In the
United States Court of Appeals
For the Seventh Circuit
____________________
No. 19-2629
JACQUELINE JONES,
Independent Administrator of the
Estate of Toya D. Frazier, Deceased,
Plaintiff-Appellant,
v.
ARNOLD MATHEWS, et al.,
Defendants-Appellees.
____________________
Appeal from the United States District Court for the
Central District of Illinois.
No. 16-cv-02364 — Eric I. Long, Magistrate Judge.
____________________
ARGUED DECEMBER 7, 2020 — DECIDED JUNE 21, 2021
____________________
Before SYKES, Chief Judge, and BRENNAN and ST. EVE, Circuit Judges.
ST. EVE, Circuit Judge. On November 30, 2015, Toya Frazier
reported to the Champaign County Satellite Jail to begin serving a 42-month sentence for felony theft. She died in her cell
less than 36 hours later.
2 No. 19-2629
Jacqueline Jones is Frazier’s sister and the Independent
Administrator of Frazier’s estate. She filed this action pursuant to 42 U.S.C. § 1983 against Sergeant Arnold Mathews, a
correctional officer at the jail, alleging that he caused Frazier’s
death by acting with deliberate indifference to Frazier’s symptoms of heroin withdrawal.1 The district court granted summary judgment in favor of the defendants, and we affirm.
I. Background
A. Factual Background
Frazier reported to the Champaign County Satellite Jail
around 8:45 a.m. on November 30, 2015. Shortly after her arrival, an officer at the jail conducted Frazier’s intake interview. Frazier, who was 45 years old at the time, informed the
officer that she was epileptic, subject to black-outs and fainting spells, had high blood pressure, had a history of substance
abuse, and over the course of 2015 had experienced a stroke
and undergone knee surgery. Frazier also reported that she
had used heroin the night before, though she was not experiencing withdrawal at the time of the intake. The officer gave
Frazier a “medical designation” because she required a cane
to walk and had high blood pressure. The medical designation meant that an officer would check on Frazier at least
every fifteen minutes. Because of the designation, Frazier was
assigned to cell F2 in the booking area with one cellmate.
Later that day, around 1:00 p.m., a nurse at the jail conducted Frazier’s health evaluation. Nurse Beth Novak noted,
1 Jones also sued Champaign County, Illinois, and other jail staff mem-
bers, but there are no issues on appeal pertaining to any party other than
Mathews.
No. 19-2629 3
among other things, that Frazier had experienced drug withdrawal once before, three years prior. Frazier informed Nurse
Novak of her prior night’s heroin use but did not report experiencing any pain or withdrawal symptoms at the time. Nurse
Novak described Frazier’s mental state at the time of the evaluation as “appropriate” in all respects. Frazier informed
Nurse Novak of several medications she was prescribed and
taking at the time, though Frazier had not brought any of her
medications with her to the jail. Because of Frazier’s high
blood pressure, Nurse Novak contacted a doctor who prescribed Frazier a blood pressure medication and Tylenol.
Nurse Novak conducted a second health evaluation later
that afternoon at 4:00 p.m., this time to gauge whether Frazier
was experiencing any withdrawal symptoms. Nurse Novak
completed a Clinical Opiate Withdrawal Scale (“COWS”)
scoresheet, and assigned Frazier a COWS score of 0, meaning
that she was not experiencing any withdrawal symptoms.
At approximately 6:45 p.m., correctional officer Jessica
Burgener escorted Frazier from her booking cell to the shower
room to conduct a strip search. She inspected Frazier’s clothing, cane, and knee brace and did not find any contraband.
Burgener then escorted Frazier back to her holding cell. Because of Frazier’s medical designation, Burgener checked on
Frazier approximately every twelve minutes. Each time Frazier reported that she was “feeling okay.”
That night, Mathews began his shift at 11:35 p.m. In general, Mathews serves as the jail’s direct supervisor while on
site. During his shifts, he is responsible for having a pulse on
everything happening at the jail and ensuring the safety of
everyone at the facility. He does not typically conduct individual cell checks but will do so when correctional officers
4 No. 19-2629
responsible for the task are otherwise occupied. Medical professionals are not on site during the night shift.
The first few hours of Mathews’s shift were uneventful. At
approximately 2:30 a.m., however, Frazier began moaning
and groaning loudly from her cell. Mathews and other correctional officers approached Frazier to find out what was
wrong, but Frazier did not explain the source of her discomfort. From Mathews’s perspective, Frazier “did not appear to
be in any medical distress” and was physically capable of
speaking, despite choosing not to. Frazier continued to loudly
moan.
