fact with regard to the timeline in the side of the fact based on a cover up medical record that said the mystical lardo never told anybody of two five ten pm that confusing and no fault of yours has other witnesses but it's very confusing and nurse whitney seems to be all over the place well blah and so what i'm good at think if we basic fact basic premise i think you agree that the key pivotal event here is when they learned he had this disease that they did everything fine if they didn't know and so when are the possible times they could have learned where oh your argument is it was your argument is it was nine twenty three in the morning twelve phone call you got zero in time record by this nurse the you know i don't do it it's a long time i never seen it on time phone on time records but here's what you might he actually the records will have a time stacked on it and you're right this members lots of things but they seem to be different every time there are the what we do know scorns is that there's two phone calls there's a nine to fifty five phone call and has a three twelve phone call we do know they before they're going to argue and i guess are arguing that given this record it's just as reasonable to infer that nurse fleming only found out about the i t he said that right when to draw a blood one essential task which was routinely conducted under those circumstances and they didn't even do that that's deliberate indifference and that's an argument below that they waited to live up they call the e r it sounded like it took a talent t duty to assign you know that they both the policy is one of the same but she said she had no authority to call an ambulance so it's three o'clock if they know he's got i t t at three o'clock if they know that they can't get blood work which is the only test or supposed to do under those circumstances and they don't do it they need to get him to and hospital a sample what do they do they do nothing of over two hours what are they waiting on to somebody from the jail to transport him  all the delay cases like over the the issue is in the delay serious of the medical need here the medical need was pretty serious the man was going to die he didn't get treatment in in you did other thing you have is the reason for  reason for the like you know that lp nann you know she's got a myriad of other jobs to do so it the evidence is going to eleven thirty seven he's still bleeding and she zones in the booking and she's missing in action for over two hours i asked her which she didn't those two hours she don't know but it is well known in the industry in a testimony from correct zero six per words that they're overwhelmed with paperwork they got to push pills they got to do all kinds of stuff and she's the only one there in this man's dying in there do not let me know what puzzles me is even when he lands at the hospital finally at about five thirty for this hour even the hospital doesn't think that it's emergency does says patient reported that at the time he had a nose bleed on and off for the past five days but did not report it to anyone and medical well that's true i mean that's what you do when you want to cover up a misdeed the evidence is that he had bleeding on the way he had bleeding on the eleventh he was taking a medical want to twelve in the thirteenth and a deputy testified that he was told that he was bleeding from direct on the night before so i mean the fact that he never told anybody and around for next two hours but i think they knew and i'm fifty five because if they didn't know at nine fifty five they wouldn't be faxing records at two forty four they would be taking his blood at three o'clock i think she was so burdened with so many tasks that sheen get around with it and daughter on the day he died yes in at that point he told her that he had been bleeding profusely that he told the medical staff he had a blood disorder and that they weren't going to treat him of the evidence or you called his attention my guess was that there was some concern on your part this was hearsay so it wasn't a missile i mean wasn't even in your brief and because she's ordering this stuff and she knows both of them even flamming misled in my brief too but i look back when i was preparing a page seven even though she claimed many ladies she's clever in his deliberate indifference understands it's a serious thing whitney's nurse practitioner judge cohen was quick to mention that she's got a doctorate well but i mean so she knows what the consequences or and that's why she she gets busy and she starts ordering blood work sta you have that thank you very much scotch thank y the quality foods case yes man is around and it's really an interesting case i mean in that case the judge hills even though the plaintiffs didn't call the statue of limitation problem to the district judge in connection with asking for a remain and the panel was compelled to remain on the to the district court for reconsideration of  guarantee of exercising supplemental jurisdiction forty of the city has to discretion but judge hill and the panel was compelled to remand to the district court and yet they also said that although this potential statute of limitations bar is a necessary consideration it's not the only consideration it's not the function of a federal court to rescue a party from the danger of limitation by permitting the litigation of inappropriate matters in federal court in scenario the movements briefing and summary judgment was completed in december twenty sixth mean the statute of repose ran in march twenty seventeen appellant filed seven response briefs to the move in summary judgment motions and across seven briefs failed to mention the looming statute of repose three months later when the statute of repose came and went in march and judge cohen still hadn't issued