Case Information
*1 Before B AUER W OOD T INDER Circuit Judges . W OOD Circuit Judge
. Phillip Okoro spent last days his short life—which ended two days before Christmas, December age 23—in Williamson County, Illinois jail cell. An autopsy determined death resulted from diabetic ketoacidosis, life threatening condition associated untreated Type I diabetes. Jaclyn *2 Currie, Okoro’s sister and administrator of his estate, brought suit federal court, alleging violations of Okoro’s federal and law. Two named defendants, Dr. Jogendra Chhabra Nurse Marilyn Ann Reynolds, were employees a private company (Health Professionals, Ltd.) contract provide services county’s inmates at death. Shortly before trial, Chhabra Reynolds filed a motion dismiss Currie’s complaint, asserting on Currie’s claims. The district court denied motion, filed interlocutory appeal. affirm.
I
Okoro was arrested without a warrant his residence October suspicion having committed a misdemeanor property crime. “requires a prompt judicial determination prerequisite extended pretrial detention following warrantless arrest,” usually within hours. Cnty. Riverside McLaughlin U.S. (1991) (discussing Gerstein Pugh (1975)). For unknown reasons, Okoro never received such “ Gerstein hearing” during his two months incarceration.
Williamson County contracts with Health Professionals, Ltd. provide inmates held county jail. As teenager, Okoro was diagnosed with Type I diabetes, which he was able control with careful monitoring his blood sugar levels. But his problems worsened while he college, he was diagnosed schizophrenia. latter disease compromised his ability monitor diabetes. Immediately *3 after his arrest, Okoro’s family members began calling Williamson County jail inform correctional employees and medical staff Okoro’s mental illness and diabetic condition. According complaint, during his jail Okoro was under Dr. Chhabra and Nurse Reynolds. For most part, he was detained in his cell, usually isolation, and thus he was dependent jail employees medical staff monitor his blood sugar level, provide insulin shots, deliver other necessary care.
On December 23, 2008, Okoro collapsed his cell; he was pronounced dead Heartland Regional Medical Center. An autopsy revealed Okoro’s death was re sult diabetic ketoacidosis, buildup acidic ketones bloodstream occurs body runs out insu lin. See Mayo Clinic Staff, Diabetic Ketoacidosis http://www. mayoclinic.com/health/diabetic ketoacidosis/DS00674 (last visited Aug. 2013). Currie’s complaint alleges Oko ro’s death “completely preventable” would occurred Okoro received adequate care, including regular testing his blood sugar levels suffi cient insulin keep blood sugar level steady.
Currie filed her initial complaint October naming defendants various jail officials, Williamson County, Reynolds, Health Professionals, Ltd. initial iterations her complaint alleged defendants acted “deliberate indifference” Okoro’s needs, suggesting claim violated due process Fourteenth Amendment. Cavalieri Shepard (“The Eighth apply *4 pretrial detainees, as pretrial detainee, [Plaintiff] entitled to least same protection [under Due Process Clause] against deliberate indifference to basic needs as available convicted prisoners Eighth Amendment.”). At close discovery, however, response defendants’ motion for summary judgment, Currie argued for first Amendment’s “objectively unreasonable” standard should govern. See Williams Rodriguez (“[C]onditions confinement pretrial detainees … who yet judicial determination (a Gerstein hearing) are … governed objectively unreasonable standard.”). court accepted this argument, ordered Currie file amended complaint reflect this theory, dismissed without prejudice Currie’s previous complaint. F ED . R. C IV . P. 16(c)(2)(B); 6A C HARLES A LAN W RIGHT A RTHUR R. M ILLER & M ARY K AY K ANE F EDERAL P RACTICE AND P ROCEDURE § (3d ed. 2012).
Hours after this ruling, Currie settled jail offi cials Williamson County, leaving Chhabra, Reynolds, Health Professionals, Ltd. sole remaining defend ants. Upon receipt Currie’s revised complaint alleging “objectively unreasonable” conduct, Chhabra, Reynolds, Health Professionals filed motion dismiss, asserting “because been applied licensed professional[s] subcon tracted detainees.” court denied mo tion. Only are before us appeal. *5 5 2709
II
Before turning heart appeal, we must address Currie’s argument that this court “lacks jurisdiction” hear Chhabra Reynolds’s interlocutory appeal because motion dismiss “was procedurally improper.” Currie maintains that should asserted qualified immunity promptly when district court ruled that it would use framework assess Currie’s claims. Instead, waited receive Currie’s amended complaint. district court wasted little ink rejecting this argument as “disingenuous,” explaining that it was not until Currie filed her final amended complaint (which, first time, alleged defendants’ conduct was “objectively unreasonable”) her pleadings “reasonably suggested applicable.”
