Tuduj v. Boswell Pharmacy Services LLC et al

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ILLINOIS
TOM TUDUJ,
Plaintiff,
vs.
BOSWELL PHARMACY SERVICES et
al.,
Defendants.
)
)
)
)
)
)
)
)
)
Case No. 20-CV-924-DWD
MEMORANDUM & ORDER
DUGAN, District Judge:
Plaintiff Tom Tuduj (“Tuduj”), an inmate of the Illinois Department of Corrections
(“IDOC”) incarcerated in Graham Correctional Center brings this pro se lawsuit pursuant
to 42 U.S.C. § 1983 for deprivations of his constitutional rights allegedly occurring when
he was housed at Menard Correctional Center. (Doc. 1; Doc. 14). Defendants Dr.
Mohammed Siddiqui (“Siddiqui”) and Dr. Donald R. Unwin (“Unwin”) have filed
motions for summary judgment pursuant to Federal Rule of Civil Procedure 56. (Docs.
128, 129, 134, and 135). 1 Plaintiff has filed cross-motions for summary judgment. (Docs.
126 and 127). For the reasons set forth below, the Court GRANTS Defendants’ motions
for summary judgment and DENIES Tuduj’s motions for summary judgment.
1 Plaintiff filed responses to both motions (Docs. 128 and 167), and Defendants filed replies (Docs.
157 and 170). Defendants filed responses to Plaintiff’s motions (Docs. 131 and 137), and Plaintiff filed reply
as to Defendant Unwin’s response (Doc. 142).
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 1 of 31 Page ID
#<pageID>

2
I. 	BACKGROUND
A. Instant Case
In the Complaint (Doc. 1), Tuduj alleges he has suffered from chronic and
persistent pain and various medical symptoms since the beginning of his incarceration at
Menard Correctional Center in 2009. He attributes many of his symptoms, including cold
sores, 	facial 	redness, 	swollen 	lips, 	extreme 	photophobia, 	severe 	migraines,
burning/tingling 	sensations, 	fever 	blisters, 	cellulitis 	of 	the 	lips, 	intolerance 	to
temperature extremes, and constant eye irritation, to varicella-zoster virus (VZV)
(sometimes described as shingles), which he believes he contracted either from a
childhood vaccine or from a defective prescription medication taken prior to his
incarceration.
The complaint alleges that Siddiqui, a physician who treated Tuduj at Menard,
exhibited deliberate indifference to his serious medical needs in violation of the Eighth
Amendment by failing to provide adequate treatment for his alleged VZV-related
symptoms. Specifically, Tuduj claims Siddiqui prescribed treatments (including a cream
and ibuprofen) that Tuduj alleges were ineffective for VZV, and that Siddiqui failed to
provide further meaningful care after Tuduj requested dimethyl sulfoxide (DMSO), a
medication Tuduj believed was appropriate for his condition. Tuduj further alleges that
on December 12, 2018, after he informed Siddiqui that he would file a lawsuit if he did
not receive proper treatment, Siddiqui retaliated against him in violation of the First
Amendment by failing to properly renew a medical permit for two “new” sponge
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 2 of 31 Page ID
#<pageID>

3
mattresses that Tuduj needed for shoulder pain, causing his shoulder condition to
worsen.
The complaint also alleges that Unwin, an off-site ophthalmologist employed at
Quantum Vision Centers who examined Tuduj on October 22, 2018, exhibited deliberate
indifference to Tuduj’s serious medical needs in violation of the Eighth Amendment by
failing to perform diagnostic tests or provide meaningful treatment for Tuduj’s eye-
related symptoms. Tuduj further alleges that Unwin acted with hostility and retaliated
against him in violation of the First Amendment by withholding appropriate treatment
because of Tuduj’s statements during the visit and/or his criminal background.
Although the complaint asserted additional claims against numerous other
defendants, those claims have been resolved. 2 The only claims that remain pending are:
Claim 1: 	Eighth Amendment deliberate indifference against Siddiqui
and Unwin for failure to treat Tuduj’s alleged VZV;
Claim 6: 	First Amendment retaliation against Siddiqui for allegedly
denying renewal of the double-mattress permit; and
Claim 7: 	First Amendment retaliation against Unwin for allegedly
withholding treatment.
2 The claims as to Defendants Boswell Pharmacy Services LLC, Menard Pharmacist, Rob Jeffreys,
John Doe, and Patty Sneed were dismissed without prejudice at screening. (Doc. 14). The claims as to
Defendants Wexford health Source, Inc. and Quantum Vision Centers were subsequently dismissed as
insufficient. (Doc. 59). The claims against Defendant Todd Brooks were dismissed because he is deceased,
and Plaintiff did not identify a substitute party. (Doc. 49). The claims against Defendant T. Bradley were
dismissed without prejudice for failure to state a claim. (Doc. 80). The claims as to Kimberly Butler, Frank
Lawrence, and John Baldwin were dismissed with prejudice as agreed to by the parties following a court-
ordered mediation. (Docs. 117, 119, 125, 162, and 176). The only remaining claims are those directed against
Defendants Siddiqui and Unwin.
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 3 of 31 Page ID
#<pageID>

4
B. Prior Litigation
In 2017, Tuduj filed a pro se § 1983 action in this District alleging Eighth
Amendment deliberate indifference to serious medical needs by medical providers at
Menard Correctional Center and their employer, Wexford Health Sources, Inc. Tuduj v.
Caldwell, No. 17-cv-0219-NJR-GCS (S.D. Ill.). He alleged that, from approximately 2006–
2009, he had suffered from a chronic VZV or shingles infection that caused severe
photophobia, migraine headaches, and recurring rashes and cold sores on his body and
face. He contended that defendants were deliberately indifferent by failing to diagnose
or treat an underlying VZV infection, particularly by denying dimethyl sulfoxide
(“DMSO”) for his skin complaints and delaying or restricting access to adequate tinted
lenses or sunglasses for photophobia. The defendants included physicians Samuel
Nwaobasi, John Trost, Reynal Caldwell, Stephen Ritz, and Wexford.
Following discovery, including Tuduj’s deposition and medical records from
approximately 2009-2016, defendants moved for summary judgment. On September 30,
2019, the district court granted summary judgment to all remaining defendants. The court
found that Tuduj admitted no medical professional had diagnosed him with shingles or
VZV and that his VZV theory was a self-diagnosis derived from “reverse engineering”
prescriptions and research rather than objective medical evidence. The court further
found that the record reflected repeated evaluation and treatment for Tuduj’s complaints,
including pain medication, glasses, lenses, and topical and oral medications (including
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 4 of 31 Page ID
#<pageID>