an order she failed to supplement her briefing and let judge cohen know about this issue and when judge cohen issued his order granting summary denied supplemental jurisdiction and in that case the district court judge considered the motion agreed that the statute of limitations was a bar to her claims declined supplemental jurisdiction anyway and did so without considering any of these gives factors and at that point  never had the opportunity to use any discretion well ok i understand your argument i'm not terribly persuaded by that i think consecrate on the main thing if you will i want to know why in fact it was not error to grant summary judgment all the mer each individual actor has to be judged on what she knew and what she did so here's what nurse fleming dead even under appellants version of the facts she treated a walking talking conscious patient and no three times in six hours she applied in a key to the key i think this is when the i t p when they knew about that if they never knew about it then we may have some issues with the ambulance and the like but they had their protocol seems to be appropriate when they know about it though i believe that you agree your position is that's when you mobilize when you know somebody is bleeding and you know you got this out of me and so did they know about it and nurse whitby says she did know about it and  she was never at the jail so somebody had to tell nurse with and she also says that knowing about it prompted her to take some of the steps like draw blood so that means it can't be nurse ayers now nurse cook who told her he was on the way to the early as nine fifty five in the morning knowing that mr kaleido had a condition called i t p still doesn't give her the subjective knowledge necessary to draw the actual inference that farmer v brennan requires a state actor to have before they can be deliberately indifferent even if they are slimming knew about the i t v she testified she never treated a patient with my t p she was she said the words i'm unfamiliar with she didn't know if the nose bleed could be a symptom of i t t she was also confronted with a v and first thing in the morning and until she's not deliberately indifferent absolutely and some point though she does tell and she told in the afternoon and nurse would be swings and action th no your honor because not all delay is unconstitutional delay we the when your nurse nurses says i don't know about i t p i'm just i'm not a licensed nurse and the nurse practitioner tells you to do something and you wait seven hours you're saying once again because it sounds like she's not real competent the she didn't know what it meant so she just didn't do anything incompetent medical care isn't delivered to friends but look let me keep this ok what if day one this is this is a hypothetical these are not the facts of this case mr coelho had told a nurse fleming look i've got this blue condition she doesn't know what it is she's never been exposed to it under your argument this could have gone on the whole time he was there here and i well know your honor because it's not that a nurse doesn't have a duty to escalate the care to someone else if they don't know what to do but even under a pilot's timeline there's plumbing when she didn't know what this was called a nurse practitioner and informed her of the situation what nurse what appellants criticize nurse flemming for is delaying and implementing a provider's orders and that's only true of course under their version of the timeline but even taking their version of the timeline distinct from the cases where there is a refusal or complete denial of care this is distinct from cases where an unconscious patient is gasping for air and begging for help and begging to go to the hospital nurse fleming like the nurse and this court decision and crucify williams treated the symptoms of which she was aware in a patient that was in front of her she escalated the care to a nurse practitioner she attempted to follow the nurse practitioners orders and when she was unable to when the medical system was unable to draw blood she called the provider back received orders for him to go to the emergency room where he went and to judge gilman's point when he arrived to drop down medical center he was reporting zero pain he was walking talking and in no visible distress if didn't say that either party's briefs you know it's a case where the supreme court held that on the fourteenth amendment and excessive force claim made ollie meet the objective component by showing that the force used against him was objective leon reasonable and see it now there seems to be a split of authority i'm on the circuits of whether that objective standard does away with the subjective standard in a case like this where the difference for serious medical needs i don't know any court yet that's passed directly on that but there are some courts of question whether this case of kingsley is now going to change the farmer standard here i'm unfamiliar with the case but she knew about it even first thing in the morning that would cause her to infer that he was at a substantial risk of serious harm by her actions to a maybe i'm out of practice case oh your honor there may be a jury question on my negligen and that's something that isn't before the court today judge cohen declined to rule on that issue by judge cohen found and we agree we believe correctly that neither of these nurses as a matter of law were deliberately indifferent even under version of the facts are we take a good morning i'm jason way myron i represent right now county defendants on appeal here the only one of my clients that the plaintiff is going after is rockdale county and the plaintiffs have waived any appeal as to my other clients who are that the sheriff's office conducted an investigation that the