by David M. Reutter

The U.S. Court of Appeals for the Seventh Circuit affirmed June 18, 2020 the grant of summary judgment for defendants in a prisoner’s lawsuit alleging deliberate indifference to his dental infection.

Illinois prisoner Aaron Murphy had a molar in his upper-left jaw extracted on May 4, 2016, by a dentist at his prison. Two days later, a Friday, Murphy went to the prison’s health-care unit with a “softball-sized” swelling in his cheek. Suspecting infection, the nurse spoke to Dr. Vipin Shah, who worked for the prison’s medical contractor, Wexford Health Services, Inc.

Shah prescribed penicillin by mouth twice a day for five days because it is “one of the most commonly chosen drugs for M.D.s for medical infection.” Murphy alleged he received one dose that morning, but he could not orally take further doses due to the swelling. The next day, Murphy reported twice to medical due to difficulty swallowing; he was unable to open his mouth wide enough for a nurse’s exam due to the swelling. He was given Benadryl. Shah was subsequently contacted and unconcerned because penicillin takes days to work, but he ordered a steroid injection.

Two days after that, Shah examined Murphy for the first time. He noted Murphy was having difficulty closing his mouth and swallowing. Another steroid injection and infirmary watch was ordered. During an examination on May 10, Shah noted indication of an infection at the extraction point. He gave Murphy an injection of a different antibiotic. Later that day, his temperature spiked to 105 degrees.

Before noon May 11, the nurse noted Murphy faint whistling when Murphy breathed. She contacted Shah by phone, and he ordered Murphy to be sent to a local hospital’s emergency room. After a CT scan, Murphy was diagnosed with Ludwig’s angina, a disease that involves infections of nearly all the anatomic spaces in the neck and requires urgent surgical treatment. Murphy underwent three surgeries to drain the fluid and clean the incisions.

Murphy sued, charging Shah with deliberate indifference in an Illinois federal district court. The district court granted Shah summary judgment, finding Murphy only raised a disagreement with his treatment.

On appeal, the Seventh Circuit agreed. While Murphy’s expert, Dr. Robert Citronberg, opined that Shah “ignored the obvious progression [to] the severe infection that [Murphy] ultimately suffered,” he also agreed Shah was provided “what he thought was the right treatment.”

The court noted that Shah did not continue with the same ineffective treatment, as he switched to a different antibiotic with the injection.

Citronberg’s testimony and statements in the case only suggest negligence and a difference of opinion with the steroid treatment “rather than deliberate indifference.” As such, the district court’s order was affirmed. See: Murphy v. Wexford Health Services, Inc., 962 F.3d 911 (7th Cir. 2020). 

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