444 P.3d 1151
Utah Ct. App.2019Background
- Jana Clyde, an LPN at Duchesne County Jail, treated an inmate booked for drug charges who vomited and had diarrhea for several days and died four days after booking weighing about 87–112 lbs.
- Clyde knew withdrawal symptoms and appropriate protocol: monitor vitals, provide fluids, and contact the physician assistant (PA); she checked blood pressure once, gave oral sports drinks, and did not contact the PA after a written medical request stating “puking for 4 days straight” and inability to hold water down.
- Jail officers observed the inmate worsening, moved her to a camera-monitored holding cell for observation, and reported her condition to Clyde; video showed repeated vomiting and little fluid intake.
- The medical examiner concluded death was due to complications of dehydration in the setting of opiate withdrawal and testified severe dehydration is generally reversible up to near death with IV fluids.
- An RN testified that four days of vomiting/diarrhea is a ‘‘potentially very dangerous situation’’ and that an LPN should monitor vitals, contact the PA, possibly start IVs or send to hospital; failure to do so deviates from the standard of care.
- At the preliminary hearing the magistrate found evidence of ordinary negligence but concluded there was no direct evidence of a gross deviation required for criminal negligence and dismissed the charge; the State appealed.
Issues
| Issue | Plaintiff's Argument (State) | Defendant's Argument (Clyde) | Held |
|---|---|---|---|
| Whether evidence sufficed to bind over for negligent homicide | Evidence established probable cause that Clyde grossly deviated from care (knew protocol, largely did nothing, inmate died) | State failed to prove (a) applicable standard for an LPN, (b) severity/probability of the risk, and (c) gross deviation beyond ordinary negligence | Reversed: bind over required — evidence met low preliminary-hearing probable-cause standard |
| Applicable standard of care | Clyde’s own statements plus RN testimony provided reasonably believable evidence of standard: monitor vitals, provide fluids, contact PA, follow up | RN’s testimony not specific to LPN/jail context; medical examiner’s testimony not a standard of care | Held: sufficient evidence of applicable standard for bindover |
| Severity of risk (substantial and unjustifiable) | Dehydration from prolonged vomiting/diarrhea can be fatal; even small probability of death with severe consequence can constitute substantial risk | No evidence of the likelihood that dehydration would cause death in this case | Held: risk of death from prolonged vomiting/diarrhea and reversible nature of dehydration supports substantial and unjustifiable risk |
| Gross deviation from standard of care | Clyde’s inaction despite knowledge and reports constituted a gross deviation (wide gulf between required and provided care) | Criminal negligence requires more than ordinary negligence; State did not show gross deviation | Held: reasonable inference of gross deviation for probable-cause purposes; magistrate erred in dismissing |
Key Cases Cited
- State v. Schmidt, 356 P.3d 1204 (Utah 2015) (bindover standard: view evidence in light most favorable to prosecution; magistrate may not weigh evidence)
- State v. Ramirez, 289 P.3d 444 (Utah 2012) (bindover requires reasonably believable evidence sufficient to sustain each element)
- State v. Warden, 813 P.2d 1146 (Utah 1991) (distinguishes ordinary negligence from criminal negligence; jury decides criminal-negligence standard)