April Myrick v. Fulton County, Georgia
69 F.4th 1277
11th Cir.2023Background
- Antonio May, appearing methamphetamine-intoxicated and paranoid, was taken from Grady Hospital to Fulton County Jail on Sept. 11, 2018; Grady recommended custody at the jail and indicated he was safe for psychiatric discharge.
- Fulton County contracts with NaphCare for jail medical services; intake EMT Travis Williams documented that May reported suicidal thoughts and suspected detox and says he informed the on-duty provider; provider Didier did not recall being told.
- May was placed in a holding cell, behaved erratically (naked, masturbating, banging on the door), and DART officers confronted him; Cook deployed a taser, other officers used tasers/pepper spray, a takedown occurred, handcuffs/leg restraints and a restraint/transport chair were used.
- After restraint and decontamination, medical staff briefly assessed May; he later became unresponsive in the restraint chair, CPR was performed, and he died; the medical examiner cited probable excited delirium with restraint and acute methamphetamine intoxication (manner undetermined).
- Plaintiffs sued under §1983 (excessive force, deliberate indifference, supervisory liability) and Georgia medical malpractice (NaphCare, Williams). District Court dismissed Sheriff Jackson and granted summary judgment to the officers, NaphCare, and Williams. On appeal, this Court affirmed dismissals/summary judgment as to Sheriff Jackson and the officers and Williams, but vacated summary judgment as to NaphCare and remanded on proximate-cause grounds.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Sheriff Jackson is entitled to Eleventh Amendment immunity in his official capacity | Jackson is an arm of the county and not the State; thus not immune | Sheriff functions (force policy, training, medical custody) are "state hat" duties; Manders/Lake govern and support state immunity | Sheriff Jackson is an arm of the State for these functions; Eleventh Amendment immunity applies; official-capacity claims dismissed |
| Whether Sheriff Jackson is liable in his individual capacity under supervisory liability (failure to train/policy) | Jackson had notice/custom/widespread practice or unconstitutional policy leading to May’s death | No facts show widespread abuse, unconstitutional policy, or Jackson’s personal direction; qualified immunity applies | Complaint fails to plead the rigorous causal-connection standard; qualified immunity bars individual-capacity supervisory claims; dismissal affirmed |
| Whether officers used excessive force (Cook’s taser, Strowder’s punches, additional restraints) | Force was excessive and objectively unreasonable given May’s condition | Force was objectively reasonable given noncompliance, aggression, and safety concerns; at minimum not clearly established law against restraints | Use of force (taser, punches) was objectively reasonable under Kingsley factors; additional restraints, while policy violations, were not conduct clearly establishing a constitutional violation; officers entitled to qualified immunity |
| Whether officers were deliberately indifferent to May’s serious medical needs | Officers knew or should have known May was detoxing/suicidal and failed to monitor/provide timely aid | Officers and on-site medical provider evaluated May, responded when he became unresponsive, and did not act with more than gross negligence | Even assuming a serious need, video shows officers and Didier responding promptly; plaintiffs cannot show subjective deliberate indifference or > gross negligence; qualified immunity applies |
| Whether NaphCare/Williams committed medical malpractice and proximately caused May’s death | NaphCare negligently failed to screen, observe, classify (suicide watch), and treat (sedation) May; experts opine such failures more likely than not caused the fatal sequence | District Court: intervening violent encounter with officers breaks causal chain; Williams communicated intake findings (no breach) | Summary judgment affirmed for Williams (no breach of duty). Summary judgment vacated as to NaphCare: expert testimony creates genuine fact issue on proximate cause; remanded for further proceedings |
Key Cases Cited
- Manders v. Lee, 338 F.3d 1304 (11th Cir. 2003) (sheriff acts as an arm of the state re: force policy, training, discipline)
- Lake v. Skelton, 840 F.3d 1334 (11th Cir. 2016) (sheriff wears a "state hat" for custodial responsibilities including medical/food services)
- Kingsley v. Hendrickson, 576 U.S. 389 (U.S. 2015) (pretrial-detainee excessive-force test is objective-reasonableness)
- Draper v. Reynolds, 369 F.3d 1270 (11th Cir. 2004) (single taser use on uncooperative, belligerent suspect not necessarily excessive)
- Hope v. Pelzer, 536 U.S. 730 (U.S. 2002) (egregious abuse can clearly establish constitutional violation for qualified-immunity purposes)
- Ashcroft v. al-Kidd, 563 U.S. 731 (U.S. 2011) (qualified immunity framework: clearly established law requirement)
- Zwiren v. Thompson, 578 S.E.2d 862 (Ga. 2003) (Georgia proximate-cause standards in medical malpractice; expert must show reasonable medical probability)