STEPHANIE TROUTMAN, Administratrix of the Estate of Charles R. Troutman, Jr., Plaintiff-Appellant, v. LOUISVILLE METRO DEPARTMENT OF CORRECTIONS, et al., Defendants, LOUISVILLE-JEFFERSON COUNTY METRO GOVERNMENT; MARK E. BOLTON, individually and in his official capacity as Director, Louisville Metro Department of Corrections; JAMES COX, Prison Classification Interviewer, individually and in his official capacity, Defendants-Appellees.
No. 20-5290
United States Court of Appeals for the Sixth Circuit
Decided and Filed: October 29, 2020
RECOMMENDED FOR PUBLICATION Pursuant to Sixth Circuit I.O.P. 32.1(b). File Name: 20a0344p.06. Argued: October 6, 2020. Before: DAUGHTERY, DONALD, and READLER, Circuit Judges.
Appeal from the United States District Court for the Western District of Kentucky at Louisville. No. 3:16-cv-00742—David J. Hale, District Judge.
COUNSEL
ARGUED: Alphonse A. Gerhardstein, GERHARDSTEIN & BRANCH CO. LPA, Cincinnati, Ohio, for Appellant. J. Denis Ogburn, JEFFERSON COUNTY ATTORNEY’S OFFICE, Louisville, Kentucky, for Appellees. ON
OPINION
BERNICE BOUIE DONALD, Circuit Judge. In this case, Charles Troutman, a pretrial detainee at the Louisville Metro Department of Corrections (“LMDC”), committed suicide after jail officials placed him in solitary confinement despite a recent suicide attempt. Plaintiff Stephanie Troutman (“Stephanie”), Charles’ daughter and administrator of his estate, filed this action pursuant to
I. BACKGROUND
A. Charles Troutman’s Arrest and Suicide Attempt
The Louisville Metro Police arrested Charles for various drug offenses on November 12, 2015. His intake paperwork showed that he was a daily user of heroin and methamphetamine, including use on the date of his arrest. Early on November 13, Charles first attempted suicide inside the holding cell. According to the deposition testimony of Sergeant Eric Schmitt (“Schmitt”), another officer found Charles “with gauze tied so tightly around his neck that [Charles] was choking.” Charles’ “inmate notes” prepared by Cox, show that Charles attempted to hang himself on the booking floor. The officer who discovered Charles said that the gauze was so tight that he could not get a finger in. Charles also allegedly asked the responding officer why he did not leave Charles for a few more minutes.
The reported reasons for the suicide attempt vary. Charles told Schmitt that he “was a junkie and had no reason to live because he was going to get 20 years for his charges,” but Dr. Donna Smith (“Smith”) later testified that Charles told her he was upset at being in holding and felt like staff was ignoring him and that Charles knew if he did “something like that, that he would get moved out of there immediately.” Smith did not consider the attempt to be serious because he did not hang from anything and did not have any mark on his neck. Bolton thought that “the attempt was really nothing more than attention getting.”
That same day, November 13, jail staff placed Charles on Level 1 suicide observation and detox. A nurse conducted a medical screening soon after the suicide attempt. That screening showed that Charles attempted suicide three to four times in the past, and that he was “currently thinking about suicide” and had “a plan or suicide instrument in [his] possession.”1
A November 14 report described Charles as distractible, agitated, and irritable with tangential thought processing and pressured speech. Charles explained that he had no head injuries within the prior six months, although Stephanie called the jail to report that he recently experienced a traumatic brain injury that required hospitalization.2 No one in the jail conveyed that information to the medical staff, according to Smith’s deposition testimony. Nonetheless, a behavioral health psychiatric evaluation conducted by Correct Care Solutions on November 16 noted that Charles experienced a traumatic brain injury the prior year which left him in a coma for nine days.
That November 14 report shows that Charles told medical staff “I’m not good at all, I’m dying! The nurses don’t like me because I’m a junkie.” The report also indicated sleep disturbance and minimal appetitive. A report from the following day, however, showed improvement. Charles denied any suicidal intent, remarking that “I love myself the most.” The reports also showed improvement in appetite and interaction with peers, though they did note continued significant sleep disturbances, presumably related to his detox.
