Jimmy Dale Miller v. Jeanne Campanella

In the
United States Court of Appeals
For the Seventh Circuit
____________________
No. 14-1990
JIMMY DALE M ILLER ,
Plaintiff-Appellant,
v.
JEANNE C AMPANELLA, et al.,
Defendants-Appellees.
____________________
Appeal from the United States District Court
for the Southern District of Illinois.
No. 3:11-cv-00436-MJR-SCW — Michael J. Reagan, Chief Judge.
____________________
S UBMITTED JUNE 18, 2015 — DECIDED J ULY 27, 2015
____________________
Before POSNER , M ANION , and WILLIAMS, Circuit Judges.
POSNER , Circuit Judge. Before us is an appeal by an inmate
at Lawrence Correctional Center (an Illinois state prison)
named Miller who has sued medical and administrative per-
sonnel at the prison under 42 U.S.C. § 1983, claiming that
they were deliberately indifferent to his gastroesophageal
reflux disease (GERD), which can cause severe heartburn.
Serious forms of the disease are commonly treated with a
drug called ranitidine, which is commonly sold under the

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2 No. 14-1990
trade name “Zantac.” (In the district court Miller also com-
plained that prison personnel were deliberately indifferent
to a skin infection that he has, but he doesn’t pursue the is-
sue in his appeal.) The district court granted summary
judgment in favor of the defendants.
When Miller arrived at the prison in November 2010 (a
transferee from a different Illinois prison), he had been tak-
ing Zantac for his GERD, but his prescription had expired.
At his intake screening on the day of his arrival he told the
screener that he suffers from GERD and that he takes a pre-
scription medication for it. Shortly afterward, at an orienta-
tion program for new inmates, he told the director of nurs-
ing that he wanted his prescription for Zantac renewed. Ac-
cording to Miller, she did nothing. A month later he saw an-
other nurse, who scheduled him to see a doctor the follow-
ing day, but the appointment was cancelled because the
prison was on lockdown, during which prisoners are permit-
ted to see doctors only in emergencies. It was four weeks be-
fore he was seen by one. A guard whom he told that he
needed to see a doctor replied that he should file a griev-
ance, which he did. Though he marked it “emergency,” the
warden, who reviewed the grievance, determined that it was
not an emergency, which meant that it would be resolved
through the normal grievance procedure and therefore Mil-
ler could not see a doctor until the lockdown ended. The
warden is not a doctor, and so far as appears did not consult
a doctor before deciding there was no emergency.
It was two months after Miller’s arrival at the prison be-
fore he was allowed to see a doctor. During that period he
complained repeatedly to the nursing staff about his GERD
symptoms, but to no avail. On one occasion during this peri-

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No. 14-1990 3
od, upon vomiting stomach acid he pressed the emergency
button in his cell and a guard responded and told Miller
“you are not bleeding, you are not dead, you are talking to
me, so it can’t be an emergency.” Later that morning he was
able to tell a nurse about his vomiting; her response was that
she would check his chart. Nothing came of that. When at
last he was seen by the doctor, the doctor renewed his pre-
scription for Zantac.
The district judge ruled that the delay in renewing Mil-
ler’s prescription was one month rather than two months.
Without explanation the judge calculated the delay from the
first scheduled doctor’s appointment (on December 29, 2010)
to the time that Miller finally saw a doctor, rather than be-
ginning with Miller’s first requests for Zantac in late No-
vember. The judge’s reasoning was that Miller’s first ap-
pointment with a doctor (later cancelled because of the lock-
down) was for a month after he arrived at the prison, and he
could not expect to get his prescription renewed before he
saw the doctor. That misses an essential point. Zantac is both
an over-the-counter drug (for Zantac pills containing only 75
to 150 milligrams of ratinidine) and a prescription drug (for
300-milligram pills). QualityPrescriptionDrugs, “Zantac: Over
the Counter, or Prescription?” November 18, 2011, www.qua
lityprescriptiondrugs.com/blog/2011/11/zantac-counter-pres
cription.html (visited July 25, 2015, as were the other web-
sites cited in this opinion); MedicineNet, “Ranitidine, Zantac,”
www.medicinenet.com/ranitidine/article.htm. Because of the
severity of his condition, Miller takes the 300-milligram pill;
hence the prescription. Some types of nurse, such as nurse
practitioners, are authorized to write prescriptions, others
not; it’s unclear whether any of the prison nurses had au-
thority to give Miller 150-milligram Zantac pills, two of

