Treatment of Mentally Ill Individuals in Custodial Settings: Eighth Amendment

Failure to follow national suicide screening prevention standards with prisoner who later commits suicide presents colorable eighth amendment claim that survives summary judgment motion

Barkes v. First Corr. Med., Inc., 766 F.3d 307 (3d Cir. 2014)

After Christopher Barkes committed suicide while being held at a correctional facility in Delaware, his wife and children brought a § 1983 suit against the commissioner of the state department of corrections (“DOC”), the warden, and the private company with whom the DOC contracted to provided medical services to the prison (“FCM”) alleging violations of the Eighth Amendment of the federal Constitution.

When Barkes was arrested in November, 2004, he underwent a medical intake screening procedure conducted by a licensed nurse employed by LCM, the private contractor hired to provide medical services to the prison. The procedure involved (1) a self-report intake form that included questions about suicidal ideation, (2) screening for seventeen suicide risk factors, and (3) a standard medical intake form with questions about “altered mental status ... or abnormal conduct.” Barkes indicated that he had attempted suicide in 2003, but made no mention of three other attempts (one in 1997 and two in 2004) and checked only two of the seventeen suicide screening factors (eight were required to initiate suicide prevention measures). Finally, the licensed practical nurse who conducted the evaluation reported that Barkes showed no signs of either altered mental status or abnormal conduct. Barkes did, however, place a call to his wife that evening and express his intention to kill himself, but his wife did not inform the DOC. The next morning, Barkes was observed lying on his bed in his cell at 10:45, 10:50, and 11:00 a.m. When an officer came to deliver his lunch at 11:35 a.m., Barkes had hanged himself with a bed sheet.

The Third Circuit held (1) for purposes of determining whether the warden and DOC commissioner were entitled to qualified immunity, Barkes’ constitutional right to “proper implementation of adequate suicide prevention tools” was clearly established at the time of his suicide; (2) that summary judgment was inappropriate given evidence that “FCM's policies and procedures in place at the time of Barkes's suicide created an unreasonable risk of a constitutional deprivation;” and (3) that a reasonable jury could have found that Barkes’ suicide was caused by the DOC’s failure to supervise FCM. The second holding was based on evidence of the DOC’s awareness that “FCM's suicide prevention screening practices were not in compliance with [National Commission on Correctional Health Care] standards, as required by their contract with the DOC.” The Third Circuit reached its third holding despite the fact that Barkes did not self-report any suicidal ideation or exhibit any suicidal behavior because, in the court’s view, “had Appellants properly supervised FCM and ensured compliance with the contract, Barkes's answers during his screening would have resulted in additional preventive measures being taken.”

Found in DMHL Volume 34 Issue 1

Sexually violent offenders

Rational basis exists for different standards of review under California law for civilly committed sexually violent offenders and other civilly committed persons, so that such difference does not violate equal protection clause of 14th amendment

Seeboth v. Allenby, 2015 WL 3772754 (9th Cir. 2015)

Cliff Allenby, a sex offender civilly committed under California’s Sexually Violent Predator Act (“SVPA”), filed a habeas petition claiming that the absence of a recommitment trial timing provision in the SVPA was a violation of equal protection. Under California law, other civilly committed persons—specifically mentally disordered offenders and those found not guilty by reason of insanity—have a statutory right to a recommitment trial within a defined period of time. The state and district courts denied the petition, holding that sexually violent predators are not “similarly situated” to other groups of civilly committed offenders for the purpose of an equal protection challenge to the lack of a timing provision in the SVPA.

On appeal, the Ninth Circuit affirmed, concluding that it was neither objectively unreasonable nor contrary to clearly established federal law for the state courts to hold that the lack of a recommitment trial timing provision in the SVPA was not an equal protection violation. The Court held that the use of the rational basis test was reasonable, and that the state legislature had a rational reason to “distinguish between individuals who have been found to be mentally ill and dangerous and individuals who have been found to be mentally ill and sexually dangerous” (emphasis in original).

Found in DMHL Volume 34 Issue 2

Mental illness and mens rea

Right to due process in criminal trial may be violated by state trial court’s exclusion of proffered expert testimony that, because of defendant’s mental condition, defendant lacked the mens rea required under state law to be guilty of the crime charged

Roberson v. Stephens, 2015 WL 3396822 (5th Cir. 2015) (per curiam) (unpublished opinion)

Robert Roberson was convicted of capital murder in the death of his daughter and sentenced to death. On direct appeal to the Texas Court of Criminal Appeals, Roberson argued inter alia that the trial court’s exclusion of his expert witness’s testimony regarding his organic brain syndrome violated his constitutional right to present a complete defense. Texas law does not recognize diminished capacity as an affirmative defense, but does allow evidence to negate the mens rea element of offenses. The Court of Criminal Appeals rejected Roberson’s claim, concluding that the doctor’s testimony was “not relevant as to Roberson’s ability to form the requisite mens rea for the offense” but “was merely being used as a mental-health defense not rising to the level of insanity.” After his direct appeal, Roberson filed applications for a writ of habeas corpus first in state court and then in the United States District Court for the Eastern District of Texas, but was denied.

The Fifth Circuit, in a per curiam opinion, granted a certificate of appealability as to Roberson’s due process mens rea evidence claim. It noted that “evidence rules that infringe upon a weighty interest of the accused and are arbitrary or disproportionate to the purposes they are designed to serve” infringe the Constitutional guarantee to “a meaningful opportunity to present a complete defense.” Although it granted the certificate of appealability, the Fifth Circuit made it clear that Roberson still bears the burden of persuading the Court that the expert testimony was “substantial enough that its exclusion constituted an unreasonable application of clearly established federal law as determined by the Supreme Court of the United States” as is required by 28 U.S.C. § 2254(d)(1) for habeas relief.

Found in DMHL Volume 34 Issue 2

Competence to enter into plea agreement

District court abused its discretion in not sua sponte ordering competency evaluation based upon medical evidence of incompetence introduced for the defendant’s sentencing hearing

U.S. v. Wingo, 2015 WL 3698157 (11th Cir. 2015)

Andrew Wingo was a defendant in a complex securities fraud case, and was represented by counsel. Wingo made only brief appearances before the court, and ultimately entered into a plea agreement in which he pleaded guilty to just one of the numerous charges against him. Some evidence of Wingo’s health concerns came to light during early proceedings (e.g., bond revocation hearing), but neither his attorney nor the government raised any concerns about Wingo’s competence at the plea hearing. The issue of Wingo’s mental capacity was not raised until the sentencing phase approximately six months later, when Wingo’s attorney requested a reduced sentence based upon diagnoses of dementia and other cognitive impairments. The pre-sentence report from the government also noted Wingo’s cognitive impairments. The court at sentencing noted the medical information submitted regarding Wingo’s condition, but determined that this should not affect the length of sentence. Wingo appealed, arguing that the court had both a statutory and a constitutional duty to order a competency hearing sua sponte because there was reasonable cause to doubt his competence.