5
acyclovir and doxycycline), and that the challenged denials of DMSO and rubber
sunglasses reflected medical judgment and applicable guidelines rather than deliberate
indifference. The court concluded that Tuduj could not establish an objectively serious
medical condition caused by shingles/VZV and, alternatively, that the evidence did not
support a finding that any defendant was deliberately indifferent. Tuduj v. Caldwell, No.
17-cv-0219-NJR-GCS, 2019 WL 4750606 (S.D. Ill. Sept. 30, 2019).
Tuduj appealed and, on October 13, 2020, the Seventh Circuit affirmed in an
unpublished decision. Tuduj v. Lawrence, 829 F. App’x 120 (7th Cir. 2020). The Appellate
Court described Tuduj’s VZV theory as self-diagnosed and held that the undisputed
evidence 	showed 	repeated 	medical 	evaluation 	and 	treatment 	for 	headaches,
photophobia, and rashes. It rejected his contention that the Constitution required the
specific treatments he sought, such as DMSO or different sunglasses, reiterating that the
Eighth Amendment does not entitle an inmate to demand specific care and that the
treatment provided did not reflect deliberate indifference. Id.
II. 	MOTION TO STRIKE
Tuduj has filed a Motion to Strike Unwin’s Motion for Summary Judgment. (Doc.
171). Tuduj contends that Unwin’s affidavit, filed in support of his Motion for Summary
Judgment, does not comply with the “personal knowledge requirement” set out in Rule
56 of the Federal Rules of Civil Procedure. The Motion will be denied for two reasons.
First, the motion is untimely and procedurally improper. Tuduj filed his response
to the summary judgment motion on August 27, 2025 (Doc. 167) and did not file the
motion to strike until September 16, 2025 (Doc. 171). Federal Rule of Civil Procedure 12(f)
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 5 of 31 Page ID
#<pageID>

6
requires such motions to be made before responding to the pleading or, if no responsive
pleading is permitted, within 21 days after service. Further, Rule 12(f) applies only to
pleadings, and a motion for summary judgment and its supporting affidavit do not
constitute a "pleading" under Rule 7(a). Thus, a motion to strike is not the proper vehicle
for challenging summary judgment evidence. Instead, challenges to summary judgment
evidence are properly addressed through objections under Rule 56(c)(2) or in the
response/opposition to the motion itself. See e.g., Davis v. McKenzie, No. 16-62499-CIV,
2017 WL 8809917 (S.D. Fla. Nov. 3, 2017).
Second, the motion fails on its merits. The affidavit substantially complies with the
personal knowledge requirement of Rule 56(c)(4). While the introductory paragraph
states that the assertions are true and correct "to the best of my knowledge, information,
and belief," the Court focuses on the substance of the affidavit rather than isolated
boilerplate phrasing. See Sherman v. Bell Atl., No. 95 CIV. 1817 (MBM), 1996 WL 492985,
at *8 (S.D.N.Y. Aug. 29, 1996) (declining to elevate form over substance where the
affidavit’s contents reflect personal knowledge); Johnson v. Yonkers, No. CIV.A. MJG-15-
237, 2015 WL 4757154, at *2 (D. Md. Aug. 11, 2015) (refusing to strike affidavit that used
“information, knowledge and belief” phrasing where the substance reflected personal
knowledge). The governing principle is that affidavits must “be made on personal
knowledge, set out facts that would be admissible in evidence, and show that the affiant
or declarant is competent to testify on the matters stated.” F ED. R. C IV. P. 56(c)(4).
Here, Unwin, as the treating ophthalmologist, attests to facts derived from his
examination of Tuduj. The affidavit’s substance reflects personal knowledge derived
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 6 of 31 Page ID
#<pageID>

7
from his role as Tuduj’s treating ophthalmologist, attesting to matters such as personally
examining Tuduj, conducting the slit-lamp examination, observing findings he recorded,
assessing Tuduj’s condition, and forming a treatment plan based on his own clinical
observations, medical judgment, education, training, experience, and review of the
relevant medical records. Those are specific factual assertions that would be admissible
at trial, and reasonable inferences drawn from such firsthand experience satisfy Rule 56.
Accordingly, Tuduj’s Motion to Strike (Doc. 171) is DENIED. Likewise, Tuduj’s
supplemental pleading (Doc. 175) seeking to strike Unwin’s Response based on the same
arguments is DENIED.
III. 	SUMMARY JUDGMENT STANDARD
“Summary judgment is appropriate ‘if the pleadings, the discovery and disclosure
materials on file, and any affidavits show that there is no genuine issue as to any material
fact and that the movant is entitled to summary judgment as a matter of law.’ ” Spivey v.
Adaptive Mktg. LLC, 622 F.3d 816, 822 (7th Cir. 2010) (quoting F ED. R. C IV. P. 56(c)). “A
genuine dispute of material fact exists if ‘the evidence is such that a reasonable jury could
return a verdict for the nonmoving party.’ ” Dunn v. Menard, Inc., 880 F.3d 899, 905 (7th
Cir. 2018) (quoting Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986)). Substantive
law determines which facts are considered material. See Jaranowski v. Indiana Harbor Belt
R.R. Co., 72 F.4th 744, 749 (7th Cir. 2023). Moreover, although a non-movant receives the
benefit of conflicting evidence and reasonable inferences, he or she is still required to
produce evidence sufficient to establish the essential elements of his or her claims. Jackson
v. Sheriff of Winnebago County, Illinois, 74 F.4th 496, 500 (7th Cir. 2023).
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 7 of 31 Page ID
#<pageID>

8
In responding to a summary judgment motion, the nonmoving party may not
simply rest upon the allegations contained in the pleadings but must present specific facts
to show that a genuine issue of material fact exists. Celotex, 477 U.S. at 322-26; Liberty
Lobby, 477 U.S. at 256-57; Modrowski, 712 F.3d at 1168. A genuine issue of material fact is
not demonstrated by the mere existence of “some alleged factual dispute between the
parties,” Liberty Lobby, 477 U.S. at 247, or by “some metaphysical doubt as to the material
facts,” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986). Rather, a
genuine issue of material fact exists only if “a fair-minded jury could return a verdict for
the [nonmoving party] on the evidence presented.” Liberty Lobby, 477 U.S. at 252.
The court reviews the parties’ cross-motions for summary judgment “construing
all facts, and drawing all reasonable inferences from those facts, in favor of ... the non-
moving party.” Wis. Cent., Ltd. v. Shannon, 539 F.3d 751, 756 (7th Cir. 2008) (quoting Auto.
Mechs. Local 701 Welfare & Pension Funds v. Vanguard Car Rental USA, Inc., 502 F.3d 740,
748 (7th Cir. 2007)). However, the court “may not grant summary judgment for either
side unless the admissible evidence as a whole -- from both motions -- establishes that no
material facts are in dispute.” Bloodworth v. Vill. of Greendale, 475 F. App'x 92, 95 (7th Cir.
2012).
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 8 of 31 Page ID
#<pageID>

