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United States Court Cases

Opinion of the

District Court, S.D. Illinois

Harrison v. Wexford Health Sources, Inc.

              IN THE UNITED STATES DISTRICT COURT                        
             FOR THE SOUTHERN DISTRICT OF ILLINOIS                       

JOSEPH HARRISON,                )                                        
                                )                                        
               Plaintiff,       )                                        
                                )                                        
vs.                             )  Case No. 3:21-CV-762-MAB              
                                )                                        
LYNN PITTMAN, et al.,           )                                        
                                )                                        
               Defendants.      )                                        
                                )                                        

                   MEMORANDUM AND ORDER                                  

BEATTY, Magistrate Judge:                                                 
    Presently before the Court are a series of motions filed by Plaintiff Joseph Harrison 
and Defendants Carissa Luking, Lynn Pittman, Doris Williams, Dee Dee Brookhart, and 
Lori Cunningham. For the reasons set forth below, Plaintiff’s motion for leave to file 
amended complaint is GRANTED in part and DENIED in part (Doc. 108); Plaintiff’s 
motion to appoint counsel is DENIED (Doc. 117); Plaintiff’s motion to strike electronically 
filed documents is DENIED as MOOT (Doc. 118); and Defendants’ motions for summary 
judgment for Plaintiff’s failure to exhaust administrative remedies are DENIED as MOOT 
(Docs. 97, 100, 103).                                                     
                PROCEDURAL AND FACTUAL BACKGROUND                        
    On June 30, 2021, Plaintiff filed this civil rights action pursuant to 
42 U.S.C. § 1983
 
(Doc. 1). Plaintiff’s Complaint alleges that, while housed at Lawrence Correctional Center 
(“Lawrence”), Defendants failed to provide with him constitutionally adequate treatment 
for his illnesses, HLA-B27 (an autoimmune disorder also referred to as ankylosing 
spondylitis) and scleritis (Id.; see also Doc. 10).                       
    Specifically, Plaintiff alleges that his mother advised him to request a test for HLA-

B27 after he began experiencing symptoms associated with the disorder (Doc. 10 at p. 2). 
On May 7, 2019, Plaintiff met with Dr. Pittman to discuss his symptoms and potential 
treatment (Id.). Plaintiff also informed Dr. Pittman that his mother, brother, sister, and 
nephew had all been diagnosed with ankylosing spondylitis (Id.). Plaintiff claims he 
received  no  testing  or  treatment  following  his  appointment.  As  a  result,  he  filed 
numerous grievances related to his symptoms, and the lack of treatment and testing (Id.).  

    Plaintiff met with nurse practitioner Sara Stover on April 30, 2020, and May 21, 
2020 (Id.). Stover had not heard of HLA-B27 and instructed Plaintiff to pursue testing 
after his release because such testing would not be performed at Lawrence (Id.). Plaintiff 
met with Dr. Pittman again on July 10, 2020, and provided Dr. Pittman with his family’s 
medical records related to HLA-B27 (Id. at p. 3). On October 30, 2020, Plaintiff had a 

medical  episode  wherein  he  experienced  numerous  symptoms  including  difficulty 
breathing, chest tightness, severe pain, and numbness (Id.). Medical staff at Lawrence 
concluded the episode was due to asthma but Plaintiff believes it was related to HLA-
B27 (Id.). Plaintiff experienced another, similar episode on November 1, 2020 (Id.).  
    Plaintiff met with Dr. Shah on November 9, 2020, to discuss his ongoing health 

issues (Id.). Dr. Shah told Plaintiff it was possible that he had HLA-B27 and that treatment 
would  begin  immediately  (Id.).  Plaintiff  claims  Dr.  Shah  stated  that  he  would  be 
prescribed folic acid, meloxicam, methotrexate, and Humira (Id.). However, Plaintiff only 
received folic acid, meloxicam, and methotrexate (Id.). As a result, Plaintiff filed an 
emergency  grievance  about  the  failure  to  provide  him  with  Humira  (Id.).  Lori 
Cunningham, the health care unit administrator, responded to his emergency grievance 

