03-3075 | 3rd Cir. | Jun 10, 2004

LAY, Circuit Judge. August 1, 1999, states that A.M . was hit

on the back of the head with a ping-pong A.M ., by and through his next paddle thrown by another resident. friend and mother, J.M.K., filed suit under Another incident report, dated August 2, 1999, relates that A.M. sustained a wound 42 U.S.C. § 1983 and state tort law against the Luzerne County Juvenile Detention to his chest. The wound would not stop Center (the “Center”) and several of its bleeding, and A.M. was taken to the administrators and staff, alleging they hospital for treatment. Other incident violated his substantive due process rights reports were completed by the Center’s child-care workers on an almost daily basis by failing to protect him from harm while he was detained at the Center. The District between August 2 and August 16, 1999. Court granted summary judgment in favor These reports reveal that other residents punched A.M. in the face, hit him, choked of all Defendants and declined to exercise supplemental jurisdiction over the him, “whipped” him in the eye with a remaining state law claims. A.M. appeals. towel, and threatened him with physical harm. The assaults left A.M. with multiple For the reasons that follow, the District Court’s order granting summary judgment bruises over his body, puncture wounds, will be reversed in part and affirmed in black eyes, and swollen lips. The assaults part. also caused A.M . to suffer humiliation, Dr. Gitlin’s diagnosis of A.M. included a fear, and emotional distress. Global Assessment Functioning scale of

20-30 out of a possible 100, indicating Prior to his detention, A.M. had behavior that is “considerably influenced eleven prior psychiatric inpatient by delusions or hallucinations or serious hospitalizations for behavior problems, impairment in communication or judgment was seeing a psychiatrist in the . . . or inability to function in almost all community, and had been taking areas.” Diagnostic and Statistical Manual medication to treat his Attention Deficit of Mental Disorders 32 (4th ed. 2000). Dr. Hyperactivity Disorder (“ADHD”). A.M. Gitlin stated that it was medically suffered from several other mental and necessary for A.M. to have a highly behavioral disabilities, including anxiety planned day, 7 days a week, 365 days a disorder, depressive disorder, atypical year, and for A.M. to receive medication bipolar disorder, and intermittent explosive on a continual basis in order to reduce his disorder. The Center’s administrators and impulsiveness and motor restlessness. Dr. supervisors were made aware of these Gitlin entered an order for A.M. to receive facts upon A.M.’s admission to the Center the medication dexedrine, and A.M. began or shortly thereafter. A.M.’s mental and receiving the medication on July 24, 1999. behavioral problems were reflected in his After Dr. Gitlin’s evaluation of A.M., and behavior at the Center, which included during the remainder of his detention, no teasing and provoking other residents. mental health professional was called in to After A.M.’s admission to the Center, he see A.M. or consult with the Center’s staff initially did not receive any medication for about A.M.’s behavior, despite the his ADHD because the Center could not ongoing difficulty child-care workers were obtain the necessary authorization to refill having with him. his prescription.

During A.M.’s detention, the On July 23, 1999, a psychiatric Center’s administrators directed that A.M. evaluation was performed on A.M. by Dr. should be placed on the girls’ side of the Paul Gitlin for the purpose of assessing Center for a majority of the day. However, A.M.’s current mental health treatment child-care workers periodically failed to needs. During the evaluation, A.M . abide by this directive, which resulted in complained to Dr. Gitlin about the A.M. being placed with boys who had treatment he was subjected to by other previously assaulted him. On one residents, and Dr. Gitlin observed that occasion, A.M. was sent from the girls’ A.M. had a bruise on his arm. Dr. Gitlin side to the boys’ side because he was noted that A.M. had a long history of “getting on the nerves” of a child-care mental health and behavioral problems and worker on the girls’ side. that A.M . was having difficulty at the Center because of his untreated ADHD.

On August 19, 1999, A.M. other children at Northwestern. appeared in the Luzerne County Court of Common Pleas, Juvenile Division, for a In July of 2001, A.M., by and disposition hearing. At the conclusion of through his next friend and mother, the hearing, the court committed A.M. to commenced a § 1983 and state tort action Northwestern Intermediate Treatment against the Center and the following F a c i l i t y ( “ N o r t h w e s t e r n ” ) i n administrators and staff: Sandra Brulo, the Northumberland County, Pennsylvania, for Center’s chief juvenile probation officer, an indeterminate period of time. who acted as the Center’s chief

