Jeremy Lockett v. Tanya Bonson ( 2019 )


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  •                              In the
    United States Court of Appeals
    For the Seventh Circuit
    ____________________
    No. 19-1012
    JEREMY LOCKETT,
    Plaintiff-Appellant,
    v.
    TANYA BONSON and BETH EDGE,
    Defendants-Appellees.
    ____________________
    Appeal from the United States District Court for the
    Eastern District of Wisconsin.
    No. 1:17-cv-00691-WCG — William C. Griesbach, Chief Judge.
    ____________________
    ARGUED MAY 17, 2019 — DECIDED AUGUST 28, 2019
    ____________________
    Before RIPPLE, MANION, and SYKES, Circuit Judges.
    RIPPLE, Circuit Judge. Jeremy Lockett, an inmate at the
    Wisconsin Secure Program Facility (“WSPF”), brought this
    action under 42 U.S.C. § 1983 to recover for alleged viola-
    tions of his constitutional rights under the Eighth Amend-
    ment to the Constitution of the United States, rights made
    2                                                            No. 19-1012
    1
    applicable to the states through the Fourteenth Amendment.
    He alleged that these rights were violated when he received
    inadequate medical care while incarcerated at WSPF.
    Mr. Lockett, who has sickle cell disease, claimed that two
    prison medical staff members, Tanya Bonson, a nurse practi-
    tioner (“NP”), and Beth Edge, a nurse, were deliberately in-
    different to his serious medical needs. The defendants
    moved for summary judgment; the district court granted the
    motion. Mr. Lockett filed a timely appeal.
    We conclude that the record will not support a jury de-
    termination that NP Bonson was deliberately indifferent to
    Mr. Lockett’s needs in prescribing medication. Mr. Lockett
    did not exhaust his administrative remedies on his claim
    against Nurse Edge. Accordingly, the judgment of the dis-
    2
    trict court is affirmed.
    I.
    BACKGROUND
    A.
    Mr. Lockett has been housed at WSPF, a facility within
    the Wisconsin Department of Corrections (“WDOC”), since
    November 2014. He has a significant medical history, having
    been diagnosed with sickle cell disease, a chronic condition
    that causes pain, sometimes acutely. During certain periods
    called sickle cell crises, the pain becomes so severe that it re-
    quires immediate emergency medical treatment. A sickle cell
    1   Estelle v. Gamble, 
    429 U.S. 97
    , 101, 104 (1976).
    2 The district court had jurisdiction over this action pursuant to 28 U.S.C.
    § 1331. Our jurisdiction is based on 28 U.S.C. § 1291.
    No. 19-1012                                                  3
    crisis usually resolves within five to seven days, although a
    severe crisis may result in pain that persists for weeks or
    months.
    Other factors further complicate Mr. Lockett’s health sit-
    uation. His records contain a diagnosis of cannabis depend-
    ence, antisocial personality disorder, adjustment disorder,
    3
    and mild depression in 2010. He also has a documented his-
    tory of substance abuse, including marijuana, ecstasy, and
    cocaine. Health care providers have prescribed various med-
    ications to treat his depression.
    The events underlying his claims occurred over a sever-
    al-month period at the end of 2016. On September 2, 2016,
    Mr. Lockett sent a health services request, complaining that
    his routine pain medication, tramadol, was not working to
    control his back pain. In response, NP Bonson switched
    Mr. Lockett’s pain medication to Tylenol #3, a mild opioid.
    Five days later, on September 7, 2016, a medical staff mem-
    ber (whose name does not appear in the record) evaluated
    Mr. Lockett. According to Mr. Lockett, during this evalua-
    tion, he told the caregiver that his Tylenol #3 was not con-
    trolling his pain. The relevant entry on his chart does not re-
    flect, however, any discussion of the efficacy of his pain
    medication—only that Mr. Lockett had reported to the med-
    ical department so that laboratory work could be undertaken
    and his neck pain evaluated and treated. Shortly thereafter,
    NP Bonson renewed Mr. Lockett’s prescription for Tylenol
    #3, first for a period of two weeks and then for another
    month.
    3   See R.42-4 at 4.
    4                                                 No. 19-1012
    Throughout the month of September, Mr. Lockett re-
    mained on Tylenol #3, administered four times daily on
    4
    what the WSPF terms medication passes. From September
    23 through September 25, he missed several doses, at least
    once because he declined it. Between September 26 and Oc-
    tober 3, Mr. Lockett did not receive his pain medication at
    all. Although he filed a health services request during that
    time, he asked only about whether he would have an ap-
    pointment with a specialist for his sickle cell disease and did
    not mention the lack of pain medication.