by informing Plaintiff that there was no order for Humira in his medical chart (Id.). 
Cunningham also wrote that Plaintiff would be placed on the physician call line for 
review of his plan of care (Id.).                                         
    On February 17, 2021, Plaintiff met with nurse practitioner Carissa Luking (Id.). 
Plaintiff asked Luking about seeing Dr. Shah and she informed him that Wexford had 
scheduled him to see a rheumatologist (Id. at pp. 3-4). Plaintiff’s symptoms continued to 

worsen during this time period (Id. at p. 4). Plaintiff met with Dr. Williams on June 10, 
2021 (Id.). At the appointment, Plaintiff again inquired about being prescribed Humira 
(Id.). Dr. Williams stated she thought he was already receiving Humira and inquired as 
to whether he had seen a rheumatologist (Id.). The next day, Plaintiff met with Stover 
who diagnosed swelling in his right elbow and hand as progressive HLA-B27 (Id.). 

Additionally, Plaintiff alleges that the continued delays he has experienced in being 
diagnosed and treated for HLA-B27 is the result of Wexford’s collegial review process 
(Id.).                                                                    
    The Court conducted a preliminary review pursuant to 28 U.S.C. § 1915A and 
permitted Count I to proceed against multiple Defendants:                 

    Count I:   Eighth Amendment deliberate indifference claim against Dr. 
              Pittman, Dr. Shah, Dr. Williams, Cunningham, Brookhart, NP 
              Stover, NP Luking, John/Jane Does 1-12 and Wexford for     
              failing to provide Harrison adequate treatment for his serious 
              medical conditions, HLA-B27 and scleritis.                 

(Doc. 10 at pp. 4-5). Count II was dismissed with prejudice and Counts III and IV were 
dismissed without prejudice (Id. at p. 8).                                
    On January 21, 2022, Luking, Dr. Shah, and Wexford filed a motion to dismiss for 

failure to state a claim (Doc. 29). The Court granted in part and denied in part the motion 
to dismiss (Doc. 59). Specifically, the Court held Plaintiff stated an adequate claim as to 
Dr. Shah and Luking (Id. at pp. 8-10). However, the Court found Plaintiff’s claim against 
Wexford and John/Jane Does 1-12 were not sufficiently pleaded because Plaintiff failed 
to demonstrate a sufficient causal link between Wexford’s policy of collegial review and 
his medical problems (Id. at pp. 10-12). “Quite the opposite, the complaint indicates that 

[Plaintiff’s]  visit  with  an  outside  specialist  was  approved  via  the  collegial  review 
process.” (Id. at p. 12) Consequently, Wexford and John/Jane Does 1-12 were dismissed 
without prejudice (Id.).                                                  
    Thereafter, Defendants Luking, Dr. Pittman, Doris Williams, Dee Dee Brookhart, 
and Cunningham filed motions for summary judgment for Plaintiff’s failure to exhaust 

administrative remedies (see Docs. 97, 100, 103).1 Several weeks later, on August 24, 2023, 
Plaintiff filed the instant motion for leave to file an amended complaint (Doc. 108). 
Plaintiff’s motion seeks to reintroduce Wexford as a defendant and reintroduce and 
identify Dr. Garcia as one of the John Doe defendants listed in his original complaint (Id. 
at pp. 1-2). Plaintiff also seeks to add three new defendants including Dr. Myers, Lars 

Gentry, and Lori Livingston as Defendants (Id. at p. 2). Defendants filed a joint response 

1 The Court acknowledges the confusion caused to the parties by the deadlines imposed in the Court’s 
initial scheduling order (Doc. 96). The Court has since revised its scheduling order policies to require 
motions to amend to be filed prior to the deadline to file dispositive motions regarding the exhaustion of 
administrative remedies.                                                  
in opposition to Plaintiff’s motion for leave to amend (Doc. 112). Plaintiff has since filed 
a reply brief in support of his motion to amend (Doc. 119).               

