Rossie Marie MILLER, Personal Representative of the Estate of John King Lindsay Stanford, Deceased, Plaintiff-Appellant, v. CALHOUN COUNTY; Sheriff Allen L. Byam; Captain Terry Cook; Sergeant Michelle Lindsay; Deputy Melinda Osteen; Deputy Lapham; Deputy Jeffrey S. Holley; Deputy Holly Thomas; Sergeant Marcia Leavell; Deputy Everett; Dr. Mehmet B. Ismailoglu, Defendants-Appellees.
No. 03-2434.
United States Court of Appeals, Sixth Circuit.
Argued: April 19, 2005. Decided and Filed: May 27, 2005.
408 F.3d 803
Before: SUHRHEINRICH and GILMAN, Circuit Judges; and ACKERMAN, District Judge.*
OPINION
ACKERMAN, District Judge.
Plaintiff, Rossie Marie Miller, appeals from two orders of the District Court granting summary judgment in favor of all of the defendants in this wrongful death action brought pursuant to
I. BACKGROUND
At 1:02 a.m. on Friday, April 24, 1998, John King Lindsay Stanford, then 44 years old, was booked into the Correctional Fa
Stanford was assigned to share a cell with inmate Michael Owen. Owen later reported that shortly before 6:00 p.m. on Friday, April 24, Stanford complained of a headache to a guard and requested aspirin. Owen further reported that sometime in the afternoon of Saturday, April 25, Stanford again complained of a headache to a guard, and again requested aspirin. According to Owen, Stanford made a third request for aspirin around 7:00 p.m. on Saturday evening.
At approximately 11:50 p.m. on Saturday, April 25, Stanford approached two corrections officers—Deputies Osteen and Lapham—and again requested pain medication for a headache behind his eye. Osteen left to obtain the necessary approval from Sergeant Lindsay, the shift commander, and returned at about ten minutes past midnight with two Motrin tablets.
At approximately 12:30 a.m. on April 26, Lapham appeared at Stanford‘s cell in response to pounding on the door by Owen. Owen later stated that he had been pounding for at least several minutes before the deputy arrived. When Lapham entered the cell, he observed Stanford lying face-up on the floor of the cell in a puddle of water. Although Stanford was awake, he did not appear to be aware of Lapham‘s presence, and did not respond to the deputy‘s verbal inquiries. Lapham immediately radioed Lindsay to report a medical situation. While they were waiting for help to arrive, Owen advised Lapham that Stanford had fallen out of bed three times in short succession.
Within a brief time, Lindsay arrived at the cell, along with Deputies Osteen, Everett, and Taylor. Lindsay observed water on the floor and noted that the front of Stanford‘s pants was wet. Upon questioning, Owen advised the sergeant that Stanford had dropped a cup of water when he fell. Lindsay then asked Stanford whether he had hit his head when he fell, to which Stanford, now responsive, stated that he had not. In the meantime, Lapham left the cell to retrieve Stanford‘s medical profile, and reported back to Lindsay that Stanford had sustained a recent head injury. Stanford advised the officers that he had been in pain since the early evening of April 25. He complained of severe pain in his eyeballs. When Lindsay asked whether Stanford had suffered any head injuries, Stanford replied that he had, “about a year and a half ago.” Joint Appendix (“J.A.“) at 284. Lindsay checked Stanford‘s pulse at this time and found it to be strong and steady.
The officers placed Stanford in a wheelchair and transported him to the prisoner intake area (“Intake“) for observation. Lindsay, Lapham, and Taylor accompanied Stanford. Lapham reported that on “numerous occasions” along the way, the officers had to stop and “sit inmate Stanford back up in the chair” because “he kept sliding out.” J.A. at 283. Lindsay later opined that this was “probably not uncommon” because the wheelchair was an older model lacking footrests. J.A. at 625 (Lindsay Dep. at 10:25-11:3). During one of these stops, Lindsay inquired whether Stanford could see her, and Stanford responded, “You look like Mickey to me,”
Upon arrival at Intake, the deputies assisted Stanford in changing into dry clothing. Meanwhile, Lindsay accessed Stanford‘s computer file and phoned Dr. Mehmet Ismailoglu, the on-call physician for the Correctional Facility. Lindsay advised the doctor that Stanford had fallen, was initially unresponsive to questioning, but had later spoken responsively and coherently to her. In addition, Lindsay told the doctor that Stanford‘s pupils were equally dilated, and that he had earlier complained of a headache behind his right eye. Lindsay also informed the doctor that Stanford had reported sustaining a head injury in the past, although she later could not recall whether she told the doctor that the injury occurred a month or a year and a half earlier.
