985 F.3d 787
10th Cir.2021Background
- Detainee Dustin Lance took a pill in jail, developed priapism (painful, persistent erection), and repeatedly sought medical help over a three-day period.
- He called the control tower and interacted with guards at various times; a nurse did not examine him until Monday, when she sent him to a local hospital; after ineffective treatment he was returned to the jail and later transported to a specialist by his father, but suffered permanent injuries (likely impotence).
- Lance sued under 42 U.S.C. § 1983, alleging Fourteenth Amendment denial of medical care against four jail guards in their individual capacities and the sheriff in his official capacity (failure to train and a policy of releasing detainees instead of transferring them to specialized care).
- The district court granted summary judgment for all defendants; the Tenth Circuit reviewed de novo.
- The Tenth Circuit affirmed summary judgment for one guard (Edward Morgan) but reversed as to three guards (Mike Smead, Dakota Morgan, Daniel Harper) and reversed the sheriff’s official-capacity summary judgment on both municipal-policy claims.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Sgt. Edward Morgan was deliberately indifferent (qualified immunity) | Lance told Morgan he had taken a pill and had an erection; Morgan should have known risk | Morgan only spoke once to Lance and received limited information; assertions about what he saw/heard are speculative | Affirmed for Morgan — no sufficient evidence he was aware of a substantial risk; qualified immunity applies |
| Whether Sgt. Mike Smead was deliberately indifferent (qualified immunity) | Lance repeatedly complained, showed his penis, reported pain; other detainees corroborated visible pain; Smead admitted dismissing it as “playing” | Smead lacked medical training and claims he could not assess urgency | Reversed — triable issue on subjective awareness and knowing disregard; qualified immunity denied |
| Whether Dakota Morgan and Daniel Harper were deliberately indifferent (qualified immunity) | Dakota manned the control tower when Lance called and could observe the dayroom; Harper delivered meal trays and Lance requested medical care then | Defendants dispute whether each guard heard or saw Lance and emphasize lack of dramatic outward symptoms | Reversed — factfinder could infer each knew of serious risk and disregarded it; qualified immunity denied |
| Whether the county (Sheriff Chris Morris) is liable under municipal-liability theories (failure to train; policy requiring release before transfer) | County failed to train non-medical staff to assess after-hours emergencies and maintained a practice of returning detainees instead of transferring to specialist care, causing delay and harm | Sheriff contends training was adequate (first aid/CPR, shadowing) and releases/transfers were decided case-by-case | Reversed — triable issues on inadequate training (deliberate indifference under failure-to-train) and on policy/practice that delayed specialist care; summary judgment improper |
Key Cases Cited
- McCowan v. Morales, 945 F.3d 1276 (10th Cir. 2019) (deliberate indifference and denial of medical care can be clearly established for lay officers)
- Olsen v. Layton Hills Mall, 312 F.3d 1304 (10th Cir. 2002) (municipal deliberate indifference where policy foreseeably causes constitutional violations)
- Sealock v. Colorado, 218 F.3d 1205 (10th Cir. 2000) (delay in treatment for serious symptoms can constitute deliberate indifference)
- Mata v. Saiz, 427 F.3d 745 (10th Cir. 2005) (subjective prong for deliberate indifference requires awareness and disregard of substantial risk)
- Al-Turki v. Robinson, 762 F.3d 1188 (10th Cir. 2014) (medical-deliberate-indifference principles applied to medical personnel)
- Farmer v. Brennan, 511 U.S. 825 (U.S. 1994) (awareness of substantial risk can be proved circumstantially where risk is obvious)
- Strain v. Regalado, 977 F.3d 984 (10th Cir. 2020) (pretrial detainees’ medical-care claims remain subject to an objective and subjective inquiry)
- Quintana v. Santa Fe Cty. Bd. of Comm’rs, 973 F.3d 1022 (10th Cir. 2020) (speculation about what a guard might have seen/heard is insufficient to survive summary judgment)
- Waller v. City & Cty. of Denver, 932 F.3d 1277 (10th Cir. 2019) (elements for municipal failure-to-train claim)
- City of Canton v. Harris, 489 U.S. 378 (U.S. 1989) (municipal liability for failure-to-train; need to show policymakers knew of an obvious training need)