There no merit all argument. To begin with, remind parties again there no duty plead legal theories. See, e.g., Alioto v. Town Lisbon, F.3d 715, (7th Cir. 2011); Hatmaker v. Mem’l Med. Ctr., F.3d (7th Cir. 2010); Aaron v. Mahl, F.3d (7th Cir. 2008). It therefore not matter complaint mentioned Amendment, Fourteenth Amendment, neither, so long it provided adequate tice plaintiff’s claim defendants. As qualified immunity particular, even though ideally immunity defense should be resolved earliest stage possible, Ta mayo Blagojevich F.3d 2008), guideline, rigid rule. Here, district court did abuse discretion it entertained defendants’ argument. Jogi Voges *6 ‐ (district court may, its sound discretion, consider belated assertion of defense procedurally complex cases). Nothing approaching a juris ‐ diction problem bars consideration of the court’s ruling.
III
On merits, defendants’ first contention Currie has failed to state a claim, since “[t]he Amendment govern provision medical ser ‐ vices [a pre ‐ Gerstein hearing] arrestee by a contracted medical professional.” (In interest clarity, we use term “arrestee” refer a person who has had a Gerstein hearing; we use term “pre trial detainee” refer someone who has a Gerstein hearing or equiva lent.) fact operate under contract County immaterial here, since they concede “provid[ed] services government contract fulfilling governmental function.” West v. At kins U.S. (1988) (delivery treatment prisoner by part contract physician qualifies action purposes U.S.C. § 1983). defendants’ real argument never governs con stitutional claims alleging inadequate provision arrestee nurse doctor, regardless de fendant’s employment arrangement.
Although Supreme Court provided relatively lit tle guidance regarding pretrial detainees, see Graham Connor n.10 (1989) (noting, without deciding, question protections extend through period pretrial detention), court’s cases foreclose defendants’ argument. In Villanova Abrams held *7 7 12 2709 “the Fourth Amendment governs period of confinement between arrest without warrant [probable determination],” 972 F.2d 792, 797 (7th Cir. 1992), have since applied Amendment’s “objectively unreasonable” standard both “conditions of confinement” “medical care” claims brought by arrestees who have yet Gerstein hearing. Ortiz v. City of Chicago , 656 F.3d 523 (7th Cir. 2011) (medical care); Williams v. Rodri guez , 509 F.3d 392 (7th Cir. 2007) (medical care); Sides v. City of Chicago , 496 F.3d 820 (7th Cir. 2007) (medical care); Lopez v. City Chicago F.3d 711, (7th Cir. (conditions confinement). Other courts so ruled as well. See, e.g., Chambers v. Pennycook, F.3d (8th Cir. 2011); Al dini Johnson, F.3d (6th Cir. 2010); Pierce Multnomah Cnty., 1996); see gen erally Catherine T. Struve, Conditions Pretrial Detention, U. P ENN . L. R EV . (2013) (endorsing “familiar standard reasonableness circumstances [to] govern treatment until there been judicial determination cause”). defendants attempt distinguish Ortiz Williams Sides cases involving objectively unreasonable denial care by jailers objectively unrea sonable provision by doctors nurses . A jailer might violate arrestee’s unreasonably denying arrestee access insulin, urge, health professional who unrea sonably withholds insulin not.
This argument lacks support law logic. “[T]he State [has] constitutional duty provide adequate treatment those custody,” claims *8 ‐ may be brought against medical care providers, regardless of “the precise terms of [their] employment,” “voluntarily assume[] obligation by contract.” West at ‐ 56. This basic principle, first announced the Eighth Amendment context, applies with equal force claims brought by pre ‐ trial detainees who have had a proba ble cause hearing, see, e.g. King Kramer F.3d (Fourteenth Amendment claim against nurses em ployed by Health Professionals, Ltd.), constitutional claims brought by who have not yet a hearing. True, the named defendants our earlier Amendment medical cases were “lockup keep ers” ( Ortiz Williams ) police detectives ( Lopez ), from perspective the arrestee, it matters not a whit it is jailer or doctor whose conduct deprives him life saving medical care. This is why cases speak broadly claims involving “ provision medical care,” Ortiz not simply “ denial a jailer” (as defendants would have it). counter should recognize a
special “carve out” for doctors nurses because Amendment’s “objectively unreasonable” standard resembles standard common law tort negligence, “Section intended negligence.” But implicit premise behind description Section provision issue Fourteenth or Eighth Amendment. quarrel proposition prison inmate’s complaint “that physician been negligent diagnosing treating condition valid claim mistreatment Eighth *9 9 No. 12 ‐ 2709 Amendment,” Estelle v. Gamble 429 U.S. 106 (1976). But different constitutional provisions, and thus different standards, govern depending relationship between state person in state’s custody. Graham Connor, U.S. 394 ‐ 95 & n.10 (1989); Belbachir County McHenry slip op. at Aug. (discussing standards civil commitment, immigration, criminal contexts).