On November 16, Charles first met with Smith. Under relevant past medical history, Smith’s evaluation indicated the traumatic brain injury the prior year as well as stuttering and hypertension. Smith wrote that Charles denied his attempt was an actual suicide attempt and noted that he was calm and cooperative during the evaluation. The two spoke about Charles’ traumatic brain injury, but Smith did not further investigate that injury. Nor did she speak with any of the officers present at the scene of the attempt, and thus she only later learned the extent to which Charles tightened the gauze around his neck or the condition in which the officers found Charles—“spitting and jerking.” According to Smith, during these three days of observation, “not one person said that [Charles] was suicidal, saw him crying, saw him sad, [or] saw him with a flat affect.”
B. Clearance to General Population
On November 17, mental health officials cleared Charles to move to general population. Bolton indicated that after staff cleared Charles to general population, there was nothing to indicate that he was acutely suicidal. According to Bolton, “[t]here was nothing to indicate that [Charles] had—was—was going to kill himself. If—if there was, we would’ve done something about it.”
The following day, Stephanie called her father and became worried at the extent of Charles’ crying, which Stephanie says was unusual for him. Consistent with his explanation to the officers who found him after the suicide attempt, Charles expressed worry that he would receive a lengthy
C. Move to Solitary
On November 18, Charles got into a verbal altercation with another inmate. Because of that altercation, jail officials moved Charles to the Community Corrections Center (“CCC”) 4 North 1. The CCC does not have single segregation cells. Days later, on November 21, Charles received another disciplinary infraction for a physical altercation with another inmate, upon which staff moved him back from CCC to the main jail complex.3 Cox was responsible for Charles’ subsequent placement, and he understood jail policy to require placement in solitary confinement pending disciplinary proceedings. When Defendant Cox moved Charles to solitary, Cox knew that Charles had a prior suicide attempt in jail, though he was not privy to all of Charles’ records from medical.4 Cox himself entered the note on November 13 indicating that Charles tried to hang himself in a booking cell. Nonetheless, Cox understood Charles’ clearance to return to general population as authorizing Charles for all movement within the jail.
Cox chose to place Charles in a solitary cell with barred windows. He then decided to notify Nurse Brown (“Brown”) of Charles’ move to solitary. In his deposition, Cox described the call to Brown as a “general courtesy” call. Cox stated that his concern at the time was the risk of seizures from detox, not suicide. Cox spoke with Brown who indicated that she would pass the message along to the Charge Nurse. Cox entered the following into XJail, the record-keeping system: “INMATE MOVED TO H5D9 PENDING DISCIPLINARY. NOTIFIED NURSE BROWN OF SINGLE CELL USE AND WAITING TO HERE [sic] BACK FROM MEDICAL ON THAT.” Cox stated in his deposition that he would expect to hear back if there were any problems with Charles going to that particular cell.5
Later, however, Cox stated in his deposition that he understood jail policy to require at minimum verbal clearance from medical before placing someone like Charles in a solitary cell. In response to a 2014 suicide in a barred solitary cell,6 the
Cox understood the procedure as requiring verbal clearance. He also stated that he believed because of Charles’ recent suicide attempt—which he knew about at the time of Charles’ placement in solitary—moving Charles to a solitary cell could “harbor a risk” of suicide, but that despite this “gut reaction” counseling against moving Charles into solitary, (1) Cox was not the one qualified to make that decision, and (2) his opposition “wouldn’t have changed [Charles’] placement.” He did note, however, that if he had said “Hey, I think this guy’s going to commit suicide,” that mental health would have performed another evaluation before moving Charles. Smith later testified that if she had received such a call, she “would [have] recommend[ed] Charles not be placed in a single cell” based on his recent suicide attempt. Another nurse supervisor testified that he would have recommended Charles be placed in a cell with no bars because of concern a barred cell presents “ligature points” and that “[t]hey were not supposed to move him until they heard back from medical.”7 Cox himself agreed that placing an inmate with a bedsheet in a barred solitary cell presented an opportunity for a suicidal inmate to commit suicide.
