Liability of Public Officials for Care of Mentally Ill Inmates in Correctional Setting

Saylor v. Nebraska, 812 F.3d 637 (8th Cir. 2016), as amended (Mar. 4, 2016)

Claim by jail inmate with mental illness against jail doctors and staff under 42 USC § 1983 did not establish deliberate indifference required under the Eighth Amendment to establish liability. Summary judgment granted to all defendants based upon qualified immunity.

Background: James Saylor sued the State of Nebraska, the Nebraska Department of Correctional Services (“NDCS”), Correct Care, LLC, and several individuals alleging violations of his First, Eighth, and Fourteenth Amendment rights under 42 U.S.C. § 1983. Saylor alleged that defendants acted with deliberate indifference to his serious medical needs by failing properly to treat him for PTSD. He claimed that his level of care at Nebraska State Prison was so low as to constitute cruel and unusual punishment. The district court dismissed Saylor’s claims against the State of Nebraska and the NDCS and the claims for monetary relief against the individual defendants in their official capacities. The district court then denied the remaining defendants’ motions for summary judgment on the basis of qualified immunity.

Holdings: On appeal, the Eighth Circuit reversed, holding that there were not genuine disputes concerning “the predicate facts material to the qualified immunity issue.” Because the Court found that the record showed that all defendants “met Saylor’s medical needs beyond the minimum standard required,” there was no deprivation of Saylor’s Eighth Amendment rights. Thus, defendants were entitled to qualified immunity.

Notable Points:

Qualified immunity for non-medical defendants: In order to overcome a defense of qualified immunity for the non-medical defendants, a plaintiff must show that supervisors had direct responsibility for the alleged violations, had actual knowledge of the violation, or gave tacit authorization for the violation. The Court held that the non-medical prison supervisors who approved Saylor’s transfer were not indifferent to his PTSD in violation of the Eight Amendment because Saylor provided “no specific evidence that they were involved in, or directly responsible for, his allegedly insufficient medical care.”

Qualified immunity for medical defendants: In order to overcome a defense of qualified immunity for the medical defendants, a plaintiff must show that defendants were personally responsible for violations, or were responsible for a systematic condition that violated Constitution. Here, the Court held that the State prison’s medical staff was not deliberately indifferent to Saylor’s PTSD even though Saylor argued that he received treatment that rose to the level of cruel and unusual punishment after his original treating physician left. Records showed that medical staff provided beyond the minimum standard required after his previous treater left, first providing Saylor with another physician at the same facility and then ultimately a physiatrist at a different facility. They also continued his medication consistent with their independent medical judgment. The staff also granted Saylor’s request for a private cell and sought his agreement for certain deviations from his original treatment plan.

Found in Found in DMHL Volume 35, Issue 1

Juvenile Offenders; Knowing Waiver of Right Against Self-Incrimination

Ohio v. Barker, 2016 Ohio 2708 (Ohio 2016)

Ohio Supreme Court rules that Ohio law providing that recorded statements made by defendant in custodial setting are presumed to be voluntary violates juvenile’s right to due process and does not remove burden from the state to prove that waiver of right against self-incrimination was knowingly made. 

Background: In October 2011, Tyshawn Barker was questioned by police while in custody concerning the shooting deaths of two individuals. The detectives recorded the interrogation, read Barker the Miranda warnings, and asked him to sign a “Notification of Rights” form, explaining “…I am going to ask you to sign it. You’re not admitting to anything. I am just telling you it just says that I read you this [the warnings], okay?” The form included a preprinted statement, “I understand my rights,” but did not indicate that by signing the form it would waive rights. Barker was evaluated as part of the juvenile court’s determination about transfer, and he was found to have a low IQ, below-gradelevel academic abilities, and to have an individualized education plan. Barker was transferred to adult court, where he moved to have his statements suppressed, arguing that he had not knowingly, intelligently and voluntarily waived his Miranda rights. The trial court dismissed his motion, not making a finding on his waiver, but finding that he had voluntarily made statements. Ohio law (R.C. 2933.81(B)) stated that recorded interrogations were presumed voluntary. Barker was convicted and he appealed. The First District Court of Appeals affirmed his convictions, finding support in the record for the trial court’s decision about his rights waiver despite the absence of an express finding on the point. Barker appealed.

Holding: The Supreme Court of Ohio reversed and remanded. The Court distinguished two issues: the rights waiver issue, which was rooted in the Fifth Amendment right against self-incrimination, and voluntary statements issue, which was rooted in the Fourteenth Amendment due process right. Addressing the rights waiver, the Court found that R.C. 2933.81(B) did not apply to waiver of Fifth Amendment rights, and noted that state and federal case law make clear that rights waivers cannot be presumed and state legislatures cannot supersede federal constitutional law. Ultimately, the Court held that the state retains the burden of proving that Barker waived his rights. As to the second issue, the Court noted that juveniles require greater protections than adults. The Court noted that voluntariness of statements is assessed via the totality of circumstances test, and that R.C. 2933.81(B) effectively blocked consideration of the totality of circumstances, at least in juvenile cases, by its presumption of voluntariness. Ultimately, it held the law to be unconstitutional as applied to juveniles.

