Minix v. CanarecciMinix v. Canarecci
Whilе incarcerated at the St. Joseph County Jail, Gregory Zick, an inmate with a history of suicidal tendencies, took his own life. Zick’s mother, Cathy Minix, brought suit under
I. Background
Gregory Zick was a mental health patient at Indiana’s Richmond State Hospital. In March 2003, Zick was on leave from the hospital at the request of his mother, Cathy Minix, to attend a family funеral. Unfortunately, Zick became separated from Minix and, on March 22, was arrested on charges of theft and battery.
Zick was incarcerated at the St. Joseph County Jail. During booking, jail personnel noted that Zick had laceration scars on his wrist and neck, and Zick admitted to attempting suicide in the previous month. It was also learned that Zick was taking several prescription medications to inhibit suicidal thoughts, and the jail arranged for Zick to continue receiving those mediсations.
The jail provided for inmates’ health care by contracting with outside companies. Memorial Home Care, Inc. had an agreement with the jail to provide medical, dental, and psychiatric care. Dr. Douglas David was a Memorial employee who performed medical director services at Memorial’s jail facility, and Nurse Jeanne James was the manager of the facility who supervised the nursing staff. The jail also had an agreement with Madison Center, Inc., a community mental health center, to provide mental health services on a referral basis.
Shortly after Zick’s incarceration, a jail classification officer wrote a letter to Nurse James indicating that Zick should be placed on a suicide watch in light of his recent suicide attempt and depressed attitude. Zick was accordingly housed in medical segregation for observation. A few days later, on March 27, Madison employee Christine Lonz met with Zick during her weekly visit tо the jail for mental heath assessments. Lonz, who had experience but no formal licensure in mental health treatment, did not review Zick’s medical chart or list of medications. She also did not speak with any jail personnel regarding Zick’s condition or learn that he had been placed on a suicide watch. During her deposition, Lonz testified that she could not recall the specifics of her conversation with Zick, only that he was generally polite and cooperаtive. After speaking with Zick, Lonz filed a brief report noting that Zick denied having suicidal thoughts.
The same day as Lonz’s assessment, Nurse James prepared a form requesting that Zick be taken off suicide watch in medical segregation and transferred into the general population, noting that Zick denied having suicidal tendencies.
About a month later, on April 21, Zick refused his medications, and jail officers noted that a blade was missing from Zick’s razor. Officers moved Zick to medical segregation fоr a suicide watch and charged Zick with “attempted suicide,” improper use of materials, and disruptive conduct. Over the next two days of obser
Minix, as the personal representative of Ziek’s estate, brought a
On Minix’s deliberate indifference claim, the district court granted summary judgment in favor of all defendants except Memorial, Dr. David, and the Sheriff in his official capacity. The court found a triable issue on whether Memorial and the Sheriff were liable for maintaining inadequate suicide-prevention policies at the jail. As for David, the court determined that a jury could find that David acted with deliberate indifference in delegating the authority to assess suicidal inmates to an unqualified nursing staff.
Upon the defendants’ motion to reconsider, however, the district court reversed its summary judgment ruling with respect to Memorial and David. The court acknowledged that, in its initial ruling, the court erroneously relied on the opinion of one of Minix’s experts, Dr. Gutierrez, who concluded that the jail nursing staff lacked the required training to assess Zick’s suicide risk. The court further determined that Gutierrez’s opinion was not reliable enough to be admitted as expert evidence under
That left Minix’s official-capacity claim against the Sheriff as the only federal claim in the lawsuit. But the Sheriff madе Minix an offer of judgment in the amount of $75,000 pursuant to
Minix appeals the district court’s adverse summary judgment ruling on her deliberate indifference claim with respect to only defendants Lonz, Madisоn Center, Nurse James, Dr. David, and Memorial Home Care. The portions of the judgment dismissing the other jail and county officials are not appealed.
II. Analysis
A. Jurisdiction and Mootness
We begin by addressing whether we have jurisdiction over this appeal, and specifically, whether Minix’s acceptance of the Sheriffs $75,000 offer of judgment mooted this case. Minix is entitled to only one full compensation for any single, indivisible injury caused by the defendants,
Still, even assuming that the Sheriffs offer fully compensated Minix’s injury (which is doubtful, when compared with verdicts in other jail suicide cases,
see, e.g., Woodward v. Corr. Med. Servs.,
We also note that, even if Minix were precluded from seeking additional compensatory damages, the possibility of punitive damages would avoid mootness with respect to several defendants. Mi-nix’s complaint demands, in addition to compensatory damages, punitive damages against the defendants in this case. Although the principle of joint and several liability prevents Minix frоm recovering duplicative compensatory damages, it does not affect the defendants’ individual liability for punitive damages, which are assessed separately against each defendant.
