Nichole Sanchez v. Young County, Texas, et , 866 F.3d 274 ( 2017 )


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  •      Case: 16-10227   Document: 00514096121    Page: 1   Date Filed: 07/31/2017
    IN THE UNITED STATES COURT OF APPEALS
    FOR THE FIFTH CIRCUIT     United States Court of Appeals
    Fifth Circuit
    FILED
    July 31, 2017
    No. 16-10227
    Lyle W. Cayce
    Clerk
    NICHOLE SANCHEZ; CASY SIMPSON; EDWARD LAROY SIMPSON, II,
    Individually and as the Representative of the Estate of Diana Lynn Simpson,
    Plaintiffs - Appellants
    v.
    YOUNG COUNTY, TEXAS; YOUNG COUNTY SHERIFF’S DEPARTMENT,
    Defendants - Appellees
    Appeal from the United States District Court
    for the Northern District of Texas
    Before JONES, BARKSDALE, and COSTA, Circuit Judges.
    PER CURIAM:
    Plaintiff-appellants, the family of Diana Simpson, challenge the district
    court’s summary judgment dismissing their § 1983 lawsuit claiming that
    Young County violated Mrs. Simpson’s constitutional rights when she died in
    the county jail from a probable suicide-caused drug overdose the evening after
    she was arrested for public intoxication. The family asserts that the County is
    liable for the acts and omissions of its personnel who arrested and jailed
    Mrs. Simpson. The family also asserts that unconstitutional conditions of
    pretrial confinement, arising from the County’s policies and procedures, caused
    Mrs. Simpson’s death. For the following reasons, the judgment of the district
    court is AFFIRMED regarding the claim that the jailers’ acts and omissions
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    No. 16-10227
    caused Mrs. Simpson’s death and render the County liable; the judgment is
    VACATED and REMANDED for further proceedings as to whether there is a
    genuine   issue   of   material   fact   that   the   County’s   policies   created
    unconstitutional conditions of confinement that caused the decedent’s death.
    BACKGROUND
    Mrs. Simpson struggled with depression and a year before her death had
    attempted suicide. In the weeks leading up to her death, she told her husband,
    Edward Simpson, that if she were to attempt suicide again, she would
    withdraw cash from the ATM, use the cash to check into a motel so that her
    presence would not be traceable, and then would overdose on pills.
    On May 18, 2015, Mr. Simpson noticed a cash withdrawal when
    reviewing his bank account online.        The night before, Mrs. Simpson had
    worked the nightshift at Stephens Memorial Hospital, where she often slept
    after her shift because her home was 75 miles away. After calling his wife and
    failing to get an answer, Mr. Simpson called the hospital to inquire if his wife
    was sleeping there and learned that she had left after her shift. Mr. Simpson
    called numerous local law enforcement agencies to report his wife missing and
    at risk for suicide. He placed a photo of his wife’s vehicle on Facebook asking
    anyone who saw it to contact the authorities.
    Alerted by a woman who saw the Facebook plea and recognized
    Mrs. Simpson’s vehicle parked on a roadside in Graham, Texas, police officer
    Kyle Ford found Mrs. Simpson asleep in the driver’s seat about 5 p.m. on
    May 19. In questioning her, Ford’s arrest documents state that he observed
    that Mrs. Simpson’s speech was slurred, she responded slowly, and she had a
    hard time keeping her eyes open when speaking. He asked Mrs. Simpson
    whether she had consumed alcohol or taken any medication. She replied that
    she had a drink the night before to help her sleep but at that point denied
    ingesting medicine.     Mrs. Simpson also denied having diabetes or other
    2
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    medical conditions.        Officer Moody, who assisted Ford, corroborated her
    intoxicated behavior.
    Ford called Young County medics to evaluate Mrs. Simpson. After an
    examination, medic Jared Cook found a slightly elevated blood pressure and
    slightly low pulse. Mrs. Simpson confirmed to him that “she normally has high
    blood pressure and a low pulse.” Her blood sugar level was normal, and there
    were no symptoms of heat stroke or dehydration. A medic asked her whether
    she was depressed or wanted to hurt herself; Mrs. Simpson replied “no” to both
    questions. Cook described Mrs. Simpson as “impaired but not altered.”
    Seeing a pill bottle on the passenger floorboard of Mrs. Simpson’s car,
    Ford obtained her consent to search the vehicle, and she walked unsteadily
    toward the ambulance to await the search. She stated, however, that her hip
    had arthritis. She then told Cook that she had taken two Benadryl earlier in
    the day to help her sleep. Mrs. Simpson dozed off while Cook attempted to
    conduct a horizontal gaze nystagmus test. 1 Simpson told Cook she did not
    want to be taken to the hospital.
    Meanwhile, in her purse, Ford found a substantial number of partially
    empty blister packs of medication and showed them to a medic. Several open
    beer cans littered the back seat.             Ford took photographs, collected, and
    inventoried the evidence. When Ford asked Mrs. Simpson again how much of
    the medication she had taken, Mrs. Simpson replied that she took all that was
    1 A horizontal gaze nystagmus test is a standardized field sobriety test often used to
    determine whether an individual is under the influence of alcohol. The test ascertains the
    extent to which a person’s eye can follow a moving object slowly with minimal jerking when
    the subject is intoxicated. Babers v. City of Tallassee, Ala., 
    152 F. Supp. 2d 1298
    , 1302 (M.D.
    Ala. 2001). As one becomes more impaired, one’s inability to track slowly the moving object
    becomes more pronounced. 
    Id.
    3
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    missing from the packages that morning. 2 She also confided that she had
    drunk alcohol the previous night “to help her sleep.” Ford then asked her if
    she was trying to hurt herself but she responded that she was not. She declined
    his offer to go to the hospital.
    Ford arrested Mrs. Simpson for public intoxication shortly after 6 p.m.
    and took her to the Young County Jail.
    Mrs. Simpson arrived at the jail about 6:30 p.m. Jailer Rich filled out
    but did not complete Mrs. Simpson’s intake medical screening form. She
    checked a box “negative” for any behavior or conditions indicative of suicide.
    In a sworn declaration, Ms. Rich testified that Mrs. Simpson was “responsive,
    talking coherently and providing satisfactory answers” to her questions during
    the intake.    Mrs. Simpson also indicated, in response to screening form
    questions, that she was not depressed, not thinking about killing herself, and
    had never attempted suicide. Mrs. Simpson walked unassisted to a female
    holding cell to sleep before finishing the booking process.
    During the book-in process, no County employee ran a Continuity of Care
    Query (CCQ), a Texas law enforcement information-sharing service that
    provides real-time identification of individuals who have received State-funded
    mental health services within the past several years.
    How frequently jail staff checked on Mrs. Simpson in the holding cell is
    disputed. There is nevertheless evidence that another female detainee was
    placed in Mrs. Simpson’s cell during the evening. And around midnight, when
    Officer Post arrived at the jail, Deputy Wacaster walked Officer Post to a
    holding cell and told him to look through the cell window. Officer Post saw
    Mrs. Simpson lying on the floor, wearing nothing but a tee-shirt.
    2 Mrs. Simpson’s autopsy report, however, did not show traces of these particular
    medications.
    4
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    In the meantime, after learning that his wife had been arrested,
    Mr. Simpson called the Graham police station and requested that they take his
    wife to the hospital. He told the officer she was a suicide risk, but he did not
    say that she might have taken drugs or overdosed because he did not know
    that. He was informed that she had been evaluated by medical personnel and
    refused to go to the hospital. He called the jail once before Mrs. Simpson
    arrived there and was told that an ambulance was there at the scene, and he
    related that she had a BOLO (“be on the lookout”) report for the safety of her
    life. In a later call to the jail, he says he “begged” them to take his wife to the
    hospital. Finally, in a call to the jail about 8 p.m., Mr. Simpson requested that
    the Texas Department of Mental Health and Mental Retardation (“MHMR”)
    assist his wife, but was told that MHMR would not see her until she was sober.
