got his medication he was supposed to have gotten two doses of medication before the doctor who did not examine him was not on site expert says that withdrawal is something that typically occurs then at least five well by forty eight hours or more and so late the night of  onto the wing so that he may not lebanon three am the next morning he had to be reprimand in order to not to wake up the other inmates nevertheless so at that point mr ireland has been very congenial use noted is smiling at the door he has been chatting about football shortly before anything more than normal garden variety negligence or malpractise how does that arise to deliberate indifference if two doctors at a different view and one thought before she was going to administer the drug which had its own serious risks she wanted an additional pass it was inappropriate let's assume a medication our treatment has been prescribed by one doctor better and countermanded by a doctor in the facility he of the courts have looked to the question of whether the doctor indifference in this case asked dr gonzales whether she had reviewed the medical records asked any questions about him she said no we didn't discuss the say that he was like the spine i think he makes a couple of comments like that before he stirred showing since late on sunday night of withdrawal which is believed to be and she numbers that she has a patient that she just reviewed she just received a call on him the day before was at risk of withdrawal so it wouldn't have been expected that he would have been and three twenty in the morning two days into his incarceration read his detention he changed he started screaming and yelling he had a dust up with his cellmate knew how to dust up with the corrections officers and the nursing staff tracy and he were exactly what we would expect them to do if they tried to get to the cell to assess him to see what he needed even or understanding that his condition was changing the only reason to call a p cell but he was mr ireland was busted in fighting and one of the corrections officers picked her up and moved her outside he was still young one on his way to the nd cell and the rd cell it was only when they questions when when the nurse makes these or call to the doctor was between three to three twenty four o'clock available to call one of the nurse practitioners that were in the jail or in this instance they called dr delgado those that doesn't work in the jail or works up in okaloosa at the time and he gave orders to the valley which is what they were after that's was the only reason for the phone call because they and their sister can't prescribe or get medication without a doctor agreeing to a correct correct specially not a schedule for  the nurses had no ability to take the one step they would have taken which was to administer the potassium as he was sustaining this for girl problem is that enough to deliberate indifference perhaps state but not prove were not because the in this case particularly in this instance it wasn't the potassium that he needed it wasn't going about that fine am i showed up and then took a while the nurses were told c p r he was there and there was about an hour of time where he was ok and no one thought he needed to go to the hospital they thought he needed to get arrest welcome corey to the medical examiner and mr cook's expert no one can distinguish his claim from his co morbid conditions which were a stunning and large liver and all their eggs are i'm sorry was there any evidence was there any expert evidence about whether valet or which was not administered in the middle of the night because the nurses couldn't get t observation whatever it is it's called the vernacular it's house c o ws and i believe it says about a calls about at the top of the record what it is there's each everything gets a number and when the total is between is over a certain number then there are the d nursing staff is to contact the physician or whatever practitioner nurse practitioner her physician assistant protocol and was the sheet of paper that had been filled out since his it mission to the jail in the record here yes ok so did he ever  and did he come close to what are any charting out anywhere near until that started mom you know what time got to del yes thank you mitt the court summer break though here on behalf of the defendant sheriff actually defendant i say absolutely sheriffs as well as all of the corrections officers there are seven of them that are name s you know there's no doubt that this case resulted in a tragic death of mr ireland which you know none of us here would contest that it was a tragic ending to this situation however the law is clear that in terms of the corrections officers involvement with mr ireland in the medical unit that they are not to be judged with two thousand and twenty hindsight which is exactly what the appellant does in this case both on the appeal as well as below and it's important based on the law and not only are these individual deputies not to be judged with two thousand and twenty hindsight they're also to be judged individually based on what each of them knew or didn't kno and whether or not what they did in regard to mr ireland whether or not that was reasonable under the law and i'm sure your your honour's are are well for more you're with the standard in that regard and the fact that in the last six years i guess it's been the kingsley case changed the standard to an objective standard in a jail setting where it was a pretty child with tb such as mr ireland and it's very similar to the granby conner type  analysis and so what what i just want to make sure that your honour's are focusing on and looking at this case from a de novo perspective us is set forth in the briefs you know when deputy shorts  trooper when he st went in to mr arland cell d you know he was alone and he you know he he had had some dealings with mr ireland in the past but not not much and he is not a medical medically trained corrections officer none of the corrections officers are medically trained though the record is clear and it's undisputed that when deputy schwartz and trooper went to mr arland cell upstairs it was cell number twenty he was accompanied by a nurse heaven r was also a named party in this case such that you know this is not a kind of a case where mr ireland was housed in the general population and the corrections officers delayed getting him any medical care or treatment whatsoever in fact it's just the opposite mr ireland it's undisputed was housed in the medical unit the