The Eleventh Circuit noted that in a prior case (Tiller v. Esposito, 911 F.2d 575, 576 (1990)) it had identified three factors to be considered in determining whether information establishes a “bona fide doubt regarding the defendant's competence.” After a detailed review of the evidence submitted prior to the sentencing hearing, the Eleventh Circuit found that the evidence was sufficient to create “reasonable cause to believe that Wingo was incompetent to proceed to trial or to plead guilty.” It found that the district court had abused its discretion in failing to sua sponte order a competency hearing, and remanded the case to the district court to determine “whether Wingo's competency can be evaluated nunc pro tunc, and if so, for an assessment of his competency at the time of his guilty plea and sentencing.” The Eleventh Circuit stated that if such evaluation were to find Wingo was incompetent at the time of the plea agreement, or if such evaluation is not possible, Wingo's conviction and sentence must be vacated, with the government having the right to try him if he becomes competent. If the evaluation were to find Wingo was competent, his conviction and sentence must be affirmed.

Found in DMHL Volume 34 Issue 2

Police search and seizure and qualified immunity in mental health emergencies

7 th Circuit reverses district court and dismisses 42 U.S.C. § 1983 claim against police officers for violating plaintiff’s fourth amendment right against unreasonable seizure, finding the officers had qualified immunity

Mucha v. Jackson, 786 F.3d 1064 (7th Cir. 2015)

Jason Mucha was a Milwaukee police sergeant referred for psychiatric examination after failing to report to duty for 7 months due to stress. In his examination, Mucha admitted to having had thoughts of committing suicide by cop, specifically “going to a command staff meeting with a rifle” and “shooting them until they shoot me.” Mucha stated that he did “not intend[] to do that” but that going back to work “could have a real bad ending.” The psychiatrist, in a report to the police department two weeks later, stated that sending Mucha back to work would be a “public safety issue.” The police sent two officers with Tactical Enforcement Unit backup to Mucha’s home to speak with him. At that time Mucha said he had no intention of harming himself or others, but he did admit to having dreams or thoughts of committing suicide or hurting others. The officers detained Mucha and took him to the Milwaukee County Mental Health Facility where he was admitted after the facility’s treatment director found that Mucha suffered from “adjustment disorder with disturbance of conduct and mood” and so “posed a threat of danger to self or others.” Mucha was released after three days and filed suit for unreasonable seizure and false imprisonment. The District Court for the Eastern District of Wisconsin denied the officers’ motion for judgment on the pleadings with respect to their claims for qualified immunity.

The Seventh Circuit Court of Appeals reversed, holding that the officers were entitled to qualified immunity, as they had not violated “any clearly established law, whether constitutional or statutory, federal or state.” Judge Posner noted that the officers had relied upon Wisconsin's emergency detention statute, which authorizes police officers to take a person to an appropriate mental health facility if they have “cause to believe” that the person is “mentally ill” and has demonstrated “a substantial probability of physical harm to himself or herself as manifested by evidence of recent threats of or attempts at suicide or serious bodily harm.” The district court had accepted Mucha’s Fourth Amendment argument that the officers did not “have probable cause to believe that he was mentally ill and posed a danger to himself and to other police officers.” The district court noted that the psychiatrist’s information was 15 days old when received, and thus was not “recent” within the meaning of the emergency detention statute. The Seventh Circuit rejected Mucha’s argument, however, noting that the Wisconsin statute does not define “recent” and that the definition can vary depending upon context. Given the nature of Mucha’s statements to the psychiatrist, the Circuit Court held that the statements were still recent or at least not clearly established as no longer recent. Moreover, the Circuit Court noted that “[a] state law cannot preempt the Fourth Amendment” but it “can establish a standard of conduct that is consistent with the amendment but particularized to a specific situation.” Because the “danger signals” known to the police at the time of their interview with Mucha reasonably triggered the emergency detention statute, “the defendant officers…were complying with a statute the validity of which is not contested.”

Found in DMHL Volume 34 Issue 2

Intellectual disability determination and the death penalty

Request to submit “newly discovered evidence” to establish intellectual disability and ineligibility for death penalty not barred by 28 U.S.C § 2255(e) even after original appeal denied

Webster v. Daniels, 784 F.3d 1123 (7th Cir. 2015) (rehearing en banc)

Bruce Webster was convicted of kidnapping resulting in death and related offenses and was sentenced to death. These convictions and his death sentence were affirmed on direct appeal in Texas, and his motions for habeas relief, which were heard in Indiana where he resides on death row, were denied. Webster sought a rehearing en banc to address the question of whether he could file for a writ of habeas corpus to present new evidence demonstrating that he was categorically and constitutionally ineligible for the death penalty under Atkins v. Virginia, 536 U.S. 304 (2002) and Hall v. Florida, 134 S.Ct. 1986 (2014). Federal prisoners who claim to be convicted or sentenced in violation of the Constitution must present a claim for relief by a motion under 28 U.S.C. § 2255. Subsection (e) generally prevents a prisoner from making an application for a writ of habeas corpus. There is, however, a savings clause in § 2255(e) that allows a prisoner to apply for a writ of habeas corpus where “it appears that the remedy by motion is inadequate or ineffective to test the legality of his detention.” A panel of the Seventh Circuit originally concluded that a claim of new evidence can never satisfy the standard in § 2255(e).

Upon rehearing en banc, the Seventh Circuit determined that “the savings clause [in § 2255(e)] permits Webster to resort to a [habeas] petition.” Of essential importance to the Court were the facts that “the Supreme Court has now established that the Constitution itself forbids the execution of certain people,” and that a “core purpose of habeas corpus is to prevent a custodian from inflicting an unconstitutional sentence.” The Court held that a categorical bar against the use of § 2255(e)’s savings clause in this way could lead to “the intolerable result of condoning an execution that violates the Eighth Amendment.” Conceding that this rule could not be applied to all newly discovered evidence due to finality considerations, the Court held that habeas relief was available to Webster because the new evidence proffered existed before the time of the trial and there was evidence “indicating that [it] was not available during the initial trial as a result of missteps by the Social Security Administration, not Webster’s counsel.”

