that there is a claim though that jones i was looking for that and never heard that issue jeff jensen however medicine jensen adamantly denied that she was ever withdrawing and said it was basically the stomach flu that she was having vomiting from nobody including clyde the sheriff any of the officers and even dr tubbs and ever experienced a difference from heroin withdrawal or dehydration in a jail the west just not something that was known to be dangerous at that time mr maher and i need to address an issue that i don't recall seeing in greece but it's really troubling me which what leads to the question of jurisdiction i mean the district court's order here did frankly what it should not have done as i view it which is focus on the question of genuine disputes and material facts in it did not focus on the question of what are the abstract legal application for a defined universe of facts which are plaintiff's version of the facts as supported by the record so what i need to get clear because i'm not clear from your  is are you operating on plaintiff's version of the facts as supported by the record because if you're not then there's a problem because there is a jurisdictional promise relates to what we can hear this case now plaintiffs but what's significant here is that the the district court only will rely on the general notion that which is not the nd prong it's the st prong whether there was a constitutional violation you said there was  thousand and seventeen and it ruled it must be the particular icepacks of the case that was never done no cases were looked at the plaintiff never showed any cases that were anywhere similar to a heroin withdrawal or a stomach flu type of case at case where an officer acting under similar circumstances as officer white was held to a really did the th amendment the question is whether in this case in two thousand and sixteen whether it concludes there is a case that prior supreme court cases interesting poly is pointing out that this is a common problem they're actually pointing out that the courts are not getting this analysis into whether there's similar chases or not help there it is there is a common rios which is that supreme court case we resurrected it made clear that we can still look at extraordinary facts and determine that any reasonable government official given those circumstances should have known that something was a constitutional violation and so if your client receives a note on tuesday that says i've been throwing up for four days and i cannot even hold down water why isn't that an extraordinary set of facts that should have let you she looked like a skeleton what i mean so she's so sick she can't respond she's on the floor so the point i'm making his irrespective of who asked her to do the no the no communicated facts which somebody is having a heart attack and your client gives her an aspirin or not and that's it oh it's moderate because molly the only nurse that was found liable was the one that said no i can't help you come back tomorrow she never did that in fact she was brought to a medical monday that janet client when she met with her on monday offered her she showed are a bunch of medications over the counter medications that typically help people that are withdrawing or have an upset stomach she basically jenna clyde treated it both ways but she hear because you have to rely on a plaintive version of the facts as accepted by the record so if they've got put record evidence to support their allegations and what the facts are you're stuck with i believe but there was no evidence that anything she said yes every day she let her have gator is when she went to herself personally on wednesday she handed her a good rate she understood evidence she got up six from her bed to receive it from the door and she asked how she was at that time she was able to walk the issue about her coming back from the medical and hardly been able to walk jim klein would have been able to see that i mean there's been she said that's in the record that that riches took her back and she on tuesday that she can't hold down water now given that circumstance why wasn't there a need to do some thing i mean i don't care who and who asked the op report she gave the report and the report says i can't hold that water and i'm not your brief makes this statement about oh she was confused about the date what difference does it make if you wasn't holding no water two days before she went to the jail ringback and then wasn't holding now are two days in the jail it's still four days well she treated her just on tuesday and she was and she was not exhibiting those kinds of difficulties when she saw her in the clinic on tuesday as far as she know she want to or from the clinic i'm on her own that was all the information that is actually given to janet klein at that point and she to international the vinyls i think were normal on tuesday and so she had taken vitals on tuesday and they were normal and so what you have here is no i'm not saying this is the best of all health i think that this is a person trying to do what she can never having experienced any severe trauma from this condition always they got better i mean i have to tell you they always got better they had a rough few days but she unlike personally yourself on wednesday before she left she authorized again rate every day monday tuesday wednesday and thursday she also put him on the list to see the doctor and brought the doc the v a to her cell one as long as the last stop on the last of the booking because they have to bring the inmates to down in the other areas and that was that practice so i ask you for having