Dr. Ismailoglu advised Lindsay that medical staff would see Stanford in the morning. Lindsay suggested that the Intake staff monitor Stanford on a half-hourly basis, and Dr. Ismailoglu agreed. Dr. Ismailoglu later testified that “there was not anything striking about the call I got from the jail. There was no urgency in the message that I got. There was nothing there to alert me that I should either respond physically or call for—have them call for 911 to have this individual transported.” J.A. at 666 (Ismailoglu Dep. at 28:7-13). The record reflects that Lindsay‘s phone call to Dr. Ismailoglu lasted 1.9 minutes. J.A. at 55, 201, 667 (Ismailoglu Dep. at 29:19); Ismailoglu‘s Br. at 8. At deposition, Dr. Ismailoglu could not specifically recall having been told that Stanford had reported a recent head injury, that he was initially unresponsive, or that he was unable to remain seated in the wheelchair while en route to Intake.
Intake staff initiated a thirty-minute log shortly before 1:00 a.m. on April 26 and made observations of Stanford roughly every half hour for the next seven hours. The stated reason for initiating the log was “possible seizure.” J.A. at 288. Stanford‘s cell was equipped with a mattress, which was placed directly on the floor. For most of the night, Intake staff observed Stanford “rolling around on floor.” J.A. at 288-89, 290. Nevertheless, the record reflects that when officers spoke to Stanford, they found him to be responsive and coherent. J.A. at 291, 741. At approximately 1:30 a.m., Stanford requested a Snickers bar, stating that he thought his blood sugar was low and that this might be causing his headache. The Intake staff administered a blood sugar test and confirmed a normal reading. Three hours later, Stanford was observed masturbating. The entry for 7:30 a.m. shows that Stanford was “[m]oving, appears o.k.” J.A. at 289. Likewise, the entry for 8:00 a.m. reflects that Stanford was “[l]ying in the bed area, appears o.k.” J.A. at 289. The record reflects that throughout the night Stanford‘s condition “neither worsend [sic] or improved.” J.A. at 290.
At 8:10 a.m., the log shows that Stanford was found “[l]ying on floor, toilet area, foot shaking and moving, wet in pants area as if to have urinated on himself.” J.A. at 289. The entry further notes that “Sgt. contacted Master who in turn contacted medical. Medical Responded.” J.A. at
Hospital records indicate that Stanford was comatose when he arrived at the emergency room at approximately 8:45 a.m. J.A. at 295, 297. Dr. Ismailoglu was again contacted. The evaluating physician at the hospital diagnosed Stanford as suffering from a “massive right vasoganglion hemorrhage” and recommended that surgery not be performed. J.A. at 295. Stanford‘s condition deteriorated throughout the day. He died at 4:20 p.m. on Sunday, April 26, 1998. It was later determined that the cause of death was a “Primary Brain Tumor—Astrocytoma.” J.A. at 294 (Certificate of Death).