Found in DMHL Volume 34 Issue 2

Intellectual disability determination and the death penalty

Habeas corpus relief granted to criminal defendant sentenced to death in state court system on grounds that he is ineligible for death penalty due to intellectual disability

Pruitt v. Neal, 788 F.3d 248 (7th Cir. 2015)

Tommy Pruitt was charged with murder, attempted murder, and related offenses in Indiana state court, and was convicted and sentenced to death. After exhausting his state post-conviction remedies, Pruitt sought federal habeas relief claiming that he was intellectually disabled and thus categorically ineligible for the death penalty. He also included several claims alleging ineffective assistance of his trial counsel, including one based on their failure to investigate and present evidence at sentencing that Pruitt suffered from schizophrenia. 

The Seventh Circuit held that the Indiana Supreme Court’s “determination that Pruitt failed to demonstrate significantly subaverage intellectual functioning based on inconsistent test scores” was objectively unreasonable and contrary to the clear and convincing weight of evidence. The Indiana Supreme Court erred by relying on “inaccurate assumptions and select pieces of evidence” in its factual determination, weighing circumstantial evidence—such as Pruitt’s ability to fill out applications for employment and his other work and school history—as more indicative of his true intellectual ability than his many subaverage IQ test scores. The Court also noted that the state court record contained “unrebutted evidence that Pruitt satisfie[d] the adaptive behavior prong of intellectual disability.” The Seventh Circuit also held that trial counsel’s failure to investigate and present evidence of Pruitt’s paranoid schizophrenia was “sufficiently egregious and prejudicial” to establish ineffective assistance. Ultimately, the Seventh Circuit reversed the judgment of the district court and remanded the case for new penalty-phase proceedings.

Found in DMHL Volume 34 Issue 2

Competence to stand trial

State courts violated clear due process standards in failing to address defendant’s competency to stand trial

McManus v. Neal, 779 F.3d 634 (7th Cir. 2015)

Paul McManus was convicted in Indiana state court of murdering his estranged wife and two daughters and was sentenced to death. On state post-conviction review, a trial judge found McManus to be intellectually disabled and ineligible for the death penalty under Atkins v. Virginia, 526 U.S. (2002) and Ind. Code § 35-36-9-6, but the Indiana Supreme Court re-imposed the death sentence. McManus then sought federal habeas review, challenging the Indiana Supreme Court’s rejection of his Atkins claim. The Seventh Circuit expanded the appeal to include the question of whether the state court “unreasonably applied federal due-process standards in finding McManus competent to stand trial.”

The Seventh Circuit held that the trial court and state supreme court failed to follow the due process competence to stand trial standard set out in Pate v. Robinson, 383 U.S. 375 (1966) and Dusky v. United States, 362 U.S. 402 (1960). During the trial, McManus suffered several panic attacks and had to be transported to the emergency room where he was treated with several psychotropic drugs, including both opioid painkillers and ones that affected memory. The Seventh Circuit held that the “powerful effect of the medications alone created substantial doubt about McManus’ mental fitness for trial” and faulted the state judge for not ordering a competency evaluation and instead focusing on “getting McManus ‘fixed-up’ enough to complete the trial.” This course of action violated not only the due process standard set out in Dusky but also the Indiana Code, which requires a trial court to appoint a team of medical experts with expertise in determining competency and to hold a hearing any time there are bona fide doubts about a defendant’s competency. See Ind. Code § 35-36-3-1. The Seventh Circuit reversed and remanded the case to the district court with instructions to grant the writ of habeas corpus unless Indiana gave notice of its intent to retry McManus within a reasonable time.

Found in DMHL Volume 34 Issue 2

Excessive force, conspiracy, and municipal liability under §1983

Weiland v. Palm Beach Cnty. Sheriff's Office, 792 F.3d 1313 (11th Cir. 2015)

District court abused its discretion in dismissing plaintiff’s §1983 claims at the pleading stage on technical, procedural grounds; plaintiff’s allegation as sufficient to state a claim against individual deputies, but not the sheriff’s office as a unit, for use of excessive force and conspiracy to deprive plaintiff of constitutional rights

Background: Christopher Weiland brought an action against the sheriff's office and deputies, asserting claims under § 1983 based on allegations of excessive force and malicious prosecution, and state law claims for excessive force, intentional infliction of emotional distress, and malicious prosecution. On April 6, 2007, Weiland’s father called 911 alleging that his son, who had bipolar disorder, was “acting up,” was “on drugs,” and “probably had a gun.” Two sheriff’s deputies were dispatched and met Weiland’s father outside the house. They then proceeded, with guns drawn, toward Weiland’s bedroom and found him sitting on the edge of his bed with a shotgun in his lap. One of the deputies fired two rounds at Weiland and knocked him off the bed. While he was on the floor bleeding, the other deputy tasered him and then both deputies physically beat him before handcuffing him to a dresser. In an effort to cover up the assault, the deputies fabricated a story that Weiland first ran from the officers then pointed the shotgun at them. The district court dismissed the plaintiff’s § 1983 claims, finding that the complaint failed to comply with the form for pleadings. Weiland appealed.

Holdings: The Court of Appeals held that: (1) the district court had abused its discretion in dismissing the § 1983 claims for failure to comply with requirements for form of pleadings; (2) allegations were sufficient to support claims for use of excessive force and conspiracy to deprive arrestee of his constitutional rights; (3) allegations were insufficient to support claims for § 1983 failure-to-train and conspiracy claims against the sheriff’s office; and (4) allegations were insufficient to support a § 1983 claim that the sheriff’s office had a policy of using internal affairs investigations to cover up use of excessive force against mentally ill citizens.

Notable Points:

Claims against individual deputies: Construing the allegations in the light most favorable to the plaintiff, the Court had little difficulty in deciding that Weiland had stated a claim for use of excessive force. The Court concluded that Weiland’s injuries were cognizable under both the Fourth and Fourteenth Amendments and that his claim specified a “causal connection between the alleged cover up and the specific deprivation of [his] constitutional rights.”

Failure-to-train and claims against the sheriff’s office: Plaintiffs cannot hold local government liable under § 1983 under a respondeat superior theory, so to be successful, a plaintiff must establish that the government unit has a “policy or custom” that caused his injury. The Court held that the claims resulted from an isolated incident involving only two deputies, and that Weiland had not provided any facts supporting either a widespread deficiency in training regarding interactions with mentally ill individuals, or a deliberate indifference to the specialized training needs of deputies interacting with the mentally ill. The Court found the conspiracy allegation against the sheriff’s office similarly deficient.