    Additionally, Plaintiff has also filed a motion to appoint counsel (Doc. 109) and a 
motion to strike two documents that were erroneously filed (Doc. 118).    
                           DISCUSSION                                    
 I.   Motion for Leave to Amend (Doc. 108)                               
    Plaintiff’s motion for leave to amend and proposed amended complaint includes 
additional allegations and defendants (see generally Doc. 108). For simplicity’s sake, the 

Court addresses the additional allegations against the proposed defendants in turn. 
Ultimately, as explained below, the Court GRANTS in part and DENIES in part Plaintiff’s 
motion for leave to amend.2                                               
      a.  Applicable Legal Standards                                     
    Federal Rule of Civil Procedure 15(a)(2) instructs the courts to “freely give leave 

[to amend a complaint] when justice so requires.” See also Glover v. Carr, 
949 F.3d 364, 370
 
(7th Cir. 2020) (“Leave to amend a complaint should be granted liberally.”). However, 
Rule 15(a)(2) does not require that leave to amend be granted in every situation. Airborne 
Beepers & Video, Inc. v. AT & T Mobility LLC, 
499 F.3d 663, 666
 (7th Cir. 2007). “Reasons for 
finding that leave should not be granted include ‘undue delay, bad faith or dilatory 


2 Defendants also argue that Plaintiff’s motion for leave to amend should be denied because it fraudulently 
relies upon Plaintiff’s mother’s prescription for Humira. The Court does not agree with this assessment. 
Plaintiff alleges that he was told he would be prescribed Humira and explains that he only provided his 
mother and brother’s medical records as further evidence of his family’s susceptibility to this condition. 
Moreover, to the extent Defendants have argued that Plaintiff must provide his own prescription for 
Humira, that argument is better addressed at summary judgment on the merits. 
motive on the part of the movant, repeated failure to cure deficiencies by amendments 
previously allowed, undue prejudice to the opposing party by virtue of allowance of the 

amendment, futility of amendment....’” 
Id.
 (quoting Foman v. Davis, 
371 U.S. 178, 182
, 
(1962)). Nonetheless, when a court is exercising its discretion to deny leave to amend, it 
must provide a justifying reason for doing so. Foman, 
371 U.S. at 182
.    
    When analyzing futility, “[a] district court need not allow the filing of an amended 
complaint, even when no responsive pleading has been filed, if it is clear that the 
proposed amended complaint is deficient and would not survive a motion to dismiss.” 

Johnson v. Dossey, 
515 F.3d 778, 780
 (7th Cir. 2008). See also Glassman v. Computervision 
Corp., 
90 F.3d 617, 623
 (1st Cir. 1996) (“There is no practical difference, in terms of review, 
between a denial of a motion to amend based on futility and the grant of a motion to 
dismiss for failure to state a claim.”). “To survive a motion to dismiss, a complaint must 
contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible 

on its face.’” McCoy v. Iberdrola Renewables, Inc., 
760 F.3d 674, 685
 (7th Cir. 2014) (quoting 
Ashcroft v. Iqbal, 
556 U.S. 662, 678
 (2009)).3                            
    Under the Eighth Amendment, prison officials are required to provide healthcare 
to incarcerated persons who cannot obtain healthcare on their own. See Howell v. Wexford 
Health Sources, Inc., 
987 F.3d 647, 653
 (7th Cir. 2021). To establish an Eighth Amendment 

claim for deliberate indifference under 
42 U.S.C. § 1983
, a plaintiff must demonstrate that: 


3 In addition, “in cases controlled by the PLRA, the Court is required to conduct a prompt, fresh threshold 
review under 28 U.S.C. 1915A.” Hardy v. Illinois Dep’t of Corr., No. 15-CV-0437-MJR-SCW, 
2017 WL 4224027
, 
at *1 (S.D. Ill. Sept. 22, 2017).                                         
(1) he or she had an objectively serious medical need; and (2) the individual defendants 
were deliberately indifferent to that need. See Dean v. Wexford Health Sources, Inc., 
18 F.4th 214
, 241 (7th Cir. 2021); Petties v. Carter, 
836 F.3d 722, 727-28
 (7th Cir. 2016). To establish 
that a defendant acted with deliberate indifference, “the Supreme Court has instructed 
us that a plaintiff must provide evidence that an official actually knew of and disregarded 
a substantial risk of harm.” Petties, 868 F.3d at 728. “Even objective recklessness—failing 
to act in the face of an unjustifiably high risk that is so obvious that it should be known—
is insufficient to make out a claim.” Id.                                 

      b.  Dr. Garcia                                                     
    Plaintiff’s motion for leave and proposed amended complaint seek to advance a 
deliberate indifference claim against Dr. Garcia, a medical director at Wexford (Doc. 108 
at pp. 1-2). Pertinently, Plaintiff seeks to impose liability against Dr. Garcia based upon 
his admission that he was aware that Plaintiff was approved for Humira (see Doc. 119, p. 