During (ordinarily brief) between warrantless arrest judicial determination probable cause, before state’s interest continued detention been estab lished, greater solicitude presumptively innocent arrestees warranted. Indeed, this concern prompted Justice Scalia dissent Riverside because he thought that hours was too long satisfy requirement prompt hearing—a requirement, he pointed out, “had primary benefi ciaries innocent … those so blameless there was not even good reason arrest them.” U.S. at (Scalia, J., dissenting). The Riverside majority was also concerned about problem “prolonged detention based incorrect unfounded suspicion.” 52. (Okoro, unfortunately, was experiencing prolonged detention, one will ever know if suspicion led arrest was well founded.) relevant legal standard who have been seized who not yet hearing, conclude, comes from Amendment, Fourteenth, certainly Eighth. issue actor’s “response [the arrestee]’s medi cal needs objectively unreasonable” “caused harm which [the arrestee] complains.” Ortiz (discussing factors inform analysis). If jail officials fear framework might im *10 pose too onerous burden on them or their agents, there is obvious solution: responsible officials can ensure arrestees receive prompt determination cause, Amendment already requires . See Cnty. Riv ‐ erside U.S. 56; see also Struve, The Conditions Pretrial Detention supra, U. P ENN . L. R EV . 1013.
IV next argue even if conduct
violated rights, qualified immunity is proper because no previous decision “applied to analyze reasonableness health care provided by contracted professionals being held by police jail.”
If there is any lack clarity previous cases, how ever, it is only respect threshold issue whether defense qualified is ever available private providers like defendants. Sain Wood (assuming, “for purposes case only,” prison doctor may be entitled assert immunity). This ambiguity help de fendants: if private professionals are categori cally barred from claiming immunity, like guards employed by privately run prison facility, Richardson McKnight (1997), it unnecessary consider whether de fense may be invoked by these particular facts. Supreme Court recently considered question “an individual hired government do
work prohibited from seeking [absolute qualified] im munity, solely because he works government *11 11 12 ‐ 2709 something other than a permanent or full time basis.” Filarsky v. Delia , S. Ct. (2012). It held that “immunity under § should not vary depending an individual working for government so as a full employee, some other basis.” Id. at 1665. On other hand, Filarsky Court reaffirmed holding Richardson categorically rejecting immunity for private prison employees there; so doing, Court emphasized that incentives private market suffice protect employees “a private firm, systematically organized assume a major lengthy administrative task ... for profit potentially competition other firms,” assumes re sponsibility managing institution. S.Ct. at (quoting Richardson 413).
In a detailed opinion tracking Court’s analysis Filarsky Sixth Circuit recently held that a doctor provid ing psychiatric services inmates prison not en titled assert qualified immunity. McCullum Tepe 2012) (discussing historical roots immunity similarly situated parties history purpose § 1983); see also Hasher Hayman WL (D.N.J. Mar. (private employees failed establish are entitled assert qualified immunity defense, “even after Filarsky ”). find Sixth Circuit’s reasoning persuasive, though we need defini tively decide issue today; even if were entitled seek general matter, would conclude defense applicable here. contours were “sufficiently clear reasonable official would stand what he doing violates right” throughout *12 the period detention. Anderson Creighton U.S. (1987). Chhabra urge otherwise, based only the argument that our previous Fourth Amendment care cases spoke only “officers” (and “medical care providers”). That too slender reed us, particularly since officials can be “on notice that conduct violates established law” even in absence “earlier cases involving ‘fundamentally similar’ [or] ‘materi ‐ ally similar’ facts.” Hope Pelzer (2002). As we already explained, nothing in opinions hints some special Fourth Amendment exemption health professionals; we discussed wrongdoing “officers” “lockup keepers” because those were positions de ‐ fendants held. Indeed, we rejected argument much like Reynolds’ in Ortiz where defendants urged that in (the alleged wrongdoing in case) “no decision had applied Fourth Amendment analyze reasonableness provision arrestees.” 538. acknowledged was probably true, since Williams Sides were de cided until three years later, even then we rejected defense. It was “quite clear” said, “that protects person’s until she had hearing.” Id. It no less clear De cember Okoro collapsed cell, same standard applies wrongdoing al leged here.
Finally, suggest they are entitled quali fied because “[t]here nothing indicating [Chhabra Reynolds] had any understanding de cedent’s status,” thus, way knowing Amendment, rather than some more forgiving *13 constitutional provision, would govern this particular ar ‐ restee’s care. This argument is not altogether frivo ‐ lous, since qualified immunity may apply to some mistakes fact, see Pearson Callahan S. Ct. (2009), it cannot prevail here. It assumes health care providers calibrate level care provide to jail in mate based their assessment inmate’s legal status, taking advantage right to be sloppy where stand ard lower. sincerely hope this is how Chhabra, Reynolds, Health Professionals, Ltd. go about caring those in State’s custody. Indulging possibility defendants really do undertake such crass triage, however, we would expect them to exercise particular sorting jail’s residents into proper camps, par ticularly after decisions Williams Sides . Crowder Lash (“A rea sonably competent public official expected know law governing conduct.”). If defendants truly tailor their (or lack thereof) fashion, then their failure ascertain Okoro’s correct status cannot be characterized as “reasonable” mistake, their claim still fails. Saucier (“The concern im munity inquiry acknowledge reasonable mistakes can be made … .”) (emphasis added).
Moreover, already indicated outset, we do consider any argument based Fourteenth be forfeited. This record easily supports finding deliberate indifference serious condition. In short, these reason think actions would be measured anything less than Fourteenth Amendment’s standard, which applied pretrial detainees decades.
V A FFIRM order district court denying quali
fied R EMAND further proceedings consistent opinion.