Anthony Perez v. City of Fresno, 98 F.4th 919

In May 2017, Fresno police encountered Joseph Perez, behaving erratically and in distress, and placed him in handcuffs for his own safety while awaiting EMS for involuntary psychiatric detention.
Officers restrained Perez on the ground after he resisted instructions, using physical force and a RIPP restraint; he remained in a prone position.
Paramedics arrived, and at their direction, officers applied their body weight to restrain Perez and secure him to a backboard for medical transport; Perez stated he could not breathe and died shortly after being turned over, with the cause of death listed as compression asphyxia and methamphetamine toxicity.
Perez’s family sued under 42 U.S.C. § 1983 for alleged Fourth and Fourteenth Amendment violations, and brought Monell failure-to-train claims against Fresno city and county, as well as state law claims.
The district court granted summary judgment for the defendants (officers, paramedic, city, county), finding qualified immunity applied and insufficient evidence for municipal liability.
Plaintiffs appealed, challenging the grants of qualified immunity and the rejection of their Monell claims.

Issue	Perez Argument	Defendants Argument	Held
Qualified immunity for law enforcement	Drummond & other precedent clearly establish prone force is unconstitutional	The law was not clearly established for force applied at paramedic’s medical direction	Qualified immunity applies; lack of clearly established law
Qualified immunity for paramedic	Paramedic was not providing medical care but causing Perez’s death	Paramedic acted in a medical capacity, not as law enforcement, and was attempting medical transport	Paramedic entitled to qualified immunity
Municipal Monell failure-to-train claim	Officers were inadequately trained on positional asphyxia risks	Departments had policies/guidance; no pattern or deliberate indifference shown by city/county	Insufficient evidence for deliberate indifference; claim denied
Effect of officers deviating from training	Departure from training defeats qualified immunity	Deviation from training does not alone negate immunity; medical context of actions	Deviation from training not enough to deny immunity

Drummond v. City of Anaheim, 343 F.3d 1052 (9th Cir. 2003) (excessive force applied in prolonged prone restraints clearly established as unconstitutional in certain contexts)
District of Columbia v. Wesby, 583 U.S. 48 (2018) (qualified immunity analysis requires clearly established law on specific facts)
Mullenix v. Luna, 577 U.S. 7 (2015) (qualified immunity requires particularity in precedent)
Monell v. Dep’t of Social Services of City of New York, 436 U.S. 658 (1978) (municipal liability under § 1983 requires policy/custom, not respondeat superior)
City of Canton v. Harris, 489 U.S. 378 (1989) (failure to train liability under Monell requires deliberate indifference by municipality)
Connick v. Thompson, 563 U.S. 51 (2011) (clarifies high standard for showing municipal deliberate indifference in failure-to-train cases)