Opinion
Civil 6:22-CV-01028-ADA-JCM
04-03-2023
JENNIFER BELKNAP, et al, Plaintiffs, v. LEON COUNTY, TEXAS, et al, Defendants.
THE HONORABLE ALAN D ALBRIGHT, UNITED STATES DISTRICT JUDGE
REPORT AND RECOMMENDATION OF THE UNITED STATES MAGISTRATE JUDGE
JEFFREY C. MANSKE UNITED STATES MAGISTRATE JUDGE
This Report and Recommendation is submitted to the Court pursuant to 28 U.S.C. § 636(b)(1)(C), Fed.R.Civ.P. 72(b), and Rules 1(f) and 4(b) of Appendix C of the Local Rules of the United States District Court for the Western District of Texas, Local Rules for the Assignment of Duties to United States Magistrate Judges. Before the Court are Defendants Leon County, Tisha Spinks, and Harry Vanskike's Motion to Dismiss (ECF No. 11) and Defendants Jennilee Page and Southern Health Partners, Inc.'s Motion to Dismiss (ECF No. 18) and the attendant responses and replies thereto. For the following reasons, the undersigned RECOMMENDS Defendants' Motions be GRANTED IN PART AND DENIED IN PART.
I. BACKGROUND
Dakota Belknap (“Decedent”) was booked into Leon County's jail on December 14, 2020. Pls.' Compl. (ECF No. 1) at ⁋13. Jailer Donald Moore completed an intake form for Decedent which Plaintiff alleges contained information indicating that Decedent was suicidal. Id. at ⁋ 13-14. The form stated that Decedent had attempted suicide on December 11, 2020; that he experienced nightmares, flashbacks, or repeated thoughts or feelings related to PTSD or something terrible from his suicide attempt; and that he felt down, depressed, and had little interest or pleasure in doing things before he was arrested. Id. at ⁋14. In response, the jail immediately placed Decedent on suicide watch. Id. Moore then completed the Inmate Mental Condition Report to notify a magistrate of Decedent's risk of suicide. Id. at ⁋16. Sergeant Harry Vanskike signed this form and checked a box next to the word “SUICIDAL.” Id. at ⁋17.
As a result of the intake form, jail staff had an employee of MHMR, Amanda Despain, talk to Decedent. Id. at ⁋18. Despain met with Decedent for around twenty minutes at the jail on December 14. Id. After the meeting, Despain evaluated Decedent on a scale of zero to three, with three being the highest, for his suicide risk. Id. at ⁋19. Despain rated Decedent at a one for suicidal ideation, a one for suicide intent, a one for suicide planning, and a one for suicide history. Id. Plaintiffs allege that this rating was for a single point in time to determine whether Decedent was in crisis when Despain interviewed him. Id. Plaintiffs further allege that Despain believed that Decedent needed to be reevaluated every day. Id. at ⁋⁋ 31, 32. Plaintiff alleges that the jail entrusted Jennilee Page, a licensed vocational nurse, with deciding whether pretrial detainees should remain on suicide watch. Id. at ⁋⁋ 49, 59, 63, 94. Page, an employee with Southern Health Partners (“SHP”), worked at the jail for fifteen hours per week. SHP is a private company that contracts with Leon County to provide medical care to pretrial detainees at Leon County Jail.
The jail took Decedent off suicide watch on December 14. Id. at ⁋⁋ 20, 68-69, 76, 111. The next morning, Jailer Tisha Spinks transferred Decedent to Cell E where he had access to bedding and tie-off points. Id. at ⁋⁋ 93, 77. Before moving Decedent, Spinks consulted with Vanskike. Id. at ⁋⁋ 93, 95. Plaintiffs allege that, in a later interview with Texas Rangers, Vanskike told Spinks, “Good. I don't care. I don't care. I mean, I don't care, because make a decision. I'm tired of making them for you.” Id. at ⁋ 95.
Spinks and Derrick Sanders, an inmate, delivered Decedent's dinner at around 5:00 p.m. on December 15. Id. at ⁋ 73. When they returned around twenty-five minutes later, they saw that Decedent had hung himself with a sheet tied to his bed. Id. Plaintiffs allege that Decedent had eaten most of the food he was served, indicating that he attempted suicide shortly before he was found. Id. at ⁋ 97.
Spinks shouted for someone to “Call EMS. Call Chief!” Id. at ⁋ 24. Sanders ran to find Vanskike. Id. at ⁋ 86. Sanders found Vanskike outside smoking a cigarette. Id. After Sanders informed Vanskike that Decedent had been found hanging, Vanskike walked to the booking desk and looked for a seatbelt cutter to cut Decedent's ligature with. Id. at ⁋ 87. After he could not find the cutter, he headed to Decedent's cell. Id. at ⁋88.
