in urgent need of medical assistance miss otis repeatedly told the officer what should have been obvious that she was bleeding badly needed to go to the hospital despite her requests in a sort as was detained for twelve hours and provided no medical assistance let me ask you something should this case of been brought under the fourth amendment rather than the fourteenth amendment's and so this was arrested without pretrial detainees consider under the fourteenth amendment's i think that's the proper way to think about it though i am certainly open to other ways of doing so and so for purposes of the fourteenth amendment and deliver and difference claim miss otis needed to allege two things and objectively serious medical need and that the relevant official displayed and deliberate indifference to that medical need here  alleged multiple times that she was bleeding badly and that she told the officer as much and in addition that it was it was visible to the officer and that she was provided no medical assistance at the disregard i think correctly determined that that was sufficient to state a for deliberate indifference and the fact that minnesota subsequently submitted a police report that contained a different version of events shouldn't have changed that for a couple reasons first and most important  very threshold stage of litigation this is the i have peace screening stage and the allegations and mis services complaint should control but actually even if the court were to go beyond her allegations there's actually more on the record here to support the first minnesota submitted records from the hospital that the officer allegedly took her to and those records don't show and he does it on the date in question so that's only one of the records appear to include a letter from her public defender with to the hospital with a release form signed by minnesota us requesting the records any records related to her at the hospital so it's a face of fair question whether they show as so we're talking about it's on page six of the appendix it's a list of visits at this particular hospital and they cover various states and none of those states are sometimes or seventeen which is the date in question she had some back issues she had a chronic fleeting disorder which is further evidence i think for her claims here but but across a period of years she including just two days after her release from this and she admitted at the time she was she was not admitted at the same hospital so this appears on appendix seventeen through twenty three different hospital on a seven september nineteenth visit and those records so that she was she presented herself at the hospital with bleeding and was given a blood transfusion and found to be a serious risk of further bleeding and that she was kept overnight and discharged the next day now  from the complaint rather than adding new defendants i don't i don't think so i think the district court's opinion can fairly be read to say that the allegations in the second and then to complain are not sufficient to state a claim against the city and the county but the court then went on to address the allegations in the amended complaint against the officer and explained why in the court's opinion the police report undercut those allegations such that they didn't see the claim but i don't think the sure the district court could have simply said she submitted a new complaints and of story and it didn't do that it went on to address the claims and the allegations and her amended complaint but if your are believe that that's the district court did it respectfully i think it was improper she's a pro se litigants think it's pretty clear what she was trying to do and in any event if if there was something improper about what she did i think the proper remedy would have simply been to deny her leave to amend ordinarily when a party seeks leave to amend a complaint and leave tremendous denied that doesn't mean that the original complaint just evaporates they're just not permitted to file the new documents so i think it would be strange particularly given that she was proceeding pro se it's signed by an individual named ted surveyed he checked a box that says medical technician there are other boxes for r n or physician or person acting under the direction of a physician and those are checked it just says medical technician there's still no evidence that she was treated for her disorder yes that's correct when she was in custody during that period yes that's correct and this court has previously recognized that the fact that some medical treatment was provided doesn't from the scar is the best case that some medical care doesn't automatically defeat a claim like this so even if she was taken to the hospital and drug tested that doesn't count as treatment for the kind of severe uterine bleeding choose experiencing at the time you're in of the facts as true as we must didn't offer cert de marsay have notice of her serious medical need but yet fail to get her treatment you agree that the officer did have notice that the plaintiff was pleading however in order for her to have a claim here she has to show that her need was objective we serious and that the official would have known the risk of not providing treatment i think what's important about the documents that she attached to her complaint is that they show why she was pleading given the reasons for her bleeding i don't know that not so i would have known that that was something i was objective the serious and i needed medical care or what what what if she have to be doing when in the context of the reason why she was leading the officer believe that she was on her menstrual cycle which is typically not something you go to the hospital for but she was just waiting  according to the what the plaintiff is alleging and written complaint that she did not ask her to hospital but that is contradicted by the documents that the plaintiff herself attached to her complaint believe that those documents should be considered because under federal rule is there a procedure ten see any written documents that are attached to a complaint are part of that complaint for all purposes and so what happens if you attach a compl by attaching it to her complaint i think there are a couple of different things here i understand that the plaintiff is alleging that the defendant lied in this case but i don't think the authenticity of the report is necessarily at issue it's i'm just i'm just trying to ask you whether you think attaching a document to a complaint particularly in this post equal world where plaintiffs have to provide a lot of factual misunderstand i believe that she was taken to the hospital for the police reports and not just the police reports but her own admissions that she had her blood drawn that she interacts with the medical technician and that she was given scrubs it's impossible that those things that have occurred outside of the hospital on top of that i don't believe that the information that she attached to her complaints shows that the issue she was having required serious medical care at the time i understand that a few days later she was admitted but at the time as the officers understood it she was having menstrual bleeding which arguably is not an object of the serious issue that requires immediate medical care and s i'm looking at the records right now and i can you can by i want to make sure we talked about the same thing and your sister referred to it as well what is the piece of paper that was generated that night with respect to the drug testing was done that night there is a state of wisconsin blood and urine analysis form it's page twenty one i believe in the district court docket nine i believe you know documented on the nineteenth the first to an emergency she did go to the emergency room  that is the letter with the attach with the documents attach from stricken that would seem to return to the first of the component which the judge thought state of the client i believe that the judge addressed that in his argument which is why after first page of his order when he says that the second complaint supersedes the first minute complaint he went on to discuss how the documents that she provided with her second complaint made the first time in a complaint implies but that's whether the claim is classical even under the old living standards the plaintiffs i'll have to state a claim that is possible and it's felt we have such competing facts here we have nothing from the hospital not that odd i don't think it's odd at this stage where we weren't in the case yet and the plaintiff you know it's it's not clear why she submitted what she submitted i think it's also on that she would submit police reports that contradicted what she's trying to claim isn't entirely possible that this woman was taken by the police officer to an e r to be trusted for drugs that this woman didn't recognize it as a healer should be trusted for drugs in custody nobody addressed her complaint and she ended up in jail she said she didn't go to the hospital to her go to the hospital was getting know now that she suffered from that it was triggered by her period but the fact of the matter is that she has a history of fortyish seventy two hours later and almost killer i don't believe that information is available to the officer at the time and that is a but isn't that why the officer should have done something more than the officer did because the information wasn't  it i don't believe that well that information was available i don't believe that information was even offered to her at the time i think that what she was saying was that she was under fear and i'm not sure how the officers would know that that was something that here and i'm looking for not one piece of paper from there there's a piece of paper that tells me what happened the night she was picked up so as my as my friend said that's in the district court docket it's at nine dash two at page twenty five it's not in europe tell me what happened i apologize to clarify on the dates the incident in question was september seventeenth in the very early morning there are a couple of records that say september sixteenth was about one am so i think that that's the source of the confusion officers account over the plaintiff's they're asking you to conclude that the officer didn't reasonably understand mr wood as to have a serious medical condition when she was admitted to the i c u two days later they're asking you to believe that it's question about documents and braided into the record i think this court in the northern indiana gun case is pretty clear that if you rely on a document such as in a contract case then the document that you attach will control if you're saying that this document entitle you to certain relief then it's done it's certainly reasonable for the just a court to look at that document but in this case where the plane just claim has nothing to do with the documents and in fact the plaintiff makes clear that she's not adopting them for the truth of their as well of course and we're going to take a short break and come right back