Rossie Marie Miller, Personal Representative of the Estate of John King Lindsay Stanford, Deceased v. Calhoun County Sheriff Allen L. Byam Captain Terry Cook Sergeant Michelle Lindsay Deputy Melinda Osteen Deputy Lapham Deputy Jeffrey S. Holley Deputy Holly Thomas Sergeant Marcia Leavell Deputy Everett Dr. Mehmet B. Ismailoglu
Docket: 03-2434
Court: Court of Appeals for the Sixth Circuit; May 27, 2005; Federal Appellate Court
Rossie Marie Miller, as the personal representative of the estate of John King Lindsay Stanford, appeals two District Court orders that granted summary judgment to all defendants in a wrongful death suit under 42 U.S.C. § 1983. The case stemmed from Stanford's death due to a brain tumor while in pretrial custody at the Calhoun County Correctional Facility on April 26, 1998. The Complaint contends that the County's medical care policies and staff training were deliberately indifferent to inmates' serious medical needs, violating the Eighth Amendment. It also alleges that specific correctional officers and Dr. Mehmet Ismailoglu, the on-call physician, displayed gross negligence regarding Stanford’s medical condition. The District Court found insufficient evidence of deliberate indifference by the defendants and denied Miller's motion to amend the Complaint to assert that Dr. Ismailoglu was a policymaker for municipal liability. The Court of Appeals affirmed the District Court's decision.
The background details reveal that Stanford was booked into the facility on April 24, 1998, after sustaining a head injury a month prior, which he did not report as problematic during the booking process. Throughout the following days, Stanford requested aspirin multiple times for headaches, with the last request made shortly before midnight on April 25, 1998.
Osteen obtained approval from Sergeant Lindsay and returned around 12:10 a.m. with Motrin for Stanford. At approximately 12:30 a.m. on April 26, Deputy Lapham responded to Owen's prolonged pounding on Stanford's cell door. Upon entering, Lapham found Stanford unresponsive, lying face-up in a puddle of water. After reporting the medical situation to Lindsay, Owen informed Lapham that Stanford had fallen out of bed three times. Lindsay arrived shortly thereafter, observed water on the floor, and learned from Owen that Stanford had spilled a cup of water during a fall. Lindsay asked Stanford if he had hit his head, to which Stanford, now responsive, said he had not. Lapham later discovered that Stanford had a recent head injury and had been in pain since the previous evening. After checking Stanford's pulse and finding it strong, the officers placed him in a wheelchair for transport to the intake area. Lapham noted that they had to frequently assist Stanford to remain upright in the chair as he appeared disoriented but coherent. At intake, deputies helped Stanford change into dry clothing. Lindsay then contacted Dr. Ismailoglu, the on-call physician, relaying Stanford's condition, including his prior head injury and headache. Dr. Ismailoglu, perceiving no urgency, advised that medical staff would see Stanford in the morning and agreed to Lindsay's suggestion for half-hour monitoring. The call between Lindsay and Dr. Ismailoglu lasted 1.9 minutes, with the doctor later indicating there was nothing alarming in Lindsay's report that warranted immediate medical intervention.
Intake staff began monitoring Stanford at 1:00 a.m. on April 26, due to concerns of a possible seizure, observing him every half hour for seven hours. He was noted to be responsive and coherent, despite rolling on the floor. At 1:30 a.m., Stanford requested a Snickers bar, indicating he believed his blood sugar was low; however, a test showed normal levels. By 4:30 a.m., he was observed masturbating, and staff noted no significant change in his condition throughout the night. At 8:10 a.m., he was found lying on the floor with shaking feet and wet pants, prompting Sergeant Leavell to contact medical personnel. A nurse was summoned, and an ambulance arrived within seven minutes, transporting Stanford to the hospital by 8:45 a.m., where he was comatose. He was diagnosed with a massive right vasoganglion hemorrhage, and surgery was deemed inappropriate. Stanford's condition worsened, and he died later that day, with the cause of death identified as a primary brain tumor (astrocytoma).
