Opinion
Civil Action 5:22-cv-02129-BHH-KDW
09-26-2024
Beatrice J. Johnson, individually, and as Personal Representative of the Estate of Paul Antoine Johnson, Plaintiff, v. Tanya Adams, Joyce Rice, Janet White and Henry Williams, LPN, Defendants.
REPORT & RECOMMENDATION
Kaymani D. West United States Magistrate Judge
Beatrice J. Johnson, individually and as personal representative of the Estate of Paul Antoine Johnson brought this action alleging violations of constitutional rights on behalf of the heirs of Paul Johnson (hereinafter, “Mr. Johnson”) pursuant to 42 U.S.C. § 1983.After being incarcerated for a brief period at the Colleton County Detention Center (the “CCDC”) as a pretrial detainee, Mr. Johnson experienced a medical emergency and later passed away at a nearby hospital. This matter comes before this court on two pending Motions for Summary Judgment. Defendant Henry Williams, LPN, filed his Motion for Summary Judgment on December 21, 2023. ECF No. 56. Plaintiff responded on February 2, 2024, ECF No. 64, and Defendant Williams filed his Reply on February 9, 2024, ECF No. 65. Defendants Tanya Adams, Joyce Rice, and Janet White (the “CCDC Defendants”) filed their Motion for Summary Judgment on December 21, 2023, as well. ECF No. 58. Plaintiff responded on February 2, 2024, ECF No. 63, and Defendants replied on February 16, 2024. ECF No. 68. There is also a pending Motion to Substitute Expert, filed by the CCDC Defendants, that will be addressed in this Report & Recommendation, as well. See ECF No. 74. Pursuant to 28 U.S.C. § 636(b)(1)(B) and Local Civil Rule 73.02(B)(2)(d), this Magistrate Judge is authorized to review pretrial matters in cases involving pro se litigants and submit findings and recommendations to the District Court.
Beatrice Johnson is the mother of Mr. Johnson, and at the time of Mr. Johnson's death, he lived with his mother in Walterboro, South Carolina. See Deposition of Beatrice Johnson 64:3-7; 65-2266:2, attached as an Exhibit to Defendant Williams's Motion at ECF No. 56-2.
I. Factual Allegations
The following facts are derived from the pleadings in this case and are considered in a light most favorable to Plaintiff, the non-moving party. Scott v. Harris, 550 U.S. 372, 380 (2007). On July 11, 2019, Mr. Johnson was arrested and booked into the CCDC. See Pl.'s Br. at 3, ECF No. 64. At all times relevant to this case, Tanya Adams was a lieutenant employed with the CCDC. See ECF No. 1 at 2. Joyce Rice is or was a supervisor employed with CCDC. Id. Janet White was a correctional officer at CCDC and is alleged to have had direct contact with Mr. Johnson. Id. at 3. Henry Williams, LPN, was employed as a nurse by Southern Health Partners, Inc., a company which contracts with Colleton County to provide medical services to detention center inmates at CCDC. See ECF No. 56-1 at 1. It is undisputed that Defendant Nurse Williams provided medical care to Mr. Johnson during his incarceration at CCDC.
Within these roles, both Defendants Adams and Rice are alleged to have supervised others and Plaintiff's claims are predicated upon either having direct contact with Mr. Johnson or having supervised others who had direct contact with him. Id.
When Mr. Johnson arrived at CCDC, he disclosed a history of hypertension and diabetes, as well as the medications he was taking at the time of booking. See Admission Data/History and Physical Form, attached as Exhibit A to Pl.'s Br., ECF No. 64-1; see also Medical Records, attached as Exhibit 1 to Affidavit of Henry Williams, ECF No. 56-4. Within his medical history, the form further indicates his medical history also included nervous disorder. See ECF No. 56-4. Because Mr. Johnson indicated he was having suicidal ideations, he was placed on suicide watch. See Exhibit 1, ECF No. 56-4; Exhibit A, ECF No. 64-1. Mr. Johnson was therefore monitored more closely while on suicide watch. According to Defendants Adams, Rice, and White, the suicide watch records evidence that during the duration of Mr. Johnson's detention, he was monitored every fifteen minutes. See Suicide Watch Log Sheets, attached as Exhibit 3 to Defs.' Motion at ECF No. 58-3. Southern Health Partners, Inc. conducts its own health screenings and keeps its own log of inmate medical encounters. See Defs.' Motion, ECF No. 58 at 2; See SHP Progress Notes attached as Exhibit 5 to Defs.' Motion, ECF No. 58-5. The records and logs kept by the facility reveal relatively unremarkable medical issues during Mr. Johnson's brief detention until the morning of July 17, 2019. The records, for example, do not indicate that Mr. Johnson advised anyone of any medical complaints until July 17, 2019. The medical records also establish relatively normal vital signs. Mr. Johnson's medical records are attached as an exhibit to the CCDC Defendants' Motion and Plaintiff's Motion. See Exhibit 5, ECF No. 58-5; See Exhibit B attached to ECF No. 63-2.
One point of contention related to the medical findings is whether Mr. Johnson's blood sugar levels should have been monitored three times a day. Plaintiff argues that Mr. Johnson's blood sugar was not evaluated other than on the day he experienced a medical emergency. Pl.'s Br. at 9, ECF No. 64. This is perhaps based on the affidavit of Dr. Grady Judson Bazzel, provided by Plaintiff, wherein he states, “as a known diabetic, the decedent should have had his blood sugar checked three times daily but there is no documentation that this was ever done.” See Bazzel Affidavit at 5, attached as Exhibit J to Pl.'s Br., ECF No. 64-10. Defendant Williams disagrees, and points out that Mr. Johnson was a Type II, non-insulin diabetic who controlled his blood sugar through medication. See Def.'s Motion at 5, ECF No. 64. Defendant Williams also argues that there is no medical policy or evidence within the record to support a finding that a policy required daily blood sugar checks on non-insulin dependent Type II diabetics. Def.'s Reply at 8, ECF No. 65. In Defendant Adams's deposition, she testified that blood sugar levels are normally checked three times a day before meals. Deposition of Tanya Adams, 73: 1-6, attached as Exhibit G to Pl.'s Br. at ECF No. 64-7. Finally, Defendant Williams points to Mr. Johnson's own medical records, wherein his personal doctor informed him to call him if his blood sugar reading was below 75 or greater than 300, supporting the notion that Mr. Johnson's reading would not have been an indicator of an emergent situation. Def.'s Reply at 6, ECF No. 65 (citing Plaintiff's Medical Records, dated April 15, 2019, attached as Exhibit F to Def.'s Motion at 13, ECF No. 56-7).
Approximately one week later, Mr. Johnson unfortunately passed away. Plaintiff contends that when Mr. Johnson was on suicide watch, both the Observation Cell Records and the Inmate Monitoring Sheet reveal that Mr. Johnson was almost never observed in any position apart from laying, sleeping, sitting, or “appears to be sleeping.” See Pl.'s Br. at 2-4, ECF No. 64; See Exhibit D and E attached to Pl.'s Br., ECF Nos. 64-4; 64-5. Plaintiff points to the medical records to show that Mr. Johnson was only observed on one occasion “walking” in his cell over the course of several days. Exhibit D at 2, ECF No. 56-4. Defendants state that the records show Mr. Johnson interacted with them during medication pass, and he was in constant correctional presence because he was held in the booking area. Def.'s Reply at 4; ECF No. 54; Defs.' Br. at 2; ECF No. 58. Specifically, Defendant Williams argues that none of the witnesses interviewed testified that Mr. Johnson was exhibiting anything other than “normal behavior for an inmate in a cell.” Def.'s Reply at 5; ECF No. 65. The impact of Mr. Johnson's interactions with medical staff or other correctional staff prior to July 17, 2019 is therefore in dispute in this case. Further, Plaintiff focuses heavily on July 17, 2019, the day Mr. Johnson was transferred to the hospital. By the afternoon of July 17, 2019, he was experiencing a medical emergency.