administrator; Louis Kwarcinski, the On the day of his admission to Center’s depu ty chief of juvenile Northwestern, John DeAngelo, a counselor probation; Jerome Prawdzik, the detention at Northwestern, saw that A.M. was supervisor at the Center; Chris Traver, bleeding from a puncture wound on his Michael Considine, and Chris Parker, chest. When DeAngelo asked A.M. about former child-care workers at the Center; the wound, A.M. told him that he had been Elaine Yozviak, a former registered nurse stabbed with an unknown object while at at the Center; and Mark Puffenberger, the Center. A.M. went on to describe to M.D., a physician who provided contract DeAngelo other physical assaults visited services to the Center. The suit alleged upon him by residents of the Center. that the Defendants violated A.M.’s DeAngelo proceeded to complete an substantive due process rights under the incident report concerning the alleged Fourteenth Amendment to be free from physical assaults. DeAngelo reported that harm and to receive appropriate medical A.M. told him staff at the Center knew treatment while in their custody. about the assaults but did not do anything to stop them . In addition to the incident report, DeAngelo completed a Report of II. DISTRICT COURT OPINION Suspected Child Abuse, dated August 26, 1999, in which he recounted A.M.’s After discovery, the Defendants allegations of abuse while at the Center moved for summary judgment. The and inaction by the Center’s staff. The District Court granted the Defendants’ Report states that A.M. feared this type of motion on June 30, 2003. In its abuse would continue at each of his future Memorandum accompanying the order placements. DeAngelo and another granting summary judgment, the District member of the Northwestern staff Court addressed each of A.M.’s claims observed that A.M.’s eyes were black and against the Defendants. blue when he arrived at Northwestern and that A.M. appeared to be very scared. Count One. Count One of A.M.’s Northwestern staff indicated that A.M. complaint alleged that the Center and expressed fear that he would be hurt by Brulo and Kwarcinski, in their official capacities, were liable for failing to protect The District Court granted summary A.M. from harm and failing to treat him, judgment in favor of Dr. Puffenberger on and that Dr. Puffenberger was liable in his A.M.’s claims that Dr. Puffenberger failed official capacity for failing to treat A.M . to develop adequate medical policies for

the Center. The District Court assumed, A.M. alleged several deficiencies for purposes of summary judgment, that on the part of the Center, Brulo, and Dr. Puffenberger was responsible for Kwarcinski as the basis for liability on developing such policies. However, the Count One. The first allegation concerned District Court held that summary judgment deficient hiring and staffing practices. The was appropriate because there was no District Court granted summary judgment direct causal connection between A.M.’s in favor of Brulo and Kwarcinski on this injuries and the allegedly deficient medical allegation, after concluding that A.M. policies. failed to show a direct causal link between A.M.’s injuries and the alleged hiring of Count Two . Count Two alleged e m ployees without the requisite that Brulo, Kwarcinski, and Prawdzik were educational degree or the alleged liable in their individual capacities for understaffing of the Center. The second failing to protect A.M. from harm and allegation concerned inadequate training failing to treat him. The claims against of the Center’s staff. The District Court Brulo, Kwarcinski, and Prawdzik in Count granted summary judgment on this Two were based on their failure to develop allegation because A.M. failed to present policies and their failure to adequately eviden ce f r o m w h i c h d e l ib e r ate supervise the Center’s child-care workers. indifference could be inferred. The third Because the District Court found that no allegation concerned the lack of a written child-care workers under the supervision policy or protocol to ensure youth safety. of these Defendants violated A.M.’s The District Court granted summary constitutional rights, it granted summary judgment to Brulo and Kwarcinski on this judgment in favor of Brulo, Kwarcinski, allegation because there was no direct and Prawdzik in their individual causal link between the lack of a policy capacities. and A.M.’s alleged injuries. The final allegation concerned the lack of policies Count Three . Count Three alleged and procedures to address the mental and that Prawdzik, Traver, Parker, and physical health needs of residents. On this Considine were liable, in their individual allegation, the District Court held that capacities, for failing to protect A.M. from there was no evidence to suggest that the harm. A.M.’s claims against Prawdzik, Defendants’ actions were deliberately Considine, Traver, and Parker were based indifferent. on allegations that the child-care staff

failed to intervene soon enough when violence between A.M. and other residents

began to develop and failed to take A.M . viewing “the underlying facts and all for medical care. reasonable inferences therefrom in the

light most favorable to the party opposing Regarding A.M.’s claims that the the motion.” Pa. Coal Ass’n v. Babbitt, 63 child-care staff did not intervene soon F.3d 231, 236 (3d Cir. 1995). Summary enough, the District Court compared the judgment is appropriately granted where situation to a prison disturbance and there is no genuine issue as to any material considered whether the staff acted fact and the moving party is entitled to “maliciously and sadistically to cause judgment as a matter of law. Fed. R. Civ. harm.” See Fuentes v. Wagner, 206 F.3d P. 56(c). However, summary judgment 335, 345 (3d Cir. 2000). In the District should not be granted where there is a Court’s view, there was no evidence that “genuine” dispute about a material fact, the staff acted maliciously or sadistically. “that is, if the evidence is such that a With regard to the alleged failure of the reasonable jury could return a verdict for staff to take A.M. to the nurse on certain the nonmoving party.” Anderson v. occasions, the District Court held that the Liberty Lobby, Inc., 477 U.S. 242, 248 evidence did not support a conclusion that (1986). this was done with deliberate indifference to a serious medical need of A.M ., since he B. Substantive Due Process sustained mostly bruises from the altercations. In order to maintain a § 1983 claim,

