him but the transfer officers pursuant to a county policy brought mr lance back to the jail where they instead made him wait while they fill out paperwork and then left him essentially to find his own way to the hospital so because of all of these delays  that he was serious he even showed officers in his condition at least three times over the course of the weekend and both the nurse and another officer confirmed that officers need have contemporaneous denied qualified immunity for his in action i'd like to ask you a question that concerns more the other individual defendants and it has to do with the with the inferences the been suggestive that about how they became knowledgeable about the condition and specifically what i'm interested in is your telling us what the record sh about how the intercom system or in the tower i wasn't clear on that it broadcasts of the whole tower bit of jail or have to pick up the phone how many jailers were in the tower could you just give us a few more church after the mcallister doctor told them to take him directly to st francis hospital did they violate or did they follow a policy yes i believe they followed a man who had cancer an oxygen issue and needed to see a respiratory specialist and he said that person would have still needed to be brought back to the jail before being sent out but if you are we believe that the  essentially left out with no way to get to the nd facility so mr clinton i just could i just ask one more question about this particular issue how would you articulate the underlying constitutional violation i think you've got a you got me it i'm sorry your honour's thank you for that big races time there my name is carson smith i'll be arguing for a police mike's mead and edward morgan edward was also known as tyler at the jail for the sake of the evidence to record what i've heard this morning from this ram in terms of the clearly established pronk i'll start there is a citation to for the idea that what we have here in the situation confronting mr morgan was similar and there was some kind of parallel with either olson or in the briefing  mcgowan and seal up however it's notable that kitana begins its analysis stating that the supreme court has insisted upon actual knowledge and as we know that's the essence of deliberate indifference the inquiry into the it is not an analysis that takes place and vacuum because clearly it's or the term obvious could be permissible if you polled ten different jailers you might get eight or nine different answers and soaking t isn't the issue in kuantan or that it that they were mistaking it for a different problem which was normal withdrawal symptoms correct your honor and  thomas says based on the case law the jurisprudential line those normal withdrawal symptoms did not constitute an obvious condition in the same way we have to be disciplined here to find the obviousness of this particular stamped this was a very obvious situation with an erection that was ongoing and the inmate in obvious pain according to other inmates who were calling in and out turkey those cases both centered on a medical professionals knowledge and so the obviousness inquiry must be disciplined to that particular position the medical professional  that a nurse robinson that knew about the inmate having diabetes and knew that the dominant pain could be symptomatic of life threatening internal injuries due to the diabetic condition and so mata and l turkey are medical professional cases and there are an opposite here and sermons of that the medical condition being contingent on timing at some point along a continuum the condition becoming a medical need a serious medical need and now your honor you mention mr sneed mr sneed came in contact with mr lance around lunch time and although miss rand and the briefing has tried to inject the idea that lance communicated excruciating or serious pain record doesn't reflect that the district court found quite clearly with respect to sneyd that he was told about the condition that it persisted he i'm sorry i yes that's what the record reflects in the light most favorable now mr smeaton i think we have to be careful to differentiate the knowledge and that circumstance is conveyed to edward morgan at five am on december th so those conveyed to mr sneed sixty seven hours later and then throughout that friday because as we know we have to assess clearly established law particular lies to the circumstances confronting that officer at that very moment and so the assessment with edward morgan the district court found he was only told that lance took a pill and that he had an erection with need smead was told so the pill had an erection which was the overnight shift the the pod would have been entirely dark at that time there is no evidence in the record that lance would have been out in a pod in the early morning hours didn't use the intercom that it did use the  to the tower during that time there's no specific evidence in the record as to that but what there is in the record and what's an undisputed fact is that lance testified he only spoke with edward morgan one time throughout the whole weekend and that he recognized morgan's voice and so that is an unassailable fact that mr lance only talked with edward morgan wants throughout the entire weekend through in any medium including the intercom and so cou charged with conducting site checks from the tower for the eleven pm to six am shift how is he why isn't that a reasonable inference that prison authorities would have sume that he is able to see  ability to see into the day room versus the ability to see into the individual cells so the individual cells are set back along the run from the day room certainly the officer may have had some vision in a dark day room however the record reflects there is no ability to see into the individual cells from the tower if you are there did you argue that in in your  cell but there was no appreciable and good vision that would have shown either pain or