nurses were there in the unit and the corrections officers i know the plaintiff the appellant takes much issue with this but the corrections officers had their role there and their role was essentially security and enforcing the rules where the medical people were dealing with the medical part of it and while the corrections officers did receive training  quite a bit of training in used and use of force and that sort of thing the record is also clear and i prefer to documentary windows seven with their complete training histories that they receive training not just in use of force but in dealing with the mentally ill in crisis and that was witnessed by nurse have a nurse who was there at the door and that is what prompted deputy swartzentruber to utilize his taser which took mr ireland down to the ground however it is undisputed and i would refer your honour's to the record it  documentary ninety nine dollars where the plaintiff responded to the factual the facts in this case and it was undisputed that mr ireland was able to after being tase able to get to his knees and remove one of the probes of the tas in trying to get this three hundred and twenty two pound man under control a lot of the record the plaintiff i know argues in his response that or the appellant's i should say argues that you know well well mr ireland was in the throes of a seizure and so you know that these deputy said have known that he was suffering a seizure and i would show you to the court that the record is clear that there was no seizure activity additionally it is the undisputed again i'd refer to documentary ninety nine the plaintiff admits the appellant admits that ireland was resisting efforts he was not complying now whether it was because he was you know reacting to you know a seizure again there's no record evidence there's no medical evidence that he was having a seizure but he was resisting he was not complying he was kicking his legs he was keeping his arms under him and it started with the deputies just trying to physically gain control of him arms behind their back arms behind his back that wasn't working very well they ended up having to use a taser help me with that spot and they appellant is that mr ireland needed medical care before medical could even go see mr ireland he needed to be under control and clearly it was not under control the the kingsley case your honor demonstrates that the united states supreme court understands as i'm sure you all do as well that running a jail is a particularly difficult undertaking and they're not to be you know  guess in terms of how the officers enforce the rules this particular incident happened at three twenty in the morning that's when it began when all these inmates are trying to sleep and you know this is unlike something that maybe would have happened at noon you know they can't just let mr ireland yell and scream and cause you know everybody to wake up and cause a problem in the unit they're trying to quell the disturbance and trying to quiet quiet everybody down unfortunately mr ireland reacted as he did and the other issue with deputy swartzentruber just closing the door he had a concern about leaving the cellmate mr wiser's belongings in the cell from the security standpoint terms of safety what mr i really could have done with those items as well as what mr wiser might have done if the items hadn't been removed at that time again we all know sitting here today how things involves de is the medical examiner testified in this case that based on her review there was no evidence of seizure seizure activity of mr ireland while he was at the jail i think that came up in regard mate another inmate that was in another cell that claims she heard somebody say he may be having a seizure i think that's where that comes from that was pure speculation on the part of that inmate more importantly to thank you for that question your honor my response to that would be number one i don't think you need to reach the qualified immunity analysis because based on what the officers knew at the time and based on the kingsley factors they did not use excessive force based on what they knew it was reasonable what they did each and every one of them separately based on what they knew but i would also as i did in my briefs submit to you that to the extent your honors were to either believe that there there is a dispute the material facts about that issue or that even if you didn't want to reach that issue i would dance to bits you that the evidence supports that these corrections officers are entitled to qualified immunity based on the fact that no reasonable officer in each of their positions based on what they knew at the time would have known that the force that they used was clearly excessive and there was no preexisting case law that would have made it obvious to any reason wasser in their position that what they did violated the law and so i would submit to you kind of the in every way shape or form whether your honors felt that you needed to reach the qualified immunity analysis whether you did  think this is that the deputies and the sheriff are entitled to summary judgment i c m over time so of course i would rest on the briefs unless your honour's had any additional questions  about the call to dr delgado there isn't a specific note saying exactly one calls were made a nurse even or in the same exhibit wrote a narrative that's kind of long after the around him said that he responded to the orders by saying i can't run trying i can't i've just been taste his demeanor at the outset was not hostile  point he was dragged out onto the catwalk and according to his neighbor boat he was at that point still and and motionless and  light actually in the video and still was and is a bad word and although mister ireland is completely restrained with his hands behind his back she is actually physically taken from the room and she doesn't have and no one else has another chance to take his vitals but that's all she can do is take his vitals as an lpn were pout supervision and she can do anything else  mr ireland gasping for breath the officers themselves say that he was flopping like a fish now the medical examiner doesn't actually say that he wasn't with the thrashing of the arms and legs with paranoia and some of the other things including the odd anomic instability which the medical examiner and are ex starvation medical examiner said the eerie of his brain were flattened which is typically been she agreed that that was a typical sign of oxygen starvation and split not getting ox oxygen