plaintiff thinks was inappropriate that's the only basis for their claim against the county so i have several things to say about that number one it was not raised in the complaint and judge cohen billows said i'm not going to review that that theory because it wasn't raised in the complaint that's a well settled legal doctrine the plaintiff cannot them in their complaint in a response to summary judgment and so that's what judge cohen did here that's not an abuse of discretion he was well within his discretion to do that and that ground alone it is a valid grounds to affirm if you reached the merits as to the county this quote sham investigation theory just doesn't hold any water number one it was done by the sheriff's office not the county the county did not control the investigation and even if it did the investigation was appropriate and can't ground a liability generally speaking that whatever happens in an investigation after an incident didn't cause the incident to happen there's no way that could ever be the case in i take if you represent rockdale county i regularly or you do this type of war in your view what legal obligation does the county have to oversee the medical care received by prisoners in your in your custody in georgia the way that this will well i'll just say that in this particular case the way that the county is related to inmate medical care is that it typically approves a contract the sheriff by law is entitled to pick a contractor and the county can't really say who the contractor should be can't really reject that contractor that's that is george none i'm sorry israel i want to say nine but i'm just i'm  trying to to draw out that the county is only related to inmate medical care as a matter of law by passing the sheriff's office budget in paying the bills that's that's that's just the way the law works and the way this situation worked so our or didn't as the case maybe didn't work well mr clark got in some sense medical care in the county didn't really ever see that couldn't ever see that the county doesn't tell the medical provider how to provide medical care and you don't want counties telling the medical provider had a private medical care i mean the medical provider is hired because they are presumably competent to provide medical care  decisions that the you know law enforcement officers and county officials aren't competent to do so i hope i've answered that adequately that basically i would say i would follow up and say it's not fair to hold a county liable for things that it doesn't control and legally can't control it i mean really it just pays the bills here that that that is the relationship of the county to in the medical care i think fundamentally this case is a medical malpractise case it doesn't have anything to do with the county policy the plaintiff hasn't pointed out a county policy that caused anything to happen here  to that if the court has no questions for me then i will sit down thank you thank you mobilize tells or do the blood work or the cost battle records whatever and they're saying even with that which is a pretty good fact for you that that's the inference they're saying even with that nurse plumbing's delay it was malpractise it w in she did what is the provider do the provider says she's got to do the blood work stat stat means immediately and that's the only thing everybody admits that's standard of care that's what supposed to do she didn't do deposition he thought he was going to die there but there is vital science there was ten but what the pain was the guy was bleeding out of three jumpsuits that's pretty noticeable i mean there aldridge case the guy had needed six ditches one like blood was pouring out now as well i mean you change somebody's out of three blood it's out of three jumpsuit and i think which deliberate indifference that of itself eleven thirty seven she sends him to a booking where he's not getting any medical monitoring and she says he still believed in at eleven thirty seven he gets there at nine twenty four she don't take much i mean you know he had been bleeding from his rectum right before he bleeding on and off for five days or first of all with regard to the sham investigation being a new claim that's not true if you look at paragraph two seventy eight to three zero five of our complaint we do say for where there was an allegation like there is in this case that there was a substandard if you look at it up our own thing that the we talk about systematic deficiencies and the fact th had people you know the evidence also is that at lemon lady she didn't know what anything was when she didn't intend you know they got no the records are on time and you know they go five times to the medical unit nobody takes a record to davey eight forty seven have second seven seventy one and seven seventy three nine hundred eighty eight case in the circuit which cox about policies of the fish and seasons happening or procedure such that the pretrial detain statements about believing it was really a cover up to try to get a defense but it's not a mortality review it was a sham board it shows is it shows what the policy that existed on the day of th impactful evidence that the sheriff and the cannie knew how bad the policies were and how substandard it was good otherwise they would have taken discipline otherwise they would have done a real investigation instead of concealment a cover up you know it's it's sad i mean that you know this case the very least should be remanded on the you know on the statute but it's much more than a medical malpractise case and also a vid's is how egregious counties be when they just ignore medical care this man was a human being and he deserved medical treatment thank you so much for your indulgence in your time thank you that concludes our court for the week so we are and r