United States District Court for the
    Eastern District of Wisconsin on July 25,
    1999, raising federal claims under 42
    U.S.C. sec. 1983-- alleging that the
    various defendants violated Matt’s Eighth
    Amendment rights--and pendent state law
    negligence and medical malpractice
    claims. The defendants moved to dismiss
    the action pursuant to Rule 12(b)(6) of
    the Federal Rules of Civil Procedure and
    filed a corresponding motion for a
    protective order prohibiting discovery
    until the court ruled on the motion to
    dismiss. On June 29, 2000, the court
    granted defendants’ motion to dismiss the
    federal claims on qualified immunity
    grounds and declined to retain
    jurisdiction of the ancillary state law
    negligence claims. See Sanville v.
    McCaughtry, No. 99-C-715, slip op. (W.D.
    Wis. June 28, 2000). Plaintiff appeals
    this judgment.
    II.    Analysis
    A.    Standard of Review
    We review dismissals under Rule 12(b)(6)
    of the Federal Rules of Civil Procedure
    de novo, examining a plaintiff’s factual
    allegations and any inferences reasonably
    drawn therefrom in the light most
    favorable to the plaintiff. See Marshall-
    Mosby v. Corporate Receivables, Inc., 
    205 F.3d 323
    , 326 (7th Cir. 2000). Dismissal
    under Rule 12(b)(6) is proper only if the
    plaintiff could prove no set of facts in
    support of her claims that would entitle
    her to relief. See Conley v. Gibson, 
    355 U.S. 41
    , 45-46, 
    78 S. Ct. 99
    , 
    2 L. Ed. 2d 80
    (1957); Veazey v. Communications &
    Cable of Chi., Inc., 
    194 F.3d 850
    , 854
    (7th Cir. 1999). "[I]f it is possible to
    hypothesize a set of facts, consistent
    with the complaint, that would entitle
    the plaintiff to relief, dismissal under
    Rule 12(b)(6) is inappropriate." 
    Veazey, 194 F.3d at 854
    (citing Graehling v.
    Village of Lombard, Ill., 
    58 F.3d 295
    ,
    297 (7th Cir. 1995)).
    The district court ruled that the
    defendants were entitled to qualified
    immunity. See Sanville, slip op at 31.
    "Qualified immunity shields government
    officials performing discretionary
    functions from liability for civil
    damages unless their conduct violates
    clearly established statutory or
    constitutional rights of which a
    reasonable person would have known." See
    Campbell v. Peters, 
    256 F.3d 695
    , 699
    (7th Cir. 2001) (citing Anderson v.
    Creighton, 
    483 U.S. 635
    , 640, 
    107 S. Ct. 3034
    , 
    97 L. Ed. 2d 523
    (1987)). We review
    a district court’s grant of qualified
    immunity de novo. See 
    id. Before we
    reach the merits of Mrs.
    Sanville’s claims, there are two
    important issues which we must address,
    neither of which were discussed by the
    district court or raised by the parties.
    Plaintiff alleges that the defendants are
    liable under 42 U.S.C. sec. 1983, which
    "requires proof that the defendants were
    acting under color of state law and that
    the defendants’ conduct violated the
    plaintiff’s rights, privileges, or
    immunities secured by the Constitution or
    laws of the United States." Chavez v.
    Ill. State Police, 
    251 F.3d 612
    , 651 (7th
    Cir. 2001) (quotation omitted). Mrs.
    Sanville sued each of the defendants in
    their official and individual capacities,
    and the district court dismissed all of
    these claims based upon the doctrine of
    qualified immunity. Sanville, slip op. at
    31. The dismissal of the official
    capacity claims was not proper, as "it is
    well established that the qualified
    immunity doctrine does not apply to
    official capacity claims." Ruffino v.
    Sheahan, 
    218 F.3d 697
    , 700 (7th Cir.
    2000).
    Yet there is another twist. Official
    capacity suits are actions against the
    government entity of which the official
    is a part. See Wolf-Lillie v. Sonquist,
    
