Aldaba v. Marshall County , 844 F.3d 870 ( 2016 )


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  •                                                                                 FILED
    United States Court of Appeals
    PUBLISH                              Tenth Circuit
    UNITED STATES COURT OF APPEALS                    December 20, 2016
    Elisabeth A. Shumaker
    FOR THE TENTH CIRCUIT                         Clerk of Court
    _________________________________
    ERMA ALDABA, as personal
    representative and next of kin to Johnny
    Manuel Leija, deceased,
    Plaintiff - Appellee,
    v.                                                  Nos. 13-7034 & 13-7035
    BRANDON PICKENS,
    Defendant – Appellant;
    JAMES ATNIP; STEVE BEEBE,
    Defendants – Appellants,
    and
    THE BOARD OF MARSHALL COUNTY
    COMMISSIONERS; THE CITY OF
    MADILL;
    Defendants.
    _________________________________
    Appeal from the United States District Court
    for the Eastern District of Oklahoma
    (D.C. No. 6:12-CV-00085-FHS)
    _________________________________
    Clark Crapster, Steidley & Neal, Tulsa, Oklahoma, and Jordan L. Miller, Collins Zorn &
    Wagner, Oklahoma City, Oklahoma (Eric D. Janzen and Philip W. Anderson, Collins
    Zorn & Wagner, Oklahoma City, Oklahoma, on the briefs), for Defendant-Appellants
    James Atnip and Steve Beebe.
    Jeremy J. Beaver, Gotcher & Beaver Law Office, McAlester, Oklahoma, for Plaintiff-
    Appellee.
    _________________________________
    Before BRISCOE, McKAY, and PHILLIPS, Circuit Judges.
    _________________________________
    PHILLIPS, Circuit Judge.
    _________________________________
    In Aldaba v. Pickens, 
    777 F.3d 1148
     (10th Cir. 2015), this Court affirmed the
    district court’s denial of summary judgment for three law-enforcement officers
    seeking qualified immunity. Relying on the facts that the district court applied to
    deny the summary-judgment motion, we concluded that a jury could find that the
    three officers had violated the Fourth Amendment by using excessive force, and that
    the law saying so was clearly established. 
    Id. at 1161
    .
    After the Supreme Court granted certiorari in Pickens v. Aldaba, 
    136 S. Ct. 479
     (2015) (mem.), it vacated our judgment and remanded “for further consideration
    in light of Mullenix v. Luna, 577 U.S. ----, 
    136 S. Ct. 305
     . . . (2015) (per curiam).”
    Having further considered our earlier opinion, we now hold that the three law-
    enforcement officers are entitled to qualified immunity because they did not violate
    clearly established law. We do not decide whether they acted with excessive force.
    Hence we reverse the district court’s judgment and remand with instructions to grant
    summary judgment in favor of the three law-enforcement officers.
    2
    I.     Mullenix v. Luna
    In Mullenix v. Luna, Israel Leija Jr., fled a Texas police officer trying to arrest
    him on a warrant at a drive-in restaurant. 
    136 S. Ct. at 306
    . The officer pursued Leija,
    as did an officer in a different patrol car, at speeds up to 110 miles per hour on an
    interstate highway. 
    Id.
     During the chase, Leija called police dispatch and threatened
    to shoot the officers unless they abandoned pursuit. 
    Id.
     The dispatcher relayed this
    information over the police radio, also reporting that Leija might be intoxicated. 
    Id.
    In response to the dispatch report, other officers began setting tire-spike strips at
    three highway locations. 
    Id.
     The first location was beneath an overpass on Leija’s
    route. 
    Id. at 307
    . Though Trooper Mullenix arrived at the overpass too late to help set
    the tire spikes, he soon hatched another plan—disabling Leija’s car by gunfire from
    the overpass. 
    Id.
     Despite his supervisor’s radio message to “stand by” to “see if the
    spikes work first,” Trooper Mullenix steadied his rifle and awaited Leija. 
    Id.
     About
    three minutes passed before Leija’s car came into sight. 
    Id.
     Trooper Mullenix fired
    six shots at the car, missing its engine block, radiator, and hood, but striking Leija
    four times. 
    Id.
     Leija’s car rolled into the tire spikes and flipped two and a half times.
    
    Id.