Plaintiff states that on the morning of July 17, 2019, Mr. Johnson reported having trouble breathing. Pl.'s Br. at 4, ECF No. 64; see also Progress Notes, attached as Exhibit B to Pl.'s Br. at ECF No. 64-2. Defendant Adams was working in booking that morning. She testified that on that particular day, she was told Mr. Johnson was having breathing issues, and this was the first time she knew anything was going on with Mr. Johnson, from the time he was booked up until that morning. Deposition of Tanya Adams, 93:20-25; 94:1-5, attached as Exhibit G to Pl.'s Br. at ECF No. 64-7. Defendant Adams further testified that when she came to work that morning, Defendant Rice informed her that Mr. Johnson had not been doing well throughout the night, and Defendant Adams went to check on Mr. Johnson. Adams Dep. 96:16-25. After checking on Mr. Johnson, Defendant Adams observed that Mr. Johnson was breathing heavily; therefore, she decided to call Defendant Williams to check on him. Adams Dep. 97:17-98:9. Defendant Williams, an LPN contracted to work at CCDC, evaluated Mr. Johnson's blood sugar one time that morning. Mr. Johnson's medical records show that his blood sugar level was 245. Around 7:00 a.m., Defendant Williams returned to check on Mr. Johnson and took his vitals. Exhibit 5, ECF No. 58-5. At some point in the morning, Defendant Adams called Mr. Williams to ask if Mr. Johnson could have a breathing treatment. Adams Dep. 101:1-24.
According to Mr. Johnson's medical records, he was advised by his personal physician to call the office if this blood sugar reading was over 300. See Exhibit F to Def.'s Motion at 13, ECF No. 56-7. Plaintiff provided an affidavit authored by medical expert Dr. Bazzel who indicates this is a problematic blood sugar reading that he considered an “emergent level.” See Exhibit J at 6, attached to Pl.'s Br., ECF No. 64-10.
Mr. Johnson was also seen by a mental health professional that morning at approximately 8:00 a.m. The notes from this appointment indicate that the physician or provider attempted to assess Mr. Johnson, however his breathing appeared to be labored, and Mr. Johnson was not able to answer any questions. See Clinical Pathway Mental Health Survey at 2, attached as Exhibit C to Pl.'s Br., ECF No. 64-3. This record also indicates that Mr. Johnson's vitals were taken by medical, “however they were normal.” Id. Mr. Johnson was apparently returned to his cell after “several attempts to talk with him,” and “medical advised to contact the provider for guidance.” Id. After his mental health visit, several officers checked on Mr. Johnson several times throughout the course of the day. Adams Dep. 108:4-22. According to Defendant Adams, she spoke to a Captain Roberts about Mr. Johnson's condition, and Defendant Williams explained to Captain Roberts that Mr. Johnson was fine and would not be “sent out” at that time. Adams Dep. 110:225. Later that afternoon, upon checking in again on Mr. Johnson, Defendant Adams noticed Mr. Johnson was slumped over with some type of liquid substance coming from his mouth. See Exhibit 5, ECF No. 58-5; Adams Dep. 112:24-25-113:1-14. EMS arrived and took Mr. Johnson to the hospital. Mr. Johnson was transported to the Medical University in Charleston, South Carolina on July 18, 2019, and on July 19, 2019, two days later, Mr. Johnson died at the hospital. See Defs.' Motion at 8, ECF No. 56-1. An autopsy determined the cause of death to be diabetic ketoacidosis (“DKA”). See Exhibit J at 7, ECF No. 64-10.
The South Carolina Law Enforcement Division (“SLED”) investigated Mr. Johnson's death. Defs.' Motion at 4, ECF No. 58. In conjunction with this investigation, several witness statements were taken. Henry Williams's statement is attached to the CCDC Defs.' Motion as Exhibit 8, ECF No. 58-8. According to his statement, on July 17, 2019, Defendant Williams was asked to assess Mr. Johnson for breathing issues. Mr. Johnson was unable to articulate what medical trouble he was having, and his vital signs were within normal range. Defendant Williams noted that Mr. Johnson was able to ambulate in his cell during med pass with no abnormality of gait. Officers on duty expressed concern for Mr. Johnson due to his rate of breathing; however, Defendant Williams apparently felt that because Mr. Johnson's O2 level was 98%, and his blood sugar was 245, his vital signs were within normal range. Defendant Williams did not believe Mr. Johnson's symptoms or vitals were alarming at that time. Defendant Williams also stated that an unnamed officer observed that Mr. Johnson's breathing rate was normal while in his cell, but the rate increased upon being taken to medical for his mental health visit that morning. After Mr. Johnson's mental health visit, Defendant Williams observed Mr. Johnson “breathing normal with no signs of distress.” Defendant Williams also contacted Dr. Wimberly and relayed the information regarding Mr. Johnson's status, to which Dr. Wimberly advised that Mr. Johnson remain on suicide watch and to observe any changes to his condition. At approximately 4 p.m., Mr. Johnson was noted to be on his side in the bunk with vomit on the bunk. Officers assisted Mr. Johnson to sit up; however, he was still breathing at this time. He was then taken to the hospital for emergency care.
Tanya Adams's statement is attached to the CCDC Defs.' Motion as Exhibit 9, ECF No. 58-9. Defendant Adams was on duty in booking July 17, 2019, along with Sgt. Rice. She went to check on Mr. Johnson that morning, and after checking on Mr. Johnson and noting that he was breathing heavily, she called the nurse, Defendant Williams. Defendant Adams gave Mr. Johnson a cup of water and continued to check on him, noting that he appeared to be asleep but still breathing heavily. She called Defendant Williams again and requested a breathing treatment for Mr. Johnson. Defendant Adams retrieved a wheelchair to assist Mr. Johnson in getting to medical to receive the breathing treatment. Because Mr. Johnson also had a mental health visit that day, Defendant Adams requested officers to escort Mr. Johnson back to medical to speak with the mental health doctor. Once he returned, Defendant Adams said Mr. Johnson was returned to his cell. Defendant Adams further stated that Defendant Williams returned to booking to explain that Mr. Johnson was to remain on suicide watch and for officers to observe him. Mr. Johnson appeared to be asleep upon the next few observations. After returning from the restroom, Defendant Adams noticed that Mr. Johnson was lying on the opposite end of the bunk. When she observed him further, she could see Mr. Johnson slumped over and a liquid substance coming from his mouth. Defendant Adams called Defendant Williams to check on Mr. Johnson. Officers Christopher Vandermark and Robert Langdale corroborate Defendant Adams's timeline of events. See statements attached to CCDC Defs.' Motion as Exhibits 10 and 11, ECF Nos. 58-10; 58-11.