“a plaintiff must show that the defendant Count Four . Count Four alleged deprived him of a right or privilege that Dr. Puffenberger and Yozviak were secured by the Constitution or laws of the liable in their individual capacities for United States while acting under color of failing to treat A.M. The District Court state law.” Williams v. Borough of West granted summary judgment in favor of Dr. Chester, Pa., 891 F.2d 458, 464 (3d Cir. Puffenberger and Yozviak, concluding that 1989). Analysis of a § 1983 claim begins any omissions by Yozviak did not amount by identifying the “exact contours of the to a wanton infliction of pain and the underlying right said to have been evidence against Dr. Puffenberger violated” and then determining “whether suggested, at most, negligence. the plaintiff has alleged a deprivation of a

constitutional right at all.” Nicini v. Morra, 212 F.3d 798" date_filed="2000-05-19" court="3rd Cir." case_name="Nicini v. Morra">212 F.3d 798, 806 (3d Cir. 2000);

III. DISCUSSION County of Sacramento v. Lewis, 523 U.S. 833, 841 n.5 (1998). A. Standard of Review There appears to be no dispute We review the District Court’s between the parties that A.M. has a liberty grant of summary judgment de novo , interest in his personal security and well- being, which is protected by the presents a situation where “forethought Fourteenth Amendment. See Youngberg about [a resident’s] welfare is not only v. Romeo, 457 U.S. 307, 315-19 (1982). feasible but obligatory.” Id. We therefore The question thus becomes whether A.M. conclude that this case is properly has adduced sufficient facts from which a analyzed using the deliberate indifference reasonable jury could conclude that the standard. The circumstances of this case Defendan ts’ conduct constituted a present a situation where the persons violation of his constitutional rights. To responsible for A.M. during his detention answer this question, we must “determine at the Center had time to deliberate what level of conduct is egregious enough concerning his welfare. See Leamer v. to amount to a constitutional violation and Fauver, 288 F.3d 532" date_filed="2002-04-19" court="3rd Cir." case_name="None">288 F.3d 532, 547 (3d Cir. 2002). . . . whether there is sufficient evidence We now turn to the claims against each of that [the Defendants’] conduct rose to that the Defendants. level.” Nicini, 212 F.3d 798" date_filed="2000-05-19" court="3rd Cir." case_name="Nicini v. Morra">212 F.3d at 809.

1. Claims Against Yozviak When executive action is at issue, a and Dr. Puffenberger violation of the Fourteenth Amendment right to substantive due process may be As to the claims in Count One and shown by conduct that “shocks the Count Four against Dr. Puffenberger and conscience.” Lewis, 523 U.S. at 846-47. Yozviak, we sustain the District Court’s Negligent conduct is never egregious grant of summary judgment in their favor. enough to shock the conscience, but We find no error in the District Court’s conduct intended to injure most likely will grant of summary judgment in favor of rise to the level of conscience-shocking. Yozviak on A.M.’s claim that she is liable See id. at 849. In between these two for failing to treat him. Like the District extremes is a middle range of conduct Court, we find no evidence in the record to known as deliberate indifference, which support A.M.’s claims that Yozviak acted may rise to the level of conscience- with deliberate indifference in her alleged shocking in certain circumstances. Id. at failure to disseminate information to the 849-50. The question of whether conduct Center’s staff about A.M.’s mental health amounting to deliberate indifference is history or take other steps in response to sufficient to “shock the conscience” the information. requires an “exact analysis of [the] circumstances” in a given case. Id. at 850. Likewise, we find no error in the

District Court’s grant of summary The deliberate indifference standard judgment in favor of Dr. Puffenberger. “is sensibly employed only when actual The evidence reveals that Dr. Puffenberger deliberation is practical.” Id. at 851. As in is a general physician who was under a prison setting, we believe the custodial contract with the Center to perform a setting of a juvenile detention center medical evaluation of each resident, including a physical examination, within constitutional violation. Bd. of County forty-eight hours of admission. Dr. Comm’rs of Bryan County, Okla. v. Puffenberger saw A.M. on only one Brown, 520 U.S. 397, 403 (1997). A occasion when he conducted the physical plaintiff can establish causation by examination, and the record does not “demonstrat[ing] that the municipal action include any evidence that Dr. Puffenberger was taken with ‘deliberate indifference’ as was asked, or required, to conduct a to its known or obvious consequences.” psychiatric evaluation of A.M. Even if we Id. at 407. assume for the purposes of summary judgment that Dr. Puffenberger had some A.M. has identified the following responsibility for formulating policies for policies or customs of the Center as the Center, our review of the record leads providing a basis for liability: (1) deficient us to the conclusion that A.M. failed to hiring and staffing policies and practices; present sufficient facts that any failure of (2) lack of an adequate training program Dr. Puffenberger with respect to his duties for the Center’s child-care workers in rose to the level of deliberate indifference. critical areas such as de-escalating