    The jail employee who took this call stated that Mrs. Simpson was just drunk
    and needed to sleep it off.
    About 2:40 a.m., Ms. Rich entered the holding cell to finish the book-in
    process and found Mrs. Simpson unresponsive. Paramedics took her to the
    hospital where she was pronounced dead. An autopsy identified the cause of
    death as mixed drug intoxication, and the manner of death was found to be
    consistent with and highly suspicious of suicide.
    Mrs. Simpson’s husband and children (collectively, “plaintiffs”), sued
    individually and as representatives of the estate of Diana Simpson, contending
    that Young County violated 
    42 U.S.C. § 1983
     and the Texas Tort Claims Act.
    The district court granted the defendant’s motion for summary judgment,
    dismissing all claims. Plaintiffs appeal only the dismissal of their § 1983 claim.
    STANDARD OF REVIEW
    This court reviews a district court’s grant of summary judgment de novo.
    Kemp v. Holder, 
    610 F.3d 231
    , 234 (5th Cir. 2010). Summary judgment is
    granted when “there is no genuine dispute as to any material fact and the
    5
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    movant is entitled to judgment as a matter of law.”               
    Id.
     (citing Fed. R. Civ.
    P. 56(a)).    The “burden of production at trial ultimately rests on the
    nonmovant” and the movant must merely show an “absence of evidentiary
    support in the record for the nonmovant’s case.” Cuadra v. Houston Indep.
    Sch. Dist., 
    626 F.3d 808
    , 812 (5th Cir. 2010). The nonmoving party must then
    come forward with specific facts showing that there is a genuine issue for trial.
    
    Id.
     And though we draw justifiable inferences in favor of the nonmovant, the
    nonmovant must put forward sufficient evidence to enable us to draw this
    inference. State Farm Life Ins. Co. v. Gutterman, 
    896 F.2d 116
    , 118 (5th Cir.
    1990). There is “no issue for trial unless there is sufficient evidence favoring
    the nonmoving party for a jury to return a verdict for that party.” Anderson v.
    Liberty Lobby, Inc., 
    477 U.S. 242
    , 249, 
    106 S. Ct. 2505
    , 2511 (1986). This court
    may affirm a grant of summary judgment on any grounds supported by the
    record and argued in the district court. Campbell v. Lamar Inst. of Tech.,
    
    842 F.3d 375
    , 378 (5th Cir. 2016).
    DISCUSSION
    Plaintiffs’ § 1983 case invokes alternative theories for the County’s
    liability for the death of Mrs. Simpson: the unconstitutional “conditions of
    confinement” at the Young County Jail, or the “episodic acts and omissions” of
    jailers. Hare v. City of Corinth, Miss., 
    74 F.3d 633
    , 644–45 (5th Cir. 1996) (en
    banc). We accept plaintiffs’ characterization of the case as concerning whether
    Mrs. Simpson exhibited serious medical needs, not simply whether she was
    suicidal upon admission to the jail. 3 The “unconstitutional conditions” theory
    3 The district court incorrectly maintained that plaintiffs may only bring a “pretrial
    detainee suicide case” under a theory of episodic acts or omissions for which individual
    defendants, not the county, ordinarily bear liability. Shepherd, 591 F.3d at 452–53. This
    case is not a classic pretrial detainee suicide case because Mrs. Simpson did not commit
    suicide while detained. But plaintiffs can bring a pretrial detainee case, whether or not it
    6
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    rests on the idea that the County has imposed what amounts to punishment
    in advance of trial on pretrial detainees, and it requires no showing of specific
    intent on the part of the County. The “episodic acts and omissions” theory, in
    contrast, requires a finding that particular jailers acted or failed to act with
    deliberate indifference to the detainee’s needs. Normally, episodic acts liability
    falls not on the County as employer, but on the individual employees for their
    particular acts. See Shepherd v. Dallas Cty., 
    591 F.3d 445
    , 452 (5th Cir. 2009).
    In this case, plaintiffs are attempting to create genuine issues of material fact
    concerning both unconstitutional conditions of confinement and episodic acts
    or omissions that allegedly flowed from the County’s unconstitutional policies
    or lack of policies.
    Because the district court focused only on the plaintiffs’ claim that
    episodic acts and omissions of the jail personnel could be imputed to the
    County, it did not analyze their unconstitutional conditions of confinement
    claim at all. In deference to the trial court’s responsibility to review the record
    in the first instance, we vacate and remand for its consideration whether there
    is any genuine issue of material fact that Mrs. Simpson was subjected to the
    County’s unconstitutional conditions of confinement.
    The plaintiffs’ theory of episodic acts and omissions, on the other hand,
    was squarely rejected by the district court on summary judgment and is poised
    for appellate review.
    A government entity may incur Section 1983 liability for episodic acts
    and omissions injurious to a pretrial detainee if plaintiffs first prove that
    County officials, acting with subjective deliberate indifference, violated her
    constitutional rights; and plaintiffs then establish that the County employees’
    ultimately involves suicide, under alternative theories of episodic acts and omissions by
    individual defendants or unconstitutional conditions of confinement. 
    Id.
     at 453 n.1.
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    acts resulted from a municipal policy or custom adopted with objective
    indifference to the detainee’s constitutional rights. Hare, 
    74 F.3d at
    649 n.4;
    Lawson v. Dallas Cty., 
    286 F.3d 257
     (5th Cir. 2002) (jail medics’ treatment of
    paraplegic inmate, leading to decubitus ulcers, was subjectively deliberately
    indifferent, and County was liable for multiple policies indicating objective
    indifference to serious medical needs).
    Plaintiffs’ claim fails on several fronts. First, the principal evidence of
    the alleged “policy or custom” arises from the treatment of Mrs. Simpson, that
    is, from this single case. To be unconstitutional, however, a municipal entity’s
    policy that derives from custom or practice must be “so common and well
    settled as to constitute a custom that fairly represents municipal policy.”
    Webster v. City of Houston, 
    735 F.2d 838
    , 841 (5th Cir. 1984) (en banc).
    Further,   “[a]   municipality   is   almost   never   liable   for   an   isolated
    unconstitutional action on the part of an employee.” Peterson v. City of Fort
    Worth, 
    588 F.3d 838
    , 847 (5th Cir. 2009). Plaintiffs offered no evidence about
    the alleged maltreatment of any other detainees at Young County’s jail.
    Second, regardless whether there was sufficient evidence to create a
    genuine, material fact issue that the failure of jailers to “complete”
    Mrs. Simpson’s intake screening questionnaire and to request a CCQ reflected
    County “policies or customs,” these are matters of file documentation. There
    is no proof that any such alleged deficiencies in jail procedures were causally
    linked to Mrs. Simpson’s death under the circumstances of this case. The
    intake questionnaire was substantially completed, in any event, and there is
    no evidence that Mrs. Simpson’s name would have appeared on a CCQ inquiry.