Vanskike found Spinks at the door of Decedent's cell. Id. The two went in together, untied Decedent, and laid him on the floor. Id. at ⁋ 88-89. Vanskike asked Spinks if EMS had been called. Id. at ⁋89. Then, Vanskike said, “Shut this f**king door. That Godd**ned Ranger is going to be up here, snooping around and secure that f**king door. Or, shut the f**king door.” Id. Plaintiffs allege that neither Vanskike nor Spinks provided CPR or any emergency medical treatment to Decedent. Id. at ⁋ 90. Instead, Vanskike locked the cell door and resumed his smoke break. Id. at ⁋⁋ 53, 99.
EMS arrived around twenty minutes later. Id. at ⁋ 114. Paramedics placed an automatic CPR device on Decedent and were able to get a strong pulse. Id. at ⁋44. EMS transported Decedent to the hospital where he was diagnosed with anoxic brain injury. Id. at ⁋ 108. Decedent was pronounced brain dead around two days later. Id. Plaintiffs allege that the delay in care caused Decedent to suffer irreparable brain injury. Id.
Plaintiffs sued Spinks, Vanskike, Leon County, Page, and SHP for violations of Decedent's constitutional rights under 42 U.S.C. § 1983. Leon County, Spinks, and Vanskike filed a Motion to Dismiss for Failure to State a Claim on October 25, 2022. Cty. Defs.' Mot. Page and SHP filed a Motion to Dismiss for Failure to State a Claim on November 23, 2022. Medical Defs.' Mot.
II. LEGAL STANDARDS
Upon motion or sua sponte, a court may dismiss an action that fails to state a claim upon which relief may be granted. Fed.R.Civ.P. 12(b)(6); Carroll v. Fort James Corp., 470 F.3d 1171, 1177 (5th Cir. 2006). To survive Rule 8, a nonmovant must plead “enough facts to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007). “The court's task is to determine whether the plaintiff has stated a legally cognizable claim that is plausible, not to evaluate the plaintiff's likelihood of success.” Lone Star Fund V (U.S.), L.P. v. Barclays Bank PLC, 594 F.3d 383, 387 (5th Cir. 2010). The court begins by identifying which allegations are well-pleaded facts and which are legal conclusions or elemental recitations, accepting as true the former and rejecting the latter. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). A court need not blindly accept every allegation of fact; properly pleaded allegations of fact amount to more than just conclusory allegations or legal conclusions “masquerading as factual conclusions.” Taylor v. Books A Million, Inc., 296 F.3d 376, 378 (5th Cir. 2002). The court then determines whether the accepted allegations state a plausible claim to relief. Id. at 379.
“Factual allegations must be enough to raise a right to relief above the speculative level, on the assumption that all the allegations in the complaint are true (even if doubtful in fact).” Twombly, 550 U.S. at 555. “The court accepts all well-pleaded facts as true, viewing them in the light most favorable to the [nonmovant].” In re Katrina Canal Breaches Litig., 495 F.3d 191, 205 (5th Cir. 2007) (quotation marks omitted). “A claim has facial plausibility when the [nonmovant] pleads factual content that allows the court to draw the reasonable inference that the [movant] is liable for the misconduct alleged.” Ashcroft, 556 U.S. at 678. “The plausibility standard . . . asks for more than a sheer possibility that a defendant has acted unlawfully.” Id. For purposes of Rule 12(b)(6), “pleadings” include the complaint, its attachments, and documents referred to in the complaint and central to a plaintiff's claims. Collins v. Morgan Stanley Dean Witter, 224 F.3d 496, 498-499 (5th Cir. 2000).
III. DISCUSSION
A. Eighth Amendment Claims
County Defendants argue that Plaintiffs' claims under the Eighth Amendment fail as a matter of law. Cty. Defs.' Mot. at 9. Plaintiffs did not address this argument in their Response. See generally Pls.' Resp. to Cty. Defs.' Mot (ECF No. 19). The constitutional rights of pretrial detainees are found in the Fourteenth Amendment. Estate of Henson v. Wichita Cty., Tex., 795 F.3d 456, 462 (5th Cir. 2015). The parties do not dispute that Decedent was a pretrial detainee. Pls.' Compl. at ¶ 13. Thus, any claim brought under the Eighth Amendment fails as a matter of law and the Court should grant the County Defendants' Motion on this cause of action.
B. Fourteenth Amendment Claims against Individual Defendants
Plaintiffs sued Defendants Spinks, Vanskike, and Page for violations of Decedent's Fourteenth Amendment rights. Pls.' Compl. at ¶ 147-53. Plaintiffs allege two specific constitutional violations: (1) a failure to prevent Decedent's suicide attempt; and (2) a failure to provide emergency medical care. The individual Defendants argue that Plaintiffs fail to allege that Decedent's rights were violated.