9
IV. 	FACTUAL RECORD 3
A. Rule 56.1 Statements and Responses
The 	Court 	considers the 	parties’ 	submissions 	under 	Federal Rule 	of 	Civil
Procedure 56 and SDIL Local Rule 56.1. Facts supported by admissible record citations
and not properly controverted with admissible evidence and pinpoint citations are
treated as admitted for purposes of summary judgment. The Court disregards “disputes”
that do not engage the asserted fact, are unsupported by the cited record, or consist of
argument, speculation, or legal conclusions rather than admissible evidence. The Court
focuses on facts that are material to the elements of the claims asserted against each
defendant. 4
B. Material Facts
Tuduj is an IDOC inmate who was housed at Menard Correctional Center during
the relevant period. He reports his highest level of education is a Master’s degree in
project management. He has no formal medical education, training, or experience. Tuduj
believes a vaccine he received earlier in life caused him to develop varicella-zoster virus
(“VZV”) as an adult and attributes intermittent facial rash and head/eye pain to VZV.
3 These facts are drawn from the parties’ Rule 56.1 statements and responses after review of the
record to determine which facts are genuinely undisputed and supported by admissible evidence. In some
instances, the Court supplies additional citations to underlying medical records or deposition testimony
where helpful to clarify the record.
4 For example, in responding to Unwin’s Statement of Material Facts, Tuduj repeatedly cites only
“Exhibit 1,” his affidavit, to dispute numerous paragraphs. (Doc. 167 Plaintiff’s responses to ¶¶ 15, 19, 25,
29, 35, 38–44, 47–48, 50–54.). Exhibit 1, however, contains no factual averments about the events at issue; it
states only that Tuduj is over eighteen and “competent to testify to everything in this motion.” Because
Exhibit 1 supplies no factual support, it does not controvert any asserted fact, and the Court disregards
those unsupported denials and deems the corresponding facts admitted. See SDIL LR 56.1(f),(g).
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 9 of 31 Page ID
#<pageID>

10
1. 	Dr. Mohammed Siddiqui
Tuduj’s claims against Siddiqui concern: (1) the treatment Siddiqi provided for
symptoms Tuduj attributes to VZV from November 2016 through October 2018; and (2)
a dispute regarding a double mattress permit that arose at a December 11, 2018 visit with
Siddiqui.
a. 	Siddiqui’s Treatment for Tuduj’s Alleged VZV symptoms
On November 3, 2016, Tuduj saw Siddiqui primarily to renew low bunk, low
gallery, 	and 	double-cuff 	permits. 	During 	that 	visit, 	Siddiqui 	also 	prescribed
triamcinolone cream, a topical corticosteroid commonly used for inflammatory or itching
skin conditions. Tuduj used the cream briefly (testifying to stopping use anywhere from
approximately one week to one month) but discontinued it because he believed it did not
work and because he had read about potential side effects of extended steroid use.
Although the prescription remained active, Tuduj testified he would throw it away or
store it.
On March 30, 2017, Tuduj saw optometrist Dr. Sutterer (a non-party) regarding
rash and head/eye pain complaints. Dr. Sutterer provided sunglasses for light sensitivity
and documented Tuduj’s desire to be treated with DMSO cream.
Tuduj next saw Siddiqui on April 27, 2017 for shoulder pain, not for complaints
Tuduj associates with VZV. Siddiqui ordered a double-mattress permit for shoulder pain.
On November 28, 2017, Tuduj saw Siddiqui for a rash complaint involving the
groin/inner leg area. Tuduj refused to be examined and requested DMSO. Siddiqui
indicated he was not familiar with DMSO being used to treat Tuduj’s complaint. On
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 10 of 31 Page ID
#<pageID>

11
March 1, 2018 and April 6, 2018, Tuduj again demanded DMSO. Siddiqui indicated
DMSO was not known to treat Tuduj’s complaints and further noted that Tuduj had been
seen by the optometrist who ordered sunglasses to address his complaints. On August 3,
2018, Tuduj again demanded DMSO for a rash he attributed to a decades-old vaccine.
Siddiqui assessed the rash as more consistent with eczema and referred Tuduj to
optometry/eye care for Tuduj’s complaints of facial rash and head/eye pain and for
further assessment.
Following that referral, Tuduj saw Dr. Sutterer on August 10, 2018. Dr. Sutterer’s
charting reflects that Tuduj was referred to “eye” on August 3, 2018 for “rash on face?”
and includes notations of “zoster” on certain forms. (Doc. 129-2, pp. 135, 301). On
September 	27, 	2018, Siddiqui 	and 	non-party 	Dr. 	Ritz 	approved 	a 	referral 	to an
ophthalmologist for Tuduj’s complaints of facial rash and head/eye pain. Tuduj
acknowledged 	that 	Siddiqui’s 	referrals 	to 	optometry 	and 	ophthalmology 	were
appropriate. Tuduj was then evaluated offsite by ophthalmologist Unwin on October 22,
2018.
b. 	Double Mattress Permit
On April 27, 2017, Siddiqui issued Tuduj a double-mattress permit in connection
with shoulder pain (including possible rotator cuff impingement). (Doc. 129-1; Doc. 129-
2 at 117).
On October 19, 2018, Tuduj filed a grievance about the double mattresses in his
cell after a housing transfer. (Doc. 129-5 at 5–7, 18–22). Tuduj reported that his double
mattresses, which were brand new, were not transferred with him. Instead, Tuduj was
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 11 of 31 Page ID
#<pageID>

12
given double mattresses that were old and worn, which aggravated his shoulder pain.
(Id.). He requested replacement with “new” double mattresses. (Id.). This grievance did
not reference Siddiqui.
On November 25, 2018, Tuduj saw a nurse practitioner seeking a knee-sleeve
permit and a permit for “new” double mattresses. The nurse practitioner determined
Tuduj did not have a medical need for either and documented that Tuduj stated he
wanted to terminate the visit and would submit another request to be seen by a different
provider “who would give him what he wanted.” (Doc. 129-2 at 118–19, 146).
On December 11, 2018, Tuduj saw Siddiqui and requested a knee sleeve and a
permit for “new” double mattresses. (Doc. 129-1 at 122–29; Doc. 129-2 at 148; Doc. 129-5
at 1–2). Siddiqui explained that he was not in charge of supplies and brought Sgt. Snell
into the room to address Tuduj’s property-related request for “new” mattresses. (Id.).
During this encounter, Tuduj referenced potential litigation in connection with the
mattress dispute and/or Siddiqui’s refusal to prescribe DMSO. (Id.). The parties dispute
the precise sequence of these statements and whether Tuduj’s litigation reference
occurred before or after Siddiqui declined to modify the permit to specify “new”
mattresses. (Id.). It is undisputed, however, that after the December 11 visit Tuduj’s
double-mattress permit remained in effect and Siddiqui ordered the knee sleeve Tuduj
requested. (Id.). Tuduj’s primary complaint is that Siddiqui did not amend the permit to
require “new” double mattresses. (Id.).
After the December 11 visit, Tuduj filed a grievance about the encounter and his
request that the permit specify “new” double mattresses. (Doc. 129-5 at 1–2). Tuduj
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 12 of 31 Page ID
#<pageID>