Despite noting that he was waiting to hear back from medical, Cox did not wait. Cox moved Charles to a solitary cell with bars. Less than two hours after his move to that solitary cell, Charles hanged himself. At 10:47 P.M. on November 24, an officer found Charles hanging from a bedsheet tied to the bars in his cell. Jail staff immediately began CPR and transported
D. Procedural History
Stephanie Troutman, as personal representative of Charles Troutman’s estate, initially brought suit against several defendants, including: Louisville Metro Department of Corrections, Louisville/Jefferson County Metro Government, Mark Bolton, seven correction officers, Correct Care Solutions, four Correct Care Solutions nurses, and several John and Jane Does. Troutman asserted claims under
Subsequently, Defendants Bolton, Cox, and Louisville-Jefferson County Metro Government moved for summary judgment, and to exclude portions of the expert testimony of Dr. Glindmeyer. On March 3, 2020, the district court granted that motion for summary judgment for all defendants on all counts. The district court dismissed Stephanie’s
II. ANALYSIS
A. Standard of Review
“We review the district court’s grant of summary judgment de novo.” Romans v. Mich. Dep’t of Hum. Servs., 668 F.3d 826, 835 (6th Cir. 2012) (citing Blackmore v. Kalamazoo County, 390 F.3d 890, 894 (6th Cir. 2004)). “The court shall grant summary judgment if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.”
B. Section 1983 Claim for Deliberate Indifference to Serious Medical Needs
Troutman asserts claims under
Though the basis for this claim for convicted prisoners arises under the
Under our traditional analysis, the deliberate indifference standard at issue has both an objective and subjective component. Downard for Est. of Downard v. Martin, 968 F.3d 594, 600 (6th Cir. 2020).8 Under the objective standard, a pretrial detainee must show an objectively “sufficiently serious” medical need. Farmer v. Brennan, 511 U.S. 825, 834 (1994). To show that the medical need was sufficiently serious, the plaintiff must show that the conditions of incarceration imposed a “substantial risk of serious harm.” See Miller v. Calhoun County, 408 F.3d 803, 812 (6th Cir. 2005) (internal citations omitted). An inmate’s “psychological needs may constitute serious medical needs, especially when they result in suicidal tendencies.” Comstock, 273 F.3d at 703 (citing Horn, 22 F.3d at 660). A plaintiff meets the objective
Under the subjective standard, “an inmate must show both that an official knew of her serious medical need and that, despite this knowledge, the official disregarded or responded unreasonably to that need.” Downard, 968 F.3d at 600 (citing Comstock, 273 F.3d at 703). Under this standard, a plaintiff “must show both that a prison official ‘subjectively perceived facts from which to infer substantial risk to the prisoner’ and that he ‘did in fact draw the inference’ but disregarded that risk. Id. (citing Comstock, 273 F.3d at 703); see also Farmer, 511 U.S. at 834. The failure to alleviate a significant risk that an officer “should have perceived but did not” is insufficient for a claim of deliberate indifference, id. at 838, but such subjective knowledge may be inferred from the fact that a pretrial detainee’s “substantial risk” of harm was “obvious.” Id. at 842.
For prison suicide cases, the subjective standard requires that it was “obvious that there was a ‘strong likelihood’ that an inmate would attempt suicide.” Downard, 968 F.3d at 600 (quoting Gray v. City of Detroit, 399 F.3d 612, 616 (6th Cir. 2005)). It is insufficient to show that an official “acted with deliberate indifference to some possibility of suicide, or even a likelihood of suicide.” Galloway v. Anuszkiewicz, 518 F. App’x 330, 336 (6th Cir. 2013) (emphasis in original). This distinction is critical “because a finding of deliberate indifference requires a sufficiently culpable state of mind, which the Supreme Court has equated with criminal recklessness.” Id. (citing Weaver v. Shadoan, 340 F.3d 398, 410 (6th Cir. 2003)). The official’s “state of mind must evince ‘deliberateness tantamount to intent to punish.’” Miller, 408 F.3d at 813 (quoting Horn, 22 F.3d at 660).
Knowledge of the “strong likelihood” of suicide is a “question of fact subject to demonstration in the usual ways, including inference from circumstantial evidence.” Farmer, 511 U.S. at 842. Demonstrating such knowledge is a “high bar” and typically requires evidence that the inmate was already on suicide watch, previously attempted suicide under similar conditions, or recently expressed a desire to self-harm. Downard, 968 F.3d at 601 (citing Grabow v. County of Macomb, 580 F. App’x 300, 309 (6th Cir. 2014) (collecting cases)). Despondency after an arrest, even if coupled with other stressors like drug withdrawal, does not itself lead to a “strong likelihood” of suicide, at least if the inmate expressly denies feeling suicidal. Barber v. City of Salem, 953 F.2d 232, 239–40 (6th Cir. 1992); Baker-Schneider v. Napoleon, 769 F. App’x 189, 193–94 (6th Cir. 2019); Nallani v. Wayne County, 665 F. App’x 498, 507–08 (6th Cir. 2016) (holding that inmate did not present a “strong likelihood” of suicide because he denied feeling suicidal, despite indicating previous suicidal thoughts and a history of self-harm).