Title 42 U.S.C. § 1983 creates a cause of action against any person who, under color of law, causes another to be deprived of a federally protected constitutional right. 42 U.S.C. § 1983. Two allegations are required to state a claim under § 1983. “First, the plaintiff must allege that some person has deprived him of a federal right. Second, he must allege that the person who has deprived him of that right acted under color of state or territorial law.” Gomez v. Toledo, 446 U.S. 635, 640 (1980); Manax v. McNamara, 842 F.2d 808, 812 (5th Cir. 1988).
Claims arising from a jail suicide are considered and treated as claims based on the failure of jail officials to provide medical care or safety for those in their custody. See Hare v. City of Corinth, 74 F.3d 633, 650 (5th Cir.1996) (en banc). Under this standard, the plaintiff must prove that a jail or detention official “had gained actual knowledge of the substantial risk of suicide and responded with deliberate indifference.” Id. “Deliberate indifference” in prison cases occurs when “an official knows of and disregards an excessive risk to inmate health or safety; the 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 inference.” Farmer v. Brennan, 511 U.S. 825, 837 (1994). This same standard is also used to measure jail officials' liability as to pretrial detainees. Hare, 74 F.3d at 643.
Deliberate indifference requires a higher degree of fault than negligence or gross negligence. Id. at 645. Negligent inaction by jail personnel does not rise to the level of deliberate indifference. Id. Instead, the state actor must know of and disregard an excessive risk to the detainee's health or safety. McClendon v. City of Columbia, 305 F.3d 314, 326 n. 8 (5th Cir. 2002) (en banc) (citations omitted). A state actor's failure to alleviate a significant risk that he should have perceived but did not does not rise to the level of deliberate indifference. Id.
1. Failure to Prevent Decedent's Suicide Attempt
Plaintiffs have adequately pled that each of the individual Defendants had actual knowledge of a substantial risk of harm to Decedent. Plaintiffs alleged that Page was aware of the intake form that indicated that Decedent was suicidal. Pls.' Compl. at ⁋⁋ 13, 14, 94. Plaintiffs further alleged that Page was required to assess Decedent after the MHMR assessment and before Decedent was released from the holding cell. Id. at ⁋⁋ 18, 34, 49, 59, 63, 94. Plaintiffs alleged that Page knew Decedent had attempted suicide three days before going to jail. Id. at ⁋⁋ 60, 94. These facts clearly indicate that Page was aware of a substantial risk of harm.
Page argues that the pre-detention suicide attempt was not actually a suicide attempt. Medical Defs.' Reply (ECF No. 29) at 2. Instead, she argues that Decedent's injuries were caused by an altercation with his brother-in-law. Id. The Court notes that this argument is inappropriate at the pleading stage because it asks this Court to look beyond the “four corners of Plaintiffs' Complaint,” which Defendants correctly identified as the standard in a motion to dismiss. Id. at 1.
Plaintiffs alleged that Spinks was familiar with Decedent's suicide history and screening form. Pls.' Compl. at ⁋82. Plaintiffs also alleged that Spinks asked for Vanskike's approval to move Decedent to a cell where he could not be watched and would have access to ligatures. Id. at ¶ 76, 82. Plaintiffs argue that the jury can infer that Spinks subjectively understood the serious risk of transferring a detainee with a recent history of suicide by checking with Vanskike before moving Decedent. Pls.' Resp. to Cty. Defs.' Mot. at 22. The Court agrees that these facts are well pleaded and support such an inference. Thus, Plaintiffs have adequately pled that Spinks had actual knowledge of a substantial risk of bodily harm.
Finally, Plaintiffs alleged that Vanskike signed the screening form as the supervisor on duty and acknowledged in writing that Decedent was a suicide risk. Pls.' Compl. at ⁋⁋ 13, 15, 17. This allegation is clearly sufficient to plead that Vanskike had actual knowledge of a substantial risk of bodily harm. Thus, Plaintiffs have alleged that Page, Spinks, and Vanskike all had actual knowledge of a substantial risk of harm.
Defendants argue that there was only a “low likelihood that [Decedent] would commit suicide.” Cty. Defs.' Mot. at 13. Plaintiffs persuasively point out that Decedent was ranked a “1” on a 0 to 3 scale. Pls.' Resp. to Cty. Defs.' Mot. at 23. The rating, while low, combined with the allegations that Decedent had recently attempted to commit suicide still rise to a substantial risk of harm at the pleading stage.