On April 18, 2001, Rossie Marie Miller, Stanford‘s sister, initiated this action in the Western District of Michigan, Southern Division, seeking relief under
On May 15, 2002, Dr. Ismailoglu moved for summary judgment. Oral argument on the motion was heard on August 21, 2002. The County Defendants and Corrections Officer Defendants moved to dismiss and/or for summary judgment on September 19, 2002. Shortly thereafter, on September 26, 2002, Miller sought leave to amend the Complaint to allege that Dr. Ismailoglu was a “policymaker” for purposes of
II. ANALYSIS
This Court reviews a district court‘s grant of summary judgment de novo. Therma-Scan, Inc. v. Thermoscan, Inc., 295 F.3d 623, 629 (6th Cir.2002). Summary judgment is appropriate only where “there is no genuine issue as to any mate
In the specific context of a
“Deliberate indifference” by prison officials to an inmate‘s serious medical needs constitutes “unnecessary and wanton infliction of pain” in violation of the Eight Amendment‘s prohibition against cruel and unusual punishment. Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976). Although the Eighth Amendment‘s protections apply specifically to post-conviction inmates, see Barber v. City of Salem, Ohio, 953 F.2d 232, 235 (6th Cir.1992), the Due Process Clause of the Fourteenth Amendment operates to guarantee those same protections to pretrial detainees as well. Thompson v. County of Medina, Ohio, 29 F.3d 238, 242 (6th Cir.1994); see also Molton v. City of Cleveland, 839 F.2d 240, 243 (6th Cir.1988) (stating that alleged violation of pretrial detainee‘s Eighth and Fourteenth Amendment rights is governed by the “deliberate indifference” standard). Where any person acting under color of state law abridges rights secured by the Constitution or United States laws, including a detainee‘s Eighth and Fourteenth Amendment rights,
The Supreme Court has adopted a mixed objective and subjective standard for ascertaining the existence of deliberate indifferеnce in the context of the Eighth Amendment:
[A] prison official cannot be found liable under the Eighth Amendment for denying an inmate humane conditions of confinement unless the official knows of and disregards an excessive risk to inmate health or safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference.
Farmer v. Brennan, 511 U.S. 825, 837, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994). The objective component of the test requires the existence of a “sufficiently serious” medical need. Blackmore v. Kalamazoo County, 390 F.3d 890, 895 (6th Cir.2004). A sufficiently serious medical need is predicated upon the inmate demonstrating that he or she “is incarcerated under conditions imposing a substantial risk of serious harm.” Id. (quoting Farmer, 511 U.S. at 834).
A. The District Court Did Not Err in Granting Summary Judgment for the County Defendants
A body politic is a “person” within the meaning of
In the proceedings below, Miller alleged that the County Defendants were deliberately indifferent to Stanford‘s serious medical needs by failing to provide adequate medical screening and treatment of inmates, and by failing to implement and enforce adequate procedures for the hiring and training of Correctional Facility staff, medical personnel, and professionals. The District Court rejected these allegations, finding that Miller had presented no evidence that the Correctional Facility engaged in a clear and persistent pattern of mistreatment of detainees, and no evidence that other detainees at the Correctional Facility had been subjected to the same alleged mistreatment. Policies and procedures were in place requiring corrections officers to contact a physician in the event of a medical emergency, the District Court found, and those procedures were followed during Stanford‘s period of incarcerаtion. The court rejected Miller‘s argument that the County Defendants failed to hire or train personnel to handle medical emergencies, finding that all of the officers at the Correctional Facility had received at least basic training in first aid and CPR. In addition, the court found no evidence that the corrections officers’ training was inadequate. Finally, the court noted that the fact that a nurse is now on duty throughout the night at the Correctional Facility is not evidence that the County Defendants were deliberately indifferent at the time of Stanford‘s incarceration.
Miller now argues that the District Court erred in focusing on the written policies of the County Defendants without considering the de facto customs and practices in place at the Correctional Facility. Specifically, Miller contends that “the
Although it is true that final policymaking authority may be delegated, Pembaur, 475 U.S. at 483, it is equally true that “mere authority to exercise discretion while performing particular functions does not make a municipal employee a final policymaker unless the official‘s decisions are final and unreviewable and are not constrained by the official policies of superior officials.” Feliciano v. City of Cleveland, 988 F.2d 649, 655 (6th Cir.1993). “[C]onsideration should ... be given to whether the employee ... formulates plans for the implementation of broad goals.” Hager v. Pike County Bd. of Educ., 286 F.3d 366, 376 (6th Cir.2002) (quoting Faughender v. City of N. Olmsted, Ohio, 927 F.2d 909, 914 (6th Cir.1991)). In light of this standard, Miller‘s argument finds no support in the record.
