Garcia v. Wexford Health Sources, Inc. et al

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ILLINOIS
OCTAVIO GARCIA, 	)
)
Plaintiff, 	)
)
vs. 	) 	Case No. 24-cv-2258-DWD
)
WEXFORD HEALTH SOURCES, INC., 	)
NURSE PRACTITIONER DESAI, 	)
CHRISTINE BROWN, 	)
)
Defendant. 	)
MEMORANDUM AND ORDER
DUGAN, District Judge:
Plaintiff Octavio Garcia, an inmate of Illinois Department of Corrections (IDOC)
brought this action pursuant to 42 U.S.C. § 1983 for alleged deprivations of his
constitutional rights. 	Specifically, he alleged that the Defendants delayed his access to
care for eye issues, ultimately resulting in blindness in his left eye. Defendants Wexford
and Desai seek summary judgment on the issue of exhaustion in one Motion (Doc. 26),
and Defendant Brown seeks summary judgment on exhaustion in a separate Motion
(Doc. 28). Plaintiff responded (Doc. 30), and Defendants filed reply briefs (Docs. 31, 32).
For reasons explained in this Order, the Motions are denied.
B ACKGROUND
Plaintiff alleged in the complaint that began to seek care on October 1, 2022,
because he was experiencing blurry/clouded vision in his left eye. 	(Doc. 1 at ¶ 5).
Plaintiff alleges this request, and a second request on October 16, 2022, were both
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reviewed by Defendant Brown who was the Healthcare Unit Manager. 	(Id. at ¶¶ 6-8).
Plaintiff alleges Brown knew he had symptoms of a detached retina, and both Brown and
Wexford knew that a detached retina required immediate attention. 	(Id. at ¶¶ 9-10).
However, the Wexford written policies did not set forth a triage protocol for these specific
symptoms. (Id. at ¶ 11). Plaintiff alleges that due to Brown’s own deliberate indifference,
and Wexford’s lack of a policy, he was not promptly examined. (Id. at ¶¶ 12-13).
Instead, Plaintiff was eventually evaluated on October 18, 2022, when he described
his symptoms to a correctional officer who, in turn, brought him to the medical unit. (Id.
at ¶ 14). Defendant Desai listened to Plaintiff’s symptoms, including a loss of vision in
his left eye and the presence of floaters. In response, Desai took Plaintiff’s blood pressure
and put him on a waiting list to see the optometrist but took no other action. (Id. at ¶¶
15-16). Plaintiff alleges Desai’s actions amounted to no treatment at all and are partially
attributable to Wexford’s lack of a policy. (Id. at ¶¶ 17-18).
On October 19, 2022, Plaintiff filed a grievance describing his symptoms and his
desire for care. Plaintiff alleges he was seen by an optometrist on November 17, 2022, but
surgery to repair his retina was unsuccessful and he is now blind in his left eye. (Id. at
¶¶ 22-23). Plaintiff seeks to proceed against Desai and Brown for deliberate indifference,
against Wexford for their policy or lack thereof, and against all defendants under state
law for medical malpractice.
The parties agree that the October 19, 2022, grievance is the sole grievance relevant
to exhaustion for this case.
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F INDINGS OF F ACT
In the October 19, 2022, grievance (number 2952-10-22), Plaintiff alleged:
On 10/1/2022 I submitted a request slip to be seen by a Doctor for having
blurry/cloudy vision in my left eye. The response I received was that I was
being placed on a back log list to see the eye doctor who is only available
on Mondays. I am having floaters in my eye and at times I cannot see at all
out of my left eye. I am not sure the cause of this issue, but it poses a severe
risk to health and sight going undiagnosed by not seeing me immediately
to evaluate this issue Pinckneyville CC is showing a deliberate indifference
to my medical needs and safety. This issue may be caused by high blood
pressure, diabetes, and other serious issues which could cause me to lose
my sight or have other dangerous side effects that could be irreparable.
(Doc. 27-1 3-4). 	As relief, Plaintiff sought “to immediately be seen doctor to diagnose,
evaluate, and treat the cause of my medical issue to prevent further risk of damage to my
health.” (Doc. 27 at 3). The grievance was submitted as an emergency.