Plaintiffs have also alleged that Page, Spinks, and Vanskike acted with deliberate indifference regarding a substantial risk of bodily harm. Plaintiffs alleged that despite having knowledge of Decedent's risk of suicide, Page removed Decedent from suicide watch. Pls.' Compl. at ¶ 65, 69. A jury could infer that Page's decision to remove Decedent from suicide watch was deliberately indifferent. Compare Gray v. Tunica Cty., Miss., 100 Fed.Appx. 281, 282 (5th Cir. 2004) (per curiam) (holding that the District Court did not err in holding that a jailer was not deliberately indifferent because he removed the detainee's socks and shoes, placed him in a padded cell, and instituted a suicide watch).
Plaintiffs' allegations against Spinks and Vanskike are closely related. Spinks was deliberately indifferent by transferring Decedent to a cell with ligatures and tie-off points. Vanskike was deliberately indifferent by telling Spinks, “I don't care. I mean, I don't care, because make a decision,” when Spinks asked whether she should move Decedent to a new cell. Pls.' Compl. at ¶ 76, 82, 95. Plaintiffs adequately alleged that Spinks and Vanskike were deliberately indifferent. See Jacobs v. West Feliciana Sherriff's Dep't, 228 F.3d 388, 397 (5th Cir. 2000) (holding that a jury could find that a sheriff acted with deliberate indifference by ordering a jailer to give a suicidal inmate a blanket and place her in a cell with tie-off points). Accordingly, Plaintiffs have stated a claim for their failure to prevent Decedent's suicide attempt and County Defendants' Motion on this ground should be denied.
Page argues that Plaintiffs cannot maintain an action against her as a private actor. Medical Defs.' Mot. at 3. This argument flies in the face of recent Fifth Circuit precedent on this question. In Sanchez v. Oliver, the Fifth Circuit held that “there is no question that [defendant], as a medical professional treating a pretrial detainee on behalf of a governmental entity, was acting under color of state law for purposes of § 1983.” 995 F.3d 461, 466 (5th Cir. 2021) citing West v. Atkins, 487 U.S. 42, 54 (1988). In Sanchez, the relevant defendant was an employee of a private company which contracted with the jail to provide healthcare services to pretrial detainees. Id. at 465. Here, Plaintiffs have alleged that Page is an employee of a private company which contracted with Leon County to provide healthcare services to pretrial detainees. Thus, Plaintiffs have satisfied their pleading burden at this stage.
2. Failure to Provide Emergency Medical Care
Plaintiffs have adequately pled that Spinks and Vanskike had actual knowledge of a substantial risk of harm posed by failing to provide emergency medical care to Decedent after they found him hanging. Plaintiffs have not adequately pled that Page had actual knowledge of that risk.
Plaintiffs alleged that Spinks saw Decedent hanging shortly after 5:30 p.m. Pls.' Compl. at I 77. Spinks sent someone for Vanskike. Id. When Vanskike arrived, Spinks and Vanskike entered the cell and untied the knot around Decedent's neck. Id. at ⁋ 77-78. Vanskike laid Decedent on the ground and checked his pulse. Id. at ⁋ 78. Plaintiffs allege that Spinks assumed Decedent did not have a pulse. Id. Plaintiffs further allege that Spinks “pushed an emergency call security button and told the dispatcher to call Bren, the Sheriff, and the deputies.” Id. Plaintiffs allege that Spinks did nothing and Vanskike returned to his smoke break after Spinks pressed the call button. Id. at ⁋ 99.
Plaintiffs' allegations state a plausible claim that Spinks and Vanskike knew that Decedent needed emergency medical care and did nothing to assist him. Plaintiffs argue that nearly anybody would know that the Decedent's best chance at survival was for someone to perform CPR until EMS arrived. Pls.' Resp. to Cty. Defs.' Mot. at 24. This is further supported by Plaintiffs' allegations that the jailers knew that twenty minutes without a pulse was likely to cause irreversible damage. Pls.' Compl. At ⁋ 21.
Plaintiffs have not stated a plausible claim that Page knew that Decedent needed emergency medical care. Plaintiffs' response does not address Page's argument that Plaintiffs have failed to state a claim against her for failing to provide emergency medical treatment. See generally Pls.' Resp. to Medical Defs.' Mot. Plaintiffs' Complaint does not allege that Page was at the jail when Decedent attempted suicide. See generally Pls.' Compl. If Page was not there, she could not have been expected to give Decedent medical treatment. Thus, Plaintiffs fail to state a claim against Page for failing to provide emergency medical treatment to Decedent.