    On October 3, 2016, medical staff determined that
    Mr. Lockett was in sickle cell crisis. In accordance with the
    emergency nursing protocol, he was transferred to the local
    emergency room for treatment. When he returned to the
    WSPF the following day, another WSPF nurse, Anderson,
    documented in Mr. Lockett’s inmate medical records a rec-
    ommendation from the treating emergency room physician
    that Mr. Lockett be given oxycodone, a stronger, immedi-
    ate-release opioid, to treat his sickle cell pain. The entry in
    Mr. Lockett’s chart originally instructed, “Please fill the Rx
    5
    in the morning,” but that note was crossed out. NP Bonson
    wrote, “Had one time dose Oxycodone 20mg from Hospital.
    6
    Admin[istered] this AM.” She noted that “Mr. Lockett has
    been successfully managed” with Tylenol #3 and concluded
    “we will continue his Tylenol #3 … as ordered on 9/20/16 x
    4   See generally R.57-1.
    5   R.42-3 at 36.
    6   
    Id. No. 19-1012
                                                      5
    7
    30 days.” In a subsequent explanation of her decision, NP
    Bonson stated that several factors led her to choose to con-
    tinue with Tylenol #3 rather than the stronger opioid. She
    noted that Mr. Lockett’s chronic symptoms had been man-
    aged successfully on the weaker drug prior to the crisis, that
    the stronger drug carried additional concerns for substance
    abuse, and that, in any event, long-term oxycodone use re-
    quired approval from a WDOC committee, a process that
    would have taken time. Finally, she believed that the rec-
    ommended dose itself was very high and, although appro-
    priate to treat crisis pain, was not indicated for Mr. Lockett’s
    chronic pain.
    Two days after his return to WSPF, Mr. Lockett filed a
    health services request. He stated that he was in constant
    pain and asked why he was not receiving the medication
    prescribed by the emergency room physician. Nurse Edge
    responded to his request by noting that he was receiving
    pain medication, although it was the Tylenol #3 he had re-
    ceived in the prior month, not the oxycodone recommended
    by the external physician. Mr. Lockett responded on October
    6 with an administrative complaint. He claimed that NP
    8
    Bonson was denying him “the correct medication.” His
    complaint was rejected.
    Just two days later, on October 8 and 9, Mr. Lockett re-
    fused his doses of Tylenol #3 during medication pass. Alt-
    hough the nurse “educated [him] about [the] importance of
    pain control and taking pain medication on [a] regular ba-
    7   
    Id. 8 R.35-2
    at 5.
    6                                                 No. 19-1012
    sis,” Mr. Lockett “reported he just didn’t need the medica-
    9
    tion at that time.”
    On November 11, Mr. Lockett did not receive his medica-
    tion during two of his four daily medication passes. Four
    days later, he filed an administrative complaint against
    Nurse Edge for failing to deliver the medication. He claimed
    that he had asked WSPF staff to call for the medication, but
    because the call was not received until after the second
    missed pass, Nurse Edge informed him that he would have
    to wait for the third pass to receive the medication. After in-
    vestigation, his complaint was dismissed. Mr. Lockett con-
    tends that he took a timely appeal of this dismissal by plac-
    ing the appeal in an outgoing box, but also admits that he
    never received a receipt or a response. The record contains
    no copy of Mr. Lockett’s appeal, and, according to the
    WDOC complaint examiner, the WDOC has no record of
    10
    having received it.
    On November 17, Mr. Lockett requested to be seen by a
    nurse. During that visit, he reported “unbearable” pain and
    11
    that the pain medication was not doing anything. The
    nurse documented that Mr. Lockett declined his pain medi-
    cation because it was ineffective. He was sent to the emer-
    gency room and treated. When he returned two days later,
    another WSPF nurse, Bethel, documented the treating physi-
    cian’s medication order for APAP, another form of aceta-
    9   R.42-3 at 17.
    10   R.35 at 3.
    11   R.42-3 at 15.
    No. 19-1012                                                 7
    minophen, on a short-term basis, and a long-term change
    from acetaminophen with codeine to one with hydrocodone.
    NP Bonson countersigned, accepting the recommendation.
    She prescribed the new medication as recommended by the
    physician first for a one-week period, and then for a
    one-month period. Her follow-up notes indicate that
    Mr. Lockett reported that it was working well.