    699 F.2d 864
    , 870 (7th Cir. 1983). To sue
    the defendants in their official
    capacities means that Mrs. Sanville is
    really suing the state entities: the
    Waupun Correctional Institution and the
    Dodge Correctional Institution./3 As we
    have recognized previously, however,
    "section 1983 does not authorize suits
    against states." Power v. Summers, 
    226 F.3d 815
    , 818 (7th Cir. 2000). We
    conclude, therefore, that the official
    capacity claims seeking money damages
    from the defendants should have been
    dismissed on the basis that they may not
    be sustained under sec. 1983.
    We thus turn to the remaining claims--
    the individual capacity claims to which
    the defendants asserted qualified
    immunity as a defense. The court must
    first decide whether the plaintiff’s
    factual allegations would, if proven,
    "show the state actor’s conduct violated
    a constitutional right." Billings v.
    Madison Metro. Sch. Dist., 
    259 F.3d 807
    ,
    816 (7th Cir. 2001) (citing Saucier v.
    Katz, 
    121 S. Ct. 2151
    , 2156 (2001)). If
    so, then we proceed to the second step of
    the analysis, which is to determine
    "whether the right was clearly
    established." 
    Id. In line
    with this
    framework, we begin by reviewing
    plaintiff’s substantive claim that the
    defendants violated Matt’s Eighth
    Amendment rights; where necessary, we
    will proceed to consider whether those
    rights were clearly established at the
    time of the violation.
    B. Did the Defendants’ Conduct Violate
    Matt’s Eighth Amendment Rights?
    Prison officials have a duty, in light
    of the Eighth Amendment’s prohibition
    against cruel and unusual punishment, to
    "ensure that inmates receive adequate
    food, clothing, shelter, and medical
    care." Farmer v. Brennan, 
    511 U.S. 825
    ,
    832, 
    114 S. Ct. 1970
    , 
    128 L. Ed. 2d 811
    (1994). To determine whether an inmate’s
    Eighth Amendment rights were violated by
    a deprivation, we examine the
    allegedviolation both objectively and
    subjectively. See 
    id. at 834.
    "First, the
    deprivation alleged must be, objectively,
    sufficiently serious." 
    Id. (quotation omitted).
    Second, the mental state of the
    prison official must have been "one of
    deliberate indifference to inmate health
    or safety." 
    Id. (quotation omitted).
    Plaintiff alleges, essentially, that the
    conditions of Matt’s incarceration were
    such that there was a substantial risk
    that Matt would commit suicide and that
    the defendants were deliberately
    indifferent to this risk. When a claim is
    based upon the failure to prevent harm,
    in order to satisfy the first element the
    plaintiff must show that the inmate was
    "incarcerated under conditions posing a
    substantial risk of serious harm." 
    Id. It goes
    without saying that "[s]uicide is a
    serious harm." Estate of Cole by Pardue
    v. Fromm, 
    94 F.3d 254
    , 261 (7th Cir.
    1996) (quotation omitted); see also
    Estate of Novack ex rel. Turbin v. County
    of Wood, 
    226 F.3d 525
    , 529 (7th Cir.
    2000); Hall v. Ryan, 
    957 F.2d 402
    , 406
    (7th Cir. 1992) (recognizing that
    prisoners have a constitutional right "to
    be protected from self-destructive
    tendencies," including suicide) (citing
    Joseph v. Brierton, 
    739 F.2d 1244
    (7th
    Cir. 1984)). In this case, not only was
    there a risk of serious harm but that
    harm actually materialized--Matt
    committed suicide. It would be difficult
    to think of a more serious deprivation
    than to be deprived of life, and thus
    plaintiff’s claim clearly satisfies the
    first element. Cf. Reed v. McBride, 
    178 F.3d 849
    , 852 (7th Cir. 1999) ("A
    condition is objectively serious if
    failure to treat it could result in
    further significant injury or unnecessary
    and wanton infliction of pain.")
    (internal quotation omitted) (collecting
    cases).
    We should note that the injury could be
    framed in a more particularized fashion
    with respect to the various groups of
    defendants. The need for a mental illness
    to be treated could certainly be
    considered a serious medical need. See
    
