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

Probation Supervision of Sex Offenders and Delegation of Judicial Authority

United States v. Morin, No. 15-50197, 2016 U.S. App. LEXIS 14549 (5th Cir. Aug. 8, 2016).

Fifth Circuit rules District Court’s probation requirement that the offender comply with “unspecified lifestyle restrictions” imposed by the offender’s therapist during supervised release constitutes an unauthorized delegation of judicial authority and the oral sentencing pronouncement controls when in conflict with the written record.

Background: Robert Morin pleaded guilty to failing to register as a sex offender as required by the Sex Offender Registration and Notification Act (SORNA). The district court sentenced Morin to 33 months of imprisonment and five years of supervised release. Morin challenged two conditions of his supervised release. He contended that the district court impermissibly delegated judicial authority by directing that Morin comply with unspecified "lifestyle restrictions" that might be imposed by a therapist throughout the term of his supervised release. He contended that the breadth of this requirement permitted a therapist, not the court, “to decide the nature and extent of the punishment imposed.” Morin additionally argued that the written requirement that he abstain from the use of alcohol during his term of supervised release was not included in the district court's oral pronouncement of the sentence, making it invalid. Holding: The Fifth Circuit agreed and vacated the two challenged conditions.

Notable Point:

Scope of conditions of supervised release: The Fifth Circuit emphasized that only courts have the authority to impose conditions of supervised release beyond the mandatory restrictions. The court agreed that the manner and means of therapy during treatment may be devised by therapists. Therapists and other non-judicial actors could forward to the court recommendations for new conditions.

Found in DMHL Volume 35, Issue 3

Excessive Force

Hughes v. Kisela, 841 F.3d 1081 (9th Cir. 2016)

Ninth Circuit reverses district court’s grant of summary judgment to police officers based on qualified immunity when there were disputed facts as to whether the officer acted reasonably when he shot a woman who was holding a knife, but not acting aggressively.

Background: In May 2010, three officers responded to a welfare check call and reports of a woman acting erratically and hacking at a tree with a large knife. Soon after the officers arrived, Amy Hughes exited her house carrying a large kitchen knife at her side with the blade pointing backwards. Sharon Chadwick, who lived with Hughes, was standing outside the house near the driveway at the time. She later testified that Hughes was composed and content. Chadwick also testified that she did not consider Hughes a threat and was not in any fear. The three officers each drew their guns and ordered Hughes to drop the knife; Corporal Kisela contended that the officers yelled several times but Chadwick remembered hearing only two commands in rapid succession. Corporal Kisela testified that he saw Hughes raise the knife as if to attack, but the other two responding officers told investigators that they did not see her raise the knife. Corporal Kisela fired four shots each of which struck Hughes, but the injuries were not fatal. Chadwick testified that Hughes was taking medication for bipolar disorder, and Chadwick was always able to manage Hughes’s behavior in the past. Chadwick also testified that she believes Hughes did not understand what was happening when the police yelled for her to drop the knife. The district court granted summary judgment in favor of the police officer on a theory of qualified immunity.

Holding: The Ninth Circuit ruled that the officer was not entitled to summary judgment with respect to the reasonableness of his actions. The court also explained that qualified immunity requires a determination that the actions of the officer were reasonable, which in this case involved disputed facts that should properly be weighed by a jury. The Ninth Circuit reversed the grant of summary judgment and remanded for a jury to determine whether the responding officer acted reasonably.

Notable Point:

Excessive Force and Mental Illness: The Ninth Circuit noted that there are not separate excessive force analyses for those with mental illness and serious criminals, but the government interest in using such force is diminished when confronted with an individual with mental illness.

Found in DMHL Volume 35, Issue 4

Content Link Block

Select a page and create a visual link to it. Learn more

Case Law

Excessive Force

Aldaba v. Pickens, 844 F.3d 870 (10th Cir. 2016)

The Tenth Circuit (following remand from the U.S. Supreme Court) reverses its prior decision that had denied qualified immunity to police officers in regard to a claim they used excessive force in subduing a medical patient attempting to leave the hospital (and risking death) due to temporary delirium, finding on remand that there were no existing case decisions that would have clearly informed those officers that their conduct violated Fourth amendment standards.

