Melisa Richmond v. Rubab Huq
885 F.3d 928
| 6th Cir. | 2018Background
- Richmond was jailed in Wayne County from Dec 26, 2012 to Feb 13, 2013 after a self-inflicted chest burn; hospital had prescribed twice-daily silvadene and follow-up care.
- Jail clinicians prescribed once-daily dressing changes and pain medication (Lortab), but records show numerous missed dressing changes and missed/late doses.
- Richmond repeatedly filed kites (grievances) noting missed dressing changes, old/dirty dressings, fear of infection, and lack of psychiatric meds.
- Jail mental-health staff diagnosed bipolar disorder and scheduled psychiatric follow-up 17 days after intake; Richmond did not receive her prior outpatient meds (Prozac, Xanax) during that period.
- After release Richmond required a skin graft for portions of the wound that failed to heal; she also alleges suffering from interruption of psychiatric treatment.
- District court granted summary judgment for most defendants; Sixth Circuit reversed in part and affirmed in part, identifying genuine disputes of material fact on deliberate-indifference and municipal-liability claims and addressing qualified immunity.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Deliberate indifference to serious physical-medical needs (burn care/dressing changes) | Richmond: Jail staff repeatedly failed to implement prescribed dressing changes and medication, causing needless pain and delayed healing. | Defs: Disagreement over adequacy of care; medical judgments are entitled to deference; wound ultimately healed so no constitutional violation. | Court: Triable issues exist as to several defendants (Dr. Clafton, nurses Hawk, Shoulders, Lonberger, MA Allen) — summary judgment improper for those defendants. |
| Deliberate indifference to psychiatric needs (failure to provide outpatient meds on intake) | Richmond: Psychiatric social workers and nurses knew she took Prozac/Xanax and scheduled delayed psychiatrist visit rather than provide meds, causing unnecessary risk/suffering. | Defs: Social workers cannot prescribe; outpatient placement and waiting for psychiatrist was medically reasonable; inpatient option existed if condition worsened. | Court: Genuine issues permit trial as to social worker Myftari and certain nurses (Fowler, Hawk); summary judgment affirmed for Rucker and others who acted reasonably. |
| Intentional infliction of unnecessary pain during wound care | Richmond: Nurse Lonberger scrubbed wound aggressively causing unnecessary pain. | Defs: Some pain is expected when cleaning burns; this is a medical judgment. | Court: Fact question on whether scrubbing was intentional and wanton; summary judgment denied as to Lonberger. |
| Municipal liability under Monell for psychiatric-medication policy/custom | Richmond: Jail custom of relying on social-workers (not prescribers) and delaying verification of outside meds caused constitutional violations. | Wayne County: No policy caused constitutional harm; isolated mistakes not municipal custom. | Court: Material factual disputes exist about practice/custom and causation; summary judgment for county reversed. |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (Eighth Amendment deliberate indifference to medical needs)
- Farmer v. Brennan, 511 U.S. 825 (subjective deliberate-indifference standard)
- Comstock v. McCrary, 273 F.3d 693 (Sixth Circuit: psychiatric needs constitute serious medical needs)
- Boretti v. Wiscomb, 930 F.2d 1150 (deliberate indifference where prescribed care was interrupted)
- Blackmore v. Kalamazoo Cty., 390 F.3d 890 (objectively serious medical needs standard)
- Monell v. Dept. of Soc. Servs., 436 U.S. 658 (municipal liability under § 1983)
- Connick v. Thompson, 563 U.S. 51 (municipal liability requires policy or custom causation)
- Pearson v. Callahan, 555 U.S. 223 (qualified immunity two-step analysis)