Sanchez v. Oliver, 995 F.3d 461

Pretrial detainee Eli Gauna, Jr. screened positive for suicide risk at Bell County jail intake and was placed on 15‑minute checks pending mental‑health evaluation.
CHC (Correctional Healthcare Companies, a large for‑profit contractor) employed licensed clinical social worker Natalee Oliver to evaluate detainees; Oliver met with Gauna the day of intake.
Gauna reported extensive suicidality (multiple prior attempts, recent self‑harm and auditory hallucinations), asked to be placed in the infirmary, but Oliver removed him from suicide watch and placed him in general population while advising follow‑up; two days later he died by suicide.
Gauna’s mother sued under 42 U.S.C. § 1983 alleging violation of the Fourteenth Amendment right of pretrial detainees to protection from a known suicide risk; the district court granted summary judgment for Oliver on qualified immunity and lack of deliberate indifference.
The Fifth Circuit reversed and remanded: (1) employees of large private firms systematically organized to perform a major administrative governmental task (like CHC) are categorically ineligible for qualified immunity, and (2) Sanchez produced enough evidence to create a genuine fact dispute that Oliver was subjectively aware of Gauna’s suicide risk and acted with deliberate indifference.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether a private mental‑health provider employed by a large, for‑profit correctional health company may assert qualified immunity	CHC employee not entitled to qualified immunity because CHC is a large, systematically organized, for‑profit contractor performing a major administrative government task	Oliver asserted qualified immunity as an official acting under color of state law and relied on precedent where private providers were protected	Held: Not eligible. Extending qualified immunity to employees of firms like CHC is inconsistent with common‑law history and the purposes of qualified immunity (preventing unwarranted timidity, recruiting talent, avoiding distraction)
Whether Oliver was deliberately indifferent to Gauna’s serious medical needs (entitling her to summary judgment)	Sufficient evidence (intake screening, Gauna’s statements of ongoing ideation and multiple prior attempts, recent self‑harm/hallucinations, request for infirmary, improper/unclear C‑SSRS use) permits a jury to infer Oliver subjectively knew the risk and ignored it	Oliver contended she administered the C‑SSRS, concluded no suicidal intent "at the moment," and her diagnosis was a reasonable medical judgment (mere misdiagnosis or negligence)	Held: Reversed summary judgment. The evidence raises a genuine dispute of material fact whether Oliver subjectively knew of a substantial suicide risk and responded with deliberate indifference

Filarsky v. Delia, 566 U.S. 377 (2012) (private individuals temporarily performing government functions may sometimes receive immunity, but distinction from systematic private contractors)
Richardson v. McKnight, 521 U.S. 399 (1997) (private firms systematically performing major government tasks are not entitled to the same immunities as public employees)
Perniciaro v. Lea, 901 F.3d 241 (5th Cir. 2018) (distinguishing independent private providers eligible for qualified immunity from large contracted firms)
Tanner v. McMurray, 989 F.3d 860 (10th Cir. 2021) (private correctional‑health contractor employees ineligible for qualified immunity)
Converse v. City of Kemah, 961 F.3d 771 (5th Cir. 2020) (pretrial detainees have Fourteenth Amendment right to protection from known suicide risk; deliberate indifference standard)
Farmer v. Brennan, 511 U.S. 825 (1994) (deliberate indifference analogous to recklessness; subjective knowledge requirement)
Hare v. City of Corinth, 74 F.3d 633 (5th Cir. 1996) (Hare II) (constitutional liability for episodic acts measured by subjective deliberate indifference)
Domino v. Texas Dep't of Criminal Justice, 239 F.3d 752 (5th Cir. 2001) (incorrect medical diagnosis alone does not establish deliberate indifference)
West v. Atkins, 487 U.S. 42 (1988) (private medical professionals providing services on behalf of government may act under color of state law)