Found in DMHL Volume 35, Issue 2

Provider Liability; Claims by Third Parties

Holloway v. State, 875 N.W.2d 435 (Neb. 2016)

Nebraska Supreme Court rules that state mental health service providers not liable for injuries to victim of a shooting by a mentally ill person released from prison upon completion of his sentence. [Editor’s Note: An 8 th Circuit case related to the same incident, Glasgow v. State, is covered in this issue of DMHL.]

Background: On July 20, 2013, Nikko Jenkins was released from prison after serving 10.5 years of his 21-year sentence. While in prison, Jenkins engaged in numerous violent activities and repeatedly exhibited signs of a serious mental health problem. On August 24, Jenkins shot Shamecka Holloway as she walked in her front yard in Omaha, Nebraska. As a result of the shooting, Holloway suffered permanent damage and incurred medical bills; she sued the State, the state department of corrections, and the company that provided mental health services for the department and several of its providers. In her complaint, Holloway stated that the State’s responsibilities with respect to the inmates included assessing and evaluating inmates in order to determine the need for mental health commitment, and providing adequate advance notice to members of the public regarding the release of a prisoner who threatened serious bodily harm to others. The complaint further alleged that Jenkins had told Baker and staff evaluators that he would hurt others upon his release. Thus, Holloway claimed that the State knew or should have known of the foreseeability of harm to her once Jenkins was released, and mental health care providers owed a duty to the citizens of Nebraska to correctly evaluate and treat all inmates. The district court dismissed all claims brought by Holloway. Holloway appealed.

Holding: On appeal, the Supreme Court of Nebraska held that the district court did not err in dismissing Holloway’s complaint. The court found that the State and its employees were entitled to immunity from suit because whether to seek commitment falls under the “discretionary function” exception to the State Tort Claims Act. Further, the Supreme Court of Nebraska affirmed the district court’s ruling that Holloway failed to plead sufficient facts to show that the mental health care provider was liable.

Notable Points:

A state actor’s performance or nonperformance of a discretionary function cannot be the basis of liability: The State Tort Claims Act (“Act”) contains a discretionary function exception to the waiver of sovereign immunity for certain claims. A two-step analysis is used to determine whether the discretionary function exception applies. The court must first consider whether the action is a matter of choice for the acting employee. Under the applicable statute of the Nebraska Mental Health Commitment Act, whether to communicate a belief that another person is believed to be mentally ill and dangerous is a matter of choice. Thus, the first step of the analysis was satisfied. The second step requires that when a statute involves an element of judgment, the judgment must be of the particular kind that the discretionary function exception was designed to protect. The court concluded that the decision as to whether to report to the county that another person is thought to be mentally ill is a policy decision that the legislature intended to shield from liability.

Mental health treatment providers are only liable for failing to warn of a patient's threatened behavior under certain exceptional circumstances: A psychologist or mental health practitioner is not liable for failing to warn of a patient’s threatened violent behavior unless the patient has threatened violence toward a reasonably identifiable victim. Here, Jenkins did not specify a particular person but rather threatened the “citizens of Nebraska.” Another source of liability could be founded on a custodial relationship, but the court concluded a custodial relationship did not exist because CCS was only contracted to provide medical services for inmates, not to exercise any kind of custody over inmates.

Found in DMHL Volume 35, Issue 2

Juvenile Offenders; Life Sentence without Parole

State v. Sweet, 879 N.W.2d 811 (Iowa 2016)

Iowa Supreme Court reverses and remands sentencing of a juvenile offender to life without parole in a doublemurder case, on the grounds that such a sentence violates the Iowa Constitution. (Vigorous dissent notes that the Court’s “categorical bar” of life without parole for juveniles goes beyond the U.S. Supreme Court’s decision in Miller v. Alabama.)

Background: Isaiah Sweet was 17 years old when he shot and killed his grandparents, who had raised him since the age of 4. He pled not guilty to two counts of first-degree murder, but after the State concluded its case, he pled guilty as part of a plea agreement with the State. The court entered an order for a presentence investigation report, per recent Iowa precedent concerning the sentencing of juveniles convicted of murder. After review of the report and expert testimony from a clinical psychologist, which detailed hardships in his life and the inherent difficulties of assessing risk in adolescents, Sweet was sentenced to life without the possibility of parole. Sweet appealed the sentence.