    Third, her treatment by the employees of the County did not indicate
    subjective deliberate indifference. Deliberate indifference is an extremely high
    standard to meet. Stewart v. Murphy, 
    174 F.3d 530
    , 534 (5th Cir. 1999). To
    demonstrate deliberate indifference, a plaintiff must show that public officers
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    were aware of facts from which an inference of a substantial risk of serious
    harm to an individual could be drawn; that they actually drew the inference;
    and that their response indicates subjective intention that the harm occur. See
    Thompson v. Upshur County, 
    245 F.3d 447
    , 458–59 (5th Cir. 2001). Here,
    Mrs. Simpson was questioned extensively about potential suicidal tendencies;
    she never admitted overdosing; the medics examined her and found normal
    vital signs and, essentially, no medical emergency; she underwent intake
    screening with only an indication of intoxication. The officers and jail
    personnel had information about Mrs. Simpson from several sources: the
    EMTs, Mrs. Simpson herself (repeatedly denying the need to go to the hospital
    or desire to kill herself to two arresting officers, two EMTs, and Officer Rich);
    their own observations; and her husband. Their individual actions may have
    amounted to negligence, even gross negligence, but that is not sufficient to
    create a genuine issue of material fact concerning deliberate indifference as to
    any one of them, much less a systemic failure attributable to the County.
    Fourth, liability cannot be imposed on the County for any failures by
    Sheriff Walls in this case, because he was not involved in and had no
    knowledge of Mrs. Simpson’s situation until after her death. Supervisors
    cannot be held liable for constitutional violations committed within the jail if
    they had no personal involvement. Thompkins v. Belt, 
    828 F.2d 298
    , 303 (5th
    Cir. 1987). And notwithstanding his status as a County policymaker, the
    County could not be liable absent the Sheriff’s direct participation. 4
    Contrary to plaintiffs’ theory, a plaintiff cannot bootstrap government
    entity liability from the individual failures of employees because there is no
    respondeat superior liability under Section 1983. Monell v. Dep’t of Soc. Servs.
    4Of course, if the Sheriff was responsible for alleged “unconstitutional conditions of
    confinement,” that would be a different issue, which the district court must address on
    remand.
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    of City of N.Y., 
    436 U.S. 658
    , 691, 
    98 S. Ct. 2018
    , 2036 (1978); Hicks-Fields v.
    Harris Cty., Texas, No. 16-20003, 
    2017 WL 2729081
    , at *4 (5th Cir. June 26,
    2017). This court’s decision in Shepherd is distinguishable because his claim
    was not based on failures of individuals but implicated “the jail’s system of
    providing medical care to inmates with chronic illness.”                  
    591 F.3d at 453
    (“Shepherd’s claim, by contrast, does not implicate the acts or omissions of
    individuals but the jail's system of providing medical care to inmates with
    chronic illness”). 5
    CONCLUSION
    The Constitution does not require that officers always take arrestees
    suspected to be under the influence of drugs or alcohol, or reported by relatives
    to be at risk, to a hospital against their wishes. Grayson v. Peed, 
    195 F.3d 692
    ,
    696 (4th Cir. 1999). Mrs. Simpson’s decision to take her own life is tragic. The
    County, however, cannot be held responsible for fatal decisions she made that
    were, under all the circumstances, not obvious to government employees.
    The judgment is AFFIRMED to the extent it rejected plaintiffs’ episodic
    acts and omissions claim; VACATED and REMANDED for consideration in
    the first instance of plaintiffs’ unconstitutional conditions of confinement
    claim.
    5 Plaintiffs also contend that the County may be liable for unconstitutional failure to
    train its employees, but they offered no evidence relevant or sufficient to create a fact issue
    on this theory.
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    RHESA HAWKINS BARKSDALE, Circuit Judge, concurring in part and
    dissenting in part:
    Although I concur in remanding the claim for unconstitutional
    conditions of confinement (UCC), in order for the district court to rule on it in
    the first instance, I must respectfully dissent from affirming the summary
    judgment against the claim for episodic acts or omissions (EA/O). Regarding
    the EA/O claim, I disagree with the majority’s factual analysis, the standard
    to be applied, and the resulting outcome.
    In this instance, such disagreement among reasonable jurists over a
    summary judgment highlights a strong likelihood a reasonable juror could find
    for the non-movant plaintiffs—the standard for denying summary judgment.
    Given the genuine disputes of material fact, discussed infra, summary
    judgment was improperly granted for the EA/O claim; it should be remanded
    for trial, following the district court’s decision on the UCC claim and a possible
    appeal from that decision.
    I.
    It is more than well-established that, in reviewing a summary judgment,
    the standard of review is de novo, applying the same standard as the district
    court. E.g., Uptown Grill, L.L.C. v. Shwartz, 
    817 F.3d 251
    , 255 (5th Cir. 2016).
    And, “[i]n reviewing a summary judgment motion, the court must ‘refrain from
    making credibility determinations or weighing the evidence’ and must view the
    facts in the light most favorable to the non-moving party and draw all
    reasonable inferences in its favor”. Devon Enters., L.L.C. v. Arlington Indep.
    Sch. Dist., 541 F. App’x 439, 441 (5th Cir. 2013) (reversing summary judgment)
    (quoting EEOC v. WC&M Enters., 
    496 F.3d 393
    , 398 (5th Cir. 2007)); see also
    Starnes v. Wallace, 
    849 F.3d 627
    , 630 n.1 (5th Cir. 2017) (reversing summary
    judgment) (“Because of the summary judgment stance, this recitation takes
    11
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    facts in the light most favorable to [the non-movant].”); Cannon v. Jacobs Field
    Serv’s. N. Am., Inc., 
    813 F.3d 586
    , 588 n.1 (5th Cir. 2016) (reversing summary
    judgment) (“Given the summary judgment posture, this section construes the
    evidence in the light most favorable to [the non-movant].”).
    In Devon Enterprises, our court vacated a summary judgment. 541 F.
    App’x at 440–41.       There, the non-movant “produced some, albeit weak,
    evidence” in support of its claim. 
    Id. at 442
    . Nonetheless, “[w]e do not pass on
    the credibility of the evidence; rather, we conclude only that a genuine
    [dispute] of material fact exists to survive summary judgment”. 
    Id.
     at 442–43.
    Depth of discovery notwithstanding, the summary-judgment standard
    only requires the non-movant’s producing sufficient evidence such that a
    reasonable juror could return a favorable verdict for the non-movant on the
    issue. Anderson v. Liberty Lobby, Inc., 
    477 U.S. 242
    , 248–49 (1986). A mere
    “scintilla” is insufficient—but the plaintiffs in this instance do not need to
    prove their EA/O claim through discovery alone. State Farm Life Ins. Co. v.
    Gutterman, 
    896 F.2d 116
    , 118 (5th Cir. 1990). Plaintiffs in Montano (a UCC
    claim), for example, exposed testimonial inconsistencies at trial which were not
    present at the close of discovery. Montano v. Orange Cty., Tex., 
    842 F.3d 865
    ,
    871 (5th Cir. 2016).
    In the light of the depositions of the sheriff and the husband, and the
    numerous other items in this summary-judgment record, such as the arrest
    report, the requisite genuine disputes of material fact have been shown which
    must be decided by a trial. As stated above, and discussed infra, plaintiffs need
    only to present a genuine dispute of material fact on, inter alia, whether a
    county policy or custom violated Mrs. Simpson’s rights. Fed. R. Civ. Pro. 56(a).
    II.
    Mr. Simpson was a respiratory therapist; Mrs. Simpson, a registered
    nurse. On Saturday, 18 May 2013, Mr. Simpson, who worked day shifts,
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    returned to their home in Brown County, Texas, while, beginning on Friday,
    Mrs. Simpson started working the weekend night shift at a hospital in
    Breckenridge, the county seat for Stephens County.             Stephens County is
    southwest of Young County.        That county’s seat, Graham, is where Mrs.
    Simpson’s Jeep was identified on Sunday, by passersby who saw a Facebook
    alert posted by Mr. Simpson.