     Inside the car, Leija lay dead, killed by the rifle shots. 
    Id.
    Trooper Mullenix moved for summary judgment on qualified-immunity
    grounds, but the district court denied the motion. 
    Id.
     It concluded that “[t]here are
    genuine issues of fact as to whether Trooper Mullenix acted recklessly, or acted as a
    reasonable, trained peace officer would have acted in the same or similar
    circumstances.” 
    Id.
     (alteration in original) (citing Luna v. Mullenix, Civil Action No.
    3
    2:12-CV-152-J, 
    2013 WL 4017124
    , at *6 (N.D. Tex. Aug. 7, 2013)). Although the
    district court found a genuine issue of material fact about whether Leija had
    presented an immediate threat of physical harm or death to others, it did not further
    decide whether Trooper Mullenix had violated clearly established law governing
    excessive force. Mullenix, 
    2013 WL 4017124
    , at *6.
    After a panel affirmed the district court’s decision, the Fifth Circuit denied en
    banc review. Mullenix, 
    136 S. Ct. at 308
    . Then the panel revised its opinion. Where it
    had earlier agreed with the district court that the “immediacy of the risk posed by
    Leija” was a fact question, it reversed course and declared that the objective
    reasonableness of Trooper Mullenix’s acts instead presented a legal question. 
    Id. at 307
    . Then, evaluating Trooper Mullenix’s conduct as set out in the district court’s
    order, the panel held that his actions were objectively unreasonable—and amounted
    to excessive force—“because several of the factors that had justified deadly force in
    previous cases were absent here: [t]here were no innocent bystanders, Leija’s driving
    was relatively controlled, Mullenix had not first given the spike strips a chance to
    work, and Mullenix’s decision was not a split-second judgment.” 
    Id. at 308
    . Almost
    in passing, the panel concluded that “the law was clearly established such that a
    reasonable officer would have known that the use of deadly force, absent a
    sufficiently substantial and immediate threat, violated the Fourth Amendment.” 
    Id.
    (quoting Luna v. Mullenix, 
    773 F.3d 712
    , 725 (5th Cir. 2014)).
    Addressing only the clearly-established-law prong of the qualified-immunity
    analysis, the Supreme Court reversed. 
    Id.
     It repeated its earlier direction to lower
    4
    courts that they not define clearly established law at a high level of generality. 
    Id.
     In
    this regard, the Court again emphasized that “[t]he dispositive question is ‘whether
    the violative nature of particular conduct is clearly established.’” 
    Id.
     (alteration in
    original) (quoting Ashcroft v. al-Kidd, 
    563 U.S. 731
    , 742 (2011)). Next, the Court
    emphasized that “[t]his inquiry ‘must be undertaken in light of the specific context of
    the case, not as a broad general proposition.’” 
    Id.
     (quoting Brosseau v. Haugen, 
    543 U.S. 194
    , 198 (2004) (per curiam)). Finally, the Court stressed that “specificity is
    especially important in the Fourth Amendment context, where the Court has
    recognized that ‘[i]t is sometimes difficult for an officer to determine how the
    relevant legal doctrine, here excessive force, will apply to the factual situation the
    officer confronts.’” 
    Id.
     (alteration in original) (quoting Saucier v. Katz, 
    533 U.S. 194
    ,
    201 (2001)).
    The Mullenix Court rejected the rationale that the Fifth Circuit used to deny
    Trooper Mullenix qualified immunity. Specifically, the Supreme Court rejected the
    Fifth Circuit’s using as clearly established law a general rule that “a police officer
    may not ‘use deadly force against a fleeing felon who does not pose a sufficient
    threat of harm to the officer or others.’” 
    136 S. Ct. at
    308–09 (quoting Luna, 773
    F.3d at 725). It harked back to Brosseau, where it had rejected as “mistaken” the
    Ninth Circuit’s use of an equally general test for excessive force taken from
    Tennessee v. Garner, 
    471 U.S. 1
     (1985), namely, that “deadly force is only
    permissible where the officer has probable cause to believe that the suspect poses a
    5
    threat of serious physical harm, either to the officer or to others.” Mullenix, 
    136 S. Ct. at 309
     (quoting Haugen v. Brosseau, 
    339 F.3d 857
    , 875 (9th Cir. 2003)).
