871 F.3d 1272
11th Cir.2017Background
- Nam Dang, a pretrial detainee, experienced headaches and neck pain after an alleged forceful arrest; he was later diagnosed with meningitis after neurological decline in February 2012 and suffered permanent injuries from strokes.
- Dang received multiple encounters with jail medical staff (LPNs Wilt, Preston‑Mayle, Scott, Roberts, Densmore) and Dr. Ogunsanwo; treatments included Motrin, muscle rub, Robaxin, observation, and eventual referral to ER.
- Medical staff documented intermittent fever, altered behavior, drooling, incontinence, and unsteady gait; providers both observed and referred him for further evaluation at different points.
- Dang sued under 42 U.S.C. § 1983 alleging inadequate medical care (Fourteenth Amendment as a pretrial detainee) against the health care providers and Sheriff Eslinger (supervisory liability).
- The district court granted summary judgment for all defendants; the Eleventh Circuit affirmed, concluding no constitutional violation and that qualified immunity applied to the individual providers and no basis for supervisor liability.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Were defendants entitled to qualified immunity (acted within discretionary authority)? | LPNs exceeded scope or lacked authority to make medical decisions. | All medical staff acted within duties and authority performing inmate care. | Held: All defendants acted within discretionary authority; qualified immunity threshold met. |
| Did defendants violate detainee’s constitutional right to medical care (deliberate indifference)? | Dang: providers ignored signs of meningitis, delayed or provided inadequate care causing harm. | Defendants: assessed, treated, observed, and referred appropriately; at most negligence, not deliberate indifference. | Held: Even assuming a serious medical need, evidence shows no deliberate indifference; qualified immunity applies. |
| Were specific actions by individual providers constitutionally deficient? | Alleged failures: missed vitals, misdiagnosis, failure to follow protocols, delayed transport. | Each provider performed reasonable assessments, administered meds, monitored, or referred to physician/ER. | Held: For Wilt, Preston‑Mayle, Scott, Roberts, Densmore, and Ogunsanwo, care was not so grossly inadequate as to shock the conscience. |
| Is there supervisor liability for Sheriff Eslinger? | Sheriff’s policies/customs caused inadequate care and harms. | No constitutional deprivation by subordinates; no basis for supervisory § 1983 liability. | Held: Because no underlying constitutional violation, supervisor liability fails; summary judgment affirmed. |
Key Cases Cited
- Harlow v. Fitzgerald, 457 U.S. 800 (qualified immunity protects officials unless clearly established rights violated)
- Conn v. Gabbert, 526 U.S. 286 (two‑step qualified immunity inquiry: constitutional violation then clearly established law)
- Goebert v. Lee Cty., 510 F.3d 1312 (standards for pretrial detainee medical care claims)
- Farmer v. Brennan, 511 U.S. 825 (deliberate indifference standard; subjective knowledge)
- Kingsley v. Hendrickson, 135 S. Ct. 2466 (noted by court; involved excessive‑force standard for pretrial detainees)
- Harris v. Coweta Cty., 21 F.3d 388 (delay in treatment can constitute constitutional violation but depends on facts)
- Rogers v. Evans, 792 F.2d 1052 (medical care violates Constitution only if it shocks the conscience)
- McElligott v. Foley, 182 F.3d 1248 (subjective knowledge and deliberate indifference elements)