    After working the Friday-to-Saturday night-shift, with the similar
    Saturday-to-Sunday night-shift awaiting her, Mrs. Simpson, on Saturday, 18
    May, ingested 24 pills of seven various prescription medications, none of which
    were prescribed for her. She combined those pills with alcohol. The empty
    blister packs and beer cans were plainly visible when she was found on Sunday
    in her Jeep on the side of a highway.
    Mrs. Simpson was taken into custody, transported to the Young County
    jail, and booked partially; she was found dead in a holding cell eight hours
    later, early Monday morning. During those eight hours, the jail provided Mrs.
    Simpson no medical attention as it both ignored the arresting officer’s report,
    which noted all the substances found in her car and her admitting having
    consumed them, and waved away repeated, concerned calls from her husband,
    telling him on one occasion, “[w]e don’t hurt people here”.
    Respectfully, I cannot agree fully with the majority’s recitation of the
    facts. For example, the majority’s discussion of Mr. Simpson’s efforts to save
    his wife is inadequate. A more complete recitation of that important chain of
    events is required. Mr. Simpson’s extensive efforts to locate Mrs. Simpson
    increased the likelihood that he was notably distraught by the time of his four
    calls to the jail. Those details in the record are striking.
    Regarding Mr. Simpson’s first call to the Graham police station,
    prompted by the tip that his wife was seen in Graham, the majority opinion at
    5 states: “He told the officer she was a suicide risk, but he did not say that she
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    might have taken drugs or overdosed because he did not know that”.
    (Emphasis added.) This statement is true for the first call; however, the
    opinion fails to mention that, in a later call, Mr. Simpson asked the jailer, “Will
    you please get her some help? . . . she had said that she was going to take
    drugs. I want to make sure that she’s safe, that she’s okay”. (Emphasis
    added.)
    According to Mr. Simpson’s deposition, on the morning of Saturday, 18
    May, after seeing online Mrs. Simpson’s ATM cash withdrawal and failing to
    reach her by telephone, Mr. Simpson called the nurses’ station at her hospital
    to ascertain whether she was sleeping at the hospital, but was told “she said
    she had to -- couldn’t sleep here today, she needed to go get a motel room”. Mr.
    Simpson observed, using an application on his mobile telephone, that Mrs.
    Simpson’s mobile telephone was located somewhere between the hospital in
    which she worked in Breckenridge and Mineral Wells.
    Given Mrs. Simpson’s recent articulation to Mr. Simpson of a potential
    repeat suicide plan—involving waiting until she went to work, withdrawing
    cash from an ATM, going to a motel, and taking pills to induce her death—
    combined with Mr. Simpson’s professional experience in emergency rooms, Mr.
    Simpson was understandably alarmed. Accordingly, he called Mineral Wells
    law enforcement around 9 or 9:30 am on Saturday, provided a description of
    Mrs. Simpson’s Jeep and her suicide plan, and asked that entity to search for
    her. Mr. Simpson was told a patrol car would “go by the motels, or the main
    drag”. About “an hour to hour and a half later”, Mineral Wells law enforcement
    called Mr. Simpson to report “they did not find anything of her”.
    Mr. Simpson next called the “highway patrol department” near
    Weatherford, a town east of Mineral Wells, “and told them, and then they told”
    him to call Abilene, southwest of Breckenridge, in case Mrs. Simpson had
    driven in the other direction. Therefore, Mr. Simpson called the Abilene DPS.
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    He also contacted the Breckenridge DPS, which recommended he “might also
    contact Brown County, as well, where she was from”. Mr. Simpson called
    Brownwood, the county seat of Brown County, where the Simpsons lived, but
    did not hear back by noon—no one had identified Mrs. Simpson’s Jeep by then.
    Officer Harper, with the Brownwood police department, came to the
    hospital where Mr. Simpson worked. Mr. Simpson recalls Officer Harper “took
    down . . . information [about Mrs. Simpson] and said that it hadn’t been
    twenty-four hours, so he really couldn’t file a missing persons [report], but to
    let him know if she didn’t show up for work that [Saturday] night”.
    Between 4 pm and 7 pm, Mr. Simpson “was still calling and waiting to
    hear from the other people that [he] had called to see if there was anything”.
    Mr. Simpson called Mrs. Simpson’s employer at 7 pm to ask if she had come to
    work. She had not.
    Therefore, as he had been directed by Officer Harper, Mr. Simpson called
    that officer but did not reach him. Mr. Simpson “called everyone to see if they
    had seen or heard anything”. He called Breckenridge, and “they had not seen
    or heard anything”. The Breckenridge police department advised Mr. Simpson
    to file a “BOLO [be on the lookout] report” so they could “attempt to make
    contact that she is safe; that she made a threat to take her own life”, and
    advised him to do likewise with Brownwood and Brown County.
    Brownwood’s Officer Harper returned Mr. Simpson’s call, and Mr.
    Simpson told the officer that the Breckenridge police advised him to file the
    BOLO report for Brownwood. Mr. Simpson recalls Officer Harper “became a
    little irritated” and said Mrs. Simpson was missing from Stephens, not Brown,
    County.
    Mr. Simpson next called law enforcement for Stephens County, where
    Mrs. Simpson worked. Stephens County insisted Mineral Wells “should be the
    ones to” put out the BOLO, because Mrs. Simpson’s mobile telephone was last
    15
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    No. 16-10227
    identified near there. Mr. Simpson argued with the contact, and advised Mrs.
    Simpson “would stay in a motel, so that was mainly what I was trying to do, is
    to make sure that maybe if she was going to a motel . . . they would check”. He
    “gave them a description of [her] Jeep, the license plate number, her
    description”, and advised she worked in Stephens County.         The Stephens
    County representative stated the BOLO report would be filed. Mr. Simpson
    stayed at home all night waiting by the telephone in case Mrs. Simpson came
    home or called.
    Early Sunday morning, 19 May, Mr. Simpson “called all . . . the law
    enforcement agencies again”. Around 8 or 9 am, Mr. Simpson called Brown
    County, his home county, and spoke with a deputy, who agreed to file a
    missing-persons report. Immediately after speaking with the deputy, Mr.
    Simpson posted to Facebook photographs of Mrs. Simpson, her Jeep, and
    license plate, along with instructions: “if someone who had please [sic] saw
    her, to contact me and the local law enforcement”. After publishing the notice
    online, Mr. Simpson “made calls”.
    At approximately 3 or 4 pm that Sunday, Mr. Simpson received a call
    from a Graham resident who remembered seeing a vehicle on the side of the
    road under a tree and sent her son-in-law to find Mrs. Simpson. “They” had
    spoken to Mrs. Simpson and said she was sleeping in the Jeep. And, the caller
    had notified the police.
    After speaking with the Graham resident, Mr. Simpson called Wichita
    Falls DPS—a town just north of Graham—and was advised to call Graham law
    enforcement. Mr. Simpson’s extensive efforts made to locate his wife are
    crucial additions, increasing the validity of his subsequent statements to the
    Young County jail, and the likelihood that a jail-staff member receiving a call
    from Mr. Simpson would have been able to detect how concerned, if not
    distraught, he was.
    16
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    The opinion also fails to provide full information from the summary-
    judgment record concerning Mrs. Simpson, Officer Ford’s arrest report, and
    Sheriff Walls’ (for Young County) stunning admissions when deposed. The
    majority opinion’s at 4, painting Mrs. Simpson, age 50, as a coherent, sensible
    communicator on the night of her arrest, ignores her nonsensical affirmative
    response when asked whether she was pregnant. Presuming notice of the
    arrest report, which was completed at the jail, other answers from Mrs.
