Obregon, Andrew v. Lavoie, M.D., Daniel

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN
ANDREW M. OBREGON,
Plaintiff,
v.
DANIEL LAVOIE, M.D.,
Defendant.
OPINION and ORDER
25-cv-474-jdp
Plaintiff Andrew M. Obregon, proceeding without counsel, alleges that the medical
director of the Department of Corrections Bureau of Health Services, defendant Dr. Daniel
Lavoie, denied him adequate pain medication for his low back problems. Obregon brings Eighth
Amendment 	medical 	care 	and 	Wisconsin-law 	medical 	negligence 	claims. 	Obregon 	is
incarcerated at Wisconsin Resource Center, but the events at issue occurred primarily at his
former prison, Stanley Correctional Institution (SCI).
Obregon proceeds without prepaying the filing fee, so I must screen the complaint under
28 U.S.C. § 1915(e)(2)(B) and dismiss any part of it that is frivolous or malicious, fails to state
a claim for which I could grant relief, or seeks money damages from an immune defendant. I
must accept Obregon’s allegations as true and construe them generously, holding the complaint
to a less stringent standard than one a lawyer drafts. Arnett v. Webster, 658 F.3d 742, 751 (7th
Cir. 2011). I will dismiss the complaint for failure to state a plausible claim for relief, but I will
allow Obregon to amend the complaint to fix this problem.
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ALLEGATIONS OF FACT
Obregon’s low back problems include severe degenerative disc disease and disc extrusion
at the L5/S1 level. Obregon’s low back problems cause him serious pain, make it hard for him
to do daily activities, and interfere with his sleep.
The Bureau of Health Services (BHS) requires Class III Committee approval before a
prisoner may be prescribed Lyrica (pregabalin), a non-formulary medication. At some point,
nurse practitioner Gruber recommended Lyrica for Obregon’s low back pain, but the Class III
Committee apparently denied the recommendation.
Gruber also emailed Lavoie about her recommendation for Lyrica, but Lavoie wanted
to try Obregon on a different medication. Obregon had already tried that medication. Gruber
saw Obregon multiple times and told him that Lavoie had denied all her requests.
In August 2024, Lavoie denied Obregon back surgery “regardless of the experts at
Gunderson in La Crosse.” Dkt. 1 at 5. 	Obregon had to wait more than two years to see a
“prison doctor.” Id. at 7.
ANALYSIS
A. Eighth Amendment medical care claim
The Eighth Amendment prohibits prison officials from consciously disregarding the
serious medical needs of prisoners. Estelle v. Gamble, 429 U.S. 97, 104 (1976). To state a
medical care claim, Obregon must plausibly allege that he had an objectively serious medical
condition that Lavoie consciously disregarded. See Cesal v. Moats, 851 F.3d 714, 721 (7th Cir.
2017). Obregon’s allegations of serious back pain related to severe degenerative disc disease
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and disc extrusion plausibly suggest a serious medical need for adequate pain medication. The
issue is whether Obregon has plausibly alleged that Lavoie consciously disregarded this need.
Conscious disregard requires that Lavoie is subjectively aware of that need. See id. That
means that Lavoie knew of facts from which the inference could be drawn that a substantial
risk of serious harm existed, and he actually drew that inference. Farmer v. Brennan, 511 U.S.
825, 837 (1994). Conscious disregard involves intentional or reckless conduct, not mere
negligence. Berry v. Peterman, 604 F.3d 435, 440 (7th Cir. 2010).
The 	Eighth 	Amendment 	entitles 	prisoners 	to 	“adequate 	medical 	care,” 	that 	is,
“reasonable measures to meet a substantial risk of serious harm.” See Johnson v. Doughty,
433 F.3d 1001, 1013 (7th Cir. 2006). The Eighth Amendment doesn’t require “specific care”
or “the best care possible.” Id.; Forbes v. Edgar, 112 F.3d 262, 267 (7th Cir. 1997). Disagreement
between Obregon and Lavoie, or among medical professionals, about the proper course of
treatment isn’t enough to show conscious disregard. Pyles v. Fahim, 771 F.3d 403, 409 (7th
Cir. 2014); Snipes v. DeTella, 95 F.3d 586, 591 (7th Cir. 1996).
Ignoring a prisoner’s request for medical assistance outright can be enough to show
conscious disregard of medical needs. Petties v. Carter, 836 F.3d 722, 729 (7th Cir. 2016)
(en banc). If a medical professional has provided some care for a prisoner’s condition, he
consciously disregards the serious medical need only if his care is so inadequate that it
demonstrates an absence of professional judgment, that is, that no minimally competent
professional would have responded in that way in the circumstances. See Stewart v. Wexford
Health 	Sources, 	Inc., 	14 	F.4th 	757, 	763 	(7th 	Cir. 2021); 	Collignon 	v. Milwaukee 	Cnty.,
163 F.3d 982, 989 (7th Cir. 1998). The key question is whether the medical professional based
his treatment decision on his medical judgment. See Dean v. Wexford Health Sources, Inc.,
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18 F.4th 214, 241 (7th Cir. 2021). Obregon must also allege that Lavoie’s medical care, or lack
of it, actually injured him. See Lord v. Beahm, 952 F.3d 902, 905 (7th Cir. 2020).