Sometime around 2:50 a.m., Mathews relocated Frazier to
another cell within the booking area, reasoning that Frazier
“may be more comfortable in her own cell, her new cell could
still be easily monitored by correctional officers,” and the
move “may reduce her ability to disturb the detainees at the
jail.” Video surveillance of the cell shows Frazier rocking back
and forth on the ground, dry heaving, and using the toilet several times over the course of the next few hours.
At approximately 4:40 a.m., Frazier began kicking the cell
door from her sleeping mat on the ground. Mathews and
other correctional officers responded to Frazier several times,
but Frazier did not articulate what, if any, issues she was experiencing. Mathews instructed a correctional officer to pull
Frazier’s sleeping mat away from her cell door so that she
could not continue to kick it. According to Mathews, he worried that Frazier “may hurt herself if she kept kicking it (given
her knee brace/cane),” and “her kicks were disturbing other
inmates.” But once the officers left Frazier’s cell, she dragged
the sleeping mat back toward the front of the cell and again
began kicking the cell door. Twice more the officers returned
No. 19-2629 5
to Frazier’s cell, moved the sleeping mat away from the door,
only for Frazier to return the mat to its original location and
again begin kicking the cell door. During these encounters,
Frazier did not report any symptoms to the officers or otherwise tell them what was wrong.
At approximately 6:30 a.m., Frazier told Mathews that her
stomach hurt.2 Frazier told Mathews a total of three times that
she was experiencing stomach pain, but only the third time,
at approximately 6:45 a.m., did she mention heroin as the
cause. Mathews told Frazier he would tell the nurse about her
stomach pain. He did so approximately twenty minutes later
at 7:05 a.m. in a one-sentence email to the medical department: “This evening inmate Frazier was complaining of stomach pain due from withdrawing from heroin use can you see
her at your early convenience.” Mathews did not directly interact with Frazier again. Before the end of his shift, however,
Mathews personally encountered a nurse whom he informed
of Frazier’s heroin-related stomach pains. Mathews’s shift
ended at 8:30 a.m. on December 1, 2015.
Around 9:00 a.m., a nurse spoke with Frazier about her
stomach pains. Frazier did not voice any complaints at that
time, nor did she display any signs or symptoms of distress,
according to medical staff. The nurse then administered Frazier’s blood pressure medication and Tylenol. Around 11:00
a.m., jail medical staff conducted a second COWS assessment.
This time, Frazier reported that she was suffering from
2 The parties dispute the exact time at which Frazier reported having
stomach pains. They agree, however, that she first told Mathews of her
pains sometime between 6:30 a.m. and 7:00 a.m. The exact time is immaterial for our discussion.
6 No. 19-2629
abdominal pain at a ‘2’ level on a scale of 0–5 and that she felt
restless at a ‘5’ level on a scale of 0–5, for a total COWS score
of 7 out of 48, which placed Frazier in the “mild withdrawal”
category. Nurse Novak contacted a doctor who prescribed
heroin withdrawal medications for Frazier and instructed the
nurses to administer the medication immediately, and during
both morning and afternoon “med passes” from that point
forward.
Later that day, at approximately 2:30 p.m., Frazier asked
Nurse Novak when she would be receiving the next dose of
withdrawal medication. Nurse Novak informed Frazier that
she would receive her next dose when she made her afternoon
medication administration rounds. Frazier, however, never
received her next dose of withdrawal medication. At 3:23
p.m., security footage shows Frazier remove several small
items (later discovered to be pills) from a tissue in her toiletry
bag and place them in her mouth one at a time. At 3:50 p.m.,
Frazier had a seizure and stopped moving. A correctional officer found Frazier unresponsive at 5:11 p.m. and immediately called emergency personnel who transported Frazier to
the hospital where she was pronounced dead. A coroner conducted an autopsy and determined that Frazier died of “diphenhydramine toxicity due to or as a consequence of diphenhydramine misuse.”3 The pills Frazier ingested were
later determined to be Advil PM, Aleve PM, or a combination
3 As the district court pointed out, it is not entirely clear from the record whether “diphenhydramine toxicity” in this case means that Frazier
died of a diphenhydramine allergy or overdose. The difference is immaterial for our analysis, however, because it is undisputed that Frazier
smuggled the medication into the jail and ingested the pills on her own
volition.
No. 19-2629 7
of the two, both of which contain diphenhydramine, and had
not been given to her by jail staff members.