Janet White's statement is attached to the CCDC Defs.' Motion as Exhibit 12, ECF No. 58-12. Her statement indicates that on July 17, 2019, she performed fifteen-minute cell checks until it was time to serve Mr. Johnson lunch. Mr. Johnson refused his lunch, but she left the lunch in his cell in case he changed his mind. She was then summoned to Mr. Johnson's cell around 3:45 p.m., and he was taken to the hospital shortly thereafter. Joyce Rice's statement is attached to the CCDC Defs.' Motion as Exhibit 13, ECF No. 58-13. According to Defendant Rice, she was working in the booking area when she noticed Mr. Johnson breathing heavily. She informed Defendant Williams, who in turn explained to her that he had previously checked on Mr. Johnson. She then entered the booking area around 3:40 p.m. when Officers Vandermark and Roberts were in Mr. Johnson's cell and EMS was on the way.
The depositions of the Defendants and officers were also provided to the court. To the extent necessary, the court refers to this deposition testimony.
II. Standard of Review
The court shall grant summary judgment “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to a judgment as a matter of law.” Fed.R.Civ.P. 56(a). The movant bears the initial burden of demonstrating that summary judgment is appropriate; if the movant carries its burden, then the burden shifts to the non-movant to set forth specific facts showing that there is a genuine issue for trial. See Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986). If a movant asserts that a fact cannot be disputed, it must support that assertion either by “citing to particular parts of materials in the record, including depositions, documents, electronically stored information, affidavits or declarations, stipulations (including those made for purposes of the motion only), admissions, interrogatory answers, or other materials;” or “showing . . . that an adverse party cannot produce admissible evidence to support the fact.” Fed.R.Civ.P. 56(c)(1).
In considering a motion for summary judgment, the evidence of the non-moving party is to be believed and all justifiable inferences must be drawn in favor of the non-moving party. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 255 (1986). However, “[o]nly disputes over facts that might affect the outcome of the suit under the governing law will properly preclude the entry of summary judgment. Factual disputes that are irrelevant or unnecessary will not be counted.” Id. at 248. All that is required is that “sufficient evidence supporting the claimed factual dispute be shown to require a jury or judge to resolve the parties' differing versions of the truth at trial.” Anderson, 477 U.S. at 249. “Mere unsupported speculation . . . is not enough to defeat a summary judgment motion.” Ennis v. Nat'l Ass'n of Bus. & Educ. Radio, Inc., 53 F.3d 55, 62 (4th Cir. 1995). A party cannot create a genuine issue of material fact solely with conclusions in his or her own argument, affidavit, or deposition that are not based on personal knowledge. See Latif v. The Cmty. Coll. of Baltimore, 354 Fed.Appx. 828, 830 (4th Cir. 2009) (affirming district court's grant of summary judgment, noting plaintiff's affidavit, which offered conclusions not based on his own knowledge, did not create genuine issues of material fact).
III. Analysis
A. Henry Williams's Motion for Summary Judgment
1. Deliberate Indifference to Plaintiff's Serious Medical Needs
Defendant Henry Williams is a licensed practical nurse (an “LPN”) in South Carolina and was formerly employed as a nurse at the CCDC. Affidavit of Henry Williams, ¶ 1, attached as Exhibit C to Def.'s Motion at ECF No. 56-4. Defendant Williams first argues that he is entitled to summary judgment as to Plaintiff's deliberate indifference claim. Plaintiff disagrees and argues that there is at the very least, a jury question as to whether Defendant Williams was deliberately indifferent as to Mr. Johnson's serious medical needs.
Defendant Williams argues that the alleged violations pursuant to the Fourth and Eighth Amendments should be dismissed because Mr. Johnson was a pretrial detainee. Therefore, Plaintiff's claims fall under the Fourteenth Amendment. Plaintiff does not dispute this argument, and the undersigned agrees.
Mr. Johnson was a pretrial detainee at CCDC at the time of the events giving rise to these claims. A pretrial detainee's claim based upon deliberate indifference to a medical need is properly brought pursuant to the Fourteenth Amendment. Moss v. Harwood, 19 F.4th 614, 624 (4th Cir. 2021) (citing Martin v. Gentile, 849 F.2d 863 (4th Cir. 1988)). A pretrial detainee's claim must be evaluated under an objective standard. Short v. Hartman, 87 F.4th 593, 611 (4th Cir. 2023).The Fourth Circuit outlines what a pretrial detainee plaintiff must allege to state such a claim: (1) he had a medical condition or injury that posed a substantial risk of serious harm; (2) the defendant intentionally, knowingly, or recklessly acted or failed to act to appropriately address the risk that the condition posed; (3) the defendant knew or should have known (a) that the detainee had the condition and (b) that the defendant's action or inaction posed an unjustifiably high risk of harm; and (4) as a result, the detainee was harmed. Short, 87 F.4th at 611. Under this standard, a plaintiff need not show “that the defendant had actual knowledge of the detainee's serious medical condition and consciously disregarded the risk that their action or failure to act would result in harm.” Id. Instead, it is sufficient to show that the defendant's action or inaction was “objectively unreasonable.” Id. (citing Kingsley v. Hendrickson, 576 U.S. 389, 397 (2015)). It is still the case that the objective test is not the sole means of showing a Fourteenth Amendment violation; indeed, a pretrial detainee makes out a violation “at least where he shows deliberate indifference to serious medical needs under cases interpreting the Eighth Amendment.” Mays v. Sprinkle, 992 F.3d 295, 300 (4th Cir. 2021).However, it is still not enough to allege a defendant negligently or accidentally failed to do right by the detainee. Id. at 611-12. Further, allegations that might be sufficient to support negligence and medical malpractice claims do not, without more, rise to the level of a cognizable § 1983 claim. See Estelle v. Gamble, 429 U.S. 97, 106 (1976).
Defendant Williams argues that Plaintiff must also show a subjective component of deliberate indifference; however Short considered the question of whether Kingsley v. Hendrickson requires the Fourth Circuit to recognize that pretrial detainees can state a claim under the Fourteenth Amendment based on a purely objective standard for a prison official's deliberate indifference to excessive risks of harm, and it answered in the affirmative. Thus, a pretrial detainee need not show that the defendant “actually knew of the serious medical condition.” Defendant Williams notes in his Reply that at the time of them briefing the instant case, Short was on appeal. However, the Supreme Court of the United States denied the petition to grant certiorari on June 10, 2024.
In other words, to satisfy the Eighth Amendment is sufficient, but is not necessary for a pretrial detainee to state a claim for deliberate indifference. Short, 87 F.4th at 612.
According to Defendant Williams, as an LPN, he cannot diagnose patients or prescribe medications; instead, that was the responsibility of Mr. Johnson's personal physicians and Dr. Wimberly. See Affidavit of Henry Williams, ¶ 3, attached as Exhibit C to Def.'s Motion, ECF No. 56-4. Defendant Williams argues that Mr. Johnson's medical condition was not objectively serious until the afternoon of July 17, 2019, when Mr. Johnson was transferred to the hospital. Defendant Williams posits that all times during his interactions with and in providing care to Mr. Johnson, he was not deliberately indifferent toward Mr. Johnson's needs. In addition to pointing to Mr. Johnson's medical records, Defendant Williams relies heavily upon the affidavit testimony of Dr. Nathaniel R. Evans, II, a medical doctor who reviewed the medical and detention center records for Mr. Johnson, to support his argument. See Affidavit of Nathaniel R. Evans II M.D., C.C.H.P., attaches as Exhibit D to Def.'s Br. at ECF No. 56-5.
