SHERELLE THOMAS, Administrator of the Estate of Terelle Thomas; T. T., a minor, individually, as child of decedent Terelle Thomas and as his sole survivor v. CITY OF HARRISBURG; OFFICER DARIL FOOSE; OFFICER SCOTT JOHNSEN; OFFICER ADRIENNE SALAZAR; TRAVIS BANNING; OFFICER BRIAN CARRIERE; HARRISBURG CITY POLICE DEPT JOHN DOE POLICE OFFICERS 1-5; DAUPHIN COUNTY ADULT PROBATION JOHN DOE SUPERVISORY OFFICERS 1-5; DAUPHIN COUNTY PRISON JOHN DOE PRISON OFFICIALS 1-5; DAN KINSINGER; DAUPHIN COUNTY; PRIMECARE MEDICAL INC; PRIMECARE JOHN DOES MEDICAL EMPLOYEES 1-5
Nos. 21-2963, 21-2964 & 21-3018
UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT
December 6, 2023
PRECEDENTIAL; Argued on January 11, 2023
Before: JORDAN, PHIPPS and ROTH, Circuit Judges
Sheryl L. Brown (ARGUED)
Siana Law
941 Pottstown Pike
Suite 200
Chester
Counsel for Appellants Officer Daril Foose, Officer Brian Carriere
Frederick B. Buck (ARGUED)
Rawle & Henderson
1500 Market Street
19th Floor, Centre Square West
Philadelphia, PA 19102
Counsel for Appellants Officer Scott Johnsen, Officer Adrienne Salazar and Travis Banning
Kimberly A. Boyer-Cohen (ARGUED)
Marshall Dennehey Warner Coleman & Goggin
2000 Market Street
Suite 2300
Philadelphia, PA 19103
Counsel for Appellant Dan Kinsinger
Kevin V. Mincey (ARGUED)
Riley H. Ross, III
Mincey Fitzpatrick Ross
1650 Market Street
36th Floor
Philadelphia, PA 19103
Counsel for Appellees
OPINION
ROTH, Circuit Judge:
Sherelle Thomas1 sued the City of Harrisburg; PrimeCare Medical, Inc.; and several individual law enforcement officers (the Officers) on behalf of her decedent relative, alleging that defendants failed both to render medical care and to intervene to prevent a violation of the right to medical care. The Officers moved to dismiss on grounds of qualified immunity. The District Court denied the motion. The court rejected the Officers’ claims of qualified immunity because it found that Sherelle Thomas alleged sufficient facts to state her claims and both rights were clearly established at the time of the violations. The Officers appealed, limited to the issue of qualified immunity. Because the District Court correctly denied the Officers’ claim of qualified immunity regarding their failure to render medical care claim, we will affirm on that issue. We conclude, however, that the District Court ruled incorrectly when it recognized a claim of failure to intervene. Because neither our Court nor the Supreme Court have recognized the right to intervene in the context of the rendering of medical care, qualified immunity for the Officers on this claim is appropriate and we will remand this claim to the District Court with instructions to dismiss it as to the Officers.
I. BACKGROUND
A. Factual Background
Sherelle Thomas, Administrator of the Estate of Terelle Thomas, alleged the following: On December 14, 2019, Harrisburg Police Officer Daril Foose was partnered with Adult Probation Officer Dan Kinsinger. At approximately 6:15 p.m., Foose observed Terelle Thomas (Thomas) and another man walk from a bar and enter a vehicle as passengers. Foose followed the vehicle and made a traffic stop. Foose then noted that Thomas “spoke to her as if he had ‘cotton mouth’ and a large amount of an unknown item inside his mouth.”2 She also observed “strands in his mouth that were almost like gum and paste,” that his lips were “pasty white,” and that his “face was covered with a white powdery substance.”3 She believed that Thomas had ingested something and was concealing it in his mouth.4 As a result, Probation Officer
During Thomas‘s detention, four additional officers (Corporal Scott Johnsen and Officers Adrienne Salazar, Travis Banning, and Brian Carriere) arrived at the scene. Probation Officer Kinsinger and Officer Foose informed each officer that they believed that Thomas had ingested cocaine. Officer Salazar independently arrived at the same conclusion after observing a white powdery substance covering Thomas‘s lips, and informed Thomas that ingesting cocaine could have an “ill effect” on Thomas‘s health.9 Corporal Johnsen “acknowledged the seriousness of ingesting cocaine by warning . . . Thomas that he could possibly die from ingesting drugs.”10 Officer Banning also observed a “large amount of white residue around and on . . . Thomas’ lips,” and did not find any evidence of candy cigarettes.11 Based on their observations, the Officers filed police reports indicating Thomas‘s cocaine ingestion, and Officer Foose prepared and signed an Affidavit of Probable Cause noting that she had observed Thomas consume “crack cocaine in order to conceal it from police.”12
The Officers jointly determined that Thomas should be transferred to Dauphin County Booking Center at the Dauphin County Prison for detention and processing. Dauphin County contracts with PrimeCare to provide limited medical care to individuals at Dauphin County Prison. PrimeCare does not have hospital features such as x-ray or CT machines but instead transfers individuals to a nearby hospital for testing and treatment. In addition, Harrisburg Police Department policy dictates that officers take arrestees to the hospital if the arrestees have “consumed illegal narcotics in a way that could jeopardize their health and welfare.”13 Despite this policy and the observations noted above, the Officers did not take Thomas to the hospital. Instead, Officer Carriere arrested Thomas and transported him to Dauphin County Booking Center. En route, Thomas told Officer Carriere that he was hot despite an outdoor temperature of 46 degrees.14 Officer Carriere opened the window.