On October 19, 2024, the Warden deemed the grievance an emergency. (Doc. 27
at 3). 	However, the grievance officer did not respond until November 4, 2022, with a
simple statement, “Per HCUA: He is scheduled to see the optometrist next week.” (Doc.
27 at 2). 	The grievance was then denied by the Warden on November 4, 2022. 	On
December 	9, 	2022, 	the 	Administrative 	Review 	Board 	denied 	the 	grievance 	as
“appropriately addressed by facility administration.” (Doc. 27-2 at 1).
CONCLUSIONS OF LAW
A. Legal Standards
Summary judgment is proper if there is no genuine issue as to any material fact
and the movant is entitled to judgment as a matter of law. 	F ED. R. C IV. P. 56(a). 	In
determining a summary judgment motion, the Court views the facts in the light most
favorable to, and draws all reasonable inferences in favor of, the nonmoving party. Apex
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Digital, Inc. v. Sears, Roebuck & Co., 735 F.3d 962, 965 (7th Cir. 2013) (citation omitted).
Courts generally cannot resolve factual disputes on a motion for summary judgment. See
Tolan v. Cotton, 572 U.S. 650, 656 (2014) (“[A] judge’s function at summary judgment is
not to weigh the evidence and determine the truth of the matter but to determine whether
there is a genuine issue for trial.”) (internal quotation marks and citation omitted).
However, when the motion for summary judgment pertains to a prisoner’s failure to
exhaust administrative remedies, the Seventh Circuit has instructed courts to conduct an
evidentiary hearing and resolve contested issues of fact regarding a prisoner’s efforts to
exhaust. 	Pavey v. Conley, 544 F.3d 739, 742 (7th Cir. 2008). 1 	After hearing evidence,
finding facts, and determining credibility, the court must decide whether to allow the
claim to proceed or to dismiss it for failure to exhaust. Wilborn v. Ealey, 881 F.3d 998, 1004
(7th Cir. 2018). The court is not required to conduct an evidentiary hearing if there is no
genuine dispute of material fact, and the determination is purely legal. See e.g., Walker v.
Harris, 2021 WL 3287832 * 1 (S.D. Ill 2021); Miller v. Wexford Health Source, Inc., 2017 WL
951399 *2 (S.D. Ill. 2017).
The Prison Litigation Reform Act (PLRA) provides that a prisoner may not bring
a lawsuit about prison conditions unless and until he has exhausted all available
administrative remedies. 42 U.S.C. § 1997e(a); Pavey, 544 F.3d at 740. “The exhaustion
requirement is an affirmative defense, which the defendants bear the burden of proving.”
1 The Supreme Court’s recent opinion in Perttu v. Richards, 605 U.S. 460 (2025), held that if the facts necessary
for a ruling on exhaustion are intertwined with the merits of the claim, a jury trial is required. But the
Perttu Court did not go so far as to extend the Seventh Amendment right to a jury trial to all exhaustion
disputes. In this case, there is no intertwinement of the facts, so Perttu does not require that this issue be
determined at a jury trial.
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Pavey v. Conley, 663 F.3d 899, 903 (7th Cir. 2011). For a prisoner to properly exhaust his
administrative remedies, the prisoner must “file complaints and appeals in the place, and
at the time, the prison’s administrative rules require.” Pozo v. McCaughtry, 286 F.3d 1022,
1025 (7th Cir. 2002). 	“[A] prisoner who does not properly take each step within the
administrative process has failed to exhaust state remedies.” Id. at 1024.
As an inmate in the IDOC, Plaintiff was required to follow the grievance process
outlined in the Illinois Administrative Code. 20 I LL. A DMIN . C ODE § 504.800, et seq. (2017).
The regulations first require an inmate to file his grievance with his counselor within 60
days of the discovery of an incident, occurrence, or problem that gave rise to the
grievance. 	20 I LL. A DMIN . C ODE § 504.810(a). 	Administrative regulations require the
grievance “contain factual details regarding each aspect of the offender’s complaint,
including what happened, when, where, and the name of each person who is the subject
of or who is otherwise involved in the complaint.” 20 I LL. A DMIN . C ODE § 504.810(c). If
the names of the individuals are unknown to the offender, he can still file the grievance
but “must include as much descriptive information about the individual as possible.” Id.
