this is a matter that stems from an incident where hector elizondo i thirty two year old pretrial detainee suffering from a long history of severe mental illness committed suicide while in the custody of the santa clara county jail the county violat laws fourteen to minorites when they failed to provide adequate medical care and failed filter protection from committing suicide the district court erred and ruling on plaintiff's claim that specter lives on a medical care w errors arguably that just be court found that there was a death of ation of mr lives on a constitutional right when the district court stated quote the prison perhaps at a level wholly failed to protect the well for one of its most inmates let me ask you this what are the factual disputes that need that a jury needs to resolve i think the facts are pretty undisputed well i mean as the are there anything are there any facts in mean what is the met one of the medical records one of the medical records or the exit of the medical records you know that as i understand it the met experts did not agree with each other correct well i think that the count expert agreed that mr luzon i was severely mentally ill and did not belong in solitary confinement and should have been transferred to a health mental health facility that's what he said confinement facility where the county did not have any other place to put him he was a severely mentally ill inmate who had ideations of suicide expressed them and the county had no appropriate place to they're intense psychiatric facility they put him in there for two days he said he's no longer suicidal so they took they took him out they put him back in to  heard and they don't have a welfare check that that is up to standard they put him in there with his clothes including his bed sheets and he previously express that he was acting out by by putting a veggie to around his neck that he would and that's how he explained who made the decision that he didn't need fifteen minute checks the decision he said he can be taken off fifteen minute checks but he needs to go to facilitate a cell where you can have close supervision how does mr man stock fit into this mystery man stark is the person because mr lozano was in protective custody and they had no place else to put him so they had two choices they had actually had three choices they can put him on a  suicidal and you know for the county that means he has to express i'm suicidal right now or they can put him in observation cell which they didn't do or they put him in isolation which they did do and he was in solitary confinement for fifty four days and every time he came out of solitary confinement because he said he was suicidal they put him back in they put him back in with his sheets and his clothing and  taking all of them in under a recent case of castro he's a pretrial detainee right he's a breach on for detainees when you go to trial he is right so it's an objective standard  yes and so your argument is that everything you just went through a reasonable trier of fact a juror yes could object that could on those facts could county as opposed to distinct from the individuals yes so for the canteen there has to be a menace a ball policy that is a direct calls a link with the constitutional deprivation please st identify for me the policy that you are relying upon to support the constitutional climb that's the policy the policy hears that this jail did not have a policy so it's the lack of a policy the lack of a policy to put to deal with severely mentally ill inmates so what you tell me what case supports the proposition that  have that case so let me answer the question in another way if i may the county knew that that they had it in mates that would be arrested that had severely mentally ill happening in their jail and they did not address the the issues so that is the policy they didn't address and obvious shortcomings  with the way they handled their mentally ill and me let me clarify one thing for my own understanding i thought that the district court said that there cannot be municipal liability here because the in the there's no individual defendant that's violated a constitutional right is that right that's what the just accord little bit so i thought that you had listed some policies or he had presented he had laid out some policies like failure to train how they  we did you know on a failure to train about how to recognize some bright you know we also the policy of having classification override mental health right which they did in this case so isn't it isn't the question really whether or not so the county the county can be how can be held liable several ways one if if it fails to train an officer and the failure of training as a result is a direct result of the officers unconstitutional conduct ok let's see if that's one way the county can also just have a policy that is the ca provide the cars a connection to the constitutional violation right yes so the just record here said well you can't hold the county liable because an individual's not liable that's i don't think that's correct but nonetheless as i understood what your argument was if you had to they were there were these other policies but the county but the district or didn't evaluate them and ask whether or not these parts there was a tribal issue of fact as to whether or not any of these other policies could be the cause of they alleged constitutional deprivation suffered by mr botha it was no less than zero not could be the cause but there is a causal link causing link between the policy and so we aren't a noble review so if the record reflects that we would be able to assess that but i didn't see in the record where there was any ca shown between any policy from the county and the suicide in the policy has to be adopted by a policy maker right the policy maker in this  case is the undersheriff who emits that that putting people in solitary confinement coming off welfare check with their sheets is not something that they should do  and during each assessment had to make a difficult prediction about whether he was suicidal when he was deemed to be a suicide risk he was placed on suicide watch and his clothing and bedding were removed and when he was stabilize his clothing and bedding were returned tragically mr lazaro committed suicide the same day a mental health professional assessed him and concluded that he was not suicidal a conclusion we now know was incorrect at most this was an error of clinical judgment but mr a was on a suicide was not the result of deliberate indifference mr mann stock did not act with deliberate indifference or reckless disregard for mr was on his constitutional rights when his sest him in determined albeit in correctly we now know that he was not suicidal mistral was on had reported that he was sleeping he was eating he was taking his medication he was not suicidal the housing marriage and family therapist saw him on may th she spoke with him she did an assessment and she placed him on fifteen minute checks so he was put into an observation cell where he was on suicide watch and he was checked again on may  th by that same mental health professional she noted that he reported that he was feeling better that he was not suicidal he was just is neat relaxed and friendly goal directed and not at imminent risk for danger to himsel was the next day that was the next day and she she made she testified in her deposition which is in the record that she kept him on suicide watch as a precaution and she came back on may th you know the next day and assessed him again and in something called a ferguson down which is a suicide smock and mr and mr choice determine that he could have his clothing and bedding returned and that he could be taken off fifteen minutes checks and it's true that mr dropout he had a history of salt assaulting other inmates he had an history of assaulting staff and because he was violent toward other inmates he could not