    id. at 853
    (citing Hudson v. McHugh, 
    148 F.3d 859
    , 863 (7th Cir. 1998), for the
    proposition that unmedicated epilepsy
    "posed a ’serious threat’ to a prisoner’s
    health"). Further, there is the
    additional possibility that Matt was
    physically unable to eat the nutri-loaf
    that he was being served (the complaint
    states both that he refused his food and
    that he was unable to eat it). We have
    held that withholding food from an inmate
    can, in some circumstances, satisfy the
    first Farmer prong. See 
    id. (recognizing that
    "the amount and duration of the
    deprivation" would be relevant to whether
    the deprivation amounted to an objective
    violation of the Eighth Amendment).
    Whether these facts would support a
    finding that Matt was denied food is not
    something we need to resolve, as we have
    already concluded that Matt demonstrated
    a serious medical need.
    We therefore turn to the second element
    of the Farmer framework: whether the
    defendants were deliberately indifferent
    to the risk that Matt would commit
    suicide. See 
    Pardue, 94 F.3d at 261
    . The
    meaning of the "deliberate indifference"
    prong has recently been clarified by the
    Supreme Court: "a prison official cannot
    be found liable under the Eighth
    Amendment for denying an inmate humane
    conditions of confinement unless the
    official knows of and disregards an
    excessive risk to inmate health or
    safety; the official must both be aware
    of facts from which the inference could
    be drawn that a substantial risk of
    serious harm exists, and he must also
    draw the inference." 
    Farmer, 511 U.S. at 837
    . With this framework in mind, we
    consider Mrs. Sanville’s claims against
    the various defendants.
    1. The Medical Defendants: Cihlar,
    Pareek, Fleck/4
    Plaintiff alleges that the doctors knew
    that Matt’s refusal to accept care was a
    symptom of his mental illness and that by
    deferring to his stated wishes, they
    deliberately disregarded the substantial
    risk that he would commit suicide. Thus,
    because they allowed him to remain
    unmedicated without taking further
    precautions to ensure his safety,
    plaintiff alleges that the doctors were
    deliberately indifferent to Matt’s
    serious medical need.
    This situation is undeniably tragic. Yet
    "a complaint that a physician has been
    negligent in diagnosing or treating a
    medical condition does not state a valid
    claim of medical mistreatment under the
    Eighth Amendment." Estelle v. Gamble, 
    429 U.S. 97
    , 106, 
    97 S. Ct. 285
    , 
    50 L. Ed. 2d 251
    (1976). To avoid dismissal, Mrs.
    Sanville must plead sufficient facts to
    demonstrate that a fact-finder could
    infer deliberate indifference from the
    doctors’ treatment decisions.
    "[D]eliberate indifference may be
    inferred . . . when the medical
    professional’s decision is such a
    substantial departure from accepted
    professional judgment, practice, or
    standards as to demonstrate that the
    person responsible did not base the
    decision on such a judgment." 
    Pardue, 94 F.3d at 261
    -62. We examine Mrs.
    Sanville’s claims against each of the
    doctor-defendants in turn.
    Plaintiff asserts that Dr. Cihlar,
    during the screening interview at Dodge,
    incorrectly found that Matt did not have
    a mental health illness and that he was
    not medicated with anti-psychotics. While
    Dr. Cihlar’s conclusions about Matt’s
    mental health may have been negligently
    drawn, stating that Matt did not have a
    mental illness does not establish
    deliberate indifference to Matt’s
    condition. To violate the Eighth
    Amendment the official must knowingly
    disregard a substantial risk to inmate
    health or safety, see 
    Farmer, 511 U.S. at 837
    . Not noticing that an inmate exhibits
    a serious medical need does not violate
    the Constitution because not noticing
    that a need exists is not considered
    "punishment" under relevant Supreme Court
    precedent. See 
    id. at 837-38./5
    Further, we note that his failure to
    recognize Matt’s condition did not
    prevent Matt from getting subsequent
    treatment for his mental illness.
    Mrs. Sanville accuses Dr. Pareek and Dr.
    Fleck of failing to provide treatment and
    medication to Matt even though they were
    aware of Matt’s history of mental
    illness, which was well-documented in his
    base file at WCI. She also claimed that
    they knew that Matt was incapable of
    making his own decisions regarding
    medication and that he had a history of
    asking for help and then denying any need
    for it. Dr. Pareek advised Matt to
    discontinue taking his medication--based
    upon his professional judgment that the
    medicine was causing Matt’s stomachaches-
    -and later determined that Matt was
    competent and did not need to be
    medicated. While plaintiff takes issue
    with the correctness of these decisions,
    a complaint that a physician negligently
    treated Matt’s mental illness does not
    state a valid Eighth Amendment medical
    mistreatment claim. See 
    Estelle, 429 U.S. at 107
    . Plaintiff thus asserts that
    advising Matt to stop taking his
    medication was such a substantial
    departure from accepted professional
    judgment that a jury could infer
    deliberate indifference. To determine
    whether this is the case, we ask whether
    a minimally competent doctor in Dr.
    Pareek’s shoes would have been aware of a
    substantial risk that allowing Matt to
    remain unmedicated would result in
    serious harm. See 
    Pardue, 94 F.3d at 262
    -
    63. Here, we cannot find that the risk
    was such that Dr. Pareek’s actions were
    deliberately indifferent. Matt saw Dr.
    Pareek on March 5, March 26, April 2, and
    in late June of 1998. The last of these
    dates was over a month before Matt
    committed suicide. In April, Matt stated
    that he no longer wanted medication or
    psychiatric services, and Dr. Pareek
    deferred to those wishes. At the time of
    Dr. Pareek’s June visit, Matt had been
    off his medication for three months
    (since March 5) and there is no
    indication that Matt was, at that time,
    suicidal or in danger of harming himself.
    Recognizing that "a medical professional
    must consider [an inmate’s] conflicting
    rights," Dr. Pareek seemingly determined
    that Matt’s desire to be free from
    medication outweighed his right (or need)
    to receive psychotropic drugs for his
    mental illness. See 
    Pardue, 94 F.3d at 262
    (noting that an inmate had both an
    Eighth Amendment right to be restrained
    so that he would not injure himself and a
    Fourteenth Amendment right to be free
    from restraint).
    Although we wish Dr. Pareek could have
    prevented Matt’s suicide, physicians do
    not practice with a crystal ball in hand.
    We thus conclude that plaintiff has not
    presented evidence from which a trier of
    fact could find that Dr. Pareek was
    deliberately indifferent to the
    substantial risk that Matt would commit
    suicide. See 
    Farmer, 511 U.S. at 837
    .
    Finally, we turn to Dr. Fleck. Dr. Fleck
    saw Matt two times in the days
    immediately preceding Matt’s suicide, and
    his notes indicate that he was concerned
    about Matt’s welfare. He recommended that
    Matt come in for a face-to-face visit and
    that he see Dr. Pareek to discuss the
    option of medication. Matt responded by
    stating: "I don’t need any drugs, I’m
    handling it myself." Mrs. Sanville points
    out that Matt was dangerously underweight
    at the time of Dr. Fleck’s June 27, 1998
    visit. She alleges that, by deferring to
    the opinion of a mentally ill and
