United States District Court, N.D. Indiana, South Bend Division
OPINION AND ORDER
L. MILLER, JR. JUDGE
Orr filed a complaint alleging that the care he has received
for his chronic headaches while incarcerated at the Westville
Correctional Facility is constitutionally inadequate. He was
granted leave to proceed against Dr. Andrew Liaw and Nurse
DeAngela Lewis for deliberant indifference to his serious
medical need for adequate treatment of his chronic headaches;
Dr. Andrew Liaw, Nurse DeAngela Lewis, and Warden Mark Sevier
to provide Michael Orr with adequate medical care for his
chronic headaches; and Wexford of Indiana for following a
policy of denying necessary medical care in order to save
money, all in violation of the Eighth Amendment. ECF 4 at
7-8. The court also ordered Dr. Liaw, DeAngela Lewis, and
Warden Sevier to file declarations in response to Mr.
Orr's request for a preliminary injunction. ECF 4 at 8.
Dr. Liaw, DeAngela Lewis, Wexford, and Warden Sevier have now
responded to the request for preliminary injunctive
relief, and Mr. Orr has filed a reply. ECF 22; ECF 25; ECF
preliminary injunction is an extraordinary and drastic
remedy, one that should not be granted unless the movant,
by a clear showing, carries the burden of
persuasion.” Mazurek v. Armstrong, 520 U.S.
968, 972 (1997) (emphasis in original). One seeking a
preliminary injunction must show: (1) he will suffer
irreparable harm before the final resolution of his claims;
(2) available remedies at law are inadequate; and (3) he has
a likelihood of success on the merits. See BBL, Inc. v.
City of Angola, 809 F.3d 317, 323-324 (7th Cir. 2015).
The court then “weighs the competing harms to the
parties if an injunction is granted or denied and also
considers the public interest.” Korte v.
Sebelius, 735 F.3d 654, 665 (7th Cir. 2013). An
injunction ordering the defendant to take an affirmative act
rather than merely refrain from specific conduct is
“cautiously viewed and sparingly issued.”
Graham v. Med. Mut. of Ohio, 130 F.3d 293, 295 (7th
Cir. 1997) (quotation marks and citation omitted). It is true
that every inmate is entitled to receive constitutionally
adequate medical care. Estelle v. Gamble, 429 U.S.
97, 104-105 (1976). Before an inmate can obtain injunctive
relief, he must make a clear showing that the medical care he
is receiving violates the Eighth Amendment prohibition on
cruel and unusual punishment. See Westefer v. Neal,
682 F.3d 679, 683 (7th Cir. 2012); Mazurek v.
Armstrong, 520 U.S. 968, 972 (1997).
complaint, Mr. Orr asserts that he suffers from chronic
headaches lasting from hours to days and, when he has a
headache, he can't sleep, read, write, work, eat, or
leave his cell. Mr. Orr alleges that, when he arrived at
Westville on October 6, 2017, he reported that he suffered
from headaches. He told Dr. Liaw about his headaches on
October 27, 2017, too, but Dr. Liaw wouldn't prescribe
pain relief because Mr. Orr had not followed the procedure of
first presenting that problem to a nurse at a sick call
visit. Furthermore, he was already receiving Tylenol 3 with
codeine for an elbow fracture, and aspirin and propanol for
hypertension. Dr. Liaw told Mr. Orr that he should submit a
health care request form when his medications for these
unrelated issues expired. Between October 27, 2017 and
January 5, 2019, Mr. Orr asserts that he made fourteen
reports to medical staff that his headaches drain his energy,
disturb his sleep, and cause him to suffer from blurred
vision. During that same time, Dr. Liaw saw Mr. Orr for nine
chronic care visits at approximately 90-day intervals. But
Dr. Liaw would not address his headaches and instead only
addressed other chronic health care issues - an elbow injury,
chronic asthma, and hypertension. Mr. Orr further alleges
that Dr. Liaw knew, based on his medical history, that
Tylenol, Aspirin and Propanol wouldn't effectively treat
his condition. He alleges that Dr. Liaw's decision to
categorize his headaches as not serious and treat them with
these medications was motivated by a desire to save money. In
his complaint, Mr. Orr sought preliminary injunctive relief
in the form or an order directing the defendants to provide
him with adequate medical care and treatment for his
filing his complaint, Mr. Orr has had another appointment
with Dr. Liaw. ECF 22-1 at 1-5. At that appointment, which
occurred on October 29, 2019, Mr. Orr discussed his headaches
with Dr. Liaw. Id. at 2. Mr. Orr reported might be
stress-related. Id. Although Mr. Orr reported having
a headache at the time of the appointment, Dr. Liaw's
notes indicate that “he did not seem in acute distress
with the regular light and sound levels.” Id.
