comatose state or who come into the job with quote prescribed medications through the receiving medical screening captain tucker learned that rauner was prescribed and taking three testified that it is highly dangerous to abruptly discontinue any of these medications whether individual individually or collectively in fact dr clarke described it as inhuman but scott county has an official o b e unwritten but certainly it stipulated to blanket policy against administering or continue any controlled substances whether they're prescribed or not so as a threshold matter mr bronner was not going to get any of these these particular medication substances can easily be applied back to trolling the controlled substances but never mind that for now our experience so it's kind of funny case because you dismissed all the individual defendants i  say this that the record is replete with evidence of individual wrongdoing then and that's true whether we're talking about a pre kingsley standard of deliberate intentional reckless indifferen has always been a very big they to me in the law whether or not you do have to prove the individual wrong runnable behavior because think of a rd train case for example where you're not going to have  some individual actor a lot of the times the liberally doing something something wrong and that what they're doing is exactly what they've been trying to do and here we get a lot of that now i think the record will show that there isn't fact that type of that deliberately indifference that the district court was was looking for and which is overlooked but i'm not so certain that when you have a policy like this that that works a constitutional train i don't see any logical reason why it's not trying case would be any different here because what you what you have off is officers following exactly what their what the counties tell them to some sort of method for determining how well we can win somebody off of these controlled substances or how whatever condition it is can be treated in some reasonable way a but it's got to me you're not going to get that because number one despite the written policies of the county which would require medical personnel to participate in the receiving screening it's got county's established policy that they just don't do that ok so you don't have anybody on the front end at at the that is medically trained screening and well that might be well and good so supposedly like that screening within a day or so but the problem  fairly before you leave what do you mean by panel control surfaces the general has the general stipulated in trial that they have an outright blanket ban on any controlled substances being administered or screening now this is against scott county don't written policy which would require medical personnel to be called in the event that somebody is is an inmate is indicating either serious illness a comatose state or prescribe medications but in reality they don't do that ok here's what they actually do which becomes our rd policy or custom thing to timothy their minimum guy now that's for all in that's not just for the inmates you come in all controlled substances or with diabetes or any other problem that's every single inmate enters the jail and so what happens here in scott county and frankly it happens these these counties all around here in east tennessee is that because now the touchstone for the county as long as they're complying with this fourteen day thing as long as they can show the suspect that they didn't make was seen within that fourteen day window that's all they care about but what happens is because there is no protocol there's no way there's no schecter on this then they like tammy braun or will come in there with prescribed medication and what see a doctor or any health care i don't want to take up any more time but there is the medical services plan is in the record and i just cannot find the exact number exactly i just have are you saying that even if this place nothing would have been done for fourteen days yes i am i am saying that because there is no other written policy that requires any in any interaction between in may and and health care whether it be licensed practical nurse which is the reality or which is what's really complex car contemplated by the regulations which is the no that is the policy and so that's that's what scott county is concerned with doing is making sure that when the state comes in and specs this jail they can show that inmate was booked him on the next night and got their physical opinion that what i have to prove is that the defendants recklessly belga act with reasonable care to mitigate the risk that the condition posed to detain it even though the defendant official knew or should have known are instances where this known narcotics policy or no conscription no controlled substance policy resulted in their the problem  my response to that is i don't know how the court which i believe the court there is confusing the district court is confusing paul thing comes you know when you're trying to establish a longstanding custom it's often helpful to show other cases where this has happened and it's turned in and turns out that that's my new means requirement and here we have an official policy one that's even stipulated to that's working we are respectfully requesting that you are firm the decision of the district court in this matter taking plaintiff issues as you presented them in the race we have st like to discuss the issue of what needs to be proven in order to reach this it what standard should be applied here is that the deliberate indifference to pronto we are used to in these medical care cases such that requires a subjective objective component in that of course as this court has held numerous times that the subjective and objective standard of the two part test is a proper standard to be used here and further you know citing your own rules the six circuit rule thirty two point one section b says that this panel is bound to uphold the publish opinion prior help keep in tell there is a determination against a supreme court or an on bach hearing and none of those as i have found now but i did see a list published in  it is not expressly or jacket it goes over the discussion of it giving officers qualified immunity but again it's still kind the same continuous standard the objective and subjective assert that kind of misrata cannot show that her constitutional rights were violated we believe that she has to show that some individual did violate her constitutional rights regardless of the fact that the individuals were dismissed out of this case  why wouldn't it be possible to have a bio lation if the policy itself is responsible who are in unconstitutional situations well i think there are certain situations where you know if you argue that it was facially unconstitutional then yes there can be that situation where the policy in and of itself can result in a constitutional violation however with this one  t that you know it he didn't make the jump that this was on its face and constitutional because narcotics have a self or controlled substance however you want to word it are inherently very dangerous in a jail population they can cause be the root of fights and violence and things like that and so sometimes you know maybe not in the case of miss bronner but a jail doctor to look at prescribe something that is not a controlled for x y and z are to prevent seizures or whatever it was just say that she was on these medications and she had several numerous prior bookings where the medication very every single time it's taken so they can but what if well what about the testimony then it doesn't in the bed it doesn't matter why you're taking it you never take these substances the way cold turkey without something else jail we are not zero denying that or are we are asserting that she did receive treatment i believe humus it on july th i think in the early morning she was it was notified that she was having seizures and she was transported to the emergency room been to the july th seizures and i do believe there was more and that was noted in the tower and then there was a seven am seizure yes we did have multiple instances of having seizures so nothing was done there's no record of anything being done in response to the six that raped an incorrect and what is what is your response to the assertion that having a policy of no controlled substances without medical to why i think that there are multiple reasons why people could be on controlled substances instead of blanket lee assert that not having access to a controlled substance would be recklessly indifferent would be incorrect in them well i think the court just looked at the fact you know taking and to count i believe it's gregory and some of the others that say you have to have that underlying individual constitutional violation and then go to it coupled with his argument that they were unconstitutional why and it doesn't really show that what happened to mr bronner was deliberate indifference yes it might be negligent but i don't believe this right is to the level of deliberate indifference as medical needs because she did still receive medical care for her if you want to say but possible side effects during that time period well i was going to go into a little bit more i wasn't sure guiding were questions for me at this time but again you know we would talk about the four policies raised by counsel starting the  to put these this county this defendant on notice that this policy was not being implemented and if it was being implemented in a way that could result in harm and that had happened here they didn't know that the policies a so at this time if you have no more questions for me to end my argument o wanted to make and that is the chemicals roll a concession that there needs to be some sort of investigation going on but figure out why if you don't have a corollary policy that requires certain he some sort of