    Just days later, however, he ran out of his supply of the
    hydrocodone. When he called for pain medication for the
    night, he was given tramadol by a separate on-call doctor,
    and a subsequent doctor switched him to Tylenol #3. When
    he filed a health services request with NP Bonson, she indi-
    cated that she had put in an order for his hydrocodone. Two
    weeks later, anticipating that he would run out over a holi-
    day, he again filed a health services request with NP Bonson,
    who replied the same day that it would be refilled because
    12
    she did not “want [him] to run out either!”
    B.
    On May 17, 2017, Mr. Lockett initiated this action by fil-
    ing a pro se complaint under 42 U.S.C. § 1983 against NP
    Bonson and Nurse Edge. He alleged that the defendants had
    acted with deliberate indifference in treating his sickle cell
    disease, in violation of the Eighth Amendment. His specific
    allegations with respect to NP Bonson included her failure to
    provide him with medication for several days from Septem-
    ber 26 to October 3, 2016, and her decision to continue him
    with his regimen of Tylenol #3 following his October 3, 2016
    hospitalization, when his treating physician recommended a
    12   
    Id. at 115.
    8                                                No. 19-1012
    stronger opioid. With respect to Nurse Edge, his allegations
    concerned the day on which he received no medication at
    the first two pass times and then had to wait until the next
    pass time to receive the medication.
    Following discovery, the defendants moved for summary
    judgment, which the district court granted in full. Although
    it was undisputed that Mr. Lockett’s sickle cell disease is a
    serious medical condition as contemplated by the Eighth
    Amendment, the court concluded that the evidence did not
    establish deliberate indifference on the part of either NP
    Bonson or Nurse Edge.
    Addressing the claim, the court found that there was no
    evidence that NP Bonson was aware that Mr. Lockett had
    not been receiving his medication over the several-day peri-
    od in September and October 2016. Therefore, she could not
    have known of a substantial risk of serious harm. With re-
    spect to her October 4, 2016 decision to continue treating
    Mr. Lockett with Tylenol #3, instead of the oxycodone,
    which had been recommended by the emergency room phy-
    sician, the court determined that her decision “was a justi-
    fied exercise of professional judgment given the information
    13
    before her.” The court found that NP Bonson “based her
    decision on Lockett’s medical record and history, her con-
    cern about opioid use and substance abuse in prison, the
    high amount of Oxycodone prescribed, and the fact that pri-
    or to the October incident, Lockett’s long-term pain ap-
    peared to have been successfully managed by the Tylenol
    13   R.63 at 10.
    No. 19-1012                                                  9
    14
    #3.” The court also found that Mr. Lockett’s assertion that
    he had notified NP Bonson on September 7, 2016, that the
    Tylenol #3 was not helping his pain was “not supported by
    15
    the record.” Further, even if this allegation were true, her
    decision did not constitute deliberate indifference because
    Mr. Lockett had made no other complaint over a month-long
    period, “indicating that the Tylenol #3 was sufficient to treat
    16
    his long-term pain.” Therefore, the court ruled, NP Bonson
    was entitled to summary judgment.
    Turning to Mr. Lockett’s claim against Nurse Edge and
    her delay in providing him with medication in November
    2016, the district court found that he had failed to exhaust
    his administrative remedies within the WDOC. Mr. Lockett
    asserted that he had filed a timely appeal from the Review-
    ing Authority’s decision but never had received a response.
    However, he presented no evidence of the Corrections
    Complaint Examiner’s receipt of his appeal. Because the
    WDOC rules provide that the Corrections Complaint Exam-
    iner “shall, within 5 working days after receiving an appeal,
    issue a written receipt of the appeal to the inmate,” Wis.
    Admin. Code DOC § 310.13(4), the court ruled that,
    “[a]bsent a receipt, … an inmate’s administrative remedies
    17
    are not considered exhausted.” The court therefore granted
    summary judgment to Nurse Edge without considering the
    14   
    Id. 15 Id.
    16   
    Id. 17 Id.
    at 14–15.
    10                                                        No. 19-1012
    merits of Mr. Lockett’s Eighth Amendment claim against
    her.
    II.
    DISCUSSION
    We review the district court’s decision to grant the de-
    fendants’ motion for summary judgment de novo. Witham v.
    Whiting Corp., 
    975 F.2d 1342
    , 1345 (7th Cir. 1992). We view
    the record and draw all reasonable inferences from it in the
    light most favorable to Mr. Lockett, the nonmoving party.
    Dunigan ex rel. Nyman v. Winnebago Cty., 
    165 F.3d 587
    , 590
    (7th Cir. 1999). We will affirm the judgment if there is no
    genuine dispute of material fact and if the defendants are
    entitled to judgment as a matter of law. Bailor v. Salvation
    Army, 
    51 F.3d 678
    , 681 (7th Cir. 1995).