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4 No. 14-1990
which equate to one 300-milligram pill. It’s true that a Dr.
James Fenoglio stated that inmates are not permitted to ob-
tain Zantac unless a doctor prescribes it. But he may not be
completely reliable. He was a defendant in another recent
suit by an inmate at Lawrence Correctional Center, and we
held that the inmate plaintiff had stated a claim against Dr.
Fenoglio for unreasonable delay in treatment. Perez v. Feno-
glio, 2015 WL 4092294, at *1–2, 4–6 (7th Cir. July 7, 2015).
And in any event why, merely because a prison is on lock-
down, can’t a prisoner see a doctor except in an emergency?
That has not been explained.
GERD can, and so far as appears in the case of Miller
does, produce persistent, agonizing pain and discomfort. It
can also produce “serious complications. Esophagitis can oc-
cur as a result of too much stomach acid in the esophagus.
Esophagitis may cause esophageal bleeding or ulcers. In ad-
dition, a narrowing or stricture of the esophagus may occur
from chronic scarring. Some people develop a condition
known as Barrett’s esophagus. This condition can increase
the risk of esophageal cancer.” WebMD, Heartburn/GERD
Health Center, “What Are the Complications of Long-Term
GERD?” www.webmd.com/heartburn-gerd/guide/reflux-dis
ease-gerd-1?page=4. The judge said in his opinion that one
month “is a short amount of time [elsewhere he calls it a
‘short delay’] to be treated for heartburn/GERD,” but he
gave no reason for that medical speculation.
The plaintiff claims that the pain he experienced from his
GERD was “so intense that he was not able to sleep at night.
[He] felt like his insides were being pushed out, and this
pain was constant.” He may be exaggerating, but that is a
matter for resolution at a trial. Leaving a serious case of

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No. 14-1990 5
GERD untreated for two months is a dereliction of medical
duty, cf. Jett v. Penner, 439 F.3d 1091, 1097–98 (9th Cir. 2006),
and given the extreme simplicity of treatment—supplying
the sufferer daily with a few pills of an over-the-counter
drug—a jury would not be irrational to conclude that the de-
fendants (or at least some of them) knew that the plaintiff
had a very unpleasant, potentially dangerous, yet readily
treatable disease, yet they had done nothing for two months
because they were indifferent to the plaintiff’s condition
(“you are not bleeding, you are not dead, you are talking to
me, so it can’t be an emergency”). A prison officer is deliber-
ately indifferent if he “knows of and disregards an excessive
risk to inmate health,” Williams v. O’Leary, 55 F.3d 320, 324
(7th Cir. 1995), quoting Farmer v. Brennan, 511 U.S. 825, 837
(1994).
We recently had occasion to note that “where an inmate
alleges an objectively serious medical condition, it may be
better to appoint counsel—so that he or she can investigate
and flesh out any claim that may exist—than to dismiss a po-
tentially meritorious claim and leave the prisoner in harm’s
way.” Perez v. Fenoglio, supra, at *11. We placed particular
emphasis on the case that has progressed from the pleading
stage “to discovery or trial. Taking depositions, conducting
witness examinations, applying the rules of evidence, and
making opening statements are beyond the ability of most
pro se litigants to successfully carry out. These tasks are
even more challenging in cases … where complex medical
evidence (including expert testimony) is needed to assess the
adequacy of the treatment received. District courts abuse
their discretion where they fail to consider the complexities
of advanced-stage litigation activities and whether a litigant
is capable of handling them.” Id. at *12 (citations omitted).

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6 No. 14-1990
These are points for the district court to bear in mind on re-
mand.
Summary judgment for the defendants was inappropri-
ate. The judgment must therefore be reversed and the case
remanded for further proceedings consistent with this opin-
ion. A number of the named defendants are not mentioned
in Miller’s brief, however, and the district judge will have to
decide on remand whether the claims against them have
been abandoned and if not whether those defendants should
be retained in, or dismissed from, the case.
R EVERSED AND R EMANDED.

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