Courtney McBride v. Mamie McCrory , 658 F. App'x 991 ( 2016 )

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[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 15-12871
Non-Argument Calendar
________________________
D.C. Docket No. 1:12-cv-01047-MHT-TFM
COURTNEY MCBRIDE,
Plaintiff - Appellee,
versus
HOUSTON COUNTY HEALTH CARE AUTHORITY,
d.b.a. Southeast Alabama Medical Center, et al.,
Defendants,
MAMIE MCCORY,
STEPHANIE JOHNSON,
Defendants - Appellants.
________________________
Appeal from the United States District Court
for the Middle District of Alabama
________________________
(September 30, 2016)
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Before JORDAN, JULIE CARNES and JILL PRYOR, Circuit Judges.
PER CURIAM:
While detained in the City of Dothan Jail, Courtney D. McBride developed a
painful, deteriorating skin condition. She contends that for more than four days,
she was unable to eat or drink and her skin turned ashy, developed black splotches,
and began to peel off. According to McBride, this condition, which led to a
potentially lethal rash requiring treatment in the intensive care unit of a hospital,
amounted to a serious medical need. She sued, among other defendants, two jail
officers, Stephanie Johnson and Mamie McCory (the “officers”), alleging civil
rights violations under 42 U.S.C. § 1983. Specifically, she alleged that the officers
were deliberately indifferent to her serious medical need in violation of the
Fourteenth Amendment to the United States Constitution. The officers moved for
summary judgment on qualified immunity grounds. Viewing the evidence in the
light most favorable to McBride, the district court held that the officers were not
entitled to qualified immunity. This interlocutory appeal followed.
Upon careful review, we affirm in part, reverse in part, and remand for
further proceedings. McBride has amassed sufficient evidence to overcome
Johnson’s assertion of qualified immunity, but the record does not support a
finding that McCory was aware of McBride’s serious medical need. Thus,
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McBride cannot show that McCory violated a clearly established constitutional
right, and McCory is entitled to qualified immunity.
I. BACKGROUND
We view the evidence and derive factual inferences therefrom in the light
most favorable to McBride as the non-movant on summary judgment. See Perez v.
Suszczynski, 809 F.3d 1213, 1216 (11th Cir. 2016). So viewed, the record supports
the following facts.
On June 21, 2012, a municipal court ordered McBride to jail pending a
domestic violence charge. While still in the courtroom, McBride suffered a
psychological breakdown and was transported to the behavioral unit of Southeast
Alabama Medical Center (“SAMC”), 1 where she remained for two weeks. There,
Dr. Dinesh Karumanchi diagnosed McBride with, among other conditions,
bipoloar disorder. He prescribed one 25mg tablet of Lamictal (the brand name for
lamotrigine) twice a day. One of the potential side effects of Lamictal is a skin
condition known as Stevens-Johnson Syndrome (“SJS”), which results in blisters
covering up to 10% of the body. If blisters continue to spread and cover 30% or
more of the body, the potentially lethal condition is known as Toxic Epidermal
Necrolysis (“TEN”). Dr. Karumanchi warned McBride about the possibility of a
1
Southeast Alabama Medical Center is the trade name for Houston County Health Care
Authority.
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lethal rash associated with her treatment, but he instructed her not to stop taking
the medication without first consulting a doctor.
On July 4, 2012, Dr. Karumanchi discharged McBride into police custody,
and she was admitted into the jail. At the time of the discharge, Dr. Karumanchi
verbally told the transferring officer, Arthur Schaefer, III, that if her condition
worsened or she had “any problems,” she should return to the hospital.
Karumanchi Dep. Tr. at 133, Doc. 172-12. 2 Although Schaefer denied receiving
such verbal instructions, he agreed that if the doctor had given him any verbal
instructions, he would have relayed them to the jail supervisor. It was then
standard operating procedure for the supervisor to share the doctor’s verbal
instructions with all jail staff who might interact with the detainee. McBride was
placed on suicide watch and sent to a holding cell separate from the general
population.
