Salter Ex Rel. Estate of Salter v. Mitchell
711 F. App'x 530
| 11th Cir. | 2017Background
- Plaintiff is the widow of William Salter, who committed suicide in Conecuh County Detention Facility on March 9, 2010, after being moved from "suicide watch" to a less-restrictive "health watch."
- Salter had a documented history of depression, prior suicide attempts, a self-inflicted stabbing, and a threatened suicide on February 25, 2010; some jail officials had general awareness of these facts.
- At booking Salter reported mental problems and prior attempts; he was placed in isolation and initially on suicide watch, then—after evaluation by Dr. Fred West—moved to health watch and resumed psychotropic and other medications.
- Health watch entailed heightened observation (checks every 15–30 minutes) and restored clothing/blanket; staff implemented measures (cell-door openings, visits by a friend/officer) and attempted probate/commitment to a psychiatric facility.
- On March 9 an officer found Salter hanging from a bedsheet in his cell; despite emergency efforts, he later died. Plaintiff sued under 42 U.S.C. § 1983 alleging deliberate indifference; three jail officials appealed denial of qualified immunity.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether defendants were deliberately indifferent to a substantial suicide risk | Salter's recent attempts (12 days earlier), ongoing symptoms, and policy violations (no mental-health face-to-face) meant officials knew of a strong likelihood of self-harm | Defendants relied on the jail physician's clinical judgment, followed health-watch protocols, and did not subjectively know of a strong likelihood of suicide | Defendants were not deliberately indifferent; reliance on physician and compliance with health-watch did not show subjective disregard |
| Whether relying on a general practitioner (Dr. West) instead of a mental-health professional violated clearly established law | Failure to obtain psychiatric consultation or inpatient commitment constituted unconstitutional inadequate psychiatric care | Reasonable to rely on an experienced jail physician who evaluated Salter, prescribed meds, and attempted commitment; failure to follow jail policy is at most negligence | Reliance on Dr. West did not constitute deliberate indifference or violate clearly established law |
| Whether the temporal proximity of a recent suicide attempt (Feb. 25) made removal from suicide watch constitutionally unreasonable | The recent attempt made suicide likely, so removal from suicide watch was constitutionally unreasonable | Officials lacked specific, personal knowledge of the February attempt (except some staff); they reasonably believed treatment and monitoring reduced risk | Proximity alone did not establish subjective knowledge of a strong likelihood of harm; not deliberate indifference |
| Whether missed or insufficient monitoring on health watch amounted to deliberate indifference | Gap in observation (discovery between 4:17–4:28 pm; EMS delay) showed failure to continuously supervise and thus deliberate indifference | Health-watch required checks every 15–30 minutes; evidence shows monitoring consistent with that protocol and not the constitutionally required constant surveillance | Periodic checks under health-watch protocol did not show deliberate indifference; constitution does not require constant monitoring |
Key Cases Cited
- Ashcroft v. al-Kidd, 563 U.S. 731 (2011) (qualified immunity protects officials unless conduct violates clearly established law)
- Farmer v. Brennan, 511 U.S. 825 (1994) (Eighth Amendment deliberate indifference requires subjective awareness of a substantial risk)
- Snow v. City of Citronelle, Ala., 420 F.3d 1262 (11th Cir. 2005) (custodian liable only when there is a strong likelihood—not mere possibility—of suicide and officials deliberately disregard it)
- Cook ex rel. Estate of Tessier v. Sheriff of Monroe County, Fla., 402 F.3d 1092 (11th Cir. 2005) (mere opportunity for suicide insufficient to impose liability)
- Jackson v. West, 787 F.3d 1345 (11th Cir. 2015) (each defendant judged on personal, subjective knowledge for deliberate-indifference inquiry)
- Greason v. Kemp, 891 F.2d 829 (11th Cir. 1990) (inadequate psychiatric care can amount to deliberate indifference where care is grossly inadequate and defendant knew it)