There is no dispute that under state law, Byam, as sheriff, enjoyed final policymaking authority over the Correctional Facility, and that he and his predecessor promulgated the “Procedures and Policies” that governed the Correctional Facility. However, Miller conflates decisionmaking with policymaking when she insists that “Lindsay was, by county poliсy, the de facto decision-maker as to emergency care for inmates on the midnight shift.” Miller‘s Br. at 34. Even assuming that Lindsay had been vested with authority to make limited decisions concerning inmate medical care during her shift, Miller fails to explain how this differs from “mere authority to exercise discretion.” Feliciano, 988 F.2d at 655; see also Pembaur, 475 U.S. at 481-82 (“The fact that a particular official—even a policymaking official—has discretion in the exercise of particular functions does not, without more, give rise to municipal liability based on an exercise of that discretion.“). Miller advances no argument and proffers no evidence that Lindsay‘s decisions were not subject to review, or that Lindsay possessed any authority to “formulate[] plans for the implementation of broad goals.” Hager, 286 F.3d at 376. Indeed, Miller‘s only evidentiary support for her argument that Lindsay had been delegated policymaking authority is a citation to Byam‘s deposition testimony, in which the sheriff expressed his belief that the officers at the Correctional Facility followed protоcol in dealing with Stanford. Such statements provide no support for the proposition that Lindsay had been delegated final authority to implement policy.2
To sidestep the absence of documentary evidence supporting her claim, Miller notes that
Miller argues that the District Court “was in error in concluding that a County may not be responsible for the de facto customs and practices that characterize its actual operation.” Miller‘s Br. at 34. The District Court, however, drew no such conclusion. In granting summary judgment for the County Defendants, the District Court properly applied the factors identified in Doe v. Claiborne County. That case, like the present case, involved a plaintiff who argued that
[t]o state a municipal liability claim under an “inaction” theory in the present case, plaintiff must establish:
(1) the existence of a clear and persistent pattern of mistreatment of detainees;
(2) notice or constructive notice on the part of the County;
(3) the County‘s tacit approval of the unconstitutional conduct, such that their deliberate indifference in their failure to act can be said to amount to an official policy of inaction; and
(4) that the County‘s custom was the “moving force” or direct causal link in the constitutional deprivation.
Miller v. Calhoun County, No. 01-245, slip op. at 12 (W.D.Mich. Sept. 29, 2003) (citing Doe, 103 F.3d at 508). Indeed, contrary to Miller‘s assertion, the lower court‘s very application of Doe evinces the court‘s recognition that a municipality may be held liable for municipal custom under certain circumstances. Those circumstances are nevertheless absent from this case.
“‘[D]eliberate indifference’ is a stringent standard of fault, requiring proof that a municipal actor disregarded a known or obvious consequence of his action.” Bd. of County Comm‘rs v. Brown, 520 U.S. 397, 410, 117 S.Ct. 1382, 137 L.Ed.2d 626 (1997). This in turn typically requires proof that the municipality was aware of prior unconstitutional actions by its employees and failed to take corrective measures. Stemler v. City of Florence, 126 F.3d 856, 865 (6th Cir.1997). Additionally, a
The District Court properly found that Miller failed to make the threshold showing of a clear and persistent pattern of mistreatment of detainеes. Miller argues that the County is at fault for permitting a situation in which Lindsay, untrained in emergency medical care, bore complete responsibility for deciding whether to contact the on-call doctor and what information to convey to him. But Miller does not deny that the Correctional Facility had a policy whereby the shift commander was to contact the on-call doctor in the event of a medical emergency, or that Lindsay followed that policy on April 26, 1998. Miller further fails to adduce independent evidence tending to show that such a policy
Miller contends, in a related argument, that the District Court overlooked the County‘s liability arising from its “failure to properly train those exercising constitutional authority over others.” Miller‘s Br. at 37. It is settled that “[o]nly where a municipality‘s failure to train its employees in a relevant respect evidences a ‘deliberate indifference’ to the rights of its inhabitants can such a shortcoming be properly thought of as a city ‘policy or custom’ that is actionable under