    In repeating the proper rule for what qualifies as clearly established law, the
    Mullenix Court quoted its earlier cases. For instance, the Court restated what
    Brosseau had set as the correct inquiry in resolving whether the plaintiff had shown
    clearly established law—“whether it was clearly established that the Fourth
    Amendment prohibited the officer’s conduct in the ‘situation [she] confronted’:
    whether to shoot a disturbed felon, set on avoiding capture through vehicular flight,
    when persons in the immediate area are at risk from that flight.” Id. at 309 (alteration
    in original) (quoting Brosseau, 
    543 U.S. at
    199–200). Highlighting that “this area is
    one in which the result depends very much on the facts of each case,” the Brosseau
    Court found no clearly established law under which the officer’s shooting was
    excessive force—“because ‘[n]one of [the cases] squarely governs the case here.” 
    Id.
    (alterations in original) (quoting Brosseau, 
    543 U.S. at 201
    ).
    Along the same line, the Mullenix Court found Anderson v. Creighton, 
    483 U.S. 635
     (1987), “instructive on the required degree of specificity.” Mullenix, 
    136 S. Ct. at 309
    . There, again, the Supreme Court had reversed denial of qualified
    immunity where the circuit court set as the clearly established law a general “right to
    be free from warrantless searches of one’s home unless the searching officers have
    probable cause and there are exigent circumstances.” 
    Id.
     (quoting Anderson, 
    483 U.S. at 640
    ). The Court “faulted that formulation for failing to address the actual question
    at issue: whether ‘the circumstances with which Anderson was confronted . . .
    6
    constitute[d] probable cause and exigent circumstances.’” 
    Id.
     (alteration in original)
    (quoting Anderson, 
    483 U.S. at
    640–41).
    Turning to Trooper Mullenix’s case, the Court began by recounting the facts.
    In particular, it noted that “Mullenix confronted a reportedly intoxicated fugitive, set
    on avoiding capture through high-speed vehicular flight, who twice during his flight
    had threatened to shoot police officers, and who was moments away from
    encountering an officer at [the underpass].” 
    Id.
     Next, as “the relevant inquiry,” it
    asked “whether existing precedent placed the conclusion that Mullenix acted
    unreasonably in these circumstances ‘beyond debate.’” Id. at 309 (quoting al-Kidd,
    
    563 U.S. at 741
    ). It declared that the Estate could not show clearly established law by
    relying on the “general principle that deadly force requires a sufficient threat.” 
    Id.
     In
    reviewing its precedents for a case that would show every reasonable official that it
    was “beyond debate” that Trooper Mullenix’s conduct was excessive force, the Court
    noted the “hazy legal backdrop” in its excessive-force, car-chase cases. 
    Id.
     It
    concluded that neither of its two high-speed-chase cases “squarely governed” under
    Mullenix’s facts. 
    Id.
     at 310 (citing Scott v. Harris, 
    550 U.S. 372
    , 384 (2007) (holding
    that an officer did not violate the Fourth Amendment by ramming the car of a
    fugitive whose reckless driving “posed an actual and imminent threat to the lives of
    any pedestrians who might have been present, to other civilian motorists, and to the
    officers involved in the chase”); Plumhoff v. Rickard, 
    134 S. Ct. 2012
     (2014)
    (holding that an officer acted reasonably when he fatally shot a fugitive who was
    “intent on resuming” a chase that “pose[d] a deadly threat for others on the road”)).
    7
    We summarize by noting that the Mullenix Court rejected the Fifth Circuit’s
    analysis applying Trooper Mullenix’s acts against a general legal rule—that is, “a
    police officer may not ‘use deadly force against a fleeing felon who does not pose a
    sufficient threat of harm to the officer or others’”—to meet the requirement of clearly
    established law. Mullenix, 
    136 S. Ct. at
    308–09. Instead, though not requiring a case
    directly on point,1 the Court looked to see if any case would make it clear to every
    reasonable official that Trooper Mullenix’s actions would amount to excessive force
    in violation of the Fourth Amendment. 
    Id. at 310
    . The Court found no case doing so.
    
    Id.