On April 18, 2001, Stanford's sister, Rossie Marie Miller, filed a lawsuit in the Western District of Michigan, asserting claims under 42 U.S.C. § 1983. The complaint included allegations of deliberate indifference and gross negligence against various defendants, including Calhoun County, Sheriff Allen L. Byam, jail administrator Captain Terry Cook, and several corrections officers. Additionally, Dr. Ismailoglu was named for similar claims. The case was assigned to Magistrate Judge Hugh W. Brenneman, Jr., who was given full judicial authority by consent. Dr. Ismailoglu moved for summary judgment on May 15, 2002, with oral arguments heard on August 21. The County and Corrections Officer Defendants sought dismissal or summary judgment on September 19, 2002. Miller later sought to amend the complaint to label Dr. Ismailoglu as a "policymaker" under § 1983. On February 12, 2003, the District Court granted Dr. Ismailoglu's summary judgment motion. On September 29, 2003, it denied Miller's amendment request as futile and granted summary judgment for the County and Corrections Officer Defendants.
Miller is appealing a district court's rulings, with this Court exercising jurisdiction under 28 U.S.C. § 1291. The Court conducts a de novo review of summary judgment grants, which are only appropriate when there are no genuine material facts in dispute and the moving party is entitled to judgment as a matter of law, as per Fed. R. Civ. P. 56(c). In evaluating evidence for summary judgment, the Court must favor the non-movant. The key consideration is whether the evidence allows for a jury submission or is so one-sided that one party must win as a matter of law.
In a § 1983 action, the non-moving party must show two elements: 1) a deprivation of a right secured by the Constitution or U.S. laws, and 2) that the deprivation was caused by someone acting under state law. It is undisputed that the Defendants acted under color of state law; therefore, the focus shifts to whether an actionable deprivation occurred. "Deliberate indifference" by prison officials to serious medical needs violates the Eighth Amendment's prohibition against cruel and unusual punishment, which applies to post-conviction inmates and is guaranteed to pretrial detainees under the Fourteenth Amendment.
Civil redress under § 1983 exists where constitutional rights are violated, including Eighth and Fourteenth Amendment rights. The Supreme Court has established a mixed standard for determining deliberate indifference, requiring that prison officials must be aware of and disregard an excessive risk to inmate health or safety. The objective component requires a "sufficiently serious" medical need, defined by conditions that pose a substantial risk of serious harm. The subjective component demands proof that the official had a culpable state of mind in denying care, which exceeds mere negligence but falls short of intent to harm.
The prison official's state of mind must demonstrate "deliberateness tantamount to intent to punish," as established in Horn v. Madison County Fiscal Court. To prove deliberate indifference, there must be knowledge of serious medical needs or circumstances indicating such needs. A failure to act on perceived significant risks does not equate to punishment under Farmer v. Brennan. The District Court correctly granted summary judgment for the County Defendants, recognizing that a body politic is considered a "person" under Section 1983, but a municipality cannot be held liable based solely on respondeat superior. Liability arises only where a municipal policy or custom directly causes a constitutional violation. Liability can apply to policies set by officials with final policymaking authority, determined by state law.
Miller's claims that the County Defendants were deliberately indifferent due to inadequate medical screening and training were dismissed by the District Court. The court found no evidence of a persistent pattern of mistreatment during Stanford's incarceration and noted that established procedures for medical emergencies were followed. Additionally, all correctional officers had basic training in first aid and CPR, and there was no evidence of inadequate training. The presence of a nurse on duty at night was deemed irrelevant to claims of prior indifference. Miller's argument about the delegation of decision-making authority to the shift commander and on-call doctor was also rejected, as mere discretionary authority does not make an employee a final policymaker unless their decisions are unreviewable and not subject to the policies of higher officials. The court determined that Miller’s claims lacked support in the record.
Byam, as sheriff, held final policymaking authority over the Correctional Facility and implemented the governing "Procedures and Policies." Miller incorrectly equates decision-making with policymaking, claiming that Lindsay acted as a de facto decision-maker for inmate emergency care. Even if Lindsay had limited decision-making authority, it does not equate to policymaking or establish municipal liability under the exercise of discretion. Miller fails to demonstrate that Lindsay's decisions were beyond review or that she could formulate broad policy goals. Her reliance on Byam's deposition does not substantiate her claim of Lindsay's policymaking authority.
Miller argues that 1983 liability can arise from custom rather than written policies but does not sufficiently establish an actionable custom. A municipal custom requires proof of a policymaking official's knowledge and acquiescence, and must be deeply embedded as a traditional practice. The District Court's ruling, which Miller challenges, correctly applied the factors from Doe v. Claiborne County to assess municipal liability based on inaction. These factors require evidence of a persistent pattern of mistreatment, the County's notice or constructive notice of such mistreatment, tacit approval of unconstitutional conduct, and a direct causal link to constitutional deprivation. Miller's assertions do not satisfy these criteria, as the standard for deliberate indifference necessitates proof of prior unconstitutional actions and a failure to act on them.