B. Procedural Background
Jones filed this action against Mathews in the wake of her
sister’s death. Jones alleges a claim of constitutional deprivation pursuant to 42 U.S.C. § 1983 and a wrongful death claim
under Illinois law.4 Defendants filed a motion for summary
judgment on May 15, 2019, which the district court granted
on August 9, 2019. Jones timely appealed.
II. Discussion
Jones argues on appeal that the district court erred in
granting summary judgment on her § 1983 and state law
wrongful death claims because it failed to construe the record
in the light most favorable to her as the non-movant. We review the district court’s grant of summary judgment de novo
and draw all inferences in favor of the non-moving party. Estate of Simpson v. Gorbett, 863 F.3d 740, 745 (7th Cir. 2017). Frazier’s death is unfortunate. But Jones has not demonstrated
that Mathews acted with deliberate indifference to deprive
Frazier of a constitutional right. We affirm the district court’s
grant of summary judgment.
A. Deliberate Indifference Claim
It is well established that “[p]rison officials violate the
Eighth Amendment’s proscription against cruel and unusual
punishment when their conduct demonstrates ‘deliberate
4Jones alleged eight additional claims in the operative complaint, including a claim for violation of the Americans with Disabilities Act, 42
U.S.C. § 12132, which are not relevant to this appeal.
8 No. 19-2629
indifference to serious medical needs of prisoners.’” Gutierrez
v. Peters,
111 F.3d 1364, 1369 (7th Cir. 1997) (quoting Estelle v.
Gamble,
429 U.S. 97, 104 (1976)). Jones contends that Mathews
caused Frazier’s death by acting with deliberate indifference
to Frazier’s heroin withdrawal. To assert a claim for deliberate
indifference, Jones must demonstrate (1) Frazier had an objectively serious medical condition, and (2) that Mathews was
deliberately indifferent to Frazier’s health or safety. See Orlowski v. Milwaukee Cnty.,
872 F.3d 417, 423 (7th Cir. 2017).
“This inquiry includes an objective and subjective component.” Jackson v. Illinois Medi-Car, Inc.,
300 F.3d 760, 764 (7th
Cir. 2002).
In general, a plaintiff satisfies the objective component of
the deliberate indifference inquiry with evidence that a physician has diagnosed a medical condition as requiring treatment, “or the need for treatment would be obvious to a layperson.” Lockett v. Bonson, 937 F.3d 1016, 1022–23 (7th Cir.
2019) (quotations and citations omitted). “A condition can be
‘obvious’ to a layperson even where he or she is unable to diagnose or properly identify the cause of an observed ailment.”
Orlowski,
872 F.3d at 423. When Frazier began expressing
physical discomfort, she had not been diagnosed by a physician as suffering from heroin withdrawal. But we will assume
for our discussion that Jones has met the objective component
of the deliberate indifference inquiry, because even assuming
that Frazier’s medical condition was sufficiently serious, Jones
has not demonstrated the subjective component.
To satisfy the subjective element, Jones must demonstrate
that Mathews was “both ‘aware of facts from which the inference could be drawn that a substantial risk of serious harm
exists,’ and that [he] actually drew the inference.” Orlowski,
No. 19-2629 9
827 F.3d at 424 (quoting Farmer v. Brennan, 511 U.S. 825, 837
(1994)). “[D]eliberate indifference describes a state of mind
more blameworthy than negligence,” Farmer,
511 U.S. at 835,
and it is Jones’s burden to show that Mathews acted with a
“sufficiently culpable state of mind.” Estate of Simpson,
863
F.3d at 747. A prison official acts with a sufficiently culpable
state of mind when he is aware of a substantial risk of serious
harm, and “effectively condones the harm by allowing it to
happen.” Eagan v. Dempsey,
987 F.3d 667, 693 (7th Cir. 2021).
Jones argues that based on his training and years of experience as a correctional officer, Mathews knew that Frazier
was experiencing opiate withdrawal, and knew that withdrawal poses a substantial risk of serious harm to someone
suffering from the condition. We are not so sure that the evidence supports this argument. First, when Mathews began his
shift, Frazier’s health records documented only that she had
used heroin the night before, and that as of 4:00 p.m. that afternoon, Frazier was not experiencing any symptoms of withdrawal. Frazier was given a medical designation because of
her knee problems and high blood pressure, not because of
her drug use. Second, when Frazier began moaning and
groaning, Mathews asked her what was wrong. Frazier
would not answer despite being capable of speaking, and did
not appear to be in medical distress. We need not decide, however, whether there is enough evidence to support a jury determination that Mathews knew that Frazier was experiencing withdrawal, because Jones faces an even bigger hurdle.