Bosco v. Serhant,
B. Deliberate Indifference Liability Under § 1983
We review de novo the district court’s grant of summary judgment for the defendants, construing the evidence and all reasonable inferences in favor of Minix.
Johnson v. Saville,
The Eighth Amendment’s ban on “cruel and unusual punishments” requires prison officials to take reasonable measures to guarantee the safety of inmates, including the provision of adequate medical care.
Farmer v. Brennan,
511 U.S.
An Eighth Amendment claim based on inadequate medical care contains two elements: (1) the prisoner suffered an objectively serious harm that presented a substantial risk to his safety, and (2) the defendants were deliberately indifferent to that risk.
Collins v. Seeman,
With these standards in mind, we address whether Minix has shown a genuine issue of material fact on her deliberate indifference claims against each of the five defendants in this appeal — Lonz, Madison Center, Nurse James, Dr. David, and Memorial Home Care. Minix has sued Lonz, James, and David in both them individual and official capacities. In the sections that follow, our discussions of each of the three individual defendants pertain to Minix’s individual-capacity claims. As for Minix’s official-capacity claims against the individual defendants, we treat those claims the same as Minix’s claims against these defendants’ corporate employers, Mаdison Center and Memorial Home Care.
See Kentucky v. Graham,
1. Lonz
Beginning with Christine Lonz, the Madison Center employee who assessed Zick shortly after his incarceration, we conclude that Lonz is entitled to summary judgment because she lacked knowledge of “the significant likelihood that [Zick] may imminently seek to take his own life.”
Collins,
Minix criticizes Lonz’s assessment of Zick, claiming that any qualified mental health professiоnal would have probed more deeply into Zick’s psychological history and discovered his recent suicidal tendencies. Assuming that Lonz’s assessment was inadequate, the fact that she “
‘should have been aware ’
” of Zick’s risk of suicide is not enough to show the required, actual knowledge of serious harm.
Collins,
2. Madison Center
Lonz’s employer, Madison Center, is a corporation that contracted with the jail to perform the public function of providing mental health services to inmates. Such contractors are treated the same as municipalities for liability purposes in a § 1983 action.
See Woodward v. Corr. Med. Servs.,
Minix does not identify any unconstitutional policy that Madison adopted or condоned. Instead, Minix argues that Madison acted with deliberate indifference by sending an employee as unqualified as Lonz to assess mental health patients at the jail. Without more evidence that Madison was aware either that its employees were routinely providing inadequate care or that Lonz in particular was unqualified, Madison’s decision to send Lonz to the jail is not enough for municipal liability.
Cf. Woodward,
Minix makes much of Madison’s representation to the jail that Lonz was a Qualified Mental Health Professional (“QMHP”), as that term is defined in the section of the Indiana Administrative Cоde providing standards for Medicaid-eligible mental health services. See 405 Ind. Admin. Code 5-21-l(c). Lonz was not a QMHP, Minix claims, because she lacked a master’s or doctoral degree in one of specified disciplines such as psychiatry, psychology, and social work. See id. § 1(c)(4). Minix’s reading of the Code is too narrow, for the relevant section also confers QMHP status on someone “with documented education, training, or experience, comparable or equivalent” to that aсquired through the specified degrees. Id. § 1(c)(6). Although Lonz might have been short on formal licenses or degrees, she had obtained course work, training, and other experience in fields such as community health, mental illness, and the treatment of prisoners. More importantly, without evidence that Madison was on notice of inadequate inmate care by Lonz, we do not see how the full scope of Lonz’s qualifications is relevant to establishing Madison’s deliberate indifference.