9). Ultimately, the Court DENIES Plaintiff’s request to amend his complaint to name Dr. 
Garcia as a defendant because such an amendment would be futile.          
    Significantly, Plaintiff’s proposed claim against Dr. Garcia relies exclusively on the 
fact  that  Dr.  Garcia  knew  of  Plaintiff’s  medical  condition.  However,  knowledge of 
Plaintiff’s condition alone is insufficient to establish Eighth Amendment liability. In order 

to state a claim for deliberate indifference, Plaintiff needed to allege that Dr. Garcia was 
aware of a substantial risk that medical staff at Lawrence would not give Plaintiff the 
Humira and then disregarded that risk. See, e.g., Perez v. Fenoglio, 
792 F.3d 768, 776
 (7th 
Cir. 2015) (“Deliberate indifference occurs when a defendant realizes that a substantial 
risk of serious harm to a prisoner exists, but then disregards that risk.”). Here, Plaintiff 
has not made such an allegation. Furthermore, given Dr. Garcia’s alleged role at Wexford 

to review medications and treatment for countless inmates, it would be untenable to 
impose a duty upon him to independently confirm that medication has been properly 
administered for every inmate whose medical file he reviews.              
    Consequently, the Court finds that granting Plaintiff leave to amend against Dr. 
Garcia would be futile. And as a result, Plaintiff will not be permitted to amend his 
complaint to include a claim against Dr. Garcia.                          

      c.  Dr. Meyers                                                     
    Plaintiff also seeks to amend his complaint to name Dr. Meyers, the medical 
director at Lawrence, as a defendant (Doc. 108 at p. 2). However, Plaintiff also concedes 
that “the deliberate indifference claim against Dr. Meyer is not a strong one[.]”  
    The Court believes that granting leave to amend and add a claim against Dr. 

Meyers would likewise be futile. For one, Plaintiff has not alleged that Dr. Meyers was 
the acting medical director at the time period in question. Plaintiff’s alleged complaint 
appears to acknowledge this point and states Dr. Meyers is “now the medical doctor here 
at Lawrence … [and] has the authority to correct all the wrongs don[e] to the plaintiff by 
prescribing the Humira as promised by Vipin Shah.” Nonetheless, even if Dr. Meyers 

was the acting medical director during the time period in question, Plaintiff has still failed 
to include allegations that could establish a claim of deliberate indifference against Dr. 
Meyers. The “contention that any public employee who knows (or should know) about a 
wrong must do something to fix it is just an effort to evade, by indirection, Monell’s rule 
that public employees are responsible for their own misdeeds but not for anyone else’s.” 
Burks v. Raemisch, 
555 F.3d 592, 596
 (7th Cir. 2009). See also Odogba v. Wisconsin Dep’t of 

Just., 
22 F. Supp. 3d 895, 910
 (E.D. Wis. 2014) (“In the context of a Rule 12(b)(6) motion, a 
plaintiff must allege enough facts to show that a defendant was personally involved in a 
constitutional deprivation.”). For all these reasons, amending his complaint to include 
Dr. Meyers would be futile, and therefore is denied.                      
      d.  Lars Gentry                                                    
    Plaintiff seeks to name Lars Gentry, an  optometry doctor at Lawrence,  as a 

defendant (Doc. 108 at p. 2). Specifically, Plaintiff’s proposed amended complaint states 
Gentry proscribed him prednisone eyedrops for twelve months to treat his scleritis. 
Plaintiff claims the eyedrops were highly effective, but after twelve months, Gentry 
would only prescribe him eyedrops for shorter periods of time after he filed complaints 
due to Gentry’s concern that Plaintiff’s continued use of prednisone could result in 

glaucoma in his eye. Plaintiff also alleges Gentry could have prescribed him Humira to 
treat his symptoms.                                                       
    Allowing Plaintiff leave to amend to add a claim against Gentry would be futile 
for several reasons. First, Plaintiff admits Gentry was treating him and that he only 
altered treatment over reasonable medical concerns about continued prednisone use. 