A plaintiff bringing a claim under Section 1983 must demonstrate that municipal policies and practices directly caused a constitutional violation. In this case, the District Court determined that Miller did not establish a clear and persistent pattern of mistreatment of detainees. Miller's argument centered on the County's alleged failure to ensure that Lindsay, who lacked emergency medical training, did not adequately decide whether to contact an on-call doctor. However, the Correctional Facility had a policy in place for emergencies, which Lindsay followed on the relevant date. Miller failed to present evidence that this policy was unreasonable or that similar incidents warranted notice to the County regarding potential constitutional violations.
The court found no deliberate indifference by the County towards Stanford's medical condition. Regarding Miller's claim of inadequate training, it is established that a municipality can only be liable for failure to train if such failure demonstrates deliberate indifference to residents' rights. Mere assertions of improper training are insufficient for liability. Lindsay had received substantial training, including first aid and CPR, and the facility followed a medical protocol for inmate care.
Miller's assertion that a reasonable jury could infer deliberate indifference was unsupported by evidence, as the lack of prior incidents and failure to show deliberate indifference undermined her argument. The legal standard requires demonstrating municipal policy through a history of inadequate training or notice of such inadequacy. Since Miller could not establish that the Correctional Facility's training policies were objectively inadequate or that the County acted with deliberate indifference, the District Court's rejection of her failure-to-train theory was upheld as legally sound.
The District Court correctly determined that Lindsay was not a "policymaker" under Section 1983, and Miller failed to demonstrate the necessary factors for a failure-to-train theory of liability. As a result, the court's summary judgment for the County Defendants is affirmed.
Miller's request on September 26, 2002, to amend her Complaint to classify Dr. Ismailoglu as a "policymaker" was denied by the District Court, which found no legal basis in Michigan law for such a classification, deeming the amendment futile. Miller renewed her argument on appeal, claiming Dr. Ismailoglu was a municipal policymaker due to delegated decision-making from the sheriff and jail administrator. However, she did not distinguish between policymaking authority and mere discretionary power, which is insufficient for establishing municipal liability under 1983.
Miller failed to show that Dr. Ismailoglu had the authority to formulate broad policy for inmate medical treatment, as he contracted for limited hours and was not involved in administrative decisions. In contrast, Sheriff Byam exercised his policymaking authority by appointing a training coordinator, seeking accreditation, changing medical providers, and initiating investigations related to medical care and incidents at the Correctional Facility.
De facto policymaking authority was determined to reside with the sheriff rather than Dr. Ismailoglu, leading to the conclusion that amending the Complaint to designate Dr. Ismailoglu as a "policymaker" would have been futile. The District Court's denial of Miller's motion for leave to amend the Complaint was affirmed. On March 6, 2003, the District Court granted summary judgment for Dr. Ismailoglu, basing its decision on undisputed facts indicating that he responded appropriately to a medical emergency involving the decedent by observing symptoms, maintaining an observation log, and examining the decedent upon staff arrival. The court found no evidence of negligence or deliberate indifference on Dr. Ismailoglu's part, and he was not deemed to have provided grossly inadequate medical care, as his decisions were based on the information provided by Lindsay.
Miller contended that reasonable minds could differ on whether Dr. Ismailoglu provided any medical care, arguing that Lindsay's deposition admission of providing "all the information" to Dr. Ismailoglu could render his claims of ignorance implausible, allowing a jury to potentially find him guilty of grossly inadequate care or deliberate indifference. The legal standard for deliberate indifference encompasses both objective and subjective elements, with the possibility that less flagrant conduct might suffice in cases of medical mistreatment. The court noted that grossly inadequate medical care must be so deficient as to shock the conscience. To determine if Dr. Ismailoglu's care was grossly inadequate, a detailed, fact-specific inquiry is required. Additionally, it was noted that the Correctional Facility had a policy for medical emergencies, wherein the shift supervisor would relay all necessary information to the doctor.