    suicidal inmate, Dr. Fleck abdicated his
    professional judgment and that, at the
    least, he should have taken extra
    precautions with regard to Matt’s health
    and well-being. These claims are
    undeniably emotionally appealing. That a
    doctor would defer to the discretion of a
    mentally ill inmate may be troubling to a
    layperson, particularly when the doctor
    appeared to recognize that Matt needed to
    be medicated. And we would hope that
    additional precautions would have been
    taken if they were thought to be
    necessary. Plaintiff has not provided us
    with any reason, however, to find that
    Dr. Fleck’s choices were not made in the
    exercise of his professional judgment.
    While Mrs. Sanville would have preferred
    the doctor to be less deferential to
    Matt’s requests and more forceful in pur
    suing the option of medicating him, we
    agree with the district court that Dr.
    Fleck’s actions and medical notes counsel
    against a finding of deliberate
    indifference. Sanville, slip op. at 21.
    In sum, the evidence does not support a
    finding that the medical professionals at
    WCI were deliberately indifferent to
    Matt’s serious medical needs. He was seen
    by medical professionals eleven times
    over the five months that he was
    incarcerated and most of these visits
    took place shortly after they were
    requested. Plaintiff points to Dr.
    Flick’s failure to see Matt promptly
    after his July 27th request, yet Dr.
    Flick had already seen Matt once that
    day. There is no indication that the
    doctor was aware that Matt was suicidal
    or in serious harm at that time (if, in
    fact, Matt was suicidal at that time).
    Further, Dr. Flick did not even receive
    the request until July 28th, at which
    time he scheduled Matt for an appointment
    on July 30th. Under the circumstances,
    this delay cannot be considered
    deliberately indifferent. See Gutierrez
    v. Peters, 
    111 F.3d 1364
    , 1374 (7th Cir.
    1997) (finding no deliberate indifference
    where the inmate "repeatedly received
    treatment over [a] ten-month period and
    that at most he experienced an isolated
    occasion or two where he did not receive
    prompt treatment"); cf. 
    Reed, 178 F.3d at 855-56
    (distinguishing prior Seventh
    Circuit cases where "the totality of the
    [inmate’s] medical care" counseled
    against a finding of deliberate
    indifference, and holding that the court
    was faced with one of those instances in
    which "mistreatment for a short time
    would be evidence of a culpable state of
    mind") (quotation omitted).
    It is troubling that this young man’s
    suicide might have been prevented had he
    been taking his prescribed psychotropic
    medication. The ultimate problem seems to
    be that none of the doctors ever noted
    that Matt might be a suicide risk, an
    observation that would not have seemed
    too obscure considering his mental
    illness and history of suicide attempts.
    Yet the doctors’ failure to correctly
    diagnose and treat Matt is not, in this
    instance, evidence of anything more than
    medical malpractice. Though we find that
    plaintiff’s claims against the doctor-
    defendants were properly dismissed by the
    district court, we note that plaintiff is
    certainly free to pursue her state law
    medical malpractice claims in state
    court./6
    2. The Guards: Scaburdine, Schroeder,
    Gilgenbach, John Does Nos. 1-5/7
    Mrs. Sanville accuses several
    correctional officers at WCI of knowing
    that Matt was likely to commit suicide
    but failing to reasonably respond to this
    risk. To be liable under the Eighth
    Amendment for an inmate’s suicide, "a
    prison official must be cognizant of the
    significant likelihood that an inmate may
    imminently seek to take his own life and
    must fail to take reasonable steps to
    prevent the inmate from performing this
    act." 
    Turbin, 226 F.3d at 529
    (citations
    omitted). However, "an Eighth Amendment
    claimant need not show that a prison
    official acted or failed to act believing
    that harm actually would befall an
    inmate; it is enough that the official
    acted or failed to act despite his
    knowledge of a substantial risk of
    serious harm." 
    Farmer, 511 U.S. at 842
    .
    Whether a prison official had the
    requisite knowledge is a question of
    fact. See 
    id. If "the
    circumstances
    suggest that the defendant-official being
    sued had been exposed to information
    concerning the risk and thus ’must have
    known’ about it, then such evidence could
    be sufficient to permit a trier of fact
    to find that the defendant-official had
    actual knowledge of the risk." 
    Id. 842- 43.
    Prison officials can still show that
    they were unaware of the risk--this is a
    subjective inquiry--or that they were
    aware of the risk but that they responded
    reasonably to it, "even if the harm
    ultimately was not averted." 
    Id. at 844-
    45. Thus we ask 1) were the prison
    officials aware of the substantial risk
    that Matt might take his own life and, if
    so, 2) did they "take reasonable steps to
    prevent the inmate from performing this
    act." 
    Turbin, 226 F.3d at 529
    .
    a.   Awareness of the Substantial Risk
    Plaintiff claims that, once Matt covered
    his cell openings with toilet paper, the
    guards were aware of the substantial risk
    that Matt would commit suicide. She
    asserts that the guards already knew: 1)
    that Matt had written a last will and
    testament contemplating his imminent
    death and telling his mother how to carry
    on his affairs after he died; 2) that
    Matt told certain guards that he planned
    to commit suicide; 3) that he had
    attempted suicide in the past; 4) that he
    had a long history of mental illness; 5)
    that he was not eating and was
    dangerously thin; and 6) that his mother
    had called the prison to alert them that
    he was paranoid, suicidal, and in
    trouble.
    It seems quite possible that, under the
    facts as alleged by the plaintiff, the
    guards could have been aware of the risk
    that Matt would commit suicide.
    Particularly if Matt told them that he
    was suicidal, that alone should have been
    enough to "impute awareness of a
    substantial risk of suicide." 
    Turbin, 226 F.3d at 529
    . It is true that "strange be
    havior alone, without indications that
    that behavior has a substantial
    likelihood of taking a suicidal turn, is
    not sufficient to impute subjective
    knowledge of a high suicide risk to jail
    personnel." 
    Id. at 530.
    Thus, if the
    inmate was a normally functioning
    individual with no history of mental
    illness or suicide attempts, who had not
    recently lost nearly one-third of his
    body weight or written letters to his
    mother contemplating his death, then
    maybe papering up his cell would not be
    enough to put the guards on notice that
    something was wrong. Matt was not a
    normally functioning individual, however,
    and it would not be inconsistent with the
    alleged facts to find that he did "put
    jail officials on notice that there was a
    significant likelihood that he would
    attempt to harm himself." 
    Id. The Eighth
    Amendment does not allow officials to
    turn a blind eye to the activities of an
    inmate, particularly one who is suicidal.
    We thus find that plaintiff’s complaint
    should not have been dismissed because
    she has alleged sufficient facts that, if
    proven, would entitle her to relief
    against the WCI guards. See 
    Hall, 957 F.2d at 405
    (finding that plaintiff
    raised a genuine issue of material fact
    regarding the defendants’ knowledge of
    Howard’s suicidal tendencies); cf.
    
