Melissa Hearring v. Karen Sliwowski, 712 F.3d 275

Six-year-old student B.H. complained of genital irritation at Mt. View Elementary; school nurse Sliwowski conducted a private visual genital examination with Back present, after B.H.’s genital concerns were reported by the school.
Parent consent was not obtained; no medical emergency was alleged.
School nurses’ and state guidelines generally require parental consent or emergency to permit genital examinations of students.
Hearring sued on behalf of B.H. under 42 U.S.C. § 1983, alleging Fourth Amendment violation; Metro was later added for failure to train.
District court denied summary judgment and held the right to be clearly established; on appeal the Sixth Circuit reversed, holding the right was not clearly established and granting qualified immunity.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether a medically motivated visual exam by a school nurse is a Fourth Amendment search	Hearring contends the examination violated the Fourth Amendment rights of her child.	Sliwowski argues the Fourth Amendment may not apply to medically provided care in this context; right not clearly established.	Not clearly established; qualified immunity applies.
Whether the right was clearly established such that qualified immunity does not apply	Hearring argues precedents show a violation in such medical examinations.	Sliwowski argues there was no clearly established precedent; reliance on out-of-circuit cases insufficient.	Right not clearly established; qualified immunity applies.

New Jersey v. T.L.O., 469 U.S. 325 (U.S. 1985) (established school-search standard under Fourth Amendment)
Safford Unified Sch. Dist. #1 v. Redding, 557 U.S. 364 (U.S. 2009) (strip searches of students; reasonableness framework in schools)
Vernonia Sch. Dist. 47J v. Acton, 515 U.S. 646 (U.S. 1995) (drug testing of student-athletes in schools)
Knisley v. Pike Cnty. Joint Vocational Sch. Dist., 604 F.3d 977 (6th Cir. 2010) (strip searches of students for stolen items; clearly established standards in school searches)
Brannum v. Overton Cnty. Sch. Bd., 516 F.3d 489 (6th Cir. 2008) (surreptitious video surveillance in school; relevance to student privacy)
Beard v. Whitmore Lake Sch. Dist., 402 F.3d 598 (6th Cir. 2005) (strip searches of students for stolen money; dignity and privacy considerations)
Peete v. Metro. Gov't of Nashville & Davidson Cnty., 486 F.3d 217 (6th Cir. 2007) (premises that medical aid by government actors may not violate the Fourth Amendment under some contexts)
Dubbs v. Head Start, Inc., 336 F.3d 1194 (10th Cir. 2003) (medical examinations of pre-school children; Fourth Amendment searchholding challenged)
al-Kidd v. Ashcroft, 131 S. Ct. 2074 (U.S. 2011) (clearly established law considerations; required precedent may not be per se)
Daugherty v. Campbell, 935 F.2d 780 (6th Cir. 1991) (out-of-circuit authorities must clearly foreshadow unconstitutional conduct)