    Mr. Lockett challenges the district court’s resolution of
    only two of his Eighth Amendment claims. First, with re-
    spect to NP Bonson, he contends that the district court erred
    in concluding that, as a matter of law, she did not act with
    deliberate indifference to his medical needs in rejecting the
    physician’s recommendation to increase his pain medication
    and in choosing instead to continue him on his prior course
    of Tylenol #3. With respect to Nurse Edge, Mr. Lockett main-
    tains that the district court erred in concluding that he had
    18
    failed to exhaust his administrative remedies. We address
    each of these contentions in turn.
    18 Mr. Lockett has abandoned any argument concerning the failure to
    provide him with medication in late September and early October 2016,
    prior to his hospitalization.
    No. 19-1012                                                   11
    A.
    We begin with the claim that NP Bonson acted with de-
    liberate indifference in treating Mr. Lockett’s pain when he
    returned from the emergency room on October 4, 2016.
    The Eighth Amendment’s prohibition on cruel and unu-
    sual punishment “protects prisoners from prison conditions
    that cause ‘the wanton and unnecessary infliction of pain,’”
    including “grossly inadequate medical care.” Pyles v. Fahim,
    
    771 F.3d 403
    , 408 (7th Cir. 2014) (quoting Rhodes v. Chapman,
    
    452 U.S. 337
    , 347 (1981)). To prevail on a claim based on defi-
    cient medical care, the plaintiff “must demonstrate two ele-
    ments: 1) an objectively serious medical condition; and 2) an
    official’s deliberate indifference to that condition.” Arnett v.
    Webster, 
    658 F.3d 742
    , 750 (7th Cir. 2011). The first element,
    an objectively serious medical condition, is satisfied if “a
    physician has diagnosed it as requiring treatment, or the
    need for treatment would be obvious to a layperson.” 
    Pyles, 771 F.3d at 409
    ; see also Gutierrez v. Peters, 
    111 F.3d 1364
    ,
    1370–73 (7th Cir. 1997). The district court found, and the par-
    ties do not dispute, that Mr. Lockett’s sickle cell disease is a
    serious medical condition. Therefore, we focus on the second
    element: whether NP Bonson acted with deliberate indiffer-
    ence.
    “Deliberate indifference is a subjective standard.” 
    Arnett, 658 F.3d at 751
    . To be found liable under the Eighth
    Amendment, a prison official “must both be aware of facts
    from which the inference could be drawn that a substantial
    risk of serious harm exists, and he must also draw the infer-
    ence.” Farmer v. Brennan, 
    511 U.S. 825
    , 837 (1994); see also Pet-
    ties v. Carter, 
    836 F.3d 722
    , 728 (7th Cir. 2016) (en banc)
    (“[T]he Supreme Court has instructed us that a plaintiff must
    12                                                   No. 19-1012
    provide evidence that an official actually knew of and disre-
    garded a substantial risk of harm.”). Whether a prison offi-
    cial acted with the requisite state of mind “is a question of
    fact subject to demonstration in the usual ways, including
    inference from circumstantial evidence.” 
    Farmer, 511 U.S. at 842
    . In making this assessment, “we must examine the totali-
    ty of an inmate’s medical care.” 
    Dunigan, 165 F.3d at 591
    (quoting 
    Gutierrez, 111 F.3d at 1375
    ). The standard is a rigor-
    ous one. To establish the requisite mental state, our cases
    make clear that “[s]omething more than negligence or even
    malpractice is required.” 
    Pyles, 771 F.3d at 409
    ; see also Estelle
    v. Gamble, 
    429 U.S. 97
    , 106 (1976) (“Medical malpractice does
    not become a constitutional violation merely because the vic-
    tim is a prisoner.”).
    Within the universe of deliberate indifference cases is a
    narrower category when a prisoner alleges not that his con-
    dition was ignored entirely, but that he received constitu-
    tionally deficient treatment for the condition. We have clari-
    fied that these cases are better framed “not [as] deliberate
    indifference to a serious medical need,” but as a challenge to
    “a deliberate decision by a doctor to treat a medical need in a
    particular manner.” Snipes v. DeTella, 
    95 F.3d 586
    , 591 (7th
    Cir. 1996). In such cases, we defer to a medical professional’s
    treatment decision “unless ‘no minimally competent profes-
    sional would have so responded under those circumstanc-
    es.’” 