C. Qualified Immunity
Defendants Spinks and Vanskike argue that they are entitled to qualified immunity. Cty. Defs.' Mot. at 18. Qualified immunity shields government officials from civil liability for claims under federal law unless their conduct “violates a clearly established constitutional right.” Mace v. City of Palestine, 333 F.3d 621, 623 (5th Cir. 2003). Qualified immunity balances “the need to hold public officials accountable when they exercise power irresponsibly and the need to shield officials from harassment, distraction, and liability when they perform their duties reasonably.” Pearson v. Callahan, 555 U.S. 223, 231 (2009). Because qualified immunity shields “all but the plainly incompetent or those who knowingly violate the law,” the Fifth Circuit considers qualified immunity the norm and admonishes courts to deny a defendant immunity only in rare circumstances. Romero v. City of Grapevine, 888 F.3d 170, 176 (5th Cir. 2018) (quoting Malley v. Briggs, 475 U.S. 335, 341 (1986)) (internal quotation marks omitted).
Courts use a two-prong analysis to determine whether an officer is entitled to qualified immunity. Cole v. Carson, 935 F.3d 444, 451 (5th Cir. 2019). A plaintiff must show (1) the official violated a constitutional right; and (2) the constitutional right was “clearly established” at the time of the defendant's alleged misconduct. Reed v. Taylor, 923 F.3d 411, 414 (5th Cir. 2019). The Supreme Court held in Pearson that “the judges of the district courts . . . should be permitted to exercise their sound discretion in deciding which of the two prongs of the qualified immunity analysis should be addressed first.” Pearson, 555 U.S. at 236. Although qualified immunity is an affirmative defense, the plaintiff bears the burden to rebut the defense and assert facts to satisfy both prongs of the analysis. Brumfield v. Hollins, 551 F.3d 322, 326 (5th Cir. 2008). If a plaintiff fails to establish either prong, the public official is immune from suit. Zarnow v. City of Wichita Falls, 500 F.3d 401, 407 (5th Cir. 2007).
As discussed above, Plaintiffs have plead a plausible claim that Spinks and Vanskike violated Decedent's constitutional rights. The Court must now determine whether these constitutional rights were clearly established at the time of the alleged misconduct. See Reed, 923 F.3d at 414. It is beyond well settled that giving obvious ligatures to a detainee known to be at risk of suicide violates the detainee's right to be protected from a substantial risk of serious bodily harm. Sanchez, 995 F.3d at 473. Thus, Decedent's right to not be given an obvious ligature was clearly established at the time of the time of Decedent's attempted suicide.
Whether the right to CPR was clearly established at the time of the alleged misconduct is more complicated. “Unless existing precedent ‘squarely governs' the conduct at issue, an official will be entitled to qualified immunity.” Cope v. Cogdill, 3 F.4th 198, 205 (5th Cir. 2021). Further, the Court must frame the constitutional question with “specificity and granularity.” Morrow v. Meachum, 917 F.3d 870, 874-75 (5th Cir. 2019).
Plaintiffs cite to Carlucci v. Chapa, 884 F.3d 534 (5th Cir. 2018) for the proposition that Decedent's need for emergency medical care was obvious. Carlucci involved inadequate dental care. Carlucci, 884 F.3d at 536-37. It did not involve emergency care at all. Thus, the case does not render the right to CPR clearly established.
Plaintiffs also argue that it is clearly established that a jailer “is deliberately indifferent if he intentionally denies or delays access to medical care.” Pls.' Resp. to Cty. Defs.' Mot. at 27, citing Estelle v. Gamble, 429 U.S. 97, 103 (1976). Again, Estelle did not involve the denial of emergency medical care. Instead, it involved prison guards refusing an inmate medical treatment many times over multiple months. Estelle, 429 U.S. at 99-101.