a concert she was having a heart attack you would still say oh you know let's just wait and we'll bring that we'll bring it you create two or at the end of the day  that's a perfect example she was having a heart attack chest pains are way worse and yet modern and ceylon there were chest pains that were not reported but there was some action actually taken and so in this instance she was exonerated because she took action isn't the best action probably not that's not the bar though is it i mean you're not telling me that the only the only issue is whether you take action or not take action i mean there's some action that again  for the heart attack or some action that it's just wholly insufficient isn't nokia's heart pain is well or you're saying that if you take any action that your excuse my belief no not at all no of course not but but i think that action thanks i have a question for you before you start got some how on earth did you get ourselves and yourself to the virtual court facing the right direction followed your wonderful clerks advice and i downloaded the the skin off of the website please the court my name is ryan hanson and i represent the police here the state of medicine jensen and as judge holmes pointed out at the very beginning the estate is intitled to its facts the inferences that are reasonably drawn from those facts on this appeal and there are there were some i think misstatements about those facts that i want to clear up right now the this is the timeline and this is what the univers of facts in the state's favor show st of all nurse client testified that she knew symptoms like medicines would create a risk of dehydration so so that's the knowledge that she has going in on monday it she gets there for the st time madison had checked in on on sunday it and she had vomited throughout the night on monday morning madison has brought down a nurse client's office and nurse  complain about vomiting about being unable to keep down food and water and about soiling or she's nursed clyde noticed that medicine was weak and sick and very thin and looked like a walking skeleton she also learned on monday morning that madison was withdrawing from heroin she learned that because one of the jail officers reported the tests the results of her drug test that she took when she entered the jail there is evidence on the record and an inference from that evidence that nurse client believed madison was a lying about being on drugs and that she perhaps with health care from that point on because of that on tuesday morning officer richards noted that madison's condition had deteriorated dramatically she brought her back down to nurse client's office and they were all three together in the office observing that she had changed quite a bit from the day before she was now looking terrible and everything that happened that observed before was the same but now she was moving really slowly as though she was going to pass out she was still throwing up consistently she would hold on to the wall for balance she leaned up against the sikh and the medical office she was still unable to keep down food or who it was she felt dizzy she had diarrhea and she was refusing meals ok th what she said it's her circumstances she said did you report these things to nurse clyde i mean on that tuesday at that conference it is one of two categories judge holmes either she reported one of those things that i just said fair enough the things that madison actually reported that day are that she was still bombing that she as she leaned up against the sink in the medical room and in front of a nurse client and she and she felt like she was going to pass out and she was moving slowly  richmond later that day she was taken back to her cell officer richards noticed that she was looking bad and she got concerned about that so she asked nurse why can i move madison to a medical observation so this is a cell that specifically designed for keeping a close eye on people nurse quite approve of the request nurse riches later that day tells nurse clive that madison is still vomiting she's still weak she's still busy she's still having a hard time walking and so nursed wife says however for a lot of medical request form which by the way was a prerequisite of this jail to see your doctor so officer richards takes the medical request form down to the gave the completeness form back to nurse quiet clyde what does she do in response she does nothing she doesn't go down and take her vitals and doesn't go down and check on her on tuesday she doesn't contact the doctor and she doesn't do anything else and i just want to point out to clarify something that mr mylar set i don't think the monday night call to logan clark has any bearing on what happened on tuesday and beyond but there is a dispute as to what took place in that call logan clerk testified that the only thing that nurse claimed brought up in the call was can she have this prescription didn't even mention her by name certainly didn't mention anything about the fact she had been  that is a disputed fact now we're into wednesday and on wednesday nurse client stops by madison cell for a minute but she doesn't ask her about her soup thems and that's something that the judge below found is that she doesn't even take the time to follow up and asked madison about the symptoms that she had reported in her medical request form the day prior she doesn't take  night before nurse clive leaves for the day officer caleb berger goes to are still to get her prescribed medication notices that she's too sick and weak to get up off of her bed to come to the door to get it so he violates protocol interest