Significantly, Plaintiff was entitled to reasonable measures to prevent a serious risk of 
harm, but not to his preferred course of treatment. See Grund v. Murphy, 
736 F. App’x 601
, 
604 (7th Cir. 2018). “To infer deliberate indifference on the basis of a physician’s treatment 
decision, the decision must be so far afield of accepted professional standards as to raise 
the inference that it was not actually based on a medical judgment.” Norfleet v. Webster, 
439 F.3d 392, 396
 (7th Cir. 2006). Here, Plaintiff’s allegations demonstrate that Gentry’s 

treatment was reasonable and came down to a matter of medical judgment, to which 
Plaintiff’s preferred course of treatment does not take precedence over. 
Id.
 Plaintiff’s 
complaint that Gentry did not prescribe him Humira fails for similar reasons, along with 
suffering from the erroneous assumption that an eye doctor can prescribe Humira. 
    For these reasons, allowing Plaintiff leave to amend his complaint to name Gentry 
would be futile. Therefore, Plaintiff’s motion for leave is denied in this regard. 

      e.  Lori Livingston                                                
    Plaintiff’s motion also seeks to amend his complaint to add Lori Livingston as a 
defendant (Doc. 108 at p. 2). As alleged, Lori Livingston is a grievance officer at Lawrence 
who denied several of Plaintiff’s grievance filings related to testing for HLA-B27 and 
Humira.                                                                   

    Notably, Plaintiff’s attempt to advance a claim against Livingston would be futile 
because it attempts to hold her responsible for denying his grievances and not taking 
action based upon them. Seventh Circuit precedent makes it abundantly clear that such 
claims are impermissible. See, e.g., George v. Smith, 
507 F.3d 605, 609
 (7th Cir. 2007) 
(“Ruling against a prisoner on an administrative complaint does not cause or contribute 

to the violation.”); Owens v. Evans, 
878 F.3d 559, 563
 (7th Cir. 2017) (“Prison officials who 
simply  processed  or  reviewed  inmate  grievances  lack  personal  involvement  in  the 
conduct forming the basis of the grievance.”); Terry v. Vandalia Corr. Ctr., No. 3:21-CV-
00878-SMY, 
2021 WL 5579579
, at *3 (S.D. Ill. Nov. 30, 2021) (“[P]rison officials incur no 
liability under § 1983 if they fail or refuse to investigate a prisoner’s complaints or 
grievances.”).  For  this  reason,  Plaintiff’s  request  to  amend  his  complaint  to  name 

Livingston as a defendant is denied.                                      
      f.  Wexford Collegial Review                                       
    Plaintiff  also  seeks  to  amend  his  complaint  to  assert  an  Eighth  Amendment 
deliberate indifference claim against Wexford alleging a delay in his treatment due to 
Wexford’s collegial review process (Doc. 108 at pp. 2-3). Plaintiff further alleges that 
Wexford’s protocols and handbook provide additional evidence of Wexford’s deliberate 

indifference to his serious medical needs (Id.).                          
    Before further examining Plaintiff’s claim, a brief summary of Wexford’s collegial 
review process is necessary. According to the Seventh Circuit:            
    Collegial review is Wexford’s procedure for discussing and approving 
    offsite care for inmates. When a Wexford doctor decides that an inmate 
    needs offsite care, the doctor submits a referral request form to the medical 
    director of the inmate’s facility. If the medical director agrees with the 
    request, the medical director presents the request at a collegial review. The 
    medical  director,  too,  can  submit  referral  request  forms.  The  collegial 
    review itself is a call between the medical director and a Wexford doctor in 
    Pittsburgh who either approves the offsite service or suggests an alternate 
    plan of care. If collegial review approves the offsite care, Wexford sends the 
    prison an authorization number, at which point the prison calls the offsite 
    specialist to schedule an appointment. Collegial reviews generally occur on 
    a weekly basis. If collegial review approves offsite care, it usually takes an 
    additional 24 to 48 hours for Wexford to send the prison an authorization 
    number.                                                              

Dean v. Wexford Health Sources, Inc., 
18 F.4th 214
, 222-23 (7th Cir. 2021). See also Howell v. 
Wexford Health Sources, Inc., 
987 F.3d 647
 (7th Cir. 2021).               
    Critically, while section 1983 creates a private right of action against any “person” 
who violates the plaintiff’s federal rights while acting under color of state law, the 