     In this regard, it cited key facts distinguishing Trooper Mullenix’s case from
    earlier ones—“when Mullenix fired, he reasonably understood Leija to be a fugitive
    fleeing arrest, at speeds over 100 miles per hour, who was armed and possibly
    intoxicated, who had threatened to kill any officer he saw if the police did not
    1
    The Estate relies heavily on Hope v. Pelzer, 
    536 U.S. 730
    , 739–40 (2002),
    which pronounced that law is clearly established if it gives officials “fair notice” or
    “fair warning” that “his conduct deprived his victim of a constitutional right.” To
    show clearly established law, the Hope Court did not require earlier cases with
    “fundamentally similar” facts, noting that “officials can still be on notice that their
    conduct violates established law even in novel factual circumstances.” 
    Id. at 741
    .
    This calls to mind our sliding-scale approach measuring the egregiousness of
    conduct. See Morris v. Noe, 
    672 F.3d 1185
    , 1196 (10th Cir. 2012). But the Supreme
    Court has vacated our opinion here and remanded for us to reconsider our opinion in
    view of Mullenix, which reversed the Fifth Circuit after finding that the cases it relied
    on were “simply too factually distinct to speak clearly to the specific circumstances
    here.” 
    136 S. Ct. at 312
    . We also note that the majority opinion in Mullenix does not
    cite Hope v. Pelzer, 
    536 U.S. 730
     (2002). As can happen over time, the Supreme
    Court might be emphasizing different portions of its earlier decisions. In this regard,
    we note Justice Thomas’s dissent in Hope, where he complains that the Court ignored
    Malley v. Briggs’s pronouncement that qualified immunity protects “all but the
    plainly incompetent or those who knowingly violate the law.” Hope, 
    536 U.S. at 752
    (Thomas, J., dissenting) (quoting Malley v. Briggs, 
    475 U.S. 335
    , 341 (1986)). In any
    event, the Supreme Court told us to apply Mullenix, so we do.
    8
    abandon their pursuit, and who was racing towards [another officer’s] position.” Id.
    at 312. The Mullenix Court concluded that none of its precedents “squarely
    governed” this situation. The precedents did not establish “beyond debate” that
    Mullenix had acted with excessive force. Id. at 310, 312. The Mullenix Court
    required more than an excessive-force finding insufficiently backed by existing
    precedent (choosing not to address whether the Fifth Circuit’s excessive-force
    finding was correct). Id. at 308, 312.
    II.    Aldaba v. Pickens
    In deciding whether the three law-enforcement officers in this case violated the
    Fourth Amendment by using excessive force, we must first review the facts that the
    district court relied upon to show excessive force. And after doing so, we must apply
    those facts against existing precedent to see whether every reasonable official would
    have known that those facts would “beyond debate” establish excessive force. Id. at
    312.
    A.    Background
    On March 24, 2011, at about 11:00 a.m., Johnny Manuel Leija was admitted to
    the Marshall County Medical Center in Madill, Oklahoma after feeling ill for several
    days. He was responsive, alert, and cooperative. Soon after his admission, doctors
    diagnosed dehydration and severe pneumonia in both lungs. To treat hypoxia—low
    oxygen levels caused by pneumonia—the hospital staff provided Leija intravenous
    antibiotics and breathing treatments to increase his oxygen-saturation level from
    77%. The treatment worked—Leija’s oxygen-saturation level began to rise.
    9
    But by 6:00 p.m., Leija’s condition had turned for the worse. When a female
    nurse then visited Leija’s room, she saw that he had cut his IV tube and disconnected
    his oxygen tubing. The nurse also saw that Leija’s arms were bleeding and had left
    blood on the floor and toilet. When the nurse reconnected the IV and oxygen tube,
    Leija seemed confused and anxious, and he repeatedly asked for his girlfriend.
    The nurse reported all this to Leija’s treating doctor. In response, the doctor
    prescribed Xanax to control Leija’s anxiety, but Leija refused to take it. Instead, he
    stood, again removed the oxygen tubing, and loudly accused the nurse of telling him
    lies and secrets. During this encounter, Leija became increasingly uncooperative and
    aggressive, shouting that the staff was trying to poison him. The nurse again sought
    the doctor’s help. She told the doctor that Leija “refused the medicine, the agitation
    and confusion continued, and we may need assistance.” Appellant’s App. vol. I at 78.