Plaintiffs' Complaint and Response fail to point the Court to a case analogous to the one before the Court. Although there is no Fifth Circuit authority on the question of whether the right to CPR is clearly established, the overwhelming authority from jurisdictions around the country demonstrates that the right is clearly established. See Brumfield v. Hollins, 551 F.3d 322, 332-33 (5th Cir. 2008) (holding that officers did not violate decedent's rights where three people felt for a pulse, found none, assumed detainee was dead, and did not attempt to resuscitate him.); see also Hearst v. Mason, No. 1:11-CV-304, 2014 WL 1203269, at *8 (W.D. Pa. Mar. 24, 2014) (summarizing relevant cases across the country as standing for the proposition that “a claim for failing to initiate CPR to an inmate who is seemingly unconscious and not breathing will not lie if the evidence indicates that the inmate had been deceased for a considerable amount of time or other signs reasonably point to the conclusion that resuscitation efforts would not have been effective.”); McRaven v. Sanders, 577 F.3d 974, 983 (8th Cir. 2009) (citations omitted) (“An officer trained in CPR, who fails to perform it on a prisoner manifestly in need of such assistance, is liable under § 1983 for deliberate indifference.”); Jones v. City of Cincinnati, 521 F.3d 555, 560 (6th Cir. 2008) (citations omitted) (holding officers are not entitled to qualified immunity on deliberate indifference claim rooted in failure to provide CPR where the knew the arrestee was handcuffed and not breathing); Tlamka v. Serrell, 244 F.3d 628, 633 (8th Cir. 2001) (holding that corrections officers were not entitled to qualified immunity on deliberate indifference claim where they failed to provide CPR for ten minutes even though they were trained in CPR and the prisoner's condition was obviously life threatening); Sparks v. Susquehanna Cnty., No. 3:05cv2274, 2009 WL 922489, at *10 (M.D. Pa. Ar. 3, 2009) (jury could find that correctional officer was deliberately indifferent when she was trained in CPR and unwilling to perform it); Ashworth v. Round Lake Beach Police Dep't, No. 03 C 7011, 2005 WL 1785314, at *7 (N.D. Ill. July 21, 2005) (holding that failure to perform CPR after calling an ambulance raises a question of fact regarding deliberate indifference); Petro v. Town of West Warwick ex rel. Moore, 889 F.Supp.2d 292, 332 (D. R.I. 2012) (holding that failure to provide CPR for four minutes and twenty seconds did not constitute deliberate indifference.); McWilliams v. City of Houston, No. 4:17-CV-00345, 2021 WL 2445878, at *11, (S.D. Tex. June 15, 2021), aff'd sub nom. McWilliams v. City of Houston, No. 21-20369, 2022 WL 17337820 (5th Cir. 2022) (“Plaintiffs haven't shown any clearly established right to something more than immediate administration of CPR.”); Wallace v. Jackson, 667 F.Supp.2d 1267, 1275 (M.D. Ala. 2009) (prison official violated a clearly established constitutional right by failing to check detainee's pulse, perform CPR, or summon medical help.); Heflin v. Stewart Cnty., Tenn., 958 F.2d 709, 713, 717-18 (6th Cir. 1992) (“There can be no doubt that in 1987 existing law clearly established the right of pretrial jail inmates to receive care for their serious needs” including CPR.); Washington v. City of St. Louis, 596 F.Supp.3d 1204, 1214 (E.D. Mo. 2022) (failure to provide prompt medical assistance, including CPR, to inmate constituted deliberate indifference.); Greer v. Cnty. of San Diego, No. 19CV378-JO-DEB, 2023 WL 2145528, at *5 (S.D. Cal. Feb. 21, 2023) (holding that the law is clearly established that jail official must provide an emergency medical response to an inmate in acute medical distress). Thus, Defendants' Motion to Dismiss on Plaintiffs' failure to provide emergency aid should be denied.
D. Monell liability for Leon County
Defendant Leon County argues that Plaintiffs have failed to state a plausible claim for relief against it. Cty. Defs.' Mot. at 25. A municipality may not face liability based on its employees' actions under the doctrine of respondeat superior. Monell v. Dep't of Soc. Serv., 436 U.S. 658, 691 (1978). Instead, municipalities face Section 1983 liability “when execution of a government's policy or custom, whether made by its lawmakers or by those whose edicts or acts may fairly be said to represent official policy, inflicts the injury.” Id. at 694. A municipality may be held liable under section 1983 only when the enforcement of the municipal policy or practice was the “moving force” behind the violation of the plaintiff's federally protected right. Bd. Of County Comm'rs v. Brown, 520 U.S. 397, 410-11 (1997). The plaintiff must prove three elements to establish liability against a municipality: (1) a policymaker; (2) an official policy; and (3) a violation of constitutional rights whose moving force is the municipal policy or custom. Piotrowski v. City of Houston, 237 F.3d 567, 578 (5th Cir. 2001) citing Monell, 436 U.S. at 694. The proper analysis of municipal liability under section 1983 “requires [a separation of] two different issues . . . (1) whether plaintiff's harm was caused by a constitutional violation, and (2) if so, whether the city is responsible for that violation.” Collins v. City of Harker Heights, 503 U.S. 115 (1992).
Here, Plaintiffs plead a de facto policy established through the practice or custom demonstrated by employees acting in the same manner under the same conditions. Pls.' Resp. to Cty. Defs.' Mot. at 30. Further, Plaintiffs plead a number of other policies: (1) Leon County allegedly has a “completely unworkable written policy regarding inmates needing emergency medical treatment;” (2) Leon County's Intervention/Emergency Treatment policy which “did not mandate emergency medical assistance by Leon County employees;” (3) policy also allegedly “did not require anyone in the jail to provide CPR;” (4) alleged policy of not requiring verification that MHMR personnel reevaluate a suicidal person; (5) policy was also to not have commonly used emergency medical equipment available for jail personnel and medical personnel to use in the event of a medical emergency; (6) have a nurse at the jail three days a week for five hours a day; (7) did not train Page about the scope of the MHMR evaluation; and (8) failed to train employees on providing emergency medical treatment to inmates who need it. Pls.' Compl. at ⁋⁋ 125, 127, 128, 130, 131, 132, 133, 135. Plaintiffs have clearly adequately alleged official policies.