have a cellmate he could not program with the vulnerable inmates that were in the special management housing units who themselves well if troy recommended the special housing need and why wasn't there some other opportunity available well at that time of the jail their special management was for mentally ill and developmentally delayed an inmate and an inmate like mistral isn't a with a history of violence could not be intermingling with inmates of that classification but the difference there was no difference in mental health treatment that mr lozano received in his housing unit where he remained because the same mental health staff treated him in the dorm he said he would have been in a single man cell whether he were in special management or his current housing units he would receive the same medication from the same mental health provider so there really an effect would not have been a difference in the course of his mental health treatment whether he was on the th floor of the jail or in the e u dorm of the jail he still receive the same mental health treatment that he would have received at that location or over mr so let me ask you this was a man stark aware of dr choice assessment the records and the exact location of mr lozano sell the one thing that mr mann stock had the power to do if his in his clinical judgment but if mr lizza no need to be put on suicide watch he could have ordered fifteen minute checks would have which would have resulted in him being placed in a different cell called an observation cell which is where inmates on suicide watch your house or mr man's docket could have deemed mistral is no suitable for an involuntary hold under california welfare and institutions code section five thousand one hundred and fifty dollars which would have meant that mr was on a would have been admitted as he had been in april to the jails acute psychiatric unit which is also called in the record eight a but mr man neither of those things because in his clinical judgment he determined that mr lasagna was not suicidal so there was no need to have a change in his housing status and he actually recommended in his note that no change in mr lasagnas housing status was rship on may the th and deemed him incompetent to stand trial and his criminal case that would have been the criminal case that he was booked on and which was the attempted murder charges but the court noted that mr lasagna faced additional charges for assaulting custody staff so instead of ordering him released from the jail and placed into a mental health hospital somewhere in the state the court actually set a further hearing in june lasagna to return to court for proceedings pertaining to those additional assault charges that he had so there was no order to remove him from the jail and place him in the hospital the courts placed him under a temporary conservatorship and and said that the court acknowledged there was perhaps some it was unclear whether castro applied in these particular circumstances but went ahead and said under even of the objective or the objectives subjective and set up to standard it applied and said as a matter of question for the jury your honor at the so that the deliberate indifference standard and even the castro standard requires something more than mere negligence and it's true the experts in this case had disagreements about whether mr mann stock suicide risk assessment met the standard of care and that could be a medical negligence claim i will concede that which we don't have in this case we have a th amendment claim and the mere fact that reasonable minds can differ about whether this was or was not an adequate suicide risk assessment that and of itself shows that mr mann structed not act with deliberate indifference he didn't act with reckless disregard to who toward mistral is on his needs he had to make a difficult decision  public officials to a negligent standard it requires more than that lynch negligence but even if this court were to find that mr mann stock violated mr was on his constitutional rights he would be entitled to qualified immunity because there is no clearly established law regarding the constitutional standard for suicide precautions so in effect he did the best he could the district court address qualified immunity i think i don't think that district court did because it correct and so this court has already pointed out that in it and i would point out the court this court has been over review and as this court has already stated there are other pass to misapply liability namely failure to train or if there is a policy that was it here two or two with deliberate indifference and a causal link between that policy and the constitutional violation and i would submit to this court that that neither of those past criminal liability exist in the need for training and disregarded that obvious need for training that in this instance the record is replete with mental health professionals seeing mr lozano repeatedly and making judgment calls based on their professional clinical judgment about whether a suicide or not and there is no evidence that the undersheriff who also served as the chief of correction was aware of some need to improve the training of the mental health staff at the jail which included social workers assessments medical assessments well was that a policy well there's there's what is incomplete about mr kraft statement on roth regard to that is that if a mental health professional believes is suicidal they have the ability to put that person on suicide watch which would automatically take that person into an observation cell where they can be monitored and checked every fifteen minutes or they have the ability if the person is a not suicidal i am not putting them on suicide watch and i'm not me admitting them into the jails acute psychiatric unit then classification has to make a decision on how to house that person to protect both the inmate the other inmates in the facility and staff at this facility so classification had to look at the totality of the circumstances and realize that he was taken off suicide watch he was no longer on suicide watch and they had to place him in a plate in an environment where causal relationship between those policies and the constitutional violation we had mentioned the the classification is decision making with regard to protective custody inmates that we just talked about he also mentioned a failure to train which there's really no evidence in the record that the county failed to train its mental health staff and he also mentioned that the county used to have contracts with other counties to provide acute psychiatric services to their inmates so inmates from other counties could come to santa clara county and be admitted into the jails acute psychiatric unit because those are rare in our county is one of the few jails that has those but there's no indeed in the record that mr mann struck for example wanted mr lazaro admitted into  and didn't have the ability to do so because there were no beds in fact just a month before mistral is on a suicide he was admitted into a day when a mental health professional wanted him to be there and it was and a psychiatry wrist is the person who discharged him from a day and i see that my time is up your honor unless there are any other questions the a police will submit ok thank you medical record which mr mann stock was required to review before he encountered mr lizanne oh so one of two things has to be true he didn't read the record or he didn't appreciate understand that and mr mann stock was the st clinical commissioned to to find mr mann stock in solitary confinement and he did nothing about it when the evidence suggested all the other mental health personnel believed he should be on eight in regards to ok this is your last point eight thank you and thank you counsel pressure we prepare your arguments in this case the matter submitted their session for today thank you