Further, the Seventh Circuit has held that an inmate is required to provide enough
information to serve a grievance’s function of giving “prison officials a fair opportunity
to address [an inmate’s] complaints.” Maddox v. Love, 655 F.3d 709, 722 (7th Cir. 2011).
If the complaint is not resolved through the counselor, the grievance may be
submitted to a grievance officer, who reports his or her findings and recommendations
in writing to the Chief Administrative Officer (CAO). 20 I LL. A DMIN. C ODE § 504.830(e).
The CAO then provides the inmate with a written decision on the grievance. Id.
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If the inmate is not satisfied with the CAO’s response, he can file an appeal with
the IDOC Director through the Administrative Review Board (ARB). 20 I LL. A DMIN . C ODE
§ 504.850(a). The ARB must receive the appeal within 30 days of the date of the CAO’s
decision. Id. The inmate must attach copies of the responses from the grievance officer
and CAO to his appeal. 	Id. 	The ARB submits a written report of its findings and
recommendations to the Director, who them makes a final determination. 20 I LL. A DMIN .
C ODE § 504.850(d), (e).
B. 	Analysis
The Court finds that the Motion for Summary Judgment can be resolved on paper
without a Pavey hearing. The parties agree that grievance 2952-10-22 is the only grievance
relevant for exhaustion. 	Defendants all argue that the grievance is not sufficient to
exhaust the claims against them because it does not name them, describe them, or
describe their individual conduct with particularity. Defendants Desai and Wexford do
not cite any caselaw in the argument section of their brief to support the proposition that
the grievance is insufficient to exhaust against them. Instead, they argue on the plain text
that the grievance says nothing explicit about the appointment with Desai or a Wexford
policy. They argue that Plaintiff’s complaints that “Pinckneyville C.C.” is responsible for
his issues are far too generic. Defendant Brown cites Roberts v. Neal, 745 F.3d 232, 235-36
(7th Cir. 2014) for the proposition that failing to name or describe an individual is
insufficient to exhaust a claim against that party. 	Defendant Brown also argues that
because the complaint described a grievance filed about Desai’s conduct, then the
grievance cannot possibly be meant to exhaust any claim against Brown. (Doc. 28 at page
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7, citing Doc. 1 at ¶ 19). In response, Plaintiff argues that he had no obligation to exhaust
after he received the relief he wanted, his grievance was sufficient to exhaust the claims
despite 	not 	naming 	the 	defendants 	individually, 	and 	the 	exhaustion 	process 	is
unavailable for medical issues in IDOC because the ARB perpetually defers to medical
discretion.
The Court will begin with relevant caselaw on the amount of detail required in a
grievance for proper exhaustion, and then it will turn to the alternative arguments about
Plaintiff not needing to exhaust after he got relief or the unavailability. In the Roberts v.
Neal case, an inmate’s grievance was found insufficient to exhaust a claim against a
Pinckneyville prison intake nurse. 745 F.3d at 235-36. The grievance explicitly stated that
it was challenging a documented issued by a Pinckneyville doctor named Obadina, but
it then went on to say a Big Muddy River doctor had guaranteed certain treatment for a
broken hand, and that when reviewing records, the intake nurse did not see anything.
The 	Roberts 	Court 	surmised 	that 	the grievance 	might 	be 	complaining 	about 	the
Pinckneyville doctor or the Big Muddy doctor, but that it could not be construed as taking
issue with the Pinckneyville intake nurse because she was not a doctor and was not
involved with the document. Id.
Unlike the grievance in Roberts that pointed to other specific and identifiable
actors, Plaintiff’s grievance in this case did not name any individual provider. 	The
grievance described Plaintiff’s effort from October 1, 2022-October 19, 2022, to secure care
for vision problems that were deteriorating, and it faulted the prison at large for failing
to ensure an appointment with a doctor. 	This could reasonably be understood by the
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prison grievance personnel to mean that Plaintiff was complaining about anyone or
anything that hindered his access to timely care.