    The nurse was concerned for her safety based on Leija’s “yelling and his body
    language.” Id. at 79. In response, the doctor sent a male nurse to Leija’s room. When
    the male nurse arrived, he saw that Leija had again disconnected his IV and oxygen
    tubing, and he heard Leija yelling, “I am Superman. I am God. You are telling me
    lies and trying to kill me.” Id. at 80. The male nurse could not calm Leija, or
    persuade him to return to bed. After advising the doctor of all this, the male nurse
    tried to inject Leija with Haldol and Ativan to calm him so the staff could reconnect
    the IV and oxygen tubing. But Leija still refused to cooperate, instead insisting that
    water alone was pure enough to help him.
    10
    Based on what he had seen and heard, the male nurse believed that, even
    together, he and the doctor could not restrain Leija sufficiently to inject the drugs.
    The doctor was concerned about Leija’s low oxygen levels and his lack of IV and
    oxygen access. The male nurse believed that he and the doctor “could not manage
    [Leija’s] safety and that we needed to contact law enforcement.” Id. at 103. At 6:36
    p.m., with the doctor’s approval, the male nurse called law enforcement “for
    assistance with a disturbed patient.” Id. at 106.
    Soon after the call, the doctor arrived at Leija’s room to assist the nurses. The
    doctor grew even more concerned for Leija’s health after seeing his changed behavior
    and personality, and after hearing Leija claim that the staff was trying to poison him
    and that he was God and Superman. The doctor left Leija’s room about when the
    responding officers arrived.
    Madill Police Officer Brandon Pickens and Marshall County Sheriff Deputies
    James Atnip and Steve Beebe were eating dinner when Officer Pickens got a call
    asking that he assist the hospital medical staff. Deputies Atnip and Beebe went with
    him to the hospital. About when the officers arrived, Leija left his hospital room and
    began walking down the hallway toward the lobby and the hospital’s exit. When
    Officer Pickens arrived, the doctor told him that “the man could not leave the
    hospital or he would die.” Appellant’s App. vol. II at 280. The three officers saw that
    Leija was agitated and upset. Officer Pickens tried to calm Leija and to persuade him
    to return to his room, but Leija refused, still insisting that the hospital was trying to
    kill him. Despite Officer Pickens’s efforts, Leija resumed walking down the hallway
    11
    toward the lobby. Along the way, Leija stopped, “became angry, very angry,” and
    pulled gauze and tape from his arms, causing a “fairly steady stream of blood out of
    each arm.” Id. at 288–90. Leija then raised and shook his clenched fists, yelling, “this
    is my blood.” Id. at 290, 372, 378–79. Facing this situation, Officer Pickens and
    Deputies Atnip and Beebe repeatedly ordered Leija to calm down and to get on his
    knees, but Leija refused, even after several warnings about using a Taser.
    When Leija continued his behavior despite the warnings, Deputy Beebe aimed
    and fired his Taser2 at Leija’s torso, but one of the two probes missed. Almost
    immediately, Deputy Atnip grabbed Leija’s right forearm and Officer Pickens
    grabbed Leija’s left arm. Though they managed to get Leija face-first against a wall,
    Leija’s strength kept the two officers from being able to move his arms to control
    him. To assist his fellow officers, Deputy Beebe tried to drive-stun Leija with the
    Taser, but nothing happened. During the ongoing struggle, Deputy Atnip managed to
    buckle Leija’s knee, sending all four men to the floor.
    During this entire encounter, medical personnel watched from nearby. As the
    officers began trying to handcuff Leija, the male nurse asked if he could inject Leija
    with the Haldol and Ativan, and the officers held Leija so the male nurse could do so.
    Almost immediately after the injection, Leija went limp, grunted, and vomited clear
    liquid. The officers moved away so the medical staff could begin CPR. Tragically,
    2
    An officer can use a taser in one of two ways. First, the officer can use the
    taser in “drive-stun” mode, where the officer presses the taser’s electrical nodes
    against a person’s body. Second, the officer can fire metal darts (prongs) into the
    body. See McKenney v. Harrison, 
    635 F.3d 354
    , 363–64 (8th Cir. 2011) (Murphy, J.,
    concurring).
    12
    their efforts to revive Leija failed, and at 7:29 p.m., he was pronounced dead. The
    medical examiner determined that Leija had died from respiratory insufficiency
    secondary to pneumonia and that Leija’s exertion during the struggle with the
    officers “exacerbated his underlying pneumonia.” Id. at 333.