conflicts between youths and managing 2. Claims Against the Center and youth behavior generally; (3) lack of Brulo and Kwarcinski in established protocols to ensure youth Their Official Capacities safety, including the management of

problematic youth behavior, de-escalation A.M. asserts claims against Brulo of conflicts, and identification and and Kwarcinski in their official capacities, protection of children at risk of based on their status as policymakers for victimization; and (4) lack of established the Center, and the Center itself. A suit policies to address the mental and physical against a governmental official in his or health needs of youth residents. her official capacity is treated as a suit against the governmental entity itself. See The District Court did not focus on Hafer v. Melo, 502 U.S. 21" date_filed="1991-11-05" court="SCOTUS" case_name="Hafer v. Melo">502 U.S. 21, 25 (1991). A whether A.M. had produced evidence of governmental entity, like the Center, the existence of the alleged policies or cannot be liable under a theory of customs. Instead, the District Court respondeat superior or vicarious liability. directed its analysis to whether there was a See Monell v. New York Dep’t of Social direct causal link between the alleged Servs., 436 U.S. 658, 691-92 (1978). policies or customs and the harms suffered Rather, in order for a governmental entity by A.M . See Kneipp v. Tedder, 95 F.3d ( g e n e r i c a l l y r e f e r re d t o a s a 1199, 1213 (3d Cir. 1996) (stating a “municipality”) to be liable for the § 1983 plaintiff must “establish that the violation of a constitutional right under government policy or custom was the § 1983, the plaintiff must identify a policy prox imate cause of the inju ries or custom of the entity that caused the sustained”). In the District Court’s view, evidence of a causal connection was the residents was inadequate. Christopher lacking. Our review of the record leads us Traver testified that he had to supervise as to hold there exist sufficient facts to many as ten residents at one time, and he prevent the grant of summary judgment submitted a resignation letter in which he such that a jury should make the ultimate complained that only one child-care determination as to the violation of the worker would be left with the residents alleged policies or customs, as we discuss while he would be directed to complete more fully below. Once evidentiary proof tasks unrelated to supervising the is adduced, the issue of proximate cause is residents, such as cleaning and other best left to the determination of a trier of janitorial-type duties. fact. See id.

There is also evidence in the record Deficient Hiring and Staffing that the Center was having problems with the supervision of residents by child-care A.M. presented evidence that a workers at or around the time A.M. was a number of the Center’s child-care workers resident. For example, there are letters of did not meet state standards for r e p r i m a n d f r o m t h e C e n t e r ’ s educational training. Under state law, the administrators to individual child-care Center’s child-care workers had to workers, rebuking those workers for possess, at a minimum, either an Associate failing to adequately supervise the Degree in one of the social sciences or residents and failing to follow certain exceptional ability in lieu of the academic security measures. credentials. 55 Pa. Code § 3760.55(b). Employment applications produced for The above evidence is at least certain child-care workers reveal that these sufficient to create a fact issue as to workers did not possess the requisite whether the Center had a policy or custom educational degree and there is no of deficient hiring and staffing. In evidence that they had the credentials that addition to this evidence, A.M. submitted would render them otherwise qualified for the unrebutted testimony of a corrections the job. expert, Paul DeMuro, who opined that the

problems with inadequate supervision of More significantly, A.M. presented residents directly contributed to the evidence from which it may be inferred abusive treatment A.M. endured at the that the Center failed to ensure that there Center. The District Court did not discuss were enough child-care workers on duty to this evidence, but we believe the evidence appropriately supervise youth at all times. provides a causal link between the hiring Although Brulo testified in her deposition and staffing policies and A.M .’s injuries. that the Center complied with staffing As long as the causal link between the ratios, other evidence suggests that the alleged policy or custom and the number of child-care workers supervising constitutional injury is “not too tenuous, the question whether the municipal policy violation of constitutional rights, that the or custom proximately caused the policymakers of the city can reasonably be constitutional infringement should be left said to have been deliberately indifferent to the jury.” Bielevicz v. Dubinon, 915 to the need.”). The deficiency of a F.2d 845, 851 (3d Cir. 1990). Based on municipality’s training program must be this standard, we conclude the evidence of closely related to the plaintiff’s ultimate the causal connection between these injuries. Id. at 391. policies and A.M.’s injuries presented a jury question. The record discloses the following

with respect to the training of the Center’s Inadequate Training child-care workers. Child-care workers received a three-day orientation after they Analysis of substantive due process were hired, which essentially involved on- claims requires full consideration of all the the-job training with respect to such issues circumstances of a given case. See Lewis, as the Center’s physical plant and fire 523 U.S. at 850. Therefore, the evidence safety. Brulo testified that the orientation of deficient hiring and staffing policies included training on dealing with must be considered in context with the behavioral issues, but she did not identify evidence A.M. submitted concerning the any specific training in this area. Brulo lack of an adequate training program for also spoke generally about training in the the Center’s child-care workers. A.M. areas of mental health and dealing with contends the Center failed to train its children, but she failed to describe with child-care workers with respect to de- any specificity the training program for escalating conflicts between youth, child-care workers. managing youth behavior generally, dealing with sex offenders, and identifying Kwarcinski testified that the entire and protecting youth in the population who staff of the Center received training on would be easily victimized. dealing with physical threats to their own