Plaintiff argues that the record establishes that Mr. Johnson reported to CCDC staff that he suffered from both diabetes and high blood pressure. Pl.'s Br. at 13; ECF No. 64. This fact is undisputed by Defendant Williams. Def.'s Motion at 3; ECF No. 56-1. Upon his admission to CCDC, Mr. Johnson did not have a cough, his breathing was not labored, his O2 saturation was at 98%, and his blood pressure reading was 120/78. See Medical Records at 12, attached as Exhibit 1 to Williams's Affidavit at ECF No. 56-4. Defendant Williams argues Mr. Johnson's medical problems were non-severe or emergent for several days and points to detention center records and medical records establishing a lack of complaints on the part of Mr. Johnson or observations by correctional officers that Mr. Johnson appeared to be in medical distress. As noted by Dr. Evans, the CCDC documents established that Mr. Johnson was regularly administered his medications from July 12 to July 17, 2019. See Medical Records at 17, ECF No. 56-4; see also Evans Aff., ¶ 5. Defendant Williams interacted with Mr. Johnson on July 12, July 13, and July 14, 2019. See Medical Records at 19, ECF No. 56-4; see also Evans Aff., ¶ 5. These interactions with Mr. Johnson were conducted because Mr. Johnson was on suicide watch; it was not because Mr. Johnson requested medical attention or presented with a medical issue. See Evans Aff., ¶ 5; see Medical Records, ECF No. 56-4; see also Suicide Watch Log, attached as Exhibit 3 to Defs.' Motion at 58-3.
Defendant Williams states that during the time Mr. Johnson was incarcerated, he had occasion to “personally provide Mr. Johnson with care for his medical conditions and administer his medications.” Williams Aff., ¶ 2. Within Mr. Johnson's medical records, from July 11, 2019 until July 17, 2019, Mr. Johnson did not complain to medical staff concerning any medical issues, and he did not request medical care or nursing care. See Medical Records, ECF No. 56-4; see also Evans Aff., ¶ 8. When Mr. Johnson first voiced a medical complaint, it was on July 17, 2019, at which point the records establish that Defendant Williams began monitoring Mr. Johnson more closely. See Medical Records, ECF No. 56-4; see also Evans Aff., ¶¶ 8, 9-12.
Plaintiff's Response focuses almost entirely on the care received by Mr. Johnson on July 17, 2019. However, she argues that Mr. Johnson exhibited several concerning symptoms prior to July 17, 2019. Specifically, Plaintiff argues that Mr. Johnson was “lethargic,' pointing to the Observation Call Records and Inmate Monitoring Sheets. These records indeed reveal that for the majority of the time that Mr. Johnson was being monitored, his status was “lying down, not asleep” or “lying down, appears asleep.” See Exhibit D at 3-6, ECF No. 64-4; Exhibit E at 2-13, ECF No. 64-5. In reviewing the Observation Call Records, Plaintiff has sufficiently established that Mr. Johnson was often observed supine in his cell. However, there are a few outliers to this being the only observation noted by correctional facility staff. For example, one notation on July 16, 2019, indicating Mr. Johnson was walking. See Exhibit D, ECF No. 64-4. The undersigned also notes that on July 12, 2019, Mr. Johnson was awake at 12 p.m. and eating lunch. See Exhibit E at 4, ECF No. 64-5. The next day, Mr. Johnson was observed sitting up in his cell around 6 p.m. (1800 hours). Id. at 6. On July 14, 2019, at 11:00 a.m., Mr. Johnson was observed standing up. Id. at 8. Still, the undersigned recognizes that the records establish Mr. Johnson had not engaged in significant physical movement for a period of days.
There is also a notation that states, “Bond Court” at 10 a.m. on July 12, 2019. However, none of the parties indicate that Plaintiff left his cell other than for medical treatment during this time.
At the same time, the undersigned does not agree that the consistent observation that Mr. Johnson was on his mattress in his prison cell establishes that he was lethargic, that his lack of movement was due to a medical condition, or that he was otherwise exhibiting some set of medical symptoms that would alert staff to the existence of a medical issue. As inferred by Defendant Williams in his Reply, the nature of correctional facilities, in particular for inmates on suicide watch, lends itself to a lack of physical activity on the part of inmates and is part and parcel of their daily routine. It does not necessarily follow that a lack of movement on the part of Mr. Johnson while incarcerated in a cell was an indicator of a medical emergency or an increasingly emergent medical condition. More to the point, the evidence within the record does not support that Defendant Williams knew or should have known that prior to July 17, 2019 that Mr. Johnson was suffering from a medical condition or injury that posed a substantial risk of serious harm.Thus, the undersigned does not find that there is a genuine issue of fact as to Defendant Williams's interaction with Mr. Johnson prior to July 17, 2019 to establish deliberate indifference as to Mr. Johnson's medical care.
The record also does not conclusively establish when Plaintiff's earliest symptoms began that ultimately led to his passing. However, within Dr. Bazzel's affidavit, he opines that Mr. Johnson's physical condition greatly deteriorated sometime between July 11, 2019 and July 17, 2019. See Exhibit J at ¶ 7, ECF No. 64-10.
There is the issue of the blood sugar level and the failure to take these levels three times a day; however, the undersigned agrees with Defendant Williams that Plaintiff has not established this to be the standard level of care. Moreover, Mr. Johnson's blood sugar reading on the day he was admitted to the hospital was not to a level that was indicated as emergent in Plaintiff's medical records from his physician.
The remaining symptoms pointed to by Plaintiff to support her contention that a constitutional violated occurred on July 17, 2019 are the main focus of this case. See Pl.'s Br. at 13, ECF No. 64. The issue presented is whether Mr. Williams violated Mr. Johnson's constitutional rights as a result of their interactions on that day. It is Plaintiff's contention that Defendant Williams did not do enough to provide Mr. Johnson medical care. According to the record, at approximately 6:20 a.m. on July 17, 2019, a nurse was called to assess Mr. Johnson's stated breathing issues. Exhibit B at 2, ECF No. 64-2. Mr. Johnson stated, “I don't know,” when asked what issues he was having. Id. His vitals included a blood pressure reading of 128/70, his pulse was 80, and his O2 was at 98%. Id. Defendant Williams stated these vitals were within normal limits. From that point forward, Mr. Johnson's condition went from bad to worse. Defendant Adams contacted medical approximately a half hour later and again stated that Mr. Johnson was having trouble breathing and requested the ability to administer a breathing treatment. Williams Aff., ¶ 5; see also Adams Dep. 103:1-10; Adams Statement attached as Exhibit 9 to Defs.' Motion, ECF No. 58-9. The breathing treatment was approved; however, Mr. Johnson was unable to walk to medical and required the assistance of a wheelchair. Adams Dep. 104:10-19. Defendant Williams was told by security staff that Mr. Johnson began breathing “more heavily” when the security staff came to get him, but prior to that time he was observed breathing normally in his cell. Williams Aff., ¶ 9. In Dr. Bazzel's affidavit, he reports that based on his review of the SLED investigation, it appears Nurse Williams may have thought the decedent was faking his shortness of breath. See Dr. Bazzel's Affidavit at 5, attached as Exhibit J to Pl.'s Br. at 64-10. The implication from Defendant William's affidavit is that either he did not feel Mr. Johnson's condition was emergent at that point or perhaps felt that Mr. Johnson's breathing issues were not as critical as alleged.