Defendants argue that “Plaintiffs have not pleaded facts which would show that [Decedent's] rights were violated due to an alleged policy of indifference to serious medical needs by failing to have proper equipment, training, or procedures to intervene in a medical emergency before the arrival of outside emergency services.” Cty. Defs.' Mot. at 28. As discussed above, Plaintiff has pled facts showing that Decedent's rights were violated as a result of Spinks and Vanskike's failure to provide emergency medical assistance. Plaintiffs have also alleged that the failure was caused by Leon County's lack of a policy requiring intervention in medical emergencies before the arrival of emergency services. Plaintiffs also alleged that this caused the Decedent's brain damage and death. Thus, Plaintiffs have pled facts showing that Decedent's rights were violated due to an alleged policy of indifference to serious medical needs.
Plaintiffs have adequately alleged that Decedent was harmed by the alleged policies. Plaintiffs allege that if a medical professional had been at the jail, that professional would have performed CPR. At the pleading stage, Plaintiffs have clearly satisfied their burden of establishing harm.
To establish a failure to supervise or train claim, plaintiffs must show that: “(1) the supervisor either failed to supervise or train the subordinate official; (2) a causal link exists between the failure to train or supervise and the violation of the plaintiff's rights; and (3) the failure to train or supervise amounts to deliberate indifference.” Estate of Davis ex rel. McCully v. City of N. Richland Hills, 406 F.3d 375, 381 (5th Cir. 2005). Plaintiffs alleged that Leon County failed to train employees in emergency lifesaving techniques. Plaintiffs also alleged that this failure led to Spinks and Vanskike failing to provide emergency lifesaving medical care. Finally, Plaintiffs alleged that such failure amounts to deliberate indifference to a serious risk of bodily harm to inmates in need of emergency medical care. Thus, Plaintiffs have stated a plausible claim for relief for failure to train employees against Leon County.
Leon County argues that the fact the Deputy Flemmons “attempted to resuscitate [Decedent] within a few minutes of his death,” undercuts Plaintiffs' claim that “no Leon County employee attempted to resuscitate [Decedent] as a matter of policy.” Defs.' Mot. at 29. Defendants misinterpret Plaintiffs' pleadings. Plaintiffs alleged that no one provided assistance to Decedent before EMS arrived because they were not required to do so. Plaintiffs alleged that Deputy Flemmons provided assistance to EMS after they arrived. Those allegations are consistent. Thus, Defendants' Motion to Dismiss Plaintiffs' claims against Leon County should be denied.
E. Monell liability for SHP
SHP argues that Plaintiff cannot state a claim against it because it is a private entity. The Supreme Court has held that “the medical treatment of prison inmates by prison physicians is state action.” West v. Atkins, 487 U.S. 42, 53 (1988). Further, the Fifth Circuit has applied Monell liability to private prisons. Moore v. LaSalle Mgmt. Co., 41 F.4th 493, 509 (5th Cir. 2022). SHP's arguments are unavailing.
SHP also argues that Plaintiffs have failed to allege that SHP or its nurses were official policy makers or that they implemented a municipal policy. Medical Defs.' Mot. at 8. Plaintiffs alleged that Leon County delegated much, if not all, of the decisions related to healthcare services in the Leon County jail to SHP. Pls.' Compl. at ⁋⁋ 120, 123, 125, 126, 129, 130, 133. Plaintiffs also alleged that SHP had a policy, practice, or custom of (1) limiting medical personnel hours to fifteen hours a week; (2) proving no treatment at the jail for emergencies; (3) not requiring emergency medical assistance; (4) not requiring MHMR reevaluations or training employees regarding the scope of those evaluations; and (5) allowing an unqualified LVN determine whether detainees should be on suicide watch. Id. Plaintiffs have, therefore, adequately alleged a policy.
SHP contends that Plaintiffs failed to plausibly allege that a policy made or implemented by a policymaker at SHP was the actual cause of a constitutional violation. Medical Defs.' Mot. at 8. As discussed above, Plaintiffs have stated a plausible claim that Decedent's rights to adequate medical care were violated. Thus, Plaintiffs have adequately alleged that policies implemented by SHP and SHP's employees were the actual cause of a conditional violation. Accordingly, Defendants' Motion should be denied.
F. Vicarious liability for private prison contractors
SHP argues that it cannot be held vicariously liable for the acts of its employee. Medical Defs.' Mot. at 7. Neither the Supreme Court nor the Fifth Circuit have addressed whether plaintiffs can hold private defendants vicariously liable under Section 1983. See Moore, 41 F.4th at 509 (noting that the Fifth Circuit has not resolved the issue). Courts addressing this issue are split.