i. Defendant Cox
Stephanie alleges that the district court erred in granting summary judgment in favor of Cox because there are genuine disputes of material fact regarding (1) whether Cox reasonably relied on the opinions of medical personnel and (2) whether Cox had subjective knowledge that Charles was at risk of committing suicide. In response, Cox asserts that he did not believe Charles was suicidal because a nurse previously cleared him from suicide
Here, Stephanie meets the objective component insofar as her father “exhibited suicidal tendencies” during his detention. Charles first attempted suicide on November 14. Such an attempt itself exhibits suicidal tendencies sufficient to meet the objective component. See, e.g., Collins v. Seeman, 462 F.3d 757, 760 (7th Cir. 2006). Even though that past attempt did not necessarily demonstrate that Charles would re-attempt suicide, we have previously held that a prior attempt alone is sufficient to raise a dispute as to the objective component. Perez, 466 F.3d at 425. In addition to the attempt, Charles exhibited numerous other suicide risk factors according to the factors set forth by Defendants’ own witness, Dr. Smith. In addition to a prior suicide attempt, Dr. Smith testified that other suicide risk factors include: (1) a history of alcohol and substance abuse, (2) feeling of hopelessness, (3) impulsive or aggressive tendencies, (4) isolation,9 (5) access to methods for suicide, (6) a history of mental illness, particularly clinical depression, and (7) prior traumatic brain injuries.
Considering next the subjective component, we have previously held that a plaintiff demonstrated deliberate indifference sufficient to overcome a motion for summary judgment when “a prison official moved an inmate from suicide watch even though the official knew the inmate threatened and attempted suicide on several occasions within the same month in jail and had previously been placed on behavior and suicide watches during multiple prior incarcerations at the same jail.” Grabow, 580 F. App’x at 308–09 (citing Perez, 466 F.3d at 424–26). In Perez, the official decided to move the detainee into single-cell housing without first requesting a medical judgment from the jail doctor as to whether that placement was appropriate for the inmate, particularly where the official knew of prior suicide attempts. Perez, 466 F.3d at 425. In addition to his prior suicide attempts, the official also knew that the detainee was refusing to take his medication and “was experiencing problems getting along with other inmates.” Id. We noted that the evidence was not conclusive as to the subjective deliberate indifference— particularly where the detainee explicitly expressed no suicidal ideation—but held that the evidence nonetheless raised a genuine issue of material fact whether the official “demonstrated deliberate indifference by disregarding a risk of known serious harm to [the detainee] by making housing decisions for him without consulting a medical professional.” Id. at 426.
The facts here are similar; a reasonable jury could find that Cox was subjectively aware of the substantial risk to Charles. Cox knew of Charles’ suicide attempt in booking. Cox knew that placing Charles in solitary confinement “harbor[ed] a risk” given Charles’ prior suicide attempt. Cox knew that barred solitary cells presented a risk of suicide to the extent they provided detainees with means of suicide. Cox knew that he at least needed to get verbal clearance from medical before placing Troutman in a single barred cell. Indeed, in XJail, Cox wrote “INMATE MOVED TO H5D9 PENDING DISCIPLINARY. NOTIFIED NURSE BROWN OF SINGLE CELL USE AND WAITING TO HERE [sic] BACK FROM MEDICAL ON THAT.” Yet despite that knowledge, and despite his own statement that he was waiting to hear back from medical, Cox did not wait to receive confirmation—written or verbal—from medical allowing Cox to place Charles in a barred single cell. Instead,
Taken together, these facts raise a genuine dispute as to whether Cox knew or understood there to be a “strong likelihood” that Charles would commit suicide if placed in solitary confinement. Downard, 968 F.3d at 600 (describing the “strong likelihood” standard and noting that evidence of a previous suicide attempt may suffice to show subjective knowledge).12
This evidence—Cox’s knowledge of the risks and disregard thereof—raises a genuine issue of material fact as to whether he demonstrated deliberate indifference by placing Charles in solitary confinement without hearing back from medical. Perez, 466 F.3d at 426. This, of course, is not conclusive evidence of deliberate indifference; rather “the evidence presents a sufficient disagreement to require submission to a jury . . . .” Calumet Farm, 398 F.3d at 558–59.