    Simpson were likewise inexplicable. The arrest report stated: “I . . . asked
    Simpson how much of the medicine she had taken. Simpson advised all of it
    that was missing this morning”. Mrs. Simpson, however, told jailer Rich she
    was not on medication. Further cutting against summary judgment’s being
    granted, Rich’s declaration about Mrs. Simpson’s partial booking was prepared
    two years after her death. Rich’s declaration does not specify whether Rich or
    Mrs. Simpson completed Mrs. Simpson’s booking-interview forms.
    In further incompletion, Rich’s declaration notes Rich was aware Officer
    Ford brought Mrs. Simpson into the jail intake area, and was told Mrs.
    Simpson was arrested for public intoxication, but makes no mention whether
    Rich was informed verbally, or through the report Officer Ford prepared at the
    jail, that Mrs. Simpson admitted taking all the missing pills from the blister
    packs in her car. Similarly, while stating Mrs. Simpson told her she had a
    peptic ulcer, Rich’s declaration is silent as to Mrs. Simpson’s stating she was
    pregnant.
    Of great importance, Rich’s declaration articulated a county policy to
    check on detainees, such as Mrs. Simpson, every 25 minutes, but made no
    affirmative statement as to whether Mrs. Simpson was checked in accordance
    with that policy. Rich stated Mrs. Simpson was fine when another inmate was
    placed in the same female holding cell, but offers no basis for that assertion,
    whether firsthand or otherwise.     Rich “understood” Mrs. Simpson moved
    17
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    around during a cell check, but provided no detail as to how anyone came to
    understand that information. These omissions raise questions as to what else
    was omitted in Rich’s two-years-delayed declaration.
    The majority states at 4, “How frequently jail staff checked on Mrs.
    Simpson in the holding cell is disputed”. In this regard, the primary genuine
    dispute of material fact is, instead, whether she was checked-on at all. Rich’s
    declaration states:
    7. Jailers have timer [sic] set for 25 minutes to check
    on detainees. We check inmates every 25 minutes as
    required by the Young County rules for jailers.
    8. Another arrestee, Stephanie Fitzgerald, was put in
    the female holding cell. Simpson was fine at that time.
    9. I understood Simpson had been moving around
    when I performed a cell check.
    This declaration merely supports that, at some unstated time, Rich somehow
    understood Mrs. Simpson “was fine” when someone placed another female in
    Mrs. Simpson’s holding cell, and somehow Rich “understood” that, at another
    unstated time, Mrs. Simpson had moved.
    The majority opinion makes no mention of key information in or about
    Officer Ford’s arrest report, which the county provided in support of its
    summary-judgment motion. Again, and of great importance for there being
    genuine disputes of material fact, Officer Ford completed the arrest report at
    the jail. The report was signed by Officer Ford and a jailer whose signature is
    illegible.
    Therefore, the    summary-judgment       record demonstrates genuine
    disputes of material fact that, when the jail received Mrs. Simpson, the county
    was on notice that she took “all of [the 24 pills] that [were] missing” from the
    wide variety of prescription blister packs found in her Jeep. Officer Ford
    reported bringing the bag of pills into the jail at that time. Obviously, this
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    information is crucial, relative to the jail staff’s subjective knowledge of Mrs.
    Simpson’s risk.
    Officer Ford’s arrest report notes Mrs. Simpson’s slurred speech, as well
    as her struggling to drink a cup of water, being “unsteady on her feet”, and
    possessing no prescription for the pills she admitted taking. And Officer Ford’s
    report includes his conclusion that Mrs. Simpson was a danger to herself or
    others. In sharp contrast, while the separate incident report prepared by the
    EMT, who was also at the arrest site, notes Mrs. Simpson reported consuming
    “two Benadryl”, but does not mention the empty beer cans or Mrs. Simpson’s
    admitted consumption of 24 pills, the incident report does not indicate if or
    when the jail received it.
    The majority opinion does not acknowledge Sheriff Walls’ admissions in
    his deposition that he was responsible for the implementation of policies at the
    jail, and was unaware of Texas’ Continuity of Care Query requirement dating
    back to 2010. The majority opinion further omits the sheriff’s admission that
    the jail had “been out of compliance ever since ’05 when -- during that jail
    inspection. We’ve been out of compliance on various things and I do not know
    what they are”. When asked whether he kept such “information at [his]
    disposal so that [he could] see what [he] failed at and make sure it doesn’t
    happen again”, Sheriff Walls said no. When plaintiffs’ counsel continued, “You
    just wait until they come in and find you out of compliance and then you fix it;
    right?” Sheriff Walls responded, “Yes, sir”.
    Likewise, the majority opinion fails to mention the news article
    documenting Young County’s May 2013 notice of non-compliance following a
    routine annual inspection of the jail that took place the very day Mrs. Simpson
    had earlier been found dead. The inspection revealed jail staff were not trained
    for emergencies and “an approved mental disabilities/suicide prevention
    screening form” was not being completed immediately and/or in its
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    entirety. That evidence alone established genuine disputes of material fact as
    to a county policy or custom—or lack thereof—and causal connection to Mrs.
    Simpson’s death.
    Concerning the misconduct at the jail, the majority’s characterization at
    4 of persons staring at Mrs. Simpson’s semi-exposed body fails to spell out its
    most important context: that it was lurid. An incident report from Officer Post
    of the Graham police department, who was on duty the night of Mrs. Simpson’s
    detainment and came to the jail to book three arrestees, notes Deputy
    Wacaster of the Young County sheriff’s office told him to look into a holding
    cell; and, upon doing so, Officer Post saw Mrs. Simpson on the floor, exposed.
    Sheriff Walls stated at his deposition: Deputy Wacaster “should have been”
    out on patrol that night, as he was a deputy and not a jailer; and he was later
    indicted for aggravated sexual assault or forcible rape of another woman.
    On the other hand, some facts are not relevant. The EA/O standard,
    discussed infra, includes “deliberate indifference” to “subjective knowledge of
    a substantial risk of serious harm”, not subsequent test results. Estate of
    Henson v. Wichita Cty. Tex., 
    795 F.3d 456
    , 464 (5th Cir. 2015). Therefore, Mrs.
    Simpson’s autopsy report, concerning, inter alia, the specific drugs that caused
    her death and discussed in the majority opinion at 4, note 2, has no bearing on
    the claim at hand.
    III.
    I must also respectfully disagree with the majority on the nature and
    standard of EA/O law pertaining to the county’s liability. This disagreement
    highlights the need for an updated articulation by our court.
    As discussed further infra, an EA/O claim against a county first requires
    plaintiffs to prove an official, or officials, committed an episodic act or omission
    in violation of a pretrial detainee’s constitutional rights. Scott v. Moore, 
    114 F.3d 51
    , 53–54 (5th Cir. 1997) (en banc). In that regard, I disagree with the
    20
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    majority opinion’s statement at 7 that “[n]ormally, episodic acts liability falls
    not on the [government-entity] as employer, but on the individual employees
    for their particular acts”. (Emphasis added.) While it is true that EA/O
    plaintiffs almost always also name as defendants the official or officials who
    committed the act or omission (but was not done in this action), the EA/O
    framework is designed to hold government entities liable for their contributions
    to an episodic act or omission. Scott, 
    114 F.3d at
    53–54; Hare v. City of Corinth,
    Miss., 
    74 F.3d 633
    , 649 n.4 (5th Cir. 1996) (en banc) (“We separate the two
    issues: the existence of a constitutional violation simpliciter and a
    [government-entity]’s liability for that violation.”).