Supreme Court has ruled that municipalities are also “persons” who may be sued under 
section 1983. See Monell v. Dep’t of Soc. Servs. of City of New York, 
436 U.S. 658, 690
 (1978); 
Dean, 18 F.4th at 235. Furthermore, the Seventh Circuit has held that “Monell governs 
Wexford’s  liability  in  this  case  because  we,  like  our  sister  circuits,  treat  private 
corporations acting under color of state law as municipalities.” Dean, 18 F.4th at 235. 
However, a municipality or private corporation is only liable under § 1983 for its own 

violations of the federal Constitution and laws. Monell, 
436 U.S. at 694
. This means a 
municipality cannot be “sued under § 1983 for an injury inflicted solely by its employees 
or agents.” Id.                                                           
    Therefore, in order to raise a successful Monell claim against Wexford, Plaintiff 
must first show that he was deprived of a federal right. Dean, 18 F.4th at 235. Second, 

Plaintiff would have to trace the deprivation to Wexford’s actions. Id. There are at least 
three types of municipal action that may give rise to liability, including: “(1) an express 
policy that causes a constitutional deprivation when enforced; (2) a widespread practice 
that is so permanent and well-settled that it constitutes a custom or practice; or (3) an 
allegation that the constitutional injury was caused by a person with final policymaking 

authority.” Spiegel v. McClintic, 
916 F.3d 611, 617
 (7th Cir. 2019) (quoting Estate of Sims ex 
rel. Sims v. Cty. of Bureau, 
506 F.3d 509, 515
 (7th Cir. 2007)). Third, Plaintiff must show that 
Wexford’s “policy or custom demonstrates municipal fault, i.e., deliberate indifference.” 
Dean, 18 F.4th at 235 (internal citation and quotation marks omitted). Finally, Plaintiff 
must also establish that Wexford’s action was the moving force behind the federal rights 
violation. Id. To establish such causation, Plaintiff must demonstrate a direct causal link 

between Wexford’s policy and the violation of his constitutional right. Id. 
    Plaintiff’s  proposed  amended  complaint  adequately  alleges  a  constitutional 
deprivation based upon his injuries due to delayed care. See Howell v. Wexford Health 
Sources, Inc., 
987 F.3d 647, 653
 (7th Cir. 2021) (“Denying or delaying appropriate treatment 
to  an  incarcerated  person  suffering  from  avoidable  pain  can  violate  the  Eighth 
Amendment.”). Additionally, the Seventh Circuit has already held that collegial review 

is an express policy. Dean, 18 F.4th at 236 (“Dean relies on an express policy (collegial 
review)[.]”).  Consequently,  the  viability  of  Plaintiff’s  proposed  amended  complaint 
hinges upon whether it adequately alleges municipal fault and moving-force causation. 
Id.                                                                       
    Ultimately,  at  this  stage  of  the  proceedings,  Plaintiff’s  proposed  amended 

complaint adequately alleges both of these requirements. For one, Plaintiff’s complaint 
adequately  alleges  that  Wexford’s  collegial  review  process  demonstrates  deliberate 
indifference  to  his  need  for  timely,  appropriate  medical  treatment.  And  similarly, 
Plaintiff’s complaint adequately alleges a direct causal link between Wexford’s collegial 
review process and the claimed delay in Plaintiff’s treatment that caused him injury and 

violated his constitutional rights.                                       
    In response, Defendants argue that the Seventh Circuit has held that the collegial 
review process is constitutional (Doc. 112 at p. 10). See Howell v. Wexford Health Sources, 
Inc., 
987 F.3d 647, 651
 (7th Cir. 2021) (“The collegial review process is not unconstitutional 
on its face, and when we dig into the details of this case, we find that Howell did not offer 
evidence that would let a reasonable jury find that the collegial review process caused 

any violation of his Eighth Amendment rights.”). Accordingly, Defendants contend that 
regardless of Plaintiff’s new allegations related to collegial review, his claim fails as a 
matter of law. Admittedly, Defendants are correct in that the Seventh Circuit has held 
collegial review is not facially unconstitutional. Id.; Dean, 18 F.4th at 236. Yet such a 
determination alone does not foreclose Plaintiff’s challenge. Plaintiff could (and has) 
alleged that collegial review caused unconstitutional delays as applied to him. Dean, 18 