We note that Cox’s reliance argument—that he reasonably relied on the medical judgment that Charles no longer presented a suicide risk—does not make summary judgment appropriate. In Perez, the prison official proffered a similar argument—asserting that the official relied on a doctor’s assessment that the detainee was not suicidal—but we found that such reliance was ineffective when the doctor made the assessment ten days prior to the official’s decision to move the inmate. Perez, 466 F.3d at 425. We also noted that “the situation did not remain stable between” the date of the doctor’s assessment and the date the jail official moved the detainee to a single cell, considering that the detainee refused to take medication and began experiencing problems with other inmates. Id.
The same is true here. The situation did not remain stable between Charles’ initial clearance from medical on November 17 and his suicide on November 24. For one, Charles, like the detainee in Perez, was “experiencing problems getting along with other inmates” in that he was involved in two separate altercations, the final of which merited his removal to isolation. Id. Further, Charles was cleared “from detox
actions before moving Charles to solitary contradict his argument that he relied on a previous medical assessment that Charles was free for placement anywhere in the jail. Cox himself noted in jail records that he was waiting to hear back from medical to move Charles to a single barred cell.
On appeal Cox argues that he relied on the initial medical clearance, but jail records (and his deposition testimony) reveal that he himself was waiting on a new assessment from medical regarding Charles’ placement in solitary. If Charles were relying on a previous medical assessment, he would have no need to wait on a new one. Like the testimony of the defendant classification officer in Linden, 167 F. App’x at 424, such inconsistent testimony at minimum raises a genuine dispute as to whether Charles’ reliance was reasonable such that he did not “disregard” a known serious medical risk. The evidence regarding Cox’s subjective awareness is not “so one-sided” that Cox must prevail as a matter of law. Calumet Farm, 389 F.3d at 558–59. Accordingly, we reverse the district court’s granting summary judgment in favor of Cox.
ii. Defendant Bolton
Stephanie next argues that the district court erred in granting summary judgment in favor of Defendant Bolton, the jail warden. Though Bolton was not involved in the events leading up to Charles’ suicide, Stephanie asserts that Bolton abandoned the duties of his position, in the face of actual knowledge of the risk of suicide by “fail[ing] to establish policies that would protect inmates at risk of suicide from harm, [fail]ing to train and supervise his staff on how to protect inmates at risk of suicide from harm, and fail[ing] to act on the recommendation that would have effectively mitigated the risk posed by the single barred isolation cells.” Defendants respond that Bolton cannot be found deliberately indifferent because there is no allegation that he “completely abdicated” any of his responsibilities but rather merely allegations that he inadequately took steps to mitigate the risk of detainee suicide.
A supervisor may not be found liable under
Two cases highlight the extent to which the supervisor must have been personally responsible for the constitutional injury for
Stephanie does not claim that Bolton encouraged a specific incident of misconduct, directly participated in that misconduct, or abandoned the specific positions of his duty in the fact of actual knowledge of a breakdown in the proper workings of the jail. Bellamy, 729 F.2d at 421; Taylor, 69 F.3d at 81. Rather, Stephanie claims that Bolton inadequately performed his responsibilities—for instance, by failing to put in writing the policy of requiring medical clearance before transfer to solitary—but such allegations of inadequate performance fall short of the requirements to impose supervisory liability. Winkler, 893 F.3d at 899 (distinguishing allegations of inadequate performance from complete abdication of responsibility). Indeed, there was a standing “no bars” policy in place that medical would place on an inmate’s XJail if medical determined the inmate was a suicide risk. Even if we are to assume a “breakdown in the proper workings” of this policy—which is plausible, considering the suicide at issue here—Stephanie does not allege that Bolton knew the policy was not working and nonetheless completely abdicated his responsibilities. She has not shown that Bolton “either encouraged the specific incident of misconduct or in some other way directly participated in it” nor has she shown that Bolton “at least implicitly authorized, approved, or knowingly acquiesced in the unconstitutional conduct of the offending officers.” Hays v. Jefferson County, 668 F.2d 869, 874 (6th Cir. 1982); see also Nallani, 665 F. App’x at 512. Rather, Stephanie claims that Bolton inadequately performed his duties, but such claims are insufficient for
