938 F.3d 672
5th Cir.2019Background
- Paul Cleveland, 72, with diabetes, hypertension, rheumatoid arthritis, and peripheral artery disease, was detained and received ongoing medical care and medications.
- On Nov. 10 he fainted, was treated by Nurse Ebony White, reported dizziness and weakness, and was placed on a list to see a doctor but not sent to the hospital.
- On Nov. 11 Nurse Lillian Bell attempted a med pass; Cleveland said he was too weak and Bell told him to stop playing. Later she was told he "seemed to be sleeping" and did not re-evaluate him in person.
- In the early hours of Nov. 12 officers found Cleveland had soiled himself; they called Nurse Bell, who said she thought he was faking. Officer Camp checked periodically; at about 4:05 a.m. he found Cleveland unresponsive and without a pulse.
- Cleveland’s survivors sued under 42 U.S.C. § 1983 for denial of medical care. The district court denied qualified immunity to Nurse Bell; the Fifth Circuit reversed and granted qualified immunity.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Bell violated Cleveland's Fourteenth Amendment right by deliberate indifference to medical needs | Cleveland contends Bell knew he was weak and in distress (prior faint, reports of tiredness, soiling himself) and failed to respond | Bell argues she lacked subjective knowledge of a substantial risk, reasonably believed he was faking, and made efforts (med pass/checks) | No constitutional violation: record lacks evidence Bell subjectively knew of a life‑threatening risk |
| Whether the law was clearly established such that Bell is not entitled to qualified immunity | Plaintiffs point to circuit precedent (e.g., Fielder) allegedly giving fair notice that ignoring such signs is unconstitutional | Bell contends precedent is factually distinguishable and did not clearly establish unlawfulness of her conduct | Not clearly established: controlling precedents are distinguishable; qualified immunity applies |
Key Cases Cited
- Pearson v. Callahan, 555 U.S. 223 (qualified immunity framework)
- Ashcroft v. al‑Kidd, 563 U.S. 731 (scope of qualified immunity)
- Farmer v. Brennan, 511 U.S. 825 (deliberate indifference standard for medical needs)
- Hare v. City of Corinth, 74 F.3d 633 (applying deliberate indifference standard to pretrial detainees)
- Mullenix v. Luna, 136 S. Ct. 305 (do not define clearly established law at high level of generality)
- Fielder v. Bosshard, 590 F.2d 105 (contrast case where failure to provide care led to denial of immunity)
- Gobert v. Caldwell, 463 F.3d 339 (extensive prior treatment plus lack of culpable intent supports immunity)
- McCormick v. Stalder, 105 F.3d 1059 (not dispositive for establishing clearly established law here)
- Taylor v. Barkes, 135 S. Ct. 2042 (caution on relying on circuit precedent to deny immunity)
- Johnson v. Jones, 515 U.S. 304 (reviewing facts assumed in light most favorable to nonmoving party)