In Hutchison v. Brooskhire Bros., Ltd., 284 F.Supp.2d 459 (E.D. Tex. 2003), the Eastern District of Texas held that Monell and its progeny do not shield private corporations from vicarious liability when their employees have committed a Section 1983 violation while acting within the scope of their employment. Hutchison, 284 F.Supp.2d at 473. The Court reasoned that there were no persuasive policy justifications from shielding private employers from vicarious liability because imposing liability does not affect a state's police power or its ability to regulate municipalities. Id. at 472-73.
The case SHP relies on, Brown v. Crowe, No. 7:17-CV-00096-M-BP, 2018 WL 4922448 (N.D. Tex. 2018), is conclusory. The Brown Court did not acknowledge the critical difference between a local government and a private corporation. Brown, 2018 WL 4922448, at *6 (holding that a vicarious liability claim against a private corporation is fatally defective under Monell). The Court does not find this holding persuasive because it is conclusory. Accordingly, the Court recommends holding that private prison contractors can be held vicariously liable for constitutional violations committed by employees while acting within the course and scope of their employment.
G. Bystander liability
Defendants Page, Spinks, and Vanskike argue that Plaintiffs failed to state a claim for bystander liability. Cty. Defs.' Mot. at 17; Medical Defs.' Mot. at 10. An officer may be liable under Section 1983 under a theory of bystander liability where the officer “(1) knows that a fellow officer is violating an individual's constitutional rights; (2) has a reasonable opportunity to prevent the harm; and (3) chooses not to act.” Hamilton v. Kindred, 845 F.3d 659, 663 (5th Cir. 2017) citing Whitley v. Hanna, 726 F.3d 631, 646 (5th Cir. 2013).
Plaintiffs have failed to plead a claim of bystander liability against Page. Plaintiffs do not allege that Page knew that Spinks and Vanskike placed Decedent in a cell with ligatures. Nor do they allege that Page knew that Decedent needed emergency medical care after his suicide attempt. Thus, Plaintiffs have failed to plausibly plead that Page knew that anyone violated Decedent's rights. Thus, Page's Motion to Dismiss the bystander claims against her should be granted.
Plaintiffs have pled a claim of bystander liability against Spinks and Vanskike. Plaintiffs' response was limited to claims regarding emergency medical care. As discussed above, Plaintiffs plausibly alleged that Spinks and Vanskike each violated Decedent's rights, that each of them knew about the violations, that they both had the opportunity to prevent the harm, and that they chose not to act. Thus, Defendants' Motion to Dismiss Plaintiffs' bystander liability claims should be denied.
IV. CONCLUSION
For the foregoing reasons, the undersigned RECOMMENDS that Leon County, Vanskike, and Spinks's Motion to Dismiss for Failure to State a Claim (ECF No. 11) and Southern Health Partners' and Page's Motion to Dismiss for Failure to State a Claim (ECF No. 18) be GRANTED in part and DENIED in part. The following claims should be dismissed: any Eighth Amendment claims brought by Plaintiffs; claims against Page for failure to provide emergency medical care; and bystander claims against Page. The following claims should not be dismissed: Plaintiffs' claims against Vanskike for failure to prevent Decedent's suicide attempt and failure to provide emergency medical assistance; claims against Spinks for failure to prevent Decedent's suicide attempt and failure to provide emergency medical assistance; claims against Page for failure to prevent Decedent's suicide attempt; Monell claims against Leon County; Monell claims against SHP; vicarious liability claims against SHP; bystander liability claims against Vanskike; and bystander liability claims against Vanskike.
V. OBJECTIONS
The parties may wish to file objections to this Report and Recommendation. Parties filing objections must specifically identify those findings or recommendations to which they object. The District Court need not consider frivolous, conclusive, or general objections. See Battle v. U.S. Parole Comm'n, 834 F.2d 419, 421 (5th Cir. 1987).
A party's failure to file written objections to the proposed findings and recommendations contained in this Report within fourteen (14) days after the party is served with a copy of the Report shall bar that party from de novo review by the District Court of the proposed findings and recommendations in the Report. See 28 U.S.C. § 636(b)(1)(C); Thomas v Arn, 474 U.S. 140, 150-53 (1985); Douglass v. United Servs. Auto. Ass'n, 79 F.3d 1415 (5th Cir. 1996) (en banc). Except upon grounds of plain error, failing to object shall further bar the party from appellate review of unobjected-to proposed factual findings and legal conclusions accepted by the District Court. See 28 U.S.C. § 636(b)(1)(C); Thomas, 474 U.S. at 150-53; Douglass, 79 F.3d at 1415.