13
reported that Siddiqui said he did not control mattress distribution, while Sgt. Snell stated
Tuduj could not receive “new” mattresses unless the permit specified “new.” (Id.). The
response noted Tuduj had a current double-mattress permit and further indicated the
counselor spoke with Sgt. Snell, who said he would address the issue. (Id.). 5
2. 	Dr. Donald R. Unwin
Unwin is a board-certified ophthalmologist employed with Quantum Vision
Centers. Tuduj presented to Quantum Vision Centers on October 22, 2018 for an
ophthalmology evaluation based on a reported history of herpes zoster and facial
rash/eye complaints. A technician recorded Tuduj’s history and performed routine
preliminary testing, including visual acuity, ocular motility, and intraocular pressure
testing, with findings within normal limits. Unwin performed an ocular examination,
including slit-lamp examination, and documented normal findings. Unwin did not
observe eye redness or a facial rash during the encounter. Based on his examination,
Unwin did not believe Tuduj had herpes zoster and found no abnormal ocular condition
requiring treatment. Unwin was unaware of the reasons for Tuduj’s imprisonment
during the encounter. 6 Unwin advised Tuduj to return as needed if pain or vision
worsened. Tuduj did not return for follow-up care.
5 To the extent that Tuduj is attempting to advance a new retaliation theory based on alleged events
in march or April 2019 (e.g., discontinuation of a medical hold for transfer) (Doc. 155 ¶ 13) in response to
Siddiqui’s summary judgment motion, that theory is disregarded. See Abuelyaman v. Illinois State Univ., 667
F.3d 800, 813-14 (7 th Cir. 2011) (Plaintiff may not advance a new theory of retaliation in response to a
summary judgment motion).
6 Tuduj purports to dispute Unwin’s statement that he did not know of Tuduj’s criminal charges,
asserting that “every medical jacket has the picture and charges on the first left page.” (Doc. 167 ¶ 38).
Plaintiff cites only “Exhibit 1,” his affidavit, which contains no factual averment that Unwin knew of the
charges (or that Unwin reviewed any “medical jacket” containing such information), nor has Tuduj
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 13 of 31 Page ID
#<pageID>

14
Tuduj 	asserts 	that, 	during 	the 	examination, 	Unwin 	was 	preoccupied 	and
unfriendly, became visibly upset when Plaintiff mentioned vaccine-related VZV, stated
that Plaintiff “did not get this virus from a vaccine,” and stated that Unwin “is the one
who went to medical school,” and that Unwin later became hostile and “stormed out,”
leaving Plaintiff without treatment. (Doc. 127, p. 10).
3. 	DMSO
DMSO is a chemical agent and industrial solvent. It is only FDA approved as an
intravesical solution for the treatment of interstitial cystitis and extravasation. DMSO is
not FDA approved to treat herpes, zoster, smallpox, or any other medical condition.
4. 	Records Tuduj claims establish he was diagnosed with VZV
Tuduj contends his medical records establish three “VZV” diagnoses: (1) a
February 2011 encounter with non-party Dr. Faheem; (2) August 2018 optometry records
associated with Dr. Sutterer; and (3) an October 22, 2018 optometry record associated
with Dr. Sutterer (Doc. 167 ¶ 57). Defendants dispute that the cited materials reflect the
diagnoses Tuduj claims. 7
a. February 2011 Record (Dr. Faheem)
Tuduj relies on a February 2011 encounter with Dr. Faheem in which he was
treated for cold sores and a secondary lip infection and was prescribed, among other
medications, an antiviral. The contemporaneous record reflects treatment for cold sores
submitted the referenced “medical jacket” or medical file into evidence. (Doc. 167 ¶ 38; Doc. 167, p. 52).
Because Plaintiff’s response is unsupported by admissible evidence and does not controvert Unwin’s
asserted lack of knowledge, the fact is deemed admitted for purposes of summary judgment.
7 Plaintiff references Dr. Faheem’s prescription of doxycycline and acyclovir on February 28, 2011,
but the cited record reflects a February 10, 2011 entry. (Doc. 167 ¶ 57; Doc. 167, p. 59).
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 14 of 31 Page ID
#<pageID>

15
and a secondary lip infection and includes an antiviral prescription, but it does not
expressly state a diagnosis of herpes zoster/varicella zoster virus. (Doc. 167 ¶ 57; Doc.
167, pp. 59–60). Tuduj similarly testified that Dr. Faheem diagnosed him with “cold
sores” and “a secondary infection in the form of cellulitis of the lips,” and that the
provider did not specify whether the cold sores were simplex virus. (Doc. 129-1, pp. 21–
22).
b. 	August 2018 and October 2018 Optometry Records (Dr. Sutterer)
Tuduj also points to optometry forms from August and October 2018 signed by
Dr. Sutterer that include the word “zoster” in a “patient diagnosis” field. (Doc. 129-2, p.
135; Doc. 129-2, p. 301). The August 2018 charting reflects a referral to “eye” for “rash on
face?” and notes that Tuduj sought DMSO, but that Drs. Siddiqui and Sutterer were
uncomfortable prescribing it. (Doc. 129-2, p. 301). It further notes that Tuduj stated he
would be willing to sign a waiver and see an ophthalmologist to obtain a DMSO
prescription. (Id.). The “patient diagnosis” field containing the “zoster” notation does not
document exam findings or ocular involvement, the eye-exam portion is blank, and it
indicates no prescriptions were written. (Doc. 129-2, p. 135). An October 22, 2018
optometry record likewise contains “zoster” in a diagnosis box and indicates no
prescriptions were written. (Doc. 167, p. 83).
The 	forms 	do 	not 	clearly 	show 	whether 	“zoster” 	reflects 	an 	independent
optometry diagnosis, a referral descriptor, or Tuduj’s reported history.
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 15 of 31 Page ID
#<pageID>