    Pyles, 771 F.3d at 409
    (quoting Sain v. Wood, 
    512 F.3d 886
    , 894–95 (7th Cir. 2008)). A “[d]isagreement between a
    prisoner and his doctor, or even between two medical pro-
    fessionals, about the proper course of treatment generally is
    insufficient, by itself, to establish an Eighth Amendment vio-
    lation.” 
    Id. Our standard
    reflects the reality that there is no
    single “‘proper’ way to practice medicine in a prison, but ra-
    No. 19-1012                                                 13
    ther a range of acceptable courses based on prevailing
    standards in the field.” Jackson v. Kotter, 
    541 F.3d 688
    , 697
    (7th Cir. 2008). Nevertheless,
    “where evidence exists that the defendant[]
    knew better than to make the medical deci-
    sion[] that [he] did,” then summary judgment
    is improper and the claim should be submitted
    to a jury. State-of-mind evidence sufficient to
    create a jury question might include the obvi-
    ousness of the risk from a particular course of
    medical treatment; the defendant’s persistence
    in “a course of treatment known to be ineffec-
    tive”; or proof that the defendant’s treatment
    decision departed so radically from “accepted
    professional judgment, practice, or standards”
    that a jury may reasonably infer that the deci-
    sion was not based on professional judgment.
    Whiting v. Wexford Health Sources, Inc., 
    839 F.3d 658
    , 662–63
    (7th Cir. 2016) (alterations in original) (citations omitted)
    (quoting 
    Petties, 836 F.3d at 730
    –31). A medical professional’s
    choice to pursue an “‘easier and less efficacious treatment’”
    or “a non-trivial delay in treating serious pain” may also
    support a claim of deliberate indifference. Berry v. Peterman,
    
    604 F.3d 435
    , 441 (7th Cir. 2010) (quoting 
    Estelle, 429 U.S. at 104
    & n.10).
    We routinely have rejected claims, however, where a
    prisoner’s claim is based on a preference for one medication
    over another unless there is evidence of a substantial depar-
    ture from acceptable professional judgment. Pointedly, in
    Burton v. Downey, 
    805 F.3d 776
    , 785–86 (7th Cir. 2015), we
    considered a claim by a detainee who had requested narcotic
    14                                                   No. 19-1012
    medication to address his pain after surgery. Prison staff
    prescribed a non-narcotic pain medication, even though a
    primary care physician outside of prison previously had
    prescribed a narcotic. Prison staff noted that the synthetic
    opiate that they administered had “less addictive potential”
    than the primary care physician’s stronger method of pain
    relief. 
    Id. at 786.
    The fact that the physician outside of prison
    had prescribed another medication merely demonstrated
    “that another doctor would have followed a different course
    of treatment,” which was “insufficient to sustain a deliberate
    indifference claim.” 
    Id. To meet
    such a standard, we reiterat-
    ed, required evidence of a “substantial departure from ac-
    cepted professional judgment.” 
    Id. at 785
    (quoting 
    Jackson, 541 F.3d at 697
    ). The decision to prescribe non-narcotic pain
    medication was within the bounds of professional judgment.
    
    Id. at 785
    –86; see also 
    Snipes, 95 F.3d at 591
    (noting that “[t]he
    administration of pain killers requires medical expertise and
    judgment” and that their use “entails risks that doctors must
    consider in light of the benefits”).
    The record before us demonstrates that NP Bonson em-
    ployed professional judgment in her treatment of Mr. Lock-
    ett’s sickle cell disease, both in the long term and in her spe-
    cific response to his October 2016 sickle cell crisis. As re-
    quired by WSPF protocol, the prison sent Mr. Lockett to the
    local emergency room for treatment of a sickle cell crisis.
    Although the external treating physician recommended that
    Mr. Lockett take oxycodone, NP Bonson elected to use a dif-
    ferent pharmaceutical. She noted that Mr. Lockett “[h]ad [a]
    one time dose [of] Oxycodone 20mg from Hospital,” but she
    discontinued that medication and returned him to his prior
    No. 19-1012                                                    15
    19
    course of Tylenol #3. She noted in the chart that Tylenol #3
    had successfully managed his chronic pain.
    Mr. Lockett submits that NP Bonson’s decision to “over-
    rule[]” the non-prison doctor and to deny him the medica-
    tion that he requested “displayed knowing disregard for his
    20
    suffering.” It is firmly established, however, that mere
    “[d]isagreement between a prisoner and his doctor, or even
    between two medical professionals, about the proper course
    of treatment generally is insufficient, by itself, to establish an
    Eighth Amendment violation.” 