safety and threats from bombs or weapons. A municipality may be liable for Although Kwarcinski testified that staff failing to train its employees if that failure received training on defensive tactics in amounts to deliberate indifference. See dealing with conflicts between residents, City of Canton v. Harris, 489 U.S. 378, he stated that there was no training on how 389-90 (1989) (explaining that failure to to de-escalate conflicts between youths or train may amount to a policy or custom identify children that could be easily that is actionable under § 1983 when “in victimized by other residents in the Center. light of the duties assigned to specific Other testimony indicates that child-care officers or employees[,] the need for more workers received training in CPR and first or different training is so obvious, and the aid but did not receive training in de- inadequacy so likely to result in the escalating youth conflicts or identifying and protecting youths that could be easily County, 520 U.S. at 409-10 (“[A] high victimized. degree of predictability may also support

Against this evidence, A.M. an inference of causation -- that the presented the unrebutted testimony of his municipality’s indifference led directly to corrections expert, DeMuro. DeM uro the very consequence that was so opined that the Center did not have an predictable.”). adequate training program for its staff and did not meet nationally recognized In our view, the evidence supports standards for training, which included an inference that the potential for conflict having forty hours of pre-service training. between residents of the Center was high. In DeMuro’s opinion, the Center’s failure Taken as a whole, we believe the evidence to train its staff and follow other concerning the Center’s failure to train its recognized standards for the operation of child-care workers in areas that would juvenile detention facilities directly reduce the risk of a resident being deprived contributed to the inappropriate treatment of his constitutional right to security and of A.M. while he was detained. well-being was sufficient to prevent the

grant of summary judgment. In other The Center suggests that the words, we cannot hold that the Center numerous incident reports filed by child- “was not deliberately indifferent to the risk care workers demonstrate that A.M.’s as a matter of law.” Berg v. County of failure-to-train claim cannot be sustained. Allegheny, 219 F.3d 261, 277 (3d Cir. However, we fail to see the logic in this 2000). Viewing the record in the light argument. Rather than support the most favorable to A.M., we conclude the Center’s position, we see how a jury could evidence concerning the Center’s training view the incident reports as additional program presents a genuine issue of evidence of the lack of training for the material fact as to the sufficiency of that child-care workers. Several of the incident program and whether the inadequacies in reports indicate that child-care workers the program bear a causal relationship to watched conflicts between A.M. and other A.M.’s injuries. residents escalate without intervening, resulting in physical injury to A.M. Lack of Policies to Ensure Youth Safety Viewing the incident reports in the light most favorable to A.M., they demonstrate On appeal, A.M. argues he the need for more or different training of presented sufficient evidence from which child-care workers to deal with residents a reasonable jury could infer that the like A.M., who have significant behavioral Center’s lack of established policies and and mental health problems. The incident procedures to ensure youth safety may reports also support an inference that have caused his injuries “at least in part.” recurrent harm to A.M. at the hands of Bielevicz, 915 F.2d at 851. In this regard, other residents was predictable. See Bryan A.M. focuses primarily on the Center’s lack of a written policy or procedure for question on whether the Center’s failure to reviewing and following up on incident establish a written policy and procedure reports. for reviewing and following up on incident

reports amounts to deliberate indifference, There is contradictory testimony in we conclude that a reasonable jury could the record regarding who was responsible conclude from the evidence that by failing for reviewing incident reports and deciding to establish such a policy the Center what course of action should be taken in disregarded an obvious consequence of its response. Brulo and Kwarcinski believed action, namely, that residents of the Center Jerome Prawdzik was responsible for could be at risk if information gleaned reviewing all incident reports in the first from the incident reports was not reviewed instance, investigating them, and giving and acted upon. Similarly, a reasonable feedback to the child-care workers. jury could infer that the failure to establish However, Prawdzik testified that incident the policy was causally related to the reports would first go to Kwarcinski, who constitutional violations of which A.M . would decide which reports should go to complains. See Natale v. Camden County Prawdzik. Prawdzik indicated that either Corr. Facility, 318 F.3d 575" date_filed="2003-02-07" court="3rd Cir." case_name="No. 01-3449">318 F.3d 575, 585 (3d Cir. Brulo or Kwarcinski had responsibility for 2003) (holding that a reasonable jury could deciding what course of action should be conclude that a governmental entity’s taken in response to the incident reports. failure to establish a policy to address the

