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7th Circuit orders appointment of counsel for Arizona inmate

May 3, 2018

The Indiana Southern District Court must appoint counsel for an Arizona inmate suing two Indiana prison doctors after a circuit court panel found the lower court erred in determining the inmate was competent to litigate his own case.

In Thomas James v. Lorenzo Eli, et al., 15-3034, Thomas James was transferred from a prison in Arizona to the New Castle Correctional Facility in April 2007 and developed an infected ingrown toenail in October. He submitted a health request to prison staff, and staff physician Dr. Lorenzo Eli ordered various tests, as well as ointment, antibiotics, dressing changes and Tylenol. James began complaining of pain one week after Eli’s initial visit, but the doctor told him to give the antibiotics time to work.

James’ toenail “looked much better” at a two-week follow-up, so Eli continued with his original treatment plan. Eli never treated James’ toenail again, but another prison doctor removed the toenail in late 2007 at James’ request. Shortly thereafter, James fell on a set of prison stairs and injured his jaw, blaming the incident on his toe, pain medications and a lack of adequate bed rest.

James submitted another health request form and was prescribed ibuprofen for a “cracked” jaw in late December 2007. Eli also examined his x-rays and found a fracture in his left jawbone, so James was sent to the Wishard Hospital Emergency Room. The hospital agreed with Eli’s diagnosis and referred James to a plastic surgeon, while Eli put him on a soft diet and placed him in the infirmary.  

Dr. Nicolas Villanustre, a plastic surgeon, ultimately decided surgery was unnecessary, and James was transferred back to Arizona in April 2008. But James sued Eli and Villanustre in September 2009, alleging they were deliberately indifferent to his toenail and jaw infirmities.

James also filed multiple requests for counsel, arguing, among other things, that he wanted to hire a medical expert and that chronic migraines impeded his self-representation. Indiana Southern District Judge William T. Lawrence denied that motion after finding James had “demonstrated his awareness of the facts surrounding (his) claims and his understanding of the applicable legal standard.” Lawrence then granted summary judgment to both doctors, but the 7th Circuit overturned that ruling on Wednesday.

Judge Joel Flaum wrote for the circuit panel that because James’ allegations involved the doctors’ “state of mind,” his case progressed beyond basic pleadings. Also, because he was litigating his claims from more than 1,000 miles away, Lawrence erred in denying his requests for counsel at the summary judgment stage. Further, James’ inability to adequately conduct discovery or respond to the doctors’ summary judgment motions established prejudice, he said.

“Plaintiff’s condition was apparently so complex that it necessitated referrals from general practitioners to a doctor who specialized in plastic surgery,” Flaum wrote. “Additionally, his treatment took place at multiple medical institutions … and included x-rays and CT scans. This not only broadened the scope of relevant discovery, but also necessitated some level of expertise for its proper interpretation.”

Thus, the circuit court reversed the denial of James’ motion for counsel, vacated summary judgment for the doctors and remanded the case for further proceedings.

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