    B.     No Violation of Clearly Established Law
    Mullenix instructs us that the Fifth Circuit erred in its method of determining
    that Trooper Mullenix’s conduct had violated clearly established law. In particular,
    the Fifth Circuit erred by concluding that the Estate’s excessive-force claim would
    violate clearly established law if it “violated the clearly established rule that a police
    officer may not ‘use deadly force against a fleeing felon who does not pose a
    sufficient threat of harm to the officer or others.’” Mullenix, 
    136 S. Ct. at
    308–09
    (quoting Luna, 773 F.3d at 725).
    We erred in a somewhat different way by relying on excessive-force cases
    markedly different from this one. Although we cited Graham v. Conner, 
    490 U.S. 386
     (1989) to lead off our clearly-established-law discussion, we did not just repeat
    its general rule and conclude that the officers’ conduct had violated it. Instead, we
    turned to our circuit’s sliding-scale approach measuring degrees of egregiousness in
    affirming the denial of qualified immunity. Aldaba, 777 F.3d at 1159. We also relied
    on several cases resolving excessive-force claims. But none of those cases remotely
    involved a situation as here: three law-enforcement officers responding to a distress
    13
    call from medical providers seeking help in controlling a disruptive, disoriented
    medical patient so they could provide him life-saving medical treatment.3
    “A clearly established right is one that is ‘sufficiently clear that every
    reasonable official would have understood that what he is doing violates that right.’”
    Mullenix, 
    136 S. Ct. at 308
     (quoting Reichle v. Howards, 
    112 S. Ct. 2088
    , 2093
    (2012)). Although plaintiffs can overcome a qualified-immunity defense without a
    favorable case directly on point, “existing precedent must have placed the statutory
    or constitutional question ‘beyond debate.’” 
    Id.
     (quoting al-Kidd, 
    563 U.S. at 741
    ).
    “The dispositive question is ‘whether the violative nature of the particular conduct is
    clearly established.’” 
    Id.
     (quoting al-Kidd, 
    563 U.S. at 742
    ). In the Fourth
    Amendment context, “the result depends very much on the facts of each case,” and
    the precedents must “squarely govern” the present case. Id. at 309 (quoting Brosseau,
    
    543 U.S. at 201
    ). “[Q]ualified immunity protects ‘all but the plainly incompetent or
    those who knowingly violate the law.” 
    Id. at 308
     (quoting Malley, 
    475 U.S. at 341
    ).
    Under these rules, the Estate cannot show that the officers violated clearly
    established law. As mentioned, the Estate’s offered cases differ too much from this
    one, so reading them would not apprise every objectively reasonable officer that
    restraining Leija for medical treatment, as here, would amount to excessive force
    (and, again, we do not decide whether the officers acted with excessive force). The
    3
    Nothing in this opinion authorizes police or hospital officials to use force to
    require a competent patient to receive medical treatment that person chooses not to
    have.
    14
    vast differences between the Estate’s primary cases and this one are best seen by
    examining them individually.
    First, the Estate relies on Casey v. City of Federal Heights, 
    509 F.3d 1278
    (10th Cir. 2007). In that case, we reversed a grant of summary judgment based on
    qualified immunity. 
    Id. at 1287
    . The police officers’ actions in Casey were shocking
    and indefensible. Casey had challenged a traffic ticket and lost. 
    Id. at 1279
    . After
    ruling, the judge gave Casey the case file to return to the cashier’s window when he
    paid his fine. 
    Id.
     Leaving his eight-year-old daughter in the restroom, Casey walked
    to his truck in the parking lot to get money to pay. 
    Id.
     A court clerk had told Casey
    not to take the file outside, but he responded that he would be right back after getting
    his money. 
    Id.
     As he returned with the court file and money, Officer Sweet
    intercepted him and ordered him back to his truck. 
    Id. at 1280
    . Casey replied that he
    needed to return the file and attend to his daughter. 
    Id.
    When Casey stepped around the officer to return the file and pay his fine,
    Officer Sweet grabbed Casey’s arm and put it in a painful arm lock. 
    Id.
     As a
    confused Casey tried to get back to the courthouse, the officer jumped on his back. A
    second officer, Officer Lor, arrived and Tasered Casey. 
    Id.