Once Mr. Johnson arrived at medical, Defendant Williams was observed by another officer advising Mr. Johnson to try and take slow, deep breaths but “to no avail.” Officer Christopher Vandermark Statement at 3, attached as Exhibit 10 to Defs.' Motion, ECF No. 58-10. During his visit with “the nurse,” Mr. Johnson was able to answer some questions, but he provided “nonsensical answers” to others such as the name of his mother, to which he responded “bottle.” Vandermark Statement at 3. At around 8 a.m., Mr. Johnson went to a scheduled mental health appointment. Deposition of Henry Williams, 152:22-25-153:1-7 attached as Exhibit H to Pl.'s Br., ECF No. 64-8. At that appointment, he answered, “I'm not sure” and “I don't know” to questions regarding place and time. Williams Dep. 153:8-10. Defendant Williams testified that one would assume “that it's not his normal.” Williams Dep. 154: 2-9. Mr. Johnson's blood sugar level was noted as 245. Williams Dep. 154: 8-11. Mr. Johnson continued to have breathing issues.
After being seen by Defendant Williams, Mr. Johnson was returned to his cell and Defendant Williams placed a call to Dr. Wimberly. Williams Dep. 157-158. Dr. Wimberly advised that Mr. Johnson remain on suicide watch. Williams Aff., ¶ 10. According to jail records, at 3:40 p.m. (the nursing records have the time closer to 1:50 p.m. due to a clerical error), Mr. Johnson was found slumped over on his side with emesis noted. Exhibit B, ECF No.64-2. Colleton County Fire-Rescue was dispatched to CCDC at approximately 3:39 p.m. Id.
According to Defendant Adams, earlier in the day she inquired of Defendant Williams whether Mr. Johnson should be sent to the hospital. Adams Dep. 111:2-16.Further, Defendant Adams told Captain Roberts that Mr. Johnson was having breathing problems and was unable to walk to medical. Adams Dep. 109:25-110:6. Defendant Adams further testified that Captain Roberts relayed this information to Defendant Williams, who indicated to Captain Roberts that Mr. Johnson was not going to be sent “out” because his vitals looked okay. Adams Dep. 110. Defendant Adams testified that at this point, she had also spoken to Defendant Williams two or three times about Mr. Johnson. Adams Dep. 111:2-4.
Specifically, Defendant Adams testified that, “I asked him, do he think he needed to go out. He told me, no. I then notified medical.” Adams Dep. 111:8-10.
Defendant White testified that on July 17, 2019, she believed Mr. Johnson “didn't look right,” and he had not been eating that day. Deposition of Janet White, 118:13-15; 119:2-6, attached as Exhibit I to Pl.'s Br., ECF No. 64-9. Defendant White believed the “nursing staff” was aware of Mr. Johnson's condition. White Dep. 119:10-18. Finally, Defendant Rice told Defendant Williams around 9:40 a.m. that Mr. Johnson was breathing heavily, but Defendant Williams explained he had checked on Mr. Johnson already and “his vitals and everything checked out okay.” Deposition of Joyce Rice, 60:6-14, attached as Exhibit F to Pl.'s Br., ECF No. 64-6. According to Defendant Rice, Defendant Williams did not come when she explained Mr. Johnson was breathing very heavily. Rice Dep. 60:6-15.
Defendant Williams correctly points out that inmates are not entitled to the medical care of their choice; however, the undersigned does not find that this case rests solely on a disagreement in medical care. Here, the court is tasked with determining whether Defendant Williams's actions or inactions were objectively reasonable in this case. Defendant Williams argues Mr. Johnson's condition was not considered serious until approximately 3:50 p.m., and at that time Mr. Johnson was transported to the hospital. In considering the Short factors,the undersigned first notes that Defendant Williams does not argue that Mr. Johnson did not have a medical condition or injury that posed a substantial risk of serious harm. The evidence established that when Mr. Johnson entered CCDC, he let the correctional officers know he had been diagnosed with diabetes and high blood pressure and indicated that he was on prescription medication. In addition, he was placed on suicide watch. However, even assuming Mr. Johnson suffered from diabetes and high blood pressure, Plaintiff has failed to establish that these medical conditions posed a substantial risk of serious harm until the afternoon of July 17, 2019. As to the second factor, the undersigned has carefully considered the evidence within the record bearing upon whether Mr. Williams intentionally, knowingly, or recklessly failed to act to appropriately address Mr. Johnson's medical conditions and the risk posed by those conditions. The progress notes show that Defendant Williams interacted with Mr. Johnson at least five times on July 17, 2019. Specifically, after Defendant Williams checked on Mr. Johnson in the morning, and after he spoke to Dr. Wimberly on the phone, he checked on Mr. Johnson two additional times. Exhibit B at 2, ECF No. 64-2. Both notes evidence that Mr. Johnson's breathing pattern appeared normal, and that Defendant Williams would continue to monitor the situation. Exhibit B at 2, ECF No. 64-2. Defendant Williams explains that based on his observations of Mr. Johnson, along with his vital signs, he had no indication that Mr. Johnson's medical status was emergent until Mr. Johnson was found slumped over with emesis noted. At least one officer, Defendant Adams, testified that she continued to contact Defendant Williams about Mr. Johnson's condition. However, as to any argument that Defendant Williams did not check on Mr. Johnson when requested, Defendant Williams argues that these medical records conclusively dispel that notion. The undersigned agrees. The record before this court shows that Defendant Williams consistently checked on Mr. Johnson and relied upon his relatively normal vital signs, as well as the observation that his breathing was normal after the breathing treatment to determine that no heightened level of care was needed. Indeed, Mr. Williams called the supervising physician, who agreed with this assessment. The record thus establishes that Defendant Williams provided consistent care to Mr. Johnson through the morning and early afternoon and called a supervising physician to confirm the course of treatment provided to Mr. Johnson.
While Defendant Williams argues that actual knowledge of the risk of harm is required, the undersigned has previously explained that in Short, the Fourth Circuit joined other circuits in determining that the Kingsley objective standard applies. That is pretrial detainees are protected from governmental action that is not rationally related to a legitimate nonpunitive governmental purpose or that is excessive in relation to its purpose. Hammock v. Barnes, No. BAH-22-482, 2024 WL 1374795, at *11 (D.S.C. April 1, 2024). Pretrial detainees no longer must show that a defendant had actual knowledge of the detainee's serious medical condition and consciously disregarded the risk. Id.
At least one court has previously found that Type II diabetes is a serious medical condition. Williams v. Pierce, No. DKC-18-2004, 2019 WL 2373445, at *4 (D. Md. June 5, 2019). Similarly, at least one court has previously implied high blood pressure is a serious medical condition. Sturkey v. Stirling, No. 2:13-cv-3451-RMG, 2014 WL 6460285, at *6 (D.S.C. Nov. 17, 2014), aff'dsub nom. Sturkey v. Dir. of SCDC, 599 Fed.Appx. 533 (4th Cir. 2015) (“Plaintiffs allegations, at most, amount to a delay in medical treatment for his serious medical condition of chronic high blood pressure.”).
