Conditions of Pre-trial Confinement

Montano v. Orange Cnty., Tex., 842 F.3d 865 (5th Cir. 2016)

Fifth Circuit upholds jury verdict finding a county jail liable for unconstitutional conditions of pre-trial confinement that resulted in the death of an inmate who was mentally ill, but assumed to be under the influence of bath salts, because evidence showed a “de facto” policy of prolonged detention without proper medical supervision for inmates held in a jail infirmary observation room for detoxification.

Background: Robert Montano was arrested for public intoxication and was taken to the county jail after a judge signed an affidavit of probable cause. The arresting officer told the intake officer at the jail that she suspected Montano was under the influence of bath salts. Montano was placed in an observation cell because he was determined to be incoherent and unable to complete the booking process. The cell did not have a sink, toilet or toilet paper. Montano was previously treated for mental illness and was in the state mental-health database, but no database query was run during his intake despite a Texas requirement to do so. While in the cell, Montano was observed by a Licensed Vocational Nurse (LVN), the Texas equivalent of a Licensed Practical Nurse, but no contract physician visited the jail during the four-and-one-half days that Montano was in the cell. There was little or no attention given to Montano during his time in the cell, and no jail staff entered the cell until the morning of his death, more than four days later. There was evidence at trial that 1) the view of Montano’s cell was partially obscured by paper taped over the cell’s glass walls, 2) his vitals were taken no more than once, and 3) food was offered through a slot in the door. More than four days after being detained in the cell, an LVN reported that it appeared as though Montano was not breathing. At that time, the cell was littered with uneaten food and human waste. The LVN reported Montano’s condition to the jail control room, but waited 20 minutes for a corporal to respond before calling an ambulance or entering the cell. Montano was pronounced dead 34 minutes later and the cause of death was determined to be acute renal failure. An action was filed against the county for unconstitutional confinement and episodic acts or omissions. A jury found in favor of the plaintiffs and awarded $1.5 million for pain and $917,000 for wrongful death. The county appealed seeking a new trial contending that insufficient evidence had been presented to support the jury’s verdict and the damages awarded were excessive.

Holding: The Fifth Circuit denied the county’s motion and upheld the jury verdict finding that sufficient evidence was presented for a reasonable jury to conclude that the conditions of confinement caused Montano’s death, and that those conditions were the result of a “de facto” policy that denied detainees adequate care for an indefinite period of time. The Court further found that the damages awarded were not excessive.

Found in DMHL Volume 35, Issue 4