16
V. 	DISCUSSION
A. Issue Preclusion as to Claim 1 Deliberate Indifference
Siddiqui argues that Tuduj’s Eighth Amendment deliberate-indifference claim is
barred in whole or in part by issue preclusion based on Tuduj’s prior § 1983 litigation,
Tuduj v. Caldwell, No. 17-cv-0219-NJR-GCS, and the Seventh Circuit’s affirmance, Tuduj
v. Lawrence, 829 F. App’x 120 (7th Cir. 2020).
Issue preclusion (collateral estoppel) bars relitigation of an issue of fact or law that
was resolved by a valid and final judgment in prior federal litigation. DeGuelle v. Camilli,
724 F.3d 933, 935 (7th Cir. 2013); Bravo-Fernandez v. United States, 580 U.S. 5, 7–8 (2016).
Because the prior judgment was entered by a federal court, the Court applies federal
common law. Under that law, issue preclusion applies when (1) the issue is identical to
one decided in the prior action, (2) it was actually litigated and decided on the merits, (3)
the determination was essential to the final judgment, and (4) the party against whom
preclusion is invoked was fully represented in the prior action. Adams v. City of
Indianapolis, 742 F.3d 720, 736 (7th Cir. 2014); Waagner v. United States, 971 F.3d 647, 657
(7th Cir. 2020).
In Tuduj’s prior § 1983 case, the district court entered summary judgment for
defendants on deliberate-indifference claims premised on Tuduj’s contention that he
suffered from a systemic VZV infection that caused migraines, photophobia, and rashes
and required particular testing and treatment. The court found, based on the summary-
judgment record, that Tuduj had not been medically diagnosed with shingles/VZV and
that his theory was a self-diagnosis derived from “reverse engineering” prescriptions and
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 16 of 31 Page ID
#<pageID>

17
research. The court further concluded that the record reflected repeated evaluation and
treatment and that Tuduj’s claim was largely a disagreement with medical judgment and
a demand for different care. The Seventh Circuit affirmed, emphasizing that the evidence
showed ongoing evaluation and treatment and reiterating that denial of DMSO to treat a
virus that no doctor diagnosed did not reflect a complete abandonment of medical
judgment; the Eighth Amendment does not entitle an inmate to specific treatment. Tuduj
v. Lawrence, 829 F. App’x 120, 124 (7th Cir. 2020).
Those determinations were essential to the judgment affirmed on appeal, and
Tuduj had a full and fair opportunity to litigate them. Issue preclusion therefore applies,
but only to the extent it forecloses relitigation of the discrete issues actually decided. In
particular, Tuduj may not relitigate the premise that the Constitution required providers
to furnish his preferred treatment (including DMSO and antiviral-centered care) for a
self-diagnosed VZV condition, nor may he revive the “reverse engineering” inference
(i.e., that prescriptions or isolated record notations necessarily establish a VZV diagnosis)
insofar 	as 	that 	inferential 	methodology 	was 	already 	rejected 	as 	speculative 	and
insufficient to establish deliberate indifference. Id.
Issue preclusion, however, is applied narrowly. The present case concerns later
encounters, including Siddiqui’s care from November 2016 through October 2018 and
Unwin’s 	October 	22, 	2018 	ophthalmology 	evaluation. 	Preclusion 	does 	not 	bar
consideration of what these defendants knew and did during the time period relevant to
Claim 1. But it does limit Tuduj’s attempt to treat his VZV theory, and his asserted
entitlement to the specific course of care he demanded, as already established through
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 17 of 31 Page ID
#<pageID>

18
the same self-diagnosis framework rejected in the prior case. In any event, as is set forth
more fully below, Defendants are entitled to summary judgment on the merits of Claim
1 even assuming issue preclusion does not apply.
B. Merits Analysis as to Claim 1 Deliberate Indifference
The Supreme Court has recognized that deliberate indifference to the serious
medical needs of prisoners may constitute cruel and unusual punishment under the
Eighth Amendment. See Estelle v. Gamble, 429 U.S. 97, 104 (1976). To prevail on a claim for
deliberate indifference to a serious medical need, there are “two high hurdles, which
every inmate-plaintiff must clear.” Dunigan ex rel. Nyman v. Winnebago Cty., 165 F.3d 587,
590 (7th Cir. 1999). First, the plaintiff must demonstrate he suffered from an objectively
serious 	medical 	condition. Id. at 	591-592. 	Second, 	the 	plaintiff 	must 	establish 	the
individual prison officials were deliberately indifferent to that condition. Id.
The first consideration is whether the prisoner has an “objectively serious medical
condition.” Arentt v. Webster, 658 F.3d 742, 750 (7th Cir. 2011). “A medical condition is
objectively serious if a physician has diagnosed it as requiring treatment, or the need for
treatment would be obvious to a layperson.” Pyles v. Fahim, 771 F.3d 403, 409 (7th Cir.
2014)(citations omitted). It is not necessary for such a medical condition to “be life-
threatening to be serious; rather, it could be a condition that would result in further
significant injury or unnecessary and wanton infliction of pain if not treated.” Gayton v.
McCoy, 593 F.3d 610, 620 (7th Cir. 2010). Accord Farmer v. Brennan, 511 U.S. 825, 828
(1994) (violating 	the 	Eighth 	Amendment 	requires 	“deliberate 	indifference 	to
a substantial risk of serious harm”) (internal quotation marks omitted) (emphasis added).
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 18 of 31 Page ID
#<pageID>

19
To show that prison officials acted with deliberate indifference, a plaintiff produce
evidence that defendants knew his medical condition posed a serious risk to his health
and consciously disregarded that risk. Holloway v. Delaware Cnty. Sheriff, 700 F.3d 1063,
1073 (7th Cir. 2012). This subjective standard requires more than negligence and
approaches intentional wrongdoing; negligence, even gross negligence, does not violate
the Constitution. Id.; Berry v. Peterman, 604 F.3d 435, 440 (7th Cir. 2010); McGowan v.
Hulick, 612 F.3d 636, 640 (7th Cir. 2010). Deliberate indifference may be shown where a
defendant’s treatment decision so substantially departs from accepted professional
judgment, practice, or standards that it is not based on judgment at all; where the
defendant refuses to take instructions from a specialist; persists in a course known to be
ineffective; chooses an easier and less efficacious treatment without exercising judgment;
or causes an inexplicable delay in treatment serving no penological interest. Petties v.
Carter, 836 F.3d 722, 729–30 (7th Cir. 2016). But an inmate has no constitutional right to
demand specific medications, tests, or treatment; he is entitled to reasonable measures to
address a substantial risk of serious harm, not the course he prefers. Arnett v. Webster, 658
F.3d 742, 754 (7th Cir. 2011).
The parties dispute whether Tuduj suffered from an objectively serious medical
condition and whether he was ever diagnosed with VZV. The Court need not resolve
whether Tuduj’s symptoms, with or without a diagnosis of VZV from a physician,
constitute 	an 	objectively 	serious 	medical 	condition 	because 	to 	survive 	summary
judgment, 	Tuduj 	must 	demonstrate 	that 	Defendants 	knew 	of 	his 	conditions 	yet
deliberately withheld treatment. But, as is discussed more fully below, the undisputed
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 19 of 31 Page ID
#<pageID>