There is no evidence establishing that Mathews was aware of
the risk of substantial harm that Frazier ultimately suffered—
death from diphenhydramine toxicity.
10 No. 19-2629
It is undisputed that Frazier died from “diphenhydramine
toxicity due to or as a consequence of diphenhydramine misuse,” not heroin withdrawal. Frazier’s diphenhydramine misuse occurred when she—hours after Mathews’s shift ended—
ingested numerous pills that she smuggled into the jail without Mathews’s knowledge. Jones nonetheless contends that
Mathews was aware of this precise harm, because he is “a specialist with knowledge that inmates may smuggle items,” and
therefore “should reasonably have foreseen the risk that Frazier would smuggle in prohibited medication and misuse it.”
There is nothing in the record, however, to support this contention. Before Mathews’s shift began, Frazier had already
spent several hours at the jail. She had been strip searched,
and the correctional officer who conducted the search determined that Frazier did not possess contraband. Jones has not
produced any evidence to suggest that Mathews had any reason to question the accuracy of the search performed before
his shift began, and cites only Mathews’s general training as
a correctional officer in which he was taught to recognize
symptoms of withdrawal. Even if Jones can establish that
Mathews recognized that Frazier was experiencing withdrawal, there is no evidence from which a jury could reasonably determine that Mathews knew that there was a substantial risk that Frazier would die of diphenhydramine toxicity
from ingesting smuggled pills. If no reasonable jury could
find that Mathews was aware of that risk, then it follows that
he could not have consciously disregarded that risk. Jones’s
deliberate indifference claim thus fails.
Rice ex rel. Rice v. Correctional Medical Services, 675 F.3d 650
(7th Cir. 2012) is instructive. Rice was an inmate at the Elkhart
County Jail who suffered from schizophrenia. He died from
psychogenic polydipsia (excessive water drinking) at the jail
No. 19-2629 11
while awaiting placement in a state psychiatric facility. His
Estate filed an action pursuant to § 1983 alleging, in relevant
part, that jail officials and medical personnel had been deliberately indifferent to Rice’s declining psychological condition.
In the fifteen months that Rice spent at the jail, he had experienced several well-documented issues: he refused to take his
medication, eat, or bathe, and on one occasion, he cut his own
throat with a razor. Rice was in administrative segregation
one night when a nearby inmate heard Rice “gulping water
and vomiting in his cell.” Rice,
675 F.3d at 662. Inmates in the
surrounding cells kicked their cell doors in an attempt to get
someone’s attention, but no one showed up.
Id. Jail staff found
Rice dead in his cell early the next morning.
Id.
In support of its deliberate indifference claim, Rice’s Estate
argued that “there were fifteen months of warning signs prior
to his death that Rice could not care for himself and suffered
from self-destructive tendencies, and a jury could find that
staff members were subjectively aware of the substantial risk
that Rice might harm himself fatally in some way.” Id. at 678.
We rejected this claim because there was no evidence that any
jail staff had notice of the possibility that Rice might die from
psychogenic polydipsia, a rare condition which had not before been observed in Rice.
Id. We explained that even if a jury
could find that the jail guards “exhibited a generalized recklessness with respect to the safety of the inmates” housed in
administrative segregation by not conducting more frequent
cell checks, there was “no evidence that the guards were subjectively aware of the possibility that Rice might engage in a
behavior such as compulsive water drinking that would cause
him to die within a matter of hours and that they consciously
disregarded that risk.”
Id. at 679. Thus, we held, “no reasonable factfinder could find that [the guards] knew of, and were
12 No. 19-2629
deliberately indifferent to, a risk that Rice might come to medical harm like cardiac arrhythmia brought on by water toxicity.”
Id. at 680. The guards’ knowledge of Rice’s schizophrenia was not enough to establish their awareness of and indifference to the risk of Rice drinking so much water that he
died.
Jones’s argument here is similarly flawed. She argues that
because Mathews was deliberately indifferent to Frazier’s
heroin withdrawal symptoms, Frazier was forced to self-medicate with contraband Advil PM pills hours after Mathews
had left the jail. But even if we assume that a reasonable factfinder could conclude that Mathews recognized that Frazier
was suffering from withdrawal, no reasonable factfinder
could determine that Mathews knew of, and was indifferent
to, a risk that Frazier might die from diphenhydramine toxicity from ingesting smuggled pain medication. See id.
Mathews had no forewarning of this possibility, particularly
when the event occurred long after his shift had ended, and
after he had informed jail medical staff of Frazier’s stomach
pains.