On her second day in the jail, McBride started to feel sick. Her symptoms
began with chapped lips, a swollen face, and chills. By the next day, July 6, she
had a sore throat and fever and generally felt very ill. On that day, the jail brought
her to a prescheduled follow-up appointment at SAMC. McBride does not
remember complaining to jail officers or SAMC staff about feeling sick or
suffering a skin rash.
2
Citations to “Doc.” refer to docket entries in the district court record in this case.
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McBride returned to the jail after her appointment. From July 6 through
July 10, her fever persisted and her condition worsened. She began to develop
black splotches on her skin. She had a headache and a throat so sore that she had
difficulty swallowing. During those four days, she was unable to eat or drink, and
she regularly complained about needing medical attention during “every shift to
everybody that opened [the cell] door.” McBride Dep. Tr. at 506-507, Doc. 172-
11. When she could muster the energy, she also banged on the door and screamed
for help.
On July 9, Correctional Officer Stephanie Johnson commented that
McBride’s lips “looked like they were peeling off.”3 McBride Dep. Tr. at 504,
Doc. 172-11. Johnson knew that McBride had not been eating, and McBride told
Johnson she was unable to drink as well. In response, Johnson brought McBride
Vaseline and ice water. McBride asked to go to the hospital, but Johnson ignored
this request in violation of jail policy, which required that officers send detainees
to the doctor on the same day they request medical attention.
McCory, who was the jail administrator during this time, was in her office
on July 5, 6, 9, and 10. She confirmed that her office was about 20 feet from
3
McBride stated that she got sick sometime between July 6 and July 9, and it was during
that time that she interacted with Johnson. McBride was unable to give a more precise date.
Johnson attested that during this period she worked only July 9 and 10, and McBride offered no
evidence to the contrary. The undisputed evidence thus supports the inference that the
interaction between McBride and Johnson occurred on July 9.
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McBride’s holding cell, close enough to hear McBride if she yelled. McCory
maintained that she did not hear McBride screaming or calling from her cell at any
time. The record contains no evidence that McCory checked on McBride during
this time; McCory explained that it was the other jail officers’ responsibility to do
that. Until July 10, none of the jail personnel reported to McCory that McBride
suffered any medical problems, lodged any medical complaints, or had requested
any medical treatment.
On July 10, McBride complained of a sore throat and refused to eat
breakfast or lunch. In response, after lunch, the jail transported her again to
SAMC.
At SAMC, McBride met with a nurse and complained of a headache and
sore throat. She also reported that she had not eaten or drunk any liquids in five
days. The nurse’s notes show that McBride’s “[g]eneral [a]ppearance” was “well”
and she was “[i]n no distress.” Pl.’s Resp. Ex. G, Doc. 172-10 at 4. But the notes
further indicate that McBride had swollen tonsils, a 101.5 degree fever, and
difficulty breathing. The nurse also observed that McBride’s eyes were “sunken”
and she was “very weak and lethargic.” Id. Finally, the nurse reported that
McBride’s skin was very dry [and] ashy” and her lips were “very dry [and]
cracked” with moderate bleeding. Id. Although not reported in the nurse’s notes,
McBride also exhibited “little black splotches . . . all over [her] face.” McBride
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Dep. at 223. The nurse ran a lab test and confirmed that McBride had “Strep A.”
Pl.’s Resp. Ex. G, Doc. 172-10 at 3.
SAMC then sent McBride to the emergency room for further evaluation and
hydration. The emergency room diagnosed her with “[p]haryngitis,” “[t]onsilitis,”
a “[c]anker sore,” and a “rash” and prescribed antibiotics. Def. Mot. Summ. J. Ex.
A, Doc. 131-16 at 399. The hospital discharged McBride. She was released from
the jail later that day, July 10.
McBride returned home and her symptoms continued to worsen that night
and into the morning of July 11. She had trouble urinating, her ears and head hurt,
and she still had splotches on her skin. She was in excruciating pain. Her
headache and fever persisted. Her throat hurt, and she still could not eat or drink.