In Glick v. Walker, 385 Fed. App’x 579, 582 (7th Cir. 2010), the Seventh Circuit
adopted the Supreme Court’s rationale from Jones v. Bock, 549 U.S. 199, 219 (2007) 2 , that
the primary purpose of the exhaustion requirement is to notify the prison of a problem
and not to notify individual defendants. In Glick the inmate filed grievances about access
to mental health care and exposure to secondhand smoke that impacted his existing
cardiac conditions. 	The grievances did not name individual prison personnel but it
clearly described two issues that the inmate desired to resolve. In his lawsuit, the inmate
faulted a smattering of prison personnel such as the warden, grievance personnel, a
healthcare administrator, and an internal affairs officer. The Court noted that when the
inmate filed a grievance he articulated facts the prison could reasonably expect from a
person in his position. 	They noted “[a]t the source of the decisions in question was a
mystifying web of rules and procedures, and behind those an army of administrators; it
would be unreasonable to expect that, for every set of facts, an inmate will be able to peel
back layers of bureaucracy and match a disputed decision with the prison employee
responsible for that decision.” 	Glick, 385 Fed. App’x at 582. 	The Court noted, it was
possible that at the time the inmate filed the grievance, he did not even know who was
responsible for the security classification that prevented his access to mental health
2 “[N]othing in the [PLRA] imposes a ‘name all defendants’ requirement along the lines of the Sixth
Circuit’s judicially created rule.” Jones, 549 U.S. at 217. “The Sixth Circuit rule may promote early notice
to those who might later be sued, but that has not been thought to be one of the leading purposes of the
exhaustion requirement.” Id. at 219. “[E]xhaustion is not per se inadequate simply because an individual
later sued was not named in the grievances.” Id.
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groups, or for the placement with a heavy smoker. 	Thus, the Glick Court emphasized
that “[g]rievances are intended to give prison administrators an opportunity to address
a shortcoming, not to put individual defendants on notice of a lawsuit.” Id. citing Jones v.
Bock, 549 U.S. at 218.
In Maddox v. Love, 655 F.3d 709 (7th Cir. 2011), the Seventh Circuit reiterated that
the failure to name individuals does not dictate a finding of failure to exhaust where the
prison system responded to the grievance at all levels on the merits, and did not reject it
for failing to identify who was at fault. The Maddox Court considered a grievance about
the cancellation of religious services for one faith that did not name particular defendants.
The inmate ended up suing two wardens and the prison chaplain. 	The Maddox Court
noted that despite not naming or describing the wardens or chaplain, the grievance
clearly notified administrators of the problem and thus served its purpose, particularly
because a warden and the chaplain were involved in responding to the grievance.
Maddox, 655 F.3d at 722.
Here, the Court finds that Plaintiff’s situation is more akin to Glick and Maddox
than it is to Roberts. 	Plaintiff’s grievance clearly and unequivocally alerted prison
administrators that he was doing everything he could to seek care for problems with his
left eye, to no avail. 	Any administrator reviewing the grievance would have easily
learned that he sent request slips and that he was seen on October 18 by Desai, but that
he had not received satisfactory care. 	The prison administrators did not reject the
grievance for a procedural defect of failing to identify those involved in his requests for
care, and they instead responded on the merits that he was scheduled for a forthcoming
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appointment, and that his medical needs were appropriately addressed by the prison.
Plaintiff 	may 	not 	have 	known 	when 	he 	lodged 	the 	grievance 	that 	Healthcare
Administrator Brown was someone who fielded requests for care like his October 1 and
16 th requests, so generically saying the prison was not doing anything to ensure care, may
have been the best he could manage. Though he could have been more specific about the
fact that he saw Desai, it is also not unreasonable to assume that diligent grievance
personnel investigating his request for urgent care for his eye would come across records
about that encounter that happened the day before he filed the grievance. Thus, unlike
Roberts where a grievance was clearly directed at one subset of providers and not another,
Plaintiff’s grievance was clearly meant to notify anyone who might be in a position to
help. The grievance was sufficient to notify the prison of the issue he needed help with
so that they had a chance to respond, even if it did not identify Brown and Desai by name
or description.