Background: Johnny Manuel Leija was admitted to the hospital after feeling ill for several days and was diagnosed with dehydration and severe pneumonia in both lungs. He was initially alert and cooperative and he was given an IV and an oxygen tube. The treatment improved Leija’s condition, but a nurse later found that Leija had cut his IV and removed his oxygen tube. She also found blood on the floor and in the bathroom. The nurse reconnected his IV and oxygen tube, but Leija became increasingly agitated. A doctor prescribed Xanax to treat his anxiety, but Leija refused to take it and again removed his IV and oxygen tube while loudly claiming that the nurse was telling lies and trying to poison him. The female nurse became concerned for her safety based on Leija’s behavior and a male nurse was sent to try to calm Leija. The male nurse found Leija claiming to be god and superman. The nurse attempted to inject Leija with Haldol and Ativan to calm him, but Leija refused to cooperate. The doctor was concerned about Leija’s low oxygen levels, and the nurse did not think they could restrain Leija sufficiently to administer the drugs for treatment. Law enforcement was called to assist. Three officers responded and found Leija in the hallway walking toward the hospital lobby and exit. The doctor told the officers that if Leija left the hospital he would die. The officers ordered Leija to return to his room, but he grew more agitated. Leija removed bandages from his arms and a “fairly steady stream of blood” began to flow from both of his arms. The officers tried to calm Leija and warned him that they might use a Taser. When Leija refused to cooperate, a Taser was deployed, but one of the probes missed. The other officers grabbed Leija and struggled to subdue him. As the three officers struggled with Leija, the male nurse injected him with Haldol and Ativan. Leija went limp, grunted and vomited clear liquid almost immediately after being injected with the drugs. Medical staff began CPR, but were unable to revive him. The cause of death was determined to be respiratory insufficiency secondary to pneumonia that was exacerbated by Leija’s exertion during the struggle with the officers. The Tenth circuit originally affirmed the district court’s denial of summary judgment for the officers, but the U.S. Supreme Court remanded with instructions to reconsider consistent with Mullenix v. Luna, 136 S. Ct. 305 (2015). In Mullenix, the Court ruled that qualified immunity should be denied only when “clearly established case law” would put officers on notice that it was “beyond debate” that their actions amounted to excessive force.

Holding: The Tenth Circuit found no cases that would have informed the officers “beyond debate” that their actions would be excessive force. Accordingly, the court remanded the case with instructions for the district court to grant summary judgment in favor of the officers based on qualified immunity.

Notable Point:

Qualified Immunity analysis: The Mullenix court emphasized that courts should not define clearly established case law at a high level of generality. The Court explained that “specificity is especially important in the Fourth Amendment context” because officers may have difficulty in determining how the legal doctrine will apply to the particular factual situation with which an officer may be confronted. The Court stressed that the inquiry must be focused on the specific facts and context of a particular case.

Found in DMHL Volume 35, Issue 4

Excessive Force

Wate v. Kubler, 839 F.3d 1012 (11th Cir. 2016)

Eleventh Circuit upholds district court’s refusal to grant law enforcement officer’s motion for summary judgment based on qualified immunity in response to a claim that he used excessive force in responding to a person in mental health crisis where there was evidence that the officer Tasered the detained person at least twice after the person had stopped actively resisting the officer.

Background: James Barnes was visiting a beach on Honeymoon Island in Florida with his aunt Paula Yount in order to conduct a baptismal ritual. While in the water, Barnes began acting erratically by flailing around and yelling about a demon. The only law enforcement officer on the Island at the time was Officer Tactuk, who responded to the commotion in the water. Yount came out of the water to speak with Tactuk, who then believed there was probable cause to arrest Barnes for battery on Yount. Tactuk entered the water and attempted to arrest Barnes, but a struggle ensued and Tactuk repeatedly struck Barnes in the face. Tactuk was able to place a handcuff on one of Barnes’s hands and they continued to struggle in the water. Bystanders eventually helped Tactuk drag Barnes onto the beach. Multiple witnesses had called 911 to report the incident and Tacktuk called for backup over the police radio. Tactuk attempted to place Barnes’s other hand in handcuffs, and a bystander observed that during the struggle, Barnes was coughing blood and appeared to have difficulty breathing. Officer Kubler responded to the incident about seven minutes after Tacktuk’s initial encounter with Barnes. Kubler and Tactuk continued to struggle with Barnes until Kubler deployed his Taser a total of five times over the course of nearly two minutes. Barnes became still and the officers were able to handcuff him. There was a dispute between the officers’ testimony and that of bystanders regarding when Barnes stopped resisting. An off-duty fire lieutenant who came to the scene at that point told the officers to take the handcuffs off because Barnes was not breathing and had turned blueish gray. The officers then removed the handcuffs and began CPR. Rescue personnel responded to the scene and took over the rescue, but Barnes died two days later. The cause of death was determined to be complications of asphyxia with contributory conditions of blunt trauma and restraint. Barnes’s representative brought suit against the officers and agencies involved. The other parties in the case settled with the plaintiff, but Officer Kubler moved for summary judgment based on qualified immunity. The district court denied the motion and Kubler appealed.