Her lips, tongue, and vaginal area were swollen, and the skin on her lips was still
peeling off. She went to the emergency room. The emergency room doctor who
evaluated McBride diagnosed her with a fever blister and vaginitis. The doctor did
not observe a rash, reported no fever, and did not diagnose a serious medical
condition. McBride returned home.
By the next morning, July 12, the skin on McBride’s ear was falling off.
She returned to the emergency room, where the doctor observed a rash over 99%
of her skin. She was diagnosed with SJS, “most likely due to Lamictal.” Doc.
131-16 at 68. The doctor ordered her to stop taking Lamictal and, after a few days,
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she was transferred to the medical intensive care unit (“ICU”) at the University of
Alabama, Birmingham. Once in the ICU, she was diagnosed with TEN,
considered “critically ill” due to a significant loss of skin, which “was similar to a
severe burn involving greater than 30 percent of the body surface area.” Doc. 172-
16 at 20. She was treated for nine days and then released.
McBride filed this lawsuit in the district court naming, among other
defendants, McCory and Johnson. 4 Relevant to this appeal, she alleged that
McCory and Johnson acted with deliberate indifference to her serious medical need
in violation of the Fourteenth Amendment. McCory and Johnson filed a motion
for summary judgment raising a qualified immunity defense. The district court
denied their motion, holding that a reasonable jury could conclude that McCory
and Johnson violated McBride’s clearly established constitutional right. The
officers timely filed this interlocutory appeal. See Scott v. Harris, 550 U.S. 372,
376 n.2 (2007) (“[A]n order denying qualified immunity is immediately appealable
even though it is interlocutory; otherwise, it would be effectively unreviewable.”
(internal quotation marks omitted)).
4
All of the other defendants were dismissed before trial except Karumanchi and the City
of Dothan. McBride’s claim against Karumanchi was tried before a jury in July 2015. The jury
found that Karumanchi had not breached the standard of care in his treatment of McBride, and
the district court entered judgment in favor of Karumanchi pursuant to Federal Rule of Civil
Procedure 54(b). The only claim against the City to survive summary judgment is a state law
negligence claim, which has not proceeded to trial because the court stayed this action as to the
claims against the City, McCory, and Johnson pending this appeal.
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II. STANDARD OF REVIEW
“On an interlocutory appeal from the denial of qualified immunity, this
Court conducts a de novo review.” Kjellsen v. Mills, 517 F.3d 1232, 1236 (11th
Cir. 2008). As with any review of a summary judgment decision, “we view all
evidence and factual inferences in the light most favorable to the non-moving
party.” Perez, 809 F.3d at 1217. “We must review the evidence in this manner
because the issues appealed here concern not which facts the parties might be able
to prove, but, rather, whether or not certain given facts showed a violation of
clearly established law.” Id. (internal quotation marks omitted). Summary
judgment should be granted when the record evidence shows there is no genuine
dispute concerning any material fact and the movant is entitled to judgment as a
matter of law. Feliciano v. City of Miami Beach, 707 F.3d 1244, 1247 (11th Cir.
2013) (citing Fed. R. Civ. P. 56(a)).
III. ANALYSIS
The officers argue that the district court erred in denying their motion for
summary judgment on qualified immunity grounds. “Qualified immunity shields
government officials acting within their discretionary authority from liability
unless the officials violate clearly established statutory or constitutional rights of
which a reasonable person would have known.” Franklin v. Curry, 738 F.3d 1246,
1249 (11th Cir. 2013) (internal quotation marks omitted). The parties do not
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dispute that McCory and Johnson were acting within their discretionary authority
at all relevant times. Thus, the burden shifts to McBride to show that “(1) the
defendant[s] violated a constitutional right, and (2) this right was clearly
established at the time of the alleged violation.” Valderrama v. Rousseau, 780
F.3d 1108, 1112 (11th Cir. 2015) (internal quotation marks omitted). We consider
each element in turn.
