A.H. v. St. Louis County, Missouri, 891 F.3d 721

Background

Pretrial detainee Jereme Hartwig, with a prior suicide attempt and recent self-inflicted head injury, was confined at the St. Louis County Jail and placed on "precautionary status" after evaluation by clinical psychologist Dr. Wendy Magnoli.
Precautionary status under the Jail policy placed inmates in general population with a cellmate, required periodic mental-health review and hourly/forty-minute staff checks (depending on shift), and permitted security blankets/bed sheets with limitations.
Corrections officer Lauren Abate conducted required hourly checks on Hartwig’s housing unit on the evening he later hanged himself; Hartwig was found hanging by his cellmate about fifty minutes after Abate’s last check and died six days later.
Plaintiffs (Hartwig’s mother and three children) sued under 42 U.S.C. § 1983 (Fourteenth Amendment failure-to-protect), Missouri wrongful-death law, and the ADA/Rehabilitation Act; the district court dismissed ADA/RA claims for lack of standing and later denied leave to amend; summary judgment was entered for defendants on § 1983 and wrongful-death claims; ADA/RA claims in a second suit were dismissed on the merits.
The Eighth Circuit affirmed: no constitutional violation by the individual defendants or the County under § 1983, official/sovereign immunity barred most state-law claims, and ADA/RA claims failed as impermissible attempts to litigate alleged inadequate medical treatment.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Dr. Magnoli was deliberately indifferent in placing Hartwig on precautionary status and discharging him from infirmary	Magnoli knew risk factors (prior attempt, depression, recent self-harm) and nonetheless returned him to general population	Her clinical judgment, based on interviews and lack of current suicidal ideation/behavior, showed low present risk and appropriate precautions	No deliberate indifference; professional judgment not equivalent to constitutional culpability
Whether Officer Abate was deliberately indifferent by failing to adequately monitor Hartwig	Abate did not specifically recall observing Hartwig on her checks and failed to discover him before he hanged himself	Abate performed the hourly checks required by policy; lapse of memory at deposition does not create genuine issue of constitutional recklessness	No deliberate indifference; evidence showed required checks were performed
Whether County/Director Bernsen liable for policy or failure-to-train leading to suicide	County policy allowed precautionary inmates to be alone, have sheets, and receive no greater monitoring than general population, reflecting deliberate indifference	Policy required screening, classification, specified precautions, training, and post-incident physical modifications—an effort to prevent suicide, not indifference	Policy not deliberately indifferent; municipal claim fails without underlying constitutional violation
Whether state-law wrongful-death claims survive against Abate/County	Abate negligently performed ministerial cell-check duties; County liable under wrongful-death	Defendants invoke sovereign immunity (County) and official immunity for discretionary acts; Abate’s monitoring was ministerial but no non-negligent breach proved	County shielded by sovereign immunity; Abate entitled to official immunity for discretionary aspects; no actionable negligence shown
Whether ADA/RA claims properly plead or should have been allowed by amendment	Plaintiffs asserted ADA/RA discrimination/denial of nonmedical accommodations and sought leave to amend after heirship established	ADA/RA do not cover claims that are essentially inadequate medical-treatment claims; amendment was untimely and would be futile	ADA/RA claims dismissed on the merits as impermissible medical-treatment claims; leave to amend properly denied as futile

Key Cases Cited

Gregoire v. Class, 236 F.3d 413 (8th Cir. 2000) (Eighth Amendment deliberate indifference includes suicide risk)
Drake ex rel. Cotton v. Koss, 445 F.3d 1038 (8th Cir. 2006) (deliberate indifference requires actual knowledge of substantial risk)
Farmer v. Brennan, 511 U.S. 825 (1994) (deliberate indifference standard for prison officials)
Luckert v. Dodge Cty., 684 F.3d 808 (8th Cir. 2012) (pretrial detainees entitled to Eighth Amendment-level protection)
Harlow v. Fitzgerald, 457 U.S. 800 (1982) (qualified immunity standard)
Rellergert v. Cape Girardeau Cty., 924 F.2d 794 (8th Cir. 1991) (suicide-prevention policies can show concern, not indifference)
Liebe v. Norton, 157 F.3d 574 (8th Cir. 1998) (municipal liability requires policy or custom causing constitutional violation)
Minix v. Canarecci, 597 F.3d 824 (7th Cir. 2010) (professional judgment short of deliberate indifference)
Yellow Horse v. Pennington Cty., 225 F.3d 923 (8th Cir. 2000) (mere failure to recall does not raise genuine issue of deliberate indifference)
City of Canton v. Harris, 489 U.S. 378 (1989) (municipal liability for failure to train requires deliberate indifference)
Bd. of Cty. Comm'rs v. Brown, 520 U.S. 397 (1997) (state of mind for municipal action mirrors underlying right)
Jenkins v. Cty. of Hennepin, 557 F.3d 628 (8th Cir. 2009) (municipal policy claims require causation and culpability)
Hott v. Hennepin Cty., 260 F.3d 901 (8th Cir. 2001) (ADA/RA do not reach claims that are essentially inadequate medical treatment)
Shelton v. Ark. Dep’t of Human Servs., 677 F.3d 837 (8th Cir. 2012) (improper medical treatment claims barred under ADA/RA)
Burger v. Bloomberg, 418 F.3d 882 (8th Cir. 2005) (limitations on bringing medical-treatment claims under ADA/RA)
United States ex rel. Roop v. Hypoguard USA, Inc., 559 F.3d 818 (8th Cir. 2009) (abuse of discretion standard for denial of leave to amend)