F.4th at 236. While such a claim creates “difficult problems of proof” and requires proving 
a pattern of similar constitutional violations, those will be challenges for Plaintiff to 
address as this case progresses and ultimately at summary judgment. See id.4 However, 
when scrutinizing Plaintiff’s complaint under a motion to dismiss standard, Plaintiff 
merely needed to allege considerably more than a single incident to establish both 

requisite fault and a causal connection between the policy and constitutional deprivation. 
And ultimately, Plaintiff’s complaint does raise such allegations.        
    Defendants  also  argue  that  Plaintiff’s  claim  necessarily  fails  because  he  was 
approved to see an outside specialist (Doc. 112 at p. 9). However, this argument is not an 

4 In Dean, the Seventh Circuit found the plaintiff failed to introduce “any substantive evidence of a pattern 
or practice of similar violations.” 18 F.4th at 237. Significantly, however, the court was reviewing Plaintiff’s 
claim following a trial based upon the district court’s decision to deny the defendants’ post-trial motion for 
judgment as a matter of law. Likewise, in Howell, the Seventh Circuit was reviewing a decision by the 
district court to grant Wexford’s motion for judgment as a matter of law after a jury verdict had been 
returned against Wexford. 
987 F.3d at 652
. Additionally, several other cases have reviewed this issue when 
dealing with a motion for summary judgment, which involves a different standard of review and additional 
evidentiary requirements. See, e.g., Cohn v. Wexford Health Sources, Inc., No. 3:19-CV-00376-NJR, 
2022 WL 2802304
, at *2 (S.D. Ill. July 18, 2022); Harper v. Wexford Health Sources, Inc., No. 14-CV-04879, 
2023 WL 6213683
, at *6 (N.D. Ill. Sept. 25, 2023), appeal pending, Case No. 14-cv-04879 (7th Cir. Oct. 16, 2023).  
accurate assessment of Plaintiff’s claim against Wexford. Plaintiff is not alleging that 
Wexford’s collegial review process altogether denied him of necessary medical care. 

Instead, Plaintiff is alleging that Wexford was deliberately indifferent to his serious 
medical needs because its collegial review process delayed his ability to receive timely, 
necessary care. Again, while Plaintiff will ultimately be required to provide sufficient 
evidence to support his allegations, he is not required to do so at this stage of the 
proceedings.                                                              
    Therefore, Plaintiff is GRANTED leave to file an amended complaint re-naming 

Wexford as a Defendant and challenging Wexford’s collegial review process.5  
 II.  Motion to Appoint Counsel (Doc. 117)                               
    Plaintiff has also filed another motion for the appointment of counsel (Doc. 117; 
see also Docs. 3; 33; 58). In this motion, Plaintiff requests court appointed counsel because 
of the complexity of this case (Doc. 117).                                

    The Court has addressed and rejected similar arguments raised by Plaintiff in prior 
motions (see Doc. 10 (denying first motion for recruitment of counsel because Plaintiff 
appears competent to try this matter); Doc. 52 (denying second motion for recruitment of 
counsel);  Doc.  72  (denying  an  additional  motion  for  counsel  because  Plaintiff  has 
repeatedly demonstrated that he is capable of representing himself)). Plaintiff’s instant 

motion again fails to explain why he cannot litigate the present stage of proceedings on 

5 Typically in cases controlled by the PLRA, after an amended complaint is filed, the Court is required to 
conduct a prompt, fresh preliminary review under 28 U.S.C. § 1915A. See Hardy v. Illinois Dep’t of Corr., No. 
15-CV-0437-MJR-SCW, 
2017 WL 4224027
, at *1 (S.D. Ill. Sept. 22, 2017). Here, however, because the Court 
already found Plaintiff’s collegial review claim against Wexford survives preliminary review and that is 
the only amended claim Plaintiff is granted leave include, the Court will not re-conduct preliminary review. 
his own. See Pruitt v. Mote, 
503 F.3d 647, 654
 (7th Cir. 2007) (articulating factors courts 
consider when evaluating motions for counsel). Plaintiff’s filings are competent, well-

written, and demonstrate a detailed understanding of the legal system that the Court 
does not commonly see in pro se litigants.                                
    Additionally, in the Court’s prior denials of Plaintiff’s motions, the Court has 
stated that Plaintiff may refile his motion after discovery has commenced if he has 
significant difficulty during the discovery process (Doc. 10 at p. 8; Doc. 52 at p. 2). 
Currently, discovery on the merits has not yet commenced because Defendants have 

challenged whether Plaintiff exhausted his administrative remedies. Moreover, nothing 
in Plaintiff’s current motion for recruitment of counsel explains why the Court should 
contradict its earlier orders and grant Plaintiff’s instant motion for recruitment of counsel 
at this stage of the proceedings.                                         
    Accordingly, the Court DENIES Plaintiff’s motion for recruitment of counsel (Doc. 