A. Constitutional Violation: Deliberate Indifference under the Fourteenth
Amendment
McBride contends that McCory and Johnson were deliberately indifferent to
her serious medical needs in violation of her rights under the Fourteenth
Amendment. Pretrial detainees like McBride “plainly have a Fourteenth
Amendment due process right to receive medical treatment for illness and
injuries.” Jackson v. West, 787 F.3d 1345, 1352 (11th Cir. 2015) (internal
quotation marks omitted). 5 “To prevail on a § 1983 claim alleging a violation of
that right, a plaintiff must satisfy both an objective and a subjective inquiry.”
Valderrama, 780 F.3d at 1116 (internal quotation marks omitted).
As regards the objective inquiry, McBride must show that she suffered an
objectively serious medical need. See id.; Farrow v. West, 320 F.3d 1235, 1243
5
The standard for deliberate indifference claims under the Fourteenth Amendment is the
same as the standard applicable for prison inmates under the Eighth Amendment. Cottrell v.
Caldwell, 85 F.3d 1480, 1490 (11th Cir. 1996). Thus, “decisional law involving prison inmates
applies equally to cases involving arrestees or pretrial detainees.” Id.
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(11th Cir. 2003). “In our circuit, a serious medical need is considered one that has
been diagnosed by a physician as mandating treatment or one that is so obvious
that even a lay person would easily recognize the necessity for a doctor’s
attention.” Farrow, 320 F.3d at 1243 (internal quotation marks omitted); accord
Goebert v. Lee Cty. 510 F.3d 1312, 1327 (11th Cir. 2007). Either way, the medical
need must be “one that, if left unattended, pos[es] a substantial risk of serious
harm.” Farrow, 320 F.3d at 1243 (alteration in original) (internal quotation marks
omitted).
On this record, a jury could find that McBride suffered an objectively
serious medical need while detained in the jail. A person who is calling for help,
in obvious pain; has a fever; is unable to eat or drink for days; and whose lips are
blistered and “peeling off,” objectively needs a doctor’s attention. See, e.g., id. at
1243-44 (holding that the pain and weight loss from having virtually no teeth
constituted a medical need warranting treatment). Moreover, McBride ultimately
was diagnosed with SJS, a painful skin condition that, when left untreated, led to
its more severe form, TEN, that put her in critical condition with a rash over 99%
of her body. With these facts, a reasonable jury could infer that McBride suffered
a serious, deteriorating medical need sometime between July 6 and July 9, while
detained in the jail.
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The officers argue that, because McBride was not diagnosed with SJS until
about two days after her release from the jail, and because some medical
professionals failed to diagnose it earlier, a reasonable jury could not conclude that
McBride suffered a serious medical condition while detained. We disagree. A
reasonable jury could conclude on this record that McBride suffered with SJS—a
known side effect of her medication—on the days leading up to her diagnosis and
that the medical professionals who overlooked her condition were themselves
grossly negligent. See Goebert, 510 F.3d at 1327 (explaining that the fact that a
pregnant inmate leaking amniotic fluid had been seen by medical staff did not
mean that a layperson could not tell she suffered from a serious medical need
because, as the inmate alleged, the medical staff themselves failed to attend to her
needs). In any event, a diagnosis is unnecessary where, as here, the serious
condition would be obvious even to lay persons. See id. In sum, McBride has
presented a triable issue regarding whether she suffered an objectively serious
medical need while she was detained in the jail.
We now turn to the subjective inquiry. To satisfy this inquiry, McBride
“must prove that the officers were deliberately indifferent to [her] serious medical
need.” Valderrama, 780 F.3d at 1116.
More specifically, the plaintiff must present, for each officer, evidence
from which a reasonable jury could conclude that (1) the officer was
aware of facts from which the inference could be drawn that a
substantial risk of serious harm exists, (2) the officer actually drew
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that inference, (3) the officer disregarded the risk of serious harm, and
(4) the officer’s conduct amounted to more than gross negligence.