We аlso conclude that Minix failed to produce evidence that any unconstitutional practice by Madison in this case was the “direct cause” of Zick’s suicide, as required for municipal liability. Lonz’s allegedly inadequate assessment took place in March 2003, shortly after Zick’s incarceration at the jail and initial placement on
3. James
Turning to the defendants associated with Memorial Home Care, we begin with Minix’s claim against Nurse James, who managed Memorial’s facility at the jail. After Zick’s placement оn suicide watches in both March and April 2003, it was James’s recommendations that led to Zick’s removal from suicide watch and transfer out of medical segregation. Shortly after the second transfer, Zick hanged himself in his cell. Although in hindsight the decision to release Zick from medical observation might have been a mistake, Minix’s evidence fails to show that James acted with deliberate indifference to a known risk that Zick would take his own life.
Prior to his final release from medical segregation in April 2003, Zick had been under observation for two days, during which time he denied suicidal thoughts and was generally alert and positive. He displayed similar behavior shortly before his release from the first suicide watch. Given Zick’s denials of suicide, James had no actual knowledge that Zick would “imminently seek to take his own life.”
Collins,
To be sure, medical experts could — and did — criticize James’s evaluations of Zick. Minix points to expert opinions produced during the summary judgment proceedings indicating that James displayed poor judgment in releasing Zick from suicide watch, and that she should not have taken Zick’s denials of suicide at face value. Still, to the extent that James committed an error in judgment, that error “leads only to negligence,” not to deliberate indifference.
Matos,
4. David
Dr. David, a director of medical services at Memorial’s jail facility, was not directly involved in Zick’s treatment except to approve the prescription medications that he received at the jail. This lack of direct participation makes Minix’s individual-capacity claim against David more difficult, since individual liability under § 1983 requires “personal involvement in the alleged constitutional deprivation.”
Palmer v. Marion County,
Although Minix’s evidence may cast doubt on David’s performance as a medical director, it does not support an inference that David condoned any unconstitutional practice by Memorial employees. David, who started at the jail just a few weeks before Zick’s arrival in March 2003, testified that he was unfamiliar with certain aspects of the jail’s suicide-prevention procedures, including how much training and experience the jail nurses had in assessing an inmate’s suicide risk. And as discussed, expert testimony questioned Nurse James’s treatment of Zick, suggesting that her own experience ultimately proved inadequate. Missing from the record, however, is evidence suggesting that David was aware that James or any other nurse was performing incompetent assessments of suicidal inmates but nevertheless acquiesced in that practice.
Cf. Woodward,
5. Memorial Home Care
Like Madison Center, Memorial Home Care is a corporation that contracted with the jail to provide medical services, so Memorial is treated the same as a municipality for liability purposes under § 1983. To prevail on her deliberate indifference claim, Minix must show that a policy either adopted or condoned by Memorial caused Zick to receive constitutionally inadequate care.
See Novack,
Memorial was subject to the jail’s poliсy of providing proper health care to inmates, which required Memorial to maintain an adequate health care staff at the jail. With respect to suicide prevention specifically, jail policy required that an inmate identified as possibly suicidal be assessed by a nurse as soon as possible, followed by continuous observation.
Minix does not directly challenge these jail policies or identify any Memorial policy that was itself unconstitutional. Instead, Minix arguеs that Memorial violated jail policy by failing to ensure that suicidal inmates received care from persons with adequate psychiatric training. But similar to the failings in Minix’s claim against Madison Center, Minix lacks evidence that Memorial condoned a widespread practice of providing inadequate mental health care to inmates. Even if Zick received inadequate care from James or other nurses, this isolated failure would not show that Memorial had notice оf ongoing conduct by its employees that created a substantial risk of harm. Cf. id. at 531 (“[A] series of bad acts” may support an inference that the municipality “was bound to have noticed what was going on .... ” (quotation omitted)).
As additional support for her claim against Memorial, Minix points to the report of her expert, Dr. Gutierrez, indicating that the jail’s nursing staff did not have the training required to competently assess an inmate’s risk of suicide. The district court, however, found that Gutierrez’s report was tоo unreliable to be admitted as an expert opinion under
We conclude that the district court acted within its discretion in excluding Gutierrez’s report. In the relevant portion of the report, Gutierrez asserted that taking an inmate off suicide watch was “beyond the scope of education, training, and experience for Nursing Personnel employed at the Jail in March and April of 2003.” Gutierrez cited no medical standards or principles in support of that conclusion. Given Gutierrez’s failure to explain his methodology, the district court could conclude that the report offered “nothing of value to the judicial process.”
Wendler,
III. Conclusion
Zick’s suicide was tragic, but the evidence produced was not enough to overcome the “high hurdle” set by the deliberate indifference standard for liability under § 1983.
Collins,