Obregon faults Lavoie for declining to prescribe him Lyrica in accordance with Gruber’s
recommendation. But Lavoie’s disagreement with Gruber’s recommendation does not suggest
conscious disregard. Obregon alleges that Lavoie wanted to try him on a different medication
that he had already tried. Even if Lavoie knew that Obregon had already tried the medication,
Obregon hasn’t alleged facts that plausibly suggest that Lavoie thought that the medication
would be ineffective. See Obregon v. Filipescu, 23-cv-681-jdp, Dkt. 86 at 8 (a doctor’s decision
to order treatment already provided does not show conscious disregard if decision is based on
medical judgment).
Along similar lines, Obregon faults Lavoie based on the Class III Committee’s apparent
denial of Gruber’s recommendation for Lyrica. But, even if Lavoie was responsible for that
decision, Lavoie’s disagreement with Gruber’s recommendation alone doesn’t plausibly suggest
conscious disregard.
More broadly, Obregon faults the BHS, which Lavoie heads, for requiring Class III
Committee approval of a provider’s recommendation for a non-formulary medication, in this
case Lyrica. But requiring such approval, whether by the Class III Committee or a high-ranking
medical official, does not deny a prisoner medical care. See, e.g., Cooper v. Dombeck, 23-cv-771-
jdp, Dkt. 72 at 3 (noting that the associate medical director approved a doctor’s request for a
non-formulary medication). Obregon has not explained how giving the Class III Committee or
high-ranking medical officials authority to reject lower-ranking providers’ recommendations
denied him necessary pain medication; he alleges only general disagreement with the policy.
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Obregon also alleges that Gruber told him that Lavoie had denied all her requests. But
without more information about these requests or how their denial harmed Obregon, I cannot
plausibly infer that Lavoie consciously disregarded his need for adequate pain medication.
Obregon faults Lavoie for denying an outside specialist’s recommendation for surgery.
But a prison doctor doesn’t always have to follow the recommendation of a specialist. See Wilson
v. Adams, 901 F.3d 816, 822 (7th Cir. 2018). Obregon hasn’t alleged any facts plausibly
suggesting that Lavoie denied the specialist’s recommendation for a non-medical reason.
See Mitchell v. Kallas, 895 F.3d 492, 498 (7th Cir. 2018).
Obregon alleges that he had to wait more than two years to see a prison doctor. This
allegation doesn’t state a plausible medical care claim because Obregon hasn’t identified which
SCI official caused this delay or explained how the delay harmed him. See Colbert v. City of
Chicago, 851 F.3d 649, 657 (7th Cir. 2017) (“Individual liability under [42 U.S.C.] § 1983 . . .
requires personal involvement in the alleged constitutional deprivation.” (alteration adopted)).
I will not allow Obregon to proceed on his federal medical care claim.
B. Medical negligence
Without a federal claim, the court would not have jurisdiction over Obregon’s state-law
claim on the basis of diversity because he is a Wisconsin citizen and he hasn’t alleged any facts
suggesting that Lavoie is a citizen of another state. See Dkt. 1 at 2.
When all federal claims have been dismissed, the general practice in federal court is to
decline to exercise supplemental jurisdiction over the related state-law claims. See Wright v.
Associated Ins. Companies Inc., 29 F.3d 1244, 1251 (7th Cir. 1994). I’ll follow that practice here
and relinquish jurisdiction over Obregon’s medical negligence claim without evaluating its
merits. Obregon may replead this claim in the amended complaint.
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CONCLUSION
I will allow Obregon to amend the complaint to fix the above pleading problems. In
drafting his amended complaint, Obregon should remember to:
• 	Carefully consider whether he is naming proper defendants and omit defendants
who did not personally participate in or cause a violation of his rights. Obregon
must take care to allege what each defendant did, or failed to do, to violate his
rights.
• 	Avoid referring to several defendants together. For instance, if more than one
defendant has taken a particular action that Obregon believes supports a claim,
he should identify each defendant who took that action.
• 	Identify by full name all the individuals whom he wishes to sue in the amended
complaint’s caption.
ORDER
IT IS ORDERED that:
1. 	Plaintiff Andrew M. Obregon’s complaint, Dkt. 1, is DISMISSED for failure to state
a plausible claim for relief.
2. 	Plaintiff may have until April 29, 2026, to submit an amended complaint that fixes
the problems identified in this order.
3. 	Plaintiff must file his amended complaint on the court’s prisoner complaint form,
which the court will send him with this order. Plaintiff must fill out the form
completely. If plaintiff requires any additional space to allege his claims, he may
submit no more than five supplemental pages. Any text on the form or a
supplemental page must be large enough and have enough spacing between lines
and in the margins for the court to read it easily.
4. 	If plaintiff fails to comply with this order, I may dismiss this case.
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5. 	Plaintiff must inform the court of any new address. If he fails to do this and
defendant or the court cannot locate him, this case may be dismissed.
6. 	Plaintiff should keep a copy of all documents for his own files. If he is unable to use
a photocopy machine, he may send out identical handwritten or typed copies of his
documents.
7. 	The clerk of court is directed to send plaintiff a copy of the court’s prisoner
complaint form.
Entered March 30, 2026.
BY THE COURT:
/s/
________________________________________
JAMES D. PETERSON
District Judge
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