Found in DMHL Volume 34 Issue 3

Cruel and unusual punishment

Cox v. Glanz, No. 14-5022, 2015 WL 5210607 (10th Cir. Sept. 8, 2015)

Claim by surviving family member that inmate’s suicide was result of deliberate indifference by jail staff survives motion for summary judgment in claim against sheriff in his official capacity, but summary judgment is granted to sheriff on claim against him in his individual capacity due to qualified immunity

Background: Charles Jernegan surrendered to the Tulsa, Oklahoma jail in response to a warrant for his arrest. His intake screening included a mental health and suicide questionnaire. Jernegan reported that he was taking medication for paranoid schizophrenia, and he answered “yes” to questions asking about experience of paranoia and experience of nervousness or depression. Jail protocols called for a person with such responses being directly referred to mental health staff, but no such referral was made. Jernegan did deny to jail staff and a screening nurse that he had any suicidal thoughts. Jernegan later made a request to “talk” with jail mental health staff about unspecified “problems,” but the responding staff person reported that when she went to see Jernegan he had been moved to another cell. The staff person had not followed up on this or seen Jernegan when, two days later, Jernegan committed suicide by hanging himself with a sheet. Jernegan’s mother brought § 1983 action against the county sheriff, in both his personal and official capacity, alleging that the jail’s “deliberate indifference” to her son’s mental health needs constituted cruel and unusual punishment in violation of the 8th amendment. The district court denied the sheriff's motion for summary judgment, on the grounds that there were facts in controversy in the matter that were determinative of the issue of the sheriff’s liability. The sheriff filed an interlocutory appeal.

Holdings: Qualified immunity for individual liability granted and claim dismissed: A 3-judge panel found that at the time of Jernegan’s suicide in 2009, there was no “clearly established” law that would have put the sheriff on notice that his conduct constituted “deliberate indifference” to Jernegan’s mental condition in the jail in violation of the 8 th amendment. The Court found that the then-existing law required a threshold finding that the sheriff had personal knowledge that Mr. Jernegan “presented a substantial risk of suicide” before liability could attach. Summary judgment motion for official capacity liability claim denied: The sheriff argued that “official capacity” liability requires proof of a policy, pattern or practice that resulted in the alleged constitutional violation, and that the record did not support a finding of any such policy, pattern or practice in this case. The panel responded that, although denial of a claim of qualified immunity is a final action that can be heard and reviewed on interlocutory appeal, the denial of a motion for summary judgment that is unrelated to a denial of qualified immunity is not a final action and therefore cannot (except in rare instances) be heard and reviewed on interlocutory appeal.

Notable Points: The panel’s decision is notable for its review of federal case law relating to jail operations that would put jail officials on notice as to what conduct constitutes such “deliberate indifference” to an inmate’s condition that it amounts to “cruel and unusual punishment” in violation of the 8 th amendment. That review included mention of the U.S. Supreme Court’s recent decision in Taylor v. Barkes, --- U.S. ----, 135 S. Ct. 2042 (2015) (per curiam), where the Court found that, as of November 2004, there was no clearly established "right" of an inmate to be adequately screened for suicide.

Found in DMHL Volume 34 Issue 3

Cruel and unusual punishment

Young v. Martin, No. 13-4057, 2015 WL 5202968 (3d Cir. Sept. 8, 2015)

Claim by prisoner with history of mental illness and behavioral disorder that being restrained naked in a chair for 14 hours violated the 8 th amendment survives summary judgment

Background: State prisoner Young brought a § 1983 action alleging violations of the 8 th Amendment. Young had a long history of serious mental illness and extensive disciplinary problems in different Pennsylvania prisons, and had been in solitary confinement for several years, during which time his symptoms of mental illness had intensified. The incident resulting in his being placed naked in four-point mechanical restraint in a restraint chair occurred when a guard inadvertently left Young’s cell door open. Young went out to an internal ledge above the prison’s law library, where he voiced his objections to the conditions of his confinement. Young never acted aggressively, never threatened others, and when taken into physical custody by guards he initially cooperated, and then engaged in passive resistance, forcing guards to carry him but offering no active resistance to being stripped naked, subjected to a body cavity search and secured to the restraint chair. Prison policies provide for use of the restraint chair when an inmate acts or threatens to act in a manner that places the inmate or others at risk of harm, and provides for a maximum time period of 8 hours (with extension requiring a written request and approval that was never obtained here).

The district court granted defendants' motion for summary judgment, finding that the guards “acted professionally and within constitutional parameters” in “subduing” Young and placing him in the restraint chair. The district court also denied Young’s request for a stay of the proceedings to allow for the release of the U.S. Department of Justice’s report on its investigation of the Pennsylvania prison system’s treatment of inmates with serious mental illness.

Holdings: A 3-judge panel of the Court of Appeals found that the conduct of the guards alleged by Young fell under the “use of excessive force” test to determine whether Young had been subjected to cruel and unusual punishment in violation of the 8 th Amendment. Reviewing the record under the criteria identified in Hope v. Pelzer, 536 U.S. 730 (2002)11 , and “drawing all inferences in favor of Young as the nonmoving party,” the Court ruled that “we cannot say that ‘there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.’”12 The Court thereupon remanded the case back to the district court. The panel directed that the district court on remand consider whether the DOJ report was admissible, and whether such admission would be “unduly prejudicial” to the defendants.

Notable Points:

Eighth amendment analysis of use of mechanical restraints—“excessive force” vs. “conditions of confinement”: The panel rejected the defendants’ claim that their treatment of Young should be analyzed under the “conditions of confinement” framework. The panel noted that the U.S. Supreme Court in Hope ruled that the use of mechanical restraints in a prison setting could constitute cruel and unusual punishment. Applying the Hope criteria, the panel found the following: (1) Young was already subdued, and further was not violent, combative or self-destructive at any point during the incident leading up to his being placed in the restraint chair, (2) the events involved in the incident leading to Young’s placement in the restraint chair did not amount to an “emergency situation,” and (3) there was an issue of fact as to whether the guards’ use of the restraint chair subjected Young to “substantial risk of physical harm” and “unnecessary pain.”

Qualified immunity of the guards: The panel noted that the defendants made a onesentence claim in their appeal that they were entitled to summary judgment on the grounds of qualified immunity—that the state of the law at that time did not give them fair warning that their treatment of Young was unconstitutional. Noting that this claim was not addressed by the district court or briefed on appeal, the panel remanded the issue to the district court for consideration.