iii. Louisville Metro Government
Finally, Stephanie seeks to hold the Louisville Metro Government liable because its “policies and procedures were the moving force behind the denial of adequate medical care to Mr. Troutman.” She argues first that Bolton, as an official with final decision-making authority, failed to ensure that LMDC operated with adequate policies, training, and supervision, and that he failed to adopt a recommendation that he make bars inaccessible in solitary cells. She also argues that Louisville Metro Government is liable based on a custom of inaction insofar as the pattern of suicides put the municipality on notice that the failure to correct the problem would place future inmates at risk of harm. Finally, she argues that inadequate policies, training, and supervision were the “moving force” behind Charles’ suicide. A municipality “cannot be held liable under
However, “[v]ery few cases have upheld municipal liability for the suicide of a pre-trial detainee,” id., and our cases clearly distinguish between deliberate indifference and negligence. Id. at n.1 (“Deliberate indifference remains distinct from mere negligence. Where a city does create reasonable policies but negligently administers them, there is no deliberate indifference and therefore no
If the plaintiff fails to establish a constitutional violation by any individual officer, the municipality itself cannot be held liable under
We agree with the district court in granting summary judgment in favor of the Louisville Metro Government. Stephanie’s allegations against the municipality may support the conclusion that it was negligent, but a “finding of negligence does not satisfy the deliberate indifference standard.” Id. (citing Gray, 399 F.3d at 618 n.1; Molton, 839 F.2d at 246). Our holding that Cox was arguably deliberately indifferent rests in large part on his failure to follow the prison’s policy regarding obtaining clearance from medical staff before placing an inmate in solitary confinement. That is to say, underlying our finding of potential liability on Cox is a finding that Cox deliberately ignored jail policy; Stephanie’s arguments suggest that if another employee had properly followed the jail’s policy, then Charles’ suicide could have been prevented. In Perez, we found a similar tension between the arguments against an individual officer and against the municipality. Id. at 432. There, the plaintiff argued that placing the decedent in a single cell before his suicide “wholly disregarded jail policy” which requires such inmates indicating potentially suicidal behavior be placed in a “multiple cell with appropriate supervision.” Id. Though we found that the individual officer was arguably deliberately indifferent in his disregard of the risk of moving the decedent into solitary, see id. at 425, we found that those same arguments counseled against finding the municipality liable. Id. at 432. In other words, the arguments against the individual officer—that he failed to follow jail policy—itself implies the existence of a policy which, if followed adequately, would have prevented the suicide. See also Linden, 167 F. App’x at 420 (“It appears Plaintiff cannot decide whether the policies or their execution was at fault.”).
Here, the municipality did have policies in place. It is plausible that the municipality was negligent in enacting and enforcing those policies, but “[d]eliberate indifference remains distinct from mere negligence. Where a city does create reasonable policies, but negligently administers them, there is no deliberate indifference and therefore no
Moreover, “[p]retrial detainees do not have a constitutional right for cities to ensure, through supervision and discipline, that every possible measure be taken to prevent their suicidal efforts.” Id. Though we find that Cox was arguably deliberately indifferent in executing jail policies, such a finding of individual liability cannot—without more—support a finding of municipal liability because a municipality
Accordingly, we affirm the district court’s grant of summary judgment in favor of the Louisville Metro Government.
C. State Law Claims
Finally, Stephanie asserts that the district court erred in declining to exercise supplemental jurisdiction over the state law claims for gross negligence and wrongful death. The district court declined such jurisdiction because it dismissed all of Stephanie’s federal claims. Because we have revived some of her federal claims, it is appropriate to reinstate the state-law claims to the extent they are relevant to the remaining federal claims against Cox. See Glazer v. Chase Home Fin. LLC, 704 F.3d 453, 465 (6th Cir. 2013) (distinguished on other grounds).
III. CONCLUSION
Because there remains a genuine dispute concerning whether Defendant Cox was deliberately indifferent, we reverse the district court’s grant of summary judgment in favor of him, as well as reinstate the state-law claims to the extent they are relevant to Cox. As to Bolton and the Louisville Metro Government, we affirm.