117). However, the denial is without prejudice, meaning Plaintiff may file another motion 
for recruitment of counsel after the Court has reached a decision on Defendants’ pending 
motions for summary judgment based on the failure to exhaust administrative remedies. 
 III.  Motion to Strike Electronically Filed Documents (Doc. 118)        
    Plaintiff has also filed a motion to strike, which seeks to strike a partially filed 

proposed amended complaint that Plaintiff submitted in error (Doc. 109). Plaintiff also 
seeks to strike a third amended complaint he claims to have filed on September 1, 2023. 
Ultimately, the Court DENIES Plaintiff’s motion as MOOT.                  
    Regarding  the  partially  filed  proposed  amended  complaint  (Doc.  109),  that 
document is not the operative complaint and was not e-filed as an amended complaint, 

so there is no need to strike it. See Johnson v. Dossey, 
515 F.3d 778, 780
 (7th Cir. 2008) 
(“When an amended complaint is filed, the prior pleading is withdrawn and the amended 
pleading is controlling.”). Similarly, the proposed amended complaint purportedly e-
filed by Plaintiff on September 1, 2023, does not need to be stricken because it was not 
even filed on the court’s docket so there is nothing to strike. Finally, in light of the Court’s 
above rulings, Plaintiff is required to file a new, narrower amended complaint that 

comports with the Court’s Order and only adds a claim against Wexford.    
 IV.  Motions for Summary Judgment on Exhaustion of Administrative Remedies 
    The Court is cognizant of the pending motions for summary judgment on the issue 
of exhaustion filed by Defendants (Docs. 97, 100, 103). However, in light of the Court’s 
decision  to  permit  Plaintiff  to  file  an  amended  complaint  re-naming  Wexford  as  a 

defendant, the Court opts to deny the pending motions for summary judgment on the 
issue of exhaustion as moot rather than leave these motions pending and then allow 
additional motions to be filed after Plaintiff files his amended complaint.  
    Accordingly,  Plaintiff  is  ordered  to  file  an  amended  complaint  on  or  before 
December 13, 2023. Thereafter, Defendants will be permitted to file new motions for 

summary judgment on the issue of exhaustion on or before January 12, 2024. Defendants 
can simply restate all of the arguments already contained in their motions if desired and, 
in the case of Wexford, add an additional argument regarding Plaintiff’s Monell claim, if 
necessary.                                                                
                          CONCLUSION                                     
    For the reasons outlined above, Plaintiff’s motion for leave to amend is GRANTED 
in part and DENIED in part (Doc. 108); Plaintiff’s motion to appoint counsel is DENIED 

(Doc. 117); and Plaintiff’s motion to strike is DENIED as MOOT (Doc. 118). Additionally, 
Plaintiff is ORDERED to file an amended complaint that complies with this Order, 
meaning the only new claim he may add is a deliberate indifference claim against 
Wexford based upon its collegial review process. Furthermore, in light of the Court’s 
decision to permit Plaintiff to amend his complaint, Defendants’ motions for summary 

judgment on the issue of exhaustion of administrative remedies are DENIED as MOOT 
(Docs. 97, 100, 103).                                                     
    Plaintiff’s amended complaint is due on or before December 13, 2023. Defendants’ 
motions for summary judgment on the issue of exhaustion are due on or before January 
12, 2024.                                                                 

    IT IS SO ORDERED.                                                    
    DATED:  November 22, 2023                                            
                                  s/ Mark A. Beatty                      
                                  MARK A. BEATTY                         
                                  United States Magistrate Judge         

Updated/additional case information may be available. To access this record:

  1. Go to: https://www.courtlistener.com/opinion/9690430/harrison-v-wexford-health-sources-inc/.