inability to see his penis when his shirt was on top throughout the whole weekend evidence to reasonably infer that he could have seen into the day were so if he was in the day room between eleven pm and six a year your knowledge of the time of morgan would have there would have been enough evidence to sustain a factual finding that he could see the in his official capacity as regard to the qualified immunity i mean dakota morgan in the towel or use in the court may have in too for deliberate indifference on the on the point of mr morgan who course this isn't spelled out in the court's order i'm just assuming that that's where he arrives and that there are that he's in the tower and that he can see into the day room during the day time period that mr morgan dakota morgan you know testified that he didn't receive any calls on the intercom and that's the only evidence that we have with regard to the intercom usage but with regard to this condition  evidence of that i mean the plight of testify that he did that what i'm saying is that tyler morgan or a dakota morgan's testimony is that he did not receive a call on the intercom with regard to that particular quote that he had no actual knowledge of this particular condition but as in the daytime in the day room the testimony that did come out from the plaintiff is that you have very good bee in his boxers he would have his pants see into the day room it would have necessarily been checks from what he was doing at that point i would state that you know simply because he might not have as pam i might be strange behavior but i don't think and we spell this out in the briefing i don't think it's necessarily indicative of that are they mention those things where he was in a very general being in some sort of distress i don't know that that would be the case here or that there's evidence of it here with regard to these two jailers now with regard to mr harper specially he had one shift at the end of him to the other now with regard to the mill claim on the policy and procedure there's no evidence that there is a string of policy and procedure causing constant claims that have been made with regard to a lack of medical care or regional or medical care and it's the council that let me be clear on your position here are you saying that they're there what happened here  did what happened here violate a policy or did they follow a policy or are you saying there was no cause i'm saying there was a policy with the policy with regard to the medical or taking them to the hospital itself i mean there are multiple small policies involved here so was it was any policy violated or did they follow the policy when they took him back to the jail instead of taking him to the hospital they would have follow the policy and i mean i don't i want others other instances but i don't think that that's in the record someone saying but i believe that they did follow the policy that because they do have to o r him and that requires a judge's signature to do so so if they followed there was a policy that required them to take take him back to and that delayed his treatment pump just doing this but i don't know if it's just me or your wife or i but i can only understand about every other sentence you're making yes and if that's ok well it's not your fault but i really want to know what you just to from the jail to actually leaving to go that it would have contributed to his injury or caused his his injury and there's a lot of evidence not in this court record indicate that it would have had no impact at all and his medical condition was still days before and in that this would not have been causal at all counsel's let me just try to restate to make sure we're getting your argument if i understand what you're saying that bringing him back to the jail as opposed to taking him straight to the hospital did not contribute to his injury now other words it just didn't matter one way or the sat is that what you're saying that is what the evidence in the case will show you are yes and also i mean listen also remember to just one last thing i mean they were told to take him to take him to the hospital and then they didn't they didn't  testimony in deposition is he told the attending jailers that you need to take him directly to saint francis in order for him to have a realistic chance that's his testimony right i believe it was record argument for the st time that he it was already too late notwithstanding what dr lee said so time was clearly of the essence based on the argument that you just make right that is that's right arguably even too late at that point to bring him back contrary to the doctor's instance the sick instructions to the jailers him in conformity with the policy to  say that you need to be bring somebody back in all circumstances to be medically or so the county doesn't have to foot the bill for st francis you're saying that that that well it's it's his fault that the one ride he could get was from his father and it's just bad luck that he had grown kids that needed somebody to sit with them before he could take them a one hundred and fifty miles from a calendar  that delay that particular piece of time it wouldn't have made any causal difference whatsoever to this man's care and that that would be that's our position because just because his the damage is done the damage wasn't counselor i think we've we've got over time of that but i think we needed to do that to make sure we understood your points and i think this fight a little choppiness that we've we've we understand your your position think your honour's underscore of how hardly related the medical or policy was to this condition the permanent nature of the condition that he must now deal with every day but on top of that the medical or policy led to several were absolutely no relevant trainings provided to the officers here and when you lock people up over a weekend every weekend every evening without medical professionals two thousand people that are treated to deal