her cell hands her the medication notices there is green vomit in a bucket next to herself he leaves and goes down and passes the nurse's office and has a conversation with her and there's a dispute about what he says but what if east a he says i mean we're taking your approach and as supported by the facts what does he say he says he says that she was vomiting and t for wins day night clive still does nothing she goes home for the day now thursday morning comes and this is the weekly visit where the doctor comes he comes once a week the p a i should say and he doesn't vary from that routine apparently but the jail practice is that when that nurse client will collect the medical request forms filled out by the various inmates for that week collect them together attach them to a file for each inmate and then as soon as the p a gets there in the morning she'll hand him the files he can go through them and apparently decide what he wants to do and then he sees the end they say one by one there's a dispute but the estate is entitled to the two to the factual pattern that that when p a clerk rived on thursday morning nurse why did not give him medicines medical him but but logan parks other words logan clark says i never saw the inference there is if she was before or he was withholding i don't know what she was doing but she certainly didn't follow her normal practice and so what does a little  clark do he looks at the file that he didn't receive and he proceeds to go build those inmates and treat them and then he's leaving for the day he's leaving for the day and as an afterthought nurse why is this so hey there's a girl you might want to go look at and they walked down to our cell and she was dead she had died about an hour earlier so that's the factor that those are the facts that the state is entitle to on this record and that's that's that's helpful for me remembering the right case and she she gave a wrong diagnosis and so based on her incorrect diagnosis she didn't pass on that information to a doctor because she didn't think there was anything concerning it and  just home to find if i'm getting that case wrong please correct me but i think that was the fact that and that is different here because here we have it's not a misdiagnosis case we have medicine so for reporting what was going on on tuesday and we have multiple officers coming in and fulfilling their responsibilities i mean they got off the hook the judge let them out on summary judgment because they fulfill their limited obligation of reporting to jenna quite even though they don take it that wind nurse clyde provided it to indicate here that that that she did try to do something and since there is not and it seems to be a fact that hurts you a lot is that there never been anybody who died of dehydration and that's the only and they didn't know of anybody to die and so under those circumstances the point would be that yes maybe they didn't anticipate that her dehydration was as great as it was but they did something they gave her begin to worry that that at least why i think they provided strain and so what's your response to that very good your honor the the  one's understanding that somebody can't keep food or liquid down it's like it's it's a pointless exercise it's like it's like getting a medical request form that's that's telling you that there's a severe symptoms but not on tuesday not after tuesday when she when she's moved to the medical observation cell you've got multiple officers saying she's really really bad and she's saying that she can't keep food or liquids down that's the it involved an inmate who who came in and was vomiting and i think the there were a group of four officers who took turns on they were on shift during his stay there but didn't say taylor versus rios but it's that same concept if it was an extraordinary set of facts that the fact that blood is in some was a vomit is so obvious of a severe of evidence of a risk of a severe medical condition that that guy should've known to report to somebody and he didn't and so that's that's that's indifference focusing on clearly established law you know what what what what's your theory if your theory to rely on this notion of extreme case therefore i don't need a case or what you're close is case that would have clearly established the unlawful lists of this conduct in twenty six november december th i think that the a and it's and the case to say that prior to january of two thousand and sixteen when a detainee has obvious and severe medical needs it's a violation of the detainees constitutional rights to ignore those ne it necessarily violates and just like with the blood involvement in quinton a jury could conclude that the seriousness of the medical risks associated with being able to keep down food and water for four days coupled with the established for law since long before the events transpire here in this case and so i think i'm running out of time so i want to just wrap up and say that i believe that the judge below understood what happened here younger still the law he didn't articulate clearly established prong pretty as well as he could have but he understood the facts here taken in the light most favorable to the state  and first of all dehydration and heroin withdrawal were not a known problem and that is very important earlier counsel was talking about mata when you asked him about strain but strain is important because of the serious problems like inch and is well is a vomiting but more importantly i think is quinn tonic kuantan is the case on point that shows that the law was not clearly established because it ruled that is not even meeting the