from from this transaction that you've seen on the tape the restraint chair was done at approximately twelve o three this was eighteen minutes after he had already been in custody the restraint restraint chair was ordered and to others that's clear put him in the chair at twelve o three she then leaves she's not present for the chair and she doesn't return to the charing until twelve all nine and at twelve oh no and when she returns to see him his aspect the way he is presenting symptoms how he looks medically to her is that he is fine he's stable in fact he talks to her he says something to the effect you are the reason why i'm here and that she is believing that at twelve o nine there is no acute event there is no problem with him medically the first indication that we have that something might be wrong of her is the twelve ten and that's when his close quote back and by the way all of the information that's contained on this comes from the testimony of jacqueline moore who is the opposing nursing expert so these times are those times which we've specified based on the opposing expert so what wealth ten which is as a clinician she's trying to figure out what's wrong with him so she begins to do a series of clinical tests in the white person's colorado case that are referred to court to indicated that assessment is a necessary part of medical treatment the assessment that she begins back and twelve ten and then she calls for nine one one or c p r that form a minute period she doesn't know what's wrong with him it's a long time you know in a medical situation yes there it is a long time on the other hand she doesn't have anything physically to tip her off what's wrong with him for example your honor this wouldn't be a case like he's he's going to burst artery and he's pulsing blood and so she would know that there's there's a problem remember this is in a jail setting so when she is talking to him and then the next thing that happens the only symptom is he goes limp she has a couple of things to think about number one is he faking i understand i think your point i think the critical issue was why is th why why why don't you think there's there's they have enough here to agree on this because i think it's a medical judgment call i think the basis of the qualified immunity for health practitioners oppose for security practitioners security person is is very and i think you prove is the fact that she was not only aware of these possible problems but she drew an inference and then disregarded it in this case my point is she didn't draw the inference now that may be malpractise and she will st have to answer for that when we go back to phoenix because there's still a short claim that's on the table with respect to the wrongful death and maybe they'll be able to establish that because of the delay here because of her misapprehension of what his symptoms were and somewhat that's what you're doing here you're breaking it down into these finite discrete moments ago looking at the overall picture and we have the lolly case which is you know you make comes into a recipe cards and with diabetes that sets the stage for anything that follows because diabetes cause carries with it various known medical risks so here this fellow is brought in and he comes in with a condition it's not just all of a sudden he normal healthy guy suddenly goes into some kind of unconscious or other kind of behavior there's a totalitarian here and that's isn't that the i think the question is whether in terms of what she knew what objective lee she should have known you take the whole picture and is it appropriate a for her to have shared in the first place maybe so you know how he was trained you said she'd laugh well i mean if this fellow is vulnerable and frail is that within her appropriate medical judgment to just leave it to the jailers to go ahead and get him strapped down and whatever getting back to the totality of the circumstances the reason why she called nine one one is one for things to coalesce they all happened at once and it was twelve fourteen having him in the chair in the first place or could or at least how he was positioned in the chair so that this episode may not have been triggered that's their theory their theory is that what brought on the circumstance  i'm sick i need help she recognized she was told when he came in he was non combative he did not resist arrest he was not violent and he was on his way to an emergency room in the middle of the night the deliberate indifference of not reacting to charles extreme life threatening condition while in the chair once he recognized that he was pulseless and have no br knew at seven minutes after the hour he was pulseless excuse me seven minutes after and chest compressions don't start until eighteen minutes our level and a half minutes later the time line is this is the right but she wasn't talking to her in her interview with that with that with the police after the death and her notes the day after she made she said he was non responsive she didn't say anything about ever talking to him and earlier in deposition she said she reaction but where's the evidence in this record that the decision to quit him in a restraint chair properly placed and properly positioned in the chair is somehow an improper medical judgment on well we have i think a fair amount on that and it comes from the county's own policies that they have not the skewed that nurse lewis knew and was comfortable with the policies themselves say first of all no inmate crosses that threshold unless that inmate has had a proper medical screening none was done on him not a thing until after he was already on the way t hospital they created a record but it was time stamped fifty nine minutes after the hour the i'm sorry mark on my this is exhibit exhibit twenty three thirty seven she is supposed to do a medical screening herself then another medical screening nothing except that she says he's unconscious now that goes against your question yes for sure she unconscious unconscious or semi conscious detainees are never supposed to be put in the chair county's own policies she says in that same exhibit the inmate what was able to contract for his safety which means he was not suicidal yes she creates a story same policy mr mr asher exhibit three of the three general conditions in the policy that defined a severe medical conditions that required him to be referred to a contract required all three of the medical conditions that are described he had she knew what she didn't send him to the medical facility she knew from another county option that she had another county policy at the cedar she had four options for putting him somewhere else all safer options she didn't do it and that his policy one day thirty nine point zero she knew from that same policy one question thirty nine point zero that any inmate who appeared to be suicidal or to exhibit result behavior had to be referred had to be referred to the medical side staff she didn't do that policy zero zero sixty four point one zero point zero that she knew she could not zero now in addition she created a record that she admitted in her deposition was incorrect and it's exhibit number twenty seven in the record e r three  part of a deliberate indifference analysis work nurse lewis is it just medical malpractise is it just deliberate indifference for a nurse to see to know that she is has a patient who was absolutely pulseless and  and wait for minutes to start some sort of treatment must take must take the best time available to her as four minutes according to her own notes with eleven and a half minutes four minutes before she has anyone apples and oranges what happened was that twelve fourteen she immediately recognized that there was a need for intervention she had nine one one call and then twenty from the record m the charles actor was suffering from an acute event that was a twelve fourteen i ran to get i v supplies from the place where they were kept which is outside the frame of the camera i left only to get the i v supplies so that when phoenix fire arrive should have been accessed for rescue drugs i did not fail to perform chest compressions in fact you can see in the video that she was starting the i v while friend mcnichols was doing the trust impression compression  kind of training and experience that is necessary to help an inmate and once the acts are done provided they're done with the correct mental state and it's not criminal recklessness everything else is a judgment call