20
record shows that Defendants evaluated his symptoms, made decisions based on medical
judgment, and provided treatment when appropriate.
1. 	Dr. Donald R. Unwin
Even construing the evidence and drawing reasonable inferences in Tuduj’s favor,
no reasonable jury could find that Unwin acted with deliberate indifference. The
undisputed record shows that Tuduj presented on October 22, 2018 for an ophthalmology
evaluation based on his reported history and complaints. A technician recorded Tuduj’s
history and performed routine preliminary testing. Unwin then performed an ocular
examination, including slit-lamp examination, and documented normal findings. Unwin
did not observe eye redness or a facial rash during the encounter, did not believe Tuduj
had herpes zoster, and found no abnormal ocular condition requiring treatment. He
advised Tuduj to return as needed if pain or vision worsened; Tuduj did not return for
follow-up care.
Tuduj’s core contention is that Unwin did not accept that Tuduj was suffering from
vaccine-induced VZV and did not order PCR or Tzanck testing or provide the specific
treatment Tuduj wanted. But disagreement with a physician’s diagnostic approach or
treatment plan does not constitute deliberate indifference, and Tuduj has no right to
demand specific testing or treatment. Arnett, 658 F.3d at 754; Tuduj v. Lawrence, 829 F.
App'x 120, 124. (7th Cir. 2020). On this record, Tuduj has not produced evidence that
Unwin knew of and consciously disregarded a serious risk to Tuduj’s health. Holloway,
700 F.3d at 1073. Nor has Tuduj produced evidence that Unwin substantially departed
from accepted professional judgment, refused specialist instructions, or persisted in a
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 20 of 31 Page ID
#<pageID>

21
course known to be ineffective. Petties, 836 F.3d at 729–30. At most, the record reflects
dissatisfaction with Unwin’s medical judgment and a demand for different care, which
does not establish a constitutional violation. See Cesal v. Moats, 851 F.3d 714, 724 (7th Cir.
2017); Whiting v. Wexford Health Sources, Inc., 839 F.3d 658, 662–63 (7th Cir. 2016); Grant v.
Heidorn, 802 F. App'x 200, 205 (7th Cir. 2020).
2. 	Dr. Mohammed Siddiqui
The same result follows for Siddiqui on the deliberate indifference claim. The
undisputed record shows Siddiqui consistently evaluated Tuduj’s complaints, provided
treatment, and escalated care when warranted, reflecting professional judgment rather
than indifference.
At their first relevant encounter on November 3, 2016, which primarily focused on
permit 	renewals, 	Siddiqui 	prescribed 	triamcinolone 	cream, 	a 	standard 	topical
corticosteroid, for Tuduj’s reported rash. Tuduj admits he discontinued it after brief use
due to perceived inefficacy and side-effect concerns, but the prescription remained active.
Subsequent visits in 2017 and 2018 were dominated by Tuduj’s repeated demands
for DMSO, a chemical agent and industrial solvent that is only FDA approved as an
intravesical solution for the treatment of interstitial cystitis and extravasation, and is not
FDA approved to treat herpes, zoster, smallpox, or any other medical condition. Siddiqui
indicated he was unfamiliar with DMSO for treating Tuduj’s reported symptoms and
assessed Tuduj’s rash as more consistent with eczema. On November 28, 2017, Tuduj
refused a physical examination, limiting Siddiqui’s ability to assess the condition further.
Siddiqui continued to assess Tuduj’s complaints in follow-up encounters on March 1,
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 21 of 31 Page ID
#<pageID>

22
2018, April 6, 2018, and August 3, 2018, reiterating that DMSO was not appropriate while
documenting Tuduj’s self-reported history. When Tuduj’s August 3, 2018 complaints
escalated to include facial rash and head/eye pain potentially implicating ocular
involvement, Siddiqui promptly referred him to optometry for specialized assessment.
That referral led to an August 10, 2018 evaluation by Dr. Sutterer, and by September 27,
2018, Siddiqui (along with Dr. Ritz) approved an offsite ophthalmology referral. Tuduj
acknowledges these referrals were appropriate, and the ophthalmology evaluation with
Dr. Unwin occurred on October 22, 2018, yielding normal findings.
Tuduj’s primary arguments are that Siddiqui delayed the eye-care referral by
nearly two years, did not provide any treatment at all, and refused to prescribe DMSO.
These 	arguments 	do 	not 	create 	a 	genuine 	dispute. 	First, 	the 	alleged 	“delay”
mischaracterizes the record. Tuduj’s November 2016 visit with Siddiqui did not involve
requests for ophthalmology or reports of ocular symptoms; it focused on a general rash,
which Siddiqui treated topically. The record shows no urgent eye-related complaints to
Siddiqui until August 2018, at which point the referral process was initiated. Prior
encounters centered on Tuduj’s DMSO demands and non-ocular rashes (e.g., groin area).
Tuduj offers no admissible evidence that Siddiqui recognized an earlier serious risk of
ocular 	herpes 	zoster 	yet 	consciously 	ignored 	it. 	Without 	such 	evidence, 	a 	mere
disagreement about timing does not support deliberate indifference, particularly where
the ultimate referral occurred promptly once eye symptoms were emphasized. See Petties,
836 F.3d at 730 (delay must be inexplicable and serve no penological interest).
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 22 of 31 Page ID
#<pageID>

23
This 	record 	also 	refutes 	any 	“no 	treatment” 	claim, 	as 	Siddiqui 	provided
evaluations, prescriptions, and referrals.
Tuduj’s arguments as to DMSO establish a disagreement over treatment, not a
constitutional violation. Tuduj, who lacks medical training, asserts he has VZV based on
his belief about a childhood vaccine and prior records (e.g., the 2011 Faheem entry
prescribing an antiviral for cold sores, and 2018 Sutterer notes mentioning “zoster”). But
even assuming those records support a historical VZV diagnosis, they do not compel
Siddiqui to adopt Tuduj’s preferred regimen, particularly where DMSO lacks FDA
approval for such conditions. Siddiqui exercised judgment by assessing the rash as
eczema, prescribing an alternative topical, and referring for specialist input when
symptoms suggested possible ocular issues. The Eighth Amendment entitles inmates to
reasonable measures addressing substantial risks, not specific medications or tests on
demand. No evidence shows Siddiqui knew better than to make the medical decisions he
made or persisted in known ineffective treatment, refused specialist recommendations
(none existed here), or chose an easier, less efficacious treatment, known to be ineffective.
Second, Tuduj’s DMSO insistence reflects disagreement over treatment, not a violation. 8
Lacking medical training, Tuduj self-diagnosed VZV based on childhood vaccine beliefs
8 Plaintiff argues that his deliberate indifference claim is not premised on specifically seeking treatment with
DMSO, pointing to his current willingness to accept alternatives to DMSO. Plaintiff’s argument is unavailing, as the
Eighth Amendment inquiry turns on Siddiqui’s knowledge and response during the challenged encounters, when
Plaintiff undisputedly demanded DMSO and rejected other treatments. See Collignon v. Milwaukee County, 163 F.3d
982, 989 (7th Cir. 1998). See also Minix v. Canarecci, 597 F.3d 824, 833 (7th Cir. 2010). Further, when deposed,
although Plaintiff indicated he was willing to “take a treatment that is effective and that doesn’t cause [him] more
harm[,]” he further testified that the only treatment he knows of that fits that description is DMSO. (Doc. 129-1, pg.
161). Plaintiff’s testimony demonstrates that his claim remains a disagreement over specific treatment, which does
not rise to deliberate indifference.
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 23 of 31 Page ID
#<pageID>