As to the third factor, Plaintiff's argument is that evidence within the record supports a finding that Mr. Johnson's condition was worsening and that his symptoms including lethargy, breathing issues, disorientation, and a high blood sugar reading evidenced the need for additional care beyond observation throughout the day. See Pl.'s Br. at 13, ECF No. 64. Plaintiff contends that Mr. Johnson's underlying health issues, coupled with the persistent worsening of his condition throughout the day, and his inability to effectively communicate with the mental health assessor, suggest that there was more than one warning sign, ignored by Defendant Williams, that Mr. Johnson needed more immediate attention than observation throughout the day. Indeed, according to Dr. Bazzel, there is some evidence that Mr. Johnson's condition greatly deteriorated over time and that, in his opinion, Defendants were negligent, grossly negligent or reckless. The record does not conclusively establish when Mr. Johnson's condition reached the point of needing emergency medical care, though the parties do not dispute that when EMS was called, Mr. Johnson needed to be transported to the hospital. Defendant Williams points out that Mr. Johnson was provided care in the hospital for an additional two days prior to his untimely passing.
Plaintiff points to Mr. Johnson's disorientation as a sign that Defendant Williams ignored; however, the mental health provider who noted this disorientation did not feel Mr. Johnson's condition was emergent. Her notes indicate that observation of Mr. Johnson should continue. The record further establishes that Defendant Williams had a breathing treatment administered to Mr. Johnson upon reports that he was breathing heavily. Defendant Williams's observation of Mr. Johnson after that treatment suggested to him that Mr. Johnson's breathing returned to normal. As to the high blood sugar reading, Defendant Adams explained that the detention center medical staff followed certain protocol, for example monitoring Mr. Johnson's' blood glucose level 3 times a day. See Adams Dep. 88:17-24. However, on the day in question, Defendant Williams did check Mr. Johnson's blood glucose level and it was not what would have been considered an emergent level for Mr. Johnson, as evidenced by Mr. Johnson's own physician's records. Further, Mr. Johnson's vital signs were otherwise normal, including his blood pressure and oxygen levels, throughout the duration of the day. Finally, Defendant Williams testified that he was familiar with diabetic ketoacidosis. Williams Dep. 182:23-25, 183:1-3. He testified that he did not expect to see that as Mr. Johnson's diagnosis, and that he did not notice any symptoms of diabetic ketoacidosis. Williams Dep. 184:5-10; 221-222. While there is evidence in the record from Dr. Bazzel that the medical staff “should have known that DKA was likely,” the only evidence in the record establishes that Defendant Williams did not notice any of those symptoms. Finally, Defendant Williams contacted and relied upon the response of Dr. Wimberly, the supervising physician, who advised him to continue observation of Mr. Johnson. While ultimately Mr. Johnson died at the hospital after suffering a medical emergency at CCDC, the record does not establish that it was a result of Defendant Williams' intentional or reckless conduct, particularly when Defendant Williams was providing some level of medical care. Thus, in viewing all facts in a light most favorable to Plaintiff, the undersigned finds that given the information available to him at the time, the evidence in the records supports a finding that Defendant Williams's actions were objectively reasonable given these circumstances. Accordingly, the undersigned recommends granting summary judgment in his favor.
2. Qualified Immunity
Defendant Williams also argues he is entitled to qualified immunity. When a qualified immunity defense is raised, the courts apply a two-part test. First, the court must determine whether the facts viewed in the plaintiff's favor make out a violation of one's constitutional rights, and second, whether the violated right was clearly established at that time. Stanton v. Elliott, 25 F.4th 227, 233 (4th Cir. 2022) (citing Pearson v. Callahan, 555 U.S. 233, 231 (2009)). The Fourth Circuit employs a split burden of proof for the qualified immunity defense. The plaintiff bears the burden of proving the first prong, and the [officer] bears the burden on the second prong. Stanton v. Elliott, 25 F.4th 227, 233 (4th Cir. 2022) (citing Henry v. Purnell, 501 F.3d 374, 377-78 & n.4 (4th Cir. 2007)); see also Mays v. Sprinkle, 992. F.3d 295, 302 n.5 (4th Cir. 2021) (explaining that plaintiff has the burden of proof to show a constitutional violation, while defendant must show the violation was not clearly established). To be a clearly established right, it must be sufficiently clear that a reasonable official would have understood that what he or she is or was doing violates that right. Taylor v. Barkes, 575 U.S. 822, 825 (2015). Qualified immunity protects all but the “plainly incompetent or those who knowingly violate the law.” Taylor v. Barkes, 575 U.S. 822, 825 (2015) (citing Ashcroft v. Al-Kidd, 563 U.S. 731, 743 (2011)). At the time that these events unfolded, July 2019, under Fourth Circuit precedent, a claim for unconstitutional deprivation for medical care brought pursuant to § 1983 required a subjective element; that is, proof that the defendant acted with deliberate indifference to a plaintiff's serious medical needs. Iko v. Shreve, 535 F.3d 225, 241 (4th Cir. 2008). A prisoner's right to adequate medical care and freedom from deliberate indifference to one's medical needs has been clearly established law in this circuit for decades. See Scinto v. Stansberry, 841 F.3d 219, 236 (4th Cir. 2016). However, as previously determined, because the undersigned has recommended finding that the evidence does not support a finding that Defendant Williams violated Mr. Johnson's constitutional rights, Plaintiff is unable to carry her burden to establish that qualified immunity is not appropriate in this case. For this reason, as explained above, the undersigned recommends finding Defendant Williams is protected by the doctrine of qualified immunity.
B. Defendants Adams, Rice and White's Motion for Summary Judgment
The CCDC Defendants first argue that to the extent Plaintiff seeks to hold any of them liable under a theory of supervisory liability, such claims fail as a matter of law. Plaintiff plausibly alleges supervisory liability on the part of Defendants White and Rice. See ECF No. 1 at 2. Liability under § 1983 involves a showing that “the official charged acted personally in the deprivation of the plaintiff's rights.” Wright v. Collins, 766 F.2d 841, 850 (4th Cir. 1985). The doctrine of respondeat superior is inapplicable in these cases. Id.; see Love-Lane v. Martin, 355 F.3d 766, 782 (4th Cir. 2004) (stating that there is no respondeat superior liability under § 1983). However, supervisory officials may be held liable in certain circumstances upon a “recognition that supervisory indifference or tacit authorization of subordinates' misconduct may be a causative factor in the constitutional injuries they inflict on those committed to their care.” Shaw v. Stroud, 13 F.3d 791, 798 (4th Cir. 1994) (quoting Slakan v. Porter, 737 F.2d 368, 372-73 (4th Cir. 1984)).
To establish supervisory liability under § 1983 one must show: (1) the “supervisor had actual or constructive knowledge that his subordinate was engaged in conduct that posed a ‘pervasive and unreasonable risk' of constitutional injury”; (2) the “supervisor's response to that knowledge was so inadequate as to show ‘deliberate indifference to or tacit authorization of the alleged offensive practices,'”; and (3) there was an “affirmative causal link between the supervisors inaction and the particular constitutional injury suffered by the plaintiff.” Shaw, 13 F.3d at 799 (internal citation omitted). Plaintiff argues Defendant White is liable under a theory of supervisory liability because she observed Mr. Johnson numerous times prior to his hospitalization, she noticed he was not eating, and she observed that Mr. Johnson did not “look right.” See Pl.'s Br. at 17; ECF No. 63. Similarly, Plaintiff argues Defendant Rice noticed Mr. Johnson was deteriorating as to his medical condition, and that when Mr. Johnson was having breathing problems, Nurse Williams did not come check on him. See Pl.'s Br. at 17; ECF No. 63.