Id. An unreasonable delay in treatment may constitute unconstitutional deliberate
indifference, whether or not it exacerbated the condition, if the delay results in “a
wanton infliction of pain.” Id. And when officials “ignore without explanation a[n
arrestee’s] serious condition that is known or obvious to them, the trier of fact may
infer deliberate indifference.” Id. (alteration in original) (internal quotation marks
omitted); accord Carswell v. Bay Cty., 854 F.2d 454, 457 (11th Cir. 1988) (holding
that jail personnel who are aware of an inmate’s need for medical care but fail to
provide it act with deliberate indifference); Ancata v. Prison Health Servs., Inc.,
769 F.2d 700, 704 (11th Cir. 1985) (holding that a jailer who was aware of a
serious medical problem but provided medical care “so cursory as to amount to no
treatment at all . . . may violate the Fourteenth Amendment”). We apply this
standard to McBride’s claims against McCory and Johnson.
As regards McCory, the record contains insufficient evidence from which a
reasonable jury could find that she was aware of McBride’s serious medical need.
There is no evidence that McCory ever saw McBride or communicated with her
about McBride’s medical condition. The uncontroverted evidence shows that none
of the jail personnel who regularly checked on detainees reported to McCory that
McBride suffered any medical problems or requested to go to the hospital. Even
drawing the inference, as we must based on this record, that McCory heard
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McBride screaming, there is no evidence to suggest that McCory actually was
aware that McBride was screaming because of a medical need. We readily
conclude that on this record a reasonable jury could find that McCory acted
negligently; as jail administrator, McCory should have personally checked on
McCory, a screaming detainee on suicide watch in a cell just 20 feet from her
office, rather than relying on jail officers to do so. But negligence is insufficient to
trigger liability under § 1983. See, e.g., Goodman v. Kimbrough, 718 F.3d 1325,
1332-33 (11th Cir. 2013) (holding that a failure to conduct a cell check and head
count amounted to negligence but could not support a deliberate indifference claim
absent evidence that the officers knew of a substantial risk of serious harm).
Because there is no evidence indicating that McCory knew McBride needed
medical attention, McCory’s failure to send McBride to the hospital or provide
other medical care did not violate McBride’s constitutional rights. See Jackson,
787 F.3d at 1354 (holding that, without evidence that officers subjectively knew of
a risk of suicide, the officers cannot be deliberately indifferent to the suicide risk
for qualified immunity purposes). Accordingly, the district court erred in denying
McCory qualified immunity.
In contrast, McBride has come forward with sufficient evidence, viewed in
the light most favorable to her, that Johnson acted with deliberate indifference in
violation of McBride’s constitutional rights. First, a reasonable jury could find that
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Johnson knew McBride suffered from a serious medical need. The evidence shows
that Johnson was aware on July 9 that McBride was unable to eat or drink. The
jury could also credit McBride’s testimony that Johnson observed and commented
on what looked like McBride’s lips “peeling off.” McBride Dep. Tr. at 504, Doc.
172-11. Moreover, a reasonable jury could find that Johnson knew the doctor had
instructed jail staff to return McBride to the hospital if her condition worsened or
she had any problems. Karumanchi testified that he relayed this instruction to the
transferring officer, and the officer confirmed that he would have then relayed the
information to the jail supervisor. Pursuant to jail policy, the jail supervisor then
would have relayed the doctor’s instruction to jail staff, including Johnson. See
Campbell v. Johnson, 586 F.3d 835, 841 (11th Cir. 2009) (acknowledging that it is
reasonable to infer that a jail would follow its policies). From these facts, the jury
could find that on July 9, Johnson was aware of McBride’s serious medical need
and the doctor’s instruction to seek medical attention.