    Turbin, 226 F.3d at 534
    (Williams, J.,
    dissenting) ("[W]e have more than
    Novack’s strange and bizarre behavior. We
    also have evidence that jail officials
    knew that Novack was a suicide risk and
    had a possible mental illness.").
    Defendants contend that they were not
    aware of any risk that Matt would harm
    himself, and assert that plaintiff cannot
    survive the first Farmer prong. We find
    their arguments unconvincing. First,
    defendants contend that the only way the
    guards would have known many of these
    facts is if they had read Matt’s prison
    file, which they characterize as an
    unreasonable endeavor. While we do not
    need to address whether the guards should
    be familiar with the mental health
    histories of the prison’s inmates, it
    seems contrary to defendants’ assertions
    that the guards could have been aware of
    many of the facts alleged by plaintiff
    without reading Matt’s file (for example:
    that Mrs. Sanville had called the prison
    to express concern over Matt’s condition,
    and that Matt had written a last will and
    testament, lost a significant amount of
    weight, and said that he planned to
    commit suicide). Second, defendants
    allege that the fact that Matt was
    requesting food other than the nutri-loaf
    and that he had filed a complaint the
    week before his suicide indicates that
    the guards would not have thought that
    Matt was a substantial suicide risk. What
    the guards thought, however, is not an
    issue for us to resolve--it is an issue
    for a trier of fact. See 
    Farmer, 511 U.S. at 842
    . Third, the defendants criticize
    the plaintiff for doing nothing more than
    alleging facts. Yet, under the
    requirements of notice pleading, Mrs.
    Sanville does not have to prove her
    factual and legal allegations at this
    stage, she need only show that relief is
    possible. See 
    Conley, 355 U.S. at 45-46
    ;
    Bartholet v. Reishauer A.G. (Zurich), 
    953 F.2d 1073
    , 1078 (7th Cir. 1992).
    Plaintiff has certainly met this
    standard. Of course, this is not the end
    of the inquiry. During discovery, the
    parties will undoubtedly explore in
    greater detail whether the "prison
    official[s] had the requisite knowledge
    of a substantial risk" to Matt’s health.
    