Plaintiff does not specifically delineate which employees Defendants Rice and White failed to supervise. There are no allegations that either Defendant interfered in any way with the ability of Mr. Johnson to obtain medical care. To the extent Plaintiff refers to supervising Nurse Williams, Nurse Williams was an employee of Southern Health Partners, Inc., but even so, prison personnel may rely on the opinion of medical staff as to the proper course of treatment. Miltier v. Beorn, 896 F.2d 848, 854-855 (4th Cir. 1990) (overruled on other grounds); see also Wright v. Ozmint, No. 2:07-cv-2515-JFA-RSC, 2008 WL 4542915, at *5 (D.S.C. Oct. 7, 2008) (noting that within the R&R adopted in that case, the court considered a claim that a warden denied an inmate's request to be examined by a treating physician and stating, “the warden is not a medical professional as therefore he had a right to rely on the medical expertise of the professionals providing inmate care.”).
Further, this court has held that establishing a “pervasive” and “unreasonable” risk of harm requires evidence that the conduct was widespread or had been used on several occasions. Slaken v. Porter, 737 F.2d 368, 373 (4th Cir. 1984). Such was not alleged or established in this case. The evidence within the record focuses solely on Mr. Johnson's medical care on the day he suffered a medical emergency. Finally, Plaintiff's claims and the evidence supporting such claims reveal that her real assertion is that these Defendants personally acted to violate Mr. Johnson's rights, rather than in failing to supervise the actions of other individuals, such as Defendant Williams or Defendant Adams. Thus, to the extent Plaintiff seeks to hold Defendants White and Rice liable on a supervisory liability theory, the undersigned does not find that Plaintiff has brought forth sufficient evidence to establish a genuine issue of fact to support this theory.
Plaintiff alleges all three officers had direct contact with Mr. Johnson and are liable under the Fourth, Eighth, and Fourteenth Amendments.In response, the CCDC Defendants argue they are entitled to the affirmative defense of qualified immunity. As has been previously noted, a pretrial detainee's claim based upon deliberate indifference to a medical need is properly brought pursuant to the Fourteenth Amendment and evaluated under an objective standard. Short, 87 F.4th at 611. Further, as discussed previously, when a qualified immunity defense is raised, the courts apply a two-part test.The Fourth Circuit employs a split burden of proof for the qualified immunity defense. The plaintiff bears the burden of proving the first prong, and the [officer] bears the burden on the second prong. Id.; see also Mays, 992 F.3d at 302 n.5. In order to determine whether the CCDC Defendants are entitled to qualified immunity, Plaintiff must first show that these Defendants violated Mr. Johnson's constitutional rights. To do so, the court must consider whether Plaintiff's allegations, if true, establish a constitutional violation. Hope v. Pelzer, 536 U.S. 730, 736 (2002). To establish the first prong of the qualified immunity test, Plaintiff must show: (1) the detainee had a medical condition or injury that posed a substantial risk of serious harm; (2) the defendant intentionally, knowingly, or recklessly acted or failed to act to appropriately address the risk that the condition posed; (3) the defendant knew or should have known (a) that the detainee had the condition and (b) that the defendant's action or inaction posed an unjustifiably high risk of harm; and (4) as a result, the detainee was harmed. Short, 87 F.4th at 611.
Like Defendant Williams, the CCDC Defendants argue they are entitled to summary judgment as to claims brought pursuant to the Fourth and Eighth Amendments because a pretrial detainees' claims are properly evaluated under the Fourteenth Amendment. The undersigned agrees.
First, the court must determine whether the facts viewed in the plaintiff's favor make out a violation of one's constitutional rights, and second, whether the violated right was clearly established at that time. Stanton, 25 F.4th at 233.
Plaintiff argues that each of the CCDC Defendants had personal knowledge that Mr. Johnson, “didn't look right,” and had a “significant issue” affecting his health. Pl.'s Br. at 16; ECF No. 63. Plaintiff argues that despite being armed with this knowledge, none of the CCDC Defendants “took efforts to obtain emergency medical care” for Mr. Johnson. Plaintiff also argues that while one of more of the CCDC Defendants notified a nurse of Mr. Johnson's condition, Plaintiff argues that when the nurse failed to act, it was not appropriate to “do nothing.” Pl.'s Br. at 17, ECF No. 63. As to Defendant Rice specifically, Plaintiff points to Defendant Rice's statement that when Mr. Johnson's condition worsened, she called for a nurse, but a nurse did not come as evidence of Defendant's Rice's liability.
In considering whether a constitutional violation occurred, evidence supports a finding that Mr. Johnson clearly had a medical condition or injury that posed a substantial risk of harm by July 17, 2019, that is, that he suffered from diabetes and high blood pressure, and the evidence of his pre-existing conditions known to the CCDC staff is well-taken. However, the undersigned disagrees that the CCDC Defendants “failed to act to appropriately address the risk,” or that it was their action or inaction that resulted in harm to the detainee. Short, 87 F.4th at 611. Plaintiff argues that the CCDC Defendants “failed to take action to ensure that [Mr. Johnson] received medical care,” but the record contradicts this assertion.
Here, the evidence is clear that the CCDC Defendants continually monitored Mr. Johnson over the course of the time he was at the facility. While it is true that Mr. Johnson was not noted to have engaged in any consistent measure of physical activity, Mr. Johnson also did not seek or request medical care or otherwise show any outwards signs of any medical issues, aside from lack of physical activity. As he was housed in a prison cell, this fact by itself does not support Plaintiff's contention that it was obvious that Mr. Johnson needed medical attention.
Of note, Plaintiff acknowledges that Defendant White had recently began working at the CCDC and was still training with Defendant Rice. See Pl.'s Br. at 8, ECF No. 63.
On the day in question, July 17, 2019, the evidence within the record shows that the CCDC Defendants continually checked on Mr. Johnson, sought a nurse on more than one occasion, and continued to inquire about his condition. Further, Defendant Adams, who was working within the area where Mr. Johnson was housed, specifically requested a breathing treatment for Mr. Johnson, provided him water, and continued to ask for medical assistance. Plaintiff argues that because all three of these Defendants had personal knowledge that Mr. Johnson did not look well on the day in question, it follows that they should have personally ensured he obtained emergency medical care. Pl.'s Br. at 16, ECF No. 63. Yet, this argument ignores the fact that these Defendants did not ignore Mr. Johnson's condition. Instead, they sought the advice of the medical professionals who were on site that morning to determine the best course of action.
Plaintiff cites to Burns v. Ashraf, for the proposition that staff members are still responsible for their own decisions regarding an inmate in their charge. Burns involved an inmate who was bleeding with a visible injury. Specifically, the inmate in Burns had passed out in his cell, fallen, and cut open a gash above his eye that was bleeding. Burns v. Ashraf, No. JKB-18-03100, 2019 WL 4169838, at *2 (D. Md. Sept. 3, 2019), aff'd in part, appeal dismissed in part, 837 Fed.Appx. 1019 (4th Cir. 2021), and aff'd in part, appeal dismissed in part, 837 Fed.Appx. 1019 (4th Cir. 2021). In that case, the officer reported the incident to a nurse, and the nurse refused to provide treatment. By contrast, the CCDC Defendants in this case observed that Plaintiff, in their layperson opinion, did not “look right,” and took several steps to ensure he was provided medical care. Once medical care arrived, the nurse took Mr. Johnson's vitals and determined that his vitals were normal. Mr. Johnson was also going to see a mental health professional that day, as well, who also returned him to his cell without advising he be taken to the hospital. Meanwhile, the CCDC Defendants continued to check on Mr. Johnson and called for immediate medical attention when they realized that Mr. Johnson's condition was emergent.
