A prisoner missed prescribed seizure medication for four days and suffered seizures that allegedly caused permanent injury. His estate sued correctional and medical employees for deliberate indifference. Resolving tension in circuit precedent under the prior-panel-precedent rule, the Eleventh Circuit applied the more-than-gross-negligence formulation and required proof of subjective awareness and a sufficiently culpable disregard of a serious medical risk. Although the record showed serious communication failures and careless conduct, it did not establish the required state of mind for any defendant or a basis for supervisory liability. The court affirmed summary judgment for all defendants.