Found in DMHL Volume 34 Issue 3

Forced medication of involuntarily committed patients

Disability Rights New Jersey, Inc. v. Comm'r, New Jersey Dep't of Human Servs., No. 13-4255, 2015 WL 4620273 (3d Cir. Aug. 4, 2015)

State administrative procedure authorizing hospital medical panel review and approval of forced medication of patients in non-emergency situations does not violate ADA or constitutional rights of patients

Background: Plaintiffs brought action challenging New Jersey’s administrative policy for the forcible medication of involuntarily committed persons in state psychiatric hospitals in non-emergency situations. The plaintiffs alleged that the policy—which required in-hospital medical panel review, approval and oversight of all proposed involuntary medications, with various procedural requirements and the right to inhospital appeal and review—violated the Americans with Disabilities Act (ADA), Rehabilitation Act (RA), and the 14th Amendment, and asked that the Court require the state to establish a procedure for judicial review. The district court found that the state’s administrative policy was valid, except as to patients who had been found by a court to be ready for discharge and were in the hospital awaiting transfer to the community (“CEPP” patients). The district court granted summary judgment to the state in regard to all but the CEPP patients. Summary judgment was awarded to the plaintiffs in regard to the CEPP patients. Both the plaintiffs and the state appealed.

Holdings: A 3-judge panel of the Court of Appeals affirmed the district court’s ruling, “though not for all its stated reasons.” The panel, relying heavily on the U.S. Supreme Court’s decision in Washington v. Harper, 494 U.S. 210 (1990), found that New Jersey’s medically-based panel review process properly balanced the liberty interests of the nonCEPP patient with the state’s interests in both the safety of the hospital and the treatment and return to the community of the patient. Relying on Mathews v. Eldridge, 424 U.S. 319 (1976), however, the panel found the CEPP patients’ due process rights were violated by New Jersey’s policy.

Notable Points:

Due process analysis by the Court for non-CEPP patients: Noting that the U.S. Supreme Court had never addressed the constitutional right of involuntarily committed patients to refuse recommended medications for treatment, the panel adopted the balancing test applied to prisoners who refuse recommended psychotropic medications. The panel explained that, although convicted criminals in prisons do not have the same due process rights as persons held in non-criminal facilities, the U.S. Supreme Court’s treatment of forced medications in such cases makes clear that they can be justified only for non-punishment purposes; thus, application of Harper was not confined to prisoners. Because the New Jersey policy was essentially identical to the policy challenged in Harper, the panel found that it met all due process and related constitutional standards.

Due process analysis by the Court for CEPP patients: The panel specifically found that the standards in Harper could not be applied to CEPP patients, who had been “adjudicated by a court to be nondangerous.” The panel turned to the 3-pronged balancing test set out in Mathews v. Eldridge. 10 The panel noted that the administrative policy would permit forcible medication “even after a judge has ruled that the factual basis for their continued civil commitment has disappeared.” If a patient on CEPP status had so deteriorated that forcible medication of that patient had become necessary, the “appropriate course” for the state would be to recommit the patient.

Found in DMHL Volume 34 Issue 3

Unreasonable seizure of firearms

Arden v. McIntosh, et al. (No. 14-1517) (10th Cir. July 23, 2015)

Deputy’s warrantless seizure of firearms from the home of a person after the person had been removed from the home and hospitalized for suicidal behavior constitutes unreasonable seizure under 4 th amendment, but deputy entitled to qualified immunity

Background: Sheriff’s deputies were dispatched to Arden’s home after a caller reported to emergency staff that Arden had called her and in slurred speech had stated that he was taking pills and would continue taking them because nobody cared about him. Deputies found the front door to Arden’s home open. Officers announced their presence, found Mr. Arden in his bedroom, incoherent and unresponsive. Medics soon arrived and took Mr. Arden to the hospital, where he was placed on an “emergency mental health hold.” While still at the home, a deputy saw 23 firearms and ammunition in plain sight; these were collected and held for safekeeping at the police station. After Mr. Arden was released from the hospital, the firearms and ammunition were returned to him.

Mr. Arden filed suit in state court alleging a 4 th amendment violation and that the Sheriff failed to provide proper policies, training, and supervision in regard to such activities. The defendants removed the case to federal court, and moved for summary judgment, claiming they were entitled to “qualified immunity” for their actions. The district court granted the motion, finding no constitutional violations in the deputies’ conduct. Mr. Arden appealed, arguing that once he was taken from his home to the hospital, exigency ended, so that the subsequent warrantless search and seizure were not justified. The deputy argued that, because she was already authorized to be in the home and the weapons were in plain sight and her seizure was temporary and carried out for public safety purposes, her actions were authorized by law enforcement’s “community caretaking” role.

Holdings: A 3-judge panel of the Circuit Court ruled that the exigency was removed when Arden was removed from the home to the hospital, so that there was no cited legal authority for removing the firearms from the home. As a result, the firearms seizure constituted an unlawful seizure under the 4 th amendment. However, at the time of that seizure, there was no existing case law that gave the deputy “fair warning” that this conduct was unreasonable. Accordingly, the deputy was protected by “qualified immunity” from liability because she could have a good faith belief that her conduct was lawful.

Notable Points: The panel noted that no authority could be found “authorizing a police officer to confiscate weapons that would otherwise be left in an unoccupied house,” but also that no authority clearly established “that firearms may not constitutionally be removed from a residence under these circumstances.”

Found in DMHL Volume 34 Issue 3

Excessive use of force

Estate of William E. Williams, et al. v. Indiana State Police Department (No. 14-2523), Nancy Brown v. Wayne Blanchard and Walworth County, Wisconsin (No. 14-2808) (7th Cir. August 13, 2015)

Post-Sheehan analysis of two separate excessive force claims in mental health emergencies results in sustaining summary judgment in one case and denial of summary judgment in the second case

Background: In the Williams case, family members reported to the police that Williams had taken all of his remaining Xanax, locked himself in a bathroom and reported that he had cut himself, and threatened to kill anyone who tried to enter the bathroom. The officers who responded were unable to look into the bathroom to confirm Williams’ condition, and carried out a plan in which they unlocked the bathroom door and then tasered Williams to keep him from carrying out his threats of self-harm and harm to others. The tasers had no effect on Williams, who pursued the officers through the house, swinging his knife. Officers shot and killed him. Williams’ estate brought suit alleging excessive use of force by the officers in violation of the 4 th amendment. The district court granted the defendants summary judgment based upon a finding that the officers were protected by qualified immunity. The Williams estate appealed.