    Pyles, 771 F.3d at 409
    ; see also
    Ciarpaglini v. Saini, 
    352 F.3d 328
    , 331 (7th Cir. 2003); 
    Snipes, 95 F.3d at 591
    . With respect to pain control specifically, our
    cases recognize that these are matters that require the appli-
    cation of “medical expertise and judgment.” 
    Snipes, 95 F.3d at 591
    . All we have here is NP Bonson’s “deliberate deci-
    sion,” based on a professional assessment, to treat Mr. Lock-
    ett’s sickle cell pain using Tylenol #3 instead of oxycodone.
    
    Id. That decision
    cannot support an Eighth Amendment vio-
    lation. As in Burton, the record, taken as a whole, demon-
    strates that NP Bonson clearly exercised her medical judg-
    ment in making her treatment decision. Far from being indif-
    ferent to his pain, NP Bonson had increased the strength of
    his pain medication during the month before his sickle cell
    crisis. In the weeks before the crisis, there were occasions
    when Mr. Lockett refused his medication as unnecessary
    and other occasions where he did not receive it and did not
    file a complaint or otherwise notify her. His medical records
    19   R.42-3 at 36.
    20   Appellant’s Br. 14–15.
    16                                                          No. 19-1012
    indicated that Tylenol #3 was sufficient to handle his chron-
    21
    ic, non-crisis sickle cell pain. NP Bonson also considered
    Mr. Lockett’s medical history including his own history of
    substance abuse, the risks associated with opioid use and
    substance abuse in prison, and the high amount of oxyco-
    done prescribed.
    Moreover, the totality of NP Bonson’s care demonstrates
    affirmatively that she was “continually solicitous of” and
    “responsive to” Mr. Lockett’s medical needs. 
    Dunigan, 165 F.3d at 592
    . She promptly responded to Mr. Lockett’s health
    services requests and timely filled and renewed his prescrip-
    tions during the relevant time frame. The district court cor-
    rectly concluded that no reasonable jury could have found
    that NP Bonson acted with deliberate indifference in treating
    Mr. Lockett’s sickle cell disease. The district court properly
    granted summary judgment in her favor.
    B.
    Mr. Lockett also asks that we review his contention that
    Nurse Edge violated the Eighth Amendment when she told
    him that he would have to wait until the next pass to receive
    his medication, even though he had not received it on the
    21 Mr. Lockett maintains that he told the health services unit that Tylenol
    #3 was insufficient to manage his pain on September 7, 2016. That claim
    is undercut by the medical records of that visit, which do not discuss
    pain management at all. However, even if Mr. Lockett did make that
    claim on September 7, the fact remains that he demanded no other pain
    medication in the month of September and did not even complain when
    doses were not received. In short, NP Bonson’s belief that Tylenol #3 was
    working to control chronic pain was not unreasonable given Mr. Lock-
    ett’s own undisputed course of conduct at the time.
    No. 19-1012                                                    17
    two earlier consecutive passes. The district court entered
    summary judgment for Nurse Edge on this claim, conclud-
    ing that Mr. Lockett had failed to exhaust his administrative
    remedies. Mr. Lockett submits he did everything required
    under the WDOC’s rules to exhaust those remedies and
    therefore had the right to present them to the district court.
    The Prison Litigation Reform Act provides that “[n]o ac-
    tion shall be brought with respect to prison conditions” un-
    der 42 U.S.C. § 1983, “or any other Federal law, by a prisoner
    confined in any jail, prison, or other correctional facility until
    such administrative remedies as are available are exhaust-
    ed.” 42 U.S.C. § 1997e(a). This provision requires that, “[t]o
    exhaust remedies, a prisoner must file complaints and ap-
    peals in the place, and at the time, the prison’s administra-
    tive rules require.” Pozo v. McCaughtry, 
    286 F.3d 1022
    , 1025
    (7th Cir. 2002). We “take[] a strict compliance approach to
    exhaustion.” Dole v. Chandler, 
    438 F.3d 804
    , 809 (7th Cir.
    2006). Failure to exhaust “is an affirmative defense, and the
    burden of proof is on the defendant[].” 
    Id. There is
    no dispute that Mr. Lockett initially took the re-
    quired steps under the Wisconsin Administrative Code to
    file his complaint. The dispute centers on whether Mr. Lock-
    ett took an appeal from the denial of that initial complaint.