Upon arrival at the Dauphin County Booking Center, Officer Carriere informed prison officials and medical staff there that Thomas “may have swallowed crack cocaine.”15
B. Procedural History
Sherelle Thomas sued numerous parties after her relative‘s death. Several defendants moved to dismiss the Complaint, and the District Court granted the motions. Sherelle Thomas then filed an Amended Complaint. The Amended Complaint asserted various state and federal claims against several defendants, including the Officers. Only Count IV (Fourteenth Amendment; Failure to Render Medical Care) and Count I (Fourteenth Amendment; Failure to Intervene) are relevant to this appeal.
The Amended Complaint drew six motions to dismiss and one motion for judgment on the pleadings and three other motions, each of which the District Court denied in full.17 As relevant to this appeal, the District Court found that the Officers were not entitled to qualified immunity on the failure to intervene and failure to render medical care claims because the rights are clearly established, and the Amended Complaint states facts sufficient to allege that the Officers violated these rights. Officers Johnsen, Salazar, Banning, Foose, and Carriere, and Probation Officer Kinsinger filed a collateral appeal, limited to the issue of qualified immunity.
II. JURISDICTION
The District Court had subject matter jurisdiction under
III. DISCUSSION
The Officers contend that they are entitled to qualified immunity on the failure to render medical care and failure to intervene claims. We review a district court‘s denial of a motion to dismiss on qualified immunity grounds de novo “as it involves a pure question of law.”19 In doing
At the motion to dismiss stage, federal and state officials are entitled to qualified immunity unless (1) the “facts, taken in the light most favorable to the plaintiff, demonstrate a constitutional violation,”21 and (2) the alleged right was clearly established at the time of the violation.22 Because Sherelle Thomas alleged a violation of the constitutional right to medical care, made applicable in this case to all the Officers due to their knowledge of Thomas‘s obvious consumption of a large amount of cocaine, the Officers are not entitled to qualified immunity on the claim of failure to render medical care. However, the District Court erred in finding that the failure to intervene claim involved a constitutional violation. We have not recognized a cause of action for such a purported constitutional violation.
A. Failure to Render Medical Care23
1. Violation of the Constitutional Right to Medical Care
To plead a violation of the right to medical care, an individual must allege (1) “a serious medical need” and (2) “acts or omissions by [individuals] that indicate a deliberate indifference to that need.”24 A serious medical need is “one that has been diagnosed by a physician as requiring treatment or one that is so obvious that a layperson would easily recognize the necessity for a doctor‘s attention.”25 Deliberate indifference is a subjective standard consistent with recklessness.26 It requires both that an individual be aware of facts from which the inference could be drawn of a substantial risk and that the individual actually draws that inference.27 In inadequate medical care cases, we have specifically found deliberate indifference where objective evidence of a serious need for care is ignored and where “necessary medical treatment is delayed for non-medical reasons.”28
We will look to the allegations of the Complaint to determine the adequacy of Sherelle Thomas‘s pleading of such a violation. She described numerous facts demonstrating a serious medical need. The facts she has alleged support the position that a layperson in the Officers’ situation29
As set forth in the Amended Complaint, Officer Foose‘s statements to Officers Salazar, Banning, and Carriere, as well as her signed Affidavit of Probable Cause, are sufficient to support the allegation that Officer Foose believed that Thomas ingested cocaine. Her belief was based on multiple observations of Thomas: a large amount of an unknown substance was in his mouth, his lips were pasty white, his face was covered with a white powdery substance, cocaine rocks fell from his shirt, and his candy cigarette explanation was not plausible.30 She also observed him spit out a “white liquid that resembled crack cocaine attempted (sic) to be swallowed.”31
The Amended Complaint also alleged that Officers Johnsen, Salazar, Banning, and Carriere and Probation Officer Kinsinger believed that Thomas had ingested a significant quantity of cocaine. A layperson would have known that created a serious medical need. Like Officer Foose, Probation Officer Kinsinger notified another officer of this belief after observing Thomas. Officer Salazar also observed a white powdery substance on Thomas‘s lips, and both Officers Salazar and Johnsen verbalized their belief that Thomas had ingested cocaine. Officer Banning observed a “large amount of white residue around and on his lips” and found no evidence of candy cigarettes.32 Moreover, after Officer Carriere was notified by the other officers that Thomas had ingested cocaine, Thomas told Officer Carriere that he was overheating despite the cold weather outside, an indication that he was in physical distress and in need of medical attention. In view of the above allegations, the Officers cannot credibly argue that Thomas‘s denial that he ingested cocaine, taken in the light most favorable to Sherelle Thomas, would negate the conclusion that a layperson would believe that he had, in fact, ingested a significant amount of cocaine and therefore had a serious medical need. Ironically, an arrestee, who consumed drugs for the purpose of concealing them, would probably deny having done so.