    The majority states correctly at 9 that such government-entity liability
    does not arise through respondeat superior.          Instead, EA/O law holds a
    government entity liable for its role in causing a constitutional violation―not
    for its role as employer. See Hare, 
    74 F.3d at
    649 n.4. Contrary to what the
    majority opinion states at 9, plaintiffs do not attempt to “bootstrap” liability,
    but instead seek to hold the county responsible for its deliberate indifference
    to the risk of Mrs. Simpson’s death.         “While the specific episode may be
    perpetrated by one or more persons, any underlying conditions that may have
    caused it or made it possible are the product of the [government-entity]’s policy,
    action, or inaction.” Scott, 
    114 F.3d at 54
    .
    In our circuit, government-entity liability for EA/O rests on a two-step
    inquiry:
    In an episodic act or omission case, . . . [t]o succeed in
    holding a [government-entity] liable, the plaintiff
    must demonstrate [the entity’s] employee’s subjective
    indifference and additionally that the . . . employee’s
    act “resulted from a [government-entity’s] policy or
    custom adopted or maintained with objective
    deliberate    indifference    to     the       [plaintiff]’s
    constitutional rights.”
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    Olabisiomotosho v. City of Hous., 
    185 F.3d 521
    , 526 (5th Cir. 1999) (emphasis
    added) (quoting Hare, 
    74 F.3d at
    649 n.4) (Olabisiomotosho erroneously cites a
    non-existent n.14 in Hare); see also Anderson v. Dallas Cty., Tex., 286 F. App’x
    850, 861 (5th Cir. 2008).         For the action at hand, the district court
    acknowledged this EA/O standard for the county’s potential liability, quoting
    Olabisiomotosho. Sanchez v. Young Cty., Tex., No. 7:15-00012-O, 
    2016 WL 3365248
    , at *5 (N.D. Tex. 27 Jan. 2016).
    For the first of the two steps for analyzing the county’s potential EA/O
    liability, “[a] jail official violates a pretrial detainee’s constitutional right to be
    secure in [her] basic human needs only when the official had ‘subjective
    knowledge of a substantial risk of serious harm’ to the detainee and responded
    to that risk with deliberate indifference”. Henson, 795 F.3d at 464 (quoting
    Hare, 
    74 F.3d at 650
    ). Therefore, for this appeal, the summary-judgment
    record is to be reviewed de novo for, inter alia, genuine disputes of material
    fact regarding whether officials overseeing Mrs. Simpson had subjective—not
    objective—knowledge of substantial risk of serious harm—not actual harm.
    Kemp v. Holder, 
    610 F.3d 231
    , 234 (5th Cir. 2010) (de novo review for summary
    judgment).
    And, while this first step does require claiming a constitutional violation
    by a government official, and even though many cases name an individual as
    at least one among other defendants, I have yet to find any fifth circuit
    precedent requiring naming an individual as a prerequisite to government-
    entity EA/O liability.       Notably, the Scott plaintiff initially sued the
    municipality as well as the jail official who had allegedly committed sexual
    assault. 
    114 F.3d at 52
    . The jail official, however, was dismissed from the
    action following his declaration of bankruptcy. 
    Id.
     Nonetheless, the action
    continued with only the city and its police chief as defendants. See 
    id.
     This
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    demonstrates its not being necessary for the individual or individuals who
    committed the underlying constitutional violation to be held liable.
    While a recent opinion from our court expounded on individual liability,
    the matter did not involve or address government-entity liability. Alderson v.
    Concordia Par. Corr. Facility, 
    848 F.3d 415
    , 419–20 (5th Cir. 2017). Still, we
    may look to Alderson for an updated understanding of the terms for step one
    for government-entity EA/O liability:       the employee’s subjective deliberate
    indifference.
    Again, for that step, “the plaintiff must demonstrate [the entity’s]
    employee’s subjective [deliberate] indifference”. Olabisiomotosho, 
    185 F.3d at 526
    .
    That is, the plaintiff must show that the official knew
    of and disregarded a substantial risk of serious
    harm. Domino v. Tex. Dep’t of Criminal Justice, 
    239 F.3d 752
    , 755 (5th Cir. 2001). “Actions and decisions
    by officials that are merely inept, erroneous,
    ineffective, or negligent do not amount to deliberate
    indifference.” Alton v. Tex. A & M Univ., 
    168 F.3d 196
    ,
    201 (5th Cir. 1999). To reach the level of deliberate
    indifference, official conduct must be “wanton,” which
    is defined to mean “reckless.” Johnson v. Treen, 
    759 F.2d 1236
    , 1238 (5th Cir. 1985).
    Alderson, 848 F.3d at 419–20. “So, [for a pretrial detainee,] as to the discrete,
    episodic act, the detainee must establish only that the constitutional violation
    complained of was done with subjective deliberate indifference to that
    detainee’s constitutional rights.” Scott, 
    114 F.3d at 54
     (emphasis in original).
    For the second step in the standard for government-entity EA/O liability
    regarding a pretrial detainee, after establishing a jail official violated the
    detainee’s constitutional rights, the entity may be held accountable if there
    exists “a direct causal link” between the violation and some entity custom or
    policy. Anderson, 286 F. App’x at 861 (quoting Piotrowski v. City of Hous., 237
    23
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    10227 F.3d 567
    , 580 (5th Cir. 2001)). Each step requires a showing of indifference.
    But, as noted, the indifference standard for the government-entity employee is
    subjective, while the indifference standard for the entity is objective.
    Olabisiomotosho, 
    185 F.3d at 526
    ; see also Hare, 
    74 F.3d at
    649 n.4.
    Our court has defined both standards. The standard for the official is
    presented supra.     As for the government entity, it “acts with objective
    deliberate indifference if it promulgates (or fails to promulgate) a policy or
    custom despite ‘the “known or obvious consequences” that constitutional
    violations would result’”. Anderson, 286 F. App’x at 861 (quoting Piotrowski,
    237 F.3d at 579). To determine whether an entity may be held accountable for
    the unconstitutional episodic act or omission, plaintiff must “put[] forth facts
    sufficient to demonstrate that the predicate episodic act or omission resulted
    from a [government-entity] custom, rule, or policy adopted or maintained with
    objective deliberate indifference to the detainee’s constitutional rights”. Scott,
    
    114 F.3d at 54
     (emphasis in original).
    IV.
    Respectfully, the majority erroneously analyzes the EA/O claim by
    employing precedent that is not EA/O specific. Obviously, whether plaintiffs
    have an EA/O claim against the county sufficient to withstand summary
    judgment cannot be decided without engaging EA/O-specific precedent.
    A.
    The majority opinion at 9–10 and throughout, however, conflates EA/O
    and 
    42 U.S.C. § 1983
     liability, despite a wealth of discrete case law. Lawson,
    relied upon by the majority and presented as though authority on EA/O, is not
    a pretrial-detainee case, let alone an EA/O case; the phrase “episodic acts”
    never appears in that opinion. See generally Lawson v. Dallas Cty., Tex., 
    286 F.3d 257
     (5th Cir. 2002). On the other hand, Henson (and other opinions from
    our court) specifically articulate our EA/O standard—and even more
    24
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    specifically, our EA/O standard for government-entity liability. At 6 and 8 the
    majority makes passing mention of Hare—a pertinent en banc opinion from
    our court delineating between EA/O and UCC claims, following specific
    standards for evaluating each. 
    74 F.3d at
    644–45, 649 n.4. Why the majority
    does not rely on Hare or its EA/O-specific progeny for substantive analysis is
    unexplained.
    Here, citation to Lawson is appropriate only in addressing (and correctly
    rejecting) the proposition for which plaintiffs cited the opinion—attempting to
    broaden the EA/O standard of subjective knowledge by the official for
    government-entity liability to mere constructive knowledge. 