     As more officers arrived,
    officers took Casey to the ground, tightly handcuffed him, and repeatedly banged his
    face into the concrete. 
    Id.
     With Casey lying on the ground, a third officer Tasered
    Casey by hand-pressing Taser barbs on Casey’s body. 
    Id.
     Next, Officer Lor again
    fired her Taser at Casey, accidentally striking a fellow officer. Then Officer Sweet
    told Officer Lor to “put the thing away.” 
    Id.
    15
    On appeal, we affirmed the denial of summary judgment to Officers Sweet and
    Lor, who had sought qualified immunity. 
    Id.
     at 1283–84, 1286. We concluded that
    clearly established law showed that the two officers’ had acted with excessive force.
    
    Id. at 1284
    . In doing so, we relied on the fair-notice test from Hope v. Pelzer. 
    Id.
     We
    then applied our sliding-scale analysis to the officers’ egregious tackling and
    Tasering of a peaceful citizen without warning or explanation. 
    Id. at 1285
    . In
    addition, we relied on Graham v. Connor as “establish[ing] that force is least
    justified against nonviolent misdemeanants who do not flee or actively resist arrest.”
    
    Id.
     at 1285–86 (quoting Graham, 
    490 U.S. at 396
    ).
    Second, the Estate relies on Cavanaugh v. Woods Cross City, 
    625 F.3d 661
    (10th Cir. 2010). In that case, police responded to a nonemergency domestic-violence
    call. 
    Id. at 662
    . They learned that Shannon Cavanaugh had earlier consumed alcohol
    and pain medication and had also tried to force her husband into a closet during a
    fight. 
    Id. at 663
    . Soon afterward, she had left the house, carrying a kitchen knife. 
    Id.
    While the officers were there, a neighbor saw Shannon returning home with empty
    hands. 
    Id.
     As Shannon approached her home, she saw an officer walking down the
    driveway. She cut across her front lawn toward her home. 
    Id.
     The officer followed
    about six feet behind her. 
    Id.
     After she stepped onto the home’s front steps, the
    officer—without warning—fired his Taser into her back. 
    Id.
     She “went rigid, spun
    around, and struck her head on the concrete steps,” causing a traumatic brain injury.
    
    Id.
    16
    In deciding whether the officers’ conduct was “objectively reasonable in light
    of the facts and circumstances confronting them,” we looked again to Graham,
    particularly its direction that we “careful[ly] balance . . . the nature and quality of the
    intrusion on the individual’s Fourth Amendment interests against the countervailing
    governmental interests at stake.” Cavanaugh, 
    625 F.3d at 664
     (alteration in original)
    (first quoting Graham, 
    490 U.S. at 396
    ; and then quoting Casey, 
    509 F.3d at 1281
    ).
    In particular, we looked to “whether the officer’s use of force was reasonable given
    the severity of the suspected crime, the immediate threat to the officer or others, and
    whether the suspect was actively resisting arrest or evading arrest by flight.” 
    Id.
     at
    664 (citing Graham, 
    490 U.S. at 396
    ). With this in mind, we concluded that the
    officer’s conduct was objectively unreasonable. Applying the Graham factors, we
    saw a minor crime, if any, no immediate threat to the officer or anyone else, and no
    active resisting or evading arrest. Id. at 665. Next, relying on Casey, we decided that
    clearly established law showed a Fourth Amendment violation. We found it sufficient
    that Casey had presented “very similar factual circumstances: a police officer used
    her Taser against a non-violent misdemeanant who appeared to pose no threat and
    who was given no warning or chance to comply with the officer’s demands.” Id. at
    665–66 (citing Casey, 
    509 F.3d at
    1281–82).
    Third, the Estate relies on Cruz v. City of Laramie, 
    239 F.3d 1183
     (10th Cir.
    2001). There, police responded to a report that a man was running around naked. 
    Id. at 1185
    . Police called for an ambulance after seeing the naked man on an apartment
    building’s outside landing. The man was yelling and kicking his legs up and down.
    17
    
    Id.
     The officers coaxed the man to the ground, but he then tried to walk past them. 
    Id.
    The officers wrestled him face-down to the ground and handcuffed him. 
    Id.
     To stop
    his kicking, the officers wrapped a nylon restraint around his ankles. 
    Id.