immediate medication needs of inmates DeM uro testified that the Center was deliberately indifferent). had diffuse accountability and poor communication in key areas such as Lack of Policies Regarding Residents’ reviewing and following up on incident Physical and Mental Health Needs reports. In his opinion, deficiencies like these illustrated that the Center had The District Court granted summary seriously flawed policies and procedures judgment in favor of the Center, Brulo, that contributed to A.M.’s injuries and and Kwarcinski on A.M.’s claim that the abusive treatment. In addition to relying lack of policies or procedures to address on this testimony, A.M. asserts that a the physical and mental health needs of written policy clarifying the roles and residents led to a violation of his r e s p o n si b i li t ie s of th e C e n t e r ’ s constitutional rights. The District Court administrators and staff with respect to the concluded that there was insufficient incident reports would have at least evidence that the Center was deliberately minimized the chance that A.M. would be indifferent to A.M.’s medical needs, and inappropriately placed with youth who had insufficient evidence that any policy or previously assaulted him. custom of not providing mental health care

worsened A.M.’s condition or otherwise Although this issue presents a close caused him constitutional injury. that the Center was deliberately indifferent We first address the District Court’s to his serious mental health needs. c o n c l u s io n t h a t A .M . p r e s e n te d insufficient evidence to suggest that the A.M. presented evidence that the Center was deliberately indifferent to his Center’s administrators were aware, upon serious medical needs. In this regard, the his admission, that he had serious mental District Court applied the deliberate health and behavioral problems, which indifference standard fo r Ei ghth required medication and psychiatric care. Amendment claims brought by prisoners There is conflicting evidence in the record against prison officials for failure-to-treat. regarding whether the Center ever A.M. takes issue with the application of contacted A.M.’s treating psychiatrist to this standard, noting that he was not a discuss his medication and treatment convicted prisoner but merely a juvenile needs. A.M. also presented evidence that detainee. Given his status as a detainee, after Dr. Gitlin’s evaluation of him on July A.M. maintains his claims must be 23, 1999, no other mental health a s s e s s e d u n d e r t h e F o u r te e n t h professionals were consulted or asked to Amendment. treat A.M., despite the ongoing difficulties

the Center was having in managing his We do not dispute that A.M.’s behavior. Rather than attending to the claims are appropriately analyzed under underl y in g m e n t a l h e a lth issues the Fourteenth Amendment since he was a contributing to the difficulties in managing detainee and not a convicted prisoner. A.M ., the Center viewed him as merely a However, the contours of a state’s due behavior problem. process obligations to detainees with respect to medical care have not been A.M. presented the unrebutted defined by the Supreme Court. See City of testimony of his psychiatric expert, Dr. Revere v. Mass. Gen. Hosp., 463 U.S. 239" date_filed="1983-06-27" court="SCOTUS" case_name="City of Revere v. Massachusetts General Hospital">463 U.S. 239, Annie Steinberg, who stated that the 244 (1983). Yet, it is clear that detainees Center did not provide appropriate are entitled to no less protection than a treatment for A.M.’s pre-existing mental convicted prisoner is entitled to under the health condition while he was a resident. Eighth Amendment. See id.; see also According to Dr. Steinberg, the Center did Fuentes, 206 F.3d at 344. In Estelle v. not “mon itor, or recogn ize th e Gamble, 429 U.S. 97" date_filed="1976-11-30" court="SCOTUS" case_name="Estelle v. Gamble">429 U.S. 97 (1976), the Supreme exacerbation of [A.M.’s] psychiatric Court held that a prisoner may state a symptoms, warning signs and the need for cause of action under § 1983 upon modifications to the intervention, or showing that a prison official was demonstrate the fundamental principles deliberately indifferent to his serious relevant to the care of juveniles.” (J.A. at illness or injury. Id. at 104-05. It is under 108a.) this standard that we assess whether A.M. has presented sufficient evidence to show We conclude the evidence A.M. presented was sufficient to survive health concerns to the staff. There were summary judgment on whether the Center also the specific recommendations made was deliberately indifferent to A.M.’s by Dr. Gitlin for managing A.M.’s mental mental health needs. A reasonable jury health problems and behavior, which do could conclude from the evidence that the not appear to have been read by the Center knew about A.M.’s significant Center’s administrators, shared with the mental health issues but was unprepared to child-care workers, or incorporated into a take the steps necessary to address those plan for A.M .’s safety or treatment. issues. We believe a genuine issue of Finally, Dr. Steinberg opined that the material fact exists as to whether the Center’s failure to provide appropriate Center’s failure to establish policies to treatment for A.M.’s pre-existing mental address the mental health needs of health illnesses and protect A.M. from residents like A.M. amounted to deliberate harm worsened A.M.’s mental health indifference. condition. A.M. argues this testimony