    Farmer, 511 U.S. at 842
    .
    b. Whether the Defendants Took
    Reasonable Steps
    While it remains to be seen whether the
    defendants were actually aware of the
    substantial risk to Matt’s health, there
    seems to be no evidence that the
    defendants "[took] reasonable steps to
    prevent the inmate from [committing
    suicide]" as is required by our case law.
    
    Turbin, 226 F.3d at 529
    . Matt was last
    seen alive by the defendants at 10:00
    a.m. In the five hours during which
    Matt’s cell window was covered with
    toilet paper, there was no apparent
    attempt to discern whether he was stable.
    The guards did not use the video camera
    to check on Matt, nor did anyone take any
    action until approximately 3:00 p.m. If
    the defendants were aware of the alleged
    risk, failing to determine what was going
    on in Matt’s cell could easily be
    considered egregious enough to rise to
    the level of deliberate indifference. The
    evidence here clearly supports an
    inference that at least some of the
    guards, if not all of them, were aware of
    Matt’s serious medical need and
    demonstrated deliberate indifference to
    that need.
    There are a number of reasons why
    defendants assert that the guards cannot
    be found liable, none of which we find
    meritorious. Contrary to defendants’
    allegations, the fact that we have
    already found that the doctors cannot be
    held liable does not erect a legal bar
    that prevents anyone else in the prison
    from being held liable. See 
    Estelle, 429 U.S. at 107
    -08 (finding that the claims
    against the doctor defendants amounted,
    at most, to medical malpractice, but
    remanded to the Court of Appeals for
    consideration of "whether a cause of
    action has been stated against the other
    prison officials" including the prison
    warden). Defendants further assert that
    the guards cannot be held liable because
    they relied upon the doctors’
    determination that Matt was not a suicide
    risk. The record, however, at least as
    currently developed, does not support
    this assertion. There is no evidence
    indicating that any of the doctors
    actually determined that Matt was not
    suicidal, much less that they then
    informed the guards that Matt was not
    suicidal and that the guards then decided
    not to act based on that information. Our
    review is intended to determine whether
    the plaintiff could prevail under any set
    of facts, not whether the defendant could
    win under any set of facts. Likewise, the
    fact that Matt was seen by mental health
    professionals eleven times during his
    incarceration does not prevent us from
    finding that someone--whether a guard or
    a warden or otherwise--was deliberately
    indifferent to his serious medical needs.
    The guards’ liability is not premised
    upon the acts or omissions of the medical
    professionals, it is premised upon their
    own deliberate indifference to Matt’s
    condition.
    We will thus consider, subsequently,
    whether this was a clearly established
    law at the time of defendants’ actions to
    determine whether this claim should be
    reinstated. We first turn to consider
    plaintiff’s claims against the final
    group of defendants--the wardens.
    3. The Wardens: Warden Gary McCaughtry,
    Deputy Warden Jane Gamble
    Mrs. Sanville alleges that the wardens
    failed to adopt and enforce adequate
    suicide prevention policies and that they
    also failed to train and supervise the
    guards and doctors./8 Because we have
    already determined that plaintiff’s
    official capacity claims against
    McCaughtry and Gamble should have been
    dismissed, we need only consider the
    claims against the wardens in their
    individual capacities. The plaintiff
    faces a substantial challenge because
    failure to train claims are usually
    maintained against municipalities, not
    against individuals, see, e.g., Williams
    v. Heavener, 
    217 F.3d 529
    , 532 (7th Cir.
    2000); Kitzman-Kelley v. Warner, 
    203 F.3d 454
    , 459 (7th Cir. 2000), and, in the
    Eighth Amendment context, such claims may
    only be maintained against a
    municipality. See 
    Farmer, 511 U.S. at 841
    (noting that the standard applied in City
    of Canton v. Harris, 
    489 U.S. 378
    , 109 S.
    Ct. 1197, 
    103 L. Ed. 2d 412
    (1989), was
    not "an appropriate test for determining
    the liability of prison officials under
    the Eighth Amendment as interpreted in
    our cases").
    The doctrine of respondeat superior does
    not apply to sec. 1983 actions; thus to
    be held individually liable, a defendant
    must be "personally responsible for the
    deprivation of a constitutional right."
    