Lindsay did not admit to violating the policy regarding Stanford's medical condition, leading Miller to argue that a jury could infer Dr. Ismailoglu had sufficient information to determine that immediate hospital care was necessary. However, Lindsay's deposition indicates she could not recall critical details about Stanford's condition, such as whether she informed Dr. Ismailoglu about a possible seizure, Stanford's inability to walk, or his reported head injury. Furthermore, Plaintiffs’ counsel acknowledged there was no direct evidence that Dr. Ismailoglu was informed of a possible seizure during the call.
Dr. Ismailoglu's recollection of the conversation aligns with Lindsay's testimony, as he noted she indicated it was not an emergency and that Stanford was conversing normally. The court found no factual inconsistencies between their accounts. Miller's assertion that the court should infer Dr. Ismailoglu's knowledge of Stanford's condition from Lindsay's lack of admission invites speculation, which the court rejected.
The court referenced previous cases establishing that deliberate indifference occurs when a known risk is disregarded. However, there was no evidence that Dr. Ismailoglu was aware of any risk to Stanford's health. Additionally, Dr. Ismailoglu expressed certainty that he inquired about Stanford's condition during their conversation.
Dr. Ismailoglu adequately addressed Stanford's medical concerns by advising observation and logging symptoms, with no evidence indicating a grossly inadequate or deliberately indifferent response. Miller did not provide proof that Dr. Ismailoglu knew of a substantial risk of serious harm and chose to ignore it, leading the District Court to correctly grant him summary judgment. Similarly, the Corrections Officer Defendants were granted summary judgment due to a lack of evidence for deliberate indifference regarding Stanford’s medical condition. The objective prong for serious medical needs was satisfied; however, the Corrections Officers argued that the risk of harm was only apparent after Stanford exhibited seizure symptoms.
Miller contended that Sergeant Lindsay failed to disclose all relevant information about Stanford's condition, suggesting she could be found untruthful and potentially concealed critical facts. Miller speculated that Stanford had ongoing seizures throughout the night and that Lindsay's inaction constituted deliberate indifference. However, established legal standards require knowledge of serious medical needs and circumstances indicating such risks. The record indicates that Lindsay did not possess actual knowledge of Stanford’s health status, and the District Court concluded that Miller did not demonstrate that Lindsay had the requisite culpable state of mind.
Lindsay could not be deemed to have acted with deliberate indifference because there was no evidence that she inferred a substantial risk of serious harm to Stanford. During her shift, she found Stanford responsive and in stable condition after assessing him, checking his pulse, and consulting with an on-call physician. Despite a cellmate's suggestion of a seizure, Lindsay did not observe any such activity and noted that Stanford was coherent after rolling on the floor for several hours. A blood sugar test showed normal results, and Dr. Ismailoglu later indicated that Stanford's seizure at 8:10 a.m. was the first sign of a neurological issue.
Lindsay's failure to provide all relevant information to Dr. Ismailoglu was acknowledged, but there was no evidence of deliberate omission, and negligence alone does not constitute a constitutional violation. The record supported the conclusion that Lindsay did not perceive a substantial risk of harm, aligning with legal standards that do not penalize failures to recognize risks that were not apparent. Consequently, the District Court's decision to grant summary judgment for Lindsay was upheld.
Regarding the remaining Corrections Officer Defendants, Miller's argument was limited, claiming that they observed Stanford's condition and the lack of medical care while he was on the floor for six hours.
Miller's argument lacks differentiation among the defendants, prompting the Court to evaluate their potential liability under 42 U.S.C. § 1983 collectively. There is insufficient evidence demonstrating that any defendant exhibited the requisite culpable mental state necessary for liability under § 1983. The responding deputies were aware that medical advice had been given for Stanford's observation, and witness testimony indicated that Stanford was responsive and coherent during the night. Notably, when Stanford requested a snack, indicating a potential medical issue, the deputies communicated this to medical staff, who confirmed normal blood sugar levels. There was no indication of worsening or improving conditions for Stanford throughout the night, and it was acknowledged that Deputy Leavell promptly called for medical assistance upon observing Stanford's seizure. The findings support the District Court's conclusion that the Corrections Officer Defendants did not demonstrate deliberate indifference.
Miller failed to provide evidence showing that any defendants acted with the necessary culpable mental state. The District Court’s decision to deny Miller's motion to amend the complaint was deemed appropriate, as the proposed changes would have been futile. Consequently, the District Court's ruling is affirmed in all respects. Additionally, there was no evidence of personal involvement by defendants Byam and Cook in the alleged misconduct; thus, they were treated as claims against the County rather than individual liability. The Court found no error in granting summary judgment for these defendants.