    286 F.3d at 264
    (applying a constructive notice standard for government-entity liability under
    a general § 1983 claim when assessing what policymakers should have known
    in maintaining an official policy with deliberate indifference). While response
    to that erroneous assertion by plaintiffs is appropriate, it cannot eclipse the
    central EA/O analysis.
    Henson highlighted multiple decisions from our court which clarified
    “subjective knowledge” for an EA/O claim. “[T]he official must both be aware
    of facts from which the inference could be drawn that a substantial risk of
    serious harm exists, and he must also draw the inference”. Henson, 795 F.3d
    at 464 (quoting Estate of Henson v. Krajca, 440 F. App’x 341, 343 (5th Cir.
    2011) (quoting Calhoun v. Hargrove, 
    312 F.3d 730
    , 734 (5th Cir. 2002)). As
    noted supra, in the context of individual liability for an EA/O claim, our court
    stated recently that an official’s “subjective deliberate indifference” means “the
    official knew of and disregarded a substantial risk of serious harm”. Alderson,
    848 F.3d at 419–20.
    In citing Thompson v. Upshur County, requiring an official’s “response
    indicate subjective intention that the harm occur”, the majority opinion at 9
    pulls not only from an action that does not expressly concern EA/O, but from a
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    basic § 1983 liability standard expressly intended for individual liability only.
    
    245 F.3d 447
    , 458–59 (5th Cir. 2001).       Again, the claim at issue here is
    expressly concerned with government-entity liability. While our court’s EA/O
    precedent first requires examination of an official’s conduct in order to next
    consider government-entity liability, we are, as discussed supra, not concerned
    with standards for liability on the part of a county employee or official. Again,
    the EA/O claim at issue is only against the county.
    Similarly, where the majority opinion at 9 states “notwithstanding his
    status as a County policymaker, the County could not be liable absent the
    Sheriff’s direct participation”, it offers no case law to support such a
    proposition.   As discussed, while Sheriff Walls was certainly a county
    policymaker, there is no claim in this action that he is personally liable for the
    EA/O; only that his unapologetic flagrant disregard for state policies, as shown
    in his deposition contained in the summary-judgment record, demonstrates the
    requisite genuine dispute of material fact regarding a county custom of
    disregarding policies to properly take in, as well as monitor, detainees.
    Likewise, the majority opinion at 10, note 5 states “Plaintiffs also
    contend that the County may be liable for unconstitutional failure to train its
    employees, but they offered no evidence relevant or sufficient to create a fact
    issue on this theory”. But, we must again delineate: while plaintiffs do not
    seek exclusively to prevail in this matter on a lack of training, the sheriff’s
    clear admission to the lack of training is most germane to there being genuine
    disputes of material fact that the customs for the county jail were
    unconstitutional.
    As noted supra, the proposition for which Monell is cited by the majority
    opinion at 9, concerning § 1983 respondeat superior liability, is likewise
    incongruous with EA/O liability. Monell v. Dep’t of Soc. Servs. of City of N.Y.,
    
    436 U.S. 658
     (1978). Monell concerned a class action about maternity leave.
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    Id.
     at 660–61. Again, EA/O liability is well-established within our circuit. E.g.,
    Henson, 795 F.3d at 464. Distinguishing Shepherd in an EA/O analysis, as the
    majority opinion does at 10, is also improper, given Shepherd was determined
    exclusively to be a UCC claim. Shepherd v. Dallas Cty., Tex., 
    591 F.3d 445
    ,
    453 (5th Cir. 2009).
    B.
    The limits of the county’s challenge to plaintiffs’ EA/O claim are notable,
    though unmentioned in the majority opinion.         Despite erroneously urging
    constructive knowledge via Lawson, as discussed supra, plaintiffs ground their
    EA/O analysis in our court’s appropriate standard, citing the proper standards
    articulated in Henson and Scott. For example, in their opening brief here,
    plaintiffs contend:    when the summary-judgment record is viewed in the
    requisite light most favorable to them, “a reasonable jury could conclude that
    Young County knew that Simpson had ingested 24 capsules of seven different
    prescription drugs and that Simpson had obvious signs of physical incapacity,
    disorientation and severe intoxication”.
    In 27 pages in its response brief regarding the EA/O claim, the county
    makes no mention of the majority’s concern at 9 that plaintiffs are attempting
    to “bootstrap government entity liability”. (Of course, it is not our role to make
    that point on the county’s behalf.) The county, rather, follows our court’s two-
    step EA/O standard and contends: “county jailers did not know Mrs. Simpson
    was at substantial or excessive risk of serious harm”; “there is no evidence
    county jailers responded to an alleged substantial or excessive risk of serious
    harm to Mrs. Simpson with deliberate indifference”; and “there is no evidence
    Sheriff Walls failed to train or supervise his officers, that such an alleged
    failure caused Mrs. Simpson’s death, or that a pattern of similar violations
    occurred”.
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    C.
    Turning to applying the appropriate legal standard for the county’s
    liability vel non for the EA/O claim, plaintiffs’ opening brief follows our court’s
    two-step standard for such a claim and presents genuine disputes of material
    fact. Again, the requisite de novo review of the summary-judgment record
    demonstrates genuine disputes of material fact for the EA/O claim, precluding
    summary judgment.
    1.
    The elements of step one’s subjective indifference by jail officials are
    provided in plaintiffs’ brief. Knowledge “that an inmate face[d] a substantial
    risk of serious bodily harm” was asserted. Anderson, 286 F. App’x at 860; see
    also Henson, 795 F.3d at 464 (quoting Hare, 
    74 F.3d at 650
    ) (“subjective
    knowledge of a substantial risk of serious harm”).
    Along that line, plaintiffs contend: “a reasonable jury could conclude that
    Young County knew that Simpson had ingested 24 capsules of seven different
    prescription drugs and that Simpson had obvious signs of physical incapacity,
    disorientation and severe intoxication”. Plaintiffs also contend county officials
    “disregard[ed] that risk by failing to take reasonable measures to abate it”.
    Anderson, 286 F. App’x at 860. Plaintiffs raised genuine disputes of material
    fact to that end: despite multiple calls from Mrs. Simpson’s husband, including
    warning she was likely suicidal, plaintiffs highlight a dearth of evidence that any
    jail employee spoke to Mrs. Simpson or entered her cell. As the majority opinion
    at 5 notes, Mr. Simpson’s deposition testimony in the summary-judgment record
    is that he “begged” for medical attention for his wife; surely that understandable
    conduct complements the other evidence in the summary-judgment record in
    establishing a genuine dispute of material fact concerning the jail staff’s
    knowledge of Mrs. Simpson’s dire need for medical attention.
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    Plaintiffs assert as a “triable issue of fact” whether the county should have
    reasonably given medical attention to Mrs. Simpson, such that the failure
    reflected deliberate indifference.   Plaintiffs made this same contention in
    district court, in their response in opposition to summary judgment:
    Defendants go so far as to argue that “when inmates
    needed care, inmates could submit a written request
    (sometimes referred to as a ‘kite’) to see a doctor to the
    officer on duty.” One is left to wonder how Mrs.
    Simpson could be expected to submit such a written
    request when she is passed out on the cell floor with
    her genital area exposed and Deputy Wacaster
    showing her off to other officers. . . . A jury should
    determine whether the jail staff’s inaction in the face
    of all the information they possess regarding Mrs.
    Simpson’s medical condition amounts to deliberate
    indifference to the medical risk Mrs. Simpson faced.
    2.
    Also presented by plaintiffs were the elements for step two: objective
    deliberate indifference on the county’s part by commission or omission of a
    policy or custom despite known or obvious resulting constitutional violations.