Alternatively, Jones argues that even if Mathews did not
directly cause Frazier’s death, he caused her pain and suffering (and Jones is thus entitled to damages) by failing to respond to Frazier’s withdrawal symptoms as soon as they began. She contends that Mathews’s 7:05 a.m. email is evidence
of his deliberate indifference to Frazier’s heroin withdrawal.
Jones asserts that Mathews unreasonably delayed contacting
medical personnel and when he finally did email jail medical
staff, he did not convey an appropriate level of urgency.
Jones relies on Lewis v. McLean, 864 F.3d 556 (7th Cir. 2017),
where we noted that a delay in treatment may constitute
No. 19-2629 13
deliberate indifference in some circumstances. But there are
two key factual distinctions between the plaintiff’s circumstances in Lewis and the circumstances leading up to Frazier’s
death. First, Lewis immediately told prison officials that he
was experiencing pain and explained his symptoms. Lewis,
864 F.3d at 558–59. Second, despite recognizing that Lewis
was in such severe pain that he was unable to move, prison
officials waited an hour and a half before contacting the oncall physicians.
Id. at 560. We have explained that “[w]hether
the length of delay is tolerable depends upon the seriousness
of the condition and the ease of providing treatment,” Perez v.
Fenoglio,
792 F.3d 768, 778 (7th Cir. 2015), and in Lewis, where
the plaintiff’s condition was so severe that it rendered him immobile, we recognized that a jury might find that the defendants exhibited deliberate indifference by delaying his treatment. Lewis, 864 F.3d at 563–64.
The circumstances here are quite different. Unlike Lewis
who promptly told jail staff about his severe pain, Frazier did
not explain her symptoms to Mathews until 6:30 a.m., four
hours after her complaints began. When she finally did tell
Mathews what was wrong, he contacted jail medical staff
shortly thereafter by sending an email and speaking to a nurse
directly. Furthermore, even if a jury could reasonably find
that Mathews knew Frazier was suffering from heroin withdrawal as early as 2:30 a.m., she, unlike Lewis, had not suddenly become immobile or unconscious, and the need for urgent treatment was far less apparent. Instead, Frazier was conscious, capable of speaking, and physically able to move her
sleeping mat to position herself to repeatedly kick her cell
door. Mathews and the other officers on duty monitored Frazier throughout the night and Frazier continued not to tell
them what was wrong despite their repeated requests, and
14 No. 19-2629
once Frazier told Mathews what was wrong, he sought medical attention on Frazier’s behalf. No reasonable jury could
conclude on this record that Mathews was deliberately indifferent to Frazier’s heroin withdrawal. See Earl v. Racine Cty.
Jail, 718 F.3d 689, 692 (7th Cir. 2013) (“[T]he officer’s prompt
call to the nurse undermines any suggestion that he acted
with the reckless or malicious intent required to sustain a deliberate-indifference claim.”).
B. Wrongful Death Claim
Jones’s wrongful death claim fails for the same reasons as
her deliberate indifference claim. Under the Illinois Wrongful
Death Act:
Whenever the death of a person shall be caused
by wrongful act, neglect or default, and the act,
neglect or default is such as would, if death had
not ensued, have entitled the party injured to
maintain an action and recover damages in respect thereof, then and in every such case the person who or company or corporation which
would have been liable if death had not ensued,
shall be liable to an action for damages, notwithstanding the death of the person injured, and although the death shall have been caused under
such circumstances as amount in law to felony.
740 ILCS 180/1. But under the Governmental Employees Tort
Immunity Act, a public employee may not be liable for failure
to provide medical care to an incarcerated person unless the
official, “through willful and wanton conduct, fails to take
reasonable action to summon medical care.” 745 ILCS 10/4-
105.
No. 19-2629 15
We have noted before that “the standard for assessing
whether conduct is willful and wanton is ‘remarkably similar’
to the deliberate indifference standard.” Chapman v. Keltner,
241 F.3d 842, 847 (7th Cir. 2001) (quoting Payne for Hicks v.
Churchich,
161 F.3d 1030, 1041 n.13 (7th Cir. 1998)). Because
summary judgment was proper on Jones’s deliberate indifference claim, it was also proper on her wrongful death claim.
Jones concedes this point, arguing only the Court should
“overturn the District Court’s summary judgment on her
Wrongful Death claim because it relies on an erroneous analysis of Plaintiff’s § 1983 claim’s deliberate indifference standard.” Having determined that the district court properly
granted summary judgment on Jones’s deliberate indifference
claim, we therefore also conclude that summary judgment is
warranted on Jones’s wrongful death claim.
AFFIRMED.