Miller offers no evidence supporting her allegation that the County‘s failure to train amounted to deliberate indifference to the medical needs of detainees at the Correctional Facility. Her argument pivots on Lindsay‘s admitted lack of emergency medical training, an argument that the District Court rejected. Lindsay testified at deposition that she had received 160 hours of training from the Department of Corrections that included instruction on handling certain medical situations, and that she was trained in first aid and CPR. J.A. at 617, 618 (Lindsay Dep. at 13:11-14, 18:6-7). Other corrections officers reported having received similar training. J.A. at 609 (Everett Dep. at 3:21), 644 (Holley Dep. at 5:9), 681-82 (Lapham Dep. at 4:25-5:1), 703, 705 (Osteen Dep. at 34:13, 41:12), 732 (Thomas Dep. at 4:9-10). Lindsay further testified that the Correctional Facility adhered to a medical policy whereby inmates were “initially checked by staff to find out what the problem is according to the inmate, and then that information is then relayed to the medical staff who handles the inmate‘s care from that point.” J.A. at 617 (Lindsay Dep. at 14:6-9). To counter this evidence, Miller merely argues that a reasonable jury could find deliberate indifference on the part of the County. She offers no evidence beyond the facts of this case tending to show that the County‘s training and staffing policies were inadequate. There is no history of similar incidents at thе Correctional Facility, nothing to show that the County was on notice, and nothing to show that the County‘s failure to take meliorative action was deliberate.
In the final equation, Miller bases her argument entirely on the circumstances surrounding her brother‘s death, but a single act may establish municipal liability only where the actor is a municipal “policymaker.” Pembaur, 475 U.S. at 480. As the Supreme Court instructed in Harris, the question is whether that training program is adequate; and if it is not, the question becomes whether such inadequate training can justifiably be said to represent “city policy.” It may seem contrary to common sense to assert that a municipality will actually have a policy of not taking reasonable steps to train its employees. But it may happen that in light of the duties assigned to specific officers or employees the need for more or different training is so obvious, and the
In summary, we believe that the record amply supports a conclusion that the District Court did not err in finding that Lindsay was not a “policymaker” for purposes of
B. The District Court Did Not Err in Denying Plaintiff‘s Motion for Leave to Amend the Complaint
On September 26, 2002, Miller sought leave to amend her Complaint to allеge that Dr. Ismailoglu was a “policymaker” for purposes of Pembaur liability. The District Court denied the motion for leave to amend, finding no basis in Michigan law to support the legal conclusion that Dr. Ismailoglu was a policymaker. Thus, the District Court concluded that amendment of the Complaint would be futile. Miller now renews her argument that Dr. Ismailoglu was a municipal policymaker.
A party may amend its pleading once as a matter of course at any time before the responsive pleading is served.
Miller argues that Dr. Ismailoglu was a municipal policymaker, and that in holding to the contrary, the District Court focused
Miller‘s argument with respect to Dr. Ismailoglu suffers from the same deficiencies as her argument with respect to Lindsay. In particular, Miller does not differentiate between policymaking and “mere authority to exercise discretion.” Feliciano, 988 F.2d at 655. Only the former confers
Miller makes no argument and advances no evidence that Dr. Ismailoglu possessed authority to set broad goals with respect to the medical treatment of inmates at the Correctional Facility. To the contrary, the record reflects that Dr. Ismailoglu contracted to provide on-site services for approximately eight hours per week, and to be on call 24 hours a day. J.A. at 561-62 (Byam Dep. at 18:24-19:12), 662 (Ismailoglu Dep. at 10:3-15). With respect to medical staffing procedures, Dr. Ismailoglu testified that he “wasn‘t involved in the administrative portion of it.” J.A. at 664 (Ismailoglu Dep. at 20:3-4). Indeed, Dr. Ismailoglu‘s deposition testimony reveals not a single instance in which the doctor set or influenced medical policy at the Correctional Facility. By way of comparison, Sheriff Byam testified that, pursuant to his policymaking authority, he had appointed a training coordinator for the Correctional Facility, J.A. at 553 (Byam Dep. at 10:21-22); sought accreditation for the Correctional Facility, J.A. at 556 (Byam Dep. at 13:6-8); requested bids for medical services, J.A. at 556-57 (Byam Dep. at 13:15-14:4); changed medical providers, J.A. at 565 (Byam Dep. at 22:19-21); formulated policy for medical care at the Correctional Facility, J.A. at 567-68 (Byam Dep. at 24:19-25:5); and initiated an investigation into Stanford‘s death, J.A. at 569 (Byam Dep. at 26:5-8). The record leaves no doubt that de facto policymaking authority resided with the sheriff, not with Dr. Ismailoglu.