Holding: On appeal, The Iowa Supreme Court ruled that a sentence of life without the possibility of parole (LWOP) for a juvenile offender violates article I, section 17 of the Iowa Constitution. The Court noted that Sweet did not expressly cite the federal Eighth Amendment, so it proceeded with its analysis under the Iowa Constitution. The Court reviewed the history of federal Eighth Amendment case law up through the recent cases concerning juveniles (e.g., Miller v. Alabama), then reviewed Iowa case law. It noted that Iowa has extended the reasoning of recent federal cases to provide even greater protection to juveniles (e.g., requiring individualized hearings in cases involving long prison sentences short of life in prison without the possibility of parole). The Court ultimately held that a categorical bar on life without parole sentences was required under the Iowa Constitution.

Notable Points:

Categorical bar to LWOP replaces case-by-case analysis: The Iowa Supreme Court first assessed whether a consensus existed in favor of a categorical approach. The Court noted that nine states have abolished LWOP sentences for juveniles, and that another 13 have functionally barred the practice. It also noted, however, that several state supreme courts have concluded that a categorical bar is not necessary. Concluding that a consensus was not present, the Court then exercised its “independent judgment to determine whether to follow a categorical approach,” ultimately concluding “that sentencing courts should not be required to make speculative up-front decisions on juvenile offenders’ prospects for rehabilitation because they lack adequate predictive information supporting such a decision.” Instead, “[t]he parole board will be better able to discern whether the offender is irreparably corrupt after time has passed, after opportunities for maturation and rehabilitation have been provided, and after a record of success or failure in the rehabilitative process is available.”

Found in DMHL Volume 35, Issue 2

Liability of Correctional and Mental Health Officials

Glasgow v. Nebraska, 819 F.3d 436 (8th Cir. 2016)

Correctional and mental health officials do not owe a duty to third parties for injuries inflicted by inmates who are returned to the community following assessment by those officials. 

Background: Nikko Jenkins was a mentally ill inmate who was released from prison after 10.5 years of his sentence because the state changed Jenkins’ recommendation from inpatient to outpatient treatment, which accelerated his release. Upon his release, Jenkins killed 4 people in Omaha, one of them Curtis Bradford. Bradford’s mother, Velita Glasgow, filed suit against the state of Nebraska, among other defendants, for violation of Bradford’s substantive due process rights under the Fourteenth Amendment (§1983) and a state law negligence claim, arguing that the state acted with deliberate indifference in accelerating a dangerous prisoner’s release and violated Bradford’s right to life. Additionally, she argued that the state had a duty to protect Bradford from their prisoners and the state abandoned that duty when they knowingly released a mentally-ill prisoner who allegedly threatened to kill someone if he was released. The district court dismissed Glasgow’s claim, stating that the complaint was “devoid of any plausible allegation against [the] defendants.” Glasgow appealed.

Holding: The Eighth Circuit affirmed the lower court’s dismissal of all claims. An official may be sued if they violated a statutory or constitutional right that was “clearly established” at the time of the conduct. The Eighth Circuit held that “there is no general substantive due process right to be protected against the release of criminals from confinement.” Furthermore, because there was no evidence that the state’s conduct created a significant risk to a precisely defined group of people and that, if that group existed, Bradford was a part of that group, the state was not required by the Due Process clause to protect Bradford’s life from private actors. The court quickly did away with the negligence claim by holding that the plaintiff did not provide any legal authority to explain that the state had a legal duty to Bradford.

Found in DMHL Volume 35, Issue 2

Medical Care and Substantive Due Process Violations in Correctional Facilities

Daniel v. Cook Cnty., No. 15-2832, 2016 U.S. App. LEXIS 14886 (7th Cir. Aug. 12, 2016)

Seventh Circuit rules that a plaintiff may submit into evidence a DOJ report showing “systemic flaws” in the jail’s medical care of inmates under the hearsay exception for “factual findings from legally authorized investigations.” [Editor’s note: While the substandard care addressed in this case did not involve mental health care, the court’s ruling has important implications for litigation involving mental health care in public facilities.].

Background: Alex Daniel was a pretrial detainee when he suffered multiple fractures in his wrist after falling during a basketball game. Daniel was initially treated by an on-duty general practitioner with an elastic bandage and a sling and after a delay was eventually treated by an orthopedic specialist. Daniel was placed in a long arm cast, which was replaced by a short arm cast three weeks later. The orthopedic specialist instructed Daniel to return in another three weeks to have the short arm cast removed; however, Daniel’s cast was not removed until ten weeks later. During this delay, Daniel filed multiple grievances with the jail staff seeking treatment for his wrist. Daniel was examined by another orthopedist who concluded that Daniel suffered from “residual and permanent stiffness of his left hand and wrist,” more likely than not caused by the long immobilization in the short arm cast. Daniel filed suit and offered as evidence a report from the DOJ detailing systemic health care problems at the jail. The district court granted summary judgment for defendant Cook County ruling that the DOJ report was inadmissible hearsay.

Holding: The Seventh Circuit ruled that the DOJ report met the requirements for a presumption of admissibility in civil cases for “factual findings from a legally authorized investigation” under the Federal Rules of Evidence. The court reversed the grant of summary judgment and remanded for further proceedings.

Found in DMHL Volume 35, Issue 3

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