24
and records (e.g., 2011 Faheem antiviral prescription; 2018 Sutterer “zoster” notes). But
even assuming a historical VZV diagnosis, such a diagnosis did not obligate Siddiqui to
prescribe unapproved DMSO. Siddiqui assessed eczema, prescribed alternatives, and
referred specialists when ocular risks arose. The Eighth Amendment requires reasonable
measures against substantial risks, not demanded remedies. Forbes v. Edgar, 112 F.3d 262,
266–67 (7th Cir. 1997).
One final note regarding whether Tuduj is demanding specific care in the form of
DMSO. The plaintiff argues that his deliberate indifference claim is not premised on a
specific demand for treatment with DMSO, emphasizing his current willingness to accept
alternative remedies. This argument is unavailing. The Eighth Amendment inquiry must
focus on Siddiqui’s knowledge and response during the relevant encounters, at which
time the plaintiff undisputedly insisted on DMSO while rejecting other proposed
treatments. See Collignon v. Milwaukee County, 163 F.3d 982, 989 (7th Cir. 1998) (explaining
that deliberate indifference claims are evaluated based on the defendant’s awareness and
actions at the time of the alleged violation, not subsequent developments); see also Minix
v. Canarecci, 597 F.3d 824, 833 (7th Cir. 2010) (reinforcing that courts assess the provider’s
mindset and decisions in the context of the contemporaneous facts). Shifting the analysis
to the Tuduj’s post-hoc flexibility would undermine the evaluation of the defendant’s
conduct under the deliberate indifference standard.
The Court further observes that Tuduj’s professed willingness to accept other
treatments is, in essence, still a demand for specific care tailored to his subjective criteria.
During his deposition, Tuduj stated that he would be open to “a treatment that is effective
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 24 of 31 Page ID
#<pageID>

25
and that doesn’t cause [him] more harm,” but he immediately qualified this by testifying
that the only treatment he knows of that satisfies these conditions is DMSO. (Doc. 129-1,
pg. 161). This testimony reveals that the Tuduj’s position is not a genuine openness to
medical judgment but rather an insistence on a remedy that aligns with his personal
standards of efficacy and safety; standards that, by his own admission, exclude all known
alternatives except DMSO. Such a stance amounts to a fundamental disagreement over
the course of treatment, which does not rise to the level of deliberate indifference under
the Eighth Amendment. See, e.g., Forbes v. Edgar, 112 F.3d 262, 267 (7th Cir. 1997) (holding
that an inmate’s dissatisfaction with prescribed care and preference for specific treatment,
without proof of reckless disregard, constitutes a mere difference of opinion insufficient
to support a constitutional claim). To establish deliberate indifference, the plaintiff must
demonstrate that the defendant acted with a culpable state of mind akin to criminal
recklessness, 	not 	simply 	that 	the 	chosen 	treatment 	failed 	to 	meet 	the 	inmate’s
expectations or that a hypothetical better option existed. Here, the record shows no such
recklessness. Instead, it reflects a medical provider offering reasonable alternatives that
the plaintiff rejected in favor of his preferred, unavailable remedy.
For these reasons, Siddiqui is entitled to summary judgment on Claim 1.
B. Merits Analysis as to Claims 6 and 7 (Retaliation)
To prevail on a First Amendment retaliation claim, a prisoner must prove three
elements: (1) he engaged in activity protected by the First Amendment; (2) he suffered a
deprivation that would likely deter a person of ordinary firmness from engaging in that
protected activity; and (3) the protected activity was at least a motivating factor in the
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 25 of 31 Page ID
#<pageID>

26
defendant’s decision to impose the deprivation. Archer v. Chisholm, 870 F.3d 603, 618 (7th
Cir. 2017); Bridges v. Gilbert, 557 F.3d 541, 546 (7th Cir. 2009); Hawkins v. Mitchell, 756 F.3d
983, 996 (7th Cir. 2014). The first element is often dispositive where the asserted
“protected activity” is an oral confrontation: a verbal complaint is protected only if made
“in a manner consistent with legitimate penological interests,” and speech that is
disruptive, confrontational, or “back talk” is not protected. Whitfield v. Spiller, 76 F.4th
698, 708 (7th Cir. 2023) (quoting Watkins v. Kasper, 599 F.3d 791, 796 (7th Cir. 2010));
Watkins, 599 F.3d at 798–99; see also Bridges, 557 F.3d at 555 (skepticism that a mere threat
to grieve is itself protected); Maus v. Lade, No. 22-2085, 2023 WL 334792, at *3 (7th Cir. Jan.
20, 2023) (same). By contrast, use of the prison grievance process is generally protected
activity, but causation still requires proof that the defendant knew of the protected
activity. West v. Kingsland, 679 F. App’x 482, 486 (7th Cir. 2016); Irons v. Fiero, 2025 WL
832211, at *4.
As to the causation element, the plaintiff must produce evidence, direct or
circumstantial, from which a reasonable jury could conclude that the protected activity
motivated the challenged action. Thomas v. Anderson, 912 F.3d 971, 976 (7th Cir. 2018);
Kidwell v. Eisenhauer, 679 F.3d 957, 965–66 (7th Cir. 2012). Circumstantial evidence may
include suspicious timing, ambiguous statements, or differential treatment, but timing
alone “will rarely be enough” to survive summary judgment. Manuel v. Nalley, 966 F.3d
678, 681 (7th Cir. 2020) (quoting Loudermilk v. Best Pallet Co., 636 F.3d 312, 315 (7th Cir.
2011)).
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 26 of 31 Page ID
#<pageID>