In the Brown case, Nancy Brown’s son John had cut himself, had a knife in his possession and was locked in his bedroom, but his mother had a key and went into her son’s room and spoke with him. He refused help, but did not threaten to harm his mother or anyone else. The first responding officer (Officer Such) spoke with Ms. Brown and then attempted to speak with Mr. Brown through the door, but Brown only responded with a profanity. A second officer (Officer Blanchard) arrived, spoke briefly with Ms. Brown and Such, and proceeded down the hall to the bedroom door as Such went outside to look at Mr. Brown through the window. Such radioed to Blanchard that Brown was sitting at his desk, in front of his computer, drinking a beer and smoking. Declining an offer by Brown’s mother to unlock the door to Brown’s room, Blanchard kicked in the door, gun drawn. Officer Such came back inside, backing up Blanchard with his taser drawn. Brown rose with knife in hand, crossed the room, and slammed the door shut. Blanchard again kicked open the bedroom door. The officers later reported that Blanchard ordered Brown to drop the knife and advised Brown that he would have to shoot him, and that Brown responded by rolling his shoulders forward and advancing toward the officers while moving the knife “in an upward position.” The officers reported that when Brown was 5 or 6 feet away from them, Blanchard shot him twice, killing him. Nancy Brown, who was in the living room at the time of the shooting, reported that she never heard either officer tell Brown to drop his knife and that she heard the fatal shot fired almost immediately after the bedroom door was kicked open the second time. Ms. Brown sued Officer Blanchard and the county, claiming excessive force was used against her son in violation of the 4 th amendment. Blanchard moved for summary judgment but the district court denied the motion, ruling that there were material facts in dispute, and that the jury’s findings on those disputed facts could result in a finding of liability on the part of the officer, under one or both of two legal theories: (1) that Blanchard’s unreasonable “pre-seizure conduct” provoked the actions by John Brown that resulted in the shooting, and (2) that at the time of the shooting, John Brown at most was only passively resisting the officers, so that the use of lethal force against Brown was unreasonable. Blanchard appealed. The Court of Appeals consolidated the two cases.

Holdings: A 3-judge panel of the Court of Appeals upheld the rulings of each district court. In upholding Williams, the panel cited and closely followed the reasoning of the U.S. Supreme Court in City and County of San Francisco v. Sheehan, 35 S. Ct. 1765 (2015), noting that the plaintiffs could not cite any case law existing at that time that found “objectively unreasonable” the strategy of the officers. In fact, the panel noted, a number of appellate courts had specifically found similar actions in other cases to be objectively reasonable. Hence, the officers were not on notice that their actions were an excessive use of force.

In Brown, the panel upheld the district court’s denial of the officer’s request for summary judgment based on qualified immunity. The panel, noting again its reliance on Sheehan, rejected the district court’s concept of liability for “pre-seizure conduct” as not having the support of case law that would put the officer on notice that his conduct violated 4 th amendment standards. However, the panel sustained the district court’s denial of summary judgment in regard to the second theory, noting that under longstanding case law it was clear that it was unreasonable for an officer to use deadly force in response to an individual who was presenting only passive resistance to the officer.

Notable Points: The opinion is a careful and detailed consideration of the facts of each case and of the proper legal framework for a court’s analysis of those facts, particularly under the guidance provided by the U.S. Supreme Court in Sheehan. The panel rejected the Brown court’s first theory of liability: “Our case law is far from clear as to the relevance of pre-seizure conduct, or even as to a determination as to what conduct falls within the designation ‘pre-seizure,’ although the majority of cases hold that it may not form the basis for a Fourth Amendment claim.”

Why the result in Brown was different: Review standard for interlocutory appeal: The panel noted that, because Blanchard’s appeal was an interlocutory appeal from the district court’s denial of qualified immunity, the scope of the panel’s review was limited to ”the purely legal question of whether ‘a given set of undisputed facts demonstrates a violation of clearly established law.’” Panel’s acceptance of district court’s second theory of liability: The panel found that the law was clear that officers cannot use significant force on non-resisting or passively resisting suspects; so, if a jury found that the facts were as Nancy Brown described them, then Blanchard’s use of deadly force against a “passively resisting” John Brown would violate the 4 th amendment. Blanchard's “pre-seizure conduct” is relevant to this analysis because it is part of the “totality of the circumstances” that must be considered in evaluating the reasonableness of the seizure. The panel noted factors, such as: John never threatened to harm anyone else; John allowed his mother to enter his room and hug him; John was clearly seen to be passively sitting at his computer; and Blanchard chose to kick in the door to John’s room, and to immediately resort to deadly force when the non-lethal taser was immediately available.

Found in DMHL Volume 34 Issue 3

​​​​​​​Excessive use of force

Clay v. Emmi, No. 14-2351, 2015 WL 4758917 (6th Cir. Aug. 13, 2015)

Claim that officer used excessive force in taking person into custody for involuntary commitment survives summary judgment

Background: Police officer Emmi went to the home of Clay upon call from Clay’s counselor, who reported that Clay, who had diagnoses of schizophrenia and bipolar disorder and a history of suicidal ideation, was making suicidal statements. Clay voluntarily rode with Emmi to the hospital and entered the hospital “to talk to somebody.” When hospital staff asked Clay to disrobe and put on a gown, he refused. In a § 1983 action against Emmi and others for excessive use of force, Clay claimed that, despite his offering no resistance, he was wrestled to the ground, handcuffed and turned face-down, and then tasered in the back by Emmi while handcuffed and offering no resistance. Emmi claims that Clay attempted to leave the hospital, physically resisted efforts to keep him there, and had to be tasered and then handcuffed in order to overcome his resistance. Witnesses provided support for Emmi’s version of events, but there was no definitive evidence (such as a video recording). Emmi moved for summary judgment on the grounds that a 14th Amendment “subjective use of force” analysis applied to his actions, he had no reason to think that his actions violated Clay’s due process rights, and therefore he was entitled to “qualified immunity” for his actions.

Holdings: The district court found, and the Court of Appeals affirmed, that (1) the 4 th Amendment’s “objectively reasonable” standard for use of force applied to Emmi’s actions because Clay was not in custody until the initial “seizure” in the hospital, and (2) because key facts were in dispute that related directly to the need to use force to manage Clay in the hospital, summary judgment action was not supported at that stage of the proceedings.