Second, a reasonable jury could find that Johnson disregarded the risk of
serious harm McBride faced and that Johnson’s conduct was more than grossly
negligent. Rather than granting McBride’s requests to receive immediate medical
attention for her readily observable conditions, as required under jail policy and
directed by the doctor, Johnson offered Vaseline and ice water. Johnson’s failure
to seek medical attention for McBride under these circumstances can support a
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§ 1983 claim of deliberate indifference. See Carswell, 854 F.2d at 458 (holding
that, after specific requests for medical attention, the failure to provide medical
care for an inmate who suffered from a skin rash, constipation, and significant
weight loss constituted deliberate indifference); Ancata, 769 F.2d at 702, 704
(holding that providing non-prescription drugs such as Ben Gay and Tylenol II to
treat a serious medical need —“swelling of the ankle, inability to sleep, chills,
lower back pain, tingling and numbness of [the] hands, hyperventilation, severe
pain in [the] back and right leg, [and] double vision”—amounted to far more than
negligence and supported a deliberate indifference claim). For these reasons, we
agree that the record supports a finding that Johnson violated McBride’s
constitutional right.
B. Clearly Established Constitutional Right
Next, we must decide whether McBride’s constitutional right was clearly
established at the time of Johnson’s conduct; if not, Johnson is entitled to qualified
immunity. See Perez, 809 F.3d at 1221-22. “A right is ‘clearly established’ if it
would have been apparent to every reasonable officer in [the defendant’s] position”
that her conduct was unlawful. Id.; see also Valderrama, 780 F.3d at 1112.
There are three ways in which [the plaintiff] may show that the right
violated was clearly established: (1) case law with indistinguishable
facts clearly establishing the constitutional right; (2) a broad statement
of principle within the Constitution, statute, or case law that clearly
establishes a constitutional right; or (3) conduct so egregious that a
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constitutional right was clearly violated, even in the total absence of
case law.
Perez, 809 F.3d at 1222 (internal quotation marks omitted).
This case falls into the second category: The broad principles of our case
law clearly establish the constitutional right violated. See Danley v. Allen, 540
F.3d 1298, 1313 (11th Cir. 2008), overruled on other grounds by Ashcroft v. Iqbal,
556 U.S. 662 (2009). “Our earlier deliberate indifference decisions have stated
that when jailers are aware of serious medical needs they may not ignore them or
provide grossly inadequate care.” Id. (citing Bozeman v. Orum, 422 F.3d 1265,
1273 (11th Cir. 2005), abrogated on other grounds by Kingsley v. Hendrickson,
135 S. Ct. 2466, 2472, 2476-77 (2015); McElligott v. Foley, 182 F.3d 1248, 1256
(11th Cir. 1999)); see, e.g., Carswell, 854 F.2d at 457 (holding that the failure to
provide medical care in the face of a known, serious medical need constitutes
deliberate indifference); Ancata, 769 F.2d at 704 (“[K]nowledge of the need for
medical care and intentional refusal to provide that care has consistently been held
to surpass negligence and constitute deliberate indifference.”). As discussed
above, viewing the evidence in McBride’s favor, her condition—a headache and
sore throat so painful that McBride had been unable to eat or drink for days and a
serious rash resulting in the skin on McBride’s lips peeling off—along with her
screaming for help, indicated the need for medical care which Johnson failed to
provide. Reasonable jailers would have been aware that Johnson’s conduct as
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described here violated clearly established constitutional rights. Accordingly, the
district court did not err in denying Johnson’s motion for summary judgment on
qualified immunity grounds.
IV. CONCLUSION
For the foregoing reasons, we conclude that, viewing the evidence in the
light most favorable to McBride, Johnson is not entitled to qualified immunity on
McBride’s claim of deliberate indifference to her serious medical need under 42
U.S.C. § 1983. But, because McBride has failed to point to evidence suggesting
that McCory was aware of McBride’s serious medical need while she was detained
in the City of Dothan Jail, McBride cannot establish that McCory violated a clearly
established constitutional right, and thus the claim against McCory must be
dismissed on qualified immunity grounds. We therefore affirm in part, reverse in
part, and remand for further proceedings.
AFFIRMED IN PART, REVERSED IN PART, AND REMANDED.
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