    See id. at 861. Plaintiffs contend the unconstitutional neglect leading to Mrs.
    Simpson’s death was rooted in customs maintained by the county—under the
    leadership of a sheriff who flatly stated in his deposition he did not endeavor
    to learn what jail procedures were State mandated, and did not follow-up when
    infractions were reported.    For their EA/O claim, plaintiffs’ opening brief
    asserts two central unconstitutional customs of the county: neglecting intake
    and screening procedures; and failing to monitor detainees.
    a.
    Plaintiffs present genuine disputes of material fact regarding the
    enduring nature of the alleged customs about intake by supplying the
    summary-judgment record with evidence of other instances in which the
    county was taken to task for failure to complete intake forms.              Those
    29
    Case: 16-10227    Document: 00514096121      Page: 30    Date Filed: 07/31/2017
    No. 16-10227
    procedures are to draw jailers’ attention to at-risk conditions for a potential
    detainee. Plaintiffs contend that the county’s custom of indifference in failing to
    screen detainees for mental health and suicide risks at intake is linked to the
    custom of inadequate medical care and attention given Mrs. Simpson during her
    detainment, which plaintiffs assert resulted in her death.
    Plaintiffs’ contentions on appeal are in line with their contentions in
    response to the summary-judgment motion in district court: “The jail staff had
    direct knowledge that Mrs. Simpson took an excessive amount of prescription
    medication, yet the staff deliberately chose not to address the risk, creating a
    fact issue regarding Plaintiffs’ § 1983 Episodic-Acts-or-Omissions claim”.
    Plaintiffs’ contention concerning the county’s unconstitutional customs for
    screening procedures was the same in district court, as stated in their response
    in opposition to summary judgment: “the jail staffs’ deliberate indifference
    directly resulted from, and was actually encouraged by, Young County’s policy
    and custom of deliberate indifference towards screening pretrial detainees for
    suicide risk”.
    The summary-judgment record, especially through the deposition of
    Sheriff Walls, demonstrates the custom of neglecting intake and screening
    procedures. Plaintiffs’ opening brief here contends this neglect extended to a
    custom of inadequate jail staff training, as reflected in Sheriff Walls’
    deposition: “[He] admitted . . . Young County took no steps to train jail staff
    with regard to completing the mental disabilities/suicide in-take form and
    never even asked the jail staff any questions to verify whether they were
    properly trained in this area”. Plaintiffs further note, in accordance with
    Sheriff Walls’ deposition, that none of the jailers who failed to provide medical
    attention to Mrs. Simpson were disciplined, and the sheriff made no effort to
    investigate.
    30
    Case: 16-10227     Document: 00514096121     Page: 31   Date Filed: 07/31/2017
    No. 16-10227
    b.
    As plaintiffs also contend, there are genuine disputes of material fact for
    whether the jail staff adequately monitored Mrs. Simpson, because the
    summary-judgment record demonstrates genuine disputes of material fact for
    whether she was ever monitored by that staff—which, as discussed, was a de
    facto custom. As noted, Rich stated in her declaration: “Jailers have timer
    [sic] set for 25 minutes to check on detainees. We check inmates every 25
    minutes as required by the Young County rules for jailers”. Rich’s present-
    tense policy statement, offered two years after Mrs. Simpson’s death, said
    nothing of whether those policies were adhered to during Mrs. Simpson’s
    detention.
    The only evidence of observations includes Rich’s stating Mrs. Simpson
    “was fine” when another detainee was placed in the same cell; and a non-jailer’s
    viewing Mrs. Simpson while she was in a compromised position on the floor.
    Concerning the latter, an undated report, signed by Officer Post and provided
    to the Graham chief of police, referencing the “Incident at Young County Jail”,
    stated:
    On May 20, 2013 at approximately 0015 hours, I,
    Officer Post arrived at the Young County Jail with 3
    subjects to book in that I had arrested. When I went
    to the booking area, Deputy Wacaster of the Young
    County Sheriff’s Office told me to come here. Deputy
    Wacaster walked over to a window to a holding cell
    that had a metal door over the window. Deputy
    Wacaster told me to look through the window and he
    opened the metal door over the window. I looked in
    the room and eventually observed a white female, later
    identified to me as Diana Simpson, lying on the ground
    at the foot of the window in only a t-shirt with her
    genital area exposed. I then immediately walked away
    from the window. I then went back to the book-in area
    and to book-in my arrestees.
    31
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    No. 16-10227
    Given the report is without a date, it may have been written two years after
    the incident, as was Rich’s declaration.
    A reasonable juror could determine from this evidence, along with the
    sheriff’s admitted ignorance of the jail’s non-compliance, that the county’s de
    facto policy did not follow the alleged official policy put forward by Rich, and
    instead could determine that the jail did not provide adequate monitoring for
    pretrial detainees.
    In sum, “view[ing] the facts in the [requisite] light most favorable to the
    non-moving party and draw[ing] all reasonable inferences in [non-movant’s]
    favor”, plaintiffs provided more than sufficient evidence to preclude summary
    judgment against the EA/O claim. See Devon Enters., 541 F. App’x at 441. Re-
    stated, analyzing plaintiffs’ contentions and the summary-judgment record in
    the light of our court’s EA/O-specific precedent for government-entity liability,
    there are genuine disputes of material fact that preclude summary judgment.
    V.
    The majority’s stating at 10 that “[t]he Constitution does not require that
    officers always take arrestees suspected to be under the influence of drugs or
    alcohol, or reported by relatives to be at risk, to a hospital against their wishes”
    is unfaithful to the summary-judgment record. Surely, at the very least, some
    modicum of care is due a pretrial detainee for whom the jail is on notice—from
    multiple, unrelated sources—of drug overdose and presumed suicidal intent.
    No authority need be cited for the rule that, in our de novo review of a
    summary judgment, we rule on issues of law, including whether there are
    genuine disputes of material fact; we do not rule on issues of fact. Therefore,
    the majority’s stating at 10 that the county “cannot be held responsible for fatal
    decisions [Mrs. Simpson] made that were, under all the circumstances, not
    obvious to government employees” is an extremely improper misstep into
    impermissible fact-finding in reviewing a summary judgment. To the contrary,
    32
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    No. 16-10227
    the summary-judgment record shows genuine disputes of material fact
    regarding county liability for EA/O—such as Mr. Simpson’s calls, Officer Ford’s
    arrest report, the pills he brought to the jail, the screening on intake, and the
    monitoring of Mrs. Simpson.
    In the light of our court’s precedent specific to government-entity liability
    for EA/O, and the evidence in the summary-judgment record regarding
    whether Mrs. Simpson was improperly screened and not monitored in
    accordance with the county’s own policies, I cannot join the majority in
    affirming summary judgment for this claim. In that regard, genuine disputes
    of material fact point toward the county’s customs and its jailers’ resulting
    misconduct toward Mrs. Simpson—a pretrial detainee who had already taken
    steps to commit suicide before being arrested—being not only unconstitutional,
    but also unconscionable. Therefore, and with all due respect for my esteemed
    colleagues in the majority, how can summary judgment against this EA/O
    claim be upheld?
    Instead, in keeping with our court’s well-established standards for de
    novo review of a summary judgment and for EA/O liability for a government
    entity, this claim must be remanded for trial. Therefore, I must respectfully
    dissent from the majority’s upholding the summary judgment against the
    EA/O claim.
    33
    

Document Info

Docket Number: 16-10227

Citation Numbers: 866 F.3d 274

Filed Date: 7/31/2017

Precedential Status: Precedential

Modified Date: 1/12/2023

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