    Chavez, 251 F.3d at 651
    (quotation
    omitted); see also 
    Wolf-Lillie, 699 F.2d at 869
    ("Section 1983 creates a cause of
    action based upon personal liability and
    predicated upon fault."). A defendant
    "will be deemed to have sufficient
    personal responsibility if he directed
    the conduct causing the constitutional
    violation, or if it occurred with his
    knowledge or consent." 
    Chavez, 251 F.3d at 652
    . This definition recognizes that
    the individual does not have to have
    participated directly in the deprivation.
    See McPhaul v. Board of Comm’rs of
    Madison Co., 
    226 F.3d 558
    , 566 (7th Cir.
    2000) (quotation omitted). Thus, a
    supervisor may be liable for "deliberate,
    reckless indifference" to the misconduct
    of subordinates. See 
    Chavez, 251 F.3d at 651
    . ("The supervisors must know about
    the conduct and facilitate it, approve
    it, condone it, or turn a blind eye for
    fear of what they might see.")
    (quotations omitted).
    Mrs. Sanville accuses defendants of
    tolerating a number of transgressions
    which she contends rose to the level of
    systematic failure: 1) on four separate
    occasions, three guards ignored the paper
    on Matt’s cell; 2) the camera in his cell
    was not active the entire three weeks he
    was in segregation; 3) Matt lost nearly
    one-third of his body weight while in
    segregation; and 4) the guards allegedly
    received no suicide prevention training.
    None of these allegations, however,
    suggest that the wardens were personally
    responsible for any deprivation. Nor does
    plaintiff allege that they "turned a
    blind eye" to any particular conduct of
    the remaining defendants. We thus agree
    with the district court that plaintiff
    has alleged no facts that would support a
    finding of liability with respect to the
    wardens.
    C. Was the Right Clearly Established at
    the Time of the Violation?
    We must now consider whether the guards
    may be held liable under sec. 1983, or
    whether they are entitled to qualified
    immunity. We have recently set forth the
    framework for making this determination:
    Qualified immunity protects government
    officials from individual liability under
    Section 1983 for actions taken while
    performing discretionary functions,
    unless their conduct violates clearly
    established statutory or constitutional
    rights of which a reasonable person would
    have known. Thus, before liability will
    attach, the contours of the right must be
    sufficiently clear that a reasonable
    official would understand that what he is
    doing violates that right.
    Brokaw v. Mercer County, 
    235 F.3d 1000
    ,
    1022 (7th Cir. 2000) (internal quotation
    and citations omitted). There can be
    little debate that it was clearly
    established, long before 1998, "that
    prison officials will be liable under
    Section 1983 for a pretrial detainee’s
    suicide if they were deliberately
    indifferent to a substantial suicide
    risk." 
    Hall, 957 F.2d at 406
    . Further,
    "[i]t was clearly established in 1986
    that police officers could not be
    deliberately indifferent to a detainee
    who is in need of medical attention
    because of a mental illness or who is a
    substantial suicide risk. Deliberate
    indifference to a prisoner’s medical
    needs constitutes cruel and unusual
    punishment in violation of the Eighth
    Amendment." 
    Id. at 404-05.
    Thus, we find
    that the guards are not immune from
    individual liability in this case./9
    III. Conclusion
    In light of the foregoing analysis, we
    AFFIRM the district court’s dismissal of
    Mrs. Sanville’s Eighth Amendment claims
    against the doctor-defendants and the
    wardens, and REVERSE the district court’s
    dismissal of her claims against the
    guards.
    FOOTNOTES
    /1 For the sake of clarity, we will refer to Matt
    Sanville as "Matt," and to Martha Sanville as
    "Mrs. Sanville."
    /2 He wrote a letter to his mom, dated July 23,
    1998, stating: "the guards are trying to feed me
    gag loaf (nasty)--I can’t eat it."
    /3 We take judicial notice of the fact that both
    these entities are state prisons: the Waupun
    Correctional Institution is a state penitentiary
    and the Dodge Correctional Institution is the
    correctional treatment center at Waupun. See Wis.
    Stat. sec. 302.01.
    /4 Plaintiff’s complaint also challenged the actions
    of Narinder Saini, Ph.D., and Gary Ankarlo, Ph.D.
    On appeal, plaintiff did not present analysis
    with respect to these doctors, thus we do not
    address them here.
    /5 The Supreme Court has rejected the argument that,
    under the subjective test for deliberate indif-
    ference, "prison officials will be free to ignore
    obvious dangers to inmates." 
    Farmer, 511 U.S. at 842
    . However, even if a risk is obvious--i.e.,
    even if it was well- documented in Matt’s file
    that he had a mental illness that, if left
    untreated, would pose substantial risk to his
    health--the prison official is not liable under
    the Eighth Amendment if "the obvious escaped
    him." 
    Id. at 843
    n.8
    /6 The district court’s denial to exercise supple-
    mental jurisdiction over these claims is still
    appropriate given the disposition of those claims
    here.
    /7 Plaintiff’s complaint also challenged the actions
    of Curtis Bender and Jodine Deppisch. On appeal,
    plaintiff did not present analysis with respect
    to these defendants, thus we do not address them
    here.
    /8 The defendants contend that these allegations
    were not in plaintiff’s district court complaint.
    We found otherwise: both were included in Count
    I (alleging violations of Matt’s Eighth Amendment
    rights), paragraph 139.
    /9 The district court relied upon State Bank of St.
    Charles v. Camic, 
    712 F.2d 1140
    (7th Cir. 1983),
    to support its conclusion that the defendants
    were entitled to qualified immunity. See Sanville
    v. McCaughtry, No. 99-C-715, slip op. at 14 (W.D.
    Wis. June 28, 2000). Camic did not address quali-
    fied immunity; rather, that case found that the
    district court’s grant of summary judgment was
    proper because the plaintiff did not raise "a
    question of material fact as to whether the
    defendants had knowledge of . . . suicidal ten-
    dencies on the part of [the inmate]." 
    Camic, 712 F.2d at 1146
    .
    