Notable Points: The Court noted that “among the factors to be considered” in determining whether an officer’s use of force was objectively reasonable were “whether the person being seized poses an immediate threat to the safety of officers or others” and “whether the person is actively resisting.”9 Therefore, “Clay's level of resistance and whether he was handcuffed before being tasered” were “central to this inquiry.”

Found in DMHL Volume 34 Issue 3

Intellectual Disability (ID) and the death penalty

Brumfield v. Cain, 2015 WL 9213235 (5th Cir. 2015)

Defendant Brumfield found intellectually disabled and therefore ineligible for the death penalty, under the standards set out by the Supreme Court in Atkins and Brumfield

Background: Kevan Brumfield was convicted of first-degree murder in 1995 and sentenced to death. After exhausting his state court remedies, Brumfield filed a petition for a writ of habeas corpus in the United States District Court for the Middle District of Louisiana, arguing that he was intellectually disabled and thus ineligible for the death penalty under Atkins v. Virginia, 536 U.S. 304 (2002). The District Court held that the state courts had erred by failing to hold an Atkins hearing and granted Brumfield a writ of habeas corpus after holding such a hearing. On appeal, the Fifth Circuit reversed without reaching the merits of the Atkins claim, holding that Brumfield had not satisfied the procedural requirements for habeas relief. The Supreme Court of the United States reversed, finding that he did meet the requirements, and remanded the case to the Fifth Circuit to ascertain whether the District Court’s determination that Brumfield was intellectually disabled was clear error.

Holdings: On remand, the Fifth Circuit held that the District Court’s determination was not clearly erroneous because it was “plausible in light of the record as a whole.” Although the State argued that prior assessments placed Brumfield consistently in the 70- 85 range,3 the Fifth Circuit noted that “no actual IQ scores…were reported anywhere in Brumfield’s records” and that tests provided only “descriptions of the ranges into which Brumfield’s scores fell”, and every expert witness before the district court “agreed that Brumfield’s scores satisfied the first prong of the intellectual disability test.” Additionally, the District Court found that Brumfield had significant conceptual limitations and “carefully explained its reasoning, identified the specific evidence it relied upon, and specifically credited the testimony of certain experts.” Where the court’s reasoning was so careful and its conclusions not implausible—even if it rejected the State’s equally coherent and plausible story—the Fifth Circuit refused to disturb or second-guess its findings. Although Brumfield was not formally diagnosed as intellectually disabled until after age 18, the district court found that the evidence produced showed this failure to diagnose was related to incentives in the school system not to identify students as intellectually disabled. Again, the district court pointed to specific evidence—Brumfield’s poor academic record, below grade reading comprehension, and etiological factors (e.g., low birth weight, family history of intellectual disability). The Fifth Circuit noted that these factors “certainly bolster[ed] the court’s conclusion that Brumfield’s intellectual disability manifested” before 18.

Found in Found in DMHL Volume 34, Issue 4

Reasonable accommodations under ADA and 14th Amendment

Dean v. University at Buffalo School of Medicine and Biomedical Sciences, 804 F.3d 178 (2nd Cir. 2015)

Medical school failed to meet “reasonable accommodations” standards of ADA regarding exams for student with mental illness, but due process afforded to the same student in regard to dismissal from school for inadequate performance met constitutional standards

Background: Maxiam Dean began to experience increased symptoms of depression after failing Step 1 of the United States Medical Licensing Examination. He met with an internist who recommended pharmacological treatment and provided him with an “excuse slip” recommending a leave of absence due to his situational depression. Dean presented the slip to his medical school, and was informed that it did not provide sufficient information to support an extended leave. The defendants offered a 10 week leave in response to Dean’s request for 3 months and informed him that he would not be extended any additional accommodations, and that he must sit for his Step 1 by May 21, 2007. After failing to pass (or sit for) his third attempt at Step 1, Maxiam Dean was dismissed from the program. Dean brought suit under Title II of the Americans with Disabilities Act (“ADA”), Section 504 of the Rehabilitation Act of 1973, and 42 U.S.C. § 1983. The United States District Court for the Western District of New York granted summary judgment to the defendants and dismissed Dean’s complaint. Dean then appealed.

Holdings: The Fifth Circuit held that the district court had erred in granting summary judgment to the defendants on the ADA and Rehabilitation Act claims because the defendants failed to show that the requested accommodation was unreasonable and to provide a “plainly reasonable” alternative. The Fifth Circuit found the record “devoid of evidence” regarding defendants’ consideration of whether Dean’s proposed accommodation would impose undue financial or administrative hardship on the M.D. program. Thus the lack of evidence regarding “the basis for denying Dean’s requested modification to the exam schedule preclude[d] any conclusion on summary judgment as to the unreasonableness of that accommodation.” Defendants would be entitled to summary judgment only if “the undisputed record reveals that the plaintiff was accorded a plainly reasonable accommodation”, but a reasonable juror could have found that the “abbreviated study period encompassed within Dean’s leave” would not have been sufficient to prepare him to sit the exam.

The Court held that Dean’s procedural due process rights had not been violated, though, because he “received notice of potential termination…and a careful and deliberate decision.”

Found in Found in DMHL Volume 34, Issue 4

Due process requirements for involuntary hospitalization

J.R. v. Hansen, 803 F.3d 1315 (11th Cir. 2015)

Florida’s statutory structure for involuntary commitment of persons with intellectual disability violates the 14th amendment, as it allows for indefinite commitment without periodic review

Background: Plaintiff-Appellant J.R., an intellectually disabled man with an IQ of 56, was charged with sexual battery and, after being found incompetent to stand trial, was admitted to non-secure residential services under F.S.A. § 393.11. He claimed that Florida’s involuntary commitment laws denied due process because they permitted the State to keep intellectually disabled people committed indefinitely without periodic review. When a person is admitted, the circuit court that first ordered the admission keeps jurisdiction over the order, and the person “may not be released except by order of the court.” The court, however, is “never required to review a continuing involuntary admission” (emphasis in original). Admitted persons may only challenge their support plans in administrative proceedings, but administrators cannot change or vacate the admission order or require release. Thus, the only means of securing release was by writ of habeas corpus.

Holding: The Eleventh Circuit held that Florida’s statutory scheme was facially unconstitutional because it violated the Due Process Clause of the Fourteenth Amendment by failing to require periodic review of continued commitments “by a decision-maker with the duty to consider and the authority to order release.” Even if the statutory scheme did require administrative agencies to conduct period reviews, however, it would still be facially unconstitutional because the agency did not have the authority to order release nor was it required to petition the circuit court.