Holding: The Eleventh Circuit ruled that Kubler was not entitled to summary judgment and affirmed the holding of the district court. The court found that by reviewing the evidence in the light most favorable to the plaintiff, as required at the summary judgment stage, “a reasonable officer in Kubler's position and under these circumstances would have had fair warning that repeatedly deploying a Taser on Barnes, after he was handcuffed and had ceased resisting, was unconstitutionally excessive.”

Found in DMHL Volume 35, Issue 4

Unlawful Seizure

May v. City of Nahunta, 841 F.3d 1173 (11th Cir. 2016)

Eleventh Circuit reverses district court’s grant of summary judgment based on qualified immunity in seizure of individual for mental health evaluation, finding that although the evidence supported the officer’s initial seizure, the officer carried out the seizure in a manner that violated the individual’s constitutionally protected privacy interests.

Background: Phyllis May was the sole caregiver for her mother who was suffering from Alzheimer’s with sundowning syndrome, a condition that caused her to stay awake for days at a time. May became exhausted and called her brother to come help care for her mother before lying down. When her brother arrived several hours later, he was unable to wake May and called 911. Four EMTs responded and used an ammonia capsule to wake May. The EMTs evaluated May, but she refused to be transported to the hospital and the EMTs determined that she did not require further treatment. May executed a form refusing treatment. At the same time, Officer Allen responded to a 911 call requesting assistance at May’s residence. The EMTs told Allen that May had “been a little combative to herself” and was upset. Allen entered May’s bedroom to investigate and found her hair in disarray and decided to transport her to a hospital for a psychological evaluation. Allen instructed the EMTs to leave the bedroom and then locked himself in the bedroom with May. He instructed her to take off her nightgown and put on suitable clothes to go to the hospital. May became upset and began to cry, but Allen insisted that she change, even pulling on her nightgown to remove it. May put on shorts, but Allen insisted she take them off and first put on undergarments. May refused, but Allen patted his gun and told her “yes you will.” Allen remained in the locked room with May for 15 to 20 minutes, while her sister was outside requesting the door be opened. When they emerged from the bedroom, Allen stated that he was taking May to the hospital and she again objected. Allen escorted May to the emergency room and asked hospital staff about May’s prior diagnoses before leaving. May was subsequently released from the hospital after no more than two hours. May brought suit alleging unlawful seizure, false imprisonment, assault and battery, and invasion of privacy. The district court granted Officer Allen’s motion for summary judgment based on qualified immunity

Holding: The Eleventh Circuit affirmed the district court’s finding of qualified immunity for Allen’s decision to seize May for a mental health evaluation, but reversed and remanded to determine whether the manner of the seizure unreasonably violated May’s privacy interests.

Notable Point:

Manner of Seizure: The court explained that searches conducted in an abusive fashion may violate the Constitution. The court emphasized that if Officer Allen’s alleged conduct were proven, it would be “representative of the type of unnecessarily invasive and demeaning intrusion that is undoubtedly within the sphere of what the Fourth Amendment prohibits.”

Found in DMHL Volume 35, Issue 4

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

Sentencing of Persons with Mental Illness

United States v. Kluball, 843 F.3d 716 (7th Cir. 2016)

Seventh Circuit holds a defendant’s history of mental illness and ineffective treatment can be considered by the sentencing judge as a prediction of the potential for future misconduct without violating the defendant’s due process rights when reasonably based on factually accurate information.

Background: Alexander Klubal pled guilty and was sentenced to 10-years confinement for transporting a 17-year-old girl across state lines to engage in prostitution. A presentence report detailed Kluball’s history of mental illness, which included diagnoses of oppositional defiant disorder, attention deficit hyperactivity disorder, bipolar disorder, posttraumatic stress disorder, and depression. Klubal had received counseling, was hospitalized several times, and was treated with drugs including Adderall, Depakote, Eskalith, Fluoxetine, lithium, Prozac, Remeron, Ritalin, Seroquel, Strattera, Valium, Zoloft, Zydis, and Zyprexa. None of the treatments succeeded or lasted very long. During sentencing, the judge remarked that Kluball’s history of mental illness did not alleviate any responsibility for his crimes and suggested that mental health treatment would not have a lasting impact on his ability refrain from engaging in criminal conduct in the future. The judge then sentenced Kluball to the statutory maximum of 10 years. Kluball appealed the sentence, challenging the judge’s assertion that treatment would not have a lasting impact on his conduct as a violation of his due process rights.

Holding: The Seventh Circuit affirmed the 10-year sentence finding no violation of due process.

Notable Point:

Sentencing: The Seventh Circuit explained that during sentencing judges are routinely required to make predictions about a defendant’s future conduct and response to treatment. The court explained that such predictions do not violate due process when they are based on accurate information rather than unsupported speculation. The court was satisfied that Kluball’s history of mental illness and response to past treatment was factually accurate and sufficient to support the judge’s predictions about Kluball’s future conduct.

Found in DMHL Volume 35, Issue 4