    22
    Mr. Lockett claims that he did; in response, Nurse Edge
    provided the affidavit of Ellen Ray, an Institution Complaint
    Examiner and Litigation Coordinator at WSPF, who stated
    that the facility has no record that Mr. Lockett ever appealed
    the denial of this complaint against Nurse Edge. Ray includ-
    22   R.37 (Lockett Aff.).
    18                                                  No. 19-1012
    ed with her declaration the complaint packet; that packet in-
    cludes no appeal.
    In Dole v. Chandler, 
    438 F.3d 804
    (7th Cir. 2006), we con-
    sidered whether an Illinois prisoner had exhausted his ad-
    ministrative remedies. Dole claimed to have filed a com-
    plaint using the appropriate prison guidelines and to have
    retained a full handwritten copy for himself to guard against
    the consequences of the original being lost. He placed his
    complaint in outgoing mail, and the parties did not dispute
    that it was picked up by a guard and should have been con-
    sidered mailed. Dole received no response to his complaint,
    however, and by the time he inquired, the deadline for filing
    had passed. Dole asked us to deem his claim exhausted, alt-
    hough prison authorities had no record of having received it,
    let alone of having reviewed it on the merits. We concluded
    that, under the circumstances, Dole “had done all that was
    reasonable to exhaust his administrative remedies.” 
    Id. at 812.
    In our opinion, we addressed the district court’s concern
    that siding with Dole meant that “all prison inmates could
    henceforth avoid the PLRA’s exhaustion requirement simply
    by claiming that they mailed a letter.” 
    Id. We observed,
    however, that Dole had produced undisputed evidence that
    his complaint had been taken by a prison guard in due
    course. Id.; see also 
    id. at 811.
    Furthermore, we noted that “fu-
    ture false claims can be minimized by setting up a receipt
    system for prison mail.” 
    Id. at 812.
    No. 19-1012                                                             19
    23
    Wisconsin has such a system. The applicable regula-
    tions mandate that the prisoner receive a receipt for a com-
    plaint: A Corrections Complaint Examiner “shall, within 5
    working days after receiving an appeal, issue a written re-
    ceipt of the appeal to the inmate.” Wis. Admin. Code DOC
    § 310.13(4). This receipt plays a very significant role in the
    complaint process and, indeed, in Mr. Lockett’s ability to
    preserve his right to initiate litigation in the district court if
    the prison system fails to resolve the complaint within the
    time prescribed by the regulations. The regulations specifi-
    cally provide that if a prisoner does not receive an answer to
    his appeal within 45 days of his receiving the receipt of fil-
    23 Under the applicable rules, Wis. Admin. Code DOC § 310 (2016), the
    process begins when an inmate files a complaint “within 14 calendar
    days after the occurrence giving rise to the complaint.” 
    Id. § 310.09(6).
    A
    complaint is “filed” when it is “deposit[ed] … in a locked box designated
    for complaints” or “submitt[ed] … to the office of the ICE [Institution
    Complaint Examiner] via institution mail.” 
    Id. § 310.09(8).
    The Rules
    provide that ICE staff shall collect complaints and “assign each com-
    plaint a file number, classification code, and date for purposes of identi-
    fication.” 
    Id. § 310.11(1),
    (2).
    Following a review and investigation of the complaint, the ICE either
    rejects the complaint or sends a recommendation for further action to the
    Reviewing Authority. See 
    id. § 310.11(11).
    The Reviewing Authority can
    dismiss, affirm, or return the complaint to the ICE for further investiga-
    tion. See 
    id. § 310.12.
    To appeal the Reviewing Authority’s decision, a
    complainant must file a written request for review “within 10 calendar
    days after the date of the decision.” 
    Id. § 310.13(1).
    A Corrections Com-
    plaint Examiner “shall, within 5 working days after receiving an appeal,
    issue a written receipt of the appeal to the inmate.” 
    Id. § 310.13(4).
    20                                                            No. 19-1012
    ing, he should deem the appeal denied and is free to initiate
    24
    suit in the district court.
    As we emphasized in Kaba v. Stepp, 
    458 F.3d 678
    , 685 (7th
    Cir. 2006), when prison officials deny a prisoner the tools
    necessary to utilize an established complaint system, they
    place themselves in a position to exploit, for their own ad-
    vantage, the exhaustion requirement of 42 U.S.C. § 1997e(a).
    Depriving a prisoner of such an important document is cer-
    tainly the sort of deprivation that justifies his use of the
    complaint system. The receipt permits him to file in federal
    court if the prison system ignores his administrative appeal.
    There is certainly nothing in WDOC’s complaint procedure
    that precludes such a use of the complaint procedure. In-
    deed, the regulations say explicitly that a prisoner must have
    an opportunity to seek information about the operation of
    25
    the complaint system.