demonstrates that the combination of his We next turn to A.M.’s argument mental health con ditions and the that he presented ample evidence that the circumstances surrounding his detention Center’s lack of policies to address the created the direct harm that led to his physical and mental health needs of injuries. residents caused him harm. A.M. presented the unrebutted testimony of We believe the evidence A.M. DeMuro that the Center had a seriously adduced on the issue of whether the lack flawed intake and assessment system, of policies to address the mental and which failed to provide for the sharing and physical health needs of residents caused dissemination of critical information about his injuries is “not too tenuous.” his mental health history. DeMuro opined Bielevicz, 915 F.2d at 851. We therefore that poor staff communication, particularly conclude that the issue of causation should concerning the medical and mental health have been left to a jury. Id. needs of residents, contributed to A.M.’s ongoing abuse by other residents. In In summary, based on the foregoing addition to DeMuro’s testimony, A.M. reasons, we hold that the District Court presented evidence that the Center never erred in granting summary judgment in contacted his treating psychiatrist after his favor of the Center and Brulo and Kwarcinski in their official capacities. [3] admission and had no protocols to address when a resident’s treating psychiatrist was to be contacted, what follow-up was to be done once a resident received a mental [3] As stated earlier, the parties do not health evaluation , and who w as appear to dispute that A.M. has a protected r e s p o n s i b l e f o r c o m m u n i c a t i n g liberty interest in his personal security and information about a resident’s mental well-being. Implicit in this opinion is the 3. Claims Against Brulo, Kwarcinski, Kwarcinski in their roles as policymakers and Prawdzik in Their Individual for the Center. Individual defendants who Capacities are policymakers may be liable under § 1983 if it is shown that such defendants, A.M.’s claims against Brulo, “with deliberate indifference to the Kwarcinski, and Prawdzik in their consequences, established and maintained individual capacities allege that they are a policy, practice or custom which directly liable for developing inadequate policies caused [the] constitutional harm.” and customs and failing to adequately Stoneking v. Bradford Area Sch. Dist., 882 supervise their subordinates. The District F.2d 720, 725 (3d Cir. 1989). Evidence in Court disposed of the claims against these the record show s that Brulo and Defendants, concluding there was no Kw arcin ski had responsibility for evidence to suggest that any person under developing policies and procedures for the their supervision violated A.M .’s Center. Given our conclusion that A.M . constitutional rights. Because A.M.’s presented sufficient evidence to present a claims implicate these Defendants in their jury question on whether the Center’s roles as supervisors, we address the claims policies and procedures caused his in terms of supervisory liability. injuries, we conclude summary judgment

in favor of Brulo and Kwarcinski in their There are two theories of individual capacities was inappropriate. supervisory liability that are applicable to this case. The first involves Brulo and The second theory of liability

provides that a supervisor may be personally liable under § 1983 if he or she participated in violating the plaintiff’s

view that, given this protected interest, a rights, directed others to violate them, or, state-run juvenile detention center at least as the person in charge, had knowledge of has a duty to protect detainees from harm and acquiesced in his subordinates’ (whether self-inflicted or inflicted by violations. See Baker v. Monroe others) and provide, or arrange for, Township, 50 F.3d 1186" date_filed="1995-05-01" court="3rd Cir." case_name="Inez Baker v. Monroe Township Officer Robert Armstrong (Individually">50 F.3d 1186, 1190-91 (3d Cir. treatment of mental and physical illnesses, 1995). Again, given our conclusion, as injuries, and disabilities. A juvenile discussed below, that A.M. presented detention center is comparable to a prison, sufficient evidence to prevent the grant of which, in general, does not have as its summary judgment on whether the child- primary aim the treatment of mental or care workers were deliberately indifferent physical illnesses, injuries, or disabilities, to A.M.’s constitutional rights, we believe but nonetheless has a duty to care for and summary judgment in favor of their protect its inmates. On remand, the district supervisors was inappropriate. The court should more precisely define the incident reports prepared by the child-care duties the Center owes to its residents and work ers provided notice to their consider the scope of those duties. supervisors that A.M. was being assaulted A.M. contends the Fuentes standard by other residents and had severe behavior is inapplicable in this case because it problems. While there is some evidence applies to the use of force by prison that Brulo, Kwarcinski, and Prawdzik took officials in a single instance of prisoner some disciplinary action with respect to unrest where there is a need to act quickly. certain child-care workers, A .M.’s In contrast to a single instance of prisoner evidence that they took little or no action unrest, A.M. points out that he was to protect him is sufficient to present a assaulted by other residents on numerous genuine issue of material fact as to their occasions over a five-week period of knowledge of and acquiescence in the detention, many times in the presence of conduct of the child-care workers. child-care workers. A.M . argues that it is

inappropriate to apply the deferential Based on the foregoing, we hold malicious and sadistic standard in a case that the District Court erred in granting such as his where there were almost daily summary judgment in favor of Brulo, physical altercations between A.M. and Kwarcinski, and Prawdzik in their other residents. A.M. urges that his case is individual capacities. more appropriately judged by the