27
1. 	Claim 6, Retaliation as to Dr. Mohammed Siddiqui
Tuduj’s First Amendment retaliation claim against Siddiqui stems from a medical
visit on December 11, 2018, during which Tuduj requested that Siddiqui amend his
existing double-mattress permit to specify “new” double mattresses. Tuduj contends
Siddiqui refused his request in retaliation after Tuduj mentioned his intent to file a
lawsuit related to the mattress dispute and/or Siddiqui’s prior refusal to prescribe
DMSO. The parties dispute the exact sequence of the exchange (i.e. whether Tuduj
referenced litigation before or after Siddiqui declined to modify the permit), but this
dispute is immaterial because the claim fails on multiple grounds even under Tuduj’s
version of events.
Tuduj’s primary asserted protected activity is not the actual filing of a lawsuit or
grievance but rather his verbal statement during the December 11 medical visit
expressing an intent to sue. But a prisoner’s speech is protected only if it is “made in a
manner consistent with legitimate penological interests.” Whitfield v. Spiller, 76 F.4th 698,
708 (7th Cir. 2023) (quoting Watkins v. Kasper, 599 F.3d 791, 796-99 (7th Cir. 2010)).
Disruptive, confrontational speech, such as using threats of litigation to pressure a
medical provider during a dispute over treatment or permits, does not qualify as
protected activity. Watkins, 599 F.3d at 798-99; see also Bridges, 557 F.3d at 555 (expressing
skepticism that mere threats to engage in First Amendment activity, like filing a
grievance, are themselves protected). Nothing in the record indicates that Tuduj’s
litigation reference was anything other than a confrontational attempt to influence
Siddiqui amid their disagreement over the mattress permit. Instead, the record shows
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 27 of 31 Page ID
#<pageID>

28
Tuduj had recently expressed dissatisfaction with another provider and sought a
different one who might “give him what he wanted.” This context reinforces that Tuduj’s
statement was inconsistent with legitimate penological interests in maintaining order and
respect during prison medical visits.
Even assuming that Tuduj could establish that his reference to filing a lawsuit was
protected activity under the first element, and further assuming that Siddiqui’s refusal to
add “new” to the permit could qualify as a deprivation likely to deter a person of ordinary
firmness under the second element, the claim fails on causation. Tuduj must produce
direct or circumstantial evidence from which a reasonable jury could infer that the
protected activity motivated Siddiqui’s action. Speculation or timing alone is insufficient,
particularly at summary judgment. Manuel v. Nalley, 966 F.3d 678, 681 (7 th Cir. 2020).
Tuduj offers no such evidence, relying instead on conjecture about Siddiqui’s
motives. The undisputed record shows that Siddiqui maintained Tuduj’s double-
mattress permit (originally issued by Siddiqui in 2017 for shoulder pain), ordered the
requested knee sleeve, and explained that he was not responsible for mattress supplies
or distribution. Siddiqui even involved Sgt. Snell to address the property-related aspect
of Tuduj’s request. Absent evidence that Siddiqui had authority to compel staff to provide
Tuduj with “new” mattresses, as opposed to evaluating whether Tuduj medically
qualified for a double mattress permit at all, a retaliatory motive cannot be inferred from
Siddiqui’s decision not to amend the permit. At most, the record reflects a disagreement
over Siddiqui’s role and limitations in the decision to issue “new” mattresses.
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 28 of 31 Page ID
#<pageID>

29
To the extent Tuduj relies on grievances as the protected activity, his claim also
fails. Tuduj filed a grievance on October 19, 2018 seeking “new” double mattresses, but
that grievance did not reference Siddiqui, and the record contains no evidence Siddiqui
knew of it before the December 11 visit. An official cannot retaliate based on protected
activity of which he is unaware. West v. Kingsland, 679 F. App’x 482, 486 (7th Cir. 2016).
Tuduj then filed a grievance after the December 11 encounter that did reference Siddiqui
and the “new” mattress issue. But that grievance cannot retroactively serve as protected
activity motivating an earlier action. See Weeks v. Warden, No. 15 C 5234, 2017 WL 3404965,
at *28 (N.D. Ill. Aug. 7, 2017). Finally, Tuduj suggests that grievances predating December
11, 2018 regarding DMSO/VZV motivated Siddiqui’s alleged retaliation, but he does not
point to any evidence linking those grievances to the dispute over the double mattress
permit. Tuduj offers only speculation and conjecture which is not enough. Rockwell
Automation, Inc. v. Nat'l Union Fire Ins. Co. of Pittsburgh, PA, 544 F.3d 752, 757 (7th
Cir.2008); Soto v. Bertrand, 328 F. App'x 331, 333 (7th Cir. 2009).
2. 	Claim 7, Retaliation as to Donald R. Unwin
Tuduj’s retaliation theory against Unwin rests on two asserted motives: (1) that
Unwin withheld testing or treatment because Tuduj was argumentative about “vaccine-
induced” VZV during the October 22, 2018 visit; and (2) that Unwin’s judgment was
“clouded” by Tuduj’s criminal case. Tuduj’s claim fails at the outset because the exchange
he describes, an argumentative, confrontational dispute with a medical provider, is not
protected speech. See Watkins v. Kasper, 599 F.3d 791, 796–99 (7th Cir. 2010); Whitfield v.
Spiller, 76 F.4th 698, 708 (7th Cir. 2023).
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 29 of 31 Page ID
#<pageID>

30
Even assuming that Tuduj could satisfy the protected-activity and deprivation
elements, he still cannot establish causation. The undisputed record reflects that Unwin
performed an ophthalmologic examination that was normal and did not diagnose a
condition or recommend treatment, which is consistent with medical judgment and not
retaliatory animus. Tuduj offers only speculation that Unwin’s clinical decision was
motivated by Tuduj’s speech, and speculation cannot defeat summary judgment.
Rockwell Automation, Inc. v. Nat'l Union Fire Ins. Co. of Pittsburgh, PA, 544 F.3d 752, 757 (7th
Cir.2008). Likewise, Tuduj’s alternative theory that Unwin acted out of hostility based
on Tuduj’s criminal charges fails because the record contains no admissible evidence that
Unwin knew anything about those charges, and an official cannot retaliate based on an
alleged motive of which he is unaware. See West v. Kingsland, 679 F. App’x 482, 486 (7th
Cir. 2016); Irons v. Fiero, 2025 WL 832211, at *4 (S.D. Ill. Mar. 17, 2025).
 	For these reasons, summary judgment is warranted for Unwin on Claim 7. 
 	 	 	 	CONCLUSION
For the reasons set forth herein, the Court GRANTS Defendant Mohammed
Siddiqui’s Motion for Summary Judgment (Doc. 128); GRANTS Defendant Donald R.
Unwin’s Motion for Summary Judgment (Doc. 134); and DENIES Plaintiff Tom Tuduj’s
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 30 of 31 Page ID
#<pageID>

31
Motions for Summary Judgment (Docs. 126 and 127). The Court DIRECTS the Clerk to
close the case and to enter judgment accordingly.
SO ORDERED.
Dated: February 20, 2026
DAVID W. DUGAN
United States District Judge
Case 3:20-cv-00924-DWD Document 178 Filed 02/20/26 Page 31 of 31 Page ID
#<pageID>