Accordingly, the record clearly supports the District Court‘s conclusion that amendment of the Complaint to allege that Dr. Ismailoglu was a “policymaker” would have been futile. We therefore affirm the District Court‘s denial of Miller‘s motion for leave to amend the Complaint.
C. The District Court Did Not Err in Granting Summary Judgment for Dr. Ismailoglu
On March 6, 2003, the District Court granted summary judgment for Dr. Ismailoglu. In an earlier opinion, the court stated that it was basing its decision on the undisputed facts that “the doctor accepted [Lindsay‘s] telephone call, listened to a recitation of facts from the facility‘s
Miller now argues that the District Court erred in granting summary judgment for Dr. Ismailoglu. She contends that reasonable minds could differ on whether Dr. Ismailoglu provided any medical care at all, and that the totality of the circumstances support a finding of deliberate indifference. Specifically, Miller notes that Lindsay effectively admitted at deposition that she gave “all the information” to Dr. Ismailoglu, J.A. at 619 (Lindsay Dep. at 23:6), and that a jury could conclude from this admission that the doctor‘s claims of ignorance are not credible. By extension, according to Miller, a jury could conclude that Dr. Ismailoglu rendered “grossly inadequate care” or was “deliberately indifferent” to Stanford.
Although the Supreme Court in Farmer set forth a mixed objective and subjective standard for deliberate indifference, this Court has held that “less flagrant conduct may also constitute deliberate indifference in medical mistreatment cases.” Terrance v. Northville Reg‘l Psychiatric Hosp., 286 F.3d 834, 843 (6th Cir.2001). Thus, a doctor‘s provision of “grossly inadequate medical care” to an involuntary detainee may amount to deliberate indifference. Id. at 844 (citing Waldrop v. Evans, 871 F.2d 1030, 1033 (11th Cir.1989)). Grossly inadequate medical care is medical care that is “so grossly incompetent, inadequate, or excessive as to shock the conscience or to be intolerable to fundamental fairness.” Id. To ascertain whether a medical care provider rendered grossly inadequate medical care to a detainee, a court must undertake a “particularized, fact-specific inquiry.” Id.