Document Info

Docket Number: 00-2933

Citation Numbers: 266 F.3d 724

Judges: Manion, Kanne, Evans

Filed Date: 9/21/2001

Precedential Status: Precedential

Modified Date: 11/4/2024

Authorities (25)

bruce-and-sharon-billings-the-parents-of-a-minor-child-bb-v-madison , 259 F.3d 807 ( 2001 )

City of Canton v. Harris , 109 S. Ct. 1197 ( 1989 )

C.A. Brokaw v. Mercer County, James Brokaw, Weir Brokaw , 235 F.3d 1000 ( 2000 )

Jewel Marshall-Mosby v. Corporate Receivables, Inc., and ... , 205 F.3d 323 ( 2000 )

Estelle v. Gamble , 97 S. Ct. 285 ( 1976 )

Farmer v. Brennan , 114 S. Ct. 1970 ( 1994 )

Arlene C. Wolf-Lillie v. Gerald M. Sonquist, Kenosha County ... , 699 F.2d 864 ( 1983 )

Hugh Joseph, Administrator of the Estate of Mark Joseph, A/... , 739 F.2d 1244 ( 1984 )

John S. Graehling v. Village of Lombard, Illinois, and ... , 58 F.3d 295 ( 1995 )

Emil J. Bartholet v. Reishauer A.G. (Zurich) and Reishauer ... , 953 F.2d 1073 ( 1992 )

Ralphfield Hudson v. Irwin M. McHugh Director, Michael Lew ... , 148 F.3d 859 ( 1998 )

Orrin S. Reed v. Daniel McBride , 178 F.3d 849 ( 1999 )

state-bank-of-st-charles-as-administrator-of-the-estate-of-christopher-a , 712 F.2d 1140 ( 1983 )

Douglas Power v. Phillip M. Summers , 226 F.3d 815 ( 2000 )

della-hall-as-guardian-of-the-estate-and-person-of-clifford-r-howard-jr , 957 F.2d 402 ( 1992 )

peso-chavez-and-gregory-lee-individually-and-on-behalf-of-all-persons , 251 F.3d 612 ( 2001 )

Cynthia Williams v. Lindsey Heavener , 217 F.3d 529 ( 2000 )

cheryl-k-mcphaul-v-board-of-commissioners-of-madison-county-indiana , 226 F.3d 558 ( 2000 )

carlos-m-gutierrez-v-howard-a-peters-iii-director-illinois-department , 111 F.3d 1364 ( 1997 )

Conley v. Gibson , 78 S. Ct. 99 ( 1957 )

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