deliberate indifference standard. We 4. Claims Against Prawdzik, Considine, agree. Traver, and Parker This case does not appear to us as The District Court granted summary one in which the child-care workers were judgment in favor of these former child- required to make split-second decisions to care workers and their immediate maintain or restore order through the use supervisor on A.M.’s claim that they of excessive physical force. Cf. Hudson v. repeatedly failed to protect him from harm. McMillian, 503 U.S. 1, 6-7 (1992) On appeal, A.M. argues the District Court (holding that the core judicial inquiry in applied the incorrect standard for assessing cases where prison officials are accused of their liability. As noted above, the District using excessive force in the prison Court relied on the standard for assessing disturbance context is “whether force was claims of excessive use of force by prison applied in a good-faith effort to maintain officials in the prison disturbance context. or restore discipline, or maliciously and See Fuentes, 206 F.3d at 345 (holding that sadistically to cause harm”). Instead, the excessive force claims in the context of a evidence in this case presents a situation in prison disturbance require a subjective which child-care workers and their inquiry into whether the force was applied immediate supervisor had the opportunity in a good-faith effort to restore or maintain over a five-week period to see a pattern of discipline, or maliciously and sadistically physical assaults against A.M. emerging, to cause harm). consult amongst each other concerning the

appropriate response to this pattern, and develop a plan to protect A.M. from We conclude that the District Court assaults by other residents. should have analyzed A.M.’s claims

against the child-care workers and their Other courts have applied the immediate supervisor using the deliberate deliberate indifference standard in cases indifference standard. The deliberate where prison officials failed to protect an indifference standard in this context inmate from attack by another inmate. requires evidence that the Defendants were See, e.g., Jeffers v. Gomez, 267 F.3d 895" date_filed="2001-10-03" court="9th Cir." case_name="Donnell Jeffers v. James Gomez">267 F.3d 895, deliberately indifferent to a substantial risk 913 (9th Cir. 2001) (applying the of harm to A.M. and did nothing to deliberate indifference standard to claim prevent it. See Farmer v. Brennan, 511 U.S. 834 (1994). [4] Applying this standard, that prison officials failed to act on rumors that Hispanic inmates were planning to we believe the evidence, viewed in the attack Black inmates); Williams v. light most favorable to A.M., is sufficient Mueller, 13 F.3d 1214, 1216 (8th Cir. to present a jury question on whether the 1994) (explaining application of the child-care workers and their immediate deliberate indifference standard to a prison supervisor were deliberately indifferent to official’s obligation to protect inmates A.M.’s right to security and well-being. from harm by other inmates); Walker v. See Nicini, 212 F.3d at 816 (Rendell, J., Norris, 917 F.2d 1449, 1453 (6th Cir. dissenting) (“whether or not a defendant’s 1990) (applying the deliberate indifference conduct amounts to deliberate indifference standard to claim that prison officials has been described as a ‘classic issue for failed to prevent one inmate from stabbing the fact finder’ and ‘a factual mainstay of and killing another inmate). actions under [§] 1983’”) (quoting

Armstrong v. Squadrito, 152 F.3d 564" date_filed="1998-07-24" court="7th Cir." case_name="Walter Armstrong v. Joseph Squadrito">152 F.3d 564, 577 While this circuit has not spoken (7th Cir. 1998)). directly on this issue, we have held that a corrections officer who witnesses but fails The evidence, in particular the to intervene in the beating of an inmate by other officers is culpable if the officer had a “reasonable opportunity” to intervene but [4] We note that the claim in Farmer was refused to do so. Smith v. Mensinger, 293 based on the Eighth Amendment, not the F.3d 641, 650 (3d Cir. 2002). Although Fourteenth Amendment. However, as we Mensinger is not directly on point, it previously discussed, the contours of a nonetheless provides support for our state’s due process obligations to detainees conclusion that the District Court erred in have not been defined. See Doe v. applying the malicious and sadistic Washington County, 150 F.3d 920, 922 standard of Fuentes to A.M.’s claims (8th Cir. 1998). We reiterate that against the child-care workers and their detainees are entitled to no less protection immediate supervisor. than a convicted prisoner. See id.; Fuentes, 206 F.3d at 344.

numerous incident reports, supports A.M.’s contention that the child-care workers failed to intervene when altercations between A.M. and other residents began. More troubling is evidence that suggests child-care workers would allow A.M. to get beaten up because they were sick of him and he deserved it. In our view, this evidence is sufficient to prevent the grant of summary judgment. Accordingly, we hold that the District Court’s grant of summary judgment in favor of Prawdzik, Considine, Traver, and Parker must be reversed.

IV. CONCLUSION

For the reasons set forth in this opinion, we will AFFIRM the District Court’s grant of summary judgment in favor of Elaine Yozviak, in her individual capacity, and Dr. Mark Puffenberger, in his individual and official capacities. However, we will REVERSE the District Court’s grant of summary judgment in favor of the Center, Sandra Brulo and Louis Kwarcinski, in their official and individual cap acitie s, and Jerome Prawdzik, Chris Traver, Chris Parker, and Michael Considine, in their individual capacities, and REMAND the case for further proceedings.

NOTES

[1] At the time of his detention, A.M . was I. BACKGROUND thirteen years old, 4'11" tall, and about 92 pounds. On July 12, 1999, A.M. was arrested in Lake Township, Pennsylvania,

[2] The parties consistently refer to the for indecent conduct. He was taken to the youths detained at the Center as Center, a secure detention facility for “residents.” For ease of reference, we will children alleged to be delinquent or use the same designation.

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