    24 The timeline for resolution of appeals is as follows: Within “35 work-
    ing days of receipt of the appeal,” the Corrections Complaint Examiner
    shall recommend a decision to the Secretary of the WDOC. 
    Id. § 310.13(6).
    The Secretary shall make a decision within “10 working days
    following receipt” of that recommendation. 
    Id. § 310.14(1).
    “If the inmate
    does not receive the [S]ecretary’s written decision within 45 working
    days of the [Corrections Complaint Examiner]’s acknowledgment of re-
    ceipt of the appeal, the inmate shall consider the administrative remedies
    to be exhausted.” 
    Id. § 310.14(3).
    The purpose of these rules is, inter alia,
    to allow inmates to raise complaints “in an orderly fashion,” to “provide
    the department an early opportunity to decide the issue before an inmate
    commences a civil action,” and to “encourage communication between
    inmates and staff.” 
    Id. § 310.01(2).
    25   Wis. Admin. Code DOC § 310.06.
    No. 19-1012                                                             21
    Reading the regulations in their totality, we must con-
    clude that Mr. Lockett was obliged to regard the absence of
    receipt as a red flag; he should have undertaken, through the
    complaint procedure, an inquiry to ascertain why he had not
    received this important document. Having failed to make
    that inquiry, he may not now counter evidence that the pris-
    on did not receive his administrative appeal with a bald as-
    26
    sertion of a timely filing.
    We also note that requiring a prisoner in Mr. Lockett’s
    position to employ the complaint system to ascertain the fate
    of his appeal and the receipt of filing is compatible with the
    primary purpose of the exhaustion doctrine: it alerts the
    prison officials to the existence of the problem and affords
    an opportunity to repair the injury. Turley v. Rednour, 
    729 F.3d 645
    , 649 (7th Cir. 2013). Moreover, it is a practice known
    to our case law. Cf. Brengettcy v. Horton, 
    423 F.3d 674
    , 678,
    682 (7th Cir. 2005) (allowing a prisoner to file an action in the
    district court after seeking, through the prison grievance sys-
    tem, an explanation for an earlier grievance to which he had
    never received a reply); Lewis v. Washington, 
    300 F.3d 829
    ,
    831–32 (7th Cir. 2002) (plaintiff followed up with Internal
    Affairs Office and with the warden and filed multiple griev-
    26 See R.63 at 14–15. We see no disagreement between our decision today
    and the decision of our colleagues in the Fifth Circuit in Cowart v. Erwin,
    
    837 F.3d 444
    , 452 (5th Cir. 2016). In the Fifth Circuit’s view, a prisoner
    had no obligation to “object in some way if they do not receive a timely
    interim reply” where the jail’s policies “afforded Cowart no ‘next step’
    once the response period for an interim reply had lapsed, but pending
    his receipt of a written answer with findings.” 
    Id. As we
    have pointed
    out in the text, the Wisconsin regulations clearly give the prisoner an
    established path for inquiry.
    22                                                 No. 19-1012
    ances renewing his claims in the face of unanswered re-
    quests).
    To be sure, the burden of proof on the exhaustion issue is
    on the defendants. 
    Kaba, 458 F.3d at 681
    . Once the defend-
    ants asserted that defense through the affidavit and attached
    documentation of Ray, the Complaint Examiner, Mr. Lockett
    had to introduce sufficient evidence to demonstrate that
    there was a genuine issue of triable fact with respect to that
    defense. His own affidavit, while relevant and probative on
    the issues of whether he ever filed an appeal or received a
    receipt, is insufficient to establish that he ever exhausted the
    opportunity to resolve the matter within the prison system
    by making a reasonable inquiry into the reason for the ab-
    sence of a receipt. In Wisconsin, the regulations clearly gave
    him an opportunity to do so, but there is no evidence that he
    availed himself of this tool.
    Absent evidence that he attempted to avail himself of
    such a reasonable course, he has not fulfilled his obligation
    to support his affidavit’s assertion that he filed the appeal.
    He does not have the receipt, and he has made no assertion
    that he ever made a reasonable inquiry as to why he never
    received one. Since the regulations clearly give him the path
    for making such an inquiry, he has not exhausted the availa-
    ble remedies. The district court committed no error in enter-
    ing summary judgment to Nurse Edge on this count.
    Conclusion
    Because the district court committed no error in resolving
    the deliberate indifference claims Mr. Lockett brought
    against NP Bonson and Nurse Edge, we affirm its judgment.
    AFFIRM