Plaintiff also argues that the CCDC Defendants violated prison policy by failing to monitor Mr. Johnson's blood sugar three times per day “as required for diabetic inmates” and failing to check on Mr. Johnson every 15 minutes. Pl.'s Br. at 20, ECF No. 63. Plaintiff cites to Dr. Bazzel's affidavit to support this contention as fact; however, his report is not specific to prison officials. To the contrary, his report states:
[i]t is my understanding that both the Detention Center and SHP policy and procedures required that a detainee/patient on a suicide watch be checked at least once every 15/30 minutes. However, SHP Observation Cell Record form indicated that the decedent was only monitored and/or checked twice a day by medical.
Dr. Bazzel's Affidavit at 5, attached as Exhibit I to Pl.'s Br. at 63-9 (emphasis added). His report makes no mention of the Suicide Watch Log documenting fifteen-minute increment observation records. As to his observation regarding the documentation of blood sugar, this again appears to be in context with medical care, as opposed to duties to correctional officers.Moreover, Plaintiff does not argue that the failure to ensure medical staff checked Plaintiffs blood sugar levels would put the correctional officers on notice that Plaintiff would suffer a medical emergency. The CCDC Defendants further point out that Plaintiff simply asserts broad allegations based upon the report of a Mr. Leonard Vare, an expert in the field of corrections practices and operations, as well as jail policies and procedures and staff responses. Defs.' Motion at 15, ECF No. 58. According to his testimony in his deposition, he opines that on July 17, 2019, the CCDC Defendants should have called 911 sooner. However, the CCDC Defendants argue, and the undersigned agrees, that even with this testimony, Mr. Vare could not say with any specificity at what time would have been appropriate to call. Moreover, Mr. Vare acknowledged that the officers worked to obtain Mr. Johnson medical care. Vare Dep. 101:1-24; 128:22-129:1.
Dr. Bazzel opines that the failure to ensure checks were taking place was a “gross deviation from the appropriate standard of care,” which lends itself to the reasonable belief that he is referring to the standard of care owed by medical professionals.
Attached to the CCDC Defendants' Motion is an excerpt from the deposition transcript of a Leonard Vare, who states he has expertise in corrections management and practices, classification, and a response to emergencies from an operational corrections perspective. Vare Dep. 25: 3-9, attached as Exhibit 17 to Defs.' Motion, ECF No. 58-17. Mr. Vare states that he believes the corrections staff that were working on “that day,” . . . “failed to do” certain things. Vare Dep. 26:616. However, he followed up that statement with the following: “I don't know if I would go as far as they violated constitutional rights.” Vare Dep. 26:18-24. Plaintiff does not rely heavily upon Mr. Vare's deposition, despite Plaintiff having offered him as an expert. See Defs.' Br. at 15, ECF No. 58.
The undersigned also notes that the record does not contain any of the actual policies and procedures in place at CCDC.
In considering the evidence as a whole and in a light most favorable to Plaintiff, the undersigned recognizes that Mr. Johnson's death was untimely and regrettable. However, the evidence within the record establishes continued action on the part of the CCDC Defendants. Nothing within the records suggests that the CCDC Defendants intentionally, knowingly or recklessly failed to act. Indeed, these Defendants did act; albeit Plaintiff's position is that these Defendants did not do enough. While that may sound in negligence, it does not establish a constitutional violation on the part of these Defendants. Thus, the undersigned finds that as to these Defendants, Plaintiff fails to establish prong one of the qualified immunity analysis, that is a showing that these Defendants engaged in actions resulting in a constitutional violation.
As a final point, at the time that these events unfolded, July 2019, under Fourth Circuit precedent, a claim for unconstitutional deprivation for medical care brought pursuant to § 1983 required a subjective element, that is, proof that the defendant acted with deliberated indifference to a plaintiff's serious medical needs. Mays v. Sprinkle, 992 F.3d 295, 300 (4th Cir. 2021). The subjective component requires that a defendant “actually know of and disregard an objectively serious condition, medical need, or risk of harm. De'lonta, 708 F.3d at 525; see also Connell v. Russell, No. 1:22-cv-935, 2024 WL 2722135, at *6-7 (M.D. N.C. May 28, 2024) (explaining that even though Short explains that the analysis for a pretrial detainee's claim for deliberate indifference no longer includes a subjective component, qualified immunity considers the law at the time of the events in question). Plaintiff's position is that Short simply reiterated that its holding was “clearly established” at the time the circumstances in this case occurred. The undersigned finds this position to be in contrast with Connell v. Russell. However, assuming without deciding that Plaintiff is correct, the undersigned disagrees with Plaintiff's position that the CCDC Defendants are not subject to qualified immunity because the undersigned agrees that Plaintiff has failed to establish these Defendants violated Plaintiff's constitutional rights under the more lenient standard. For this reason, explained above, the undersigned recommends finding that they are protected by the doctrine of qualified immunity.
IV. Conclusion and Recommendation
The undersigned has carefully considered the arguments made by all parties in this case. After considering these arguments, the undersigned recommends granting Defendant Williams's Motion for Summary Judgment, ECF No. 56, and granting the CCDC Defendants' Motion for Summary Judgment, ECF No. 58, for the reasons stated herein. The undersigned also notes that the CCDC Defendants filed a Motion to Substitute Expert Witness, ECF No. 74. Should the court accept this recommendation, this motion would become moot. Nonetheless, the undersigned has reviewed the merits of the Motion, wherein the CCDC Defendants indicate that their formerly named trial expert is unavailable due to his untimely passing and requesting to substitute Michael W. Quinn. ECF No. 74. The undersigned notes that Plaintiff did not file an objection to the requested relief. Upon review, the undersigned recommends granting this Motion, ECF No. 74, should the recommendation to grant the CCDC Defendants summary judgment as to Plaintiff's claims not be accepted.
IT IS SO RECOMMENDED.
The parties are directed to note the important information in the attached “Notice of Right to File Objections to Report and Recommendation.”
Notice of Right to File Objections to Report and Recommendation
The parties are advised that they may file specific written objections to this Report and Recommendation with the District Judge. Objections must specifically identify the portions of the Report and Recommendation to which objections are made and the basis for such objections. [I]n the absence of a timely filed objection, a district court need not conduct a de novo review, but instead must only satisfy itself that there is no clear error on the face of the record in order to accept the recommendation. Diamond v. Colonial Life & Acc. Ins. Co., 416 F.3d 310 (4th Cir. 2005) (quoting Fed.R.Civ.P. 72 advisory committee's note).
Specific written objections must be filed within fourteen (14) days of the date of service of this Report and Recommendation. 28 U.S.C. § 636(b)(1); Fed.R.Civ.P. 72(b); See Fed.R.Civ.P. 6(a), (d). Filing by mail pursuant to Federal Rule of Civil Procedure 5 may be accomplished by mailing objections to:
Robin L. Blume, Clerk United States District Court Post Office Box 2317 Florence, South Carolina 29503
Failure to timely file specific written objections to this Report and Recommendation will result in waiver of the right to appeal from a judgment of the District Court based upon such Recommendation. 28 U.S.C. § 636(b)(1); Thomas v. Arn, 474 U.S. 140 (1985); Wright v. Collins, 766 F.2d 841 (4th Cir. 1985); United States v. Schronce, 727 F.2d 91 (4th Cir. 1984).