     The officers
    may have “hog-tied” him—by wrapping his ankles within a foot of his wrists. 
    Id.
    Before an ambulance arrived, Cruz’s face blanched, leading the officers to remove
    the restraint. 
    Id.
     Despite the emergency crew’s CPR efforts, Cruz died. 
    Id.
     His
    autopsy revealed a large amount of cocaine in his system. 
    Id.
    On appeal, we noted that our circuit had not yet ruled on the constitutionality
    of hog-tie restraints. 
    Id. at 1188
    . We held that officers “may not apply this technique
    when an individual’s diminished capacity is apparent.” 
    Id.
     Although we found cases
    outside our circuit prohibiting hog-tying, we could not say that “a rule prohibiting
    such a restraint in this situation was ‘clearly established’ at the time of this
    unfortunate incident.” 
    Id. at 1189
    .
    None of these three cases would advise “every reasonable official” that
    Tasering Leija to hasten life-saving care would amount to excessive force under the
    Fourth Amendment. Here, the three law-enforcement officers were not arresting
    Leija. Instead, they were assisting his medical providers, who needed to control him
    so they could provide emergency care. Leija was beyond reason and if allowed to
    leave the hospital would face death—so said his doctor. Unlike the officers in the
    three cases above, the law-enforcement officers here tried to calm Leija and Tasered
    him only after their other efforts had failed. Undoubtedly, they faced a difficult
    situation, and no nearby medical provider advised against using the Taser. We have
    18
    found no case presenting a similar situation. We certainly cannot say that every
    reasonable officer would know that the Fourth Amendment condemned using a Taser
    to avoid a full-out physical confrontation with a patient whose life depended on
    immediate treatment. No case renders a Fourth Amendment violation “beyond
    debate.”
    Finally, the Estate relies on a line of cases in which plaintiffs alleged that law-
    enforcement officers had used excessive force against persons suffering from mental
    illness or diminished capacity. As with the above cases, these cases did not involve
    medical providers standing nearby while officers used a Taser to subdue a person
    temporarily out of his mind and needing life-assisting medical treatment. Instead,
    these additional cases involve force used to detain persons for non-medical reasons.
    With this key difference in mind, we cannot say that clearly established law informed
    the officers that their actions would violate the Fourth Amendment. See Giannetti v.
    City of Stillwater, 216 F. App’x 756 (10th Cir. 2007) (concluding officers did not act
    with excessive force in death of a physically combative, bipolar woman detained on a
    misdemeanor traffic offense after they forcefully held her to the floor while readying
    her to wear jail clothing, despite her repeatedly advising that she couldn’t breathe and
    that her lungs were collapsing); Abdullahi v. City of Madison, 
    423 F.3d 763
     (7th Cir.
    2005) (concluding that the Estate had raised a genuine issue of material fact about
    excessive force in the death of a combative, disoriented pedestrian in view of
    conflicting evidence about whether the officer had applied undue pressure to the
    prone man’s back in a joint effort with other officers to handcuff him); Champion v.
    19
    Outlook Nashville, Inc., 
    380 F.3d 893
    , 901 (6th Cir. 2004) (denying qualified
    immunity to officers when the evidence in the surviving family’s favor showed that
    as officers lay atop an autistic man—whom they knew to be “mentally ill or
    retarded”—they continued to pepper spray him in the face after he had stopped
    resisting arrest and was not a flight risk); Deorle v. Rutherford, 
    272 F.3d 1272
     (9th
    Cir. 2001) (denying qualified immunity to an officer who, without warning, had fired
    a lead-filled bag from a shotgun into the face of an emotionally disturbed man—
    destroying one eye and leaving lead in his skull—when the man had complied with
    officers’ orders despite being verbally abusive).
    As with the Estate’s other cases, none of these additional cases would inform
    the three officers “beyond debate” that their actions would be excessive force. Again,
    the officers here were acting to restrain Leija so that his medical providers—standing
    by observing—could administer life-saving care. The three officers’ conduct is
    nothing like that exhibited in the cited cases. Certainly, none of those cases squarely
    governs this one. And nothing suggests that the three law-enforcement officers were
    plainly incompetent or knowingly violated the law.
    III.   Conclusion
    Accordingly, we remand this case with instructions that the district court grant
    summary judgment in favor of the three officers based on qualified immunity.
    20