Jeffrey Hinneburg v. Nicole Miron, 676 F. App'x 483

Ashlee Hinneburg was arrested and jailed on April 14, 2014; she had filled a prescription for hydrocodone earlier that day and was observed by other inmates as appearing "very high" and nodding off while in holding cell 10.
Hinneburg was screened by Nurse Tiffany DeLuca between ~3:36–3:58 p.m.; DeLuca completed a multi-page medical questionnaire, found Hinneburg alert, coherent, and showed no signs of opiate distress; Hinneburg denied other drug use.
Officers Nicole Miron and Lukas Edringer responded to cell 10 disturbance at ~4:29 p.m., observed Hinneburg as responsive and able to change clothes and walk unassisted, and moved her to a detox cell.
Officer David Ealy performed hourly checks; at ~8:19 p.m. he found Hinneburg unresponsive, called medical staff, and began CPR after smelling salts failed; she was pronounced dead at the hospital due to hydrocodone intoxication.
Plaintiff (personal representative) sued under 42 U.S.C. § 1983 alleging Eighth Amendment deliberate indifference against Miron, Edringer, and DeLuca; the district court granted summary judgment for defendants and this appeal followed (plaintiff later abandoned claims against some defendants).

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether defendants were deliberately indifferent to a serious medical need	Hinneburg was severely intoxicated and inmates warned she needed medical attention; defendants should have recognized and acted on life-threatening overdose risk	Defendants observed at most intoxication; they reasonably concluded she was coherent and not in need of emergency care	Defendants did not have subjective knowledge of a substantial risk; summary judgment affirmed
Whether medical screening met constitutional duty	DeLuca’s screening was cursory and missed signs of overdose; she should have inferred risk	DeLuca reasonably assessed Hinneburg as alert, answered questions, and showed no opiate signs during screening	No genuine dispute that DeLuca lacked subjective awareness of serious risk
Whether officers’ observations could be imputed to unobserved behavior	Plaintiff contends other inmates’ observations create dispute that officers knew risk	Court: officers cannot be charged with observations they did not actually witness; inquiry is individualized	Court held plaintiff failed to show officers knew or drew inference of substantial risk
Entitlement to qualified immunity (alternative)	Not reached in detail on appeal after merits disposition	Defendants argued they are entitled to qualified immunity if no constitutional violation	Court affirmed on merits and did not decide qualified immunity

Estelle v. Gamble, 429 U.S. 97 (1976) (deliberate indifference to serious medical needs violates Eighth Amendment)
Farmer v. Brennan, 511 U.S. 825 (1994) (deliberate indifference requires subjective awareness of substantial risk)
Anderson v. Liberty Lobby, 477 U.S. 242 (1986) (summary judgment standard and requirement that evidence permit reasonable jury verdict)
Celotex Corp. v. Catrett, 477 U.S. 317 (1986) (summary judgment burden shifting; plaintiff must show genuine dispute)
Comstock v. McCrary, 273 F.3d 693 (6th Cir. 2001) (elements and burdens of subjective knowledge in deliberate-indifference claims)
Phillips v. Roane County, Tennessee, 534 F.3d 531 (6th Cir. 2008) (lay recognition of need for medical attention supports objective prong)
Weaver v. Shadoan, 340 F.3d 398 (6th Cir. 2003) (knowing or suspecting ingestion of drugs alone insufficient for liability absent incapacity or request for help)
Border v. Trumbull County Board of Commissioners, [citation="414 F. App'x 831"] (6th Cir. 2011) (officials must not decline to verify facts they strongly suspect to be true)
Smith v. Erie County Sheriff’s Department, [citation="603 F. App'x 414"] (6th Cir. 2015) (officers not deliberately indifferent where decedent appeared intoxicated but not in need of immediate medical attention)