Miller notes that Lindsay testified at deposition that the Correctional Facility adhered to a policy whereby the shift supervisor, in the event of a medical emergency, “called the doctor and gave all the information to him.” J.A. at 619 (Lindsay Dep. at 23:5-6). Because Lindsay did not admit to having violated this policy, Miller argues, a reasonable jury could infer that Dr. Ismailoglu had all the information necessary for him to conclude that Stanford required immediate hospital care. But Miller‘s assertions to the contrary, Lindsay‘s deposition testimony, when viewed in full, hardly amounts to an admission that she provided the doctor with all information that was collectively known by the Corrections Facility staff about Stanford‘s medical condition in the early morning hours of April 26, 1998. Indeed, Lindsay went on to testify that she could not recall whether she told the doctor that Stanford had suffered a possible seizure, J.A. at 629 (Lindsay Dep. at 27:2-7); that Stanford was unable to walk, J.A. at 629 (Lindsay Dep. at 28:3-5); that Stanford was transported to Intake in a wheelchair, J.A. at 629 (Lindsay Dep. at 28:13-15); or that Stanford needed help remaining in the wheelchair, J.A. at 630 (Lindsay Dep. at 29:3-5). She further could not recall whether she told the doctor that Stanford had reported at the time of booking that he had sustained a head injury one month
When viewed in full, Lindsay‘s deposition testimony largely comports with Dr. Ismailoglu‘s general recollection of the phone call he received in the early morning of April 26. Dr. Ismailoglu testified that he recalled Lindsay telling him that this was not an emergency medical situation, that Stanford was conversing normally, and that there was no inappropriate conduct. There does not appear to be any factual inconsistency between Lindsay‘s and Dr. Ismailoglu‘s respective versions of the phone call. Miller asks the Court to overlook significant evidence to the contrary and infer from Lindsay‘s failure to admit to violating County policy that Dr. Ismailoglu must have known all relevant information about Stanford‘s condition. In making this argument, Miller invites this Court to engage in speculation to overcome the lack of evidence that Dr. Ismailoglu in fact knew Stanford‘s true medical condition and chose tо ignore a substantial risk of serious harm. We decline the invitation.
In Terrance, this Court observed that “[w]hen the need for treatment is obvious, medical care which is so cursory as to amount to no treatment at all may amount to deliberate indifference.” Id. at 843 (internal quotation marks omitted). However, both of the cases that the Court cited for this proposition involved a known risk that was disregarded. See Mandel v. Doe, 888 F.2d 783, 789 (11th Cir.1989) (a physician‘s assistant‘s failure to inform his superior or a medical doctor of a prisoner‘s known injured leg constitutes deliberate indifference); Cooper v. Dyke, 814 F.2d 941, 945-46 (4th Cir.1987) (a prison employee‘s two-hour delay in providing medical care to an inmate known to have gunshot wounds constitutes deliberate indifference). In the instant case, there is simply no evidence that Dr. Ismailoglu knew of the risk posed to Stanford. To the extent Miller argues that Dr. Ismailoglu should have inquired of the details of Stanford‘s condition, Dr. Ismailoglu testified that “I‘m sure I did in that phone conversation. I can‘t imagine just sitting there and listening to [Lindsay], and then saying, well, have a good night. I‘m sure I asked her some questions that satisfied what I wanted to hear and know.” J.A. at 670 (Ismailoglu Dep. at 41:15-19). Ultimately, there is no dispute that Dr. Ismailoglu listened to Lindsay‘s recitation of Stanford‘s symptoms, advised the sergeant to place Stanford under observation and begin a 30-minute log, and informed Lindsay that the medical staff would examine Stanford in the morning. Miller advances no evidence that Dr. Ismailoglu‘s medical advice was a grossly inadequate or deliberately indifferent response to the information that Dr. Ismailoglu and Lindsay agree was conveyed.
Because Miller has failed to proffer any evidence that Dr. Ismailoglu in fact knew all relevant information and chose to disregard a substantial risk of serious harm, the District Court did not err in granting summary judgment for Dr. Ismailoglu. We reach this conclusion even in light of the relaxed standard for deliberate indifference set forth in Terrance.
D. The District Court Did Not Err in Granting Summary Judgment for the Corrections Officer Defendants
In an Opinion and an Order, both dated September 29, 2003, the District Court
The standard for deliberate indifference, as we have noted, is the mixed objective-subjective standard articulated by the Supreme Court in Farmer. There appears to be no dispute among the parties that the objective prong, which requires proof of a “sufficiently serious” medical need, has been satisfied. The Corrections Officer Defendants contend, however, that a substantial risk of serious harm became apparent only after Stanford “was found twitching and showing signs of seizure shortly after 8:00 a.m. on April 26, 1998.” Defs.‘/Appellees’ Br. at 10. Accordingly, this Court need only address the subjective element of the deliberate indifferеnce inquiry.