Notable Points:

The availability of habeas corpus does not provide constitutionally adequate process: The Eleventh Circuit, relying on Williams v. Wallis, 734 F.2d 1434 (11th Cir. 1984), stated that “habeas corpus is not adequate in and of itself” and “can be at most a backstop.” The Court distinguished habeas from periodic review because habeas is only available if a petitioner seeks it.

Found in Found in DMHL Volume 34, Issue 4

Qualified immunity

Waters v. Coleman, No. 14-1431, 2015 WL 6685394 (10th Cir. Nov. 3, 2015)

Officers involved in the subduing and arresting of a man experiencing “excited delirium” were entitled to qualified immunity against an excessive force claim by the man’s estate

Background: On July 18, 2011, Alonzo Ashley and his girlfriend visited the Denver Zoo. Zoo patrons called security when Ashley tried to cool off under a water fountain, and the police were called when zoo security reported that Ashley attacked a security officer. When the first officer on scene, Jones, approached Ashley, he noticed that Ashley was sweating profusely—a symptom of excited delirium. Ashley and Jones struggled, and Jones eventually tackled Ashley with the assistance of two zoo officers. Ashley attempted to punch Jones, and Jones deployed his Taser to Ashley’s back. When the second officer, Coleman, arrived, Ashley was still resisting, and Jones deployed his Taser again. Coleman also deployed his Taser two times and noticed that “Mr. Ashley seemed extremely strong.” When three more officers, the officers were eventually able to subdue Ashley, and after he was handcuffed he remained on his stomach for between 2 and 5 minutes. Noticing that Ashley had vomited, Conner called for medical assistance. Ashley vomited once more and then stopped breathing. The officers began chest compressions, but Ashley was pronounced dead after paramedics transported him to the hospital. Ashley’s mother, Gail Waters, brought a § 1983 action against the police officers alleging excessive use of force that led to his death. The United States District Court for the District of Colorado denied the officers’ motions for summary judgment on the grounds of qualified immunity. The officers appealed.

Holding: The Tenth Circuit Court of Appeals reversed in part and dismissed in part, holding that all officers who participated in the arrest were entitled to qualified immunity. Additionally, the Tenth Circuit held that the Court of Appeals lacked jurisdiction to consider the denial of qualified immunity for lieutenant’s supervisory conduct as the ranking officer on scene after Ashley was handcuffed.

Notable Points:

Excessive force when detainee may be suffering from excited delirium: The Tenth Circuit did not reach the question of whether any officer’s conduct was objectively unreasonable and therefore unconstitutional because it found that, on the day of the incident, the law was not clearly established so as to alert the officers to the potential illegality of their conduct. Even though Ashley presented symptoms of excited delirium, the Tenth Circuit stated that it has never “required officers to refrain from a minimal use of force when dealing with an impaired individual,” noting several times the fact that a struggle was ongoing at the time that force was used. The Court noted that existing case law does, however, make it clear that continued use of force against a subdued or nonresisting person is not constitutionally permissible.

Found in Found in DMHL Volume 34, Issue 4

Qualified immunity

Pena v. Givens, No. 14-11020, 2015 WL 7434253 (5th Cir. Nov. 23, 2015)

State psychiatric ER employees are entitled to qualified immunity against claim by the estate of a man who died in the ER

Background: After arriving at a fire station and complaining that he was being chased, George Cornell was taken by police to the Parkland psychiatric emergency room (the “Psych ER”). Cornell resisted when technicians tried multiple times to take his vitals, and tried to leave the Psych ER. Cornell was taken into a seclusion room, held on a mat on the floor, and given a mixture of Haldol, Ativan, and Benadryl to calm him. When Cornell became agitated again and ripped up a floor tile, the technicians attempted to move him to a new room, but he resisted and they administered another injection of the same three medications. Cornell was held on his stomach for some amount of time (possibly up to 15 minutes) following the second injection before the technicians left the room. A nurse found him lying prone in the room, and Cornell was transferred to the main emergency room, where he died. Following Cornell’s death, the medical examiner found the cause of death to be undetermined but listed three potential causes: (1) mechanical compression; (2) underlying cardiac issues; or (3) effects of the medication he received in the Psych ER. Cornell’s representatives sued technicians, doctors, nurses, and hospital supervisors alleging excessive force, physical restraint, denial of adequate medical care, staff supervision violations. The United States District Court for the Northern District of Texas denied defendants’ motions for summary judgment on grounds of qualified immunity, and the defendants brought an interlocutory appeal.

Holding: On interlocutory appeal, the Fifth Circuit held per curiam that the technicians, nurse, doctor, and supervisors were all entitled to qualified immunity. The Court noted a lack of binding authority holding that “a medical professional’s restraint of an individual in an emergency medical situation constitutes a Fourth Amendment seizure.” Further, the Court noted that “even police officers’ use of restraint does not implicate the Fourth Amendment if they are acting in an emergency-medical-response capacity” (emphasis in original). Important to the Fifth Circuit on both the excessive force and substantive due process claims was the fact that Cornell resisted the Parkland staff. Regarding the substantive due process violation due to physical restraint, the Fifth Circuit noted that the staff’s conduct violated hospital policy but did not amount to conduct that “shocks the conscience.” 

Regarding the denial of adequate medical care, the Fifth Circuit noted the “recognized…special relationship for incarcerated and involuntarily committed individuals,” which requires a state to protect the citizen from harm.2 Plaintiffs must demonstrate that state official acted with “deliberate indifference.” Thus, the defendants must have been “on notice” of Cornell’s heart condition and then consciously refused to provide further care. Here, the Fifth Circuit pointed out that “Cornell resisted the officers when they tried to provide care,” and posited that they could not say “that a reasonable jury could conclude that the failure to treat a heart condition after a patient refuses care and begins attacking staff amounts to deliberate indifference.” Finally, regarding the lack of supervision claim, the Fifth Circuit noted that the subordinates’ actions had not been found to be a constitutional violation, therefore the supervisors could not be held liable for constitutional violations.

Notable Points:

Restraint while rendering emergency medical aid: Even though the training given to technicians warned not to hold patients in a prone position for extended periods of time, the Fifth Circuit cited Sheehan in saying that “if an officer acts contrary to her training…that does not itself negate qualified immunity where it would otherwise be warranted.”

Found in Found in DMHL Volume 34, Issue 4