that he attempted suicide before the police even arrived and that they were aware that his girlfriend reported that he had tried to cut himself with a knife so the facts in the light most favorable show that mr community may have attempted suicide and she may have gotten in the way and tried to stop him they were aware of that but in any event that was a suicide attempt and mr mccann eventually ended up at the a walk to center for three hundred fifty days where he reported that that was not the only suicide attempt to shift over  minimum when they are aware of a heightened risk of suicide a must either hospitalized the detainee or they must report it to jail personnel i think the record in the light most favorable to mr kmiec shows that officer to top off brought him to central even division but the record does not reflect what was said officer top of made a declaration where he merely said that he reported all facts and circumstances he did not say who he told what and when about the risk of suicide  facility have any medical facilities the record does not reflect whether they had medical facilities or not but isn't that why he was transferred to the c c c well as i understand it the center seemed vision is kind of where detainees are brought initially and then there transferred if they're going to be hold held for trial isn't that why he was moved your client was moved from the city jail if you will to the c c c i don't think the record shows that he was transferred specifically for the purposes of any form of mental health treatment and i think the record also shows that when he arrived at the center although he received an evaluation for mental health treatment the record shows that he reported his past diagnoses and suicide attempts but the two doctors that he was able to see yamamoto both saw him briefly just missed and disregarded any serious medical need that he may have been declined to treat him in any way so i think again here the facts are important and the inferences drawn from those disputed facts are important psychotherapy counseling even routine follow ups and yet they chose none of those treatment methods so again this is not a case like like many the case law where it's differing medical opinions or the prisoner wants some you know stronger form of pain medication this is a case where the prisoners is know the prisoner wanted a specific form of drug he wanted well well bew training and the doctor instead treated with seroquel and another medication that's a case where a prisoner cannot raise a claim because again he's trying to say he wants specific treatments harm well i think your honor if it's justified if there truly is if it's justified it's really a question of professional negligence is not you know i think your honor in this case what you have is you have awareness of specific symptoms that mr comedian is suffering and you know doctors can disagree about diagnoses but at the end of the day he is suffering from symptoms of bipolar disorder and p t s d and i think one of the inferences the district court failed to draw is that before and especially immediately after his time center mr comey kind of needed some form of treatment once mr comey can it was treated transferred from the wahoo center doctors were immediately prescribing him ultimately three different psychotropic medications and he began receiving quarterly psychotherapy and if this were a medical malpractise case you might have a good clean with this is deliberate indifference is perfect absolutely and so that we know it at a minimum of the doctors were aware of the condition and declined to treat it i thought  they were subjectively aware that he was a danger to himself well i think there's two things danger to himself is the risk of suicide but i think also you know the case law makes clear that symptoms symptoms suffered from from psychological problems alone insomnia other other other symptoms of his mental health illnesses he made that clear that he was suffering from that and again i think we can also look at the the medical documentation after once mr mckenna was transferred to the new facility  they again documented that he was you know cycling still cycling and he needed more specific medication for bipolar disorder i think the record reflects that at the very least you know if he was experiencing these symptoms immediately after the natural and logical inference is that the record or said that they had not reviewed certain documentation or that they did not have to certain parts access to certain parks parts of his record so at the very least on awareness we have a disputed issue of fact and restrict media can be can it has a right to take it to trial and with four officers who are on scene there's a fifth officer officer part of path who's the only officer that is placing mr coming under arrest and then he's also the transporting officer who takes him to c r d so for the purposes of you know this appeal we would submit that there's no constitutional obligation by the first four officers from the fourteenth amendment context because they mr comey i was never in their custody  handed off to but in fact his own police report as well as decker collect declaration in support of the motion for summary judgment stated that he apprised lieutenant frederick of the facts and circumstances and who accepted the so just addressing that there's no there's no issue of fact both at the record at the record below there is no issue of fact as to whether  apprised of the occurrences and what he witnessed and that's all documented in his police report as well all five officers in fact in this case because contrary to some of the case law out there such as in conn where they didn't document they didn't inform anyone and that's the tenor of those of that case law right is that the officers observed in fact not just a suicide attempt but a woman choking herself in a paddy wagon with the seat belt and the court said that their only obligation was not to transport her to a