The notes indicate that he flinched when the light of an
otoscope was shined in his eyes, but the light was close to
full brightness. Id. Dr. Liaw assessed headaches
“with possible multifactorial causes.”
Id. His notes indicate that “migraines are a
consideration but pt's presentation does not appear to be
consistent with a typical migraine presentation.”
Id. The notes further indicate that Mr. Orr
“is already on bblocker, which can help with stress and
prevent migraines.” Id. He ordered that sinus
x-rays were to be obtained. Id. And, he recommended
a mental health evaluation to provide instructions to Mr. Orr
on coping with stress. Id.
Constitution is not a medical code that mandates specific
medical treatment.” Snipes v. DeTella, 95 F.3d
586, 592 (7th Cir. 1996). “Whether and how pain
associated with medical treatment should be mitigated is for
doctors to decide free from judicial interference, except in
the most extreme situations.” Id. Inmates are
“not entitled to demand specific care [nor] entitled to
the best care possible.” Forbes v. Edgar, 112
F.3d 262, 267 (7th Cir. 1997).
Mr. Orr asserts that his requests for medical care for
headaches have largely been ignored, the record establishes
that Dr. Liaw has now discussed Mr. Orr's headaches with
him and developed a treatment plan. Mr. Orr will have a
chance to litigate whether the defendants were deliberately
indifferent to his earlier requests for care, but a
preliminary injunction isn't focused on the past - it is
instead focused on the present and the future. Mr. Orr is now
receiving care. The Constitution does not require that Mr.
Orr receive the treatment of his choice or even proper
treatment - only treatment that reflects professional
judgment. See Jackson v. Kotter, 541 F.3d 688, 697
(7th Cir. 2008) (“[M]edical professionals are not
required to provide proper medical treatment to prisoners,
but rather they must provide medical treatment that reflects
professional judgment, practice, or standards.”)
(internal quotation marks and citation omitted). The record
suggests that he is now receiving treatment that reflects
professional judgment, even if medical professionals could
disagree about the best treatment option. Given Dr.
Liaw's willingness to treat Mr. Orr's headaches,
should Mr. Orr require additional treatment for headaches,
there is nothing in the record suggesting that an injunction
is necessary to ensure he receives that care. In short, Mr.
Orr hasn't shown a likelihood of success on the merits of
his claim for preliminary injunctive relief.
final matter, the court notes that, instead of signing his
documents, Mr. Orr has been typing his name on the signature
line. Perhaps he was confused by similar
“signatures” on motions filed by counsel.
However, the typed name of an attorney on an electronically
filed document is not a signature for purposes of Rule 11.
Instead, the “attorney's/participant's password
issued by the court combined with the user's
identification, serves as and constitutes the
attorney/participant's signature for Rule 11 and other
purposes.” Northern District of Indiana CM/ECF Civil
and Criminal User Manual I.C. Accordingly, Mr. Orr must begin
signing his documents and must stop typing his name in lieu
of a signature. If future documents are submitted without a
signature, they may be stricken or summarily denied.
these reasons, the court DENIES Michael Orr's requests
for preliminary injunctive relief (ECF 1).
 Although responses were filed, only
Warden Galipeau provided the requested ...