Having established objective evidence of a serious medical need, the Amended Complaint alleged facts to support that the Officers were deliberately indifferent to that need. First, each Officer was aware of numerous facts from which one could draw an inference of a substantial risk to Thomas‘s health. In view of the undisputed evidence of record, the Officers fail in their argument that Thomas‘s alleged lack of observable symptoms negate the facts from which an inference of a substantial risk to Thomas‘s health could be drawn.
Second, the Complaint alleges that each Officer actually drew the inference of a substantial risk to Thomas‘s health. Cocaine ingestion poses an obvious health risk,33 and the Amended Complaint asserts
Finally, the Complaint alleges that the Officers ignored evidence of this risk and delayed medical care by deciding to book Thomas and by taking him to a booking center that was ill-equipped to handle emergencies. Moreover, this decision was in direct violation of the department policy cited in the Complaint, which states that individuals who have consumed narcotics should be taken to the hospital if the narcotic consumed could jeopardize their health.35
These facts distinguish this case from those the Officers cite in opposition to a holding that there was a constitutional violation. Most of these cases involved officers who demonstrated no actual belief of narcotic ingestion or officers who failed to draw an inference of substantial risk.36 Because there are sufficient allegations here from which to find deliberate indifference, as well as a serious medical need, Sherelle Thomas has plausibly alleged a violation of the right to medical care.
2. Clearly Established Right
However, before the Officers can be denied qualified immunity from being sued for deliberate indifference to a serious medical need, the constitutional right violated must be clearly established.37 In other words, qualified immunity operates “to ensure that before officers are subjected to suit, they are on notice their conduct is unlawful.”38
The District Court properly recognized the “right to medical care for persons in custody of law enforcement.”39 The Supreme
The Officers suggest we should articulate the right as follows:
whether Mr. Thomas had a constitutional right established “beyond debate” to be taken to a hospital emergency room for treatment when none of the officers witnessed him ingest drugs, he repeatedly denied cocaine ingestion even when warned it could cause his death, his companions denied seeing cocaine, he denied experiencing symptoms consistent with cocaine or fentanyl toxicity, he did not request medical care, showed no overt signs of being in medical distress and was taken directly to the prison booking center where he was assessed medically and cleared by the prison‘s medical staff to remain.41
The law, however, does not require such specificity. Although the Officers are correct that the right must be defined beyond a high level of generality,42 there need not be “a case directly on point for a right to be clearly established.”43 “‘A public official,’ after all, ‘does not get the benefit of “one liability-free violation” simply because the circumstance of his case is not identical to that of a prior case.‘”44 Instead, the law requires only that the right “is sufficiently clear that a reasonable official would understand that what he is doing violates that right.”45 That standard is met when a violation is “so obvious” it becomes likewise evident that a clearly established right is in play, “even in the absence of closely analogous precedent.”46 As a result, qualified immunity is not appropriate when the case in question presents “extreme circumstances” to which “a general constitutional rule already identified in the decisional law may apply with obvious clarity.”47 That is the case before us.
We may rely on general principles to find that the facts here present a violation that is “so obvious” “that every objectively reasonable government official facing the circumstances would know that the [Officers‘] conduct . . . violate[d] federal law when [they] acted.”48 In such a case, “general standards can ‘clearly establish’ the answer, even without a body of relevant
As applied to the facts of this case, we hold therefore that when an officer is aware of the oral ingestion of narcotics by an arrestee under circumstances suggesting the amount consumed was sufficiently large that it posed a substantial risk to health or a risk of death, that officer must take reasonable steps to render medical care.51 In this case, that care would have been to take the arrestee to a hospital, as provided for in the Harrisburg Police Department policy.52
For the above reasons we will affirm the District Court‘s denial the Officers’ claims for qualified immunity.
B. Failure to Intervene
The Officers contend that the District Court improperly denied their motion to dismiss because (1) Sherelle Thomas cannot adequately plead a violation of failure to intervene to prevent a violation of the right to medical care where no such cause of action exists and (2) there is no clearly established right to intervention in the context of medical care.
The District Court does not directly address whether individuals have a clearly established right to intervention. We agree with the Officers that we have not recognized any such right, nor has the Supreme Court. Though we have recognized a right to have a government actor intervene when the underlying constitutional violation involves excessive force or sexual assault of a person in custody or detention, we have since concluded that our precedent does not establish, let alone clearly establish, a right to intervention in other contexts.53
Because there is no clearly established right to intervention in the medical context, we need not address the Officers’ contention that Sherelle Thomas has failed to plausibly allege a violation of such a right.54
Because there is not a clearly established right to intervention to prevent a violation of the right to medical care, the Officers are entitled to qualified immunity as to Sherelle Thomas‘s failure to intervene claim.
IV. CONCLUSION
For the foregoing reasons, we will affirm in part and reverse in part the District Court‘s order denying qualified immunity.