1. Sergeant Michelle Lindsay
Miller argues that a jury might find that Lindsay had not disclosed “all the information” concerning Stanford‘s medical condition as she was required to do under County policy. From this starting point, Miller then makes the extraordinary leap of speculating that a jury could find that Lindsay “testified untruthfully during her deposition” and that she “concealed most of the background facts regarding the decedent‘s head injuries.” Miller‘s Br. at 42. In similar fashion, Miller conjectures that the initial episode that Stanford experienced in his cell was a seizure, and that he suffered “continued seizures” throughout the night while under observation. Id. at 42-43.
In this Circuit, it is established that “[k]nowledge of the asserted serious needs or of circumstances clearly indicating the existence of such needs, is essential to a finding of deliberate indifference.” Blackmore, 390 F.3d at 896 (citing Horn, 22 F.3d at 660); see also Farmer, 511 U.S. at 837 (“[T]he official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference.“). When viewed under this standard, the record supports the District Court‘s conclusion that Miller failed to demonstrate that Lindsay possessed a sufficiently culpable state of mind. There is no dispute that Lindsay lacked actual knowledge of Stanford‘s true health status. Miller argues instead that Lindsay had knowledge of the circumstances surrounding Stanford‘s deteriorating condition as they unfolded in the early morning of April 26, 1998, and her failure to take action amounted to deliberate indifference. As the Supreme Court has instructed, however, Lindsay would have had to draw the inference that a substantial risk of serious harm existed before a jury could be permitted to consider whether her failure to act amounted to deliberate indifference. Miller has produced no evidence that Lindsay drew such an inference.
Indeed, the record contains numerous instances of uncontroverted evidence tending to show that at no time during her shift did Lindsay infer the existence of a substantial risk of serious harm. Upon arriving at Stanford‘s cell, Lindsay questioned Stanford and found him to be resрonsive. He indicated that he had not hit his head when he fell. Lindsay checked Stanford‘s pulse and found it to be “strong and steady.” J.A. at 284. Although Stanford‘s cellmate expressed an opinion that Stanford had suffered a possible seizure, Lindsay observed no seizure activity. She
With respect to Lindsay‘s phone call to Dr. Ismailoglu, the record does support a conclusion that the sergeant may have failed to relate all relevant information concerning Stanford‘s condition. There is no evidence, however, that Lindsay‘s omissions were deliberate. See Estelle, 429 U.S. at 106, 97 S.Ct. 285 (holding that prisoner must allege acts or omissions evidencing deliberate indifference to serious medical needs). Accordingly, while the record might support a conclusion that Lindsay was negligent in failing to inform the doctor of all relevant facts, there is no support for a finding that such failure rose to the level of a constitutional violation. See Farmer, 511 U.S. at 838, 114 S.Ct. 1970 (“[A]n official‘s failure to alleviate a significant risk that he shоuld have perceived but did not, while no cause for commendation, cannot under our cases be condemned as the infliction of punishment.“).
For the reasons discussed, we find that the record fully supports the District Court‘s grant of summary judgment for Lindsay.
2. Remaining Corrections Officer Defendants
The remaining Corrections Officer Defendants consist of the individual deputies who interacted with and observed Stanford on the morning of April 26 and Leavell, the shift commander who relieved Lindsay and who discovered Stanford having an apparent seizure at 8:10 a.m. In an argument confined to a single paragraph, Miller contends that these defendants witnessed Stanford‘s condition when they found him on the floor of his cell, they knew Stanford was not receiving medical care, and they watched as Stanford rolled on the floor of the observation cell for six hours. Because Miller‘s argument does not differentiate among these defendants, this Court will address their potential
There is no evidence that any of these defendants acted with a sufficiently culpable mental state necessary to confer liability under
III. CONCLUSION
For the foregoing reasons, we find that Miller has failed to adduce evidence demonstrating that any of the Defendants acted with a sufficiently culpable mental state to establish deliberate indifference. We further find that the District Court did not err in denying Miller‘s motion for leave to amend the Complaint on the ground that the proposed amendment would be futile. Accordingly, we AFFIRM the District Court‘s adjudication of this matter in all respects.
HAROLD A. ACKERMAN
UNITED STATES DISTRICT JUDGE