Wexford attempts to dodge the Monell claim by arguing Plaintiff did not name
them and did not mention a policy claim, but it should be quite familiar with the fact that
courts generally have not required artfully pled Monell allegations at the grievance phase
to interpret a claim as exhausted. Wexford argues that Plaintiff’s generic attempt to fault
Pinckneyville C.C. could not be interpreted as applying to it, but it is reasonable to think
that as the contractor for medical services, it is included in a grievance that the prison is
not providing adequate care. 	See e.g., Morrow v. Wexford Health Sources, Inc., 2021 WL
3030329 at * 4 (S.D. Ill. July 19, 2021) (collecting cases for the proposition that grieving
activities for which Wexford was responsible or for which Wexford was involved in the
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decision making process, or generally grievance health care treatment as a whole, is
sufficient to exhaust a Monell claim against Wexford); Daval v. Zahtz, 2021 WL 2072127 at
* 8 (N.D. Ill. May 24, 2021) (finding that an inmate did not need to name Wexford or
clearly describe a policy, practice, or custom to exhaust a Monell claim); Conley v. Birch,
2012 WL 4202702 at * 5 (S.D. Ill. Sept. 19, 2012) (finding that an inmate did not need to
name Wexford or describe policies or practices to exhaust a Monell claim); Wojtaszek v.
Litherland, 2010 WL 7633990 at * 5 (S.D. Ill. Sept. 1, 2010) (noting that federal courts in
Illinois have rejected Defendant Wexford’s argument that an inmate must identify
Wexford by name in a grievance prior to bringing a suit against it, and finding that a
grievance about dental care was sufficient to exhaust a claim against Wexford). This is
especially so where Plaintiff’s grievance was focused on a course of inadequate care or
an ongoing problem, as opposed to an isolated interaction with a single provider. 	See
Morrow, 2021 WL 3030329 at *4-5 (comparing grievances about single instances with a
provider to more generic grievances about a course of care and finding the former
insufficient for Monell exhaustion and the latter sufficient). 	Here, the Court finds that
Plaintiff’s general grievance about his inability to secure expedient care for his eye issues
for nearly three weeks is sufficient to exhaust the Monell claim against Wexford.
Two other issues are worth brief mention. First, in the Reply briefs, Defendants
faulted Plaintiff for tendering additional material facts in his response that were not
adequately supported or were not relevant to the narrow issue of exhaustion. (Docs. 31,
32). Local Rule 56.1(a) states that a material fact is one that bears directly on a legal issue
raised in the motion, and one that is supported by citations to the record. 	Defendants
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take issue with a variety of statements of additional material fact, such as paragraph 3,
which describes retinal detachment by citation to a Mayo Clinic webpage. (Doc. 30 at p.
5, ¶ 3; Doc. 31; Doc. 32). Defendants are correct that this fact is not relevant to the legal
issue of exhaustion. Plaintiff also made statements of additional fact that relied purely
on citation to bare factual assertions in his Complaint, but at summary judgment this
generally is not enough support. The Court did not rely on facts that were not relevant
or were not adequately supported, so these identified defects did not impact the outcome
of the exhaustion analysis.
Second, Plaintiff urges the Court to find that Plaintiff’s duty to use the grievance
process ended when he got the relief he desired, and the grievance process was
unavailable to Plaintiff because the ARB regularly defers to decisions of treating
providers and thus medical issues are non-grievable. Plaintiff supported this proposition
by citing to a response that he got to a separate 2023 grievance wherein the ARB indicated
it was deferring to licensed medical professionals. (Doc. 30 at p. 9 ¶ 21). Given that the
Court found proper exhaustion, it does not need to discuss these arguments at length,
but it is worth pointing out that the ARB ruling for grievance 2952-10-22 merely stated
“denied, this office finds that the issue was appropriately addressed by the facility
Administration,” and it did not contain any additional caveat about the ARB being
unable or unwilling to substantively review this instance of medical care. (Doc. 27-1 at
1). 	Thus, the argument about availability on the facts of this specific grievance in this
case is misplaced. 	Additionally, any argument that the ARB always defers to treating
professionals seems more like an argument for futility than unavailability. Inmates are
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still required to exhaust a claim even if they view the process as futile. 	See e.g., Dole v.
Chandler, 438 F.3d 804, 890 (7th Cir. 2006).
DISPOSITION
The Defendants’ Motions for Summary Judgment (Docs. 26, 28) are DENIED. This
case shall proceed to merits discovery on all claims against all defendants.
IT IS SO ORDERED.
Dated: October 30, 2025
/s/ David W. Dugan
______________________________
DAVID W. DUGAN
United States District Judge
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