medical facility but that when a detainee attempts or threaten suicide on route to jail it is obvious that the transporting officers must report the incident to those who will next be responsible for her custody and safety that is exactly what officer part of paf did in his case and that's where his constitutional obligations ended because he then passed them off into the custody of security and those officer media you know psychiatric conditions i'm not trying to discount we're not trying to discount a psychiatric condition if there was something you know warranted you media treatment and there are situations like in gibson in the ninth circuit case where they said inmate was so obviously ill because he was suffering from a manic depressive depressive episode and he was kicking and screaming in the car on the way to the facility and again as in conn the woman attempts to choke herself as so you that yes she reported that there was this there was this potentially as some sort of suicide attempt we're not disputing that well does not give the officers subjective knowledge of risk so what we would say is the actions of mr comic a on a as a whole the whole circumstance that he was he had just stabbed his girlfriend that he had barricaded himself on a balcony do you know they're responding to a call of a domestic argument they have no knowledge of mr prior medical history you know dating back which apparently dates back to two thousand and four or his childhood or any of those circumstances this is the first time they're coming upon him and so they they assess this situation as essentially a suspect that was here to convince you that judge seabright got it right judge seabright as one can see simply by reading his summary judgment order did a very thorough examination of the record and was able to determine th the plaintive had ample opportunities to complain of any mental health problems that were affecting him and did not i want to also a command problem coun for their preparation of this case but they seem to have confused the issue and applied a test that failure to provide active treatment modalities is ipso facto deliberate indifference that is not the law for pretrial detainees and remove the subjective component but they can't remove the entire subjective component from deliberate indifference because it is inherently subjective so what i understand we're looking at is proving it trial that's that's the normal facility for holding pretrial detainees the most just waiting probably was just awaiting trial your honor yes yes now we seem to know that he didn't acquire some  he had not received treatment for far at least medical treatment for five years prior to his incarceration he had been seeing a sterile post which was in conjunction with alcoholics anonymous dr leland noted that he was aware of this treatment but it was quite clear that he had not received received any medication for five years before his incarceration but let me just tried since my time is very limited both of the defend of psychiatrists examined the plane both arrived at a diagnosis that at the time he was not suffering from any active mental health pathology consistent with that diagnosis he they provided no active treatment  modalities that itself cannot be into labor indifference now either or both of them could have been wrong had they been wrong that would have been negligence and most medical malpractise theoretically it's possible that they did did not put him or her did believe that he had an active pathology and the term to conceal it that might be deliberate indifference of course there is no evidence to support that but on the contrary we haven't and there were well we do have the contemporary and his concerns consultation reports of three other mental health professionals who actually unknown to the defendants examined deplaning for his fitness to stand trial similarly each of them found no active pathology to treat it's true the doctor blender didn't know the history of pathologies but he found no axis one diagnosis specifically stated that axis one is the act that the psychiatric type of diagnosis that requires treatment dr blendr did express dismay that the plane he was not receiving treatment but he never told us what he needed treatment for with the three independent doctors supporting my two clients there's really no evidence of even medical negligence thank you for your overtime if you have a couple minutes left taken to the central receiving division instead of either hospitalized or at the very least the record reflects that you know the symptoms were not sufficiently treated it's difficult to tell what would have happened but so no pardon me i'm not saying what creepily should have received what would have happened my question is a factual one what injury did your client receive two and a half days that he was jailed i think in his declaration he talks about suffering from about the difference between active treatment and passive treatment modalities we're not arguing for a pro se rule here that you know every time someone asked for treatment they need to receive some sort of treatment i think it's a disputed issue in fact at the very least is whether i'm strict mckenna needed competency in his trial against the advice of his is attorney and the record reflects the only reason he did that is because he thought it was some reason to get some sort of treatment those doctors evaluated him for companies companies he did stand trial there was out certain pathologies but again the only doctor that commented on treatment and again treatment is different from pathologies the only doctor the comment on treatment expressed concern that mr comey and i was not receiving any form of treatment and that doctor evaluated my closest in time only ten days after mr comey and i had seen dr yamamoto and just a quick point about the passive treatment modality point here even if we were except accepting opposing counsel's contention that passive treatment was appropriate here