Rouster Ex Rel. Estate of Rouster v. County of Saginaw
2014 U.S. App. LEXIS 6491
| 6th Cir. | 2014Background
- Pretrial detainee Jerry Rouster was jailed in Saginaw County May 7–11, 2007; within ~36 hours of first complaining of abdominal pain he died of sepsis from a perforated duodenal ulcer.
- During the final 36 hours three Saginaw medical staff (RMA Cathleen Conley, LPNs Debra Marrs and Stella Menchaca) evaluated and observed Jerry, ultimately diagnosing and treating him for presumed alcohol withdrawal and mild gastrointestinal complaints; no staff member knew of his prior perforated-ulcer history.
- Staff observed bizarre behaviors (drinking from toilet, eating from floor, tremors, disorientation) and abdominal complaints (cramping, diarrhea, vomiting, guarding); they moved him to an observation cell and followed withdrawal protocols, including CIWA scoring and Librium prescribed by the on-call physician.
- Medical experts agreed the nurses provided substandard care under optimal professional standards and should have called a physician sooner, but experts were split on whether symptoms were consistent with withdrawal vs. a surgical abdomen.
- The district court granted summary judgment for the three nurses and Secure Care, finding no genuine issue that any defendant subjectively knew of and consciously disregarded a substantial risk to Jerry’s health; the court dismissed federal claims and declined supplemental jurisdiction over state malpractice/negligence claims.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether nurses were deliberately indifferent under § 1983 | Rouster: nurses knew of abdominal pain and alarming behaviors so risk was obvious and they consciously disregarded need by not summoning a physician | Nurses: they reasonably interpreted symptoms as alcohol withdrawal or minor GI issues, treated per protocols, and lacked information (prior ulcer) that would have changed their assessment | Summary judgment for Conley, Marrs, Menchaca — no sufficient evidence of subjective knowledge and deliberate indifference |
| Whether Secure Care liable for failure to train/supervise under § 1983 | Rouster: corporate defendant failed to staff and train competent medical personnel, causing constitutional deprivation | Secure Care: municipal-like liability requires an underlying constitutional violation and a policy/custom causing it | Summary judgment for Secure Care — because no constitutional violation proven, failure-to-train claim fails |
| Whether district court should retain state malpractice/negligence claims | Rouster: state-law claims can proceed with federal claims adjudicated | Defendants: federal claims resolved, so supplemental jurisdiction discretionary | District court properly declined to exercise supplemental jurisdiction; state claims dismissed without prejudice to state-court filing |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (Eighth Amendment deliberate indifference standard)
- Farmer v. Brennan, 511 U.S. 825 (subjective knowledge requirement; obvious risk inference)
- Comstock v. McCrary, 273 F.3d 693 (Sixth Cir. standard for deliberate indifference; recklessness analog)
- Blackmore v. Kalamazoo Cnty., 390 F.3d 890 (pretrial detainee Eighth/Fourteenth Amendment analysis in Sixth Circuit)
- Jones v. Muskegon Cnty., 625 F.3d 935 (misdiagnosis/medical judgment not per se Eighth Amendment violation)
- Johnson v. Karnes, 398 F.3d 868 (importance of medical history to deliberate-indifference inquiry)
- Street v. Correctional Corp. of Am., 102 F.3d 810 (private contractor liability under § 1983)