Lloyd Johnson v. Karen Rimmer
936 F.3d 695
7th Cir.2019Background
- Plaintiff Lloyd Johnson, diagnosed with serious psychiatric disorders, self-mutilated while under care at the Milwaukee County Medical Health Complex (MHC) after being transferred there following a March 3 self-injury and a brief prior February admission.
- On March 8–16 Johnson was in the ITU, placed on 1:1 observation; Dr. David Macherey (psychologist/treatment director) and Dr. Thomas Harding assessed improvement and removed him from 1:1 on March 16; routine 15-minute nursing checks then applied.
- On March 18 Johnson presented to staff with his penis severed; he claimed he found bandage scissors in his bathroom; investigation could not identify who (if anyone) left scissors there.
- Johnson sued under 42 U.S.C. § 1983 claiming (1) inadequate medical care (substantive due process) for removal from 1:1 observation, (2) Monell liability for institutional policies, and (3) conspiracy and state-created danger based on access to scissors; also asserted state-law claims.
- District court granted summary judgment for defendants on federal claims; declined supplemental jurisdiction over state claims. On appeal Johnson challenged only rulings as to Dr. Macherey and Nurse Ade George.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether removal from 1:1 observation violated substantive due process | Johnson: removal was deliberately indifferent/constituted a substantial departure from professional judgment given his ongoing risk | Macherey: removal was a reasonable exercise of professional judgment based on documented improvement and team concurrence | Court: Affirmed for Macherey — reasonable clinicians could remove 1:1; no constitutional violation (at most negligence) |
| Whether leaving scissors (or otherwise enabling access) violated substantive due process / state-created danger | Johnson: a nurse (arguably George) left bandage scissors in bathroom, affirmatively creating danger | George: no evidence ties her to scissors; multiple plausible sources; inadvertence is insufficient for § 1983 | Court: Affirmed for George — plaintiff failed to show personal involvement or sufficient evidence that George left scissors |
| Whether institutional policies (Monell) or conspiracy support § 1983 liability | Johnson: MHC customs/procedures and cover-up caused injury | Defendants: no underlying constitutional violation and no proof of unconstitutional policy or conspiracy | Court: District court dismissed these claims; not challenged on appeal beyond individual liability issues |
| Whether voluntary admission negates due process protections | Johnson: argued special-relationship and state-created danger exceptions apply | Defendants: voluntary admission limits Youngberg-based duties | Court: Did not decide voluntariness; ruled that even if duties existed, plaintiffs failed to show constitutional violations |
Key Cases Cited
- DeShaney v. Winnebago Cty. Dep’t of Soc. Servs., 489 U.S. 189 (1989) (general rule that Due Process Clause does not impose affirmative duty to protect from private harms; limited exceptions)
- Youngberg v. Romeo, 457 U.S. 307 (1982) (professional-judgment standard for care of involuntarily committed persons)
- Monell v. Dep’t of Soc. Servs., 436 U.S. 658 (1978) (municipal liability requires unconstitutional policy or custom)
- Collignon v. Milwaukee Cty., 163 F.3d 982 (7th Cir. 1998) (applying Youngberg standard; requirements for showing inadequate medical care)
- King ex rel. King v. E. St. Louis Sch. Dist. 189, 496 F.3d 812 (7th Cir. 2007) (three-part state-created danger framework)
- Jackson v. Indian Prairie Sch. Dist. 204, 653 F.3d 647 (7th Cir. 2011) (conduct must shock the conscience; negligence insufficient)
- Petties v. Carter, 836 F.3d 722 (7th Cir. 2016) (disagreed medical judgments among professionals do not, by themselves, create constitutional violations)